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Wyświetlanie 1-10 z 19
Tytuł:
Ocena profilu korzyści i ryzyka leczenia idelalizybem u chorych na przewlekłą białaczkę limfocytową i chłoniaki nie-Hodgkina
Autorzy:
Puła, Bartosz
Giza, Agnieszka
Rej, Magdalena
Piotrowska, Magdalena
Subocz, Edyta
Rybka, Justyna
Waszczuk-Gajda, Anna
Jurczak, Wojciech
Jamroziak, Krzysztof
Długosz-Danecka, Monika
Opis:
Idelalisib is a selective inhibitor of phosphoinositide 3-kinase d, approved in relapsed/refractory (RR) chronic lymphocytic leukemia (CLL), first line CLL with del17p/TP53 mutation in patients unsuitable for immunochemotherapy and RR follicular lymphoma (FL) in whom at least two lines of therapy have failed. Despite good clinical efficacy, the development of this drug has been hampered due to its adverse events (i.e. autoimmune reactions and life-threatening opportunistic infections). In this retrospective study, we summarise the tolerability of idelalisib therapy in a Polish population, analysing 61 patients treated with idelalisib in monotherapy or idelalisib-based combination regimens. Idelalisib treatment was feasible for the majority of patients, with upper respiratory tract infections (N = 13.21%) being the most common adverse event (AE), and pneumonia (N = 11.18%) — the most prevalent grade 3 or higher non-hematological AE. We observed two cases of pneumonitis, one case of gastroenteritis, and no cases of liver transaminases elevation (all regarded as the AEs characteristic of idelalisib). Most of the patients were treated in haematology reference centres where physicians are more accustomed to dealing with opportunistic infections. Cotrimoxazole prophylaxis was given to 20 (32.8%) patients, whereas acyclovir prophylaxis was administered in 33 (54.1%) cases. This could explain the less frequent life-threatening infections and decreased mortality rate compared to the published registration studies. Our study confirms the high clinical efficacy of idelalisib in CLL and RR FL.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Tytuł:
High efficacy of BGD (bendamustine, gemcitabine, and dexamethasone) in relapsed/refractory Hodgkin Lymphoma
Autorzy:
Krzywon, Aleksandra
Szwedyk, Paweł
Czyż, Anna
Mendrek, Włodzimierz
Zaucha, Jan Maciej
Kulikowski, Waldemar
Wilk, Agata
Taszner, Michał
Paszkiewicz-Kozik, Ewa
Spychałowicz, Wojciech
Subocz, Edyta
Czerw, Tomasz
Swoboda, Ryszard
Drozd-Sokołowska, Joanna
Chmielowska, Ewa
Giza, Agnieszka
Knopińska-Posłuszny, Wanda
Giebel, Sebastian
Najda, Jacek
Olszewska-Szopa, Magdalena
Opis:
The optimal salvage therapy in relapsed/refractory Hodgkin lymphoma (R/R HL) has not been defined so far. The goal of this multicenter retrospective study was to evaluate efficacy and safety of BGD (bendamustine, gemcitabine, dexamethasone) as a second or subsequent line of therapy in classical R/R HL. We have evaluated 92 consecutive R/R HL patients treated with BGD. Median age was 34.5 (19–82) years. Fifty-eight patients (63%) had received 2 or more lines of chemotherapy, 32 patients (34.8%) radiotherapy, and 21 patients (22.8%) an autologous hematopoietic stem cell transplantation (autoHCT). Forty-four patients (47.8%) were resistant to first line of chemotherapy. BGD therapy consisted of bendamustine 90 mg/m$^{2}$ on days 1 and 2, gemcitabine 800 mg/$^{2}$ on days 1 and 4, dexamethasone 40 mg on days 1–4. Median number of BGD cycles was 4 (2–7). The following adverse events ≥ 3 grade were noted: neutropenia (22.8%), thrombocytopenia (20.7%), anemia (15.2%), infections (10.9%), AST/ALT increase (2.2%), and skin rush (1.1%). After BGD therapy, 51 (55.4%) patients achieved complete remission, 23 (25%)—partial response, 7 (7.6%)—stable disease, and 11 (12%) patients experienced progression disease. AutoHCT was conducted in 42 (45.7%) patients after BGD therapy, and allogeneic HCT (alloHCT) in 16 (17.4%) patients. Median progression-free survival was 21 months. BGD is a highly effective, well-tolerated salvage regimen for patients with R/R HL, providing an excellent bridge to auto- or alloHCT.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Tytuł:
Early efficacy and safety of obinutuzumab with chemotherapy in previously untreated patients with follicular lymphoma : a real-world retrospective report of the Polish Lymphoma Research Group
Autorzy:
Wiśniewska, Anna
Twardosz, Maja
Morawska, Marta
Targoński, Łukasz
Kalicińska, Elżbieta
Lewicka, Barbara
Paszkiewicz-Kozik, Ewa
Długosz-Danecka, Monika
Subocz, Edyta
Wąsik-Szczepanek, Ewa
Romejko-Jarosińska, Joanna
Swoboda, Ryszard
Kotarska, Martyna
Lech-Maranda, Ewa
Drozd-Sokołowska, Joanna
Dębowska, Małgorzata
Szymański, Marcin
Walewski, Jan
Końska, Agnieszka
Tyczyńska, Agata
Giza, Agnieszka
Palka, Monika
Joks, Monika
Hus, Iwona
Opis:
