Deok-Hwan Yang

Chonnam National University Hospital, Sŏul, Seoul, South Korea

Are you Deok-Hwan Yang?

Claim your profile

Publications (84)171.98 Total impact

  • Moo-Kon Song, Joo-Seop Chung, Je-Jung Lee, Deok-Hwan Yang, In-Suk Kim, Dong-Hoon Shin, Ho-Jin Shin
    [Show abstract] [Hide abstract]
    ABSTRACT: Approximately 10–25 % of patients with diffuse large B cell lymphoma (DLBCL) at the time of diagnosis exhibit bone marrow involvement (BMI). After introduction of rituximab, immunohistochemistry (IHC) markers lost to prognostic value in DLBCL patients. However, the specimens used have mainly been diagnostic tissues, not bone marrow (BM). It would thus be useful to determine the prognostic value of specific IHC markers of pathologic BM in DLBCL patients with BMI in the rituximab era. In the present study, a total of 580 DLBCL patients were analyzed 67 of whom had BMI. CD10, Bcl-6, MUM-1, Bcl-6 and Ki-67 dyeing on pathologic BM were applied. Bcl-2 positivity was more frequent in discordant BMI (P = 0.039) and high Ki-67 expression was more frequent in concordant BMI (P = 0.016). High Ki-67 expression independently predicted poor prognosis between the negative BMI group and each of the following BMI-positive groups: entire BMI (PFS, P P P = 0.024; OS, P = 0.007), and discordant BMI (PFS, P = 0.033; OS, P = 0.026). We found that Ki-67 expression in pathologic BM is a novel significant prognostic parameter of worse prognosis in DLBCL patients with BMI in the rituximab era.
    International Journal of Hematology 12/2014; · 1.68 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (hyper-CVAD) regimen has been widely used for lymphoblastic lymphoma (LBL) as a primary treatment. However, there is few data about its treatment outcome in Asian patients. Thus, we conducted this study to evaluate the efficacy of hyper-CVAD induction and stem cell transplantation (SCT) consolidation in LBL patients. The treatment responses of 49 patients treated with the hyper-CVAD regimen were retrospectively analyzed in 13 institutions. Given 24 patients who responded to hyper-CVAD underwent consolidation treatment with SCT, overall survival (OS) and progression-free survival (PFS) of patients who received SCT were compared with patients who did not. The overall response rate was 79 %: 73 % (36/49) complete responses, 6 % (3/49) partial responses, and 4 % (2/49) induction deaths. The major limitation for the delivery of the planned hyper-CVAD cycles was hematological toxicity. Among 39 responders, 24 patients underwent autologous (n = 16) and allogeneic SCT (n = 8) consolidation. Their 3-year OS and PFS rates were 76 and 78 %, respectively, and there was no difference in survival outcomes between autologous and allogeneic SCT. However, 15 patients without SCT consolidation showed poorer PFS even though they all achieved complete response. Thus, only seven patients maintained their response at the time of analysis. In conclusion, the hyper-CVAD regimen is effective for remission induction in LBL, and SCT consolidation after hyper-CVAD induction produced better clinical outcomes than did continuation of hyper-CVAD.
    Annals of Hematology 12/2014; · 2.87 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Bortezomib-based therapy is commonly used in treatment for relapsed or refractory multiple myeloma (MM). Unfortunately, many patients showed relapse or progression in heterogeneous patterns. In this study, we retrospectively evaluated patterns of relapse or progression after bortezomib-based salvage therapy in patients with MM and analyzed prognostic significance according to patterns of relapse or progression. One hundred forty-eight patients were treated with bortezomib-based therapy between November 2004 and April 2012. Of these patients, 104 (70.3%) patients relapsed or progressed after bortezomib-based salvage therapy. We divided the patterns of relapse or progression to the two groups: 1) the isoform relapse or progression (group A) in 89 (85.6%) patients as disease findings at initiation of bortezomib-based therapy and 2) transformed relapse or progression (group B) in 15 (14.4%) patients (plasmacytoma n=7, light chain escape n=6, and plasma cell leukemia n=2) different from initial disease findings. Median overall survivals in group A and group B were 32.7 months (95% CI: 21.3-44.1) and 10.7 months (95% CI: 2.0-19.4) (p < 0.001), retrospectively. In conclusion, MM patients who relapsed or progressed as the transformed pattern for bortezomib-based salvage therapy have an extremely poor prognosis and might require new innovative approaches.
