bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can PET/CT substitute for bone scintigraphy in assessment of bone metastases in lung cancer patients?
Authors: Watanabe H. , Monzawa S. , Adachi S. , Hamanaka A. , Kitamura Y. , Izaki K. , Okada M. , Satouchi M. , Negoro S. , Takada Y. 
Published: March 2020

7203 Background: Bone is a frequent site of lung cancer metastasis. However, false positive lesions detected by conventional bone scintigraphy often become problematic. We compared the efficacy of whole-body [18F]-2-Fluoro-2-deoxy- D- glucose PET/CT imaging and conventional bone scintigraphy for assessment of bone lesions in lung cancer patients on an individual patient basis. Methods: The study population comprised 106 consecutive patients with suspected or proven lung cancer (73 men and 33 women; age range: 40 to 85 years) who underwent both whole-body PET/CT imaging and conventional bone scintigraphy using 740 MBq of Tc-99m hydroxymethylene diphosphonate for cancer staging. Diagnostic radiologists interpreted and assessed all images on a patient-by-patient basis. Clinical information and the findings of follow-up imaging studies were used as the gold standard for the identification of bone metastases. Results: On the basis of the gold standard, 11 of the 106 patients were identified as having bone metastases. Bone scintigraphy showed a sensitivity of 67% (7/11) while that of PET/CT was 100% (11/11) for detection of bone metastases. Seven of these 11 patients were deemed positive based on both bone scintigraphy and PET/CT. Bone metastases not identified on bone scintigraphy were detected on PET/CT in another four patients. For 39 of 95 patients without bone metastases, the assessment was false-positive for bone scintigraphy but negative for PET/CT. In two of the 39 patients, CT images of PET/CT could identify a benign fracture causing a false positive finding for bone scintigraphy. Conclusions: PET/CT might actually substitute for bone scintigraphy in lung cancer patients because of its superior ability to detect unsuspected bone metastases and to differentiate bone metastases from false positive lesions detected by bone scintigraphy. No significant financial relationships to disclose.
A multicenter prospective randomized study testing non-inferiority of thalidomide 100 mg/day as compared with 400 mg/day in patients with refractory/relapsed multiple myeloma: Results of the final analysis of the IFM 01–02 study
Authors: Yakoub-Agha I. , Doyen C. , Hulin C. , Marit G. , Voillat L. , Grosbois B. , Harousseau J. , Duguet C. , Zerbib R. , Facon T. , Mary J. 
Published: March 2020

7520 Background: Thalidomide (THAL) is effective in pts with relapsed or refractory multiple myeloma (RRMM). A study by Yakoub-Agha et al of 83 patients (Hematol J, 2002) supported this effectiveness but showed a high incidence of THAL toxicity ≥ grade II, related to either THAL cumulative dose or dose-intensity. Themean daily dose of THAL in the first 90-day treatment period, however, did not influence response, overall survival (OS), or event-free survival. Given the dose-related toxicities and an unknown minimally effective THAL dose, the IFM conducted a prospective randomized study to compare the efficacy of THAL 100 mg/d with 400 mg/d in pts with RRMM after ≥2 lines of prior therapy. Methods: The study design was approved by the ethics committee at Lille University Hospital, and all pts gave written informed consent. Given the improved response seen with THAL plus dexamethasone (DEX), this combination was specified per protocol in both study arms for treatment failure (TF) defined as progression at any time or stable disease after 3 months of THAL treatment. THAL dose reduction for toxicity was permitted, but no increase over the initial dose was allowed. All pts received pamidronate routinely. The primary end point was 1-year OS. Secondary endpoints were response rate, EFS, and safety. Results: All results are based on intent-to-treat analyses. In all, 400 pts were enrolled (400 mg, n = 195; 100 mg, n = 205). The 2 groups were comparable in terms of patient characteristics, disease features including Ch13 deletion and prior therapy. Pts in the THAL 100 mg arm received DEX more frequently for TF than those in the 400 mg group, but this difference did not influence 1-year OS: 73 ± 3% vs 69 ± 3% in the 400 mg and 100 mg groups, respectively. The hypothesis of inferiority of 100 mg was rejected. Also, THAL 100 mg was better tolerated than 400 mg with less high-grade somnolence, constipation, and peripheral neuropathy (p < .001, p = .01 et p = .05, respectively). There was no difference regarding deep vein thrombosis. Conclusion: THAL 100 mg/d is comparable in terms of survival with 400 mg/d (with DEX as salvage therapy in case of TF in both arms) in pts with RRMM and better tolerated. [Table: see text]
Dose finding trial of Yttrium 90 ibritumomab tiuxetan (90YIT) with autologous stem cell transplantation (ASCT) in patients with relapsed or refractory B-cell non-Hodgkin’s lymphoma (NHL)
Authors: Flinn I. W. , Kahl B. S. , Frey E. C. , Bianco J. A. , Hammes R. J. , Webb J. , Swinnen L. J. , Sgouros G. , Wahl R. L. 
