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Sehly A, He A, Ihdayhid A, Grey C, O'Connor S, Rankin J, Fegan P, Yeap B, Dwivedi G, Lan N. SGLT2 Inhibitor use Pre-Discharge Improves Left Atrial Reservoir and Contractile Function Following Acute Coronary Syndrome in Patients With Siabetes. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Murphy J, Yeap B, Dagogo-Jack I. FP09.04 Impact of Brain Metastasis Status on Adverse Events (AEs) Requiring Dose Reduction Among Patients Receiving Lorlatinib. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lan N, Ali U, Yeap B, Fegan P, Larbalestier R, Bell D. Attainment of Low-Density Lipoprotein Cholesterol Targets Following Coronary Artery Bypass Graft Surgery. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lan N, Ali U, Fegan G, Larbalestier R, Hitchen S, Hort A, Yeap B. 604 Contemporary Clinical Characteristics and Short-Term Outcomes Following Coronary Artery Bypass Graft Surgery in Patients With Diabetes. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Farago A, Yeap B, Heist R, Marcoux J, Rangachari D, Barbie D, Kennedy E, Mino-Kenudson M, Shaw A. OA15.01 Combination Olaparib and Temozolomide in Relapsed Small Cell Lung Cancer: Updated Results from Phase 1/2 Clinical Trial. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Parikh A, Clark J, Wo J, Yeap B, Allen J, Blaszkowsky L, Ryan D, Giantonio B, Weekes C, Zhu A, Van Seventer E, Ly L, Matlack L, Foreman B, Drapek L, Ting D, Corcoran R, Hong T. Proof of concept of the abscopal effect in MSS GI cancers: A phase 2 study of ipilimumab and nivolumab with radiation in metastatic pancreatic and colorectal adenocarcinoma. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz154.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Jimenez RB, Yeap B, Hickey S, DePauw N, Batin E, Taghian AG, Lu HM, MacDonald SM. Abstract P2-11-03: Not presented. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-11-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was not presented at the symposium.
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Affiliation(s)
- RB Jimenez
- Massachusetts General Hospital, Boston, MA
| | - B Yeap
- Massachusetts General Hospital, Boston, MA
| | - S Hickey
- Massachusetts General Hospital, Boston, MA
| | - N DePauw
- Massachusetts General Hospital, Boston, MA
| | - E Batin
- Massachusetts General Hospital, Boston, MA
| | - AG Taghian
- Massachusetts General Hospital, Boston, MA
| | - H-M Lu
- Massachusetts General Hospital, Boston, MA
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Lan N, Bell D, McCaul K, Vasikaran S, Yeap B, Norman P, Almeida O, Golledge J, Hankey G, Flicker L. High-Sensitivity Cardiac Troponin I Augments Cardiovascular Risk-Stratification in Older Men: Results From the Health in Men Study. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lin J, Zhu V, Yoda S, Yeap B, Jessop N, Schrock A, Dagogo-Jack I, Gowen K, Stephens P, Ross J, Ali S, Miller V, Gainor J, Hata A, Iafrate A, Ou S, Shaw A. MA 07.07 Clinical Outcomes and ALK Resistance Mutations in ALK+ Non-Small Cell Lung Cancer According to EML4-ALK Variant. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Flicker L, Morar B, Hankey G, Yeap B, Golledge J, Jablensky A, Almeida O. LONGEVITY KLOTHO GENE POLYMORPHISM AND THE RISK OF DEMENTIA IN OLDER MEN. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- L. Flicker
- Western Australian Centre for Health & Ageing, University of Western Australia, Perth, Western Australia, Australia,
| | - B. Morar
- University of Western Australia, Perth, Western Australia, Australia
| | - G. Hankey
- University of Western Australia, Perth, Western Australia, Australia
| | - B. Yeap
- University of Western Australia, Perth, Western Australia, Australia
| | - J. Golledge
- James Cook University, Townsville, Queensland, Australia,
| | - A. Jablensky
- University of Western Australia, Perth, Western Australia, Australia
| | - O. Almeida
- Western Australian Centre for Health & Ageing, University of Western Australia, Perth, Western Australia, Australia,
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Underwood T, Grassberger C, Bass R, Jimenez R, Meyersohn N, Yeap B, MacDonald S, Paganetti H. OC-0245: Clinical evidence that end-of-range proton RBE exceeds 1.1: lung density changes following chest RT. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30688-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chasland L, Knuiman M, Divitini M, Chan Y, Handelsman D, Naylor L, Yeap B, Green D. Physical Activity Level and Androgen Concentrations Are Independently and Additively Associated with Lower Cardiometabolic Risk in Men. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Handelsman DJ, Yeap B, Flicker L, Martin S, Wittert GA, Ly LP. Age-specific population centiles for androgen status in men. Eur J Endocrinol 2015; 173:809-17. [PMID: 26385186 DOI: 10.1530/eje-15-0380] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 09/18/2015] [Indexed: 01/14/2023]
Abstract
AIM The age-specific population profiles in men of circulating testosterone and its two bioactive metabolites dihydrotestosterone (DHT) and estradiol (E2) across the adult lifespan and its determinants are not well described. OBJECTIVE Our objective was to deduce smoothed age-specific centiles of circulating testosterone, DHT, and E2 in men using pooled data from population-based studies in three Australian cities from liquid chromatography-mass spectrometry steroid measurements in a single laboratory. DESIGN, SETTING, AND PARTICIPANTS We pooled data of 10 904 serum samples (serum testosterone, DHT, E2, age, height, and weight) from observational population-based studies in three major cities across Australia. MAIN OUTCOME MEASURES Age-specific smoothed centiles for serum testosterone, DHT, and E2 in men aged 35-100 years were deduced by large sample data analysis methods. RESULTS We found that serum testosterone, DHT, and E2 decline gradually from ages 35 onwards with a more marked decline after 80 years of age. Higher weight, BMI, and body surface area as well as shorter stature are associated with reduced serum testosterone, DHT, and E2. CONCLUSIONS Among Australian men, there is a gradual progressive population-wide decline in androgen status during male aging until the age of 80 years after which there is a more marked decline. Obesity and short stature are associated with reduced androgen status. Research into the age-related decline in androgen status should focus on the progressive accumulation of age-related comorbidities to better inform optimal clinical trial design.
