Application of pixantrone in a III line of treatment as a bridge therapy to allotransplantation of stem cells Case report
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Abstrakt
Diffuse large B-cell lymphomas are the most common group among all lymphomas. Despite the effectiveness of the I line therapy in 10–40% of patients, the possibility of relapse should be taken into account. The anthracycline antibiotics used in the II line therapy carry a high risk of cardiac complications. In patients with refractory or recurrent disease, emergency treatment is used, aiming for the transplantation of hematopoietic cells. If the II line therapy fails, the prognosis is bad. A new chance for patients with refractory or recurrent B-cell lymphoma is pixantrone dimaleate, a drug structurally related to anthracyclines with a significantly lower cardiotoxic potential.
The paper presents a case of a 65-year-old patient with relapsing DLBCL lymphoma, after two treatment lines: R-CHOP and R-DHAP, and after autologous transplantation of stem cells, in which the use of pixantrone in the treatment of recurrence allowed to achieve remission and prepare the patient for the allo-HSCT procedure.
Pobrania
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Copyright: © Medical Education sp. z o.o. This is an Open Access article distributed under the terms of the Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
Bibliografia
2. Appio L, Landoni C, La Targia M. Single-agent pixantrone as a bridge to autologous stem cell transplantation in a patient with refractory diffuse large B-cell lymphoma. Chemotherapy. 2017; 62(3): 187-91.
3. Tilly H, Gomes da Silva M, Vitolo U. Diffuse large B-cell lymphoma (DLBCL): ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2015; 26(Suppl 5): v116-25. http://doi.org/10.1093/annonc/mdv304.
4. Piętka I, Lelonek M. Kardiomyopatia poantracyklinowa – diagnostyka, leczenie i zapobieganie. Folia Cardiologica Excerpta. 2010; 5(3): 130-4.
5. Minotti G, Ronchi R, Salvatorelli E et al. Doxorubicin irreversibly inactivates iron regulatory proteins 1 and 2 in cardiomyocytes: evidence for distinct metabolic pathways and implications for iron-mediated cardiotoxicity of antitumor therapy. Cancer Res. 2001; 61(3): 8422-8.
6. Dudziak J, Słomczyński M, Torliński L. Powikłania kardiologiczne po chemioterapii – patomechanizm, diagnostyka, leczenie i zapobieganie. Choroby Serca i Naczyń. 2009; 6(2): 73-9.
7. Chao MP. Treatment challenges in the management of relapsed or refractory non-Hodgkin’s lymphoma – novel and emerging therapies. Cancer Manag Res. 2013; 5: 251-69.
8. Boyle EM, Morschhauser F. Pixantrone: a novel anthracycline-like drug for the treatment of non-Hodgkin lymphoma. Expert Opinon on Drug Safety. 2015; 14(4): 601-17.
9. The European Medicines Agency review of pixantrone for the treatment of adult patients with multiply relapsed or refractory aggressive non-Hodgkin’s B-cell lymphomas: summary of the scientific assessment of the committee for medicinal products for human use. Oncologist. 2013; 18(5): 625-33.
10. Pettengell R, Coiffier B, Narayanan G et al. Pixantrone dimaleate versus other chemotherapeutic agents as a single-agent salvage treatment in patients with relapsed or refractory aggressive non-Hodgkin lymphoma: a phase 3, multicentre, open-label, randomized trial. Lancet. 2012; 13(7): 696-706.
11. Piksantron w leczeniu chłoniaków złośliwych. https://www.gov.pl/web/zdrowie/choroby-onkologiczne.
12. Warzocha K, Puła B. Rozpoznawanie i leczenie chorych na chłoniaka rozlanego z dużych komórek B. Hematologia. 2017; 8(2): 113-31.
13. Swerdlow SH, Campo E, Piler SA et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016; 127(20): 2375-90.
14. Lenart K, Szyda A, Kiełbasiński M et al. Kliniczne skutki oporności wielolekowej w nowotworach. Onkologia w Praktyce Klinicznej. 2005; 1(1): 18-26.
15. Menna P, Salvatorelli E, Minotti G. Rethinking drugs from chemistry to therapeutic opportunities: pixantrone beyond anthracyclines. Chem Res Toxicol. 2016; 29(8): 1270-8.
16. Singal KS, Iliskovic N. Doxorubicin-induced cardiomyopathy. N Engl J Med. 1998; 339(13): 900-5.
17. Salvatorelli E, Menna P, Paz OG et al. The novel anthracenedione, pixantrone, lacks redox activity and inhibits doxorubicinol formation in human myocardium: insight to explain the cardiac safety of pixantrone in doxorubicin-treated patients. J Pharmacol Exp Ther. 2013; 344(2): 467-78.
18. Pettengel R, Coiffier B, Egorov A et al. Long-Term Response and Remission with Pixantrone in Patients with Relapsed or Refractory Aggressive Non-Hodgkin Lymphoma: Post-Hoc Analysis of the Multicenter, Open-Label, Randomized PIX301 Trial. Clin Drug Investig. 2018; 38(6): 527-33.
19. Czerw T. Znaczenie allogenicznego przeszczepienia krwiotwórczych komórek macierzystych w leczeniu chorych na chłoniaki. Hematologia. 2012; 3(1): 49-57.
20. van Besien K. Current status of allogeneic transplantation for aggressive non-Hodgkin lymphoma. Curr Opin Oncol. 2011; 23(6): 681-91.