Publications by authors named "Vincent Delwail"
The therapy of relapsed or refractory (r/r) mantle cell lymphoma (MCL) patients remains a major clinical challenge to date. We conducted a randomized, open-label, parallel-group phase-III trial hypothesizing superior efficacy of rituximab, high-dose cytarabine and dexamethasone with bortezomib (R-HAD + B) versus without (R-HAD) in r/r MCL ineligible for or relapsed after autologous stem cell transplant (ASCT). Primary endpoint was time to treatment failure (TTF), secondary endpoints included response rates, progression free survival, overall survival, and safety.
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- - Obinutuzumab (O) and rituximab (R) were compared in a long-term study (LyMa-101) for treating newly diagnosed mantle cell lymphoma (MCL) patients, focusing on outcomes like measurable residual disease (MRD), progression-free survival (PFS), and overall survival (OS).
- - Results showed that the O group had a higher rate of MRD negativity (83.1% vs 63.4%) and better long-term outcomes, with 5-year PFS at 82.8% and OS at 86.4%, compared to 66.6% and 71.4% for the R group, respectively.
- - The study concluded that using
Article Synopsis
- - The phase II trial assessed the effectiveness of the RiBVD treatment (rituximab, bendamustine, velcade, and dexamethasone) in patients over 65 with mantle cell lymphoma (MCL), which resulted in a median progression-free survival of 79 months and overall survival of 111 months.
- - TP53 mutation status and albumin levels were identified as significant prognostic factors, with TP53 mutations linked to a higher risk of shorter progression-free survival and overall survival in the analyzed patient population.
- - A scoring system combining TP53 mutation status and albumin levels allowed differentiation of patient outcomes, indicating varying survival rates based on the presence of these factors, thus enhancing prognostic assessments
Background: Parsaclisib is a potent and highly selective PI3Kδ inhibitor that has shown clinical benefit in patients with relapsed/refractory (R/R) B-cell malignancies. In this phase 2 study (CITADEL-205; NCT03235544, EudraCT 2017-003148-19), the efficacy and safety of parsaclisib was evaluated in patients with R/R mantle cell lymphoma (MCL).
Methods: Patients ≥18 years old with pathologically confirmed R/R MCL and prior treatment with 1-3 systemic therapies, with (cohort 1) or without (cohort 2) previous Bruton kinase inhibitor (BTKi) treatment, received oral parsaclisib 20 mg once-daily (QD) for 8 weeks, then either parsaclisib 20 mg once-weekly (weekly dosing group [WG]) or parsaclisib 2.
Article Synopsis
- F-FDG PET/CT is important for diagnosing and monitoring Hairy Cell Leukemia (HCL), especially in atypical cases with bone involvement.
- The study highlighted two patients with BRAF mutation who had significant bone lesions and limited bone marrow infiltration, demonstrating the utility of F-FDG PET/CT.
- The authors emphasize integrating F-FDG PET/CT into standard HCL management to improve patient outcomes and detect less common manifestations.
Purpose: This study aims to investigate the relationship between the intensity of the initial treatment given to patients with de novo diffuse large B-cell lymphoma (DLBCL) and the impact of their baseline cell-free DNA (cfDNA) levels on their long-term survival.
Experimental Design: The GOELAMS 075 randomized clinical trial compared rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) with high-dose R-chemotherapy plus autologous stem cell transplantation (R-HDT) for patients aged ≤60. An interim PET assessment was used to refer patients for salvage therapy.
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- Preservation of fertility is increasingly important for young women with Hodgkin lymphoma (HL), prompting a study on the effects of the ABVD chemotherapy regimen on their reproductive health.
- The study involved 67 female patients of childbearing age, revealing that about 53.7% became pregnant after treatment, which is similar to the 54.5% pregnancy rate in controls not exposed to chemotherapy.
- Results indicated no significant differences in pregnancy rates, birth outcomes, or time to pregnancy between patients treated with ABVD and the control group, suggesting that females with HL can be reassured about their fertility post-treatment.
