Janusz Halka - Academia.edu (original) (raw)

Papers by Janusz Halka

Hematological Oncology, Jun 1, 2023

Hematology, 2021

ABSTRACT Background Azacitidine (AZA) is the standard of care for higher-risk myelodysplastic syn... more ABSTRACT Background Azacitidine (AZA) is the standard of care for higher-risk myelodysplastic syndrome (HR-MDS) patients ineligible for intensive therapy. Clinical outcome discrepancies reported in clinical trials and real-life settings stimulate the search for new prognostic factors. Methods We retrospectively evaluated 315 MDS, 20–30% blast acute myeloid leukemia (AML) and chronic myelomonocytic leukemia (CMML) patients treated with azacitidine in 12 centers cooperating within the Polish Adult Leukemia Group (PALG). Results The median number of AZA cycles was 7 (1–69) and 24% patients received fewer than 4 cycles (early failure, EF). Serum albumin level was an independent predictor of EF occurrence. Complete remission (CR) was obtained in 20% and partial remission (PR) in 12% of patients. Hematologic improvement – erythroid (HI-E), neutrophil (HI-N), or platelet (HI-P) was achieved in 51%, 36%, and 48% of patients, respectively. No factors significantly predicted CR or PR in the multivariate analysis. For HI-E and HI-P, lower LDH level predicted response. Median survival was 15 (13–19) months. Lower serum albumin level, serious infection and receiving <4 AZA cycles independently predicted a worse overall survival (OS) (p < 0.05). Conclusion Serum albumin assessment before azacitidine treatment can help to identify patients with higher risk of early failure and worse clinical outcome.

Fragility scales are intended to help in therapeutic decisions. Here we asked if the fragility as... more Fragility scales are intended to help in therapeutic decisions. Here we asked if the fragility as-sessment in MM patients ≥75 years old qualified for treatment by the local physician correlates with the choice of treatment: a 2- or 3-drug regimen. Between 7/2018 to 12/2019 we prospectively enrolled 197 MM patients at the start of treatment from the 13 Polish Myeloma Group centers. The data to assess fragility were prospectively collected, but centrally assessed fragility was not disclosed to the local center. The activity of daily living (ADL) could be assessed in 192 (97.5%) and was independent in 158 (80.2%), moderately impaired in 23 (11.7%), and 11 (5.6%) in com-pletely dependent. Patients with more than 3 comorbidities were 26.9% (53 patients). Thus, ac-cording to the Palumbo calculator, 43 patients were in the intermediate-fitness group (21.8%), and the rest belonged to the frailty group (153, 77.7%). Overall, 79.7% of patients (157) received 3-drug regimens and 20.3% (40) rec...

Acta Haematologica Polonica, 2017

Acta Haematologica Polonica, 2013

Współczesne protokoły terapeutyczne pozwalają wyleczyć 70-80% dzieci i zaledwie 30-40% dorosłych ... more Współczesne protokoły terapeutyczne pozwalają wyleczyć 70-80% dzieci i zaledwie 30-40% dorosłych z ALL. Cel: Porównanie wyników leczenia młodzieży (14-18 lat) i młodych dorosłych (18-23 lat) z ALL.

Archives of Medical Science, 2021

IntroductionThis research aimed to study CD49d expression – a potential prognosis marker in chron... more IntroductionThis research aimed to study CD49d expression – a potential prognosis marker in chronic lymphocytic leukaemia (CLL) patients – at the protein and mRNA levels. It was analysed in terms of time to first treatment and compared to currently known prognostic markers and novel molecular markers.Material and methodsUsing samples from 199 newly diagnosed CLL patients, we conducted immunophenotypical analyses of CD49d with flow cytometry, and assessed its expression on the mRNA level using quantitative polymerase chain reaction (PCR).ResultsCytometric analysis showed significantly higher expression of CD49d protein in ZAP-70+ (cut-off of 20%) patients than that in ZAP-70 patients (18.52 vs. 6.57, p = 0.028), and a tendency of higher CD49d expression in CD38+ patients than in CD38 patients (20.48 vs. 7.25, p = 0.072). CD49d expression significantly correlated with serum β2-microglobulin (r = 0.273, p = 0.012) and lactate dehydrogenase activity (r = 0.159, p < 0.01). Analysed in...

