bluuebunny/crossref_metadata_2025_split huggingface dataset:
Life expactation and intensity of cancer in brief: Family histories of the patients with myeloproliferative neoplasms.
Authors: Bolaman Ali Zahit , Unubol Mustafa , Kadikoylu Gurhan , Yavasoglu Irfan 
Published: September 2018

e18564 Background: Thrombosis and bleeding are the most important prognostic factors in myeloproliferative neoplasm (MPN). But there is not a prognostic factor for predicting survival at diagnosis. The determination of the intensity of the cancer incidence in brief- and family histories of patients may help to make a comment on the nature of the MPN. We investigated the effects of the concomitant diseases on survival and cancer intensity in brief- and family histories of the patients with MPN. Methods: Thirty-five (19 female, mean age 59 ±11 years) patients with MPN were enrolled to the study. The diagnosis of the patients were essential thrombocythemia in 19, polycythemia vera in six and primary myelofibrosis in six, and chronic myelocytic leukemia in four. By using Charlson’s concomitant disease index, concomitant disease weight incidence, concomitant state-age relationship, and probability of 10 years survey were investigated. Results: In brief history of the patients, only one (3%) patient had skin cancer. However there were some cancers in family history of 9 patients (26%). These were hematological malignancies in four patients (2 acute myelocytic leukemia and 2 non-Hodgkin’s lymphoma) and solid tumors in five patients (2 breast, 2 colon cancer, one skin and lung cancers). Mean Charlson’s concomitant disease weight index was 1.4±1.5 (0-6), concomitant state-age relationship was 3.2±2 (0-8), and probability of 10 years survey was 63±35% (0-98%). Conclusions: Although our study group is small, Charlson’s concomitant disease index may be used for the determining of life expectancy in MPN. Moreover cancer cluster in family history of these patients was notable.
Blastic transformation in Mexican population with chronic myelomonocytic leukemia treated in a tertiary referral center.
Authors: Rivera Duarte Alfonso Alfredo , Armengol Alonso Alejandra , Tuna-Aguilar Elena 
Published: September 2018

e18566 Background: Chronic myelomonocytic leukemia (CMML) is the most aggressive of chronic leukemias, with a short overall survival and a high transformation rate to acute leukemia. We investigated factors related to blastic transformation in Mexican population treated in a tertiary referral center Methods: Records of patients diagnosed with CMML between 2000-2015 were reviewed; patients with incomplete data were excluded. IBM SPSS Statics 21.0 software was used to perform statistical analysis. Results: 54 patients were included, with a median age of 71 years and an overall survival of 16 months. The rate of blastic transformation found was 33% (18 patients), with a time to progression of 9 (0-87) months. Comparing patients who didn’t underwent blastic transformation to those who did, those who progress to acute leukemia tend to be younger (58 vs. 71 years, p = 0.001), have a higher peripheral blood blast count (2% vs. 0%, p = 0.003), where more likely to have immature myeloid precursors circulating in peripheral blood (94% vs. 64%, p = 0.02). In multivariate analysis, age continued to be statistically significant (HR 0.97, 95% IC = 0.929-0.987). There where no statistical difference in the two groups regarding hemoglobin levels (8.2g/dL vs. 10.1g/dL) platelets count (115 X 109 vs. 93 X 109), absolute neutrophil count (5.83 X 109 vs. 5.18 X 109), absolute monocyte count (3.09 X 109 vs. 2.680 X 109), and bone marrow blast count (0 vs. 2%). Cytogenetic considered as high risk was not predictor of blastic progression. Intensive chemotherapy was offered to 7(38.9%) patients, with a complete response rate of 0%, the overall survival was 1.4 months (0-9). Conclusions: Contrary to other reported series;Mexican patients with CMML that progresses to overt acute leukemia were considerably younger, with a higher tumor burden and a very short overall survival. In this population, it is important to consider more aggressive treatments at diagnosis, focusing in high dose chemotherapy and hematopoietic stem cell transplantation in a short term ratter than watching and waiting or using agents that do not impact in disease natural history.
Safety and efficacy of autologous stem cell transplantation in lymphoma patients in their 70s.
Authors: Sun Lova , Li Shuli , Armand Phillippe , Chen Yi-Bin Albert , DeFilipp Zachariah 
Published: September 2018

