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1. Impact of Detectable Monoclonal Protein at Diagnosis on Outcomes in Marginal Zone Lymphoma: A Multicenter Cohort Study

Author

Epperla, Narendranath, Zhao, Qiuhong, Karmali, Reem, Torka, Pallawi, Shea, Lauren, Oh, Timothy S., Anampa-Guzmán, Andrea, Reves, Heather, Tavakkoli, Montreh, Greenwell, Irl Brian, Hansinger, Emily, Umyarova, Elvira, Annunzio, Kaitlin, Sawalha, Yazeed, Christian, Beth, Thomas, Colin, Barta, Stefan K., Geethakumari, Praveen Ramakrishnan, Bartlett, Nancy L., Grover, Natalie S., Olszewski, Adam J, Epperla, Narendranath, Zhao, Qiuhong, Karmali, Reem, Torka, Pallawi, Shea, Lauren, Oh, Timothy S., Anampa-Guzmán, Andrea, Reves, Heather, Tavakkoli, Montreh, Greenwell, Irl Brian, Hansinger, Emily, Umyarova, Elvira, Annunzio, Kaitlin, Sawalha, Yazeed, Christian, Beth, Thomas, Colin, Barta, Stefan K., Geethakumari, Praveen Ramakrishnan, Bartlett, Nancy L., Grover, Natalie S., and Olszewski, Adam J

Abstract

Given the paucity of data surrounding the prognostic relevance of monoclonal paraprotein (M-protein) in marginal zone lymphoma (MZL), we sought to evaluate the impact of detecting M-protein at diagnosis on outcomes in patients with MZL in a large retrospective cohort. The study included 547 patients receiving first-line therapy for MZL. M-protein was detectable at diagnosis in 173 (32%) patients. There was no significant difference in the time from diagnosis to initiation of any therapy (systemic and local) between the M-protein and no M-protein groups. Patients with M-protein at diagnosis had significantly inferior progression-free survival (PFS) compared with those without M-protein at diagnosis. After adjusting for factors associated with inferior PFS in univariate models, presence of M-protein remained significantly associated with inferior PFS (hazard ratio, 1.74; 95% confidence interval, 1.20-2.54; P = .004). We observed no significant difference in the PFS based on the type or quantity of M-protein at diagnosis. There were differential outcomes in PFS based on the first-line therapy in patients with M-protein at diagnosis, in that, those receiving immunochemotherapy had better outcomes compared with those receiving rituximab monotherapy. The cumulative incidence of relapse in stage 1 disease among the recipients of local therapy was higher in the presence of M-protein; however, this did not reach statistical significance. We found that M-protein at diagnosis was associated with a higher risk of histologic transformation. Because the PFS difference related to presence of M-protein was not observed in patients receiving bendamustine and rituximab, immunochemotherapy may be a preferred approach over rituximab monotherapy in this group and needs to be explored further.

Published
2023

2. Impact of Early Relapse within 24 Months after First-Line Systemic Therapy (POD24) on Outcomes in Patients with Marginal Zone Lymphoma: A US Multisite Study

Author

Epperla, Narendranath, Welkie, Rina Li, Torka, Pallawi, Shouse, Geoffrey, Karmali, Reem, Shea, Lauren, Anampa-Guzmán, Andrea, Oh, Timothy S, Reaves, Heather, Tavakkoli, Montreh, Lindsey, Kathryn, Greenwell, Irl Brian, Hansinger, Emily, Thomas, Colin, Chowdhury, Sayan Mullick, Annunzio, Kaitlin, Christian, Beth, Barta, Stefan K, Geethakumari, Praveen Ramakrishnan, Bartlett, Nancy L, Herrera, Alex F, Grover, Natalie S, Olszewski, Adam J, Epperla, Narendranath, Welkie, Rina Li, Torka, Pallawi, Shouse, Geoffrey, Karmali, Reem, Shea, Lauren, Anampa-Guzmán, Andrea, Oh, Timothy S, Reaves, Heather, Tavakkoli, Montreh, Lindsey, Kathryn, Greenwell, Irl Brian, Hansinger, Emily, Thomas, Colin, Chowdhury, Sayan Mullick, Annunzio, Kaitlin, Christian, Beth, Barta, Stefan K, Geethakumari, Praveen Ramakrishnan, Bartlett, Nancy L, Herrera, Alex F, Grover, Natalie S, and Olszewski, Adam J

