8 results on '"Hegenbart, Ute"'
Search Results
2. Lenalidomide and dexamethasone in relapsed/refractory immunoglobulin light chain (AL) amyloidosis: results from a large cohort of patients with long follow‐up.
- Author
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Basset, Marco, Kimmich, Christoph R., Schreck, Nicholas, Krzykalla, Julia, Dittrich, Tobias, Veelken, Kaya, Goldschmidt, Hartmut, Seckinger, Anja, Hose, Dirk, Jauch, Anna, Müller‐Tidow, Carsten, Benner, Axel, Hegenbart, Ute, and Schönland, Stefan O.
- Subjects
LENALIDOMIDE ,PROGNOSIS ,OVERALL survival ,SURVIVAL rate ,AMYLOIDOSIS - Abstract
Summary: Lenalidomide and dexamethasone (RD) is a standard treatment in relapsed/refractory immunoglobulin light chain (AL) amyloidosis (RRAL). We retrospectively investigated toxicity, efficacy and prognostic markers in 260 patients with RRAL. Patients received a median of two prior treatment lines (68% had been bortezomib‐refractory; 33% had received high‐dose melphalan). The median treatment duration was four cycles. The 3‐month haematological response rate was 31% [very good haematological response (VGHR) in 18%]. The median follow‐up was 56·5 months and the median overall survival (OS) and haematological event‐free survival (haemEFS) were 32 and 9 months. The 2‐year dialysis rate was 15%. VGHR resulted in better OS (62 vs. 26 months, P < 0·001). Cardiac progression predicted worse survival (22 vs. 40 months, P = 0·027), although N‐terminal prohormone of brain natriuretic peptide (NT‐proBNP) increase was frequently observed. Multivariable analysis identified these prognostic factors: NT‐proBNP for OS [hazard ratio (HR) 1·71; P < 0·001]; gain 1q21 for haemEFS (HR 1·68, P = 0·014), with a trend for OS (HR 1·47, P = 0·084); difference between involved and uninvolved free light chains (dFLC) and light chain isotype for OS (HR 2·22, P < 0·001; HR 1·62, P = 0·016) and haemEFS (HR 1·88, P < 0·001; HR 1·59, P = 0·008). Estimated glomerular filtration rate (HR 0·71, P = 0·004) and 24‐h proteinuria (HR 1·10, P = 0·004) were prognostic for renal survival. In conclusion, clonal and organ biomarkers at baseline identify patients with favourable outcome, while VGHR and cardiac progression define prognosis during RD treatment. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
3. Challenges in the management of patients with systemic light chain (AL) amyloidosis during the COVID‐19 pandemic.
- Author
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Kastritis, Efstathios, Wechalekar, Ashutosh, Schönland, Stefan, Sanchorawala, Vaishali, Merlini, Giampaolo, Palladini, Giovanni, Minnema, Monique, Roussel, Murielle, Jaccard, Arnaud, Hegenbart, Ute, Kumar, Shaji, Cibeira, Maria T., Blade, Joan, and Dimopoulos, Meletios A.
- Subjects
CARDIAC amyloidosis ,COVID-19 pandemic ,COVID-19 ,RESPIRATORY infections ,HYPOTENSION ,HEALTH services accessibility - Abstract
Summary: The severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2)‐associated coronavirus disease 2019 (COVID‐19) is primarily manifested as a respiratory tract infection, but may affect and cause complications in multiple organ systems (cardiovascular, gastrointestinal, kidneys, haematopoietic and immune systems), while no proven specific therapy exists. The challenges associated with COVID‐19 are even greater for patients with light chain (AL) amyloidosis, a rare multisystemic disease affecting the heart, kidneys, liver, gastrointestinal and nervous system. Patients with AL amyloidosis may need to receive chemotherapy, which probably increases infection risk. Management of COVID‐19 may be particularly challenging in patients with AL amyloidosis, who often present with cardiac dysfunction, nephrotic syndrome, neuropathy, low blood pressure and gastrointestinal symptoms. In addition, patients with AL amyloidosis may be more susceptible to toxicities of drugs used to manage COVID‐19. Access to health care may be difficult or limited, diagnosis of AL amyloidosis may be delayed with detrimental consequences and treatment administration may need modification. Both patients and treating physicians need to adapt in a new reality. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
4. Impact of telomere length on the outcome of allogeneic stem cell transplantation for poor-risk chronic lymphocytic leukaemia: results from the GCLLSG CLL3X trial.
