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Papers by Ewa Kalinka-Warzocha

Research paper thumbnail of The Effectiveness of Pemetrexed Monotherapy Depending on Polymorphisms in TS and MTHFR Genes as Well as Clinical Factors in Advanced NSCLC Patients

Pathology & Oncology Research, 2015

In NSCLC, second-line chemotherapy using pemetrexed or docetaxel has limited efficacy and should ... more In NSCLC, second-line chemotherapy using pemetrexed or docetaxel has limited efficacy and should be dedicated to selected groups of patients. Pemetrexed is an antifolate compound with the ability to inhibit enzymes (TS, DHFR and GARFT) involved in pyrimidine and purine synthesis. The objective of this study was to evaluate the association between polymorphisms of TS and MHFR genes and clinical outcomes in NSCLC patients treated with pemetrexed monotherapy. DNA was isolated from peripheral blood of 72 non-squamous NSCLC patients treated with pemetrexed. Using PCR and RFLP methods, the variable number of tandem repeats (VNTR), the G > C SNP in these repeats and insertion/deletion polymorphism of TS gene as well as 677C > T SNP in MTHFR gene were analyzed and correlated with disease control rate, progression-free survival and overall survival (OS) of NSCLC patients. Carriers of 2R/3R(G), 3R(C)/3R(G), 3R(G)/3R(G) genotypes showed significantly more frequent early progression than carriers of 2R/2R, 2R/3R(C), 3R(C)/3R(C) genotypes of TS gene (p < 0.05). Among carriers of triple 28 bp tandem repeats (3R) in TS gene and C/C genotype of MTHFR gene a significantly shorter OS was observed (HR = 3.07; p = 0.003). In multivariate analysis, significantly higher risk of death was observed in carriers of both 3R/3R genotype in TS and C/C genotype in 677C > T SNP in MTHFR (HR = 3.85; p < 0.005) as well as in patients with short duration of response to first-line chemotherapy (HR = 2.09; p < 0.005). Results of our study suggested that genetic factors may have a high predictive and prognostic value (even greater than clinical factors) for patients treated with pemetrexed monotherapy.

Research paper thumbnail of Correlation Between TS, MTHFR, and ERCC1 Gene Polymorphisms and the Efficacy of Platinum in Combination With Pemetrexed First-Line Chemotherapy in Mesothelioma Patients

Clinical Lung Cancer, 2014

TS, MTHFR and ERCC1 polymorphisms may have implications for effectiveness of pemetrexed and plati... more TS, MTHFR and ERCC1 polymorphisms may have implications for effectiveness of pemetrexed and platinium chemotherapy and the impact on outcomes of mesothelioma patients. Studied polymorphism were analyzed in 59 mesothelioma patients and correlated with clinical data, disease control rate and survival rate. Different variants of 1494del6 in the 3 0 UTR of the TS gene were associated with differences in disease control rate and PFS of studied patients. Introduction: The combination of pemetrexed and platinum compound represents the standard regimen for first-line chemotherapy in malignant pleural mesothelioma patients. Pemetrexed is a multitarget antifolate agent that inhibits folate-dependent enzymes (eg, thymidylate synthase [TS]) and thus synthesis of nucleotides and DNA. Expression of TS and folate availability, regulated by gene polymorphisms, have implications for effectiveness of chemotherapy and the outcome of mesothelioma patients. The aim of this retrospective multicenter study was to assess the correlation between TS, 5,10-methylenetetrahydrofolate reductase (MTHFR) and excision repair cross-complementing group 1 (ERCC1) gene polymorphisms and the efficacy of pemetrexed-based first-line chemotherapy of mesothelioma patients. Patients and Methods: Fifty-nine mesothelioma patients (31 men with a median age of 62 years) treated in firstline chemotherapy with platinum in combination with pemetrexed or pemetrexed monotherapy were enrolled. Genomic DNA was isolated from peripheral blood. Using polymerase chain reaction and high resolution melt methods, the variable number of tandem repeat, the G>C single nucleotide polymorphism (SNP) in these repeats, and 6-base pair (bp) insertion/deletion polymorphism of the TS gene, the SNP of 677C>T in MTHFR, and 19007C>T in the ERCC1 gene were analyzed and correlated with disease control rate, progression-free survival (PFS), and overall survival (OS) of mesothelioma patients. Results: Greater risk of early disease progression (PD), and shortening of PFS and OS were associated with several clinical factors (eg, anemia for early PD and OS), weight loss (for PFS and OS), and previous surgical treatment (for early PD, PFS, and OS). Insertion of 6-bp in both alleles of the TS gene (1494del6) was the only genetic factor that increased the incidence of early progression (P ¼ .028) and shortening of median PFS (P ¼ .06) in patients treated with pemetrexed-based chemotherapy. In multivariate analysis, the 1494del6 in the 3 0 untranslated region (UTR) of the TS gene also had a predictive role for PFS (P ¼ .0185; hazard ratio, 2.3258 for þ6/þ6 homozygotes) in analyzed

