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Collier-Bain HD, Emery A, Causer AJ, Brown FF, Oliver R, Dutton D, Crowe J, Augustine D, Graby J, Leach S, Eddy R, Rothschild-Rodriguez D, Gray JC, Cragg MS, Cleary KL, Moore S, Murray J, Turner JE, Campbell JP. A single bout of vigorous intensity exercise enhances the efficacy of rituximab against human chronic lymphocytic leukaemia B-cells ex vivo. Brain Behav Immun 2024; 118:468-479. [PMID: 38503395 DOI: 10.1016/j.bbi.2024.03.023] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 02/15/2024] [Accepted: 03/16/2024] [Indexed: 03/21/2024] Open
Abstract
Chronic lymphocytic leukaemia (CLL) is characterised by the clonal proliferation and accumulation of mature B-cells and is often treated with rituximab, an anti-CD20 monoclonal antibody immunotherapy. Rituximab often fails to induce stringent disease eradication, due in part to failure of antibody-dependent cellular cytotoxicity (ADCC) which relies on natural killer (NK)-cells binding to rituximab-bound CD20 on B-cells. CLL cells are diffusely spread across lymphoid and other bodily tissues, and ADCC resistance in survival niches may be due to several factors including low NK-cell frequency and a suppressive stromal environment that promotes CLL cell survival. It is well established that exercise bouts induce a transient relocation of NK-cells and B-cells into peripheral blood, which could be harnessed to enhance the efficacy of rituximab in CLL by relocating both target and effector cells together with rituximab in blood. In this pilot study, n = 20 patients with treatment-naïve CLL completed a bout of cycling 15 % above anaerobic threshold for ∼ 30-minutes, with blood samples collected pre-, immediately post-, and 1-hour post-exercise. Flow cytometry revealed that exercise evoked a 254 % increase in effector (CD3-CD56+CD16+) NK-cells in blood, and a 67 % increase in CD5+CD19+CD20+ CLL cells in blood (all p < 0.005). NK-cells were isolated from blood samples pre-, and immediately post-exercise and incubated with primary isolated CLL cells with or without the presence of rituximab to determine specific lysis using a calcein-release assay. Rituximab-mediated cell lysis increased by 129 % following exercise (p < 0.001). Direct NK-cell lysis of CLL cells - independent of rituximab - was unchanged following exercise (p = 0.25). We conclude that exercise improved the efficacy of rituximab-mediated ADCC against autologous CLL cells ex vivo and propose that exercise should be explored as a means of enhancing clinical responses in patients receiving anti-CD20 immunotherapy.
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Affiliation(s)
| | | | - Adam J Causer
- Department for Health, University of Bath, United Kingdom
| | - Frankie F Brown
- Department for Health, University of Bath, United Kingdom; School of Applied Sciences, Edinburgh Napier University, Edinburgh, United Kingdom
| | - Rebecca Oliver
- Department for Health, University of Bath, United Kingdom; Department for Haematology, Royal United Hospitals Bath NHS Foundation Trust, United Kingdom
| | - David Dutton
- Department for Haematology, Great Western Hospitals NHS Foundation Trust, United Kingdom
| | - Josephine Crowe
- Department for Haematology, Royal United Hospitals Bath NHS Foundation Trust, United Kingdom
| | - Daniel Augustine
- Department of Cardiology, Royal United Hospitals Bath NHS Foundation Trust, United Kingdom
| | - John Graby
- Department for Health, University of Bath, United Kingdom; Department of Cardiology, Royal United Hospitals Bath NHS Foundation Trust, United Kingdom
| | - Shoji Leach
- Department for Health, University of Bath, United Kingdom
| | - Rachel Eddy
- Department for Health, University of Bath, United Kingdom
| | | | - Juliet C Gray
- Antibody and Vaccine Group, Centre for Cancer Immunology, University of Southampton, United Kingdom
| | - Mark S Cragg
- Antibody and Vaccine Group, Centre for Cancer Immunology, University of Southampton, United Kingdom
| | - Kirstie L Cleary
- Antibody and Vaccine Group, Centre for Cancer Immunology, University of Southampton, United Kingdom
| | - Sally Moore
- Department for Haematology, Royal United Hospitals Bath NHS Foundation Trust, United Kingdom
| | - James Murray
- Department for Haematology, Royal United Hospitals Bath NHS Foundation Trust, United Kingdom
| | - James E Turner
- Department for Health, University of Bath, United Kingdom; School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - John P Campbell
- Department for Health, University of Bath, United Kingdom; School of Medical and Health Sciences, Edith Cowan University, Perth, Australia.
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Yoshimura Y, Suwabe T, Fujiki A, Kaji D, Asano-Mori Y, Oba Y, Mizuno H, Yamanouchi M, Tanaka K, Hasegawa E, Miki K, Yokoyama T, Namamura Y, Ishii Y, Yamashita S, Kono K, Kinowaki K, Takazawa Y, Sawa N, Ubara Y. Gastric Burkitt's monomorphic post-transplant lymphoproliferative disorder after kidney transplantation: A case report. Clin Nephrol 2024; 101:250-256. [PMID: 38329919 DOI: 10.5414/cn111321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2024] [Indexed: 02/10/2024] Open
Abstract
We report on a 53-year-old Japanese man diagnosed with gastric Burkitt's monomorphic post-transplant lymphoproliferative disorder (B-PTLD) after endoscopy for gastric discomfort 28 months after the patient underwent renal transplantation in Ethiopia. Serum Epstein-Barr virus (EBV) tests were negative before transplantation, but the tumor cells collected from a gastric biopsy showed positive EBV-encoded small RNAs (EBER) at B-PTLD onset. Intensive treatment started with R(rituximab)-CHOP therapy and continued with DA-EPOCH-R therapy has been effective, and relapse has not yet occurred. Burkitt lymphoma has a poor prognosis, but B-PTLD may be effectively treated with high-dose chemotherapy. This is a rare case of gastric B-PTLD in a Japanese patient.
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Dai L, Chen H, Tan Q, Wang Y, Li L, Lou N, Fan G, Xie T, Luo R, Wang S, Zhou Y, Zhong Q, Yao J, Zhang Z, Tang L, Shi Y, Han X. Identification of novel prognostic autoantibodies in diffuse large B-cell lymphoma treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone via a high-throughput antigen microarray. Cancer 2024; 130:1257-1269. [PMID: 38133926 DOI: 10.1002/cncr.35158] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/18/2023] [Accepted: 11/20/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone) is a standard first-line treatment for diffuse large B-cell lymphoma (DLBCL). However, 20%-40% of patients survive less than 5 years. Novel prognostic biomarkers remain in demand. METHODS Baseline plasma autoantibodies (AAbs) were assessed in 336 DLBCLs. In the discovery phase (n = 20), a high-density antigen microarray (∼21,000 proteins) was used to expound AAb profiles. In the verification phase (n = 181), with a DLBCL-focused microarray, comparative results based on event-free survival at 24 months (EFS24) and lasso Cox regression models of progression-free survival (PFS) and overall survival (OS) were integrated to identify potential biomarkers. They were further validated by enzyme-linked immunosorbent assay in validation phase 1 (n = 135) and a dynamic cohort (n = 12). In validation phase 2, a two-AAb-based risk score was established. They were further validated in an immunohistochemistry cohort (n = 55) and four independent Gene Expression Omnibus datasets (n = 1598). RESULTS Four AAbs (CREB1, N4BP1, UBAP2, and DEAF1) were identified that showed associations with EFS24 status (p < .05) and superior PFS and OS (p < .05). A novel risk score model based on CREB1 and N4BP1 AAbs was developed to predict PFS with areas under the curve of 0.72, 0.71, 0.76, and 0.82 at 1, 3, 5, and 7 years, respectively, in DLBCL treated with R-CHOP independent of the International Prognostic Index (IPI) and provided significant additional recurrence risk discrimination (p < .05) for the IPI. CREB1 and N4BP1 proteins and messenger RNAs were also associated with better PFS and OS (p < .05). CONCLUSIONS This study identified a novel prognostic panel of CREB1, N4BP1, DEAF1, and UBAP2 AAbs that is independent of the IPI in DLBCL.
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Affiliation(s)
- Liyuan Dai
- Department of Clinical Laboratory, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Haizhu Chen
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, China
| | - Qiaoyun Tan
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, China
| | - Yanrong Wang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, China
| | - Lin Li
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Ning Lou
- Department of Clinical Laboratory, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Guangyu Fan
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, China
| | - Tongji Xie
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, China
| | - Rongrong Luo
- Department of Clinical Laboratory, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Shasha Wang
- Department of Clinical Laboratory, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yu Zhou
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, China
| | - Qiaofeng Zhong
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, China
| | - Jiarui Yao
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, China
| | - Zhishang Zhang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, China
| | - Le Tang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, China
| | - Yuankai Shi
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, China
| | - Xiaohong Han
- Clinical Pharmacology Research Center, Peking Union Medical College Hospital, State Key Laboratory of Complex Severe and Rare Diseases, NMPA Key Laboratory for Clinical Research and Evaluation of Drug, Beijing Key Laboratory of Clinical PK & PD Investigation for Innovative Drugs, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Chu Y, Liu Y, Yu Z, Zhan L, Lu T, Jiang Y, Fang X, Zhou X, Wang X. Maintenance and consolidation strategies for patients with untreated advanced follicular lymphoma: A systematic review and network meta-analysis of randomized trials. Cancer 2024; 130:1072-1082. [PMID: 38041532 DOI: 10.1002/cncr.35137] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/31/2023] [Accepted: 11/03/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND The emergence of novel and efficient antibody maintenance approaches has provided more options for post-induction treatment of advanced follicular lymphoma (FL), and further comparisons are required to determine the most clinically beneficial regimen. The authors conducted a systematic review and meta-analysis to evaluate the maintenance or consolidation strategy. METHODS The authors performed two independent searches in PubMed, Web of Science, the Cochrane library databases, Scopus, and Embase for randomized controlled trials (RCTs) evaluating maintenance or consolidation therapy in untreated FL patients. Extracted data included the clinical characteristics, treatment regimen, progression-free survival (PFS), overall survival (OS), and adverse effects. They then pooled the data and used a Bayesian random-effects model to combine direct comparisons with indirect evidence. RESULTS The authors screened 1515 records and identified 13 eligible RCTs that assessed nine different regimens in 5681 advanced FL patients. Reconstructed individual survival data presented that obinutuzumab had the highest effect sizes and certainty of the evidence for PFS (hazard ratio, 0.43; 95% confidence interval, 0.22-0.79) and tolerability compared with observation. However, no benefit was observed in patients according to the OS, regardless of which regimen was taken. Considering other regimens, although an extended course of rituximab maintenance and consolidation therapies presented PFS benefits compared with standard rituximab maintenance, they were also associated with higher toxicity. CONCLUSIONS Although obinutuzumab and rituximab maintenance treatment improved PFS significantly, its clinical benefit requires further validation in larger populations. Furthermore, because few trials informed each treatment comparison, research is needed to refine the understanding of this complex and rapidly evolving treatment landscape.
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Affiliation(s)
- Yurou Chu
- Department of Hematology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Yingyue Liu
- Department of Hematology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Zhuoya Yu
- Department of Hematology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Linquan Zhan
- Department of Hematology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Tiange Lu
- Department of Hematology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Yujie Jiang
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xiaosheng Fang
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xiangxiang Zhou
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Branch of National Clinical Research Center for Hematologic Diseases, Jinan, Shandong, China
| | - Xin Wang
- Department of Hematology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Branch of National Clinical Research Center for Hematologic Diseases, Jinan, Shandong, China
- National Clinical Research Center for Hematologic Diseases, the First Affiliated Hospital of Soochow University, Suzhou, China
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Muller I, Maioli S, Armenti M, Porcaro L, Currò N, Iofrida E, Pignataro L, Manso J, Mian C, Geginat J, Salvi M. Alemtuzumab-induced thyroid eye disease successfully treated with a single low dose of rituximab. Eur Thyroid J 2024; 13:e230236. [PMID: 38471303 PMCID: PMC11046353 DOI: 10.1530/etj-23-0236] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 03/12/2024] [Indexed: 03/14/2024] Open
Abstract
Introduction Secondary thyroid autoimmunity, especially Graves' disease (GD), frequently develops in patients with multiple sclerosis (MS) following alemtuzumab treatment (ALTZ; anti-CD52). Thyroid eye disease (TED) can also develop, and rituximab (RTX; anti-CD20) is a suitable treatment. Case presentation A 37-year-old woman with MS developed steroid-resistant active moderate-to-severe TED 3 years after ALTZ, that successfully responded to a single 500 mg dose of i.v. RTX. Before RTX peripheral B-cells were low, and were totally depleted immediately after therapy. Follow-up analysis 4 years post ALTZ and 1 year post RTX showed persistent depletion of B cells, and reduction of T regulatory cells in both peripheral blood and thyroid tissue obtained at thyroidectomy. Conclusion RTX therapy successfully inactivated TED in a patient with low B-cell count derived from previous ALTZ treatment. B-cell depletion in both thyroid and peripheral blood was still present 1 year after RTX, indicating a likely cumulative effect of both treatments.
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Affiliation(s)
- Ilaria Muller
- Department of Clinical Sciences and Community Health, University of Milan, Italy
- Endocrinology Unit, Graves’ Orbitopathy Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Sara Maioli
- Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - Mirco Armenti
- Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - Laura Porcaro
- Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - Nicola Currò
- Endocrinology Unit, Graves’ Orbitopathy Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Ophthalmology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Elisabetta Iofrida
- Department of Specialistic Surgical Sciences, Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Lorenzo Pignataro
- Department of Clinical Sciences and Community Health, University of Milan, Italy
- Department of Specialistic Surgical Sciences, Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Jacopo Manso
- Endocrinology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy
| | - Caterina Mian
- Endocrinology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy
| | - Jens Geginat
- Department of Clinical Sciences and Community Health, University of Milan, Italy
- National Institute of Molecular Genetics (INGM) “Romeo and Enrica Invernizzi”, Milan, Italy
| | - Mario Salvi
- Endocrinology Unit, Graves’ Orbitopathy Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
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Acheampong T, Gu T, Le TK, Keating SJ. Treatment patterns and costs among US patients with diffuse large B-cell lymphoma not treated with 2L stem cell transplantation. Future Oncol 2024; 20:623-634. [PMID: 38230990 DOI: 10.2217/fon-2023-0385] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024] Open
Abstract
Aim: To assess treatment patterns, healthcare resource utilization (HCRU), and costs for patients with diffuse large B-cell lymphoma (DLBCL) who did not receive stem cell transplantation in second-line. Patients & methods: An administrative MarketScan® database study to assess DLBCL claims from 01/01/2009-30/09/2020. Results: Most patients (n = 750) received rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone in first-line (86.8%) and rituximab (39.5%) or bendamustine ± rituximab ± other (16.3%) in second-line. Over half were hospitalized (mean duration: 16.5 (standard deviation [SD]: 25.8) days per patient per year). Mean medical/pharmacy costs were US$141,532 per patient per year (SD: $189,579), driven by DLBCL-related claims. Conclusion: Healthcare resource utilization and costs for DLBCL-related claims were due to hospitalizations and outpatient visits. Novel therapies to reduce clinical and economic burdens are needed.
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Affiliation(s)
| | - Tao Gu
- Bristol Myers Squibb, 3401 Princeton Pike, Lawrenceville, NJ 08648, USA
| | - Trong Kim Le
- Bristol Myers Squibb, 3401 Princeton Pike, Lawrenceville, NJ 08648, USA
| | - Scott J Keating
- Bristol Myers Squibb, 3401 Princeton Pike, Lawrenceville, NJ 08648, USA
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Cristiano F, Verratti V, Di Matteo G, Fulle S, Cristiano J, D'Angelo B, Caravelli L, Posari C, Schiazza A, Piano A. [Steroid-Dependent Nephrotic Syndrome Due to Minimal Change Glomerulonephritis Treated with Rituximab]. G Ital Nefrol 2024; 41:2024-vol1. [PMID: 38426681] [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] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
47-year-old woman suffering from minimal lesion glomerulonephritis previously undergone high-dose steroid therapy and subjected to exacerbations of nephrotic syndrome after therapy discontinuation. It was decided to initiate off-label treatment with Rituximab at a dosage of 375 mg/m2 administred at zero-time, one-month and three months with good therapeutic response and resolution of the clinical laboratory picture. The therapy was well tolerated and had no side effects. This scheme could be an alternative to the conventional therapeutic scheme with steroids or other classes of immunosuppressive drugs, especially in order to avoid problems related to prolonged exposure to steroid therapy.
