bluuebunny/crossref_metadata_2025_split huggingface dataset:
Current treatment (Tx) patterns in relapsed or refractory multiple myeloma (MM): A retrospective chart review study
Authors: Reece D. E. , Zaman F. , Teixeira B. L. , Yoong K. , Camacho F. , Plante R. K. 
Published: August 2020

e19503 Background: New Tx options, including IMiDs [thalidomide, lenalidomide (Revlimid)] and bortezomib (Bz) (Velcade), have in the last few years become available on the market or as investigational agents in Canada for relapsed or refractory MM. These new agents are changing the Tx pattern and the clinical outcome of this disease. Methods: This retrospective chart review included all relapsed/refractory MM Pts who initiated drug Tx between Jul-06 and Jun-07 inclusive at Princess Margaret Hospital, Toronto, ON. Results: A total of 151 Pts were treated for relapsed/refractory MM between Jul-06 & Jun-07. 57 Pts (40 receiving IMiD, 14 Bz, 3 other) were on clinical trials and thus not included in the analysis due to proprietary restrictions. Mean age, % male and BSA was 64.8 (SD±9.5) yrs, 68.1%, 1.9 (SD±0.2), respectively. Time from diagnosis to current therapy was 46.3 (SD±24.7) months. Nearly half the Pts were receiving treatment for 1st disease relapse (48.9%), 24.5% for 2nd relapse, 14.9% for 3rd relapse, and the remainder for ≥ 4th relapse. 74.5% of Pts had received at least 1 stem SCT prior to current study Tx. Current Txs included cyclophosphamide ± steroid (36.2%), Bz-based (26.6%), IMiD-based [17.0% (thalidomide only)], steroid monotherapy (13.8%), melphalan + prednisone (1.1%) and other (5.3%). Overall best RR was 43.6%, and 41.5% of Pts experienced PD up to the follow-up period. Mean TTP was 9.6 (SE±0.5) months. 30.9% of Pts received ESAs, 12.8% of Pts required RBC or platelet transfusion, 6.4% of Pts received G-CSF, and 47.9% of Pts received supportive pain medication. 27.7% of Pts required unscheduled hospitalization (56.4% due to MM and 7.7% due to Tx). Incidence of any grade drug-related varicella zoster, increased neuropathic pain, and thromboembolic events were 6.4%, 16.0%, 2.1%, respectively. Four Pts died while on current Tx and 14 died during the follow-up period of up to Dec-07. Conclusions: Bz was rarely used prior to public funding in Jul-06. Since then Bz (either as monotherapy or in combination) is the most commonly used novel Tx outside a clinical study and is replacing the use of the older agents. As the first analysis of current real world MM Txs in Canada from a large tertiary academic centre, this data is reflective of emerging treatment trends. [Table: see text]
Evaluation of brain natriuretic peptide (BNP), troponin levels, and left ventricular ejection fraction (LVEF) in older adults with diffuse large B cell lymphoma (DLBCL)
Authors: Rodriguez M. A. , Wei W. , Huang X. , Fisch M. , Durand J. B. 
Published: August 2020

e19506 Background: Troponin and BNP are markers that rise acutely during myocardial injury and cardiac dysfunction, respectively. Doxorubicin (Dox) is an effective drug for treatment of DLBCL, in the regimen RCHOP (Coiffier, et.al. NEJM, 2002). Dox has risk of myocardial toxicity, which is higher in older patients (pts). Pegylated liposomal doxorubicin (D) has greater cardiac safety yet similar efficacy to Dox in breast cancer. D replaced Dox in RCHOP (DRCOP) in a phase II study in patients >60 yrs of age, with troponin and BNP levels pre and post-treatment to see if they would predict a fall in LVEF secondary to DRCOP. Methods: DRCOP is: Rituximab 375 mg/m2 IV day (d) 1; D 40 mg/m2 IV d 1; cyclophosphamide 750 mg/m2 IV d 1; vincristine 2 mg IV d 1 total dose; prednisone 100 mg/d p.o. d 1–5. Eligibility criteria: > 60 years; untreated DLBCL; Ann Arbor stage II-IV; baseline LVEF ≥ 50%. Consult at baseline by Cardiologist required, and at follow-up as indicated. The Wilcoxon rank sign test was used to compare baseline BNP with subsequent BNP. A linear mixed model was used to assess the effect of time on troponin at baseline, midpoint and endpoint. All tests were two-sided and p-values of 0.05 or less were considered statistically significant.. Statistical analysis was carried out using SAS version 9 (SAS Institute, Cary, NC). Results: 60 patients are enrolled; only one patient has developed systolic dysfunction, (LVEF to <50%). Conclusions: DLBLC older patients Older adults with DLBCL treated with DRCOP maintain preserved LVEF and troponin levels, suggesting less cardiotoxicity. There is a significant rise in BNP without clinical cardiac dysfunction. This is a new observation that merits further study. [Table: see text] No significant financial relationships to disclose.
Effect of dose on denileukin diftitox (Dd) response in treatment-naïve cutaneous T-cell lymphoma (CTCL) subjects: A retrospective analysis of three phase III studies
Authors: Dang N. H. , Sun Y. , Gao J. 
Published: August 2020

