1.Outcomes in Refractory Diffuse Large B-Cell Lymphoma: Results from Two Prospective Korean Cohorts
Jun Ho YI ; Seong Hyun JEONG ; Seok Jin KIM ; Dok Hyun YOON ; Hye Jin KANG ; Youngil KOH ; Jin Seok KIM ; Won-Sik LEE ; Deok-Hwan YANG ; Young Rok DO ; Min Kyoung KIM ; Kwai Han YOO ; Yoon Seok CHOI ; Whan Jung YUN ; Yong PARK ; Jae-Cheol JO ; Hyeon-Seok EOM ; Jae-Yong KWAK ; Ho-Jin SHIN ; Byeong Bae PARK ; Seong Yoon YI ; Ji-Hyun KWON ; Sung Yong OH ; Hyo Jung KIM ; Byeong Seok SOHN ; Jong Ho WON ; Dae-Sik HONG ; Ho-Sup LEE ; Gyeong-Won LEE ; Cheolwon SUH ; Won Seog KIM
Cancer Research and Treatment 2023;55(1):325-333
Purpose:
Diffuse large B-cell lymphoma (DLBCL) is the most common hematologic malignancy worldwide. Although substantial improvement has been achieved by the frontline rituximab-based chemoimmunotherapy, up to 40%-50% of patients will eventually have relapsed or refractory disease, whose prognosis is extremely dismal.
Materials and Methods:
We have carried out two prospective cohort studies that include over 1,500 DLBCL patients treated with rituximab plus CHOP (#NCT01202448 and #NCT02474550). In the current report, we describe the outcomes of refractory DLBCL patients. Patients were defined to have refractory DLBCL if they met one of the followings, not achieving at least partial response after 4 or more cycles of R-CHOP; not achieving at least partial response after 2 or more cycles of salvage therapy; progressive disease within 12 months after autologous stem cell transplantation.
Results:
Among 1,581 patients, a total of 260 patients met the criteria for the refractory disease after a median time to progression of 9.1 months. The objective response rate of salvage treatment was 26.4%, and the complete response rate was 9.6%. The median overall survival (OS) was 7.5 months (95% confidence interval, 6.4 to 8.6), and the 2-year survival rate was 22.1%±2.8%. The median OS for each refractory category was not significantly different (p=0.529).
Conclusion
In line with the previous studies, the outcomes of refractory DLBCL patients were extremely poor, which necessitates novel approaches for this population.
2.Current Treatment Patterns and the Role of Upfront Autologous Stem Cell Transplantation in Patients with Peripheral T-Cell Lymphoma: A Korean Nationwide, Multicenter Prospective Registry Study (CISL 1404)
Hyungwoo CHO ; Dok Hyun YOON ; Dong-Yeop SHIN ; Youngil KOH ; Sung-Soo YOON ; Seok Jin KIM ; Young Rok DO ; Gyeong-Won LEE ; Jae-Yong KWAK ; Yong PARK ; Min Kyoung KIM ; Hye Jin KANG ; Jun Ho YI ; Kwai Han YOO ; Won Sik LEE ; Byeong Bae PARK ; Jae Cheol JO ; Hyeon-Seok EOM ; Hyo Jung KIM ; Seong Hyun JEONG ; Young-Woong WON ; Byeong Seok SOHN ; Ji-Hyun KWON ; Cheolwon SUH ; Won Seog KIM
Cancer Research and Treatment 2023;55(2):684-692
Purpose:
We conducted a nationwide, multicenter, prospective registry study for newly diagnosed patients with peripheral T-cell lymphoma (PTCL) to better define the clinical characteristics, treatment patterns, survival outcomes, and the role of upfront autologous stem cell transplantation (ASCT) in these patients.
Materials and Methods:
Patients with PTCL receiving chemotherapy with curative intent were registered and prospectively monitored. All patients were pathologically diagnosed with PTCL.
