Publications by authors named "Trawinska M"
Ruxolitinib is beneficial in patients with myelofibrosis (MF) and polycythemia vera (PV). Information on ruxolitinib adherence is scant. The Ruxolitinib Adherence in Myelofibrosis and Polycythemia Vera (RAMP) prospective multicenter study (NCT06078319) included 189 ruxolitinib-treated patients.
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- Managing chronic myeloid leukemia (CML) during pregnancy is rare; a study of 87 cases from a registry showed favorable outcomes for most women diagnosed in the chronic phase between 2001-2022.
- Normal childbirth rates were high at 76%, with only 12% of infants being low birth weight, and a low rate of complications was noted regardless of treatment (imatinib or interferon-α).
- About 95% of patients achieved complete hematologic response by labor time, with no disease progression during pregnancy, indicating that specific treatments can be safe for both the mother and baby in later trimesters.
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- Anemia is common in patients with myelofibrosis (MF) and is worsened by the treatment drug ruxolitinib (RUX), with new cases of blast phase (BP) emerging in anemic patients not previously on this treatment.
- A study of 886 MF patients treated with RUX found a BP incidence rate of 3.74 per 100 patient-years, with higher rates in patients who had varying levels of anemia; the most severe cases were in those dependent on transfusions.
- The findings suggest that both pre-existing and treatment-induced anemia significantly increase the risk of BP development, indicating a need for better anemia treatments alongside MF therapies.
Chronic myeloid leukemia (CML) has evolved from an invariably fatal disease to a chronic disorder that can be treated with targeted drugs and allows survival expectations approaching age-matched controls. Thus, pregnancy and conception in CML should not be precluded anymore; however, to ensure the well-being of both the mother and the developing fetus careful planning and management are required. Tyrosine Kinase Inhibitors (TKIs) are not genotoxic or carcinogenic but can pose a risk to the developing fetus, due to their teratogenic potential.
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- - Patients with chronic myeloid leukemia (CML) treated with nilotinib or ponatinib have a risk of arterial occlusive events (AOEs), prompting recommendations for cardiovascular risk assessments before starting treatment.
- - A study of 455 CML patients showed that using the updated SCORE2/SCORE2-OP algorithm, which accounts for various cardiovascular risk factors, identified a greater percentage of patients at high risk compared to the older SCORE method.
- - Those classified as high to very high risk under SCORE2/SCORE2-OP experienced a significantly higher incidence of AOEs, emphasizing the algorithm's importance in guiding treatment decisions and enhancing patient care management.
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- A significant number of myelofibrosis patients stop using ruxolitinib within the first 5 years due to treatment failure, highlighting the need for early identification of those at risk.* -
- A study analyzed data from 889 patients and found that factors like low platelet count, low hemoglobin, and certain disease types increase the likelihood of stopping ruxolitinib treatment early.* -
- A new prognostic model called STR-PM was developed to categorize patients into low, intermediate, and high-risk groups for early treatment failure, suggesting that those in higher risk categories might benefit from alternative treatments.*
Background: Hematological patients are a highly vulnerable population with an increased risk of developing severe COVID-19 symptoms due to their immunocompromised status. COVID-19 has proven to cause serious mental health issues, such as stress, anxiety, and depression in the general population. However, data on the psycho-social impact of COVID-19 on hematological patients are lacking.
View Article and Find Full Text PDFMinimal Residual Disease Detection at RNA and Leukemic Stem Cell (LSC) Levels: Comparison of RT-qPCR, d-PCR and CD26+ Stem Cell Measurements in Chronic Myeloid Leukemia (CML) Patients in Deep Molecular Response (DMR).
Cancers (Basel)
August 2023
A Deep Molecular Response (DMR), defined as a transcript at levels ≤ 0.01% by RT-qPCR, is the prerequisite for the successful interruption of treatment among patients with Chronic Myeloid Leukemia (CML). However, approximately 50% of patients in Treatment-Free Remission (TFR) studies had to resume therapy after their transcript levels rose above the 0.
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- Patients with cytopenic myelofibrosis (MF) face more challenges in treatment options and prognosis compared to those with a myeloproliferative phenotype, with common definitions for cytopenia including low leukocyte, hemoglobin, or platelet counts.
- In a study of 886 patients treated with ruxolitinib, 45.9% had cytopenic MF and factors like high molecular risk mutations and high prognostic scores were linked to this phenotype.
- Patients with cytopenia received lower doses of ruxolitinib and had poorer response rates for symptoms and spleen size, along with a higher likelihood of treatment discontinuation over five years compared to those
Article Synopsis
- - Systemic anaplastic lymphoma kinase-negative (ALK-) anaplastic large cell lymphoma (ALCL) is a diverse disease classified as a unique type by the 2016 WHO, which can involve lymph nodes and other tissues, presenting with significant inflammation.
