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Marinos A, Ramdial J, Khawaja F, Saliba RM, Shigle TL, Alousi AM, Rondon G, Chen J, Ledesma C, Champlin RE, Daher M, Chen G, Marin D, Rezvani K, Shpall EJ, Chemaly RF. Hematopoietic cell transplantation can be safely performed after COVID-19. Bone Marrow Transplant 2023; 58:1410-1412. [PMID: 37726490 DOI: 10.1038/s41409-023-02105-1] [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: 07/12/2023] [Revised: 08/23/2023] [Accepted: 08/31/2023] [Indexed: 09/21/2023]
Affiliation(s)
- Alejandro Marinos
- Affiliation University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Jeremy Ramdial
- Affiliation University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Fareed Khawaja
- Affiliation University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Rima M Saliba
- Affiliation University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Terri Lynn Shigle
- Affiliation University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Amin M Alousi
- Affiliation University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Gabriela Rondon
- Affiliation University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Julianne Chen
- Affiliation University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Celina Ledesma
- Affiliation University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Richard E Champlin
- Affiliation University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - May Daher
- Affiliation University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - George Chen
- Affiliation University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - David Marin
- Affiliation University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Katayoun Rezvani
- Affiliation University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Elizabeth J Shpall
- Affiliation University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Roy F Chemaly
- Affiliation University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Marinos A, Ramdial JL, Saliba RM, Khawaja F, Alousi AM, Rondon G, Chen J, Ledesma C, Chemaly DRF, Champlin RE, Marin D, Daher M, Rezvani K, Shpall EJ. Long-Term Follow-up Outcomes of Patients That Underwent Allogeneic or Autologous Hematopoietic Transplant Shortly after a COVID-19 Infection. Transplant Cell Ther 2023. [PMCID: PMC9899537 DOI: 10.1016/s2666-6367(23)00518-3] [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: 02/07/2023]
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Pasvolsky O, Saliba RM, Ledesma C, Popat UR, Alousi A, Olson A, Oran B, Hosing C, Bashir Q, Qazilbash MH, Short NJ, Ravandi F, Champlin R, Shpall EJ, Kebriaei P. Prognostic significance of measurable residual disease in patients with acute lymphoblastic leukemia undergoing allogeneic hematopoietic stem cell transplantation in second or later complete remission. Am J Hematol 2023; 98:E35-E37. [PMID: 36502492 DOI: 10.1002/ajh.26789] [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] [Received: 11/04/2022] [Accepted: 11/18/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Oren Pasvolsky
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA.,Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Petah-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Rima M Saliba
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
| | - Celina Ledesma
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
| | - Uday R Popat
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
| | - Amin Alousi
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
| | - Amanda Olson
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
| | - Betul Oran
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
| | - Chitra Hosing
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
| | - Qaiser Bashir
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
| | - Muzaffar H Qazilbash
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
| | - Nicholas J Short
- Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
| | - Farhad Ravandi
- Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
| | - Richard Champlin
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
| | - Elizabeth J Shpall
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
| | - Partow Kebriaei
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
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Gonzalez Gomez CA, Cosatti M, Castro Coello VV, Haye M, Tissera Y, Reyes AA, Albiero JA, Ornella S, Alba P, Gobbi C, Gamba MJ, Exeni IE, Cusa A, Gallino Yanzi J, Bellomio VI, Gomez G, Zelaya D, Takashima L, Carlevaris L, Correa MDLA, Rojas Tessel R, García M, German N, Mercé AL, Bertoli A, Aguero SE, Calvo ME, Martire V, Mauri M, Martin ML, Picco E, Castrillon Bustamante D, Ibañez Zurlo L, Tamborenea MN, Subils GC, Vasquez DL, Soares de Souza S, Herscovich N, Raiti L, Cosentino V, Rodriguez F, Ledesma C, Diaz MP, Mamani Ortega ML, Castaño MS, Gómez G, Roberts K, Quintana R, Isnardi CA, Pons-Estel G, Pisoni C. AB1101 PREVALENCE OF LONG COVID IN RHEUMATIC DISEASE PATIENTS: ANALYSIS OF SAR COVID REGISTRY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundPersistent symptoms after acute COVID have been described previously. Main symptoms reported are fatigue, arthralgias, myalgias and mental sickness. Definition and methods vary widely.1ObjectivesTo asses prevalence and related factors to long COVID in a retrospective cohort of patients with rheumatic diseases from Argentina.MethodsA total of 1915 patients were registered from August 18th, 2020 to July 29th, 2021. Patients > 18 years old, with rheumatic disease and confirmed infection by SARS-CoV-2 (antigen or RT-PCR) were included. Those dead, with unknown outcome, wrong date or missing data were excluded. Demographic data, comorbidities, rheumatic disease, and characteristics of SARS-CoV-2 infection were recorded.Long COVID was defined according to NICE guidelines (persistent symptoms for more than 4 weeks, without alternative diagnosis). Long COVID symptoms were defined by rheumatologist. Severity of infection was classified according to WHO ordinal scale.We used descriptive statistics, univariate model (Student’s test, chi square test, ANOVA) and multivariate logistic regression analysis.Results230 (12%) had long COVID. Median age was 51 (IQR 40-61]) years, 82% were females, 51% were not caucasian. Median of education was 13.3 years (IQR 12 – 16), 79 % had private health insurance and 55 % were employed. Nearly half (n=762, 46%) had comorbidities, the most prevalent was hypertension (n=396, 24%).The most frequent rheumatic diseases were rheumatoid arthritis (n=719, 42%) and systemic lupus erythematosus (n=280, 16 %). Most were in low activity/remission (79%), used Conventional DMARD (n=773 patients, 45%) and steroids (n=588, 34%) at low dose (n=415, 71%).Main laboratory findings were abnormal D-dimer (n=94, 28%) and leukopenia (n=93, 26%). Most patients had a WHO ordinal scale < 5 (n=1472, 86%). Median of hospitalization at intensive care unit (ICU) was 8 days [IQR 5, 13]. Treatment for SARS-CoV-2 infection (steroids, anticoagulation, azithromycin, convalescent plasma) was used in 461 (27%) patients.Most of long COVID (n= 152, 69%) reported 1 symptom, the most frequent was fatigue (n= 55, 22%). Figure 1.Univariate analysis is presented in Table 1. In multivariate logistic regression analysis non-caucasian ethnicity OR 1.44 (1.07-1.95), years of education OR 1.05 (1-1.09), treatment with cyclophosphamide OR 11.35 (1.56-112.97), symptoms of COVID – 19 OR 13.26 (2.75-242.08), severity scale WHO ≥ 5 OR 2.46 (1.68-3.57), and ICU hospitalization days OR 1.09 (1.05-1.14) were factors associated to long COVID.Table 1.Univariate analysis of long COVID syndrome in SAR – COVID registryVariableAcute COVID n=1486Long COVID n=221P valueAge, years, median [IQR]51 [40, 60]54 [42, 62]0.032Caucasian, n (%)744 (48)132 (53)0.227Female sex, n (%)1242 (80)215 (86)0.066Education, years, median [IQR]12 [10, 17]13 [12, 16]-Private health insurance, n (%)1161 (79)181 (82)0.325Smoking, n (%)381 (25)71 (29)0.224Comorbidities, n (%)650 (45)108 (52)0.066Dyslipidemia, n (%)173 (12)39 (19)0.008Hypertension, n (%)332 (23)60 (29)0.053Low activity/remission disease, n (%)1140 (80)179 (77)1Rheumatoid arthritis, n (%)623 (42)96 (42)1Systemic lupus erythematosus, n (%)243 (16)37 (16)0.996DMARD, n (%)664 (45)109 (47)0.486Cyclophosphamide, n (%)3 (0.2)3 (1)0.035Rituximab, n (%)19 (1)9 (34)0.008Lymphocyte66 (23)19 (30)0.011<1.500 / mm3, n (%)Ferritin > 2000 ng/ml, n (%)32 (11)16 (25)0.011ICU hospitalization, days,7 [4, 10]10 [8, 24]<0.001median [IQR]Treatment for COVID-19, n (%)394 (27)91 (41)<0.001ConclusionPrevalence of long COVID was 12%. Non-caucasian ethnicity, higher education, treatment with cyclophosphamide, symptoms of COVID – 19, severe disease and ICU hospitalization days were related to long COVID.References[1]Cabrera Martimbianco AL, Pacheco RL, Bagattini ÂM, Riera R. Frequency, signs and symptoms, and criteria adopted for long COVID-19: A systematic review. Int J Clin Pract.Disclosure of InterestsNone declared
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Gómez Vara AB, Barbich T, Isnardi CA, Schneeberger EE, Citera G, Castro Coello VV, Baez R, Haye M, Reyes AA, Albiero JA, Tanten R, Velozo E, Alba P, Gamba MJ, Alonso CG, Maldonado Ficco H, Gallino Yanzi J, Savio V, Asnal C, Matellan C, Takashima L, Carlevaris L, Gálvez Elkin MS, Scafati J, García M, German N, Werner ML, Aeschlimann C, Aguero SE, Calvo ME, Gonzalez Lucero L, Rodriguez Gil GF, Mauri M, Petruzzelli S, Castrillon Bustamante D, Ibañez Zurlo L, Alonso D, Tomas JL, Vasquez DL, Soares de Souza S, Herscovich N, Raiti L, Mareco JM, Guaglianone D, Ledesma C, Diaz MP, Bedoya ME, Kisluk B, Gómez G, Roberts K, Quintana R, Pons-Estel G. POS1238 GLUCOCORTICOIDS, RITUXIMAB AND THE PRESENCE OF INTERSTITIAL LUNG DISEASE ARE ASSOCIATED WITH POOR OUTCOMES OF THE SARS-COV-2 INFECTION IN PATIENTS WITH RHEUMATOID ARTHRITIS: DATA FROM THE NATIONAL REGISTRY SAR-COVID. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundHigh disease activity, treatment with glucocorticoids (GC) and rituximab (RTX), have been related to worse outcomes of COVID-19.ObjectivesTo assess the clinical characteristics and severity of the SARS-CoV-2 infection in patients with rheumatoid arthritis (RA) included in the SAR-COVID registry and to identify factors associated with poor outcomes.MethodsSAR-COVID is a national, longitudinal and observational registry. Patients of ≥18 years old, with diagnosis of RA (ACR-EULAR criteria 2010) who had confirmed SARS-CoV-2 infection (RT-PCR or positive serology) were included between 13-8-20 and 31-7-21. Sociodemographic and clinical data, comorbidities, disease activity and treatment at the moment of the SARS-CoV-2 infection were collected. Additionally, infection symptoms, complications, medical interventions and treatments for COVID-19 were registered. Infection severity was assessed using the WHO-ordinal scale (WHO-OS)1. A cut-off value of ≥5 identified patients with severe COVID-19 and those who died.Statistical analysis: Descriptive statistics. Chi2 or Fischer test, Student T test or Mann-Whitney and Kruskal Wallis or ANOVA, as appropriate. Multiple logistic regression model.ResultsA total of 801 patients were included, with a mean age of 53.1 ± 12.9 years, most of them were female (84.5%) and the median (m) disease duration was 8 years (IQR 4-14). One third were in remission and 46.4% had comorbidities, being the most frequent, hypertension (26.9 %), dyslipidemia (13.5 %), obesity (13.4 %) and diabetes (8.9%). Moreover, 3.2% had interstitial lung disease (ILD) associated with RA. At SARS-CoV-2 diagnosis, 42.5% were receiving glucocorticoids (GC), 73.9% conventional (c) disease modifying antirheumatic drugs (DMARD), 24% biologic (b) DMARD and 9.1% targeted synthetic (ts) DMARD. Among bDMARD, the most frequently used were TNF inhibitors (17%), followed by abatacept (2.8%), IL-6 inhibitors (2.4%) and rituximab (RTX) (2.1%). During the SARS-CoV-2 infection, 95.8% had symptoms, 27% required hospitalization, 7.9% presented complications and 4.4% died due to COVID-19. Severe disease and death (WHO-OS≥5) was present in 7.5% of the patients. They were older (62.9±12.5 vs 52.2±12.7, p<0.001), and they had more frequently ILD (18.5% vs 2%, p<0.001), comorbidities (82.5% vs 43.7%, p<0.001), ≥2 comorbidities (60.3% vs 25.8%, p<0.001), treatment with GC (61% vs 40.7%, p=0.04) and RTX (8.3% vs 1.6%, p=0.007). Conversely, the use of cDMARD and TNF inhibitors was more frequent in patients with WHO-OS<5, nevertheless this difference was not significant. Disease activity was comparable between groups. In multivariable analysis, older age, the presence of diabetes, ILD, the use of GC and RTX were significantly associated with WHO-OS≥5 (Figure 1). Furthermore, older age (65.7±10.8 vs 52.4±12.8, p<0.001), the presence of comorbidities (87.9% vs 44.7%, p<0.001), chronic obstructive pulmonary disease (21.9% vs 5.2%, p=0.002), diabetes (30.3% vs 7.9%, p<0.001), hypertension (57.6% vs 25.6%, p<0.001), cardiovascular disease (15.6% vs 3.2%, p=0.005), cancer (9.1% vs 1.3%, p=0.001), ILD (23.3% vs 2.4%, p<0.001) and the use of GC (61.8% vs 41.4%, p=0.02) were associated with mortality. Older age [OR 1.1 IC95% 1.06-1.13] and the use of GC 5-10 mg/day [OR 4.6 IC95% 1.8-11.6] remained significantly associated with death due to COVID-19.Figure 1.Factors associated with severe disease and death due to COVID-19 (WHO-OS≥5) in patients with rheumatoid arthritis. Multivariable analysis. (ref.: reference; PDN: prednisone; OR: odds ratio; CI: confidence interval)ConclusionTreatment with RTX and GC, as well as older age, the presence of diabetes and ILD were associated with poor COVID-19 outcomes in this national cohort of patients with RA. Older patients and those taking GC had a higher mortality rate.References[1]World Health Organization coronavirus disease (COVID-19) Therapeutic Trial Synopsis Draft 2020.Disclosure of InterestsNone declared
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Alatrash G, Saberian C, Bassett R, Thall PF, Ledesma C, Lu Y, Daher M, Valdez BC, Kawedia J, Popat U, Mehta R, Oran B, Nieto Y, Olson A, Anderlini P, Marin D, Hosing C, Alousi AM, Shpall EJ, Rondon G, Chen J, Qazilbash M, Champlin RE, Andersson BS, Kebriaei P. Vorinostat combined with Busulfan, Fludarabine, and Clofarabine Conditioning Regimen for Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Acute Leukemia: Long-term Study Outcomes. Transplant Cell Ther 2022; 28:501.e1-501.e7. [DOI: 10.1016/j.jtct.2022.05.021] [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] [Received: 01/23/2022] [Revised: 04/15/2022] [Accepted: 05/14/2022] [Indexed: 11/30/2022]
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Mukherjee A, Milton DR, Jabbour EJ, Gulbis AM, Kadia T, Jain N, Ledesma C, Burger J, Ferrajoli A, Wierda W, Medeiros LJ, Kantarjian H, Champlin R, Khouri IF. Clinical outcome of allogeneic stem cell transplantation in patients with B-cell lymphoid malignancies following treatment with targeted small molecule inhibitors. Leuk Lymphoma 2022; 63:885-893. [PMID: 35225133 PMCID: PMC9730341 DOI: 10.1080/10428194.2022.2043302] [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: 11/12/2022]
Abstract
We aimed to study the risks of graft-versus-host disease (GVHD), non-relapse mortality (NRM) and survival outcomes of allogeneic stem cell transplantation (alloSCT) in patients with chronic lymphocytic leukemia (n = 17), Richter's syndrome (n = 14), or lymphoma (n = 18) after small molecule inhibitors (SMIs). Patients had a median of 4 prior therapies, including ibrutinib (n = 46; 94%), venetoclax (n = 19; 39%), and idelalisib (n = 6; 12%). Twenty-one (43%) had >1 SMI. P53 mutation was detected in 58% of patients. The 3-year overall and progression-free survival rates were 68% and 59%, respectively. The rates of grade II-IV and III-IV acute GVHD were 33% and 7%. The 1-year rates of chronic GVHD, NRM and relapse were 19%, 10% and 21%, respectively. Results were comparable to a historical control of patients who received alloSCT without a prior exposure to SMI. We conclude that a prior use of SMI does not impair the outcomes after alloSCT.
