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Sokołowska B, Majowicz D, Kozioł M, Czabak O, Wąsik-Szczepanek E, Juda A, Soroka-Wojtaszko M, Hus M. RAEB II type of myelodysplastic syndrome associated with axillary abscesses - Case Report. Ann Agric Environ Med 2021; 28:733-736. [PMID: 34969238 DOI: 10.26444/aaem/140006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Myelodysplastic syndromes (MDS) are clonal haematopoetic stem cells disorders, characterized by bone marrow dysplasia, ineffecitive haematopoesis and cytopenias. Due to neutropenia, infections are common. A case is presented of a patient with high-risk myelodysplastic syndrome (MDS) complicated by hidradenitis suppurativa that developed in both axillae. Abscesses required multiple incisions and drainage. After five cycles of treatment with azacitidine, the patient underwent allogenic bone marrow transplantation. Unfortunately, six months after the procedure, the patient lost post-transplant chimerism.Treatment with azacitidine was re-started. After the subsequent ten months, blast transformation was observed. Skin lesions in the course of hidradenitis suppurative persisted and were still considerably active.
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Affiliation(s)
- Bożena Sokołowska
- Department of Haematooncology and Bone Marrow Transplantation, Medical University, Lublin, Poland
| | - Daria Majowicz
- Department of Haematooncology and Bone Marrow Transplantation, Medical University, Lublin, Poland
| | - Magdalena Kozioł
- Department of Haematooncology and Bone Marrow Transplantation, Medical University, Lublin, Poland
| | - Olga Czabak
- Department of Haematooncology and Bone Marrow Transplantation, Medical University, Lublin, Poland
| | - Ewa Wąsik-Szczepanek
- Department of Haematooncology and Bone Marrow Transplantation, Medical University, Lublin, Poland
| | - Adrian Juda
- Department of Haematooncology and Bone Marrow Transplantation, Medical University, Lublin, Poland
| | - Maria Soroka-Wojtaszko
- Department of Haematooncology and Bone Marrow Transplantation, Medical University, Lublin, Poland
| | - Marek Hus
- Department of Haematooncology and Bone Marrow Transplantation, Medical University, Lublin, Poland
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2
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Wołowiec D, Szymczyk A, Potoczek S, Krochmalczyk D, Zawirska D, Piotrowska M, Malenda A, Soroka-Wojtaszko M, Kopacz A, Wąsik-Szczepanek E, Graboś-Michalak J, Raźny M, Wichary R, Bramowicz-Jarosz B, Seweryn M, Długosz-Danecka M, Hus I. Safety and Efficacy of Bendamustine Monotherapy in the First-Line Treatment of Patients with Chronic Lymphocytic Leukemia: Polish Lymphoma Research Group Real-Life Analysis. Chemotherapy 2019; 64:155-162. [PMID: 31715597 DOI: 10.1159/000503220] [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: 04/22/2019] [Accepted: 09/06/2019] [Indexed: 11/19/2022]
Abstract
Bendamustine is a cytostatic drug with a unique structure, combining the features of purine nucleoside analogs and alkylating agents. In patients with chronic lymphocytic leukemia (CLL) it is commonly used in combination with rituximab (BR protocol) both in the first-line as well as subsequent lines of therapy, and in clinical trials it is often combined with new targeted therapies. Therefore, the data on its real-life safety and efficacy are of clinical significance. As the Polish Lymphoma Research Group (PLRG), we retrospectively analyzed the efficacy and tolerability of bendamustine monotherapy in 96 patients with CLL. The median number of bendamustine cycles was 5, and 44 patients did not complete the planned 6 cycles (46%). Among the adverse events associated with the earlier termination of bendamustine treatment, infections were the most common (20.5%), followed by neutropenia (15.9%) and thrombocytopenia (15.9%). Dose reductions and/or delays occurred in 31% of treatment cycles (132 of 425) with neutropenia (17.9%) as the most frequent cause. Efficacy analysis showed an overall response rate of 88.2% with complete remission and partial remission achieved in 43.8 and 41.7% of patients, respectively. At the 24th month of follow-up, progression-free survival was 52% and overall survival was 69.7%. Bendamustine in monotherapy was found to be safe and efficacious, at least in terms of early response. Special attention should be paid to infectious complications, and especially that immune disorders are characteristic in the clinical course of CLL. Our observations suggest efforts must be made to ensure the proper timing and proper dose in the administration of the drug, and to avoid the premature termination of the treatment.