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Affiliation(s)
- Fabrizio Cristiano
- UOSD Nefrologia Dialisi, Ospedale di Ortona, Contrada Santa Liberata ‒ Asl 2 Lanciano Vasto Chieti
| | - Vittore Verratti
- Department of Psychological, Health and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti
| | - Ginevra Di Matteo
- Department of Neuroscience, Imaging and Clinical Science, G. D'Annunzio University of Chieti-Pescara
| | - Stefania Fulle
- Department of Neuroscience, Imaging and Clinical Science, G. D'Annunzio University of Chieti-Pescara
| | - Jenny Cristiano
- UOC Farmacia Ospedaliera - Ospedale Clinicizzato di Chieti - Asl 2 Lanciano Vasto Chieti
| | - Benito D'Angelo
- UOSD Nefrologia Dialisi, Ospedale di Ortona, Contrada Santa Liberata ‒ Asl 2 Lanciano Vasto Chieti
| | - Ludovico Caravelli
- UOSD Nefrologia Dialisi, Ospedale di Ortona, Contrada Santa Liberata ‒ Asl 2 Lanciano Vasto Chieti
| | - Cosima Posari
- UOSD Nefrologia Dialisi, Ospedale di Ortona, Contrada Santa Liberata ‒ Asl 2 Lanciano Vasto Chieti
| | - Alessandra Schiazza
- UOSD Nefrologia Dialisi, Ospedale di Ortona, Contrada Santa Liberata ‒ Asl 2 Lanciano Vasto Chieti
| | - Alessandra Piano
- UOSD Nefrologia Dialisi, Ospedale di Ortona, Contrada Santa Liberata ‒ Asl 2 Lanciano Vasto Chieti
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Noerenberg D, Briest F, Hennch C, Yoshida K, Hablesreiter R, Takeuchi Y, Ueno H, Staiger AM, Ziepert M, Asmar F, Locher BN, Toth E, Weber T, Amini RM, Klapper W, Bouzani M, Poeschel V, Rosenwald A, Held G, Campo E, Ishaque N, Stamatopoulos K, Kanellis G, Anagnostopoulos I, Bullinger L, Goldschmidt N, Zinzani PL, Bödör C, Rosenquist R, Vassilakopoulos TP, Ott G, Ogawa S, Damm F. Genetic Characterization of Primary Mediastinal B-Cell Lymphoma: Pathogenesis and Patient Outcomes. J Clin Oncol 2024; 42:452-466. [PMID: 38055913 DOI: 10.1200/jco.23.01053] [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: 05/14/2023] [Revised: 09/22/2023] [Accepted: 10/04/2023] [Indexed: 12/08/2023] Open
Abstract
PURPOSE Primary mediastinal large B-cell lymphoma (PMBCL) is a rare aggressive lymphoma predominantly affecting young female patients. Large-scale genomic investigations and genetic markers for risk stratification are lacking. PATIENTS AND METHODS To elucidate the full spectrum of genomic alterations, samples from 340 patients with previously untreated PMBCL were investigated by whole-genome (n = 20), whole-exome (n = 78), and targeted (n = 308) sequencing. Statistically significant prognostic variables were identified using a multivariable Cox regression model and confirmed by L1/L2 regularized regressions. RESULTS Whole-genome sequencing revealed a commonly disrupted p53 pathway with nonredundant somatic structural variations (SVs) in TP53-related genes (TP63, TP73, and WWOX) and identified novel SVs facilitating immune evasion (DOCK8 and CD83). Integration of mutation and copy-number data expanded the repertoire of known PMBCL alterations (eg, ARID1A, P2RY8, and PLXNC1) with a previously unrecognized role for epigenetic/chromatin modifiers. Multivariable analysis identified six genetic lesions with significant prognostic impact. CD58 mutations (31%) showed the strongest association with worse PFS (hazard ratio [HR], 2.52 [95% CI, 1.50 to 4.21]; P < .001) and overall survival (HR, 2.33 [95% CI, 1.14 to 4.76]; P = .02). IPI high-risk patients with mutated CD58 demonstrated a particularly poor prognosis, with 5-year PFS and OS rates of 41% and 58%, respectively. The adverse prognostic significance of the CD58 mutation status was predominantly observed in patients treated with nonintensified regimens, indicating that dose intensification may, to some extent, mitigate the impact of this high-risk marker. By contrast, DUSP2-mutated patients (24%) displayed durable responses (PFS: HR, 0.2 [95% CI, 0.07 to 0.55]; P = .002) and prolonged OS (HR, 0.11 [95% CI, 0.01 to 0.78]; P = .028). Upon CHOP-like treatment, these patients had very favorable outcome, with 5-year PFS and OS rates of 93% and 98%, respectively. CONCLUSION This large-scale genomic characterization of PMBCL identified novel treatment targets and genetic lesions for refined risk stratification. DUSP2 and CD58 mutation analyses may guide treatment decisions between rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone and dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab.
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Affiliation(s)
- Daniel Noerenberg
- Department of Hematology, Oncology and Cancer Immunology, Campus Virchow, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Franziska Briest
- Department of Hematology, Oncology and Cancer Immunology, Campus Virchow, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Cornelius Hennch
- Department of Hematology, Oncology and Cancer Immunology, Campus Virchow, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Kenichi Yoshida
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Division of Cancer Evolution, National Cancer Center Research Institute, Tokyo, Japan
| | - Raphael Hablesreiter
- Department of Hematology, Oncology and Cancer Immunology, Campus Virchow, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Yasuhide Takeuchi
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroo Ueno
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Annette M Staiger
- Department of Clinical Pathology, Robert-Bosch-Krankenhaus, Stuttgart, Germany
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology Stuttgart, and University of Tuebingen, Stuttgart, Germany
| | - Marita Ziepert
- Institute of Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Fazila Asmar
- Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Benjamin N Locher
- Department of Hematology, Oncology and Cancer Immunology, Campus Virchow, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Erika Toth
- Department of Surgical and Molecular Pathology, National Tumour Biology Laboratory, National Institute of Oncology, Budapest, Hungary
| | - Thomas Weber
- Department of Internal Medicine IV, Haematology and Oncology, University Hospital Halle (Saale), Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Rose-Marie Amini
- Department of Immunology, Genetics and Pathology, Uppsala University and University Hospital, Uppsala, Sweden
| | - Wolfram Klapper
- Department of Pathology, Hematopathology Section and Lymph Node Registry, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Maria Bouzani
- Department of Hematology and Lymphoma, BMTU, Evaggelismos General Hospital, Athens, Greece
| | - Viola Poeschel
- Department of Internal Medicine 1 (Oncology, Hematology, Clinical Immunology, and Rheumatology), Saarland University Medical School, Homburg, Germany
| | - Andreas Rosenwald
- Institute of Pathology, University of Würzburg and Comprehensive Cancer Center (CCC) Mainfranken, Würzburg, Germany
| | - Gerhard Held
- Department of Internal Medicine 1 (Oncology, Hematology, Clinical Immunology, and Rheumatology), Saarland University Medical School, Homburg, Germany
- Department Internal Medicine I, Westpfalzklinikum Kaiserslautern, Kaiserslautern, Germany
| | - Elías Campo
- Centro de Investigacion Biomedica en Red en Oncologia (CIBERONC), Madrid, Spain
- Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Naveed Ishaque
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Center of Digital Health, Berlin, Germany
| | - Kostas Stamatopoulos
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - George Kanellis
- Department of Hematopathology, Evangelismos General Hospital, Athens, Greece
| | - Ioannis Anagnostopoulos
- Institute of Pathology, University of Würzburg and Comprehensive Cancer Center (CCC) Mainfranken, Würzburg, Germany
- Department of Pathology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Lars Bullinger
- Department of Hematology, Oncology and Cancer Immunology, Campus Virchow, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Pier Luigi Zinzani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Bologna, Italy
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Csaba Bödör
- HCEMM-SE Molecular Oncohematology Research Group, 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Richard Rosenquist
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Theodoros P Vassilakopoulos
- Department of Internal Medicine IV, Haematology and Oncology, University Hospital Halle (Saale), Martin-Luther-University Halle-Wittenberg, Halle, Germany
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - German Ott
- Department of Clinical Pathology, Robert-Bosch-Krankenhaus, Stuttgart, Germany
| | - Seishi Ogawa
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Medicine, Centre for Haematology and Regenerative Medicine, Karolinska Institutet, Stockholm, Sweden
- Institute for the Advanced Study of Human Biology (WPI-ASHBi), Kyoto University, Kyoto, Japan
| | - Frederik Damm
- Department of Hematology, Oncology and Cancer Immunology, Campus Virchow, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
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9
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Yang ST, Chang WH, Chou FW, Liu HH, Lee WL, Wang PH. Front-line chemoimmunotherapy for treating epithelial ovarian cancer: Part II promising results of phase 2 study of paclitaxel-carboplatin-oregovomab regimen. Taiwan J Obstet Gynecol 2024; 63:10-16. [PMID: 38216242 DOI: 10.1016/j.tjog.2023.11.005] [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] [Accepted: 11/03/2023] [Indexed: 01/14/2024] Open
Abstract
In the Part I, we have discussed the background of CA125 and the development of anti-CA125 monoclonal antibody (MAb) to highlight the potential role of CA125 and anti-CA125 MAb in the management of women with advanced stage epithelial ovarian cancer (EOC). Glycosylation change either by N-link or by O-link of CA125 is supposed to play a role in the modification of immunity. Anti-CA125 MAb, which can be classified as OC 125-like Abs, M11-like Abs, and OV197-like Abs, is often used for diagnosing, screening, monitoring and detecting the mesothelin-related diseases of the abdominal cavity, particular for those women with EOC. Additionally, anti-CA125 MAb also plays a therapeutic role, named as OvaRex MAb-B43.13 (oregovomab), which has also been extensively reviewed in the Part I review article. The main mechanisms include (a) forming CA125 immune complexes to activate the antigen-presenting cells; (b) triggering induction of CA125-specific immune responses, including anti-CA125 Abs against various epitopes and CA125-specific B and T cell responses; and (c) triggering CD4 and CD8 T-cell responses specific for B43.13 to produce specific and non-specific immune response. With success in vitro, in vivo and in primitive studies, phase II study was conducted to test the effectiveness of chemoimmunotherapy (CIT) for the management of EOC patients. In the 97 EOC patients after optimal debulking surgery (residual tumor <1 cm or no gross residual tumor), patients treated with CIT had a dramatical and statistically significant improvement of both progression-free survival (PFS) and overall survival (OS) compared to those treated with chemotherapy alone with a median PFS of 41.8 months versus 12.2 months (hazard ratio [HR] 0.46, 95 % confidence interval [CI] 0.28-0.7) and OS not yet been reached (NE) versus 42.3 months (HR 0.35, 95 % CI 0.16-0.74), respectively. The current review as Part II will explore the possibility of using CIT as front-line therapy in the management of advanced-stage EOC patients after maximal cytoreductive surgery based on the evidence by many phase 2 studies.
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Affiliation(s)
- Szu-Ting Yang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wen-Hsun Chang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Fang-Wei Chou
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hung-Hsien Liu
- Department of Medical Imaging and Intervention, Tucheng Hospital, New Taipei City, Taiwan
| | - Wen-Ling Lee
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Medicine, Cheng-Hsin General Hospital, Taipei, Taiwan.
| | - Peng-Hui Wang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Female Cancer Foundation, Taipei, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
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10
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Turdo A, Gaggianesi M, D’Accardo C, Porcelli G, Bella SD, Cricchio D, Pillitteri I, Porcasi R, Lo Iacono M, Verona F, Modica C, Roozafzay N, Florena AM, Stassi G, Mancuso S, Todaro M. EBF1, MYO6 and CALR expression levels predict therapeutic response in diffuse large B-cell lymphomas. Front Immunol 2023; 14:1266265. [PMID: 38035116 PMCID: PMC10682075 DOI: 10.3389/fimmu.2023.1266265] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/17/2023] [Indexed: 12/02/2023] Open
Abstract
Background Diffuse large B-cell lymphoma (DLBCL) is a hematological malignancy representing one-third of non-Hodgkin's lymphoma cases. Notwithstanding immunotherapy in combination with chemotherapy (R-CHOP) is an effective therapeutic approach for DLBCL, a subset of patients encounters treatment resistance, leading to low survival rates. Thus, there is an urgent need to identify predictive biomarkers for DLBCL including the elderly population, which represents the fastest-growing segment of the population in Western countries. Methods Gene expression profiles of n=414 DLBCL biopsies were retrieved from the public dataset GSE10846. Differentially expressed genes (DEGs) (fold change >1.4, p-value <0.05, n=387) have been clustered in responder and non-responder patient cohorts. An enrichment analysis has been performed on the top 30 up-regulated genes of responder and non-responder patients to identify the signatures involved in gene ontology (MSigDB). The more significantly up-regulated DEGs have been validated in our independent collection of formalin-fixed paraffin-embedded (FFPE) biopsy samples of elderly DLBCL patients, treated with R-CHOP as first-line therapy. Results From the analysis of two independent cohorts of DLBCL patients emerged a gene signature able to predict the response to R-CHOP therapy. In detail, expression levels of EBF1, MYO6, CALR are associated with a significant worse overall survival. Conclusions These results pave the way for a novel characterization of DLBCL biomarkers, aiding the stratification of responder versus non-responder patients.
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Affiliation(s)
- Alice Turdo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Miriam Gaggianesi
- Department of Surgical, Oncological and Stomatological Sciences (DICHIRONS), University of Palermo, Palermo, Italy
| | - Caterina D’Accardo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Gaetana Porcelli
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Sebastiano Di Bella
- Department of Surgical, Oncological and Stomatological Sciences (DICHIRONS), University of Palermo, Palermo, Italy
| | - Dario Cricchio
- Department of Surgical, Oncological and Stomatological Sciences (DICHIRONS), University of Palermo, Palermo, Italy
| | - Irene Pillitteri
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Rossana Porcasi
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Melania Lo Iacono
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Francesco Verona
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Chiara Modica
- Department of Surgical, Oncological and Stomatological Sciences (DICHIRONS), University of Palermo, Palermo, Italy
| | - Narges Roozafzay
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Ada Maria Florena
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Giorgio Stassi
- Department of Surgical, Oncological and Stomatological Sciences (DICHIRONS), University of Palermo, Palermo, Italy
| | - Salvatrice Mancuso
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Matilde Todaro
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
- A.O.U.P. “Paolo Giaccone”, University of Palermo, Palermo, Italy
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11
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Abstract
Diffuse large B-cell lymphoma (DLBCL) is the most common lymphoma and a heterogeneous B-cell disease. The majority of patients with newly diagnosed disease are cured with first-line combination immunochemotherapy treatment however, those who experience treatment failure have dismal outcomes. Antibody therapies and immunotherapy have provided the single most major advance in the treatment of DLBCL in the last 4 decades. Rituximab, the first immunotherapy, and a monoclonal antibody targeting CD20, improved DLBCL overall survival when added to chemotherapy 2 decades ago. Since then, the advent of further "naked" monoclonal antibodies that target malignant B-cells or stimulate the immune system to kill cancer, as well as antibody-drug conjugates and bispecific antibodies have all entered the DLBCL armamentarium; with 5 antibody therapy approvals in the last 6 years alone. Here we review the literature on antibodies and immunotherapies for DLBCL and the future directions involving this successful group of drugs.
