Publications by authors named "Bishton M"

In this global phase 2 study in patients with relapsed/refractory follicular lymphoma (FL), zandelisib was administered on intermittent dosing to mitigate immune-related adverse events and infections that have been reported with oral PI3Kδ inhibitors administered daily continuously. Eligible patients with measurable disease and progression after at least two prior therapies were administered zandelisib until disease progression or intolerability. The primary efficacy endpoint was objective response rate (ORR) and the key secondary efficacy endpoint was duration of response (DOR).

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We report 1- and 5-year survival after acute myeloid leukemia (AML) diagnosis and early mortality within 30 days of systemic anticancer therapy (SACT) treatments, using national cancer registry data in England. Patients aged 18 to 99 years diagnosed between 2013 and 2020 were included. Overall survival (OS) was calculated using Kaplan-Meier methodology, and adjusted hazard ratios (aHRs; adjusted for intensity of treatment, age at diagnosis, sex, ethnicity, socioeconomic deprivation, comorbidity, and year of diagnosis) using Cox proportional hazards regression.

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Article Synopsis
  • The REFRACT trial is a UK-based clinical trial aimed at improving treatments for relapsed or refractory follicular lymphoma (rrFL) by testing a new combination therapy of epcoritamab and lenalidomide against standard treatment options.
  • Eligible participants are adults with specific types of follicular lymphoma, and the trial's main goal is to assess the effectiveness of the new therapy based on complete metabolic response as measured by PET-CT after 24 weeks.
  • The study aims to fill the gap in understanding the safety and efficacy of novel therapies in comparison to existing standards, using a unique design to streamline the process and reduce the number of patients needed for reliable results.
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To address the lack of contemporary population-based epidemiological studies of hepatosplenic T-cell lymphoma (HSTCL), we undertook a population-based study of ICD-O-3-coded HSTCL in England. We used the National Cancer Registration Dataset and linked datasets on hospital admissions, Systemic Anti-Cancer Therapy, socio-demographics, comorbidities and death, identifying cases from 1 January 2013 to 31 December 2019 with survival data up to 5 January 2021. Crude and directly age-standardised incidence rates per million persons per year were calculated.

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  • * There is a global disparity in awareness and access to effective treatment for HLH, with inconsistent terminology and classification criteria complicating diagnosis.
  • * The HiHASC group created comprehensive guidelines aimed at helping healthcare teams recognize and manage HLH in adults, emphasizing early diagnosis and identifying the cause using accessible tests while also acknowledging the need for specialized evaluations.
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During the COVID-19 pandemic, ibrutinib with or without rituximab was approved in England for initial treatment of mantle cell lymphoma (MCL) instead of immunochemotherapy. Because limited data are available in this setting, we conducted an observational cohort study evaluating safety and efficacy. Adults receiving ibrutinib with or without rituximab for untreated MCL were evaluated for treatment toxicity, response, and survival, including outcomes in high-risk MCL (TP53 mutation/deletion/p53 overexpression, blastoid/pleomorphic, or Ki67 ≥ 30%).

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Bendamustine is among the most effective chemotherapeutics for indolent B-cell non-Hodgkin lymphomas (iNHL), but trial reports of significant toxicity, including opportunistic infections and excess deaths, led to prescriber warnings. We conducted a multicenter observational study evaluating bendamustine toxicity in real-world practice. Patients receiving at least 1 dose of bendamustine with/without rituximab (R) for iNHL were included.

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Article Synopsis
  • Mantle cell lymphoma (MCL) is a type of non-Hodgkin lymphoma with varied clinical outcomes, often requiring multiple treatment lines, but resulting in shorter disease control periods over time.
  • Novel treatments like chimeric antigen receptor T-cell therapies and bispecific antibodies may be effective but are usually given late in the treatment process, potentially missing chances to help patients with more aggressive forms of the disease.
  • A study of 389 patients over 10 years revealed that mortality from MCL increases with each treatment line, highlighting the need for earlier trials of innovative therapies for high-risk patients, especially older individuals and those relapsing early.
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  • The study investigates the effectiveness of high-dose methotrexate (HD-MTX) in preventing CNS (central nervous system) progression in high-risk patients with aggressive B-cell lymphoma.
  • It involved over 2,400 patients, comparing those who received HD-MTX to those who did not, and found a lower risk of CNS progression in the overall group but no significant results in patients who had a complete response after initial treatment.
  • Ultimately, the research concluded that HD-MTX did not show a clear benefit in reducing CNS progression risk, with 7.2% of high-risk patients still progressing over two years.
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Haemophagocytic lymphohistiocytosis (HLH) is a lethal syndrome of excessive immune activation. We undertook a nationwide study in England of all cases of HLH diagnosed between 2003 and 2018, using linked electronic health data from hospital admissions and death certification. We modelled interactions between demographics and comorbidities and estimated one-year survival by calendar year, age group, gender and comorbidity (haematological malignancy, auto-immune, other malignancy) using Cox regression.

