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https://www.readbyqxmd.com/read/29923432/autoimmune-cytopenias-in-chronic-lymphocytic-leukemia-a-concise-review-and-treatment-recommendations
#1
Tim R de Back, Arnon P Kater, Sanne H Tonino
Chronic lymphocytic leukemia (CLL) is frequently complicated by cytopenias, either due to bone marrow infiltration or autoimmunity, resulting in autoimmune hemolytic anemia (AIHA), immune thrombocytopenia (ITP), pure red cell aplasia (PRCA) or autoimmune neutropenia (AIN). Morbidity due to autoimmune cytopenias (AIC) can be substantial; in addition, infection risk increases and pre-existing infections might deteriorate due to immunosuppressive medication. In the aging population, CLL occurs more frequently and AIC related to CLL represent a growing clinical challenge...
June 20, 2018: Expert Review of Hematology
https://www.readbyqxmd.com/read/29911929/cytomegalovirus-reactivation-can-be-a-cause-of-dat-negative-hemolytic-anemia-in-patients-with-chronic-lymphocytic-leukemia
#2
Paolo Strati, Cristina Gabutti, Philip A Thompson, Dimitrios P Kontoyiannis, Alessandra Ferrajoli
No abstract text is available yet for this article.
June 18, 2018: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/29895707/comprehensive-safety-analysis-of-venetoclax-monotherapy-for-patients-with-relapsed-refractory-chronic-lymphocytic-leukemia
#3
Matthew S Davids, Michael Hallek, William Wierda, Andrew W Roberts, Stephan Stilgenbauer, Jeffrey A Jones, John F Gerecitano, Su Young Kim, Jalaja Potluri, Todd Busman, Andrea Best, Maria E Verdugo, Elisa Cerri, Monali Desai, Peter Hillmen, John F Seymour
PURPOSE: The oral BCL-2 inhibitor venetoclax is an effective therapy for patients with relapsed/refractory (R/R) chronic lymphocytic leukemia (CLL), including disease with high-risk genomic features such as chromosome 17p deletion (del[17p]) or progressive disease following B-cell receptor pathway inhibitors. EXPERIMENTAL DESIGN: We conducted a comprehensive analysis of the safety of 400mg daily venetoclax monotherapy in 350 patients with CLL using an integrated dataset from three phase-I/II studies...
June 12, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/29880603/sustained-efficacy-and-detailed-clinical-follow-up-of-first-line-ibrutinib-treatment-in-older-patients-with-chronic-lymphocytic-leukemia-extended-phase-3-results-from-resonate-2
#4
Paul M Barr, Tadeusz Robak, Carolyn Owen, Alessandra Tedeschi, Osnat Bairey, Nancy L Bartlett, Jan A Burger, Peter Hillmen, Steven Coutre, Stephen Devereux, Sebastian Grosicki, Helen McCarthy, Jianyong Li, David Simpson, Fritz Offner, Carol Moreno, Cathy Zhou, Lori Styles, Danelle James, Thomas J Kipps, Paolo Ghia
The results of RESONATE-2 (PCYC-1115/1116) supported the approval of ibrutinib for first-line treatment of chronic lymphocytic leukemia. An extended analysis of RESONATE-2 was conducted to determine long-term efficacy and safety of ibrutinib in older patients with chronic lymphocytic leukemia. A total of 269 patients aged ≥65 years with previously untreated chronic lymphocytic leukemia were randomized 1:1 to ibrutinib (n=136) or chlorambucil (n=133) on days 1 and 15 of a 28-day cycle for 12 cycles. Median ibrutinib treatment duration was 28...
