1.Plasma cell leukemia in North India: retrospective analysis of a distinct clinicohematological entity from a tertiary care center and review of literature.
Karthik BOMMANNAN ; Man Updesh Singh SACHDEVA ; Pankaj MALHOTRA ; Narender KUMAR ; Prashant SHARMA ; Shano NASEEM ; Jasmina AHLUWALIA ; Reena DAS ; Neelam VARMA ; Gaurav PRAKASH ; Alka KHADWAL ; Radhika SRINIVASAN ; Subhash VARMA
Blood Research 2016;51(1):23-30
BACKGROUND: Plasma cell leukemia (PCL) is a rare and aggressive plasma cell neoplasm. In PCL, clonal plasma cells comprise ≥20% of the peripheral blood (PB) leukocytes and/or the absolute clonal PB plasma cell count is ≥2×10(9)/L. Primary PCL (PPCL) originates de novo, whereas, secondary PCL (SPCL) evolves from pre-existing multiple myeloma. METHODS: Clinicohematological features, immunophenotypic profile, and survival of PCL patients were analyzed retrospectively. RESULTS: Between January 2007 and December 2014, ten PPCL and four SPCL patients were investigated (8 PPCLs and 3 SPCLs had complete clinical data). All were North Indians, sharing common geography and ethnicity. Our cohort showed less frequent renal failure, more frequent hepatomegaly, and non-secretory type disease. In contrast to western literature, flow cytometric immunophenotyping of our cohort revealed altered expression of CD138 (67%), CD56 (33%), and CD20 (0%). With novel therapeutic agents, these PPCL patients had a median overall survival of 15 months. CONCLUSION: We highlight that our PPCL patients from North India had distinct clinicohematological and immunophenotypic profiles. The significance of our findings must be tested in a larger patient cohort and must be supported by molecular and cytogenetic investigations to unmask possible significant effects on pathogenesis.
Cohort Studies
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Cytogenetics
;
Geography
;
Hepatomegaly
;
Humans
;
Immunophenotyping
;
India*
;
Leukemia, Plasma Cell*
;
Leukocytes
;
Multiple Myeloma
;
Neoplasms, Plasma Cell
;
Plasma Cells*
;
Plasma*
;
Renal Insufficiency
;
Retrospective Studies*
;
Tertiary Care Centers*
;
Tertiary Healthcare*
2.Bendamustine in combination with ifosfamide, etoposide, and vinorelbine (VIBE) is an effective salvage regimen for heavily pre-treated patients with relapsed or refractory Hodgkin lymphoma:a single-center experience
Gaurav PRAKASH ; Arihant JAIN ; Kamalkant SAHU ; Amanjit BAL ; Charanpreet SINGH ; Rajender BASHER ; Harmandeep SINGH ; Kundan MISHRA ; Aditya JANDIAL ; Deepesh LAD ; Alka KHADWAL ; Radhika SRINIVASAN ; Ashim DAS ; Neelam VARMA ; Subhash VARMA ; Pankaj MALHOTRA
Blood Research 2021;56(3):134-140
Background:
This study evaluated the outcomes of patients with refractory/relapsed Hodgkin lymphoma (RRHL) treated with a bendamustine-based regimen in combination with ifosfamide, etoposide, and vinorelbine (VIBE).
Methods:
Consecutive RRHL patients who were treated with the VIBE regimen were identified and studied for clinicopathologic characteristics, response to VIBE regimen, event-free survival (EFS), and feasibility of an autologous stem-cell transplant (autoSCT).
Results:
In total, 24 patients received the VIBE regimen, and a median of 3 cycles were administered. In this cohort, 80% of the patients had received ≥2 prior lines of therapy. The overall and complete response rates with VIBE were 79% and 42%, respectively. After a median follow-up (following VIBE regimen) of 14 months (range, 3‒76), the 3-year EFS and OS were 46% and 74%, respectively. Of the eligible patients, 92% underwent successful AutoSCT. The mean CD34+ cell count in the autograft was 5.5×106/kg (SD 2.07). Neutropenia was the commonest hematologic toxicity and it was observed in 42% of the patients. However, only 9% of the patients developed grade III/IV febrile neutropenia. Chemotherapy-induced nausea and vomiting were the second most common grade III/IV toxicities in our cohort of patients.
Conclusion
In this retrospective analysis, the combination regimen, VIBE, has shown good efficacy in heavily pre-treated patients with RRHL without compromising stem cell collection. These encouraging results provide a rationale for further development of this regimen.
3.Bendamustine in combination with ifosfamide, etoposide, and vinorelbine (VIBE) is an effective salvage regimen for heavily pre-treated patients with relapsed or refractory Hodgkin lymphoma:a single-center experience
Gaurav PRAKASH ; Arihant JAIN ; Kamalkant SAHU ; Amanjit BAL ; Charanpreet SINGH ; Rajender BASHER ; Harmandeep SINGH ; Kundan MISHRA ; Aditya JANDIAL ; Deepesh LAD ; Alka KHADWAL ; Radhika SRINIVASAN ; Ashim DAS ; Neelam VARMA ; Subhash VARMA ; Pankaj MALHOTRA
Blood Research 2021;56(3):134-140
Background:
This study evaluated the outcomes of patients with refractory/relapsed Hodgkin lymphoma (RRHL) treated with a bendamustine-based regimen in combination with ifosfamide, etoposide, and vinorelbine (VIBE).
Methods:
Consecutive RRHL patients who were treated with the VIBE regimen were identified and studied for clinicopathologic characteristics, response to VIBE regimen, event-free survival (EFS), and feasibility of an autologous stem-cell transplant (autoSCT).
Results:
In total, 24 patients received the VIBE regimen, and a median of 3 cycles were administered. In this cohort, 80% of the patients had received ≥2 prior lines of therapy. The overall and complete response rates with VIBE were 79% and 42%, respectively. After a median follow-up (following VIBE regimen) of 14 months (range, 3‒76), the 3-year EFS and OS were 46% and 74%, respectively. Of the eligible patients, 92% underwent successful AutoSCT. The mean CD34+ cell count in the autograft was 5.5×106/kg (SD 2.07). Neutropenia was the commonest hematologic toxicity and it was observed in 42% of the patients. However, only 9% of the patients developed grade III/IV febrile neutropenia. Chemotherapy-induced nausea and vomiting were the second most common grade III/IV toxicities in our cohort of patients.
Conclusion
In this retrospective analysis, the combination regimen, VIBE, has shown good efficacy in heavily pre-treated patients with RRHL without compromising stem cell collection. These encouraging results provide a rationale for further development of this regimen.