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  • 1
    Language: English
    In: Blood, 2012, Vol.119 (4), p.933-939
    Description: Lenalidomide plus dexamethasone is effective in the treatment of multiple myeloma (MM) but is associated with an increased risk of venous thromboembolism (VTE). This prospective, open-label, randomized substudy of a phase 3 trial compared the efficacy and safety of thromboprophylaxis with low-dose aspirin (ASA) or low-molecular-weight heparin (LMWH) in patients with newly diagnosed MM, treated with lenalidomide and low-dose dexamethasone induction and melphalan-prednisone-lenalidomide consolidation. Overall, 342 patients who did not have clinical indications or contraindications to antiplatelet or anticoagulant therapy were randomly assigned to receive ASA 100 mg/d (n = 176) or LMWH enoxaparin 40 mg/d (n = 166). The incidence of VTE was 2.27% in the ASA group and 1.20% in the LMWH group. Compared with LMWH, the absolute difference in the proportion of VTE was 1.07% (95% confidence interval, -1.69-3.83; P = .452) in the ASA group. Pulmonary embolism was observed in 1.70% of patients in the ASA group and none in the LMWH group. No arterial thrombosis, acute cardiovascular events, or sudden deaths were reported. No major hemorrhagic complications were reported. In previously untreated patients with MM receiving lenalidomide with a low thromboembolic risk, ASA could be an effective and less-expensive alternative to LMWH thromboprophylaxis.
    Subject(s): Hematologic and hematopoietic diseases ; Immunopathology ; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis ; Biological and medical sciences ; Immunoglobulinopathies ; Medical sciences ; Immunodeficiencies. Immunoglobulinopathies ; Pulmonary Embolism - prevention & control ; Venous Thrombosis - chemically induced ; Humans ; Middle Aged ; Antineoplastic Combined Chemotherapy Protocols - adverse effects ; Male ; Antineoplastic Agents - therapeutic use ; Antineoplastic Agents - administration & dosage ; Enoxaparin - therapeutic use ; Pulmonary Embolism - epidemiology ; Enoxaparin - adverse effects ; Incidence ; Thalidomide - analogs & derivatives ; Venous Thromboembolism - prevention & control ; Multiple Myeloma - drug therapy ; Antineoplastic Agents - adverse effects ; Aspirin - adverse effects ; Adult ; Female ; Venous Thrombosis - prevention & control ; Aspirin - therapeutic use ; Platelet Aggregation Inhibitors - therapeutic use ; Venous Thromboembolism - epidemiology ; Platelet Aggregation Inhibitors - adverse effects ; Thalidomide - adverse effects ; Lenalidomide ; Risk Factors ; Anticoagulants - therapeutic use ; Thalidomide - administration & dosage ; Anticoagulants - adverse effects ; Israel - epidemiology ; Venous Thrombosis - epidemiology ; Venous Thromboembolism - chemically induced ; Italy - epidemiology ; Pulmonary Embolism - chemically induced ; Thalidomide - therapeutic use ; Index Medicus ; Abridged Index Medicus
    ISSN: 0006-4971
    E-ISSN: 1528-0020
    Source: HighWire Press (Free Journals)
    Source: Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
    Source: American Society of Hematology
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 2
    Language: English
    In: British journal of haematology, 2003-11, Vol.123 (4), p.746-747
    Subject(s): multiple myeloma ; anti-CD20 ; rituximab ; autologous stem cell transplantation ; anti‐CD20 ; Antibodies, Monoclonal, Murine-Derived ; Multiple Myeloma - mortality ; Humans ; Middle Aged ; Rituximab ; Antibodies, Monoclonal - therapeutic use ; Male ; Combined Modality Therapy ; Disease-Free Survival ; Multiple Myeloma - drug therapy ; Multiple Myeloma - therapy ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Treatment Failure ; Female ; Peripheral Blood Stem Cell Transplantation ; Index Medicus
    ISSN: 0007-1048
    E-ISSN: 1365-2141
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 3
    Language: English
    In: Leukemia & lymphoma, 2003-06, Vol.44 (9), p.1545-1548
    Description: Ninety patients with untreated, stage I-II A myeloma, were randomised to receive or not monthly infusions of pamidronate (PMD) for 1 year, without additional therapies. Follow-up ranged from 36 to 72 months (median 51 months). Three years after the start of the treatment, the disease had progressed in 25% of PMD treated patients and in 26.8% of controls (p n.s). Median time-to-progression was 16 and 17.4 months, respectively (p n.s). Among the 21 patients who required chemo-radiotherapy, skeletal events (osteolytic lesions, pathological fractures and/or hypercalcemia) developed in 9/11 (81.8%) controls and in 4/10 (40%) of treated patients (p〈0.01). "Prophylactic" administration of PMD may decrease the development of skeletal events, but does not reduce the rate and the time of disease progression in early-stage myeloma.