Results:
A total of 191 patients with PTCL were enrolled in this prospective registry study. PTCL, not otherwise specified (PTCL-NOS) was the most common pathologic subtype (n=80, 41.9%), followed by angioimmunoblastic T-cell lymphoma (AITL) (n=60, 31.4%). With a median follow-up duration of 3.9 years, the 3-year progression-free survival (PFS) and overall survival (OS) rates were 39.5% and 60.4%, respectively. The role of upfront ASCT was evaluated in patients who were considered transplant-eligible (n=59). ASCT was performed as an upfront consolidative treatment in 32 (54.2%) of these patients. There were no significant differences in PFS and OS between the ASCT and non-ASCT groups for all patients (n=59) and for patients with PTCL-NOS (n=26). However, in patients with AITL, the ASCT group was associated with significantly better PFS than the non-ASCT group, although there was no significant difference in OS.
Conclusion
The current study demonstrated that the survival outcomes with the current treatment options remain poor for patients with PTCL-NOS. Upfront ASCT may provide a survival benefit for patients with AITL, but not PTCL-NOS.
3.Treatment pattern of chronic lymphocytic leukemia/small lymphocytic lymphoma in Korea: a multicenter retrospective study (KCSG LY20-06)
Jung Sun KIM ; Tae Min KIM ; Myoung Joo KANG ; Sung Ae KOH ; Hyunkyung PARK ; Seung-Hyun NAM ; Jae Joon HAN ; Gyeong-Won LEE ; Young Jin YUH ; Hee Jeong LEE ; Jung Hye CHOI
The Korean Journal of Internal Medicine 2023;38(5):747-757
Background/Aims:
Little attention is paid to chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) in Korea due to the rarity of the disease. With its rising incidence, we aimed to evaluate recent changes in treatment patterns and survival outcomes of patients with CLL/SLL.
Methods:
A total of 141 patients diagnosed with CLL/SLL between January 2010 and March 2020 who received systemic therapy were analyzed in this multicenter retrospective study.
Results:
The median patient age was 66 years at diagnosis, and 68.1% were male. The median interval from diagnosis to initial treatment was 0.9 months (range: 0–77.6 months), and the most common treatment indication was progressive marrow failure (50.4%). Regarding first-line therapy, 46.8% received fludarabine, cyclophosphamide, plus rituximab (FCR), followed by chlorambucil (19.9%), and obinutuzumab plus chlorambucil (GC) (12.1%). The median progression-free survival (PFS) was 49.3 months (95% confidence interval [CI], 32.7–61.4), and median overall survival was not reached (95% CI, 98.4 mo– not reached). Multivariable analysis revealed younger age (≤ 65 yr) (hazard ratio [HR], 0.46; p < 0.001) and first-line therapy with FCR (HR, 0.64; p = 0.019) were independently associated with improved PFS. TP53 aberrations were observed in 7.0% (4/57) of evaluable patients. Following reimbursement, GC became the most common therapy among patients over 65 years and second in the overall population after 2017.
Conclusions
Age and reimbursement mainly influenced treatment strategies. Greater effort to apply risk stratifications into practice and clinical trials for novel agents could help improve treatment outcomes in Korean patients.
4.Pegfilgrastim Prophylaxis Is Effective in the Prevention of Febrile Neutropenia and Reduces Mortality in Patients Aged ≥ 75 Years with Diffuse Large B-Cell Lymphoma Treated with R-CHOP: A Prospective Cohort Study
Seong Hyun JEONG ; Seok Jin KIM ; Dok Hyun YOON ; Yong PARK ; Hye Jin KANG ; Youngil KOH ; Gyeong-Won LEE ; Won-Sik LEE ; Deok-Hwan YANG ; Young Rok DO ; Min Kyoung KIM ; Kwai Han YOO ; Yoon Seok CHOI ; Hwan Jung YUN ; Jun Ho YI ; Jae-Cheol JO ; Hyeon-Seok EOM ; Jae-Yong KWAK ; Ho-Jin SHIN ; Byeong Bae PARK ; Shin Young HYUN ; Seong Yoon YI ; Ji-Hyun KWON ; Sung Yong OH ; Hyo Jung KIM ; Byeong Seok SOHN ; Jong Ho WON ; Se-Hyung KIM ; Ho-Sup LEE ; Cheolwon SUH ; Won Seog KIM
Cancer Research and Treatment 2022;54(4):1268-1277
Purpose:
Febrile neutropenia (FN) can cause suboptimal treatment and treatment-related mortality (TRM) in diffuse large B-cell lymphoma (DLBCL) patients treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP).
