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https://www.readbyqxmd.com/read/27878822/wide-variations-in-blood-product-transfusion-practices-among-providers-who-care-for-patients-with-acute-leukemia-in-the-united-states
#1
Alexander B Pine, Eun-Ju Lee, Mikkael Sekeres, David P Steensma, Daniel Zelterman, Thomas Prebet, Amy DeZern, Rami Komrokji, Mark Litzow, Selina Luger, Richard Stone, Harry P Erba, Guillermo Garcia-Manero, Alfred I Lee, Nikolai A Podoltsev, Lisa Barbarotta, Stephanie Kasberg, Jeanne E Hendrickson, Steven D Gore, Amer M Zeidan
BACKGROUND: Transfusion of blood products is a key component of the supportive management in patients with acute leukemia (AL). However high-quality trial evidence and clinical outcome data to support specific transfusion goals for blood products for patients with AL remain limited leading to diverse transfusion practices. The primary objective of this study was to determine the spectrum of transfusion patterns in a variety of care settings among providers who treat AL patients. STUDY DESIGN AND METHODS: A 31-question survey queried providers caring for AL patients about the existence of institutional guidelines for transfusion of blood products, transfusion triggers for hemoglobin (Hb), platelets (PLTs), and fibrinogen in various settings including inpatient and outpatient and before procedures...
November 22, 2016: Transfusion
https://www.readbyqxmd.com/read/27849645/current-management-of-patients-with-chronic-myelomonocytic-leukemia
#2
Ana Alfonso, Guillermo Montalban-Bravo, Guillermo Garcia-Manero
PURPOSE OF REVIEW: The present review will focus on the current management of patients with chronic myelomonocytic leukemia (CMML) as well as in future therapeutic perspectives. RECENT FINDINGS: CMML is a clonal hematopoietic stem cell disorder characterized by peripheral blood monocytosis and myelodysplastic and myeloproliferative alterations in the bone marrow. Clinical behavior of the disease can be heterogeneous, with some patients having an indolent form of the disease, whereas others experience an aggressive course with decreased survival and eventual transformation to leukemia...
January 2017: Current Opinion in Oncology
https://www.readbyqxmd.com/read/27795561/a-clinical-trial-for-patients-with-acute-myeloid-leukemia-or-myelodysplastic-syndromes-not-eligible-for-standard-clinical-trials
#3
G Montalban-Bravo, X Huang, E Jabbour, G Borthakur, C D DiNardo, N Pemmaraju, J Cortes, S Verstovsek, T Kadia, N Daver, W Wierda, Y Alvarado, M Konopleva, F Ravandi, Z Estrov, N Jain, A Alfonso, M Brandt, T Sneed, H-C Chen, H Yang, C Bueso-Ramos, S Pierce, E Estey, Z Bohannan, H M Kantarjian, G Garcia-Manero
Most clinical trials exclude patients with poor performance or comorbidities. To study whether patients with these characteristics can be treated within a clinical trial, we conducted a study for patients with acute myeloid leukemia (AML) or myelodysplastic syndromes (MDS) with poor performance, organ dysfunction or comorbidities. Primary endpoint was 60-day survival. Study included stopping rules for survival and response. Treatment consisted on a combination of azacitidine and vorinostat. Thirty patients (16 with MDS, 14 with AML) were enrolled...
October 31, 2016: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
https://www.readbyqxmd.com/read/27774847/differential-response-to-hypomethylating-agents-based-on-sex-a-report-on-behalf-of-the-mds-clinical-research-consortium-mds-crc
#4
Amy E DeZern, Amer M Zeidan, John Barnard, Wesley Hand, Najla Al Ali, Francis Brown, Cassie Zimmerman, Gail J Roboz, Guillermo Garcia-Manero, David P Steensma, Rami S Komrokji, Mikkael A Sekeres
First-line therapy for higher-risk myelodysplastic syndromes (MDS) includes decitabine (DAC) or azacitidine (AZA). Variables have not identified differential response rates between these. We assessed the influence of patient sex on outcomes including overall survival (OS) in 642 patients with higher-risk MDS treated with AZA or DAC. DAC-treated patients (35% of females, 31% of males) had marginally better OS than AZA-treated patients (p = .043), (median OS of 18.7 months versus 16.4 months), but the difference varied strongly by sex...