Abstract

Progression of disease within 24 months (POD24) from diagnosis in marginal zone lymphoma (MZL) was shown to portend poor outcomes in prior studies. However, many patients with MZL do not require immediate therapy, and the time from diagnosis-to-treatment interval can be highly variable with no universal criteria to initiate systemic therapy. Hence, we sought to evaluate the prognostic relevance of early relapse or progression within 24 months from systemic therapy initiation in a large US cohort. The primary objective was to evaluate the overall survival (OS) in the two groups. The secondary objective included the evaluation of factors predictive of POD24 and the assessment of cumulative incidence of histologic transformation (HT) in POD24 versus non-POD24 groups. The study included 524 patients with 143 (27%) in POD24 and 381 (73%) in non-POD24 groups. Patients with POD24 had inferior OS compared to those without POD24, regardless of the type of systemic therapy received (rituximab monotherapy or immunochemotherapy) at diagnosis. After adjusting for factors associated with inferior OS in the univariate Cox model, POD24 remained associated with significantly inferior OS (HR = 2.50, 95% CI = 1.53-4.09, p = 0.0003) in multivariable analysis. The presence of monoclonal protein at diagnosis and those who received first-line rituximab monotherapy had higher odds of POD24 on logistic regression analysis. Patients with POD24 had a significantly higher risk for HT compared to those without POD24. POD24 in MZL might be associated with adverse biology and could be used as an additional information point in clinical trials and investigated as a marker for worse prognosis.

Published
2023

3. Postibrutinib Relapse Outcomes for Patients with Marginal Zone Lymphoma

Author

Epperla, Narendranath, Zhao, Qiuhong, Chowdhury, Sayan Mullick, Shea, Lauren, Moyo, Tamara K., Reddy, Nishitha, Sheets, Julia, Weiner, David M., Geethakumari, Praveen Ramakrishnan, Kandarpa, Malathi, Bruno, Ximena Jordan, Thomas, Colin, Churnetski, Michael C., Hsu, Andrew, Zurbriggen, Luke, Tan, Xiao-Wei Cherie, Lindsey, Kathryn, Maakaron, Joseph, Caimi, Paolo F., Torka, Pallawi, Bello, Celeste, Ayyappan, Sabarish, Oh, Timothy S., Karmali, Reem, Kim, Seo-Hyun, Kress, Anna, Kothari, Shalin, Sawalha, Yazeed, Christian, Beth, David, Kevin A., Greenwell, Irl Brian, Janakiram, Murali, Kenkre, Vaishalee P., Olszewski, Adam J., Cohen, Jonathon B., Palmisiano, Neil, Umyarova, Elvira, Wilcox, Ryan A., Awan, Farrukh T., Alderuccio, Juan Pablo, Barta, Stefan K., Grover, Natalie S., Ghosh, Nilanjan, Bartlett, Nancy L., Herrera, Alex F., Shouse, Geoffrey, Epperla, Narendranath, Zhao, Qiuhong, Chowdhury, Sayan Mullick, Shea, Lauren, Moyo, Tamara K., Reddy, Nishitha, Sheets, Julia, Weiner, David M., Geethakumari, Praveen Ramakrishnan, Kandarpa, Malathi, Bruno, Ximena Jordan, Thomas, Colin, Churnetski, Michael C., Hsu, Andrew, Zurbriggen, Luke, Tan, Xiao-Wei Cherie, Lindsey, Kathryn, Maakaron, Joseph, Caimi, Paolo F., Torka, Pallawi, Bello, Celeste, Ayyappan, Sabarish, Oh, Timothy S., Karmali, Reem, Kim, Seo-Hyun, Kress, Anna, Kothari, Shalin, Sawalha, Yazeed, Christian, Beth, David, Kevin A., Greenwell, Irl Brian, Janakiram, Murali, Kenkre, Vaishalee P., Olszewski, Adam J., Cohen, Jonathon B., Palmisiano, Neil, Umyarova, Elvira, Wilcox, Ryan A., Awan, Farrukh T., Alderuccio, Juan Pablo, Barta, Stefan K., Grover, Natalie S., Ghosh, Nilanjan, Bartlett, Nancy L., Herrera, Alex F., and Shouse, Geoffrey

