F. Abar - Academia.edu (original) (raw)

Papers by F. Abar

Clinical Lymphoma Myeloma and Leukemia, 2014

High dose therapy for light chain amyloidosis (AL) was performed in 31 patients at a single insti... more High dose therapy for light chain amyloidosis (AL) was performed in 31 patients at a single institution. This is a retrospective study, describing the outcomes of patients with and without cardiac involvement, patients not pre-treated as well as those that received induction chemotherapy. Bortezomib is well tolerated and results in higher overall response rates and shorter time to hematologic response. Introduction/Background: High-dose melphalan (HDM) followed by autologous stem cell transplant (ASCT) for light chain amyloidosis (AL) was performed in 31 patients at Oregon Health and Science University between 2005 and 2012. Fifteen patients had cardiac involvement. Patients and Methods: Patients received melphalan 200 mg/m 2 or doseadjusted HDM (100-140 mg/m 2) depending on high risk features. Thirteen patients proceeded directly to ASCT after diagnosis, 12 patients received a bortezomib-containing regimen, and 6 received a variety of other induction regimens. Results: The day 100 treatment-related mortality was 9.6%. Overall hematologic (ORR) and organ response rates (OR) in the whole cohort after ASCT were 77% and 58%. ORR and OR in the bortezomib pretreated group were 92% and 75% vs. 69% and 54% in the group that received no pretreatment. The median time to maximum hematologic response after ASCT was reduced in the group that received bortezomib induction (3 vs. 14 months). Overall cardiac response rate was 60%; 100% in patients pretreated with bortezomib and 43% in those without induction treatment. With a median follow-up of 2.9 years, the 3-year progression-free and overall survival rates in the entire cohort were 66% and 73% and in those with cardiac involvement, 73% and 80%. Conclusion: We observed that bortezomib-based induction is well tolerated in patients with and without cardiac involvement and suggest that this approach be studied in prospective multi-institutional trials.

Blood and Marrow Transplant Handbook, 2010

Chronic graft-versus-host disease (cGvHD) is the single major factor influencing long-term outcom... more Chronic graft-versus-host disease (cGvHD) is the single major factor influencing long-term outcome and quality of life after allogeneic transplantation. However, the presence of cGvHD has been linked to decrease in relapse rate of patients with CML, ALL, and AML. In a recent CIBMTR/NMDP analysis of ∼3500 transplant patients with cGvHD, risk of relapse was reduced by 50%. Traditionally, cGvHD has

Biology of Blood and Marrow Transplantation, 2009

during therapy in patients with cGVHD, and correlating cell numbers with response. Methods: We st... more during therapy in patients with cGVHD, and correlating cell numbers with response. Methods: We studied 25 adult pts with histories of hematological malignancies who developed cGVHD after allogeneic, HLAmatched HPCT. At the time of ECP initiation, pts were either dependent upon corticosteroids for control of cGvHD (21 pts), or steroid-intolerant (4 pts). A good response was defined as having. 50% reduction in the corticosteroid dose within 4 months of starting ECP, with improved or stable lesions on skin and other sites. For steroid-intolerant pts, improvement in skin condition was used to identify responders. PBMCs were analyzed before ECP began and every 2 months during ECP therapy. The numbers of plasmacytoid DCs (pDC, Lin-CD1231CD11c-HLA-DR1), myeloid DCs (mDC, Lin-CD123-CD11c1HLA-DR1), and CD41 and CD81 T-cells in blood were determined by flow cytometry. Results: The median number of ECP treatments was 26 (range 2-68). Fourteen pts (56%) had good response, and 11 were non-responders. Responders had an estimated 2-yr survival of 88% after starting ECP, vs 18% for non-responders (p 5 0.004). Responders had higher baseline numbers of pDCs (average 5.8 vs. 0.6 cells/ mcL, p 5 0.025) and mDCs (average 15 vs. 3.8 cells/mcL, p 5 0.01) compared with non-responders. Baseline CD41 T-cell numbers were higher in responders compared with non-responders (average 623 vs. 178 cells/mcL, p 5 0.005), as were CD81 T-cell numbers (712 vs. 251 cells/mcL, p 5 0.047). There was no correlation between incidence of infection and numbers of T-cells or DCs, or response to ECP. Contrary to the original hypothesis, there were no consistent changes in the numbers of circulating DCs and T-cells among responders over a 12-month period. Conclusion: Our results demonstrate that higher numbers of circulating DCs and T-cells predict response to ECP in pts with cGVHD. Response to ECP was significantly associated with improved survival in univariate and multivariate analyses (p\0.03). Our findings support a newer model for the mechanism of response to ECP therapy, involving interactions between donor-derived DCs and donor T-cells.