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Affiliation(s)
- Dariusz Wołowiec
- Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Agnieszka Szymczyk
- Department of Clinical Transplantology, Medical University of Lublin, Lublin, Poland,
| | - Stanisław Potoczek
- Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Dorota Krochmalczyk
- Department of Hematology, Collegium Medicum, Jagiellonian University, Kracow, Poland
| | - Daria Zawirska
- Department of Hematology, Collegium Medicum, Jagiellonian University, Kracow, Poland
| | - Magdalena Piotrowska
- Department of Hematology, Collegium Medicum, Jagiellonian University, Kracow, Poland
| | - Agata Malenda
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Lublin, Poland
| | - Maria Soroka-Wojtaszko
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Agnieszka Kopacz
- Department of Hematology, Clinical Hospital No. 2 in Rzeszów, Rzeszów, Poland
| | - Ewa Wąsik-Szczepanek
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | | | - Małgorzata Raźny
- Department of Hematology, Ludwik Rydygier Memorial Specialized Hospital, Kracow, Poland
| | - Ryszard Wichary
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Silesia, Katowice, Poland
| | | | - Marek Seweryn
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Silesia, Katowice, Poland
| | | | - Iwona Hus
- Department of Clinical Transplantology, Medical University of Lublin, Lublin, Poland
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3
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Madry K, Waszczuk-Gajda A, Drozd-Sokotowska J, Lis K, Sikorska A, Szwedyk P, Kapelko-Stowik K, Dutka M, Jachalska A, Kopińka A, Konopińska-Posłuszny W, Subocz E, Pogłódek B, Krochmalczyk D, Kopacz A, Soroka-Wojtaszko M, Wądałowska A, Grądzka K, Kołkowska-Leśniak A, Dwilewicz-Trojaczek J. Prognostic Relevance of Who 2016 Chronic Myelomonocytic Leukemia (CMML) Categories – Polish MDS Registry Results (Polish Adult Leukemia Group). Leuk Res 2017. [DOI: 10.1016/s0145-2126(17)30364-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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4
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Drozd-Sokołowska JE, Mądry K, Waszczuk-Gajda A, Żółtak T, Sikorska A, Mital A, Wajs J, Semeńczuk G, Szmigielska-Kapłon A, Szczepańska M, Wasilewska E, Szwedyk P, Hołojda J, Wątek M, Stella-Hołowiecka B, Soroka-Wojtaszko M, Homenda W, Polak M, Guzicka-Kazimierska R, Porowska A, Wiktor-Jędrzejczak W, Dwilewicz-Trojaczek J. Are myelodysplastic syndromes underdiagnosed in Poland? A report by the Polish Adult Leukaemia Group. Eur J Haematol 2016; 98:154-159. [DOI: 10.1111/ejh.12814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2016] [Indexed: 12/15/2022]
Affiliation(s)
| | - Krzysztof Mądry
- Department of Haematology, Oncology and Internal Diseases; Medical University of Warsaw; Warsaw Poland
| | - Anna Waszczuk-Gajda
- Department of Haematology, Oncology and Internal Diseases; Medical University of Warsaw; Warsaw Poland
| | | | - Anna Sikorska
- Department of Haematology; Institute of Haematology and Transfusion Medicine; Warsaw Poland
| | - Andrzej Mital
- Department of Haematology and Transplantology; Medical University of Gdansk; Gdansk Poland
| | - Jarosław Wajs
- Department of Haematology; Military Medical Institute in Warsaw; Warsaw Poland
| | - Grażyna Semeńczuk
- Department of Haematology; Nicolaus Copernicus University in Toruń; Collegium Medicum in Bydgoszcz; Bydgoszcz Poland
| | | | | | - Ewa Wasilewska
- Department of Haematology; Medical University of Białystok; Białystok Poland
| | - Paweł Szwedyk
- Department of Haematology; Ludwik Rydygier Hospital; Cracow Poland
| | - Jadwiga Hołojda
- Department of Haematology; Voivodal Specialist Hospital in Legnica; Legnica Poland
| | - Marzena Wątek
- Department of Haematology; Świętokrzyskie Cancer Centre; Kielce Poland
| | - Beata Stella-Hołowiecka
- Department of Haematology and Bone Marrow Transplantation; Medical University of Silesia; Katowice Poland
| | | | - Wojciech Homenda
- Department of Internal Diseases and Haematology; Voivodal Specialist Hospital in Słupsk; Słupsk Poland
| | - Mirosław Polak
- Department of Haematology; Non-Public Hospital; Zamość Poland