Published
2023

4. Predictive Factors and Outcomes for Ibrutinib in Relapsed/refractory Marginal Zone Lymphoma: A multicenter Cohort Study

Author

Epperla, Narendranath, Zhao, Qiuhong, Chowdhury, Sayan Mullick, Shea, Lauren, Moyo, Tamara K, Reddy, Nishitha, Sheets, Julia, Weiner, David M, Geethakumari, Praveen Ramakrishnan, Kandarpa, Malathi, Bruno, Ximena Jordan, Thomas, Colin, Churnetski, Michael C, Hsu, Andrew, Zurbriggen, Luke, Tan, Cherie, Lindsey, Kathryn, Maakaron, Joseph, Caimi, Paolo F, Torka, Pallawi, Bello, Celeste, Ayyappan, Sabarish, Karmali, Reem, Kim, Seo-Hyun, Kress, Anna, Kothari, Shalin, Sawalha, Yazeed, Christian, Beth, David, Kevin A, Greenwell, Irl Brian, Janakiram, Murali, Kenkre, Vaishalee P, Olszewski, Adam J, Cohen, Jonathon B, Palmisiano, Neil D., Umyarova, Elvira, Wilcox, Ryan A, Awan, Farrukh T, Alderuccio, Juan Pablo, Barta, Stefan K, Grover, Natalie S, Ghosh, Nilanjan, Bartlett, Nancy L, Herrera, Alex F, Shouse, Geoffrey, Epperla, Narendranath, Zhao, Qiuhong, Chowdhury, Sayan Mullick, Shea, Lauren, Moyo, Tamara K, Reddy, Nishitha, Sheets, Julia, Weiner, David M, Geethakumari, Praveen Ramakrishnan, Kandarpa, Malathi, Bruno, Ximena Jordan, Thomas, Colin, Churnetski, Michael C, Hsu, Andrew, Zurbriggen, Luke, Tan, Cherie, Lindsey, Kathryn, Maakaron, Joseph, Caimi, Paolo F, Torka, Pallawi, Bello, Celeste, Ayyappan, Sabarish, Karmali, Reem, Kim, Seo-Hyun, Kress, Anna, Kothari, Shalin, Sawalha, Yazeed, Christian, Beth, David, Kevin A, Greenwell, Irl Brian, Janakiram, Murali, Kenkre, Vaishalee P, Olszewski, Adam J, Cohen, Jonathon B, Palmisiano, Neil D., Umyarova, Elvira, Wilcox, Ryan A, Awan, Farrukh T, Alderuccio, Juan Pablo, Barta, Stefan K, Grover, Natalie S, Ghosh, Nilanjan, Bartlett, Nancy L, Herrera, Alex F, and Shouse, Geoffrey

Abstract

Ibrutinib is effective in the treatment of relapsed/refractory (R/R) marginal zone lymphoma (MZL) with an overall response rate (ORR) of 48%. However, factors associated with response (or lack thereof) to ibrutinib in R/R MZL in clinical practice are largely unknown. To answer this question, we performed a multicenter (25 US centers) cohort study and divided the study population into three groups: "ibrutinib responders"-patients who achieved complete or partial response (CR/PR) to ibrutinib; "stable disease (SD)"; and "primary progressors (PP)"-patients with progression of disease as their best response to ibrutinib. One hundred and nineteen patients met the eligibility criteria with 58%/17% ORR/CR, 29% with SD, and 13% with PP. The median PFS and OS were 29 and 71.4 months, respectively, with no difference in PFS or OS based on the ibrutinib line of therapy or type of therapy before ibrutinib. Patients with complex cytogenetics had an inferior PFS (HR = 3.08, 95% CI 1.23-7.67, p = 0.02), while those with both complex cytogenetics (HR = 3.00, 95% CI 1.03-8.68, p = 0.04) and PP (HR = 13.94, 95% CI 5.17-37.62, p < 0.001) had inferior OS. Only primary refractory disease to first-line therapy predicted a higher probability of PP to ibrutinib (RR = 3.77, 95% CI 1.15-12.33, p = 0.03). In this largest study to date evaluating outcomes of R/R MZL treated with ibrutinib, we show that patients with primary refractory disease and those with PP on ibrutinib are very high-risk subsets and need to be prioritized for experimental therapies.

