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pubmed: Eur J Hem[jour]



NCBI: db=pubmed; Term="European Journal of Haematology"[jour]



 



Anthropometrics and Prognosis in Diffuse Large B-Cell Lymphoma: A Multicentre Study of 653 Patients.

Anthropometrics and Prognosis in Diffuse Large B-Cell Lymphoma: A Multicentre Study of 653 Patients.

Eur J Haematol. 2016 Nov 28;:

Authors: Bendtsen MD, Munksgaard PS, Severinsen MT, Bekric E, Brieghel C, Nielsen KB, de Nully Brown P, Dybkaer K, Johnsen HE, Bøgsted M, El-Galaly TC

Abstract
OBJECTIVE: The impact of body mass index (BMI) and body surface area (BSA) on survival in diffuse large B-cell lymphoma (DLBCL) is controversial. Recent studies show superior outcomes for overweight and obese patients.
PATIENTS AND METHODS: 653 R-CHOP(-like) treated DLBCL patients were included in this retrospective cohort study. Patients, baseline clinicopathologic characteristics and treatment information were retrieved from the Danish Lymphoma Registry. Anthropometric measures were obtained from chemotherapy prescription charts.
RESULTS: Underweight (BMI <18.5 kg/m(2) ) was associated with significantly worse PFS for male patients only in sex-stratified analyses (HR 3.92, 95% CI: 1.57-9.75, p=0.003 for males; HR 1.65, 95% CI: 0.90-3.02, p=0.107 for females). In multivariate analyses, underweight was associated with worse PFS for both sexes (HR 5.34, 95% CI: 2.07-13.79, p=0.001 for males; HR 2.14, 95% CI: 1.12-4.08, p=0.021 for females). Similar results were obtained in analyses of overall survival. In crude analyses, BSA<1.8 m(2) was associated with worse PFS for men and women (HR 1.65, 95% CI: 1.03-2.65, p=0.039 for men; HR 1.62, 95% CI: 1.03-2.56, p=0.037 for women). In multivariate analyses, however, these associations diminished.
CONCLUSIONS: Our study demonstrates that underweight DLBCL patients have worse outcomes following R-CHOP as compared to normal as well as overweight patients. This article is protected by copyright. All rights reserved.

PMID: 27893172 [PubMed - as supplied by publisher]




Salvage therapy in first relapse: a retrospective study in a large patient population with Multiple Myeloma.

Salvage therapy in first relapse: a retrospective study in a large patient population with Multiple Myeloma.

Eur J Haematol. 2016 Nov 28;:

Authors: Offidani M, Corvatta L, Bringhen S, Gentili S, Troia R, Maracci L, Larocca A, Leoni P, Boccadoro M

Abstract
OBJECTIVE: there is no strong evidence to guide therapeutic approach to multiple myeloma (MM) patients who experience first relapse. The treatment choice can be difficult since currently all patients are exposed to novel agents as thalidomide, bortezomib and lenalidomide.
METHODS: in this retrospective analysis we evaluated the best therapeutic sequence, the role of re-treatment and the most beneficial cut-off of first remission in order to choose re-treatment, analyzing 476 patients relapsed after first-line therapy.
RESULTS: bortezomib-based regimens upfront followed by lenalidomide-based regimens at first relapse resulted in significantly better second progression-free survival (2ndPFS), PFS2 and overall survival (OS) compared to the opposite sequence. Changing therapy resulted in significantly better 2ndPFS in the whole population whereas PFS2 was significantly longer only in patients who underwent maintenance therapy. Moreover, until PFS1 was shorter than 27 months, changing therapy at first relapse significantly extended 2ndPFS and PFS2 compared to re-treatment, whereas similar outcomes were observed between the two strategies, when PFS1 was longer than 27 months.
CONCLUSION: lacking randomized trials, our study could help to choose the most appropriate therapy algorithm in patients with MM. This article is protected by copyright. All rights reserved.

PMID: 27893171 [PubMed - as supplied by publisher]




Safety Profiles of Iron Chelators in Young Patients with Haemoglobinopathies.

Safety Profiles of Iron Chelators in Young Patients with Haemoglobinopathies.

Eur J Haematol. 2016 Nov 28;:

Authors: Botzenhardt S, Li N, Chan EW, Sing CW, Wong IC, Neubert A

Abstract
BACKGROUND: This review describes the safety of deferoxamine (DFO), deferiprone (DFP), deferasirox (DFX), and combined therapy in young patients less than 25 years of age with haemoglobinopathies.
METHOD: Searches in electronic literature databases were performed. Studies reporting adverse events associated with iron chelation therapy were included. Study and reporting quality was assessed using AHRQ Risk of Bias Assessment Tool and McMaster Quality Assessment Scale of Harms. Prospective clinical studies were pooled in a random-effects meta-analysis of proportions.
RESULTS: Safety data of 2,040 patients from 34 studies were included. 92 case reports of 246 patients were identified. DFX (937 patients) and DFP (667 patients) possess the largest published safety evidence. Fewer studies on combination regimens are available. Increased transaminases were seen in all regimens (3.9-31.3%) and gastrointestinal disorders with DFP and DFX (3.7-18.4% and 5.8-18.8%, respectively). Therapy discontinuations due to adverse events were low (0-4.1%). Reporting quality was selective and poor in most of the studies.
CONCLUSION: Iron chelation therapy is generally safe in young patients and published data corresponds to summary of product characteristics. Each iron chelation regimen has its specific safety risks. DFO seems not to be associated with serious adverse effects in recommended doses. In DFP and DFX rare, but serious adverse reactions can occur. Data on combined therapy is scarce, but it seems equally safe compared to monotherapy. This article is protected by copyright. All rights reserved.

PMID: 27893170 [PubMed - as supplied by publisher]




Sorafenib and Azacitidine as salvage therapy for relapse of FLT3-ITD mutated AML after allo-SCT.

Sorafenib and Azacitidine as salvage therapy for relapse of FLT3-ITD mutated AML after allo-SCT.

Eur J Haematol. 2016 Nov 28;:

Authors: Rautenberg C, Nachtkamp K, Dienst A, Schmidt PV, Heyn C, Kondakci M, Germing U, Haas R, Kobbe G, Schroeder T

Abstract
OBJECTIVE: Patients with acute myeloid leukemia (AML) carrying FLT3-ITD mutations (FLT3-ITD+) who relapse after allogeneic 3transplantation (allo-SCT) have a very dismal prognosis with the currently available treatment options.
METHODS: We treated 8 patients with FLT3-ITD+ AML who had relapsed in median 91 days (range, 28 - 249) following allo-SCT with a combination of the multikinase inhibitor Sorafenib and the DNA methyltransferase inhibitor Azacitidine (Aza).
RESULTS: Patients received a median of 5 cycles of Aza (range, 2 to 9) and Sorafenib with a median daily dosage of 750 mg (range 400 to 800) for 129 days (range, 61 to 221). Six of 8 patients received donor lymphocyte infusions (DLI) with a median number of 2 DLI per patient (range, 1 - 4). Following this treatment 4 patients (50%) achieved a complete remission and 3 of them a complete molecular remission. Median duration of CR was 182 days (range, 158 to 406) and 2 patients remain in ongoing remission for 406 and 168 days. Median overall survival was 322 days (range, 108 to 574 days) with 3 patients being currently alive.
CONCLUSION: Taken together, the combination of Sorafenib, Aza and DLI shows promising efficacy and deserves further evaluation in larger patients groups. This article is protected by copyright. All rights reserved.

PMID: 27893163 [PubMed - as supplied by publisher]