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Bendamustine transplantation

Sylvain P Chantepie, Sylvain Garciaz, Emmanuelle Tchernonog, Frederic Peyrade, Marie-Virginie Larcher, Momar Diouf, Luc Mathieu Fornecker, Roch Houot, Thomas Gastinne, Carole Soussain, Sandra Malak, Richard Lemal, Caroline Delette, Ahmad Ibrahim, Anne-Claire Gac, E Reboursière, Jean-Pierre Vilque, Mohamed Amine Bekadja, Rene-Olivier Casasnovas, Remy Gressin, Stéphanie Guidez, Diane Coso, Charles Herbaux, Krimo Bouabdallah, Eric Durot, Gandhi Damaj
Carmustine shortage has led to an increase use of alternative conditioning regimens prior to autologous stem cell transplantation for the treatment of lymphoma, including Bendamustine-based (BeEAM). The aim of this study was to evaluate the safety of the BeEAM regimen in a large cohort of patients. A total of 474 patients with a median age of 56 years were analyzed. The majority of patients had diffuse large B-cell lymphoma (43.5%). Bendamustine was administered at a median dose of 197 mg/m2 /day (50-250) on days -7 and -6...
February 23, 2018: American Journal of Hematology
Matthew Ettleson, Kale S Bongers, Kaitlyn Vitale, Anthony J Perissinotti, Tycel Phillips, Bernard L Marini
Mantle cell lymphoma is a mature B-cell non-Hodgkin lymphoma characterized by the hallmark (11;14) chromosomal translocation, which often presents with lymphadenopathy and extra-nodal involvement. Young, fit patients are generally treated with chemotherapy approaches that incorporate high-dose cytarabine (e.g. the Nordic regimen) followed by autologous hematopoietic cell transplantation. Because of the significant activity of cytarabine in mantle cell lymphoma, increasingly, high- and intermediate-dose cytarabine are being used in the treatment of elderly mantle cell lymphoma patients...
January 1, 2018: Journal of Oncology Pharmacy Practice
Owen A O'Connor, Jennifer K Lue, Ahmed Sawas, Jennifer E Amengual, Changchun Deng, Matko Kalac, Lorenzo Falchi, Enrica Marchi, Ithamar Turenne, Renee Lichtenstein, Celeste Rojas, Mark Francescone, Lawrence Schwartz, Bin Cheng, Kerry J Savage, Diego Villa, Michael Crump, Anca Prica, Vishal Kukreti, Serge Cremers, Joseph M Connors, John Kurvuilla
BACKGROUND: Brentuximab vedotin is currently approved for patients with relapsed or refractory Hodgkin's lymphoma who previously received an autologous stem cell transplant or two previous multiagent chemotherapy regimens, and for patients with relapsed or refractory systemic anaplastic large-T-cell lymphoma who previously received at least one chemotherapy regimen. A high proportion of patients with CD30-expressing relapsed or refractory lymphomas have durable responses to single-agent brentuximab vedotin and show longer progression-free survival than do patients treated with chemotherapy...
February 2018: Lancet Oncology
Khalil Saleh, Alina Danu, Serge Koscielny, Clémence Legoupil, Sylvain Pilorge, Cristina Castilla-Llorente, David Ghez, Julien Lazarovici, Jean-Marie Michot, Nadine Khalife-Saleh, Valerie Lapierre, Kamelia Alenxandrova, Julia Arfi-Rouche, Jean-Henri Bourhis, Vincent Ribrag
The combination of carmustine, etoposide, aracytin, and melphalan(BEAM) conditioning regimen in autologous stem-cell transplantation (ASCT) is widely used in patients with relapsed/refractory non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma. It is also an option in patients with very-high risk aggressive NHL in first complete remission (CR). Recently, a phase Ib-II feasibility study using bendamustine replacing carmustine (BCNU) was reported. We report herein a safety and efficacy analysis of bendamustine-EAM (BeEAM) with a control BEAM counterpart paired cohort (1/2)...
