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Remission, recovery, relapse

Bérangère S Joly, Alain Stepanian, Thierry Leblanc, David Hajage, Hervé Chambost, Jérôme Harambat, Fanny Fouyssac, Vincent Guigonis, Guy Leverger, Tim Ulinski, Thérésa Kwon, Chantal Loirat, Paul Coppo, Agnès Veyradier
BACKGROUND: Thrombotic thrombocytopenic purpura is a rare thrombotic microangiopathy, related to a severe ADAMTS13 deficiency (a disintegrin and metalloprotease with thromboSpondin type 1 repeats, member 13; activity <10% of normal). Childhood-onset thrombotic thrombocytopenic purpura is very rare and initially often misdiagnosed, especially when ADAMTS13 deficiency is acquired (ie, not linked to inherited mutations of the ADAMTS13 gene). We aimed to investigate initial presentation, management, and outcome of acquired thrombotic thrombocytopenic purpura in children...
October 3, 2016: Lancet Haematology
Stephen S Y Lam, Eric S K Ho, Bai-Liang He, Wui-Wing Wong, Chae-Yin Cher, Nelson K L Ng, Cheuk-Him Man, Harinder Gill, Alice M S Cheung, Ho-Wan Ip, Chi-Chiu So, Jerome Tamburini, Chi Wai Eric So, Dona N Ho, Chun-Hang Au, Tsun-Leung Chan, Edmond S K Ma, Raymond Liang, Yok-Lam Kwong, Anskar Y H Leung
An in vitro drug-screening platform on patient samples was developed and validated to design personalized treatment for relapsed/refractory acute myeloid leukemia (AML). Unbiased clustering and correlation showed that homoharringtonine (HHT), also known as omacetaxine mepesuccinate, exhibited preferential antileukemia effect against AML carrying internal tandem duplication of fms-like tyrosine kinase 3 (FLT3-ITD). It worked synergistically with FLT3 inhibitors to suppress leukemia growth in vitro and in xenograft mouse models...
October 5, 2016: Science Translational Medicine
Erkki Soini, Taru Hallinen, Mélanie Brignone, Rosanne Campbell, Françoise Diamand, Sandrine Cure, Maria Aalto-Setälä, Natalya Danchenko, Hannu J Koponen, Katarzyna Kolasa
OBJECTIVES: To assess the cost-utility of vortioxetine versus relevant comparators (agomelatine, bupropion SR, sertraline, and venlafaxine XR) in the Finnish setting in major depressive disorder (MDD) patients with inadequate response to selective serotonin- /serotonin-norepinephrine reuptake inhibitors. METHODS: A one-year analysis was conducted using a decision tree with a Markov state transition component. The health states were remission, relapse and recovery...
September 29, 2016: Expert Review of Pharmacoeconomics & Outcomes Research
Ygal Benhamou, Gilles Paintaud, Elie Azoulay, Pascale Poullin, Lionel Galicier, Céline Desvignes, Jean-Luc Baudel, Julie Peltier, Jean-Paul Mira, Frédéric Pène, Claire Presne, Samir Saheb, Christophe Deligny, Alexandra Rousseau, Frédéric Féger, Agnès Veyradier, Paul Coppo
The standard four-rituximab infusions treatment in acquired thrombotic thrombocytopenic purpura (TTP) remains empirical. Peripheral B cell depletion is correlated with the decrease in serum concentrations of anti-ADAMTS13 and associated with clinical response. To assess the efficacy of a rituximab regimen based on B cell depletion, 24 TTP patients were enrolled in this prospective multicentre single arm phase II study and then compared to patients from a previous study. Patients with a suboptimal response to a plasma exchange-based regimen received two infusions of rituximab 375 mg/m(2) within 4 days, and a third dose at day +15 of the first infusion if peripheral B cells were still detectable...
September 19, 2016: American Journal of Hematology
W Blum, B L Sanford, R Klisovic, D J DeAngelo, G Uy, B L Powell, W Stock, M R Baer, J E Kolitz, E S Wang, E Hoke, K Mrózek, J Kohlschmidt, C D Bloomfield, S Geyer, G Marcucci, R M Stone, R A Larson
In this prospective phase 2 clinical trial conducted by Cancer and Leukemia Group B (CALGB, now the Alliance), we studied decitabine as maintenance therapy for younger adults with acute myeloid leukemia (AML) who remained in first complete remission (CR1) following intensive induction and consolidation. Given that decitabine is clinically active in AML and with hypomethylating activity distinct from cytotoxic chemotherapy, we hypothesized that 1 year of maintenance therapy would improve disease-free survival (DFS) for AML patients <60 years, who did not receive allogeneic stem cell transplantation in CR1...