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Affiliation(s)
| | - B Yeap
- AndrologyANZAC Research Institute, University of Sydney, Sydney, New South Wales 2139, AustraliaSchool of Medicine and PharmacologyUniversity of Western Australia, Perth, Western Australia, AustraliaDepartment of Endocrinology and DiabetesFiona Stanley Hospital, Perth, Western Australia, AustraliaWestern Australian Centre for Health and AgingCentre for Medical Research, University of Western Australia, Perth, Western Australia, AustraliaDiscipline of MedicineUniversity of Adelaide, Adelaide, South Australia, Australia AndrologyANZAC Research Institute, University of Sydney, Sydney, New South Wales 2139, AustraliaSchool of Medicine and PharmacologyUniversity of Western Australia, Perth, Western Australia, AustraliaDepartment of Endocrinology and DiabetesFiona Stanley Hospital, Perth, Western Australia, AustraliaWestern Australian Centre for Health and AgingCentre for Medical Research, University of Western Australia, Perth, Western Australia, AustraliaDiscipline of MedicineUniversity of Adelaide, Adelaide, South Australia, Australia
| | - L Flicker
- AndrologyANZAC Research Institute, University of Sydney, Sydney, New South Wales 2139, AustraliaSchool of Medicine and PharmacologyUniversity of Western Australia, Perth, Western Australia, AustraliaDepartment of Endocrinology and DiabetesFiona Stanley Hospital, Perth, Western Australia, AustraliaWestern Australian Centre for Health and AgingCentre for Medical Research, University of Western Australia, Perth, Western Australia, AustraliaDiscipline of MedicineUniversity of Adelaide, Adelaide, South Australia, Australia AndrologyANZAC Research Institute, University of Sydney, Sydney, New South Wales 2139, AustraliaSchool of Medicine and PharmacologyUniversity of Western Australia, Perth, Western Australia, AustraliaDepartment of Endocrinology and DiabetesFiona Stanley Hospital, Perth, Western Australia, AustraliaWestern Australian Centre for Health and AgingCentre for Medical Research, University of Western Australia, Perth, Western Australia, AustraliaDiscipline of MedicineUniversity of Adelaide, Adelaide, South Australia, Australia
| | - S Martin
- AndrologyANZAC Research Institute, University of Sydney, Sydney, New South Wales 2139, AustraliaSchool of Medicine and PharmacologyUniversity of Western Australia, Perth, Western Australia, AustraliaDepartment of Endocrinology and DiabetesFiona Stanley Hospital, Perth, Western Australia, AustraliaWestern Australian Centre for Health and AgingCentre for Medical Research, University of Western Australia, Perth, Western Australia, AustraliaDiscipline of MedicineUniversity of Adelaide, Adelaide, South Australia, Australia
| | - G A Wittert
- AndrologyANZAC Research Institute, University of Sydney, Sydney, New South Wales 2139, AustraliaSchool of Medicine and PharmacologyUniversity of Western Australia, Perth, Western Australia, AustraliaDepartment of Endocrinology and DiabetesFiona Stanley Hospital, Perth, Western Australia, AustraliaWestern Australian Centre for Health and AgingCentre for Medical Research, University of Western Australia, Perth, Western Australia, AustraliaDiscipline of MedicineUniversity of Adelaide, Adelaide, South Australia, Australia
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Wo J, Zhu A, McDonnell E, Yeap B, Borger D, Iafrate A, Drapek L, Blaszkowsky L, Kwak E, Clark J, Goyal L, Allen J, Ryan D, Arellano R, Wolfgang J, Mullen J, Mamon H, DeLaney T, Hong T. Clinical and Molecular Predictors of Local Failure After SBRT for Liver Metastases: A Secondary Analysis of a Prospective Phase II Trial. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Richards WG, Van Oss SB, Glickman JN, Chirieac LR, Yeap B, Dong L, Gordon GJ, Mercer H, Gill KK, Imrich A, Bueno R, Sugarbaker DJ. A microaliquoting technique for precise histological annotation and optimization of cell content in frozen tissue specimens. Biotech Histochem 2015; 82:189-97. [PMID: 17917854 DOI: 10.1080/10520290701488121] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Knowledge of the exact cell content of frozen tissue samples is of growing importance in genomic research. We developed a microaliquoting technique to measure and optimize the cell composition of frozen tumor specimens for molecular studies. Frozen samples of 31 mesothelioma cases were cut in alternating thin and thick sections. Thin sections were stained and evaluated visually. Thick sections, i.e., microaliquots, were annotated using bordering stained sections. A range of cellular heterogeneity was observed among and within samples. Precise annotation of samples was obtained by integration and compared to conventional single face and "front and back"’ section estimates of cell content. Front and back estimates were more highly correlated with block annotation by microaliquoting than were single face estimates. Both methods yielded discrepant estimates, however, and for some studies may not adequately account for the heterogeneity of mesothelioma or other malignancies with variable cellular composition. High yield and quality RNA was extracted from precision annotated, tumor-enriched subsamples prepared by combining individual microaliquots with the highest tumor cellularity estimates. Microaliquoting provides accurate cell content annotation and permits genomic analysis of enriched subpopulations of cells without fixation or amplification.
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Affiliation(s)
- W G Richards
- Division of Thoracic Surgery, 2Department of Pathology, Brigham and Women’s Hospital, Boston, MA 02115, USA.
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Shih H, Sherman J, Nachtigall L, Colvin M, Fullerton B, Winrich B, Batchelor T, Thornton L, Daartz J, Mancuso S, Oh K, Curry W, Loeffler J, Yeap B. AT-52 * PROSPECTIVE EARLY RESULTS OF LOW GRADE GLIOMA PATIENTS TREATED WITH PROTON THERAPY. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou237.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Giantsoudi D, Sethi R, Yeap B, Yock T, Tarbell N, Paganetti H, MacDonald S. Symptomatic Treatment Change in Medulloblastoma Patients After Proton RT: LET Distributions and RBE Associations. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.2618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sim M, Dawson B, Landers G, Swinkels D, Tjalsma H, Yeap B, Trinder D, Peeling P. The effects of oral contraception on post-exercise interleukin-6 and hepcidin. J Sci Med Sport 2013. [DOI: 10.1016/j.jsams.2013.10.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hattangadi J, Kuhlthau K, Szymonifka J, Yeap B, MacDonald S, Hurson J, Delahaye J, Tarbell N, Yock T. Health-related Quality of Life (HrQOL) in Children Treated With Proton Radiation Therapy for Extracranial Tumors: A Prospective Study. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Gray P, Paly J, Yeap B, Sanda M, Talcott J, Sandler H, Michalski J, Hamstra D, Bekelman J, Efstathiou J. Patient-reported Quality of Life in Prostate Cancer Patients Treated With 3D Conformal Intensity Modulated or Proton Beam Radiation Therapy. