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Publications (188)
Highlights
This EHA–ESMO Clinical Practice Guideline provides key recommendations for managing HIV‐associated lymphomas.
The guideline covers clinical, imaging and pathological diagnosis; staging and risk assessment; treatment and follow‐up.
The author group encompasses a multidisciplinary group of experts from different institutions and countries...
Background and Objectives: eBEACOPP is the most effective chemotherapy regimen for younger patients with early unfavorable (EU) and advanced-stage (AS) Hodgkin lymphoma (HL), albeit with significant toxicities. The 14-day/cycle prednisone course contributes to side effects, including osteoarticular events like avascular bone necrosis (AVN). Our cen...
Simple Summary
Radiotherapy plays a crucial role in managing lymphomas. Advancements in radiation oncology have resulted in smaller treatment volumes and an improved ability to avoid nearby critical tissues and organs. Additionally, radiation therapy doses have been reduced. Our retrospective study aimed to compare the efficacy and side effects of...
Patients with lymphoid malignancies are at increased risk of death or prolonged infection due to COVID-19. Data on the influence of different antineoplastic treatment modalities on outcomes are conflicting. Anti-CD20 monoclonal antibodies increase the risk of prolonged infection. It is unclear whether this risk is affected by the choice of the anti...
GZL with features between classical Hodgkin lymphoma (HL) and diffuse large B-cell lymphoma (DLBCL) is a rare entity originally introduced in the 2008 World Health Organization (WHO) classification. GZL has been included in KroHem Lymphoma Treatment Guidelines since 2012. The recommended treatment was induction with escalated BEACOPP (escBEACOPP) i...
Chronic kidney dysfunction is associated with increased mortality in multiple cancer types. Preliminary evidence suggests the same to be true for B-large cell lymphomas (B-LCL). To analyze the relationship of glomerular filtration rate (GFR) and outcome of B-LCL in detail we collected data on outcomes of 285 consecutive patients with newly diagnose...
Purpose
Dose‐adjusted EPOCH and rituximab (DA‐EPOCH‐R) is a regimen used for the treatment of high‐risk diffuse large B‐cell lymphoma (DLBCL) designed to overcome resistance to standard R‐CHOP by combining prolonged exposure of lymphoma cells to cytotoxic agents and dose‐adjustment based on toxicity. Data on outcomes of older patients are scarce....
Purpose:
Data on efficacy and toxicity of infradiaphragmal radiotherapy fields in lymphoma patients are scarce. We therefore performed this retrospective study to analyse our experience with radiotherapy exclusively to infradiaphragmal fields.
Materials and methods:
we retrospectively evaluated 101 patients treated between 2003 and 2014. Median...
In the H10 and RAPID randomised trials, chemotherapy+radiotherapy (combined modalities treatment, CMT) was compared with chemotherapy (C) in limited‐stage Hodgkin lymphoma (HL), with negative early positron emission tomography (ePETneg). We analysed patterns of relapses in the H10 trial, validated findings in the RAPID trial and performed a combine...
Background
Hematology patients are intensive platelet users. In clinical practice, a substantial proportion of platelet (PLT) transfusions are routinely administered outside the guidelines despite compelling evidence for recommendations. Those unnecessary PLT transfusions are an unjustified extra burden on a scarce healthcare resource and may also...
Obinutuzumab (G) has become part of front-line treatment of follicular lymphoma (FL) based on results of a large randomized study. Data on patients treated outside of clinical trials are lacking. We have retrospectively investigated efficacy and safety of G-based immunochemotherapy regimens in 114 patients treated in a real-life setting during a pe...
Elderly patients make up a significant number of cases of newly diagnosed Hodgkin lymphoma. However, unlike in young patients, the outcomes of elderly patients are poor, and they are under-represented in phase III trials. Prior to treatment initiation, geriatric assessment should ideally be performed to address the patient’s fitness and decide whet...
Disease- and treatment-mediated immunodeficiency might render SARS-CoV-2 vaccines less effective in patients with hematologic diseases. We performed a prospective non-interventional study to evaluate humoral response after one and two doses of mRNA-1273, BNT162b2, or ChAdOx1 nCoV-19 vaccine in 118 patients with different malignant or non-malignant...