OncoReview, Feb 4, 2021

Termin gammapatia monoklonalna o znaczeniu nerkowym (MGRS, monoclonal gammopathy of renal signifi... more Termin gammapatia monoklonalna o znaczeniu nerkowym (MGRS, monoclonal gammopathy of renal significance) dotyczy grupy chorób nerek będącej skutkiem obecności białka monoklonalnego wydzielanego przez komórki plazmatyczne bądź inne klony komórek B. Chorzy, u których rozpoznaje się MGRS, nie spełniają kryteriów diagnostycznych szpiczaka plazmocytowego, a także innych nowotworów wywodzących się z komórek B. Dysfunkcja nerek związana z MGRS wynika z zajęcia różnych ich struktur. Białko monoklonalne może uszkadzać zarówno struktury kłębuszka nerkowego (także naczynia), jak i cewek nerkowych (szerzej-śródmiąższ). Wczesne rozpoznanie MGRS sprawia trudności diagnostyczne, natomiast późne wykrycie jest obarczone dużym ryzykiem nieodwracalnego uszkodzenia nerek. Ta nowa metajednostka hematonefrologiczna wiąże się z relatywnie wysoką zachorowalnością i śmiertelnością, w tym z nawrotami w przeszczepionej nerce. Z tego względu istotne znaczenie w poprawie skuteczności diagnostyki i leczenia chorych z MGRS ma współpraca wielospecjalistyczna-szczególnie obejmująca lekarzy rodzinnych oraz nefrologów, hematologów i nefropatologów. W przypadku MGRS podjęcie decyzji o leczeniu przeciwko toksycznemu klonowi wynika głównie z przesłanek nefrologicznych. W artykule przedstawiono aktualne możliwości zarówno diagnostyczne, jak i terapeutyczne u chorych z MGRS. Praca ma na celu przedstawienie aktualnego stanu wiedzy dotyczącego możliwości w zakresie diagnostyki i leczenia MGRS. Słowa kluczowe: gammapatia monoklonalna o znaczeniu nerkowym, gammapatia monoklonalna o nieokreślonym znaczeniu, choroba nerek

Hematology in Clinical Practice, 2011

Translokacja (9;22)(q34:q11.2), zwana chromosomem Filadelfia (Ph), jest najczęstszym zaburzeniem ... more Translokacja (9;22)(q34:q11.2), zwana chromosomem Filadelfia (Ph), jest najczęstszym zaburzeniem cytogenetycznym stwierdzanym u dorosłych chorych na ostrą białaczkę limfoblastyczną (ALL). Przed wprowadzeniem inhibitorów kinazy tyrozynowej (TKI) podtyp ALL Ph+ był obciążony szczególnie złym rokowaniem. Wprowadzenie imatynibu (IM), stosowanego w skojarzeniu z chemioterapią indukującą i konsolidującą, pozwoliło na zwiększenie odsetka całkowitych remisji do ponad 90% i zwiększenie szansy na allogeniczne przeszczepienie krwiotwórczych komórek macierzystych. Pierwsze doniesienia dotyczące wyników odległych wskazują na poprawę prawdopodobieństwa przeżycia, które w perspektywie 5-letniej wynosi obecnie około 50%. Konieczne jest przeprowadzenie dalszych badań klinicznych zmierzających do ustalenia optymalnego sposobu stosowania IM oraz określenia ewentualnej roli TKI II generacji w leczeniu I linii.

Cancer management and research, Oct 1, 2020

Purpose: Mean platelet volume (MPV) is a readily accessible and commonly tested hematological ind... more Purpose: Mean platelet volume (MPV) is a readily accessible and commonly tested hematological indicator. Recent studies revealed a significant impact of MPV on the course and prognosis of many diseases, including some types of cancer, as well as on the incidence of atrial fibrillation and bleeding. The study aimed to perform a retrospective analysis of MPV in terms of time to first treatment (TTFT) and to determine its prognostic value in the group of patients with chronic lymphocytic leukemia (CLL). Moreover, the study includes a retrospective analysis of platelet parameters in patients treated with ibrutinib concerning bleeding and atrial fibrillation. Patients and Methods: The study included 523 patients with CLL, for 344 the most important cytogenetic aberrations were reported. The Mann-Whitney, Kruskal-Wallis, Kaplan-Meier, chi-squared, log-rank tests and multivariate Cox proportional hazard regression model were used to analyze collected data. Results: The receiver operating characteristic curve analysis was performed to identify optimal cutoff value for MPV. The analysis of survival curves showed that in the group of patients with higher values of MPV TTFT was significantly longer than in the group with lower MPV (17.9 vs 36 months, p=0.0015, cutoff value for MPV= 10.4 fl). In multivariate Cox proportional hazard regression model low MPV, the presence of del11q and del13q provided independent prognostic value for TTFT (HR=0.69, 95%-CI, 0.5293 to 0.9081; p=0.0078; HR=1.76, 95%-CI, 1.3000 to 2.3882, p=0.0003, HR=0.74, 95%-Cl, 0.5674 to 0.9588, p=0.0229, respectively). In the group treated with ibrutinib, 59 patients had no significant correlation between MPV level and the incidence of therapy complications, although in the group of patients with low MPV there was a tendency for more frequent occurrence of atrial fibrillation (p=0.259). Conclusion: Low MPV values are associated with unfavorable prognosis and might represent a novel, independent prognostic factor in CLL.