JCO We previously reported the results of a randomized phase II study in patients with newly diagnosed primary CNS lymphoma (age 18-60 years). Patients were treated with high-dose methotrexate-based induction chemotherapy followed by whole-brain radiotherapy (WBRT) or high-dose chemotherapy (thiotepa-busulfan-cyclophosphamide) with autologous stem-cell transplantation (ASCT). The median follow-up was 33 months.
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- - Most relapses of primary central nervous system lymphoma (PCNSL) typically occur in the brain and have a poor prognosis, while isolated intraocular relapses (IIORs) are rare and not well understood.
- - A study analyzed 55 PCNSL patients with IIOR and found that a significant number had high IL-10 levels in their eye fluid, and the majority received systemic chemotherapy, with some undergoing high-dose chemotherapy followed by stem cell transplantation (HCT-ASCT).
- - After an average follow-up of nearly 6 years, 76% of patients relapsed, especially those who didn't have HCT-ASCT; however, prognosis was better for IIOR compared to brain relapses, undersc
Intensive chemotherapy followed by autologous stem cell transplantation in primary central nervous system lymphomas (PCNSLs). Therapeutic outcomes in real life-experience of the French Network.
Bone Marrow Transplant
June 2022
Article Synopsis
- * The study found that patients receiving treatment at first relapse and those treated with specific chemotherapy combinations faced poorer prognoses and higher treatment-related mortality, especially when SCAT was administered beyond the first relapse.
- * Overall survival rates were significant, with 5-year survival at 80% for first-line treatment and 50% for first-relapse treatment, indicating the importance of timing in ASCT to improve the benefit/risk ratio for different chemotherapy regimens.
Article Synopsis
- Primary or secondary immune deficiency (ID) is a rare risk factor for developing Waldenström macroglobulinemia (WM), with a study showing 3.6% of WM patients had a history of ID.
- Among these patients, half required treatment for WM within a median of 1.5 years after diagnosis, while the progression to active disease typically occurred 8 years after ID onset.
- The research suggests that while WM can arise from ID, the outcomes are generally not poor, with many cases remaining indolent despite the associated immune deficiency.
Article Synopsis
- - ABP 798 is a biosimilar being tested against rituximab, a treatment for non-Hodgkin lymphoma, in a clinical study called JASMINE, which involved adult patients who had not previously received anti-CD20 therapy.
- - In this study, 256 patients were randomized to receive either ABP 798 or rituximab, with assessments made on their tumor response at specific weeks; results showed that 78.0% of the ABP 798 group and 70.2% of the rituximab group had a positive overall response rate by week 28.
- - Statistical analysis indicated that ABP 798 was clinically equivalent to rituximab, as the
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- The study aimed to gather real-life data on how ibrutinib is used and its safety profiles in patients between November 2014 and November 2018.
- A total of 102 patients participated, mainly receiving ibrutinib for chronic lymphocytic leukemia (CLL), with 47.1% experiencing serious adverse drug reactions (SADRs) within the first year.
- The findings highlighted that older patients (aged ≥80) and those with CLL had a higher risk of developing SADRs, indicating that they require closer monitoring during treatment.
Objective: Real-life studies on patients with primary CNS lymphoma (PCNSL) are scarce. Our objective was to analyze, in a nationwide population-based study, the current medical practice in the management of PCNSL.
Methods: The French oculo-cerebral lymphoma network (LOC) database prospectively records all newly diagnosed PCNSL cases from 32 French centers.
Article Synopsis
- The study examined kidney infiltration in 52 adults with different B-cell lymphoproliferative disorders, highlighting variations in kidney disease presentations among conditions like Waldenström's macroglobulinemia and DLBCL.
- DLBCL showed severe kidney involvement, with high rates of acute kidney injury and kidney enlargement, while other disorders often had immunoglobulin-related nephropathies, leading to chronic kidney issues.
- The findings suggest that the underlying disorder impacts renal presentation and outcomes, emphasizing the need for kidney biopsies for accurate diagnosis and prognosis in these patients.
