bluuebunny/crossref_metadata_2025_split huggingface dataset:
External validation of prognostic indices for aggressive adult T-cell leukemia/lymphoma (ATL-PI/JCOG-PI) in Okinawa.
Authors: Tamaki Keita , Morishima Satoko , Nomura Shogo , Tomoyose Takeaki , Nakachi Sawako , Nishi Yukiko , Taira Naoya , Miyagi Takashi , Karimata Kaori , Ohama Masayo , Yamanoha Atsushi , Tamaki Kazumitsu , Hayashi Masaki , Uchihara Jun-nosuke , Ohshiro Kazuiku , Asakura Yoshitaka , Kuba-Miyara Megumi , Karube Kennosuke , Fukushima Takuya , Masuzaki Hiroaki 
Published: September 2018

e19036 Background: Aggressive adult T-cell leukemia/lymphoma (aATL) has an extremely poor prognosis (median OS, 8-10 months). Okinawa, Japan’s only subtropical region, is hyperendemic for aATL. Recently, we demonstrated poorer outcomes among aATL patients in Okinawa compared with patients elsewhere in Japan, and a possible association of strongyloidiasis with ATL-related death. Two prognostic indices (PIs)—ATL-PI and JCOG-PI—have been developed using a database of national surveys and clinical trials. However, aATL patients in Okinawa were not included. This study aimed to validate these PIs using an Okinawa database. We also investigated the impact of strongyloidiasis on aATL patient survival. Methods: We constructed a clinical database of aATL patients from 7 institutions in Okinawa diagnosed between January 2002 and December 2011. The study endpoint was OS. Standard survival analysis methods (Kaplan-Meier method, log-rank test, and Cox proportional-hazards model) were used. Results: The study involved 433 evaluable patients (median OS, 6 months). Risks according to the two PIs in each patient were not always consistent (Table), but both PIs stratified aATL patients by risk. Three-year OS rates for ATL-PI were 35.9% (low-risk, n=66), 10.4% (intermediate-risk, n=256), and 1.6% (high-risk, n=111); rates for JCOG-PI were 22.4% (moderate-risk, n=176) and 5.3% (high-risk, n=257). Strongyloidiasis had little impact on OS (HR and 95% CI from univariate Cox analysis, 1.22 and 0.90-1.66, respectively). Multivariable Cox analysis returned almost the same factors as had been screened out in the previous studies to construct the two PIs. Conclusions: ATL-PI and JCOG-PI were well reproducible in Okinawa database. Strongyloidiasis did not affect prognosis in aATL patients. ATL-PI identifies low-risk aATL patients more clearly than JCOG-PI, and both identify high-risk patients with extremely poor prognosis. These will be useful to devise novel treatment strategies based on risk stratification of all Japan/world aATL patients. [Table: see text]
Hyperfractionated cyclophosphamide as urgent therapy: A single institution experience.
Authors: Landau Danny , El-Far Ahmad , Anscher Daniel , Landis Michael 
Published: September 2018

e19045 Background: Hematologic cancers can present with severe issues such as airway compromise, hypercalcemia, etc. Due to high drug costs and payment concerns, therapies that are inexpensive but effective are necessary. Within our institution, we utilize hyperfractionated cyclophosphamide (cyclophosphamide 300 mg/m2 IV q 12 hours X 6) [HyperC] for these patients. We opted to see if this approach is justified. Methods: We reviewed data via our EMR of people who received HyperC. Data was limited to urgent therapy. Data was collected from 2015-2017. The cost of therapy was also looked at relative to other therapies with our pharmacy team. Categories are as per the charts below. Results: See Table. Conclusions: HyperC is cost effective and efficacious for patients who need urgent therapy. [Table: see text][Table: see text][Table: see text]
Mediastinal gray zone lymphoma-morphollogically heterogenous group of lymphomas.
Authors: Kharchenko Evgeniya Vladimirovna , Semiglazova Tatiana 
Published: September 2018

