omar shahin - Academia.edu (original) (raw)

Papers by omar shahin

Research paper thumbnail of Poster: ABCL-242 Definition of Bulky Disease in Early-Stage Diffuse Large B-Cell Lymphoma on Longitudinal and Axial Planes

Clinical Lymphoma Myeloma and Leukemia

Research paper thumbnail of ABCL-242 Definition of Bulky Disease in Early-Stage Diffuse Large B-Cell Lymphoma on Longitudinal and Axial Planes

Clinical Lymphoma Myeloma and Leukemia

Research paper thumbnail of Pembrolizumab for the Treatment of Relapsed and Refractory Classical Hodgkin Lymphoma After Autologous Transplant and in Transplant-Naïve Patients

Clinical Lymphoma Myeloma and Leukemia, 2022

Research paper thumbnail of Treatment of adult Burkitt lymphoma with the CALGB 1002 protocol: a single center experience in Jordan

BLOOD RESEARCH, 2021

Background The treatment of adult Burkitt lymphoma with pediatric-based chemotherapy protocols us... more Background The treatment of adult Burkitt lymphoma with pediatric-based chemotherapy protocols usually results in high cure rates, although with significant toxicity. We report our experience with the Cancer and Leukemia Group B1002 (CALGB 1002) protocol. Methods The files of adult patients diagnosed with Burkitt lymphoma and treated with the CALGB 1002 protocol at King Hussein Cancer Center between 2008 and 2017 were reviewed. Baseline demographics, clinical laboratory features, treatment details, and responses were collected. The correlations between clinical and laboratory variables with event-free survival (EFS) and overall survival (OS) were determined by univariate and multivariate analyses using backward stepwise Cox regression models. EFS and OS were plotted using Kaplan-Meier curves. Results This study included 19 patients with a median age of 33 years (range, 19-65). Eleven (58%) and two (10.5%) patients had advanced-stage and central nervous system disease, respectively. Among 106 administered cycles, the median interval between cycles was 23 days (range, 19-84 days). Sixteen patients (84%) achieved a complete response. After a median follow-up of 40.8 months, the 3-year EFS and OS rates were 78.95%. Patients with a low-risk International Prognostic Index (IPI) had better survival than those with intermediate-or high-risk IPI. Grade III-IV hematological toxicities occurred in 88% of patients, while 73% had grade III-IV mucositis. Conclusion In adult Burkitt lymphoma, the CALGB 1002 protocol provides high cure rates and can be administered promptly, but is associated with significant toxicity. Risk-adapted approaches and other, less toxic, chemotherapeutic regimens should be considered.

Research paper thumbnail of Amenorrhea, fertility preservation, and counseling among young women treated with anthracyclines and taxanes for early-stage breast cancer, a retrospective study

Medicine, 2020

Chemotherapy may cause ovarian toxicity and infertility. Cancer patients are usually overwhelmed,... more Chemotherapy may cause ovarian toxicity and infertility. Cancer patients are usually overwhelmed, and focus exclusively on cancer diagnosis and may not pay attention to fertility-related issues. In this paper we look at the rate of amenorrhea and fertility counseling among such young patients. Premenopausal women with early-stage breast cancer treated with adjuvant or neoadjuvant chemotherapy were recruited. Amenorrhea was defined as absence of menstruation for ≥12 months after the completion of chemotherapy. A total of 94 patients met the eligibility criteria and were included in this analysis. Median age at diagnosis was 35.7 (range, 22-44) years. Seventy-nine (85.9%) respondents were counseled about amenorrhea and 37 (40.2%) were considering having children. Long-term amenorrhea was reported by 51 (54.3%) patients. The addition of taxanes to anthracyclines, in 2 different regimens, increased the risk of amenorrhea to 69.2% and 66.7% compared to 38.9% with anthracycline-alone, P < .0001. Longer duration of chemotherapy (≥24 weeks) might also be associated with higher rate of amenorrhea (67.7%) compared to 43.4% in those who had shorter duration (<24 weeks), P = .031. The addition of taxanes to anthracycline-based chemotherapy increased the risk of amenorrhea. However, shorter duration of chemotherapy, even with taxanes, may lower such risk. Our study highlights the importance of fertility counseling to improve fertility preservation rates. Given the importance of taxanes, shorter regimens are associated with lower amenorrhea rates and should be preferred over longer ones. Abbreviations: AC = adriamycin and cyclophosphamide, CMF = cyclophosphamide, methotrexate and 5-fluorouracil, FEC = 5flurouracil, epirubicin and cyclophosphamide, GnRHa = gonadotropin-releasing hormone agonists, POF = premature ovarian failure.