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Zaghloul M, Elbeltagy M, Mousa A, Eldebawy E, Amin A, Pavelka Z, Vranova V, Valaskova I, Tomasikova L, Oltova A, Ventruba J, Mackerle Z, Kren L, Skotakova J, Zitterbart K, Sterba J, Milde T, Kleber S, Korshunov A, Witt H, Hielscher T, Koch P, Koch HG, Jugold M, Deubzer HE, Oehme I, Lodrini M, Grone HJ, Benner A, Brustle O, Gilbertson RJ, von Deimling A, Kulozik AE, Pfister SM, Ana MV, Witt O, Milde T, Hielscher T, Witt H, Kool M, Mack SC, Deubzer HE, Oehme I, Lodrini M, Benner A, Taylor MD, von Deimling A, Kulozik AE, Pfister SM, Witt O, Korshunov A, Fouyssac F, Schmitt E, Mansuy L, Marchal JC, Coffinet L, Bernier V, Chastagner P, Sperl D, Zacharoulis S, Massimino M, Schiavello E, Pizer B, Piette C, Kitanovski L, von Hoff K, Quehenberger F, Rutkowski S, Benesch M, Tzaridis TD, Witt H, Milde T, Bender S, Pfaff E, Barbus S, Bageritz J, Jones DTW, Kulozik A, Lichter P, Korshunov A, Witt O, Pfister SM, Song SH, Kang CW, Kim SH, Bandopadhayay P, Ullrich N, Goumnerova L, Scott RM, Silvera VM, Ligon KL, Marcus KJ, Robison N, Manley PE, Chi S, Kieran MW, Schiavello E, Biassoni V, Pierani P, Cesaro S, Maura M, Witt H, Mack S, Jager N, Jones DTW, Bender S, Stutz A, Milde T, Northcott PA, Fults DW, Gupta N, Karajannis M, Kulozik AE, von Deimling A, Witt O, Rutka JT, Lichter P, Korbel J, Korshunov A, Taylor MD, Pfister SM, de Rezende ACP, Chen MJ, da Silva NS, Cappellano A, Cavalheiro S, Weltman E, Currle S, Thiruvenkatam R, Murugesan M, Kranenburg T, Phoenix T, Gupta K, Gilbertson R, Rogers H, Kilday JP, Mayne C, Ward J, Adamowicz-Brice M, Schwalbe E, Clifford S, Coyle B, Grundy R, Rogers H, Mayne C, Kilday JP, Coyle B, Grundy R, Kilday JP, Mitra B, Domerg C, Ward J, Andreiuolo F, Osteso-Ibanez T, Mauguen A, Varlet P, Le Deley MC, Lowe J, Ellison DW, Gilbertson RJ, Coyle B, Grill J, Grundy RG, Fleischhack G, Pajtler K, Zimmermann M, Rutkowski S, Warmuth-Metz M, Kortmann RD, Pietsch T, Faldum A, Bode U, Gandola L, Pecori E, Scarzello G, Barra S, Mascarin M, Scoccianti S, Mussano A, Garre ML, Jacopo S, Pierani P, Viscardi E, Balter R, Bertin D, Giangaspero F, Massimino M, Pearlman M, Khatua S, Van Meter T, Koul D, Yung A, Paulino A, Su J, Dauser R, Whitehead W, Teh B, Chintagumpala M, Perek D, Drogosiewicz M, Filipek I, Polnik MP, Baginska BD, Wachowiak J, Kazmierczak B, Sobol G, Musiol K, Kowalczyk J, Slusarz HW, Peregud-Pogorzelski J, Grajkowska W, Roszkowski M, Teo WY, Chintagumpala M, Okcu F, Dauser R, Mahajan A, Adesina A, Whitehead W, Jea A, Bollo R, Paulino AC, Velez-Char N, Doerner E, Muehlen AZ, Vladimirova V, Warmuth-Metz M, Kortmann R, von Hoff K, Friedrich C, Rutkowski S, von Bueren AO, Pietsch T, Barszczyk M, Buczkowicz P, Morrison A, Tabori U, Hawkins C, Krajewski K, von Hoff K, Kammler G, Friedrich C, von Bueren A, Kortmann RD, Krauss J, Warmuth-Metz M, Rutkowski S, Ferreira C, Dieffenbach G, Barbosa C, Cuny P, Grill J, Piccinin E, Massimino M, Giangaspero F, Brenca M, Lorenzetto E, Sardi I, Genitori L, Pollo B, Bertin D, Maestro R, Modena P, MacDonald S, Ebb D, Lavally B, Yeap B, Marcus K, Tarbell N, Yock T, Schittone S, Donson A, Birks D, Amani V, Griesinger A, Handler M, Madey M, Merchant T, Foreman N, Hukin J, Ailon T, Dunham C, Carret AS, Tabori U, McNeely PD, Zelcer S, Wilson B, Lafay-Cousin L, Johnston D, Eisenstat D, Silva M, Jabado N, Yip S, Goddard K, Fryer C, Hendson G, Hawkins C, Dunn S, Singhal A, Lassen-Ramshad Y, Vestergaard A, Seiersen K, Schultz HP, Hoeyer M, Petersen JB, Moreno L, Popov S, Jury A, Al Sarraj S, Jones C, Zacharoulis S, Bowers D, Gargan L, Horton CJ, Rakheja D, Margraf L, Yeung J, Hamilton R, Okada H, Jakacki R, Pollack I, Fleming A, Jabado N, Saint-Martin C, Freeman C, Albrecht S, Montes JL. EPENDYMOMA. Neuro Oncol 2012; 14:i33-i42. [PMCID: PMC3483345 DOI: 10.1093/neuonc/nos099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
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Hong T, Ryan D, Blaszkowsky L, Mamon H, Wadlow R, Kwak E, Ferrone C, Adams J, Yeap B, Winrich B. Phase I/II study of Proton-based Short Course Chemoradiation and Early Surgery for Adenocarcinoma of the Pancreas. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Yeo W, Riely GJ, Yeap B, Lau MW, Warner J, Bodio KA, Kris MG, Pao W, Kobayashi S, Costa DB. Erlotinib at a dose of 25 mg daily for non-small cell lung cancers with EGFR mutations. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.7572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Shaw AT, Yeap B, Costa DB, Solomon BJ, Kwak EL, Nguyen AT, Bergethon K, Engelman JA, Iafrate AJ. Prognostic versus predictive value of EML4-ALK translocation in metastatic non-small cell lung cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.7606] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Hong T, Ryan DP, Blaszkowsky LS, Mamon HJ, Mino-Kenudson M, Adams J, Yeap B, Winrich B, DeLaney TF, Fernandez-del Castillo C. Phase I study of preoperative (pre-op) short course chemoradiation (CRT) with proton beam therapy (PBT) and capecitabine (cape) for resectable pancreatic ductal adenocarcinoma (PDAC) of the head. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e15536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e15536 Background: Standard adjuvant 6 week CRT may delay and reduce tolerability of adjuvant gemcitabine-based chemotherapy. We explore the feasibility of a one-week course of pre-op CRT with PBT and cape followed by pancreaticoduodenectomy (PD). Methods: 15 pts with radiographically resectable, biopsy-proven PDAC of the head were enrolled from May 2007- September 2008. Eligibility included no CT involvement of SMA or celiac artery; adequate renal, hepatic and hematopoetic function; and ECOG PS 0/1. Dose level 1 consisted of PBT delivered 3 Gy x 10 Monday to Friday. Pts in subsequent dose levels received 5 Gy x 5 in progressively shortened schedules: level 2 (wk 1 M W F, wk 2 T Th), level 3 (wk 1 M T Th F, wk 2 M), level 4 (wk 1 M-F). Radiation was targeted at pancreatic mass with elective nodal coverage. Pts received Cape 825 mg/m2 BID wk 1 and 2 M-F. PD was performed 1–6 wks after completion of chemotherapy. Results: 15 pts were enrolled on study. 3 pts were treated at each of dose levels 1–3. 6 pts were at dose level 4, which was selected as MTD. No dose limiting toxicities were observed. Gr 3 toxicity was noted in 4 pts (pain-1, GI-1, stent obstruction/infxn- 2). 11 pts underwent resection. Reasons for no resections were: metastatic disease-3 and unresectable tumor- 1. Mean time from last therapy to surgery was 28 d (10–44). Mean post-PD length of stay was 6 days (range 5–10). No unexpected 30-d post-op complications, including leak or infection, were noted in comparison to historical controls. 9/11 resected pts had R0 resection. 9/11 had positive nodes. Mean resected tumor diameter was 2.9 cm (2.2–4.3). Average percentage of fibrosis in tumor mass was 74%. Conclusions: Pre-op CRT with 1 wk of PBT and capecitabine followed by early surgery is feasible. A phase II study is underway. No significant financial relationships to disclose.