October 24, 2016: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/27763690/chronic-myeloid-leukemia-among-patients-with-a-history-of-prior-malignancies-a-tale-of-dual-survivorship
#5
Paul B Koller, Hagop M Kantarjian, Graciela M Nogueras-Gonzalez, Elias Jabbour, Srdan Verstovsek, Gautam Borthakur, Zeev Estrov, William G Wierda, Guillermo Garcia-Manero, Alessandra Ferrajoli, Farhad Ravandi, Susan M O'Brien, Jorge E Cortes
BACKGROUND: Some patients with chronic myeloid leukemia (CML) have a history of previous malignancies. To the authors' knowledge, outcomes for CML diagnosed in these patients have not been well described. The current study was conducted to determine the outcome of patients with CML and a history of prior malignancies. METHODS: The current study included patients who were enrolled in clinical trials of tyrosine kinase inhibitors as initial therapy for CML in chronic phase from July 2000 to January 2014...
October 20, 2016: Cancer
https://www.readbyqxmd.com/read/27760759/kir-gene-haplotype-an-independent-predictor-of-clinical-outcome-in-mds-patients
#6
Kate Stringaris, David Marin, A John Barrett, Robert Hills, Catherine Sobieski, Kai Cao, Jerome G Saltarrelli, May Daher, Hila Shaim, Nathaniel Smith, David Linch, Rosemary Gale, Christopher Allen, Takuya Sekine, Rohtesh Mehta, Richard Champlin, Elizabeth J Shpall, Hagop Kantarjian, Guillermo Garcia-Manero, Katayoun Rezvani
Myelodysplastic syndromes (MDS) are a group of hematopoietic disorders affecting the myeloid lineage, characterized by cytopenias and clonal evolution to acute myeloid leukemia (AML). We hypothesized that natural killer (NK) cells and their activating killer immunoglobulin-like receptors (aKIRs) influence the immune surveillance and clinical outcome of patients with MDS. Here, we first examined the distribution of aKIR genes and haplotype in two independent cohorts of MDS and AML patients. The median number of aKIR genes was lower in MDS patients than healthy controls (2 vs...
October 19, 2016: Blood
https://www.readbyqxmd.com/read/27741352/phase-2-study-of-low-dose-clofarabine-plus-cytarabine-for-patients-with-higher-risk-myelodysplastic-syndrome-who-have-relapsed-or-are-refractory-to-hypomethylating-agents
#7
Elias Jabbour, Stefan Faderl, Koji Sasaki, Tapan Kadia, Naval Daver, Naveen Pemmaraju, Keyur Patel, Joseph D Khoury, Carlos Bueso-Ramos, Zachary Bohannan, Farhad Ravandi, Gautam Borthakur, Srdan Verstovsek, Darla Miller, Rita Maduike, Chitra Hosing, Hagop M Kantarjian, Guillermo Garcia-Manero
BACKGROUND: The outcome of patients with higher risk myelodysplastic syndromes (MDS) after hypomethylating agent (HMA) failure is poor. This study evaluated the safety and activity of a combination of low-dose clofarabine and cytarabine for these patients. METHODS: Seventy patients with higher risk MDS who had no response, progressed, or relapsed after at least 4 cycles of HMA therapy were treated. RESULTS: The median age was 72 years. Thirty-nine percent of the patients had high-risk disease according to the International Prognostic Scoring System, and 50% of the patients had poor-risk cytogenetics...