Research paper thumbnail of Does diabetes alter the risk of neoplasms? Real-world data analysis in Poland: incidence rates for selected neoplasms in patients with diabetes

Polish Archives of Internal Medicine, 2016

Research paper thumbnail of Postępy w diagnostyce i leczeniu chorych na chłoniaki nie-Hodgkina

Research paper thumbnail of HLA-G and MHC Class II Protein Expression in Diffuse Large B-Cell Lymphoma

Archivum Immunologiae et Therapiae Experimentalis, 2015

The expression of human leukocyte antigen-G (HLA-G) and HLA class II protein was studied by immun... more The expression of human leukocyte antigen-G (HLA-G) and HLA class II protein was studied by immunohistochemical staining of lymph nodes from 148 patients with diffuse large B-cell lymphoma (DLBCL) and related to the clinical course of the disease. Negative HLA-G expression was associated with a lower probability of achieving a complete remission (p = 0.04). Patients with negative HLA-G expression tended towards a lower 3-year overall survival (OS) rate compared to those with positive expression of HLA-G (p = 0.08). When restricting the analysis to patients receiving chemotherapy with rituximab, the estimated 3-year OS rate of patients with positive HLA-G expression was 73.3 % compared with 47.5 % (p = 0.03) in those with negative expression. Patients with negative HLA class II expression presented a lower 3-year OS rate compared to subjects with positive expression (p = 0.04). The loss of HLA class II expression (p = 0.05) and belonging to the intermediate high/high IPI risk group (p = 0.001) independently increased the risk of death. HLA class II expression also retained its prognostic value in patients receiving rituximab; the 3-year OS rate was 65.3 % in patients with positive HLA class II expression versus 29.6 % (p = 0.04) in subjects that had loss of HLA class II expression. To our knowledge, for the first time, the expression of HLA-G protein in DLBCL and its association with the clinical course of the disease was demonstrated. Moreover, the link between losing HLA class II protein expression and poor survival of patients treated with immunochemotherapy was confirmed.

Research paper thumbnail of Zasady profilaktyki nudności i wymiotów indukowanych chemioterapia i radioterapią u chorych leczonych z powodu nowotworów układów krwiotwórczego i chłonnego

Nudności i wymioty (NV) stanowią najczęstsze objawy niepożądane leczenia przeciwnowotworowego. W ... more Nudności i wymioty (NV) stanowią najczęstsze objawy niepożądane leczenia przeciwnowotworowego. W niniejszej pracy podsumowano obecny stan wiedzy na temat profilaktyki NV indukowanych chemioterapią lub radioterapią; omówiono leki stosowane w tym wskazaniu i zasady oceny ryzyka wystąpienia NV oraz przedstawiono praktyczne przykłady planowania terapii zgodnie z zaleceniami.

Research paper thumbnail of Efficacy, safety and biomarker analysis of RG7160 (GA201), a novel dual-acting monoclonal antibody (mAb) designed to enhance antibody-dependent cellular cytotoxicity (ADCC), in combination with 1st line cisplatin and pemetrexed in metastatic non-squamous NSCLC