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Affiliation(s)
- T. Hong
- Massachusetts General Hospital, Boston, MA; Brigham and Women's Hospital/DFCI, Boston, MA
| | - D. P. Ryan
- Massachusetts General Hospital, Boston, MA; Brigham and Women's Hospital/DFCI, Boston, MA
| | - L. S. Blaszkowsky
- Massachusetts General Hospital, Boston, MA; Brigham and Women's Hospital/DFCI, Boston, MA
| | - H. J. Mamon
- Massachusetts General Hospital, Boston, MA; Brigham and Women's Hospital/DFCI, Boston, MA
| | - M. Mino-Kenudson
- Massachusetts General Hospital, Boston, MA; Brigham and Women's Hospital/DFCI, Boston, MA
| | - J. Adams
- Massachusetts General Hospital, Boston, MA; Brigham and Women's Hospital/DFCI, Boston, MA
| | - B. Yeap
- Massachusetts General Hospital, Boston, MA; Brigham and Women's Hospital/DFCI, Boston, MA
| | - B. Winrich
- Massachusetts General Hospital, Boston, MA; Brigham and Women's Hospital/DFCI, Boston, MA
| | - T. F. DeLaney
- Massachusetts General Hospital, Boston, MA; Brigham and Women's Hospital/DFCI, Boston, MA
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Mamon H, Hattangadi J, Yeap B. 2141. Int J Radiat Oncol Biol Phys 2006. [DOI: 10.1016/j.ijrobp.2006.07.545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bueno R, Dong L, Richards W, Yeap B, Mani M, Alsup C, Sugarbaker D, Gordon G. 63 Prognostic gene ratio test for mesothelioma validated in a prospective clinical trial. Lung Cancer 2006. [DOI: 10.1016/s0169-5002(07)70139-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jackman DM, Yeap B, Lucca J, Ostler PA, Morse LK, Fidias P, Lynch TJ, Temel J, Johnson BE, Janne PA. Phase II trial of erlotinib in elderly patients (age > 70) with previously untreated advanced non-small cell lung cancer (NSCLC): An analysis of quality of life and symptom response. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.7168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7168 Background: Elderly patients derive survival benefit but significant toxicity from chemotherapy for NSCLC. Erlotinib is associated with reasonable toxicity and has a survival benefit for relapsed patients previously treated with 1–2 chemotherapy regimens. This targeted agent may prove an effective and well-tolerated first-line therapy in elderly patients with advanced disease. Methods: 80 patients (chemo-naïve, age ≥ 70, PS 0–2, stage IIIB/IV NSCLC) were treated with erlotinib 150 mg/d as part of a phase II study. Primary endpoint was survival. QoL was a secondary endpoint, as assessed by LCSS at baseline and q4 weeks until progression. The primary endpoint of QoL analysis was to determine changes from baseline in LCSS score. Patients were eligible for QoL analysis if they completed an LCSS questionnaire at baseline and ≥ 1 other monthly follow-up visit. Each of 9 items was assessed on a 100mm visual analog scale from 0 (best) to 100 (worst); symptom improvement or worsening was based on a change of ≥ 10mm, with decreased scores implying improvement. Score differences between the baseline and best follow-up response of each subscale and total LCSS are assessed by the signed rank test. Results: 64 patients (80%) were eligible for QoL analysis. There was a trend towards improvement in QoL, based on the total LCSS score. Statistically significant improvements in dyspnea, cough, fatigue, and pain were seen, both in terms of median changes from baseline and the proportion of patients improved (Table). No patients were symptomatic for hemoptysis at baseline, so improvement could not be calculated. Conclusions: Erlotinib in elderly patients with advanced NSCLC was associated with encouraging survival (10.9 mo), a trend towards improved QoL, and statistically significant improvements in key symptoms of dyspnea, cough, fatigue, and pain. Mixed effects longitudinal modeling showing changes in LCSS over time will be presented at the conference. [Table: see text] [Table: see text]
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Affiliation(s)
- D. M. Jackman
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - B. Yeap
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - J. Lucca
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - P. A. Ostler
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - L. K. Morse
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - P. Fidias
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - T. J. Lynch
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - J. Temel
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - B. E. Johnson
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - P. A. Janne
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
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Yock T, Oberg J, Yeap B, Tarbell N. Preliminary Report of Proton Radiotherapy for Pediatric Low-Grade Gliomas. Int J Radiat Oncol Biol Phys 2005. [DOI: 10.1016/j.ijrobp.2005.07.756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Talcott JA, Yeap B, Godley PA, Lu C, Siegel RD, Clark JA. Does home antibiotic therapy increase medical risk for patients with low-risk febrile neutropenia? A multi-institutional randomized trial. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.8113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- J. A. Talcott
- Massachusetts General Hospital, Boston, MA; University of North Carolina, Chapel Hill, NC; UT MD Anderson Cancer Center, Houston, TX; Helen and Harry Gray Cancer Center, Hartford, CT; Boston University Medical Center, Boston, MA
| | - B. Yeap
- Massachusetts General Hospital, Boston, MA; University of North Carolina, Chapel Hill, NC; UT MD Anderson Cancer Center, Houston, TX; Helen and Harry Gray Cancer Center, Hartford, CT; Boston University Medical Center, Boston, MA
| | - P. A. Godley
- Massachusetts General Hospital, Boston, MA; University of North Carolina, Chapel Hill, NC; UT MD Anderson Cancer Center, Houston, TX; Helen and Harry Gray Cancer Center, Hartford, CT; Boston University Medical Center, Boston, MA
| | - C. Lu
- Massachusetts General Hospital, Boston, MA; University of North Carolina, Chapel Hill, NC; UT MD Anderson Cancer Center, Houston, TX; Helen and Harry Gray Cancer Center, Hartford, CT; Boston University Medical Center, Boston, MA
| | - R. D. Siegel
- Massachusetts General Hospital, Boston, MA; University of North Carolina, Chapel Hill, NC; UT MD Anderson Cancer Center, Houston, TX; Helen and Harry Gray Cancer Center, Hartford, CT; Boston University Medical Center, Boston, MA
| | - J. A. Clark
- Massachusetts General Hospital, Boston, MA; University of North Carolina, Chapel Hill, NC; UT MD Anderson Cancer Center, Houston, TX; Helen and Harry Gray Cancer Center, Hartford, CT; Boston University Medical Center, Boston, MA
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Liu G, Zhou W, Park S, Gurubhagavatula S, Yeap B, Nishioka NS, Su L, Wain JC, Lynch TJ, Christiani DC. Polymorphisms of DNA repair and glutathione s-transferase genes and progression-free survival (PFS) in treated advanced esophageal cancer (EC) patients. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.9564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- G. Liu
- Massachusetts General Hospital, Boston, MA; Harvard School of Public Health, Boston, MA
| | - W. Zhou
- Massachusetts General Hospital, Boston, MA; Harvard School of Public Health, Boston, MA
| | - S. Park
- Massachusetts General Hospital, Boston, MA; Harvard School of Public Health, Boston, MA
| | - S. Gurubhagavatula
- Massachusetts General Hospital, Boston, MA; Harvard School of Public Health, Boston, MA
| | - B. Yeap
- Massachusetts General Hospital, Boston, MA; Harvard School of Public Health, Boston, MA
| | - N. S. Nishioka
- Massachusetts General Hospital, Boston, MA; Harvard School of Public Health, Boston, MA
| | - L. Su
- Massachusetts General Hospital, Boston, MA; Harvard School of Public Health, Boston, MA
| | - J. C. Wain
- Massachusetts General Hospital, Boston, MA; Harvard School of Public Health, Boston, MA
| | - T. J. Lynch
- Massachusetts General Hospital, Boston, MA; Harvard School of Public Health, Boston, MA
| | - D. C. Christiani
- Massachusetts General Hospital, Boston, MA; Harvard School of Public Health, Boston, MA
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Mamon HJ, Yeap B, Reblando J, Shrager S, Jaklitsch MT, Lukanich JM, Sugarbaker DJ, Baldini E, Janne P, Bueno R. High risk of brain metastases in surgically staged IIIA NSCLC patients treated with surgery, chemotherapy and radiation. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.7173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- H. J. Mamon
- Dana Farber/Brigham & Women's Cancer Center, Boston, MA; Massachusetts General Hospital, Boston, MA; Brigham & Women's Hospital, Boston, MA; Thoracic Surgery, Brigham & Women's Hospital, Boston, MA
