9 results on '"Kwon, M."'
Search Results
2. 295 (PB075) - Cancer-associated fibroblast-derived SPP1 is a potential target for overcoming sorafenib and lenvatinib resistance in hepatocellular carcinoma.
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Ahn, H.R., Eun, J.W., Yoon, J.H., Son, J.A., Weon, J.H., Baek, G.O., Yoon, M.G., Han, J.E., Kwon, M., Kim, S.S., Cheong, J.Y., and Cho, H.J.
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THERAPEUTIC use of antineoplastic agents , *FIBROBLASTS , *CONFERENCES & conventions , *CANCER , *TREATMENT effectiveness , *SORAFENIB , *PHOSPHOPROTEINS , *HEPATOCELLULAR carcinoma , *DRUG resistance in cancer cells , *EVALUATION - Published
- 2022
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3. Financial toxicity in allogeneic haematopoietic stem cell transplant patients from a social determinants of health perspective.
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Navas Huerga R, Salcedo de Diego I, de Miguel Jiménez C, Muñoz Martínez C, Kwon M, Pedraza García N, Calbacho M, Royuela Vicente A, and Serrano Gallardo P
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- Humans, Female, Male, Middle Aged, Cross-Sectional Studies, Adult, Spain, Surveys and Questionnaires, Transplantation, Homologous, Aged, Financial Stress, Socioeconomic Factors, Cost of Illness, Hematopoietic Stem Cell Transplantation adverse effects, Hematopoietic Stem Cell Transplantation economics, Social Determinants of Health
- Abstract
Purpose: Financial toxicity (FT) refers to the subjective perception of financial distress resulting from objective economic strain due to illness, exerting a detrimental influence on health outcomes. This study aimed to describe FT among allogeneic haematopoietic stem cell transplant (allo-HSCT) recipients within a public health framework, employing a social determinants of health approach., Methods: A multi-centre cross-sectional study involving adult allo-HSCT patients was conducted across three public hospitals in Madrid. FT was assessed using a validated COST scale (range 0-44; lower scores indicating higher FT). Patient-administered paper/online questionnaires were utilized to collect data on sociodemographic, socioeconomic, clinical, and healthcare access variables. Descriptive, non-parametric univariate statistical analysis and multiple linear regression models were performed., Results: Sixty-six patients, with a mean age: 52.5 years (SD: 11.5), 50% women, 28.7% displaced to Madrid for HSCT, and 71.4% lacking financial support were included. The median FT score was 20 points (IQR 12-27.25). Independent factors associated with higher FT included being females (Coef = -3.26; p = 0.079), perceived income loss after HSCT (Coef = -6.81; p < 0.001) and a monthly household income of ≤1000 € compared to 1001-2500€ (Coef = 8.29; p = 0.005) or >2500 € (Coef = 15.75; p < 0.001)., Conclusions: Despite the limited sample size, our findings underscore the presence of financial toxicity among allo-HSCT patients, shaped by social determinants of health. Recognizing and addressing FT within the HSCT process is essential to mitigate social inequalities in health., Competing Interests: Declaration of competing interest The authors have no competing interests to declare., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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- 2024
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4. Quantifying the available capacity and resource needs for provision of CAR-T therapies in the National Health Service in Spain: a survey-based study.
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Solano C, Castro-Rebollo P, Pérez-Martínez A, López-Corral L, Barba-Suñol P, Kwon M, Ortiz V, Sanz-Caballer J, Caballero AC, Martínez J, Cedillo Á, and Sureda A
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- Humans, State Medicine, Spain, Hospitals, Immunotherapy, Adoptive methods, Receptors, Chimeric Antigen
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Objectives: To estimate the readiness of Spanish National Health Service (NHS) hospitals to provide chimeric antigen receptor T cell (CAR-T), and to identify and quantify the different resources needed to provide CAR-T considering three scenarios defined by 10, 25 and 50 patients per centre per year., Design: Targeted literature review and quantitative study using a questionnaire and telephone interviews. An algorithm was created to determine hospitals' readiness based on their capacity and capability. All the requirements for quantification were assessed and validated by the steering committee, formed by members of the Spanish Group of Haematopoietic Transplantation and Cell Therapy. A weighting system (from 0 to 1) was established for capability quantification. For resources quantification, a scoring system was established, with 0 points representing the minimum and 3 points the maximum of additional resources that a hospital indicated necessary., Setting: 40 Spanish hospital centres that perform allogeneic haematopoietic stem cell transplantation were invited to complete the questionnaire for capacity quantification, 28 of which provided valid responses. Nine hospitals participated in the interviews for resource quantification, eight of which had previously been designated by the Ministry of Health (MoH) to provide CAR-T., Outcome Measure: Current capacity of NHS Spanish sites to administer CAR-T under different theoretical scenarios with varying numbers of procedures, and the potential healthcare resources that would be needed to realise the theoretical capacity requirements., Results: Four hospitals