Research paper thumbnail of Chłoniaki strefy brzeżnej

Chłoniaki strefy brzeżnej (MZL, marginal zone lymphoma) to grupa chłoniaków nie-Hodgkina (NHL, no... more Chłoniaki strefy brzeżnej (MZL, marginal zone lymphoma) to grupa chłoniaków nie-Hodgkina (NHL, non-Hodgkin lymphoma) wywodząca się z dojrzałych obwodowych limfocytów B pochodzących ze strefy brzeżnej otaczającej ośrodki rozmnażania. Różnorodność cech biologicznych i klinicznych stała się podstawą ich podziału na jednostki histokliniczne, do których należą: 1) śledzionowy chłoniak strefy brzeżnej (SMZL, splenic B-cell marginal zone lymphoma); 2) węzłowy chłoniak strefy brzeżnej (NMZL, nodal marginal zone lymphoma); 3) pozawęzłowy chłoniak strefy brzeżnej MALT (MALT, mucosa-associated lymphoid tissue). Prowizoryczną kategorią w klasyfikacji Światowej Organizacji Zdrowia (WHO, World Health Organization) z 2008 roku jest dziecięcy węzłowy chłoniak strefy brzeżnej (pediatric nodal marginal zone lymphoma), który należy do wyjątkowo rzadko występujących chłoniaków w tej grupie wiekowej.

Research paper thumbnail of Leki antyosteolityczne

Research paper thumbnail of Perforation of the small intestine as an early complication of R-CHOP immunochemotherapy in patients with DLBCL — a report of two cases

Research paper thumbnail of Nowotwory z komórek T i NK

Research paper thumbnail of Fludarabine, mitoxantrone and dexamethasone in the treatment of relapsed and refractory low-grade non-Hodgkin lymphoma

Research paper thumbnail of Synchroniczne zachorowanie na nowotwór podścieliska przewodu pokarmowego i szpiczaka

We report a case of a 60-year-old man in whom synchronous appearance of gastrointenstinal stromal... more We report a case of a 60-year-old man in whom synchronous appearance of gastrointenstinal stromal tumor (GIST) and myeloma plasmocyticum (MP) with c-kit expression on both tumors. The treatment of MP with VAD (vincristine, adriamycin, dexamethasone), followed by a 9-month administration of thalidomide, combined with melphalan and dexamethasone given once a month, resulted in achieving and maintaining partial remission (PR)

Research paper thumbnail of Chłoniak Hodgkina u chorej w ciąży

Występowanie choroby nowotworowej u chorej w ciąży jest rzadkim problemem w onkologii i hematolog... more Występowanie choroby nowotworowej u chorej w ciąży jest rzadkim problemem w onkologii i hematologii. Przedstawiony opis przebiegu klinicznego dotyczy 29-letniej pacjentki w 28. tygodniu ciąży, u której rozpoznano chłoniaka Hodgkina (nodular sclerosis [NS] II). Zaawansowanie określono jako stopień IIA z masą "bulky" według klasyfikacji Ann Arbor. Ze względu na narastającą duszność, spowodowaną limfadenopatią śródpiersia, pierwszy cykl leczenia według schematu EVA (etopozyd, winblastyna, doksorubicyna) podano w 32. tygodniu ciąży. Pacjentka w 35. tygodniu ciąży urodziła zdrową córkę. Po zakończeniu ciąży rozpoczęto leczenie właściwe dla chłoniaka Hodgkina. W badaniach obrazowych po zakończonej terapii stwierdzono całkowitą remisję choroby. Przedstawiony opis przypadku ukazuje liczne problemy diagnostyczne, terapeutyczne oraz etyczne, jakie stawia przed lekarzem współwystępowanie u pacjentki aktywnej choroby nowotworowej i ciąży.

Research paper thumbnail of Attitudes of physicians toward risk assessment and use of granulocyte-colony stimulating factor (G-CSF) as primary prophylaxis (PP) in patients (pts) receiving chemotherapy with an intermediate risk of febrile neutropenia (FN)

Research paper thumbnail of Attitudes of physicians toward assessing risk and using granulocyte colony-stimulating factor as primary prophylaxis in patients receiving chemotherapy associated with an intermediate risk of febrile neutropenia