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Affiliation(s)
- Akash Mukherjee
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Denái R. Milton
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Elias J. Jabbour
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Alison M. Gulbis
- Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Tapan Kadia
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Nitin Jain
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Celina Ledesma
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jan Burger
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Alessandra Ferrajoli
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - William Wierda
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - L. Jeffrey Medeiros
- Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Hagop Kantarjian
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Richard Champlin
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Issa F. Khouri
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Khouri IF, Milton DR, Gulbis AM, Jabbour EJ, Nastoupil L, Ledesma C, Anderlini P, Bashir Q, Daher M, Im JS, Iyer SP, Marin D, Mehta RS, Olson AL, Popat UR, Qazilbash M, Saini N, Samaniego F, Rondon G, Medeiros LJ, Champlin RE. Nine-Year Follow-up of Patients with Relapsed Follicular Lymphoma after Nonmyeloablative Allogeneic Stem Cell Transplant and Autologous Transplant. Clin Cancer Res 2021; 27:5847-5856. [PMID: 34380640 DOI: 10.1158/1078-0432.ccr-21-1377] [Citation(s) in RCA: 1] [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] [Received: 04/15/2021] [Revised: 06/27/2021] [Accepted: 07/30/2021] [Indexed: 02/03/2023]
Abstract
PURPOSE To compare outcomes between patients with relapsed follicular lymphoma who received a nonmyeloablative allogeneic stem cell transplant (alloSCT) and those who received an autologous transplant (autoSCT). PATIENTS AND METHODS We evaluated 194 patients with follicular lymphoma who received an alloSCT (n = 98) or autoSCT (n = 96) at MD Anderson Cancer Center (Houston, TX). The transplant type used was based on donor availability and by Medicare reimbursement guidelines. Patients who received an alloSCT were enrolled in four consecutive trials in which they received fludarabine, cyclophosphamide (or bendamustine), and rituximab conditioning. autoSCT patients received R-BEAM (rituximab, carmustine, etoposide, cytarabine, and melphalan). RESULTS The median follow-up of survivors was 108 months for the alloSCT group and 102 months for the autoSCT group. Overall survival was significantly better for patients who received an alloSCT compared with those who received an autoSCT (62% vs. 46%; P = 0.048). Similarly, progression-free survival rates were 52% in patients who received an alloSCT and 31% in those who received an autoSCT (P < 0.001), and the 8-year relapse rates were 11% and 43%, respectively (P < 0.0001). Only three patients in the alloSCT group relapsed beyond 3.5 years. In the alloSCT group, the rates for grade 2 to 4 acute graft-versus-host disease (GVHD), grade 3 to 4 acute GVHD, and extensive chronic GVHD were 22%, 9%, and 38%, respectively. In the autoSCT group, the 8-year incidence of secondary myelodysplasia was 11%. Nonrelapse mortality was similar between the two groups (15% vs. 11% at 8 years; P = 0.27). CONCLUSIONS This study shows that alloSCT is curative and confers superior survival compared with autoSCT in patients with follicular lymphoma.
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Affiliation(s)
- Issa F Khouri
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas.
| | - Denái R Milton
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Alison M Gulbis
- Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Elias J Jabbour
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Loretta Nastoupil
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Celina Ledesma
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Paolo Anderlini
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Qaiser Bashir
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - May Daher
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jin S Im
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Swaminathan P Iyer
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - David Marin
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Rohtesh S Mehta
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Amanda L Olson
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Uday R Popat
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Muzaffar Qazilbash
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Neeraj Saini
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Felipe Samaniego
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Gabriela Rondon
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Richard E Champlin
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Koller P, Saliba RM, Ledesma C, Rondon G, Popat U, Alousi A, Mehta R, Oran B, Olson A, Hosing C, Qazilbash M, Khouri I, Ciurea S, Shpall E, Jorgensen J, Wang S, Jain N, Jabbour E, Kantarjian H, Champlin R, Konopleva M, Kebriaei P. Outcomes in patients with CRLF2 overexpressed acute lymphoblastic leukemia after allogeneic hematopoietic cell transplantation. Bone Marrow Transplant 2021; 56:1746-1749. [PMID: 33767403 DOI: 10.1038/s41409-021-01262-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 02/02/2021] [Accepted: 02/23/2021] [Indexed: 11/09/2022]
Affiliation(s)
- Paul Koller
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA, USA
| | - Rima M Saliba
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Celina Ledesma
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Gabriela Rondon
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Uday Popat
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Amin Alousi
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Rohtesh Mehta
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Betul Oran
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Amanda Olson
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Chitra Hosing
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Muzaffar Qazilbash
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Issa Khouri
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Stefan Ciurea
- Division of Hematology/Oncology, Department of Medicine, University of California Irvine School of Medicine, Irvine, CA, USA
| | - Elizabeth Shpall
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jeffrey Jorgensen
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sa Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Nitin Jain
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Elias Jabbour
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Hagop Kantarjian
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Richard Champlin
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Marina Konopleva
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Partow Kebriaei
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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10
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Varma A, Rondon G, Srour SA, Chen J, Ledesma C, Champlin RE, Ciurea SO, Saliba RM. Endothelial Activation and Stress Index (EASIX) at Admission Predicts Fluid Overload in Recipients of Allogeneic Stem Cell Transplantation. Biol Blood Marrow Transplant 2020; 26:1013-1020. [PMID: 32045652 DOI: 10.1016/j.bbmt.2020.01.028] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 01/28/2020] [Accepted: 01/29/2020] [Indexed: 12/13/2022]
Abstract
Fluid overload (FO) grade ≥2 (more than 10% weight gain from baseline) has recently been recognized as an important toxicity associated with a high rate of nonrelapse mortality in recipients of allogeneic hematopoietic cell transplantation (AHCT). The causes for FO remain unclear. We hypothesized that endothelial damage, possibly due to treatments received prior to AHCT, may be associated with this toxicity and sought to determine whether the Endothelial Activation and Stress Index (EASIX) (defined as lactate dehydrogenase [U/L] × creatinine [mg/dL]/platelets [109 cells/L]) correlates with grade ≥2 FO in 2 cohorts of recipients of AHCT at our institution. We tested our hypothesis in a cohort of 145 consecutive recipients (study cohort) of AHCT transplant from HLA-haploidentical donors and validated the findings in a cohort of 449 (validation cohort) recipients of AHCT from HLA-matched donors who underwent transplantation between 2010 and 2015. Predictors of grade ≥2 FO were evaluated using competing risks regression in univariate analysis and classification and regression tree (CART) analysis in multivariate analysis. The cumulative incidence of grade ≥2 FO was estimated considering death as a competing risk. EASIX scores were evaluated based on log2-transformed values. Optimal predictive EASIX cutoff values were determined based on receiver operating characteristics curve analysis. Grade ≥2 FO occurred in 21% and 6% of the study and validation cohorts, respectively, with the majority of these cases being diagnosed before the day of AHCT. Median log2 EASIX score at admission was 2.4 (interquartile range [IQR], 1.3, 3.7) and 2.5 (IQR, 1.4, 3.9) in the 2 respective cohorts. In univariate analysis, high EASIX at admission was a significant predictor of grade ≥2 FO in the study (cutoff: 4.4, hazard ratio [HR] = 4.8, P < .001) and in the validation (cutoff: 4.3, HR = 4.8, P < .001) cohorts. The significant effect of EASIX persisted in multivariate CART analysis in the study (HR = 6.3, P < .001) and the validation (HR = 28, P = .002) cohorts. Additional predictors in multivariate analysis included body weight below 80 kg in recipients older than 55 years (HR = 4.5, P < .001) in the study cohort and diabetes (HR = 34, P = .001) and age >60 years (HR = 9.6, P = .04) in the validation cohort. At admission, the prevalence of EASIX score of >4.3 (18% versus 17%, P = .9) was not different between the diabetics and nondiabetics. EASIX score at admission is a significant predictor of grade ≥2 FO in recipients of AHCT from HLA-haploidentical or HLA-matched donors. Independently of EASIX, older patients with low weight were associated with increased risk of grade ≥2 FO for recipients of HLA-haploidentical transplants. For the HLA-matched cohort, diabetes and older age were associated with increased FO risk. These findings require validation in external cohorts.
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Affiliation(s)
- Ankur Varma
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas; Division of Hematology, Oncology and Cellular Therapy, Rush University, Chicago, Illinois
| | - Gabriela Rondon
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Samer A Srour
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Julianne Chen
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Celina Ledesma
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Richard E Champlin
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Stefan O Ciurea
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Rima M Saliba
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas.
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11
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Mukherjee A, Milton DR, Jabbour E, Gulbis A, Kadia TM, Thompson PA, Keating MJ, Jain N, Ledesma C, Fayad L, Nastoupil LJ, Burger JA, Ferrajoli A, Estrov Z, Kantarjian HM, Champlin RE, Khouri IF. Allogeneic stem cell transplantation (AlloSCT) for patients (pts) with lymphoma and chronic lymphocytic leukemia (CLL) following targeted small molecules inhibitors (SMIs). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.7550] [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
7550 Background: SMIs have improved outcomes in lymphoma/CLL. There is paucity of information about the safety and efficacy of alloSCT following SMIs. Methods: Data from 49 pts who received alloSCT between 2013-2018 at MDA and who have been previously treated with SMIs were retrospectively analyzed. Results: Histologies included CLL (n=31, 63%), mantle cell lymphoma (MCL) (n= 13, 27%), and follicular lymphoma (n= 5, 10%). Prior SMIs included ibrutinib [(n=46; 94%); 57% as ≥ 3rd line of therapy], venetoclax [(n=19, 39%); 68% as ≥ 3rd line of therapy], idelalisib (n=6, 12%). Ibrutinib was discontinued prior alloSCT in 31(67%) pts. due to refractoriness (n=25), or intolerance (n=6). Seven of 19 (37%) pts had venetoclax discontinued to due refractoriness (n=6) or intolerance (n=1). Risk factors for CLL pts at alloSCT included a prior Richter’s (n=14, 45%), unmutated IGHV (15/23, 65%), presence of del17p (n=23; 74%), and complex cytogenetics (n=15; 48%). In addition, 18/20 (90%) CLL pts had abnormal mutations: most frequent were TP53 (n=14; 78%), BTK (n=6; 33%), SF3B1 (n=4; 22%) and 8/18 (44%) pts had > 2 mutations. Risk factors for MCL pts included: Ki67≥ 30 % (n=10/12, 83%), blastoid histology (n=6, 46%). Median age was 51 years, and 9 (18%) pts had a HCT-CI >4. Median prior lines of therapies was 4. Median duration of SMI therapy was 4.6 months. At transplant 40 (82%) pts had sensitive and 9 (18%) had refractory disease. Conditioning was nonmyeloablative (BFR or FCR) in 62%, RIC in 20% and myeloablative in 18%. Most pts (61%) received matched unrelated or matched sibling donors (22%); 8 (16%) had an alternative donor. The median follow-up for survivors was 12.4 months (range, 1-41.6). OS and PFS at 1 year were 77% and 68%, respectively. The CI of acute grade 2-4 and 3-4 GVHD were 33% and 7%, respectively. CI of 1-year chronic GVHD was 19%. Disease refractoriness and acute 3-4 GVHD were predicators for inferior OS and PFS by MV analysis. Similar survival results were observed in pts with or without mutations. Fourteen pts died due to progression (n=9), infection (n=2), acute (n=2) or chronic GVHD (n=1). Conclusions: AlloSCT is an effective therapy in pts with lymphoma/CLL pretreated with SMI. Our results suggest that alloSCT can overcome high-risk mutations associated with exposure to SMIs. Prospective confirmation in a larger # of pts is needed.
