Kardiotoksyczność po leczeniu chorych z chłoniakami złośliwymi

Efficacy of anti-lymphoma therapy, prolonging significantly overall survival, allows us to observe late adverse effects of antineoplastic drugs. Cardiotoxicity of anthracyclins is dose dependent and increasing with time elapsed after therapy. It is more pronounced in patients with pre-existing heart disorders, treated with combined chemotherapy regimens or concomitant mediastinal radiotherapy. Cardiotoxic effects may be attenuated by using regimens with a low cumulative dose of anthracyclins, their liposomal formulations or cardioprotective substances. Onkol. Prak. Klin. 2010; supl. A: A18–A24Wzrost skuteczności leczenia chłoniaków przekłada się na wydłużenie życia pacjentów, co daje coraz częściej możliwość obserwacji odległych działań niepożądanych stosowanych leków. Kardiotoksyczność antybiotyków antracyklinowych zależy od ich kumulacyjnej dawki i zwiększa się z czasem, jaki upływa od zakończenia leczenia. Jest ona silniej wyrażona u pacjentów ze współistniejącą chorobą serca lub po leczeniu skojarzonym, z zastosowaniem innych cytostatyków czy radioterapii. Efekty kardiotoksycznego działania można w większości przypadków ograniczyć, stosując schematy chemioterapii z niską dawką kumulacyjną antracyklin ich postacie liposomalne lub substancje kardioprotekcyjne. Onkol. Prak. Klin. 2010; supl. A: A18–A2

Liposomal cytarabine in the prophylaxis and treatment of CNS lymphoma : toxicity analysis in a retrospective case series study conducted at Polish Lymphoma Research Group Centers

Lymphomas with primary or secondary involvement of central nervous system (CNS) have poor prognosis despite specific treatment protocols which include whole brain radiotherapy and high-dose systemic and/or intrathecal chemotherapy. Toxicity of intrathecal liposomal cytarabine-based regimens collected between November 2006 and January 2012 was assessed retrospectively. Data from 120 adult lymphoma patients with, or at high risk of CNS involvement who received intrathecal liposomal cytarabine-based regimens at six Polish Lymphoma Research Group centres between November 2006 and January 2012 were assessed retrospectively. Patients were divided into three cohorts: A (high risk of CNS disease, n = 88), B (cerebrospinal fluid pleocytosis without neurological symptoms or pathological imaging findings, n = 7), and C (CNS disease/neurological involvement; n = 25). In all examined groups, toxicity of treatment was found to be acceptable (including the prophylactic setting). None of the patients in cohorts A or B who took intrathecal liposomal cytarabine 50 mg, repeated every 2–4 weeks (mean 3.8 doses) had experienced a CNS relapse at a median follow-up time of 3 years. Patients in cohort C had a 76 % overall neurological response rate (including a 40 % complete response rate) and median overall survival of 4.8 years. Regimens incorporating liposomal cytarabine seem to be safe and effective treatments for lymphomas with CNS involvement

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