| 1. |
- Eichhorst, B., et al.
(författare)
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First-Line Venetoclax Combinations in Chronic Lymphocytic Leukemia.
- 2023
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Ingår i: New England Journal of Medicine. - : MASSACHUSETTS MEDICAL SOC. - 0028-4793 .- 1533-4406. ; 388:19, s. 1739-1754
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Tidskriftsartikel (refereegranskat)abstract
- Background Randomized trials of venetoclax plus anti-CD20 antibodies as first-line treatment in fit patients (i.e., those with a low burden of coexisting conditions) with advanced chronic lymphocytic leukemia (CLL) have been lacking. Methods In a phase 3, open-label trial, we randomly assigned, in a 1:1:1:1 ratio, fit patients with CLL who did not have TP53 aberrations to receive six cycles of chemoimmunotherapy (fludarabine-cyclophosphamide-rituximab or bendamustine-rituximab) or 12 cycles of venetoclax-rituximab, venetoclax-obinutuzumab, or venetoclax-obinutuzumab-ibrutinib. Ibrutinib was discontinued after two consecutive measurements of undetectable minimal residual disease or could be extended. The primary end points were undetectable minimal residual disease (sensitivity,
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| 2. |
- Giebel, Sebastian, et al.
(författare)
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The prophylactic use of granulocyte-colony stimulating factor during remission induction is associated with increased leukaemia-free survival of adults with acute lymphoblastic leukaemia : A joint analysis of five randomised trials on behalf of the EWALL
- 2012
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Ingår i: European Journal of Cancer. - : Elsevier BV. - 0959-8049 .- 1879-0852. ; 48:3, s. 360-367
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Granulocyte-colony stimulating factor (G-CSF) is used to prevent febrile neutropenia and support intense chemotherapy. However, its impact on long-term outcome in oncological patients including adults with acute lymphoblastic leukaemia (ALL) has not been determined so far.METHODS: In the current study follow-up data from individual patients recruited in five multicentre, prospective, randomised trials were pooled to perform a joint analysis. Among 347 adults and adolescents with ALL, 185 were assigned to receive prophylactically G-CSF along with induction chemotherapy while 162 patients were treated without G-CSF support.RESULTS:With the median follow-up of 5.3years, there was a tendency towards increased 5year probability of the overall survival for the G-CSF arm compared to the controls (32%±4% versus 23%±4%, p=.07), which reached statistical significance in a subgroup of T-ALL (51%±8% versus 29%±9%, p=.01) and among patients aged 21-40years (44%±6% versus 27%±6%, p=.03). The probability of leukaemia-free survival was 38%±4% and 24%±4% (p=.01) while the median remission duration equalled 33 and 17months (p=.007), respectively. In a multivariate analysis the prophylactic use of G-CSF was independently associated with reduced risk of relapse (hazard ratio (HR)=.64, p=.007) and treatment failure (HR=.67, p=.02).CONCLUSIONS:The prophylactic use of G-CSF during induction of ALL is associated with improved long-term outcome and should be recommended especially in a setting of T-ALL and in 'young adults'. Our analysis provides the first direct evidence coming from prospective trials for the impact of primary G-CSF prophylaxis on disease-free survival of oncological patients.
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| 3. |
- Gui, W. F., et al.
(författare)
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Colitis ameliorates cholestatic liver disease via suppression of bile acid synthesis
- 2023
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Ingår i: Nature Communications. - 2041-1723. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease characterized by chronic inflammation and progressive fibrosis of the biliary tree. The majority of PSC patients suffer from concomitant inflammatory bowel disease (IBD), which has been suggested to promote disease development and progression. However, the molecular mechanisms by which intestinal inflammation may aggravate cholestatic liver disease remain incompletely understood. Here, we employ an IBD-PSC mouse model to investigate the impact of colitis on bile acid metabolism and cholestatic liver injury. Unexpectedly, intestinal inflammation and barrier impairment improve acute cholestatic liver injury and result in reduced liver fibrosis in a chronic colitis model. This phenotype is independent of colitis-induced alterations of microbial bile acid metabolism but mediated via hepatocellular NF-kappa B activation by lipopolysaccharide (LPS), which suppresses bile acid metabolism in-vitro and in-vivo. This study identifies a colitis-triggered protective circuit suppressing cholestatic liver disease and encourages multi-organ treatment strategies for PSC.
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| 4. |
- Jaeger, Julius W., et al.