    Clinical lymphoma, myeloma & leukemia 10/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Fluoroquinolone is recommended as a prophylactic antibiotic for high-risk patients with profound neutropenia. We previously reported that multiple myeloma (MM) patients who received bortezomib-based regimens were at higher risk of severe infections (30.9 %) associated with lymphocytopenia. In the study, we evaluated whether severe infectious complications can be prevented by prophylactic administration of oral levofloxacin in MM patients treated with bortezomib-based regimens. A total of 80 patients received oral levofloxacin 500 mg daily during the median four cycles of treatment. The prophylactic group (n = 80) with levofloxacin showed significantly decreased severe infections compared to a historical control group (n = 139) without levofloxacin prophylaxis during treatment of bortezomib-based regimens (17.5 vs. 30.9 %, P = 0.037). In the prophylactic group, two patients (2.5 %) died of pneumonia and septic shock. Four patients (5 %) stopped levofloxacin due to side effects that consisted of gastrointestinal discomfort (2.5 %), itching sense (1.25 %), and QTc prolongation (1.25 %). In conclusion, prophylaxis with levofloxacin may be effective in the prevention of severe infection in MM patients receiving bortezomib-based regimens. A prospective randomized study is needed to test the prophylactic effect of levofloxacin in MM patients treated with bortezomib-based regimens.
    International Journal of Hematology 09/2014; · 1.68 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Mitoxantrone is a conventional agent for relapsed or refractory acute lymphoblastic leukemia (ALL). However, an effective combination with other drugs and a feasible dosage has not been identified. A retrospective study of 46 patients with relapsed or refractory ALL was conducted to determine the efficacy of mitoxantrone and Ara-C treatment with (MEC) and or without etoposide (MC). Twenty-seven and 19 patients received MC and MEC chemotherapy, respectively. Twenty-two (48%) patients showed overall response [complete response (CR), 33%; CR with incomplete platelet recovery (CRp), 15%], and 10 of 22 responders received allogeneic stem cell transplantation (SCT). Median overall survival (OS) was 6.2 months (95% confidence interval, 3.41-9.0). Thirteen (48%) patients in the MC group and 9 (47%) in the MEC group achieved CR/CRp (p = 0.96). Treatment-related mortalities in the MC and MEC groups were 3 (11%) and 4 (21%), respectively (p = 0.36). However, the MEC group frequently presented with grade 3 or higher bacteremia/candidemia (p = 0.013). No difference in OS was observed between the two groups (p = 0.769). In conclusion, salvage therapy consisting of mitoxantrone and Ara-C without etoposide appeared to be an effective bridge therapy to allogeneic SCT for patients with refractory or relapsed ALL. © 2014 S. Karger AG, Basel.
    Acta haematologica. 08/2014; 133(1):91-97.
