Search

Lenalidomide following whole-brain radiotherapy in patients with primary central nervous system lymphoma ineligible for intensive systemic therapy Seven patients were refractory and five patients had relapsed, while three were patients with newly diagnosed PCNSL ineligible for systemic high-dose methotrexate-based therapy. Lenalidomide has been used as maintenance therapy in elderly patients with newly diagnosed PCNSL after high-dose methotrexate-based systemic therapy.[9] In 13 patients reported by Vu et al.[9] PFS was not reached and only one patient died of lymphoma at 35 months follow-up. [Extracted from the article]

The FDA recommended dose of rasburicase 0.2 mg/kg/day till the resolution of TLS or up to 5 days, might be in excess and is prohibitively expensive. The quality of evidence supporting low dose rasburicase is limited. The objective is to study the plasma uric acid response rate. This is a single center, non-randomised phase II study. Duration is 10 June 2017 till 30 July 2019. Study setting is at Adult Hematolymphoid Unit, Tata Memorial Center. Participants are patients with acute leukemia and high-grade lymphomas aged >/=18 years, with ECOG PS of 0–3, with either laboratory or clinical TLS. Rasburicase was administered at fixed-dose of 1.5 mg. The subsequent doses (1.5 mg each dose) were administered only if plasma UA levels did not decline by >50% on day 2, at the physician's discretion. We demonstrate that a low-dose rasburicase strategy leads to rapid and sustained reductions of uric acid in about 52% patients. [ABSTRACT FROM AUTHOR]

Summary: Management of acquired immunodeficiency syndrome (AIDS)‐related diffuse large B‐cell (DLBCL) and plasmablastic lymphomas (PBL) poses significant challenges. The evidence supports use of dose‐adjusted EPOCH (etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin) with or without rituximab as first‐line therapy. The need for central venous access, growth factors and significant toxicities limits its use in resource‐constrained settings. To address these challenges, we have developed a novel regimen, CVEP (cyclophosphamide, vinblastine, etoposide, and prednisolone) based on the pharmacodynamic principles of dose‐adjusted EPOCH. This single‐centre phase II study evaluated the efficacy and safety of CVEP regimen in patients with de novo systemic AIDS‐related DLBCL and PBL. The primary objective was complete response (CR) rates as assessed by positron emission tomography‐computed tomography. The secondary objectives were incidence of Grade 3/4 toxicities, toxicities requiring hospitalisation, and disease‐free survival. From May 2011 to February 2017, 42 patients were enrolled. At the end of therapy the CR rates were 69% (29/42) in the intention‐to‐treat population and 80.5% (29/36) in evaluable patients. At a median follow‐up of 69 months, the 5‐year disease‐free survival was 65.3%. Out of 217 cycles administered, febrile neutropenia occurred in 19.3% and hospitalisation was required in 18.3% of cycles. There were two treatment‐related deaths. The CVEP regimen is an active and safe regimen for AIDS‐related DLBCL and PBL. [ABSTRACT FROM AUTHOR]