Publications by authors named "Linch D"

Traditionally, patients with asymptomatic, advanced-stage follicular lymphoma were managed with a watchful-waiting approach until disease progression. The 'Watch and Wait' Phase-3 randomised international trial examined whether rituximab could delay the need for treatment and the effect on quality of life (QoL). In this article, we present the long-term results of the QoL aspect of the trial.

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  • Acute myeloid leukemia (AML) often involves deletions of chromosome 7, which are linked to poor patient outcomes, but the full impact of other genetic changes related to this is not well understood.
  • Researchers analyzed genetic alterations in 519 AML patients, using whole-exome sequencing and a specialized gene panel, finding that mutations in TP53, which occurred in 33% of cases, were among the most common.
  • The study identified specific genes, like TP53 and PTPN11, that have a significant negative effect on overall and relapse-free survival, highlighting the complex relationship between chromosome 7 abnormalities and patient prognosis in AML.
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Despite recent refinements in the diagnostic and prognostic assessment of CEBPA mutations in AML, several questions remain open, i.e. implications of different types of basic region leucin zipper (bZIP) mutations, the role of co-mutations and the allelic state.

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  • The study explores the immune microenvironment of nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) and its similarities with T-cell/histiocyte-rich large B-cell lymphoma (THRLBCL), focusing on the variations in immune cell types present in different histological patterns.
  • Researchers used advanced imaging techniques to examine how certain immune cells were expanded or depleted in NLPHL cases with various histological features compared to THRLBCL cases.
  • The results revealed significant depletion of T-regulatory cells in NLPHL and an increase in cytotoxic immune cells as the disease progressed, suggesting a connection between NLPHL and THRLBCL and highlighting potential new biomarkers for targeting immune checkpoints in treatment.
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Relapse after CD19-directed chimeric antigen receptor T-cell (CAR-T) therapy for large B-cell lymphoma (LBCL) is commonly ascribed to antigen loss or CAR-T exhaustion. Multiantigen targeting and programmed cell death protein-1 blockade are rational approaches to prevent relapse. Here, we test CD19/22 dual-targeting CAR-T (AUTO3) plus pembrolizumab in relapsed/refractory LBCL (NCT03289455).

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  • - The study focuses on the complex organization of immune cells within lymphoid tissues in patients with follicular lymphoma (FL), using advanced image analysis to assess interactions among T cells, macrophages, and other immune cells in biopsy samples from 32 patients.
  • - Findings revealed that lower densities of specific immune cells (CD8+FOXP3+) in certain areas were linked to a higher risk of cancer relapse and shorter progression times, indicating their potential significance in FL prognosis.
  • - The research suggests that the spatial relationships between immune cells, particularly the co-localization of CD8+FOXP3+ with CD4+CD8+ cells, could serve as important predictors for disease progression, prompting the need for additional studies with larger groups.*
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Although we earlier reported a very poor outcome for younger adult patients with isocitrate dehydrogenase 2 (IDH2) -mutated acute myeloid leukaemia (AML) entered into UK trials compared to IDH2 and IDH2 -mutated patients, this was not corroborated by a study from the German-Austrian AML Study Group. We have therefore investigated a later cohort of IDH2-mutated patients to identify any changes in outcome and whether this could inform the optimal treatment for IDH2 AML. We found an improved outcome for IDH2 -mutated AML in the later trials and the data suggests that this may be due to the increased use of allogeneic transplantation to consolidate first remission.

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  • Acute myeloid leukemia (AML) is a type of blood cancer with unclear genetic risk factors, and this study explores its hereditary aspects through a meta-analysis.
  • Researchers analyzed data from four studies involving 4,018 AML patients and 10,488 controls, finding significant genetic risk loci at two locations: 11q13.2 related to KMT5B and 6p21.32 related to HLA.
  • The study enhances understanding of AML development and highlights the roles of genes linked to histone methylation and immune response.
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Purpose: Prognosis for adult B-cell acute lymphoblastic leukemia (B-ALL) is poor, and there are currently no licensed CD19 chimeric antigen receptor (CAR) therapeutics. We developed a novel second-generation CD19-CAR (CAT19-41BB-Z) with a fast off rate, designed for more physiologic T-cell activation to reduce toxicity and improve engraftment. We describe the multicenter phase I ALLCAR19 (NCT02935257) study of autologous CAT19-41BB-Z CAR T cells (AUTO1) in relapsed or refractory (r/r) adult B-ALL.