October 7, 2016: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
Katie Joyce, Andrew Thompson, Steven Marwaha
BACKGROUND: We aimed to investigate a key element of the early intervention approach whether treatment at an earlier stage of bipolar disorder is more effective than later in its course. METHODS: A comprehensive literature review using Medline, Embase, Psychinfo, PsycArticle, and Web of Science, as data sources, with a subsequent narrative synthesis. Study quality was assessed using the Cochrane risk of bias method. RESULTS: Our search strategy yielded eight primary papers and two meta-analyses (of psychological therapies and Olanzapine) in total representing 8942 patients...
December 2016: International Journal of Bipolar Disorders
Jeffrey R Vittengl, Lee Anna Clark, Michael E Thase, Robin B Jarrett
BACKGROUND: Acute-phase cognitive therapy (CT) is an efficacious treatment for major depressive disorder (MDD), but responders experience varying post-acute outcomes (e.g., relapse vs. recovery). Responders' symptom-change trajectories during response to acute-phase CT may predict longer term outcomes. METHOD: We studied adult outpatients (N = 220) with recurrent MDD who responded to CT but had residual symptoms. Responders with linear (steady improvement), log-linear (quicker improvement earlier and slower later), one-step (a single, relatively large, stable improvement between adjacent assessments), or undefined (not linear, log-linear, or one-step) symptom trajectories were assessed every 4 months for 32 additional months...
August 18, 2016: Behaviour Research and Therapy
Chunmeng Wang, Zhiqiang Wu, Yao Wang, Yelei Guo, Hanren Dai, Xiao-Hui Wang, Xiang Li, Ya-Jing Zhang, Wen-Ying Zhang, Mei-Xia Chen, Yan Zhang, Kai-Chao Feng, Yang Liu, Su-Xia Li, Qing-Ming Yang, Weidong Han
PURPOSE: Relapsed or refractory Hodgkin's lymphoma is a challenge for medical oncologists because of poor overall survival. We aimed to assess the feasibility, safety, and efficacy of CD30-targeting CAR T cells in patients with progressive relapsed or refractory HL. EXPERIMENTAL DESIGN: Patients with relapsed or refractory HL received a conditioning chemotherapy followed by the CART-30 cell infusion. The level of CAR transgenes in peripheral blood and biopsied tumor tissues was measured periodically according to an assigned protocol by quantitative Polymerase Chain Reaction...
August 31, 2016: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Betül Oran, Jeff L Jorgensen, David Marin, Sa Wang, Sairah Ahmed, Amin M Alousi, Borje S Andersson, Qaiser Bashir, Roland Bassett, Genevieve Lyons, Julianne Chen, Katy Rezvani, Uday Popat, Partow Kebriaei, Keyur Patel, Gabriela Rondon, Elisabeth J Shpall, Richard E Champlin
Our aim was to improve outcome prediction after allogeneic hematopoetic stem cell transplantation in acute myeloid leukemia by combining cytogenetic and molecular data at diagnosis with minimal residual disease assessment by multicolor flow-cytometry at transplantation. Acute myeloid leukemia patients in first complete remission with minimal residual disease assessment at transplant were included and categorized by European LeukemiaNet classification. Primary outcome was 1- year relapse incidence after transplant...
August 18, 2016: Haematologica
Xiangyu Zhao, Feng Gao, Xiaohui Zhang, Yu Wang, Lanping Xu, Kaiyan Liu, Xiaosu Zhao, Yingjun Chang, Han Wei, Huan Chen, Yuhong Chen, Zhengfan Jiang, Xiaojun Huang
The effects of haploidentical rhG-CSF-mobilized blood and marrow transplantation (HBMT) on hematological malignances are well established. Previous prospective single-center studies have demonstrated better survival after HBMT versus haploidentical rhG-CSF-mobilized peripheral blood stem cell transplantation (HPBSCT) for acute leukemia (AL) not in remission (NR) or in more than the second complete remission (>CR2). To test the hypothesis that HBMT is still superior to HPBSCT for patients with AL, multiple myeloma (MM), or non-Hodgkin lymphoma (NHL) in CR1/CR2 and for patients with chronic myeloid leukemia in the first and second chronic phase lacking a matched donor, we designed a propensity score method-based multicenter study...