Published
2022

5. Early relapse identifies MCL patients with inferior survival after intensive or less intensive frontline therapy.

Author

Bond, David A, Bond, David A, Switchenko, Jeffrey M, Villa, Diego, Maddocks, Kami, Churnetski, Michael, Gerrie, Alina S, Goyal, Subir, Shanmugasundaram, Krithika, Calzada, Oscar, Kolla, Bhaskar, Bachanova, Veronika, Gerson, James N, Barta, Stefan K, Hill, Brian T, Sawalha, Yazeed, Martin, Peter, Maldonado, Edward, Gordon, Max, Danilov, Alexey V, Grover, Natalie S, Mathews, Stephanie, Burkart, Madelyn, Karmali, Reem, Ghosh, Nilanjan, Park, Steven I, Epperla, Narendranath, Badar, Talha, Guo, Jin, Hamadani, Mehdi, Fenske, Timothy S, Malecek, Mary-Kate, Kahl, Brad S, Flowers, Christopher R, Blum, Kristie A, Cohen, Jonathon B, Bond, David A, Bond, David A, Switchenko, Jeffrey M, Villa, Diego, Maddocks, Kami, Churnetski, Michael, Gerrie, Alina S, Goyal, Subir, Shanmugasundaram, Krithika, Calzada, Oscar, Kolla, Bhaskar, Bachanova, Veronika, Gerson, James N, Barta, Stefan K, Hill, Brian T, Sawalha, Yazeed, Martin, Peter, Maldonado, Edward, Gordon, Max, Danilov, Alexey V, Grover, Natalie S, Mathews, Stephanie, Burkart, Madelyn, Karmali, Reem, Ghosh, Nilanjan, Park, Steven I, Epperla, Narendranath, Badar, Talha, Guo, Jin, Hamadani, Mehdi, Fenske, Timothy S, Malecek, Mary-Kate, Kahl, Brad S, Flowers, Christopher R, Blum, Kristie A, and Cohen, Jonathon B

Abstract

Although an expanding array of effective treatments has resulted in recent improvement in survival of patients with mantle cell lymphoma (MCL), outcomes remain heterogeneous, and identification of prognostic factors remains a priority. We assessed the prognostic impact of time to progression of disease (POD) after first-line therapy among 455 patients with relapsed MCL. Patients were categorized by duration of first remission as PRF/POD6, defined as progressive disease during induction or POD within 6 months of diagnosis (n = 65; 14%); POD6-24, defined as POD between 6 and 24 months after diagnosis (n = 153; 34%); and POD>24, defined as POD >24 months after diagnosis (n = 237; 53%). The median overall survival from POD (OS2) was 1.3 years (95% confidence interval [CI], 0.9-2.4) for patients with PRF/POD6, 3 years (95% CI, 2-6.8) for those with POD6-24, and 8 years (95% CI, 6.2-NR) for those with POD>24. Median OS2 was inferior in patients with early POD (defined as PRF/POD6 or POD6-24) after both intensive and less intensive frontline treatment. The prognostic performance of time until POD was replicated in an independent cohort of 245 patients with relapsed MCL, with median OS2 of 0.3 years (95% CI, 0.1-0.5) for PRF/POD6, 0.8 years (95% CI, 0.6-0.9) for POD6-24, and 2.4 years (95% CI 2.1-2.7) for POD>24. Early POD is associated with inferior OS2 in patients with relapsed MCL, identifying a high-risk population for future prospective studies.

Published
2021

6. HIV-associated Hematological Malignancies / edited by Marcus Hentrich, Stefan K. Barta.

Author

Hentrich, Marcus. editor., Barta, Stefan K. editor., SpringerLink (Online service), Hentrich, Marcus. editor., Barta, Stefan K. editor., and SpringerLink (Online service)

Abstract

This book presents a general introduction to and review of HIV-associated hematological malignancies, with a special focus on practical management issues. Each of the relevant malignancies is addressed individually, with an overview of treatment approaches, assessment of evidence regarding their efficacy, and discussion of therapeutic controversies. In addition, careful consideration is paid to issues in molecular and clinical pathology, epidemiological aspects, symptomatology, diagnosis, and risk factors. Separate chapters are devoted to autologous and allogeneic stem cell transplantation and to chemotherapy and interactions with antiretroviral agents. Many of the chapters are written by experts who have been instrumental in shifting the balance for people living with HIV and blood cancers. While two decades ago this diagnosis represented a death sentence, advances in treatment have transformed these cancers into often curable conditions. Nevertheless, optimal treatment of hematological malignancies remains a challenge, particularly in patients with severe immunosuppression. This book will be an invaluable source of information for all practitioners in the fields of clinical hematology and medical oncology and HIV medicine.