  • [Show abstract] [Hide abstract]
    ABSTRACT: We evaluated the relationship between serum lactate dehydrogenase (LDH) level with systemic inflammation score and survival in 213 patients with diffuse large B-cell lymphoma (DLBCL) receiving R-CHOP chemotherapy. The patients were classified into 3 groups based on LDH with the Glasgow Prognostic Score (L-GPS). A score of 2 was assigned to patients with elevated C-reactive protein, hypoalbuminemia and elevated LDH, a score of 1 to those with one or two abnormalities and a score of 0 to those with no abnormality. In multivariate analysis, independent poor prognostic factors for progression-free survival were L-GPS 2 [hazard ratio (HR) 5.415, p = 0.001], Eastern Cooperative Oncology Group performance status (ECOG PS) ≥2 (HR 3.504, p = 0.001) and bulky lesion (HR 2.030, p = 0.039). Independent poor prognostic factors for overall survival were L-GPS 2 (HR 5.898, p = 0.001) and ECOG PS ≥2 (HR 3.525, p = 0.001). The overall response rate for the R-CHOP chemotherapy decreased according to the L-GPS; it was 96.7% at L-GPS 0, 87% at L-GPS 1 and 75% at L-GPS 2 (p = 0.009). L-GPS based on systemic inflammatory indicators may be a useful clinical prognostic indicator for survival, and predicts the response for R-CHOP chemotherapy in patients with newly diagnosed DLBCL. © 2014 S. Karger AG, Basel.
    Acta haematologica. 06/2014; 133(1):10-17.
  • [Show abstract] [Hide abstract]
    ABSTRACT: We conducted a phase II trial of concurrent chemoradiotherapy (CCRT) followed by 2 cycles of L-asparaginase-containing chemotherapy for patients who were newly diagnosed with stages IE and IIE nasal extranodal NK/T cell lymphoma (ENKTL). CCRT consisted of 40-44 Gy of radiotherapy with weekly administration of 30 mg/m(2) of cisplatin for 4 weeks. Two cycles of VIDL (etoposide (100 mg/m(2)), ifosfamide (1,200 mg/m(2)), and dexamethasone (40 mg) from days 1 to 3, and L-asparaginase (4,000 IU/m(2)) every other day from days 8 to 20) were administered sequentially. CCRT yielded a 90 % overall response rate without significant side effects in 30 patients, including 20 patients with complete response (CR); however, two patients showed distant disease progression. After CCRT, VIDL chemotherapy showed an 87 % final CR rate (26/30). Although grade III or IV hematologic toxicity was frequent during VIDL chemotherapy, no treatment-related mortality was observed, and L-asparaginase-associated toxicity was manageable. With a median follow-up of 44 months, 11 patients showed local (n = 4) and distant (n = 7) relapse or progression. The estimated 5-year progression-free and overall survival rates were 73 and 60 %, respectively. In conclusion, CCRT followed by L-asparaginase-containing chemotherapy is a feasible treatment for newly diagnosed stages IE/IIE nasal ENKTL.
    Annals of Hematology 06/2014; · 2.87 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The association between hyperglycemia and infections during induction chemotherapy has been reported in a number of hematologic disorders. This retrospective study evaluated the incidence of hyperglycemia during induction therapy in 155 patients with newly diagnosed multiple myeloma (MM) and its effect on serious infections during the first 60 days of induction. A total of 20 (12.9%) patients developed overt hyperglycemia (≥200 mg/dL) during induction therapy. Serious infections occurred in 28 (18.1%) of 155 patients and infection-related mortality within 2 months after treatment was 0.6% (1 patient). In a univariate analysis, overt hyperglycemia, poor performance status (≥2), International Staging System III, lymphopenia (<500/ μ L), and elevated serum creatinine (≥2 mg/dL) were found to be associated with serious infections. In multivariate analysis, only overt hyperglycemia (HR 7.846, 95% CI 2.512-24.503, P < 0.001) and poor performance status (HR 5.801, 95% CI 1.974-17.050, P = 0.001) remained significant. In conclusion, this study demonstrated an association between hyperglycemia and serious infections during induction therapy in patients with MM.
