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García-Noblejas A, Cannata-Ortiz J, Conde E, González Barca E, Gutiérrez N, Rojas R, Vidal MJ, Ramírez MJ, Jiménez-Ubieto A, García-Ruiz JC, Sancho JM, López A, Ríos Rull P, Novelli S, Albo C, Debén G, López-Guillermo A, Nicolás C, González de Villambrosia S, Mercadal S, Martín García-Sancho A, Arranz R. Autologous stem cell transplantation (ASCT) in patients with mantle cell lymphoma: a retrospective study of the Spanish lymphoma group (GELTAMO). Ann Hematol 2017; 96:1323-1330. [PMID: 28536895 DOI: 10.1007/s00277-017-2998-6] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 04/10/2017] [Indexed: 01/21/2023]
Abstract
Guidelines recommend autologous stem cell transplantation (ASCT) consolidation in first complete or partial response after regimens including rituximab (R) and high-dose AraC (HDAC), but its use beyond that response is questioned. We present a retrospective analysis of 268 patients with MCL who received ASCT. With a median follow-up for survival patients of 54 months, progression-free survival and overall survival for the whole series were 38 and 74 months, respectively, and for patients transplanted in first CR 49 and 97 months, respectively. Patients without CR before transplant were analyzed separately, those who achieved CR after transplantation had better PFS (48 vs 0.03 months, p < 0.001) and OS (92 vs 16 months, p < 0.001) than the remaining. In univariate analysis, first CR at transplant (p = 0.01) and prior rituximab (p = 0.02) were the variables associated with PFS. For OS, the same variables resulted significant (p = 0.03 and p < 0.001, respectively). In multivariate analysis, only the status at transplant (first CR) remained significant. This retrospective study concludes that ASCT consolidation in first CR induces high survival rates. In other stages of disease, the need of ASCT as consolidation may be questioned.
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Affiliation(s)
- A García-Noblejas
- Hospital Universitario La Princesa, Diego de Leon, 62, 28006, Madrid, Spain
| | - J Cannata-Ortiz
- Hospital Universitario La Princesa, Diego de Leon, 62, 28006, Madrid, Spain
| | - E Conde
- HU Marqués de Valdecilla, Santander, Spain
| | | | | | - R Rojas
- HU Reina Sofía, Córdoba, Spain
| | | | | | | | | | - J M Sancho
- H. Germans Trias i Pujol, Barcelona, Spain
| | - A López
- HU Vall d'Hebron, Barcelona, Spain
| | - P Ríos Rull
- HU Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain
| | | | - C Albo
- H Xeral-Cíes, Madrid, Spain
| | | | | | - C Nicolás
- HU Central de Asturias, Oviedo, Spain
| | | | - S Mercadal
- Instituto Catalán de Oncología, Barcelona, Spain
| | | | - R Arranz
- Hospital Universitario La Princesa, Diego de Leon, 62, 28006, Madrid, Spain.
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2
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Ramos F, Thépot S, Pleyer L, Maurillo L, Itzykson R, Bargay J, Stauder R, Venditti A, Seegers V, Martínez-Robles V, Burgstaller S, Récher C, Debén G, Gaidano G, Gardin C, Musto P, Greil R, Sánchez-Guijo F, Fenaux P. Azacitidine frontline therapy for unfit acute myeloid leukemia patients: clinical use and outcome prediction. Leuk Res 2014; 39:296-306. [PMID: 25601157 DOI: 10.1016/j.leukres.2014.12.013] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [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: 09/01/2014] [Revised: 11/02/2014] [Accepted: 12/22/2014] [Indexed: 01/03/2023]
Abstract
Hypomethylating agents are able to prolong the overall survival of some patients diagnosed with acute myeloid leukemia. The aim of this study was to evaluate the clinical use of azacitidine as front-line therapy in unfit acute myeloid leukemia (AML) patients and to develop a clinical prediction model to identify which patients may benefit more from the drug. One hundred and ten untreated unfit AML patients received front-line azacitidine therapy in Spain, and response and survival were evaluated in them following European LeukemiaNet (ELN) guidelines. A clinical prediction rule was obtained from this population that was validated and refined in 261 patients treated in France, Austria and Italy. ELN response was achieved in 21.0% of the 371 patients (CI95% 17.0-25.5) and did not depend on bone marrow blast cell percentage. Median overall survival was 9.6 months (CI95% 8.5-10.8) and 40.6% of the patients were alive at 1 year (CI95% 35.5-45.7). European ALMA score (E-ALMA), based on performance status, white blood cell counts at azacitidine onset and cytogenetics, discriminated three risk groups with different survival and response rates. Azacitidine seems a reasonable therapeutic option for most unfit AML patients, i.e. those displaying a favorable or intermediate E-ALMA score.