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Affiliation(s)
- Akash Mukherjee
- The University of Texas MD Anderson Cancer Center, Department of Stem Cell Transplantation and Cellular Therapy, Houston, TX
| | - Denai R. Milton
- The University of Texas MD Anderson Cancer Center, Department of Biostatistics, Houston, TX
| | - Elias Jabbour
- The University of Texas MD Anderson Cancer Center, Department of Leukemia, Houston, TX
| | - Alison Gulbis
- The University of Texas MD Anderson Cancer Center, Division of Pharmacy, Houston, TX
| | - Tapan M. Kadia
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Philip A. Thompson
- The University of Texas MD Anderson Cancer Center, Department of Leukemia, Houston, TX
| | - Michael J. Keating
- The University of Texas MD Anderson Cancer Center, Department of Leukemia, Houston, TX
| | - Nitin Jain
- The University of Texas MD Anderson Cancer Center, Department of Leukemia, Houston, TX
| | - Celina Ledesma
- The University of Texas MD Anderson Cancer Center, Department of Stem Cell Transplantation and Cellular Therapy, Houston, TX
| | - Luis Fayad
- The University of Texas MD Anderson Cancer Center, Department of Lymphoma/Myeloma, Houston, TX
| | - Loretta J. Nastoupil
- The University of Texas MD Anderson Cancer Center, Department of Lymphoma/Myeloma, Houston, TX
| | - Jan Andreas Burger
- The University of Texas MD Anderson Cancer Center, Department of Leukemia, Houston, TX
| | - Alessandra Ferrajoli
- The University of Texas MD Anderson Cancer Center, Department of Leukemia, Houston, TX
| | - Zeev Estrov
- The University of Texas MD Anderson Cancer Center, Department of Leukemia, Houston, TX
| | | | - Richard E. Champlin
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Issa F. Khouri
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX
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12
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Mukherjee A, Milton D, Ledesma C, Olson A, Alatrash G, Anderlini P, Alousi AM, Bashir Q, Ciurea SO, Kebriaei P, Marin D, Molldrem JJ, Oran B, Popat UR, Qazilbash MH, Rondon G, Champlin RE, Gulbis AM, Khouri IF. Influence of the Intensity of the Allogeneic Conditioning Regimen on the Risk of Hemorrhagic Cystitis (HC) in Patients Receiving Post- Transplant Cyclophosphamide (PT-Cy) As Gvhd Prophylaxis. Biol Blood Marrow Transplant 2019. [DOI: 10.1016/j.bbmt.2018.12.441] [Citation(s) in RCA: 3] [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: 10/27/2022]
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13
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Saliba RM, Rondon G, Chen J, Ledesma C, Champlin RE, Ciurea SO. Endothelial Activation and Stress Index (EASIX) Is Associated with Fluid Overload and Survival in Recipients of Allogeneic Stem Cell Transplantation. Biol Blood Marrow Transplant 2019. [DOI: 10.1016/j.bbmt.2018.12.105] [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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14
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Ledesma C, Rosario C, Gracia-Mora J, Tapia G, Gutiérrez L, Sumano H. Antibacterial activity of amoxicillin in vitro and its oral bioavailability in broiler chickens under the influence of 3 water sanitizers. Poult Sci 2018; 97:2391-2399. [PMID: 29897502 DOI: 10.3382/ps/pey114] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 03/12/2018] [Indexed: 11/20/2022] Open
Abstract
The interaction of 3 water sanitizers (sodium hypochlorite, iodine-polyvinylpyrrolidone, and citrate) utilized in poultry production on antibacterial activity and bioavailability of amoxicillin trihydrate (AMX) were studied. Sanitizers were mixed with AMX in prepared water, the resulting substances were regarded as amoxicillin-sanitizer products (ASP). First, the in vitro antibacterial activity of each ASP was compared to that of AMX. Then, pharmacokinetics (PK) of ASP and AMX diluted in prepared water, were carried out in broiler-chickens. Amoxicillin or ASP (20 mg/kg) from different concentrations of sanitizers was directly placed into the chicken's crop and blood samples were taken. Basic PK parameters were obtained. Serum activity/concentrations of AMX were assessed by agar diffusion and corroborated with high performance liquid chromatography. Results show that ASP of AMX/sodium hypochlorite decrease both, the antimicrobial activity of in vitro AMX and its relative bioavailability (Fr) assessed with the maximum serum concentration (Cmax), the area under the concentration-time curve, and the mean residence time (MRT) (3.80 μg/mL, 2.70 μg/mL·h, and 0.59 h, respectively), compared to the AMX administered alone (12.54 μg/mL, 44.02 μg/mL·h, and MRT 2.78 h). ASP from amoxicillin/ionophore, reduced the Cmax (10.62 μg/mL), Fr (94.67%), and MRT (2.07 h), at the highest tested concentrations. In contrast, the 2 highest concentrations of the citrate sanitizer increased the Cmax (15.07 and 15.47 μg/mL), Fr (119 and 132%), and MRT (3.32 and 4.06 h) and their in vitro antimicrobial activity. Interactions between the tested water sanitizers and AMX modify the Cmax, Fr, MRT of the latter, altering the PK/pharmacodymanic ratios for a time-dependent antibiotic. Results also reveal that the use of amoxicillin trihydrate administered through the drinking water does not meet the required PK/pharmacodymanic ratios. Thus, it is here postulated that this antibiotic should be administered at least twice a day and that its interaction with water sanitizers should be considered.
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Affiliation(s)
- C Ledesma
- Department of Physiology and Pharmacology, School of Veterinary Medicine, National Autonomous University of Mexico, Av. Universidad 3000, Coyoacán, Mexico City 04510, Mexico
| | - C Rosario
- Department of Avian Medicine, School of Veterinary Medicine, National Autonomous University of Mexico, Av. Universidad 3000, Coyoacán, Mexico City 04510, Mexico
| | - J Gracia-Mora
- Department Nuclear and Inorganic Chemistry, School of Chemistry, National Autonomous University of Mexico, Av. Universidad 3000, Coyoacán, Mexico City 04510, Mexico
| | - G Tapia
- Department of Genetic and Biostatistics, School of Veterinary Medicine, National Autonomous University of Mexico, Av. Universidad 3000, Coyoacán, Mexico City 04510, Mexico
| | - L Gutiérrez
- Department of Physiology and Pharmacology, School of Veterinary Medicine, National Autonomous University of Mexico, Av. Universidad 3000, Coyoacán, Mexico City 04510, Mexico
| | - H Sumano
- Department of Physiology and Pharmacology, School of Veterinary Medicine, National Autonomous University of Mexico, Av. Universidad 3000, Coyoacán, Mexico City 04510, Mexico
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15
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Ledesma C, Rosario C, Gracia-Mora J, Tapia G, Sumano H, Gutiérrez L. Influence of chlorine, iodine, and citrate-based water sanitizers on the oral bioavailability of enrofloxacin in broiler chickens. J APPL POULTRY RES 2018. [DOI: 10.3382/japr/pfx044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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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16
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Rondón G, Saliba RM, Chen J, Ledesma C, Alousi AM, Oran B, Hosing CM, Kebriaei P, Khouri IF, Shpall EJ, Popat UR, Champlin RE, Ciurea SO. Impact of Fluid Overload as New Toxicity Category on Hematopoietic Stem Cell Transplantation Outcomes. Biol Blood Marrow Transplant 2017; 23:2166-2171. [PMID: 28844946 DOI: 10.1016/j.bbmt.2017.08.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 08/12/2017] [Indexed: 11/29/2022]
Abstract
Fluid overload (FO) commonly occurs during hospitalization for allogeneic hematopoietic stem cell transplantation. We hypothesized that FO is associated with transplantation outcomes and evaluated this complication in 2 cohorts of patients. FO was graded based on post-transplantation weight gain, symptoms, and need for treatment, scored in real time by an independent team. The first cohort (study cohort; n = 145) underwent haploidentical transplantation for hematologic malignancies following a melphalan-based conditioning regimen. In univariate analysis, factors associated with day +100 nonrelapse mortality (NRM) were FO grade ≥2 (hazard ratio [HR], 15; 95% confidence interval [CI], 4.2 to 55; P < .001), creatinine >1 mg/dL (HR, 4.7; 95% CI, 1.6 to 14; P = .005), and age >55 years (HR, 4.5; 95% CI, 1.5 to 13; P = .008). In multivariate analysis, factors associated with day +100 NRM were FO grade ≥2 (HR, 13.1; 95% CI, 3.4 to 50; P < .001) and serum creatinine level >1 mg/dL at transplantation admission (HR, 3.5; 95% CI, 1.1 to 11; P = .03). These findings were verified in a separate cohort (validation cohort) of patients with acute myelogenous leukemia/myelodysplastic syndrome who underwent HLA-matched transplantation with busulfan-based conditioning (n = 449). In multivariate analysis, factors associated with day +100 NRM were FO grade ≥2 (HR, 34; 95% CI, 7.2 to 158; P < .001) and, in patients with FO grade <2, advanced disease status (HR, 5; 95% CI, 1.1 to 22; P = .03). A higher NRM translated to significantly poorer 1-year overall survival rates for patients with FO ≥2 than for patients without FO (70% versus 42%, P < .001 in the study cohort and 64% versus 38%, P < .001 in the validation cohort). In conclusion, FO grade ≥2 is strongly associated with higher NRM and shorter survival and should be considered an important prognostic factor in transplantation.
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Affiliation(s)
- Gabriela Rondón
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Rima M Saliba
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Julianne Chen
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Celina Ledesma
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Amin M Alousi
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Betul Oran
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Chitra M Hosing
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Partow Kebriaei
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Issa F Khouri
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Elizabeth J Shpall
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Uday R Popat
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Richard E Champlin
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Stefan O Ciurea
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas.
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17
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Nieto Y, Tu SM, Campbell MT, Bassett R, Tannir NM, Ward JF, Hofstetter WL, Jones RB, Andersson B, Gulbis AM, Ledesma C, Timmons M, Trapp M, Champlin RE, Pagliaro LC. Infusional gemcitabine + docetaxel/melphalan/carboplatin (GemDMC) ± bevacizumab (BEV) as an effective high-dose chemotherapy (HDC) regimen for refractory of poor-risk relapsed germ-cell tumors (GCT). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.4519] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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
4519 Background: Tandem HDC with carbo/etoposide (CE) is curative for a portion of relapsed GCT pts. However, outcomes of refractory or high-risk relapsed pts remain poor. We tested a new HDC regimen of GemDMC, based on DNA damage repair inhibition. We combined BEV with HDC given their potential synergy and the high vascularity of GCT metastases. Methods: Eligibility: Intermediate (int)/high-risk (Beyer Model), creatinine ≤1.8 mg/dL and adequate organ function. HDC included BEV (5 mg/kg) preceding GemDMC (HDC #1) and ifosfamide/CE (ICE) (HDC #2). Following accrual of 42 pts, we amended the trial omitting BEV. The trial was powered to distinguish a target 50% 2-yr RFS from an expected 25% in this population. Results: We enrolled 69 male pts in cohorts 1 (BEV, N=42) and 2 (no BEV, N=27) (Table). Pts were heavily pretreated and most had refractory tumors. Main AE: mucositis and renal (4 HDC-related deaths in cohort 1, 1 in cohort 2). Tumor markers normalized in 90% pts with active tumors at HDC. After HDC, 19 pts were in CR and 28 in PRm- (of these, 22 had residual lesions resected with no viable tumor found in 20/22, 2 xRT, 4 monitored). Median f/u = 39 (2-105) mo. The 2-yr RFS rates in cohorts 1 and 2 = 52% and 78%, respectively. Their respective 2-yr OS rates = 55% and 81%. Conclusions: Sequential HDC with GemDMC–ICE shows encouraging outcomes in heavily pretreated and refractory GCT, exceeding the anticipated results. Addition of BEV increases toxicity but not tumor control. Clinical trial information: NCT00936936. [Table: see text]
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Affiliation(s)
- Yago Nieto
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Shi-Ming Tu
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Roland Bassett
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Nizar M. Tannir
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | - Roy B. Jones
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Borje Andersson
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Alison M Gulbis
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Celina Ledesma
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Melissa Timmons
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Michelle Trapp
- The University of Texas MD Anderson Cancer Center, Houston, TX
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18
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Khouri MR, Jabbour EJ, Gulbis AM, Turturro F, Ledesma C, Korbling M, Samuels BI, Ahmed S, Alousi AM, Ciurea SO, Marin D, Patel KK, Popat UR, Bueso-Ramos CE, Bassett RL, Khouri IF. Feasibility of Lenalidomide Therapy for Persistent Chronic Lymphocytic Leukemia after Allogeneic Transplantation. Biol Blood Marrow Transplant 2017; 23:1405-1410. [PMID: 28495642 DOI: 10.1016/j.bbmt.2017.04.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 11/12/2016] [Accepted: 04/29/2017] [Indexed: 12/30/2022]
Abstract
In patients with chronic lymphocytic leukemia (CLL), persistence of disease after allogeneic stem cell transplantation (alloSCT) can result in poor outcomes. In an effort to improve these outcomes, patients with persistent CLL who were 90 to 100 days beyond alloSCT with no evidence of graft-versus-host-disease (GVHD) were randomized to receive lenalidomide or standard care (withdrawal of immunosuppression followed by donor lymphocyte infusion). Lenalidomide was initiated at 5 mg every other day and increased to 10 mg daily, if tolerated, in each patient. Of 38 patients enrolled, 17 (45%) met the eligibility criteria for randomization. Of these 17 patients, 8 were randomized to undergo lenalidomide therapy. Five (62%) patients had to stop taking the drug because of toxicity. The main reason for drug discontinuation was acute GVHD in 43% of patients. This incidence was 11% in the patients who were randomized to not receive lenalidomide. With a median follow-up of 2.6 years, the median survival was 3.4 years for those receiving lenalidomide. This was not reached in patients randomized to not receive lenalidomide and in patients in complete remission who were not randomized. These results suggested that treatments other than lenalidomide are needed for persistent CLL after alloSCT.
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Affiliation(s)
- Maria R Khouri
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Elias J Jabbour
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Alison M Gulbis
- Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Francesco Turturro
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Celina Ledesma
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Martin Korbling
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Barry I Samuels
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sairah Ahmed
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Amin M Alousi
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Stefan O Ciurea
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - David Marin
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Krina K Patel
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Uday R Popat
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Carlos E Bueso-Ramos
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Roland L Bassett
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Issa F Khouri
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas.
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Thompson PA, Stingo F, Keating MJ, Wierda WG, O'Brien SM, Estrov Z, Ledesma C, Rezvani K, Qazilbash M, Shah N, Parmar S, Popat U, Anderlini P, Yago N, Ciurea SO, Kebriaei P, Champlin R, Shpall EJ, Hosing CM. Long-term follow-up of patients receiving allogeneic stem cell transplant for chronic lymphocytic leukaemia: mixed T-cell chimerism is associated with high relapse risk and inferior survival. Br J Haematol 2017; 177:567-577. [PMID: 28295181 DOI: 10.1111/bjh.14596] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 09/22/2016] [Accepted: 12/11/2016] [Indexed: 12/01/2022]
Abstract
There is limited information regarding the immunological predictors of post-allogeneic stem cell transplant (alloSCT) outcome in chronic lymphocytic leukaemia (CLL), such as mixed T-cell chimerism. We analysed 143 consecutive patients with relapsed/refractory CLL, transplanted between 2000 and 2012, to determine the prognostic relevance of mixed chimerism post-alloSCT and the ability of post-transplant immunomodulation to treat relapse. Mixed T-cell chimerism occurred in 50% of patients at 3 months and 43% at 6 months post-alloSCT; upon 3- and 6-month landmark analysis, this was associated with inferior progression-free survival (PFS) [Hazard ratio (HR) 1·93, P = 0·003 and HR 2·58, P < 0·001] and survival (HR 1·66, P = 0·05 and HR 2·17, P < 0·001), independent of baseline patient characteristics, and a lower rate of grade II-IV acute graft-versus-host disease (GHVD) (16% vs. 52%, P < 0·001). Thirty-three patients were treated with immunomodulation for relapse post-alloSCT (immunosuppression withdrawal, n = 6, donor lymphocyte infusion, n = 27); 17 achieved complete response (CR), which predicted superior PFS (53 months vs. 10 months, P < 0·001) and survival (117 months vs. 30 months, P = 0·006). Relapsed patients with mixed chimerism had inferior response to immunomodulation; conversion to full donor chimerism was highly correlated both with CR and with the development of severe acute GVHD, which was fatal in 3/8 patients. Novel therapeutic strategies are required for patients with mixed T-cell chimerism post-alloSCT for CLL.