Materials and methods:
We conducted a prospective cohort study to evaluate the effectiveness of pegfilgrastim prophylaxis in DLBCL patients receiving R-CHOP, and we compared them with the PROCESS cohort (n=485).
Results:
Since January 2015, 986 patients with DLBCL were enrolled. Pegfilgrastim was administered at least once in 930 patients (94.3%), covering 90.3% of all cycles. FN developed in 137 patients (13.9%) in this cohort (23.7% in the PROCESS cohort, p<0.001), and 4.2% of all cycles (10.2% in the PROCESS cohort, p<0.001). Dose delay was less common (≥3 days: 18.1% vs. 23.7%, p=0.015; ≥5 days: 12.0% vs. 18.3%, p=0.023) in this cohort than in the PROCESS cohort. The incidence of TRM (3.2% vs. 5.6%, p=0.047) and infection-related death (1.8% vs. 4.5%, p=0.004) was lower in this cohort than in the PROCESS cohort. The 4-year overall survival (OS) and progression-free survival (PFS) rates of the two cohorts were not different (OS: 73.0% vs. 71.9%, p=0.545; PFS: 69.5% vs. 68.8%, p=0.616). However, in patients aged ≥75 years, the 4-year OS and PFS rates were higher in this cohort than in the PROCESS cohort (OS: 49.6% vs. 33.7%, p=0.032; PFS: 44.2% vs. 30.3% p=0.047).
Conclusion
Pegfilgrastim prophylaxis is effective in the prevention of FN and infection-related death in DLBCL patients receiving R-CHOP, and it also improves OS in patients aged ≥75 years.
5.Consensus Update for Systemic Treatment of Atopic Dermatitis
Ji Hyun LEE ; Jung Eun KIM ; Gyeong-Hun PARK ; Jung Min BAE ; Ji Yeon BYUN ; Min Kyung SHIN ; Tae Young HAN ; Seung Phil HONG ; Yong Hyun JANG ; Hye One KIM ; Chan Ho NA ; Bark-Lynn LEW ; JiYoung AHN ; Chang Ook PARK ; Young-Joon SEO ; Yang Won LEE ; Sang Wook SON ; Eung Ho CHOI ; Young Lip PARK ; Joo Young ROH
Annals of Dermatology 2021;33(6):497-514
Background:
In 2015, the Korean Atopic Dermatitis Association (KADA) working group published consensus guidelines for treating atopic dermatitis (AD).
Objective:
We aimed to provide updated consensus recommendations for systemic treatment of AD in South Korea based on recent evidence and experience.
Methods:
We compiled a database of references from relevant systematic reviews and guidelines on the systemic management of AD. Evidence for each statement was graded and classified based on thestrength of the recommendation. Forty-two council members from the KADA participated in three rounds of voting to establish a consensus on expert recommendations.
Results:
We do not recommend long-term treatment with systemic steroids forpatients with moderate-to-severe AD due to the risk of adverse effects. We recommend treatment with cyclosporine or dupilumab and selective treatment with methotrexate or azathioprine for patients with moderate-to-severe AD. We suggest treatment with antihistamines as an option for alleviating clinical symptoms of AD. We recommend selective treatment with narrowband ultraviolet B for patients with chronic moderate-to-severe AD. We do not recommend treatment with oral antibiotics for patients with moderate-to-severe AD but who have no signs of infection. We did not reach a consensus on recommendations for treatment with allergen-specific immunotherapy, probiotics, evening primrose oil, orvitamin D for patients with moderate-to-severe AD. We also recommend educational interventions and counselling for patients with AD and caregivers to improve the treatment success rate.
Conclusion
We look forward to implementing a new and updated consensus of systemic therapy in controlling patients with moderate-to-severe AD.