| | - B. Yeap
- Dana Farber/Brigham & Women's Cancer Center, Boston, MA; Massachusetts General Hospital, Boston, MA; Brigham & Women's Hospital, Boston, MA; Thoracic Surgery, Brigham & Women's Hospital, Boston, MA
| | - J. Reblando
- Dana Farber/Brigham & Women's Cancer Center, Boston, MA; Massachusetts General Hospital, Boston, MA; Brigham & Women's Hospital, Boston, MA; Thoracic Surgery, Brigham & Women's Hospital, Boston, MA
| | - S. Shrager
- Dana Farber/Brigham & Women's Cancer Center, Boston, MA; Massachusetts General Hospital, Boston, MA; Brigham & Women's Hospital, Boston, MA; Thoracic Surgery, Brigham & Women's Hospital, Boston, MA
| | - M. T. Jaklitsch
- Dana Farber/Brigham & Women's Cancer Center, Boston, MA; Massachusetts General Hospital, Boston, MA; Brigham & Women's Hospital, Boston, MA; Thoracic Surgery, Brigham & Women's Hospital, Boston, MA
| | - J. M. Lukanich
- Dana Farber/Brigham & Women's Cancer Center, Boston, MA; Massachusetts General Hospital, Boston, MA; Brigham & Women's Hospital, Boston, MA; Thoracic Surgery, Brigham & Women's Hospital, Boston, MA
| | - D. J. Sugarbaker
- Dana Farber/Brigham & Women's Cancer Center, Boston, MA; Massachusetts General Hospital, Boston, MA; Brigham & Women's Hospital, Boston, MA; Thoracic Surgery, Brigham & Women's Hospital, Boston, MA
| | - E. Baldini
- Dana Farber/Brigham & Women's Cancer Center, Boston, MA; Massachusetts General Hospital, Boston, MA; Brigham & Women's Hospital, Boston, MA; Thoracic Surgery, Brigham & Women's Hospital, Boston, MA
| | - P. Janne
- Dana Farber/Brigham & Women's Cancer Center, Boston, MA; Massachusetts General Hospital, Boston, MA; Brigham & Women's Hospital, Boston, MA; Thoracic Surgery, Brigham & Women's Hospital, Boston, MA
| | - R. Bueno
- Dana Farber/Brigham & Women's Cancer Center, Boston, MA; Massachusetts General Hospital, Boston, MA; Brigham & Women's Hospital, Boston, MA; Thoracic Surgery, Brigham & Women's Hospital, Boston, MA
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Chawla A, Horick N, Yeap B, Willett C. An evaluation of patient-reported gastrointestinal and urinary symptoms following surgery and radiation therapy for localized rectal cancer. Int J Radiat Oncol Biol Phys 2003. [DOI: 10.1016/s0360-3016(03)00974-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Colby C, Koziol S, McAfee SL, Yeap B, Spitzer TR. High-dose carboplatin and regimen-related toxicity following autologous bone marrow transplant. Bone Marrow Transplant 2002; 29:467-72. [PMID: 11960264 DOI: 10.1038/sj.bmt.1703417] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [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: 04/05/2001] [Accepted: 12/20/2001] [Indexed: 11/08/2022]
Abstract
Pharmacokinetic analysis of carboplatin dosing suggests a more accurate prediction of toxicity when the dose is based on the area under the plasma concentration vs time curve (AUC) instead of body surface area (BSA). We retrospectively calculated the carboplatin AUC of 117 patients who received an autologous stem cell transplant following a conditioning regimen consisting of carboplatin 1800 mg/m(2) and cyclophosphamide 6000 mg/m(2) to identify whether higher carboplatin exposure resulted in an increase in regimen-related non-hematologic toxicities. The most common non-hematologic toxicities were gastrointestinal and hepatic. Twenty (17%) patients experienced additional > or =grade 2 toxicity, specifically, renal toxicity significantly associated with a higher median AUC of 10.2 mg/ml(-1) min (P = 0.001). Prior platinum therapy was also significantly associated with toxicity (P = 0.052). While carboplatin dose based on BSA varied minimally (median 990 (range 450-1340) mg, the calculated AUC showed a near four-fold range of exposure (median 7.8 (range 3.6 to 13.8) mg/ml(-1) min). These data suggest a relationship between non-hematologic adverse events and the estimated AUC. Prospective trials will be necessary to identify the target carboplatin AUC which optimizes outcome and minimizes toxicity in the autologous transplant setting.
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Affiliation(s)
- C Colby
- Bone Marrow Transplantation Program/Department of Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
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Lavin JH, Wittert GA, Andrews J, Yeap B, Wishart JM, Morris HA, Morley JE, Horowitz M, Read NW. Interaction of insulin, glucagon-like peptide 1, gastric inhibitory polypeptide, and appetite in response to intraduodenal carbohydrate. Am J Clin Nutr 1998; 68:591-8. [PMID: 9734735 DOI: 10.1093/ajcn/68.3.591] [Citation(s) in RCA: 73] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The relation between gastrointestinal incretin hormones in the control of insulin release and short-term satiety by intestinal carbohydrate was investigated in 8 fasted, healthy male volunteers. Insulin, gastric inhibitory polypeptide (GIP), glucagon-like peptide 1 (GLP-1), and appetite ratings were measured during, and food intake was measured after, intraduodenal infusions of glucose or saline. Studies were conducted under hyperinsulinemic and euglycemic conditions. Raising plasma insulin with intravenous insulin infusion to concentrations slightly above usual postprandial concentrations (356.4 +/- 4.8 pmol/L) had no effect on GIP, GLP-1, or appetite ratings before the intraduodenal infusions began. Intraduodenal glucose infusion resulted in a further increase in plasma insulin to a peak of 779.4 +/- 114.0 pmol/L, caused an early increase in plasma GIP and a later increase in GLP-1 concentrations (P < 0.01), suppressed appetite (P < 0.05), and reduced energy intake (P < 0.01) compared with intraduodenal infusion of saline. There was a close association between the increase in GLP-1 and decrease in appetite. Infusion of octreotide to suppress the release of gastrointestinal hormones prevented the rise in insulin, GIP, and GLP-1 induced by intraduodenal glucose infusion and reversed the suppression of appetite and reduction in energy intake. These results suggest that 1) when infused to result in plasma concentrations slightly above usual postprandial concentrations, insulin does not inhibit its own release and 2) the effects of intraduodenal glucose on appetite may be mediated through the release of GLP-1 and not insulin.
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Affiliation(s)
- J H Lavin
- Department of Medicine, University of Adelaide, Royal Adelaide Hospital, South Australia, Australia
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Chang A, Yeap B, Davis T, Blum R, Hahn R, Khanna O, Fisher H, Rosenthal J, Witte R, Schinella R, Trump D. Double-blind, randomized study of primary hormonal treatment of stage D2 prostate carcinoma: flutamide versus diethylstilbestrol. J Clin Oncol 1996; 14:2250-7. [PMID: 8708714 DOI: 10.1200/jco.1996.14.8.2250] [Citation(s) in RCA: 96] [Impact Index Per Article: 3.4] [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: 02/01/2023] Open
Abstract
PURPOSE Patients with stage D2 prostate carcinoma are often treated initially with hormones to decrease endogenous testosterone. Therapy with diethylstilbestrol (DES), leuprolide, or bilateral orchiectomy has been reported to be equivalent. DES is the cheapest preparation, but has the potential for serious cardiovascular or thromboembolic complications. Flutamide is a novel antiandrogen with fewer side effects. PATIENTS AND METHODS The Eastern Cooperative Oncology Group (ECOG) conducted a double-blind, randomized study to compare the efficacy of flutamide (250 mg three times daily) to DES (1 mg three times daily) as the primary hormonal therapy for patients with stage D2 prostate cancer. Patients were stratified by performance status, disease sites, and history of cardiovascular disease at randomization. RESULTS Forty-eight patients received DES and 44 flutamide. Patient characteristics were evenly distributed between the two treatments. The overall response rate was similar (DES, 62%; flutamide, 50%). Grade III or worse cardiovascular or thromboembolic toxicity developed in 33.3% of patients on DES and in 17.6% on flutamide (P = .051). Other toxicities were similar between the two treatment arms. However, DES produced significantly longer time to treatment failure (26.4 v 9.7 months, P = .016) and longer survival than flutamide (43.2 v 28.5 months, P = .040). CONCLUSION As the primary hormonal therapy for stage D2 prostate cancer, DES caused more serious cardiovascular or thromboembolic complications than flutamide. Despite this, flutamide was not as active an initial agent as DES. However, the effectiveness of flutamide in conjunction with other agents compared with DES remains undetermined, and the optimal initial hormone therapy of stage D2 prostate cancer requires further studies.
