Leukemia & lymphoma
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Leukemia & lymphoma · Mar 2020
Changing landscape of frontline therapy in chronic lymphocytic leukemia.
The therapeutic landscape for chronic lymphocytic leukemia has significantly evolved in recent years as our understanding of the biology of this disease has advanced. Chemoimmunotherapy has been the standard frontline treatment for patients of all age groups with chronic lymphocytic leukemia over the last decade. ⋯ The advent of novel small-molecule therapy for the treatment of chronic lymphocytic leukemia targeting the B-cell receptor signaling pathway has dramatically changed the therapeutic landscape with recent studies establishing ibrutinib, a Bruton's tyrosine kinase inhibitor, as the frontline treatment of choice regardless of patient's age, performance status or risk-category. Although these current advances along with the approval of other newer agents for the treatment of chronic lymphocytic leukemia is a significant step forward, newer challenges have emerged on how to best utilize these new treatment options.
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Leukemia & lymphoma · Oct 2019
Procalcitonin as a marker of Gram-negative bloodstream infections in hematological patients with febrile neutropenia.
The aim of this study was to explore the predictive value of procalcitonin (PCT) in Gram-negative bloodstream infections (BSIs) in hematological patients with febrile neutropenia. A total of 1466 samples (396 blood culture (BC)-positive, 1052 BC-negative, and 18 contaminated specimens) were included, comprising 268 Gram-negative, 88 Gram-positive, 19 fungal, and 21 polymicrobial BSIs. ⋯ PCT levels were significantly higher in BSIs from multidrug-resistant (MDR) Gram-negative strains than from non-MDR (p < .01). This study confirms that elevated PCT may predict Gram-negative BSIs in hematological patients with febrile neutropenia, and demonstrates higher PCT levels in MDR Gram-negative BSIs in these patients.
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Leukemia & lymphoma · Jul 2019
Meta AnalysisThe magnitude of improvement in progression-free survival with targeted therapy in relapsed/refractory chronic lymphocytic leukemia based on prognostic risk category: a systematic review and meta-analysis.
Chronic lymphocytic leukemia (CLL) guidelines highlight the relevance of cytogenetic and molecular testing to identify patients with high-risk genetic features. However, at the moment, only 17p del/TP53 mutation are universally recognized parameters influencing choice of therapy. ⋯ Meta-analysis of seven randomized trials comprising 2409 patients with R/R CLL revealed that improvement over traditional treatments observed with BCR or BCL2 pathway inhibitors is common to all patients, including those patients with unfavorable and favorable prognostic parameters. These findings provide quantitative evidence to support the choice of therapy in R/R CLL not solely on the basis of 17p del/TP53 mutations.