Treatment of classical Hodgkin lymphoma in young adults aged 18-30 years with a modified paediatric Hodgkin lymphoma protocol. Results of a multicentre phase II clinical trial (CRUK/08/012)

This phase II trial was designed to determine the safety and efficacy of a modified paediatric risk-stratified protocol in young adults (18-30 years) with classical Hodgkin Lymphoma. The primary end-point was neurotoxicity rate. The incidence of grade 3 neurotoxicity was 11% (80% CI, 5-19%); a true rate of neuropathy of >15% cannot be excluded. Neuropathy and associated deterioration in quality of life was largely reversible. The overall response rate was 100% with 40% complete remission (CR) rate. Twelve months disease-free survival (DFS) was 91%. We demonstrate that a risk-stratified paediatric combined modality treatment approach can be delivered to young adults without significant irreversible neuropathy

Loncastuximab tesirine in relapsed/refractory high-grade B-cell lymphoma: a subgroup analysis from the LOTIS-2 study

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Utilization Pattern, Demand and Supply of Pearl Millet Grain and Fodder in Western India. Working Paper Series No. 37

This paper gives an estimate of the demand and supply of pearl millet grain and fodder for the year 2011 and 2020 in western India comprising (Rajasthan, Gujarat and Haryana). The projected pearl millet grain and stover production for 2020 was based on historical growth rates in production from 1996-2009. On the demand side, food demand was projected based on population projections for 2020 by maintaining 2004/05 per capita consumption based on NSSO 61st round. The demand for alternative uses of grain (alcohol industry) was projected based on a field survey conducted during 2011. The demand for feed and stover was based on the livestock census 2007 and feed ration from Dikshit and Birthal (2010) and projected growth rates of livestock population. Overall in 2011, in western India 46% of production of pearl millet grain goes for food use, 37.5% for cattle feed, 7.7% for poultry feed, 8.8% for alcohol industry production and only a small fraction, 0.4%, is used for seed purpose. The relative share of different uses of grain by 2020 indicated that the share of cattle feed will increase to 38.6%, share of poultry feed will increase to 9.4%, alcohol industry and other non-food uses will be increased to 11.7%, while food uses will decrease to 40%. Even though currently there is shortage of pearl millet grain production in western India, which is indicated by higher prices, by 2020 the region will become surplus to the extent of 5% if it maintains the production growth trend of the recent past, which is very high (4.22% per annum). However, Gujarat state will continue to be deficient in grain even by 2020. Dry fodder will, however, continue to be in short supply and the paper projects a deficit of 10% by 2020

Comparison of PET/MRI With PET/CT in the Evaluation of Disease Status in Lymphoma

PURPOSE: The primary aim was to compare the diagnostic performance of PET/MRI (performed with basic anatomical MRI sequences) in detecting sites of disease in adult patients with lymphoma compared with the current standard of care, PET/CT. Secondary aims were to assess the additional value of diffusion-weighted imaging to PET/MRI in disease detection and to evaluate the relationship between the standardized uptake value on PET/MR and the apparent diffusion coefficient on diffusion-weighted imaging. METHODS: Sixty-eight studies in 66 consecutive patients with histologically proven Hodgkin or non-Hodgkin lymphoma were prospectively evaluated. Each patient had whole body PET/CT, followed by whole body PET/MR. Two experienced readers independently evaluated the PET/MRI studies, and two other experienced readers independently evaluated PET/CT. Site of lymphoma involvement and SUVmax at all nodal sites more avid than background liver were recorded. Readers provided stage (in baseline cases) and disease status (remission vs active disease). The apparent diffusion coefficient mean value corresponding to the most avid PET site of disease was recorded. RESULTS: Ninety-five nodal and 8 extranodal sites were identified on both PET/CT and PET/MRI. In addition, 3 nodal and 1 extranodal sites were identified on PET/MRI. For positive lesion detection, reader agreement in PET/MR was perfect between the 2 readers and almost perfect between PET/CT and PET/MR (k > 0.978). Intermodality agreement between PET/CT and PET/MRI was also near perfect to perfect for staging/disease status k = (0.979–1.000). SUVmax from PET/CT and PET/MRI correlated significantly (Spearman rho correlation coefficient, 0.842; P < 0.001). Diffusion-weighted imaging did not alter lesion detection or staging in any case. A negative correlation was demonstrated between ADC mean and SUVmax (Spearman rho correlation coefficient r, -0.642; P < 0.001). CONCLUSIONS: PET/MRI is a reliable alternative to PET/CT in the evaluation of patients with lymphoma. Diffusion-weighted imaging did not alter diagnostic accuracy. With comparable accuracy in detection of disease sites and added benefit of radiation dose reduction, PET/MRI has a potential to become part of routine lymphoma imaging