e19509 Background: Three phase III studies (10, 11, 14) have been conducted with Dd, a novel IL-2 receptor-targeted recombinant fusion protein, in subjects with CTCL. Dd is approved for the treatment of persistent/recurrent CD25(+) CTCL and is the most extensively studied agent in CTCL. We retrospectively analyzed the efficacy of two Dd doses in treatment-naïve CD25(+) CTCL subjects to understand the relationship between dose and response to therapy. Methods: Studies 10 and 11 included early or advanced stage CD25(+) subjects (CD25 immunostaining in >20% of malignant cells) while 14 included CD25(-). Subjects received 9 or 18 mcg/kg/day IV for 5 days, repeating every 21 days for up to 8 courses; subjects in study 14 only received the higher dose. Study 11 included a placebo arm. Subject demographics were similar among the three studies and between the 2 dose groups in each. Response confirmation required ≥2 consecutive courses (3 observations) and was adjudicated by an independent Data Endpoint Review Committee in each study, using a weighted severity skin, blood and lymph node count. The primary endpoint was ORR (CR, CCR, PR) and the key secondary endpoint was progression-free survival (PFS). Results: Integrated efficacy results for ORR and PFS are shown in the table for treatment-naïve CD25(+) subjects. In general, the nature and incidence of the adverse events reported in the 3 studies were similar, with studies 11 and 14 proving to be broadly consistent with study 10 in terms of safety. Tolerability of 9 and 18 mcg/kg/d was similar in study 10. In study 11, the only AEs that were more frequent in the high-dose group were vomiting (13.3% vs 34.5%) and dysgeusia (0% vs 10.9%). Conclusions: Overall, there was a trend towards higher efficacy favoring 18 mcg/kg/day in treatment-naïve CD25(+) subjects. The ORR was statistically significant for the higher dose group. [Table: see text]
Helicobacter pylori-independent MALT lymphoma patients responsive to thalidomide—the molecular mechanism and the clinical application
Authors: Kuo S. , Chen L. , Wu M. , Hsu C. , Lin C. , Hsu P. , Yeh K. , Tzeng Y. , Cheng A. 
Published: August 2020

e19512 Background: We have recently demonstrated that nuclear expression of BCL10 or NF-κB helps predict H. pylori-independent status; and inflammatory cytokines such as TNF-α may be related to BCL10 nuclear translocation (Blood 2005;106:1037–41;J Biol Chem 2006;281:167–75). Recent studies have been shown that the chimeric protein of t(11;18)(q21;q21) can lead to constitutive NF-κB activity and thereby mediate cell survival and anti-apoptotic signals. The present study was conducted to investigate the molecular mechanism and the clinical efficacy of thalidomide, an TNF-α or NF-κB inhibitor, in H. pylori-independent MALT lymphoma. Methods: Between October 2003 and June 2007, our study enrolled 11 H. pylori-independent MALT lymphoma patients ( 7 men and 4 women; age range, 43 to 79 years; 7 patients who had failed chemotherapy or rituximab) with nuclear expression of BCL10 or NF-κB in pretreatment lymphoma tissues treated at National Taiwan University Hospital with thalidomide 100mg to 200 mg oral given daily. The presence of t(11;18)(q21;q21) was identified by a multiplex reverse transcriptase polymerase chain reaction of the API2-MALT1 chimeric transcript. Results: Three (27.3%) of 11 patients achieved a complete response (CR), and 3 (27.3) of 11 patients achieved a partial response (PR), resulting in an overall response rate of 54.5% (95% CI, 19.5%-89.6%). The median time from thalidomide therapy to CR was 3.0 months (range, 2.7–4.9 months). At a median follow-up of 41.6 months (range, 17.7–63.8 months), the 3-year event-free survival and overall survival after thalidomide treatment was 80.8%, and 88.9%, respectively. The API2-MALT1 fusion transcript for t(11;18)(q21;q21) was detected in 1 (16.7%) of 6 patients with CR or PR, and 4 (80.0%) of 5 patients with stable or progressive disease (P = 0.08). Conclusions: Our results indicate that thalidomide can be an adjuvant treatment for H. pylori-independent MALT lymphoma patients. Additional investigation of the molecular mechanisms and biologic significance of the API2-MALT1 fusion transcript responsible for thalidomide resistance in this group of tumors is needed. No significant financial relationships to disclose.
Long term follow-up of primary B and T cell non-Hodgkin's lymphoma (NHL) of the gastrointestinal (GI) tract
Authors: Cadoo K. A. , Lowery M. A. , Cumiskey J. , McCaffrey J. , Carney D. N. 
Published: August 2020