Biology of Blood and Marrow Transplantation, 2013

recorded data that includes blood pressure (BP) readings 4 weeks before the transplant and then a... more recorded data that includes blood pressure (BP) readings 4 weeks before the transplant and then at days 0, 30,100 and 180. Other data includes GFR which is calculated by using the Cockcroft Gault formula at the same intervals, sub-type of MM and Durie-Salmon stage at diagnosis, disease response to therapy, BMI at baseline; and other comorbidities such as diabetes, hyperlipedemia and coronary artery disease. Statistical analyses were performed using the statistical package of SPSS version 18. All P-values were 2-sided. Results: In this study 184 patients were included. The sample demographics at baseline are presented in Table 1. Association between BP stages and disease status before ASCT and at day 0 was statistically significant (p¼.025 , X 2 ¼14.408); there was no statistically significant association between stages of HTN at 0 , 30,100 and 180 days after the ASCT in regards to age , race or gender. Mean Systolic and diastolic BP-value showed no statistically significant difference at the same intervals respectively. In addition, there was no correlation between stages of HTN, and stages or type of MM. The only statistically significant association between chronic kidney disease (CKD) stages and BP stages was at day 0 (day ASCT infused) (P¼.032, X 2 ¼ 26.670. The association between CKD stages and disease status at 100 days after melphalan was statistically significant (P¼.043, X 2 ¼25.568). The associations between BP stages and BMI stages were borderline or statistically significant at 30 days (P¼.054 and X 2 ¼16.665), 100 days (P¼.026 and X 2 ¼18.947) and 180 days(P¼.001, X 2 ¼27.120). Conclusion: There was no direct effect of ASCT on blood pressure improvement. Other factors such as BMI and disease status at baseline appear to play more roles on Bp control. Majority of our patient were transplanted at early stages of (CKD) which can explain the result. We suggest a prospective study that evaluates the impact of ASCT in MM patients with high BP.

Purpose-Despite recent advances, multiple myeloma remains incurable and most patients eventually ... more Purpose-Despite recent advances, multiple myeloma remains incurable and most patients eventually develop progressive disease. Allogeneic hematopoietic stem cell transplantation (allo HCT) offers a potentially curative option in 10-20% of patients with relapsed or refractory disease. We evaluated the outcome of patients undergoing allo HCT with reduced-intensity conditioning (RIC) for relapsed and/or refractory myeloma at our institution.

Biology of Blood and Marrow Transplantation, 2012

Biology of Blood and Marrow Transplantation, 2010

Biology of Blood and Marrow Transplantation, 2010

Purpose-Despite recent advances, multiple myeloma remains incurable and most patients eventually ... more Purpose-Despite recent advances, multiple myeloma remains incurable and most patients eventually develop progressive disease. Allogeneic hematopoietic stem cell transplantation (allo HCT) offers a potentially curative option in 10-20% of patients with relapsed or refractory disease. We evaluated the outcome of patients undergoing allo HCT with reduced-intensity conditioning (RIC) for relapsed and/or refractory myeloma at our institution.

Biology of Blood and Marrow Transplantation, 2009

during therapy in patients with cGVHD, and correlating cell numbers with response.

