9 results on '"Bolwell, Brian J."'
Search Results
2. A phase I trial of bortezomib in combination with everolimus for treatment of relapsed/refractory non-Hodgkin lymphoma.
- Author
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Hill BT, Smith MR, Shelley M, Jagadeesh D, Dean RM, Pohlman B, Sweetenham JW, Bolwell BJ, and Smith SD
- Subjects
- Adult, Aged, Aged, 80 and over, Bortezomib administration & dosage, Everolimus administration & dosage, Female, Follow-Up Studies, Humans, Lymphoma, Non-Hodgkin pathology, Male, Maximum Tolerated Dose, Middle Aged, Neoplasm Recurrence, Local pathology, Prognosis, Prospective Studies, Remission Induction, Survival Rate, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Drug Resistance, Neoplasm drug effects, Lymphoma, Non-Hodgkin drug therapy, Neoplasm Recurrence, Local drug therapy, Salvage Therapy
- Abstract
B-cell non-Hodgkin lymphomas (NHL) display dysregulation of pathways controlling cell proliferation and apoptosis. Combined proteasome and mTOR inhibition, demonstrated with bortezomib and everolimus in a preclinical model, thus warrants evaluation in humans. We conducted a phase I study to identify the maximum tolerated dose (MTD) and safety of this combination in relapsed/refractory (r/r) NHL. Twenty-nine patients were enrolled from July 2008 to March, 2015. Toxicities were primarily hematologic, and dose-limiting thrombocytopenia defined the MTD as 5 mg everolimus daily with 1.3 mg/m
2 bortezomib d1, 4, 8, and 11 every 21 days. Of 25 response-evaluable patients there was one complete response in a patient with MCL and three partial responses (two MCL, one FL) for an overall response rate of 16%. In conclusion, the combination of everolimus and bortezomib results in dose limiting thrombocytopenia, but is tolerable. This combination has limited clinical activity in heavily pretreated NHL.- Published
- 2018
- Full Text
- View/download PDF
3. Efficacy of Standard Dose R-CHOP Alternating With R-HDAC Followed by Autologous Hematopoietic Cell Transplantation as Initial Therapy of Mantle Cell Lymphoma, a Single-Institution Experience.
- Author
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Sawalha Y, Hill BT, Rybicki LA, Sun D, Dean RM, Jagadeesh D, Hamilton BK, Gerds AT, Sobecks RM, Andresen S, Liu HK, Majhail NS, Pohlman B, Kalaycio ME, Bolwell BJ, and Smith MR
- Subjects
- Adult, Aged, Antineoplastic Combined Chemotherapy Protocols pharmacology, Female, Humans, Lymphoma, Mantle-Cell drug therapy, Lymphoma, Mantle-Cell pathology, Male, Middle Aged, Retrospective Studies, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Hematopoietic Stem Cell Transplantation methods, Lymphoma, Mantle-Cell therapy, Transplantation Conditioning methods
- Abstract
Background: Young fit patients with mantle cell lymphoma (MCL) are commonly treated with induction chemotherapy followed by high-dose chemotherapy and autologous hematopoietic cell transplantation (AHCT). Induction regimens with modifications of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) and/or incorporation of high-dose cytarabine (HDAC) appear more effective than R-CHOP alone., Patients and Methods: We adopted a modification of the Nordic protocol using standard, rather than higher dose R-CHOP, alternating with HDAC (rituximab plus HDAC), for 3 cycles each or, for patients already treated with R-CHOP alone before referral for AHCT, an additional 2 cycles of rituximab plus HDAC. We herein report our experience with 28 patients treated with this regimen who proceeded to AHCT, and compare their outcomes with patients treated with either standard-dose R-CHOP (n = 38) or R-HCVAD/MA (cyclophosphamide, vincristine, doxorubicin, dexamethasone alternating with methotrexate, and cytarabine; n = 21), before AHCT., Results: With a median follow-up duration of 26 months, our data show that this modification of the Nordic regimen is a highly effective pre-AHCT first-line therapy for MCL (3-year progression-free and overall survival rates of 69% and 75%, respectively)., Conclusion: By using a less intense induction, this regimen can serve as a platform for combined use of novel agents, with less risk of additive toxicity., (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Published
- 2018
- Full Text
- View/download PDF
4. Better leukemia-free and overall survival in AML in first remission following cyclophosphamide in combination with busulfan compared with TBI.