October 14, 2016: Cancer
https://www.readbyqxmd.com/read/27696391/prognostic-impact-of-pretreatment-cytogenetics-in-adult-philadelphia-chromosome-negative-acute-lymphoblastic-leukemia-in-the-era-of-minimal-residual-disease
#8
Ghayas C Issa, Hagop M Kantarjian, C Cameron Yin, Wei Qiao, Farhad Ravandi, Deborah Thomas, Nicholas J Short, Koji Sasaki, Guillermo Garcia-Manero, Tapan M Kadia, Jorge E Cortes, Naval Daver, Gautam Borthakur, Nitin Jain, Marina Konopleva, Issa Khouri, Partow Kebriaei, Richard E Champlin, Sherry Pierce, Susan M O'Brien, Elias Jabbour
BACKGROUND: The introduction of novel prognostic factors such as minimal residual disease (MRD) and genomic profiling has led to the reevaluation of the role of cytogenetics and other conventional factors in risk stratification for acute lymphoblastic leukemia (ALL). METHODS: This study assessed the impact of baseline cytogenetics on the outcomes of 428 adult patients with Philadelphia chromosome-negative ALL who were receiving frontline chemotherapy. Three hundred thirty patients (77%) were treated with hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone-based regimens, and 98 (23%) were treated with the augmented Berlin-Frankfurt-Munster regimen...
October 3, 2016: Cancer
https://www.readbyqxmd.com/read/27673440/buparlisib-a-pi3k-inhibitor-demonstrates-acceptable-tolerability-and-preliminary-activity-in-a-phase-i-trial-of-patients-with-advanced-leukemias
#9
Brittany Knick Ragon, Hagop Kantarjian, Elias Jabbour, Farhad Ravandi, Jorge Cortes, Gautam Borthakur, LaKiesha DeBose, Zhihong Zeng, Heather Schneider, Naveen Pemmaraju, Guillermo Garcia-Manero, Steven Kornblau, William Wierda, Jan Burger, Courtney D DiNardo, Michael Andreeff, Marina Konopleva, Naval Daver
Phosphatidylinositol-3-kinase (PI3K) signaling plays a crucial role in oncogene-mediated tumor growth and proliferation. Buparlisib (BKM120) is an oral pan-class I PI3K inhibitor. This phase I study was conducted to determine the dose limiting toxicity (DLT) and maximum tolerated dose (MTD) of BKM120 in patients (pts) with relapsed/refractory acute leukemias. Fourteen pts (12 acute myeloid leukemia, 1 acute lymphoblastic leukemia, 1 mixed phenotype leukemia) were enrolled. Twelve pts received BKM-120 80 mg/day and two 100 mg/day...
September 27, 2016: American Journal of Hematology
https://www.readbyqxmd.com/read/27602508/differential-impact-of-minimal-residual-disease-negativity-according-to-the-salvage-status-in-patients-with-relapsed-refractory-b-cell-acute-lymphoblastic-leukemia
#10
Elias Jabbour, Nicholas J Short, Jeffrey L Jorgensen, Musa Yilmaz, Farhad Ravandi, Sa A Wang, Deborah A Thomas, Joseph Khoury, Richard E Champlin, Issa Khouri, Partow Kebriaei, Susan M O'Brien, Guillermo Garcia-Manero, Jorge E Cortes, Koji Sasaki, Courtney D Dinardo, Tapan M Kadia, Nitin Jain, Marina Konopleva, Rebecca Garris, Hagop Kantarjian
BACKGROUND: Minimal residual disease (MRD) assessment predicts survival for patients with newly diagnosed acute lymphoblastic leukemia (ALL). Its significance in relapsed/refractory ALL is less clear. METHODS: This study identified 78 patients with relapsed/refractory B-cell ALL who achieved a morphologic response with inotuzumab ozogamicin (n = 41), blinatumomab (n = 11), or mini-hyperfractionated cyclophosphamide, vincristine, and doxorubicin plus inotuzumab (n = 26) during either salvage 1 (S1; n = 46) or salvage 2 (S2; n = 32) and had undergone an MRD assessment by multiparameter flow cytometry at the time of remission...