were optimally ready, 17 were somewhat ready and 7 were not ready. The actual extrapolated capacity of the currently designated MoH CAR-T sites would allow treatment of approximately 250 patients per year. Regarding healthcare resource needs, the numbers of haematologists, nurses and beds were the most important limiting factors, and those requiring further growth as patient numbers increased., Conclusions: Increasing the number of CAR-T-qualified centres and/or increasing resources in the current designated sites are two potential strategies that should be considered to treat CAR-T-eligible patients in Spain., Competing Interests: Competing interests: CS declares having received honoraria from BMS, Kite/Gilead, MSD, Pfizer, Jazz Pharmaceuticals, Novartis and Pierre Fabre. PC-R declares having received honoraria from participation in advisory boards from Alexion, Janssen and Gilead. PB-S declares having received honoraria from Allogene, Amgen, BMS, Kite/Gilead, Incyte, Jazz Pharmaceuticals, Miltenyi Biomedicine, Nektar Novartis and Pierre Fabre. VO declares having received honoraria from Kite, Celgene-BMS, Novartis, Miltenyi and Janssen. ACC declares having received honoraria from Gilead and Novartis. JM declares having received honoraria from AbbVie, Sanofi, BMS, Janssen, Gilead, Novartis and Roche., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2023
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5. Impact of hematologic malignancy and type of cancer therapy on COVID-19 severity and mortality: lessons from a large population-based registry study.
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García-Suárez J, de la Cruz J, Cedillo Á, Llamas P, Duarte R, Jiménez-Yuste V, Hernández-Rivas JÁ, Gil-Manso R, Kwon M, Sánchez-Godoy P, Martínez-Barranco P, Colás-Lahuerta B, Herrera P, Benito-Parra L, Alegre A, Velasco A, Matilla A, Aláez-Usón MC, Martos-Martínez R, Martínez-Chamorro C, Susana-Quiroz K, Del Campo JF, de la Fuente A, Herráez R, Pascual A, Gómez E, Pérez-Oteyza J, Ruiz E, Alonso A, González-Medina J, Martín-Buitrago LN, Canales M, González-Gascón I, Vicente-Ayuso MC, Valenciano S, Roa MG, Monteliu PE, López-Jiménez J, Escobar CE, Ortiz-Martín J, Diez-Martin JL, and Martinez-Lopez J
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- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Antineoplastic Agents adverse effects, Antiviral Agents therapeutic use, Betacoronavirus, COVID-19, Comorbidity, Coronavirus Infections drug therapy, Coronavirus Infections mortality, Female, Humans, Male, Middle Aged, Pandemics, Pneumonia, Viral drug therapy, Pneumonia, Viral mortality, Prospective Studies, Risk Factors, SARS-CoV-2, Spain epidemiology, Treatment Outcome, Young Adult, COVID-19 Drug Treatment, Antineoplastic Agents therapeutic use, Coronavirus Infections complications, Coronavirus Infections epidemiology, Hematologic Neoplasms complications, Hematologic Neoplasms drug therapy, Pneumonia, Viral complications, Pneumonia, Viral epidemiology, Registries, Severity of Illness Index
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Background: Patients with cancer have been shown to have a higher risk of clinical severity and mortality compared to non-cancer patients with COVID-19. Patients with hematologic malignancies typically are known to have higher levels of immunosuppression and may develop more severe respiratory viral infections than patients with solid tumors. Data on COVID-19 in patients with hematologic malignancies are limited. Here we characterize disease severity and mortality and evaluate potential prognostic factors for mortality., Methods: In this population-based registry study, we collected de-identified data on clinical characteristics, treatment and outcomes in adult patients with hematologic malignancies and confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection within the Madrid region of Spain. Our case series included all patients admitted to 22 regional health service hospitals and 5 private healthcare centers between February 28 and May 25, 2020. The primary study outcome was all-cause mortality. We assessed the association between mortality and potential prognostic factors using Cox regression analyses adjusted for age, sex, comorbidities, hematologic malignancy and recent active cancer therapy., Results: Of 833 patients reported, 697 were included in the analyses. Median age was 72 years (IQR 60-79), 413 (60%) patients were male and 479 (69%) and 218 (31%) had lymphoid and myeloid malignancies, respectively. Clinical severity of COVID-19 was severe/critical in 429 (62%) patients. At data cutoff, 230 (33%) patients had died. Age ≥ 60 years (hazard ratios 3.17-10.1 vs < 50 years), > 2 comorbidities (1.41 vs ≤ 2), acute myeloid leukemia (2.22 vs non-Hodgkin lymphoma) and active antineoplastic treatment with monoclonal antibodies (2·02) were associated with increased mortality; conventional chemotherapy showed borderline significance (1.50 vs no active therapy). Conversely, Ph-negative myeloproliferative neoplasms (0.33) and active treatment with hypomethylating agents (0.47) were associated with lower mortality. Overall, 574 (82%) patients received antiviral therapy. Mortality with severe/critical COVID-19 was higher with no therapy vs any antiviral combination therapy (2.20)., Conclusions: In this series of patients with hematologic malignancies and COVID-19, mortality was associated with higher age, more comorbidities, type of hematological malignancy and type of antineoplastic therapy. Further studies and long-term follow-up are required to validate these criteria for risk stratification.
