5 research outputs found
FLUDARABINE, CYCLOPHOSPHAMIDE AND RITUXIMAB (FCR) IN THE TREATMENT OF CHRONIC LYMPHOCYTIC LEUKEMIA (CLL): UNIVERSITY HOSPITAL CENTRE ZAGREB EXPERIENCE
U kliniÄkim je studijama kombinacija fludarabina, ciklofosfamida i rituksimaba (FCR) pokazala odliÄne rezultate u lijeÄenju bolesnika s kroniÄnom limfocitnom leukemijom (KLL) i postala zlatni standard u prvoj liniji lijeÄenja takvih bolesnika bez znatnijih komorbiditeta. Cilj rada bio je ispitati terapijsku djelotvornost, toksiÄnost i provedivost ovog protokola u svakodnevnoj kliniÄkoj praksi. Retrospektivno su analizirani tijek i ishodi lijeÄenja 43-oje bolesnika s KLL-om sa Zavoda za hematologiju Klinike za unutarnje bolesti KliniÄkoga bolniÄkog centra Zagreb. Shema primjene rituksimaba razlikovala se od one u kliniÄkim studijama; primjenjivan je infuzijski u dozi od 375 mg/m2 u svim ciklusima, u ukupno osam doza u prvoj, odnosno Å”est u kasnijim linijama lijeÄenja. Na lijeÄenje je odgovorilo 95% bolesnika, a 83% postignulo je kompletnu remisiju. TrogodiÅ”nje preživljenje i preživljenje bez progresije bolesti u prvoj liniji lijeÄenja (29 bolesnika) bilo je 90 i 80%, a u kasnijim linijama 86 i 62%. TeÅ”ke neutropenije zabilježene su u 46% bolesnika, a teÅ”ke infekcije u 9% bolesnika. Ishodi lijeÄenja i toksiÄni profil u svakodnevnome kliniÄkom radu usporedivi su s onima iz kliniÄkih studijaIn clinical trials the combination of fludarabine, cyclophosphamide and rituximab (FCR) demonstrated superior results and became the gold standard for first-line treatment of fit patients with chronic lymphocytic leukemia (CLL). The aim of this study was to evaluate the efficacy, toxicity and feasibility of this protocol in everyday clinical practice. We Āretrospectively analyzed the outcomes of 43 CLL patients treated at the Division of Haematology, Department of Internal Medicine, University Hospital Centre Zagreb. The dosing of rituximab differed from that in clinical trials, we administered 375mg/m2 of rituximab per cycle, in previously untreated patients for eight and in relapsed/refractory patients for six cycles. The response rate was 95% with 83% of complete remissions. Twentyānine patients received FCR as a frontāline therapy; three-year overall and progressionāfree survival were 90% and 80%, respectively. In relapsed/refractory disease threeāyear overall and progressionāfree survival were 86% and 62%, respectively. Severe neutropenias occurred in 46% and serious infections in 9% of patients. According to these results, the toxicity profile and treatment outcomes in everyday routine clinical practice are similar to those reported in clinical trials
Fludarabin, ciklofosfamid i rituksimab (FCR) u lijeÄenju bolesnika s kroniÄnom limfocitnom leukemijom (KLL): iskustvo KliniÄkoga bolniÄkog centra Zagreb [Fludarabine, cyclophosphamide and rituximab (FCR) in the treatment of chronic lymphocytic leukemia (CLL): University Hospital Centre Zagreb experience]
In clinical trials the combination of fludarabine, cyclophosphamide and rituximab (FCR) demonstrated superior results and became the gold standard for first-line treatment of fit patients with chronic lymphocytic leukemia (CLL). The aim of this study was to evaluate the efficacy, toxicity and feasibility of this protocol in everyday clinical practice. We Āretrospectively analyzed the outcomes of 43 CLL patients treated at the Division of Haematology, Department of Internal Medicine, University Hospital Centre Zagreb. The dosing of rituximab differed from that in clinical trials, we administered 375mg/m2 of rituximab per cycle, in previously untreated patients for eight and in relapsed/refractory patients for six cycles. The response rate was 95% with 83% of complete remissions. Twentyānine patients received FCR as a frontāline therapy; three-year overall and progressionāfree survival were 90% and 80%, respectively. In relapsed/refractory disease threeāyear overall and progressionāfree survival were 86% and 62%, respectively. Severe neutropenias occurred in 46% and serious infections in 9% of patients. According to these results, the toxicity profile and treatment outcomes in everyday routine clinical practice are similar to those reported in clinical trials
Non-Myelofibrosis Chronic Myeloproliferative Neoplasm Patients Show Better Seroconversion Rates after SARS-CoV-2 Vaccination Compared to Other Hematologic Diseases: A Multicentric Prospective Study of KroHem
Disease- and treatment-mediated immunodeficiency might render SARS-CoV-2 vaccines less effective in patients with hematologic diseases. We performed a prospective non-interventional study to evaluate humoral response after one and two doses of mRNA-1273, BNT162b2, or ChAdOx1 nCoV-19 vaccine in 118 patients with different malignant or non-malignant hematologic diseases from three Croatian treatment centers. An electrochemiluminescent assay was used to measure total anti-SARS-CoV-2 S-RBD antibody titers. After one vaccine dose, 20/66 (33%) achieved seropositivity with a median antibody titer of 6.1 U/mL. The response rate (58/90, 64.4%) and median antibody titer (>250 U/mL) were higher after two doses. Seropositivity varied with diagnosis (overall p 67 years, non-Hodgkinās lymphoma, active treatment, and anti-CD20 monoclonal antibody therapy increased the likelihood of no vaccine response, while hematopoietic stem cell recipients were more likely to respond. Age and anti-CD20 monoclonal antibody therapy remained associated with no response in a multivariable model. Patients with the hematologic disease have attenuated responses to SARS-CoV-2 vaccines, and significant variations in different disease subgroups warrant an individualized approach