An expert panel convened by the European Alliance for Personalized Medicine (EAPM) reflected on achievements and outstanding challenges in Europe in mantle cell lymphoma (MCL). Through the prism of member state experience, the panel noted advances in outcomes over the last decade, but highlighted issues constituting barriers to better care. The lis...
PURPOSE
The prognosis of patients with early-stage unfavorable Hodgkin lymphoma remains unsatisfactory. We assessed the efficacy and safety of brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine (BV-AVD) in previously untreated, early-stage unfavorable Hodgkin lymphoma (ClinicalTrials.gov identifier: NCT02292979 ).
METHODS
BREACH is...
Bendamustine is an alkylating agent classified into the group of nitrogen mustard analogues, synthesized almost sixty years ago. It was registered in former East Germany in 1971 and approved by the US Food and Drug Administration in 2008 for treatment of chronic lymphocytic leukemia and indolent B‑cell non‑Hodgkin lymphoma. Considering its benefici...
In 2016, the European Hematology Association (EHA) published the EHA Roadmap for European Hematology Research1 iming to highlight achievements in the diagnostics and treatment of blood disorders and to better inform European policy makers and other stakeholders about the urgent clinical and scientific needs and priorities in the field of hematology...
U članku: Popović N, Mravak Stipetić M, Lelas A, Pulanić D, Radić Krišto D, Aurer I, et al. Prevencija i liječenje mukozitisa u bolesnika sa zloćudnim hematološkim bolestima: pregled područja i stav Hrvatske kooperativne grupe za hematološke bolesti (KROHEM). Medicina Fluminensis. 2021 Dec 1;57(4):373–83. DOI: 10.21860/medflum2021_264893, nepotpuno...
Mukozitis označava bolnu upalu i oštećenje sluznice usta i gastrointestinalnog trakta koja se javlja kao komplikacija kemoterapijskog i/ili radioterapijskog liječenja i tijekom transplantacije krvotvornih matičnih stanica u bolesnika oboljelih od zloćudnih hematoloških bolesti. Navedeno stanje uvelike utječe na kvalitetu života i ishode liječenja b...
Background
Patients with hematologic malignancy have a higher risk of death from COVID-19 compared to the general population. A blunted immune response from both the underlying disease and applied treatment may contribute to development of more severe forms of COVID-19, absence of seroconversion, prolonged viral shedding, and might also impair humo...
Patients with lymphoid malignancies are at increased risk of death due to COVID19. Currently, it is not completely clear whether this is mainly due to disease biology or to anti-lymphoma treatment and whether the prognosis of infection differs in patients treated with different therapies. Anti-CD20 monoclonal antibodies increase the risk of prolong...
Background
Primary refractory (PREF) follicular lymphoma (FL) has a completely different clinical course from that of FL that responds to front-line treatments. In addition to having poor responses to salvage therapies, it seems that patients with PREF are at increased risk of histological transformation (HT). The Aristotle consortium presented the...
Aim:
To compare the outcomes of Croatian patients with mantle cell lymphoma (MCL) who started treatment in 2007 and 2008 (historical cohort) and of those who started treatment between 2015 and 2017 (recent cohort).
Methods:
The historical cohort consisted of 40 patients who started treatment with rituximab in 2007 and 2008. Data on the recent co...
Background: Autoimmune hemolytic anemia (AIHA) is an autoimmune-mediated disease in which erythrocytes are destroyed through (auto)antibodies against their surface antigens, resulting in premature lysis. It is a rare disorder and data about characteristics of AIHA from clinical practice are rare, especially if collected prospectively.
Aims: This p...
Background: Acquired haemophilia A (AHA) is a rare autoimmune disease, caused by antibodies (inhibitors) against coagulation FVIII and characterized by spontaneous hemorrhage in patients with no previous history of bleeding. Risk factors for the occurrence of AHA include advanced age and underlying diseases (malignancy, autoimmune disorders, pregna...
Currently, there is no consensus regarding optimal front-line treatment for younger high-risk patients with large B cell lymphoma. American recommendations list only R-CHOP as standard, while European also include R-ACVBP and R-CHOEP14. We have been routinely using the latter regimen at our institution since 2011 and performed this retrospective re...
Aim: The aim of this study was to present the first Croatian experience with eltrombopag (a peroral thrombopoietin receptor agonist) as the novel treatment option for aplastic anemia (AA). Patients and Methods: This was a retrospective analysis on the use of eltrombopag for adult patients with acquired AA among Croatian hematology centers. Results:...