Medical Oncology, 2015

Febrile neutropenia (FN) is a potentially fatal complication of chemotherapy. This prospective, o... more Febrile neutropenia (FN) is a potentially fatal complication of chemotherapy. This prospective, observational study describes physicians' approaches toward assessing FN risk in patients receiving chemotherapy regimens with an intermediate (10-20 %) FN risk. In the baseline investigator assessment, physicians selected factors considered important when assessing overall FN risk and deciding on granulocyte colony-stimulating factor (G-CSF) primary prophylaxis (PP). Physicians then completed patient assessments using the same lists of factors. The final FN risk scores and whether G-CSF PP was planned were reported. The final analysis included 165 physicians and 944 patients. The most frequently considered factor in both assessments was chemotherapy agents in the backbone (88 % of investigator and 93 % of patient assessments). History of FN (83 %), baseline laboratory values (76 %) and age (73 %) were commonly selected at baseline, whereas tumor type (72 %), guidelines (62 %) and tumor stage (43 %) were selected most during patient assessments. Median investigator-reported FN risk threshold for G-CSF PP was 20 % (range 10-85 %). G-CSF PP was planned in 82 % of patients with an FN risk at or above this threshold; therefore, almost one-fifth of qualifying patients would not receive G-CSF PP. Physicians generally follow guidelines, but also consider individual patient characteristics when assessing FN risk and deciding on G-CSF PP. A standardized FN risk assessment may optimize the use of G-CSF PP, which may minimize the incidence of FN in patients undergoing chemotherapy with an intermediate FN risk. ClinicalTrials.gov Identifier: NCT01813721.

Research paper thumbnail of Leczenie podtrzymujące rytuksymabem u chorych na chłoniaka grudkowego w pierwszej i kolejnych remisjach choroby

Leczenie chorych na chłoniaka grudkowego (FL) wymaga starannego i indywidualnego zaplanowania mom... more Leczenie chorych na chłoniaka grudkowego (FL) wymaga starannego i indywidualnego zaplanowania momentu rozpoczęcia leczenia. Obecnie w leczeniu pierwszej linii standardem pozostaje immunochemioterapia z rytuksymabem (R). Niezależnie od metody indukcji pierwszej remisji (także monoterapia R i chemioterapia) chorzy odpowiadający na to leczenie odnoszą korzyść z leczenia podtrzymującego R. U wymagających leczenia pacjentów z nawrotem FL do wyboru jest kilka metod terapii, takich jak R w monoterapii lub w połączeniu z chemioterapią, radioimmunoterapią albo przeszczepieniem krwiotwórczych komórek macierzystych u wybranych chorych. Rytuksymab w leczeniu podtrzymującym, stosowany przez 2 lata według schematu cztery infuzje raz na tydzień co 6 miesięcy lub jedna infuzja co 2-3 miesiące, powinien wejść do standardów leczenia chorych z nawrotowym lub opornym FL po skutecznym leczeniu reindukującym.

Research paper thumbnail of Chłoniaki nie-Hodgkina

Research paper thumbnail of Chemotherapy (CT) treatment patterns and neutropenia management in gastric cancer patients (pts) receiving myelosuppressive chemotherapy in Europe

Research paper thumbnail of Genetic polymorphisms in the human leukocyte antigens (HLA DRB) and tumor necrosis factor (TNF) loci influence non-Hodgkin’s lymphoma outcome

Tumor necrosis factor (TNF) production and non-Hodgkin's lymphoma (NHL) outcome was found to be r... more Tumor necrosis factor (TNF) production and non-Hodgkin's lymphoma (NHL) outcome was found to be related to the TNF -308 polymorphism. To explore whether this could be linked to neighboring polymorphisms, we genotyped the TNF -376 , -308,-238,-163 , lymphotoxin alpha (LTá) +252 , and HLA DRB1 alleles in 204 NHL patients and 120 controls. TNF -308A was the only allele associated with higher TNF and its p55 and p75 receptors' levels (p=.009, p=.03, and p=.007) and lower complete remission rates (p=.006). Freedom from progression (FFP) and overall survival (OS) were shorter in patients with TNF -308A (p=.009 and p=.02), null HLA DRB1*02 allele (p=.007 and p=.14), or both genetic markers (p=.004 and p=.005). Multivariate analysis incorporating International Prognostic Index (IPI) identified TNF -308A (p<.0001, relative risk [RR]=1.63; p<.0001, RR=1.51) and null HLA DRB1*02 alleles (p=.015, RR=1.18; p<.0001, RR=1.25) as independent factors for FFP and OS. These results indicate the existence of at least two inherited factors involved in NHL outcome.