- Author
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Copelan EA, Hamilton BK, Avalos B, Ahn KW, Bolwell BJ, Zhu X, Aljurf M, van Besien K, Bredeson C, Cahn JY, Costa LJ, de Lima M, Gale RP, Hale GA, Halter J, Hamadani M, Inamoto Y, Kamble RT, Litzow MR, Loren AW, Marks DI, Olavarria E, Roy V, Sabloff M, Savani BN, Seftel M, Schouten HC, Ustun C, Waller EK, Weisdorf DJ, Wirk B, Horowitz MM, Arora M, Szer J, Cortes J, Kalaycio ME, Maziarz RT, and Saber W
- Subjects
- Acute Disease, Adolescent, Adult, Busulfan administration & dosage, Child, Child, Preschool, Combined Modality Therapy, Cyclophosphamide administration & dosage, Disease-Free Survival, Female, Humans, Male, Middle Aged, Multivariate Analysis, Remission Induction, Siblings, Time Factors, Transplantation, Homologous, Treatment Outcome, Unrelated Donors, Young Adult, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Hematopoietic Stem Cell Transplantation methods, Leukemia, Myeloid therapy, Whole-Body Irradiation
- Abstract
Cyclophosphamide combined with total body irradiation (Cy/TBI) or busulfan (BuCy) are the most widely used myeloablative conditioning regimens for allotransplants. Recent data regarding their comparative effectiveness are lacking. We analyzed data from the Center for International Blood and Marrow Transplant Research for 1230 subjects receiving a first hematopoietic cell transplant from a human leukocyte antigen-matched sibling or from an unrelated donor during the years 2000 to 2006 for acute myeloid leukemia (AML) in first complete remission (CR) after conditioning with Cy/TBI or oral or intravenous (IV) BuCy. Multivariate analysis showed significantly less nonrelapse mortality (relative risk [RR] = 0.58; 95% confidence interval [CI]: 0.39-0.86; P = .007), and relapse after, but not before, 1 year posttransplant (RR = 0.23; 95% CI: 0.08-0.65; P = .006), and better leukemia-free survival (RR = 0.70; 95% CI: 0.55-0.88; P = .003) and survival (RR = 0.68; 95% CI: 0.52-0.88; P = .003) in persons receiving IV, but not oral, Bu compared with TBI. In combination with Cy, IV Bu is associated with superior outcomes compared with TBI in patients with AML in first CR.
- Published
- 2013
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- View/download PDF
5. Treatment with hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone combined with cytarabine and methotrexate results in poor mobilization of peripheral blood stem cells in patients with mantle cell lymphoma.
- Author
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Hill BT, Rybicki L, Smith S, Dean R, Kalaycio M, Pohlman B, Sweetenham J, Tench S, Sobecks R, Andresen S, Copelan E, and Bolwell BJ
- Subjects
- Adult, Aged, Antigens, CD34 blood, Cyclophosphamide administration & dosage, Cytarabine administration & dosage, Dexamethasone administration & dosage, Doxorubicin administration & dosage, Etoposide administration & dosage, Female, Hematopoietic Stem Cell Mobilization, Hematopoietic Stem Cells metabolism, Humans, Leukapheresis methods, Lymphoma, Mantle-Cell blood, Male, Methotrexate administration & dosage, Middle Aged, Retrospective Studies, Time Factors, Transplantation, Autologous, Treatment Outcome, Vincristine administration & dosage, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Hematopoietic Stem Cells drug effects, Lymphoma, Mantle-Cell therapy, Peripheral Blood Stem Cell Transplantation methods
- Abstract
Hyper-CVAD (fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone combined with cytarabine and methotrexate) is an intense chemotherapy regimen frequently used for hematologic malignancies including mantle cell lymphoma. To address whether treatment with hyper-CVAD impairs mobilization of peripheral blood stem cells, we retrospectively analyzed mobilization data from 77 consecutive adult patients with mantle cell lymphoma who underwent peripheral blood stem cell (PBSC) mobilization for planned autologous stem cell transplant (ASCT). Compared to patients treated with alternative regimens, patients treated with hyper-CVAD collected fewer CD34+ cells, required more total days of pheresis, and more frequently required a second mobilization attempt, despite being more likely to have undergone mobilization with a VP16-containing regimen. In multivariable linear regression analysis, treatment with hyper-CVAD was associated with a significant reduction in total CD34+ cells mobilized (p < 0.001). These findings suggest that alternative mobilizing strategies prior to ASCT are needed for patients with mantle cell lymphoma who have received hyper-CVAD.