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MESH Headings
- Adult
- Aftercare/methods
- Aged
- Chimerism
- Epidemiologic Methods
- Female
- Graft Survival/genetics
- Graft vs Host Disease/etiology
- Humans
- Immunosuppressive Agents/therapeutic use
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/mortality
- Leukemia, Lymphocytic, Chronic, B-Cell/therapy
- Lymphocyte Transfusion/adverse effects
- Male
- Middle Aged
- Recurrence
- Stem Cell Transplantation/methods
- Stem Cell Transplantation/mortality
- T-Lymphocytes/physiology
- Transplantation, Homologous
- Treatment Outcome
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Affiliation(s)
- Philip A Thompson
- Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Francesco Stingo
- Department of Biostatistics, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Michael J Keating
- Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - William G Wierda
- Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Susan M O'Brien
- Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Zeev Estrov
- Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Celina Ledesma
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Katayoun Rezvani
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Muzaffar Qazilbash
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Nina Shah
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Simrit Parmar
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Uday Popat
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Paolo Anderlini
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Nieto Yago
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Stefan O Ciurea
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Partow Kebriaei
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Richard Champlin
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Elizabeth J Shpall
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Chitra M Hosing
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
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Kebriaei P, Bassett R, Lyons G, Valdez B, Ledesma C, Rondon G, Oran B, Ciurea S, Alousi A, Popat U, Patel K, Ahmed S, Olson A, Bashir Q, Shah N, Jones R, Marin D, Rezvani K, Nieto Y, Khouri I, Qazilbash M, Hosing C, Shpall E, Champlin RE, Andersson BS. Clofarabine Plus Busulfan is an Effective Conditioning Regimen for Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Acute Lymphoblastic Leukemia: Long-Term Study Results. Biol Blood Marrow Transplant 2016; 23:285-292. [PMID: 27816651 DOI: 10.1016/j.bbmt.2016.11.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 11/01/2016] [Indexed: 11/25/2022]
Abstract
We investigated the long-term safety and disease control data obtained with i.v. busulfan (Bu) combined with clofarabine (Clo) in patients with acute lymphoblastic leukemia (ALL) undergoing allogeneic hematopoietic stem cell transplantation (HSCT). A total of 107 patients, median age 38 years (range, 19 to 64 years) received a matched sibling donor (n = 52) or matched unrelated donor (n = 55) transplant for ALL in first complete remission (n = 62), second complete remission (n = 28), or more advanced disease (n = 17). Nearly one-half of the patients had a high-risk cytogenetic profile as defined by the presence of t(9;22) (n = 34), t(4;11) (n = 4), or complex cytogenetics (n = 7). Clo 40 mg/m2 was given once daily, with each dose followed by pharmacokinetically dosed Bu infused over 3 hours daily for 4 days, followed by hematopoietic cell infusion after 2 days of rest. The Bu dose was based on the drug clearance as determined by a test Bu dose of 32 mg/m2. The target daily area under the curve was 5500 µmol/min for patients aged <60 years and 4000 µmol/min for patients aged >59 years. With a median follow-up of 3.3 years among surviving patients (range, 1 to 5.8 years), the 2-year progression-free survival (PFS) for patients undergoing HSCT in first complete remission (CR1), second complete remission (CR2), or more advanced disease was 62%, 34%, and 35%, respectively. The regimen was well tolerated, with nonrelapse mortality (NRM) of 10% at 100 days and 31% at 2 years post-HSCT. The incidence of grade II-IV and III-IV acute graft-versus-host disease (GVHD) was 35% and 10%, respectively; 18% patients developed extensive chronic GVHD. The 2-year overall survival (OS) for patients undergoing HSCT in CR1, CR2, or more advanced disease was 70%, 57%, and 35%, respectively. Among 11 patients aged >59 years treated with reduced-dose Bu in CR1 (n = 7) or CR2 (n = 4), 4 remain alive and disease-free, with a median follow-up of 2.6 years (range, 2 to 4.7 years). Only the presence of minimal residual disease at the time of transplantation was associated with significantly worse PFS and OS in multivariate analysis. Our data indicate that the Clo-Bu combination provides effective disease control while maintaining a favorable safety profile. OS and NRM rates compare favorably with those for traditional myeloablative total body irradiation-based conditioning regimens.
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Affiliation(s)
- Partow Kebriaei
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas.
| | - Roland Bassett
- Department of Biostatistics, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Genevieve Lyons
- Department of Biostatistics, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Ben Valdez
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Celina Ledesma
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Gabriela Rondon
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Betul Oran
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Stefan Ciurea
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Amin Alousi
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Uday Popat
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Krina Patel
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Sairah Ahmed
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Amanda Olson
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Qaiser Bashir
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Nina Shah
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Roy Jones
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - David Marin
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Katayoun Rezvani
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Yago Nieto
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Issa Khouri
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Muzaffar Qazilbash
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Chitra Hosing
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Elizabeth Shpall
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Richard E Champlin
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Borje S Andersson
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
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22
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Brammer JE, Khouri I, Marin D, Ledesma C, Rondon G, Ciurea SO, Nieto Y, Champlin RE, Hosing C, Kebriaei P. Stem cell transplantation outcomes in lymphoblastic lymphoma. Leuk Lymphoma 2016; 58:366-371. [DOI: 10.1080/10428194.2016.1193860] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Anderlini P, Saliba RM, Ledesma C, Plair T, Alousi AM, Hosing CM, Khouri IF, Nieto Y, Popat UR, Shpall EJ, Fanale MA, Hagemeister FB, Oki Y, Neelapu S, Romaguera JE, Younes A, Champlin RE. Gemcitabine, Fludarabine, and Melphalan for Reduced-Intensity Conditioning and Allogeneic Stem Cell Transplantation for Relapsed and Refractory Hodgkin Lymphoma. Biol Blood Marrow Transplant 2016; 22:1333-1337. [PMID: 27064056 DOI: 10.1016/j.bbmt.2016.03.028] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 03/27/2016] [Indexed: 01/22/2023]
Abstract
Forty patients (median age, 31 years; range, 20 to 63) with Hodgkin lymphoma underwent an allogeneic stem cell transplant with the gemcitabine-fludarabine-melphalan reduced-intensity conditioning regimen. Thirty-one patients (77%) had undergone a prior autologous stem cell transplant, with a median time to progression after transplant of 6 months (range, 1 to 68). Disease status at transplant was complete remission/complete remission, undetermined (n = 23; 57%), partial remission (n = 14; 35%), and other (n = 3; 8%). Twenty-six patients (65%) received brentuximab vedotin before allotransplant. The overall complete response rate before allotransplant was 65% in brentuximab-treated patients versus 42% in brentuximab-naive patients (P = .15). At the latest follow-up (October 2015) 31 patients were alive. The median follow-up was 41 months (range, 5 to 87). Transplant-related mortality rate at 3 years was 17%. Pulmonary, skin toxicities, and nausea were seen in 13 (33%), 11 (28%), and 37 (93%) patients, respectively. At 3 years, estimates for overall and progression-free survival were 75% (95% CI, 57% to 86%) and 54% (95% CI, 36% to 70%). Overall incidence for disease progression was 28% (95% CI, 16% to 50%). We believe the gemcitabine-fludarabine-melphalan regimen allows moderate dose intensification with acceptable morbidity and mortality. The inclusion of gemcitabine affected nausea, pulmonary, and likely skin toxicity. Exposure to brentuximab vedotin allowed more patients to reach allogeneic stem cell transplantation in complete remission. With over 50% of patients progression-free at 3 years, allogeneic stem cell transplantation with reduced-intensity conditioning remains an effective and relevant treatment option for Hodgkin lymphoma in the brentuximab vedotin era.
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Affiliation(s)
- Paolo Anderlini
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas.
| | - Rima M Saliba
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Celina Ledesma
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Tamera Plair
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Amin M Alousi
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Chitra M Hosing
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Issa F Khouri
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Yago Nieto
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Uday R Popat
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Elizabeth J Shpall
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Michelle A Fanale
- Department of Lymphoma, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | | | - Yasuhiro Oki
- Department of Lymphoma, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Saatva Neelapu
- Department of Lymphoma, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Jorge E Romaguera
- Department of Lymphoma, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Anas Younes
- Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Richard E Champlin
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
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Brammer JE, Khouri IF, Ledesma C, Rondon G, Ciurea SO, Nieto Y, Champlin RE, Hosing C, Kebriaei P. T-Cell Acute Lymphoblastic Lymphoma (T-LBL) and Stem Cell Transplantation (SCT): A Comparison of Outcomes with T-Cell Acute Lymphoblastic Leukemia (T-ALL). Biol Blood Marrow Transplant 2016. [DOI: 10.1016/j.bbmt.2015.11.618] [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: 11/30/2022]
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Nieto Y, Tu SM, Bassett R, Jones RB, Gulbis AM, Tannir N, Kingham A, Ledesma C, Margolin K, Holmberg L, Champlin R, Pagliaro L. Bevacizumab/high-dose chemotherapy with autologous stem-cell transplant for poor-risk relapsed or refractory germ-cell tumors. Ann Oncol 2015; 26:2507-8. [PMID: 26487577 DOI: 10.1093/annonc/mdv479] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Brammer JE, Khouri I, Gaballa S, Anderlini P, Tomuleasa C, Ahmed S, Ledesma C, Hosing C, Champlin RE, Ciurea SO. Outcomes of Haploidentical Stem Cell Transplantation for Lymphoma with Melphalan-Based Conditioning. Biol Blood Marrow Transplant 2015; 22:493-8. [PMID: 26497906 DOI: 10.1016/j.bbmt.2015.10.015] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [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: 08/11/2015] [Accepted: 10/08/2015] [Indexed: 11/18/2022]
Abstract
Haploidentical transplantation (Haplo-SCT) with post-transplantation cyclophosphamide (PTCy) is increasingly utilized for the treatment of lymphoma and almost exclusively with the nonmyeloablative fludarabine (Flu)/cyclophosphamide/total body irradiation (TBI) conditioning regimen. We present early results of a reduced-intensity (RIC) regimen utilizing fludarabine and melphalan (FM) for the treatment of advanced lymphoma. All patients with a diagnosis of lymphoma or chronic lymphocytic leukemia (CLL) who received Haplo-SCT at the University of Texas MD Anderson Cancer Center between 2009 and 2014 were reviewed (N = 22). Patients received Flu 160 mg/m(2) and melphalan 100 mg/m(2) to 140 mg/m(2) with thiotepa 5 mg/kg or 2 Gy TBI. Because of concerns of increased treatment-related mortality (TRM) with the melphalan 140 mg/m(2) regimen (FM140), a RIC regimen with melphalan 100 mg/m(2) (FM100) was devised. Rituximab was included for CD20(+) disease. Graft-versus-host disease prophylaxis consisted of PTCy 50 mg/kg on days +3 and + 4, tacrolimus, and mycophenolate mofetil. Sixty-eight percent of all patients were not in complete remission at the time of transplantation. The 2-year progression-free survival (PFS) and overall survival (OS) for the entire cohort were 54%, 1-year TRM was 19%, and the cumulative incidence of relapse at 2 years was 27%. Two-year PFS for Hodgkin lymphoma, non-Hodgkin lymphoma, and CLL/small lymphocytic lymphoma were 57%, 51%, and 75%. Patients treated with FM100 compared to FM140 had equivalent PFS (71% versus 37%, P = .246) and OS (71% versus 58%, P = .32). These early results establish Flu and melphalan 100 mg/m(2) with 2 Gy TBI or thiotepa 5 mg/kg as a very promising conditioning regimen for the treatment of advanced lymphoma with Haplo-SCT and PTCy.
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Affiliation(s)
- Jonathan E Brammer
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, Texas.
| | - Issa Khouri
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sameh Gaballa
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Paolo Anderlini
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ciprian Tomuleasa
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sairah Ahmed
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Celina Ledesma
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Chitra Hosing
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Richard E Champlin
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Stefan O Ciurea
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, Texas
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Nieto Y, Tu SM, Bassett R, Jones RB, Gulbis AM, Tannir N, Kingham A, Ledesma C, Margolin K, Holmberg L, Champlin R, Pagliaro L. Bevacizumab/high-dose chemotherapy with autologous stem-cell transplant for poor-risk relapsed or refractory germ-cell tumors. Ann Oncol 2015. [PMID: 26199392 DOI: 10.1093/annonc/mdv310] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND High-dose chemotherapy (HDC) using sequential cycles of carboplatin/etoposide is curative for relapsed germ-cell tumors (GCT). However, outcomes of high-risk patients in advanced relapse remain poor. We previously developed a new HDC regimen combining infusional gemcitabine with docetaxel/melphalan/carboplatin (GemDMC), with preliminary high activity in refractory GCT. Given the high vascular endothelial growth factor expression in metastatic GCT and the synergy between bevacizumab and chemotherapy, we studied concurrent bevacizumab and sequential HDC using GemDMC and ifosfamide/carboplatin/etoposide (ICE) in patients with poor-risk relapsed or refractory disease. PATIENTS AND METHODS Eligibility criteria included intermediate/high-risk relapse (Beyer Model), serum creatinine ≤ 1.8 mg/dl and adequate pulmonary/cardiac/hepatic function. Patients received sequential HDC cycles with bevacizumab preceding GemDMC (cycle 1) and ICE (cycle 2). The trial was powered to distinguish a target 50% 2-year relapse-free survival (RFS) from an expected 25% 2-year RFS in this population. RESULTS We enrolled 43 male patients, median age 30 (20-49) years, with absolute refractory (N = 20), refractory (N = 17) or cisplatin-sensitive (N = 6) disease, after a median 3 (1-5) prior relapses. Disease status right before HDC was unresponsive (N = 24, progressive disease 22, stable disease 2), partial response with positive markers (PRm(+)) (N = 8), PRm(-) (N = 7) or complete response (N = 4). Main toxicities were mucositis and renal. Four patients (three with baseline marginal renal function) died from HDC-related complications. Tumor markers normalized in 85% patients. Resection of residual lesions (N = 13) showed necrosis (N = 4), mature teratoma (N = 2), necrosis/teratoma (N = 3) and viable tumor (N = 4). At median follow-up of 46 (9-84) months, the RFS and overall survival rates are 55.8% and 58.1%, respectively. CONCLUSIONS Sequential bevacizumab/GemDMC-bevacizumab/ICE shows encouraging outcomes in heavily pretreated and refractory GCT, exceeding the results expected in this difficult to treat population. CLINICALTRIALSGOV NCT00936936.