e19050 Background: Mediastinal Gray zone lymphoma (MGZL) could be refer to group of large B-cell lymphomas of mediastinum, where Hodgkin’s lymphoma and Diffuse large B-cell lymphoma also included. These kinds of lymphomas have common pathogenic mechanisms, but different epidemiological,clinical , morphological, IHC features, different therapy and prognosis. Methods: We analyzedhistological and IHC features of 11 patients with MGZL. Middle age of patients were 35 years old (25-42), Man(7 )and woman (4) ratio was 1,75:1. Results: We distinguished 5 types of MGZL: 1) Hodgkin’s lymphoma-like variant (ring-shaped fibrosis, expressed cellular polymorphism, large cells seems like Hodgkin’s and Reed-Shteinberg cells,mixed-cell background infiltrate; high expression of CD 20 and another B-lines antigens. 2) type, seems like primary mediastinum large B-cell lymphoma (PMBL-like) (about monotonous composition of the cells, diffuse alveolar stroma’sfibrosis, scarce background infiltrate, high diffuse expression of CD 30 and/or lack of LCA and CD 20 expression 3) mixed variant (mixture of cells PMBL and Hodgkin's lymphoma, irregularly expressed fibrosis, lack of zonality, transientimmunophenotype. 4) dual-component variant (well-defined zonality, Hodgkin's like areas and structuresspecific for PMBL with appropriate or changed immunophenotype 5) Metachronous variant (during progression or relapse we observedmodification of morphological and IHC features). Conclusions: MGZL is heterogenous group of neoplasms with different morphological and IHC features causes difficulties in differential diagnostics in large B-cell lymphomas of mediastinum group.Diagnostic algorithm should be used for high efficacy and accuracy. Clinical features and prognostic factors in these subtypes of MGZL is still unclear and need further investigations.
Outcome after autologous transplantation in the terms of comorbidity for patients with lymphoproliferative diseases: Single center experience.
Authors: Pivkova Veljanovska Aleksandra , Genadieva-Stavrik Sonja Genco , Stojanoski Zlate , Chadievski Lazar , Panovska Stavridis Irina , Trajkova Sanja Aleksandar , Cevreska Lidija , Georgievski Borce 
Published: September 2018

e19502 Background: Autologous stem cell transplantation (ASCT) improves survival in patients with myeloma and lymphoma but is associated with morbidity and nonrelapse mortality (NRM). Hematopoietic cell transplant comorbidity index (HCT-CI) was shown to predict risk of NRM and survival after allogeneic transplantation. We tested the utility of HCT-CI as a predictor of NRM and overall survival (OS) in patients undergoing ASCT. Methods: We analyzed outcomes of 220 patients after high-dose melphalan and high –dose anti lymphoma chemotherapy during year 2000 to 2015. Individual comorbidities were prospectively collected at the time of ASCT. The impact of HCT-CI and other potential prognostic factors, including Karnofsky performance score (KPS), on NRM and survival were studied in multivariate Cox regression models. Results: HCT-CI score was 0, 1, 2, 3, and >3 in 42%, 18%, 13%, 13%, and 14% of the study cohort, respectively. Subjects were stratified into 3 risk groups: HCT-CI score of 0 (42%) versus HCT-CI score of 1 to 2 (32%) versus HCT-CI score > 2 (26%). Higher HCT-CI was associated with lower KPS < 90 (33% of subject’s score of 0 versus 50% in HCT-CI score > 2). HCT-CI score > 2 was associated with melphalan dose reduction (22% versus 10% in score 0 cohorts). One-year NRM was low at 2% (95% confidence interval, 1% to 4%). On multivariate analysis, overall survival was inferior in groups with HCT-CI score of 1 to 2 (relative risk, 1.37, [95% confidence interval, 1.01 to 1.87], P = .04) and HCT-CI score > 2 (relative risk, 1.5 [95% confidence interval, 1.09 to 2.08], P = .01). Factors that affect OS in the autologous recipients among lymphoma and myeloma patients were: HCT-CI, Karnofsky score, number of CD34+ cells/kg and time from diagnosis until transplant (p<0.05). Factors that affect TRM/NRM were HCT-CI, ECOG, Karnofsky score and number of hospital days and body weight.(p<0.05). Conclusions: ASCT for MM and lymphoma is associated with low NRM, and death is predominantly related to disease progression. Comorbidity evaluation during autologous transplantation for lymphoproliferative diseases can be a useful tool in predicting transplant outcome.
Venous thromboembolism (VTE) in multiple myeloma (MM) patients undergoing autologous hematopoietic cell transplantation (HCT).
Authors: Covut Fahrettin , Pinto Raisa , Park Michelle , Malek Ehsan , Lazarus Hillard , Caimi Paolo Fabrizio , Tomlinson Ben Kent , Metheny Leland L. , De Lima Marcos J.G. , Cooper Brenda W. 
Published: September 2018