September 7, 2016: Cancer
https://www.readbyqxmd.com/read/27601000/outcome-of-patients-with-therapy-related-acute-myeloid-leukemia-with-or-without-a-history-of-myelodysplasia
#11
Koji Sasaki, Elias Jabbour, Jorge Cortes, Tapan Kadia, Guillermo Garcia-Manero, Gautam Borthakur, Preetesh Jain, Sherry Pierce, Naval Daver, Koichi Takahashi, Susan O'Brien, Hagop Kantarjian, Farhad Ravandi
PURPOSE: To learn whether an antecedent hematologic disorder (AHD) is associated with additional risk in patients with therapy-related acute myeloid leukemia (t-AML). PATIENTS AND METHODS: We reviewed data of 301 patients with newly diagnosed t-AML who sought care from January 2000 to January 2014 (183 t-AML without AHD, 118 t-AML with AHD). Overall, median follow-up was 44 months. RESULTS: The primary malignancy was non-Hodgkin lymphoma in 92 (31%), breast cancer in 80 (27%), and prostate cancer in 49 (16%)...
November 2016: Clinical Lymphoma, Myeloma & Leukemia
https://www.readbyqxmd.com/read/27538433/connect-mds-aml-design-of-the-myelodysplastic-syndromes-and-acute-myeloid-leukemia-disease-registry-a-prospective-observational-cohort-study
#12
David P Steensma, Medrdad Abedi, Rafael Bejar, Christopher R Cogle, Kathryn Foucar, Guillermo Garcia-Manero, Tracy I George, David Grinblatt, Rami Komrokji, Xiaomei Ma, Jaroslaw Maciejewski, Daniel A Pollyea, Michael R Savona, Bart Scott, Mikkael A Sekeres, Michael A Thompson, Arlene S Swern, Melissa Nifenecker, Mary M Sugrue, Harry Erba
BACKGROUND: Myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) are myeloid neoplasms in which outgrowth of neoplastic clones disrupts normal hematopoiesis. Some patients with unexplained persistent cytopenias may not meet minimal diagnostic criteria for MDS but an alternate diagnosis is not apparent; the term idiopathic cytopenia of undetermined significance (ICUS) has been used to describe this state. MDS and AML occur primarily in older patients who are often treated outside the clinical trial setting...
August 19, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27535995/cytopenia-levels-for-aiding-establishment-of-the-diagnosis-of-myelodysplastic-syndromes
#13
Peter L Greenberg, Heinz Tuechler, Julie Schanz, Guillermo Sanz, Guillermo Garcia-Manero, Francesc Solé, John M Bennett, David Bowen, Pierre Fenaux, Francois Dreyfus, Hagop Kantarjian, Andrea Kuendgen, Alessandro Levis, Luca Malcovati, Mario Cazzola, Jaroslav Cermak, Christa Fonatsch, Michelle M Le Beau, Marilyn L Slovak, Otto Krieger, Michael Luebbert, Jaroslaw Maciejewski, Silvia M M Magalhaes, Yasushi Miyazaki, Michael Pfeilstöcker, Mikkael Sekeres, Wolfgang R Sperr, Reinhard Stauder, Sudhir Tauro, Peter Valent, Teresa Vallespi, Arjan A van de Loosdrecht, Ulrich Germing, Detlef Haase
No abstract text is available yet for this article.