e19003 Background: High-dose chemotherapy and autologous stem cell transplantation (ASCT) can offer durable remission in many patients with relapsed or high-risk lymphoma. Elderly patients, who make up an increasing proportion of lymphoma patients, are often not considered candidates due to concern for excess toxicity and mortality. However, preliminary reports suggest that ASCT in carefully selected elderly patients can be feasible, safe, and effective. Methods: We identified patients ≥70 years of age with Hodgkin or non-Hodgkin lymphoma who underwent ASCT between 2000 and 2016 at two partner institutions. We recorded clinical characteristics, lymphoma diagnosis, conditioning regimen; and outcomes regarding engraftment, treatment toxicities, and relapse. Kaplan-Meier survival analysis for overall and relapse-free survival was performed. Results: 119 elderly patients with lymphoma who were treated with ASCT were identified. Median age at transplant was 72 (range, 70-79). The most common lymphoma subtype was diffuse large B-cell (n=75, 63%); others were T-cell (n=19), mantle cell (n=12), follicular (n=7), and Hodgkin (n=6). Conditioning regimens included BEAM (BCNU, etoposide, Ara-C, melphalan), CBV (cyclophosphamide, BCNU, etoposide), and Bu/Cy (busulfan/cyclophosphamide). Median time to neutrophil recovery (ANC>500) and platelet recovery (>20,000) were 10 and 12 days, respectively. Three patients had early mortality (within 100 days) from rapid disease progression (n=1) or treatment toxicity (n=2). Median follow up for survivors was 23 months (range, 0-157). Two-year progression-free survival and overall survival were 58% (95%CI, 48-67%) and 66% (95%CI, 55-74%), respectively. The leading cause of treatment failure was disease relapse, which occurred in 33% of patients (n=39). Two-year estimate for non-relapse mortality was 7% (95%CI, 3-14%). Conclusions: ASCT is safe and feasible in selected elderly lymphoma patients, although relapse and non-relapse mortality may be higher than in younger patients. Eligibility for ASCT should be an individualized decision, and age should not be an absolute barrier to ASCT referral in healthy elderly patients with lymphoma.
An in-depth interview study of oncology nurses and infusion pharmacists of bendamustine product attributes that drive relative product preferences.
Authors: Gabriel Susan , Welstead Jennifer , Shockley Shannon , Barr Peri 
Published: September 2018

e19007 Background: Two bendamustine products, Treanda and Bendeka, are currently in the market. This study sought to better understand which attributes are meaningful in driving product preferences between these products as determined by a sample of front-line oncology nurses and infusion pharmacists. Methods: Two target panels of 10-15 oncology nurses and infusion pharmacists/pharmacy technicians who practice at different settings across the US were identified. Each study-eligible respondent was required to complete a pre-interview survey designed to collect background information on their practice site and their relative preferences for the two bendamustine products. All interviews were conducted between October and December 2016 by a trained nurse facilitator, and were taped and later transcribed. The survey results were analyzed using descriptive statistics, while content analysis was used to analyze the interview transcripts. Results: A total of 11 nurses and 10 pharmacists completed the pre-interview survey and participated in the in-depth interviews. The majority of nurse respondents were female (90.1%), resided in the South (72.7%), and practiced primarily in ambulatory care clinics (60%). The pharmacist respondents were also mostly female (60%), resided in the Mid-West (40%), and practiced primarily in comprehensive cancer care centers (40%). Both nurse and pharmacist responders reported that product attributes that address better safety, cost savings, productivity improvements, and improved workflow efficiency were most meaningful to them and drove their preferences for either Treanda or Bendeka. The majority of respondents reported a stronger preference for Bendeka over Treanda based on their respective product attributes that addressed these domains. Conclusions: Nurses and pharmacists involved in compounding, dispensing, and administering Bendeka or Treanda revealed that specific product attributes that impact safety, cost, productivity, and workflow efficiency drive usage of Bendeka.
Outcomes of de novo CD5+ diffuse large b-cell lymphoma (DLBCL) in the rituximab (R) era.
Authors: Hu Bei , Loghavi Sanam , Fayad Luis , Noorani Mansoor , Fowler Nathan Hale , Hagemeister Fredrick B. , Lee Hun Ju , Nastoupil Loretta J. , Neelapu Sattva Swarup , Fanale Michelle A. , Samaniego Felipe , Turturro Francesco , Wang Michael , Davis Richard Eric , Westin Jason R. , Medeiros L Jeffrey , Oki Yasuhiro 
Published: September 2018