e19503 Background: HCT is commonly used for consolidation for MM patients (pts). These pts have a significant risk of VTE and may potentially be candidates for prophylactic anticoagulation. However, incidence and outcomes of VTE in peri-transplant period remain unclear for MM pts. Methods: Between 2006 and 2016, 160 MM pts underwent autologous HCT at our institution. Peri-transplant period was defined as between initiation of stem cell collection (SCC) and 30 days after discharge from HCT hospitalization. No pts received routine VTE prophylaxis. Clinically significant bleeding was defined as a bleeding event that led to a specific clinical intervention, such as transfusion. We used Cox regression to assess risk factors for peri-transplant VTE. We compared overall survival (OS) using log-rank test. Results: In peri-transplant period, 18 symptomatic VTE occurred in 17 pts (10.6%; 95% CI 7 - 17). Twelve (7.5%) were catheter-related, 4 (2.5%) were non-catheter-related deep venous thrombosis, and 2 (1.3%) were pulmonary emboli. Seven VTE occurred between SCC and HCT. Importantly, among 11 VTE after HCT, only 1 VTE occurred before neutrophil engraftment and only 2 VTE occurred at a platelet count less than 50 x 109/L (median: 138, range: 30 - 464). Clinically significant bleeding occurred in 9 (5.6%) pts during peri-transplant period, without any fatal bleeding. Multivariate analysis was performed including; treatment with immunomodulatory drugs (p = 0.008), HCT comorbidity index ≥ 2 (p = 0.036), age > 60 (p = 0.07), smoking at any time (p = 0.07), BMI > 30 at HCT (p = 0.19), partial remission at HCT (p = 0.20), ISS stage 3 at diagnosis (p = 0.37). At median follow-up of 31 months since HCT, 3-year OS for pts with and without peri-transplant VTE was 58.8% (CI 38% - 91%) and 77.6% (CI 70% - 86%), respectively (p = 0.11). Conclusions: Peri-transplant symptomatic VTE was highly prevalent in our cohort of pts with MM and vast majority of VTE events occurred either between SCC and HCT or after neutrophil engraftment. Our findings indicate that routine VTE prophylaxis in peri-transplant period should be considered for MM pts and timing of VTE prophylaxis can be tailored to optimize balance between safety and efficacy.
Outcomes of G-CSF alone vs G-CSF with upfront plerixafor vs G-CSF/chemotherapy for collection of autologous stem cells in patients with multiple myeloma.
Authors: Talamo Giampaolo , George Melissa , Ehmann W. Christopher , Drabick Joseph J. , Mineishi Shin 
Published: September 2018

e19504 Background: Strategies for optimizing the collection of peripheral blood stem cells (PBSC) for autologous stem cell transplant (ASCT) in patients with multiple myeloma (MM) vary among transplant centers, and include the use of G-CSF alone or in combination with plerixafor, or mobilization chemotherapy + G-CSF. In 2010, we started using “upfront” plerixafor, given on the day before the PBSC collection. Methods:We retrospectively analyzed the outcomes of 423 consecutive MM patients who underwent PBSC collections at the Penn State Hershey Cancer Institute. PBSC were collected after mobilization chemotherapy + G-CSF 5 mcg/Kg/day (group A, 91 pts), G-CSF alone, 10-16 mcg/Kg/day (group B, 72 pts), and G-CSF with “upfront” plerixafor 0.16-0.24 mg/Kg on the day before the stem cell collection (group C, 245 pts). Fifteen patients were excluded from the analysis because they collected with chemotherapy + plerixafor, received pegylated G-CSF, or plerixafor “on demand”, i.e., after failure to achieve an adequate number of stem cells on the first day of collection. We compared yields, number of days required for apheresis, clinical outcomes, and adverse events among these groups. Results: The median number of PBSC collected was 16.4 (range, 0.1-134), 4.2 (range, 0-12), and 6.2 (range, 0.2-41.2) million CD34+ cells/Kg in group A, B, and C, respectively (p<0.001). The mean number of days to collect PBSC was 1.5, 1.5, and 1.3 in group A, B, and C, respectively (p=0.033). Collection failure, defined as a yield <2 million CD34+cells/Kg, was observed in 5 (5.5%), 9 (12.5%), and 15 (6.1%) patients of group A, B, and C, respectively (p<0.001). Twenty patients in group A developed neutropenic fever requiring hospital admission, and 1 of them died of septic shock, whereas no mortality was observed in groups B or C. No difference in the rapidity of PBSC engraftment, progression-free survival, and overall survival was observed among the 3 groups. Conclusions:In patients with MM, the upfront use of plerixafor with G-CSF provided the best collection strategy: it avoided the morbidity and mortality associated with the mobilization chemotherapy, and it provided higher yields than G-CSF alone.
Reticulocytic indices in assessing erythropoiesis effectiveness in multiple myeloma.
Authors: Lysenko Irina B. , Guskova Nailya , Guskova Ekaterina , Avanesova Kristina , Tselishcheva Irina V. , Zakharchenko Viktoria , Donskaya Aliya K. , Gusareva Marina A. , Torpudzhyan Izabella , Golomeeva Nadezhda , Abakumova Svetlana V. , Gornostaeva Ekaterina , Belgova Svetlana V. , Nozdricheva Anastasia 
Published: September 2018