    BioMed research international. 01/2014; 2014:413149.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We assessed the success rate of empirical antifungal therapy with itraconazole and evaluated risk factors for predicting the failure of empirical antifungal therapy. A multicenter, prospective, observational study was performed in patients with hematological malignancies who had neutropenic fever and received empirical antifungal therapy with itraconazole at 22 centers. A total of 391 patients who had abnormal findings on chest imaging tests (31.0%) or a positive result of enzyme immunoassay for serum galactomannan (17.6%) showed a 56.5% overall success rate. Positive galactomannan tests before the initiation of the empirical antifungal therapy (P=0.026, hazard ratio [HR], 2.28; 95% confidence interval [CI], 1.10-4.69) and abnormal findings on the chest imaging tests before initiation of the empirical antifungal therapy (P=0.022, HR, 2.03; 95% CI, 1.11-3.71) were significantly associated with poor outcomes for the empirical antifungal therapy. Eight patients (2.0%) had premature discontinuation of itraconazole therapy due to toxicity. It is suggested that positive galactomannan tests and abnormal findings on the chest imaging tests at the time of initiation of the empirical antifungal therapy are risk factors for predicting the failure of the empirical antifungal therapy with itraconazole. (Clinical Trial Registration on National Cancer Institute website, NCT01060462).
    Journal of Korean medical science 01/2014; 29(1):61-8. · 0.84 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The damage caused by oxidative stress and exposure to cigarette smoke and alcohol necessitate DNA damage repair and transport by multidrug resistance-1 (MDR1). To explore the association between polymorphisms in these genes and non-Hodgkin lymphoma risk, we analyzed 15 polymorphisms of 12 genes in a population-based study in Korea (694 cases and 1700 controls). Four genotypes of DNA repair pathway genes (XRCC1 399 GA, OGG1 326 GG, BRCA1 871 TT, and WRN 787 TT) were associated with a decreased risk for NHL [odds ratio (OR)XRCC1 GA = 0.80, p = 0.02; OROGG1 GG = 0.70, p = 0.008; ORBRCA1 TT = 0.71, p = 0.048; ORWRN TT = 0.68, p = 0.01]. Conversely, the MGMT 115 CT genotype was associated with an increased risk for NHL (OR = 1.25, p = 0.04). In the MDR1 gene, the 1236 CC genotype was associated with a decreased risk for NHL (OR = 0.74, p = 0.04), and the 3435 CT and TT genotypes were associated with an increased risk (OR3435CT = 1.50, p < 0.0001; OR3435TT = 1.43, p = 0.02). These results suggest that polymorphisms in the DNA repair genes XRCC1, OGG1, BRCA1, WRN1, and MGMT and in the MDR1 gene may affect the risk for NHL in Korean patients.
    International Journal of Molecular Sciences 01/2014; 15(4):6703-16. · 2.46 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: To identify prognostic factors for the outcomes of empirical antifungal therapy, we performed a multicenter, prospective, observational study in immunocompromised patients with hematological malignancies. Materials and Methods: Three hundred seventy-six patients (median age of 48) who had neutropenic fever and who received intravenous (IV) itraconazole as an empirical antifungal therapy for 3 or more days were analyzed. The patients with possible or probable categories of invasive fungal disease (IFD) were enrolled. Results: The overall success rate was 51.3% (196/376). Age >50 years, underlying lung disease (co-morbidity), poor performance status [Eastern Cooperative Oncology Group (ECOG) ≥2], radiologic evidence of IFD, longer duration of baseline neutropenic fever (≥4 days), no antifungal prophylaxis or prophylactic use of antifungal agents other than itraconazole, and high tumor burden were associated with decreased success rate in univariate analysis. In multivariate analysis, age >50 years (p=0.009) and poor ECOG performance status (p=0.005) were significantly associated with poor outcomes of empirical antifungal therapy. Twenty-two patients (5.9%) discontinued itraconazole therapy due to toxicity. Conclusion: We concluded that empirical antifungal therapy with IV itraconazole in immunocompromised patients is effective and safe. Additionally, age over 50 years and poor performance status were poor prognostic factors for the outcomes of empirical antifungal therapy with IV itraconazole.