November 22, 2017: Leukemia & Lymphoma
Sabina Kersting, Suzanne I M Neppelenbroek, Hein P J Visser, Michel van Gelder, Mark-David Levin, Rogier Mous, Ward Posthuma, Hanneke M van der Straaten, Arnon P Kater
INTRODUCTION: In recent years, considerable progress has been made in the treatment of patients with chronic lymphocytic leukemia (CLL), and new potent drugs have become available. Therefore, the CLL working party revised the Dutch guidelines. Not only efficacy but also quality of life and socio-economic impact were taken into account in the formulation of treatment recommendations. MATERIALS AND METHODS: The working party discussed a set of questions regarding diagnostic tests and treatment and wrote the draft guideline...
January 2018: Clinical Lymphoma, Myeloma & Leukemia
Zsuzsa Molnár, László Imre Pinczés, Klára Piukovics, Ildikó Istenes, Krisztina Wolf, Zoltán Csukly, Árpád Szomor, Árpád Illés, Zsófia Miltényi
INTRODUCTION: The treatment of relapsed or refractory Hodgkin lymphoma is still a major therapeutic challenge. The use of brentuximab vedotin, an anti-CD30 antibody-drug conjugate, represents a promising approach for these patients, however clinical outcomes have not yet been evaluated in Hungary. AIM: Our aim was to assess the efficacy, safety and outcome of brentuximab vedotin treatment in Hungarian Hodgkin lymphoma patients. METHOD: In this retrospective case note review we enrolled patients at 6 clinical sites countrywide who were diagnosed with Hodgkin lymphoma and received brentuximab vedotin between 1 January 2013 and 31 December 2016...
October 2017: Orvosi Hetilap
Shelagh M Szabo, Ishan Hirji, Karissa M Johnston, Ariadna Juarez-Garcia, Joseph M Connors
OBJECTIVES: Although brentuximab vedotin (BV) has changed the management of patients with relapsed or refractory Hodgkin lymphoma (RRHL), little information is available on routine clinical practice. We identified treatment patterns and costs of care among RRHL patients in the United States (US) treated with BV. METHODS: A retrospective observational study of adults initiating BV for RRHL from 2011-2015, with ≥6 months of data prior to and following BV initiation, was conducted...
2017: PloS One
Koji Izutsu
Mantle cell lymphoma (MCL) is an aggressive B-cell lymphoma characterized by CD5+, CCND1+, and the CCND1-IGH translocation. Although patients with MCL respond, at least temporarily, to conventional chemotherapy, they eventually have a relapse and the prognosis is generally poor. As a primary treatment option for patients with untreated MCL, a rituximab-containing chemotherapy regimen is administered according to the patient's eligibility for high-dose chemotherapy followed by autologous stem cell transplantation (ASCT)...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Alessandro Broccoli, Lisa Argnani, Pier Luigi Zinzani
Patients with relapsed or refractory peripheral T-cell lymphoma display a dismal prognosis and their therapy represents an unmet medical need, as the best treatment strategy is yet to be determined. Exciting data on novel targeted agents are now emerging from recently concluded and ongoing clinical trials in patients with relapsed and refractory PTCL. Four recently approved compounds are used as single agents: pralatrexate, a novel antifolate agent; romidepsin and belinostat, both histone deacetylase (HDAC) inhibitors; brentuximab vedotin, an anti-CD30 drug-conjugated monoclonal antibody...
November 2017: Cancer Treatment Reviews
Bita Fakhri, Brad Kahl
Mantle cell lymphoma (MCL) is a B-cell non-Hodgkin lymphoma with typically aggressive behavior. The genetic signature is the chromosomal translocation t(11;14)(q13;q32) resulting in overexpression of cyclin D1. Asymptomatic newly diagnosed MCL patients with low tumor burden can be closely observed, deferring therapy to the time of disease progression. Although MCL classically responds to upfront chemotherapy, it remains incurable with standard approaches. For patients in need of frontline therapy, the initial decision is whether to proceed with an intensive treatment strategy or a non-intensive treatment strategy...
August 2017: Therapeutic Advances in Hematology
Julie M Vose
DISEASE OVERVIEW: Mantle cell lymphoma (MCL) is a non-Hodgkin lymphoma characterized by involvement of the lymph nodes, spleen, blood and bone marrow with a short remission duration to standard therapies and a median overall survival (OS) of 4-5 years. DIAGNOSIS: Diagnosis is based on lymph node, bone marrow, or tissue morphology of centrocytic lymphocytes, small cell type, or blastoid variant cells. A chromosomal translocation t (11:14) is the molecular hallmark of MCL, resulting in the overexpression of cyclin D1...