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Affiliation(s)
- Allison Barraclough
- Fiona Stanley Hospital, Perth, Australia; University of Melbourne, Melbourne, Victoria, Australia
| | - Eliza A Hawkes
- University of Melbourne, Melbourne, Victoria, Australia; Olivia Newton John Cancer Research & Wellness Centre, Austin Health, Melbourne, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
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12
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Taylor RP, Lindorfer MA. Measurement of Trogocytosis: Quantitative Analyses Validated with Rigorous Controls. Curr Protoc 2023; 3:e897. [PMID: 37830752 DOI: 10.1002/cpz1.897] [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] [Indexed: 10/14/2023]
Abstract
Trogocytosis is a process in which receptors on acceptor cells remove and internalize cognate ligands from donor cells. Trogocytosis has a profound and negative impact on mAb-based cancer immunotherapy, as seen in the treatment of chronic lymphocytic leukemia (CLL) with CD20 mAbs, such as rituximab (RTX) and ofatumumab (OFA). Our clinical observations of RTX/OFA-mediated loss of the CD20 target from circulating CLL cells have been replicated in our in vitro studies. Here we describe flow cytometry and fluorescence microscopy experiments, which demonstrate that acceptor cells, such as monocytes/macrophages that express FcγR, remove and internalize both antigen and donor cell-bound cognate IgG mAbs for several different mAb-donor cell pairs. Fluorescent mAbs and portions of the plasma cell membrane are transferred from donor cells to acceptor cells, which include the THP-1 monocytic cell line as well as freshly isolated monocytes. We describe rigorous controls to validate the reactions and eliminate dissociation or internalization as alternative mechanisms. Trogocytosis is likely to contribute to neutropenia, thrombocytopenia, and liver damage associated with use of antibody-drug conjugates. The methods we have described should allow for examination of strategies focused on blocking trogocytosis and its adverse effects. © 2023 The Authors. Current Protocols published by Wiley Periodicals LLC. Basic Protocol 1: Trogocytosis of mAb-opsonized donor cells mediated by adherent THP-1 cells Alternate Protocol: Application of fluorescence microscopy to examine THP-1 cell-mediated trogocytosis Support Protocol 1: Alexa labeling of mAbs and determination of F/P ratios Support Protocol 2: Standard washing procedure Support Protocol 3: Labeling and opsonization of cells Basic Protocol 2: Trogocytosis mediated by human monocytes as acceptor cells Support Protocol 4: Isolation of human monocytes Basic Protocol 3: Trogocytosis mediated by THP-1 cells in solution Support Protocol 5: Retinoic acid treatment of THP-1 cells Support Protocol 6: Culturing of SCC-25, BT-474, MOLT-4 and THP-1 cell lines.
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Affiliation(s)
- Ronald P Taylor
- Department of Biochemistry and Molecular Genetics, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Margaret A Lindorfer
- Department of Biochemistry and Molecular Genetics, University of Virginia School of Medicine, Charlottesville, Virginia
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13
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Di M, Long JB, Kothari SK, Sethi T, Zeidan AM, Podoltsev NA, Shallis RM, Wang R, Ma X, Huntington SF. Treatment patterns and real-world effectiveness of rituximab maintenance in older patients with mantle cell lymphoma: a population-based analysis. Haematologica 2023; 108:2218-2223. [PMID: 36655436 PMCID: PMC10388284 DOI: 10.3324/haematol.2022.282252] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/05/2023] [Indexed: 01/20/2023] Open
Affiliation(s)
- Mengyang Di
- Section of Hematology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT; Yale Cancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center.
| | - Jessica B Long
- Yale Cancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center
| | - Shalin K Kothari
- Section of Hematology, Department of Internal Medicine, Yale School of Medicine
| | - Tarsheen Sethi
- Section of Hematology, Department of Internal Medicine, Yale School of Medicine
| | - Amer M Zeidan
- Section of Hematology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT; Yale Cancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center
| | - Nikolai A Podoltsev
- Section of Hematology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT; Yale Cancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center
| | - Rory M Shallis
- Section of Hematology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT; Yale Cancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center
| | - Rong Wang
- Yale Cancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center, New Haven, CT; Department of Chronic Disease Epidemiology, Yale School of Public Health
| | - Xiaomei Ma
- Yale Cancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center, New Haven, CT; Department of Chronic Disease Epidemiology, Yale School of Public Health
| | - Scott F Huntington
- Section of Hematology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT; Yale Cancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center
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14
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Shi Q, He Y, Yi H, Mu R, Jiang X, Fu D, Dong L, Qin W, Xu P, Cheng S, Song Q, Chen S, Wang L, Zhao W. Positron emission tomography-adapted therapy in low-risk diffuse large B-cell lymphoma: results of a randomized, phase III, non-inferiority trial. Cancer Commun (Lond) 2023; 43:896-908. [PMID: 37403255 PMCID: PMC10397561 DOI: 10.1002/cac2.12462] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 05/17/2023] [Accepted: 06/27/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND The current standard of care for non-bulky diffuse large B-cell lymphoma (DLBCL) patients with an International Prognostic Index (IPI) of 0 is four cycles of rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) but whether the same efficacy can be achieved with reduced chemotherapy regimen of four cycles for non-bulky DLBCL patients with an IPI of 1 remains unclear. This study compared four cycles versus six cycles of chemotherapy in non-bulky low-risk DLBCL patients with negative interim positron emission tomography with computed tomography (PET-CT, Deauville 1-3), irrespective of age and other IPI risk factors (IPI 0-1). METHODS This was an open-label, randomized, phase III, non-inferiority trial. Patients aged 14-75 years with newly diagnosed low-risk DLBCL, according to IPI, achieving PET-CT confirmed complete response (CR) after four cycles of R-CHOP were randomized (1:1) between four cycles of rituximab (4R-CHOP+4R arm) or two cycles of R-CHOP plus two cycles of rituximab (6R-CHOP+2R arm). The primary endpoint was 2-year progression-free survival (PFS), conducted in the intention-to-treat population. Safety was assessed in patients with at least one cycle of assigned treatment. The non-inferiority margin was -8%. RESULTS A total of 287 patients were included in the intention-to-treat analysis, the median follow-up was 47.3 months, and the 2-year PFS rate was 95% (95% confidence interval [CI], 92% to 99%) and 94% (95% CI, 91% to 98%) for the 4R-CHOP+4R and 6R-CHOP+2R arm. The absolute difference in 2-year PFS between the two arms was 1% (95% CI, -5% to 7%), supporting the non-inferiority of 4R-CHOP+4R. Grade 3-4 neutropenia was lower in the last four cycles of rituximab alone in the 4R-CHOP+4R arm (16.7% versus 76.9%), with decreased risk of febrile neutropenia (0.0% versus 8.4%) and infection (2.1% versus 14.0%). CONCLUSIONS For newly diagnosed low-risk DLBCL patients, interim PET-CT after four cycles of R-CHOP was effective in identifying patients with Deauville 1-3 who would have a good response and Deauville 4-5 patients who might have high-risk biological features or develop resistance. Reducing the standard six cycles to four cycles of chemotherapy had comparable clinical efficacy and fewer adverse events in low-risk, non-bulky DLBCL with interim PET-CT confirmed CR.
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Affiliation(s)
- Qing Shi
- State Key Laboratory of Medical GenomicsNational Research Center for Translational Medicine at ShanghaiShanghai Institute of HematologyRuijin Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiP. R. China
| | - Yang He
- State Key Laboratory of Medical GenomicsNational Research Center for Translational Medicine at ShanghaiShanghai Institute of HematologyRuijin Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiP. R. China
| | - Hong‐Mei Yi
- Department of PathologyRuijin Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiP. R. China
| | - Rong‐Ji Mu
- Clinical Research InstituteShanghai Jiao Tong University School of MedicineShanghaiP. R. China
| | - Xu‐Feng Jiang
- Department of Nuclear MedicineRuijin Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiP. R. China
| | - Di Fu
- State Key Laboratory of Medical GenomicsNational Research Center for Translational Medicine at ShanghaiShanghai Institute of HematologyRuijin Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiP. R. China
| | - Lei Dong
- Department of PathologyRuijin Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiP. R. China
| | - Wei Qin
- State Key Laboratory of Medical GenomicsNational Research Center for Translational Medicine at ShanghaiShanghai Institute of HematologyRuijin Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiP. R. China
| | - Peng‐Peng Xu
- State Key Laboratory of Medical GenomicsNational Research Center for Translational Medicine at ShanghaiShanghai Institute of HematologyRuijin Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiP. R. China
| | - Shu Cheng
- State Key Laboratory of Medical GenomicsNational Research Center for Translational Medicine at ShanghaiShanghai Institute of HematologyRuijin Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiP. R. China
| | - Qi Song
- Department of RadiologyRuijin Hospital affiliated to Shanghai Jiao Tong University School of MedicineShanghaiP. R. China
| | - Sai‐Juan Chen
- State Key Laboratory of Medical GenomicsNational Research Center for Translational Medicine at ShanghaiShanghai Institute of HematologyRuijin Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiP. R. China
- Laboratory of Molecular PathologyPôle de Recherches Sino‐Français en Science du Vivant et GénomiqueShanghaiChina
| | - Li Wang
- State Key Laboratory of Medical GenomicsNational Research Center for Translational Medicine at ShanghaiShanghai Institute of HematologyRuijin Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiP. R. China
- Laboratory of Molecular PathologyPôle de Recherches Sino‐Français en Science du Vivant et GénomiqueShanghaiChina
| | - Wei‐Li Zhao
- State Key Laboratory of Medical GenomicsNational Research Center for Translational Medicine at ShanghaiShanghai Institute of HematologyRuijin Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiP. R. China
- Laboratory of Molecular PathologyPôle de Recherches Sino‐Français en Science du Vivant et GénomiqueShanghaiChina
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15
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de Jonge AV, van Werkhoven E, Dinmohamed AG, Nijland M, Zwinderman AH, Bossuyt PM, Veldhuis MS, Rutten EGGM, Mous R, Vermaat JSP, Sandberg Y, de Jongh E, Bilgin YM, Boersma R, Koene H, Kersten MJ, de Jong D, Chamuleau MED. A non-randomized risk-adjusted comparison of lenalidomide + R-CHOP versus R-CHOP for MYC-rearranged DLBCL patients. Blood Cancer J 2023; 13:85. [PMID: 37217463 PMCID: PMC10203347 DOI: 10.1038/s41408-023-00854-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/25/2023] [Accepted: 05/03/2023] [Indexed: 05/24/2023] Open
Abstract
Patients with MYC rearranged (MYC-R) diffuse large B-cell lymphoma (DLBCL) have a poor prognosis. Previously, we demonstrated in a single-arm phase II trial (HOVON-130) that addition of lenalidomide to R-CHOP (R2CHOP) is well-tolerated and yields similar complete metabolic remission rates as more intensive chemotherapy regimens in literature. In parallel with this single-arm interventional trial, a prospective observational screening cohort (HOVON-900) was open in which we identified all newly diagnosed MYC-R DLBCL patients in the Netherlands. Eligible patients from the observational cohort that were not included in the interventional trial served as control group in the present risk-adjusted comparison. R2CHOP treated patients from the interventional trial (n = 77) were younger than patients in the R-CHOP control cohort (n = 56) (median age 63 versus 70 years, p = 0.018) and they were more likely to have a lower WHO performance score (p = 0.013). We adjusted for differences at baseline using 1:1 matching, multivariable analysis, and weighting using the propensity score to reduce treatment-selection bias. These analyses consistently showed improved outcome after R2CHOP with HRs of 0.53, 0.51, and 0.59, respectively, for OS, and 0.53, 0.59, and 0.60 for PFS. Thus, this non-randomized risk-adjusted comparison supports R2CHOP as an additional treatment option for MYC-R DLBCL patients.
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Grants
- Genmab (consultancy), Takeda (research funding), Roche (research funding)
- BMS/Celgene, Kite, Roche (honoraria and research funding) Miltenyi Biotech, Novartis, Takeda, Adicet Bio (honoraria)
- KWF Kankerbestrijding (Dutch Cancer Society)
- BMS/Celgene (Honoraria and research funding), Gilead and Genmab (research funding), Roche, Abbvie, Novartis (honoraria)
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Affiliation(s)
- A Vera de Jonge
- Department of Hematology, Amsterdam UMC location VU, Amsterdam, The Netherlands.
| | - Erik van Werkhoven
- HOVON Data Center, Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Avinash G Dinmohamed
- Department of Hematology, Amsterdam UMC location VU, Amsterdam, The Netherlands
- Erasmus MC, Department of Public Health, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Marcel Nijland
- Department of Hematology, University Medical Center Groningen, Groningen, The Netherlands
| | - Aeilko H Zwinderman
- Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Patrick M Bossuyt
- Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Martine S Veldhuis
- Department of Hematology, Amsterdam UMC location VU, Amsterdam, The Netherlands
| | - Emma G G M Rutten
- Department of Pathology, Amsterdam UMC location VU, Amsterdam, The Netherlands
| | - Rogier Mous
- Department of Hematology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Joost S P Vermaat
- Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands
| | - Yorick Sandberg
- Department of Internal Medicine, Maasstad Hospital, Rotterdam, The Netherlands
| | - Eva de Jongh
- Department of Hematology, Albert Schweitzer Ziekenhuis, Dordrecht, The Netherlands
| | - Yavuz M Bilgin
- Department of Internal Medicine, Adrz, Goes, The Netherlands
| | - Rinske Boersma
- Department of Internal Medicine, Amphia Ziekenhuis, Breda, The Netherlands
| | - Harry Koene
- Department of Hematology, St Antonius Ziekenhuis, Nieuwegein, The Netherlands
| | - Marie José Kersten
- Department of Hematology, Amsterdam UMC location VU, Amsterdam, The Netherlands
| | - Daphne de Jong
- Department of Pathology, Amsterdam UMC location VU, Amsterdam, The Netherlands
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16
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Davies AJ, Barrans S, Stanton L, Caddy J, Wilding S, Saunders G, Mamot C, Novak U, McMillan A, Fields P, Collins GP, Stephens R, Cucco F, Sha C, van Hoppe M, Tooze R, Davies JR, Griffiths G, Schuh A, Burton C, Westhead DR, Du MQ, Johnson PW. Differential Efficacy From the Addition of Bortezomib to R-CHOP in Diffuse Large B-Cell Lymphoma According to the Molecular Subgroup in the REMoDL-B Study With a 5-Year Follow-Up. J Clin Oncol 2023; 41:2718-2723. [PMID: 36972491 PMCID: PMC10414744 DOI: 10.1200/jco.23.00033] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 02/10/2023] [Indexed: 03/29/2023] Open
Abstract
Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.The REMoDL-B phase III adaptive trial compared rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) versus R-CHOP + bortezomib (RB-CHOP) in patients with diffuse large B-cell lymphoma (DLBCL), stratified by molecular subtype. Primary analysis at a median follow-up of 30 months found no effect of bortezomib on progression-free survival (PFS) or overall survival (OS). Retrospective analysis using a gene expression-based classifier identified a molecular high-grade (MHG) group with worse outcomes. We present an updated analysis for patients successfully classified by the gene expression profile (GEP). Eligible patients were age older than 18 years with untreated DLBCL, fit enough for full-dose chemotherapy, and with adequate biopsies for GEP. Of 1,077 patients registered, 801 were identified with Activated B-Cell (ABC), Germinal Center B-cell, or MHG lymphoma. At a median follow-up of 64 months, there was no overall benefit of bortezomib on PFS or OS (5-year PFS hazard ratio [HR], 0.81; P = .085; OS HR, 0.86; P = .32). However, improved PFS and OS were seen in ABC lymphomas after RB-CHOP: 5-year OS 67% with R-CHOP versus 80% with RB-CHOP (HR, 0.58; 95% CI, 0.35 to 0.95; P = .032). Five-year PFS was higher in MHG lymphomas: 29% versus 55% (HR, 0.46; 95% CI, 0.26 to 0.84). Patients with ABC and MHG DLBCL may benefit from the addition of bortezomib to R-CHOP in initial therapy.