August 17, 2016: Science China. Life Sciences
I Poizot-Martin, S Brégigeon, C Tamalet, R Bouabdallah, O Zaegel-Faucher, V Obry-Roguet, A Ivanova, C E Cano, C Solas
Background. Non-AIDS-defining cancers represent a rising health issue among HIV-infected patients. Nevertheless, HIV testing is not systematic during the initial cancer staging. Here, we report a case of HIV infection diagnosed three years after chemotherapy initiation for multiple myeloma. Results. A 57-year-old woman diagnosed with multiple myeloma underwent a first round of chemotherapy by bortezomib/lenalidomide and then with bortezomib/liposomal-doxorubicine/dexamethasone, with partial remission, poor hematological tolerance, and multiple episodes of pneumococcal infection...
2016: Case Reports in Oncological Medicine
Armin Ghobadi, Jaebok Choi, Mark A Fiala, Theresa Fletcher, Jingxia Liu, Linda G Eissenberg, Camille Abboud, Amanda Cashen, Ravi Vij, Mark A Schroeder, Iskra Pusic, Keith Stockerl-Goldstein, Meagan Jacoby, Geoffrey Uy, John DiPersio, Peter Westervelt
Donor lymphocyte infusion (DLI) without prophylactic immunosuppression has been used for relapsed AML after allogeneic stem cell transplant (allo-SCT). However DLI is associated with an increased incidence of acute Graft vs. Host Disease (aGVHD). In mice, administration of azacitidine (AzaC) on days 4, 6, 8, and 10 post DLI increases regulatory T cell (Treg) numbers and prevents GVHD without hindering Graft vs. Leukemia (GVL). Based on these findings, we conducted a phase 1 study of AzaC post DLI for AML relapse post allo-SCT...
October 2016: Leukemia Research
Xiao-Ling Niu, Sheng Hao, Ping Wang, Wei Zhang, Gui-Mei Guo, Ying Wu, Xin-Yu Kuang, Guang-Hua Zhu, Wen-Yan Huang
Rituximab (RTX) can be used in children with nephrotic syndrome, particularly in those with steroid-dependent nephrotic syndrome (SDNS). However, at present there is no unified standard of how to use RTX, with regard to the amount of doses and frequency, in children with nephrotic syndrome. The study aimed to investigate the therapeutic efficacy of a single dose of RTX in children with steroid-dependent minimal change nephrotic syndrome (SD-MCNS). The patients with biopsy-proven minimal change disease (MCD) and clinical features of SDNS received a single dose of RTX (375 mg/m(2))...
August 2016: Biomedical Reports
Karen W L Yee, Hsiao-Wei T Chen, David W Hedley, Sue Chow, Joseph Brandwein, Andre C Schuh, Aaron D Schimmer, Vikas Gupta, Deborah Sanfelice, Tara Johnson, Lisa W Le, Jamie Arnott, Mark R Bray, Carolyn Sidor, Mark D Minden
ENMD-2076 is a novel, orally-active molecule that inhibits Aurora A kinase, as well as c-Kit, FLT3 and VEGFR2. A phase I study was conducted to determine the maximum tolerated dose (MTD), recommended phase 2 dose (RP2D) and toxicities of ENMD-2076 in patients with acute myeloid leukemia (AML) and chronic myelomonocytic leukemia (CMML). Patients received escalating doses of ENMD-2076 administered orally daily [225 mg (n = 7), 375 mg (n = 6), 325 mg (n = 9), or 275 mg (n = 5)]. Twenty-seven patients were treated (26 AML; 1 CMML-2)...
