Journal Article Granulocyte colony-stimulating factor in acute myeloid leukemia Kensuke Usuki, Kensuke Usuki Division of Hematology, Kanto Teishin Hospital, Tokyo, Japan Search for other works by this author on: Oxford Academic Google Scholar Seiko Iki, Seiko Iki Division of Hematology, Kanto Teishin Hospital, Tokyo, Japan Search for other works by this author on: Oxford Academic Google Scholar Mitsue Endo, Mitsue Endo Division of Hematology, Kanto Teishin Hospital, Tokyo, Japan Search for other works by this author on: Oxford Academic Google Scholar Koichi Kitazume, Koichi Kitazume Division of Hematology, Kanto Teishin Hospital, Tokyo, Japan Search for other works by this author on: Oxford Academic Google Scholar Keiko Ito, Keiko Ito Division of Hematology, Kanto Teishin Hospital, Tokyo, Japan Search for other works by this author on: Oxford Academic Google Scholar Masahiko Watanabe, Masahiko Watanabe Pharmaceutical Research Laboratory, Kirin Brewery Co., Ltd., Tokyo, Japan Search for other works by this author on: Oxford Academic Google Scholar Akio Urabe Akio Urabe Pharmaceutical Research Laboratory, Kirin Brewery Co., Ltd., Tokyo, Japan Correspondence: Dr. Akio Urabe, Division of Hematology, Kanto Teishin Hospital, 5–9–22 Higashi-Gotanda, Shinagawa-ku, Tokyo, Japan 141. Search for other works by this author on: Oxford Academic Google Scholar Stem Cells, Volume 13, Issue 6, January 1995, Pages 647–654, https://doi.org/10.1002/stem.5530130609 Published: 01 January 1996 Article history Received: 27 March 1995 Accepted: 21 July 1995 Published: 01 January 1996
Background: The role of consolidation therapy with 90 Y‐ibritumomab tiuxetan ( 90 YIT) for patients with follicular lymphoma (FL) after receiving second or third line immunochemotherapy has not been established. Aims: Thus, we conducted a multicenter phase II trial evaluating the efficacy and toxicities of bendamustine and rituximab (BR) followed by 90 YIT for patients with relapsed FL. Methods: This study included patients who had biopsy‐proven, relapsed FL (Grade 1/2 or 3a); one or two prior therapies; age of 20–74 years; ECOG performance status of 0–2; measurable lesion(s); no severe organ dysfunction; 3 months or longer life expectancy; and written informed consent. BR consisted of rituximab (375 mg/m 2 , day 1) and bendamustine (90 mg/m 2 , day 2 and 3), and repeated every 4 weeks up to 4–6 cycles. As the consolidation therapy, 14.8 MBq/kg of 90 YIT was administered to patients who achieved complete response (CR) or partial response after BR therapy. The primary endpoint was 2‐year progression‐free survival (PFS) after the consolidation with 90 YIT. The secondary endpoints were response rates after BR therapy, response rates after consolidation with 90 YIT, 2‐year overall survival (OS) rate after the consolidation with 90 YIT, and toxicities. Results: A total of 30 patients were registered between 2013 and 2015. Of these patients, 6 were excluded from the study because of pathological diagnoses other than FL in the central review (n = 3), unmet criteria (n = 2), and the other advanced cancer found (n = 1), respectively. Thus, 24 patients with a median 60 years of age (range 47–74 years) and a median of 6.7 years (range 1.6–14.8 years) of duration from the initial diagnosis were evaluated. Among them, R‐CHOP based chemotherapy was the most common initial treatment (92%). The FLIPI2 score at the time of registration was high in 3, intermediate in 7, and low in 14 patients, respectively. After re‐induction treatment with BR, 22 patients (92%) ultimately received consolidation with 90 YIT, resulting in an overall response rate of 95% and a CR rate of 91%, respectively. Within the 2‐year observation period, 10 patients relapsed and 3 of them had a histological transformation to diffuse large B‐cell lymphoma. Severe non‐hematological toxicities were rare and no treatment‐related mortality was observed. Within the observation period, one patient died of disease progression. Second primary malignancies were not observed. Consequently, the 2‐year PFS and OS rates after the consolidation were 58%, and 94%, respectively. Summary/Conclusion: Consolidation therapy with 90 YIT after BR re‐induction therapy was feasible in patients with relapsed FL. Clinical efficacy was comparable, but the long‐term effect should be further investigated. Trial protocol number: UMIN000008793, release date: 03. September 2012 image
A prospective evaluation was carried out on the effect of lamivudine administration as a prophylactic measure to prevent exacerbation of hepatitis in HBV carrier or chronic hepatitis B patients with malignant lymphoma undergoing chemotherapy. Eighteen patients were registered between 1997 and 2002 from institutions of the Research Group for the Treatment of Malignant Lymphoma. The patients' median age was 53 years old (39-73), and consisted of 8 males and 10 females. HBe-seroconversion had already occurred in 13 and liver biopsy had been performed in 8. No adverse effects of lamivudine were noted and the serum HBV-DNA content did not increase during lamivudine administration. Planned treatment courses could be completed in all patients. In 2, however, the viral load increased and the HBe antibody (Ab) value declined after the cessation of lamivudine, which were reversed to the normal ranges following the resumption of lamivudine. As for the overall outcome, 14 of the patients survived, and there were 4 fatalities due to malignant lymphoma. Serum HBeAb status may be regarded as a useful laboratory marker for deciding the safe cessation of lamivudine. An additional case is described, who had recovered from past HBV infection, but eventually succumbed to fulminant hepatitis after the cessation of lamivudine covering prolonged courses of chemotherapy. This illustrates a need for inclusion of such cases for the prophylactic use of lamivudine.
