bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of advanced stage non-small cell lung cancer (NSCLC) patients reexposed to platinum-based chemotherapy upon progression
Authors: Souza P. H. , Rodrigues A. N. , Dienstmann R. , Small I. A. , Roriz W. , Martins R. G. , Zukin M. , Ferreira C. G. 
Published: March 2020

17136 Background: Platinum-based chemotherapy (PtCT) is the standard 1st-line treatment for advanced stage NSCLC patients. Nearly all patients (pts) that respond to 1st-line CT will relapse and some of them will be candidates for 2nd-line CT. There is no consensus definition of sensitive or resistant pts to PtCT and there are conflicting results about the relationship between response to prior PtCT and response to a 2nd-line reexposure. The aim of this study was to evaluate the outcomes of a subset of pts considered sensitive to platinum, who were reexposed to a PtCT regimen as 2nd-line CT. Methods: Based on a criterion of disease progression > 6 months of completing 1st-line as a hallmark platinum-sensitivity, pts were retrospectively selected. We reviewed the outcomes of 11 advanced NSCLC pts (stages IIIB or IV) treated between Jan 2000 and Jun 2005 at 1st-line with a PtCT (cisplatin or carboplatin combined to etoposide) and who upon progression were reexposed to a regimen of Carboplatin plus etoposide. Pts were evaluated for overall (OS) and progression-free survival (PFS) after 1st- and 2nd-line CT by Kaplan-Meyer method. Results: There were 6 women (54.5%) and 5 men (45.5%). Median age was 62 (range 49–78) and adenocarcinoma was the most prevalent histology (54.5%). At 1st-line CT, 6 patients (54.5%) were stage IIIB and ECOG PS 0/1 were 36.4 and 63.6%, respectively. The median number of cycles per patient was 6 (range 2–8) at 1st-line and 4 (range 2–4) at 2nd-line treatment. With a median follow-up of 29 months, there were 4 deaths (36.5%) with a median OS of 49 months (CI 95%; 29.38–68.62). The median PFS after first-line was 17 months (IC 95%; 13.87–20.13). To date, 7 pts have progressed after 2nd-line CT with a median PFS of 8 months (IC 95%; 5.92–10.09). Conclusions: This subset of pts with longer progression-free interval (> 6 months) after 1st-line PtCT seems to remain sensitive to platinum compounds upon disease progression. Despite the high proportion of stage III in our sample, based on the long DFS and OS observed, it seems that this population has a more favorable biology than the general population with NSCLC. Further studies, in particular pharmacogenetic analyses, are needed in order to better characterize and treat this population. No significant financial relationships to disclose.
Prognostic factors for patients with lymphoma requiring intensive care
Authors: Scheliga A. , Vieira F. M. , Spector N. , Romano S. , Salluh J. I. , Bello R. D. , Soares M. 
Published: March 2020

17519 Background: Prognosis of patients (pts) with hematological malignancies (HM) in the intensive care unit (ICU) seems to be improving, despite different biological behaviors and outcomes. The study of homogenous groups of pts might provide useful clinical insights. The aim of this study was to evaluate the outcomes of critically ill patients with lymphomas (CIPL). Methods: During 66 months, all consecutive CIPL admitted to an oncologic ICU were studied. Variables collected were: age, gender, performance status, type and status of lymphoma, neutropenia, infection at admission, use of mechanical ventilation (MV), the Acute Physiology and Chronic Health Evaluation (APACHE) II score, comorbidities and number of acute organ failures (AOF). Variables selected in the univariate analysis (p < 0.25) and those clinically relevant were entered in a multivariable logistic regression analysis [results expressed as odds-ratios (OR), 95% confidence interval (CI)]. The end-point was hospital mortality. Results: A total of 120 CIPL were studied. Mean age was 51 ± 20 years and 54% were males. APACHE II was 19 ± 7 points. Diagnoses were High Grade Non-Hodgkin’s Lymphoma (77.5%), Hodgkin’s disease (17.5%) and Low Grade Non-Hodgkin’s Lymphoma (5%). Reasons for ICU admission were severe sepsis (62%) and acute respiratory failure (22%). During ICU stay 90% pts received MV, 71% vasopressors and 27.5% dialysis. Twenty-three (19%) pts had neutropenia. End-of-life decisions were implemented in 31% pts and all of them died at the ICU. The ICU and hospital mortality rates were 53% and 67% respectively, with no difference among the groups of lymphomas (p = 0.877). Variables identified in the multivariate analysis were: age [OR = 1.03 (95% CI = 1.01–1.06)], male gender [3.72 (1.27–10.90)], uncontrolled disease [OR = 6.28 (1.80–21.95), for pts with newly diagnosed disease and OR = 5.33 (1.45–19.47), for those with recurrence/progression, sepsis [OR = 5.31 (1.62–17.37)] and AOF [OR = 2.35 (1.53–3.61)]. Conclusions: Higher age, male gender, the severity of organ failures, sepsis and disease status were the main adverse factors. Type of lymphoma and neutropenia had no impact in the outcome. The appropriate use of such easily available clinical characteristics may avoid forgoing intensive care for lymphoma pts with a chance of survival. No significant financial relationships to disclose.
Long-term outcomes after laparoscopic splenectomy for splenomegaly
Authors: Brethauer S. A. , Chalikonda S. , Dan A. , Nfonsam V. , Goncalves C. , Rosenblatt S. , Lichtin A. , Walsh R. M. 
Published: March 2020