Published: March 2020

7535 Background: 90YIT is an effective agent for patients with lymphoma. Unfortunately, dose escalation is limited by hematopoetic toxicity. In order to determine the non-hematopoetic maximum tolerated dose, we are conducting a dose finding study of 90YITwith ASCT. Methods: Eligible patients had relapsed or refractory NHL, rituximab sensitive disease, age ≥18 years, platelet count ≥75,000/mm3, WBC >3,000/mm3, bone marrow involvement ≤35%, and acceptable renal and hepatic function. Patients receive weekly rituximab (375 mg/m2) for 4 consecutive weeks followed by a single dose of cyclophosphamide (2.5 g/m2). Filgrastim 10 mcg/kg is administered post cyclophosphamide until stem cell collection. Following successful collection of at least 2 X 106 CD34/kg, patients receive a dosimetric dose of indium 111 (111In) ibritumomab tiuxetan (5 mCi) on day 1, quantitative planar and SPECT/CT scans followed by cohort specific dose of 90Y IT on day 15. Stem cell infusion occurs when estimated marrow dose rate is < 1 cGy/hour. Results: 22 patients (12M:10F) (median age 55, 44–70) with a median of 2 prior regimens (range, 1–8) have been entered onto study. 5 patients failed to mobilize stem cells and did not receive 90YIT. 16 patients have been treated with 90Y IT to the following dose cohorts based on dosimetry-predicted maximal organ radiation absorbed dose: 0.4 mCi/kg = 3; 14–18 Gy = 5; 24 Gy = 6, 28 Gy = 2. The range of administered 90Y IT activities was 20.2–143.1 mCi. All patients engrafted rapidly. One patient died from treatment-related causes: pneumonia day 27 post-transplant. At 60 days post-transplant, 10 patients achieved a CR, 3 patients had a PR, and 2 had progressive disease. The most common treatment-related toxicities were hematologic, as expected. This therapy was delivered completely in the outpatient setting. 4 patients required admission post 90YIT for febrile neutropenia. No significant hepatotoxicity has been seen to date despite the fact that the liver is the organ that receives the highest absorbed dose of radiation. Conclusions: Significant dose escalation with 90YIT can be achieved with ASCT. Dose escalation continues and the MTD has yet to be determined. [Table: see text]
A prospective study of the effects of once weekly bortezomib on markers of bone metabolism in patients with multiple myeloma (MM)
Authors: Peles S. , Fisher N. M. , Gao F. , Tomasson M. H. , Dipersio J. F. , Vij R. 