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Affiliation(s)
- Andrew J. Davies
- School of Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Sharon Barrans
- Haematological Malignancy Diagnostic Service, Leeds Cancer Centre, Leeds Teaching Hospitals, Leeds, United Kingdom
| | - Louise Stanton
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - Josh Caddy
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - Sam Wilding
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - Geoff Saunders
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | | | - Urban Novak
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andrew McMillan
- Department of Haematology, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - Paul Fields
- Department of Haematology, Guy's and St Thomas's Hospitals NHS Trust, Kings Health Partners, London, United Kingdom
| | - Graham P. Collins
- Oxford Cancer and Haematology Centre, Churchill Hospital, Oxford, United Kingdom
| | - Richard Stephens
- National Cancer Research Institute Consumer Forum, London, United Kingdom
| | - Francesco Cucco
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Chulin Sha
- School of Molecular and Cellular Biology, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Moniek van Hoppe
- Haematological Malignancy Diagnostic Service, Leeds Cancer Centre, Leeds Teaching Hospitals, Leeds, United Kingdom
| | - Reuben Tooze
- Section of Experimental Haematology, University of Leeds, Leeds, United Kingdom
| | - John R. Davies
- School of Molecular and Cellular Biology, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Gareth Griffiths
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - Anna Schuh
- Department of Oncology, University of Oxford, Oxford, United Kingdom
| | - Catherine Burton
- Haematological Malignancy Diagnostic Service, Leeds Cancer Centre, Leeds Teaching Hospitals, Leeds, United Kingdom
| | - David R. Westhead
- School of Molecular and Cellular Biology, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Ming-Qing Du
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Peter W.M. Johnson
- School of Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
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17
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Ernst M, Dührsen U, Hellwig D, Lenz G, Skoetz N, Borchmann P. Diffuse Large B-Cell Lymphoma and Related Entities. Dtsch Arztebl Int 2023; 120:289-296. [PMID: 36942797 PMCID: PMC10391525 DOI: 10.3238/arztebl.m2023.0035] [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] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 11/15/2022] [Accepted: 02/02/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Diffuse large B-cell lymphoma (DLBCL) is the most common malignant B-cell neoplasm, with an incidence of 5.6 per 100 000 persons per year and a mean age of onset of approximately 65 years. It is an aggressive type of non-Hodgkin's lymphoma requiring urgent treatment with curative intent. Evidence-based guidelines have not been available to date. METHODS For this first international evidence-based DLBCL-specific guideline, various systematic literature searches were performed. 5 systematic reviews, 21 randomized controlled trials (RCTs), and 36 non-randomized studies were used to formulate 42 recommendations. 142 were formulated on the basis of expert consensus. All recommendations were approved in a structured consensus-finding process. RESULTS For staging, combined positron emission tomography and computed tomography (PET/CT) should be performed (evidence: a prospective registry study). For all patients with a new diagnosis of DLBCL and without contraindications, R-CHOP based immunochemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) should be initiated with curative intent (evidence: RCTs). The individual treatment strategy is tailored to the patient's age and risk constellation. Once immunochemotherapy has been completed, PET/CT should be performed again to check for remission. Patients with PET-positive residual disease that is amenable to radiotherapy should be treated with consolidating irradiation (evidence: retrospective cohort study). CONCLUSION This clinical practice guideline on the diagnosis, treatment, and followup of patients with DLBCL and related entities provides a standardized clinical management approach, identifies areas where improvement would be desirable, and can serve as a basis for the development of further studies.
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Affiliation(s)
- Moritz Ernst
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne
| | | | - Dirk Hellwig
- Department for Nuclear Medicine, University Hospital Regensburg
| | - Georg Lenz
- Department of Medicine A for Hematology, Oncology, and Pneumology, University Hospital Münster
| | - Nicole Skoetz
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne
| | - Peter Borchmann
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne
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18
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Arambulo S, Calle A, Vela JM, Sotelo MJ. Advanced penile lymphoma: Case report and review of the literature. J Cancer Res Ther 2023; 19:823-825. [PMID: 37470619 DOI: 10.4103/jcrt.jcrt_593_21] [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] [Indexed: 07/21/2023]
Abstract
Primary penile lymphomas are extremely rare. They are aggressive neoplasms that can present as double-or triple-hit lymphomas, and because the associate with a high risk of central nervous system dissemination, treatment consists of high-dose chemotherapy regimens plus intrathecal prophylaxis. Pathology can be confused with squamous cell carcinoma of the penis, leading to inappropriate treatments and unnecessary amputations. We report the case of a patient diagnosed with clinical Stage IV penile non-Hodgkin lymphoma that was treated with a complete and durable response. In addition, we review the available literature on penile lymphoma.
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Affiliation(s)
- Stella Arambulo
- Department of Medical Oncology, Hospital María Auxiliadora, Lima, Peru
| | - Ana Calle
- Department of Medical Oncology, Hospital María Auxiliadora; Aliada Oncological Center, Lima, Peru
| | - Jose Manuel Vela
- Department of Medical Oncology, Hospital María Auxiliadora, Lima, Peru
| | - Miguel Jhonatan Sotelo
- Department of Medical Oncology, Hospital María Auxiliadora; Aliada Oncological Center; Oncological Research Unit, Clínica San Gabriel, Lima, Peru
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19
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Qualls D, Imber BS, Okwali M, Hamlin PA, Kumar A, Lahoud OB, Matasar MJ, Noy A, Owens C, Zelenetz AD, North VS, Schöder H, Dogan A, Salles G, Yahalom J, Falchi L. Long-term outcomes of patients with limited-stage ocular adnexal DLBCL treated with combined modality therapy in the rituximab era. Br J Haematol 2023; 200:524-527. [PMID: 36484627 PMCID: PMC10407681 DOI: 10.1111/bjh.18590] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 11/07/2022] [Accepted: 11/22/2022] [Indexed: 12/13/2022]
Affiliation(s)
- David Qualls
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Brandon S Imber
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Michelle Okwali
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Paul A Hamlin
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Anita Kumar
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Oscar B Lahoud
- Department of Medicine, Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Matthew J Matasar
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Ariela Noy
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Colette Owens
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Andrew D Zelenetz
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Victoria S. North
- Edward S. Harkness Eye Institute, Department of Ophthalmology, Columbia University Irving Medical Center - New York-Presbyterian Hospital, USA
| | - Heiko Schöder
- Department of Radiology, Nuclear Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Ahmet Dogan
- Department of Radiology, Nuclear Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Gilles Salles
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Joachim Yahalom
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Lorenzo Falchi
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
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20
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Alebbi SM, Kambal A, Abo Samra H, Sharaf Eldean MZ, Mohamed SF, Al-Shokri SD. Case Report: Tuberculosis-Induced Autoimmune Hemolytic Anemia. Am J Trop Med Hyg 2023; 108:313-316. [PMID: 36535253 PMCID: PMC9896313 DOI: 10.4269/ajtmh.22-0217] [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: 03/22/2022] [Accepted: 09/01/2022] [Indexed: 12/23/2022] Open
Abstract
Tuberculosis (TB) is an infectious disease that affects different organs, causing multiple complications, including hematological sequelae. One of the most common TB-hematological complications is anemia of chronic disease. Very rarely autoimmune hemolytic anemia (AIHA) has been reported as an uncommon manifestation of TB. In this case, we present a female who presented with refractory AIHA, which was attributed to disseminated TB. The patient responded well to steroids, anti-TB medications, and rituximab.
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Affiliation(s)
- Seham M. Alebbi
- Department of Medical Education, Hamad Medical Corporation, Doha, Qatar
| | - Aalaa Kambal
- Clinical Imaging Department, Hamad Medical Corporation, Doha, Qatar
| | - Hayan Abo Samra
- Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar
- Histopathology Department, Hamad Medical Corporation, Doha, Qatar
| | - Mouhammad Z. Sharaf Eldean
- Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar
- Histopathology Department, Hamad Medical Corporation, Doha, Qatar
| | - Shehab Fareed Mohamed
- Department of Hematology and Medical Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Shaikha D. Al-Shokri
- Department of Medical Education, Hamad Medical Corporation, Doha, Qatar
- Department of Internal Medicine, Case Western Reserve University–MetroHealth Medical Center, Cleveland, Ohio
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21
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Vaughan J, Wiggill T, Lawrie D, Machaba M, Patel M. The prognostic impact of monocyte fluorescence, immunosuppressive monocytes and peripheral blood immune cell numbers in HIV-associated Diffuse Large B-cell Lymphoma. PLoS One 2023; 18:e0280044. [PMID: 36630466 PMCID: PMC9833596 DOI: 10.1371/journal.pone.0280044] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 12/20/2022] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION Diffuse large B-cell lymphoma (DLBCL) is a high grade non-Hodgkin lymphoma which is common among immunodeficient people. Derangements of peripheral blood immune cells have been described to have a prognostic impact in DLBCL in high income countries, including a monocytosis, the ratios of lymphocytes to both monocytes (L:M) and neutrophils (N:L), as well as the numbers of regulatory T-cells (Tregs) and immunosuppressive monocytes (HLA-DRlow monos). To date, the impact of these variables has not been assessed in the setting of HIV-associated DLBCL (HIV-DLBCL), which is among the most common malignancies seen in people living with HIV. In this study, we assessed these factors in a cohort of South African patients with DLBCL and a high HIV-seropositivity-rate. In addition, we evaluated the prognostic value of monocyte activation (as reflected by monocyte fluorescence (MO-Y) on a Sysmex haematology analyser). This parameter has to date not been assessed in the setting of DLBCL. METHODS A full blood count and differential count as well as flow cytometry for HLA-DRlow monocyte and Treg enumeration were performed in patients with incident DLBCL referred to the Chris Hani Baragwanath Academic Hospital in Johannesburg, South Africa between November 2019 and May 2022. Additional clinical and laboratory data were recorded from the patient charts and laboratory information system. RESULTS Seventy-six patients were included, of whom 81.3% were people living with HIV with a median CD4 count of 148 cells/ul. Most patients had advanced stage disease (74.8%) and were predominantly treated with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP)-based chemotherapy (without Rituximab). At a median follow-up period of 19 months, the median survival time was 3.5 months, with a 12-month survival rate of 27.0%. All of the immune-cell-related variables (with the exception of the CD4 count) were similar between the people living with HIV and the HIV-negative individuals. In contrast to previous studies, a high monocyte count, the L:M and increased numbers of HLA-DRlow monocytes were not significantly associated with survival in HIV-DLBCL, while a neutrophilia (>8 x 109/L), the N:L (>6:1), high numbers of Tregs (≥5.17% of CD4s) and lymphopenia (<1.3 x 109/L) were. In addition, increased monocyte fluorescence (MO-Y >115.5) was associated with superior outcomes, which we speculate to reflect a more robust antitumour immune response among individuals with high levels of monocyte activation. On Cox Proportional hazard analysis, immune-cell factors independently associated with survival included a CD4 count <150 cells/ul and a neutrophilia. CONCLUSION The monocyte count, L:M and the number of HLA-DRlow monos are not strong prognostic indicators in HIV-DLBCL, while a low CD4 count and neutrophilia are. Elevation of the MO-Y shows some promise as a potential biomarker of antitumour immunity; further study in this regard would be of interest.
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Affiliation(s)
- Jenifer Vaughan
- Department of Molecular Medicine and Haematology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- National Health Laboratory Services, Johannesburg, South Africa
- * E-mail:
| | - Tracey Wiggill
- Department of Molecular Medicine and Haematology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- National Health Laboratory Services, Johannesburg, South Africa
| | - Denise Lawrie
- Department of Molecular Medicine and Haematology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- National Health Laboratory Services, Johannesburg, South Africa
| | - Merriam Machaba
- Department of Molecular Medicine and Haematology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- National Health Laboratory Services, Johannesburg, South Africa
| | - Moosa Patel
- Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Clinical Haematology Unit, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
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22
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Zhu H, Li F, Chang Y, Sun Y, Wang N, Wang R. Evaluation of the Effects of R-CHOP Chemotherapy on Brain Glucose Metabolism in Patients with Diffuse Large B Cell Lymphoma: A Baseline, Interim, and End-of-Treatment PET/CT Study. Tomography 2022; 8:2565-2573. [PMID: 36287813 PMCID: PMC9607544 DOI: 10.3390/tomography8050214] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 10/07/2022] [Accepted: 10/08/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND To investigate the effect of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy on brain glucose metabolism in patients with diffuse large B cell lymphoma (DLBCL). METHODS Seventy-two patients with newly diagnosed DLBCL underwent FDG PET/CT brain and whole-body scans at baseline (PET0), in the interim of chemotherapy (PET2), and at the end (PET6) of chemotherapy. All three brain scans of each patient were analyzed using statistical parametric mapping software. RESULTS Compared with the PET0 scan, the PET2 and PET6 scans revealed a significantly higher glucose metabolism throughout the whole brain, with the PET6 scan revealing a higher metabolism than the PET2 scan. Patients with a complete response (CR) displayed decreased glucose metabolism in the lingual gyrus and increased glucose metabolism in the pons after chemotherapy compared with the findings in patients with partial responses or progressive disease. CONCLUSIONS Brain glucose metabolism was affected by R-CHOP treatment throughout the entire chemotherapy protocol.
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Affiliation(s)
- Haiyan Zhu
- Department of Hematology, The Fifth Medical Center, Beijing 100039, China
| | - Fei Li
- Department of Hematology, The Fifth Medical Center, Beijing 100039, China
| | - Yan Chang
- Department of Nuclear Medicine, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Yabing Sun
- Department of Nuclear Medicine, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Nan Wang
- Department of Hematology, The Fifth Medical Center, Beijing 100039, China
| | - Ruimin Wang
- Department of Nuclear Medicine, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
- Correspondence: ; Tel.: +86-10-669-36793
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23
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Zhang JL, Xing HZ, Wang F, Wan DM, Jiang ZX, Wang M. [Clinical characteristics and outcome of 69 patients with thrombotic thrombocytopenic purpura]. Zhonghua Nei Ke Za Zhi 2022; 61:797-800. [PMID: 35764564 DOI: 10.3760/cma.j.cn112138-20210810-00541] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
To analyze the clinical characteristics, diagnosis, treatment and outcome of patients with thrombotic thrombocytopenic purpura (TTP). The clinical data of 69 adult patients with TTP were retrospectively analyzed. There were 19 males and 50 females with a median age of 42 (18-79) years. PLASMIC score 6-7 was recognized in 82.8% (53/64) patients. The activity of von Willebrand factor-cleaving protease (ADAMTS13), which was detected in 21 patients before treatment, was less than 5% in 17 patients and 5%-10% in 3 patients. All 69 patients were treated with plasma exchange (PEX) and/or fresh frozen plasma infusion (PI), 43 of whom were also given glucocorticoid. In addition to PEX/PI and glucocorticoid, rituximab and/or immunosuppressants were administrated in 20 patients. The median follow-up time was 12 (1-57) months. The remission rate was 69.6%, while the relapse rate was 11.6%. The 2-year overall survival (OS) rate was 69.6%±5.5%. The univariate and multivariate analysis showed that relapsed/refractory disease was an independent risk factor for OS. The 2-year OS rate of relapsed/refractory patients was significantly lower than that of the rest patients (41.5%±9.8% vs. 83.7%±5.6%, P<0.001). Regarding the unfavorable prognosis in relapsed/refractory patients, rituximab and/or immunosuppressants are strongly recommended for sake of improving the overall survival.
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Affiliation(s)
- J L Zhang
- Department of Hematology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - H Z Xing
- Department of Hematology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - F Wang
- Department of Hematology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - D M Wan
- Department of Hematology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Z X Jiang
- Department of Hematology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - M Wang
- Department of Hematology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
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24
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Yamaguchi M. [Current status and future prospects of diffuse large B-cell lymphoma treatment]. Rinsho Ketsueki 2022; 63:1126-1134. [PMID: 36198538 DOI: 10.11406/rinketsu.63.1126] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
R-CHOP therapy (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) has been used as the standard treatment regimen for patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL), since the introduction of rituximab in the early 2000s. Recently, polatuzumab vedotin and anti-CD19 chimeric antigen receptor T-cell (CAR-T) therapy have been introduced as potential treatment options for relapsed or refractory DLBCL. The effectiveness of polatuzumab vedotin, rituximab, cyclophosphamide, doxorubicin, and prednisone for newly diagnosed CD20-positive DLBCL, except for the low-risk group of the international prognostic index, was reported in 2022. Bispecific antibodies such as epcoritamab, mosunetuzumab, and glofitamab, anti-CD19 antibody drug tafasitamab combined with lenalidomide, CD19 antibody drug conjugate loncastuximab tesirine, oral selective inhibitor of nuclear export selinexor, and several new agents have been investigated for DLBCL. For non-germinal center B-cell type DLBCL, R-CHOP combined with acalabrutinib is being evaluated. This review summarizes the current standard of care for DLBCL and outlines the recently introduced therapeutic agents or those that are under development in Japan.