$Research paper thumbnail of L-Mind: A Safety and Efficacy Analysis of Tafasitamab in Patients with Relapsed/Refractory Diffuse Large B-Cell Lymphoma (R/R DLBCL) Receiving Treatment for at Least 2 Years$

$Research paper thumbnail of ABCL-388 L-MIND: Safety and Efficacy of Tafasitamab in Patients With Relapsed/Refractory Diffuse Large B-Cell Lymphoma on Treatment for at Least 2 Years$

Clinical Lymphoma, Myeloma & Leukemia, Oct 1, 2022

OncoReview, Jun 30, 2020

Pixantrone is a first drug aza-anthracenedione approved as monotherapy of relapsed or refractory ... more Pixantrone is a first drug aza-anthracenedione approved as monotherapy of relapsed or refractory aggressive lymphomas. This drug has the unique chemical structure and mode of action properties distinguishing it from anthracyclines and anthracenediones. Pixantrone is one of the treatment option for heavily pretreated patients which to receive their living with doxorubicin and the further application from anthracyclines potentially can lead anthracycline-induced congestive heart failure. The benefit of pixantrone treatment has not been established in patients when used as v line or greater chemotherapy in patients who are refractory to last therapy. In general, pixantrone seems to be safe and manageable. In various trials, there were no unexpected side effects reported and no trials were closed prematurely because of side effects. In an evaluation of 12 clinical trials with pixantrone, the most common side effect (all grades) was hematological toxicity, mainly neutropenia (50% of patients; grade third/fourth: 41%), leukopenia (25%), anemia (31%), and thrombocytopenia (21%). Hematological toxicity was the main reason for a delayed start of subsequent cycles or for omitting the day-15 dose of pixantrone. In the outpatient setting, it is worth considering the use of hematopoietic growth factors. Other side effects included asthenia (23%), pyrexia (23%), and nausea, most patients experienced reversible skin discoloration.

Blood, Dec 2, 2016

The clinical course of chronic lymphocytic leukemia (CLL) is highly heterogeneous, from stable to... more The clinical course of chronic lymphocytic leukemia (CLL) is highly heterogeneous, from stable to a rapidly progressive. The variety of prognostic factors has been already described, nevertheless they are not fully efficient in predicting the course of CLL, especially when the disease is diagnosed at an early stage. Recently, beside well established cytogenetic prognostic factors, novel molecular mutations of predictive value have been identified. Many of them have been thoroughly characterized, including TP53 mutation, which is commonly considered as a strong, negative prognostic factor. The use of next-generation sequencing technology has also revealed previously unknown genomic alterations, such as neurogenic locus notch homolog protein1 (NOTCH1), splicing factor 3B subunit 1 (SF3B1) or myeloid differentiation primary response 88 (MYD88). These new mutations could partly explain the CLL heterogeneity and help in identifying clinically relevant groups of patients. The aim of the study was to characterize CLL patients with NOTCH1, MYD88 and SF3B1 mutations with regard to molecular and immunological prognostic markers in CLL. Peripheral blood mononuclear cells (PBMCs) were obtained from 369 CLL patients at the moment of diagnosis and the median age reached 65 years. Sixty percent of the patients were male. Distribution of disease stages according to the Rai classification was the following: 0 stage=93, I stage=52, II stage=69, III stage=14, IV stage=26. Clinically, the prognostic significance in terms of time to first treatment (TTFT) was assessed for 202 CLL patients. DNA samples were extracted from PBMCs obtained after Ficoll density gradient centrifugation. NOTCH1 c.7544_7545delCT (n=316) in PEST domain (exon 34) and MYD88 L265P (n=323) mutations were investigated by ARMS PCR. Screening for SF3B1 (n=364) mutations K700, E622/R625 and H662/K666 (exons 14 and 15) were performed using HRM analysis and the results were confirmed by Sanger sequencing. The IGHV gene mutations were investigated by Sanger sequencing. NOTCH1 mutations were found in 19/316 (6.0%) patients. Patients harbouring NOTCH1 mutations prevalently have unfavourable prognostic factors including unmutated IGHV gene status, expression of CD38 (&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;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;gt;30%) and expression of ZAP-70 (&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;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;gt;20%). The complete analysis of correlations between NOTCH1, MYD88 and SF3B1 mutations and prognostic markers in CLL are presented in Table 1. Analysis of IGHV subsets in patients with…

