P Vivancos

Publications (16)87.9 Total impact

• Article: Prognostic value of minimal residual disease (MRD) in acute myeloid leukemia (AML) with favorable cytogenetics [t(8;21) and inv(16)].

  G Perea, A Lasa, A Aventín, A Domingo, N Villamor, M Paz Queipo de Llano, A Llorente, J Juncà, C Palacios, C Fernández, [......], L Florensa, J Bargay, J M Martí, P Vivancos, P Torres, J J Berlanga, I Badell, S Brunet, J Sierra, J F Nomdedéu
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  ABSTRACT: Most patients with acute myeloid leukemia (AML) and t(8;21) or inv(16) have a good prognosis with current anthracycline- and cytarabine-based protocols. Tandem analysis with flow cytometry (FC) and real-time RT-PCR (RQ-PCR) was applied to 55 patients, 28 harboring a t(8;21) and 27 an inv(16), including one case with a novel CBFbeta/MYH11 transcript. A total of 31% (n=17) of CR patients relapsed: seven with t(8;21) and 10 with inv(16). The mean amount of minimal residual disease (MRD) detected by FC in relapsed and nonrelapsed patients was markedly different: 0.3 vs 0.08% (P=0.002) at the end of treatment. The mean number of fusion transcript copies/ ABL x 10(4) also differed between relapsed and non-relapsed patients: 2385 vs 122 (P=0.001) after induction, 56 vs 7.6 after intensification (P=0.0001) and 75 vs 3.3 (P=0.0001) at the end of chemotherapy. Relapses were more common in patients with FC MRD level >0.1% at the end of treatment than in patients with < or = 0.1%: cumulative incidence of relapse (CIR) was 67 and 21% (P=0.03), respectively. Likewise, using RQ-PCR, a cutoff level of >10 copies at the end of treatment correlated with a high risk of relapse: CIR was 75% for patients with RQ-PCR >10 compared to 21% for patients with RQ-PCR levels < or = 10 (P=0.04). Combined use of FC and RQ-PCR may improve MRD detection, and provide useful clinical information on relapse kinetics in AML patients.
  Leukemia 02/2006; 20(1):87-94. · 9.56 Impact Factor
• Article: Prognostic value of minimal residual disease (MRD) in acute myeloid leukemia (AML) with favorable cytogenetics [t(8;21) and inv(16)]

  G Perea, A Lasa, A Avent|[iacute]|n, A Domingo, N Villamor, M Paz Queipo de Llano, A Llorente, J Junc|[agrave, C Palacios, C Fern|[aacute]|ndez, [......], L Florensa, J Bargay, J M Mart|[iacute, P Vivancos, P Torres, J J Berlanga, I Badell, S Brunet, J Sierra, J F Nomded|[eacute]|u
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  ABSTRACT: Most patients with acute myeloid leukemia (AML) and t(8;21) or inv(16) have a good prognosis with current anthracycline- and cytarabine-based protocols. Tandem analysis with flow cytometry (FC) and real-time RT-PCR (RQ-PCR) was applied to 55 patients, 28 harboring a t(8;21) and 27 an inv(16), including one case with a novel CBFbeta/MYH11 transcript. A total of 31% (n=17) of CR patients relapsed: seven with t(8;21) and 10 with inv(16). The mean amount of minimal residual disease (MRD) detected by FC in relapsed and nonrelapsed patients was markedly different: 0.3 vs 0.08% (P=0.002) at the end of treatment. The mean number of fusion transcript copies/ABLx104 also differed between relapsed and non-relapsed patients: 2385 vs 122 (P=0.001) after induction, 56 vs 7.6 after intensification (P=0.0001) and 75 vs 3.3 (P=0.0001) at the end of chemotherapy. Relapses were more common in patients with FC MRD level >0.1% at the end of treatment than in patients with 0.1%: cumulative incidence of relapse (CIR) was 67 and 21% (P=0.03), respectively. Likewise, using RQ-PCR, a cutoff level of >10 copies at the end of treatment correlated with a high risk of relapse: CIR was 75% for patients with RQ-PCR >10 compared to 21% for patients with RQ-PCR levels 10 (P=0.04). Combined use of FC and RQ-PCR may improve MRD detection, and provide useful clinical information on relapse kinetics in AML patients.Keywords: leukemia, minimal residual disease, molecular methods, flow cytometry
  Leukemia 11/2005; 20(1):87-94. · 9.56 Impact Factor
• Article: Adverse prognostic impact of CD36 and CD2 expression in adult de novo acute myeloid leukemia patients.