Background. The first-line obinutuzumab-based immunochemotherapy improves the outcome of patients with follicular lymphoma (FL) compared with rituximab-based regimens. However, infusion-related reactions occur in almost half of patients during the 1st obinutuzumab administration. Objectives. The study aimed to evaluate the early effectiveness and safety of obinutuzumab-based induction regimens in a real-world setting. Materials and methods. Outcomes of patients diagnosed with FL and treated with obinutuzumab between January 2020 and September 2021 were analyzed. Results. The study group included 143 treatment-naïve patients with FL. The median age was 52 years (range: 28–89 years); 45.1% of patients had a high-risk disease as assessed using the Follicular Lymphoma International Prognostic Index (FLIPI). Induction chemotherapy included: O-CVP (obinutuzumab, cyclophosphamide, vincristine, prednisolone) in 49.0% of patients, O-CHOP (O-CVP plus doxorubicin) in 28.7% and O-BENDA (obinutuzumab, bendamustine) in 22.4%. Complete response (CR) and partial response (PR) rates were 69.9% and 26.5%, respectively. There was no difference in response rates between different regimens (p = 0.309). Maintenance was started in 115 patients (85.2%). In the 1st cycle, obinutuzumab was administered as a single 1000-milligram infusion in 47.9% of patients, whereas in 52.1%, initial infusions were split over 2 days (100 mg/900 mg). Infusion-related reactions were reported only during the 1st administration of obinutuzumab in 9.1% of patients, with a similar incidence in those receiving the total dose on a single day or split over 2 days (p = 0.458). The most common adverse events were hematological. Five patients died from coronavirus disease 2019 (COVID-19). Conclusions. The early responses to induction regimens and adverse events profile were similar for every type of induction treatment. The infusion-related reactions were rare and limited to the 1st dose of obinutuzumab.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Tytuł:
The real-world evidence on the fragility and its impact on the choice of treatment regimen in newly diagnosed patients with multiple myeloma over 75 years of age
Autorzy:
Wiśniewska, Anna
Hałka, Janusz
Waszczuk-Gajda, Anna
Woszczyk, Dariusz
Porowska, Agnieszka
Zaucha, Jan M.
Guzicka-Kazimierczak, Renata
Basak, Grzegorz Władysław
Świderska, Alina
Wiśniewski, Kamil
Zdziarska, Barbara
Kulikowska de Nałęcz, Anna
Subocz, Edyta
Ciepłuch, Hanna
Krzempek, Marcela Krzysława
Drozd-Sokołowska, Joanna
Cortez, Alexander Jorge
Godlewska, Katarzyna
Kłoczko, Janusz
Tyczyńska, Agata
Rzepecki, Piotr
Knopińska-Posłuszny, Wanda
Symonowicz, Hanna
Jurczyszyn, Artur
Jamroziak, Krzysztof
Opis:
Fragility scales are intended to help in therapeutic decisions. Here, we asked if the fragility assessment in MM patients ≥ 75 years old qualified for treatment by the local physician correlates with the choice of treatment: a two- or three-drug regimens. Between 7/2018 and 12/2019, we prospectively enrolled 197 MM patients at the start of treatment from the 13 Polish Myeloma Group centers. The data to assess fragility were prospectively collected, but centrally assessed fragility was not disclosed to the local center. The activity of daily living (ADL) could be assessed in 192 (97.5%) and was independent in 158 (80.2%), moderately impaired in 23 (11.7%), and 11 (5.6%) in completely dependent. Patients with more than three comorbidities made up 26.9% (53 patients). Thus, according to the Palumbo calculator, 43 patients were in the intermediate fitness group (21.8%), and the rest belonged to the frailty group (153, 77.7%). Overall, 79.7% of patients (157) received three-drug regimens and 20.3% (40) received two-drug regimens. In each ECOG group, more than three out of four patients received three-drug regimens. According to the ADL scale, 82.3% of the independent 65.2% of moderately impaired, and 81.8% of the dependent received three-drug regimens. Out of 53 patients with at least four comorbidities, 71.7% received three-drug regimens, and the rest received two-drug regimens. Thirty-four patients from the intermediate fit group (79.0%), and 123 (79.9%) from the frail group received three-drug regimens. Early mortality occurred in 25 patients (12.7%). No one discontinued treatment due to toxicity. To conclude, MM patients over 75 are mainly treated with triple-drug regimens, not only in reduced doses, regardless of their frailty scores. However, the absence of prospective fragility assessment did not negatively affect early mortality and the number of treatment discontinuations, which brings into question the clinical utility of current fragility scales in everyday practice.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Wyświetlanie 1-10 z 19

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