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https://www.readbyqxmd.com/read/28094456/waldenstr%C3%A3-m-macroglobulinemia-2017-update-on-diagnosis-risk-stratification-and-management
#1
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
https://www.readbyqxmd.com/read/28056114/diagnosis-and-management-of-waldenstr%C3%A3-m-macroglobulinemia-mayo-stratification-of-macroglobulinemia-and-risk-adapted-therapy-msmart-guidelines-2016
#2
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...
January 5, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28011985/beeam-conditioning-with-bendamustine-replacing-bcnu-before-autologous-transplantation-is-safe-and-effective-in-lymphoma-patients
#3
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...
December 24, 2016: Annals of Hematology
https://www.readbyqxmd.com/read/28002971/new-and-developing-therapies-for-al-amyloidosis
#4
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...
December 29, 2016: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/27992063/rb-but-not-r-hcvad-is-a-feasible-induction-regimen-prior-to-auto-hct-in-frontline-mcl-results-of-swog-study-s1106
#5
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...
December 19, 2016: British Journal of Haematology
https://www.readbyqxmd.com/read/27927586/rituximab-bendamustine-and-low-dose-cytarabine-as-induction-therapy-in-elderly-patients-with-mantle-cell-lymphoma-a-multicentre-phase-2-trial-from-fondazione-italiana-linfomi
#6
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
https://www.readbyqxmd.com/read/27739312/-treatment-of-relapsed-and-refractory-hodgkin-lymphoma-recommendations-of-the-czech-hodgkin-lymphoma-study-group
#7
H Móciková, J Marková, Ľ Gahérová, Z Král, A Sýkorová, D Belada, V Procházka, L Martinková, T Papajík, T Kozák
High-dose chemotherapy with autologous stem cell transplantation remains the current standard of treatment for young patients with Hodgkin lymphoma in first relapse or in those who are refractory to first-line treatment. The most important prognostic factors in relapses are clinical stage IV, poor performance status, bulky mass, and less than partial remission after salvage chemotherapy. Standard salvage chemotherapy in relapse before autologous transplantation has not been defined; however, DHAP and ICE are most frequently used in this setting...
2016: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
https://www.readbyqxmd.com/read/27595282/bendamustine-added-to-allogeneic-conditioning-improves-long-term-outcomes-in-patients-with-cll
#8
I F Khouri, D Sui, E J Jabbour, B I Samuels, F Turturro, G Alatrash, P Anderlini, S Ahmed, B Oran, S O Ciurea, D Marin, A Olson, K K Patel, U R Popat, C Ledesma, T M Kadia, A Ferrajoli, J A Burger, J L Jorgensen, L J Medeiros, R L Bassett, A M Gulbis
Bendamustine has shown a favorable safety profile when included in chemotherapy regimens for several types of lymphoma, including CLL. This study investigated the long-term effect of adding bendamustine to a conditioning regimen on survival, rate of engraftment, immune recovery and GvHD after allogeneic stem cell transplantation (alloSCT) in CLL patients. These outcomes were compared with the fludarabine, cyclophosphamide and rituximab (FCR) conditioning regimen. We reviewed the data for 89 CLL patients treated on three trials at our institution...
January 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/27525143/a-case-of-undiagnosed-hiv-infection-in-a-57-year-old-woman-with-multiple-myeloma-consequences-on-chemotherapy-efficiency-and-safety
#9
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
https://www.readbyqxmd.com/read/27416486/new-uses-for-brentuximab-vedotin-and-novel-antibody-drug-conjugates-in-lymphoma
#10
Michele Merli, Andrea Ferrario, Margherita Maffioli, Cecilia Olivares, Alessandra Stasia, Luca Arcaini, Francesco Passamonti
INTRODUCTION: Brentuximab vedotin (BV) is a potent anti-CD30 antibody drug conjugate (ADC) that has been approved in relapsed or refractory Hodgkin lymphoma (HL) after autologous stem cell transplantation (ASCT) and anaplastic large-cell lymphoma (ALCL). Beyond these consolidated indications, BV has been tested in a number of different settings with promising results, leading for example to the recent approval as a consolidation after ASCT in high-risk HL patients. AREAS COVERED: Main emerging areas of clinical investigation of BV include the use as a single-agent or in combination with bendamustine in first-salvage therapy of HL (bridge to ASCT), in the frontline setting in combination with AVD chemotherapy in HL and with CHP in ALCL, in relapsed or refractory cutaneous T-cell lymphomas and finally in diffuse large B-cell lymphomas (DLBCL) expressing CD30...
