Publications by authors named "Peter De Nully Brown"

Objectives: Accurate prevalence estimates of diffuse large B-cell lymphoma (DLBCL) are important for numerous purposes including orphan drug designation. A key criterion for orphan drug designation is a disease prevalence of less than 5/10,000 persons. The objective is to apply and compare different methods of prevalence assessment.

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Up to 50% of diffuse large B-cell lymphoma (DLBCL) patients are ineligible for participation in clinical trials. Ineligible patients have inferior outcomes, but less is known about the impact of commonly used organ-function-based inclusion criteria on drug efficacy estimates. Data on DLBCL patients treated with CHOP+/-rituximab were retrieved from the Danish Lymphoma Registry.

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Article Synopsis
  • Advancements in lymphoma treatment have led to more long-term survivors who may face late effects like sexual dysfunction and testosterone deficiency, prompting this review's investigation into these issues among male survivors.* -
  • The review analyzed 20 articles, revealing a wide prevalence of low total testosterone (0%-50%) and compromised sexual health (23%-61%), with total testosterone levels being associated with sexual health outcomes.* -
  • Despite significant findings, the studies had high risk of bias, resulting in low confidence in the evidence; thus, further longitudinal studies are needed to improve understanding and establish standard procedures for assessing sexual health in these patients.*
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The documented treatment-induced excess mortality in Hodgkin lymphoma (HL) has spurred important treatment changes over recent decades. This study aimed to examine mortality among young HL patients treated with contemporary strategies, including historical data comparison. This nationwide study included 1348 HL patients, diagnosed in 1995-2015 and aged 15-40 at diagnosis.

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To provide insights into targetable oncogenic pathways, this retrospective cohort study investigated the genetic profile of 26 patients with diffuse large B-cell lymphoma, not otherwise specified (DLBCL-NOS), and two patients with high-grade B-cell lymphoma with and rearrangements (HGBCL) presenting in the ocular adnexa. Pathogenic variants and copy number variations in 128 B-cell lymphoma-relevant genes were analyzed by targeted next-generation sequencing. Genetic subtypes were determined with the LymphGen algorithm.

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Primary sinonasal diffuse large B-cell lymphoma (PSDLBCL) is a rare lymphoma with a variable prognosis and a unique relapse/dissemination pattern involving the central nervous system and skin. The underlying molecular mechanisms leading to this heterogeneity and progression pattern remain uncharted, hampering patient-tailored treatment. To investigate associated mechanisms, we analyzed clinical data and used immunohistochemistry, gene-expression profiling, cytogenetics, and next-generation sequencing in a cohort of 117 patients with PSDLBCL.

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In the current study, we report the prevalence of male testosterone deficiency in a cohort of 60 male long-term survivors of malignant lymphoma with normal total testosterone but in the lower part of the reference level. Testosterone deficiency was defined as subnormal concentrations of total testosterone or subnormal concentrations of calculated free testosterone. The aim was to clarify whether total testosterone was sufficient for identification of testosterone deficiency in male survivors of malignant lymphoma.

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Article Synopsis
  • The study focuses on cancer survivors in Denmark, exploring how health-related quality of life (HRQoL) varies based on education levels among survivors of different cancers (breast, prostate, lung, colon).
  • A cross-sectional questionnaire was used to assess various HRQoL factors, with a notable participation rate of 42%, revealing that those with less education face more significant impairments and severe symptoms.
  • Findings indicate that cancer survivors with shorter education (≤9 years) are at a higher risk for HRQoL issues, highlighting the importance of targeted screening and symptom management in post-cancer care.
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UNFOLDER (Unfavorable Young Low-Risk Densification of R-Chemo Regimens) is an international phase-3 trial in patients 18-60 years with aggressive B-cell lymphoma and intermediate prognosis defined by age-adjusted International Prognostic Index (aaIPI) of 0 and bulky disease (≥7.5 cm) or aaIPI of 1. In a 2 × 2 factorial design patients were randomized to 6× R-CHOP-14 or 6× R-CHOP-21 (rituximab, cyclophosphamide, doxorubicin, vincristine, and prediso[lo]ne) and to consolidation radiotherapy to extralymphatic and bulky disease or observation.

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UNFOLDER (NCT00278408, EUDRACT 2005-005218-19) is a phase-3 trial in patients with aggressive B-cell lymphoma and intermediate prognosis, including primary mediastinal B-cell lymphoma (PMBCL). In a 2 × 2 factorial design, patients were randomized to 6× R-CHOP-14 or R-CHOP-21 (rituximab, cyclophosphamide, doxorubicin, vincristine, and prediso(lo)ne) and to consolidation radiotherapy to extralymphatic/bulky disease or observation. Response was assessed according to the standardized criteria from 1999, which did not include F-18 fluordesoxyglucose positron emission tomography/computed tomography (FDG-PET) scans.

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Background: Many cancer survivors experience late effects after cancer. Comorbidity, health literacy, late effects, and help-seeking behavior may affect healthcare use and may differ among socioeconomic groups. We examined healthcare use among cancer survivors, compared with cancer-free individuals, and investigated educational differences in healthcare use among cancer survivors.

