Salvage chemotherapy followed by autologous stem cell transplantation using targeted busulfan for refractory diffuse large B-cell lymphoma with dialysis-dependent end-stage renal disease

Publication date: Available online 7 November 2019Source: Clinical Lymphoma Myeloma and LeukemiaAuthor(s): Kaoru Morita, Masahiro Ashizawa, Yumiko Toda, Takashi Ikeda, Shin-ichiro Kawaguchi, Shoko Ito, Shin-ichi Ochi, Takashi Nagayama, Kiyomi Mashima, Kento Umino, Daisuke Minakata, Hirofumi Nakano, Ryoko Yamasaki, Chihiro Yamamoto, Kaoru Hatano, Shin-ichiro Fujiwara, Kazuya Sato, Iekuni Oh, Ken Ohmine, Kazuo MuroiAbstractAbout 40% of patients with diffuse large B cell lymphoma (DLBCL) relapse after or are refractory to standard chemotherapy with rituximab plus cyclophosphamide, hydroxydaunorubicin, vincristine, and prednisolone (R-CHOP). In such cases, salvage chemotherapy followed by autologous stem cell transplantation (ASCT) is the standard treatment for transplant-eligible patients. Although recent clinical trials have reported several promising salvage chemotherapy and preconditioning regimens, they have all excluded patients with end-stage renal disease on hemodialysis. Therefore, a treatment strategy for such patients has not yet been established. Here, we report a successful salvage chemotherapy and ASCT in a patient on maintenance hemodialysis who had primary refractory DLBCL. In this case, we examined the feasibility of a pharmacokinetic analysis with a test dose for deciding upon the optimal dose of busulfan as a conditioning regimen. Our case illustrates a promising strategy for treating patients with relapsed or refractory DLBCL who also have end-stage renal dise...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research

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ConclusionPlerixafor proved effective to mobilize adequate numbers of PBSCs in individual patients with relapsed malignancies after prior single or tandem HDC+PBSCT. These PBSCs could establish sustained multi-lineage hematopoietic engraftment without any sequelae.
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
The objective of this pharmacogenetic study was to investigate the relationship of methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms with methotrexate (MTX) induced toxicities and plasma homocysteine level in Acute Lymphoblastic Leukemia (ALL) patients of Bangladesh. Several polymorphisms result in reduced MTHFR activity that causes impaired remethylation of homocysteine to methionine and abnormal MTX metabolism especially in tissues with high turnover. Therefore, the risk of elevated plasma homocysteine as well as MTX induced toxicities become higher with MTHFR polymorphisms.Patients and MethodsWe recruited 1...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
MicroAbstract: Plerixafor, a stem cell mobilizer with proven potential to rescue "poorly" mobilizing patients, was applied after salvage chemotherapy (+G-CSF) in a limited series of patients with potentially curable malignancies, who had relapsed after a previous autograft. This led to successful stem cell mobilization in all patients, who experienced sustained engraftment after further high-dose chemotherapy supported by the plerixafor-mobilized stem cells.
Source: Clinical Lymphoma, Myeloma and Leukemia - Category: Hematology Authors: Tags: Original Study Source Type: research
The present study investigated the effect of MTHFR C677T and A1298C polymorphisms on methotrexate (MTX) induced toxicities and increased plasma homocysteine level in Acute Lymphoblastic Leukemia (ALL) patients for the first time in Bangladesh. MTX induced mucositis and diarrhea are found to be significantly associated with MTHFR C677T and MTHFR A1298C polymorphisms. In addition, the risk of elevated plasma homocysteine level was 5 to 6 times higher for both polymorphisms.
Source: Clinical Lymphoma, Myeloma and Leukemia - Category: Hematology Authors: Tags: Original Study Source Type: research
Authors: Bouchla A, Thomopoulos T, Papageorgiou S, Tsirigotis P, Bazani E, Gkirkas K, Vasilatou D, Glezou E, Stavroulaki G, Gkontopoulos K, Dimitriadis G, Pappa V Abstract The coexistence of a myeloid and a lymphoid neoplasm in the same patient is a rare finding. We retrospectively searched the records of the Hematology Division of the Second Department of Internal Medicine and Research Institute at Attikon University General Hospital of Athens from 2003 to 2018. Nine cases have been identified in a total of 244 BCR-/ABL1- negative MPN and 25 MDS/MPN patients and 1062 LPD patients referred to our institution betwee...
Source: Advances in Hematology - Category: Hematology Tags: Adv Hematol Source Type: research
Source: Clinical Lymphoma, Myeloma and Leukemia - Category: Hematology Source Type: research
Source: Clinical Lymphoma, Myeloma and Leukemia - Category: Hematology Source Type: research
ConclusionChemotherapy followed by ASCT using a conditioning regimen of reduced melphalan and pharmacokinetically targeted busulfan is a promising strategy for treating patients with relapsed or refractory DLBCL who also have end-stage renal disease and are receiving hemodialysis.
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
ConclusionVenetoclax therapy in a real-world cohort offered modest benefits in heavily pretreated patients. Adverse events were observed at a greater incidence than in the clinical trials. A wide heterogeneity of venetoclax dose escalation, multiagent combinations, and timing of initiation were identified and require investigation in subsequent clinical trials.
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
This study compared time to next treatment (TTNT), health care resource utilization (HRU), and total direct costs among patients with chronic lymphocytic leukemia (CLL) initiating front-line ibrutinib single agent (Ibr) or CIT.Materials and MethodsOptum Clinformatics Extended DataMart De-Identified Databases were used to identify adults with ≥ 2 claims with a CLL diagnosis initiating front-line Ibr or CIT from February 12, 2014 to June 30, 2017. Inverse probability of treatment weighting was used to control for potential differences in baseline characteristics between the Ibr and CIT cohorts. Two periods were consi...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
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