June 7, 2018: Haematologica
https://www.readbyqxmd.com/read/29651369/unusual-relapse-of-chronic-lymphocytic-leukemia-after-remission
#5
Wajeeha Rizvi, Quoc Truong
Chronic lymphocytic leukemia (CLL) is the most prevalent leukemia with over 20,000 estimated cases in 2017. Leukemic involvement of the nervous system from CLL causing neurologic symptoms is reported in only about one percent of patients. Unfortunately, there is no current standard therapy for the treatment of CLL leptomeningeal disease. In this case, we discuss an unusual presentation of CLL leptomeningeal disease misdiagnosed as chronic rebound headache. A 61-year-old female was diagnosed with Rai stage I CLL in 2002...
February 9, 2018: Curēus
https://www.readbyqxmd.com/read/29569742/lenalidomide-as-immune-adjuvant-to-a-dendritic-cell-vaccine-in-chronic-lymphocytic-leukemia-patients
#6
Marzia Palma, Lotta Hansson, Tom A Mulder, Lars Adamson, Barbro Näsman-Glaser, Ingrid Eriksson, Kia Heimersson, Harriet Ryblom, Fariba Mozaffari, Ann Svensson, Giusy Gentilcore, Anders Österborg, Håkan Mellstedt
OBJECTIVES: We previously showed that immunization with ex vivo- generated autologous dendritic cells loaded with apoptotic tumor cells (Apo-DC) potentiated tumor-specific immunity in chronic lymphocytic leukemia (CLL) patients. Here, we evaluated safety and immunogenicity of Apo-DC in combination with lenalidomide, granulocyte-macrophage colony-stimulating factor (GM-CSF), and low-dose cyclophosphamide (CTX). METHODS: Ten previously untreated patients with slowly progressing CLL received 5 Apo-DC vaccinations and lenalidomide orally for 24 weeks either alone (cohort I, n = 5) or together with subcutaneous GM-CSF and intravenous CTX (cohort II, n = 5)...
March 23, 2018: European Journal of Haematology
https://www.readbyqxmd.com/read/29524963/coexistence-of-chronic-myeloid-leukemia-and-diffuse-large-b-cell-lymphoma-with-antecedent-chronic-lymphocytic-leukemia-a-case-report-and-review-of-the-literature
#7
Khadega A Abuelgasim, Hinna Rehan, Maha Alsubaie, Nasser Al Atwi, Mohammed Al Balwi, Saeed Alshieban, Areej Almughairi
BACKGROUND: Chronic lymphocytic leukemia and chronic myeloid leukemia are the most common types of adult leukemia. However, it is rare for the same patient to suffer from both. Richter's transformation to diffuse large B-cell lymphoma is frequently observed in chronic lymphocytic leukemia. Purine analog therapy and the presence of trisomy 12, and CCND1 gene rearrangement have been linked to increased risk of Richter's transformation. The coexistence of chronic myeloid leukemia and diffuse large B-cell lymphoma in the same patient is extremely rare, with only nine reported cases...
March 11, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29488168/mir-150-regulates-b-lymphocyte-in-autoimmune-hemolytic-anemia-evans-syndrome-by-c-myb
#8
Limin Xing, Wenyan Xu, Yingying Qu, Manjun Zhao, Hongli Zhu, Hong Liu, Huaquan Wang, Xin Su, Zonghong Shao
The objective of the study was to study the regulation of B lymphocytes in patients with autoimmune hemolytic anemia (AIHA)/Evans syndrome. From October 2015 to May 2016, 35 patients with AIHA/Evans in the Department of Hematology, Tianjin Medical University General Hospital were enrolled into this study. c-Myb mRNA and miR-150 expression in B lymphocytes were measured using real-time PCR (RT-PCR). Correlation between c-Myb and miR-150 and clinical parameters in patients with AIHA/Evans were analyzed. c-Myb mRNA expression in hemolysis patients was significantly higher than in remission patients and CLL patients, negatively correlated with hemoglobin (Hb) level and complement 3(C3) levels, and positively correlated with total bilirubin (TBIL) concentration and indirect bilirubin (IBIL) concentration...