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Affiliation(s)
- Motoko Yamaguchi
- Department of Hematological Malignancies, Mie University Graduate School of Medicine
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25
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Miyazaki K. [Therapeutic developments and advances in B-cell lymphoma]. Rinsho Ketsueki 2022; 63:619-625. [PMID: 35831197 DOI: 10.11406/rinketsu.63.619] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
B-cell lymphoma accounts for approximately 70% of malignant lymphomas, and its treatment outcomes have drastically improved after the introduction of rituximab. Most patients with diffuse large B-cell lymphoma (DLBCL) are successfully treated with the current standard chemotherapeutic regimen of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). However, 30-40% of patients with DLBCL have unsatisfactory treatment outcomes. Molecular genetic research has greatly contributed to the identification of pathogenic mechanisms of lymphoma and factors leading to poor prognosis. Thus, novel agents for targeting factors in key signaling pathways, relevant targeted antigens, and epigenetic enzymes have been developed. Additionally, development of immunotherapies such as anti-CD19-chimeric antigen receptor (CAR) T cell and bispecific antibody therapy have led to a paradigm shift for relapsed or refractory DLBCL treatments. Herein, we discuss the results of clinically impactful studies on the treatment strategies of B-cell lymphoma, including DLBCL, follicular lymphoma, and lymphoplasmacytic lymphoma.
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Affiliation(s)
- Kana Miyazaki
- Department of Hematology and Oncology, Mie University Graduate School of Medicine
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26
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Ogawa MA, Ieda M, Hayakawa M, Mizutani H, Ogawa K, Sato T, Satake T, Kojima Y. [Intravascular large B-cell lymphoma diagnosed by total hysterectomy]. Rinsho Ketsueki 2022; 63:182-188. [PMID: 35387930 DOI: 10.11406/rinketsu.63.182] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Intravascular large B-cell lymphoma (IVLBCL) is a rare form of non-Hodgkin B-cell lymphoma which occurs mainly in capillaries and small blood vessels. Successful diagnosis of IVLBCL is challenging since it lacks tumor formation and presents various clinical manifestations. An 82-year-old Asian female patient presented to our emergency department with a history of general fatigue, weight loss, and fever for two weeks. The patient's random skin biopsy was negative, and her bone marrow biopsy revealed hemophagocytic syndrome with no obvious involvement of lymphoma cells. Gallium scintigraphy showed mild uptake in the uterus, pelvis, and spine. The repetitive bone marrow biopsy result and the endometrial cytology/biopsy were negative; however, the pelvic MRI was compatible with lymphoma, revealing lesions in the corpus uteri, pelvis, and vertebral body. After laparoscopic-assisted vaginal total hysterectomy and bilateral salpingo-oophorectomy, the diagnosis of the Asian variant of IVLBCL was made. Although total hysterectomy remains controversial for elderly patients with declining performance status, we could successfully diagnose the condition and initiate the treatment. The patient's general condition improved soon after starting rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone regimen on day 26, and she was discharged on day 45.
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Affiliation(s)
| | - Miho Ieda
- Department of Hematology, Nagoya Ekisaikai Hospital
| | | | | | | | - Tomoko Sato
- Division of Diagnostic Pathology, Nagoya Ekisaikai Hospital
| | | | - Yumi Kojima
- Department of Hematology, Nagoya Ekisaikai Hospital
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Porkert S, Mai P, Jonak C, Weihsengruber F, Rappersberger K, Bauer W, Simonitsch-Klupp I, Raderer M, Valencak J. Long-term Therapeutic Success of Intravenous Rituximab in 26 Patients with Indolent Primary Cutaneous B-cell Lymphoma. Acta Derm Venereol 2021; 101:adv00383. [PMID: 33475146 PMCID: PMC9366677 DOI: 10.2340/00015555-3746] [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] [Indexed: 11/30/2022] Open
Abstract
Systemic monotherapy with rituximab is a well-known treatment approach for primary cutaneous follicle centre lymphoma and primary cutaneous marginal zone lymphoma. Both have excellent prognosis despite high relapse rates. To investigate the long-term effectiveness and clinical outcome of intravenous rituximab at a dose of 375 mg/m2 once weekly, data for 26 patients (17 primary cutaneous follicle centre lymphoma and 9 primary cutaneous marginal zone lymphoma) were analysed retrospectively. Complete remissions occurred in 20 (77%) and partial remissions in 6 patients (23%), demonstrating an overall response rate of 100%. The relapse rate was 52.9% in primary cutaneous follicle centre lymphoma and 88.9% in primary cutaneous marginal zone lymphoma. Ongoing complete remissions after therapy with rituximab were observed in 9 patients (34.6%) with a median progression-free survival of 161 months (13.4 years). These results confirm that intravenous rituximab is an effective and well-tolerated treatment with durable responses in a relevant percentage of patients at a median follow-up of 148 months (12.3 years).
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Affiliation(s)
- Stefanie Porkert
- Department of Dermatology, Medical University of Vienna, Waehringer Guertel 18-20, AT-1090 Vienna, Austria
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28
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Vacchi C, Visentini M, Gragnani L, Fraticelli P, Tavoni A, Filippini D, Saccardo F, Lauletta G, Colantuono S, Atzeni F, Pioltelli P, Manfredi A, Casato M, Zignego AL, Monti G, Pietrogrande M, Galli M, Sebastiani M. Safety and effectiveness of biosimilar of Rituximab CT-P10 in the treatment of cryoglobulinemic vasculitis: the MARBLe study (Mixed cryoglobulinemiA Rituximab BiosimiLar). Intern Emerg Med 2021; 16:149-156. [PMID: 32524338 DOI: 10.1007/s11739-020-02386-0] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 05/27/2020] [Indexed: 01/29/2023]
Abstract
Rituximab (RTX) represents a milestone in the treatment of mixed cryoglobulinemic vasculitis (MCV). Despite usually well-tolerated, RTX may induce different types of adverse drug reactions, including exacerbation of vasculitis. Recently, RTX biosimilar CT-P10 has been approved in Europe for the treatment of rheumatoid arthritis, but no data are available about effectiveness and safety of CT-P10 in the treatment of MCV. In this multicenter open-label study, we analyzed the safety of CT-P10 in patients with MCV treated in first-line or after a shift by RTX originator. Fifty-one consecutive MCV patients (females/males 35/16, median age 68 years, median disease duration 42 months, 51% HCV positive) were included in the study between July and December 2018 and were treated with CT-P10 (group 1). Safety and effectiveness of CT-P10 were compared with a retrospective group (group 2) including 75 consecutive patients treated with RTX originator between July 2017 and July 2018. Thirty-six patients were treated with CT-P10 for the first time, while the other 15 switched from RTX originator. RTX was administrated with high or dosage schemes (375 mg/m2 four times a week apart/1000 mg twice one week apart or 250 mg/m2 twice one week apart). During a month period after the last infusion, 13/51 adverse events (AE) were observed in group 1 and 17/75 in group 2 (p not significant). Among them, 7/13 and 6/17 (in group 1 and 2, respectively) could be considered immune-mediated AE (p not significant). At univariate analysis patients with IM-AE were more frequently males (p = 0.04) and with a lower disease duration (p = 0.03), but both the parameters were not significant at logistic regression. About clinical response after 6 months by the end of the treatment, no differences were observed between patients treated with originator and CT-P10 regarding the response to the therapy. No differences were observed in safety and effectiveness between patients naïve at RTX or switching from originator. Despite the higher prevalence of immune-mediated AE among patients treated with CT-P10 than originator, we have observed no significant differences between the 2 groups. The use of a low-dosage regimen is more common in group 1 than in group 2, representing a possible bias of the study, possibly influencing the appearance of AE. Considering the cost/efficacy ratio of biosimilars, their use could be helpful to treat a large number of MCV patients with an effectiveness and safety comparable to originator. Multicenter studies including a large number of patients and the new RTX biosimilars could be useful to fully elucidate the possible risk of immune-mediated adverse events with biosimilar drugs. Considering the cost/efficacy ratio of CT-P10, its use could help to treat a large number of MCV patients with an effectiveness and safety comparable to originator.
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Affiliation(s)
- Caterina Vacchi
- Rheumatology Unit, University of Modena and Reggio Emilia, Modena, Italy
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Marcella Visentini
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Laura Gragnani
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Paolo Fraticelli
- Department of Internal Medicine, Azienda Ospedaliero Universitaria Ospedali Riuniti Di Ancona, Ancona, Italy
| | - Antonio Tavoni
- Clinical Immunology Unit, University Hospital of Pisa, Pisa, Italy
| | - Davide Filippini
- Rheumatology Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | | | - Gianfranco Lauletta
- Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Stefania Colantuono
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Fabiola Atzeni
- Rheumatology Unit, University of Messina, Messina, Italy
| | - Pietro Pioltelli
- Hematology Unit, AO San Gerardo, Università Di Milano-Bicocca, Monza, Italy
| | - Andreina Manfredi
- Rheumatology Unit, University of Modena and Reggio Emilia, Modena, Italy
| | - Milvia Casato
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Anna Linda Zignego
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Giuseppe Monti
- Presidio Ospedaliero Di Saronno, ASST Della Valle Olona, Saronno, Italy
| | | | - Massimo Galli
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Marco Sebastiani
- Rheumatology Unit, University of Modena and Reggio Emilia, Modena, Italy.
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Chin CK, Rodriguez MA, Qing Y, Feng L, Samaniego F, Jain P, Noorani M, Fowler NH, Fayad LE, Westin JR, Neelapu SS, Hagemeister FB, Flowers CR, Nastoupil LJ. Impact of maintenance rituximab in patients with de novo transformed indolent B cell lymphoma. Leuk Lymphoma 2020; 61:2985-2989. [PMID: 32628087 DOI: 10.1080/10428194.2020.1789631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Collin K Chin
- Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Maria A Rodriguez
- Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yun Qing
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lei Feng
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Felipe Samaniego
- Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Preetesh Jain
- Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mansoor Noorani
- Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Nathan H Fowler
- Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Luis E Fayad
- Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jason R Westin
- Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sattva S Neelapu
- Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Frederick B Hagemeister
- Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Christopher R Flowers
- Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Loretta J Nastoupil
- Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, Houston, TX, USA
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30
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Liu LD, Lian C, Yeap LS, Meng FL. The development of neutralizing antibodies against SARS-CoV-2 and their common features. J Mol Cell Biol 2020; 12:980-986. [PMID: 33377928 PMCID: PMC7799018 DOI: 10.1093/jmcb/mjaa070] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/23/2020] [Accepted: 11/25/2020] [Indexed: 12/23/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a worldwide severe coronavirus disease 2019 (COVID-19) pandemic since December 2019. There is a great demand for effective therapies for the prevention and treatment of COVID-19. Developing therapeutic neutralizing antibodies (NAbs), which could block viral infection, is such a promising approach, as NAbs have been successfully applied to the treatment of other viral infections. The recent advances of antibody technology have greatly accelerated the discovery of SARS-CoV-2 NAbs, and many of which are now actively tested in clinical trials. Here, we review the approaches applied for SARS-CoV-2 NAb development, and discuss the emerging technologies underlining the antibody discovery. We further summarize the common features of these antibodies including the shared neutralizing epitopes and sequence features.
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MESH Headings
- Animals
- Antibodies, Monoclonal, Humanized/immunology
- Antibodies, Monoclonal, Humanized/isolation & purification
- Antibodies, Monoclonal, Humanized/therapeutic use
- Antibodies, Monoclonal, Murine-Derived/immunology
- Antibodies, Monoclonal, Murine-Derived/isolation & purification
- Antibodies, Monoclonal, Murine-Derived/therapeutic use
- Antibodies, Neutralizing/immunology
- Antibodies, Neutralizing/isolation & purification
- Antibodies, Neutralizing/therapeutic use
- Antibodies, Viral/immunology
- Antibodies, Viral/isolation & purification
- Antibodies, Viral/therapeutic use
- Antibody Diversity
- COVID-19/immunology
- COVID-19/therapy
- COVID-19/virology
- Drug Discovery
- Epitopes/chemistry
- Epitopes/immunology
- Humans
- Mice
- Models, Molecular
- Pandemics
- SARS-CoV-2/immunology
- Spike Glycoprotein, Coronavirus/chemistry
- Spike Glycoprotein, Coronavirus/immunology
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Affiliation(s)
- Liu Daisy Liu
- State Key Laboratory of Molecular Biology, Shanghai Institute of Biochemistry and Cell Biology, Center for Excellence in Molecular Cell Science, Chinese Academy of Sciences; University of Chinese Academy of Sciences, Shanghai 200031, China
| | - Chaoyang Lian
- Shanghai Institute of Immunology, State Key Laboratory of Oncogenes and Related Genes, Department of Immunology and Microbiology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Leng-Siew Yeap
- Shanghai Institute of Immunology, State Key Laboratory of Oncogenes and Related Genes, Department of Immunology and Microbiology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Fei-Long Meng
- State Key Laboratory of Molecular Biology, Shanghai Institute of Biochemistry and Cell Biology, Center for Excellence in Molecular Cell Science, Chinese Academy of Sciences; University of Chinese Academy of Sciences, Shanghai 200031, China
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Affiliation(s)
- Heinz Feldmann
- From the Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Rocky Mountain Laboratories, Hamilton, MT (H.F.); Médecins sans Frontières, Brussels (A.S.); and the Department of Microbiology and Immunology and Galveston National Laboratory, University of Texas Medical Branch at Galveston, Galveston (T.W.G.)
| | - Armand Sprecher
- From the Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Rocky Mountain Laboratories, Hamilton, MT (H.F.); Médecins sans Frontières, Brussels (A.S.); and the Department of Microbiology and Immunology and Galveston National Laboratory, University of Texas Medical Branch at Galveston, Galveston (T.W.G.)
| | - Thomas W Geisbert
- From the Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Rocky Mountain Laboratories, Hamilton, MT (H.F.); Médecins sans Frontières, Brussels (A.S.); and the Department of Microbiology and Immunology and Galveston National Laboratory, University of Texas Medical Branch at Galveston, Galveston (T.W.G.)
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32
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Bonavida B. Cross-Talk Cell Signaling between Anti-CD20 Antibodies and Nitric Oxide Donors. Crit Rev Oncog 2020; 25:291-300. [PMID: 33463947 DOI: 10.1615/critrevoncog.2020036042] [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: 06/12/2023]
Abstract
Rituximab (a chimeric anti-CD20 monoclonal antibody [mAb]) was the first U.S. Food and Drug Administration- approved therapeutic antibody for non-Hodgkin's lymphomas (NHLs). Although initially monotherapy treatments with anti-CD20 mAb were partially effective clinically, its combination with a cocktail of chemotherapeutic drugs (R-CHOP) resulted in significant improvement of clinical responses and progression free survivals. Several mechanisms have been reported on the underlying mechanisms of the activities of anti-CD20 mAbs; those consisted of ADCC, CDC, PCD, and inhibition of intracellular survival signaling pathways (leading to sensitization to both chemo and immunotherapeutic drugs). Such mechanisms share in common the pleiotropic effects of nitric oxide (NO) donors' treatment of B-NHL cells, including the inhibition of intracellular survival/anti-apoptotic pathways and the reversal of resistance of chemo-immunotherapeutic drugs. This review describes briefly both the mechanisms of activity of anti-CD20 antibodies and NO donors and establishes the presence of cell signaling cross-talks. Therefore, the combination of anti-CD20 and NO donors should result in the inhibition of tumor cell proliferation and the reversal of resistance of B-NHL cells. It is postulated that the combination use of well-designed subtoxic NO donors in combination with anti-CD20 mAbs should result in the improved treatment of patients who are initially unresponsive and/or are refractory to prior treatments.