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  • Bendamustine and rituximab (BR) therapy is effective for treating Waldenström Macroglobulinemia (WM), but the optimal dose of Bendamustine and its effects in different treatment settings remain unclear.
  • In a study of 250 WM patients, response rates were significantly better in patients treated in the frontline setting compared to those with relapsed disease (91.4% vs 73.9%).
  • Achieving a complete response (CR) or very good partial response (VGPR) improved survival rates, and higher doses of Bendamustine were linked to better progression-free survival (PFS) outcomes in both frontline and relapsed patients.
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  • * A study evaluated real-world data from 389 DLBCL patients across Europe, focusing on clinical effectiveness and safety outcomes over 30 months.
  • * Key findings revealed high survival rates (86% at 12 months) and a significant proportion of patients (82%) achieving a complete response to CT-P10, with adverse events aligning with typical chemotherapy effects, indicating its potential as a viable treatment option for DLBCL.
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  • Grade 3B follicular lymphoma (G3BFL) is a rare subtype that shares characteristics with both low-grade follicular lymphoma and diffuse large B-cell lymphoma (DLBCL), but its clinical features and outcomes are not well understood due to limited research.* -
  • An analysis of 157 G3BFL cases showed that, despite being younger and having better health status, G3BFL patients experienced better survival rates compared to DLBCL patients, with a 24% relapse rate after treatment.* -
  • The study found that G3BFL patients had similar overall and progression-free survival to those with Grade 3A follicular lymphoma (G3AFL), highlighting a favorable prognosis for G
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Hemophagocytic lymphohistiocytosis (HLH) is rare, results in high mortality, and is increasingly being diagnosed. We aimed to quantify the incidence of diagnosed HLH and examine temporal trends in relation to age and associated diseases. Using national linked electronic health data from hospital admissions and death certification cases of HLH that were diagnosed in England between January 1, 2003, and December 31, 2018.

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This analysis is the largest population-based study to date to provide contemporary and comprehensive epidemiological estimates of all third edition of the International Classification of Diseases for Oncology (ICD-O-3) coded Langerhans cell histiocytosis (LCH) from England. People of all ages were identified from the National Cancer Registration Dataset using ICD-O-3 morphologies 9751-9754 for neoplasms diagnosed in 2013-2019. A total of 658 patients were identified, of whom 324 (49%) were children aged <15 years.

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Rapid infusion (RI) of the rituximab biosimilar CT-P10 is currently only an approved treatment regimen for the treatment of rheumatoid arthritis. Although both CT-P10 and reference rituximab are known to be frequently administered using a RI regimen (≤90 min) in clinical practice, published data on the safety of RI of CT-P10 in patients with NHL and CLL are limited. Hence, this study collected real-world safety and effectiveness data on RI-CT-P10 from the medical records of 196 patients with NHL or CLL in 10 European centers, 6 months after the date of the first RI (index date); the infusion-related reaction (IRR) rate was compared to previously published data.

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Background: Haemophagocytic lymphohistiocytosis (HLH) is a rare hyper-inflammatory condition with poor outcomes.

Objectives: Few population-based estimates of the incidence and survival in adults exist. We aimed to provide these data for England.

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Ibrutinib plus venetoclax, given with an ibrutinib lead-in, has shown encouraging clinical activity in early phase studies in mantle cell lymphoma (MCL). The ongoing phase 3 SYMPATICO study evaluates the safety and efficacy of concurrently administered, once-daily, all-oral ibrutinib plus venetoclax in patients with relapsed/refractory MCL. A safety run-in (SRI) cohort was conducted to inform whether an ibrutinib lead-in should be implemented for the randomized portion.

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  • Systemic anaplastic large-cell lymphoma (sALCL) is a rare and aggressive form of T-cell lymphoma that often has a poor prognosis after relapse, but brentuximab vedotin (BV) has been used since 2013 to improve outcomes.
  • A population-based study in England analyzed the results for 127 patients with relapsed sALCL treated with BV between 2014 and 2019, finding a median overall survival rate of 46.6% at two years.
  • Patients who received BV as their second line of treatment had a significantly better survival rate compared to those treated later, highlighting the importance of early intervention.
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We assessed the validity of coded healthcare data to identify cases of haemophagocytic lymphohistiocytosis (HLH). Hospital Episode Statistics (HES) identified 127 cases within five hospital Trusts 2013-2018 using ICD-10 codes D76.1, D76.

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Observational studies with long-term follow-up of patients with primary central nervous system lymphoma (PCNSL) are scarce. Patient data over a period of four decades were retrospectively analysed from databases at Nottingham University Hospitals Trust, UK. The cohort was delineated by two distinct therapeutic eras; the first from 01/01/1982 to 31/12/2010 (n = 147) and the second 01/01/2011 to 31/07/2020 (n = 125).

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  • Brentuximab vedotin (BV)-CHP is now the recommended first-line treatment for systemic anaplastic large cell lymphoma (sALCL), backed by a retrospective analysis of 214 patients across multiple UK and Australian centers.
  • The study revealed that while the overall response rate for CHOP-treated patients was 65%, only 9% of them underwent autologous stem cell transplant; ALK-positive status was linked to better time to treatment failure.
  • The findings establish a benchmark for future comparisons with BV-CHP's efficacy, emphasizing the importance of real-world evidence to validate results from previous major studies like ECHELON-2.
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