Publications by authors named "Krish Patel"

Chimeric antigen receptor (CAR) T-cell therapy has revolutionized treatment of aggressive large B-cell lymphoma (aLBCL). Patients with transformed indolent non-Hodgkin lymphoma (tiNHL) were included in key CAR trials, but outcomes of CAR for this distinct, historically high-risk group are poorly understood. We conducted a multicenter retrospective study of 1182 patients with aLBCL receiving standard-of-care CAR T between 2017 and 2022, including 338 (29%) with tiNHL.

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  • * Many patients in the US still receive chemoimmunotherapy, indicating a difference between current treatment guidelines and what is actually happening in practice.
  • * The Lymphoma Research Foundation organized a workshop with CLL/SLL experts to create consensus recommendations that serve as a practical clinical guide, aiming to improve treatment choices for patients in real-world settings.
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  • * A study by Polk County Fire Rescue developed a three-step protocol for identifying SAH, utilizing specific criteria and symptoms, while also managing patients' acute conditions.
  • * Implementation of this protocol significantly reduced unnecessary transfers for patients being treated for strokes, indicating a potential model for improving early recognition and care of SAH nationwide. *
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  • Bruton tyrosine kinase inhibitors (BTKi) have significantly improved treatment for B-cell malignancies, but many patients stop using them due to side effects, with cardiac issues being the most common reason for discontinuation.* -
  • The BRUIN study tested pirtobrutinib, a new non-covalent BTKi, on 127 patients who were intolerant to previous BTKi treatments, finding that many experienced fewer or no cardiac issues while showing a high overall response rate.* -
  • Results indicated pirtobrutinib had a median time on treatment of 15.3 months, with notable side effects like fatigue and neutropenia; overall, it proved to be a safe and effective alternative for
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This case report and literature review explore Crohn's disease (CD), a chronic inflammatory disorder of the gastrointestinal tract characterized by unpredictable flare-ups and remissions. The study highlights the diverse clinical manifestations, including abdominal pain, diarrhea, and weight loss, which significantly affect quality of life. It examines the interplay of genetic, environmental, and immune factors in CD's pathogenesis and the complexities in managing the disease.

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This multicenter, open-label, phase 1b study (ACE-LY-106) assessed the safety and efficacy of acalabrutinib, bendamustine, and rituximab (ABR) in treatment-naive (TN) and relapsed or refractory (R/R) mantle cell lymphoma (MCL). Patients received acalabrutinib from cycle 1 until disease progression or treatment discontinuation, bendamustine on days 1 and 2 of each cycle for up to 6 cycles, and rituximab on day 1 of each cycle for 6 cycles, continuing every other cycle from cycle 8 for 12 additional doses (TN cohort). Eighteen patients enrolled in the TN and 20 in the R/R cohort.

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Introduction: Chimeric antigen receptor T-cell (CAR T) therapies have transformed diffuse large B-cell lymphoma (DLBCL) treatment. It is important to better understand their use in Medicare Fee-for-Service (FFS) patients, who often differ from commercially insured populations in important ways.

Methods: We analyzed Medicare FFS claims data, focusing on the utilization patterns across three CAR T products-lisocabtagene maraleucel (liso-cel), tisagenlecleucel (tisa-cel), and axicabtagene autoleucel (axi-cel)-which are indicated for the treatment of DLBCL.

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  • Pirtobrutinib is a new reversible drug that targets Bruton tyrosine kinase, showing effective results in treating B-cell malignancies with low patient dropout and dose reduction rates.
  • A study from the BRUIN trial evaluated the safety of pirtobrutinib in patients who were treated for 12 months or more, revealing common side effects like fatigue and diarrhea, with most adverse events occurring in the first year of treatment.
  • Overall, the findings suggest that pirtobrutinib has a favorable safety profile for long-term use, with no new significant toxicity concerns reported.
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Key Clinical Message: Identifying pulmonary pathology while evaluating electrolyte disorders is crucial for optimal patient management. Physicians working in endemic regions of tuberculosis should consider this pathology as a differential for electrolyte imbalances.

Abstract: Hyponatremia, a common electrolyte imbalance, can arise from various underlying etiologies such as diuretics, diarrhea, vomiting, congestive heart failure, and liver and renal disease.

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Type I interferons (IFNs) increase the excitability of dorsal root ganglia (DRGs) neurons via MNK-eIF4E signaling to promote pain sensitization in mice. Activation of stimulator of interferon response cGAMP interactor 1 (STING) signaling is pivotal for type I IFN induction. We hypothesized that vinorelbine, a chemotherapeutic and activator of STING, would cause a neuropathic pain-like state in mice via STING signaling in DRG neurons associated with IFN production.

