Therapy of relapsed and refractory plasma cell myeloma in Polish population – analysis

The treatment of relapsed and refractory plasma cell myeloma is a real challenge, especially in case of resistance to proteasome inhibitors and immunomodulatory drugs (IMiDs). The situation is complicated by the lack of commonly accepted therapeutic guidelines. This study summarizes therapeutic strategies used to treat recurrent plasma cell myeloma in Polish population before 2015, when bortezomib has become available in the first-line therapy. We focused mainly on the use of IMiDs and proteasome inhibitors. To analyze the situation medical records of patients treated in 21 Polish hematological centers have been reviewed. In total data on 400 patients were analyzed and extrapolated to the national level to obtain data on 7293 patients (400/7293). Mean number of applied therapies was 1.7. Half of the patients were treated with two or more chemotherapy regimens. Second-line therapy most commonly included: VD, PAD, thalidomide in monotherapy and MP regimen. Combinations of two drugs, namely lenalidomide, thalidomide or bortezomib with dexamethasone, were most often used in third-line therapy. Fourth-line treatment most commonly consisted of MPT regimen and dexamethasone monotherapy. At least PR was observed in 73%, 82%, and 50% of patients treated with II, III and IV-line therapy, respectively. Complications were observed in at least half of the patients regardless the type of treatment. Polyneuropathy and myelotoxicity were the most common adverse events.The outcome of recurrent plasma cell myeloma treatment in Polish patients was relatively good, probably because of rare use of bortezomib and lenalidomide in first-line therapy

Detection of splenic tissue by 99mTc-labelled Sn-colloid SPECT/CT scintigraphy

This paper presents a case of an 80-year-old man with idiopathic thrombocytopenic purpura after splenectomy performed many years ago, which normalized platelet count, presented with severe thrombocytopenia with no response to treatment. A SPECT/CT study was performed using 99mTc-labelled Sn-colloid. The histology confirmed the presence of splenic tissue in those foci. Spleen examination (SPECT/CT) using 99mTc-labelled Sn-colloid is able to detect splenic tissue and in our opinion is a simpler and less time-consuming procedure than using 99mTc DRBC. Nuclear Med Rev 2011; 14, 2: 116–11

Impedance cardiography in the diagnosis of capillary leak syndrome caused by doxorubicin therapy in a patient with myeloma multiplex

Cytotoxicity of drugs can be a cause of cardiorespiratory disorders connected with chemotherapy. Doxorubicin is an antibiotic from the group of anthracyclines effective in antineoplastic therapy of solid and hematopoetic tumors. The most common cause of therapy ceasing is its cardiotoxicity. However, a lung injury connected with its cytotoxic activity to pulmonary endothelium (capillary leak syndrome) can be an equally serious complication. In the case presented, rapid, multi-profile diagnostics with the use of impedance cardiography, a modern noninvasive tool of hemodynamic monitoring, led to the recognition and effective treatment of a rare clinical syndrome. (Cardiol J 2010; 17, 1: 88-91

Influence of the Modifier Type and its Concentration on Electroosmotic Flow of the Mobile Phase in Pressurized Planar Electrochromatography

The aim of this work was to find a relationship between electroosmotic flow (EOF) velocity of the mobile phase in pressurized planar electrochromatography (PPEC) and physicochemical properties like zeta potential, dielectric constant, and viscosity of the mobile phase as well as its composition. The study included different types of organic modifiers (acetonitrile, methanol, ethanol, acetone, formamide, N-methylformamide and N,N-dimethylformamide) in the full concentration range. In all experiments, chromatographic glass plates HPTLC RP-18 W from Merck (Darmstadt) were used as a stationary phase. During the study we found that there is no linear correlation between EOF velocity of the mobile phase and single variables such as zeta potential or dielectric constant or viscosity. However, there is quite strong linear correlation between EOF velocity of the mobile phase and variable obtained by multiplying zeta potential of the stationary phase–mobile phase interface, by dielectric constant of the mobile phase solution and dividing by viscosity of the mobile phase. Therefore, it could be concluded that the PPEC system fulfilled the Helmholtz–Smoluchowski equation