6.Standardized Pathology Report for Colorectal Cancer, 2nd Edition
Baek-hui KIM ; Joon Mee KIM ; Gyeong Hoon KANG ; Hee Jin CHANG ; Dong Wook KANG ; Jung Ho KIM ; Jeong Mo BAE ; An Na SEO ; Ho Sung PARK ; Yun Kyung KANG ; Kyung-Hwa LEE ; Mee Yon CHO ; In-Gu DO ; Hye Seung LEE ; Hee Kyung CHANG ; Do Youn PARK ; Hyo Jeong KANG ; Jin Hee SOHN ; Mee Soo CHANG ; Eun Sun JUNG ; So-Young JIN ; Eunsil YU ; Hye Seung HAN ; Youn Wha KIM ;
Journal of Pathology and Translational Medicine 2020;54(1):1-19
The first edition of the ‘Standardized Pathology Report for Colorectal Cancer,’ which was developed by the Gastrointestinal Pathology Study Group (GIP) of the Korean Society of Pathologists, was published 13 years ago. Meanwhile, there have been many changes in the pathologic diagnosis of colorectal cancer (CRC), pathologic findings included in the pathology report, and immunohistochemical and molecular pathology required for the diagnosis and treatment of colorectal cancer. In order to reflect these changes, we (GIP) decided to make the second edition of the report. The purpose of this standardized pathology report is to provide a practical protocol for Korean pathologists, which could help diagnose and treat CRC patients. This report consists of “standard data elements” and “conditional data elements.” Basic pathologic findings and parts necessary for prognostication of CRC patients are classified as “standard data elements,” while other prognostic factors and factors related to adjuvant therapy are classified as “conditional data elements” so that each institution could select the contents according to the characteristics of the institution. The Korean version is also provided separately so that Korean pathologists can easily understand and use this report. We hope that this report will be helpful in the daily practice of CRC diagnosis.
7.The lived experience of health-management in patients with Parkinson’s disease
Hye Gyeong SON ; Hyun-Joo PARK ; Sang Jin KIM ; A-Leum HAN
Journal of Korean Academic Society of Nursing Education 2020;26(4):423-433
Purpose:
The purpose of this study was to describe the health care experiences among patients with Parkinson’s disease.
Methods:
Of the qualitative research methods, Colaizzi’s phenomenological method was used in this study. A total of nine patients, who were diagnosed with Parkinson’s disease and receiving outpatient treatment, were selected as the subjects of this study. Subsequently, data were collected through individual in-depth interview.
Results:
The four categories obtained as a result were ‘strenuous efforts to control my own body,’ ‘subject of health that no one can replace,’ ‘focus on the current while expecting a breakthrough in health management,’ and ‘human dignity that cannot be lost to the end.’
Conclusion
The study results are expected to help health care providers deeply understand the experiences in health care among patients with Parkinson’s disease and to provide source data for nursing intervention development that can be helpful in managing the health status of patients with Parkinson’s disease.
8.Analysis of Tumor Size between Imaging of Preoperative Ultrasound, MRI and Pathologic Measurements in Early Breast Carcinoma
Eun Hyeok KIM ; Chan Gyun PARK ; Eun Hye CHOI ; Ye Jeong KIM ; Mi Jin KIM ; Kyu Dam HAN ; Young Sam PARK ; Cheol Seung KIM ; Kyun Hui NO ; Eun Ae YU ; Gyeong Gyun NA
Journal of Breast Disease 2020;8(1):19-24
Purpose:
Preoperative tumor size is associated with clinical stage, treatment plan and even survival rate of patient. We investigated the accuracy of tumor size estimation between magnetic resonance imaging (MRI) and ultrasonography (US) findings, comparing these with pathologic tumor size in the diagnosis of early breast carcinoma.
Methods:
Between 2011 and 2016, 136 patients with early breast cancer were analyzed and their tumor size on US and MRI findings were compared with their pathologic tumor size retrospectively. The background parenchymal enhancement of MRI was categorized as minimal, mild, moderate, and extreme. The patients who underwent neoadjuvant chemotherapy, had positive resection margins, underwent excisional biopsy for cancer diagnosis, and had non-mass lesions on MRI scans, were excluded.
Results:
In all, 83.1% of the cases showed concordance between MRI findings and pathologic tumor size within 0.5cm. MRI overestimated the findings by 10.3% and underestimated them by 6.6%; 78.7% showed concordance between US findings and pathologic tumor size within 0.5cm. US overestimated the findings by 5.9% and underestimated them by 15.4%. The tumor size on MRI (r=0.87) showed a stronger correlation to the pathologic tumor size than that on US (r=0.64) in early breast cancer patients. US had a tendency to underestimate the tumor size. The degree of breast parenchyma did not affect the accuracy of the measurement of preoperative tumor size.