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Bispecific antibodies (BsAb) that target CD3 and CD20 represent a new milestone in the treatment of patients with B-cell non-Hodgkin lymphoma. These drugs have demonstrated remarkable single-agent activity in patients with heavily pretreated disease, and 3 drugs have so far received regulatory approvals in various countries. However, BsAbs can potentially lead to severe toxicity associated with T-cell activation, particularly cytokine release syndrome (CRS).

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  • * The study analyzed 32 research articles, finding that middle-aged men were predominantly affected, with common symptoms including dyspnoea, chest pain, and fever.
  • * Key diagnostic findings included significant electrocardiogram changes, leukocyte infiltration in biopsies, and reduced ejection fraction in echocardiography, emphasizing the importance of corticosteroids and immunomodulators in treatment.
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  • Patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) often struggle after failing treatment with covalent BTK inhibitors, prompting the need for new options like pirtobrutinib, a selective noncovalent BTK inhibitor designed to resume BTK inhibition.* -
  • In a phase 1-2 trial involving 317 patients, 73.3% responded positively to pirtobrutinib, with a notable 82.2% response rate when including those showing partial responses with lymphocytosis; the median progression-free survival was reported at 19.6 months.* -
  • Common side effects from pirtobrutinib treatment included infections (71%),
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Type I interferons (IFNs) increase the excitability of dorsal root ganglion (DRG) neurons via activation of MNK-eIF4E translation signaling to promote pain sensitization in mice. Activation of STING signaling is a key component of type I IFN induction. Manipulation of STING signaling is an active area of investigation in cancer and other therapeutic areas.

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  • Pirtobrutinib is a new, selective Bruton tyrosine kinase inhibitor (BTKi) that shows promise for patients with mantle-cell lymphoma (MCL) who have previously been treated with covalent BTK inhibitors due to a generally poor prognosis.
  • In a phase I/II trial, the drug demonstrated an overall response rate of 57.8% with a median duration of response lasting 21.6 months, indicating effectiveness in this challenging patient group.
  • The treatment was well tolerated, with only a small percentage of patients discontinuing therapy due to adverse events such as fatigue and diarrhea, suggesting it may be a viable option for patients with previously recurRent MCL.
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Bartter syndrome is a rare, salt-wasting tubulopathy with impaired ion reabsorption in the ascending limb of the loop of Henle, which results in hypokalemia, hypochloremia, and hypercalciuria. It usually presents in neonates, with vomiting, dehydration, and failure to thrive. It results from mutations in several genes, including KCNJ1, CLCNKB, CLCNKA, BSND, and ROMK, which encode ion transporters.

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Follicular lymphoma (FL) is the second most common lymphoma in the United States and is characterized by a variable clinical course, disease heterogeneity, and a relapse-and-remittance pattern historically accompanied by successive shortening of clinical response with every line of treatment. Factors such as progression of disease within 24 months of initial treatment are associated with poor survival outcomes. Although rituximab-based regimens are preferred for early lines of treatment, no clear standard of care exists for treatment of FL in the third-line setting or later as approved third-line treatments have not been compared in a prospective, randomized clinical trial.

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Chimeric antigen receptor T-cell therapy (CART) has extended survival of patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL). However, limited durability of response and prevalent toxicities remain problematic. Identifying patients who are at high risk of disease progression, toxicity, and death would inform treatment decisions.

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  • Some doctors are debating whether to change treatment for Hodgkin Lymphoma patients who still have cancer after two cycles of ABVD therapy.
  • Researchers looked at data from 15 hospitals to see how many patients with positive PET scans switched their treatment between 2015 and 2019.
  • They found that not many patients changed their treatment, and results showed that those who did aren’t always getting better, so better ways to treat these patients are needed.
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  • ROR1 is an oncofetal protein linked to various cancers, and Zilovertamab vedotin (ZV) is a targeted treatment combining an antibody for ROR1 and a cytotoxic drug, tested in patients with lymphoid cancers.
  • In a phase 1 study with 32 patients who had undergone multiple prior therapies, ZV was administered every 3 weeks, starting from various dose levels, with side effects mostly being neutropenia and neuropathy.
  • Results showed significant tumor responses, particularly in patients with mantle cell lymphoma and diffuse large B-cell lymphoma, supporting ROR1's potential as a targeted treatment strategy in cancer therapy.
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