Background
Plasmablastic lymphoma is a rare, extremely uncommon highly aggressive type of non-Hodgkin lymphoma. Although initially described as being associated with HIV it has also been identified in patients with solid organ transplantation, autoimmune diseases and HIV negative immunocompetent patients. It is characterized by CD20 and PAX5 negati...
Objectives
There are more than 12 million long-term survivors of cancer in Europe. Yet, research on outcomes of cancer treatment has not reached its full potential due to operational, regulatory and methodological constrains. The current study aims to show the complementary roles between clinical research and population-based cancer registry in thi...
While classical nodal mantle cell lymphoma (cMCL) is often associated with involvement of multiple extranodal sites, isolated extranodal disease (ED) at the time of diagnosis is a rare event; data on the outcome of these forms are lacking. On behalf of the European MCL Network, we conducted a retrospective analysis on the clinical characteristics a...
Background
Biosimilars are highly similar to the licensed biologic (“reference product”), with no clinically meaningful differences in safety, purity, or potency between the two products.
Objective
This comparative 52-week clinical study evaluated the efficacy, safety, immunogenicity, pharmacokinetics (PK), and pharmacodynamics (PD) of PF-05280586...
Epidemiologija i klinička slika stečene hemofilije Stečena hemofilija (SH) je rijetki, stečeni pore-mećaj koagulacije s pojavom krvarenja koja mogu biti potencijalno smrtonosna ako se pravovremeno ne prepozna i ne započne liječenje. Incidencija ste-čene hemofilije iznosi 1-2/milijun stanovnika. 1 Ovaj poremećaj koagulacije karakterizira pojava auto...
Purpose of review:
Mantle cell lymphoma (MCL) is a disease predominantly affecting elderly patients with bad prognosis. Recently, a number of new agents have been shown to be active in this disease. This article reviews this data from the standpoint of everyday practice.
Recent findings:
Front-line regimens combining rituximab with CHOP, cytarab...
Background
DHL is a new lymphoma entity defined in the WHO 2018 classification. Diagnosis of DHL requires the use of FISH for MYC, BCL2 and BCL6, a technic that is not routinely used in the diagnostics of diffuse large‐B cell lymphomas (DLBCL). Treatment recommendations for DHL differ from those of DLBCL, but the level of evidence for them is low....
Background
Cardiovascular and thromboembolic events are the leading causes of morbidity and mortality for patients with myeloproliferative disorders (MPN).
Aims
This retrospective study aimed to evaluate the incidence and the risk factors for the arterial and venous thrombosis in treated patients with MPN.
Methods
The study included 329 adult MPN...
Background:
Autoimmune hemolytic anemia (AIHA) is a rare autoimmune disease in which red blood cells (RBC) are targeted by autoantibodies confirmed with positive direct antiglobulin test (DAT), resulting in premature destruction of RBC. AIHA may be subdivided into warm antibody AIHA (wAIHA) and cold antibody AIHA (cAIHA), and also to primary and s...
Background
Thromboembolism frequently complicates treatment of acute lymphoblastic leukemia (ALL).
Aims
A single‐center retrospective study was conducted with the objective of assessing the risk factors for thromboembolism in adult patients with ALL.
Methods
The study included 87 consecutive patients (aged 19–70 years; 57 males) treated for ALL;...
Background
Maintenance therapy after autologous hematopoietic stem cell transplantation (AHSCT) in multiple myeloma (MM) patients was a matter of debate until recently, when lenalidomide in this setting proved to increase overall survival (OS). Before lenalidomide interferon alpha (IFN) was standard maintenance therapy.
Aims
The aim of this analys...
Background
Due to availability and pricing problems recently many transplant centers substituted carmustine in the BEAM regimen (carmustine, etoposide, cytarabine, melphalan), used for conditioning of lymphoma patients undergoing autologous stem cell transplantation (ASCT), with bendamustine (BeEAM). Very few comparisons of the toxicity and efficac...
INTRODUCTION
There is a growing interest in analyzing the biological and clinical variables that might help in identifying patients at risk of histological transformation (HT), a critical event that can still lead to reduced survival in patients with follicular lymphoma (FL). As part of the Aristotle study, we have previously reported that the risk...