e19510 Background: The purpose of the study was to analyze changes in reticulocytic indices and their role in assessing the effectiveness of erythropoiesis in patients with multiple myeloma. Methods: Thestudy included 10 patients with primary multiple myeloma (MM) and 16 patients with recurrent MM, stage II-III. Parameters of the peripheral blood were studied: Hb, RBC, MCV, MCH, RBC-He (red cell hemoglobin content), RET (number and percentage), IRF (immature reticulocyte fraction), high (HFR), median (MFR) and low (LFR) fluorescence reticulocytes, RET-He (reticulocyte hemoglobin content), RPI (reticulocyte production index). Results: Anemia was found in21 (80.8%) patients before treatment: grade I in 30.8%, II in 46.1%, III in 3.8%; normocytic hypochromic anemia – 6, normocytic normochromic – 15. Anemia detection rate in primary MM was 60.0%, recurrent – 93.7%. RET levels in grade I-II anemia were close to the norm, but IRF was increased due to MFR increase by 3.7 times and HFR – by 4.7 times. Grade III anemia: RET number decreased by 1.6 times due to IRF reduction by 2 times, in particular MFR and HFR fractions. As a result, RET-He was decreased to varying degrees in all cases. Patients with complete or partial remission showed no significant changes in erythrocyte parameters, but had RET level increased by 2.5 times, IRF – by 9 times due to MFR increase by 6.5 times and HFR by 30.8 times, RPI - by 2.0 times. The data showed the effectiveness of erythropoiesis during anticancer therapy. We did not observe signs of increasing anemia syndrome in patients with stabilization or patients resistant to treatment, as well as in patients with initial grade III anemia. Hb, RBC, RET and RPI were unchanged, but the ratio of fractions changed: the number of mature ones - LFR increased by 1.4 times and young ones - HFR decreased by 2.5 times, RBC-He were increased and RET-He doubled compared to the levels before treatment, which indicated the activation of processes of erythrokaryocyte hemoglobinization. Conclusions: RET, IRF, RET-He and RPI indices adequately reflect the process of recovery of erythropoiesis and its effectiveness in real time which is extremely important in tumor therapy monitoring.
Real-world treatment patterns of adult multiple myeloma patients treated with carfilzomib in the US community oncology setting.
Authors: Panjabi Sumeet , Medhekar Rohan , Aguilar Kathleen , Wilson Thomas , Amirian E. Susan , Mezzi Khalid , Rifkin Robert M. 
Published: September 2018

e19513 Background: The purpose of this retrospective cohort study was to describe the treatment regimens received by adult multiple myeloma (MM) patients who were exposed to carfilzomib (K) in the US Oncology Network (USON). Methods: Eligible patients received K-based regimens for MM at least once between 11/01/2013 and 02/29/2016, were ≥18 years old, were not in a clinical trial, and had at least 2 visits at a USON clinic. Data on systemic therapies, lines of therapy (LOT), clinic visits and treatment administration dates were abstracted from the electronic health records (EHR). Treatment sequencing logic was used to identify progression by LOT. Sequencing rules were based on regimens, duration, and administration dates. Treatment regimens utilized at any time during the study period were analyzed by LOT. Results: 718 MM patients received a K-containing regimen at least once over the course of treatment. The frequency distribution of regimens for K-exposed patients by LOT (2 to 5) are provided (see Table). Among these patients, K-based regimens comprised 66.6% of LOT2 regimens, 55.3% of LOT3 regimens, and 45.9% of regimens used beyond LOT3. K+ lenalidomide + dex (KRd) was the most common K-containing regimen used in LOT2 (24.7%). K-triplets containing an immunomodulatory agent were most frequent in LOT 2 and K-doublets (Kd) were most frequent in LOT 3. Conclusions: In our study, K-based regimens were used across LOTs 2 to 5 with highest frequency observed in LOT2. K-triplets with immunomodulatory drugs were more common in earlier LOTs. [Table: see text]
Clinical manifestation and prognostic features of extramedullary plasmacytomas.
Authors: Jung Hyun Ae , Maeng Chi Hoon , Jang Jun Ho , Jung Chul Won , Kim Kihyun 
Published: September 2018

