T-cell prolymphocytic leukemia

T-cell prolymphocytic leukemia (T-PLL) is a rare mature T-cell lymphoma. The diagnosis of T-PLL is made based on the criteria proposed in 2019 by the T-PLL International Study Group (TPLL-ISG). T-PLL may be diagnosed in an ‘active’ or an ‘inactive’ form. While T-PLL is most often characterized by an aggressive clinical course, approximately 20–30% of patients may have a stable or slowly progressive disease in the initial period. Only the active form requires treatment. The treatment initiation criteria were defined in the consensus proposed by the TPLL-ISG. Data on the effectiveness of various therapeutic approaches comes from small, non-randomized studies. No drug is approved for the treatment of T-PLL. The standard of care in the first line of treatment is intravenous alemtuzumab. Consolidation therapy in eligible patients consists of allogeneic hematopoietic stem cell transplantation, preferably after TBI-based conditioning. In the remaining patients, neither maintenance nor consolidation treatment is recommended. There is no standard therapy for the relapse, although, based on genome studies, many drugs may be potentially effective, including histone deacetylase inhibitors and BCL2 inhibitors

Stosowanie leków biopodobnych w hematoonkologii – stanowisko Polskiego Towarzystwa Hematologów i Transfuzjologów

Leki biopodobne odgrywają coraz większą rolę w terapii wielu chorób wraz z wygaśnięciem ochrony patentowej dla kolejnych leków biologicznych. Celem niniejszego opracowania jest przybliżenie terminologii i zasad wprowadzania na rynek leków biopodobnych, zagadnień dotyczących ich etykietowania, ekstrapolacji, wymienialności i automatycznej substytucji. Opracowanie to przedstawia stanowisko Polskiego Towarzystwa Hematologów i Transfuzjologów dotyczące leków biopodobnych, oparte na wytycznych EMA (European Medicine Agency) i stanowisku ESMO (European Society of Medical Oncology)

Early and late follow-up of patients with Hodgkin’s lymphoma. Recommendations of the Polish Lymphoma Research Group

Optymalny sposób monitorowania chorych na chłoniaka Hodgkina (HL) po zakończeniu leczenia przeciwnowotworowego nie jest do końca ustalony i opiera się w głównej mierze na praktyce klinicznej. Przez pierwsze lata obserwacji największy nacisk kładzie się na wykrycie ewentualnej wznowy, następnie większe znaczenie ma monitorowanie późnych powikłań terapii. W artykule przedstawiono dostępne zalecenia oraz rekomendacje monitorowania chorych po leczeniu chłoniaka Hodgkina przygotowane przez Polską Grupę Badawczą Chłoniaków.Post-treatment follow-up of patients with Hodgkin’s lymphoma has not yet been fully optimised and is still basedmainly on clinical practice and experience. During the first years of follow-up, the principal aims are to detectrelapse and monitor any post-treatment complications or side effects. Such as they are, current guidelines onfollow-up are herein considered and discussed, together with those now recommended by the Polish LymphomaResearch Group

Plerixafor for patients who fail cytokine-or chemotherapy-based stem cell mobilization: Results of a prospective study by the Polish Lymphoma Research Group (PLRG)

Autologous hematopoietic stem cell transplantation (autoHSCT) requires collection of sufficient number of hematopoietic stem cells. The goal of this study was to evaluate efficacy of plerixafor used in patients with lymphoid malignancies failing conventional stem cell mobilization.This was a prospective, non-interventional study. All consecutive patients (n = 109) treated with plerixafor in 11 centers were reported. The drug was used either in case of previous mobilization failure (n = 67) or interventionally, in case of insufficient CD34 cell output during current mobilization (n = 42). Successful mobilization was defined as resulting in collection of ≥ 2 × 10 CD34 cells/kg for single autoHSCT or ≥ 4 × 10 CD34 cells/kg for double procedure.The overall rate of successful mobilization was 55% (55% for single and 56% for double autoHSCT). The median total number of collected CD34 cells/kg was 2.4 (range, 0-11.5) for patients intended for a single transplantation while 4.0 (0.6-16.9) for double procedure. The number of circulating CD34 cells increased after the use of plerixafor regardless of baseline values. The median fold increase was 3.3 (0.3-155). Data from this observational study confirm high efficacy of plerixafor used in routine clinical practice as salvage for patients with lymphoid malignancies failing conventional stem cell mobilization