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- 2020
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6. Cytokine release syndrome after allogeneic stem cell transplantation with posttransplant cyclophosphamide.
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Solán L, Landete E, Bailén R, Dorado N, Oarbeascoa G, Anguita J, Díez-Martín JL, and Kwon M
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- Adolescent, Adult, Aged, Combined Modality Therapy, Cytokine Release Syndrome epidemiology, Cytokine Release Syndrome pathology, Female, Follow-Up Studies, Graft vs Host Disease epidemiology, Graft vs Host Disease pathology, Hematologic Neoplasms pathology, Humans, Incidence, Male, Middle Aged, Prognosis, Retrospective Studies, Spain epidemiology, Survival Rate, Transplantation Conditioning, Transplantation, Homologous, Young Adult, Antineoplastic Agents, Alkylating adverse effects, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Cyclophosphamide adverse effects, Cytokine Release Syndrome etiology, Graft vs Host Disease etiology, Hematologic Neoplasms drug therapy, Hematopoietic Stem Cell Transplantation adverse effects
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Cytokine release syndrome (CRS) is a systemic inflammatory response with aberrant immune activation and immune hyperstimulation, that leads to increased cytokine levels and inflammation. CRS has been described after antibody and cellular-based therapies. The use of posttransplant cyclophosphamide (PTCy) as graft-vs-host disease (GVHD) prophylaxis in haploidentical hematopoietic stem cell transplantation (haplo-HSCT) has led to the extension of allogeneic HSCT to patients without HLA-identical donors. Furthermore, PTCy has also been introduced in matched and unrelated donor HSCT. However, description of incidence and clinical impact of CRS on outcomes in these patients is scarce. We retrospectively analyzed 107 consecutive haplo-HSCT and 39 HLA-identical HSCT with PTCy from 2010 to 2017 in our institution. We used published CRS criteria to identify 76% and 14% of patients who developed CRS after haplo-HSCT and HLA-identical HSCT, respectively. Most patients presented CRS grades 1 and 2. Only one patient from the whole series presented grade 3 CRS and required tocilizumab therapy. The use of peripheral blood stem cells (PBSC), as well as total nucleated cells infused were associated with an increased risk of CRS. Patients who presented CRS developed grade II-IV acute GVHD more frequently than those who did not (60% vs 28.6% respectively, P = .012). The development of CRS was not significantly associated with nonrelapse mortality or overall survival. CRS is a frequent complication after PBSC haploidentical T-repleted HSCT, but significantly less frequent after HLA-identical HSCT. Most cases are mild. Prompt identification allows adequate management of severe forms., (© 2020 John Wiley & Sons Ltd.)
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- 2020
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7. A retrospective cohort of invasive fusariosis in the era of antimould prophylaxis.