February 27, 2018: International Journal of Hematology
https://www.readbyqxmd.com/read/29457831/low-t3-syndrome-as-a-predictor-of-poor-prognosis-in-chronic-lymphocytic-leukemia
#9
Rui Gao, Rui-Ze Chen, Yi Xia, Jin-Hua Liang, Li Wang, Hua-Yuan Zhu, Jia- Zhu Wu, Lei Fan, Jian-Yong Li, Tao Yang, Wei Xu
Low triiodothyronine (T3) state is associated with poor prognosis in critical acute and prolonged illness. However, the information on thyroid dysfunction and cancer is limited. The aim of our study was to evaluate the prognostic value of low T3 syndrome in chronic lymphocytic leukemia (CLL). Two hundred and fifty-eight patients with detailed thyroid hormone profile at CLL diagnosis were enrolled. Low T3 syndrome was defined by low free T3 (FT3) level accompanied by normal-to-low free tetraiodothyronine (FT4) and thyroid-stimulating hormone (TSH) levels...
February 19, 2018: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/29415938/-acquisition-of-igh-ccnd1-translocation-during-the-natural-disease-course-in-a-patient-with-chronic-lymphocytic-leukemia
#10
Kosuke Arai, Fumisato Takagi, Saeko Sonokawa, Sayaka Suzuki, Eisaku Ito, Kengo Takeuchi, Takashi Kumagai
A 69-year-old man visited a doctor because of systemic lymphadenopathy. Peripheral blood examination revealed leukocytosis, anemia, and decreased platelet count (WBC, 103,060/µl; lymph, 92.2%; Hb, 8.9 g/dl; and Plt, 4.1×104 /µl). Bone marrow biopsy revealed that approximately 70% of nucleated cells were small, mature lymphoid cells with positive immunostaining for CD5, CD20, and CD23. He was diagnosed with chronic lymphocytic leukemia (CLL). The IgH/CCND1 translocation and ATM locus loss in 20% and 95% peripheral cells, respectively, were detected by fluorescence in situ hybridization...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/29343153/cryptococcal-infections-in-two-patients-receiving-ibrutinib-therapy-for-chronic-lymphocytic-leukemia
#11
Matthew Stankowicz, Megan Banaszynski, Russell Crawford
Cryptococcal infections are responsible for significant morbidity and mortality in immunocompromised patients. Reports of these infections in patients on small molecular kinase inhibitors have not been widely reported in clinical trials. We describe one case of cryptococcal meningoencephalitis and one case of cryptococcal pneumonia in two patients who were receiving ibrutinib for chronic lymphocytic leukemia. Despite different sites of cryptococcal infection, both patients had similar presentations of acute illness...
January 1, 2018: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/29317454/casein-kinase-1-is-a-therapeutic-target-in-chronic-lymphocytic-leukemia
#12
Pavlina Janovska, Jan Verner, Jiri Kohoutek, Lenka Bryjova, Michaela Gregorova, Marta Dzimkova, Hana Skabrahova, Tomasz Radaszkiewicz, Petra Ovesna, Olga Vondalova Blanarova, Tereza Nemcova, Zuzana Hoferova, Katerina Vasickova, Lucie Smyckova, Alexander Egle, Sarka Pavlova, Lucie Poppova, Karla Plevova, Sarka Pospisilova, Vitezslav Bryja
Casein kinase 1δ/ε (CK1δ/ε) is a key component of noncanonical Wnt signaling pathways, which were shown previously to drive pathogenesis of chronic lymphocytic leukemia (CLL). In this study, we investigated thoroughly the effects of CK1δ/ε inhibition on the primary CLL cells and analyzed the therapeutic potential in vivo using 2 murine model systems based on the Eµ-TCL1-induced leukemia (syngeneic adoptive transfer model and spontaneous disease development), which resembles closely human CLL. We can demonstrate that the CK1δ/ε inhibitor PF-670462 significantly blocks microenvironmental interactions (chemotaxis, invasion and communication with stromal cells) in primary CLL cells in all major subtypes of CLL...