Research paper thumbnail of Generic Imatinib Therapy Among Jordanians: An Observational Assessment of Efficacy and Safety in Routine Clinical Practice

Clinical Lymphoma Myeloma and Leukemia, 2017

This observational study was conducted to assess the efficacy and safety of generic imatinib in 9... more This observational study was conducted to assess the efficacy and safety of generic imatinib in 91 patients with chronic myeloid leukemia (either treated first-line or switched from patented to generic imatinib). Efficacy and safety of generic imatinib was comparable with patented imatinib. These results support the use of generic imatinib to reduce health care expenditure per patient and increase patient access. Introduction: Generic imatinib therapy is being globally considered owing to cost considerations. However, evidence of its efficacy and safety in Middle Eastern clinical settings is scarce. Patients and Methods: The efficacy and safety of generic imatinib (Cemivil) were assessed among Jordanian patients diagnosed with chronic myeloid leukemia using an observational, multicenter, prospective study design. Responses were defined using European LeukemiaNet 2009 guidelines and assessed by complete blood counts, fluorescence in situ hybridization, and real-time quantitative polymerase chain reaction. Results: All patients (N ¼ 91) were adults with chronic myeloid leukemia treated with generic imatinib 400 mg/day. Thirty-three patients received generic imatinib as first-line therapy, and 58 switched from patented imatinib to generic imatinib after a median of 4.5 years (range, 0.5-13.6 years) of imatinib therapy. The majority (85%; n ¼ 28) of the first-line patients achieved complete hematologic response within 3 months of starting generic imatinib therapy (100% after 6 months [n ¼ 33]). The 12-month major molecular response rate in the intentionto-treat population was 45%. The 12-month major molecular response rate was 88% for patients who switched therapy. The 12-month progression-free and overall survival rates were 92% and 100%, respectively. Most (85%; n ¼ 144) adverse events were mild. Frequencies of drug-related adverse events were similar to patented imatinib. Conclusion: This study suggests that the efficacy and safety of generic imatinib in this Middle Eastern population in routine clinical practice are comparable to patented imatinib, and to that of the global population.

Research paper thumbnail of Poster: ABCL-242 Definition of Bulky Disease in Early-Stage Diffuse Large B-Cell Lymphoma on Longitudinal and Axial Planes

Clinical Lymphoma Myeloma and Leukemia

Research paper thumbnail of ABCL-242 Definition of Bulky Disease in Early-Stage Diffuse Large B-Cell Lymphoma on Longitudinal and Axial Planes

Clinical Lymphoma Myeloma and Leukemia

Research paper thumbnail of Pembrolizumab for the Treatment of Relapsed and Refractory Classical Hodgkin Lymphoma After Autologous Transplant and in Transplant-Naïve Patients

Clinical Lymphoma Myeloma and Leukemia, 2022

Research paper thumbnail of Treatment of adult Burkitt lymphoma with the CALGB 1002 protocol: a single center experience in Jordan

BLOOD RESEARCH, 2021

Background The treatment of adult Burkitt lymphoma with pediatric-based chemotherapy protocols us... more Background The treatment of adult Burkitt lymphoma with pediatric-based chemotherapy protocols usually results in high cure rates, although with significant toxicity. We report our experience with the Cancer and Leukemia Group B1002 (CALGB 1002) protocol. Methods The files of adult patients diagnosed with Burkitt lymphoma and treated with the CALGB 1002 protocol at King Hussein Cancer Center between 2008 and 2017 were reviewed. Baseline demographics, clinical laboratory features, treatment details, and responses were collected. The correlations between clinical and laboratory variables with event-free survival (EFS) and overall survival (OS) were determined by univariate and multivariate analyses using backward stepwise Cox regression models. EFS and OS were plotted using Kaplan-Meier curves. Results This study included 19 patients with a median age of 33 years (range, 19-65). Eleven (58%) and two (10.5%) patients had advanced-stage and central nervous system disease, respectively. Among 106 administered cycles, the median interval between cycles was 23 days (range, 19-84 days). Sixteen patients (84%) achieved a complete response. After a median follow-up of 40.8 months, the 3-year EFS and OS rates were 78.95%. Patients with a low-risk International Prognostic Index (IPI) had better survival than those with intermediate-or high-risk IPI. Grade III-IV hematological toxicities occurred in 88% of patients, while 73% had grade III-IV mucositis. Conclusion In adult Burkitt lymphoma, the CALGB 1002 protocol provides high cure rates and can be administered promptly, but is associated with significant toxicity. Risk-adapted approaches and other, less toxic, chemotherapeutic regimens should be considered.