| | | | - Agnieszka Porowska
- Department of Oncology and Haematology; Central Clinical Hospital of the Ministry of the Interior; Warsaw Poland
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Abstract
Multiple myeloma is a malignant neoplastic disease, characterized by uncontrolled proliferation and accumulation of plasma cells in the bone marrow, which is usually connected with production of a monoclonal protein. It is the second most common hematologic malignancy. It constitutes approximately 1% of all cancers and 10% of hematological malignancies. Despite the huge progress that has been made in the treatment of multiple myeloma in the past 30 years including the introduction of new immunomodulatory drugs and proteasome inhibitors, it is still an incurable disease. According to current data, the five-year survival rate is 45%. Multiple myeloma is a very heterogeneous disease with a very diverse clinical course, which is expressed by differences in effectiveness of therapeutic strategies and ability to develop chemoresistance. This diversity implies the need to define risk stratification factors that would help to create personalized and optimized therapy and thereby improve treatment outcomes. Prognostic markers that aim to objectively evaluate the risk of a poor outcome, relapse and the patient's overall outcome are useful for this purpose. The existing, widely used prognostic classifications, such as the Salmon-Durie classification or ISS, do not allow for individualization of treatment. As a result of the development of diagnostic techniques, especially cytogenetics and molecular biology, we were able to discover a lot of new, more sensitive and specific prognostic factors. The paper presents recent reports on the role of molecular, cytogenetic and biochemical alterations in pathogenesis and prognosis of the disease.
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Affiliation(s)
- Aneta Szudy-Szczyrek
- Katedra i Klinika Hematoonkologii i Transplantacji Szpiku Uniwersytetu Medycznego w Lublinie
| | - Michał Szczyrek
- Katedra Interny z Zakładem Pielęgniarstwa Internistycznego Uniwersytetu Medycznego w Lublinie
| | - Maria Soroka-Wojtaszko
- Katedra i Klinika Hematoonkologii i Transplantacji Szpiku Uniwersytetu Medycznego w Lublinie
| | - Marek Hus
- Katedra i Klinika Hematoonkologii i Transplantacji Szpiku Uniwersytetu Medycznego w Lublinie
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6
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Walter-Croneck A, Grzasko N, Soroka-Wojtaszko M, Jurczyszyn A, Torosian T, Rymko M, Nowicki A, Druzd-Sitek A, Lech-Maranda E, Madro E, Zielinska P, Grygoruk-Wisniowska I, Blonska D, Usnarska-Zubkiewicz L, Potoczek S, Iskierka E, Masternak A, Holojda J, Dawidowska D, Gawron L, Barchnicka A, Olszewska-Szopa M, Rybicka M, Gontarska A, Jachalska A, Rzepecki P, Subocz E, Boguradzki P, Charlinski G, Dzierzak-Mietla M, Wisniewska-Piaty K, Swistek W, Kopacz A, Blajer-Olszewska B, Swiderska A, Dmoszynska A. Case-adjusted bortezomib-based strategy in routine therapy of relapsed/refractory multiple myeloma shown to be highly effective--a report by Polish Myeloma Study Group. Leuk Res 2014; 38:788-94. [PMID: 24862794 DOI: 10.1016/j.leukres.2014.04.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 04/19/2014] [Accepted: 04/24/2014] [Indexed: 01/10/2023]
Abstract
The observational study was aimed at evaluating response, survival and toxicity of bortezomib-based, case-adjusted regimens in real-life therapy of 708 relapsed/refractory MM patients. Bortezomib was combined with anthracyclines, steroids, thalidomide, alkylators or given in monotherapy. The ORR was 67.9% for refractory and 69.9% for relapsed MM. The median PFS was 14 months and OS 57 months. Patients responding to the therapy had the probability of a 4-year OS at 67.0%. No toxicity was noted in 33.1% of patients. Severe events (grade 3/4) were reported in 35.9% of patients: neurotoxicity (16.7%), neutropenia (9.2%), thrombocytopenia (8.5%), and infections (6.5%). Bortezomib-based, case-adjusted regimens are in real-life practice effective in salvage therapy offering reliable survival with acceptable toxicity for relapsed/refractory MM patients.