Diffuse large B cell lymphoma (DLBCL) is a heterogeneous disease treated with anti-CD20-based immuno-chemotherapy (R-CHOP). We identified that low levels of GAPDH predict a poor response to R-CHOP treatment. Importantly, we demonstrated that GAPDH lymphomas use OxPhos metabolism and rely on mTORC1 signaling and glutaminolysis.
View Article and Find Full Text PDFPurpose: To determine the efficacy and toxicity of chemoimmunotherapy followed by either whole-brain radiotherapy (WBRT) or intensive chemotherapy and autologous stem-cell transplantation (ASCT) as a first-line treatment of primary CNS lymphoma (PCNSL).
Patients And Methods: Immunocompetent patients (18 to 60 years of age) with untreated PCNSL were randomly assigned to receive WBRT or ASCT as consolidation treatment after induction chemotherapy consisting of two cycles of R-MBVP (rituximab 375 mg/m day (D) 1, methotrexate 3 g/m D1; D15, VP16 100 mg/m D2, BCNU 100 mg/m D3, prednisone 60 mg/kg/d D1-D5) followed by two cycles of R-AraC (rituximab 375 mg/m D1, cytarabine 3 g/m D1 to D2). Intensive chemotherapy consisted of thiotepa (250 mg/m/d D9; D8; D7), busulfan (8 mg/kg D6 through D4), and cyclophosphamide (60 mg/kg/d D3; D2).
We present results of a prospective, multicenter, phase II study evaluating rituximab, bendamustine, bortezomib and dexamethasone as first-line treatment for patients with mantle cell lymphoma aged 65 years or older. A total of 74 patients were enrolled (median age, 73 years). Patients received a maximum of six cycles of treatment at 28-day intervals.
View Article and Find Full Text PDFPurpose To perform an updated analysis of the randomized phase III GADOLIN trial in patients with rituximab-refractory indolent non-Hodgkin lymphoma treated with obinutuzumab (GA101; G) and bendamustine (B). Patients and Methods Patients with histologically documented, rituximab-refractory CD20 indolent non-Hodgkin lymphoma received G 1,000 mg (days 1, 8, and 15, cycle 1; day 1, cycles 2 to 6) plus B 90 mg/m/d (days 1 and 2, all cycles) or B 120 mg/m/d monotherapy. Patients who did not experience disease progression with G-B received G maintenance (1,000 mg every 2 months) for up to 2 years.
View Article and Find Full Text PDFCNS relapse is reported in 2-5% of diffuse large B-cell lymphoma (DLBCL) patients, dramatically decreasing overall survival (OS). Very few studies address incidence and risk factors of CNS relapse in very elderly patients, a challenging population to treat given their commonly associated comorbidities. A retrospective analysis was performed of 270 DLBCL patients >80 years treated between 2004 and 2013 in two multicentre phase II LYSA trials (LNH03-7B, LNH09-7B) evaluating the addition of rituximab or ofatumumab to mini-CHOP as front-line therapy.
View Article and Find Full Text PDFThe benefit of radiotherapy (RT) after chemotherapy in limited-stage diffuse large B-cell lymphoma (DLBCL) remains controversial. We conducted a randomized trial in patients with nonbulky limited-stage DLBCL to evaluate the benefit of RT after rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). Patients were stratified according to the modified International Prognostic Index, including lactate dehydrogenase, Eastern Cooperative Oncology Group performance status, age, and disease stage.
View Article and Find Full Text PDFAutoimmune haemolytic anaemia (AIHA) in mantle cell lymphoma (MCL) is a rare but life-threatening complication. To date, there are no relevant data for treatment of AIHA in MCL. Ibrutinib, which has been approved for relapse/refractory MCL, is an immunomodulatory drug inhibiting Th2 activation and consequently the production of autoantibodies.
View Article and Find Full Text PDFBackground: In 2011 we reported a rituximab plus miniCHOP (reduced-dose cyclophosphamide, doxorubicin, vincristine, and prednisone) combination for patients older than 80 years with diffuse large B-cell lymphoma (DLBCL). The 2-year overall survival was 59% (95% CI 49-67) with an excess of early toxicity. To improve those results we tested the same chemotherapy protocol in combination with ofatumumab and a pre-phase treatment.
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