Research paper thumbnail of The Effectiveness of Pemetrexed Monotherapy Depending on Polymorphisms in TS and MTHFR Genes as Well as Clinical Factors in Advanced NSCLC Patients

Pathology & Oncology Research, 2015

In NSCLC, second-line chemotherapy using pemetrexed or docetaxel has limited efficacy and should ... more In NSCLC, second-line chemotherapy using pemetrexed or docetaxel has limited efficacy and should be dedicated to selected groups of patients. Pemetrexed is an antifolate compound with the ability to inhibit enzymes (TS, DHFR and GARFT) involved in pyrimidine and purine synthesis. The objective of this study was to evaluate the association between polymorphisms of TS and MHFR genes and clinical outcomes in NSCLC patients treated with pemetrexed monotherapy. DNA was isolated from peripheral blood of 72 non-squamous NSCLC patients treated with pemetrexed. Using PCR and RFLP methods, the variable number of tandem repeats (VNTR), the G &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; C SNP in these repeats and insertion/deletion polymorphism of TS gene as well as 677C &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; T SNP in MTHFR gene were analyzed and correlated with disease control rate, progression-free survival and overall survival (OS) of NSCLC patients. Carriers of 2R/3R(G), 3R(C)/3R(G), 3R(G)/3R(G) genotypes showed significantly more frequent early progression than carriers of 2R/2R, 2R/3R(C), 3R(C)/3R(C) genotypes of TS gene (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Among carriers of triple 28 bp tandem repeats (3R) in TS gene and C/C genotype of MTHFR gene a significantly shorter OS was observed (HR = 3.07; p = 0.003). In multivariate analysis, significantly higher risk of death was observed in carriers of both 3R/3R genotype in TS and C/C genotype in 677C &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; T SNP in MTHFR (HR = 3.85; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.005) as well as in patients with short duration of response to first-line chemotherapy (HR = 2.09; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.005). Results of our study suggested that genetic factors may have a high predictive and prognostic value (even greater than clinical factors) for patients treated with pemetrexed monotherapy.

Research paper thumbnail of Correlation Between TS, MTHFR, and ERCC1 Gene Polymorphisms and the Efficacy of Platinum in Combination With Pemetrexed First-Line Chemotherapy in Mesothelioma Patients

Clinical Lung Cancer, 2014

TS, MTHFR and ERCC1 polymorphisms may have implications for effectiveness of pemetrexed and plati... more TS, MTHFR and ERCC1 polymorphisms may have implications for effectiveness of pemetrexed and platinium chemotherapy and the impact on outcomes of mesothelioma patients. Studied polymorphism were analyzed in 59 mesothelioma patients and correlated with clinical data, disease control rate and survival rate. Different variants of 1494del6 in the 3 0 UTR of the TS gene were associated with differences in disease control rate and PFS of studied patients. Introduction: The combination of pemetrexed and platinum compound represents the standard regimen for first-line chemotherapy in malignant pleural mesothelioma patients. Pemetrexed is a multitarget antifolate agent that inhibits folate-dependent enzymes (eg, thymidylate synthase [TS]) and thus synthesis of nucleotides and DNA. Expression of TS and folate availability, regulated by gene polymorphisms, have implications for effectiveness of chemotherapy and the outcome of mesothelioma patients. The aim of this retrospective multicenter study was to assess the correlation between TS, 5,10-methylenetetrahydrofolate reductase (MTHFR) and excision repair cross-complementing group 1 (ERCC1) gene polymorphisms and the efficacy of pemetrexed-based first-line chemotherapy of mesothelioma patients. Patients and Methods: Fifty-nine mesothelioma patients (31 men with a median age of 62 years) treated in firstline chemotherapy with platinum in combination with pemetrexed or pemetrexed monotherapy were enrolled. Genomic DNA was isolated from peripheral blood. Using polymerase chain reaction and high resolution melt methods, the variable number of tandem repeat, the G>C single nucleotide polymorphism (SNP) in these repeats, and 6-base pair (bp) insertion/deletion polymorphism of the TS gene, the SNP of 677C>T in MTHFR, and 19007C>T in the ERCC1 gene were analyzed and correlated with disease control rate, progression-free survival (PFS), and overall survival (OS) of mesothelioma patients. Results: Greater risk of early disease progression (PD), and shortening of PFS and OS were associated with several clinical factors (eg, anemia for early PD and OS), weight loss (for PFS and OS), and previous surgical treatment (for early PD, PFS, and OS). Insertion of 6-bp in both alleles of the TS gene (1494del6) was the only genetic factor that increased the incidence of early progression (P ¼ .028) and shortening of median PFS (P ¼ .06) in patients treated with pemetrexed-based chemotherapy. In multivariate analysis, the 1494del6 in the 3 0 untranslated region (UTR) of the TS gene also had a predictive role for PFS (P ¼ .0185; hazard ratio, 2.3258 for þ6/þ6 homozygotes) in analyzed