17527 Background: Numerous studies have demonstrated the feasibility of laparoscopic splenectomy (LS) for splenomegaly. There is little published data on the long-term efficacy of LS. The aim of this study is to determine long-term outcomes following LS for splenomegaly. Methods: Retrospective review of patients undergoing LS between 8/95 and 5/05. Splenomegaly was defined by CT criteria of craniocaudal length > 17 cm. Preoperative diagnoses included lymphoma in 13 patients (20%), leukemia in 15 (23%), autoimmune hemolytic anemia in 3 (5%) and other hematologic disorders in 8 (12%). 26 patients (40%) had no definitive diagnosis prior to splenectomy. Patients with ITP were excluded. Patient demographics, operative indications, operative morbidity and mortality, pathology, pre- and postoperative hematological indices were collected. Follow-up was obtained from patient records and telephone interviews. Results: 311 patients underwent LS during the study period. 65 patients underwent LS for splenomegaly. The mean age was 59 and 62% were male. There were no operative deaths. 7 patients (11%) were converted from LS to open. There were 9 (14%) major complications including 4 re-operations (3 for bleeding), 3 portal vein thromboses, 1 intra-abdominal abscess and 1 postoperative hemorrhage managed non-operatively. Thirty-two patients underwent LS primarily for diagnostic purposes. Nine had an existing hematologic disease and LS was performed to evaluate splenic involvement. LS confirmed a diagnosis in 19 (59%) patients including 11 lymphomas (34%). Thirty-three patients underwent LS primarily for treatment of either symptoms (33%) or cytopenias (66%). LS effectively treated mass symptoms in all patients. Among all patients 33 (51%) had associated cytopenias. At median f/u of 20 months 15 (45%) patients had no recurrence of cytopenias, 15 (45%) patients required further treatment and 3 were lost to follow up. One responder (7%) died of lymphoma 3 months after surgery without recurrence of cytopenia. The 15 non-responders had progression of disease requiring chemotherapy and transfusions and 9 (60%) died a median of 6 months after LS. Conclusions: LS is a valuable diagnostic and therapeutic tool for patients with splenomegaly and provides durable treatment for splenomegaly-associated cytopenias. No significant financial relationships to disclose.
An initial analysis of an allele-specific quantitative PCR (Q-PCR) assay which detects minimal residual disease (MRD) in the peripheral blood of follicular lymphoma (FL) patients
Authors: Theriault T. , Kautz N. , Mason K. , Ingolia D. , Denney D. W. 
Published: March 2020