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Affiliation(s)
- Benjamin Bonavida
- Department of Microbiology, Immunology, & Molecular Genetics, David Geffen School of Medicine, Johnson Comprehensive Cancer Center, University of California at Los Angeles, Los Angeles, CA 90025-1747
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33
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Torres D, Hou X, Bale L, Heinzen EP, Maurer MJ, Zanfagnin V, Oberg AL, Conover C, Weroha SJ. Overcoming platinum resistance in ovarian cancer by targeting pregnancy-associated plasma protein-A. PLoS One 2019; 14:e0224564. [PMID: 31751381 PMCID: PMC6872139 DOI: 10.1371/journal.pone.0224564] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 10/16/2019] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES Inhibition of pregnancy-associated plasma protein-A (PAPP-A), an upstream activator of the insulin-like growth factor (IGF) pathway, is known to augment sensitivity to platinum-based chemotherapy. This study further tests the efficacy of PAPP-A inhibition with a monoclonal antibody inhibitor (mAb-PA) in ovarian cancer (OC) platinum-resistant patient-derived xenograft (PDX) models. METHODS PAPP-A expression was quantitated in platinum-resistant PDX models by ELISA. A subset with High (n = 5) and Low (n = 2) expression were revived in female SCID/beige mice for studies with either saline, carboplatin/paclitaxel (CP) + mAb-PA, or CP + IgG2a. The primary endpoint was tumor area by ultrasound on day 28 relative to baseline. Conversion to platinum-sensitive was defined by average tumor regression below baseline. Statistical analyses included linear mixed effects modeling and Kaplan Meier curves. Response to therapy was correlated with changes in the ratio of phosphorylated/total AKT and ERK 1/2 using Wes analysis. RESULTS The addition of mAb-PA to CP induced tumor regression below baseline in one High PAPP-A PDX model; another three models exhibited notable growth inhibition relative to CP + IgG2a. None of the Low PAPP-A PDX models regressed below baseline. The PDX model with the greatest magnitude of tumor regression from baseline after combination therapy was maintained on single agent mAb-PA or IgG2a, but no benefit was observed. Decreased phosphorylation of ERK1/2 correlated with conversion to platinum-sensitive. CONCLUSIONS The addition of mAb-PA to CP overcame platinum-resistance in one of five High PAPP-A PDX models; three other models demonstrated improved platinum-response. This supports further clinical development of this novel therapeutic.
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Affiliation(s)
- Diogo Torres
- Department of Obstetrics and Gynecology, Division of Gynecologic Surgery, Mayo Clinic, Rochester, MN, United States
| | - Xiaonan Hou
- Department of Oncology, Division of Medical Oncology, Mayo Clinic, Rochester, MN, United States
| | - Laurie Bale
- Division of Endocrinology, Mayo Clinic, Rochester, MN, United States
| | - Ethan P. Heinzen
- Department of Health Science Research, Division of Biomedical Statistics and Informatics, Rochester, MN, United States
| | - Matthew J. Maurer
- Department of Health Science Research, Division of Biomedical Statistics and Informatics, Rochester, MN, United States
| | - Valentina Zanfagnin
- Department of Oncology, Division of Medical Oncology, Mayo Clinic, Rochester, MN, United States
| | - Ann L. Oberg
- Department of Health Science Research, Division of Biomedical Statistics and Informatics, Rochester, MN, United States
| | - Cheryl Conover
- Division of Endocrinology, Mayo Clinic, Rochester, MN, United States
| | - S. John Weroha
- Department of Oncology, Division of Medical Oncology, Mayo Clinic, Rochester, MN, United States
- * E-mail:
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Purdum A, Tieu R, Reddy SR, Broder MS. Direct Costs Associated with Relapsed Diffuse Large B-Cell Lymphoma Therapies. Oncologist 2019; 24:1229-1236. [PMID: 30850561 DOI: 10.1634/theoncologist.2018-0490] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 08/10/2018] [Accepted: 01/04/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND About one third of patients with diffuse large B-cell lymphoma (DLBCL) relapse after receiving first-line (1L) treatment of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). Relapsed patients may then be eligible for second-line (2L) therapy. The study's objective was to examine health care use and costs among treated patients with DLBCL receiving 2L therapy versus those without relapse. MATERIALS AND METHODS We analyzed Truven Health MarketScan® claims data between 2006 and 2015. Patients (≥18 years of age) had ≥1 DLBCL claim from 1 year before to 90 days after beginning 1L therapy, and comprised those without 2L treatment for ≥2 years (cured controls) versus those who initiated non-R-CHOP chemotherapy after discontinuing 1L therapy (2L cohort). 2L patients were further subgrouped: hematopoietic stem cell transplant (HSCT [yes/no]) and time of relapse (months between 1L and 2L): early (≤3), mid (4-12), and late (>12) relapse. The primary outcome was 1- and 2-year health care costs. Hospitalization rate and length of stay were also measured. RESULTS A total of 1,374 patients with DLBCL received R-CHOP and fulfilled all criteria: 1,157 cured controls and 217 2L patients (87 early-relapse, 66 mid-relapse, 64 late-relapse). Twenty-eight percent of 2L patients received HSCT. Charlson Comorbidity Index/mortality risk was higher for 2L patients (4.2 [SD: 3.0]) versus controls (3.8 [2.6]; p = .039), as were yearly costs (Year 1: $210,488 [$172,851] vs. $25,044 [$32,441]; p < .001 and Year 2: $267,770 [$266,536] vs. $42,272 [$49,281]; p < .001). HSCT and chemotherapy were each significant contributors of cost among 2L patients. CONCLUSION DLBCL is resource intensive, particularly for 2L patients. Great need exists for newer, effective therapies for DLBCL that may save lives and reduce costs. IMPLICATIONS FOR PRACTICE This study identified multiple important drivers of cost in the understudied population of patients with diffuse large B-cell lymphoma (DLBCL) receiving second-line (2L) treatment. Such drivers included hematopoietic stem cell transplant (HSCT) and chemotherapy. Even though HSCT is currently the only curative therapy for DLBCL, less than one third of patients receiving 2L and subsequent treatment underwent transplant, which indicates potential underuse. The variation in chemotherapy regimens suggested a lack of consensus for best practices. Further research focusing on newer and more effective treatment options for DLBCL has the potential to decrease mortality, in addition to reducing the extensive costs related to therapy options such as transplant.
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MESH Headings
- Antibodies, Monoclonal, Murine-Derived/economics
- Antibodies, Monoclonal, Murine-Derived/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/economics
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Cyclophosphamide/economics
- Cyclophosphamide/therapeutic use
- Doxorubicin/economics
- Doxorubicin/therapeutic use
- Female
- Humans
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/economics
- Lymphoma, Large B-Cell, Diffuse/epidemiology
- Male
- Middle Aged
- Neoplasm Recurrence, Local/drug therapy
- Neoplasm Recurrence, Local/economics
- Neoplasm Recurrence, Local/epidemiology
- Prednisone/economics
- Prednisone/therapeutic use
- Prognosis
- Rituximab/economics
- Rituximab/therapeutic use
- Treatment Outcome
- Vincristine/economics
- Vincristine/therapeutic use
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Affiliation(s)
- Anna Purdum
- Kite Pharma, Inc., Santa Monica, California, USA
| | - Ryan Tieu
- Partnership for Health Analytic Research, LLC, Beverly Hills, California, USA
| | - Sheila R Reddy
- Partnership for Health Analytic Research, LLC, Beverly Hills, California, USA
| | - Michael S Broder
- Partnership for Health Analytic Research, LLC, Beverly Hills, California, USA
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35
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Watanabe K, Yoshifuji K, Saito T, Yamashita T, Nogami A, Sakashita C, Fukuda T, Arai A, Tohda S, Kawamata N, Miura O, Yamamoto M. [Follicular lymphoma accompanied by paraneoplastic pemphigus and bronchiolitis obliterans: a case report]. Rinsho Ketsueki 2019; 60:7-11. [PMID: 30726827 DOI: 10.11406/rinketsu.60.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
A 54-year-old female complained of oral erosion. A flaccid blister appeared on the trunk 2 months after the onset. The high titer of the anti-desmoglein 1 antibody in the absence of Nikolsky's sign led to the diagnosis of pemphigus vulgaris. The lymphadenopathy in the mesenteric and para-aortic regions indicated the possibility of paraneoplastic pemphigus. The steroid pulse therapy and therapeutic plasma exchange were ineffective. As CT-guided intraperitoneal lymph node biopsy revealed follicular lymphoma, R-CHOP therapy was performed. Although partial remission was attained accompanied by an improvement in the skin and mucosal findings after four courses of R-CHOP therapy, an occlusive ventilatory disturbance, possibly attributed to bronchiolitis obliterans, appeared 4 months after the treatment initiation. Although the treatment with tacrolimus was attempted, it was not feasible to be continued because of opportunistic infection, and the patient died 9 months after the onset of the skin lesion. Although specific anti-plakin antibodies were negative, this case was diagnosed as paraneoplastic pemphigus due to follicular lymphoma and complicated by obstructive bronchiolitis based on the clinical findings. The accumulation of similar cases is needed to establish effective treatment strategies.
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Affiliation(s)
- Ken Watanabe
- Department of Hematology, Tokyo Medical and Dental University
| | - Kota Yoshifuji
- Department of Hematology, Tokyo Medical and Dental University
| | - Tatsuya Saito
- Department of Hematology, Tokyo Medical and Dental University
| | | | - Ayako Nogami
- Department of Clinical Laboratory, Medical Hospital, Tokyo Medical and Dental University
| | | | - Tetsuya Fukuda
- Department of Hematology, Tokyo Medical and Dental University
| | - Ayako Arai
- Department of Laboratory Molecular Genetics of Hematology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Shuji Tohda
- Department of Clinical Laboratory, Medical Hospital, Tokyo Medical and Dental University
| | - Norihiko Kawamata
- Tokyo Medical and Dental University Graduate School, Department of Immunotherapy for Hematopoietic Disorders
| | - Osamu Miura
- Department of Hematology, Tokyo Medical and Dental University
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36
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Ogura M, Sancho JM, Cho SG, Nakazawa H, Suzumiya J, Tumyan G, Kim JS, Lennard A, Mariz J, Ilyin N, Jurczak W, Lopez Martinez A, Samoilova O, Zhavrid E, Yañez Ruiz E, Trneny M, Popplewell L, Coiffier B, Buske C, Kim WS, Lee SJ, Lee SY, Bae YJ, Kwak LW. Efficacy, pharmacokinetics, and safety of the biosimilar CT-P10 in comparison with rituximab in patients with previously untreated low-tumour-burden follicular lymphoma: a randomised, double-blind, parallel-group, phase 3 trial. Lancet Haematol 2018; 5:e543-e553. [PMID: 30389036 DOI: 10.1016/s2352-3026(18)30157-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 08/31/2018] [Accepted: 09/10/2018] [Indexed: 01/25/2023]
Abstract
BACKGROUND Studies in patients with rheumatoid arthritis and advanced follicular lymphoma have shown that CT-P10, a rituximab biosimilar, has equivalent or non-inferior efficacy and pharmacokinetics to rituximab. We aimed to assess the therapeutic equivalence of single-agent CT-P10 and rituximab in patients with newly diagnosed low-tumour burden follicular lymphoma. METHODS In this ongoing, randomised, double-blind, parallel-group, active-controlled, phase 3 trial, adult patients (≥18 years) with stage II-IV low-tumour-burden follicular lymphoma were randomly assigned (1:1) using an interactive web or voice response system stratified by region, stage, and age to CT-P10 or US-sourced rituximab. Patients received CT-P10 or rituximab (375 mg/m2 intravenous) on day 1 of four 7-day cycles (induction period). Patients who had disease control after the induction period continued to a maintenance period of CT-P10 or rituximab administered every 8 weeks for six cycles and, if completed, a second year of maintenance therapy of additional CT-P10 (every 8 weeks for six cycles) was offered. The study was partially unmasked after database lock (Feb 23, 2018) for all data up to 7 months (before cycle 3 of the maintenance period). The primary endpoint was the proportion of patients who achieved an overall response by 7 months in the intention-to-treat population. Efficacy equivalence was shown if the two-sided 90% CIs for the treatment difference in the proportion of responders between CT-P10 and rituximab was within the equivalence margin of 17%. This trial is registered with ClinicalTrials.gov, number NCT02260804. FINDINGS Between Nov 9, 2015, and Jan 4, 2018, 402 patients were assessed for eligibility, of whom 258 were randomly assigned: 130 to CT-P10 and 128 to rituximab. 108 (83%) of 130 patients assigned to CT-P10 and 104 (81%) of 128 assigned to rituximab achieved an overall response by month 7 (treatment difference estimate 1·8%; 90% CI -6·43 to 10·20). Therapeutic equivalence was shown (90% CIs were within the prespecified margin of 17%). The most common grade 3 or 4 treatment-emergent adverse events were decreased neutrophil count (two grade 3 in the CT-P10 group) and neutropenia (one in each group); all other grade 3 or 4 treatment-emergent adverse events occurred in one patient each. Six (5%) of 130 patients who received CT-P10 and three (2%) of 128 who received rituximab experienced at least one treatment-emergent serious adverse event. INTERPRETATION CT-P10 was equivalent to rituximab in terms of efficacy and was well tolerated. CT-P10 monotherapy is suggested as a new therapeutic option for patients with low-tumour-burden follicular lymphoma. FUNDING Celltrion, Inc.
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MESH Headings
- Antibodies, Monoclonal, Murine-Derived/adverse effects
- Antibodies, Monoclonal, Murine-Derived/pharmacokinetics
- Antibodies, Monoclonal, Murine-Derived/pharmacology
- Antibodies, Monoclonal, Murine-Derived/therapeutic use
- Biosimilar Pharmaceuticals/adverse effects
- Biosimilar Pharmaceuticals/pharmacokinetics
- Biosimilar Pharmaceuticals/pharmacology
- Biosimilar Pharmaceuticals/therapeutic use
- Disease-Free Survival
- Double-Blind Method
- Female
- Humans
- Lymphoma, Follicular/drug therapy
- Lymphoma, Follicular/metabolism
- Lymphoma, Follicular/pathology
- Male
- Middle Aged
- Rituximab/adverse effects
- Rituximab/pharmacokinetics
- Rituximab/pharmacology
- Rituximab/therapeutic use
- Safety
- Treatment Outcome
- Tumor Burden/drug effects
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Affiliation(s)
- Michinori Ogura
- Department of Haematology and Oncology, Kasugai Municipal Hospital, Kasugai, Japan; School of Medicine, Fujita Medical University, Toyoake, Japan
| | - Juan Manuel Sancho
- Hematology Department, The Catalan Institute of Oncology-The Josep Carreras Leukaemia Research Institute, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Seok-Goo Cho
- Department of Hematology, Catholic Blood and Marrow Transplantation Center, Seoul St Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Hideyuki Nakazawa
- Department of Hematology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Junji Suzumiya
- Shimane University Hospital, Innovative Cancer Center/Oncology-Hematology, Izumo, Japan
| | - Gayane Tumyan
- Division of Hematology and Bone Marrow Transplantation, N N Blokhin Russian Cancer Research Center, Moscow, Russia
| | - Jin Seok Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea
| | - Anne Lennard
- Northern Institute for Cancer Care, Newcastle University, Newcastle-upon-Tyne, UK
| | - José Mariz
- Department of Onco-Hematology, Portuguese Institute of Oncology, Porto, Portugal
| | - Nikolai Ilyin
- Russian Research Center for Radiology and Surgical Technologies, Ministry of Health of the Russian Federation, St Petersburg, Russia
| | - Wojciech Jurczak
- Department of Haematology, Jagiellonian University, Kraków, Poland
| | | | - Olga Samoilova
- Department of Hematology, Nizhniy Novgorod Region Clinical Hospital, Nizhniy Novgorod, Russia
| | - Edvard Zhavrid
- N N Alexandrov Republican Scientific and Practical Centre of Oncology and Medical Radiology, Minsk, Belarus
| | - Eduardo Yañez Ruiz
- Department of Internal Medicine, Universidad de la Frontera, Temuco, Chile
| | - Marek Trneny
- Department of Medicine, Charles University, General Hospital in Prague, Prague, Czech Republic
| | - Leslie Popplewell
- Toni Stephenson Lymphoma Center and Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, USA
| | | | - Christian Buske
- Comprehensive Cancer Center Ulm, University Hospital of Ulm, Ulm, Germany
| | - Won-Seog Kim
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | | | | | | | - Larry W Kwak
- Toni Stephenson Lymphoma Center and Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, USA.