Published
2016

11. CNS involvement in patients with AIDS-related lymphomas.

Author

Joshi, Jitesh, Mounier, Nicolas, Xue, Xiaonan, Wang, Dan, Ribera, Josep-Maria, Wyen, Christoph, Dunleavy, Kieron, Little, Richard F., Wilson, Wyndham Hopkins, Noy, Ariela, Sparano, Joseph A., Barta, Stefan K., Joshi, Jitesh, Mounier, Nicolas, Xue, Xiaonan, Wang, Dan, Ribera, Josep-Maria, Wyen, Christoph, Dunleavy, Kieron, Little, Richard F., Wilson, Wyndham Hopkins, Noy, Ariela, Sparano, Joseph A., and Barta, Stefan K.

Published
2014

12. A new prognostic score for AIDS-related lymphomas in the rituximab-era

Author

Barta, Stefan K., Xue, Xiaonan, Wang, Dan, Lee, Jeannette Y., Kaplan, Lawrence D., Ribera, Josep-Maria, Oriol, Albert, Spina, Michele, Tirelli, Umberto, Boue, Francois, Wilson, Wyndham H., Wyen, Christoph, Dunleavy, Kieron, Noy, Ariela, Sparano, Joseph A., Barta, Stefan K., Xue, Xiaonan, Wang, Dan, Lee, Jeannette Y., Kaplan, Lawrence D., Ribera, Josep-Maria, Oriol, Albert, Spina, Michele, Tirelli, Umberto, Boue, Francois, Wilson, Wyndham H., Wyen, Christoph, Dunleavy, Kieron, Noy, Ariela, and Sparano, Joseph A.

Abstract

While the International Prognostic Index is commonly used to predict outcomes in immunocompetent patients with aggressive B-cell non-Hodgkin lymphomas, HIV-infection is an important competing risk for death in patients with AIDS-related lymphomas. We investigated whether a newly created prognostic score (AIDS-related lymphoma International Prognostic Index) could better assess risk of death in patients with AIDS-related lymphomas. We randomly divided a dataset of 487 patients newly diagnosed with AIDS-related lymphomas and treated with rituximab-containing chemoimmunotherapy into a training (n=244) and validation (n=243) set. We examined the association of HIV-related and other known risk factors with overall survival in both sets independently. We defined a new score (AIDS-related lymphoma International Prognostic Index) by assigning weights to each significant predictor [age-adjusted International Prognostic Index, extranodal sites, HIV-score (composed of CD4 count, viral load, and prior history of AIDS)] with three risk categories similar to the age-adjusted International Prognostic Index (low, intermediate and high risk). We compared the prognostic value for overall survival between AIDS-related lymphoma International Prognostic Index and age-adjusted International Prognostic Index in the validation set and found that the AIDS-related lymphoma International Prognostic Index performed significantly better in predicting risk of death than the age-adjusted International Prognostic Index (P=0.004) and better discriminated risk of death between each risk category (P=0.015 vs. P=0.13). Twenty-eight percent of patients were defined as low risk by the ARL-IPI and had an estimated 5-year overall survival (OS) of 78% (52% intermediate risk, 5-year OS 60%; 20% high risk, 5-year OS 50%).

Published
2014

13. CNS involvement in patients with AIDS-related lymphomas.

Author

Joshi, Jitesh, Mounier, Nicolas, Xue, Xiaonan, Wang, Dan, Ribera, Josep-Maria, Wyen, Christoph, Dunleavy, Kieron, Little, Richard F., Wilson, Wyndham Hopkins, Noy, Ariela, Sparano, Joseph A., Barta, Stefan K., Joshi, Jitesh, Mounier, Nicolas, Xue, Xiaonan, Wang, Dan, Ribera, Josep-Maria, Wyen, Christoph, Dunleavy, Kieron, Little, Richard F., Wilson, Wyndham Hopkins, Noy, Ariela, Sparano, Joseph A., and Barta, Stefan K.