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Affiliation(s)
- Adam Walter-Croneck
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Poland.
| | - Norbert Grzasko
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Poland
| | - Maria Soroka-Wojtaszko
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Poland
| | - Artur Jurczyszyn
- Department of Haematology, Collegium Medicum, Jagiellonian University, Cracow, Poland
| | - Tigran Torosian
- Department of Haematology, Oncology and Internal Medicine, Medical University of Warsaw, Poland
| | | | - Adam Nowicki
- Department of Haematology Medical University of Poznan, Poland
| | | | - Ewa Lech-Maranda
- Centre of Postgraduate Medical Education, Warsaw, Poland; Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Elzbieta Madro
- Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Patrycja Zielinska
- Department of Haematology and Bone Marrow Transplantation, Silesian Medical University, Katowice, Poland
| | | | - Danuta Blonska
- Department of Haematology Medical University of Bydgoszcz, Poland
| | - Lidia Usnarska-Zubkiewicz
- Department of Haematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Poland
| | - Stanislaw Potoczek
- Department of Haematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Poland
| | | | | | | | | | | | | | | | - Malwina Rybicka
- Department of Haematology and Bone Marrow Transplantation, Silesian Medical University, Katowice, Poland
| | | | - Anna Jachalska
- Department of Haematology Medical University of Bydgoszcz, Poland
| | - Piotr Rzepecki
- Department of Haematology, Military Institute of Medicine in Warsaw, Poland
| | - Edyta Subocz
- Department of Haematology, Military Institute of Medicine in Warsaw, Poland
| | - Piotr Boguradzki
- Department of Haematology, Oncology and Internal Medicine, Medical University of Warsaw, Poland
| | - Grzegorz Charlinski
- Department of Haematology, Oncology and Internal Medicine, Medical University of Warsaw, Poland
| | - Monika Dzierzak-Mietla
- Department of Haematology and Bone Marrow Transplantation, Silesian Medical University, Katowice, Poland
| | - Katarzyna Wisniewska-Piaty
- Department of Haematology and Bone Marrow Transplantation, Silesian Medical University, Katowice, Poland
| | - Wojciech Swistek
- Department of Haematology Medical University of Bydgoszcz, Poland
| | | | | | | | - Anna Dmoszynska
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Poland
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7
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Dwilewicz-Trojaczek J, Madry K, Mital A, Kolkowska A, Szmigielska A, Holowiecka B, Mendrek W, Nita E, Obara A, Biedron M, Zalewska M, Kruger W, Katinas K, Guzicka-Kazimierczak R, Wasilewska E, Pędziwiatr M, Nowicki A, Kopacz A, Jachalska A, Blasiak A, Wojciechowska M, Soroka-Wojtaszko M, Salamanczuk Z, Sedzimirska M, Gornik S, Witkowska M. 96 Hyperferritinemia in MDS patients – Polish MDS Registry results. Leuk Res 2011. [DOI: 10.1016/s0145-2126(11)70098-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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8
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Grzasko N, Dmoszynska A, Hus M, Soroka-Wojtaszko M. Stimulation of erythropoiesis by thalidomide in multiple myeloma patients: its influence on FasL, TRAIL and their receptors on erythroblasts. Haematologica 2006; 91:386-9. [PMID: 16531263] [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: 05/07/2023] Open
Abstract
The expression of proteins of the tumor necrosis factor (TNF) family on erythroblasts was measured during thalidomide treatment in 29 patients with multiple myeloma (MM). A clinical response was observed in 17 patients (58.6%) and haemoglobin concentration increased in 22 patients (75.9%). The expression of FasL, Fas, TNF-related apoptosis-inducing ligand (TRAIL) and TRAIL-R1 on erythroblasts decreased significantly during thalidomide treatment. Additional in vitro studies revealed that the apoptosis of erythroblasts and the expression of FasL, TRAIL, TRAIL-R1 and TRAIL-R2 was lower in cultures with thalidomide than in control cultures. Altogether our results suggest that thalidomide may stimulate erythropoiesis in MM patients by decreasing the expression of TNF-like ligands/receptors on erythroblasts.