Research paper thumbnail of Amenorrhea, fertility preservation, and counseling among young women treated with anthracyclines and taxanes for early-stage breast cancer, a retrospective study

Medicine, 2020

Chemotherapy may cause ovarian toxicity and infertility. Cancer patients are usually overwhelmed,... more Chemotherapy may cause ovarian toxicity and infertility. Cancer patients are usually overwhelmed, and focus exclusively on cancer diagnosis and may not pay attention to fertility-related issues. In this paper we look at the rate of amenorrhea and fertility counseling among such young patients. Premenopausal women with early-stage breast cancer treated with adjuvant or neoadjuvant chemotherapy were recruited. Amenorrhea was defined as absence of menstruation for ≥12 months after the completion of chemotherapy. A total of 94 patients met the eligibility criteria and were included in this analysis. Median age at diagnosis was 35.7 (range, 22-44) years. Seventy-nine (85.9%) respondents were counseled about amenorrhea and 37 (40.2%) were considering having children. Long-term amenorrhea was reported by 51 (54.3%) patients. The addition of taxanes to anthracyclines, in 2 different regimens, increased the risk of amenorrhea to 69.2% and 66.7% compared to 38.9% with anthracycline-alone, P < .0001. Longer duration of chemotherapy (≥24 weeks) might also be associated with higher rate of amenorrhea (67.7%) compared to 43.4% in those who had shorter duration (<24 weeks), P = .031. The addition of taxanes to anthracycline-based chemotherapy increased the risk of amenorrhea. However, shorter duration of chemotherapy, even with taxanes, may lower such risk. Our study highlights the importance of fertility counseling to improve fertility preservation rates. Given the importance of taxanes, shorter regimens are associated with lower amenorrhea rates and should be preferred over longer ones. Abbreviations: AC = adriamycin and cyclophosphamide, CMF = cyclophosphamide, methotrexate and 5-fluorouracil, FEC = 5flurouracil, epirubicin and cyclophosphamide, GnRHa = gonadotropin-releasing hormone agonists, POF = premature ovarian failure.

Research paper thumbnail of Generic Imatinib Therapy Among Jordanians: An Observational Assessment of Efficacy and Safety in Routine Clinical Practice

Clinical Lymphoma Myeloma and Leukemia, 2017

This observational study was conducted to assess the efficacy and safety of generic imatinib in 9... more This observational study was conducted to assess the efficacy and safety of generic imatinib in 91 patients with chronic myeloid leukemia (either treated first-line or switched from patented to generic imatinib). Efficacy and safety of generic imatinib was comparable with patented imatinib. These results support the use of generic imatinib to reduce health care expenditure per patient and increase patient access. Introduction: Generic imatinib therapy is being globally considered owing to cost considerations. However, evidence of its efficacy and safety in Middle Eastern clinical settings is scarce. Patients and Methods: The efficacy and safety of generic imatinib (Cemivil) were assessed among Jordanian patients diagnosed with chronic myeloid leukemia using an observational, multicenter, prospective study design. Responses were defined using European LeukemiaNet 2009 guidelines and assessed by complete blood counts, fluorescence in situ hybridization, and real-time quantitative polymerase chain reaction. Results: All patients (N ¼ 91) were adults with chronic myeloid leukemia treated with generic imatinib 400 mg/day. Thirty-three patients received generic imatinib as first-line therapy, and 58 switched from patented imatinib to generic imatinib after a median of 4.5 years (range, 0.5-13.6 years) of imatinib therapy. The majority (85%; n ¼ 28) of the first-line patients achieved complete hematologic response within 3 months of starting generic imatinib therapy (100% after 6 months [n ¼ 33]). The 12-month major molecular response rate in the intentionto-treat population was 45%. The 12-month major molecular response rate was 88% for patients who switched therapy. The 12-month progression-free and overall survival rates were 92% and 100%, respectively. Most (85%; n ¼ 144) adverse events were mild. Frequencies of drug-related adverse events were similar to patented imatinib. Conclusion: This study suggests that the efficacy and safety of generic imatinib in this Middle Eastern population in routine clinical practice are comparable to patented imatinib, and to that of the global population.