Publications by authors named "Maria-Teresa Gomez-Casares"

Article Synopsis
  • Hydroxyurea (HU) is the primary treatment for essential thrombocythemia (ET), but there are no clear guidelines for when to switch therapies.
  • In a study of 1080 patients, 67% achieved a complete hematological response (CHR) after five years, with high-risk patients showing lower risks of arterial thrombosis if they achieved CHR.
  • Patients with HU resistance or intolerance had a higher chance of developing myelofibrosis, but this did not significantly impact overall survival or thrombotic risk; CHR is linked to improved outcomes and may guide future treatment decisions.
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  • * Bosutinib has been proven effective in inducing sustained molecular responses, even in advanced stages of CML, making it suitable for second- and later-line therapies.
  • * Its favorable safety profile, particularly the low occurrence of vascular complications, positions bosutinib as a strong option for optimizing treatment in CML, especially for patients intolerant or resistant to other TKIs.
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  • - New treatments are urgently needed for chronic myeloid leukemia (CML) to improve successful treatment discontinuations, with anti-PD-L1 checkpoint inhibitors showing promise due to increased levels in CML patients.
  • - A phase Ib/II trial evaluated the safety of the anti-PD-L1 antibody atezolizumab combined with bosutinib in newly diagnosed CML patients, but was terminated early due to safety concerns after only 9 patients were enrolled.
  • - The trial reported 44 adverse events, primarily gastrointestinal issues, with significant hepatotoxicity noted, including serious liver function test increases, leading to the conclusion that this drug combination should not be pursued in future studies.
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Background: Second- and third-generation tyrosine kinase inhibitors (TKIs) are now available to treat chronic-phase chronic myeloid leukemia (CP-CML) in the first and second line. However, vascular adverse events (VAEs) have been reported for patients with CML treated with some TKIs.

Methods: We retrospectively evaluated the cumulative incidence (CI) and cardiovascular risk for 210 patients included in the Canarian Registry of CML.

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Recent progress in the use of massive sequencing technologies has greatly enhanced our understanding of acute myeloid leukemia (AML) pathology. This knowledge has in turn driven the development of targeted therapies, such as venetoclax, a BCL-2 inhibitor approved for use in combination with azacitidine, decitabine, or low-dose cytarabine for the treatment of newly diagnosed adult patients with AML who are not eligible for intensive chemotherapy. However, a significant number of AML patients still face the challenge of disease relapse.

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Prognostic impact of non-MPN driver gene mutations in primary myelofibrosis. MIPSS70: Mutation-Enhanced International Prognostic Score System.

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Article Synopsis
  • The primary goal of therapy for essential thrombocythemia (ET) is to lower the risk of blood clots, with a retrospective analysis of 1,381 ET patients revealing a low rate of major bleeding (MB) events.
  • Factors such as age and leukocyte count increase the risk of MB, whereas low hemoglobin levels appear to offer some protection; however, existing risk scoring systems for thrombosis do not predict hemorrhage effectively.
  • Anticoagulation therapies, particularly vitamin K antagonists, significantly raise the risk of MB events in ET patients, highlighting the need for improved risk assessment and further research on treatment options in ET management.
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V617F is the predominant driver mutation in patients with Philadelphia-negative myeloproliferative neoplasms (MPN). mutations are also frequent in clonal hematopoiesis of indeterminate potential (CHIP) in otherwise "healthy" individuals. However, the period between mutation acquisition and MPN diagnosis (known as latency) varies widely between individuals, with mutations detectable several decades before diagnosis and even from birth in some individuals.

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The International Prognostic Score of thrombosis in Essential Thrombocythemia (IPSET-thrombosis) and its revised version have been proposed to guide thrombosis prevention strategies. We evaluated both classifications to prognosticate thrombosis in 1366 contemporary essential thrombocythemia (ET) patients prospectively followed from the Spanish Registry of ET. The cumulative incidence of thrombosis at 10 years, taking death as a competing risk, was 11.