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Affiliation(s)
- Norbert Grzasko
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Staszica 11, 20-080 Lublin, Poland
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9
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Hus I, Dmoszynska A, Manko J, Hus M, Jawniak D, Soroka-Wojtaszko M, Hellmann A, Ciepluch H, Skotnicki A, Wolska-Smolen T, Sulek K, Robak T, Konopka L, Kloczko J. An evaluation of factors predicting long-term response to thalidomide in 234 patients with relapsed or resistant multiple myeloma. Br J Cancer 2005; 91:1873-9. [PMID: 15520820 PMCID: PMC2409770 DOI: 10.1038/sj.bjc.6602225] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The aim of this study was to assess the prognostic value of pretreatment clinical and laboratory parameters in refractory or relapsed multiple myeloma (MM) patients who have a long-term response to thalidomide (THAL), lasting at least 18 months. The study was carried out on 234 patients who received THAL for relapsed/refractory myeloma. Out of the 234 patients, 129 patients (55.1%) responded to THAL with a mean response duration of 11.9 months (ranging from 1 to 48) and an overall survival rate of 20.3 months (ranging 1–55 months). In 64 patients (27.4% of the whole group), the response to THAL lasted ⩾18 months with a mean response lasting 24 months. Statistical analysis of the group of nonresponders and patients with long-term response to THAL showed a significantly higher serum albumin level (P=0.0003) and haemoglobin level (P=0.05), as well as a lower β2 microglobulin (β2M) (P=0.022), LDH (P=0.045) serum level in patients with long-term response. In this study, the LDH and serum albumin level were predictors for response to THAL therapy. The β2M serum level was not a predictor for response to THAL. The albumin serum level was the best parameter distinguishing the group of patients with long-term response to THAL from the entire responding group (P=0.02).
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Affiliation(s)
- I Hus
- Department of Haematooncology, Medical University of Lublin, Poland.
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10
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Soroka-Wojtaszko M, Dmoszyńska A, Słoma-Madej K, Grzaśko N. [Hemostatic and fibrinolysis markers in the early phase of acute ischaemic stroke]. Pol Arch Med Wewn 2004; 112:1303-9. [PMID: 15773512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Stroke is the most frequent cause of focal brain damage. It seems that some coagulation and fibrinolysis abnormalities play an important role in this disease. We measured coagulation parameters in 39 patients with acute ischaemic stroke within 1 week of onset of the stroke (1st, 3rd and 7th day), including thrombin-antithrombin complex (TAT), prothrombin fragment F1+2 (F1+2), fibrin degradation products (D-dimer) and fibrinogen (FBG). Marker levels in stroke were compared with controls (n=25). A significant elevation of plasma concentration of TAT, F1+2 and fibrinogen was observed in all days of measurements (p < 0.001). D-dimer level was significantly elevated in 30.7% of patients at the 1st day and in 23.0% of patients at the 3rd day of stroke onset. Marker utility in acute stroke awaits a larger study.
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11
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Dmoszyńska A, Podhorecka M, Roliński J, Soroka-Wojtaszko M. Influence of lovastatin on BCL-2 and BAX expression by plasma cells and T lymphocytes in short-term cultures of multiple myeloma bone marrow mononuclear cells. Pol J Pharmacol 2004; 56:485-9. [PMID: 15520505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/23/2004] [Revised: 04/30/2004] [Indexed: 05/01/2023]
Abstract
Lovastatin (LOV), until now largely used for the treatment of hypercholesterolemia is a new promising drug in multiple myeloma (MM), however, the precise mechanism of its antitumor activity is not clear yet. It is probable that this effect is mediated by down-regulation of BCL-2 expression. In this study, we analyzed BCL-2 and BAX expression in cells of MM patients exposed to LOV in short-term culture. The obtained results indicate an increase in susceptibility to apoptosis both in CD138+ malignant cells and CD8+ T lymphocytes. Interestingly, such a tendency was confirmed in vivo in MM patient subjected to 3 cycles of LOV therapy.