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Affiliation(s)
- F Ramos
- Department of Hematology, University Hospital, León, Spain; Institute of Biomedicine (IBIOMED), University of León, Spain.
| | - S Thépot
- Department of Blood Diseases/Hematology, CHU, Angers, France
| | - L Pleyer
- 3rd Med. Dept. with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Laboratory for Immunological and Molecular Cancer Research, Oncologic Center; Paracelsus Medical University Hospital Salzburg, Austria
| | - L Maurillo
- Department of Hematology, Tor Vergata Foundation Polyclinic, University of Rome, Italy
| | - R Itzykson
- Department of Hematology, Saint Louis Hospital Paris VII University (APHP), France
| | - J Bargay
- Department of Hematology, Son Llatzer Hospital, Palma de Mallorca, Spain
| | - R Stauder
- Department of Internal Medicine V (Hematology and Oncology), Innsbruck Medical University, Innsbruck, Austria
| | - A Venditti
- Department of Hematology, Tor Vergata Foundation Polyclinic, University of Rome, Italy
| | - V Seegers
- Department of Hematology, Avicenne Hospital, Paris XIII University (APHP), Bobigny, France
| | | | - S Burgstaller
- Department of Internal Medicine IV, Wels-Grieskirchen Hospital, Wels, Austria
| | - C Récher
- Department of Hematology, CHU, Toulouse, France
| | - G Debén
- Department of Hematology, University Hospital, A Coruña, Spain
| | - G Gaidano
- Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy
| | - C Gardin
- Department of Hematology, Avicenne Hospital, Paris XIII University (APHP), Bobigny, France
| | - P Musto
- Scientific Direction, IRCCS; Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - R Greil
- 3rd Med. Dept. with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Laboratory for Immunological and Molecular Cancer Research, Oncologic Center; Paracelsus Medical University Hospital Salzburg, Austria
| | - F Sánchez-Guijo
- Department of Hematology, University Hospital, Salamanca, Spain
| | - P Fenaux
- Department of Hematology, Saint Louis Hospital Paris VII University (APHP), France
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3
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Jarque I, Tormo M, Bello JL, Rovira M, Batlle M, Julià A, Tabares S, Rivas C, Fernández-Sevilla A, García-Boyero R, Debén G, González-Campos J, Capote FJ, Sanz MA. Caspofungin for the treatment of invasive fungal disease in hematological patients (ProCAS Study). Med Mycol 2013; 51:150-4. [DOI: 10.3109/13693786.2012.693213] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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4
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Pastor MA, Vasco B, Mosquera JM, Debén G, Bautista P, Requena L. Dos enfermedades relacionadas con el VHH-8 en un paciente VIH-negativo: sarcoma de Kaposi y enfermedad de Castleman multicéntrica. Respuesta a tratamiento con rituximab y CHOP. Actas Dermo-Sifiliográficas 2006; 97:385-90. [PMID: 16956518 DOI: 10.1016/s0001-7310(06)73425-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Human herpes virus 8 (HHV8) was discovered in 1994 in the biopsy of a Kaposi's sarcoma in a patient with AIDS. Since then it has been identified in all variants of Kaposi's sarcoma and in another two rare disorders: multicentric Castleman's disease and primary body-cavity based lymphomas. The case discusses a 68 year old, HIV-negative male patient, presenting Kaposi's sarcoma for one year and being monitored by dermatology, who presented for weakness, anorexia and fever. On examination, he was found to have adenitis of the lymph nodes in his neck, underarm and groin. A biopsy on one of the swellings led to findings characteristic of multicentric plasma cell variant Castleman's disease. Blood tests for HHV8 and HIV were carried out, resulting positive and negative respectively (IgG anti-HHV8 positive, title 1/640, indirect immunofluorescence). PCR amplification showed HHV8 in peripheral blood. Patient received 8 cycles of CHOP and rituximab, leading to complete disappearance of the adenitis and general symptoms, with no worsening of his Kaposi's sarcoma. Patient remained in complete remission for 10 months after treatment. This paper discusses the case of a HIV-, HHV8+ patient, diagnosed with classic Kaposi's sarcoma, who developed multicentric plasma cell variant Castleman's disease. The coincidence of two or more HHV8-related illnesses in a HIV-negative patient has rarely been described in medical literature. Treatment with rituximab combined with CHOP chemotherapy was effective in this case, and no worsening of the patient's KS was observed.
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Affiliation(s)
- M A Pastor
- Servicio de Dermatología, Hospital Santa Bárbara, Puertollano, España.