  G Perea, A Domingo, N Villamor, C Palacios, J Juncà, P Torres, A Llorente, C Fernández, M Tormo, M P Queipo de Llano, [......], P Vivancos, J M Martí, Ll Font, J Berlanga, J Esteve, J Bueno, J M Ribera, S Brunet, J Sierra, J F Nomdedéu
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  ABSTRACT: A consecutive series of acute myeloid leukemias (AML) patients was analyzed in conditions which reduce the inter-assay variations (the same flow cytometer, the same observers and the same panel of monoclonal antibodies) in order to investigate the prognostic information provided by flow cytometry. Two hundred and sixty-six bone marrow (BM) samples from 326 patients enrolled in the LMA-99 protocol from the CETLAM group were studied by multiparametric flow cytometry. Immunophenotyping studies were performed on erythrocyte-lysed BM samples. Antigen expression of leukemic cells was analyzed using triple stainings with fluorochrome-conjugated combinations of monoclonal antibodies. CD2 was positive in 21 cases (8%); an associated inv(16) was detected in eight CD2+ cases (38%). Two-year overall survival (OS) rate for CD2+/inv(16)+ patients was 75%, whereas it was 0% for CD2+/inv(16)- patients and 47% for CD2- patients (p=0.0001). CD36 was expressed in 37% of patients (n=98). Two-year leukemia-free survival (LFS) rate was 34% for CD36+ patients and 55% for CD36- patients (p=0.001). In the multivariate analysis, CD2+ (RR=8.4; p=0.0001) and adverse karyotype (RR=10.2; p=0.0001) were associated with a lower CR rate, CD36+ (RR=1.5; p=0.03), CD2+ (RR=2; p=0.04) and adverse karyotype (RR=4; p=0.0001) were associated with a lower OS and CD36+ (RR=2; p=0.002) and adverse karyotype (RR=3.5; p=0.005) predicted a lower LFS. CD2+ patients had a very poor OS when CD2/inv(16)+ cases were excluded. CD36 and CD2 expression at diagnosis can provide prognostically important information in adult de novo AML.
  Leukemia Research 11/2005; 29(10):1109-16. · 2.92 Impact Factor
• Article: Favourable effect of the combination of acute and chronic graft-versus-host disease on the outcome of allogeneic peripheral blood stem cell transplantation for advanced haematological malignancies.

  S Brunet, A Urbano-Ispizua, E Ojeda, D Ruiz, J M Moraleda, M A Díaz, D Caballero, J Bargay, J de la Rubia, C Solano, [......], A Alegre, J P Torres, M Jurado, M Fernández, P Vivancos, E Carreras, F Hernández, J Maldonado, J Sierra, C Rozman
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  ABSTRACT: To assess the influence of graft-versus-host disease (GVHD) on the outcome of patients with advanced haematological malignancies (AHM) who received a primary, unmodified allogeneic peripheral blood progenitor cells transplant (allo-PBT) from a human leucocyte antigen (HLA) identical sibling donor, we analysed 136 patients with myeloid neoplasms (n = 70) or lymphoproliferative disorders (n = 66), transplanted at 19 Spanish institutions. Median age was 35 years (range 1-61). The cumulative incidence of relapse for all patients was 34% (95% CI, 26-42%), 41% (95% CI, 33-49) for patients without GVHD and 14% (95% CI, 3-25) (P = 0.001) for patients with acute and chronic GVHD. After a median follow-up of 11 months (range 2-49), 60 (44%) patients remained alive with an actuarial probability of overall survival and disease-free survival (DFS) at 30 months of 31% (95% CI, 21-41%) and 28% (95% CI, 17-39%) respectively. In patients surviving > 100 d, the low incidence of relapse in those with acute and chronic GVHD led to a DFS of 57% (95% CI, 38-76%) compared with a DFS of 34% (95% CI, 17-51%) in the remaining patients (P = 0.03). Our results indicate a reduced incidence of relapse for patients with AHM receiving an unmodified allo-PBT and developing acute and chronic GVHD, which results in an improved DFS.
  British Journal of Haematology 09/2001; 114(3):544-50. · 4.94 Impact Factor
• Article: Rituximab can be useful as treatment for minimal residual disease in bcr-abl-positive acute lymphoblastic leukemia.