Published: March 2020

7548 Background: Increased osteoclast activity in MM leads to bone resorption, osteoporosis and osteolytic bone lesions. Urinary excretion of N-telopeptide (NTX), a marker of bone resorption, decreases by 20–70% following treatment with bisphosphonates. Preclinical studies have shown bortezomib to decrease osteoclast function through inhibition of NF-kB. However, no clinical data exists on the effect of bortezomib on markers of bone resorption. Methods: Six cycles of consolidation bortezomib 1.3mg/m2 were given once weekly for 4 of every 5 weeks, 90–120 days post transplant. Urinary NTX excretion and serum osteocalcin were measured on day 1 of cycles 1, 2 and 3 of therapy. Bisphosphonates were prohibited from 42 days prior to stem cell collection and until cycle 3 of consolidation therapy. Results: 33 of 40 enrolled patients received bortezomib consolidation. Patient population and disease characteristics (no. of patients): male (22), female (11), median age 56 years (range 39–70), Stage II (9), Stage III (24), IgG (22), IgA (9), free light chain (2). The median duration between discontinuation of bisphosphonates and initiation of consolidation bortezomib was 158 days (Range 110–196). Only one patient had a >50% reduction in myeloma paraprotein. Nevertheless, excretion of NTX declined by a mean of 32% over baseline values after 2 cycles of consolidation therapy. The only patient with an increase in NTX of >30% was also the only patient with evidence of disease progression during this period of therapy. Contrary to reports of proteasome inhibition resulting in increased osteoblastic bone formation, a decline was seen in osteocalcin. Conclusions: Bortezomib has an inhibitory effect on osteoclastic bone resorption in MM similar to that with bisphosphonates even in the absence of effects on malignant plasma cells. Bisphosphonates may result in nephrotoxicity and osteonecrosis of the jaw and bortezomib represents an alternative agent that may control both the myeloma and bone disease. [Table: see text] No significant financial relationships to disclose.
Incidence of AIDS- and non-AIDS-defining malignomas in HIV-positive patients—A nation-wide German overview 2000–2002
Authors: Mosthaf F. A. , Goetzenich A. , Ostrop-Hanhoff N. J. , Wolf E. , Knechten H. , Von Wussow P. 
Published: March 2020

7554 Background: The primary purpose of this study was to gather data on the epidemiology of AIDS- and non-AIDS-defining malignomas in HIV-positive patients nation-wide in Germany. The secondary objective was to obtain information on their therapy and outcomes. Methods: Surveys were conducted targeting all HIV-specialty clinics and ambulatory care centres as well as all members of the national society of oncologists (BNHO). The surveys requested information on all AIDS- and non-AIDS-defining hematological neoplasms and solid tumors over 3 years (2000–2002) in HIV-positive patients, their tumor stage, their treatments and their clinical course. Further parameters were the CDC (Center for Disease Control)-stage of the HIV-infection and for 2002 the sex of the patient. Results: 60 centres participated in the evaluation and provided 382 data sets. Two data sets were dismissed, where the diagnosis was not made within the defined time frame. Thus 380 data sets from 376 patients could be evaluated (4 patients had 2 malignomas). 180 (47.4%) were AIDS-defining as follows: 89 Kaposi Sarcomas, 82 aggressive B-cell lymphomas, 9 invasive cervix carcimomas. The B-cell lymphomas further included 19 Burkitt’s lymphomas, 8 Castleman diseases, 12 primary cerebral lymphomas. Among the 200 cases (52.6%) of non-AIDS defining malignomas were 133 solid tumors including 40 anal carcinomas (= 20.0% of all non-AIDS defining malignancies) and 67 hemoblastoses including 22 Hodgkin lymphomas (= 11% of all non-AIDS defining malignancies). Conclusions: Our observation showed an unexpected high incidence of non AIDS-defining malignomas over the 3-year time interval followed. Anal carcinomas and M. Hodgkin lymphomas in particular were markedly more prevalent in our HIV-positive cohort compared to published reports of the general population. A conservative estimate showed the incidence of Hodgkin lymphomas to be 6- to 17-times higher, and that of anal carcinomas to be 30- to 60-times elevated. No significant financial relationships to disclose.
Randomized, double-blind, phase 2, study evaluating same-day vs next-day administration of pegfilgrastim with R-CHOP in non-Hodgkin’s lymphoma patients
Authors: Saven A. , Schwartzberg L. , Kaywin P. , Bartlett N. , Dean L. , Shahin S. , Dreiling L. 
