Purpose: Inhibitors of the mammalian target of rapamycin (mTOR) kinase have shown clinical activity in several lymphoma subtypes. Sirolimus, an mTOR inhibitor, also has activity in the treatment and prophylaxis of graft-versus-host disease (GVHD) after allogeneic hematopoietic stem-cell transplantation (HSCT). We hypothesized that the use of sirolimus for GVHD prophylaxis in patients with lymphoma might lead to improved survival after transplantation through a decreased incidence of disease progression.
Patients And Methods: We retrospectively analyzed 190 patients who underwent transplantation for lymphoma. We compared the outcomes of patients who received sirolimus for GVHD prophylaxis with those of patients who received transplantation with a combination of a calcineurin inhibitor and methotrexate without sirolimus.
Results: Overall survival (OS) after transplantation was significantly superior in the sirolimus group, which was confirmed in multivariable analysis. The benefit was restricted to patients undergoing reduced-intensity conditioning (RIC) HSCT (3-year OS, 66% for sirolimus group v 38% for no-sirolimus group; P = .007; hazard ratio [HR] for mortality in multivariable analysis = 0.5, P = .042). Patients who received sirolimus had a similar incidence of nonrelapse mortality but a decreased incidence of disease progression compared with patients who did not receive sirolimus (3-year cumulative incidence of progression, 42% v 74%, respectively; P < .001; HR for progression in multivariable analysis = 0.4, P = .01). The effect of sirolimus persisted after adjusting for the occurrence of GVHD. No such survival advantage was apparent in a similar comparison of patients who underwent transplantation for diseases other than lymphoma.
Conclusion: This study suggests that sirolimus can independently decrease the risk of lymphoma progression after RIC HSCT, paving the way for prospective clinical trials.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2645102 | PMC |
| http://dx.doi.org/10.1200/JCO.2008.17.7279 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Discrepancies in long-leg alignment and knee joint line obliquity between two- and three-dimensional measurements under weight-bearing conditions: Effects on coronal plane alignment of the knee classification.
Knee
January 2025
Department of Radiology, Keio University School of Medicine, Shinjuku, Tokyo, Japan.
Background: Long-leg alignment and joint line obliquity have traditionally been assessed using two-dimensional (2D) radiography, but the accuracy of this measurement has remained unclear. This study aimed to evaluate the accuracy of 2D measurements of lateral distal femoral angle (LDFA) and medial proximal tibial angle (MPTA) using upright three-dimensional (3D) computed tomography (CT).
Methods: This study involved 66 knees from 38 patients (34 women, four men) with knee osteoarthritis (OA), categorized by Kellgren-Lawrence (KL) grade.
Individualized total knee arthroplasty achieves better functional results than off-the-shelf implants in patients undergoing personalized coronal alignment.
Knee
January 2025
IULS-University Institute for Locomotion and Sports, Pasteur 2 Hospital, University Côte d'Azur, Nice, France; ICARE Team, Côte d'Azur University, Inserm, CNRS, Valrose Institute of Biology, Nice, France. Electronic address:
Background: Several studies have demonstrated the interest in patient-specific custom cutting guides in total knee arthroplasty (TKA), but clinical improvement remains debated. The purpose of this study was to evaluate the functional outcomes (Forgotten Joint Score, FJS) of patients undergoing individualized TKA compared with those receiving off-the-shelf (OTS) implants, both using patient-specific cutting guides with personalized alignment over a minimum follow up period of 12 months. We hypothesized that individualized TKA demonstrates significantly better functional outcomes than OTS TKA (FJS and percentage of patients reaching the minimum clinically important difference).
View Article and Find Full Text PDFCharacterizing Telehealth Barriers and Preferences to Promote Acceptable Implementation Strategies in Central Uganda: Multilevel Formative Evaluation.
JMIR Form Res
January 2025
Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, United States.
Background: Telehealth approaches can address health care access barriers and improve care delivery in resource-limited settings around the globe. Yet, telehealth adoption in Africa has been limited, due in part to an insufficient understanding of effective strategies for implementation.
Objective: This study aimed to conduct a multi-level formative evaluation identifying barriers and facilitators for implementing telehealth among health service providers and patients in Central Uganda.
A Medication Management App (Smart-Meds) for Patients After an Acute Coronary Syndrome: Pilot Pre-Post Mixed Methods Study.
JMIR Cardio
January 2025
Medicine Faculty, University of Geneva, Geneva, Switzerland.
Background: Medication nonadherence remains a significant challenge in the management of chronic conditions, often leading to suboptimal treatment outcomes and increased health care costs. Innovative interventions that address the underlying factors contributing to nonadherence are needed. Gamified mobile apps have shown promise in promoting behavior change and engagement.
View Article and Find Full Text PDFDoes oral hygiene prevents nosocomial infections in hospitalized patients? A systematic review and meta-analysis.
Med Oral Patol Oral Cir Bucal
January 2025
Background: This study aimed to evaluate the impact of oral hygiene (OH) with chlorhexidine (CHX) on the evolution of nosocomial infections (NI).
Material And Methods: Electronic searches were carried out in PubMed, Scopus, Cochrane Library, Web of Science, VHL, and Grey Literature databases. Randomized clinical trials were included.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!