17541 Background: MyVax Personalized Immunotherapy is an active immunotherapy that targets the idiotype of surface immunoglobulin (Ig) on malignant B cells and is currently in a pivotal Phase 3 trial. Idiotype vaccines have shown promising results in early phase clinical trials. The monitoring of circulating tumor cells in peripheral blood lymphocytes (PBLs) may provide important information regarding disease status and response to therapy. A standard method of assessing MRD in FL is by PCR amplification of the t(14:18) translocation at the major breakpoint region (MBR) locus. Studies have shown that 35–50% of FL tumors are not detected by the MBR assay. Circulating non-malignant cells that carry the t(14:18) translocation may complicate MBR analysis. We have developed an allele-specific oligonucleotide (ASO) Q-PCR assay that detects unique Ig heavy chain sequence. This patient-specific ASO assay has the ability to monitor tumor in PBLs of all patients. Methods: Three TaqMan assays were performed on each sample analyzed: 1) ASO; 2) MBR; 3) albumin. The MBR and albumin assays were standard for all patients. The ASO assay was developed for each patient based on amplification using patient-specific primers and TaqMan probes that span the CDR2/CDR3 region of each patient Ig heavy chain. The Ig heavy chain sequences identified during the production of MyVax Personalized Immunotherapy were used to develop patient-specific primers and probes. MBR and ASO counts were normalized using the results of the albumin assay. Assays were performed on DNA samples isolated from PBLs collected before and 6 months after chemotherapy and following MyVax Personalized Immunotherapy. Results: Q-PCR data were grouped into MBR positive and MBR negative sets. We were able to monitor tumor-specific cells present in peripheral blood by the ASO assay in all patients. ASO values appear to correlate with MBR values. Both the ASO and MBR assays allowed detection of 1 tumor cell in 104 to 105 PBLs with reaction efficiencies of 1.80 or higher. Conclusions: The ASO assay is broadly applicable for detecting MRD in both MBR positive and MBR negative FL patients. [Table: see text]
Autologous stem cell transplantation (ASCT) in AL amyloidosis: Feasibility outside national amyloidosis referral centers and proposal for simpler pre-transplant staging
Authors: Jain N. , Pasquini M. , Paul M. , Hari P. 
Published: March 2020

17545 Background: Single center data from national amyloidosis referral centers suggest that high dose melphalan based ASCT is an effective upfront treatment strategy for AL amyloidosis. Absence of published randomized control trials, referral bias and center experience make generalizability of this data difficult since data from outside of major referrals centers is limited. Pre-transplant staging is complicated by the profusion of articles describing various adverse risk factors. Methods: Retrospective review of bone marrow transplant database at our institution was conducted. All patients with AL amyloidosis who underwent ASCT were included in the study. We stratified patients based on International Staging System (ISS) for multiple myeloma. Organ and hematological response were assessed using 2005 consensus guidelines. Results: 13 patients (6 males) underwent ASCT for AL amyloidosis with risk adapted high dose melphalan dosing (melphalan mg/m2 100 (n = 1), 150 (n = 8) and 200 (n = 4)). Median age of the patient population was 53 years (range 31–75 years). Organ involvement was as follows - single organ = 6, 2 organs = 4 and 3 organs = 3. 4 patients had cardiac amyloidosis. 100 day transplant related mortality (TRM) was 15.3%. Overall survival was 84 % (95 % CI 51–96%) @ 1 yr and 75% (95% CI 38–91%) @ 2 yrs. Median follow up was 18 months. No deaths were observed >17 months post-transplant. 45 % patients had organ response. Complete hematological response was observed in 45 % patients. Mean duration of peri-transplant hospital stay for ISS stage I, II and III were 20.5 days (n = 2), 23.3 days (n = 9) and 29 days (n = 1) respectively. Number of deaths observed in ISS stage I, II and III were 0 (0/2), 2 (2/9) and 1 (1/1) respectively. Conclusions: Autologous stem cell transplant (ASCT) for AL amyloidosis is a feasible, effective and safe procedure outside of major national referral centers. Pretransplant stratification of amyloidosis patients using ISS for multiple myeloma indicated a trend towards longer peri-transplant hospital stay and mortality with increasing ISS stage. This hypothesis needs to be tested in larger studies. No significant financial relationships to disclose.
Prognostic value of hemoglobin in natural killer cell lymphoma
Authors: Xiao J. , Lin T. , Cao Y. , Fu X. , Guo C. , Zhai L. , Guan Z. 
Published: March 2020