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Affiliation(s)
- Y Nieto
- Department of Stem Cell Transplantation and Cellular Therapy
| | - S-M Tu
- Department of Genitourinary Medical Oncology
| | | | - R B Jones
- Department of Stem Cell Transplantation and Cellular Therapy
| | - A M Gulbis
- Department of Pharmacy, University of Texas MD Anderson Cancer Center, Houston
| | - N Tannir
- Department of Genitourinary Medical Oncology
| | - A Kingham
- Department of Stem Cell Transplantation and Cellular Therapy
| | - C Ledesma
- Department of Stem Cell Transplantation and Cellular Therapy
| | - K Margolin
- Department of Medical Oncology, Fred Hutchinson Cancer Research Center, Seattle, USA
| | - L Holmberg
- Department of Medical Oncology, Fred Hutchinson Cancer Research Center, Seattle, USA
| | - R Champlin
- Department of Stem Cell Transplantation and Cellular Therapy
| | - L Pagliaro
- Department of Genitourinary Medical Oncology
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Sanguinetti JM, Lotero Polesel JC, Iriarte SM, Ledesma C, Canseco Fuentes SE, Caro LE. Informed consent in colonoscopy: A comparative analysis of 2 methods. Rev Gastroenterol Mex 2015; 80:144-9. [PMID: 26021940 DOI: 10.1016/j.rgmx.2015.03.001] [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] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 03/25/2015] [Accepted: 03/27/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND The manner in which informed consent is obtained varies. The aim of this study is to evaluate the level of knowledge about colonoscopy and comparing 2 methods of obtaining informed consent. MATERIALS AND METHODS A comparative, cross-sectional, observational study was conducted on patients that underwent colonoscopy in a public hospital (Group A) and in a private hospital (Group B). Group A received information verbally from a physician, as well as in the form of printed material, and Group B only received printed material. A telephone survey was carried out one or 2 weeks later. RESULTS The study included a total of 176 subjects (group A [n=55] and group B [n=121]). As regards education level, 69.88% (n=123) of the patients had completed university education, 23.29% (n= 41) secondary level, 5.68% (n=10) primary level, and the remaining subjects (n=2) had not completed any level of education. All (100%) of the subjects knew the characteristics of the procedure, and 99.43% were aware of its benefits. A total of 97.7% received information about complications, 93.7% named some of them, and 25% (n=44) remembered major complications. All the subjects received, read, and signed the informed consent statement before the study. There were no differences between the groups with respect to knowledge of the characteristics and benefits of the procedure, or the receipt and reading of the consent form. Group B responded better in relation to complications (P=.0027) and group A had a better recollection of the major complications (P<.0001). Group A had a higher number of affirmative answers (P<.0001). CONCLUSIONS The combination of verbal and written information provides the patient with a more comprehensive level of knowledge about the procedure.
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Affiliation(s)
- J M Sanguinetti
- Instituto de Gastroenterología y Endoscopia Salta, Salta, Argentina; Universidad Nacional de Salta, Salta, Argentina.
| | - J C Lotero Polesel
- Instituto de Gastroenterología y Endoscopia Salta, Salta, Argentina; Hospital Militar Salta, Salta, Argentina
| | - S M Iriarte
- Hospital Militar Central, Buenos Aires, Argentina
| | - C Ledesma
- Hospital Militar Central, Buenos Aires, Argentina
| | | | - L E Caro
- GEDYT Gastroenterología Diagnóstica y Terapéutica, Buenos Aires, Argentina
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Sanguinetti J, Lotero Polesel J, Iriarte S, Ledesma C, Canseco Fuentes S, Caro L. Informed consent in colonoscopy: A comparative analysis of 2 modes. Revista de Gastroenterología de México (English Edition) 2015. [DOI: 10.1016/j.rgmxen.2015.03.004] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Anderlini P, Saliba R, Ledesma C, Chancoco CM, Alexander TR, Alousi AM, Hosing C, Khouri IF, Nieto Y, Popat UR, Shpall EJ, Fanale MA, Oki Y, Romaguera JE, Neelapu SS, Younes A, Champlin RE. Reduced-Intensity Conditioning and Allogeneic Stem Cell Transplantation For Relapsed/Refractory Hodgkin Lymphoma In The Brentuximab Vedotin Era. Biol Blood Marrow Transplant 2014. [DOI: 10.1016/j.bbmt.2013.12.086] [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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Jimenez-Candil J, Anguera I, Ledesma C, Rama JC, Fernandez-Portales J, Morinigo JL, Martin-Luengo C. The morphology of far-field electrograms: a new marker of ATP effectiveness. Results of a multicenter study. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p1386] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Poon L, Hamdi A, Saliba R, Rondon G, Ledesma C, Kendrick M, Qazilbash M, Hosing C, Jones RB, Popat UR, Nieto Y, Alousi A, Ciurea S, Shpall EJ, Champlin RE, Kebriaei P. Outcomes of adults with acute lymphoblastic leukemia relapsing after allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 2013; 19:1059-64. [PMID: 23644077 PMCID: PMC8439154 DOI: 10.1016/j.bbmt.2013.04.014] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [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: 02/12/2013] [Accepted: 04/16/2013] [Indexed: 11/24/2022]
Abstract
For patients with acute lymphoblastic leukemia (ALL) who relapse after allogeneic hematopoietic stem cell transplantation (HSCT), treatment options are limited, and the clinical course and prognostic factors affecting outcome have not been well characterized. We retrospectively analyzed outcomes of 123 adult patients with ALL who relapsed after a first HSCT performed at our center between 1993 and 2011. First-line salvage included second HSCT (n = 19), donor lymphocyte infusion with or without prior chemotherapy (n = 11), radiation therapy (n = 6), cytoreductive chemotherapy (n = 30), mild chemotherapy (n = 27), or palliative care (n = 23), with median postrelapse overall survival (OS) of 10 months, 6.5 months, 3 months, 4 months, 4 months, and 1 month, respectively. Despite a complete remission rate of 38% after first-line salvage in the treated patients, the OS rate remained limited with 1- and 2- year OS rates of 17% (95% confidence interval, 13 to 29) and 10% (95% confidence interval, 6 to 20), respectively. On univariate analysis, adverse factors for OS included active disease at the time of first HSCT and short time to progression from first HSCT (<6 months). There was no difference in the 6-month survival postrelapse in patients with isolated extramedullary relapse (44%) compared with combined extramedullary and bone marrow relapse (29%) or those with isolated bone marrow relapse (34%) (P = .8). Our data provide more insight into the disease behavior and treatment outcomes of ALL at relapse after HSCT against which future trials may be compared.
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Affiliation(s)
- L.M. Poon
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
- Department Of Hematology-Oncology, National University Cancer Institute, Singapore
| | - Amir Hamdi
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Rima Saliba
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Gabriela Rondon
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Celina Ledesma
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Monique Kendrick
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Muzaffar Qazilbash
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Chitra Hosing
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Roy B. Jones
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Uday R. Popat
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Yago Nieto
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Amin Alousi
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Stefan Ciurea
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Elizabeth J. Shpall
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Richard E. Champlin
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Partow Kebriaei
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
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Kebriaei P, Madden T, Wang X, Thall PF, Ledesma C, de Lima M, Shpall EJ, Hosing C, Qazilbash M, Popat U, Alousi A, Nieto Y, Champlin RE, Jones RB, Andersson BS. Intravenous BU plus Mel: an effective, chemotherapy-only transplant conditioning regimen in patients with ALL. Bone Marrow Transplant 2013; 48:26-31. [PMID: 22732703 PMCID: PMC4346146 DOI: 10.1038/bmt.2012.114] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [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: 02/28/2012] [Revised: 04/30/2012] [Accepted: 04/30/2012] [Indexed: 11/08/2022]
Abstract
We investigated the administration of i.v. BU combined with melphalan (Mel) in patients with ALL undergoing allogeneic hematopoietic SCT. Forty-seven patients with a median age of 33 years (range 20-61) received a matched sibling (n=27) or matched unrelated donor transplant (n=20) for ALL in first CR (n=26), second CR (n=13), or with more advanced disease (n=8). BU was infused daily for 4 days, either at a fixed dose of 130 mg/m² (5 patients) or using pharmacokinetic (PK) dose adjustment (42 patients), to target an average daily area-under-the-curve (AUC) of 5000 μmol/min, determined by a test dose of i.v. BU at 32 mg/m². This was followed by a rest day, then two daily doses of Mel at 70 mg/m². Stem cells were infused on the following day. The 2-year OS, PFS and non-relapse mortality (NRM) rates were 35% (95% confidence interval (CI), 23-51%), 31% (95% CI, 21-48%) and 37% (95% CI, 23-50%), respectively. Acute NRM at 100 days was favorable at 12% (95% CI, 5-24%); however, the 2-year NRM was significantly higher for patients older than 40 years, 58% vs 20%, mainly due to GVHD.
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Affiliation(s)
- P Kebriaei
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
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Kebriaei P, Basset R, Ledesma C, Ciurea S, Parmar S, Shpall EJ, Hosing C, Khouri I, Qazilbash M, Popat U, Alousi A, Nieto Y, Jones RB, de Lima M, Champlin RE, Andersson BS. Clofarabine combined with busulfan provides excellent disease control in adult patients with acute lymphoblastic leukemia undergoing allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 2012; 18:1819-26. [PMID: 22750645 PMCID: PMC4319530 DOI: 10.1016/j.bbmt.2012.06.010] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [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] [Received: 05/28/2012] [Accepted: 06/13/2012] [Indexed: 11/21/2022]
Abstract
We investigated the safety and early disease control data for i.v. busulfan (Bu) in combination with clofarabine (Clo) in patients with acute lymphoblastic leukemia undergoing allogeneic hematopoietic stem cell transplantation (SCT). Fifty-one patients (median age, 36 years; range, 20-64 years) received a matched sibling (n = 24), syngeneic (n = 2), or matched unrelated donor transplant (n = 25) for acute lymphoblastic leukemia in first complete remission (n = 30), second complete remission (n = 13), or active disease (n = 8). More than one-half of the patients had a high-risk cytogenetic profile, as defined by the presence of t(9;22) (n = 17), t(4;11) (n = 3), or complex cytogenetics (n = 7). Clo 40 mg/m(2) was given once daily, with each dose followed by pharmacokinetically dosed Bu infused over 3 hours daily for 4 days, followed by hematopoietic SCT 2 days later. The Bu dose was based on drug clearance, as determined by the patient's response to a 32-mg/m(2) Bu test dose given 48 hours before the high-dose regimen. The target daily area under the receiver-operating characteristic curve was 5500 μM/min for patients age <60 years and 4000 μM/min for those age ≥60 years. The regimen was well tolerated, with a 100-day nonrelapse mortality rate of 6%. With a median follow-up of 14 months among surviving patients (range, 6-28 months), the 1-year overall survival, disease-free survival, and nonrelapse mortality rates were 67% (95% confidence interval [CI], 55%-83%), 54% (95% CI, 41%-71%), and 32% (95% CI, 16%-45%), respectively. For patients undergoing SCT in first remission, these respective rates were 74%, 64%, and 25%. Our data indicate that the combination of Clo and Bu provides effective disease control while maintaining a favorable safety profile.
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Affiliation(s)
- Partow Kebriaei
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, USA.