August 2017: American Journal of Hematology
Sarah Bétrian, Sarah Guenounou, Isabelle Luquet, Cécile Demur, Anne Huynh, Loïc Ysebaert, Christian Recher, Françoise Huguet
Optimal treatment of blastic plasmacytoid dendritic cell neoplasm (BPDCN), a rare entity of dismal prognosis previously described as CD4+/CD56+ hematodermic malignancies, is not defined. We report five cases of relapsed BPDCN treated with bendamustine hydrochloride, a well-tolerated bifunctional drug acting as an alkylating and antimetabolite agent. All patients were above the age of 50 years and in advanced disease (early first relapse in two, subsequent relapse in three; multi-organ involvement in four; previous intensive chemotherapy in five; and stem cell transplantation in four)...
June 2017: Hematological Oncology
Amandeep Salhotra, Yuan Shan, Ni-Chun Tsai, James F Sanchez, Ibrahim Aldoss, Haris Ali, Tanya Paris, Ricardo Spielberger, Thai M Cao, Auayporn Nademanee, Stephen J Forman, Robert Chen
Induction regimens for mantle cell lymphoma (MCL) can be categorized into highly intensive regimens containing cytarabine and less intense regimens, such as rituximab, cyclophosphamide, hydroxydaunorubicin, vincristine, and prednisone (R-CHOP) or rituximab with bendamustine (R-bendamustine). Prior publications have shown rituximab and hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (R-hyperCVAD) can be associated with stem cell mobilization failures. However, those studies did not include the use of plerixafor as rescue for stem cell mobilization failure...
August 2017: Biology of Blood and Marrow Transplantation
Jean El Cheikh, Radwan Massoud, Basel Haffar, Elie Fares, Rami Mahfouz, Tamima Jisr, Mohamed A Kharfan-Dabaja, Anas Mougharbel, Ali Youssef, Ali Bazarbachi, Ahmad Ibrahim
No abstract text is available yet for this article.
March 28, 2017: Leukemia & Lymphoma
Morie A Gertz
Disease Overview: Waldenström macroglobulinemia (WM) is a lymphoplasmacytic lymphoma with immunoglobulin M (IgM) monoclonal protein. Clinical features include anemia, thrombocytopenia, hepatosplenomegaly, lymphadenopathy, and rarely hyperviscosity. DIAGNOSIS: Presence of IgM monoclonal protein associated with ≥10% clonal lymphoplasmacytic cells in bone marrow confirms the diagnosis. The L265P mutation in MYD88 is detectable in more than 90% of patients. Risk Stratification: Age, hemoglobin level, platelet count, β2 microglobulin, and monoclonal IgM concentrations are characteristics required for prognosis...
February 2017: American Journal of Hematology
Prashant Kapoor, Stephen M Ansell, Rafael Fonseca, Asher Chanan-Khan, Robert A Kyle, Shaji K Kumar, Joseph R Mikhael, Thomas E Witzig, Michelle Mauermann, Angela Dispenzieri, Sikander Ailawadhi, A Keith Stewart, Martha Q Lacy, Carrie A Thompson, Francis K Buadi, David Dingli, William G Morice, Ronald S Go, Dragan Jevremovic, Taimur Sher, Rebecca L King, Esteban Braggio, Ann Novak, Vivek Roy, Rhett P Ketterling, Patricia T Greipp, Martha Grogan, Ivana N Micallef, P Leif Bergsagel, Joseph P Colgan, Nelson Leung, Wilson I Gonsalves, Yi Lin, David J Inwards, Suzanne R Hayman, Grzegorz S Nowakowski, Patrick B Johnston, Steven J Russell, Svetomir N Markovic, Steven R Zeldenrust, Yi L Hwa, John A Lust, Luis F Porrata, Thomas M Habermann, S Vincent Rajkumar, Morie A Gertz, Craig B Reeder
Importance: Waldenström macroglobulinemia (WM), an IgM-associated lymphoplasmacytic lymphoma, has witnessed several practice-altering advances in recent years. With availability of a wider array of therapies, the management strategies have become increasingly complex. Our multidisciplinary team appraised studies published or presented up to December 2015 to provide consensus recommendations for a risk-adapted approach to WM, using a grading system. Observations: Waldenström macroglobulinemia remains a rare, incurable cancer, with a heterogeneous disease course...