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Affiliation(s)
- Anna Dmoszyńska
- Department of Hematooncology and Bone Marrow Transplantation, PL 20-950 Lublin, Poland
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12
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Mańko J, Dmoszyńska A, Hus I, Skora D, Jawniak D, Soroka-Wojtaszko M, Hus M. 255. Wpływ działania talidomidu na gęstość naczyń krwionośnych w szpiku kostnym chorych na szpiczaka plazmocytowego. Rep Pract Oncol Radiother 2003. [DOI: 10.1016/s1507-1367(03)70738-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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13
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Dmoszyńska A, Bojarska-Junak A, Domański D, Roliński J, Hus M, Soroka-Wojtaszko M. Production of proangiogenic cytokines during thalidomide treatment of multiple myeloma. Leuk Lymphoma 2002; 43:401-6. [PMID: 11999576 DOI: 10.1080/10428190290006224] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [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: 10/20/2022]
Abstract
Recently a growing number of studies have suggested the efficacy of thalidomide (THAL) in the treatment of relapsed or resistant multiple myeloma. Some of these studies indicate that the thalidomide antimyeloma effect is associated with decreased vessel density. Here we first present our experience with THAL treatment and then focus on the determination of the role of proangiogenic cytokines during THAL therapy. Thirty relapsing or resistant multiple myeloma (MM) patients were treated with THAL at a median dose of 400 mg/daily. Eighteen responded to THAL therapy and 12 were resistant or intolerant to THAL. We determined the plasma level of basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF) as the main biological parameters associated with tumour angiogenesis. In addition I1-6 and TNFalpha levels were also assayed. Assessment of peripheral blood (PB) and bone marrow (BM) cytokine levels were done before and during THAL treatment at weeks 4 and 8 of therapy. In the responder group VEGF, bFGF I1-6 and TNFalpha concentrations were significantly decreased after four weeks of therapy both in PB and BM. In the non-responder group no significant changes in bFGF and VEGF levels were observed. However, a significant increase in IL-6 and TNF concentrations was evident. We conclude that the significant decrease of VEGF, bFGF, I1-6 and TNFalpha concentrations reflected response to THAL therapy. Also it seems that VEGF is a better marker of response to treatment than bFGF.
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Affiliation(s)
- Anna Dmoszyńska
- Department of Haematology, University School of Medicine, Lublin, Poland.
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14
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Dmoszynska A, Bojarska-Junak A, Domanski D, Rolinski J, Hus M, Soroka-Wojtaszko M. Production of Proangiogenic Cytokines During Thalidomide Treatment of Multiple Myeloma. Leuk Lymphoma 2002. [DOI: 10.1080/10428190290006224>/doi>] [Citation(s) in RCA: 3] [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: 10/28/2022]
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Dmoszyńska A, Roliński J, Bojarska-Junak A, Mańko J, Jawniak D, Walter-Croneck A, Soroka-Wojtaszko M, Hus M. Influence of thalidomide on Bcl2 expression and proangiogenic cytokine levels in short-term culture of peripheral blood and bone marrow mononuclear cells of multiple myeloma patients. Pol J Pharmacol 2001; 53:709-13. [PMID: 11985351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Supernatants from short-term culture of peripheral blood and bone marrow mononuclear cells obtained from 22 multiple myeloma patients were used to measure the concentration of TNF-alpha, HGF, IL-6 and its soluble receptor (sIL-6R), VEGF and bFGF. Cells were cultured with or without thalidomide (THAL). We observed statistically significant decrease in TNF-alpha, HGF, IL-6, sIL-6R in supernatants from THAL cultures compared to cells cultured without THAL. Flow cytometry technique was applied to study the Bcl2 expression on CD 4, CD 8 and CD 138 positive cells. The statistically significant decrease in Bcl2 expression on myeloma cells (CD 138+) was observed both in PB and BM cultures. THAL could inhibit the plasma cell growth both by diminishing proangiogenic cytokines production and enhancing myeloma cell apoptosis.
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Affiliation(s)
- A Dmoszyńska
- Haematooncology Department, University School of Medicine, Lublin, Poland
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Grzaśko N, Dmoszyńska A, Krawczyk S, Hus M, Soroka-Wojtaszko M, Ciepłuch H, Hellmann A. [Evaluation of blood morphology in patients with refractory multiple myeloma treated with thalidomide]. Pol Arch Med Wewn 2001; 106:573-9. [PMID: 11928568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Thalidomide, a derivative of alpha-N-phthalimidoglutarimide acid, was withdrawn from the market in the 1960s because of severe birth defects. Recent reports have suggested antiangiogenic and antitumor activity of this drug. We have treated 52 patients with refractory multiple myeloma at age from 32 to 79 years (mean 63) with thalidomide at a dose of 200-400 mg daily. Out of the group of 52 patients, 27 patients (52%) responded to the therapy, in 25 patients (48%) a response was not achieved (decline in monoclonal protein was smaller than 25%). There was a systematic improvement in haemoglobin concentration, erythrocyte count and thrombocyte count during thalidomide therapy. Leukocyte count showed an inclination to decrease, however observed changes were not statistically significant. The improvement in morphotic parameters of blood was observed both in responder and nonresponder patients.