(författare)
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Microbiota modulation by dietary oat beta-glucan prevents steatotic liver disease progression
- 2024
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Ingår i: JHEP Reports. - 2589-5559. ; 6:3
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Tidskriftsartikel (refereegranskat)abstract
- Background & Aims: Changes in gut microbiota in metabolic dysfunction-associated steatotic liver disease (MASLD) are important drivers of disease progression towards fibrosis. Therefore, reversing microbial alterations could ameliorate MASLD progression. Oat beta-glucan, a non-digestible polysaccharide, has shown promising therapeutic effects on hyperlipidemia associated with MASLD, but its impact on gut microbiota and most importantly MASLD-related fibrosis remains unknown. Methods: We performed detailed metabolic phenotyping, including assessments of body composition, glucose tolerance, and lipid metabolism, as well as comprehensive characterization of the gut-liver axis in a western-style diet (WSD)-induced model of MASLD and assessed the effect of a beta-glucan intervention on early and advanced liver disease. Gut microbiota were modulated using broad-spectrum antibiotic treatment. Results: Oat beta-glucan supplementation did not affect WSD-induced body weight gain or glucose intolerance and the metabolic phenotype remained largely unaffected. Interestingly, oat beta-glucan dampened MASLD-related inflammation, which was associated with significantly reduced monocyte-derived macrophage infiltration and fibroinflammatory gene expression, as well as strongly reduced fibrosis development. Mechanistically, this protective effect was not mediated by changes in bile acid composition or signaling, but was dependent on gut microbiota and was lost upon broad-spectrum antibiotic treatment. Specifically, oat beta-glucan partially reversed unfavorable changes in gut microbiota, resulting in an expansion of protective taxa, including Ruminococcus, and Lactobacillus followed by reduced translocation of Toll-like receptor ligands. Conclusions: Our findings identify oat beta-glucan as a highly efficacious food supplement that dampens inflammation and fibrosis development in diet-induced MASLD. These results, along with its favorable dietary profile, suggest that it may be a cost-effective and well-tolerated approach to preventing MASLD progression and should be assessed in clinical studies. Impact and Implications: Herein, we investigated the effect of oat beta-glucan on the gut-liver axis and fibrosis development in a mouse model of metabolic dysfunction-associated steatotic liver disease (MASLD). Beta-glucan significantly reduced inflammation and fibrosis in the liver, which was associated with favorable shifts in gut microbiota that protected against bacterial translocation and activation of fibroinflammatory pathways. Together, oat beta-glucan may be a cost-effective and well-tolerated approach to prevent MASLD progression and should be assessed in clinical studies.
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| 5. |
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| 6. |
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| 7. |
- Pfreundschuh, Michael, et al.
(författare)
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Prognostic significance of maximum tumour (bulk) diameter in young patients with good-prognosis diffuse large-B-cell lymphoma treated with CHOP-like chemotherapy with or without rituximab: an exploratory analysis of the MabThera International Trial Group (MInT) study
- 2008
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Ingår i: The Lancet Oncology. - 1474-5488. ; 9:5, s. 435-444
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Tidskriftsartikel (refereegranskat)abstract
- Background The definition and role of bulky disease in young patients (ie, aged 18-60 years) with good-prognosis diffuse large-B-cell lymphoma (DLBCL), who have been treated with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone)-like chemotherapy with or without rituximab, remain controversial. We aimed to assess the effect of maximum tumour diameter (MTD) in these patients. Methods Patients from the MInT (Mabthera International Trial Group) study were eligible. We analysed event-free (EFS) and overall survival (OS) after CHOP-like chemotherapy with or without rituximab, according to MTD, by Martingale residual analyses and Cox regression models. Radiotherapy was given to sites of primary bulky disease according to national standards, and to primary extranodal disease at physician discretion. The primary endpoint was EFS and the secondary endpoint was OS. Analyses were by intention to treat. This trial is registered with ClinicalTrials. gov, number NCT 00064116. Findings Of the 824 patients enrolled in the MInT study, the informed-consent form of one patient was missing, leaving 823 patients evaluable for intention-to-treat analysis. Data on MTD of involved sites were available for 802 patients. Martingale residual analysis showed an adverse prognostic effect of MTD on EFS and OS, which increased linearly. In a multivariable analysis with MTD as a linear regression variable, the effect of MTD was significant after CHOP-like treatment alone for EFS (hazard ratio 1.090 [95% CI 1.051-1-130], p<0.0001) and OS (1-119 [1-057-1-184], p=0.0001), and after CHOP-like treatment and rituximab for OS (1-089 [1-003-1-183],p=0.043), but not for EFS (1-044 [0-991-1-099], p=0.103). For CHOP-like treatment alone, 3-year EFS ranged from 78-2% (MTD <5.0 cm, 95% CI 68.3-85.4) to 41.3% (MTD >= 10.0 cm, 31.8-50.4). For CHOP-like treatment and rituximab, 3-year EFS ranged from 83.2% (MTD <5.0 cm, 72.8-89.9) to 72.7% (MTD >= 10.0 cm, 63.8-79.7). With CHOP-like treatment alone, 3-year OS decreased from 92.9% (MTD <5.0 cm, 84.9-96.8) to 73.5% (MTD >= 10.0 cm, 63.9-81.0); for CHOP-like treatment and rituximab, 3-year OS decreased from 98.0% (MTD <5.0 cm, 92.2-99.5) to 85.2% (MTD >= 10.0 cm, 77.0-90.6). For CHOP-like treatment, any cut-off point between 5.0 cm and 10.0 cm separated two populations with a significant EFS difference (p<0.0001 for all log-rank tests) and OS difference (p <= 0.003 for all log-rank tests). For CHOP-like treatment and rituximab, only a cut-off point of 10.0 cm separated two populations with a significant EFS difference (log-rank p=0.047), but any cut-off point of 6.0 cm or more separated two populations with a significant OS difference (log-rank p values 0.0009-0.037). Interpretation Rituximab decreased, but did not eliminate the adverse prognostic effect of MTD in young patients with good-prognosis DLBCL. Due to the linear prognostic effect of MTD on outcome, arbitrary cut-off points for bulky disease can be set between 5.0 cm and 10.0 cm, depending on clinical considerations. Based on this study, a cut-off point of 10.0 cm might be a suitable margin in the rituximab era to delineate those patients with bulky disease. Funding Roche, Basel, Switzerland (M39045).