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37
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Josephs DH, Nakamura M, Bax HJ, Dodev TS, Muirhead G, Saul L, Karagiannis P, Ilieva KM, Crescioli S, Gazinska P, Woodman N, Lombardelli C, Kareemaghay S, Selkirk C, Lentfer H, Barton C, Canevari S, Figini M, Downes N, Dombrowicz D, Corrigan CJ, Nestle FO, Jones PS, Gould HJ, Blower PJ, Tsoka S, Spicer JF, Karagiannis SN. An immunologically relevant rodent model demonstrates safety of therapy using a tumour-specific IgE. Allergy 2018; 73:2328-2341. [PMID: 29654623 PMCID: PMC6492130 DOI: 10.1111/all.13455] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Designing biologically informative models for assessing the safety of novel agents, especially for cancer immunotherapy, carries substantial challenges. The choice of an in vivo system for studies on IgE antibodies represents a major impediment to their clinical translation, especially with respect to class-specific immunological functions and safety. Fcε receptor expression and structure are different in humans and mice, so that the murine system is not informative when studying human IgE biology. By contrast, FcεRI expression and cellular distribution in rats mirror that of humans. METHODS We are developing MOv18 IgE, a human chimeric antibody recognizing the tumour-associated antigen folate receptor alpha. We created an immunologically congruent surrogate rat model likely to recapitulate human IgE-FcεR interactions and engineered a surrogate rat IgE equivalent to MOv18. Employing this model, we examined in vivo safety and efficacy of antitumour IgE antibodies. RESULTS In immunocompetent rats, rodent IgE restricted growth of syngeneic tumours in the absence of clinical, histopathological or metabolic signs associated with obvious toxicity. No physiological or immunological evidence of a "cytokine storm" or allergic response was seen, even at 50 mg/kg weekly doses. IgE treatment was associated with elevated serum concentrations of TNFα, a mediator previously linked with IgE-mediated antitumour and antiparasitic functions, alongside evidence of substantially elevated tumoural immune cell infiltration and immunological pathway activation in tumour-bearing lungs. CONCLUSION Our findings indicate safety of MOv18 IgE, in conjunction with efficacy and immune activation, supporting the translation of this therapeutic approach to the clinical arena.
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MESH Headings
- Animals
- Antibodies, Monoclonal, Murine-Derived/administration & dosage
- Antibodies, Monoclonal, Murine-Derived/adverse effects
- Antibodies, Monoclonal, Murine-Derived/metabolism
- Antibodies, Monoclonal, Murine-Derived/therapeutic use
- Cell Line, Tumor
- Folate Receptor 1/immunology
- Humans
- Immunoglobulin E/administration & dosage
- Immunoglobulin E/adverse effects
- Immunoglobulin E/immunology
- Immunoglobulin E/therapeutic use
- Immunoglobulin G/immunology
- Immunoglobulin G/metabolism
- Immunotherapy/methods
- Mice
- Models, Animal
- Neoplasms/pathology
- Neoplasms/therapy
- Protein Binding
- Rats
- Receptors, IgE/metabolism
- Statistics, Nonparametric
- Treatment Outcome
- Tumor Necrosis Factor-alpha/blood
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Affiliation(s)
- D. H. Josephs
- St. John's Institute of DermatologySchool of Basic & Medical BiosciencesKing's College LondonLondonUK
- School of Cancer & Pharmaceutical SciencesGuy's HospitalKing's College LondonLondonUK
| | - M. Nakamura
- St. John's Institute of DermatologySchool of Basic & Medical BiosciencesKing's College LondonLondonUK
| | - H. J. Bax
- St. John's Institute of DermatologySchool of Basic & Medical BiosciencesKing's College LondonLondonUK
- School of Cancer & Pharmaceutical SciencesGuy's HospitalKing's College LondonLondonUK
| | - T. S. Dodev
- Randall Centre for Cell and Molecular BiophysicsKing's College LondonLondonUK
| | - G. Muirhead
- Department of InformaticsFaculty of Natural and Mathematical SciencesKing's College LondonLondonUK
| | - L. Saul
- St. John's Institute of DermatologySchool of Basic & Medical BiosciencesKing's College LondonLondonUK
- School of Cancer & Pharmaceutical SciencesGuy's HospitalKing's College LondonLondonUK
| | - P. Karagiannis
- St. John's Institute of DermatologySchool of Basic & Medical BiosciencesKing's College LondonLondonUK
- School of Cancer & Pharmaceutical SciencesGuy's HospitalKing's College LondonLondonUK
| | - K. M. Ilieva
- St. John's Institute of DermatologySchool of Basic & Medical BiosciencesKing's College LondonLondonUK
- Breast Cancer Now Research UnitSchool of Cancer & Pharmaceutical SciencesGuy's Cancer CentreKing's College LondonLondonUK
| | - S. Crescioli
- St. John's Institute of DermatologySchool of Basic & Medical BiosciencesKing's College LondonLondonUK
| | - P. Gazinska
- Breast Cancer Now Research UnitSchool of Cancer & Pharmaceutical SciencesGuy's Cancer CentreKing's College LondonLondonUK
- King's Health Partners Cancer BiobankSchool of Cancer & Pharmaceutical SciencesKing's College LondonLondonUK
| | - N. Woodman
- King's Health Partners Cancer BiobankSchool of Cancer & Pharmaceutical SciencesKing's College LondonLondonUK
| | - C. Lombardelli
- King's Health Partners Cancer BiobankSchool of Cancer & Pharmaceutical SciencesKing's College LondonLondonUK
| | - S. Kareemaghay
- King's Health Partners Cancer BiobankSchool of Cancer & Pharmaceutical SciencesKing's College LondonLondonUK
| | - C. Selkirk
- Biotherapeutics Development UnitCancer Research UKSouth MimmsUK
| | - H. Lentfer
- Biotherapeutics Development UnitCancer Research UKSouth MimmsUK
| | - C. Barton
- Centre for Drug DevelopmentCancer Research UKLondonUK
| | - S. Canevari
- Department of Applied Research and Technology DevelopmentFondazione IRCCS Istituto Nazionale dei TumouriMilanItaly
| | - M. Figini
- Department of Applied Research and Technology DevelopmentFondazione IRCCS Istituto Nazionale dei TumouriMilanItaly
| | | | - D. Dombrowicz
- CHU LilleInstitut Pasteur de LilleInsermUniv. LilleLilleFrance
| | - C. J. Corrigan
- Medical Research Council & Asthma UK Centre in Allergic Mechanisms of AsthmaKing's College LondonLondonUK
| | - F. O. Nestle
- St. John's Institute of DermatologySchool of Basic & Medical BiosciencesKing's College LondonLondonUK
- Immunology and Inflammation Therapeutic Research AreaSanofi USCambridgeMAUSA
| | - P. S. Jones
- Centre for Drug DevelopmentCancer Research UKLondonUK
| | - H. J. Gould
- Randall Centre for Cell and Molecular BiophysicsKing's College LondonLondonUK
| | - P. J. Blower
- Imaging Chemistry & BiologyDivision of Imaging Sciences and Biomedical EngineeringSt. Thomas's HospitalKing's College LondonLondonUK
| | - S. Tsoka
- Department of InformaticsFaculty of Natural and Mathematical SciencesKing's College LondonLondonUK
| | - J. F. Spicer
- School of Cancer & Pharmaceutical SciencesGuy's HospitalKing's College LondonLondonUK
| | - S. N. Karagiannis
- St. John's Institute of DermatologySchool of Basic & Medical BiosciencesKing's College LondonLondonUK
- Breast Cancer Now Research UnitSchool of Cancer & Pharmaceutical SciencesGuy's Cancer CentreKing's College LondonLondonUK
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38
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Iemura T, Oba A, Matsui M, Mano C, Kawabata N, Horisawa Y, Miyahara Y, Itoh M. Substantial Improvement in a Nerve Conduction Study of Lymphoma-associated Demyelinating Neuropathy Treated by Intravenous Immunoglobulin and Chemotherapy. Intern Med 2018; 57:3467-3472. [PMID: 30101902 PMCID: PMC6306548 DOI: 10.2169/internalmedicine.0678-17] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
A 64-year-old woman with lymphoma-associated demyelinating neuropathy was treated by 6 cycles of R-CHOP with intravenous immunoglobulin in the first 2 cycles. We noted substantial improvement in the findings of a nerve conduction study (NCS) after the first cycle, followed by more protracted improvement during the second to sixth cycles. The improvement of the neurological symptoms paralleled the findings of the NCS. Our case provides important information for understanding the etiology and optimization of treatments for lymphoma-associated demyelinating neuropathy.
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Affiliation(s)
- Tomoki Iemura
- Department of Hematology, Kyoto City Hospital, Japan
| | - Akifumi Oba
- Department of Hematology, Kyoto City Hospital, Japan
| | | | - Chihiro Mano
- Department of Hematology, Kyoto City Hospital, Japan
| | | | | | | | - Mitsuru Itoh
- Department of Hematology, Kyoto City Hospital, Japan
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39
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Lekovic GP, Batra A, Barnard ZR, Wilkinson EP, Balena R, Palejwala S, Barkhoudarian G. Growth hormone-secreting pituitary macroadenoma presenting concurrently with non-Hodgkin's lymphoma and responding to doxorubicin treatment: case report and review of the literature. Acta Neurochir (Wien) 2018; 160:2363-2366. [PMID: 30370442 DOI: 10.1007/s00701-018-3714-6] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 10/18/2018] [Indexed: 01/21/2023]
Abstract
We present a case report of a patient who presented with nausea and vomiting, as well as acromegalic features. Following testing, a pituitary adenoma and mediastinal non-Hodgkin's lymphoma were diagnosed. Following two cycles of R-CHOP chemotherapy, imaging showed significant decrease in size of the sellar tumor. Following resection of tumor, both frozen and permanent section revealed only necrotic material. Further research into the potential utility of doxorubicin for the treatment of recurrent or refractory pituitary adenomas may be warranted.
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Affiliation(s)
- Gregory P Lekovic
- House Clinic, House Ear Institute, 2100 West Third Street, Los Angeles, CA, 90057, USA.
| | - Asheesh Batra
- House Clinic, House Ear Institute, 2100 West Third Street, Los Angeles, CA, 90057, USA
| | - Zachary R Barnard
- House Clinic, House Ear Institute, 2100 West Third Street, Los Angeles, CA, 90057, USA
| | - Eric P Wilkinson
- House Clinic, House Ear Institute, 2100 West Third Street, Los Angeles, CA, 90057, USA
| | - Richard Balena
- John Wayne Cancer Institute, 2200 Santa Monica Boulevard, Santa Monica, CA, 90404, USA
| | - Sheri Palejwala
- John Wayne Cancer Institute, 2200 Santa Monica Boulevard, Santa Monica, CA, 90404, USA
| | - Garni Barkhoudarian
- John Wayne Cancer Institute, 2200 Santa Monica Boulevard, Santa Monica, CA, 90404, USA
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40
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Abstract
OPINION STATEMENT Central nervous system (CNS) relapse is an undesirable event in the course of patients with diffuse large B cell lymphoma (DLBCL) with a median survival of approximately 6 months following CNS relapse. CNS prophylaxis for the prevention of CNS recurrence, in addition to the standard R-CHOP chemotherapy, is thus preferable. For an overall relapse risk of 2-5%, administration of CNS-directed therapies for all patients with DLBCL is unnecessary and prophylaxis should be targeted for the high-risk patients. CNS-International Prognostic Index (CNS-IPI) score has enabled risk stratification with risk ranging < 1% (low-risk group) compared to > 10% (high-risk group). The latter could be considered for CNS prophylaxis. CNS-IPI, however, is not perfect and may not capture patients with high-risk extra-nodal sites such as testicular DLBCL. Cell-of-origin and MYC/BCL2 expression can further build on CNS-IPI to narrow higher risk patients. CNS prophylaxis strategies are controversial. Common strategies include intrathecal (IT) chemotherapy and systemic CNS penetrants such as methotrexate. IT chemotherapy does not adequately penetrate the brain parenchyma and hence it is insufficient in preventing parenchymal CNS recurrences. Most experts promote systemic methotrexate for high-risk groups, which penetrates both the leptomeningeal and parenchymal CNS compartments. Even though systemic CNS prophylaxis is widely promoted over IT alone, its efficacy is unclear. Ongoing efforts in search for appropriate CNS prophylaxis strategies are warranted. My personal practice is to administer systemic high-dose methotrexate in conjunction with R-CHOP chemotherapy for eligible patients deemed at a high risk of CNS recurrence, especially those with high-risk CNS-IPI and extra-nodal involvement.
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Affiliation(s)
- Roopesh Kansara
- Department of Internal Medicine, Section of Medical Oncology/Hematology, CancerCare Manitoba, University of Manitoba, 409 Tache Avenue, Winnipeg, MB, R2H 2A6, Canada.
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41
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Gordon LI. Lenalidomide and R-CHOP in follicular lymphoma: where do we go from here? Lancet Haematol 2018; 5:e381-e382. [PMID: 30172340 DOI: 10.1016/s2352-3026(18)30138-8] [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] [Received: 08/03/2018] [Accepted: 08/07/2018] [Indexed: 06/08/2023]
Affiliation(s)
- Leo I Gordon
- Division of Hematology/Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine and The Robert H Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL 60611, USA.
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42
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Barr PM. Counterpoint: Can Chemotherapy Be Eliminated in the Treatment of Follicular Lymphoma? Oncology (Williston Park) 2018; 32:404-409. [PMID: 30153320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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43
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Kamal WSA, Affandi AM, Bhullar A, Kamal WSZ. Relapsed lymphoma mimicking venous ulcer: A case report. Med J Malaysia 2018; 73:253-254. [PMID: 30121690] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Lymphoma presenting with ulceration is not typical. We report a case of relapsed DLBCL in a 73-year-old man presenting with a chronic non-healing leg ulcer. He has underlying varicose veins with recurrent venous ulcers. This patient was diagnosed to have DLBCL six years earlier when he presented with recurrent epistaxis originating from a left nasal cavity nodule. Complete resolution was achieved after eight cycles of R-CHOP and intrathecal methotrexate. For this current problem, this patient was treated with rituximab combined with chemotherapy which resulted in healing of the ulcer.
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Affiliation(s)
- W S A Kamal
- Universiti Teknologi MARA, Faculty of Medicine, Department of Dermatology, Selangor, Malaysia.
| | - A M Affandi
- Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - A Bhullar
- Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - W S Z Kamal
- Hospital Tuanku Fauziah, Pusat Bandar Kangar, Perlis, Malaysia
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44
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Zhang Y, Wei Z, Li J, Gao R, Liu P. Monoclonal gammopathies regardless of subtypes are associated with poor prognosis of diffuse large B-cell lymphoma: A STROBE-compliant article. Medicine (Baltimore) 2018; 97:e11719. [PMID: 30045337 PMCID: PMC6078747 DOI: 10.1097/md.0000000000011719] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 07/05/2018] [Indexed: 12/15/2022] Open
Abstract
Monoclonal gammopathy (MG), a positive result of serum immunofixation electrophoresis (SIFE), has been reported in cases of diffuse large B-cell lymphoma (DLBCL). We performed this study to further investigate the prognostic value of MG in DLBCL.We retrospectively reviewed patients diagnosed with DLBCL between January 2007 and December 2014, and identified 37 patients with MG. The clinical characteristics of these patients were then reviewed. A 1:2 case-control analysis was conducted on 74 matched controls, who were patients with DLBCL and without MG. Both cases and controls were age-matched and were diagnosed within the same year.Among 37 DLBCL patients with MG, the monoclonal component of IgM was the most frequent compared to the other subtypes. Laboratory tests showed that the presence of MG was correlated with a decreased platelet-to-lymphocyte ratio (PLR). Survival analysis showed that MG-secreting DLBCL patients had an inferior overall survival (OS) and progression-free survival (PFS), compared with MG-nonsecreting patients, regardless of MG subtype. However, treatment response analysis showed that MG was not a good indicator for tumor relapse. When patients with DLBCL were grouped by immunophenotype, we found that MG was associated with poor prognosis in the non-germinal center B-cell-like (GCB) type, rather than GCB type in OS analysis. Meanwhile, there was no statistical significance upon PFS analysis in both immunophenotypes. Furthermore, our study found that the appearance of MG during treatment did make prognostic sense compared to nonsecretors.Overall, MG can serve as a prognostic factor for DLBCL. We hypothesize that its presence in DLBCL may reflect the immune microenvironment in tumor progression and warrants further study to unveil the underlying molecular pathogenesis.