e19516 Background: Extramedullary plasmacytomas (EMPs) is a rare presentation of plasma cell neoplasm and accounts for 7 to 15% of all plasma cell neoplasm. Fluorescence in-situ hybridization (FISH)-detected abnormalities, including del(17p), del(13q), and t(4;14), have been associated with inferior prognosis. However, there are few data about the prognostic significance of cytogenetic abnormalities in multiple myeloma (MM) patients with EMPs. This study aimed the clinical features, FISH data and outcome of patients with EMPs Methods: The data were collected from multiple myeloma patients with EMPs, retrospectively. We excluded skeletal plasmacytomas. The clinic-pathologic variables and treatment outcome retrospectively reviewed. Results: Seventeen patients had solitary EMPs. Most common site of solitary EMP was nasal cavity and most patients received radiotherapy (n=7) and surgery (n=6). A total of 905 patients with newly diagnosed MM were included, and 53 patients (8.7 %) had EMPs at diagnosis. Thirty three patients had conventional FISH data. By conventional cytogenetic analysis and FISH, 35.8% (19/53) and 54.5% (18/33) patients were identified genetic abnormalities, respectively. By comprehensive cytogenetic/FISH approach, the most common genetic aberration was 1q21 amplification and/or 1p32 deletion (42.4%, 14/33), followed by -13 or del (13q) (24.3%, 8/33), del (17p) (15.2%, 5/33), IGH/FGFR3 rearrangement (15%, 2/33) and IGH/CCND1 rearrangement (12%, 2/33). Patients with initial EMPs had significantly worse overall survival compared to those without initial EMPs. Del(13q), and t(4;14), have been associated with inferior prognosis. Conclusions: In the current study, del(13q), and t(4;14) were associated with worse survival in MM patients with EMP.
Real-world outcomes with panobinostat in patients with penta- and quad-refractory multiple myeloma.
Authors: Biran Noa , Vesole David H. , Zhang Shijia , Richter Joshua Ryan , Kuo Yen Hong , Schmidt Linda , McBride Laura , Anand Palka , Ivanovski Kristin , Pierre Amy , Kumka Susan , Cucurrulo Carmella , Siegel David 
Published: September 2018

e19522 Background: Panobinostat (pano) is a pan histone de-acetylatase inhibitor (HDAC-i) approved by the FDA for use with bortezomib (btz) and dexamethasone (dex) for patients with multiple myeloma (MM) who have had ≥2 prior lines of therapy including both btz and an immunomodulatory agent (IMiD). The goal of this retrospective study is to evaluate the efficacy and safety of pano in combination with a variety of FDA approved agents as would be utilized in a real world management in relapsed/refractory (RR) MM. Methods: Between February 2015 and July 2016, 37 consecutive patients with RRMM treated with commercial pano were identified and the electronic medical record was reviewed. Results: Median age was 62 (range 27-78), with 57% percent male. Ten (27%) had high-risk FISH as defined by t(14;16), t(4;14), del p53, and gain 1q21. Median number of prior lines was 6 (range 2-9). All patients were RR to their last line of therapy, and 20 (54%) were btz-refractory, 27 (73%) were lenalidomide-refractory, 29 (78%) were pomalidomide-refractory, and 29 (78%) were carfilzomib-refractory. Thirty-three (89%) were penta-refractory; eight (21%) were penta-refractory, and 4 (11%) were refractory to prior HDAC-i therapy. Median number of cycles with pano was 2 (range 0.25 - 10). The overall response rate (≥ partial response) was 29.4% and the clinical benefit rate (≥ minor response) was 71.4%. Median progression-free survival was 2.4 months (95% CI: [1.63 – 4.43]). Median duration of response (≥SD) was 4.1 months. Median overall survival from initiation of pano was 7.5 months (95% CI: [5.17, NA]). One patient discontinued pano due to AEs. Grade 3 and 4 non-hematologic toxicities were diarrhea (N = 1), and respiratory failure (N = 1). Grade 3 and 4 hematologic adverse events (AEs) occurred in 13 (35%) patients, with 7 (19%) anemia, 11 neutropenia (30%), and 10 (37%) thrombocytopenia. Serious AEs included acute kidney injury, GI bleed, and febrile neutropenia each occurring in 1 patient. Conclusions: Use of pano outside of the FDA indication in combination with PI and IMiD-based regimens has activity and is well tolerated in quad and penta-refractory MM patients.