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Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego, Aug 1, 2008

One of the haematological causes of stroke is essential thrombocythemia (ET). It is one of the pr... more One of the haematological causes of stroke is essential thrombocythemia (ET). It is one of the proliferative syndromes of the haematopoietic system. Patients with ET have an increased risk of thrombosis and/or haemorrhage of veins and arteries. The patient aged 58 had a history of two stroke incidents within two month despite the treatment with acenocumarole for chronic atrial fibrillation. The clinical diagnostic procedure revealed an increased platelet count was 668 000/ml, and these cerebrovascular events were the first manifestation of ET Antithrombotic drugs were not effective in the secondary prevention of stroke while antiplatelets prevented this patient from further ischemic events for 12 months.

Acta haematologica Polonica, Nov 1, 2015

a c t a h a e m a t o l o g i c a p o l o n i c a 4 6 (2 0 1 5) 3 8 5-3 9 2 i n f o r m a c j e o... more a c t a h a e m a t o l o g i c a p o l o n i c a 4 6 (2 0 1 5) 3 8 5-3 9 2 i n f o r m a c j e o a r t y k u l e Historia artykułu:

PubMed, 2010

Cytotoxicity of drugs can be a cause of cardiorespiratory disorders connected with chemotherapy. ... more Cytotoxicity of drugs can be a cause of cardiorespiratory disorders connected with chemotherapy. Doxorubicin is an antibiotic from the group of anthracyclines effective in antineoplastic therapy of solid and hematopoetic tumors. The most common cause of therapy ceasing is its cardiotoxicity. However, a lung injury connected with its cytotoxic activity to pulmonary endothelium (capillary leak syndrome) can be an equally serious complication. In the case presented, rapid, multi-profile diagnostics with the use of impedance cardiography, a modern noninvasive tool of hemodynamic monitoring, led to the recognition and effective treatment of a rare clinical syndrome.

Polskie Archiwum Medycyny Wewnetrznej-polish Archives of Internal Medicine, May 17, 2022

Histopathological examination showed the infiltration of plasma cells with various degrees of mor... more Histopathological examination showed the infiltration of plasma cells with various degrees of morphological maturity. Immunophenotyping revealed CD138+, λ+ > κ+ (FIGurE 1F-1H). Plasma cell tumor was diagnosed based on the following results: CD20-, CD3-, cyclin D1-, CK Pan-, CD38+, CD56+ and Ki-67 of approximately 65%. Additional tests revealed an increased total serum calcium concentration of 6.02 mmol/l (normal range, 4.3-5.1 mmol/l), decreased serum albumin of 2.5 g/dl (normal range, 3.5-5.2 g/dl), elevated white blood count (WBC) of 18 150/mm 3 A 53-year-old man with no history of chronic diseases was admitted to the hospital due to lumbar pain. Magnetic resonance imaging showed a vertebral tumor-like mass at the L5/S1 level (FIGurE 1A-1D). Basic laboratory results were normal. An open biopsy of the mass was performed. Pain exacerbation and leg muscle weakness appeared, and urination and defecation problems developed. Radiotherapy was introduced to reduce the neurological problems. The total radiotherapy dose was 20 Gy divided into 4 Gy fractions administered on 5 consecutive days (FIGurE 1E).

Wspolczesna Onkologia-Contemporary Oncology, 2017

18-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET)/computed tomography (CT) is ... more 18-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET)/computed tomography (CT) is currently the most valuable imaging technique in Hodgkin lymphoma. Since its first use in lymphomas in the 1990s, it has become the gold standard in the staging and end-of-treatment remission assessment in patients with Hodgkin lymphoma. The possibility of using early (interim) PET during first-line therapy to evaluate chemosensitivity and thus personalize treatment at this stage holds great promise, and much attention is now being directed toward this goal. With high probability, it is believed that in the near future, the result of interim PET-CT would serve as a compass to optimize treatment. Also the role of PET in pre-transplant assessment is currently evolving. Much controversy surrounds the possibility of detecting relapse after completed treatment with the use of PET in surveillance in the absence of symptoms suggestive of recurrence and the results of published studies are rather discouraging because of low positive predictive value. This review presents current knowledge about the role of 18-FDG-PET/CT imaging at each point of management of patients with Hodgkin lymphoma.