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5
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Sanz MA, Martin G, Rayón C, Debén G, Tormo M, Díaz-Mediavilla J, Esteve J, González-San Miguel JD. Uncertain role of increased intensity chemotherapy with high-dose cytarabine in acute promyelocytic leukemia. Leukemia 2001; 15:1999-2002. [PMID: 11753627 DOI: 10.1038/sj.leu.2402297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2000] [Accepted: 06/13/2001] [Indexed: 11/08/2022]
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González M, Barragán E, Bolufer P, Chillón C, Colomer D, Borstein R, Calasanz MJ, Gómez-Casares MT, Villegas A, Marugán I, Román J, Martín G, Rayón C, Debén G, Tormo M, Díaz-Mediavilla J, Esteve J, González-San Miguel J, Rivas C, Pérez-Equiza K, García-Sanz R, Capote FJ, Ribera JM, Arias J, León A, Sanz MA. Pretreatment characteristics and clinical outcome of acute promyelocytic leukaemia patients according to the PML-RAR alpha isoforms: a study of the PETHEMA group. Br J Haematol 2001; 114:99-103. [PMID: 11472351 DOI: 10.1046/j.1365-2141.2001.02915.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Of 167 newly diagnosed acute promyelocytic leukaemia patients, 83 patients were long (L)-form (50%), eight variable (V)-form (5%) and 76 short (S)-form (45%). The V-form and S-form groups presented a significantly higher percentage of patients with white blood cell counts > 10 x 10(9)/l (P < 0.05). The S-form cases displayed a significantly higher number of cases with M3v microgranular features (P = 0.005) and CD34 expression (P < 0.0001). There were no differences between the three isoforms in complete remission (CR) rate (overall CR 90%), but the 3-year disease-free survival was lower for V-form cases than it was for L- and S-form cases (62% vs. 94% and 89%, P = 0.056). We conclude that the V-form and S-form types are associated with some negative prognostic features at diagnosis. However, our data were only able to demonstrate an association with adverse prognosis in the V-form type and, moreover, as the number of cases was limited, needs to be confirmed in large, uniformly treated series.
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MESH Headings
- Adolescent
- Adult
- Aged
- Antigens, CD34/analysis
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Child
- Child, Preschool
- Disease-Free Survival
- Female
- Humans
- Infant
- Infant, Newborn
- Leukemia, Promyelocytic, Acute/drug therapy
- Leukemia, Promyelocytic, Acute/immunology
- Leukemia, Promyelocytic, Acute/metabolism
- Leukocyte Count
- Male
- Middle Aged
- Neoplasm Proteins/genetics
- Oncogene Proteins, Fusion/genetics
- Polymerase Chain Reaction/methods
- Prognosis
- Proportional Hazards Models
- Protein Isoforms/genetics
- Treatment Outcome
- Tretinoin/therapeutic use
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Affiliation(s)
- M González
- Department of Haematology, Hospital Universitario, Salamanca, Spain.
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7
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Sanz MA, Martín G, Rayón C, Esteve J, González M, Díaz-Mediavilla J, Bolufer P, Barragán E, Terol MJ, González JD, Colomer D, Chillón C, Rivas C, Gómez T, Ribera JM, Bornstein R, Román J, Calasanz MJ, Arias J, Alvarez C, Ramos F, Debén G. A modified AIDA protocol with anthracycline-based consolidation results in high antileukemic efficacy and reduced toxicity in newly diagnosed PML/RARalpha-positive acute promyelocytic leukemia. PETHEMA group. Blood 1999; 94:3015-21. [PMID: 10556184] [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: 02/14/2023] Open
Abstract
The Spanish PETHEMA group designed a protocol for newly diagnosed PML/RARalpha-positive acute promyelocytic leukemia (APL) in which induction and consolidation followed the original AIDA regimen, except for the omission of cytarabine and etoposide from consolidation. Induction consisted of 45 mg/m(2) all-trans retinoic acid (ATRA) daily until complete remission (CR) and 12 mg/m(2) idarubicin on days 2, 4, 6, and 8. Patients in CR received 3 monthly chemotherapy courses: idarubicin 5 mg/m(2)/d x 4 (course no. 1), mitoxantrone 10 mg/m(2)/d x 5 (course no. 2), and idarubicin 12 mg/m(2)/d x 1 (course no. 3). Maintenance therapy consisted of 90 mg/m(2)/d mercaptopurine orally, 15 mg/m(2)/wk methotrexate intramuscularly, and, intermittently, 45 mg/m(2)/d ATRA for 15 days every 3 months. Between November 1996 and December 1998, 123 patients with newly diagnosed PML/RARalpha-positive APL from 39 centers were enrolled. A total of 109 patients achieved CR (89%; 95% confidence interval [CI], 83 to 95), 12 died of early complications, and the remaining 2 were resistant. Consolidation treatment was associated with very low toxicity and no deaths in remission were recorded. Molecular assessment of response by reverse transcriptase-polymerase chain reaction (RT-PCR) showed conversion to PCR-negative in 48 of 99 (51%) and 82 of 88 patients (93%) after induction and consolidation, respectively. The 2-year Kaplan-Meier estimates of overall survival and event-free survival were 82% +/- 4% and 79% +/- 4%, respectively. For patients who achieved CR, the 2-year disease-free survival (DFS) was 92% +/- 3%. These data indicate that a significant reduction in toxicity might be obtained in APL using a less intensive consolidation without apparently compromising the antileukemic effect. These results also suggest a minor role for cytarabine and etoposide in the treatment of newly diagnosed PML/RARalpha-positive APL patients.
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Affiliation(s)
- M A Sanz
- Servicio de Hematología, Hospital Universitario La Fe, Valencia, Spain.
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8
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Galed I, Herranz J, López G, Debén G, Alvarez A, García JA, Arnal F. [Solitary plasmacytoma of the larynx. Presentation of a case]. Acta Otorrinolaringol Esp 1988; 39:95-7. [PMID: 3273775] [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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