- Published
- 2011
- Full Text
- View/download PDF
6. Incidence and reasons for late failure after allogeneic haematopoietic cell transplantation following BuCy2 in acute myeloid leukaemia.
- Author
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Pant S, Hamadani M, Dodds AJ, Szer J, Crilley PA, Stevenson D, Phillips G, Elder P, Nivison-Smith I, Avalos BR, Penza S, Topolsky D, Sobecks R, Kalaycio M, Bolwell BJ, and Copelan EA
- Subjects
- Adolescent, Adult, Bone Marrow Purging methods, Busulfan therapeutic use, Cyclophosphamide therapeutic use, Epidemiologic Methods, Female, Humans, Leukemia, Myeloid, Acute drug therapy, Male, Middle Aged, Prognosis, Treatment Failure, Young Adult, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Hematopoietic Stem Cell Transplantation, Leukemia, Myeloid, Acute therapy
- Abstract
The long-term follow-up is presented for 317 patients with acute myeloid leukaemia who underwent human leucocyte antigen-identical sibling marrow transplants between 1984 and 1995 following preparation with busulfan 16 mg/kg and cyclophosphamide 120 mg/kg. Among the 142 (45%) who were alive and leukaemia-free 3 years following transplantation, the leukaemia-free survival at 15 years was 72.8%. The cumulative incidence of late (>3 years beyond transplant) non-relapse mortality at 15 years was 12.9% and of late relapse was 16.5%. None of the variables considered (including age, disease stage, and graft-versus-host disease) were predictive of late failure.
- Published
- 2010
- Full Text
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7. Impact of pre-transplant rituximab on survival after autologous hematopoietic stem cell transplantation for diffuse large B cell lymphoma.
- Author
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Fenske TS, Hari PN, Carreras J, Zhang MJ, Kamble RT, Bolwell BJ, Cairo MS, Champlin RE, Chen YB, Freytes CO, Gale RP, Hale GA, Ilhan O, Khoury HJ, Lister J, Maharaj D, Marks DI, Munker R, Pecora AL, Rowlings PA, Shea TC, Stiff P, Wiernik PH, Winter JN, Rizzo JD, van Besien K, Lazarus HM, and Vose JM
- Subjects
- Adult, Aged, Antibodies, Monoclonal administration & dosage, Antibodies, Monoclonal pharmacology, Antibodies, Monoclonal, Murine-Derived, Disease-Free Survival, Female, Graft Survival drug effects, Humans, Kaplan-Meier Estimate, Lymphoma, Large B-Cell, Diffuse surgery, Male, Middle Aged, Premedication, Proportional Hazards Models, Recurrence, Remission Induction, Retrospective Studies, Rituximab, Salvage Therapy, Treatment Outcome, Young Adult, Antibodies, Monoclonal adverse effects, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Lymphoma, Large B-Cell, Diffuse drug therapy, Peripheral Blood Stem Cell Transplantation statistics & numerical data
- Abstract
Incorporation of the anti-CD20 monoclonal antibody rituximab into front-line regimens to treat diffuse large B cell lymphoma (DLBCL) has resulted in improved survival. Despite this progress, however, many patients develop refractory or recurrent DLBCL and then undergo autologous hematopoietic stem cell transplantation (AuHCT). It is unclear to what extent pre-transplant exposure to rituximab affects outcomes after AuHCT. Outcomes of 994 patients receiving AuHCT for DLBCL between 1996 and 2003 were analyzed according to whether rituximab was (n = 176; +R cohort) or was not (n = 818; -R cohort) administered with front-line or salvage therapy before AuHCT. The +R cohort had superior progression-free survival (PFS; 50% vs 38%; P = .008) and overall survival (OS; 57% vs 45%; P = .006) at 3 years. Platelet and neutrophil engraftment were not affected by exposure to rituximab. Nonrelapse mortality (NRM) did not differ significantly between the 2 cohorts. In multivariate analysis, the +R cohort had improved PFS (relative risk of relapse/progression or death, 0.64; P < .001) and improved OS (relative risk of death, 0.74; P = .039). We conclude that pre-transplant rituximab is associated with a lower rate of progression and improved survival after AuHCT for DLBCL, with no evidence of impaired engraftment or increased NRM.