September 1, 2017: JAMA Oncology
Stefanie Gilli, Urban Novak, Behrouz Mansouri Taleghani, Gabriela M Baerlocher, Kurt Leibundgut, Yara Banz, Thilo Zander, Daniel Betticher, Thomas Egger, Daniel Rauch, Thomas Pabst
BEAM with BCNU is commonly used for conditioning treatment followed by autologous stem cell transplantation (ASCT). However, pulmonary toxicity and availability issues associated with BCNU prompted us to evaluate bendamustine-replacing BCNU (BeEAM). We analyzed 39 lymphoma patients receiving BeEAM conditioning with 200 mg/m(2) bendamustine at days -7 and -6. The median duration until neutrophil recovery was 11 days, and 15 days for platelet recovery (>20 g/L). The most common grade 3/4 non-hematologic toxicities comprised mucosal side effects (27 pts...
March 2017: Annals of Hematology
Giulia Zumbo, Omid Sadeghi-Alavijeh, Philip N Hawkins, Marianna Fontana
Systemic light-chain (AL) amyloidosis is an infiltrative disorder associated with an underlying plasma cells dyscrasia, in which monoclonal immunoglobulin light chains accumulate in an abnormal misfolded form as amyloid fibrils in the extracellular space. Symptoms and prognosis are governed by which organs are affected, and cardiac involvement is the major determinant of survival. Diagnosis requires demonstration of amyloid deposition and confirmation of the fibril protein type. Areas covered: This review will focus on the available treatments for systemic AL amyloidosis and on new drug targets and therapeutic approaches...
February 2017: Expert Opinion on Pharmacotherapy
Robert W Chen, Hongli Li, Steven H Bernstein, Samir Kahwash, Lisa M Rimsza, Stephen J Forman, Louis Constine, Thomas C Shea, Amanda F Cashen, Kristie A Blum, Timothy S Fenske, Paul M Barr, Tycel Phillips, Michael Leblanc, Richard I Fisher, Bruce D Cheson, Sonali M Smith, Malek Faham, Jennifer Wilkins, John P Leonard, Brad S Kahl, Jonathan W Friedberg
Aggressive induction chemotherapy followed by autologous haematopoietic stem cell transplant (auto-HCT) is effective for younger patients with mantle cell lymphoma (MCL). However, the optimal induction regimen is widely debated. The Southwestern Oncology Group S1106 trial was designed to assess rituximab plus hyperCVAD/MTX/ARAC (hyperfractionated cyclophosphamide, vincristine, doxorubicin and dexamethasone, alternating with high dose cytarabine and methotrexate) (RH) versus rituximab plus bendamustine (RB) in a randomized phase II trial to select a pre-transplant induction regimen for future development...
March 2017: British Journal of Haematology
Carlo Visco, Annalisa Chiappella, Luca Nassi, Caterina Patti, Simone Ferrero, Daniela Barbero, Andrea Evangelista, Michele Spina, Annalia Molinari, Luigi Rigacci, Monica Tani, Alice Di Rocco, Graziella Pinotti, Alberto Fabbri, Renato Zambello, Silvia Finotto, Manuel Gotti, Angelo M Carella, Flavia Salvi, Stefano A Pileri, Marco Ladetto, Giovannino Ciccone, Gianluca Gaidano, Marco Ruggeri, Maurizio Martelli, Umberto Vitolo
BACKGROUND: The combination of rituximab, bendamustine, and cytarabine (R-BAC) was highly active in a pilot trial of mantle cell lymphoma, but its use was restricted by high haematological toxicity. We aimed to assess the efficacy and safety of an R-BAC regimen with low-dose cytarabine (RBAC500). METHODS: In this multicentre, phase 2 trial, we recruited previously untreated patients with an established histological diagnosis of mantle cell lymphoma from 29 Fondazione Italiana Linfomi centres in Italy...
January 2017: Lancet Haematology
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