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For chronic myeloid leukemia (CML) patients with a known risk of cardiovascular events (CVE), imatinib is often recommended for first-line tyrosine kinase inhibitor (TKI) treatment rather than a second-generation TKI (2G-TKI) such as nilotinib or dasatinib. To date, very few studies have evaluated the genetic predisposition associated with CVE development on TKI treatment. In this retrospective study of 102 CML patients, 26 CVEs were reported during an average follow-up of over 10 years.

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  • * After 5 years, 44% of patients who discontinued dasatinib successfully maintained treatment-free remission, with no relapses occurring after 39 months.
  • * Those who did relapse were able to quickly regain a major molecular response after restarting dasatinib, indicating that stopping the medication can be a viable long-term option with manageable side effects.
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  • This study investigated the safety and tolerability of a treatment combining ruxolitinib, nilotinib, and prednisone in patients with myelofibrosis (MF) who were either naïve or resistant to ruxolitinib.
  • A total of 15 patients participated, with the majority having prior ruxolitinib treatment; most experienced adverse events, particularly hyperglycemia, although no deaths occurred and the combination showed acceptable tolerability.
  • At Cycle 7, 27% of patients had significant spleen size reductions, indicating the treatment demonstrated relevant clinical activity in MF cases.
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Diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL) are the most common forms of aggressive and indolent lymphoma, respectively. The majority of patients are cured by standard R-CHOP immunochemotherapy, but 30%-40% of DLBCL and 20% of FL patients relapse or are refractory (R/R). DLBCL and FL are phenotypically and genetically hereterogenous B-cell neoplasms.

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Next-Generation Sequencing (NGS) implementation to perform accurate diagnosis in acute myeloid leukemia (AML) represents a major challenge for molecular laboratories in terms of specialization, standardization, costs and logistical support. In this context, the PETHEMA cooperative group has established the first nationwide diagnostic network of seven reference laboratories to provide standardized NGS studies for AML patients. Cross-validation (CV) rounds are regularly performed to ensure the quality of NGS studies and to keep updated clinically relevant genes recommended for NGS study.

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Myelofibrosis (MF) is a myeloproliferative neoplasm (MPN) with heterogeneous clinical course. Allogeneic hematopoietic cell transplantation remains the only curative therapy, but its morbidity and mortality require careful candidate selection. Therefore, accurate disease risk prognostication is critical for treatment decision-making.

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Available data have proved insufficient to develop consensus recommendations on the prevention of thrombosis and bleeding in myelofibrosis (MF). We evaluated the incidence and risk factors of vascular complications in 1613 patients from the Spanish Myelofibrosis Registry. Over a total of 6981 patient-years at risk, 6.

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Hematological control, incidence of complications, and need for cytoreduction were studied in 453 patients with low-risk polycythemia vera (PV) treated with phlebotomies alone. Median hematocrit value decreased from 54% at diagnosis to 45% at 12 months, and adequate hematocrit control over time (< 45%) was observed in 36%, 44%, and 32% of the patients at 6, 12, and 24 months, respectively. More than 5 phlebotomies per year in the maintenance phase were required in 19% of patients.

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Article Synopsis
  • Thrombosis and haemorrhage are common issues for patients with essential thrombocythaemia (ET), and the revised r-IPSET-t score is more effective than the original in predicting these risks among patients.
  • In a study involving 1,381 ET patients over about 88 months, thrombotic events occurred at a rate of 0.578 per person-year, with a remarkable 10-year thrombosis-free survival of 88% for low-risk and 99% for very-low-risk groups.
  • The findings also highlight concerns about the use of cytoreductive therapy and aspirin, which may pose additional risks for certain patients, despite the European LeukemiaNET not recommending aspirin for very-low-risk individuals.
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Chronic lymphocytic leukemia (CLL) has a variable clinical evolution, with some patients living treatment-free for decades while others require therapy shortly after diagnosis. In a consecutive series of 217 CLL patients, molecular biomarkers with prognostic value (IGHV status, mutations, and cytogenetics), whose analysis is recommended prior to treatment start, were studied at diagnosis. Multivariate analyses identified prognostic variables for overall survival (OS) and time to first treatment (TTFT) and validated the CLL-IPI and IPS-E variables for all or early-stage patients (Rai 0-2/Binet A), respectively.

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