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Fernández-Cruz A, Semiglia MA, Guinea J, Martínez-Jiménez MDC, Escribano P, Kwon M, Rodríguez-Macías G, Chamorro-de-Vega E, Rodríguez-González C, Navarro R, Galar A, Sánchez-Carrillo C, Díez-Martín JL, and Muñoz P
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- Chemoprevention, Fusariosis mortality, Fusarium, Humans, Incidence, Invasive Fungal Infections mortality, Microbial Sensitivity Tests, Neutropenia complications, Retrospective Studies, Risk Factors, Spain epidemiology, Tertiary Care Centers, Antifungal Agents administration & dosage, Fusariosis drug therapy, Invasive Fungal Infections drug therapy
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Mould-active prophylaxis is affecting the epidemiology of invasive mycoses in the form of a shift toward less common entities such as fusariosis. We analyze the characteristics of invasive fusariosis and its association to antifungal prophylaxis in a retrospective cohort (2004-2017) from a tertiary hospital in Madrid, Spain. Epidemiological, clinical, microbiological, and antifungal consumption data were retrieved. Isolates were identified to molecular level, and antifungal susceptibility was tested. Eight cases of invasive fusariosis were diagnosed. Three periods were identified according to incidence: <2008 (three cases), 2008-2013 (zero cases), >2014 (five cases). All except one case involved breakthrough fusariosis. During the earliest period, the episodes occurred while the patient was taking itraconazole (two) or fluconazole (one); more recently, while on micafungin (three) or posaconazole (one). Early cases involved acute leukemia at induction/consolidation, recent cases relapsed/refractory disease (P = .029). Main risk factor for fusariosis (62.5%) was prolonged neutropenia (median 44 days). Galactomannan and beta-D-glucan were positive in 37.5% and 100% of cases, respectively. All isolates except F. proliferatum presented high minimal inhibitory concentrations (MICs) against the azoles and lower MIC to amphotericin B. Most patients received combined therapy. Mortality at 42 days was 62.5%. Resolution of neutropenia was associated with survival (P = .048). Invasive fusariosis occurs as breakthrough infection in patients with hematologic malignancy, prolonged neutropenia, and positive fungal biomarkers. Recent cases were diagnosed in a period of predominant micafungin use in patients who had more advanced disease and protracted neutropenia and for whom mortality was extremely high. Resolution of neutropenia was a favorable prognostic factor., (© The Author(s) 2019. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology.)
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- 2020
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8. Allogeneic stem-cell transplantation in HIV-1-infected patients with high-risk hematological disorders.
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Kwon M, Bailén R, Balsalobre P, Jurado M, Bermudez A, Badiola J, Esquirol A, Miralles P, López-Fernández E, Sanz J, Yañez L, Colorado M, Piñana JL, Dorado N, Solán L, Martínez Laperche C, Buño I, Anguita J, Serrano D, and Díez-Martin JL
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- Adult, Anti-Retroviral Agents therapeutic use, Female, HIV Infections drug therapy, Humans, Male, Middle Aged, Retrospective Studies, Spain, Survival Analysis, Treatment Outcome, HIV Infections complications, Hematologic Neoplasms therapy, Stem Cell Transplantation, Transplantation, Homologous
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Introduction: Although a number of patients with HIV infection and hematological disease have successfully undergone allogeneic hematopoietic stem-cell transplantation (HSCT), short and long-term outcomes remain not well known. We report the largest Spanish experience treating HIV-infected adult patients with high-risk hematological malignancies with allogeneic HSCT., Methods: We retrospectively reviewed 22 HIV-positive patients who received allogeneic HSCT in five centers in Spain., Results: A total of 22 patients with high-risk hematological malignancies were transplanted between 1999 and 2018. Median age was 44 years. With a median follow-up of 65 months (8-112), overall survival and event-free survival were 46%. Nonrelapse mortality was 14% at 12 months and relapse was 24% at 24 months. Grade II-IV acute graft-versus-host disease (GVHD) rate was 44%, and moderate/severe chronic GVHD rate was 41% at 24 months. All patients received combination antiretroviral therapy. Two patients showed severe toxicity related to drug interaction with antiretroviral therapy. 68% of patients showed infectious complications with viral infections as the most frequent cause. Two patients had invasive aspergillosis and one patient presented disseminated tuberculosis. All survivors except one maintained undetectable HIV load at last follow-up after HSCT., Conclusion: Allogeneic HSCT is an effective therapy for high-risk hematological malignancies in patients with HIV infection, and long-term HIV suppression with combination antiretroviral therapy is feasible. However, drug interactions with antiretroviral agents, occurrence of GVHD, and frequent infectious complications account for a complex procedure in this population. Selected HIV-infected patients with hematologic malignancies should be considered for allo-HSCT when indicated, in experienced centers.
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- 2019
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9. Wilms Tumor 1 gene expression levels improve risk stratification in AML patients. Results of a multicentre study within the Spanish Group for Molecular Biology in Haematology.
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Martínez-Laperche C, Kwon M, Franco-Villegas AC, Chillón MC, Castro N, Anguita E, Dolz S, Rodríguez-Medina C, Hermosín L, Bellón JM, Prieto-Conde MI, Barragán E, Gómez-Casares M, Ayala R, Martínez-López J, González-Díaz M, Díez-Martin JL, and Buño I
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- Adolescent, Adult, Aged, Female, Humans, Leukemia, Myeloid, Acute drug therapy, Leukemia, Myeloid, Acute genetics, Male, Middle Aged, Neoplasm, Residual, Risk Assessment, Risk Factors, Spain epidemiology, WT1 Proteins genetics, Gene Expression Regulation, Leukemic, Leukemia, Myeloid, Acute metabolism, Leukemia, Myeloid, Acute mortality, WT1 Proteins biosynthesis
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- 2018
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