October 2016: Investigational New Drugs
Taku Omura, Eizo Watanabe, Yasufumi Otsuka, Yoko Yoshida, Hideki Kato, Masaomi Nangaku, Toshiyuki Miyata, Shigeto Oda
UNLABELLED: To describe a case of complete remission of thrombotic microangiopathy after treatment with eculizumab in a patient with non-Shiga toxin-associated bacterial enteritis. CASE REPORT: Medical/surgical intensive care unit (ICU) of a university teaching hospital.A 62-year-old man presented to a local hospital with mucous and bloody stool persisting for 1 month and worsening abdominal pain for 2 weeks. He had thrombocytopenia and renal dysfunction and was admitted with a diagnosis of sepsis due to intraabdominal infection...
July 2016: Medicine (Baltimore)
(no author information available yet)
According to a phase III study, the antibody-drug conjugate inotuzumab ozogamicin is more likely to induce complete remissions, with full or incomplete hematologic recovery, in patients with relapsed or refractory acute lymphocytic leukemia. Data from a phase I study of another antibody-drug conjugate, vadastuximab talirine, demonstrates that it is safe and effective against acute myeloid leukemia.
September 2016: Cancer Discovery
Koen van Besien, Nebu Koshy, Usama Gergis, Sebastian Mayer, Melissa Cushing, Hannah Rennert, Ronit Reich-Slotky, Tomer Mark, Roger Pearse, Adriana Rossi, Adrienne Phillips, Liljana Vasovic, Rosanna Ferrante, Yen-Michael Hsu, Tsiporah Shore
Haplo-cord stem cell transplantation combines the infusion of CD34 selected hematopoietic progenitors from a haplo-identical donor with an umbilical cord blood (UCB) graft from an unrelated donor and allows faster count recovery, with low rates of disease recurrence and chronic graft-versus-host disease (GVHD). But the contribution of the umbilical cord blood graft to long-term transplant outcome remains unclear. We analyzed 39 recipients of haplo-cord transplants with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS), engrafted and in remission at 2 months...
June 23, 2016: Leukemia & Lymphoma
W-R Huang, H-H Li, C-J Gao, J Bo, F Li, L-P Dou, L-L Wang, Y Jing, L Wang, D-H Liu, L Yu
Emerging data demonstrate promising results of related haploidentical allogeneic hematopoietic stem cell transplantation (haplo-HCT) for the treatment of hematologic malignancies. Data about G-CSF primed PBSC as reliable source of graft with myeloablative conditioning are lacking. We updated the outcomes in 130 adult patients with high-risk hematologic malignancies who received haplo-PBSC transplantation consecutively under busulfan-based conditioning. PBSC were freshly isolated and infused without ex vivo T-cell depletion into the recipients...
June 20, 2016: Bone Marrow Transplantation
Hagop M Kantarjian, Daniel J DeAngelo, Matthias Stelljes, Giovanni Martinelli, Michaela Liedtke, Wendy Stock, Nicola Gökbuget, Susan O'Brien, Kongming Wang, Tao Wang, M Luisa Paccagnella, Barbara Sleight, Erik Vandendries, Anjali S Advani
BACKGROUND: The prognosis for adults with relapsed acute lymphoblastic leukemia is poor. We sought to determine whether inotuzumab ozogamicin, an anti-CD22 antibody conjugated to calicheamicin, results in better outcomes in patients with relapsed or refractory acute lymphoblastic leukemia than does standard therapy. METHODS: In this phase 3 trial, we randomly assigned adults with relapsed or refractory acute lymphoblastic leukemia to receive either inotuzumab ozogamicin (inotuzumab ozogamicin group) or standard intensive chemotherapy (standard-therapy group)...
August 25, 2016: New England Journal of Medicine
Chang-Yien Chan, Isaac Desheng Liu, Lourdes Paula Resontoc, Kar-Hui Ng, Yiong-Huak Chan, Perry Yew-Weng Lau, Mya Than, Stanley C Jordan, Kong-Peng Lam, Wee-Song Yeo, Hui-Kim Yap
BACKGROUND AND OBJECTIVES: Rituximab is used with variable success in difficult FSGS. Because B cell depletion significantly affects T cell function, we characterized T cell subsets in patients with FSGS to determine if an immunologic signature predictive of favorable response to rituximab could be identified. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Twenty-two consecutive patients with FSGS (median age =14.4 years old; range =6.2-25.0 years old) and age of onset of nephrotic syndrome 1-18 years old receiving rituximab for clinical indications between October of 2009 and February of 2014 were studied...
August 8, 2016: Clinical Journal of the American Society of Nephrology: CJASN
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