- Published
- 2009
- Full Text
- View/download PDF
8. Late mortality and relapse following BuCy2 and HLA-identical sibling marrow transplantation for chronic myelogenous leukemia.
- Author
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Copelan EA, Crilley PA, Szer J, Dodds AJ, Stevenson D, Phillips G, Elder P, Nivison-Smith I, Avalos BR, Penza S, Topolsky D, Sobecks R, Kalaycio M, and Bolwell BJ
- Subjects
- Adolescent, Adult, Age Factors, Busulfan administration & dosage, Cyclophosphamide administration & dosage, Disease-Free Survival, Female, Follow-Up Studies, Histocompatibility Testing, Humans, Male, Middle Aged, Recurrence, Survival Rate, Transplantation, Homologous, Antineoplastic Combined Chemotherapy Protocols administration & dosage, Bone Marrow Transplantation, Leukemia, Myelogenous, Chronic, BCR-ABL Positive mortality, Leukemia, Myelogenous, Chronic, BCR-ABL Positive therapy, Siblings
- Abstract
Allogeneic hematopoietic stem cell transplantation (HSCT) is the only known curative therapy for chronic myelogenous leukemia (CML). Failure, because of relapse or nonrelapse mortality (NRM), generally occurs within 3 years of transplantation, but large studies with long-term follow-up are limited. We present mature results in 335 patients with CML who underwent allogeneic bone marrow transplantation (BMT) from HLA-identical siblings following busulfan and cyclophosphamide (BU/Cy2). Two hundred twenty-nine were in chronic phase (CP) and 106 in accelerated or blastic phase at transplantation. Median follow-up exceeded 14 years. The estimated probability of 18-year leukemia-free survival (LFS) for CP patients was 55.6% and for those beyond CP, 10.5%. Of 182 patients who survived leukemia-free at 3 years, the estimated probability of LFS at 18 years was 61.9%. Late relapse (P = .039) and late NRM (P = .008) occurred at higher rates in patients beyond CP at transplantation. There was no plateau in LFS.
- Published
- 2009
- Full Text
- View/download PDF
9. Comparison of outcome following allogeneic bone marrow transplantation with cyclophosphamide-total body irradiation versus busulphan-cyclophosphamide conditioning regimens for acute myelogenous leukaemia in first remission.
- Author
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Litzow MR, Pérez WS, Klein JP, Bolwell BJ, Camitta B, Copelan EA, Gale RP, Giralt SA, Keating A, Lazarus HM, Marks DI, McCarthy PL, Miller CB, Milone G, Prentice HG, Russell JA, Schultz KR, Trigg ME, Weisdorf DJ, and Horowitz MM
- Subjects
- Adult, Analysis of Variance, Busulfan administration & dosage, Combined Modality Therapy, Cyclophosphamide administration & dosage, Cyclophosphamide therapeutic use, Disease-Free Survival, Female, Follow-Up Studies, Humans, Male, Middle Aged, Proportional Hazards Models, Recurrence, Registries, Retrospective Studies, Survival Rate, Treatment Outcome, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Bone Marrow Transplantation, Leukemia, Myeloid, Acute therapy, Transplantation Conditioning methods, Whole-Body Irradiation
- Abstract
We evaluated transplant-related mortality (TRM), leukaemia relapse, leukaemia-free survival (LFS) and overall survival (OS) in patients receiving busulphan and cyclophosphamide (BuCy) or cyclophosphamide and total body irradiation (CyTBI) prior to allogeneic bone marrow transplantation (BMT) for acute myelogenous leukaemia (AML) in first remission. Outcomes of 381 human leucocyte antigen (HLA)-matched sibling transplants using BuCy were compared with 200 transplants using CyTBI performed between 1988 and 1996. The incidence of hepatic veno-occlusive disease was higher with BuCy (13%) than with CyTBI (6%) (P = 0.009). Risks of acute and chronic GVHD were similar. In multivariate analysis, relapse risk was higher in the BuCy group [relative risk (RR) = 1.72; 95% confidence interval (CI), 1.05-2.81; P = 0.031]. Eleven of 373 evaluable patients in the BuCy group had a central nervous system relapse in contrast to none of 194 evaluable patients in the CyTBI group (P = 0.016). There were no differences in TRM, LFS and OS. CyTBI conditioning may lower relapse risk but produces comparable TRM, LFS and OS to BuCy for HLA-matched sibling transplantation in first remission AML.
- Published
- 2002
- Full Text
- View/download PDF
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