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Zerga M, Dragosky M, Isnardi S, Stemmelin G, Yantorno S, Caccione R, Otero V, Marquez M, Gotta D, Suero A, Alfonso G, Beligoy L, Flores G, Fischman L, Martinez M, Rodriguez A, Diaz Velez N, Luchetta P, Welsh V, Tartas N, Schutz N, Zoppegno L, Bonnacorso S, Pujol M, Garate G, Mahuad C, Vicente A, De stefano G, Cugliari S, Miodosky M, Melillo L, Fernandez D, Kornblihtt L, Casali C, Aizpuria F. RELATIONSHIP BETWEEN SOCIOECONOMIC FACTORS AND DELAY IN DIAGNOSIS AND INITIAL TREATMENT IN PATIENTS WITH DIFUSSE LARGE B CELL LYMPHOMA (DLBCL). DO THESE FACTORS IMPACT ON THE RESPONSE RATE? RESULTS OF A MULTICENTRIC ARGENTINIAN STUDY. Hematol Oncol 2019. [DOI: 10.1002/hon.82_2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- M.E. Zerga
- Hematology; Instituto Roffo; Buenos Aires Argentina
| | - M. Dragosky
- Hematology; Instituto Henry Moore; Buenos Aires Argentina
| | - S. Isnardi
- Hematology; Hospital San Martin De La Plata; La Plata Argentina
| | - G. Stemmelin
- Hematology; Hospital Britanico; Buenos Aires Argentina
| | - S. Yantorno
- Hematology; Hospital San Martin De La Plata; La Plata Argentina
| | | | - V. Otero
- Hematology; Hospital Italiano; Buenos Aires Argentina
| | - M. Marquez
- Hematology; Hospital Marie Curie; Buenos Aires Argentina
| | - D. Gotta
- Hematology; Cemic; Buenos Aires Argentina
| | - A. Suero
- Hematology; Unidad Asistencial Dr Cesar Milstein; Buenos Aires Argentina
| | - G. Alfonso
- Hematology; Hospital Posadas; El Palomar Argentina
| | - L. Beligoy
- Hematology; Hospital Perrando; Resistencia Argentina
| | - G. Flores
- hematology; Hospital Durand; Buenos Aires Argentina
| | - L. Fischman
- hematology; Hospital Durand; Buenos Aires Argentina
| | - M. Martinez
- Hematology; Hospital De Clinicas; Buenos Aires Argentina
| | - A. Rodriguez
- hematology; Academia Nacional De Medicina; Buenos Aires Argentina
| | - N. Diaz Velez
- Hematology; Hospital Marie Curie; Buenos Aires Argentina
| | - P. Luchetta
- Hematology; Hospital Naval; Buenos Aires Argentina
| | - V. Welsh
- hematology; Instituto Oncohematologico Formosa; Formosa Argentina
| | - N. Tartas
- Hematology; Instituto Alexander Fleming; Buenos Aires Argentina
| | - N. Schutz
- Hematology; Hospital Italiano; Buenos Aires Argentina
| | - L. Zoppegno
- Hematology; Hospital San Martin De La Plata; La Plata Argentina
| | - S. Bonnacorso
- Hematology; Hospital De Clinicas; Buenos Aires Argentina
| | - M. Pujol
- Hematology; Hospital Angela Llano; Corrientes Argentina
| | - G. Garate
- Hematology; Hospital Aleman; Buenos Aires Argentina
| | - C. Mahuad
- Hematology; Hospital Aleman; Buenos Aires Argentina
| | - A. Vicente
- Hematology; Hospital Aleman; Buenos Aires Argentina
| | | | - S. Cugliari
- Hematology; Instituto Roffo; Buenos Aires Argentina
| | - M. Miodosky
- Hematology; Instituto Roffo; Buenos Aires Argentina
| | - L. Melillo
- Hematology; Instituto Roffo; Buenos Aires Argentina
| | - D. Fernandez
- Hematology; Instituto Roffo; Buenos Aires Argentina
| | - L. Kornblihtt