- Author
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Scheffold, Annika, Jebaraj, Billy Michael Chelliah, Jaramillo, Sonia, Tausch, Eugen, Steinbrecher, Daniela, Hahn, Michael, Böttcher, Sebastian, Ritgen, Matthias, Bunjes, Donald, Zeis, Matthias, Stadler, Michael, Uharek, Lutz, Scheid, Christoph, Hegenbart, Ute, Hallek, Michael, Kneba, Michael, Schmitz, Norbert, Döhner, Hartmut, Dreger, Peter, and Stilgenbauer, Stephan
- Subjects
LYMPHOCYTIC leukemia ,STEM cell transplantation ,TELOMERES ,STEM cell treatment ,CHROMOSOMES ,LEUKEMIA treatment ,THERAPEUTICS - Abstract
The article reports on a study which investigated the impact of telomere length on the outcome of allogeneic stem cell transplantation (SCT) for patients with poor risk chronic lymphocytic leukaemia (CLL) based on the German CLL3X trial which included 100 patients. Topics covered include association of telomere length with clinical characteristics, and analysis of telomere length using quantitative polymerase chain reaction.
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- 2017
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5. Prognostic relevance of‘early-onset’ graft-versus-host disease following non-myeloablative haematopoietic cell transplantation.
- Author
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Mielcarek, Marco, Burroughs, Lauri, Leisenring, Wendy, Diaconescu, Razvan, Martin, Paul J., Sandmaier, Brenda M., Maloney, David G., Maris, Michael B., Chauncey, Thomas R., Shizuru, Judith A., Blume, Karl G., Hegenbart, Ute, Niederwieser, Dietger, Forman, Stephen, Bruno, Benedetto, Woolfrey, Ann, and Storb, Rainer
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GRAFT versus host disease ,CELL transplantation ,CELLULAR therapy ,SURGERY ,THERAPEUTICS ,PROGNOSIS - Abstract
We retrospectively analysed outcomes among 395 patients with haematologic malignancies who underwent non-myeloablative haematopoietic cell transplantation (HCT) from human leucocyte antigen (HLA)-matched related (n = 297) or unrelated donors (n = 98) in order to identify a possible correlation between the time of onset of graft-versus-host disease (GVHD) and survival. The non-myeloablative regimen consisted of 2 Gy total body irradiation with or without fludarabine, followed by postgrafting immunosuppression with mycophenolate mofetil and cyclosporine. The cumulative incidences of grades II–IV acute GVHD and extensive chronic GVHD were 45% and 47%, respectively, with related donors, and 68% and 68%, respectively, with unrelated donors. High-dose corticosteroid treatment for acute or chronic GVHD was started at a median of 79 (range, 8–799) days and 30 (range, 5–333) days after transplantation from related and unrelated donors respectively. With related donors, the cumulative incidence of non-relapse mortality among patients with GVHD was 55% at 4 years when prednisone was started before day 50 (n = 72), compared with 29% when treatment was started after day 50 (n = 115) (P < 0·001). With unrelated donors, time to onset of treatment for GVHD was not associated with survival. Patients with early-onset GVHD after non-myeloablative HCT from HLA-identical related donors might benefit from intensified primary immunosuppressive treatment. [ABSTRACT FROM AUTHOR]
- Published
- 2005
- Full Text
- View/download PDF
6. Non-myeloablative allografting from human leucocyte antigen-identical sibling donors for treatment of acute myeloid leukaemia in first complete remission.
- Author
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Feinstein, Lyle C., Sandmaier, Brenda M., Hegenbart, Ute, McSweeney, Peter A., Maloney, David G., Gooley, Theodore A., Maris, Michael B., Chauncey, Thomas R., Bruno, Benedetto, Appelbaum, Frederick R., Niederwieser, Dietger W., and Storb, Rainer F.
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ACUTE myeloid leukemia ,LEUCOCYTES ,HOMOGRAFTS ,CYCLOSPORINE - Abstract
Summary. Many patients with acute myeloid leukaemia (AML) in first complete remission (CR1) are ineligible for allogeneic transplantation as a result of age or medical problems other than leukaemia. Eighteen patients (median age 59 years, range 36–73 years) with de novo (n = 13) and secondary (n = 5) AML in morphological CR1, who were not candidates for conventional allografting, received non-myeloablative peripheral blood stem cell transplants from human leucocyte antigen identical sibling donors after conditioning with 2 Gy total body irradiation (TBI; n = 10) or 2 Gy TBI and 90 mg/m
2 of fludarabine (n = 8). Postgrafting immunosuppression was with cyclosporine and mycophenolate mofetil. Two rejections were observed in patients not given fludarabine and one died with relapse. Overall, 10 patients died between 77 and 841 d, seven from relapse and three from non-relapse mortality (NRM). Day +100 NRM was 0% with a 1-year estimated NRM of 17%[95% confidence interval (CI) 0–35%]. The median follow-up among the eight survivors was 766 d (range, 188–1141 d). Seven of these eight survivors remain in complete remission (CR). One-year estimates of overall and progression-free survivals were 54% (95% CI 31–78%) and 42% (95% CI 19–66%) respectively. While follow-up is short, this analysis demonstrates that the procedure is sufficiently safe to be studied in a wider group of patients. [ABSTRACT FROM AUTHOR]- Published
- 2003
- Full Text
- View/download PDF
7. Autografting with CD34[sup +] peripheral blood stem cells: retained engraftment capability and reduced tumour cell content.