Clinical Lymphoma Myeloma and Leukemia, 2014

High dose therapy for light chain amyloidosis (AL) was performed in 31 patients at a single insti... more High dose therapy for light chain amyloidosis (AL) was performed in 31 patients at a single institution. This is a retrospective study, describing the outcomes of patients with and without cardiac involvement, patients not pre-treated as well as those that received induction chemotherapy. Bortezomib is well tolerated and results in higher overall response rates and shorter time to hematologic response. Introduction/Background: High-dose melphalan (HDM) followed by autologous stem cell transplant (ASCT) for light chain amyloidosis (AL) was performed in 31 patients at Oregon Health and Science University between 2005 and 2012. Fifteen patients had cardiac involvement. Patients and Methods: Patients received melphalan 200 mg/m 2 or doseadjusted HDM (100-140 mg/m 2) depending on high risk features. Thirteen patients proceeded directly to ASCT after diagnosis, 12 patients received a bortezomib-containing regimen, and 6 received a variety of other induction regimens. Results: The day 100 treatment-related mortality was 9.6%. Overall hematologic (ORR) and organ response rates (OR) in the whole cohort after ASCT were 77% and 58%. ORR and OR in the bortezomib pretreated group were 92% and 75% vs. 69% and 54% in the group that received no pretreatment. The median time to maximum hematologic response after ASCT was reduced in the group that received bortezomib induction (3 vs. 14 months). Overall cardiac response rate was 60%; 100% in patients pretreated with bortezomib and 43% in those without induction treatment. With a median follow-up of 2.9 years, the 3-year progression-free and overall survival rates in the entire cohort were 66% and 73% and in those with cardiac involvement, 73% and 80%. Conclusion: We observed that bortezomib-based induction is well tolerated in patients with and without cardiac involvement and suggest that this approach be studied in prospective multi-institutional trials.

Blood and Marrow Transplant Handbook, 2010

Chronic graft-versus-host disease (cGvHD) is the single major factor influencing long-term outcom... more Chronic graft-versus-host disease (cGvHD) is the single major factor influencing long-term outcome and quality of life after allogeneic transplantation. However, the presence of cGvHD has been linked to decrease in relapse rate of patients with CML, ALL, and AML. In a recent CIBMTR/NMDP analysis of ∼3500 transplant patients with cGvHD, risk of relapse was reduced by 50%. Traditionally, cGvHD has

Biology of Blood and Marrow Transplantation, 2009

during therapy in patients with cGVHD, and correlating cell numbers with response. Methods: We st... more during therapy in patients with cGVHD, and correlating cell numbers with response. Methods: We studied 25 adult pts with histories of hematological malignancies who developed cGVHD after allogeneic, HLAmatched HPCT. At the time of ECP initiation, pts were either dependent upon corticosteroids for control of cGvHD (21 pts), or steroid-intolerant (4 pts). A good response was defined as having. 50% reduction in the corticosteroid dose within 4 months of starting ECP, with improved or stable lesions on skin and other sites. For steroid-intolerant pts, improvement in skin condition was used to identify responders. PBMCs were analyzed before ECP began and every 2 months during ECP therapy. The numbers of plasmacytoid DCs (pDC, Lin-CD1231CD11c-HLA-DR1), myeloid DCs (mDC, Lin-CD123-CD11c1HLA-DR1), and CD41 and CD81 T-cells in blood were determined by flow cytometry. Results: The median number of ECP treatments was 26 (range 2-68). Fourteen pts (56%) had good response, and 11 were non-responders. Responders had an estimated 2-yr survival of 88% after starting ECP, vs 18% for non-responders (p 5 0.004). Responders had higher baseline numbers of pDCs (average 5.8 vs. 0.6 cells/ mcL, p 5 0.025) and mDCs (average 15 vs. 3.8 cells/mcL, p 5 0.01) compared with non-responders. Baseline CD41 T-cell numbers were higher in responders compared with non-responders (average 623 vs. 178 cells/mcL, p 5 0.005), as were CD81 T-cell numbers (712 vs. 251 cells/mcL, p 5 0.047). There was no correlation between incidence of infection and numbers of T-cells or DCs, or response to ECP. Contrary to the original hypothesis, there were no consistent changes in the numbers of circulating DCs and T-cells among responders over a 12-month period. Conclusion: Our results demonstrate that higher numbers of circulating DCs and T-cells predict response to ECP in pts with cGVHD. Response to ECP was significantly associated with improved survival in univariate and multivariate analyses (p\0.03). Our findings support a newer model for the mechanism of response to ECP therapy, involving interactions between donor-derived DCs and donor T-cells.