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| 8. |
- Schlotthauer, Tina, et al.
(författare)
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A multidonor-photosensitizer-multiacceptor triad for long-lived directional charge separation
- 2017
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Ingår i: Physical Chemistry, Chemical Physics - PCCP. - : Royal Society of Chemistry (RSC). - 1463-9076 .- 1463-9084. ; 19:42, s. 28572-28578
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Tidskriftsartikel (refereegranskat)abstract
- The modular assembly of a directional photoredox-active multidonor-photosensitizer-multiacceptor (Dn-P-A(m)) architecture is presented. The triad assembly features a central Ru(II) sensitizer equipped with pendant polymer chains consisting of multiple triarylamine (pTARA) and naphthalene diimide (pNDI) units, respectively. Upon excitation, the efficient formation (496%) of charge separation (CS) was observed featuring similar CS lifetimes (400 ns) as related molecular triads. In contrast, a significant additional longer-lived CS component (2400 ns, 30%) is observed indicating multiple contributing pathways.
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| 9. |
- Schlotthauer, Tina, et al.
(författare)
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Aryl-Decorated Ru-II Polypyridyl-type Photosensitizer Approaching NIR Emission with Microsecond Excited State Lifetimes
- 2016
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Ingår i: Inorganic Chemistry. - : American Chemical Society (ACS). - 0020-1669 .- 1520-510X. ; 55:11, s. 5405-5416
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Tidskriftsartikel (refereegranskat)abstract
- Bis-tridentate Ru-II complexes based on the dqp scaffold (dqp is 2,6-di(quinolin-8-yl)pyridine) with multiple aryl substituents were explored to tailor the absorption and emission properties. A synthetic methodology was developed for the facile synthesis and purification of homo- and heteroleptic bis-tridentate Ru complexes. The effect of the aryl substituents in the para positions of the pyridine and quinoline subunits was detailed by X-ray crystallography, steady state and time-resolved spectroscopy, electrochemistry, and computational methods. The attachment of the aryl groups results in enhanced molar extinction coefficients with the largest effect in the pyridine position, whereas the quinoline substituent leads to red-shifted emission tailing into the NIR region (up to 800 nm). Notably, the excited state lifetimes remain in the microsecond time scale even in the presence of O-2, whereas the emission quantum yields are slightly increased with respect to the parental complex [Ru(dqp)(2)](2+). The peripheral functional groups (Br, Me, OMe) have only a minor impact on the optical properties and are attractive to utilize such complexes as functional building blocks.
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| 10. |
- Schlotthauer, Tina, et al.
(författare)
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Asymmetric Cyclometalated RuII Polypyridyl-Type Complexes with Π-Extended Carbanionic Donor Sets
- 2017
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Ingår i: Inorganic Chemistry. - : American Chemical Society (ACS). - 0020-1669 .- 1520-510X. ; 56:14, s. 7720-7730
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Tidskriftsartikel (refereegranskat)abstract
- A series of novel cyclometalated Ru-II complexes were investigated featuring the tridentate dqp ligand platform (dqp is 2,6-di(quinolin-8-yl)pyridine), in order to utilize the octahedral coordination mode around the Ru center to modulate the electrochemical and photophysical properties. The heteroleptic complexes feature C-1 symmetry due to symmetry breaking by the peripheral five- or six-membered carbanionic chelate (phenyl, naphthyl, or anthracenyl units). The chelation mode is controlled by the steric effects and C-H activation selectivity of the ligand, which prompted the development of a general synthesis protocol. The optimized conditions to achieve high overall yields (55-75%) involve NaHCO3 as the base and an simplified purification protocol: i.e., facile chromatographic separation using commercially available amino-functionalized silica applying nonaqueous salt-free conditions to omit the necessity of counterion exchange. The structural, photophysical, and electrochemical properties were studied in depth, and the results were corroborated by density functional theory (DFT) calculations. Steady state and time-resolved spectroscopy revealed red-shifted absorption (up to 750 run) and weak IR emission (800-1000 nm) combined with prolonged emission lifetimes (up to 20 ns) in comparison to classical tpy-based (tpy is 2,2':6',2 ''-terpyridine) complexes. An enhanced stability was observed by blocking the reactive positions of the carbanionic ligand framework, while the reactive positions may be exploited for further functionalization.
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