- Author
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Voso, Maria Teresa, Hohaus, Stefan, Moos, Marion, Pförsich, Margit, Cremer, Friedrich W., Schlenk, Richard F., Martin, Simona, Hegenbart, Ute, Goldschmidt, Hartmut, and Haas, Rainer
- Subjects
LEUKAPHERESIS ,HODGKIN'S disease ,MULTIPLE myeloma ,BREAST cancer patients ,PATIENTS - Abstract
The efficacy of an immunomagnetic purging method and the Isolex 300 devices were assessed for selecting CD34
+ cells from leukapheresis products of 29 patients with non-Hodgkin's lymphoma (NHL), 39 with multiple myeloma and 34 with breast cancer. The mean purity of the CD34+ cell population was 93.6% and the mean recovery was 67.7%. Following enzymatic cleavage by chymopapain the expression of Thy-1 and Leu-8 was significantly reduced without affecting haematological recovery. The population of selected CD34+ cells of 4/8 patients with follicular lymphoma became PCR-negative. A 2.5 log reduction of tumour cells could be achieved in four patients with multiple myeloma as shown by a quantitative PCR assay. There were no tumour cells detectable in any of the 19 CD34+ cell preparations of patients with breast cancer. In 64 patients who received 94 cycles of high-dose therapy, a mean number of 4.7 × 106 CD34+ cells/kg were autografted. The time needed for platelet reconstitution was different when a comparison was made with 156 patients, who had received unmanipulated leukapheresis products (10 v 12 d, P = 0.006). No significant differences with regard to neutrophil recovery were noted. Five patients had a graft failure. Two of them died (on day 78 and 88 following PBSCT), and three patients were rescued with unmanipulated back-up transplants. In conclusion, the immunomagnetic selection of CD34+ cells provides autografts with reduced tumour cell content and an engraftment ability similar to that of unmanipulated autografts. [ABSTRACT FROM AUTHOR]- Published
- 1999
- Full Text
- View/download PDF
8. Prognostic relevance of 'early-onset' graft-versus-host disease following non-myeloablative haematopoietic cell transplantation.
- Author
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Mielcarek M, Burroughs L, Leisenring W, Diaconescu R, Martin PJ, Sandmaier BM, Maloney DG, Maris MB, Chauncey TR, Shizuru JA, Blume KG, Hegenbart U, Niederwieser D, Forman S, Bruno B, Woolfrey A, and Storb R
- Subjects
- Acute Disease, Adolescent, Adult, Aged, Child, Child, Preschool, Chronic Disease, Drug Administration Schedule, Female, Glucocorticoids administration & dosage, Graft vs Host Disease drug therapy, Histocompatibility Testing, Humans, Immunosuppression Therapy methods, Infant, Male, Middle Aged, Prednisone administration & dosage, Prognosis, Retrospective Studies, Severity of Illness Index, Sex Factors, Survival Analysis, Time Factors, Transplantation Conditioning, Treatment Outcome, Whole-Body Irradiation, Graft vs Host Disease etiology, Hematologic Neoplasms therapy, Hematopoietic Stem Cell Transplantation methods
- Abstract
We retrospectively analysed outcomes among 395 patients with haematologic malignancies who underwent non-myeloablative haematopoietic cell transplantation (HCT) from human leucocyte antigen (HLA)-matched related (n = 297) or unrelated donors (n = 98) in order to identify a possible correlation between the time of onset of graft-versus-host disease (GVHD) and survival. The non-myeloablative regimen consisted of 2 Gy total body irradiation with or without fludarabine, followed by postgrafting immunosuppression with mycophenolate mofetil and cyclosporine. The cumulative incidences of grades II-IV acute GVHD and extensive chronic GVHD were 45% and 47%, respectively, with related donors, and 68% and 68%, respectively, with unrelated donors. High-dose corticosteroid treatment for acute or chronic GVHD was started at a median of 79 (range, 8-799) days and 30 (range, 5-333) days after transplantation from related and unrelated donors respectively. With related donors, the cumulative incidence of non-relapse mortality among patients with GVHD was 55% at 4 years when prednisone was started before day 50 (n = 72), compared with 29% when treatment was started after day 50 (n = 115) (P < 0.001). With unrelated donors, time to onset of treatment for GVHD was not associated with survival. Patients with early-onset GVHD after non-myeloablative HCT from HLA-identical related donors might benefit from intensified primary immunosuppressive treatment.
- Published
- 2005
- Full Text
- View/download PDF
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