    Yonsei medical journal 01/2014; 55(1):9-18. · 0.77 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Obesity increases morbidity in and mortality of patients with various types of cancer. However, the proportion of obese individuals in Asia is smaller than that in Western populations and only a few studies have explored the effect of obesity at the time of diagnosis on the survival of Asian patients with multiple myeloma (MM). Therefore, we investigated the relationship between body mass index (BMI) at diagnosis, and clinical manifestations, in MM patients. We also measured overall survival (OS) in terms of BMI groupings. Patients were subdivided into three groups based on hazard ratios (HRs) associated with BMIs of <20, 20-24.9, and ≥25 kg/m(2). The median survival times were 25.5 months in patients with a BMI of <20 kg/m(2), 56.8 months for those with a BMI of 20-24.9 kg/m(2), and 76 months in patients with a BMI of ≥25 kg/m(2). Patients with a BMI of <20 kg/m(2) exhibited poorer performance status and a lower hemoglobin level at diagnosis than did others, and renal failure (serum creatinine ≥2 mg/dl) was much more often observed in such patients than in those of other groups. Both univariate and multivariate analyses showed that BMI <20 kg/m(2) (HR 1.831, 95 % confidence interval [CI] 1.005-3.337; P = 0.048) and performance of autologous stem cell transplantation (HR 0.257, 95 % CI 0.139-0.475, P < 0.001) were significantly (negatively) associated with OS. In conclusion, a low BMI (<20 kg/m(2)) at the time of diagnosis was associated with poor survival of MM patients.
    Annals of Hematology 12/2013; · 2.87 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: We conducted a multicenter retrospective study to compare the efficacy and toxicity of various chemomobilization regimens: high-dose (HD) cyclophosphamide, HD etoposide (VP-16), and platinum-based chemotherapies. We reviewed the experiences of 10 institutions with 103 non-Hodgkin's lymphoma patients who had previously only been treated with cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP)-based chemotherapy. The mobilization yields for each regimen were analyzed. HD VP-16 mobilized a significantly higher median number of CD34+ cells (16.22 × 106 cells/kg) than HD cyclophosphamide (4.44 × 106 cells/kg) or platinum-based chemotherapies (6.08 × 106 cells/kg, P <.001). The rate of successful mobilization (CD34+ cell count ≥5.0 × 106 cells/kg) was also significantly higher for HD VP-16 (86%) than for HD cyclophosphamide (45%) or platinum-based chemotherapies (61%, P = .004). The successful mobilization rate on day 1 of 72% for HD VP-16 was significantly higher than the rates for HD cyclophosphamide (13%) and platinum-based chemotherapies (26%, P <.001). In multivariate analysis, HD VP-16 was a significant predictor of successful mobilization (P = .014, odds ratio = 5.25, 95% confidence interval 1.40-19.63). Neutropenic fever occurred in 67% of patients treated with HD VP-16. The incidence was similar for HD cyclophosphamide (58%, P = .454), but was significantly lower for platinum-based chemotherapies (12%, P <.001). However, fatal (grade ≥4) infection and treatment-related mortality were not observed in this study. In conclusion, the mobilization yield was significantly influenced by the chemomobilization regimen and HD VP-16 was a highly effective mobilization regimen in patients with NHL.
    Biology of blood and marrow transplantation: journal of the American Society for Blood and Marrow Transplantation 10/2013; · 3.15 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Several studies have suggested the possibility of a prognostic relationship between Epstein-Barr virus (EBV) and diffuse large B-cell lymphoma (DLBCL). The clinical outcome of EBV-associated DLBCL is not clear, especially since the introduction of rituximab. We retrospectively analyzed 222 elderly patients (≥50 years) with DLBCL who received R-CHOP chemotherapy and evaluated the state of EBV-encoded RNA-1 (EBER). Eighteen cases (8.1%) were EBER-positive (+). After a median of six cycles of R-CHOP chemotherapy, the response rate (≥partial response) was 72.2% (13/18) in the EBV (+) patients and 90.2% (184/204) in the EBV (-) DLBCL patients (p = 0.021). Four of 18 (22.2%) EBV (+) DLBCL patients received two or fewer cycles of R-CHOP chemotherapy. R-CHOP chemotherapy was also interrupted early more frequently compared with the EBV (-) group (2.5%) (p = 0.00). At a median follow-up of 32.8 months, there was no significant difference in the overall survival between the groups (p = 0.627). The EBV (+) DLBCL patients with early interruption of R-CHOP chemotherapy showed a trend toward a high EBV-DNA titer (≥1,000 copies/mL) (p = 0.091). The results suggest that the EBV (+) tumoral status of elderly DLBCL patients who undergo R-CHOP chemotherapy does not predict their survival but that their EBV status may contribute to the early interruption of R-CHOP chemotherapy.