Współpraca Instytutu Łączności z wybranymi partnerami zagranicznymi, Telekomunikacja i Techniki Informacyjne, 2018, nr 1-2

Artykuł przedstawia pokrótce historię międzynarodowej współpracy Instytutu Łączności – Państwowego Instytutu Badawczego (IŁ) w wybranych dziedzinach, ze szczególnym uwzględnieniem najistotniejszych międzynarodowych konferencji, których był inicjatorem i organizatorem oraz w zakresie współpracy w ramach najważniejszych organizacji międzynarodowych (ITU, CEPT, IEC, IALA-IMO, ETSI, URSI, IEEE-EMCS, ICTP, OWŁ/RWPG)

Treatment of patients with Philadelphia positive acute lymphoblastic leukemia

Translokacja (9;22)(q34:q11.2), zwana chromosomem Filadelfia (Ph), jest najczęstszym zaburzeniem cytogenetycznym stwierdzanym u dorosłych chorych na ostrą białaczkę limfoblastyczną (ALL). Przed wprowadzeniem inhibitorów kinazy tyrozynowej (TKI) podtyp ALL Ph+ był obciążony szczególnie złym rokowaniem. Wprowadzenie imatynibu (IM), stosowanego w skojarzeniu z chemioterapią indukującą i konsolidującą, pozwoliło na zwiększenie odsetka całkowitych remisji do ponad 90% i zwiększenie szansy na allogeniczne przeszczepienie krwiotwórczych komórek macierzystych. Pierwsze doniesienia dotyczące wyników odległych wskazują na poprawę prawdopodobieństwa przeżycia, które w perspektywie 5-letniej wynosi obecnie około 50%. Konieczne jest przeprowadzenie dalszych badań klinicznych zmierzających do ustalenia optymalnego sposobu stosowania IM oraz określenia ewentualnej roli TKI II generacji w leczeniu I linii. Hematologia 2011; 2, 1: 33–41Translocation (9;22)(q34:q11.2), called Philadelphia chromosome (Ph), is the most frequent cytogenetic aberration among adults with acute lymphoblastic leukemia (ALL). Before the era of tyrosine kinase inhibitors (TKI), ALL Ph+ was associated with particularly poor prognosis. Introduction of imatinib (IM) in combination with induction-consolidation chemotherapy increased complete remission rate to over 90% and allowed application of allogeneic hematopoietic stem cell transplantation to greater proportion of patients. First reports on long term results indicate that 5-year probability of the overall survival is now approximately 50%. Further improvement requires prospective clinical trials aimed to optimize the protocols of IM administration and evaluate potential role of 2nd generation TKI in the up-front therapy of adults with ALL Ph+. Hematologia 2011; 2, 1: 33–4

Analysis of ibrutinib efficacy in a subgroup of chronic lymphocytic leukemia patients with 17p deletion: observational study of the Polish Adult Leukemia Group (PALG)

BackgroundThe 17p deletion is regarded as the strongest poor prognostic factor in chronic lymphocytic leukemia (CLL). Results of recently performed clinical trials have suggested that ibrutinib significantly improves the outcome in this patient group.AimThe study aimed at analyzing the efficacy and adverse events profile of ibrutinib monotherapy in CLL patients with 17p deletion treated in routine clinical practice outside clinical trials.Materials and MethodsClinical response and adverse events profile of ibrutinib monotherapy were assessed in thirty-five CLL patients with 17p deletion treated within the ibrutinib named patients program in Poland.ResultsOverall response rate was 80% (28/35 patients) with median observation time of 24.2 months (range 0,1 – 30,9). Complete remission was observed in 5 patients (14.3%), partial remission in 11 (31.4%), partial remission with lymphocytosis in 13 (37.1%), whereas stable disease and progression was noted in 4 (11.4%) and 1 (2.9%) respectively. Response was not assessed in 1 patient. Median progression-free survival was 29.5 months, whereas median overall survival was not reached. Eleven patients died (7 because of infection, 1 of CLL progression, 1 of sudden cardiac death, 1 of disseminated breast cancer and 1 of unknown causes). In 13 patients (37.1%) at least one 3 or 4 grade adverse event occurred. In 11 patients (31.4%) the treatment was temporary withheld or the dose reduced due to adverse events.ConclusionIbrutinib is characterized by high clinical efficacy and acceptable toxicity in CLL patients with 17p deletion in daily clinical practice