e19019 Background: De novo CD5+ DLBCL is associated with poor prognosis. Methods: We retrospectively reviewed the MD Anderson Lymphoma Outcome Database and identified 104 patients (pts) with de novo CD5+ DLBCL diagnosed between 2001-2016. We excluded primary CNS lymphoma and Richter’s transformation. Results: Median age was 62 (range 29-96); 55% were male. Most (71%) pts had advanced stage at diagnosis, with 55% being Stage IV. Eighty percent (n = 79) had extranodal disease at presentation with bone/bone marrow being the most common site (40%); central nervous involvement was seen in 5%. Two-thirds had elevated LDH; 37% had B symptoms on presentation. ECOG PS was ≥2 in 26% of pts; beta-2 microglobulin was elevated in 68%. Of the 77 pts with IPI score, 21% (n = 16), 23% (n = 18), 26% (n = 20), and 30% (n = 23) were considered low, low-intermediate, high-intermediate, and high risk, respectively. In the diagnostic specimen, median Ki67 was 85%. Majority were non-GCB by Han’s criteria (n = 47 of 77). Two pts were double-hit lymphoma. All received R-containing regimens for primary therapy, including RCHOP (n = 64), dose-adjusted R-EPOCH (n = 24), R-HyperCVAD (n = 6), and other (n = 10). Prophylactic intrathecal chemotherapy use was 35%. Sixty-eight (65%) pts achieved complete response (CR) with primary therapy. Two pts underwent frontline autologous stem cell transplant. Median PFS duration was 28 months (mo) (95% CI: 10-27). Median OS duration was 112 mo (95% CI: 10-214). Pts with primary refractory disease had the worst OS duration of 14 mo. Pts with relapse within 1 year of achieving CR fared no better with median OS of 22 mo. PFS and OS were not significantly different by choice of primary therapy. By multivariate analysis using Cox proportional hazard model, male gender (HR = 3.0, 95% CI: 1.1-8.1, p = 0.029) and high IPI (HR = 2.5, 95% CI: 1.4-4.3, p = 0.001) were associated with shorter PFS. Only IPI score was significantly associated with worse OS (HR = 3.0, 95% CI: 1.6-5.7, p = 0.001). Conclusions: De novo CD5+ DLBCL is frequently associated with extranodal presentation and poor outcome with R-containing intensive chemotherapy. IPI remains the most significant prognostic factor for worse PFS and OS. There is clearly an unmet need for novel treatment for this disease.
Hypereosinophilic syndrome (HES) during rituximab treatment.
Authors: Basu Chinmay 
Published: September 2018

e19021 Background: Hypereosinophilic syndrome (HES) is a rare disease defined by organ damage directly attributable to hypereosinophilia of any type. The most commonly involved organ is the lung, followed by the skin. Methods: We report a single-center cohort of patients with NHL (DLBCL). Of these patients, nine had been treated with RCHOP on standard reatment protocol (6 cycle chemotherapy). In a retrospective analysis, data on treatment response, frequency of relapses, adverse events reconstitution were evaluated. Heamotology and biochemistry tests abs analysis were performed after every cycle. Results: All patients had high disease activity before RTX treatment. We found 3 patients who developed severe drug-induced hypereosinophilia with gastrointestinal involvement as a consequence of RCHOP infusion. For the case 1 Full blood count revealed a new mild eosinophilia with eosinophil count of 1 9 109 /l. After the third infusion, the eosinophil count had risen to 7.0 9 109 /L. In case 2, after the 6th infusion, the eosinophil count had risen to 6.4 9 109/L. In case 3 also it occurred in follow up period after 6th infusion and 6.8 9 109 /L. However the finding was not associated with any severe toxicity or other malignancy. No alarming feature was also notice alongside this abnormality Conclusions: Preemptive retreatment with RTX, combined with CHOP, resulted in a sustained treatment response. Hence clinical significant is not clear this stage. Strict post marketing vigilance for evaluating the use of RCHOP was warranted.
Effect of adding immunotherapy (IT) to treatment regimen of mantle cell lymphoma (MCL): Analysis of the National Cancer Data Base (NCDB).
Authors: Altahan Alaa , Vick Eric , Giri Upama , Wiedower Eric , Martin Michael Gary 
Published: September 2018