August 2016: Expert Review of Hematology
https://www.readbyqxmd.com/read/27382096/bendamustine-in-combination-with-gemcitabine-and-vinorelbine-is-an-effective-regimen-as-induction-chemotherapy-before-autologous-stem-cell-transplantation-for-relapsed-or-refractory-hodgkin-lymphoma-final-results-of-a-multicenter-phase-ii-study
#11
Armando Santoro, Rita Mazza, Alessandro Pulsoni, Alessandro Re, Maurizio Bonfichi, Vittorio Ruggero Zilioli, Flavia Salvi, Francesco Merli, Antonella Anastasia, Stefano Luminari, Giorgia Annechini, Manuel Gotti, Annalisa Peli, Anna Marina Liberati, Nicola Di Renzo, Luca Castagna, Laura Giordano, Carmelo Carlo-Stella
PURPOSE: This multicenter, open-label, phase II study evaluated the combination of bendamustine, gemcitabine, and vinorelbine (BeGEV) as induction therapy before autologous stem-cell transplantation (ASCT) in patients with relapsed or refractory Hodgkin lymphoma (HL). PATIENTS AND METHODS: Patients with HL who were refractory to or had relapsed after one previous chemotherapy line were eligible. The primary end point was complete response (CR) rate after four cycles of therapy...
September 20, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/27243412/novel-regimens-prior-to-autologous-stem-cell-transplantation-for-the-management-of-adults-with-relapsed-refractory-non-hodgkin-lymphoma-and-hodgkin-lymphoma-alternatives-to-beam-conditioning
#12
Alessandro Isidori, Anna Christofides, Giuseppe Visani
High-dose therapy (HDT) followed by autologous stem cell transplant (ASCT) is the standard treatment for relapsed or refractory non-Hodgkin and Hodgkin lymphoma. Until recently, carmustine, etoposide, cytarabine and melphalan (BEAM) was the most commonly used conditioning regimen in this setting, given its acceptable efficacy and tolerability. Despite reasonable success with BEAM, carmustine is associated with a number of acute and late toxicities. Moreover, recent supply and cost issues for this agent have created an urgent need for alternative conditioning regimens...
November 2016: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/27214069/bendamustine-etoposide-and-dexamethasone-to-mobilize-peripheral-blood-hematopoietic-stem-cells-for-autologous-transplantation-in-patients-with-multiple-myeloma
#13
D J Green, W I Bensinger, L A Holmberg, T Gooley, B G Till, L E Budde, J M Pagel, S L Frayo, J E Roden, L Hedin, O W Press, A K Gopal
Chemotherapeutic agents without cross-resistance to prior therapies may enhance PBSC collection and improve patient outcomes by exacting a more potent direct antitumor effect before autologous stem cell transplant. Bendamustine has broad clinical activity in transplantable lymphoid malignancies, but concern remains over the potential adverse impact of this combined alkylator-nucleoside analog on stem cell mobilization. We performed a prospective, nonrandomized phase II study including 34 patients with multiple myeloma (MM) (n=34; International Staging System (ISS) stages I (35%), II (29%) and III (24%); not scored (13%)) to evaluate bendamustine's efficacy and safety as a stem cell mobilizing agent...
October 2016: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/27186193/practical-approach-to-management-of-chronic-lymphocytic-leukemia
#14
Lukáš Smolej, Martin Šimkovič
Revolutionary progress has recently changed the landscape of chronic lymphocytic leukemia (CLL). Powerful prognostic factors, especially p53 mutation and/or deletion and IGHV mutation status, have refined individual patient prognosis. Purine analogs and monoclonal antibodies paved the way from palliative treatment to chemoimmunotherapy capable of eradication of minimal residual disease and prolongation of survival. Obinutuzumab (GA-101) and ofatumumab have been recently approved for the treatment of comorbid patients...
April 1, 2016: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/27091808/patients-with-classical-hodgkin-lymphoma-experiencing-disease-progression-after-treatment-with-brentuximab-vedotin-have-poor-outcomes
#15
C Y Cheah, D Chihara, S Horowitz, A Sevin, Y Oki, S Zhou, N H Fowler, J E Romaguera, F Turturro, F B Hagemeister, L E Fayad, M Wang, S S Neelapu, L J Nastoupil, J R Westin, M A Rodriguez, F Samaniego, P Anderlini, Y Nieto, M A Fanale
BACKGROUND: Brentuximab vedotin (BV) is a key therapeutic agent for patients with relapsed/refractory classical Hodgkin lymphoma (cHL). The outcomes of patients experiencing disease progression after BV are poorly described. PATIENTS AND METHODS: We reviewed our institutional database to identify patients with cHL treated with BV who were either refractory to treatment or experienced disease relapse. We collected clinicopathologic features, treatment details at progression and outcome...