- - A rare case of systemic ALK- ALCL with unusual myxoid changes is discussed, highlighting specific chromosomal abnormalities that can influence patient outcomes.
- - Accurate diagnosis involves detailed examination of morphology, immunohistochemistry, and molecular analysis, with emphasis on identifying prognostic markers like DUSP22 and TP63 rearrangements for predicting clinical results in ALK- ALCL patients.
The overwhelming success of tyrosine kinase inhibitor (TKI) therapy in chronic myeloid leukemia (CML) patients has opened a discussion among medical practitioners and the lay public on the real possibility of pregnancy and conception in females and males with CML. In the past 10 years this subject has acquired growing interest in the scientific community and specific knowledge has been obtained "from bench to bedside". Embryological, pharmacological, and pathophysiological studies have merged with worldwide patient databases to provide a roadmap to a successful pregnancy and birth in CML patients.
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- Peripheral blasts (PB) in myelofibrosis patients are linked to worse outcomes, with PB levels of 4% or higher significantly impacting prognosis.
- A study of 794 chronic-phase myelofibrosis patients treated with ruxolitinib (RUX) found that those with higher PB percentages had poorer responses in spleen size reduction and overall survival compared to those without PB.
- The findings suggest that patients with higher PB levels may benefit from treatment strategies that go beyond standard RUX therapy.
Ruxolitinib is approved for polycythemia vera (PV) patients after failure to previous cytoreductive therapy, based on durable results observed in phase 3 trials. We report a multicenter retrospective study demonstrating the efficacy and safety of ruxolitinib in real-life setting. Eighty-three patients were evaluated.
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- - Deferasirox (DFX) is used to treat iron overload in myelofibrosis (MF) patients receiving ruxolitinib (RUX), and a study evaluated the safety and efficacy of the RUX-DFX combination in 69 MF patients.
- - Results showed that 47.8% of patients achieved iron chelation response (ICR) and 46.4% had an erythroid response (ER), with 18.9% becoming transfusion-independent; no unexpected toxicities were reported.
- - Factors predicting improved survival included the absence of leukocytosis and achieving ICR, indicating that the RUX-DFX regimen may benefit MF patients and warrants further research.
Background: A limited amount of data has been published in chronic-phase chronic myeloid leukemia (CP-CML) patients aged >75 years treated frontline with second-generation tyrosine kinase inhibitors.
Aims: To address this issue in a clinical 'real-life' setting, we retrospectively analyzed 45 CP-CML patients (pts) followed in 20 Italian Centers and treated frontline with dasatinib (DAS).
Patients And Methods: Median age was 78.
Background: Patients with hematological malignancies are at an increased risk of SARS-CoV-2 disease (COVID-19) and adverse outcome. However, a low mortality rate has been reported in patients with chronic myeloid leukemia (CML). Preclinical evidence suggests that tyrosine kinase inhibitors (TKIs) may have a protective role against severe COVID-19.
View Article and Find Full Text PDFBackground: Acute promyelocytic leukemia (APL) is uncommon among subjects aged ≥ 70 years and the better therapeutic strategy represents an unmet clinical need.
Materials And Methods: This prompted us to explore our real-life data on a retrospective cohort of 45 older APL patients (≥ 70 years) consecutively diagnosed at eight different hematologic institutions in Latium, Italy, from July 1991 to May 2019.
Results: Two patients (4.
Background: After ruxolitinib discontinuation, the outcome of patients with myelofibrosis (MF) is poor with scarce therapeutic possibilities.
Methods: The authors performed a subanalysis of an observational, retrospective study (RUX-MF) that included 703 MF patients treated with ruxolitinib to investigate 1) the frequency and reasons for ruxolitinib rechallenge, 2) its therapeutic effects, and 3) its impact on overall survival.
Results: A total of 219 patients (31.
To evaluate the role of bosutinib in elderly patients aged >65 years with chronic myeloid leukemia (CML), a real-life cohort of 101 chronic-phase CML patients followed up in 23 Italian centers and treated with bosutinib in second or a subsequent line was retrospectively evaluated. Starting dose of bosutinib was 500 mg/day in 25 patients (24.8%), 400 mg/day in 7 patients (6.
View Article and Find Full Text PDFRecommendations for dyslipidemia management aimed at reducing arterial occlusive events (AOEs) have been recently published. So far, no data have been reported on the management of dyslipidemia in chronic myeloid leukemia (CML) patients treated with nilotinib. We investigated 369 CML adult patients, stratified according to the new Systematic Coronary Risk Evaluation (SCORE) scoring system.
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