Published: March 2020

7570 Background: R-CHOP is associated with a high risk of febrile neutropenia (FN). Pegfilgrastim is indicated to lower infection incidence, manifested by FN, when administered once-per-cycle 24 hrs after chemotherapy (CT). However, eliminating an office visit the day after CT is desirable. Methods: Pts ≥ 18 years with previously untreated non-Hodgkin’s lymphoma (NHL) who received R-CHOP (rituximab 375 mg/m2, C 750 mg/m2, H 50 mg/m2, O 1.4 mg/m2, prednisone 100 mg; for 6 cycles Q21D) were randomized 1:1 to pegfilgrastim 6mg within 4 hours or ∼24hrs after CT. The primary endpoint was the duration of severe (grade 4) neutropenia (DSN) in cycle 1. Same-day administration was considered noninferior to next-day if the upper limit of the 2-sided 95% CI for the difference in mean cycle 1 DSN (same day - next day) was <2 days. Results: 77 pts (8 mantle-cell, 69 diffuse large B-cell) were enrolled of 90 planned (due to slow accrual). 75 pts (36 same-day, 39 next-day) received CT and pegfilgrastim. Most pts had stage 3/4 disease (69% same-day, 74% next-day), no bone marrow involvement (75% same-day, 69% next-day) and ECOG status 0 or 1 (94% same-day, 97% next-day). Difference in mean cycle 1 DSN was 0.9 days (95% CI: 0.3–1.4) longer in the same-day than the next-day group (mean [SD]: 2.1 [1.22] vs 1.2 [1.20] days; grade 4 neutropenia incidence: 86% vs 64%). In cycle 1, more pts had a DSN ≥ 3 days in the same-day (36%) than the next-day group (15%). In cycle 4, mean DSN was longer in the same-day than the next-day group (mean [SD] 1.4 [1.40] vs 0.7 [0.94] days; grade 4 neutropenia incidence: 57% vs 42%). Pts in the 2 groups had similar occurrence of FN (17% vs 15%) and serious adverse events (33% vs 36%) across the study. Full dose on schedule, and the incidence of IV anti-infective use or hospitalization due to FN were also similar between groups. Conclusions: In cycles 1 and 4, the mean DSN was nearly 1 day longer for pts in the same-day group compared with the next-day group. Although the protocol-specified 2-day non-inferiority margin for DSN was met, for pts with NHL receiving R-CHOP, we recommend administering pegfilgrastim 24 hours after CT per labeling guidelines. [Table: see text]
Brief duration rituximab(R)/chemotherapy (CNOP or CVP) followed by maintenance rituximab in elderly/poor performance status patients (pts) with diffuse large B-cell lymphoma (DLBCL): A phase II trial of the Minnie Pearl Cancer Research Network
Authors: Raefsky E. L. , Greco F. A. , Spigel D. R. , Doss H. H. , Farley C. , Saez R. , Kommor M. , Hainsworth J. D. 
Published: March 2020

7577 Background: R-CHOP is the standard first-line treatment for pts with DLBCL; however, some pts are poor candidates due to general debility, cardiac disease, or other medical problems. Maintenance R is not effective after full course R-CHOP chemotherapy for DLBCL (ECOG 4494), but improves outcome following CHOP alone. In this phase II trial, we evaluated short course R/chemotherapy, followed by maintenance R, in pts who were not candidates for full-course R-CHOP. Methods: Eligibility: previously untreated DLBCL; stage II-IV; ECOG PS 0–2; age ≥ 70 years or poor CHOP candidate; adequate kidney, liver, bone marrow function; no HIV infection; informed consent. Pts received 3 courses of R-CNOP (cyclophosphamide 500mg/m2, mitoxantrone 10mg/m2, vincristine 1.0mg/m2, prednisone 80mg PO days 1–5, rituximab 375mg/m2) followed by pegfilgrastim 6mg sq day 2, at 21-day intervals. Mitoxantrone was omitted for pts with EF < 40%. Pts with response/stable disease after chemotherapy began maintenance R (375mg/m2 weekly × 4 doses, administered at 6-month intervals × 4 courses). Results: 31 pts entered this trial between 5/03 and 11/05. Clinical characteristics: median age, 78 years; ECOG PS 2, 45%; IPI 3–5, 79%. 27 pts (87%) have completed short course R-chemotherapy; 20 pts (65%) are currently receiving maintenance R. After completion of R-chemotherapy, 17 pts (63%) had responses (9 CR/CRu, 8 PR); 10 pts had stable disease/minor response. After median 16 month follow-up, 29 of 31 pts (94%) are progression-free; actuarial 2-year PFS is 90%. The 2-year overall survival is 74%. 4 pts have died (progressive lymphoma 2, intercurrent illnesses 2). Grade 3/4 toxicities: neutropenia 38%, other toxicities < 10%, no treatment-related deaths. Conclusions: Short-course R-chemotherapy followed by maintenance R was active and well tolerated in a group of elderly, poor prognosis pts with DLBCL. In spite of modest CR/CRu rate; the 90% 2-year PFS suggests a role for maintenance R. If these findings persist with further followup, this approach is worthy of further study in this patient group. [Table: see text]
Changing prevalence of indolent lymphoid malignancies among the elderly
Authors: Swenson W. T. 