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Outcome after failure of initial therapy in younger adult patients with acute myeloid leukaemia (AML) is highly variable. Cytogenetics, length of first remission (CR1) before relapse, and allogeneic transplantation are known prognostic factors, but the contribution of leukaemic genotype is less clear, particularly in resistant disease. Of 5,651 younger adult patients entered into UK MRC/NCRI AML trials between 1988 and 2014 with available FLT3 and NPM1 genotype, 326 (6%) had resistant disease and 2338 (41 %) relapsed after achieving CR1.

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Objectives: To estimate the impact of the COVID-19 pandemic on cancer care services and overall (direct and indirect) excess deaths in people with cancer.

Methods: We employed near real-time weekly data on cancer care to determine the adverse effect of the pandemic on cancer services. We also used these data, together with national death registrations until June 2020 to model deaths, in excess of background (pre-COVID-19) mortality, in people with cancer.

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At the time of the formation of the British Society of Haematology diffuse large B-cell lymphoma was not recognised as a specific entity and was included in the category of 'large cell' or 'aggressive' lymphomas. These were fatal in 95% of cases. Today the cure rate in adults entered into clinical trials is ~70% and a large number of British physicians have contributed to this progress.

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AML is a genetically heterogeneous disease and understanding how different co-occurring mutations cooperate to drive leukemogenesis will be crucial for improving diagnostic and therapeutic options for patients. MIR142 mutations have been recurrently detected in IDH-mutated AML samples. Here, we have used a mouse model to investigate the interaction between these two mutations and demonstrate a striking synergy between Mir142 loss-of-function and IDH2, with only recipients of double mutant cells succumbing to leukemia.

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Background: Outcomes for patients with high-risk diffuse large B-cell lymphoma (DLBCL) treated with R-CHOP chemotherapy are suboptimal but, to date, no alternative regimen has been shown to improve survival rates. This phase 2 trial aimed to assess the efficacy of a Burkitt-like approach for high-risk DLBCL using the dose-intense R-CODOX-M/R-IVAC regimen.

Patients And Methods: Eligible patients were aged 18-65 years with stage II-IV untreated DLBCL and an International Prognostic Index (IPI) score of 3-5.

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We compared the International Prognostic Index (IPI), Revised (R)-IPI and age-adjusted (aa)-IPI as prognostic indices for patients with diffuse large B-cell lymphoma (DLBCL) in the UK National Cancer Research Institute (NCRI) R-CHOP 14 versus 21 trial (N = 1080). The R-IPI and aa-IPI showed no marked improvement compared to the IPI for overall and progression-free survival, in terms of model fit or discrimination. Similar results were observed in exploratory analyses incorporating the Grupo Español de Linfomas/Transplante de Médula Ósea (GELTAMO)-IPI, where baseline β2-microglobulin data were available (N = 655).

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Article Synopsis
  • Loss-of-function mutations in PRC2's EZH2 component are linked to poor outcomes and chemotherapy resistance in T-cell acute lymphoblastic leukemia (T-ALL).
  • A study using edited T-ALL cells showed that EZH2-deficient cells are more sensitive to CHK1 inhibitors, which can delay tumor growth in models with EZH2 mutations.
  • This research suggests that EZH2 loss leads to immature T-ALL characteristics and increased reliance on CHK1 for survival, revealing a potential therapeutic target for treating high-risk T-ALL cases.
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Introduction: Outcomes after frontline treatment of Burkitt lymphoma (BL) have improved with the introduction of dose-intense chemotherapy regimens, such as CODOX-M/IVAC. While rituximab has increased survival rates for most forms of high-grade B-cell lymphoma, there has previously been hesitancy about incorporating it into BL treatment, partly due to concerns about increased toxicity. Prospective data using the standard dose CODOX-M/IVAC regimen in combination with rituximab are lacking.

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We evaluated the role of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in transplant-naïve patients with relapsed/refractory Hodgkin lymphoma (HL) who failed to attain metabolic complete response (mCR) to 1 to 2 lines of salvage chemotherapyThose with residual but nonprogressive disease assessed by positron emission tomography/computed tomography scanning were eligible. An additional 1 to 2 cycles of salvage therapy were permissible in those with progressive disease or when required to bridge to allo-HSCT, with additional imaging at baseline before transplantation. Conditioning consisted of carmustine, etoposide, cytarabine, melphalan, and alemtuzumab.

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