Research paper thumbnail of Does diabetes alter the risk of neoplasms? Real-world data analysis in Poland: incidence rates for selected neoplasms in patients with diabetes

Polish Archives of Internal Medicine, 2016

Research paper thumbnail of Postępy w diagnostyce i leczeniu chorych na chłoniaki nie-Hodgkina

Research paper thumbnail of HLA-G and MHC Class II Protein Expression in Diffuse Large B-Cell Lymphoma

Archivum Immunologiae et Therapiae Experimentalis, 2015

The expression of human leukocyte antigen-G (HLA-G) and HLA class II protein was studied by immun... more The expression of human leukocyte antigen-G (HLA-G) and HLA class II protein was studied by immunohistochemical staining of lymph nodes from 148 patients with diffuse large B-cell lymphoma (DLBCL) and related to the clinical course of the disease. Negative HLA-G expression was associated with a lower probability of achieving a complete remission (p = 0.04). Patients with negative HLA-G expression tended towards a lower 3-year overall survival (OS) rate compared to those with positive expression of HLA-G (p = 0.08). When restricting the analysis to patients receiving chemotherapy with rituximab, the estimated 3-year OS rate of patients with positive HLA-G expression was 73.3 % compared with 47.5 % (p = 0.03) in those with negative expression. Patients with negative HLA class II expression presented a lower 3-year OS rate compared to subjects with positive expression (p = 0.04). The loss of HLA class II expression (p = 0.05) and belonging to the intermediate high/high IPI risk group (p = 0.001) independently increased the risk of death. HLA class II expression also retained its prognostic value in patients receiving rituximab; the 3-year OS rate was 65.3 % in patients with positive HLA class II expression versus 29.6 % (p = 0.04) in subjects that had loss of HLA class II expression. To our knowledge, for the first time, the expression of HLA-G protein in DLBCL and its association with the clinical course of the disease was demonstrated. Moreover, the link between losing HLA class II protein expression and poor survival of patients treated with immunochemotherapy was confirmed.

Research paper thumbnail of Zasady profilaktyki nudności i wymiotów indukowanych chemioterapia i radioterapią u chorych leczonych z powodu nowotworów układów krwiotwórczego i chłonnego

Nudności i wymioty (NV) stanowią najczęstsze objawy niepożądane leczenia przeciwnowotworowego. W ... more Nudności i wymioty (NV) stanowią najczęstsze objawy niepożądane leczenia przeciwnowotworowego. W niniejszej pracy podsumowano obecny stan wiedzy na temat profilaktyki NV indukowanych chemioterapią lub radioterapią; omówiono leki stosowane w tym wskazaniu i zasady oceny ryzyka wystąpienia NV oraz przedstawiono praktyczne przykłady planowania terapii zgodnie z zaleceniami.

Research paper thumbnail of Efficacy, safety and biomarker analysis of RG7160 (GA201), a novel dual-acting monoclonal antibody (mAb) designed to enhance antibody-dependent cellular cytotoxicity (ADCC), in combination with 1st line cisplatin and pemetrexed in metastatic non-squamous NSCLC