Published: March 2020

7579 Background: Reported changes in incidence rates and improved survival rates among patients with common indolent B-cell lymphoid malignancies have potential implications for increased disease burden among the elderly. This study examines incidence, survival, and prevalence rates of elderly patients with follicular lymphoma (FL) and CLL/SLL using a large population based database. The indolent and incurable nature of these diseases makes the prevalence rate a good indicator of total disease burden. Methods: The SEER 9 public use database was analyzed using SEER*Stat software version 6.1.4. Subjects were identified by ICD-O-3 diagnostic codes. Incidence rates and trends (from 1973 to 2002) were calculated (per 100,000 population) and were age-adjusted to the 2000 US standard population. Survival rates were calculated for patients diagnosed during the periods 1980–1985 and 1990–1995. Prevalence rates include patients diagnosed within 15 years prior to the prevalence date (15-year limited prevalence). Results: Annual percent change of incidence rate (per 100,000) among patients ≥65 years (from 1973 to 2002) was 2.76 (95% CI: 1.92, 3.60) for FL and -0.18 (95% CI: -0.47, 0.11) for CLL/SLL. Survival rates for patients ≥65 years was improved for both FL and CLL/SLL. Among patients with FL diagnosed between 1975–1980 and 1990–1995, 5-year survival rates were 42.2% (95% CI: 38.8, 45.6) and 50.3% (95% CI: 47.9, 52.7). Among patients with CLL diagnosed between 1975–1980 and 1990–1995, 5-year survival rates were 40.6% (95% CI: 38.8, 42.4) and 50.4% (95% CI: 48.9, 51.9). Prevalence percent increased for FL patients among ages 65–74 years, 75–84 years, and ≥85 years. Prevalence percents were unchanged among CLL/SLL patients. Conclusions: Increased FL incidence and increased survival rates have resulted in a growing disease burden among the elderly over the last decade; the prevalence of CLL/SLL has remained static. [Table: see text] No significant financial relationships to disclose.
High-dose chemotherapy and autologous peripheral blood stem cell rescue (Auto-SCT) in multiple myeloma (MM) patients: Busulfan + melphalan-140 (BuMel) versus (vs) melphalan-200 (Mel-200) as conditioning regimens
Authors: Carrion Galindo R. , Serrano D. , Perez-Corral A. , Balsalobre P. , Buno I. , Anguita J. , Gomez-Pineda A. , Mayayo M. , Diez-Martin J. 
