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Ferra C.,Institute Catala dOncologia Hospital Universitari Germans Trias i Pujol | Sanz J.,Hospital La Fe | Diaz-Perez M.-A.,Hospital Nino Jesus | Morgades M.,Institute Catala dOncologia Hospital Universitari Germans Trias i Pujol | And 16 more authors.
Leukemia and Lymphoma | Year: 2015

Strategies for reversing graft failure (GF) after allogeneic stem cell transplant (SCT) depend on the options available in each situation. GF was reported in 16 Spanish institutions from January 2006 to July 2011. Primary GF was defined as an absolute neutrophil count (ANC) > 0.5 × 109/L not reached by day 28 after SCT from peripheral blood (PB) or bone marrow (BM) progenitors and by day 42 after SCT from unrelated cord blood (UCB) progenitors. Secondary GF was defined as a recurrent ANC < 0.5 × 109/L. Eighty-nine patients with GF were reported, and 80 patients received a second SCT. The 5-year survival probability was 31% (95% confidence interval [CI]: 1844%), and the incidences of non-relapse mortality and relapse estimated by competing risks were 47% (95% CI: 3658%) and 21% (95% CI: 428%). The strategy adopted to treat GF was heterogeneous, and no approach could be unequivocally recommended for this situation. The prognosis of patients with GF was poor even after successful recovery from GF. © 2014 Informa UK, Ltd. Source


Puiggros A.,Laboratori Of Citogenetica Molecular | Venturas M.,Laboratori Of Citogenetica Molecular | Salido M.,Laboratori Of Citogenetica Molecular | Blanco G.,Laboratori Of Citogenetica Molecular | And 23 more authors.
Genes Chromosomes and Cancer | Year: 2014

Deletion of 13q14 as the sole abnormality is a good prognostic marker in chronic lymphocytic leukemia (CLL). Nonetheless, the prognostic value of reciprocal 13q14 translocations [t(13q)] with related 13q losses has not been fully elucidated. We described clinical and biological characteristics of 25 CLL patients with t(13q), and compared with 62 patients carrying interstitial del(13q) by conventional G-banding cytogenetics (CGC) [i-del(13q)] and 295 patients with del(13q) only detected by fluorescence in situ hybridization (FISH) [F-del(13q)]. Besides from the CLL FISH panel (D13S319, CEP12, ATM, TP53), we studied RB1 deletions in all t(13q) cases and a representative group of i-del(13q) and F-del(13q). We analyzed NOTCH1, SF3B1, and MYD88 mutations in t(13q) cases by Sanger sequencing. In all, 25 distinct t(13q) were described. All these cases showed D13S319 deletion while 32% also lost RB1. The median percentage of 13q-deleted nuclei did not differ from i-del(13q) patients (73% vs. 64%), but both were significantly higher than F-del(13q) (52%, P<0.001). Moreover, t(13q) patients showed an increased incidence of biallelic del(13q) (52% vs. 11.3% and 14.9%, P<0.001) and higher rates of concomitant 17p deletion (37.5% vs. 8.6% and 7.2%, P<0.001). RB1 involvement was significantly higher in the i-del(13q) group (79%, P<0.001). Two t(13q) patients (11.8%) carried NOTCH1 mutations. Time to first treatment in t(13q) and i-del(13q) was shorter than F-del(13q) (67, 44, and 137 months, P=0.029), and preserved significance in the multivariate analysis. In conclusion, t(13q) and del(13q) patients detected by CGC constitute a subgroup within the 13q-deleted CLL patients associated with a worse clinical outcome. © 2014 Wiley Periodicals, Inc. Source

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