17557 Background: Natural Killer (NK) cell lymphoma is a group of increasingly recognized but poorly defined disease entities. This study investigated its clinical features and prognostic factors for southern China population. Methods: Patients with pathologically confirmed NK cell lymphoma in one center since 1999 to 2004 were included. Central histological and immunohistochemical review was undertaken to every case. The major study endpoint was overall survival. Survival curves were estimated by the Kaplan-Meier method. Detailed clinical, pathological and laboratory data were included in univariate analysis and statistically significant factors in univariate analysis were then included in multivariate analysis. Results: Totally 64 eligible patients were identified. Of these, 59 patients were extranodal NK cell lymphoma nasal type, 3 patients were aggressive NK cell lymphoma and 2 patients were blastic NK cell lymphoma. From the basic analysis, 47% of the patients had stage I disease, 42% were stage II, 11% were stage III or IV. B-symptoms were present in 39%. 73% of these patients had International Prognostic Index (IPI) 0 or 1. Before treatment, 25% complicated with anemia. As to the therapy, 38% received chemotherapy alone, 3% received radiotherapy alone and 59% received a multidisciplinary therapy. After initial therapy, 59% achieved CR, 22% achieved PR and 19% were refractory disease. With a median follow-up duration of 20 months, the median overall survival was 28 months (95% CI: 10, 45). Hb lower than 110 g/l before treatment was statistically significant in multivariate analysis (p = 0.031). Presenting B-symptoms and ECOG PS score higher than 1 were also independent prognostic factors (P = 0.001 and 0.006 respectively). Conclusions: The outcome of patients with NK cell lymphoma was poor even for Stage I or II cases. Our data suggested Hemoglobin < 110 g/l had more prognostic value than IPI and Ann Arbor staging system for NK cell lymphoma in southern China, but it needs further confirmation. No significant financial relationships to disclose.
Supportive and unsupportive behaviors of friends and families as experienced by cancer patients
Authors: Grange C. , Matsuyama R. , Lyckholm L. , Smith T. J. 
Published: March 2020

18625 Background: Interpersonal support can help individuals manage stressors associated with cancer diagnosis and treatment. This study reveals cancer patients’ experiences with supportive and unsupportive behaviors of friends and families. Insufficient or inappropriate social support can negatively impact coping, quality of life and other patient outcomes. Methods: Eleven focus groups were conducted with 39 African-American and Caucasian cancer patients recruited from a university-affiliated cancer clinic, using established qualitative methodology. Data analysis included whole group analysis with a team of 4 researchers. Atlas Ti software was used to validate coding and establish intra-rater and inter-rater reliability. Results: Supportive behaviors included practical assistance (e.g., providing meals), family providing housing and daily care, family/friends who listen, prayer, and a social context that demonstrates positive attitudes. Unsupportive behavior included limitations of independence and withdrawal from patients due to fear or discomfort, as well as having to provide emotional support to family or friends. African-American participants were more likely than Caucasian participants to report family or community resources available for daily care and expressed greater concern about limitations to independence. Conclusions: Findings have implications for interventions to improve the quality of support provided to cancer patients from their caregivers and communities. Results can be used to inform family, friends and caregivers about the types of support valued by patients. [Table: see text] No significant financial relationships to disclose.
Doxorubicin and DTIC in organ transplant recipients with metastastic soft tissue sarcoma
Authors: Schoeler D. , Hildebrandt B. , Bachmann U. , Reichardt P. 
Published: March 2020