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Affiliation(s)
- A Chang
- University of Rochester Cancer Center, New York, USA
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Wadler S, Yeap B, Vogl S, Carbone P. Randomized trial of initial therapy with melphalan versus cisplatin-based combination chemotherapy in patients with advanced ovarian carcinoma: initial and long term results--Eastern Cooperative Oncology Group Study E2878. Cancer 1996; 77:733-42. [PMID: 8616766] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Following surgical debulking, most patients with international Federation of Gynecology and Obstetrics (FIGO) Stage III or IV carcinoma of the ovary receive treatment with combination chemotherapy. However, the optimal postsurgical therapy for ovarian carcinoma remains to be defined. METHODS To define better the role of initial therapy with a cisplatin-based chemotherapy regimen, the Eastern (Cooperative Oncology Group (ECOG) initiated a randomized, Phase III trial, EST 2878, comparing initial therapy with a single, orally administered alkylating agent, melphalan, versus a complex regimen employing cyclophosphamide, hexamethylmelamine, doxorubicin, and cisplatin (CHAD). Women who failed treatment with melphalan were crossed-over to treatment with CHAD minus the cyclophosphamide (HAD). Study endpoints included response to therapy, time to treatment failure, and overall survival. RESULTS Between October, 1978, and November, 1980, EST 2878 accrued 253 patients with advanced epithelial carcinoma of the ovary. There were 118 eligible patients initially treated with melphalan and 126 with CHAD. Two patients experienced lethal toxicities, including gastrointestinal hemorrhage (1 patient) and neutropenic sepsis (1 patient), and 22 patients experienced life-threatening toxicities, including hematologic toxicity (21 patients) and anaphylaxis (1 patient). Response to treatment and clinical complete response rates were higher in women receiving CHAD (60% and 38%, respectively) versus melphalan (42% and 21%, respectively) (P = 0.037 and P = 0.024, respectively), but these differences were confined to women older than 50 years of age. Likewise, time to treatment failure was significantly longer in women receiving CHAD (P = 0.014), but the difference was again confined to women older than 50 years of age and to women suboptimally debulked at the time of surgery. Survival did not differ between the two arms (median survivals of 17.5 months with initial melphalan therapy and 19.5 months with CHAD), probably because women treated initially with melphalan received salvage therapy with HAD). Twenty-three patients survived longer than 10 years. Among 18 long term survivors who had retrospective pathologic review, 8 had borderline tumors of the ovary. CONCLUSIONS In women with advanced ovarian cancer, initial therapy with a cisplatin-based combination chemotherapy regimen resulted in higher clinical complete response rates and longer time to failure compared with initial therapy with a single, oral alkylating agent; however, the benefits of this approach were confined to women older than 50 years of age at diagnosis, and there was no significant difference in survival.
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Affiliation(s)
- S Wadler
- Albert Einstein College of Medicine, Bronx, New York, 10467, USA
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Judd SJ, Wong J, Saloniklis S, Maiden M, Yeap B, Filmer S, Michailov L. The effect of alprazolam on serum cortisol and luteinizing hormone pulsatility in normal women and in women with stress-related anovulation. J Clin Endocrinol Metab 1995; 80:818-23. [PMID: 7883836 DOI: 10.1210/jcem.80.3.7883836] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Alprazolam, a benzodiazepine derivative, stimulates specific gamma-aminobutyric acidA receptors and has been found to inhibit CRH activity in the brain. This study examined the effect of alprazolam on serum cortisol and LH pulsatility in six women in the early follicular phase (EFP), six women in the midluteal phase (MLP), and six women with stress-related anovulation (SRA) of normal weight, but with a previous history of anorexia nervosa. Subjects were given alprazolam (2 mg, orally) or an identical placebo capsule at 0900 h, and blood samples were collected through an indwelling venous catheter every 10 min for 8 h in the SRA women and 10 h in EFP and MLP women. Women with SRA were also given clomiphene (100 mg/day) for 5 days before a further 8-h blood sampling session. As expected, there was a diurnal decline in serum levels of cortisol, which was significantly less in women with SRA (55 +/- 4%) than those in both EFP (76 +/- 4%) and MLP women (75 +/- 3%; P < 0.005). The food-related rise of cortisol that follows lunch in normal women was absent in women with SRA. Alprazolam accentuated the decline in serum cortisol, and in all three groups, the mean serum cortisol level after alprazolam treatment was significantly less (P < 0.05) than that after placebo. In SRA women, alprazolam restored visible LH pulses in all women and increased the mean LH pulse frequency (P < 0.02) and pulse amplitude (P < 0.05). This was associated with an increase in mean serum LH from 1.3 +/- 0.3 to 3.0 +/- 0.06 IU/L (P < 0.02). In EFP women, alprazolam reduced the frequency of LH pulsatility from a mean of 5.8 +/- 0.7 to 3.2 +/- 0.5 pulses/10 h (P < 0.02) and increased the mean pulse amplitude from 2.4 +/- 0.5 to 5.0 +/- 1.1 IU/L (P < 0.0005). Alprazolam had no significant effect on LH pulsatility or amplitude in MLP women. To explain this variation in response to alprazolam, we propose that alprazolam accelerates the GnRH pacemaker in SRA women by inhibiting excessive CRH activity, which blocks the GnRH pacemaker in these women. In normal women, we hypothesize that tonic inhibition of the GnRH pacemaker by CRH is minimal, and the reduced pulsatility of LH after alprazolam treatment in EFP women results from inhibition of stimulatory noradrenergic neurons. In MLP women, we propose that preexisting opioid inhibition of noradrenergic neurons by progesterone blocks this effect of alprazolam.