Introduction: The role of consolidation therapy with 90Y-ibritumomab tiuxetan (90YIT) for patients with relapsed follicular lymphoma (FL) who receive re-induction immunochemotherapy has not been established. Therefore, we conducted a multicenter prospective phase II trial evaluating the efficacy and toxicities of bendamustine and rituximab (BR) followed by 90YIT for patients with relapsed FL. Methods: This study included patients who had biopsy-proven, relapsed FL (Grade 1/2 or 3a); one or two prior therapies; age of 20–74 years; ECOG performance status of 0–2; measurable lesion(s); no severe organ dysfunction; 3 months or longer life expectancy; and written informed consent. BR consisted of rituximab (375 mg/m2, day 1) and bendamustine (90 mg/m2, day 2 and 3), and repeated every 4 weeks up to 4–6 cycles. As the consolidation therapy, 14.8 MBq/kg of 90YIT was administered to patients who achieved complete response (CR) or partial response after BR therapy. The primary endpoint was 2-year progression-free survival (PFS) after the consolidation with 90YIT. The secondary endpoints were response rates after BR therapy, response rates after consolidation with 90YIT, 2-year overall survival (OS) rate after the consolidation with 90YIT, and toxicities. Results: A total of 30 patients were registered between 2013 and 2015. Of these patients, 6 were excluded from the study because of pathological diagnoses other than FL in the central review (n = 3), unmet criteria (n = 2), and the other advanced cancer found (n = 1), respectively. Thus, 24 patients with a median 60 years of age (range 47–74 years) and a median of 6.7 years (range 1.6–14.8 years) of duration from the initial diagnosis were evaluated. Among them, R-CHOP based chemotherapy was the most common initial treatment (92%). The FLIPI2 score at the time of registration was high in 3, intermediate in 7, and low in 14 patients, respectively. After re-induction treatment with BR, 22 patients (92%) ultimately received consolidation with 90YIT, resulting in an overall response rate of 95% and a CR rate of 91%, respectively. Within the 2-year observation period, 10 patients relapsed and 3 of them had a histological transformation to diffuse large B-cell lymphoma. Severe non-hematological toxicities were rare and no treatment-related mortality was observed. Within the observation period, one patient died of disease progression. Second primary malignancies were not observed. Consequently, the 2-year PFS and OS rates after the consolidation were 58%, and 94%, respectively. Keywords: 90-yttrium; follicular lymphoma (FL); radioimmunotherapy (RIT). Disclosures: Kanno, M: Research Funding: NPO-ACRO (Advanced Clinical Research Organization).
Abstract Background Decision-making models for elderly patients with diffuse large B-cell lymphoma (DLBCL) treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) are in great demand. Patients and Methods The Society of Lymphoma Treatment in Japan (SoLT-J), in collaboration with the West-Japan Hematology and Oncology Group (West-JHOG), collected and retrospectively analyzed the clinical records of ≥65-year-old patients with DLBCL treated with R-CHOP from 19 sites across Japan to build an algorithm that can stratify adherence to R-CHOP. Results A total of 836 patients with a median age of 74 years (range, 65–96 years) were analyzed. In the SoLT-J cohort (n = 555), age >75 years, serum albumin level <3.7 g/dL, and Charlson Comorbidity Index score ≥3 were independent adverse risk factors and were defined as the Age, Comorbidities, and Albumin (ACA) index. Based on their ACA index score, patients were categorized into “excellent” (0 points), “good” (1 point), “moderate” (2 points), and “poor” (3 points) groups. This grouping effectively discriminated the 3-year overall survival rates, mean relative total doses (or relative dose intensity) of anthracycline and cyclophosphamide, unanticipated R-CHOP discontinuance rates, febrile neutropenia rates, and treatment-related death rates. Additionally, the ACA index showed comparable results for these clinical parameters when it was applied to the West-JHOG cohort (n = 281). Conclusion The ACA index has the ability to stratify the prognosis, tolerability to cytotoxic drugs, and adherence to treatment of elderly patients with DLBCL treated with R-CHOP.