  B M Jándula, J Nomdedeu, P Marín, P Vivancos
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  ABSTRACT: We report the results of administering CD20 monoclonal antibody (MoAb) in a 32-year-old man with bcr-abl-positive acute lymphoblastic leukemia. Morphological complete remission was achieved after two lines of chemotherapy with persistence of blast cells (2%) in flow cytometric analysis of marrow cells. Since no HLA-matched donor for allogeneic bone marrow transplantation (BMT) was found, anti-CD20 MoAb therapy was administered for in vivo marrow purging, prior to autologous peripheral blood stem cell (PBSC) harvest and transplantation. After MoAb therapy <0.1% of blast cells were observed and the molecular abnormality (bcr-abl gene rearrangement) disappeared.
  Bone Marrow Transplantation 01/2001; 27(2):225-7. · 3.75 Impact Factor
• Article: Treatment with interleukin-2 (IL-2) and interferon (IFN(alpha 2b)) after autologous bone marrow or peripheral blood stem cell transplantation in onco-hematological malignancies with a high risk of relapse.

  P Vivancos, A Grañena, J Sarrá
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  ABSTRACT: Nine patients with onco-hematological malignancies with a poor prognosis due to high risk of relapse received immunotherapy with interleukin-2 (IL-2) and interferon (IFN(alpha 2b)) s.c. as maintenance therapy after receiving autologous bone marrow or peripheral blood stem cell transplantation (ABMT/PBSCT). All the patients were considered at very high risk of relapse. We attempted to assess the efficiency, toxicity and clinical effects of these cytokines in these patients. Five patients were treated with high-dose of IL-2 and the other four patients with escalating doses every month. Side-effects in the first group of patients consisted of fever, chills, weakness, nausea, anorexia, loss of weight and local dermatitis in the injection site. Toxicity on the WHO scale was grade II in three patients and grade IV in the other two patients. In the second group of patients, the same clinical signs of toxicity appeared, but these were grade I on the WHO scale in all patients. None of the patients had infections or died in relation to administration of IL-2. Four patients died of relapse or progression of their hematological malignancies. The other five patients are alive, one in chronic phase of CML and the other four patients are in complete remission of their malignancies.
  Bone Marrow Transplantation 02/1999; 23(2):169-72. · 3.75 Impact Factor
• Article: Multiple risk factors for high-dose chemotherapy.

  J Sarrá, P Vivancos, R Sola, A Grañena
  Bone Marrow Transplantation 12/1998; 22(9):933. · 3.75 Impact Factor
• Article: Immunomagnetic bone marrow purging in children with acute lymphoblastic leukemia.

  C Canals, C Torrico, M Picón, B Amill, J A Cancelas, G Fraga, I Badell, J Cubells, T Olivé, J Ortega, P Vivancos, J García
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  ABSTRACT: Autologous bone marrow transplantation (ABMT) offers a therapeutic alternative for children with poor prognosis acute lymphoblastic leukemia (ALL) who lack an HLA-matched sibling donor. The most common cause of treatment failure after ABMT in these patients is leukemia relapse. We have developed an ex vivo autologous marrow purging program for children with ALL using an immunomagnetic method. BM purging has been performed in 37 children with ALL (31 B-lineage ALL and 6 T-lineage ALL) following an indirect method, using panels of mouse monoclonal antibodies (MAbs) directed against B or T cell antigens, Dynabeads M-450 (Dynal) coated with sheep antimouse (SAM) antibodies, and the MaxSep Magnetic Cell Separator (Baxter). Purging efficiency has been assessed by flow cytometry. Considering the limit of detection of target cells 0.1%, the median depletion was 2.0 log (range 0.8- > 2.8 log) for the B-lineage ALL and 2.7 (range 2.2- > 2, 9 log) for the T-lineage ALL patients. Twenty-seven patients have been autografted (6 in first complete remission, CR, 13 in second CR, and 8 in third or subsequent CR). Engraftment has been satisfactory in all of them, reaching levels of 500 neutrophils/mm3 and 20,000 platelets/mm3 after a median of 17 (range 12-39) and 30 (range 13-96) days post-ABMT, respectively. In summary, our results show that this immunomagnetic procedure achieves high levels of target cell depletion and can be safely applied to bone marrow purging in childhood ALL patients.
  Journal of Hematotherapy 06/1997; 6(3):261-8.
• Article: [Allogenic transplant of non-manipulated hematopoietic progenitor peripheral blood cells. Spanish experience of 79 cases. Allo-Peripheral Blood Transplantation Group].