    Subject(s): Pamidronate ; Monoclonal gammopathies ; Myeloma ; Zoledronate ; Bisphosphonates ; Follow-Up Studies ; Multiple Myeloma - mortality ; Humans ; Middle Aged ; Male ; Osteolysis - etiology ; Life Tables ; Osteolysis - drug therapy ; Multiple Myeloma - drug therapy ; Aged, 80 and over ; Diphosphonates - therapeutic use ; Female ; Hypercalcemia - drug therapy ; Multiple Myeloma - complications ; Fractures, Spontaneous - etiology ; Treatment Outcome ; Combined Modality Therapy ; Disease Progression ; Disease-Free Survival ; Multiple Myeloma - pathology ; Fractures, Spontaneous - prevention & control ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Hypercalcemia - etiology ; Aged ; Multiple Myeloma - radiotherapy ; Neoplasm Staging ; Index Medicus
    ISSN: 1042-8194
    E-ISSN: 1029-2403
    Source: Academic Search Ultimate
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 4
    Language: English
    In: American journal of hematology, 2020-10, Vol.95 (10), p.1200-1208
    Description: The optimal myeloablative conditioning (MAC) for patients undergoing haploidentical hematopoietic cell transplantation (haplo‐HCT) is unknown. We studied the outcomes of total body irradiation (TBI) vs chemotherapy (CT) based MAC regimens in acute myeloid leukemia (AML) patients. The study included 1008 patients who underwent first haplo‐HCT with post‐transplant cyclophosphamide, following TBI (N = 89, 9%) or CT (n = 919, 91%) based MAC. Patients in the TBI cohort were younger (median age, 38 vs 47 years, P 〈 .01) and more likely to receive BM graft (57% vs 43%, P = .01). Two‐year overall chronic GVHD (cGVHD) incidence was 42% vs 27% (P 〈 .01) and extensive cGVHD incidence was 9% vs 12% (P = .33) in TBI and CT cohorts, respectively. Graft failure was reported in two (2%) TBI‐ and 65 (7%) CT‐MAC recipients (P = .08). Death from veno‐occlusive disease was reported in one (3%) TBI and 11 (3%) CT patients who died during the study period. In the multivariate analysis, TBI was associated with increased risk for overall cGVHD (hazard ratio = 1.95, 95% confidence interval:1.2‐3.1, P 〈 .01) compared to CT‐based MAC. The choice of conditioning regimen did not impact relapse incidence, leukemia‐free survival, non‐relapse mortality, overall survival or GVHD‐relapse‐free survival in multivariate analysis. In conclusion, major transplant outcomes were not statistically different between TBI‐based MAC and CT‐based MAC in patients with AML after haplo‐HCT/PTCy.