Published
2014

14. A new prognostic score for AIDS-related lymphomas in the rituximab-era

Author

Barta, Stefan K., Xue, Xiaonan, Wang, Dan, Lee, Jeannette Y., Kaplan, Lawrence D., Ribera, Josep-Maria, Oriol, Albert, Spina, Michele, Tirelli, Umberto, Boue, Francois, Wilson, Wyndham H., Wyen, Christoph, Dunleavy, Kieron, Noy, Ariela, Sparano, Joseph A., Barta, Stefan K., Xue, Xiaonan, Wang, Dan, Lee, Jeannette Y., Kaplan, Lawrence D., Ribera, Josep-Maria, Oriol, Albert, Spina, Michele, Tirelli, Umberto, Boue, Francois, Wilson, Wyndham H., Wyen, Christoph, Dunleavy, Kieron, Noy, Ariela, and Sparano, Joseph A.

Abstract

While the International Prognostic Index is commonly used to predict outcomes in immunocompetent patients with aggressive B-cell non-Hodgkin lymphomas, HIV-infection is an important competing risk for death in patients with AIDS-related lymphomas. We investigated whether a newly created prognostic score (AIDS-related lymphoma International Prognostic Index) could better assess risk of death in patients with AIDS-related lymphomas. We randomly divided a dataset of 487 patients newly diagnosed with AIDS-related lymphomas and treated with rituximab-containing chemoimmunotherapy into a training (n=244) and validation (n=243) set. We examined the association of HIV-related and other known risk factors with overall survival in both sets independently. We defined a new score (AIDS-related lymphoma International Prognostic Index) by assigning weights to each significant predictor [age-adjusted International Prognostic Index, extranodal sites, HIV-score (composed of CD4 count, viral load, and prior history of AIDS)] with three risk categories similar to the age-adjusted International Prognostic Index (low, intermediate and high risk). We compared the prognostic value for overall survival between AIDS-related lymphoma International Prognostic Index and age-adjusted International Prognostic Index in the validation set and found that the AIDS-related lymphoma International Prognostic Index performed significantly better in predicting risk of death than the age-adjusted International Prognostic Index (P=0.004) and better discriminated risk of death between each risk category (P=0.015 vs. P=0.13). Twenty-eight percent of patients were defined as low risk by the ARL-IPI and had an estimated 5-year overall survival (OS) of 78% (52% intermediate risk, 5-year OS 60%; 20% high risk, 5-year OS 50%).

Published
2014

15. Treatment factors affecting outcomes in HIV-associated non-Hodgkin lymphomas: a pooled analysis of 1546 patients

Author

Barta, Stefan K., Xue, Xiaonan, Wang, Dan, Tamari, Roni, Lee, Jeannette Y., Mounier, Nicolas, Kaplan, Lawrence D., Ribera, Josep-Maria, Spina, Michele, Tirelli, Umberto, Weiss, Rudolf, Galicier, Lionel, Boue, Francois, Wilson, Wyndham H., Wyen, Christoph, Oriol, Albert, Navarro, Jose-Tomas, Dunleavy, Kieron, Little, Richard F., Ratner, Lee, Garcia, Olga, Morgades, Mireia, Remick, Scot C., Noy, Ariela, Sparano, Joseph A., Barta, Stefan K., Xue, Xiaonan, Wang, Dan, Tamari, Roni, Lee, Jeannette Y., Mounier, Nicolas, Kaplan, Lawrence D., Ribera, Josep-Maria, Spina, Michele, Tirelli, Umberto, Weiss, Rudolf, Galicier, Lionel, Boue, Francois, Wilson, Wyndham H., Wyen, Christoph, Oriol, Albert, Navarro, Jose-Tomas, Dunleavy, Kieron, Little, Richard F., Ratner, Lee, Garcia, Olga, Morgades, Mireia, Remick, Scot C., Noy, Ariela, and Sparano, Joseph A.