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Affiliation(s)
- S J Judd
- Department of Medicine, Flinders Medical Center, Australia
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Wiernik PH, Yeap B, Vogl SE, Kaplan BH, Comis RL, Falkson G, Davis TE, Fazzini E, Cheuvart B, Horton J. Hexamethylmelamine and low or moderate dose cisplatin with or without pyridoxine for treatment of advanced ovarian carcinoma: a study of the Eastern Cooperative Oncology Group. Cancer Invest 1992; 10:1-9. [PMID: 1735009 DOI: 10.3109/07357909209032783] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.6] [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: 12/28/2022]
Abstract
A total of 248 analyzable patients with Stages III-IV ovarian epithelial cancer (114 with and 134 without prior chemotherapy) were randomized to one of four cisplatin (DDP)-hexamethylmelamine (HMM) regimens. In each, HMM, 200 mg/m2 was given orally daily on days 8-21 of each 21-day cycle. DDP was given i.v. on Day 1 at a dose of 37.5 mg/m2 (regimens A and B) or 75 mg/m2 (regimens C and D). In addition, since pyridoxine administration has been reported to reduce the neurotoxicity of HMM, that agent was given at a dose of 300 mg/m2 orally on Days 1-21 in regimens B and D. Randomization was stratified for performance status (0-1, 2-3) and largest tumor diameter at entry (greater than 2- less than or equal to 10 cm, greater than 10 cm) for previously untreated patients, and for performance status and time from initial diagnosis to entry on study (less than or equal to 1 year, greater than 1 year) for previously treated patients. The overall response rate (PR + CR) was 54%, with 25% of patients achieving a complete response. The 61% response rate with the higher dose DDP regimens was significantly greater than the 47% response rate with the lower dose regimens (p = 0.031). Multivariate analysis identified higher DDP dose, age less than 60 years, no prior chemotherapy, small tumor bulk and favorable tumor grade as significant prognosticators for response. The overall median response duration was 8.3 months (range 1-70 months). Prior chemotherapy, pyridoxine administration, recent diagnosis, and large tumor size were identified by multivariate analysis as factors adversely affecting response duration. Patients treated with the higher dose DDP regimens had more severe nausea, vomiting, and neurotoxicity. This study demonstrates that the combination of DDP + HMM is an effective regimen for advanced ovarian carcinoma that yields response rates comparable to other more complex regimens, and that there is a dose-response relationship for DDP in ovarian cancer. Although pyridoxine administration significantly reduced neurotoxicity, its adverse effect on response duration suggests that the agent should not be administered with DDP or HMM. The mechanism by which pyridoxine may unfavorably affect response duration deserves further investigation.
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Affiliation(s)
- P H Wiernik
- Albert Einstein Cancer Center, Bronx, New York
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Freedman AS, Ritz J, Neuberg D, Anderson KC, Rabinowe SN, Mauch P, Takvorian T, Soiffer R, Blake K, Yeap B. Autologous bone marrow transplantation in 69 patients with a history of low-grade B-cell non-Hodgkin's lymphoma. Blood 1991; 77:2524-9. [PMID: 2039834] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Sixty-nine patients with a history of low-grade B-cell non-Hodgkin's lymphoma (NHL) in sensitive relapse or incomplete first remission underwent high-dose chemoradiotherapy and anti-B-cell monoclonal antibody (MoAb)-treated autologous bone marrow transplantation (ABMT). At ABMT, 51 patients had low-grade histology and 18 patients had a history of low-grade NHL that had undergone histologic transformation to a higher-grade NHL. Before ABMT, only 20 of the 51 low-grade patients and 10 of the 18 patients with transformed histologies were in complete remission. Moreover, at the time of marrow harvest, 24 of the low-grade and eight of the transformed histology patients had histologic evidence of lymphoma cells infiltrating the marrow. Following high-dose therapy, only one acute, in-hospital death was observed. There was no significant difference in the disease-free survival (DFS) between patients with low-grade and patients with transformed histologies. Among patients with low-grade NHL, the patients in complete remission before ABMT experienced significantly longer DFS than those in partial remission (P less than .05). This preliminary study suggests that some patients with relapsed low-grade NHL may experience prolonged DFS following high-dose ablative therapy.
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Affiliation(s)
- A S Freedman
- Division of Tumor Immunology, Dana-Farber Cancer Institute, Boston, MA 02115
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Freedman AS, Takvorian T, Anderson KC, Mauch P, Rabinowe SN, Blake K, Yeap B, Soiffer R, Coral F, Heflin L. Autologous bone marrow transplantation in B-cell non-Hodgkin's lymphoma: very low treatment-related mortality in 100 patients in sensitive relapse. J Clin Oncol 1990; 8:784-91. [PMID: 2332768 DOI: 10.1200/jco.1990.8.5.784] [Citation(s) in RCA: 99] [Impact Index Per Article: 2.9] [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: 12/31/2022] Open
Abstract
One hundred patients with B-cell non-Hodgkin's lymphoma (NHL) in sensitive relapse or incomplete first remission underwent high-dose chemoradiotherapy and anti-B-cell monoclonal antibody (MAb)-treated autologous bone marrow transplantation (ABMT). These patients demonstrated good performance status with a Karnofsky score of 80% or greater. The majority of these patients had one or more adverse prognostic features including a failure to achieve a complete remission (CR) with conventional combination chemotherapy (37 patients), bone marrow infiltration (69 patients), a history of extranodal disease other than bone marrow infiltration (42 patients), and histologic conversion (18 patients). At the time of ABMT, only 52 patients were in CR; however, all patients achieved a minimal disease state following conventional intensive therapy. Moreover, at the time of marrow harvest, 37 of these patients had histologic evidence of lymphoma cells infiltrating the marrow. Following high-dose ablative therapy, two acute in-hospital treatment-related deaths were observed. Two late deaths were observed, not due to recurrent lymphoma. Of the remaining 96 patients, 61 are in unmaintained CR with a median follow-up of 13 months. Kaplan-Meier actuarial analysis predicts 50% probability of disease-free survival (DFS) at 37.8 months. This very low treatment-related mortality provides the rationale to apply high-dose therapy and ABMT as consolidative therapy for patients in first remission who are at high risk for relapse following conventional therapy.
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Affiliation(s)
- A S Freedman
- Division of Tumor Immunology, Dana-Farber Cancer Institute, Boston, MA 02115
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Down JD, Berman AJ, Warhol M, Yeap B, Mauch P. Late complications following total-body irradiation and bone marrow rescue in mice: predominance of glomerular nephropathy and hemolytic anemia. Int J Radiat Biol 1990; 57:551-65. [PMID: 1968948 DOI: 10.1080/09553009014552691] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.7] [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: 12/29/2022]
Abstract
Late mortality and pathology were assessed in various mouse strains following total-body irradiation (TBI) and bone marrow transplantation. A, C57BL/6, B6AF1, LP and C3H mice received TBI in two fractions 3 h apart at total doses of between 11 and 15 Gy. They were then transplanted with syngeneic bone marrow cells providing sufficient reconstitution to avoid hemopoietic failure. Long-term survival data revealed both radiation dose- and strain-dependent onset of mortality between 1 and 2 years post-treatment. Renal damage appeared to have contributed to the late mortality in most treatment groups as shown by glomerular lesions, elevated blood urea nitrogen and an accompanying fall in hematocrit. Hemolysis was deduced to be the major cause of anemia, as concluded from results of 51Cr-labeled erythrocyte survival. No decrease in erythropoiesis was evident as seen from spleen and bone marrow 59Fe uptake. These findings are together consistent with the manifestation of a hemolytic uremic syndrome (HUS) with kidney glomeruli representing the principal sites of injury responsible for both renal dysfunction and microangiopathic hemolysis.