e19516 Background: Anthracycline based chemotherapy is the treatment of choice for aggressive primary lymphomas of the GI tract, with surgery reserved for management of complications. We report long term follow up of 71 cases of primary GI NHL treated with chemotherapy and/or surgery. Methods: Cases were identified from the institutional histology database & records reviewed. Results: 71 patients over an 24 year period were identified; 43 (61%) male, 28 (39%) female. Median age at diagnosis was 60 (15–83). 52 (73%) were DLBCL, 11 (16%) were T-cell, 8 (11%) were MALT. The 8 patients with MALT were treated with single agent chemotherapy; 7 (88%) are alive at median follow up of 8.5 years (2–16). Of the aggressive lymphomas (63), all patients with T cell lymphoma had small bowel as primary site and histological evidence of celiac associated enteropathy, even in the absence of known celiac disease. Primary sites of DLBCL were stomach 35 (67%), small bowel 11 (21%) & colon 6 (12%). 39 (62%) patients underwent surgery at diagnosis due to acute presentation with perforation, bleeding or obstruction, or to obtain histology. Following confirmed diagnosis, 61 patients received anthracycline based chemotherapy. 2 patients with T cell lymphoma presented with perforation, were treated with surgery only and died of rapid disease progression. Of the 63 patients with aggressive NHL, 37 (59%) remain alive & disease free at median follow up of 13 years (1–24). 35 (67%) patients with DLBCL are alive & disease free. Only 2 (18%) of the T cell lymphomas are alive & disease free. 5 deaths in the DLBCL group were not related to cancer or treatment. All deaths in the T cell group were due to progressive disease. There was no difference in survival between patients treated with chemotherapy only and those who also underwent surgery. Conclusions: Patients with aggressive primary B cell GI NHL have almost 70 % survival following anthracycline based chemotherapy. However, in contrast, coeliac enteropathy associated T-cell lymphomas present with rapidly progressive disease & have a survival of < 20% with chemotherapy and/or surgery. A novel therapeutic approach is required to improve outcome in this group. No significant financial relationships to disclose.
Diagnostic and prognostic use of FDG-PET scans in Waldenstrom's macroglobulinemia
Authors: Harris B. , Leleu X. , Leduc R. , Yarar D. , Sam A. , Rourke M. , Chuma S. , Roccaro A. , Ghobrial I. 
Published: August 2020

e19518 Background: Waldenstrom's macroglobulinemia (WM) is a rare lymphoplasmacytic lymphoma. More sensitive tools of tumor burden and prognosis are needed in these patients (pts). The use of FDG-PET has not been previously studied in WM but has proved an effective diagnostic and prognostic tool effective in low-grade lymphomas. Therefore the objective of this study was to determine whether FDG-PET was an effective tool in evaluating pts with WM. Methods: We included all pts enrolled on a prospective phase II clinical trial of bortezomib and rituximab for pts with upfront or relapsed/refractory (RR) WM. All pts were CD20 positive with histologically confirmed disease and underwent staging evaluation by FDG-PET in combination with CT scan before and after therapy. Patients received 6 cycles of bortezomib IV weekly at 1.6mg/m2 on days 1, 8, 15q28 and rituximab at 375 mg/m2 on days 1, 8, 15 and 22 in cycles 1 and 4. Correlation was made with the international prognostic scoring system for WM and monoclonal protein response rate. Results: 53 pts were included, of which 35 were RR and 18 pts were upfront. Median age was 63 years (range 42–81), 64% were male. Before therapy, 34 pts (64.2%) had positive FDG-PET findings with a median IgM of 2825, Beta 2 microglobulin of 3.6, and Age of 61. 36 pts showed a minor response or greater with a correlation to negative PETs after therapy. Conclusions: Over 60% of WM pts demonstrated FDG-avid disease when using FDG-PET scans, with the majority showing negative disease after therapy. This correlates with the 67.9% response rate. Positive PET images were inversely correlated to IgM level and directly related to elevated Beta-2 microglobulin and age. Significantly PET positive individuals may demonstrate a poorer prognosis. FDG-PET scans may prove an effective tool in the diagnosis and prognosis in WM. [Table: see text]
Safety analysis of radioimmunotherapy (RIT) in patients with relapsed or refractory low grade, follicular or transformed non-Hodgkin's lymphoma and mantle cell lymphoma based on age at time of therapy
Authors: Braun E. , Katz D. , Venugopal P. , Larson M. , Shammo J. , Fung H. , Gregory S. 
Published: August 2020