Abstract

Limited comparative data exist for the treatment of HIV-associated non-Hodgkin lymphoma. We analyzed pooled individual patient data for 1546 patients from 19 prospective clinical trials to assess treatment-specific factors (type of chemotherapy, rituximab, and concurrent combination antiretroviral [cART] use) and their influence on the outcomes complete response (CR), progression free survival (PFS), and overall survival (OS). In our analysis, rituximab was associated with a higher CR rate (odds ratio [OR] 2.89; P < .001), improved PFS (hazard ratio [HR] 0.50; P < .001), and OS (HR 0.51; P < .0001). Compared with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), initial therapy with more dose-intense regimens resulted in better CR rates (ACVBP [doxorubicin, cyclophosphamide, vindesine, bleomycin and prednisolone]: OR 1.70; P < .04), PFS (ACVBP: HR 0.72; P = .049; intensive regimens: HR 0.35; P < .001) and OS (intensive regimens: HR 0.54; P < .001). Infusional etoposide, prednisone, infusional vincristine, infusional doxorubicin, and cyclophosphamide (EPOCH) was associated with significantly better OS in diffuse large B-cell lymphoma (HR 0.33; P = .03). Concurrent use of cART was associated with improved CR rates (OR 1.89; P = .005) and trended toward improved OS (HR 0.78; P = .07). These findings provide supporting evidence for current patterns of care where definitive evidence is unavailable.

Published
2013

16. Treatment factors affecting outcomes in HIV-associated non-Hodgkin lymphomas: a pooled analysis of 1546 patients

Author

Barta, Stefan K., Xue, Xiaonan, Wang, Dan, Tamari, Roni, Lee, Jeannette Y., Mounier, Nicolas, Kaplan, Lawrence D., Ribera, Josep-Maria, Spina, Michele, Tirelli, Umberto, Weiss, Rudolf, Galicier, Lionel, Boue, Francois, Wilson, Wyndham H., Wyen, Christoph, Oriol, Albert, Navarro, Jose-Tomas, Dunleavy, Kieron, Little, Richard F., Ratner, Lee, Garcia, Olga, Morgades, Mireia, Remick, Scot C., Noy, Ariela, Sparano, Joseph A., Barta, Stefan K., Xue, Xiaonan, Wang, Dan, Tamari, Roni, Lee, Jeannette Y., Mounier, Nicolas, Kaplan, Lawrence D., Ribera, Josep-Maria, Spina, Michele, Tirelli, Umberto, Weiss, Rudolf, Galicier, Lionel, Boue, Francois, Wilson, Wyndham H., Wyen, Christoph, Oriol, Albert, Navarro, Jose-Tomas, Dunleavy, Kieron, Little, Richard F., Ratner, Lee, Garcia, Olga, Morgades, Mireia, Remick, Scot C., Noy, Ariela, and Sparano, Joseph A.

Abstract

Limited comparative data exist for the treatment of HIV-associated non-Hodgkin lymphoma. We analyzed pooled individual patient data for 1546 patients from 19 prospective clinical trials to assess treatment-specific factors (type of chemotherapy, rituximab, and concurrent combination antiretroviral [cART] use) and their influence on the outcomes complete response (CR), progression free survival (PFS), and overall survival (OS). In our analysis, rituximab was associated with a higher CR rate (odds ratio [OR] 2.89; P < .001), improved PFS (hazard ratio [HR] 0.50; P < .001), and OS (HR 0.51; P < .0001). Compared with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), initial therapy with more dose-intense regimens resulted in better CR rates (ACVBP [doxorubicin, cyclophosphamide, vindesine, bleomycin and prednisolone]: OR 1.70; P < .04), PFS (ACVBP: HR 0.72; P = .049; intensive regimens: HR 0.35; P < .001) and OS (intensive regimens: HR 0.54; P < .001). Infusional etoposide, prednisone, infusional vincristine, infusional doxorubicin, and cyclophosphamide (EPOCH) was associated with significantly better OS in diffuse large B-cell lymphoma (HR 0.33; P = .03). Concurrent use of cART was associated with improved CR rates (OR 1.89; P = .005) and trended toward improved OS (HR 0.78; P = .07). These findings provide supporting evidence for current patterns of care where definitive evidence is unavailable.

Published
2013

17. A Pooled Analysis of 1,546 Patients with HIV-Associated Lymphoma: Assessment of Lymphoma-, HIV-, and Treatment-Specific Factors On Clinical Outcomes