e19022 Background: There has been some improvement in overall survival (OS) for patients with MCL over the past years [Gordon 2014]. However, side effects of treatment remain a major concern. With introduction of novel therapies like IT, it is imperative to optimize treatment regimens to improve survival while minimizing toxicity. Methods: MCL patients (pts) who were diagnosed in 2013 or later with information available about chemotherapy (CT) and IT and did not receive transplant were extracted from NCDB. Pts were assigned to age categories and were sorted into six groups based on different combinations of CT (none, single agent (SA), and multi-agent (MA)) with or without IT. Cox regression analysis was used to perform multivariate analysis that included age category, sex, race, clinical stage, Charlson/Deyo score, CT, radiation, and IT for each group. Multivariate p values (p) were used to analyze statistical significance. Kaplan Meier method was utilized to analyze OS. T-test was used to compare means (t-p). Results: 1438 total pts were identified with a mean age of 70 (range 24-90); 71% male; 93% white, 4% black, 3% others; 42% with stage III/IV disease. 667 pts did not receive CT or IT, and 40 received IT alone and both of these groups were excluded from further analysis. 52 pts received SA- (without) IT, 206 received SA+(with) IT and 260 pts received MA-IT and 213 MA+IT. Mean age was 72 and 66 for SA and MA groups, respectively (t-p<0.01). Mean OS for SA+IT was 27 months (m) vs SA-IT 16 m (p < 0.01). MA+IT v MA-IT showed no difference in mean OS (25 vs 26 m, respectively, p =0.49). Although there was a significant difference in OS between SA and MA groups without IT (16 vs 25 months, p < 0.01). SA + IT group showed comparable mean OS time to MA + IT (27 vs 26 m, p =0.145). Conclusions: For MCL pts, MA has superior OS to SA group. However, adding IT significantly improves OS for SA group and makes it comparable to MA. Adding IT to MA did not provide significant difference in OS. These results highlight the possibility of achieving same OS with less toxic regimens. Hence further evaluation in a prospective study to optimize treatment while reducing toxicity is warranted.
Cost burden of first-line antineoplastic treatment failure in patients with chronic lymphocytic leukemia.
Authors: Senbetta Mekre , Lafeuille Marie-Helene , Lefebvre Patrick , Romdhani Hela , Emond Bruno , Wang Song 
Published: September 2018

e19037 Background: Treatment failure (TF) is associated with significant cost burden in patients with non-Hodgkin’s lymphoma (NHL) in the US. This study assessed treatment patterns and healthcare cost burden of first-line (FL) TF in patients with chronic lymphocytic leukemia (CLL), a subtype of NHL, overall, and for the top 5 FL regimens. Methods: A retrospective study of a large national claims database identified adult patients with CLL who initiated an antineoplastic agent (AA) after their first CLL diagnosis (index date) from 01/2011- 07/2016. Patients included had ≥12 and ≥6 months of observation pre- and post-index, respectively, and were treatment-naïve with no solid or selected blood malignancies in the pre-index period. FL therapy included AA administered within the first 30 days post-index. TF occurred at the earliest of: initiation of a new AA, resumption of initial treatment following a gap of ≥3 months, radiotherapy, stem cell transplant, or hospice care. The total cost difference between patients with and without FL TF was estimated using ordinary least squares regressions adjusted for baseline characteristics. Non-parametric bootstrap was used to estimate confidence intervals (CI) and p-values. Results: Among the 2,226 patients included (mean age: 68 years; female: 41%), 46% experienced FL TF. Overall, the average adjusted total cost difference between patients with and without FL TF was $3,011 per patient per month (PPPM) (95% CI: 2,400, 3,583; P < 0.001). Among the 5 most common FL regimens, fludarabine / cyclophosphamide / rituximab (FCR) regimen was associated with the highest PPPM cost of TF (N = 281; $4,758; 95% CI: 2,652, 7,346), followed by other cyclophosphamide-based regimens (N = 142; $4,579; 95% CI: 2,474, 6,311), chlorambucil-based regimens (N = 223; $3,761; 95% CI: 2,029, 5,602), bendamustine / rituximab (BR) regimen (N = 592; $3,163; 95% CI: 2,206, 4,148), and other rituximab-based regimens (N = 474; $3,030; 95% CI: 2,164, 3,956) (P < 0.001 for all). Conclusions: The most common FL regimens used in patients with CLL were associated with 46% treatment failure. Clinicians should consider the cost of treatment failure when selecting the initial therapy in these patients.
Primary non-Hodgkin’s lymphoma of the thoracic spine: A case report with a review of the literature.
Authors: Man Muran , Liu Qinghua 
Published: September 2018