Pixantrone – anticancer drug in the monotherapy of aggressive lymphomas

Pixantrone is a first drug aza-anthracenedione approved as monotherapy of relapsed or refractory aggressive lymphomas. This drug has the unique chemical structure and mode of action properties distinguishing it from anthracyclines and anthracenediones. Pixantrone is one of the treatment option for heavily pretreated patients which to receive their living with doxorubicin and the further application from anthracyclines potentially can lead anthracycline-induced congestive heart failure. The benefit of pixantrone treatment has not been established in patients when used as V line or greater chemotherapy in patients who are refractory to last therapy. In general, pixantrone seems to be safe and manageable. In various trials, there were no unexpected side effects reported and no trials were closed prematurely because of side effects. In an evaluation of 12 clinical trials with pixantrone, the most common side effect (all grades) was hematological toxicity, mainly neutropenia (50% of patients; grade third/fourth: 41%), leukopenia (25%), anemia (31%), and thrombocytopenia (21%). Hematological toxicity was the main reason for a delayed start of subsequent cycles or for omitting the day-15 dose of pixantrone. In the outpatient setting, it is worth considering the use of hematopoietic growth factors. Other side effects included asthenia (23%), pyrexia (23%), and nausea, most patients experienced reversible skin discoloratio

Długotrwała odpowiedź na leczenie brentuksymabem vedotin u pacjenta z nawrotem chłoniaka Hodgkina po auto-HSCT

The standard of care for patients with refractory or relapsed Hodgkin lymphoma is salvage chemotherapy followed by autologous hematopoietic stem cell transplantation. This method is not always effective, however. For patient who do not respond or those who relapse again treatment opportunities are limited. Before of the brentuximab vedotin ”era” the prognosis of such patients was poor, with a 5-year overall survival not exceeding 30%. Allogeneic stem cell transplantation (allo-HSCT) may be curative, but its success is highly dependent on prior good disease control. Brentuximab vedotin can be effective bridging treatment before allo-HSCT because 34% of patients can achive complete remission. In addition, in some patients, used as monotherapy without additional consolidation treatment allows for long-term responses.Standardowym postępowaniem w przypadku opornego na leczenie lub nawrotowego chłoniaka Hodgkina jest ratunkowa chemioterapia zakończona przeszczepieniem autologicznych krwiotwórczych komórek macierzystych. Jednak metoda ta nie zawsze jest skuteczna. W przypadku pacjentów, którzy nie reagują na tę formę leczenia lub u których dochodzi do kolejnego nawrotu, możliwości leczenia są ograniczone. Przed „erą” brentuksymabu vedotin rokowanie u takich chorych było bardzo złe, z 5-letnim całkowitym przeżyciem nieprzekraczającym 30%. Przeszczepienie allogenicznych krwiotwórczych komórek macierzystych (allo-HSCT) może spowodować wyleczenie, ale jego powodzenie jest silnie uzależnione od wcześniejszej dobrej kontroli choroby. Brentuksymab vedotin jest skutecznym leczeniem pomostowym przed allo-HSCT, ponieważ u 34% pacjentów pozwala uzyskać całkowitą remisję. Dodatkowo u części pacjentów, zastosowany w monoterapii bez dodatkowego leczenia konsolidującego, pozwala uzyskać długotrwałe odpowiedzi

Spontaneous tumor lysis syndrome in diffuse large B-cell lymphoma patient as a cause of acute kidney injury

Idiopathic tumor lysis syndrome is a rare complication in the course of neoplastic disease. This condition requires an interdisciplinary therapeutic procedure. The presented case of spontaneous tumor lysis syndrome in the course of malignant large B-cell lymphoma describes an effective therapeutic approach in this type of cases