Published: March 2020

7612 Background: Auto-SCT is the preferred treatment modality for MM. From the results of IFM 9502 (Moreau et al. Blood, 2002) melphalan 200 mg/m2 was considered the new standard as conditioning regimen due to its lower toxicity. However, many chemotherapy regimens have been tested. We present our results with two cohorts of consecutive patients (pts) diagnosed of MM and treated with Auto-SCT between 1996 and 2005 in our BMT Unit. Methods: Following induction chemotherapy (median of 6 courses) 20 pts were conditioning with busulfan 16 mg/kg + melphalan 140 mg/m2 (BuMel) and 23 (since September-2002) with melphalan 200 mg/m2 (Mel-200). Clinical features: median age (BuMel vs Mel-200) 55 vs 58 (p=0.5); female sex 10 vs 10; Bence-Jones MM 5 vs 5; renal failure (B) 2/20 (10%) vs 7/23 (30%)(p=0.48); previous treatment with local irradiation 6/20 vs 3/23; status previous Auto-SCT (complete remission, CR) 7/20 (35%) vs 6/23 (26%), p=0.5. A median of 4.8 vs 4.4 x 10e6/kg CD34+ cells were infused, respectively (p=0.15). Results: Four toxic deaths: 2 pts by hemorrhagic cystitis-enterocolitis (at day +84 and +96), 1 pt with disseminated candidiasis (day +7), and 1 pt by pulmonary fibrosis (day +452). At 3 months following Auto-SCT, 13/19 (68%) treated with BuMel and 12/23 (52%) of those treated with Mel-200 achieved CR (p=0.28). At 24 months, probability of remaining disease free was 87% for BuMel group and 55% for Mel-200 (p=0.08). Conclusions: 1) Conditioning regimen BuMel was associated with a higher toxicity than Mel-200, as well as a higher mortality treatment related. 2) However, a trend for higher CR rates and probability of disease free progression were shown in BuMel group without statistical significance [Table: see text] No significant financial relationships to disclose.
Solid organ second malignant neoplasms among children diagnosed with malignant bone tumors treated on Children Cancer Study Group/Pediatric Oncology Group protocols after 1980
Authors: Goldsby R. , Burke C. , Nagarajan R. , Zhou T. , Chen Z. , Inskip P. , Marina N. , Friedman D. , Neglia J. , Bhatia S. 
Published: March 2020

9007 Background: The growing number of individuals surviving childhood cancer has increased the awareness and recognition of long-term sequelae. One of the most worrisome complications following cancer therapy is the development of second malignant neoplasms (SMN), in particular, late-occurring solid second malignancies related radiation therapy. Methods: We describe the incidence of solid organ SMN in survivors of pediatric malignant bone tumors (MBT) treated on legacy CCG/POG protocols from 1980 to 2005. This retrospective cohort study included 2,842 patients, 1,686 treated for osteosarcoma (OS) and 1,156 treated for Ewings Sarcoma (ES). The cohort included 56% males and 44% females, with a median age at primary diagnosis of 13 years. The median length of follow-up was 4.3 years (range: 0 to 20.9 years). Results: At the time of the analysis, 64% of patients in this study are alive. Seventeen patients with solid organ SMN were identified, and included three patients with breast cancer, three with malignant fibrous histiocytoma, two with osteosarcoma, and 9 patients with other solid organ malignancies. The standardized incidence ratio (SIR=observed/expected cases) was 2.9 (95% confidence interval [CI], 1.4–5.4) for patients treated for OS and 5.0 (95%CI 2.6–9.4) for patients treated for ES. The median time from diagnosis to develop solid organ SMN was 7 years (range: 1 to 13 years). The 10-year cumulative incidence of solid organ SMN for the entire cohort was 1% (95%CI 0.6–2%). In univariate analysis, treatment with etoposide, cyclophosphamide or radiotherapy were each associated with a higher than expected incidence of cancer with SIR of 4.8 (95% CI, 2.5–9.5), 5.8 (95% CI, 3.5–9.5) and 4.1 (95% CI, 2.4–7.1), respectively. Conclusions: Solid organ SMNs are rare after treatment for OS and ES, although higher in patients treated for ES. Recurrence remains the most significant problem for patients diagnosed with MBT and development of improved therapies with fewer long-term consequences remains paramount. However, solid organ cancers are likely to increase with longer follow-up. Therefore, surveillance should focus on monitoring for both recurrence of primary malignancies and development of SMN. No significant financial relationships to disclose.