July 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/27088375/a-phase-ii-single-arm-prospective-study-of-bendamustine-plus-melphalan-conditioning-for-second-autologous-stem-cell-transplantation-in-de-novo-multiple-myeloma-patients-through-a-tandem-transplant-strategy
#16
M Martino, G Tripepi, G Messina, I D Vincelli, G Console, A G Recchia, M Gentile, S Molica, F Morabito
This phase II trial evaluates, for the first time, the safety and efficacy of bendamustine plus high-dose melphalan (HDM) as a conditioning regimen before the second autologous stem cell transplantation (ASCT) in previously untreated multiple myeloma (MM) patients. In total, 32 ASCT patients received HDM (200 mg/m(2)) as conditioning for the first ASCT. After 3-6 months from the first ASCT, responding patients underwent a second ASCT following bendamustine (200 mg/m(2)) and HDM (140 mg/m(2)). High-dose chemotherapy and ASCT were performed with complete neutrophil and platelet recovery in all patients...
September 2016: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/27071634/therapeutic-options-in-peripheral-t-cell-lymphoma
#17
REVIEW
Yaping Zhang, Wei Xu, Hong Liu, Jianyong Li
Peripheral T cell lymphoma (PTCL) is a rare and heterogeneous group of non-Hodgkin lymphomas with a very poor prognosis. The standard first-line treatments have resulted in unsatisfactory patient outcomes. With the exception of low-risk anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma (ALCL), the majority of patients relapse rapidly; the current 5-year overall survival rates are only 10-30%. Novel targeted therapies and combination chemotherapies are required for the treatment of patients with PTCL...
April 12, 2016: Journal of Hematology & Oncology
https://www.readbyqxmd.com/read/27055577/refractory-chronic-lymphocytic-leukemia-a-therapeutic-challenge
#18
Lukáš Smolej
Despite impressive therapeutic progress represented by the advent of chemoimmunotherapy, chronic lymphocytic leukemia (CLL) remains incurable by conventional modalities. Refractory CLL defined by non-response to treatment or relapse/progression within 6 months is associated with multiple unfavourable prognostic factors such as p53 pathway disruption, deteriorating patient condition, increased risk of severe infections, and poor response to treatment, resulting in a very short overall survival. Therefore, refractory CLL represents a highly challenging situation for the hematologist as well as the patient...
April 8, 2016: Current Cancer Drug Targets
https://www.readbyqxmd.com/read/27030315/post-transplant-bendamustine-reduces-gvhd-while-preserving-gvl-in-experimental-haploidentical-bone-marrow-transplantation
#19
Jessica Stokes, Emely A Hoffman, Yi Zeng, Nicolas Larmonier, Emmanuel Katsanis
Advances in haploidentical bone marrow transplantation (h-BMT) have drastically broadened the treatment options for patients requiring BMT. The possibility of significantly reducing the complications resulting from graft-versus-host disease (GvHD) with the administration of post-transplant cyclophosphamide (PT-CY) has substantially improved the efficacy and applicability of T cell-replete h-BMT. However, higher frequency of disease recurrence remains a major challenge in h-BMT with PT-CY. There is a critical need to identify novel strategies to prevent GvHD while sparing the graft-versus-leukaemia (GvL) effect in h-BMT...
July 2016: British Journal of Haematology
https://www.readbyqxmd.com/read/26967234/-changes-in-the-prognosis-and-treatment-of-waldenstr%C3%A3-m-macroglobulinemia-literature-overview-and-own-experience
#20
REVIEW
Zdeněk Adam, Luděk Pour, Marta Krejčí, Sabina Ševčíková, Eva Pourová, Eva Ševčíková, Zdeněk Král, Jiří Mayer
Waldenström macroglobulinemia is defined by the presence of monoclonal immunoglobulin IgM type (M-IgM) and evidence of lymphoplasmacytic bone marrow infiltration. The disease has an indolent course, the treatment is only initiated when the disease has begun to damage its carrier. The following symptoms are regarded as proven indications for initiating therapy: B symptoms, symptomatic lymphadenopathy, splenomegaly, anemia with hemoglobin below 100 g / l or thrombocytopenia < 100 × 10(9)/l, caused by lymphoplasmacytic bone marrow infiltration...
January 2016: Vnitr̆ní Lékar̆ství
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