March 15, 2018: Blood
https://www.readbyqxmd.com/read/29305552/venetoclax-for-patients-with-chronic-lymphocytic-leukemia-who-progressed-during-or-after-idelalisib-therapy
#13
Steven Coutre, Michael Choi, Richard R Furman, Herbert Eradat, Leonard Heffner, Jeffrey A Jones, Brenda Chyla, Lang Zhou, Suresh Agarwal, Tina Waskiewicz, Maria Verdugo, Rod A Humerickhouse, Jalaja Potluri, William G Wierda, Matthew S Davids
B-cell receptor pathway inhibitors (BCRis) have transformed treatment of chronic lymphocytic leukemia (CLL); however, the efficacy of therapies for patients whose disease is refractory to/relapses after (R/R) BCRis is unknown. Venetoclax is a selective, orally bioavailable BCL-2 inhibitor with activity in patients with CLL, including those who are heavily pretreated or have 17p deletion. This phase 2 study prospectively evaluated venetoclax in patients with R/R CLL after ibrutinib or idelalisib; here we report on patients who received idelalisib as the last BCRi before enrollment...
April 12, 2018: Blood
https://www.readbyqxmd.com/read/29191916/duvelisib-a-novel-oral-dual-inhibitor-of-pi3k-%C3%AE-%C3%AE-is-clinically-active-in-advanced-hematologic-malignancies
#14
Ian W Flinn, Susan O'Brien, Brad Kahl, Manish Patel, Yasuhiro Oki, Francine F Foss, Pierluigi Porcu, Jeffrey Jones, Jan A Burger, Nitin Jain, Virginia M Kelly, Kerstin Allen, Mark Douglas, Jennifer Sweeney, Patrick Kelly, Steven Horwitz
Duvelisib is an oral dual inhibitor of phosphoinositide 3-kinase-δ (PI3K-δ) and PI3K-γ in late-stage clinical development for hematologic malignancy treatment. This phase 1 study evaluated maximum tolerated dose (MTD), pharmacokinetics, pharmacodynamics (PD), efficacy, and safety of duvelisib in 210 patients with advanced hematologic malignancies. In the dose escalation phase (n = 31), duvelisib 8 to 100 mg twice daily was administered, with MTD determined as 75 mg twice daily. In the expansion phase (n = 179), patients with indolent non-Hodgkin lymphoma (iNHL), chronic lymphocytic leukemia (CLL), or T-cell lymphoma (TCL) were treated with 25 or 75 mg duvelisib twice daily continuously...
February 22, 2018: Blood
https://www.readbyqxmd.com/read/29122300/using-prognostic-models-in-cll-to-personalize-approach-to-clinical-care-are-we-there-yet
#15
REVIEW
Alain Mina, Jose Sandoval Sus, Elsa Sleiman, Javier Pinilla-Ibarz, Farrukh T Awan, Mohamed A Kharfan-Dabaja
Four decades ago, two staging systems were developed to help stratify CLL into different prognostic categories. These systems, the Rai and the Binet staging, depended entirely on abnormal exam findings and evidence of anemia and thrombocytopenia. Better understanding of biologic, genetic, and molecular characteristics of CLL have contributed to better appreciating its clinical heterogeneity. New prognostic models, the GCLLSG prognostic index and the CLL-IPI, emerged. They incorporate biologic and genetic information related to CLL and are capable of predicting survival outcomes and cases anticipated to need therapy earlier in the disease course...