    Subject(s): Graft-versus-host reaction ; Transplants & implants ; Myeloid leukemia ; Leukemia ; Radiation ; Transplantation ; Multivariate analysis ; Hemopoiesis ; Rejection ; Cyclophosphamide ; Chemotherapy ; Grafts ; Acute myeloid leukemia ; Index Medicus ; Life Sciences ; Immunology
    ISSN: 0361-8609
    E-ISSN: 1096-8652
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 5
    Language: English
    In: Haematologica (Roma), 2018-11, Vol.103 (11), p.e514-e518
    Subject(s): Index Medicus ; Online Only
    ISSN: 0390-6078
    E-ISSN: 1592-8721
    Source: HighWire Press (Free Journals)
    Source: PubMed Central
    Source: Directory of Open Access Journals
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 6
    Language: English
    In: Haematologica (Roma), 2013-11-01, Vol.98 (11), p.1732-1738
    Description: Despite improvements in standard therapy with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone for patients with untreated, diffuse large B-cell lymphoma, up to 40% of these patients relapse. Lenalidomide alone or in combination with rituximab has been shown to be active in relapsed/refractory aggressive lymphomas. In this phase I study we determined the maximum tolerated dose of lenalidomide plus rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone in untreated, elderly (median age 68 years) patients with diffuse large B-cell lymphoma. Four lenalidomide doses (5, 10, 15, and 20 mg/day on days 1-14) allocated using the continual reassessment method were planned to be administered for 14 days in combination with each course of rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone for a total of six courses. Seven cohorts of patients (n=3 in each cohort) were treated (total n=21) at 10, 20, 15, 15, 15, 10, and 10 mg of lenalidomide. Dose-limiting toxicities occurred in seven patients during the first three courses of treatment. The third dose-level of lenalidomide (15 mg/day) was selected as the maximum tolerated dose, with an estimated probability of dose-limiting toxicities of 0.345 (95% credibility interval 0.164-0.553). Grade 3-4 hematologic adverse events were: neutropenia in 28% of the courses, thrombocytopenia in 9%, and anemia in 3%. Non-hematologic toxicities were moderate: grade 4 increase of creatinine phosphokinase (n=1), grade 3 cardiac (n=2), grade 3 neurological (n=3), and grade 3 gastrointestinal (n=1). In this phase I study, the overall response rate was 90%, with 81% achieving complete remission. This combination regimen appears safe in elderly patients with diffuse large B-cell lymphoma and its efficacy will be assessed in the ongoing phase II trial. This trial was registered at www.clinicaltrials.gov as NCT00907348.
    Subject(s): Cyclophosphamide - administration & dosage ; Antineoplastic Combined Chemotherapy Protocols - administration & dosage ; Humans ; Middle Aged ; Antibodies, Monoclonal, Murine-Derived - administration & dosage ; Antineoplastic Combined Chemotherapy Protocols - adverse effects ; Male ; Cyclophosphamide - adverse effects ; Thalidomide - analogs & derivatives ; Aged, 80 and over ; Vincristine - administration & dosage ; Female ; Chemotherapy-Induced Febrile Neutropenia - diagnosis ; Doxorubicin - administration & dosage ; Prednisone - administration & dosage ; Lymphoma, Large B-Cell, Diffuse - drug therapy ; Prednisone - adverse effects ; Chemotherapy-Induced Febrile Neutropenia - epidemiology ; Rituximab ; Treatment Outcome ; Thalidomide - administration & dosage ; Lymphoma, Large B-Cell, Diffuse - diagnosis ; Lymphoma, Large B-Cell, Diffuse - epidemiology ; Vincristine - adverse effects ; Italy - epidemiology ; Aged ; Antibodies, Monoclonal, Murine-Derived - adverse effects ; Doxorubicin - adverse effects ; Index Medicus
    ISSN: 0390-6078
    E-ISSN: 1592-8721
    Source: HighWire Press (Free Journals)
    Source: PubMed Central
    Source: Directory of Open Access Journals
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 7
    Language: English
    In: Annals of hematology, 2019-06-01, Vol.98 (6), p.1449-1455
    Description: This study reports a retrospective multicenter experience by the Rete Ematologica Pugliese (REP) over the past 16 years, aiming to compare the patients characteristics and outcomes of 21 brentuximab vedotin (BV)–pre-treated patients to 51 patients who received reduced-intensity conditioning (RIC) allogeneic stem cell transplantation (SCT) without prior BV. In total, 72 patients with classical Hodgkin’s lymphomas who received allogeneic SCT were retrospectively studied. Prior use of BV had no effect on either engraftment or the incidence and severity of acute graft versus host disease (GVHD). Indeed, a lower incidence of chronic GVHD was observed in the BV group, with a 43% cumulative incidence at 3 years versus 47% in the no BV group, although this was not statistically significant. Despite the low incidence of chronic GVHD, survival was not worse in the BV-treated group: 3-year progression-free survival (PFS) was 53%, 3-year overall survival (OS) was 62%, 3-year non-relapse mortality (NRM) was 24%. In the no BV group, the 3-year PFS was 33%, 3-year OS was 44%, and 3-year NRM was 14%. In chemorefractory patients at the time of transplant, we found a statistically significant difference in PFS between the BV and no BV groups (51% vs. 10%, p = 0.013).