Author

Barta, Stefan K., Xue, Xiaonan, Wang, Dan, Tamari, Roni, Lee, Jeannette Y., Mounier, Nicolas, Kaplan, Lawrence D., Ribera, Josep-Maria, Spina, Michele, Tirelli, Umberto, Weiss, Rudolf, Galicier, Lionel, Boue, Francois, Wilson, Wyndham H., Wyen, Christoph, Oriol, Albert, Navarro, Jose-Tomas, Dunleavy, Kieron, Little, Richard F., Ratner, Lee, Garcia, Olga, Morgades, Mireia, Oksenhendler, Eric, Remick, Scot, Sparano, Joseph A., Barta, Stefan K., Xue, Xiaonan, Wang, Dan, Tamari, Roni, Lee, Jeannette Y., Mounier, Nicolas, Kaplan, Lawrence D., Ribera, Josep-Maria, Spina, Michele, Tirelli, Umberto, Weiss, Rudolf, Galicier, Lionel, Boue, Francois, Wilson, Wyndham H., Wyen, Christoph, Oriol, Albert, Navarro, Jose-Tomas, Dunleavy, Kieron, Little, Richard F., Ratner, Lee, Garcia, Olga, Morgades, Mireia, Oksenhendler, Eric, Remick, Scot, and Sparano, Joseph A.

Published
2012

18. ARL-IPI - A New Prognostic Score for AIDS-Related Lymphomas in the Rituximab Era

Author

Barta, Stefan K., Xue, Xiaonan, Wang, Dan, Lee, Jeannette Y., Kaplan, Lawrence D., Ribera, Josep-Maria, Oriol, Albert, Garcia, Olga, Morgades, Mireia, Spina, Michele, Tirelli, Umberto, Boue, Francois, Wilson, Wyndham H., Wyen, Christoph, Dunleavy, Kieron, Sparano, Joseph A., Barta, Stefan K., Xue, Xiaonan, Wang, Dan, Lee, Jeannette Y., Kaplan, Lawrence D., Ribera, Josep-Maria, Oriol, Albert, Garcia, Olga, Morgades, Mireia, Spina, Michele, Tirelli, Umberto, Boue, Francois, Wilson, Wyndham H., Wyen, Christoph, Dunleavy, Kieron, and Sparano, Joseph A.

Published
2012

19. A Pooled Analysis of 1,546 Patients with HIV-Associated Lymphoma: Assessment of Lymphoma-, HIV-, and Treatment-Specific Factors On Clinical Outcomes

Author

Barta, Stefan K., Xue, Xiaonan, Wang, Dan, Tamari, Roni, Lee, Jeannette Y., Mounier, Nicolas, Kaplan, Lawrence D., Ribera, Josep-Maria, Spina, Michele, Tirelli, Umberto, Weiss, Rudolf, Galicier, Lionel, Boue, Francois, Wilson, Wyndham H., Wyen, Christoph, Oriol, Albert, Navarro, Jose-Tomas, Dunleavy, Kieron, Little, Richard F., Ratner, Lee, Garcia, Olga, Morgades, Mireia, Oksenhendler, Eric, Remick, Scot, Sparano, Joseph A., Barta, Stefan K., Xue, Xiaonan, Wang, Dan, Tamari, Roni, Lee, Jeannette Y., Mounier, Nicolas, Kaplan, Lawrence D., Ribera, Josep-Maria, Spina, Michele, Tirelli, Umberto, Weiss, Rudolf, Galicier, Lionel, Boue, Francois, Wilson, Wyndham H., Wyen, Christoph, Oriol, Albert, Navarro, Jose-Tomas, Dunleavy, Kieron, Little, Richard F., Ratner, Lee, Garcia, Olga, Morgades, Mireia, Oksenhendler, Eric, Remick, Scot, and Sparano, Joseph A.

Published
2012

20. ARL-IPI - A New Prognostic Score for AIDS-Related Lymphomas in the Rituximab Era

Author

Barta, Stefan K., Xue, Xiaonan, Wang, Dan, Lee, Jeannette Y., Kaplan, Lawrence D., Ribera, Josep-Maria, Oriol, Albert, Garcia, Olga, Morgades, Mireia, Spina, Michele, Tirelli, Umberto, Boue, Francois, Wilson, Wyndham H., Wyen, Christoph, Dunleavy, Kieron, Sparano, Joseph A., Barta, Stefan K., Xue, Xiaonan, Wang, Dan, Lee, Jeannette Y., Kaplan, Lawrence D., Ribera, Josep-Maria, Oriol, Albert, Garcia, Olga, Morgades, Mireia, Spina, Michele, Tirelli, Umberto, Boue, Francois, Wilson, Wyndham H., Wyen, Christoph, Dunleavy, Kieron, and Sparano, Joseph A.

Published
2012

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