- Hematology; Hospital De Clinicas; Buenos Aires Argentina
| | - C. Casali
- Hematology; Hospital Aleman; Buenos Aires Argentina
| | - F. Aizpuria
- Hematology; Hospital Aleman; Buenos Aires Argentina
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Duboscq C, Martinuzzo ME, Ceresetto J, Lopez M, Barrera L, Oyhamburu J, Stemmelin G. The fibrinogen prothrombin time-derived method is not useful in patients anticoagulated with low molecular weight heparins or rivaroxaban. J Thromb Haemost 2018; 16:S1538-7836(22)02205-X. [PMID: 29790645 DOI: 10.1111/jth.14158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Indexed: 11/29/2022]
Abstract
Essentials Fibrinogen prothrombin time-derived (FIBPT-d) behavior in anticoagulated patients is under studied. FIBPT-d method overestimates fibrinogen in rivaroxaban and low molecular weight heparin samples. Unfractionated heparin and dabigatran samples showed similar bias to the control group. Rabbit brain and human recombinant thromboplastin behavior was different in rivaroxaban samples. SUMMARY Background The fibrinogen prothrombin time-derived (FIBPT-d) method with photo-optical coagulometers is easy and economical. However, there are few reports on the behavior of this test on samples from patients anticoagulated with direct oral anticoagulants or low molecular weight heparin (LMWH). Objective To compare fibrinogen results obtained with the Clauss (FIB C) method and the FIBPT-d method with two thromboplastins in anticoagulated patients. Population The study population comprised 295 consecutive anticoagulated patients: 99 treated with vitamin K antagonists (VKAs), 49 treated with unfractionated heparin (UFH), 47 treated with LMWH, 50 treated with rivaroxaban, 50 treated with dabigatran, and 100 normal controls (NCs). Methods Dabigatran samples were analyzed by the use of FIB C with HemosIL Fibrinogen C or 100 NHI thrombin units mL-1 reagents; rabbit brain and human recombinant thromboplastins with HemosIL PTFibrinogen HS plus (HS) and Recombiplastin 2G (RP) were used for FIBPT-d method. Heparin and rivaroxaban levels were assessed with HemosIL Liq antiXa with specific calibrators; dabigatran levels were determined with the HemosIL Direct Thrombin Inhibitor Assay. All assays were performed on the ACL TOP platform in two laboratories. Percentage biases for the FIBPT-d method versus the FIB C method were calculated by the use of Bland-Altman plots. Results Positive biases of the FIBPT-d method versus the FIB C method with both thromboplastins were seen in NC samples (13.7% and 18.9% for HS and RP, respectively), but biases with HS in rivaroxaban and VKA patient samples were higher than that in NC samples, at 31.9% and 34.0%, respectively. LMWH patient samples showed higher bias than NC samples: 26.5% and 29.3.0% with HS and RP, respectively. UFH and dabigatran patient samples showed similar bias as NC samples. Conclusion The FIBPT-d method should not be used in anticoagulated patients, because the FIBPT-d mathematical algorithm has been validated only in normal subjects, so overestimation could occur in these patients.