Introduction
Lymphoma patients are at increased risk of thromboembolic events (TE), however, thromboprophylaxis in these patients is largely under utilized. Actual guidelines recommend different models for thromboembolic risk estimation in cancer patients. Proposed models are of limited use in lymphoma patients as their development is not based on...
Background: This comparative 52 week clinical study (NCT02213263) evaluated the efficacy, safety, immunogenicity, pharmacokinetics (PK) and pharmacodynamics (PD) of PF-05280586 (a potential rituximab biosimilar) vs. rituximab reference product sourced from the European Union (MabThera®; rituximab-EU).
Methods: Subjects with previously untreated CD2...
Introduction:
Thrombosis is the most common complication in Philadelphia chromosome negative (Ph-) myeloproliferative neoplasms patients.
Patients and methods:
In a cohort of 258 Ph- myeloproliferative neoplasm patients, the difference between patients with and without thrombosis was analyzed according to genetic thrombophilia factors, JAK2 V617...
Objectives: Serum chitotriosidase activity (CHIT1) is a biomarker of macrophage activation with an important role in inflammation-induced tissue remodeling and fibrosis. Macrophages have been described to play a crucial role in regulating pathological erythropoiesis in polycythemia vera (PV). The aim of this study was to evaluate CHIT1 in patients...
Background:
Histological transformation of follicular lymphoma to aggressive lymphoma is a serious event with a substantial effect on patient outcome. The aim of the Aristotle study was to assess the effect of rituximab on the risk of histological transformation and its outcome.
Methods:
11 cooperative groups or institutions across Europe contri...
Recent developments in the diagnosis and treatment of chronic lymphocytic leukemia (B-CLL) have led to change of approach in clinical practice. New treatments have been approved based on the results of randomized multicenter trials for first line and for salvage therapy, and the results of numerous ongoing clinical trials are permanently providing...
Background: About 15-20% of patients with early-stage unfavorable Hodgkin lymphoma (HL) relapse or are refractory to first-line treatment with combined modality therapies. Early assessment of metabolic response after 2 cycles of ABVD has been shown to be an accurate predictor of progression-free survival and overall survival. Brentuximab vedotin (B...
Patients with mantle cell lymphoma (MCL) usually respond to initial combination chemotherapy, but the disease inevitably relapses and often follows an aggressive course. Here, clinical study results published since 2008 for patients with relapsed/refractory MCL were reviewed to compare available evidence for treatment guidance. Most trials identifi...
Background:
Escalated BEACOPP (eBEACOPP) is an effective but fairly toxic regimen for treatment of Hodgkin lymphoma (HL). Avascular necrosis of femoral head (AVN) was previously reported to be increased in patients treated with eBEACOPP, but so far no systematic analysis of its frequency has been published.
Aims:
We aimed to analyze frequency an...
In clinical trials the combination of fludarabine, cyclophosphamide and rituximab (FCR) demonstrated superior results and became the gold standard for first-line treatment of fit patients with chronic lymphocytic leukemia (CLL). The aim of this study was to evaluate the efficacy, toxicity and feasibility of this protocol in everyday clinical practi...
In recent years, the number of approved and investigational agents that can be safely administered for the treatment of lymphoma patients for a prolonged period of time has substantially increased. Many of these novel agents are evaluated in early-phase clinical trials in patients with a wide range of malignancies, including solid tumors and lympho...
Hepatosplenic T-cell lymphoma (HSTL) is a rare and lethal lymphoma; the genetic drivers of this disease are unknown. Through whole-exome sequencing of 68 HSTLs, we define recurrently mutated driver genes and copy-number alterations in the disease. Chromatin-modifying genes, including SETD2, INO80, and ARID1B, were commonly mutated in HSTL, affectin...
Background
The prognostic nutritional index (PNI), an indicator of nutritional status and systemic inflammation, is associated with short-term and long-term outcomes of various malignancies. The prognostic value of PNI in diffuse large B cell lymphoma (DLBCL) remains unknown. The aim of the present study was to determine the prognostic value of bas...
Background: Given the role of inflammation in tumor progression, as well as in diffuse large B-cell lymphoma (DLBCL), researchers are trying to identify easily applicable, easy accessible prognostic markers for individual risk assessment. The most frequently used inflammatory prognostic markers are the neutrophil-to-lymphocyte ratio (NLR), the plat...