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Anderlini P, Saliba R, Acholonu S, Okoroji GJ, Ledesma C, Andersson BS, Jones R, Popat UR, Hosing CM, Nieto Y, Qazilbash MH, Ueno NT, Giralt SA, de Lima MJ, Champlin RE. Donor leukocyte infusions in recurrent Hodgkin lymphoma following allogeneic stem cell transplant: 10-year experience at the M. D. Anderson Cancer Center. Leuk Lymphoma 2012; 53:1239-41. [PMID: 22132837 DOI: 10.3109/10428194.2011.644547] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Anderlini P, Saliba RM, Ledesma C, Chancoco C, Alousi AM, Shpall EJ, Popat UR, Hosing CM, Khouri IF, Nieto Y, Ciurea S, Younes A, Fanale MA, Acholonu S, Valverde R, Champlin RE. Gemcitabine, fludarabine and melphalan as a reduced-intensity conditioning regimen for allogeneic stem cell transplant in relapsed and refractory Hodgkin lymphoma: preliminary results. Leuk Lymphoma 2011; 53:499-502. [PMID: 21859247 DOI: 10.3109/10428194.2011.615427] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Andersson T, Magnusson A, Bryngelsson IL, Frobert O, Henriksson KM, Edvardsson N, Poci D, Polovina M, Potpara T, Licina M, Mujovic N, Kocijancic A, Simic D, Ostojic MC, Providencia RA, Botelho A, Trigo J, Nascimento J, Quintal N, Mota P, Leitao-Marques AM, Bosch RF, Kirch W, Rosin L, Willich SN, Pittrow D, Bonnemeier H, Valenza MC, Martin L, Munoz Casaubon T, Valenza G, Botella M, Serrano M, Valenza B, Cabrera I, Anderson K, Benzaquen BS, Koziolova N, Nikonova J, Shilova Y, Scherr D, Narayan S, Wright M, Krummen D, Jadidi A, Jais P, Haissaguerre M, Hocini M, Hunter R, Liu Y, Lu Y, Wang W, Schilling RJ, Bernstein S, Wong B, Rooke R, Vasquez C, Shah R, Rosenberg S, Chinitz L, Morley G, Bashir Choudhary M, Holmqvist F, Carlson J, Nilsson HJ, Platonov PG, Jadidi AS, Cochet H, Miyazaki S, Shah AJ, Scherr D, Marrouche N, Haissaguerre M, Jais P, Calvo N, Nadal M, Andreu D, Tamborero D, Diaz FE, Berruezo A, Brugada J, Mont L, Fichtner S, Hessling G, Estner HL, Jilek C, Reents T, Ammar S, Wu J, Deisenhofer I, Nakanishi H, Kashiwase K, Hirata A, Wada M, Ueda Y, Skoda J, Neuzil P, Popelova J, Petru J, Sediva L, Lavergne T, Le Heuzey JY, Mousseaux E, Hersi A, Alhabib K, Alfaleh H, Sulaiman K, Almahmeed W, Alsuwidi J, Amin H, Reddy VY, Almotarreb A, Pang HWK, Redfearn DP, Simpson CS, Michael K, Pereira EJ, Munt PW, Fitzpatrick MF, Baranchuk A, Revishvili AS, Uldry L, Simonyan G, Dzhordzhikiya T, Sopov O, Kalinin V, Locati ET, Vecchi AM, Cattafi G, Sachero A, Lunati M, Sayah S, Forclaz A, Alizadeh A, Nazari N, Hekmat M, Moradi M, Zeighami M, Ghanji H, Suzuki K, Takagi M, Maeda K, Tatsumi H, Virag N, Gomes C, Meireles A, Anjo D, Roque C, Vieira P, Lagarto V, Reis H, Torres S, Toth A, Vago H, Hocini M, Takacs P, Edes E, Marki A, Balazs GY, Huttl K, Merkely B, Lainis F, Buckley MM, Johns EJ, Seifer CM, Vesin JM, Daba L, Liebrecht K, Pietrucha AZ, Borowiec A, Mroczek-Czernecka D, Bzukala I, Wnuk M, Piwowarska W, Nessler J, Toquero Ramos J, Jais P, Perez Pereira E, Mitroi C, Castro Urda V, Fernandez Villanueva JM, Corona Figueroa A, Hernandez Reina L, Fernandez Lozano I, Bartoletti A, Bocconcelli P, Giuli S, Kappenberger L, Massa R, Svetlich C, Tarsi G, Tronconi F, Vitale E, Pietrucha AZ, Bzukala I, Wnuk M, Stryjewski P, Konduracka E, Haissaguerre M, Wegrzynowska M, Kruszelnicka O, Nessler J, Lousinha A, Labandeiro J, Antunes E, Silva S, Alves S, Timoteo A, Oliveira M, Sehra R, Cruz Ferreira R, Pietrucha AZ, Wnuk M, Jedrzejczyk-Spaho J, Bzukala I, Kruszelnicka O, Wegrzynowska M, Piwowarska W, Nessler J, Krummen D, Briggs C, Rappel WJ, Narayan S, Sediva L, Neuzil P, Petru J, Skoda J, Janotka M, Chovanec M, Yamashiro K, Takami K, Sakamoto Y, Satoh K, Suzuki T, Nakagawa H, Romanov A, Pokushalov E, Artemenko S, Shabanov V, Stenin I, Elesin D, Turov A, Yakubov A, Hioki M, Matsuo S, Ito K, Narui R, Yamashita S, Sugimoto K, Yoshimura M, Yamane T, Pokushalov E, Romanov A, Artemenko S, Shabanov V, Elesin D, Stenin I, Turov A, Yakubov A, Miyazaki S, Shah AJ, Hocini M, Jais P, Haissaguerre M, Di Biase L, Gallinghouse JD, Rajappan K, Kautzner J, Dello Russo A, Tondo C, Lorgat F, Natale A, Balta O, Buenz K, Paessler M, Anders H, Horlitz M, Deneke T, Lickfett L, Liberman I, Linhart M, Andrie R, Mittmann-Braun E, Stockigt F, Nickenig G, Schrickel J, Tilz R, Rillig A, Feige B, Metzner A, Fuernkranz A, Burchard A, Wissner E, Ouyang F, Betts TR, Jones MA, Wong KCK, Qureshi N, Bashir Y, Rajappan K, Romanov A, Pokushalov E, Corbucci G, Artemenko S, Shabanov V, Turov A, Losik D, Selina V, Crandall MA, Daniels C, Daoud E, Kalbfleisch S, Yamaji H, Murakami T, Kawamura H, Murakami M, Hina K, Kusachi S, Dakos G, Vassilikos V, Paraskevaidis S, Mantziari A, Theophylogiannakos S, Chouvarda I, Chatzizisis I, Styliadis I, Kimura T, Fukumoto K, Nishiyama N, Aizawa Y, Fukuda Y, Sato T, Miyoshi S, Takatsuki S, Navarrete Casas AJ, Ali I, Conte FC, Moran M, Graham BG, Kalejs O, Lacis R, Stradins P, Koris A, Putnins I, Vikmane M, Lejnieks A, Erglis A, Estrada A, Perez Silva A, Castrejon S, Doiny D, Merino JL, Baranchuk A, Greiss I, Simpson CS, Abdollah H, Redfearn DP, Buys-Topart M, Nitzsche R, Thibault B, Deisenhofer I, Reents T, Ammar S, Fichtner S, Kathan S, Kolb C, Hessling G, Reif S, Schade S, Taggeselle J, Frey A, Birkenhagen A, Kohler S, Schmidt M, Cano Perez O, Buendia F, Igual B, Osca JM, Sanchez JM, Sancho-Tello MJ, Olague JM, Salvador A, Calvo N, Tolosana JM, Fernandez-Armenta J, Matas M, Barbarin MC, Berruezo A, Brugada J, Mont L, Habibovic M, Van Den Broek KC, Theuns DAMJ, Jordaens L, Alings M, Van Der Voort PH, Pedersen SS, Pupita G, Molini S, Brambatti M, Capucci A, Molodykh S, Idov EM, Belyaev OV, Segreti L, Soldati E, Zucchelli G, Di Cori A, Viani S, Paperini L, De Lucia R, Bongiorni MG, Binner L, Taborsky M, Bello D, Heuer H, Ramza B, Jenniskens I, Johnson WB, Silvetti MS, Rava' L, Russo MS, Di Mambro C, Ammirati A, Gimigliano G, Prosperi M, Drago F, Santos AR, Picarra B, Semedo P, Dionisio P, Matos R, Leitao M, Jacinto A, Trinca M, Mazzone P, Ciconte G, Marzi A, Paglino G, Vergara P, Sora N, Gulletta S, Della Bella P, Koppitz P, Fach A, Hobbiesiefken S, Fiehn E, Hambrecht R, Sperzel J, Jung M, Schmitt J, Pajitnev D, Burger H, Burger H, Goebel G, Ehrlich W, Walther T, Ziegelhoeffer T, Vancura V, Wichterle D, Melenovsky V, Kautzner J, Glikson M, Goldenberg G, Segev A, Dvir D, Kuzniec J, Finkelstein A, Hay I, Guetta V, Choo WK, Gupta S, Kirkfeldt R, Johansen J, Nohr E, Moller M, Arnsbo P, Nielsen J, Santos AR, Picarra B, Semedo P, Dionisio P, Matos R, Leitao M, Banha M, Trinca M, Stojanov P, Raspopovic S, Vasic D, Savic D, Nikcevic G, Jovanovic V, Defaye P, Mondesert B, Mbaye A, Cassagneau R, Gagniere V, Jacon J, Sanfins V, Reis HR, Nobre JN, Martins VM, Duarte LD, Morais CM, Conceicao JC, Hero M, Rey JL, Thibault B, Ducharme A, Simpson C, Stuglin C, Blier L, Senaratne M, Khaykin Y, Pinter A, Mlynarska A, Mlynarski R, Sosnowski M, Wilczek J, Iorgulescu C, Bogdan S, Constantinescu D, Caldararu C, Dorobantu M, Radu A, Vatasescu RG, Yusu S, Ikeda T, Mera H, Miwa Y, Abe A, Miyakoshi M, Tsukada T, Yoshino H, Nayar V, Cantelon P, Rawling A, Belham MRD, Pugh PJ, Osca Asensi J, Sanchez JM, Cano O, Tejada D, Munoz B, Rodriguez M, Sancho-Tello MJ, Olague J, Wecke L, Van Hunnik A, Thompson T, Di Carlo L, Zdeblick M, Auricchio A, Prinzen F, Doltra Magarolas A, Bijnens B, Silva E, Penela D, Mont L, Tolosana JM, Brugada J, Sitges M, Ofman P, Navaravong L, Leng J, Peralta A, Hoffmeister P, Levine R, Cook J, Stoenescu M, Tettamanti ME, Revilla Orodea A, Lopez Diaz J, De La Fuente Galan L, Arnold R, Garcia Moran E, San Roman Calvar JA, Gomez Salvador I, Nakamura K, Takami M, Keida T, Mesato A, Higa S, Shimabukuro M, Masuzaki H, Proietti R, Sagone A, Domenichini G, Burri H, Valzania C, Biffi M, Sunthorn H, Gavaruzzi G, Foulkes H, Boriani G, Koh S, Hou W, Rosenberg S, Snell J, Poore J, Dalal N, Bornzin G, Kloppe A, Mijic D, Bogossian H, Ninios I, Zarse M, Lemke B, Guedon-Moreau L, Kouakam C, Klug D, Marquie C, Ziglio F, Kacet S, Mohamed Fereig Hamed H, Hamdy AMAL, Abd El Aziz AHMED, Nabih MRVAT, Hamdy REHAB, Yaminisaharif A, Davoudi GH, Kasemisaeid A, Sadeghian S, Vasheghani Farahani A, Yazdanifard P, Shafiee A, Alonso C, Grimard C, Jauvert G, Lazarus A, Fernandez-Armenta J, Berruezo A, Mont LL, Sitges M, Andreu D, Ortiz-Perez J, Caralt T, Brugada J, Escudero J, Perez F, Griffith KM, Ferreyra R, Urena P, Demas M, Muratore C, Mazzetti H, Guardado J, Sanfins V, Fernandes M, Pereira VH, Canario-Almeida F, Ferreira F, Rodrigues B, Almeida J, Sokal A, Jedrzejczyk E, Lenarczyk R, Pluta S, Kowalski O, Pruszkowska P, Swiatkowski A, Kalarus Z, Heinke M, Ismer B, Kuehnert H, Heinke T, Surber R, Osypka N, Prochnau D, Figulla HR, Iacopino S, Landolina M, Proclemer A, Padeletti L, Calvi V, Pierantozzi A, Di Stefano P, Boriani G, Bauer A, Bode F, Le Gal F, Deharo JC, Delay M, Nitzsche R, Clementy J, Kawamura M, Munetsugu Y, Tanno K, Kobayashi Y, Cannom D, Hosoda J, Ishikawa T, Andoh K, Nobuyoshi M, Fujii S, Shizuta S, Kimura T, Isshiki T, Castel MA, Tolosana JM, Perez-Villa F, Mont L, Sitges M, Vidal B, Brugada J, Pluta S, Lenarczyk R, Kowalski O, Pruszkowska-Skrzep P, Sokal A, Szulik M, Kukulski T, Kalarus Z, Gianfranchi L, Bettiol K, Pacchioni F, Alboni P, Abu Sham'a R, Buber J, Nof E, Kuperstein R, Feinberg M, Luria D, Eldar M, Glikson M, Parks K, Stone JR, Singh JP, Hatzinikolaou-Kotsakou E, Kotsakou M, Beleveslis TH, Moschos G, Reppas E, Latsios P, Tsakiridis K, Kazemisaeid A, Davoodi G, Yamini Sharif A, Sadeghian S, Sheikhvatan M, Toniolo M, Zanotto G, Rossi A, Tomasi L, Vassanelli C, Versteeg H, Van Den Broek KC, Theuns DAMJ, Mommersteeg PMC, Alings M, Van Der Voort PH, Jordaens L, Pedersen SS, Vergara G, Blauer J, Ranjan R, Vijayakumar S, Kholmovski E, Volland N, Macleod R, Marrouche N, Aguinaga Arrascue LE, Bravo A, Garcia Freire P, Gallardo P, Hasbani E, Dantur J, Quintana R, Adragao PP, Cavaco D, Parreira L, Reis Santos K, Carmo P, Miranda R, Marcelino S, Cabrita D, Sommer P, Gaspar T, Rolf S, Arya A, Piorkowski C, Hindricks G, Valles Gras E, Bazan V, Portillo L, Suarez F, Bruguera J, Marti J, Huo Y, Arya A, Richter S, Schoenbauer R, Sommer P, Hindricks G, Piorkowski C, Rivas N, Casaldaliga J, Roca I, Dos L, Perez-Rodon J, Pijuan A, Garcia-Dorado D, Moya A, Carter HB, Garg A, Hegrenes J, Sih HJ, Teplitsky LR, Kuroki K, Tada H, Seo Y, Ishizu T, Igawa M, Sekiguchi Y, Kuga K, Aonuma K, Rodriguez A C, Mejias J, Hidalgo P, Hidalgo L JA, Orczykowski M, Derejko P, Walczak F, Szufladowicz E, Urbanek P, Bodalski R, Bieganowska K, Szumowski L, Peichl P, Wichterle D, Cihak R, Skalsky I, Kautzner J, Kubus P, Vit P, Zaoral L, Peichl P, Gebauer RA, Fiala M, Janousek J, Hiroshima K, Goya M, Ohe M, Hayashi K, Makihara Y, Nagashima M, An Y, Nobuyoshi M, Schloesser M, Lawrenz T, Meyer Zu Vilsendorf D, Strunk-Mueller C, Stellbrink C, Papagiannis J, Avramidis D, Kokkinakis C, Kirvassilis G, Eidelman G, Arenal A, Datino T, Atienza F, Gonzalez Torrecilla E, Miracle A, Hernandez J, Fernandez Aviles F, Ene E, Caldararu C, Iorgulescu C, Dorobantu M, Vatasescu RG, Insulander P, Bastani H, Braunschweig F, Drca N, Kenneback G, Schwieler J, Tapanainen J, Jensen-Urstad M, Andrea B, Andrea EMA, Maciel WM, Siqueira LS, Cosenza RC, Mittidieri FM, Farah SF, Atie JA, Kanoupakis E, Kallergis E, Mavrakis H, Goudis C, Saloustros I, Malliaraki N, Chlouverakis G, Vardas P, Bonnes JL, Jaspers Focks J, Westra SW, Brouwer MA, Smeets JLRM, Inama G, Pedrinazzi C, Landolina M, Oliva F, Senni M, Proclemer A, Zoni Berisso M, Mostov S, Haim M, Nevzorov R, Hasadi D, Starsberg B, Porter A, Kuschyk J, Schoene A, Streitner F, Veltmann CG, Schimpf R, Borggrefe M, Luesebrink U, Gardiwal A, Oswald H, Koenig T, Duncker D, Klein G, Bastiaenen R, Batchvarov V, Atty O, Cheng JH, Behr ER, Gallagher