    Subject(s): Oncology ; Brentuximab vedotin ; Medicine & Public Health ; Hematology ; Allogeneic stem cell transplant ; Hodgkin lymphoma ; Care and treatment ; Patient outcomes ; Mortality ; Stem cells ; Lymphomas ; Transplantation ; Cancer ; Monoclonal antibodies ; Transplants & implants ; Targeted cancer therapy ; Immunotherapy
    ISSN: 0939-5555
    E-ISSN: 1432-0584
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 8
    Language: English
    In: Journal of hematology and oncology, 2018-08-30, Vol.11 (1), p.110-110
    Description: Thiotepa-busulfan-fludarabine (TBF) is a widely used conditioning regimen in single umbilical cord blood transplantation (SUCBT). More recently, it was introduced in the setting of non-T cell depleted haploidentical stem cell transplantation (NTD-Haplo). Whether TBF based conditioning provides additional benefit in transplantation from a particular alternative donor type remains to be established. This was a retrospective study based on an international European registry. We compared outcomes of de-novo acute myeloid leukemia patients in complete remission receiving NTD-Haplo (n = 186) vs. SUCBT (n = 147) following myeloablative conditioning (MAC) with TBF. Median follow-up was 23 months. Treatment groups resembled in baseline characteristics. SUCBT was associated with delayed engraftment and higher graft failure. In multivariate analysis no statistically significant differences were observed between the two groups in terms of acute or chronic graft-versus-host disease (GvHD) (HR = 1.03, p = 0.92 or HR = 1.86, p = 0.21) and relapse incidence (HR = 0.8, p = 0.65). Non-relapse mortality (NRM) was significantly higher in SUCBT as compared to NTD-Haplo (HR = 2.63, p = 0.001); moreover, SUCBT did worse in terms of overall survival (HR = 2.18, p = 0.002), leukemia-free survival (HR = 1.94, p = 0.007), and GvHD relapse-free survival (HR = 2.38, p = 0.0002). Our results suggest that TBF-MAC might allow for a potent graft-versus-leukemia, regardless of the alternative donor type. Furthermore, in patients receiving TBF-MAC, survival with NTD-Haplo may be better compared to SUCBT due to decreased NRM.
    Subject(s): Thiotepa - therapeutic use ; Busulfan - pharmacology ; Busulfan - therapeutic use ; Leukemia, Myeloid, Acute - pathology ; Humans ; Middle Aged ; Male ; Survival Rate ; Vidarabine - analogs & derivatives ; Vidarabine - therapeutic use ; Transplantation, Haploidentical - mortality ; Transplantation Conditioning - mortality ; Young Adult ; Cord Blood Stem Cell Transplantation - methods ; Vidarabine - pharmacology ; Transplantation, Haploidentical - methods ; Adult ; Female ; Aged ; Retrospective Studies ; Thiotepa - pharmacology ; Cord Blood Stem Cell Transplantation - mortality ; Transplantation Conditioning - methods ; Leukemia, Myeloid, Acute - therapy ; Fetal blood ; Care and treatment ; Leukemia ; Physiological aspects ; Transplantation ; Research ; Methods ; Index Medicus ; Life Sciences ; Stem cell transplantation ; Haploidentical stem cell transplantation ; Acute myeloid leukemia ; Conditioning regimens ; Thiotepa-busulfan-fludarabine ; Umbilical cord blood transplantation
    ISSN: 1756-8722
    E-ISSN: 1756-8722
    Source: BioMedCentral Open Access
    Source: Academic Search Ultimate
    Source: PubMed Central
    Source: Directory of Open Access Journals
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 9
    Language: English
    In: Stem cell research & therapy, 2019-05-20, Vol.10 (1), p.138-138
