Reimer P.,Clinic for Hematology
Cancer Management and Research | Year: 2015
Peripheral T-cell lymphomas (PTCL) represent a heterogeneous group of rare malignancies that with the exception of anaplastic lymphoma kinase expressing anaplastic large cell lymphoma, share a poor outcome after standard (eg, anthracycline-based) chemotherapy. Most patients are either refractory to initial therapy or eventually relapse. Randomized studies for relapsed/refractory PTCL are not available, however, recently published data show that con-ventional chemotherapy has very limited efficacy in the salvage setting. Thus, novel drugs are urgently needed to improve the outcome in this setting. Belinostat, a pan-histone deacetylase inhibitor, has demonstrated meaningful efficacy and a favorable toxicity profile in two single-arm Phase II trials on 153 patients with relapsed/refractory PTCL. The conclusive results led to an accelerated approval by the US Food and Drug Administration. The present review summarizes the clinical data available for belinostat, its current role, and future perspectives. © 2015 Reimer.
Heigener D.F.,German Center for Lung Research |
Schumann C.,Kempten Oberallgaeu Hospitals GmbH |
Sebastian M.,University Hospital Frankfurt |
Sadjadian P.,Clinic for Hematology |
And 5 more authors.
Oncologist | Year: 2015
Background. Afatinib, an irreversible ErbB family blocker, is approved for treatment of patients with previously untreated non-small cell lung cancer (NSCLC) harboring activating epidermal growth factor receptor (EGFR) mutations. Efficacy of afatinib in EGFR tyrosine kinase inhibitor-naïve (TKI-naïve) patients with uncommon EGFR mutations (other than exon 19 deletions or exon 21 point mutations) has been reported; however, efficacy in TKI-pretreated patients with uncommon EGFR mutations is unknown. Materials and Methods. In the afatinib compassionate use program (CUP), patients with advanced or metastatic, histologically confirmed NSCLC progressing after at least one line of chemotherapy and one line of EGFR-TKI treatment were enrolled. Demographic data, mutation type, response rates, time to treatment failure (TTF), and safety in patients harboring uncommon EGFR mutations were reported. Results. In 60 patients (63% female, median age 63 years [range: 30–84 years]), a total of 66 uncommon EGFR mutations including 30 T790M mutations were reported (18.4% and 11%, respectively, of known EGFR mutations within the CUP). Most patients (67%) received afatinib as third- or fourth-line treatment. Median TTF was 3.8 months (range: 0.2 to >24.6 months; p = .244) in patients with uncommon mutations compared with 5.1 months (range: 0.1 to >21.1 months) in patients with common mutations (n = 165). Pronounced activity was observed with E709X mutations (TTF >12 months). No new safety signals were detected. Conclusion. Afatinib is clinically active and well tolerated in many TKI-pretreated NSCLC patients harboring uncommon EGFR mutations. Compared with results reported in TKI-naïve patients, activity was also indicated in patients with T790M and exon 20 insertion mutations. © AlphaMed Press 2015.
Lekovic D.,Clinic for Hematology |
Gotic M.,University of Belgrade |
Ljubic A.,University of Belgrade
Srpski Arhiv za Celokupno Lekarstvo | Year: 2015
Introduction The management of pregnancy in young women with essential thrombocythemia is complex and may present a difficult problem. An adverse pregnancy outcome due to thrombosis or bleeding is a common complication. In addition, little is known about fertility in these women prior to the disease. Case Outline We present the first case of a young woman with primary infertility and essential thrombocythemia who had uneventfully delivered a healthy boy in the fortieth week of pregnancy. Her platelet count was normalized during treatment with interferon-alfa. The patient failed to become pregnant in the natural way and after three attempts of programmed intercourse. She conceived only following intrauterine insemination. During pregnancy, the patient was carefully controlled by a hematologist and gynecologist. Conclusion Natural course and prognosis of essential thrombocythemia is not adversely affected by pregnancy. In these women, the pregnancy should be planned only after normalization of platelet count. The interferon-alpha should be administered before the pregnancy to regulate and maintain the platelet count within the normal range. Intrauterine insemination with minimal hormonal stimulation due to the risk of thrombosis could be recommended as the safest treatment option of infertility in women with essential thrombocythemia. © 2015, Serbia Medical Society. All rights reserved.
Kojic M.,Clinic for Infectious and Tropical Diseases |
Nozic D.,Clinic for Infectious and Tropical Diseases |
Nozic D.,University of Belgrade |
Tarabar O.,Clinic for Hematology |
And 2 more authors.
Vojnosanitetski Pregled | Year: 2016
Introduction. Extraintestinal manifestations of nontyphoidal salmonellosis are usually seen in patients with cellular immunodeficiency. Pleural empyema caused by nontyphoidal Salmonella is very rare clinical presentation of salmonellosis and there are just a few cases described in a literature. We presented a very rare case of pleural empyema caused by Salmonella enteritidis in a patient with non-Hodgkin limphoma. Case report. A 60-year-old male with low grade B-cell lymphoma, mucosa associated lymphoid tissue (MALT) type in IV clinical degree, manifested with infiltration of stomach, bronchus, pleura and peritoneum was admitted to the hospital. Initially the patient was presented with nonspecific symptoms and signs, suggesting poor general condition. During the hospitalization his pleural fluid became purulent and changes in blood counts were registered with the increase of leukocytes, especially neutrophils. A large number of leukocytes was found by microscopic evaluation of pleural fluid and Salmonella enteritidis was isolated by its culture. There were no pathogenic bacteria in stool culture and hemoculture remained sterile. Toxins A and B of Clostridium difficile were not detected in stool. The patient was treated by ciprofloxacin and cefrtiaxone for 14 days with drainage of the purulent content, what was followed by the resolution and organization of the pleural fluid. After the stabilization of his general condition, chemotherapy with cyclophosphamide, vincristine, prednisone (COP) was introduced, with complete response. Conclusion. Although rare, pleural empyema caused by nontyphoidal Salmonella should be considered in patients with severe immunosuppression, because appropriate antimicrobial therapy with surgical measures are very important for the outcome in these patients. © 2016, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved.
Giagounidis A.,Clinic for Hematology
Current Hematologic Malignancy Reports | Year: 2015
Lenalidomide is nowadays an accepted standard treatment for del(5q) MDS. In non-del(5q) disease, its role is more difficult ot define. Studies have shown that about 18 % of patients treated with a standard dose of 10 mg/day on 21 out of 28 days might achieve erythroid transfusion independence rates that last 6 months or longer. The responses to lenalidomide seem to be inversely correlated to the pre-treatment EPO level. The higher the EPO level, the lower the responses. In the absence of other cytogenetic or molecular predictive factors that allow to discern which patient benefit most from treatment, its incorporation into the treatment algorithm is dependent on the available alternatives, including erythropoietic agents, immunosupressive treatments and experimental strategies like thrombopoietin receptor agonists or the antagonists of transforming growth factor beta. Given that 90 % of responses to lenaldiomide occur within four months of treatment, patients not responding within this time frame should discontinue therapy. © 2015, Springer Science+Business Media New York.