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1.
In Vivo ; 36(3): 1302-1315, 2022.
Article in English | MEDLINE | ID: mdl-35478115

ABSTRACT

BACKGROUND/AIM: Primary mediastinal large B-cell lymphoma (PMLBCL) is an aggressive B-cell non-Hodgkin lymphoma (NHL), whose prognosis has greatly improved since the incorporation of the anti-CD20 monoclonal antibody rituximab into current therapeutic regimens. Evidence, however, on the optimal time interval between consecutive chemoimmunotherapy (CIT) cycles is still scarce. This study aimed to evaluate the efficacy outcomes of the more commonly administered 3-weekly regimens to the biweekly ones in a PMLBCL patients' population, who were mostly treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone every 21 days (R-CHOP-21) or R-CHOP-14. PATIENTS AND METHODS: We retrospectively studied our cohort of consecutively treated PMLBCL patients, focusing on their treatment density, in order to determine possible differences in treatment outcomes. RESULTS: CIT, in the form of both R-CHOP-21 as well as R-CHOP-14 (or similar regimens), is highly active in PMLBCL, with low rates of early treatment failure. In our cohort of patients, R-CHOP-14 did not result in a meaningful improvement of freedom from progression (FFP) or overall survival (OS). CONCLUSION: Both R-CHOP-14 and R-CHOP-21 are probably equally effective in PMLBCL, yet further, prospective, randomized studies are warranted to clarify whether dose-dense regimens can be associated with better disease control and long-term results.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols , Lymphoma, B-Cell , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cyclophosphamide/therapeutic use , Doxorubicin , Humans , Lymphoma, B-Cell/drug therapy , Prednisone/therapeutic use , Prospective Studies , Retrospective Studies , Rituximab/therapeutic use , Vincristine/therapeutic use
2.
Article in English | MEDLINE | ID: mdl-26126819

ABSTRACT

BACKGROUND: Myelodysplastic Syndromes (MDS) are a group of clonal hematopoietic stem cell disorders with significant heterogeneity in their clinical presentation and the prognosis of the patients. Several attempts have been made to incorporate flow cytometry (FC) findings into the diagnostic and/or prognostic criteria of dysplasia, but bone marrow (BM) aspirate morphology evaluation remains the gold-standard for diagnosis. The purpose of this study was to provide a diagnostic tool for MDS that relies on BM immunophenotyping and objectifies the interpretation of FC analysis and to validate its capacity to discriminate MDS from other causes of cytopenias. METHODS: To that purpose, a mathematical formula was developed which incorporates granulocytic maturation markers and the percentage of selected myeloid populations and translates them into a single parameter that quantifies the maturation and differentiation defects of BM granulocytes, named Dysmyelopoiesis Index (DMI). Bone marrow samples from 84 MDS patients and 47 non-MDS cytopenic patients were analyzed with FC and DMI was calculated for every patient. RESULTS: DMI detected clonal dysplasia with 84.5% sensitivity and 93.6% specificity, identified as MDS 77.2% of low grade patients and revealed multilineage dysplasia for a number of RA and RARS cases. It discriminated prognostic subgroups of MDS patients (P< .005) and negatively correlated with IPSS (r= - .472, P= .000), WPSS (r= - .481, P= .000) and IPSS-R (r= -.395, P= .000). CONCLUSIONS: DMI represents an accurate quantification of dysmyelopoiesis and an effective stand-alone diagnostic test for MDS, facilitating FC analysis and daily clinical practice.


Subject(s)
Bone Marrow Cells/immunology , Bone Marrow Cells/pathology , Flow Cytometry , Immunophenotyping , Myelodysplastic Syndromes/diagnosis , Myelopoiesis , Aged , Antigens, CD/immunology , Cohort Studies , Data Interpretation, Statistical , Humans , Karyotyping , Myelodysplastic Syndromes/genetics , Myelodysplastic Syndromes/immunology , Myelodysplastic Syndromes/pathology , Myelopoiesis/genetics , Myelopoiesis/immunology , Prognosis , ROC Curve
3.
Ann Hematol ; 92(6): 739-46, 2013 Jun.
Article in English | MEDLINE | ID: mdl-23412560

ABSTRACT

Chronic hepatitis C (CHC) and iron overload are the main causes of liver disease in ß-thalassemia major (ßTM). There is limited data regarding the course of CHC in this population. All patients (n=144) from the thalassemia centre of the University Hospital of Patras were evaluated (January 1981 to June 2012). Patients were classified into group A (n=57), which consisted of patients with CHC, who either had received antiviral treatment (n=49) or not (n=8), and group B which included 87 patients without CHC. Nineteen patients died during follow-up (median: 257.5 months (1-355)). Survival rates were 84.2 % and 88.5 % for group A and B, respectively. The causes of death were heart failure (63.2 %), accident (10.5 %), sepsis (5.3 %), liver failure (5.3 %), hepatocellular carcinoma (HCC) (5.3 %), non-Hodgkin lymphoma (5.3 %) and multiorgan failure (5.3 %). There were no differences in total survival between the two groups (p=0.524). In the multivariate analysis, survival was neither correlated with CHC (p=ns), nor with anti-HCV treatment (p=ns), whereas independent negative predictors were presence of heart failure (p<0.001), presence of malignancy other than HCC (p=0.001) and non-adherence to chelation treatment (p=0.013). Predictive factors for the development of cirrhosis were: CHC (p<0.001), age>35 years (p=0.007), siderosis grade 3/4 (p=0.029) and splenectomy (p=0.001); however, multivariately, only siderosis grade 3/4 was found to be significant (p=0.049). In this study, survival of patients with ßTM was mainly associated with heart failure, presence of malignancy other than HCC and non-adherence to chelation treatment, rather than with liver disease. Multicentre studies need to be designed to define more accurately the indications of antiviral treatment in this population.


Subject(s)
Hepatitis C, Chronic/epidemiology , beta-Thalassemia/epidemiology , Adolescent , Adult , Antiviral Agents/therapeutic use , Carcinoma, Hepatocellular/epidemiology , Carcinoma, Hepatocellular/etiology , Cause of Death , Chelation Therapy , Child , Child, Preschool , Comorbidity , Female , Greece/epidemiology , Hepatitis C, Chronic/drug therapy , Hepatitis C, Chronic/etiology , Hepatitis C, Chronic/pathology , Humans , Infant , Iron Chelating Agents/therapeutic use , Iron Overload/epidemiology , Iron Overload/etiology , Iron Overload/pathology , Iron Overload/therapy , Kaplan-Meier Estimate , Liver/chemistry , Liver/pathology , Liver/virology , Liver Cirrhosis/epidemiology , Liver Cirrhosis/etiology , Liver Neoplasms/epidemiology , Liver Neoplasms/etiology , Male , Medication Adherence , Middle Aged , Proportional Hazards Models , Retrospective Studies , Risk Factors , Splenectomy/statistics & numerical data , Transfusion Reaction , Young Adult , beta-Thalassemia/therapy
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