MM, Starrenburg AH, Kraaier K, Pedersen SS, Scholten MF, Van Der Palen J, Adhya S, Smith LA, Zhao T, Bannister C, Kamdar RH, Martinelli M, Siqueira S, Greco R, Nishioka SAD, Pedrosa AAA, Alkmim-Teixeira R, Peixoto GL, Costa R, Pedersen SS, Versteeg H, Nielsen JC, Mortensen PT, Johansen JB, Kwasniewski W, Filipecki A, Urbanczyk-Swic D, Orszulak W, Trusz - Gluza M, Jimenez-Candil J, Hernandez J, Morinigo J, Ledesma C, Martin-Luengo C, Vogtmann T, Gomer M, Stiller S, Kuehlkamp V, Zach G, Loescher S, Kespohl S, Baumann G, Snell JD, Korsun N, Rooke R, Snell JR, Morley B, Bharmi R, Nabutovsky Y, Mollerus M, Naslund L, Meyer A, Lipinski M, Libey B, Dornfeld K, Jimenez-Candil J, Hernandez J, Martin A, Gallego M, Morinigo J, Ledesma C, Martin-Luengo C, De Bie MK, Van Rees JB, Borleffs CJ, Thijssen J, Jukema JW, Schalij MJ, Van Erven L, Van Der Velde ET, Witteman TA, Foeken H, Van Erven L, Schalij MJ, Szili-Torok T, Akca F, Caliskan K, Ten Cate F, Jordaens L, Michels M, Cozma DC, Petrescu L, Mornos C, Dragulescu SI, Groeneweg JA, Velthuis BK, Cox MGPJ, Loh P, Dooijes D, Cramer MJ, De Bakker JMT, Hauer RNW, Park SD, Shin SH, Woo SI, Kwan J, Park KS, Kim DH, Kwan J, Iorio A, Vitali Serdoz L, Brun F, Daleffe E, Zecchin M, Dal Ferro M, Santangelo S, Sinagra GF, Ouali S, Hammemi R, Hammas S, Kacem S, Gribaa R, Neffeti E, Remedi F, Boughzela E, Korantzopoulos P, Letsas K, Christogiannis Z, Kalantzi K, Ntorkos A, Goudevenos J, Foley PWX, Yung L, Barnes E, Munetsugu Y, Tanno K, Kikuchi M, Ito H, Miyoshi F, Kawamura M, Kobayashi Y, Pecini R, Marott JM, Jensen GB, Theilade J, Mine T, Kodani T, Masuyama T, Mozos IM, Serban C, Costea C, Susan L, Barthel P, Mueller A, Malik M, Schmidt G, Schmidt G, Barthel P, Mueller A, Malik M, Karakurt O, Kilic H, Munevver Sari DR, Mroczek-Czernecka D, Pietrucha AZ, Borowiec A, Wnuk M, Bzukala I, Kruszelnicka O, Konduracka E, Nessler J, Kikuchi Y, Meireles A, Gomes C, Anjo D, Roque C, Pinheiro Vieira A, Lagarto V, Hipolito Reis A, Torres S, Nof E, Miller L, Kuperstein R, Eldar M, Glikson M, Luria D, Vedrenne G, Bruguiere E, Redheuil A. Poster Session 2. Europace 2011. [DOI: 10.1093/europace/eur222] [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: 11/15/2022] Open
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Tada H, Yamasaki H, Sekiguchi Y, Igarashi M, Kuroki K, Machino T, Yoshida K, Aonuma K, Heinzel FR, Forstner H, Lercher P, Bisping E, Rotman B, Fruhwald FM, Pieske BM, Dabrowski R, Kowalik I, Borowiec A, Smolis-Bak E, Trybuch A, Sosnowski C, Szwed H, Baturova MA, Lindgren A, Shubik YV, Olsson B, Platonov PG, Van Den Broek KC, Denollet J, Widdershoven J, Kupper N, Allam R, Allam RAGAB, Galal WAGDY, El-Damnhoury HAYAM, Mortada AYMAN, Jimenez-Candil J, Martin A, Hernandez J, Martin F, Gallego M, Martin-Luengo C, Quintanilla JG, Moreno Planas J, Molina-Morua R, Archondo T, Garcia-Torrent MJ, Perez-Castellano N, Macaya C, Perez-Villacastin J, Saiz J, Tobon C, Rodriguez JF, Hornero F, Ferrero JM, Ito K, Date T, Kawai M, Hioki M, Narui R, Matsuo S, Yoshimura M, Yamane T, Tabatabaei N, Lin G, Powell BD, Smairat R, Glockner JF, Brady PA, Fichtner S, Czudnochowsky U, Estner H, Reents T, Jilek C, Ammar S, Hessling G, Deisenhofer I, Shah DC, Kautzner J, Saoudi N, Herrera C, Jais P, Hindricks G, Neuzil P, Kuck KH, Wong KCK, Jones M, Qureshi N, Muthumala A, Betts TR, Bashir Y, Rajappan K, Vogtmann T, Wagner M, Schurig J, Hein P, Hamm B, Baumann G, Lembcke A, Saad B, Piwowarska W, Nessler J, Edvardsson N, Rieger G, Garutti C, Linker N, Jorge C, Silva Marques J, Veiga A, Cruz J, Slater C, Correia MJ, Sousa J, Miltenberger-Miltenyi G, Nunes Diogo A, Matic D, Mrdovic I, Stankovic G, Asanin M, Antonijevic N, Matic M, Oliveira LA, Kocev N, Vasiljevic Z, Ramirez-Marrero MA, Perez-Villardon B, Delgado-Prieto JL, Jimenez-Navarro M, De Teresa-Galvan E, De Mora-Martin M, Pietrucha AZ, Bzukala I, Elias R, Sztefko K, Wnuk M, Malek A, Piwowarska W, Nessler J, Szili-Torok T, Bauernfeind T, De Groot N, Shalganov T, Schalij M, Camiletti A, Jordaens L, Rivas N, Casaldaliga J, Roca I, Pijuan A, Perez-Rodon J, Dos L, Garcia-Dorado D, Moya A, Baruteau AE, Moura D, Behaghel A, Chatel S, Mabo P, Schott JJ, Daubert JC, Le Marec H, Probst V, Zorio Grima E, Navarro-Manchon J, Molina P, Maldonado P, Igual B, Cano O, Bermejo M, Giner J, Salvador A, Bourgonje VJA, Vos MA, Ozdemir S, Doisne N, Van Der Heyden MAG, Camanho LE, Van Veen AAB, Sipido K, Antoons G, Altieri PI, Escobales N, Crespo M, Banchs HL, Sciarra L, Bloise R, Allocca G, Bulava A, Marras E, Lioy E, Delise P, Priori S, Calo' L, Hanis J, Sitek D, Novotny A, Chik WB, Lim TW, Choon HK, See VA, Mccall R, Thomas L, Ross DL, Thomas SP, Chen J, De Bortoli A, Rossvoll O, Hoff PI, Solheim E, Sun LZ, Schuster P, Ohm OJ, Ardashev AV, Zhelyakov E, Rybachenko MS, Konev AV, Belenkov YUN, Gunawardene M, Chun KRJ, Schulte-Hahn B, Windhorst V, Kulikoglu M, Nowak B, Schmidt B, Albina GA, Rivera RS, Scazzuso F, Laino RL, Giniger GA, Arbelo E, Calvo N, Tamborero D, Andreu D, Borras R, Berruezo A, Brugada J, Mont L, Stefan L, Eisenberger M, Celentano E, Peytchev P, Bodea O, Geelen P, De Potter T, Oliveira MM, Silva N, Cunha PS, Feliciano J, Lousinha A, Toste A, Santos S, Ferreira RC, Matsuda H, Harada T, Soejima K, Ishikawa Y, Mizukoshi K, Sasaki T, Mizuno K, Miyake F, Adragao PP, Cavaco D, Miranda R, Santos M, Morgado F, Reis Santos K, Candeias R, Marcelino S, Zoppo F, Grandolino G, Zerbo F, Bertaglia E, Schlueter SM, Grebe O, Vester EG, Miracle Blanco AL, Arenal Maiz A, Atienza Fernandez F, Datino Romaniega T, Gonzalez Torrecilla E, Eidelman G, Hernandez Hernandez J, Fernandez Aviles F, Fukumoto K, Takatsuki S, Kimura T, Nishiyama N, Aizawa Y, Sato T, Miyoshi S, Fukuda K, Richter B, Gwechenberger M, Socas A, Zorn G, Albinni S, Marx M, Wojta J, Goessinger H, Deneke T, Balta O, Paesler M, Buenz K, Anders H, Horlitz M, Muegge A, Shin DI, Natsuyama K, Yamaguchi KM, Nishida YN, De Bortoli A, Ohm OJ, Hoff PI, Solheim E, Schuster P, Sun LZ, Chen J, Kosiuk J, Bode K, Arya A, Piorkowski C, Gaspar T, Sommer P, Hindricks G, Bollmann A, Wichterle D, Peichl P, Simek J, Havranek S, Bulkova V, Cihak R, Kautzner J, Jurado Roman A, Salguero Bodes R, Lopez Gil M, Fontenla Cerezuela A, De Riva Silva M, Arribas Ynsaurriaga F, Fernandez Herranz AI, De Dios Perez S, Revishvili AS, Dishekov M, Tembotova Z, Barsamyan S, Vaccari D, Alvarenga C, Jesus I, Layher J, Takahashi A, Singh N, Siot P, Elkaim JP, Savelieva I, Mcclelland L, Lovegrove A, Jones S, Camm J, Folino AF, Breda R, Calzavara P, Comisso J, Borghetti F, Iliceto S, Buja G, Mlynarski R, Mlynarska A, Sosnowski M, Wilczek J, Mabo P, Carrault G, Bordachar P, Makdissi A, Duchemin L, Alonso C, Neri G, Masaro G, Vittadello S, Vaccari D, Gardin A, Barbetta A, Di Gregorio F, Sciaraffia E, Ginks MR, Gustafsson JS, Hollmark MC, Rinaldi CA, Blomstrom Lundqvist C, Brusich S, Tomasic D, Ferek-Petric B, Mavric Z, Kutarski A, Malecka B, Kolodzinska A, Grabowski M, Dovellini EV, Giurlani L, Cerisano G, Carrabba N, Valenti R, Antoniucci D, Kolodzinska A, Kutarski A, Grabowski M, Malecka B, Opolski G, Tomassoni G, Baker J, Corbisiero R, Martin D, Niazi I, Sheppard R, Sperzel J, Gutleben K, Petru J, Sediva L, Skoda J, Neuzil P, Mazzone P, Ciconte G, Vergara P, Marzi A, Paglino G, Sora N, Gulletta S, Della Bella P, Kutarski A, Pietura R, Czajkowski M, Cabanelas N, Martins VP, Alves M, Valente FX, Marta L, Francisco A, Silva R, Ferreira Da Silva G, Huo Y, Holmqvist F, Carlson J, Arya A, Wetzel U, Hindricks G, Bollmann A, Platonov P, Nof E, Abu Shama R, Kuperstein R, Feinberg MS, Eldar M, Glikson M, Luria D, Kubus P, Materna O, Gebauer RA, Matejka T, Gebauer R, Tlaskal T, Janousek J, Muessigbrodt A, Arya A, Wetzel U, Hindricks G, Richter S, Stockburger M, Boveda S, Defaye P, Stancak Branislav P, Kaliska G, Rolando M, Moreno J, Ohlow MAG, Lauer B, Buchter B, Schreiber M, Geller JC, Val-Mejias JE, Ouali S, Azzez S, Kacem S, Ben Salem H, Hammas S, Neffeti E, Remedi F, Boughzela E, Miyazaki H, Miyanaga S, Shibayama K, Tokuda M, Narui R, Kudo T, Yamane T, Yoshimura M, Coppola B, Shehada REN, Costandi P, Healey J, Hohnloser SH, Gold MR, Capucci A, Van Gelder IC, Carlson M, Lau CP, Connolly SJ, Bogaard MD, Leenders GE, Maskara B, Tuinenburg AE, Loh P, Hauer RN, Doevendans PA, Meine M, Thibault B, Dubuc M, Karst E, Ryu K, Paiement P, Farazi T, Puetz V, Berndt C, Buchholz J, Dorszewski A, Mornos C, Cozma D, Ionac A, Petrescu L, Mornos A, Pescariu S, Puetz V, Berndt C, Buchholz J, Dorszewski A, Benser M, Roscoe G, De Jong S, Roberts G, Boileau P, Rec A, Ryu K, Folman C, Morttada A, Abd El Kader M, Samir R, Roushdy R, Khaled S, Abo El Maaty M, Van Gelder B, Houthuizen P, Bracke FA, Osca Asensi J, Tejada D, Sanchez JM, Munoz B, Cano O, Rodriguez M, Sancho-Tello MJ, Olague J, Hou W, Rosenberg S, Koh S, Poore J, Snell J, Yang M, Nirav D, Bornzin G, Deering T, Dan D, Wickliffe AC, Cazeau S, Karimzadeh K, Mukerji S, Loghin C, Kantharia B, Bogaard MD, Leenders GE, Maskara B, Tuinenburg AE, Loh P, Hauer RN, Doevendans PA, Meine M, Betts TR, Jones MA, Wong KCK, Qureshi N, Rajappan K, Bashir Y, Lamba J, Simpson CS, Redfearn DP, Michael KA, Fitzpatrick M, Baranchuk A, Heinke M, Ismer B, Kuehnert H, Surber R, Haltenberger AM, Prochnau D, Figulla HR, Delarche N, Bizeau O, Couderc P, Chapelet A, Amara W, Lazarus A, Kubus P, Krupickova S, Gebauer RA, Janousek J, Van Deursen CJM, Strik M, Vernooy K, Van Hunnik A, Kuiper M, Crijns HJGM, Prinzen FW, Islam N, Gras D, Abraham W, Calo L, Birgersdotter-Green U, Clyne C, Herre J, Sheppard R, Abraham W, Gras D, Birgersdotter-Green U, Calo L, Clyne C, Klein N, Herre J, Sheppard R, Kowalski O, Lenarczyk R, Pruszkowska P, Sokal A, Kukulski T, Zielinska T, Pluta S, Kalarus Z, Schwab JO, Gasparini M, Anselme F, Clementy J, Santini M, Martinez Ferrer J, Burrone V, Santi E, Nevzorov R, Porter A, Kusniec J, Golovchiner G, Ben-Gal T, Strasberg B, Haim M, Rordorf R, Savastano S, Sanzo A, Vicentini A, Petracci B, De Amici M, Striuli L, Landolina M, Tolosana JM, Martin AM, Hernandez-Madrid A, Macias A, Fernandez-Lozano I, Osca J, Quesada A, Mont L, Igarashi M, Tada H, Yamasaki H, Sekiguchi Y, Kuroki K, Yoshida K, Noguchi Y, Aonuma K, Shahrzad S, Karim Soleiman N, Tavoosi A, Taban S, Emkanjoo Z, Fukunaga M, Goya M, Hiroshima K, Ohe M, Hayashi K, Iwabuchi M, Nosaka H, Nobuyoshi M, Doiny D, Perez-Silva A, Castrejon Castrejon S, Estrada A, Ortega M, Lopez-Sendon JL, Merino JL, Garcia Fernandez FJ, Gallardo R, Pachon M, Almendral J, Gonzalez Torrecilla E, Martin J, Yahya D, Al-Mogheer B, Gouda S, Eweis E, El Ramly M, Abdelwahab A, Kassenberg W, Wittkampf FHM, Hof IE, Heijden JH, Neven KGEJ, Meine M, Hauer RNW, Loh P, Baratto F, Bignami E, Pappalardo F, Maccabelli G, Nicolotti D, Zangrillo A, Della Bella P, Hayashi K, Goya M, Hiroshima K, Nagashima M, An Y, Fukunaga M, Okreglicki A, Russouw C, Tilz R, Yoshiga Y, Mathew S, Fuernkranz A, Rillig A, Wissner E, Kuck KH, Ouyang F, De Sisti A, Tonet J, Gueffaf F, Amara W, Touil F, Aouate P, Hidden-Lucet F, Doiny D, Castrejon Castrejon S, Estrada A, Ortega M, Perez-Silva A, Lopez-Sendon JL, Merino JL, Makimoto H, Satomi K, Yamada Y, Okamura H, Noda T, Shimizu W, Aihara N, Kamakura S, Estrada A, Perez Silva A, Doiny D, Castrejon S, Gonzalez Vasserot M, Merino JL, Tilz R, Senges J, Brachmann J, Andresen D, Hoffmann E, Schumacher B, Willems S, Kuck KH, Reents T, Deisenhofer I, Ammar S, Springer B, Fichtner S, Jilek C, Kolb C, Hessling G, Akca F, Bauernfeind T, De Groot NMS, Schwagten B, Witsenburg M, Jordaens L, Szili-Torok T, Hata Y, Nakagami R, Watanabe T, Sato A, Watanabe H, Kabutoya T, Mituhashi T, Theuns DAMJ, Smith T, Pedersen SS, Dabiri-Abkenari L, Jordaens L, Prull MW, Unverricht S, Bittlinsky A, Wirdemann H, Sasko B, Wirdeier S, Trappe HJ, Zorio Grima E, Rueda J, Medina P, Jaijo