August 17, 2016: Blood
https://www.readbyqxmd.com/read/27521329/pde4-differential-expression-is-a-potential-prognostic-factor-and-therapeutic-target-in-patients-with-myelodysplastic-syndrome-and-chronic-myelomonocytic-leukemia
#14
Ali N Chamseddine, Monica Cabrero, Yue Wei, Irene Ganan-Gomez, Simona Colla, Koichi Takahashi, Hui Yang, Zachary S Bohannan, Guillermo Garcia-Manero
BACKGROUND (OR PURPOSE): Inflammation has an essential role in the pathogenesis of myelodysplastic syndromes (MDS). Its expression is controlled by phosphodiesterase 4 (PDE4). Thus, PDE4 inhibitors might be useful therapeutic targets for MDS. PATIENTS (OR MATERIALS) AND METHODS: We evaluated the expression of each isoform of PDE4 (A, B, C, and D) using transcriptomic profiling and examined the potential impact on the outcome of patients with MDS in terms of survival and response to hypomethylating agents...
August 2016: Clinical Lymphoma, Myeloma & Leukemia
https://www.readbyqxmd.com/read/27509035/a-propensity-score-matching-analysis-of-dasatinib-and-nilotinib-as-a-frontline-therapy-for-patients-with-chronic-myeloid-leukemia-in-chronic-phase
#15
Koichi Takahashi, Hagop M Kantarjian, Yulong Yang, Koji Sasaki, Preetesh Jain, Sara DellaSala, Farhad Ravandi, Tapan Kadia, Naveen Pemmaraju, Naval Daver, Gautam Borthakur, Guillermo Garcia-Manero, Elias Jabbour, Jorge E Cortes
BACKGROUND: Both dasatinib and nilotinib are approved frontline therapy for chronic myeloid leukemia in chronic phase (CML-CP) based on randomized trials compared with imatinib. However, no head-to-head comparison of dasatinib and nilotinib has been conducted in patients with newly diagnosed CML-CP. METHODS: The authors conducted a propensity score (PS) matched comparison of patients with CML-CP who received frontline therapy with either dasatinib (N = 102) or nilotinib (N = 104) under the respective phase 2 trials conducted in parallel...
November 15, 2016: Cancer
https://www.readbyqxmd.com/read/27508525/prognostic-significance-of-day-14-bone-marrow-evaluation-in-adults-with-philadelphia-chromosome-negative-acute-lymphoblastic-leukemia
#16
Nicholas J Short, Hagop M Kantarjian, Koji Sasaki, Jorge E Cortes, Farhad Ravandi, Deborah A Thomas, Guillermo Garcia-Manero, Issa Khouri, Partow Kebriaei, Richard E Champlin, Sherry Pierce, Ghayas C Issa, Marina Konopleva, Tapan M Kadia, Carlos Bueso-Ramos, Joseph D Khoury, Nitin Jain, Susan M O'Brien, Elias Jabbour
BACKGROUND: The role of day 14 (D14) bone marrow (BM) assessment in detecting increased blasts in patients undergoing induction for acute lymphoblastic leukemia (ALL) is not well defined. METHODS: This study evaluated 389 adolescent and adult patients with previously untreated Philadelphia chromosome-negative ALL who received frontline induction chemotherapy and for whom a D14 BM assessment was performed. RESULTS: A D14 BM blast proportion < 10% (including blast-free aplastic BM) was observed in 319 patients (82%), 10% to 29% was observed in 31 patients (8%), and ≥30% was observed in 39 patients (10%)...
August 10, 2016: Cancer
https://www.readbyqxmd.com/read/27494751/clinical-use-of-ruxolitinib-in-an-academic-medical-center-in-unselected-patients-with-myeloproliferative-neoplasms-not-on-clinical-study
#17
Kiran Naqvi, Naval Daver, Naveen Pemmaraju, Prithviraj Bose, Guillermo Garcia-Manero, Jorge Cortes, Hagop M Kantarjian, Srdan Verstovsek
Ruxolitinib is the only approved therapy for myelofibrosis (MF). However, its use in patients with myeloproliferative neoplasms (MPN) not participating in clinical studies has been poorly described. We reviewed the medical records of 45 patients (35 MF, 10 others) treated with ruxolitinib at our center, off clinical study, during the year after its approval. Patients had advanced features and were refractory to multiple therapies. Ruxolitinib was effective in reducing splenomegaly (51% response rate) and constitutional symptoms (42% response rate)...