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Affiliation(s)
- J D Down
- Joint Center for Radiation Therapy, Harvard Medical School, Boston, MA 02115
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Mauch P, Larson D, Osteen R, Silver B, Yeap B, Canellos G, Weinstein H, Rosenthal D, Pinkus G, Jochelson M. Prognostic factors for positive surgical staging in patients with Hodgkin's disease. J Clin Oncol 1990; 8:257-65. [PMID: 2299369 DOI: 10.1200/jco.1990.8.2.257] [Citation(s) in RCA: 89] [Impact Index Per Article: 2.6] [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: 12/31/2022] Open
Abstract
Staging laparotomy was performed as part of the routine recommended diagnostic evaluation following clinical staging (CS) in 692 patients presenting with supradiaphragmatic Hodgkin's disease (HD). Various clinical factors were analyzed by multivariate analysis for prediction of abdominal involvement. Factors that were statistically significant for predicting disease below the diaphragm included CS III-IV disease (P less than .001), B symptoms (P less than .001), mixed cellularity (MC) or lymphocytic depletion (LD) histology (P = .017), number of supradiaphragmatic sites greater than or equal to 2 (P = .001), male sex (P = 0.034) and age greater than or equal to 40 years (P = .004). Separate analyses were performed for various subgroups of CS IA-IIA, CS IB-IIB, CS IIIA-IVA, and CS IIIB-IVB patients. Upstaging was seen in 0% to 55% of CS I-II patients based on subgroup. Male sex, B symptoms, and number of sites above the diaphragm greater than or equal to 2 all independently predicted for positive surgical staging in CS I-II patients. Sixty-four percent of CS I-II patients who were upstaged had extensive abdominal disease by positive lower abdominal nodes or multiple splenic nodules (greater than or equal to 5). Downstaging (to pathological stage [PS] I-II) was seen in 9% to 68% of patients with CS III-IV disease based on subgrouping. Age greater than or equal to 40, MC or LD histology, and B symptoms all independently predicted for positive surgical staging in CS III-IV patients. Downstaging was more frequently seen in CS IIIA-IVA patients (55%) than in patients who were CS III-IVB (22%). Four subgroups of patients who had a low probability (less than 10%) of stage or treatment change following laparotomy were identified. These included CS IA female patients, CS IA male patients with lymphocyte predominance histology or high neck presentations, and patients with CS IIIB-IVB disease and account for 21% of the study population. Staging laparotomy altered the stage and treatment of a significant number of the remaining 79% patients and should continue to be recommended for this group of patients.
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Affiliation(s)
- P Mauch
- Joint Center for Radiation Therapy, Brigham and Women's Hospital, Boston, MA 02115
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Down JD, Berman AJ, Warhol M, Van Dijken PJ, Ferrara JL, Yeap B, Hellman S, Mauch PM. Late tissue-specific toxicity of total body irradiation and busulfan in a murine bone marrow transplant model. Int J Radiat Oncol Biol Phys 1989; 17:109-16. [PMID: 2663795 DOI: 10.1016/0360-3016(89)90377-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [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: 01/02/2023]
Abstract
Total body irradiation (TBI) and busulfan were compared for late effects in a murine model of bone marrow transplantation (BMT). Male C57BL/6 mice were given fractionated TBI or busulfan given in 4 equal daily doses followed by infusion of 10(7) syngeneic bone marrow cells. Total doses of 16.4 Gy TBI and 3.4 mg busulfan were chosen for their equivalence in inducing near complete engraftment of allogeneic marrow from donor mice of the LP strain. The two treatment groups had a late wave of mortality starting at about 80 weeks after transplantation. Specific tissue damage was manifested in bone marrow stem cells, splenic T-cell precursors, hair greying and cataract formation for both TBI and busulfan but to varying degrees. Severe nephrotoxicity and anemia were observed only after TBI. Although both busulfan and TBI kill early marrow stem cells and are effective preparative agents in bone marrow transplantation, their effects on other stem cell and organ systems are not similar. In addition, many of the injuries seen are late to occur. The delayed expression of injury deserves careful long-term evaluation of BMT recipients before the therapeutic potential of effective preparative regimens can be fully appreciated.
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Affiliation(s)
- J D Down
- Joint Center for Radiation Therapy, Harvard Medical School, Boston, MA 02115
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Shipp MA, Klatt MM, Yeap B, Jochelson MS, Mauch PM, Rosenthal DS, Skarin AT, Canellos GP. Patterns of relapse in large-cell lymphoma patients with bulk disease: implications for the use of adjuvant radiation therapy. J Clin Oncol 1989; 7:613-8. [PMID: 2468746 DOI: 10.1200/jco.1989.7.5.613] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
In patients with large-cell lymphoma (LCL) treated with combination chemotherapy, the presence of bulk disease has consistently been associated with a poorer response rate and a shortened survival. The optimal therapy for patients with bulk disease (greater than or equal to 10 cm) will depend on whether treatment failures result from inadequate tumor eradication in prior bulk sites or from distant dissemination. To address this issue, we have evaluated patterns of relapse in patients with bulk disease who relapsed after achieving a complete remission with methotrexate, bleomycin, doxorubicin, cyclophosphamide, vincristine, and dexamethasone (M- or m-BACOD). Eighty-one II, III, or IV patients with disease greater than or equal to 10 cm were identified; 45 of the 81 patients achieved a confirmed complete response (CR) and are included in the analysis. The 45 complete responders included 21 patients with localized (stage II) disease and 24 patients with advanced (stage III/IV) disease. Six of the 21 stage II complete responders and three of the 24 stage II/IV complete responders also received adjuvant radiation therapy following completion of M- or m-BACOD. Only one of the 21 patients with stage II disease relapsed, doing so in the site of prior bulk involvement. In contrast, nine of 24 patients with stage III/IV disease relapsed, although no patient failed solely in the site of prior bulk disease. Stage III/IV patients recurred in either a new site (one patient), a new and old site (five), an old non-bulk site (two), or both old non-bulk and bulk sites (one). These results indicate that advanced-stage bulk-disease patients do not consistently relapse in sites of prior bulk disease; therefore, this group of patients is unlikely to benefit from adjuvant radiation therapy administered following completion of combination chemotherapy. Although the low relapse rate and the addition of adjuvant radiation therapy in a subgroup of the stage II bulk-disease patients precludes a definitive analysis, our results further suggest that these patients may be effectively treated with combination chemotherapy alone.
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Affiliation(s)
- M A Shipp
- Divisio of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02115
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Takvorian T, Canellos GP, Ritz J, Freedman AS, Anderson KC, Mauch P, Tarbell N, Coral F, Daley H, Yeap B. Prolonged disease-free survival after autologous bone marrow transplantation in patients with non-Hodgkin's lymphoma with a poor prognosis. N Engl J Med 1987; 316:1499-505. [PMID: 3295542 DOI: 10.1056/nejm198706113162402] [Citation(s) in RCA: 167] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Despite advances in the primary treatment of non-Hodgkin's lymphoma, relapse is common and treatment after relapse is unsatisfactory. Autologous bone marrow transplantation, although sometimes successful, has generally had disappointing results. We conducted a trial of such transplantation in patients with relapsed non-Hodgkin's lymphoma, using strict criteria in selecting patients; we included only those in whom disease was minimal after conventional treatment (nodal disease less than 2 cm and bone marrow involvement less than or equal to 5 percent on histologic examination) and whose tumor cells expressed the B1 antigen. Forty-nine patients meeting these criteria received cyclophosphamide and whole-body irradiation supported by transplantation of autologous bone marrow that had been treated in vitro with anti-B1 monoclonal antibody and complement. All patients had features of a poor prognosis, including relapse from primary chemotherapy, histologic conversion to more aggressive disease, and extra-nodal dissemination. Thirty-three patients had a history of bone marrow involvement--16 at the time that marrow was obtained. Hematologic and immunologic engraftment was achieved in all patients. Only two treatment-related deaths occurred, from venoocclusive disease of the liver and intracerebral hemorrhage, respectively. Disease-free remission without maintenance therapy has lasted from greater than 2 to greater than 52 months in 34 patients (median follow-up, greater than 11 months). These results are similar to those obtained in patients with advanced, high-grade non-Hodgkin's lymphoma treated with primary combination chemotherapy. This study demonstrates that autologous bone marrow transplantation has tolerable toxicity and high efficacy in a subset of patients who are otherwise incurable but still responsive to cytoreductive therapy. The results suggest a role for such transplantation in the treatment of selected patients with newly diagnosed non-Hodgkin's lymphoma.
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