  S Brunet, A Urbano-Ispizua, C Solano, E Ojeda, D Caballero, M Torrabadella, J de la Rubia, J Pérez-Oteiza, J Moraleda, I Espigado, [......], J Petit, J Bargay, R Mataix, P Vivancos, A Figuera, J Sierra, A Domingo-Albós, F Hernández, J García Conde, C Rozman
  Sangre 05/1997; 42 Suppl 1:42-3.
• Article: Allogeneic peripheral blood progenitor cell transplantation: analysis of short-term engraftment and acute GVHD incidence in 33 cases. allo-PBPCT Spanish Group.

  A Urbano-Ispizua, C Solano, S Brunet, F Hernández, G Sanz, A Alegre, J Petit, J Besalduch, P Vivancos, M A Díaz, J M Moraleda, E Carreras, E Ojeda, J de la Rubia, I Benet, A Domingo-Albós, J García-Conde, C Rozman
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  ABSTRACT: The results of 33 allogeneic peripheral blood progenitor cells transplants (allo-PBPCT) in adult patients with hematologic malignancies were analyzed in a retrospective and multicenter study. In 21 of 33 cases (63%) the disease was refractory or in advanced stage and eight of the 33 cases (24%) were second transplants after relapse. Donors were treated with a median of 10 (4-16) micrograms/kg/day of rhG-CSF subcutaneously for 5-7 days. Three required a central venous line for harvesting. Peripheral blood leukapheresis product contained a median of 5.9 (1.8-13) 10(6)/kg CD34+ cells and a median of 309.5 (153-690) 10(6)/kg CD3+ cells. After a myeloablative regimen, all patients received PBPC from HLA-identical donors as the sole source of progenitor cells. Cyclosporin A (CsA) alone (n = 2), CsA and steroids (n = 9), and CsA and methotrexate (MTX) (n = 22) were used for GVHD prophylaxis. Growth factors post-transplant were given to 11 patients (33%). The median follow-up of the patients was 3 months. Actuarial median day for hemopoietic recovery was: neutrophils to >0.5 (>1) x 10(9)/l, day 14 (15); platelets to >20 (>50) x 10(9)/l, day 14 (21). The quantity of CD34+ cells infused did not significantly affect the engraftment kinetics, from a starting cutoff of 2.5 x 10(6)/kg. The speed of neutrophil recovery seemed to be influenced strongly by using rhG-CSF post-transplant and marginally by the type of GVHD prophylaxis. Actuarial probability for grade II-IV acute GVHD of the whole group was 37% (95% Cl, 20-54%).
  Bone Marrow Transplantation 07/1996; 18(1):35-40. · 3.75 Impact Factor
• Article: Feasibility and results of bone marrow transplantation after remission induction and intensification chemotherapy in de novo acute myeloid leukemia. Catalan Group for Bone Marrow Transplantation.

  J Sierra, S Brunet, A Grañena, T Olivé, J Bueno, J M Ribera, J Petit, C Besses, A Llorente, R Guardia, [......], C Díaz de Heredia, P Vivancos, E Carreras, E Feliu, E Montserrat, A Julía, J Cubells, C Rozman, A Domingo, J J Ortega
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  ABSTRACT: To evaluate prospectively the feasibility and results of bone marrow transplantation (BMT) after induction and intensification chemotherapy (CT) in patients with de novo acute myeloid leukemia (AML). A total of 159 patients less than 51 years of age were treated. Induction CT consisted of daunorubicin 60 mg/m2 for 3 days, cytarabine (ARA-C) 100mg/m2 for 7 days, and etoposide 100 mg/m2 for 3 days. The first intensification therapy included mitoxantrone 10 mg/m2 for 3 days and ARA-C 1.2 g/m2 every 12 hours for 4 days. Amsacrine (100 or 150 mg/m2 for 3 days) and ARA-C (1.2 g/m2 every 12 hours for 2 or 4 days) were given as the second intensification therapy. Depending on the availability of a human leukocyte antigen (HLA)-identical sibling, the intention of treatment after CT was allogeneic BMT (allo-BMT) or autologous BMT (ABMT). Complete remission (CR) was obtained in 120 patients (75%) and partial remission (PR) in 11 (7%), while 15 patients (10%) were refractory and 13 (8%) died during induction. There was a trend for better leukemia-free survival (LFS) at 4 years for patients assigned to the ABMT group (50% +/- 6%) compared with the allo-BMT group (31% +/- 7%) (P = .08). This difference in LFS reached statistical significance when considering only transplanted patients (63% +/- 3% at 4 years after ABMT and 38% +/- 11% after allo-BMT, P = .02). The favorable results in patients who received ABMT (no toxic deaths and 37% +/- 7% probability of relapse at 4 years) contrast with the poor outcome of allografted patients (11 patients with transplant-related mortality). Our study reflects the difficulties in the completion of a therapeutic strategy that include BMT and suggests that intensification before BMT may be useful in the setting of ABMT, but this approach was associated with a high mortality rate in allo-BMT patients.
  Journal of Clinical Oncology 05/1996; 14(4):1353-63. · 18.37 Impact Factor
• Article: Kaposi's sarcoma after autologous bone marrow transplantation for multiple myeloma.

