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  • Kolstad, ArneOslo Univ Hosp, Radiumhospitalet, Dept Oncol, Oslo, Norway.,Oslo university hospital (author)

Molecular Monitoring after Autologous Stem Cell Transplantation and Preemptive Rituximab Treatment of Molecular Relapse; Results from the Nordic Mantle Cell Lymphoma Studies (MCL2 and MCL3) with Median Follow-Up of 8.5 Years

  • Article/chapterEnglish2017

Publisher, publication year, extent ...

  • ELSEVIER SCIENCE INC,2017
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-320346
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-320346URI
  • https://doi.org/10.1016/j.bbmt.2016.12.634DOI
  • https://lup.lub.lu.se/record/d70232ac-cf9d-457b-b290-0dcef083f33aURI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:135391140URI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Written for the Nordic Lymphoma Group
  • The main objectives of the present study were to monitor minimal residual disease (MRD) in the bone marrow of patients with mantle cell lymphoma (MCL) to predict clinical relapse and guide preemptive treatment with rituximab. Among the patients enrolled in 2 prospective trials by the Nordic Lymphoma Group, 183 who had completed autologous stem cell transplantation (ASCT) and in whom an MRD marker had been obtained were included in our analysis. Fresh samples of bone marrow were analyzed for MRD by a combined standard nested and quantitative real-time PCR assay for Bcl-1/immunoglobulin heavy chain gene (IgH) and clonal IgH rear-rangements. Significantly shorter progression-free survival (PFS) and overall survival (OS) was demonstrated for patients who were MRD positive pre-ASCT (54 patients) or in the first analysis post-ASCT (23 patients). The median PFS was only 20 months in those who were MRD-positive in the first sample post-ASCT, compared with 142 months in the MRD-negative group (P <.0001). OS was 75% at 10 years and median not reached in the MRD-negative group, compared with only 35 months in the MRD-positive group (P <.0001). Of the 86 patients (47%) who remained in continuous molecular remission, 73% were still in clinical remission after 10 years. For all patients, the median time from ASCT to first molecular relapse was 55 months, with a continuous occurrence of late molecular relapses. Fifty-eight patients who experienced MRD relapse received rituximab as preemptive treatment on 1 or more occasions, and in this group, the median time from first molecular relapse to clinical relapse was 55 months. In most cases, rituximab converted patients to MRD negativity (87%), but many patients became MRD-positive again later during follow-up (69%). By multivariate analysis, high-risk Mantle Cell Lymphoma International Prognostic Index score and positive MRD status pre-ASCT predicted early molecular relapse. In conclusion, preemptive rituximab treatment converts patients to MRD negativity and likely postpones clinical relapse. Molecular monitoring offers an opportunity to select some patients for therapeutic intervention and to avoid unnecessary treatment in others. MRD-positive patients in the first analysis post-ASCT have a dismal prognosis and thus are in need of novel strategies.

Subject headings and genre

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  • Pedersen, Lone BredoCopenhagen Univ Hosp, Rigshospitalet, Dept Hematol, Copenhagen, Denmark.,Copenhagen University Hospital (author)
  • Eskelund, Christian W.Copenhagen Univ Hosp, Rigshospitalet, Dept Hematol, Copenhagen, Denmark.,Copenhagen University Hospital (author)
  • Husby, SimonCopenhagen Univ Hosp, Rigshospitalet, Dept Hematol, Copenhagen, Denmark.,Copenhagen University Hospital (author)
  • Gronbaek, KirstenCopenhagen Univ Hosp, Rigshospitalet, Dept Hematol, Copenhagen, Denmark. (author)
  • Jerkeman, MatsLund University,Lunds universitet,Tumörmikromiljö,Sektion I,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Tumor microenvironment,Section I,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital(Swepub:lu)onk-mje (author)
  • Laurell, AnnaUppsala universitet,Experimentell och klinisk onkologi,Uppsala University Hospital(Swepub:lu)onk-ala (author)
  • Raty, RiikkaUniv Helsinki, Cent Hosp, Dept Hematol & Oncol, Helsinki, Finland.,Helsinki University Central Hospital (author)
  • Elonen, ErkkiKarolinska Institutet (author)
  • Andersen, Niels SmedegaardCopenhagen Univ Hosp, Rigshospitalet, Dept Hematol, Copenhagen, Denmark.,Copenhagen University Hospital (author)
  • Brown, Peter deNullyCopenhagen Univ Hosp, Rigshospitalet, Dept Hematol, Copenhagen, Denmark.,Copenhagen University Hospital (author)
  • Kimby, EvaKarolinska Institutet (author)
  • Bentzen, HansAarhus Univ Hosp, Dept Hematol, DK-8000 Aarhus, Denmark.,Aarhus University Hospital (author)
  • Sundström, ChristerUppsala universitet,Klinisk och experimentell patologi,Department of Pathology, Uppsala University Hospital, Uppsala, Sweden.,Rose-Marie Amini(Swepub:uu)chrisund (author)
  • Ehinger, MatsLund University,Lunds universitet,Uppsala universitet,Institutionen för immunologi, genetik och patologi,Tumörmikromiljö,Sektion I,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Tumor microenvironment,Section I,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital(Swepub:lu)efor-meh (author)
  • Karjalainen-Lindsberg, Marja-LiisaSkane Univ Hosp, Dept Pathol, Lund, Sweden.,Helsinki University Central Hospital (author)
  • Delabie, JanHelsinki Univ Cent Hosp, Dept Pathol, Helsinki, Finland.,Oslo university hospital (author)
  • Ralfkiaer, ElisabethCopenhagen Univ Hosp, Rigshospitalet, Dept Hematol, Copenhagen, Denmark.;Oslo Univ Hosp, Dept Pathol, Oslo, Norway.,Copenhagen University Hospital (author)
  • Fagerli, Unn-MereteCopenhagen Univ Hosp, Rigshospitalet, Dept Pathol, Copenhagen, Denmark.,St. Olav’s University Hospital (author)
  • Nilsson-Ehle, HermanSt Olavs Univ Hosp, Dept Oncol, Trondheim, Norway.,Sahlgrenska University Hospital (author)
  • Lauritzsen, Grete FossumOslo Univ Hosp, Radiumhospitalet, Dept Oncol, Oslo, Norway.,Oslo university hospital (author)
  • Kuittinen, OutiSahlgrens Univ Hosp, Dept Hematol, Gothenburg, Sweden. Oulu Univ Hosp, Dept Oncol, Oulu, Finland.,Oulu University Hospital (author)
  • Niemann, CarstenCopenhagen Univ Hosp, Rigshospitalet, Dept Hematol, Copenhagen, Denmark.,Copenhagen University Hospital (author)
  • Geisler, Christian HartmanCopenhagen Univ Hosp, Rigshospitalet, Dept Hematol, Copenhagen, Denmark.,Copenhagen University Hospital (author)
  • Grønbæk, KirstenCopenhagen University Hospital (author)
  • Oslo Univ Hosp, Radiumhospitalet, Dept Oncol, Oslo, Norway.Oslo university hospital (creator_code:org_t)

Related titles

  • In:Biology of blood and marrow transplantation: ELSEVIER SCIENCE INC23:3, s. 428-4351083-87911523-6536

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