August 5, 2016: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/27491594/comparative-evaluation-of-four-risk-scores-for-predicting-mortality-in-patients-with-implantable-cardioverter-defibrillator-for-primary-prevention
#18
Moisés Rodríguez-Mañero, Emad Abu Assi, Juan Miguel Sánchez-Gómez, Juan Fernández-Armenta, Ernesto Díaz-Infante, Ignacio García-Bolao, Juan Benezet-Mazuecos, Ana Andrés Lahuerta, Víctor Expósito-García, Vicente Bertomeu-González, Álvaro Arce-León, María Teresa Barrio-López, Rafael Peinado, Luis Martínez-Sande, Miguel A Arias
INTRODUCTION AND OBJECTIVES: Several clinical risk scores have been developed to identify patients at high risk of all-cause mortality despite implantation of an implantable cardioverter-defibrillator. We aimed to examine and compare the predictive capacity of 4 simple scoring systems (MADIT-II, FADES, PACE and SHOCKED) for predicting mortality after defibrillator implantation for primary prevention of sudden cardiac death in a Mediterranean country. METHODS: A multicenter retrospective study was performed in 15 Spanish hospitals...
August 1, 2016: Revista Española de Cardiología
https://www.readbyqxmd.com/read/27479888/hyper-cvad-plus-ponatinib-versus-hyper-cvad-plus-dasatinib-as-frontline-therapy-for-patients-with-philadelphia-chromosome-positive-acute-lymphoblastic-leukemia-a-propensity-score-analysis
#19
Koji Sasaki, Elias J Jabbour, Farhad Ravandi, Nicholas J Short, Deborah A Thomas, Guillermo Garcia-Manero, Naval G Daver, Tapan M Kadia, Marina Y Konopleva, Nitin Jain, Ghayas C Issa, Vicki Jeanis, Haim G Moore, Rebecca S Garris, Naveen Pemmaraju, Jorge E Cortes, Susan M O'Brien, Hagop M Kantarjian
BACKGROUND: The clinical efficacy of hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (HCVAD) plus ponatinib has not been compared with that of HCVAD plus dasatinib in patients with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) in a randomized clinical trial. METHODS: The authors analyzed 110 patients with newly diagnosed Ph+ ALL who were enrolled in 2 consecutive, prospective, phase 2 clinical trials of frontline HCVAD with either dasatinib (63 patients) or ponatinib (47 patients)...
August 1, 2016: Cancer
https://www.readbyqxmd.com/read/27474808/peripheral-blood-blast-clearance-is-an-independent-prognostic-factor-for-survival-and-response-to-acute-myeloid-leukemia-induction-chemotherapy
#20
Nicholas J Short, Christopher B Benton, Hsiang-Chun Chen, Peng Qiu, Lisa Gu, Sherry Pierce, Mark Brandt, Abhishek Maiti, Taejin L Min, Kiran Naqvi, Alfonso Quintas-Cardama, Marina Konopleva, Tapan Kadia, Jorge Cortes, Guillermo Garcia-Manero, Farhad Ravandi, Elias Jabbour, Hagop Kantarjian, Michael Andreeff
In patients with acute myeloid leukemia (AML), rapid reduction of circulating blasts with induction chemotherapy may serve as an in vivo marker of chemosensitivity. We performed a retrospective analysis of 363 patients with untreated AML who received induction chemotherapy in order to determine the relationship between day of blast disappearance (DOBD) and complete remission (CR) rates, event-free survival (EFS), and overall survival (OS). DOBD ≤ 5 vs. >5 was identified as the most discriminating cutoff for OS...
December 2016: American Journal of Hematology
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