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Background: With improved survival in patients with lymphoma, long-term toxicity and quality of life (QoL), including sexual health, have become increasingly important.

Aim: We aimed to (1) determine the prevalence of erectile dysfunction (ED) in adult male lymphoma survivors; (2) determine whether testosterone deficiency, comorbidities, or lifestyle factors were associated; and (3) evaluate their impact on QoL.

Methods: A cross-sectional study including 172 male survivors of Hodgkin lymphoma or diffuse large B cell lymphoma diagnosed in adulthood between 2008 and 2018 was performed.

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Article Synopsis
  • Peripheral T-Cell Lymphomas (PTCLs) are rare, aggressive cancers that show poor outcomes, particularly in limited-stage disease, which is not well-studied.
  • A study analyzed outcomes and prognostic factors for 239 patients with limited-stage nodal PTCL treated with CHOP(-like) therapy, finding a median follow-up of 127 months and a 5-year overall survival of 58%.
  • Factors like age over 60 and presence of B-symptoms were unfavorable for survival, while young patients without B-symptoms showed significantly better outcomes, with no difference in survival between those receiving 3-4 cycles versus 6-8 cycles of treatment.
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  • Extraosseous plasmacytoma (EOP) is a rare type of plasma cell cancer that often progresses to plasma cell myeloma (PCM) in about 11% to 35% of cases, particularly affecting the upper respiratory tract.
  • The study analyzed data from 1980 to 2017, focusing on 23 patients, mostly older males, and found that most tumors were small and surgically resectable.
  • While radiotherapy was the main treatment and showed good initial response rates, there were notable relapse and conversion rates to PCM, indicating a need for careful monitoring and potentially more aggressive treatment.
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Background: Mediastinal radiation is associated with increased risk of myocardial infarction (MI) among non-Hodgkin lymphoma (NHL) survivors.

Objective: To evaluate how preexisting cardiovascular risk factors (CVRFs) modify the association of mediastinal radiation and MI among a national population of NHL survivors with a range of CVRFs.

Material And Methods: Using Danish registries, we identified adults diagnosed with lymphoma 2000-2010.

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Background: Consolidation radiotherapy for advanced Hodgkin lymphoma (AHL) is controversial. Precise knowledge of the most likely relapse location is crucial for radiotherapy planning. We performed detailed patterns of relapse analyses and evaluated if initial bulky disease, initial 18F-fluoro-deoxy-glucose (FDG)-avidity and/or a residual mass on computed tomography (CT)-scan after chemotherapy are sites with a high risk of relapse.

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Compared to Asian and Latin American populations, sinonasal NK- or T-cell lymphoma is rare in Europe. All patients with sinonasal NK- or T-cell lymphoma in Denmark from 1980 to 2017 were validated histologically, and the disease behavior and demographics were extracted from medical records and national registries. Prognostic factors associated with mortality were determined using survival statistics.

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Psychological distress following cancer diagnosis may lead to mental health complications including depression and anxiety. Non-Hodgkin lymphomas (NHLs) include indolent and aggressive subtypes for which treatment and prognosis differ widely. Incident use of psychotropic drugs (PDs-antidepressants, antipsychotics, and anxiolytics) and its correlation to lymphoma types can give insights into the psychological distress these patients endure.

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Lymphomas of the nasal cavity and paranasal sinuses (NPS) are rare. Knowledge on sinonasal B-cell lymphoma (SNBCL) primarily comes from case series or single-center studies on small cohorts. We sought to determine the subtype distribution, clinical characteristics, disease behavior, and prognosis on a nationwide scale, with an emphasis on prognostic factors for the most common sinonasal lymphoma, primary sinonasal diffuse large B-cell lymphoma (PSDLBCL).

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Disease progression after frontline therapy for Diffuse large B-cell lymphoma (DLBCL) is a clinically significant event. Patients who experience early progression or have refractory disease have especially poor outcomes. Simple, clinically applicable prognostic tools are needed for selecting patients for consideration for novel therapies and prognostication in the relapsed/refractory (R/R) setting.

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Article Synopsis
  • This study evaluated the effectiveness of adding extra rituximab during the first four cycles of R-CHOP, a standard treatment for diffuse large B-cell lymphoma (DLBCL), to see if it improved patient outcomes.
  • The trial included 574 patients and measured success by the rate of complete remission and long-term survival outcomes, showing no significant difference between those receiving standard R-CHOP and those receiving rituximab intensification.
  • It was found that older patients experienced more side effects with the intensified regimen, leading to the conclusion that early rituximab intensification does not enhance treatment outcomes for DLBCL.
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Background And Purpose: Involved node radiation therapy (INRT) in the combined modality treatment for early-stage Hodgkin lymphoma (ESHL) has reduced the irradiated volume dramatically. Limiting the irradiated volume further based on initial disease bulk, 18F-fluoro-deoxy-glucose (FDG)-avidity, or residual computed tomography (CT) abnormality after chemotherapy seems attractive. In a cohort of patients treated with INRT a meticulous pattern-of-relapse analysis was performed to examine these options.

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