Biology of Blood and Marrow Transplantation, 2013

recorded data that includes blood pressure (BP) readings 4 weeks before the transplant and then a... more recorded data that includes blood pressure (BP) readings 4 weeks before the transplant and then at days 0, 30,100 and 180. Other data includes GFR which is calculated by using the Cockcroft Gault formula at the same intervals, sub-type of MM and Durie-Salmon stage at diagnosis, disease response to therapy, BMI at baseline; and other comorbidities such as diabetes, hyperlipedemia and coronary artery disease. Statistical analyses were performed using the statistical package of SPSS version 18. All P-values were 2-sided. Results: In this study 184 patients were included. The sample demographics at baseline are presented in Table 1. Association between BP stages and disease status before ASCT and at day 0 was statistically significant (p¼.025 , X 2 ¼14.408); there was no statistically significant association between stages of HTN at 0 , 30,100 and 180 days after the ASCT in regards to age , race or gender. Mean Systolic and diastolic BP-value showed no statistically significant difference at the same intervals respectively. In addition, there was no correlation between stages of HTN, and stages or type of MM. The only statistically significant association between chronic kidney disease (CKD) stages and BP stages was at day 0 (day ASCT infused) (P¼.032, X 2 ¼ 26.670. The association between CKD stages and disease status at 100 days after melphalan was statistically significant (P¼.043, X 2 ¼25.568). The associations between BP stages and BMI stages were borderline or statistically significant at 30 days (P¼.054 and X 2 ¼16.665), 100 days (P¼.026 and X 2 ¼18.947) and 180 days(P¼.001, X 2 ¼27.120). Conclusion: There was no direct effect of ASCT on blood pressure improvement. Other factors such as BMI and disease status at baseline appear to play more roles on Bp control. Majority of our patient were transplanted at early stages of (CKD) which can explain the result. We suggest a prospective study that evaluates the impact of ASCT in MM patients with high BP.

Purpose-Despite recent advances, multiple myeloma remains incurable and most patients eventually ... more Purpose-Despite recent advances, multiple myeloma remains incurable and most patients eventually develop progressive disease. Allogeneic hematopoietic stem cell transplantation (allo HCT) offers a potentially curative option in 10-20% of patients with relapsed or refractory disease. We evaluated the outcome of patients undergoing allo HCT with reduced-intensity conditioning (RIC) for relapsed and/or refractory myeloma at our institution.

Biology of Blood and Marrow Transplantation, 2012

Biology of Blood and Marrow Transplantation, 2010

Biology of Blood and Marrow Transplantation, 2010

Purpose-Despite recent advances, multiple myeloma remains incurable and most patients eventually ... more Purpose-Despite recent advances, multiple myeloma remains incurable and most patients eventually develop progressive disease. Allogeneic hematopoietic stem cell transplantation (allo HCT) offers a potentially curative option in 10-20% of patients with relapsed or refractory disease. We evaluated the outcome of patients undergoing allo HCT with reduced-intensity conditioning (RIC) for relapsed and/or refractory myeloma at our institution.

Biology of Blood and Marrow Transplantation, 2009

during therapy in patients with cGVHD, and correlating cell numbers with response.