Conclusion
MRI is relatively more accurate than US for assessing preoperative tumor size in breast cancer patients. US tends to underestimate tumor size.
9.Organizing an in-class hackathon to correct PDF-to-text conversion errors of Genomics & Informatics 1.0
Sunho KIM ; Royoung KIM ; Ryeo-Gyeong KIM ; Enjin KO ; Han-Su KIM ; Jihye SHIN ; Daeun CHO ; Yurhee JIN ; Soyeon BAE ; Ye Won JO ; San Ah JEONG ; Yena KIM ; Seoyeon AHN ; Bomi JANG ; Jiheyon SEONG ; Yujin LEE ; Si Eun SEO ; Yujin KIM ; Ha-Jeong KIM ; Hyeji KIM ; Hye-Lynn SUNG ; Hyoyoung LHO ; Jaywon KOO ; Jion CHU ; Juwon LIM ; Youngju KIM ; Kyungyeon LEE ; Yuri LIM ; Meongeun KIM ; Seonjeong HWANG ; Shinhye HAN ; Sohyeun BAE ; Sua KIM ; Suhyeon YOO ; Yeonjeong SEO ; Yerim SHIN ; Yonsoo KIM ; You-Jung KO ; Jihee BAEK ; Hyejin HYUN ; Hyemin CHOI ; Ji-Hye OH ; Da-Young KIM ; Hee-Jo NAM ; Hyun-Seok PARK
Genomics & Informatics 2020;18(3):e33-
This paper describes a community effort to improve earlier versions of the full-text corpus of Genomics & Informatics by semi-automatically detecting and correcting PDF-to-text conversion errors and optical character recognition errors during the first hackathon of Genomics & Informatics Annotation Hackathon (GIAH) event. Extracting text from multi-column biomedical documents such as Genomics & Informatics is known to be notoriously difficult. The hackathon was piloted as part of a coding competition of the ELTEC College of Engineering at Ewha Womans University in order to enable researchers and students to create or annotate their own versions of the Genomics & Informatics corpus, to gain and create knowledge about corpus linguistics, and simultaneously to acquire tangible and transferable skills. The proposed projects during the hackathon harness an internal database containing different versions of the corpus and annotations.
10.Organizing an in-class hackathon to correct PDF-to-text conversion errors of Genomics & Informatics 1.0
Sunho KIM ; Royoung KIM ; Ryeo-Gyeong KIM ; Enjin KO ; Han-Su KIM ; Jihye SHIN ; Daeun CHO ; Yurhee JIN ; Soyeon BAE ; Ye Won JO ; San Ah JEONG ; Yena KIM ; Seoyeon AHN ; Bomi JANG ; Jiheyon SEONG ; Yujin LEE ; Si Eun SEO ; Yujin KIM ; Ha-Jeong KIM ; Hyeji KIM ; Hye-Lynn SUNG ; Hyoyoung LHO ; Jaywon KOO ; Jion CHU ; Juwon LIM ; Youngju KIM ; Kyungyeon LEE ; Yuri LIM ; Meongeun KIM ; Seonjeong HWANG ; Shinhye HAN ; Sohyeun BAE ; Sua KIM ; Suhyeon YOO ; Yeonjeong SEO ; Yerim SHIN ; Yonsoo KIM ; You-Jung KO ; Jihee BAEK ; Hyejin HYUN ; Hyemin CHOI ; Ji-Hye OH ; Da-Young KIM ; Hee-Jo NAM ; Hyun-Seok PARK
Genomics & Informatics 2020;18(3):e33-
This paper describes a community effort to improve earlier versions of the full-text corpus of Genomics & Informatics by semi-automatically detecting and correcting PDF-to-text conversion errors and optical character recognition errors during the first hackathon of Genomics & Informatics Annotation Hackathon (GIAH) event. Extracting text from multi-column biomedical documents such as Genomics & Informatics is known to be notoriously difficult. The hackathon was piloted as part of a coding competition of the ELTEC College of Engineering at Ewha Womans University in order to enable researchers and students to create or annotate their own versions of the Genomics & Informatics corpus, to gain and create knowledge about corpus linguistics, and simultaneously to acquire tangible and transferable skills. The proposed projects during the hackathon harness an internal database containing different versions of the corpus and annotations.

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