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Affiliation(s)
- C Duboscq
- Servcio de Hematología Hospital Británico de Buenos Aires, Buenos Aires, Argentina
| | - M E Martinuzzo
- Grupo Bioquímico, Laboratorio Central del Hospital Italiano de Buenos Aires, Instituto Universitario Hospital Italiano, Buenos Aires, Argentina
| | - J Ceresetto
- Servcio de Hematología Hospital Británico de Buenos Aires, Buenos Aires, Argentina
| | - M Lopez
- Grupo Bioquímico, Laboratorio Central del Hospital Italiano de Buenos Aires, Instituto Universitario Hospital Italiano, Buenos Aires, Argentina
| | - L Barrera
- Grupo Bioquímico, Laboratorio Central del Hospital Italiano de Buenos Aires, Instituto Universitario Hospital Italiano, Buenos Aires, Argentina
| | - J Oyhamburu
- Grupo Bioquímico, Laboratorio Central del Hospital Italiano de Buenos Aires, Instituto Universitario Hospital Italiano, Buenos Aires, Argentina
| | - G Stemmelin
- Servcio de Hematología Hospital Británico de Buenos Aires, Buenos Aires, Argentina
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Bezares R, Stemmelin G, Argentieri D, Lanari E, Guy-Garay E, Campestri R, Bartomioli M, García J, Giralt S, Milone G. Subcutaneous alemtuzumab in patients with refractory/relapsed B-CLL after a fludarabine-based regimen. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.6600] [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
6600 Background: Alemtuzumab is the only immunotherapy that is effective as a single agent in patients with B-CLL who are refractory to, or who have relapsed after, fludarabine therapy. The optimized schedule for alemtuzumab that achieves maximal efficacy with manageable toxicity is still being explored. We report the first interim analysis of a new, less intensive schedule of alemtuzumab SC to patients with refractory/relapsed B-CLL. Methods: Alemtuzumab was dose escalated from 10 to 20 mg during the first week, 30 mg bid during the second and third weeks, and 30 mg once weekly during weeks 4, 6, 8, 10, 12, 16, 20, 24, 28, 34, and 40. Antiviral prophylaxis included TMP/SMX bid 3 times a week and acyclovir 200 mg tid. Results: Patients (N = 36) with refractory (19%) or relapsed (81%) B-CLL had a median age of 67 years (range, 43–86 years), 28 were male, 61%/39% had Binet stage B/C disease, and 2 had B-cell prolymphocytic transformation. The median number of prior therapies was 1 (range, 1–4). The median duration of treatment was 7 weeks (range, 2–24 weeks), with a median cumulative alemtuzumab dose of 412 mg (range, 150–1,080 mg). Thirty-two patients were evaluable for response. The overall response rate of 93%: complete response (CR), 34%; unconfirmed CR, 6%; partial response (PR), 53%. Two patients (7%) did not respond to therapy. Of the 7 refractory patients, 5 had a PR, 1 did not respond, and 1 was not yet evaluable. Median overall survival was 10 months, which correlated with response and pretreatment status. Minimal residual disease (MRD) was measured by flow cytometry in 5 patients who achieved a CR: 3 patients had <0.5% of CD5/CD19/CD23+ cells, 1 patient had <5% of CLL cells, and 1 patient had <10% CLL cells. According to WHO toxicity criteria, 5 patients experienced grade 3/4 infection; 2 patients had grade 3 granulocytopenia/thrombocytopenia; 1 patient had cytomegalovirus (CMV) reactivation without CMV disease; and 1 patient developed Epstein-Barr Virus with prolonged bone marrow hypoplasia. Conclusions: Results of this interim analysis suggest that a less intense regimen of alemtuzumab is feasible, effective, and safe for patients with refractory/relapse B-CLL after fludarabine therapy. No significant financial relationships to disclose.
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Affiliation(s)
- R. Bezares
- Hospital General de Agudos, Ciudad de Buenos Aires, Argentina; Hospital Britanico, Buenos Aires, Argentina; Sanatorio Mitre, Buenos Aires, Argentina; Centro Medico Corrientes, Buenos Aires, Argentina; CEMIC, Buenos Aires, Argentina; Hospital Pena Bahia Blanca, Buenos Aires, Argentina; Hospital Privado de Cordova, Cordova, Argentina; M. D. Anderson Cancer Center, Houston, TX; Fundaleu, Buenos Aires, Argentina