Prospects for kharif (Rainy Season)and Summer Pearl Millet in Western India. Working Paper Series no. 36

Pearl millet is a major cereal crop in northwestern India. The crop is grown in very harsh, arid, dry climatic areas having high temperature and low and erratic rainfall. It’s use as food is declining but its use as cattle feed, poultry feed and source of starch in the alcohol industry is increasing. Its fodder is an important source of animal feed particularly in dry months when alternative sources of feed are not available. In the last decade, pearl millet was also grown under irrigation in the summer months. Gujarat state has the highest area under summer pearl millet not only among the northwestern states but also at the all-India level. In this paper, we have analyzed the productive potential of both kharif (rainy season) and summer pearl millet particularly in Gujarat state. Kharif pearl millet still contributes to the bulk of the pearl millet production in western India although its yields are relatively low. To compete with crops like guar, green gram, cotton, etc, both grain and fodder yields of the kharif crop need to be increased. With the adoption of improved cultivars and low-cost improved technology, yields can be increased by 20-30% from the existing levels. Yields of summer pearl millet are much higher since it is grown under irrigation and its grain quality is also superior. It is grown as a commercial crop with the bulk of the crop sold domestically, and also exported to neighboring countries. There is a need to explore opportunities to expand the area under summer pearl millet particularly in areas where irrigation is available and the fields are vacant during the summer season

The MAGNOLIA Trial: Zanubrutinib, a Next-Generation Bruton Tyrosine Kinase Inhibitor, Demonstrates Safety and Efficacy in Relapsed/Refractory Marginal Zone Lymphoma

Purpose: Marginal zone lymphoma (MZL) is an uncommon non-Hodgkin lymphoma with malignant cells that exhibit a consistent dependency on B-cell receptor signaling. We evaluated the efficacy and safety of zanubrutinib, a next-generation selective Bruton tyrosine kinase inhibitor, in patients with relapsed/ refractory (R/R) MZL. Patients and Methods: Patients with R/R MZL were enrolled in the phase II MAGNOLIA (BGB-3111-214) study. The primary endpoint was overall response rate (ORR) as determined by an independent review committee (IRC) based on the Lugano 2014 classification. Results: Sixty-eight patients were enrolled. After a median follow-up of 15.7 months (range, 1.6 to 21.9 months), the IRCassessed ORR was 68.2% and complete response (CR) was 25.8%. The ORR by investigator assessment was 74.2%, and the CR rate was 25.8%. The median duration of response (DOR) and median progression-free survival (PFS) by independent review was not reached. The IRC-assessed DOR rate at 12 months was 93.0%, and IRC-assessed PFS rate was 82.5% at both 12 and 15 months. Treatment was well tolerated with the majority of adverse events (AE) being grade 1 or 2. The most common AEs were diarrhea (22.1%), contusion (20.6%), and constipation (14.7%). Atrial fibrillation/flutter was reported in 2 patients; 1 patient had grade 3 hypertension. No patient experienced major hemorrhage. In total, 4 patients discontinued treatment due to AEs, none of which were considered treatment-related by the investigators. Conclusions: Zanubrutinib demonstrated highORRand CR rate with durable disease control and a favorable safety profile in patients with R/R MZL. _2021 The Authors; Published by the American Association for Cancer Research

Rituximab in B-Cell Hematologic Malignancies: A Review of 20 Years of Clinical Experience

Rituximab is a human/murine, chimeric anti-CD20 monoclonal antibody with established efficacy, and a favorable and well-defined safety profile in patients with various CD20-expressing lymphoid malignancies, including indolent and aggressive forms of B-cell non-Hodgkin lymphoma. Since its first approval 20 years ago, intravenously administered rituximab has revolutionized the treatment of B-cell malignancies and has become a standard component of care for follicular lymphoma, diffuse large B-cell lymphoma, chronic lymphocytic leukemia, and mantle cell lymphoma. For all of these diseases, clinical trials have demonstrated that rituximab not only prolongs the time to disease progression but also extends overall survival. Efficacy benefits have also been shown in patients with marginal zone lymphoma and in more aggressive diseases such as Burkitt lymphoma. Although the proven clinical efficacy and success of rituximab has led to the development of other anti-CD20 monoclonal antibodies in recent years (e.g., obinutuzumab, ofatumumab, veltuzumab, and ocrelizumab), rituximab is likely to maintain a position within the therapeutic armamentarium because it is well established with a long history of successful clinical use. Furthermore, a subcutaneous formulation of the drug has been approved both in the EU and in the USA for the treatment of B-cell malignancies. Using the wealth of data published on rituximab during the last two decades, we review the preclinical development of rituximab and the clinical experience gained in the treatment of hematologic B-cell malignancies, with a focus on the well-established intravenous route of administration. This article is a companion paper to A. Davies, et al., which is also published in this issue