File Download
Supplementary
-
Citations:
- Appears in Collections:
Conference Paper: Oral arsenic trioxide based regimen as salvage treatment for relapsed or refractory mantle cell lymphoma
Title | Oral arsenic trioxide based regimen as salvage treatment for relapsed or refractory mantle cell lymphoma |
---|---|
Authors | |
Issue Date | 2013 |
Publisher | American Society of Hematology. The Journal's web site is located at http://bloodjournal.hematologylibrary.org/ |
Citation | The 55th Annual Meeting and Exposition of the American Society of Hematology (ASH 2013), New Orleans, LA., 7-10 December 2013. In Blood, 2013, v. 122 n. 21, p. 4346 How to Cite? |
Abstract | Mantle cell lymphoma (MCL) is an aggressive B-cell lymphoproliferative disorder, and relapsed/refractory disease has a poor prognosis. In patients with relapsed / refractory MCL, optimal treatment strategy remains undefined. Oral arsenic trioxide (As2O3) was initially developed for the treatment of relapsed acute promyelocytic leukemia (APL). As2O3 inhibits neoplastic cellular proliferation by a wide array of mechanisms, including induction of apoptosis, targeting of signaling pathways, and down-regulation of BCL-2. Evidence in vitro also suggested that As2O3 might be effective in lymphoma, but clinical data are hitherto not available. In this study, we investigated the use of an oral-As2O3-based regimen for the treatment of patients with relapsed / refractory MCL. Thirty-nine patients (men=34, women=5) at 64 (41–82) years of age with relapsed/refractory MCL, who had received 2 (1–5) prior regimens and were ineligible for high-dose chemotherapy, were treated with a continuous oral regimen, comprising oral arsenic trioxide (oral-As2O3), chlorambucil and ascorbic acid. The overall response rate was 49% (complete response: 28%; partial response: 21%). Only grade 1/2 toxicities were observed (hematologic: 56%, hepatic: 8%). Independent prognostic factors for response were increased lactate dehydrogenase (P=0.04) and unfavorable MCL international prognostic index (P=0.04). At a median follow up of 21(range:1-118) months, the median progression-free-survival (PFS) was 16 months, and overall-survival (OS) 38 months. The 2-year and 5-year PFS were 41% and 29% respectively. The 2-year and 5-year OS were 56% and 43% respectively. Independent prognostic factors for PFS were female gender (P=0.002), Eastern Cooperative Oncology Group (ECOG) performance score of 2 (P=0.009), and non-response to treatment (P<0.001). Independent prognostic factors for OS were female gender (P<0.001), ECOG performance score of 2 (P=0.03), non-response to treatment (P<0.001), and disease progression while on treatment (P=0.05). These findings showed that an oral regimen of oral-As2O3, chlorambucil and ascorbic acid was an active regimen with minimal toxicity in relapsed/refractory MCL, achieving durable responses in some cases. © 2013 by The American Society of Hematology |
Description | This journal issue contain 2013 ASH Annual Meeting Abstracts |
Persistent Identifier | http://hdl.handle.net/10722/207344 |
ISSN | 2023 Impact Factor: 21.0 2023 SCImago Journal Rankings: 5.272 |
DC Field | Value | Language |
---|---|---|
dc.contributor.author | Gill, H | en_US |
dc.contributor.author | Au, WY | en_US |
dc.contributor.author | Cheung, WWW | en_US |
dc.contributor.author | Kwong, YL | en_US |
dc.date.accessioned | 2014-12-19T10:54:28Z | - |
dc.date.available | 2014-12-19T10:54:28Z | - |
dc.date.issued | 2013 | en_US |
dc.identifier.citation | The 55th Annual Meeting and Exposition of the American Society of Hematology (ASH 2013), New Orleans, LA., 7-10 December 2013. In Blood, 2013, v. 122 n. 21, p. 4346 | en_US |
dc.identifier.issn | 0006-4971 | - |
dc.identifier.uri | http://hdl.handle.net/10722/207344 | - |
dc.description | This journal issue contain 2013 ASH Annual Meeting Abstracts | - |
dc.description.abstract | Mantle cell lymphoma (MCL) is an aggressive B-cell lymphoproliferative disorder, and relapsed/refractory disease has a poor prognosis. In patients with relapsed / refractory MCL, optimal treatment strategy remains undefined. Oral arsenic trioxide (As2O3) was initially developed for the treatment of relapsed acute promyelocytic leukemia (APL). As2O3 inhibits neoplastic cellular proliferation by a wide array of mechanisms, including induction of apoptosis, targeting of signaling pathways, and down-regulation of BCL-2. Evidence in vitro also suggested that As2O3 might be effective in lymphoma, but clinical data are hitherto not available. In this study, we investigated the use of an oral-As2O3-based regimen for the treatment of patients with relapsed / refractory MCL. Thirty-nine patients (men=34, women=5) at 64 (41–82) years of age with relapsed/refractory MCL, who had received 2 (1–5) prior regimens and were ineligible for high-dose chemotherapy, were treated with a continuous oral regimen, comprising oral arsenic trioxide (oral-As2O3), chlorambucil and ascorbic acid. The overall response rate was 49% (complete response: 28%; partial response: 21%). Only grade 1/2 toxicities were observed (hematologic: 56%, hepatic: 8%). Independent prognostic factors for response were increased lactate dehydrogenase (P=0.04) and unfavorable MCL international prognostic index (P=0.04). At a median follow up of 21(range:1-118) months, the median progression-free-survival (PFS) was 16 months, and overall-survival (OS) 38 months. The 2-year and 5-year PFS were 41% and 29% respectively. The 2-year and 5-year OS were 56% and 43% respectively. Independent prognostic factors for PFS were female gender (P=0.002), Eastern Cooperative Oncology Group (ECOG) performance score of 2 (P=0.009), and non-response to treatment (P<0.001). Independent prognostic factors for OS were female gender (P<0.001), ECOG performance score of 2 (P=0.03), non-response to treatment (P<0.001), and disease progression while on treatment (P=0.05). These findings showed that an oral regimen of oral-As2O3, chlorambucil and ascorbic acid was an active regimen with minimal toxicity in relapsed/refractory MCL, achieving durable responses in some cases. © 2013 by The American Society of Hematology | - |
dc.language | eng | en_US |
dc.publisher | American Society of Hematology. The Journal's web site is located at http://bloodjournal.hematologylibrary.org/ | en_US |
dc.relation.ispartof | Blood | en_US |
dc.rights | This research was originally published in The Hematologist: ASH News and Reports. Author(s). Title. The Hematologist: ASH News and Reports. Year;Vol,Issue:pp-pp. © the American Society of Hematology. | - |
dc.title | Oral arsenic trioxide based regimen as salvage treatment for relapsed or refractory mantle cell lymphoma | en_US |
dc.type | Conference_Paper | en_US |
dc.identifier.email | Kwong, YL: ylkwong@hku.hk | en_US |
dc.identifier.authority | Kwong, YL=rp00358 | en_US |
dc.description.nature | link_to_OA_fulltext | - |
dc.identifier.hkuros | 241799 | en_US |
dc.identifier.volume | 122 | en_US |
dc.identifier.issue | 21 | en_US |
dc.identifier.spage | 4346 | - |
dc.identifier.epage | 4346 | - |
dc.publisher.place | United States | - |
dc.identifier.issnl | 0006-4971 | - |