Research paper thumbnail of Chłoniaki strefy brzeżnej

Chłoniaki strefy brzeżnej (MZL, marginal zone lymphoma) to grupa chłoniaków nie-Hodgkina (NHL, no... more Chłoniaki strefy brzeżnej (MZL, marginal zone lymphoma) to grupa chłoniaków nie-Hodgkina (NHL, non-Hodgkin lymphoma) wywodząca się z dojrzałych obwodowych limfocytów B pochodzących ze strefy brzeżnej otaczającej ośrodki rozmnażania. Różnorodność cech biologicznych i klinicznych stała się podstawą ich podziału na jednostki histokliniczne, do których należą: 1) śledzionowy chłoniak strefy brzeżnej (SMZL, splenic B-cell marginal zone lymphoma); 2) węzłowy chłoniak strefy brzeżnej (NMZL, nodal marginal zone lymphoma); 3) pozawęzłowy chłoniak strefy brzeżnej MALT (MALT, mucosa-associated lymphoid tissue). Prowizoryczną kategorią w klasyfikacji Światowej Organizacji Zdrowia (WHO, World Health Organization) z 2008 roku jest dziecięcy węzłowy chłoniak strefy brzeżnej (pediatric nodal marginal zone lymphoma), który należy do wyjątkowo rzadko występujących chłoniaków w tej grupie wiekowej.

Research paper thumbnail of Leki antyosteolityczne

Research paper thumbnail of Perforation of the small intestine as an early complication of R-CHOP immunochemotherapy in patients with DLBCL — a report of two cases

Research paper thumbnail of Nowotwory z komórek T i NK

Research paper thumbnail of Fludarabine, mitoxantrone and dexamethasone in the treatment of relapsed and refractory low-grade non-Hodgkin lymphoma

Research paper thumbnail of Synchroniczne zachorowanie na nowotwór podścieliska przewodu pokarmowego i szpiczaka

We report a case of a 60-year-old man in whom synchronous appearance of gastrointenstinal stromal... more We report a case of a 60-year-old man in whom synchronous appearance of gastrointenstinal stromal tumor (GIST) and myeloma plasmocyticum (MP) with c-kit expression on both tumors. The treatment of MP with VAD (vincristine, adriamycin, dexamethasone), followed by a 9-month administration of thalidomide, combined with melphalan and dexamethasone given once a month, resulted in achieving and maintaining partial remission (PR)

Research paper thumbnail of Chłoniak Hodgkina u chorej w ciąży

Występowanie choroby nowotworowej u chorej w ciąży jest rzadkim problemem w onkologii i hematolog... more Występowanie choroby nowotworowej u chorej w ciąży jest rzadkim problemem w onkologii i hematologii. Przedstawiony opis przebiegu klinicznego dotyczy 29-letniej pacjentki w 28. tygodniu ciąży, u której rozpoznano chłoniaka Hodgkina (nodular sclerosis [NS] II). Zaawansowanie określono jako stopień IIA z masą "bulky" według klasyfikacji Ann Arbor. Ze względu na narastającą duszność, spowodowaną limfadenopatią śródpiersia, pierwszy cykl leczenia według schematu EVA (etopozyd, winblastyna, doksorubicyna) podano w 32. tygodniu ciąży. Pacjentka w 35. tygodniu ciąży urodziła zdrową córkę. Po zakończeniu ciąży rozpoczęto leczenie właściwe dla chłoniaka Hodgkina. W badaniach obrazowych po zakończonej terapii stwierdzono całkowitą remisję choroby. Przedstawiony opis przypadku ukazuje liczne problemy diagnostyczne, terapeutyczne oraz etyczne, jakie stawia przed lekarzem współwystępowanie u pacjentki aktywnej choroby nowotworowej i ciąży.

Research paper thumbnail of Attitudes of physicians toward risk assessment and use of granulocyte-colony stimulating factor (G-CSF) as primary prophylaxis (PP) in patients (pts) receiving chemotherapy with an intermediate risk of febrile neutropenia (FN)

Research paper thumbnail of Attitudes of physicians toward assessing risk and using granulocyte colony-stimulating factor as primary prophylaxis in patients receiving chemotherapy associated with an intermediate risk of febrile neutropenia