e19529 Background: Radioimmunotherapy is a therapeutic option for relapsed or refractory indolent, follicular and transformed non Hodgkin's lymphoma and mantle cell lymphoma. Although prolongued myelotoxicity has been described with use of iodine I 131 tositumomab (TOSI) and yttrium 90 ibritumomab tiuxetan (IBRI), analysis of toxicity according to patients’ age at therapy still lacks. Methods: Utilizing the Rush University Medical Center database 61 subjects who received RIT between November/2003 and June/2008, either with TOSI or IBRI were divided in 2 groups according to age at time of therapy. Group 1 included patients between 33 and 60 (51.8±6.5) years of age (N=29) and group 2 included patients 61 years old or older (70.1±7.8) (N=32). Parameters compared between groups were: Time to nadir of lowest absolute neutrophil count (ANC), time to recovery ANC above 1000/mcL, time to nadir of lowest hemoglobin levels, time to recovery to hemoglobin levels above 8g/dL, time to lowest platelet count and time to recovery to platelet count above 100,000/mcL. Incidence o myelodysplastic syndrome (MDS) was also compared between groups. Groups characteristics such as sex, type of RIT, presence of disease in bone marrow, FLIPI/IPI and use of G-CSF were noted. Results: There was no significant statistical difference between groups in time (number of days) to achieve nadir of ANC (group 1 85.3±208; group 2 50.3±19.9), nadir of hemoglobin levels (group 1 106±60.6; group 2 84±57.0) and time to nadir of platelet level (group 1 53.5±70.7; group 2 41.8±9.6). There was no statistical significant difference between groups in duration of cytopenias, except for time for platelet recovery which was significant longer in group 2 using the Pearson Correlation analysis. (p=0.008). (Days for platelets recovery to levels above 100,000/mcL group 1 29.4±27.7; group 2 108.8 ±207.3). One patient in group 1 and three patients on group 2 were diagnosed with MDS but were also treated with different chemotherapy regimens. Conclusions: RIT should be considered a safe therapeutic modality in patients with refractory or relapsed indolent, follicular, NHL, transformed and Mantle Cell lymphoma regardless of age. [Table: see text]
Clinical usefulness of PET/CT in initial staging and response evaluation of primary gastric lymphoma
Authors: Yi J. , Kim S. , Lee S. , Park S. , Ko Y. , Choi J. , Kim W. 
Published: August 2020

e19541 Background: Positron emission tomography (PET)/computed tomography (CT) scan has a well-established role in the management of non-Hodgkin's lymphoma (NHL). However, in case of the primary gastric lymphoma, which is the most frequent extranodal NHL, the role of PET/CT scan is still controversial. Methods: We retrospectively analyzed 42 patients with primary gastric lymphoma who underwent PET/CT scans; 32 patients with diffuse large B-cell lymphoma (DLBCL) and 10 patients with extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) were analyzed. The PET/CT scans were compared with clinicopathologic features and the results of CT and endoscopy. After corresponding treatment, response was evaluated by conventional CT scans or PET/CT scans and endoscopy with biopsy Results: Nine patients were up-staged based on the results of their PET/CT scan compared to CT (7 DLBCL, 2 MALT lymphomas) while six patients were down-staged by the PET/CT scan. The high SUVmax group, defined as SUVmax ≥ median value, was significantly associated with an advanced Lugano stage (P < 0.001). Three patients with DLBCL, who showed an initially high SUVmax, died of disease progression. Although not statistically significant, there was a tendency of inferior outcome in the group with high SUVmax. Among 24 patients for whom follow-up PET/CT scan with endoscopy was performed, 11 patients with ulcerative or mucosal lesions showed residual FDG uptake. All of these gastric lesions were grossly and pathologically benign lesions without evidence of lymphoma cells. Conclusions: PET/CT scan can help staging patients with primary gastric lymphoma, and the maximum SUV has possibility to have prognostic value. However, the residual FDG uptake observed during follow-up should be interpreted cautiously in association with the results of endoscopy and multiple gastric biopsies. No significant financial relationships to disclose.
AIDS-related lymphoma (ARL): Efficacy of highly active anti retroviral therapy (HAART) on survival and prognostic factors in a general hospital in Peru
Authors: Reategui R. D. , Beltran B. , Morales D. , Vera L. , Quinones P. , Portugal K. , Desposorio C. , Capellino A. , Castillo J. 
Published: August 2020