| | - G. Stemmelin
- Hospital General de Agudos, Ciudad de Buenos Aires, Argentina; Hospital Britanico, Buenos Aires, Argentina; Sanatorio Mitre, Buenos Aires, Argentina; Centro Medico Corrientes, Buenos Aires, Argentina; CEMIC, Buenos Aires, Argentina; Hospital Pena Bahia Blanca, Buenos Aires, Argentina; Hospital Privado de Cordova, Cordova, Argentina; M. D. Anderson Cancer Center, Houston, TX; Fundaleu, Buenos Aires, Argentina
| | - D. Argentieri
- Hospital General de Agudos, Ciudad de Buenos Aires, Argentina; Hospital Britanico, Buenos Aires, Argentina; Sanatorio Mitre, Buenos Aires, Argentina; Centro Medico Corrientes, Buenos Aires, Argentina; CEMIC, Buenos Aires, Argentina; Hospital Pena Bahia Blanca, Buenos Aires, Argentina; Hospital Privado de Cordova, Cordova, Argentina; M. D. Anderson Cancer Center, Houston, TX; Fundaleu, Buenos Aires, Argentina
| | - E. Lanari
- Hospital General de Agudos, Ciudad de Buenos Aires, Argentina; Hospital Britanico, Buenos Aires, Argentina; Sanatorio Mitre, Buenos Aires, Argentina; Centro Medico Corrientes, Buenos Aires, Argentina; CEMIC, Buenos Aires, Argentina; Hospital Pena Bahia Blanca, Buenos Aires, Argentina; Hospital Privado de Cordova, Cordova, Argentina; M. D. Anderson Cancer Center, Houston, TX; Fundaleu, Buenos Aires, Argentina
| | - E. Guy-Garay
- Hospital General de Agudos, Ciudad de Buenos Aires, Argentina; Hospital Britanico, Buenos Aires, Argentina; Sanatorio Mitre, Buenos Aires, Argentina; Centro Medico Corrientes, Buenos Aires, Argentina; CEMIC, Buenos Aires, Argentina; Hospital Pena Bahia Blanca, Buenos Aires, Argentina; Hospital Privado de Cordova, Cordova, Argentina; M. D. Anderson Cancer Center, Houston, TX; Fundaleu, Buenos Aires, Argentina
| | - R. Campestri
- Hospital General de Agudos, Ciudad de Buenos Aires, Argentina; Hospital Britanico, Buenos Aires, Argentina; Sanatorio Mitre, Buenos Aires, Argentina; Centro Medico Corrientes, Buenos Aires, Argentina; CEMIC, Buenos Aires, Argentina; Hospital Pena Bahia Blanca, Buenos Aires, Argentina; Hospital Privado de Cordova, Cordova, Argentina; M. D. Anderson Cancer Center, Houston, TX; Fundaleu, Buenos Aires, Argentina
| | - M. Bartomioli
- Hospital General de Agudos, Ciudad de Buenos Aires, Argentina; Hospital Britanico, Buenos Aires, Argentina; Sanatorio Mitre, Buenos Aires, Argentina; Centro Medico Corrientes, Buenos Aires, Argentina; CEMIC, Buenos Aires, Argentina; Hospital Pena Bahia Blanca, Buenos Aires, Argentina; Hospital Privado de Cordova, Cordova, Argentina; M. D. Anderson Cancer Center, Houston, TX; Fundaleu, Buenos Aires, Argentina
| | - J. García
- Hospital General de Agudos, Ciudad de Buenos Aires, Argentina; Hospital Britanico, Buenos Aires, Argentina; Sanatorio Mitre, Buenos Aires, Argentina; Centro Medico Corrientes, Buenos Aires, Argentina; CEMIC, Buenos Aires, Argentina; Hospital Pena Bahia Blanca, Buenos Aires, Argentina; Hospital Privado de Cordova, Cordova, Argentina; M. D. Anderson Cancer Center, Houston, TX; Fundaleu, Buenos Aires, Argentina
| | - S. Giralt
- Hospital General de Agudos, Ciudad de Buenos Aires, Argentina; Hospital Britanico, Buenos Aires, Argentina; Sanatorio Mitre, Buenos Aires, Argentina; Centro Medico Corrientes, Buenos Aires, Argentina; CEMIC, Buenos Aires, Argentina; Hospital Pena Bahia Blanca, Buenos Aires, Argentina; Hospital Privado de Cordova, Cordova, Argentina; M. D. Anderson Cancer Center, Houston, TX; Fundaleu, Buenos Aires, Argentina
| | - G. Milone
- Hospital General de Agudos, Ciudad de Buenos Aires, Argentina; Hospital Britanico, Buenos Aires, Argentina; Sanatorio Mitre, Buenos Aires, Argentina; Centro Medico Corrientes, Buenos Aires, Argentina; CEMIC, Buenos Aires, Argentina; Hospital Pena Bahia Blanca, Buenos Aires, Argentina; Hospital Privado de Cordova, Cordova, Argentina; M. D. Anderson Cancer Center, Houston, TX; Fundaleu, Buenos Aires, Argentina
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