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MESH Headings
- Antibodies, Monoclonal, Murine-Derived/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Case-Control Studies
- Cyclophosphamide/therapeutic use
- Doxorubicin/therapeutic use
- Female
- Humans
- Immunoelectrophoresis/methods
- Lymphoma, Large B-Cell, Diffuse/complications
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/immunology
- Lymphoma, Large B-Cell, Diffuse/mortality
- Male
- Middle Aged
- Paraproteinemias/complications
- Paraproteinemias/diagnosis
- Prednisone/therapeutic use
- Prognosis
- Retrospective Studies
- Rituximab
- Vincristine/therapeutic use
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45
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Hall KH, Panjic EH, Valla K, Flowers CR, Cohen JB. How to Decide Which DLBCL Patients Should Receive CNS Prophylaxis. Oncology (Williston Park) 2018; 32:303-309. [PMID: 29940062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Secondary central nervous system (CNS) relapse in aggressive non-Hodgkin lymphoma (NHL) is a dismal diagnosis with poor outcomes. While prophylaxis against secondary CNS disease is recommended in patients with highly aggressive NHLs, such as Burkitt lymphoma, patients with diffuse large B-cell lymphoma (DLBCL) present a challenging clinical dilemma due to an inherently lower risk of CNS relapse. Current guidelines suggest that prophylaxis may benefit DLBCL patients at high risk for CNS relapse; however, it has been difficult to define which patients are truly at high risk. Many studies have attempted to clarify the issue, with conflicting results. Here we review current prognostic models, risk factors, and prophylaxis methods to provide a practical approach to preventing CNS relapse in patients with DLBCL.
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46
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Pál I, Illés Á, Gergely L, Pál T, Radnay Z, Szekanecz Z, Zilahi E, Váróczy L. The Impact of Drug Metabolism Gene Polymorphisms on Therapeutic Response and Survival in Diffuse Large B-Cell Lymphoma Patients. Isr Med Assoc J 2018; 20:217-221. [PMID: 29629728] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Diffuse large B-cell lymphoma (DLBCL) accounts for 30% of all non-Hodgkin lymphomas (NHL) and 80% of agressive lymphomas. Besides the traditional International Prognostic Index (IPI), some other factors may also influence the prognosis of DLBCL patients. OBJECTIVES To study how the genetic polymorphisms in the metabolic pathway influence the event-free and overall survivals and therapeutic responses in DLBCL. METHODS The study was comprised of 51 patients (32 men, 19 women). The average age was 53.1 years. DLBCL was diagnosed between 2011 and 2016 and the average follow-up time was 3.78 years. These patients received 1-8 cycles (an average of 6.2 cycles) of rituximab, cyclophosphamide, doxorubicin, vincristin, prednisolon (R-CHOP) immunochemotherapy. Real-time polymerase chain reaction was used to determine the genetic polymorphisms of CYP2E1, GSTP1, NAT1, and NAT2 genes. RESULTS Our results showed that the polymorphisms of CYP2E1, GSTP1, and NAT1 genes did not influence the prognosis of DLBCL patients significantly. In terms of the NAT2 gene, GG homozygous patients showed slightly better therapeutic response and survival results compared to those bearing an A allele; however, the differences were not statistically significant. CONCLUSIONS Our results could not confirm that genetic polymorphism in metabolic pathways has any predictive role in DLBCL.
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Affiliation(s)
- Ildikó Pál
- Department of Hematology, Institute for Medicine,University of Debrecen, Debrecen, Hungary
| | - Árpád Illés
- Department of Hematology, Institute for Medicine,University of Debrecen, Debrecen, Hungary
| | - Lajos Gergely
- Department of Hematology, Institute for Medicine,University of Debrecen, Debrecen, Hungary
| | - Tibor Pál
- Department of Hematology, Institute for Medicine,University of Debrecen, Debrecen, Hungary
| | - Zita Radnay
- Department of Hematology, Institute for Medicine,University of Debrecen, Debrecen, Hungary
| | - Zoltán Szekanecz
- Department of Rheumatology, Institute for Medicine,University of Debrecen, Debrecen, Hungary
| | - Erika Zilahi
- Regional Laboratory of Immunology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - László Váróczy
- Department of Hematology, Institute for Medicine,University of Debrecen, Debrecen, Hungary
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Barr PM, Li H, Burack WR, LeBlanc M, Smith SM, Gopal AK, Floyd JD, Persky DO, Press OW, Fisher RI, Friedberg JW. R-CHOP, radioimmunotherapy, and maintenance rituximab in untreated follicular lymphoma (SWOG S0801): a single-arm, phase 2, multicentre study. Lancet Haematol 2018; 5:e102-e108. [PMID: 29396094 PMCID: PMC6501182 DOI: 10.1016/s2352-3026(18)30001-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 12/01/2017] [Accepted: 12/01/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Despite an abundance of therapeutic options, advanced-stage follicular lymphoma remains incurable. Furthermore, the ideal sequence and absolute benefit of post-induction therapy is unclear. We designed SWOG S0801 to assess the efficacy and safety of consolidative radioimmunotherapy and sequential maintenance rituximab following chemoimmunotherapy. METHODS For this single-arm, phase 2, multicentre study, we enrolled patients aged 18 years and older with a diagnosis of stage III, IV, or bulky stage II follicular lymphoma, grades 1, 2, or 3a, who had not received previous therapy, from from 20 institutions within the United States National Cancer Institute Clinical Trials Network. Patients were assigned to a 5-year treatment plan consisting of R-CHOP (rituximab plus cyclophosphamide [750 mg/m2], doxorubicin [50 mg/m2], vincristine [1·4 mg/m2], and prednisone or prednisolone [100 mg]) every 21 days for up to six cycles, with rituximab 375 mg/m2 given on day 1 of cycles 1-4, followed by 131iodine tositumomab radioimmunotherapy and subsequent maintenance rituximab 375 mg/m2 within 12 weeks after the sixth cycle of R-CHOP, every 3 months for up to 4 years. The primary endpoint was 3-year progression-free survival in the intention-to-treat population. Efficacy and safety analyses were done in the intention-to-treat population and the per-protocol population. This trial was registered with ClinicalTrials.gov, number NCT00770224. FINDINGS Between April 1, 2009, and Dec 15, 2010, we enrolled 84 evaluable patients, of whom 73 completed R-CHOP and radioimmunotherapy. Of 69 patients who registered to maintenance therapy, only 41 completed the 4-year rituximab maintenance treatment. Progression-free survival at 3 years was 90% (95% CI 82-95). The most common grade 3 or worse adverse events included neutropenia in 48 (57%) patients, leucopenia in 34 (40%) patients, thrombocytopenia in 17 (20%) patients, and febrile neutropenia in 14 (17%) patients. Nine patients had possible treatment-related deaths during the study from secondary or unknown causes (n=3), cirrhosis (n=1), cardiac arrest (n=1), and secondary malignancies (n=4). Secondary malignancies occurred in seven patients, including two sarcomas, two colorectal carcinomas, two acute myelogenous leukaemias, and one case of renal-cell carcinoma. INTERPRETATION SWOG S0801 showed near universal responses following chemoimmunotherapy and radioimmunotherapy. However, most discontinuations occurred during maintenance therapy, suggesting that rituximab over a 4-year span is not feasible for many patients. Nonetheless, this sequential therapeutic strategy resulted in good overall outcomes for patients, including a low incidence of early disease progression. FUNDING The National Cancer Institute and GlaxoSmithKline.
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MESH Headings
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Murine-Derived/adverse effects
- Antibodies, Monoclonal, Murine-Derived/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Bone Marrow/pathology
- Combined Modality Therapy
- Cyclophosphamide/adverse effects
- Cyclophosphamide/therapeutic use
- Doxorubicin/adverse effects
- Doxorubicin/therapeutic use
- Female
- Humans
- Induction Chemotherapy
- Lymphoma, Follicular/diagnosis
- Lymphoma, Follicular/mortality
- Lymphoma, Follicular/therapy
- Maintenance Chemotherapy
- Male
- Middle Aged
- Neoplasm Grading
- Neoplasm Staging
- Positron-Emission Tomography
- Prednisone/adverse effects
- Prednisone/therapeutic use
- Radioimmunotherapy/methods
- Rituximab/administration & dosage
- Rituximab/adverse effects
- Rituximab/therapeutic use
- Survival Analysis
- Tomography, X-Ray Computed
- Treatment Outcome
- Vincristine/adverse effects
- Vincristine/therapeutic use
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Affiliation(s)
- Paul M Barr
- James P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA.
| | - Hongli Li
- SWOG Statistical Center, Seattle, WA, USA
| | - W Richard Burack
- James P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA
| | | | | | - Ajay K Gopal
- University of Washington, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Justin D Floyd
- Cancer Care Specialists of Illinois/Heartland NCORP, Swansea, IL, USA
| | | | - Oliver W Press
- University of Washington, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Richard I Fisher
- Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA
| | - Jonathan W Friedberg
- James P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA
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Brown JR, Cymbalista F, Sharman J, Jacobs I, Nava-Parada P, Mato A. The Role of Rituximab in Chronic Lymphocytic Leukemia Treatment and the Potential Utility of Biosimilars. Oncologist 2018; 23:288-296. [PMID: 29212732 PMCID: PMC5905689 DOI: 10.1634/theoncologist.2017-0150] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 10/17/2017] [Indexed: 11/17/2022] Open
Abstract
Chronic lymphocytic leukemia (CLL) is managed with observation for asymptomatic or clinically silent disease; pharmacologic intervention is generally required for symptomatic patients with clinically significant adenopathy or cytopenia. In the front-line treatment of CLL, the current standard-of-care includes chemotherapy in combination with an anti-CD20 monoclonal antibody (e.g., rituximab, ofatumumab, or obinutuzumab) or ibrutinib as single agent. Despite the evolving treatment paradigm toward targeted therapy, it is likely that rituximab (plus chemotherapy), with or without targeted agents, will retain a significant role in CLL treatment. However, patents for many biologics, including rituximab, have expired or will expire in the near future. Furthermore, access to rituximab has remained challenging, particularly in countries with restricted resources. Together, these concerns have prompted the development of safe and effective rituximab biosimilars. The term "biosimilar" refers to a biologic that is highly similar to an approved reference (originator) product, notwithstanding minor differences in clinically inactive components, and for which there are no clinically meaningful differences in purity, potency, or safety. Biosimilars are developed to treat the same condition(s) using the same treatment regimens as an approved reference biologic and have the potential to increase access to more affordable treatments. We review the importance of rituximab in the current treatment of CLL, the scientific basis of its future role in combination with chemotherapy, and the role of new and emerging agents in the treatment of CLL, which could potentially be used in combination with rituximab biosimilars. We also discuss rituximab biosimilars currently in development. IMPLICATIONS FOR PRACTICE Front-line treatments for chronic lymphocytic leukemia (CLL) include chemotherapy in combination with an anti-CD20 monoclonal antibody (e.g., rituximab, ofatumumab, or obinutuzumab) or ibrutinib as single agent. Despite the evolving treatment paradigm, it is likely rituximab (plus chemotherapy) and targeted agents undergoing clinical evaluation will retain a significant role in CLL treatment. However, patents for many biologics, including rituximab, have expired or will expire in the near future and, in many regions, access to rituximab remains challenging. Together, these concerns have prompted the development of safe and effective rituximab biosimilars, with the potential to increase access to more affordable treatments.
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Affiliation(s)
| | | | - Jeff Sharman
- Willamette Valley Cancer Institute, Springfield, Oregon, USA
- US Oncology Research, The Woodlands, Texas, USA
| | - Ira Jacobs
- Pfizer, Inc., New York City, New York, USA
| | | | - Anthony Mato
- University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
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49
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Shadman M, Li H, Rimsza L, Leonard JP, Kaminski MS, Braziel RM, Spier CM, Gopal AK, Maloney DG, Cheson BD, Dakhil S, LeBlanc M, Smith SM, Fisher RI, Friedberg JW, Press OW. Continued Excellent Outcomes in Previously Untreated Patients With Follicular Lymphoma After Treatment With CHOP Plus Rituximab or CHOP Plus 131I-Tositumomab: Long-Term Follow-Up of Phase III Randomized Study SWOG-S0016. J Clin Oncol 2018; 36:697-703. [PMID: 29356608 PMCID: PMC6553811 DOI: 10.1200/jco.2017.74.5083] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose SWOG S0016 was a phase III randomized study that compared the safety and efficacy of R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone) with CHOP-RIT (CHOP followed by consolidation with iodine-133-tositumomab radioimmunotherapy) for previously untreated patients with follicular lymphoma. Understanding the long-term outcome of patients provides a benchmark for novel treatment regimens for FL. Patients and Methods Between 2001 and 2008, 531 previously untreated patients with FL were randomly assigned to receive either six cycles of R-CHOP or six cycles of CHOP-RIT. Patients with advanced-stage disease (bulky stage II, III, or IV) of any pathologic grade (1, 2, or 3) were eligible. Results After a median follow-up of 10.3 years, 10-year estimates of progression-free and overall survival were 49% and 78% among all patients, respectively. Patients in the CHOP-RIT arm had significantly better 10-year progression-free survival compared with patients in the R-CHOP arm (56% v 42%; P = .01), but 10-year overall survival was not different between the two arms (75% v 81%; P = .13). There was no significant difference between the CHOP-RIT and R-CHOP arms in regard to incidence of second malignancies (15.1% v 16.1%; P = .81) or myelodysplastic syndrome or acute myeloid leukemia (4.9% v 1.8%; P = .058). The estimated 10-year cumulative incidences of death resulting from second malignancies were not different (7.1% v 3.2%; P = .16), but cumulative incidence of death resulting from myelodysplastic syndrome or acute myeloid leukemia was higher in the CHOP-RIT arm compared with the R-CHOP arm (4% v 0.9%; P = .02). Conclusion Given these outstanding outcomes, immunochemotherapy should remain the standard induction approach for patients with high-risk FL until long-term follow-up of alternative approaches demonstrates superiority.
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Affiliation(s)
- Mazyar Shadman
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
| | - Hongli Li
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
| | - Lisa Rimsza
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
| | - John P. Leonard
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
| | - Mark S. Kaminski
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
| | - Rita M. Braziel
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
| | - Catherine M. Spier
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
| | - Ajay K. Gopal
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
| | - David G. Maloney
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
| | - Bruce D. Cheson
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
| | - Shaker Dakhil
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
| | - Michael LeBlanc
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
| | - Sonali M. Smith
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
| | - Richard I. Fisher
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
| | - Jonathan W. Friedberg
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
| | - Oliver W. Press
- Mazyar Shadman, Ajay K. Gopal, David G. Maloney, and Oliver W. Press, University of Washington and Fred Hutchinson Cancer Research Center; Hongli Li and Michael LeBlanc, SWOG Statistical Center, Seattle, WA; Lisa Rimsza, Mayo Clinic Arizona, Scottsdale; Catherine M. Spier, University of Arizona, Tucson, AZ; John P. Leonard, Weill Cornell Medical College, New York; Jonathan W. Friedberg, Wilmot Cancer Institute, University of Rochester, Rochester, NY; Mark S. Kaminski, University of Michigan Health System, Ann Arbor, MI; Rita M. Braziel, Oregon Health & Science University, Portland, OR; Bruce D. Cheson, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC; Shaker Dakhil, University of Kansas School of Medicine–Wichita, Wichita, KS; Sonali M. Smith, University of Chicago Medicine, Chicago, IL; and Richard I. Fisher, Fox Chase Cancer Center and Temple University School of Medicine, Philadelphia, PA
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Vollmer K, Mamot C. [Not Available]. Praxis (Bern 1994) 2018; 107:31-34. [PMID: 29295676 DOI: 10.1024/1661-8157/a002861] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Zusammenfassung. Aufgrund der verbesserten therapeutischen Möglichkeiten kann mittels Immunochemotherapie eine beträchtliche Anzahl der Patienten mit diffusem grosszelligem B-Zell-Lymphom geheilt werden. In diesem Zusammenhang stellt sich die Frage nach der korrekten Nachsorge zur Früherkennung eines Rezidivs. Die im Rahmen dieses Mini-Reviews dargelegte Evidenz zeigt, dass weder mit Routinebildgebungen noch mit entsprechender routinemässiger Labordiagnostik die Früherkennung von asymptomatischen Rezidiven gelingt. Auch kann die Früherkennung des Rezidivs die Prognose der Patienten nicht verbessern. Das Rezidiv wird meist klinisch diagnostiziert mit neuen Symptomen oder Befunden. Die Nachsorge, die klinisch orientiert durchgeführt werden sollte, soll in erster Linie der Erkennung von Spätfolgen und zur Wiedereingliederung in Beruf und Gesellschaft dienen.
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