March 2018: Blood Reviews
https://www.readbyqxmd.com/read/29108368/phase-i-clinical-trial-of-the-base-excision-repair-inhibitor-methoxyamine-in-combination-with-fludarabine-for-patients-with-advanced-hematologic-malignancies
#16
Paolo F Caimi, Brenda W Cooper, Basem M William, Afshin Dowlati, Paul M Barr, Pingfu Fu, John Pink, Yan Xu, Hillard M Lazarus, Marcos de Lima, Stanton L Gerson
Purpose: We determined the safety, pharmacokinetics, pharmacodynamics and recommended phase II dose of the base excision repair blocker methoxyamine combined with fludarabine. Materials and Methods: This was a phase I study with intravenous fludarabine (25 mg/m2 , days 1-5), and methoxyamine (15 mg/m2 -120 mg/m2 , once). A maximum of six cycles were given. Adult patients with relapsed/refractory hematologic malignancies, excluding acute myeloid leukemia, were eligible...
October 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/29081197/-clinical-features-and-prognosis-of-17-patients-with-primary-cold-agglutinin-disease
#17
Y Y Wu, X X Cao, H Cai, L Zhang, D B Zhou, J Li
Objective: To explore the clinical characteristics, treatment and prognosis in 17 patients with primary cold agglutinin disease (CAD) . Methods: Clinical data, treatment and survival status of 17 patients diagnosed with primary cold agglutinin disease in Peking Union Medical College Hospital during April 2007 to October 2016 were retrospectively analyzed. The MYD88(L265P) mutation was tested in 4 patients. Results: The median age of 17 patients was 67 years (range, 51-86 years) , and male- to female ratio was 1...
September 14, 2017: Zhonghua Xue Ye Xue za Zhi, Zhonghua Xueyexue Zazhi
https://www.readbyqxmd.com/read/28945711/venetoclax-management-and-care-for-patients-with-relapsed-or-refractory-chronic-lymphocytic-leukemia
#18
Heather Brumbaugh Paradis, Debbie Alter, Diane Llerandi
BACKGROUND: Venetoclax (Venclexta™) is a potent, selective, orally available, small-molecule B-cell lymphoma 2 inhibitor that achieves response rates of about 80% and has an acceptable safety profile for patients with relapsed or refractory chronic lymphocytic leukemia (CLL).
. OBJECTIVES: The aim was to describe treatment management considerations when caring for patients using venetoclax.
. METHODS: A review was done of safety and management considerations based on current clinical practice and 240 patients with CLL who received venetoclax monotherapy on clinical trials from 2011-2016...
October 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28871936/xanthoma-like-skin-changes-in-an-elderly-woman-with-a-normal-lipid-profile
#19
Piotr Nockowski, Zdzisław Woźniak, Adam Reich, Joanna Maj
Dear Editor, An 83-year-old woman developed yellow-brownish infiltrates, nodules, and tumors mimicking xanthomas, mostly involving the periorbital and chest area within three months (Figure 1). She had no abnormalities in serum cholesterol or triglycerides levels. A detailed laboratory analysis revealed the presence of mild monoclonal gammopathy with a presence of immunoglobulin G (IgG) kappa light chains; however, according to hematologist consultation, it did not require medical intervention. Imaging assessment and ultrasound examination did not show any specific involvement of internal organs...
July 2017: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/28708231/ibrutinib-treatment-of-a-patient-with-relapsing-chronic-lymphocytic-leukemia-and-sustained-remission-of-richter-syndrome
#20
Elisa Albi, Stefano Baldoni, Patrizia Aureli, Erica Dorillo, Beatrice Del Papa, Stefano Ascani, Mauro Di Ianni, Franca Falzetti, Paolo Sportoletti
PURPOSE: Richter syndrome (RS) is a rare event in chronic lymphocytic leukemia (CLL) that is influenced by biological factors and prior CLL treatments. Ibrutinib is a Bruton tyrosine kinase inhibitor that has shown remarkable efficacy in CLL; however, little is known about its relationship to RS. We report a case of ibrutinib efficacy against CLL in a patient with prolonged remission of RS. METHODS: The patient was diagnosed with CLL in 2003. Biological findings at onset included absent ZAP70 expression, mutated IGVH, and NOTCH1 mutation...
November 15, 2017: Tumori
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