e19039 Background: Primary non-Hodgkin lymphomas of thoracic vertebra are rare, hard to confirm the diagnosis and with unfavorable prognosis. It is characterized by pain, asthenia, numbness, motor disturbances, etc. However, these symptoms don’t have their specificity. Biopsies are needed to confirm the diagnosis. Methods: A 37-year- old man presented with 3 months lumbar region pains and 4 days motor disturbances before he was admitted. The lumbar spine MRI showed lumbar disc herniation with no spinal compression. The thoracic spine MRI revealed altered vertebra signal and compressed marrow in the T10 vertebra. After the posterior tumor reduction and decompression and internal fixation of T10, the histopathology and immunohistochemistry was consistent with diffuse large B cell lymphoma. After surgery, treatment of chemotherapy (ECHOP, RCHOP) in combination with radiotherapy (T8-T12, L5-S1, 45Gy/25F) were followed. Results: Six-year follow-up MRI showed no relapses, metastasis and instability. The patient currently has the self-care ability which could deal with the everyday activities. Conclusions: Primary non-Hodgkin lymphoma originated in the thoracic vertebra is rare, easily to be misdiagnosed. To learn more about the diagnoses and to do the needle biopsy as early as possible would be beneficial to improve the survival rate and the quality of patients’ lives. Key words: Non-Hodgkin Lymphoma, Thoracic Vertebra, Case Report
Venetoclax (VEN) in patients with relapsed/refractory non-Hodgkin lymphoma (NHL).
Authors: Davids Matthew Steven , Roberts Andrew Warwick , Seymour John Francis , Wierda William G. , Puvvada Soham D. , Gressick Lori A. , Alter Debbie , Zhou Lang , Kim Su Young , Verdugo Maria , Gerecitano John F. 
Published: September 2018

e19041 Background: VEN is a selective orally bioavailable BCL-2 inhibitor. The dose-escalation Phase 1 study of VEN in 106 patients (pts) with relapsed/refractory NHL reported an ORR of 44%. Most pts had diffuse large B-cell/follicular lymphoma; we report on updated results in pts with less common NHL subtypes. Methods: VEN was administered and continued until progressive disease (PD)/unacceptable toxicity, in dose cohorts ranging from 300–1200 mg. Adverse events (AEs) were assessed by NCI-CTCAE v4.0 and response by 2007 Cheson IWG response criteria, utilizing CT scans beginning at wk 6. Results: 35 of 106 pts had mantle cell lymphoma (MCL, n=28), marginal zone lymphoma (MZL, n=3) or Waldenström macroglobulinemia (WM, n=4). Most common all grade treatment emergent AEs were nausea (51%), diarrhea (49%) and fatigue (34%); grade 3/4 AEs in >10% of pts were neutropenia and anemia (17% each). Laboratory TLS was reported in a single pt (bulky MCL). MCL pts (median age: 72 years) had received a median of 3 (1–7) prior treatments (tx). Median time from start of prior tx to start of VEN was 13 mo (2–148) and time on VEN was 11 mo (0.2–42). ORR was 75%, 6 pts (21%) achieved CR and remain on study (DORs: 25–40 mo). One pt with a PR proceeded to elective allogeneic stem cell transplant and remained disease free at last protocol defined follow-up (24 mo after coming off study). Median PFS was 11 mo and DOR was 15 mo. MZL pts (median age: 63 years) had received a median of 4 (2–6) prior tx. Time from start of prior tx to start of VEN was 8, 14, 73 mo and time on VEN was 5, 1, 35 mo. One pt (6 prior tx) received VEN for <1 mo due to progressive cytopenias; 1 pt (4 prior tx) achieved a PR with VEN at wk 6 but had PD at wk 16; 1 pt (2 prior tx) achieved PR at wk 6 and is the only pt to remain on study (DOR:32 mo). WM pts (median age: 67 years) had a median of 4 (3–5) prior tx. Time from start of prior tx to start of VEN was 5, 18, 33, 67 mo and time on VEN was 42, 17, 54, 20 mo. All pts achieved PR (at wks 6 [n=2], 16 and 36), with DORs of 11, 12, 38 and 50+ mo (latter is ongoing and remains on study). Conclusions: VEN monotherapy has a tolerable safety profile in MCL, MZL and WM pts. ORR were high and most responses durable; median PFS and DOR suggest significant activity in MCL pts. Further investigation of VEN in each disease is indicated. Clinical trial information: NCT01328626.