No advantage of antimicrobial prophylaxis in AML/MDS/CMML patients treated with azacitidine—a prospective multicenter study by the Polish Adult Leukemia Group

IntroductionInfections represent one of the most frequent causes of death of higher-risk MDS patients, as reported previously also by our group. Azacitidine Infection Risk Model (AIR), based on red blood cell (RBC) transfusion dependency, neutropenia <0.8 × 109/L, platelet count <50 × 109/L, albumin <35g/L, and ECOG performance status ≥2 has been proposed based on the retrospective data to estimate the risk of infection in azacitidine treated patients.MethodsThe prospective non-intervention study aimed to identify factors predisposing to infection, validate the AIR score, and assess the impact of antimicrobial prophylaxis on the outcome of azacitidine-treated MDS/AML and CMML patients.ResultsWe collected data on 307 patients, 57.6 % males, treated with azacitidine: AML (37.8%), MDS (55.0%), and CMML (7.1%). The median age at azacitidine treatment commencement was 71 (range, 18-95) years. 200 (65%) patients were assigned to higher risk AIR group. Antibacterial, antifungal, and antiviral prophylaxis was used in 66.0%, 29.3%, and 25.7% of patients, respectively. In total, 169 infectious episodes (IE) were recorded in 118 (38.4%) patients within the first three azacitidine cycles. In a multivariate analysis ECOG status, RBC transfusion dependency, IPSS-R score, and CRP concentration were statistically significant for infection development (p < 0.05). The occurrence of infection within the first three azacitidine cycles was significantly higher in the higher risk AIR group – 47.0% than in lower risk 22.4% (odds ratio (OR) 3.06; 95% CI 1.82-5.30, p < 0.05). Administration of antimicrobial prophylaxis did not have a significant impact on all-infection occurrence in multivariate analysis: antibacterial prophylaxis (OR 0.93; 0.41-2.05, p = 0.87), antifungal OR 1.24 (0.54-2.85) (p = 0.59), antiviral OR 1.24 (0.53-2.82) (p = 0.60).DiscussionThe AIR Model effectively discriminates infection-risk patients during azacitidine treatment. Antimicrobial prophylaxis does not decrease the infection rate

High efficacy and safety of VTD as an induction protocol in patients with newly diagnosed multiple myeloma eligible for high dose therapy and autologous stem cell transplantation : a report of the Polish Myeloma Study Group

The present retrospective analysis evaluated the efficacy and safety of the VTD (bortezomib, thalidomide, dexamethasone) regimen in 205 newly‑diagnosed patients with multiple myeloma (MM) eligible for high dose therapy and autologous stem cell transplantation (HDT/ASCT) in routine clinical practice. With a median of 6 cycles (range, 1‑8), at least partial response was achieved in 94.6% and at least very good partial response (VGPR) was achieved in 67.8% of patients. Peripheral neuropathy (PN) grade 2‑4 was observed in 28.7% of patients. In 72% of patients undergoing stem cell mobilization one apheresis allowed the number of stem cells sufficient for transplantation to be obtained. Following HDT/ASCT the sCR rate increased from 4.9 to 14.4% and CR from 27.8 to 35.6%. The results demonstrated that VTD as an induction regimen was highly efficient in transplant eligible patients with MM with increased at least VGPR rate following prolonged treatment (≥6 cycles). Therapy exhibited no negative impact on stem cell collection, neutrophils and platelets engraftment following ASCT. Therapy was generally well tolerated and PN was the most common reason of dose reduction or treatment discontinuation

Age-dependent determinants of infectious complications profile in children and adults after hematopoietic cell transplantation : lesson from the nationwide study

Incidence and outcome of microbiologically documented bacterial/viral infections and invasive fungal disease (IFD) in children and adults after hematopoietic cell transplantation (HCT) were compared in 650 children and 3200 adults in multicenter cross-sectional nationwide study. Infections were diagnosed in 60.8% children and 35.0% adults, including respectively 69.1% and 63.5% allo-HCT, and 33.1% and 20.8% auto-HCT patients. The incidence of bacterial infections was higher in children (36.0% vs 27.6%; p  21 days were risk factors for death from infection. In conclusion, pediatric patients have 2.9-fold higher incidence and 2.5-fold better outcome of infections than adults after HCT