T, Sevilla T, Osca J, Arnau MA, Salvador A, Starrenburg AH, Kraaier K, Pedersen SS, Scholten MF, Van Der Palen J, De Haan S, Commandeur J, De Boer K, Beek AM, Van Rossum AC, Allaart CP, Berne P, Porres JM, Fernandez-Lozano I, Arnaiz JA, Mont L, Berruezo A, Brugada R, Brugada J, Man S, Maan AC, Thijssen J, Van Der Wall EE, Schalij MJ, Burattini L, Burattini R, Swenne CA, Bonny A, Hidden-Lucet F, Ditah I, Larrazet F, Frank R, Fontaine G, Van Den Broek KC, Pedersen SS, Theuns DAMJ, Jordaens L, Van Der Voort PH, Alings M, Denollet J, Shimane A, Okajima K, Kanda G, Yokoi K, Yamada S, Taniguchi Y, Hayashi T, Kajiya T, Santos MC, Wright J, Betts J, Denman R, Dominguez-Perez L, Arias Palomares MA, Toquero J, Jimenez-Candil J, Olague J, Diaz-Infante E, Tercedor L, Valverde I, Miracle Blanco AL, Datino Romaniega T, Arenal Maiz A, Atienza Fernandez F, Gonzalez Torrecilla E, Eidelman G, Hernandez Hernandez J, Fernandez Aviles F, Napp A, Joosten S, Stunder D, Zink M, Marx N, Schauerte P, Silny J, Trucco ME, Arce M, Palazzolo J, Femenia F, Glad JM, Szymkiewicz SJ, Glad JM, Szymkiewicz SJ, Fernandez-Armenta J, Camara O, Mont LL, Andreu D, Diaz E, Silva E, Frangi A, Berruezo A, Brembilla-Perrot B, Laporte F, Jimenez-Candil J, Martin A, Gallego M, Morinigo J, Ledesma C, Martin-Luengo C, Hadid C, Almendral J, Ortiz M, Quesada A, Wolpert C, Cobo E, Navarro X, Arribas F, Miki Y, Naitoh S, Kumagai K, Goto K, Kaseno K, Oshima S, Taniguchi K, Rivera S, Scazzuso F, Albina G, Klein A, Laino R, Sammartino V, Giniger A, Fukumoto K, Takatsuki S, Kimura T, Nishiyama N, Aizawa Y, Sato T, Miyoshi S, Fukuda K, Muggenthaler M, Raju H, Papadakis M, Chandra N, Bastiaenen R, Behr ER, Sharma S, Samniah N, Radezishvsky Y, Omari H, Rosenschein U, Perez Riera AR, Ferreira M, Hopman WM, Mcintyre WF, Baranchuk AR, Wongcharoen W, Keanprasit K, Phrommintikul A, Chaiwarith R, Yagishita A, Hachiya H, Nakamura T, Tanaka Y, Higuchi K, Kawabata M, Hirao K, Isobe M, Havranek S, Simek J, Wichterle D, Stoickov V, Ilic S, Deljanin Ilic M, Aagaard P, Sahlen A, Bergfeldt L, Braunschweig F, Sousa A, Lebreiro A, Sousa C, Oliveira S, Correia AS, Rangel I, Freitas J, Maciel MJ, Asensio Lafuente E, Aguilera AAC, Corral MACC, Mendoza KLMC, Nava PEND, Rendon ALRC, Villegas LVC, Castillo LCM, Schaerf R, Develle R, Brembilla-Perrot B, Oliver C, Zinzius PY, Providencia RA, Botelho A, Trigo J, Nascimento J, Quintal N, Mota P, Leitao-Marques AM, Borbola J, Abraham P, Foldesi CS, Kardos A, Miranda R, Almeida S, Santos MB, Cavaco D, Quaresma R, Morgado FB, Adragao P, Fatemi M, Didier R, Le Gal G, Etienne Y, Jobic Y, Gilard M, Boschat J, Mansourati J, Zubaid M, Rashed W, Alsheikh-Ali A, Almahmeed W, Shehab A, Sulaiman K, Asaad N, Amin H, Boersma LVA, Swaans M, Post M, Rensing B, Jarverud K, Broome M, Noren K, Svensson T, Hjelm S, Hollmark M, Bjorling A, Providencia RA, Botelho A, Trigo J, Nascimento J, Quintal N, Mota P, Leitao-Marques AM, Maeda K, Takagi M, Suzuki K, Tatsumi H, Yoshiyama M, Simeonidou E, Michalakeas C, Kastellanos S, Varounis C, Nikolopoulou A, Koniari C, Anastasiou-Nana M, Furukawa T, Maggi R, Bertolone C, Fontana D, Brignole M, Pietrucha AZ, Wnuk M, Bzukala I, Mroczek-Czernecka D, Konduracka E, Kruszelnicka O. Poster Session 4. Europace 2011. [DOI: 10.1093/europace/eur231] [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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Kebriaei P, Madden T, Kazerooni R, Wang X, Thall PF, Ledesma C, Nieto Y, Shpall EJ, Hosing C, Qazilbash M, Popat U, Khouri I, Champlin RE, Jones RB, Andersson BS. Intravenous busulfan plus melphalan is a highly effective, well-tolerated preparative regimen for autologous stem cell transplantation in patients with advanced lymphoid malignancies. Biol Blood Marrow Transplant 2010; 17:412-20. [PMID: 20674757 DOI: 10.1016/j.bbmt.2010.07.016] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2010] [Accepted: 07/20/2010] [Indexed: 11/27/2022]
Abstract
We investigated the administration of intravenous (i.v.) busulfan (Bu) combined with melphalan (Mel) in patients with advanced lymphoid malignancies undergoing autologous stem cell transplantation. Bu 130 mg/m(2) was infused daily for 4 days, either as a fixed dose per body surface area (BSA), or to target an average daily area under the curve of 5000 μmol-min, determined by a test dose of i.v. Bu at 32 mg/m(2) given 48 hours prior to the high-dose regimen, followed by a rest day, followed by 2 daily doses of Mel at 70 mg/m(2). Stem cells were infused the following day. Eighty patients had i.v. Bu delivered per test dose guidance. The median daily systemic Bu exposure was 4867 μmol-min. One hundred two patients (Hodgkin lymphoma n = 49, non-Hodgkin lymphoma n = 12, multiple myeloma = 41) with a median age of 44 years (range: 19-65 years) were treated. The 2-year overall survival and progression-free survival rates were 85% and 57%, respectively, for patients with Hodgkin lymphoma, 67% and 64%, respectively, for patients with non-Hodgkin lymphoma, and 82% and 42%, respectively, for patients with multiple myeloma. The regimen was very well tolerated with treatment-related mortality at 100 days, 1 year, and 2 years of 1%, 3%, and 3%, respectively. Intravenous Bu-Mel was well tolerated. Disease control wa encouraging, and should be explored in larger phase II studies.
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Affiliation(s)
- Partow Kebriaei
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030, USA.
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Jimenez-Candil J, Hernandez J, Martin A, Ruiz-Olgado M, Herrero J, Ledesma C, Morinigo J, Martin-Luengo C. Influence of beta-blocker therapy on antitachycardia pacing effectiveness for monomorphic ventricular tachycardias occurring in implantable cardioverter-defibrillator patients: a dose-dependent effect. Europace 2010; 12:1231-8. [DOI: 10.1093/europace/euq164] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [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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41
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Kwasniewski W, Filipecki A, Orszulak W, Urbanczyk D, Szydlo K, Trusz Gluza M, Borleffs CJW, Van Rees JB, Van Welsenes GH, Van Erven L, Van Bommel RJ, Van Der Velde ET, Bax JJ, Schalij MJ, Jimenez-Candil J, Ruiz M, Morinigo J, Martin A, Ledesma C, Martin-Luengo C, Cozar-Leon R, Diaz-Infante E, Prado-Gotor B, Nieto P, Maldonado J, Borrego I, Cruz JM, Satomi K, Yamada Y, Okamura H, Noda T, Shimizu W, Suyama K, Aihara N, Kamakura S, Hatzinikolaou-Kotsakou E, Moschos G, Beleveslis TH, Reppas E, Kotsakou M, Tsakiridis K, Nageh MF, Kim JJ, Yao J, Deering TF, Epstein A, Goldman D, Greenberg S, Dalal Y, Kreuz J, Balta O, Lickfett L, Nickenig G, Schwab J, Horlbeck FW, Bitzen A, Liliegren N, Jegorova A, Nickenig G, Schwab JO. Moderated Posters: Sudden cardiac death. Europace 2009. [DOI: 10.1093/europace/euq231] [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: 11/12/2022] Open
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42
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Abstract
Hemochromatosis is characterized by an excessive iron deposit in different tissues. Cardiac involvement may be observed in one third of the patients due to hemochromatosis and occurs as a consequence of ferritin accumulation in the heart which on one hand induces alterations in systolic and diastolic ventricular function and on the other hand, an arrythmogenic substrate. The clinical manifestations can be indistinctly related to atrial tachyarrhythmia, ventricular tachyarrhythmia, atrio-ventricular blockade and congestive heart failure, with the first being the most frequent. We present the case of one patient with secondary hemochromatosis to repeated transfusions due to sideroblastic anemia with cardiac involvement, whose initial heart manifestations were recurrent atrial tachyarrhythmia and sustained ventricular tachycardia with syncope for which an automatic defibrillator was implanted.
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Ledesma C, Garces M, Ibarra A, Portilla J, Hernandez JC. Ameloblastoma in Latin America. Analysis of 338 cases. Med Oral 2000; 5:254-260. [PMID: 11507562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Affiliation(s)
- C. Ledesma
- Patologia Bucal. Universidad Autonoma de Mexico. Mexico
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Abstract
Endocarditis related to pacemaker lead is a rare complication of permanent transvenous pacing, of which the diagnosis is carried out with the presence of verrucae in echocardiography and positive blood cultures, its treatment being mixed -medical and surgical- because the isolated medical treatment is rarely successful and the lead should be extracted. We present the case of recurrent endocarditis of several years of evolution, in the which it was not possible to extract of the electrode due to the special characteristics of the patiente (epicardial lead perforating into right atrial).
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Affiliation(s)
- J L Moríñigo
- Servicio de Cardiología, Hospital Clínico de Salamanca
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45
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Moríñigo JL, Sánchez PL, Arribas A, Ledesma C, Martín F, Martín Luengo C. [Atrial standstill and rheumatic mitral valvulopathy]. Rev Esp Cardiol 1999; 52:1159-61. [PMID: 10659665] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Atrial standstill is a very rare form of bradyarrhythmia and consists of a transitory or permanent loss of the electrical and mechanical activity of the atria. We report a series of 8 patients, all of them with rheumatic valve disease (5 of them with a prosthetic valve) with symptomatic bradyarrhythmia secondary to atrial standstill, requiring an implantable pacemaker.
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Affiliation(s)
- J L Moríñigo
- Servicio de Cardiología, Hospital Universitario de Salamanca
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46
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Ledesma C, Portilla J, Hernandez F, Garces M, Hernandez JC. Paraglandular ancient schwannoma. Med Oral 1999; 4:398-402. [PMID: 11507515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- C. Ledesma
- Patologia Bucal. Universidad Autonoma de Mexico. Mexico
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47
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Ledesma C, Garces M, Mosqueda A. Dentin dysplasia. Med Oral 1999; 4:351-354. [PMID: 11507509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- C. Ledesma
- Patologia Bucal. Universidad Autonoma de Mexico. Mexico
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Levy B, Portilla J, Leyva E, Gaitán L, Ledesma C. [Induction of "sterile" periapical lesions in rodents. Preliminary report]. Pract Odontol 1988; 9:11, 14-5, 18-9. [PMID: 3253728] [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: 01/04/2023]
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49
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Cabello JB, Castaño L, Ledesma C, Rufilanchas J. [Complex hydatid cyst of the myocardium with subpulmonary obstruction]. Rev Esp Cardiol 1988; 41:120-3. [PMID: 3368614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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50
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Moro Serrano C, Rufilanchas JJ, Tamargo J, Ledesma C, Novo L, Martín Luengo C. [Continuous automatic atrial tachycardia; electrophysiological and anatomic analysis of a successful surgical case]. Rev Esp Cardiol 1986; 39:344-8. [PMID: 3786901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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