e19545 Background: Since the introduction of HAART in 1996, the profile of ARL has shifted considerably. The impact of HAART on the survival of ARL in developing countries in the post-HAART era has not been clearly defined. The aims of this study were to evaluate efficacy of HAART on survival and prognostic factors in our population. Methods: The clinical records of 2,502 HIV-infected patients seen in our institution from March 1997 to March 2008 were reviewed. The survival was calculated using the Kaplan-Meier method and the prognostic factors were evaluated by chi square. Results: Forty-eight patients with HIV-associated lymphoma were identified. From the 48 ARL identified 44 were non Hodgkin lymphoma (NHL) and 4 were Hodgkin lymphoma. Two patients with CNS primary were excluded for analysis. From 42 systemic NHL: 38 (90,5%) were of B-cell and 4 (9,5%) were of T-cell. The 5-year overall survival (OS) was 27%. Three groups of patients were included: 13 patients (31%) received HAART previous the diagnosis of ARL, 21 patients (50%) initiated HAART after ARL diagnosis and 8 patients (19%) did not receive HAART. HAART treatment before the diagnosis of NHL increases the survival (54% versus 9,5% versus 25% respectively, p=0.048). Twenty of 42 patients (47,6%) received chemotherapy. This group had a better survival rate than those who did not receive chemotherapy (50% versus 4,5%, p< 0.0001) The overall response to chemotherapy was 80% with CR (n=11, 55%), PR(n=5, 25%) and PD in four (20%). In a multivariate analysis, IPI score > 2, presence of B symptoms and no HAART previous ARL diagnosis were statistically associated to worse survival with p-values of 0.0001, 0.018 and 0.048 respectively. Conclusions: In our study the use of HAART is effective when started before ARL diagnosis. IPI score > 2, B symptoms and no HAART previous the diagnosis were unfavorable prognostic factors. These latest findings are in concordance with prior reports. This is the first Latinamerican report on the impact of HAART on the OS in ARL patients. No significant financial relationships to disclose.
Primary breast lymphomas: An Argentinian cooperative study
Authors: Gil Deza E. , Dragosky M. , Annetta I. , Marquez M. , Corzo A. , Gercovich N. , Morgenfeld E. , Tognelli F. , Rivarola E. , Gercovich F. G. 
Published: August 2020

e19555 Background: Primary Breast Lymphomas are rare tumors (less than 1% of all primary breast tumors). Because of that, the records of two institutions dedicated exclusively to the treatment of cancer (Hospital Municipal de Oncologia “Maria Curie” and Instituto Oncologico Henry Moore) have been working together in a single series. Objective: To make a retrospective study of the clinical onset, treatment and evolution of the patients with Primary Breast Lymphoma (PBL). Methods: Patients from hemato-oncological databases of both institutions, that presented PBL, were studied. A database containing characteristics of the population, clinical onset, treatments, evolution and survival Results: Gender F/M=2/15 pt. Mean age (range)=54.1 years (24–87). Pathology: Hodgkin's Lymphoma = 1 pt, NHL follicular = 8 pt, Large-Cell Diffuse NHL = 6 pt, lymphoplasmocytic NHL = 1 pt, Marginal Zone NHL = 1 pt. Stages: IA = 2 pt, IIA = 8 pt, IIIA = 1 pt, IVA = 6 pt. Radiotherapy: 11 pt. Polychemotherapy: CVP = 7 pt, COPP = 1 pt, CHOP = 2 pt, CNOP = 4 pt, CVP/CHOP = 1 pt, RCHOP = 1 pt, RESHAP = 1 pt. Response: CR16/16 evaluable pt. Evolution: Recurrence = 3 pt, Second tumors = 3 pt (breast cancer = 3 pt), Third tumors = 1 pt (melanoma = 1 pt). Survival. Dead = 4 pt. Alive with no illness = 12 pt, Alive under treatment = 1 pt. Conclusions: 1) Seventeen pt with PBL were identified. 2) Sixteen out of 17 were non-Hodgkin lymphomas. 3) Fifteen of 17 pt were women 4) Fourteen of the 17 cases affected only one breast. 5) Seven out of 17 cases were tumors of less than 5 cm. 6) Response reached 100% of the evaluable pt. 7) There was an important rate of second and third tumors (20%). 8) With a mean follow up time of 82 months, 75% of the population is alive and free of the illness. No significant financial relationships to disclose.