  P Vivancos, J Sarrá, J Palou, A Valls, J Garćia, A Grañena
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  ABSTRACT: We report a case of Kaposi's sarcoma in a patient who underwent autologous bone marrow transplantation (ABMT) for multiple myeloma. Four months after ABMT he presented with numerous asymptomatic, dark blue and purplish macules and nodules on the trunk and lower extremities. Biopsy revealed the typical histologic pattern of Kaposi's sarcoma. The patient died due to disseminated Kaposi's sarcoma while in complete remission of his hematologic malignancy.
  Bone Marrow Transplantation 05/1996; 17(4):669-71. · 3.75 Impact Factor
• Article: Outpatient total body irradiation for bone marrow transplantation.

  M Algara, A Valls, P Vivancos, A Grañena
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  ABSTRACT: Five selected patients entering a BMT program were included in a prospective feasibility study to evaluate the tolerance to total body irradiation (TBI) on an outpatient basis. Four fractions of 3 Gy in 4 consecutive days (8 Gy lung total dose) were given. Ondansetron 8 mg/8 h orally was used without sedation as anti-emetic regimen. After each treatment dose, patients went home where they remained in close telephone contact with the BMT team. After the last TBI fraction, patients were hospitalized and treated with cyclophosphamide 60 mg/g/day for 2 consecutive days. The outpatient TBI regimen was well tolerated in four cases. Only one patient presented with nausea and vomiting after the second treatment day. She was admitted to the hospital and treated with chlorpromazine. During the conditioning and hematological recovery period, no complications related to the outpatient TBI could be identified. We conclude that TBI can be given on an outpatient basis with safety. Additionally, it represents a cost saving of US$ 1160 per patient.
  Bone Marrow Transplantation 10/1994; 14(3):381-2. · 3.75 Impact Factor
• Article: Immunomagnetic purging in autologous bone marrow transplantation: experience in fourteen patients.

  C Canals, C Puntí, M Picón, B Amill, D Tugues, T Sanchez, I Badell, N Pardo, J Ortega, P Vivancos
  Progress in clinical and biological research 02/1992; 377:289-96.
• Article: Mediastinal germ cell tumor and acute megakaryoblastic leukemia.

  A Domingo, V Romagosa, M Callis, P Vivancos, N Guionnet, J Soler
  Annals of internal medicine 10/1989; 111(6):539. · 16.73 Impact Factor
• Article: Post-remission therapy in acute myeloblastic leukemia. A randomized trial comparing early consolidation plus maintenance versus maintenance therapy alone.

  J Maldonado, S Gardella, J M Rodriguez Fernandez, R Parody, J Muncunill, P Vivancos, C Alonso, L Hernandez-Nieto, A Domingo, J Marin
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  ABSTRACT: During a 5-year period 203 previously untreated patients with acute myeloblastic leukemia entered an intensive induction chemotherapy regimen with daunorubicin, cytosine arabinoside, 6-thioguanine, vincristine and prednisone (DATOP). The complete remission rate was 64%. Patients in complete remission were randomly assigned to 3 courses of early consolidation with DATOP at lower dosage followed by maintenance chemotherapy, or to the same maintenance regimen in the absence of any consolidation courses. No significant differences were found between these options concerning disease-free survival (median 7.0 vs. 9.8 months; p greater than 0.10) or survival (median 15.8 vs. 19.4 months; p greater than 0.10). This study, in addition to the few previously reported randomized trials, suggests that early low-dose consolidation adds no benefit to maintenance chemotherapy in acute myeloblastic leukemia once complete remission has been achieved.
  Acta Oncologica 02/1989; 28(2):223-6. · 3.33 Impact Factor