Medical Oncology, 2015

Febrile neutropenia (FN) is a potentially fatal complication of chemotherapy. This prospective, o... more Febrile neutropenia (FN) is a potentially fatal complication of chemotherapy. This prospective, observational study describes physicians&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; approaches toward assessing FN risk in patients receiving chemotherapy regimens with an intermediate (10-20 %) FN risk. In the baseline investigator assessment, physicians selected factors considered important when assessing overall FN risk and deciding on granulocyte colony-stimulating factor (G-CSF) primary prophylaxis (PP). Physicians then completed patient assessments using the same lists of factors. The final FN risk scores and whether G-CSF PP was planned were reported. The final analysis included 165 physicians and 944 patients. The most frequently considered factor in both assessments was chemotherapy agents in the backbone (88 % of investigator and 93 % of patient assessments). History of FN (83 %), baseline laboratory values (76 %) and age (73 %) were commonly selected at baseline, whereas tumor type (72 %), guidelines (62 %) and tumor stage (43 %) were selected most during patient assessments. Median investigator-reported FN risk threshold for G-CSF PP was 20 % (range 10-85 %). G-CSF PP was planned in 82 % of patients with an FN risk at or above this threshold; therefore, almost one-fifth of qualifying patients would not receive G-CSF PP. Physicians generally follow guidelines, but also consider individual patient characteristics when assessing FN risk and deciding on G-CSF PP. A standardized FN risk assessment may optimize the use of G-CSF PP, which may minimize the incidence of FN in patients undergoing chemotherapy with an intermediate FN risk. ClinicalTrials.gov Identifier: NCT01813721.

Research paper thumbnail of Leczenie podtrzymujące rytuksymabem u chorych na chłoniaka grudkowego w pierwszej i kolejnych remisjach choroby

Leczenie chorych na chłoniaka grudkowego (FL) wymaga starannego i indywidualnego zaplanowania mom... more Leczenie chorych na chłoniaka grudkowego (FL) wymaga starannego i indywidualnego zaplanowania momentu rozpoczęcia leczenia. Obecnie w leczeniu pierwszej linii standardem pozostaje immunochemioterapia z rytuksymabem (R). Niezależnie od metody indukcji pierwszej remisji (także monoterapia R i chemioterapia) chorzy odpowiadający na to leczenie odnoszą korzyść z leczenia podtrzymującego R. U wymagających leczenia pacjentów z nawrotem FL do wyboru jest kilka metod terapii, takich jak R w monoterapii lub w połączeniu z chemioterapią, radioimmunoterapią albo przeszczepieniem krwiotwórczych komórek macierzystych u wybranych chorych. Rytuksymab w leczeniu podtrzymującym, stosowany przez 2 lata według schematu cztery infuzje raz na tydzień co 6 miesięcy lub jedna infuzja co 2-3 miesiące, powinien wejść do standardów leczenia chorych z nawrotowym lub opornym FL po skutecznym leczeniu reindukującym.

Research paper thumbnail of Chłoniaki nie-Hodgkina

Research paper thumbnail of Chemotherapy (CT) treatment patterns and neutropenia management in gastric cancer patients (pts) receiving myelosuppressive chemotherapy in Europe

Research paper thumbnail of Genetic polymorphisms in the human leukocyte antigens (HLA DRB) and tumor necrosis factor (TNF) loci influence non-Hodgkin’s lymphoma outcome

Tumor necrosis factor (TNF) production and non-Hodgkin's lymphoma (NHL) outcome was found to be r... more Tumor necrosis factor (TNF) production and non-Hodgkin's lymphoma (NHL) outcome was found to be related to the TNF -308 polymorphism. To explore whether this could be linked to neighboring polymorphisms, we genotyped the TNF -376 , -308,-238,-163 , lymphotoxin alpha (LTá) +252 , and HLA DRB1 alleles in 204 NHL patients and 120 controls. TNF -308A was the only allele associated with higher TNF and its p55 and p75 receptors' levels (p=.009, p=.03, and p=.007) and lower complete remission rates (p=.006). Freedom from progression (FFP) and overall survival (OS) were shorter in patients with TNF -308A (p=.009 and p=.02), null HLA DRB1*02 allele (p=.007 and p=.14), or both genetic markers (p=.004 and p=.005). Multivariate analysis incorporating International Prognostic Index (IPI) identified TNF -308A (p<.0001, relative risk [RR]=1.63; p<.0001, RR=1.51) and null HLA DRB1*02 alleles (p=.015, RR=1.18; p<.0001, RR=1.25) as independent factors for FFP and OS. These results indicate the existence of at least two inherited factors involved in NHL outcome.