19502 Background: The development of cancer in organ transplant recipients is well known. Depressed immunosurveillance induced by the use of immunosuppressive agents for prevention of rejection is a causative factor. Kaposi’s sarcoma (KS), non-Hodgkin lymphoma and nonmelanoma skin cancers are more than 20-fold increased than in general population, EBV, HSV and HHV-8 seem to be causative. Other soft tissue sarcoma (STS) than KS are extremely rare post-organ transplantation tumours. Methods: Due to the fact that there is no “standard therapy” in organ transplanted STS patients we studied the feasibility, toxicity and response to a chemotherapy with doxorubicin (75 mg/m2, d1) and dacarbacine (DTIC, 300 mg/m2, d1–4). Two patients with metastatic disease (histology: poor differentiated uterine stromal sarcoma, poor differentiated malignant peripheral nerve sheath tumour, each n=1) were treated with up to 6 cycles of therapy. Results: One patient achieved a partial remission and dramatic improvement in life quality, the other patient achieved a stable disease after 2 cycles of therapy. Conclusions: Therapy with doxorubicin and DTIC is feasible in organ transplant recipients. Handling of the immunosuppression while chemotherapy is unproblematic. No significant financial relationships to disclose.
A single team experience of adjuvant radiation therapy in adults with intermediate or high-grade limb soft tissue sarcoma
Authors: Merimsky O. , Soyfer V. , Kovner F. , Meller I. , Kollender Y. , Issakov J. , Inbar M. J. 
Published: March 2020

19509 Background: Limb Soft tissue sarcomas (STS) are currently treated with limb sparing surgery (LSS) followed by radiation therapy (RT). This paper summarizes a one-team experience with homogenous population of adult patients, with intermediate or high grade STS confined to a limb, who were approached by LSS and postoperative RT. Methods: From October 1994 through October 2002, 133 adult patients (75 males, 58 females, age range 18–88 years, median 54) with biopsy-proven intermediate or high-grade limb STS were approached by LSS followed by RT. Their files were retrospectively reviewed for treatment outcome: local control, RT side effects, and time to progression. Tumor site was classified according to its proximal border. STS that involved the arm and the upper axilla was classified as axillary STS. Results: RT related toxicity was manageable, with a low rate of severe effects. At 4-year median follow up, there were 48 recurrences of any type, 23 of isolated local failure, and 35 of systemic spread w/o local failure. DFS and OS were influenced by disease stage II versus I, primary site in the upper limb versus lower limb, MPNST versus other types, induction therapy versus no induction, adequate resection Vs marginal resection or involved margins, and good response to induction therapy versus bad response. DFS and OS were Patient’s age and sex, tumor depth, acute or late toxicity of RT, or the interval of time between the date of definitive surgery and the start of RT did not affect DFS and or OS. Conclusions: The RT protocol is applicable in the era of complicated, expensive and time-consuming 3-D therapy. Our results of LSS + RT in adults with limb HG STS are satisfactory. No significant financial relationships to disclose.
Excellent survival of pediatric dermatofibrosarcoma protuberans in Taiwanese
Authors: Chien C. , Chang Y. , Lin D. , Lin Z. , Yang R. 
Published: March 2020

19512 Background: Pedicatric dermatofibrosarcoma protuberans (PDFSP) was a rare disease. We reported our institutional experience with PDFSP treated from 1977–2002. Methods: Twelve patients with PDFSP diagnosed before age 18 years were treated in our institute from 1977–2002 according to institutional cancer registry. After approved by institutional research ethic committee (ClinicalTrials.gov Identifier: NCT00173355 ), active patient contact and linkage with National Residency Registry was done to survey the disease status. Results: There were 6 boys and 6 girls in this study. The median age at diagnosis were 16 years (range: 3 months ∼18 years). The disease sites were diverse, from scalp to knee. Nine of them underwent wide excision in our hospital for their primary disease; the other 3 patients underwent wide excision in our hospital for local recurrent disease. None of them underwent neoadjuvant or adjuvant therapy. All of them had low grade T1a (≤ 5cm in size, superficially located) disease except T staging was not available in two patients. Negative margin was obtained in all in the operation of our instituion except close margin in one patient, who had uncontrolled recurrence and died of progressive disease later. The clinical follow-up (FU) period range from 1 to 214 months (median: 30). Active patients contact via telephone followed by twice postcard invitation was done. No evidence of disease (NED) was revealed by medical FU for three patients and by telephone FU for three patients. For the remaining six patients who had no response after telephone and postcards contact, data from linkage with National Residency Registry was used. Death was noted in one patient and aliveness was noted in five patients (all of them were NED in their last FU in our hospital). The 10-year/15-year progression free and overall survival rates were 100%/75% and 100%/83% respectively without obvious complications. Conclusion: The prognosis of PDFSP in Taiwanese was excellent when adequate surgical margin was obtained. No significant financial relationships to disclose.