    American Journal of Hematology 06/2013; · 4.00 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We investigated the clinical outcome of bone marrow (BM) involvement in patients with diffuse large B-cell lymphoma (DLBCL) who received rituximab-based therapy. A total of 567 consecutive patients with newly diagnosed DLBCL treated with rituximab-CHOP (RCHOP) between November 2001 and March 2010 were included in the current study. All of the patients underwent a BM study at the initial staging and the clinical characteristics and prognosis of these patients with or without BM involvement were analyzed retrospectively. The total cohort included 567 patients. The overall incidence of BM involvement was 8.5%. With a median follow-up duration of 33.2 months (range, 0.1 to 80.7 months) for patients who were alive at the last follow-up, the five-year overall survival (OS) and event-free survival (EFS) rate in patients without BM involvement (76.3% and 67.5%, p<0.001) was statistically higher than that in patients with BM involvement (44.3% and 40.1%, p<0.001). In multivariate analysis, among total patients, BM involvement showed a significant association with OS and EFS. In univariate and multivariate analyses, even among stage IV patients, a significant association with worse EFS was observed in the BM involvement group. BM involvement at diagnosis affected the survival of patients with DLBCL who received RCHOP. Although use of RCHOP can result in significant improvement of the therapeutic effect of DLBCL, BM involvement is still a negative prognostic factor of DLBCL patients in the era of rituximab.
    Cancer Research and Treatment 06/2013; 45(2):112-7. · 1.96 Impact Factor
  • Source
    Blood research. 06/2013; 48(2):72-3.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Several chemotherapeutic agents are known to develop pulmonary toxicities in cancer patients, although the frequency of incidence varies. Cyclophosphamide is a commonly encountered agent that is toxic to the lung. Additionally, granulocyte colony-stimulating factor (G-CSF) being used for the recovery from neutropenia can exacerbate lung injury. However, most of the patients reported previously that the drug-induced interstitial pneumonitis were developed after three to four cycles of chemotherapy. Hereby, we report a case of peripheral T cell lymphoma which rapidly developed a fatal interstitial pneumonitis after the first cycle of combined chemotherapy with cyclophosphamide, adriamycin, vincristine, prednisolone, and etoposide and the patient had also treated with G-CSF during neutropenic period.
    Tuberculosis and Respiratory Diseases 05/2013; 74(5):235-9.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Bortezomib administration leads to a transient decrease in CD4(+) T cells, increasing the susceptibility to opportunistic infections. The activation and proliferation of CD4(+) T cells are particularly important in the host's defense against tuberculosis infection. The aim of this study was to determine the incidence and clinical significance of tuberculosis infection in patients with multiple myeloma (MM) treated with a bortezomib-containing regimen. We retrospectively investigated the incidence of Mycobacterium tuberculosis in 115 patients with MM who were given a bortezomib-containing regimen and studied the disease prognosis. All patients received chemotherapy prior to bortezomib administration, and the median duration from diagnosis to bortezomib administration was 12.4 months (range, 0.2-230). We diagnosed tuberculosis in 8 patients (8/115, 7%): 7 patients had a pulmonary granulomatous lesion prior to chemotherapy and 1 developed reactivation of tuberculosis, but none of them died of uncontrolled tuberculosis infection. In 50% of patients with tuberculosis, bortezomib-containing therapy was interrupted. This resulted in significantly lower response rates to the bortezomib-containing therapy (P<0.05) and significantly shorter overall survival times amongst tuberculosis vs. non-tuberculosis patients (P=0.017). Tuberculosis infection was not uncommon among the patients with MM who were treated with bortezomib-containing therapy, and tuberculosis infection in these patients resulted in an interruption of bortezomib administration, which significantly affected patient outcomes. Therefore, early diagnosis and treatment of tuberculosis infection are critical to avoid worsening outcomes in such patients.