    Description: Allogeneic hematopoietic stem cell transplantation (AHSCT) is a curative therapeutic approach for different hematological malignancies (HMs), and epigenetic modifications, including DNA methylation, play a role in the reconstitution of the hematopoietic system after AHSCT. This study aimed to explore global DNA methylation dynamic of bone marrow (BM) hematopoietic stem and progenitor cells (HSPCs) from donors and their respective recipients affected by acute myeloid leukemia (AML), acute lymphoid leukemia (ALL) and Hodgkin lymphoma (HL) during the first year after transplant. We measured DNA methylation profile by Illumina HumanMethylationEPIC in BM HSPC of 10 donors (t0) and their matched recipients at different time points after AHSCT, at day + 30 (t1), + 60 (t2), + 120 (t3), + 180 (t4), and + 365 (t5). Differential methylation analysis was performed by using R software and CRAN/Bioconductor packages. Gene set enrichment analysis was carried out on promoter area of significantly differentially methylated genes by clusterProfiler package and the mSigDB genes sets. Results show significant differences in the global methylation profile between HL and acute leukemias, and between patients with mixed and complete chimerism, with a strong methylation change, with prevailing hyper-methylation, occurring 30 days after AHSCT. Functional analysis of promoter methylation changes identified genes involved in hematopoietic cell activation, differentiation, shaping, and movement. This could be a consequence of donor cell "adaptation" in recipient BM niche. Interestingly, this epigenetic remodeling was reversible, since methylation returns similar to that of donor HSPCs after 1 year. Only for a pool of genes, mainly involved in dynamic shaping and trafficking, the DNA methylation changes acquired after 30 days were maintained for up to 1 year post-transplant. Finally, preliminary data suggest that the methylation profile could be used as predictor of relapse in ALL. Overall, these data provide insights into the DNA methylation changes of HSPCs after transplantation and a new framework to investigate epigenetics of AHSCT and its outcomes.
    Subject(s): Epigenetic inheritance ; Stem cell research ; Homografts ; Stem cells ; Genetic aspects ; Transplantation ; Research ; Methylation ; Hematopoietic stem cells ; Analysis ; Genes ; DNA ; Bone marrow ; Lymphomas ; Cell differentiation ; Health aspects ; Transplants & implants ; Syngeneic grafts ; Leukemia ; Bone marrow transplantation ; Stem cell transplantation ; Genomes ; Blood ; Cell activation ; DNA methylation ; Deoxyribonucleic acid--DNA ; Acute lymphatic leukemia ; Myeloid leukemia ; Lymphatic leukemia ; Gene expression ; Lymphoma ; Progenitor cells ; Hemopoiesis ; Epigenetics ; Chimerism ; Acute myeloid leukemia ; Chemokines ; Hodgkin's disease ; Index Medicus ; Promoter methylation region ; Allogeneic hematopoietic bone marrow stem cell transplantation ; Hematopoietic stem and progenitor cells ; CpG sites ; Hematological malignancies
    ISSN: 1757-6512
    E-ISSN: 1757-6512
    Source: BioMedCentral Open Access
    Source: Academic Search Ultimate
    Source: PubMed Central
    Source: Directory of Open Access Journals
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 10
    Language: English
    In: American journal of hematology, 2013-03, Vol.88 (3), p.185-192
    Description: By using the GRADE system, we updated the guidelines for management of follicular cell lymphoma issued in 2006 from SIE, SIES, and GITMO group. We confirmed our recommendation to frontline chemoimmunotherapy in patients with Stage III–IV disease and/or high tumor burden. Maintenance rituximab was also recommended in responding patients. In patients relapsing after an interval longer than 12 months from frontline therapy, we recommended chemoimmunotherapy with non cross‐resistant regimens followed by rituximab maintenance. High dose chemotherapy followed by hematopoietic stem cell transplant was recommended for young fit patients who achieve a response after salvage chemoimmunotherapy. Am. J. Hematol. 88:185–192, 2013. © 2012 Wiley Periodicals, Inc.
    Subject(s): Lymphomas ; Index Medicus
    ISSN: 0361-8609
    E-ISSN: 1096-8652
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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