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Affiliation(s)
- N Grzaśko
- Klinika Hematoonkologii i Transplantacji Szpiku AM w Lublinie
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Hus M, Dmoszynska A, Soroka-Wojtaszko M, Jawniak D, Legiec W, Ciepnuch H, Hellmann A, Wolska-Smolen T, Skotnicki A, Manko J. Thalidomide treatment of resistant or relapsed multiple myeloma patients. Haematologica 2001; 86:404-8. [PMID: 11325647] [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: 02/19/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Thalidomide is currently used as a very promising drug in patients with recurrent multiple myeloma or those refractory to chemotherapy. Literature data show prolonged survival in patients with advanced multiple myeloma treated with thalidomide but the optimal time and dose of thalidomide treatment remain to be established. DESIGN AND METHODS We have treated 53 refractory or relapsed myeloma patients with thalidomide (Grunenthal, Aachen). The patients received thalidomide orally as monotherapy at a starting dose of 200 mg daily, with a dose increase of 100 mg every week to a maximum well-tolerated dose of 400 mg. All the patients qualified for the therapy underwent clinical and laboratory assessments every 4 weeks. Laboratory tests included complete blood count, electrophoresis, immunoglobulin level, lactate dehydrogenase (LDH), C-reactive protein, b2 microglobulin concentration, liver and renal function tests and there was also a monthly neurological examination. Bone marrow aspiration was performed every 3 months during the 12-month treatment. RESULTS Among 53 evaluable patients, a clinical response was observed in 27 (51%): there was a major response in 7 patients, a partial response in 12 and a minor response in 8. INTERPRETATION AND CONCLUSIONS In responding patients the earliest response was observed after 4 weeks of treatment and the latest after 12 weeks of treatment. Our results, obtained during a long observation period, show that thalidomide is an effective drug, with an acceptable degree of toxicity, in patients with refractory multiple myeloma.
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Affiliation(s)
- M Hus
- Department of Hematology University Medical School, Lublin, Poland
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Robak T, Bloński JZ, Kasznicki M, Konopka L, Ceglarek B, Dmoszyńska A, Soroka-Wojtaszko M, Skotnicki AB, Nowak W, Dwilewicz-Trojaczek J, Tomaszewska A, Hellmann A, Lewandowski K, Kuliczkowski K, Potoczek S, Zdziarska B, Hansz J, Kroll R, Komarnicki M, Holowiecki J, Grieb P. Cladribine with or without prednisone in the treatment of previously treated and untreated B-cell chronic lymphocytic leukaemia - updated results of the multicentre study of 378 patients. Br J Haematol 2000; 108:357-68. [PMID: 10691866 DOI: 10.1046/j.1365-2141.2000.01850.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Between January 1992 and January 1999, we treated 378 B-chronic lymphocytic leukaemia (CLL) patients with cladribine (2-CdA), and 255 of the patients were also treated with prednisone. A total of 194 patients were previously untreated, and 184 had relapsed or refractory disease after previous other therapy. Complete response (CR) was obtained in 111 (29.4%) and partial response (PR) in 138 (36.5%) patients, giving an overall response (OR) rate of 65.9%. CR and OR were achieved more frequently in patients in whom 2-CdA was a first-line treatment (45.4% and 82.5% respectively) than in the pretreated group (12.5% and 48.4% respectively) (P < 0.0001). The median duration of OR for previously untreated patients was 14.7 months and for pretreated patients 13.5 months (P = 0.09). The median survival evaluated from the beginning of 2-CdA treatment was shorter in the pretreated group (16.3 months) than in the untreated group (19.4 months) (P < 0.0001). A total of 117 (63.9%) patients died in the pretreated group and 63 (32.6%) in the untreated group. In pretreated patients, 2-CdA + prednisone (P) and 2-CdA alone resulted in similar OR (51.0% and 45.0% respectively; P = 0.4). In contrast, in untreated patients, 2-CdA + P produced a higher OR (85.4%) than 2-CdA alone (72.1%) (P = 0.04). Infections and fever of unknown origin, observed in 91 (49.4%) pretreated and 74 (38.1%) untreated patients (P = 0.03), were the most frequent toxic effects. Our results indicate that 2-CdA is an effective, relatively well-tolerated drug, especially in previously untreated CLL.
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Affiliation(s)
- T Robak
- Department of Haematology, Medical University of Lódz, Institute of Haematology and Blood Transfusion, Warsaw, Poland.
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