    Blood research. 03/2013; 48(1):35-9.
  • [Show abstract] [Hide abstract]
    ABSTRACT: The effectiveness of high-dose chemotherapy (HDT) followed by autologous stem cell transplantation (ASCT) as a frontline treatment in peripheral T cell lymphomas (PTCLs) is still unclear. We retrospectively investigated the clinical outcomes of HDT/ASCT as an intensifying frontline treatment in 31 patients with newly diagnosed PTCLs. The conditioning regimen of HDT/ASCT consisted of busulfan, cyclophosphamide, and etoposide (BuCyE). At diagnosis, five (16.1 %) patients were classified as high risk according to the prognostic index for PTCL (PIT). The disease status of the patients before HDT/ASCT consisted of 23 patients (74.2 %) with complete response (CR) and eight patients (25.8 %) with partial response (PR). Six (75 %) out of eight patients with PR at pretransplantation were improved in terms of the response to CR after HDT/ASCT. At a median follow-up of 32.4 months, the 3-year probability of overall survival (OS) and progression-free survival (PFS) was 64.5 ± 8.6 %. Transplant-related mortality occurred in three patients (9.7 %), due to septic shock, hemorrhage, and delayed pneumonia, respectively. Bone marrow involvement of PTCL at diagnosis was a poor prognostic factor for OS. In conclusion, frontline HDT/ASCT with a conditioning regimen of BuCyE may be an effective and tolerable intensifying therapeutic option to improve outcomes in patients with PTCLs.
    Annals of Hematology 01/2013; · 2.87 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Bortezomib is a proteasome inhibitor with potent antimyeloma activity in relapsed/refractory multiple myeloma (MM) patients. We evaluated the types and factors affecting the onset of infectious complications and mortality owing to infection in MM patients treated with bortezomib-based regimens. We reviewed 139 patients with MM treated with regimens containing bortezomib in order to assess the types and factors affecting the development of severe infections. Infections occurred in 56 (40.3 %) of 139 patients and 83 (7.8 %) cases of the 1,069 evaluable cycles. Severe infections developed in 43 (30.9 %) patients and ten patients (7.1 %) died during bortezomib-based treatment. Multivariate analysis determined lymphocytopenia grade 3-4 (OR 3.17, 95 % CI 1.38-7.31, P = 0.007) and number of cycles ≤8 (OR 3.91, 95 % CI 1.39-11.02, P = 0.010) as risk factors associated with increased severe infection. This study showed that MM patients who received bortezomib-based regimens are at a higher risk of severe infections within eight cycles of treatment during especially severe lymphocytopenic periods. MM patients treated with bortezomib-based regimens should be closely monitored for the development of infectious complications during lymphocytopenia.
    International journal of hematology 01/2013; · 1.17 Impact Factor

Publication Stats

588 Citations
171.98 Total Impact Points

Institutions

  • 2007–2014
    • Chonnam National University Hospital
      Sŏul, Seoul, South Korea
    • Kyungpook National University Hospital
      • Department of Hemato-Oncology
      Sŏul, Seoul, South Korea
  • 2011
    • Sungkyunkwan University
      • School of Medicine
      Seoul, Seoul, South Korea
  • 2004–2011
    • Chonnam National University
      • • Department of Internal Medicine
      • • Department of Hematology and Oncology
      Gwangju, Gwangju, South Korea