RESUMO
We report the largest retrospective, phase IV non-interventional, observational study of ofatumumab therapy in heavily pre-treated patients with poor-prognosis chronic lymphocytic leukemia. Total number of patients was 103; median age was 65 years (range 39-85). Median number of prior lines of therapy was 4 (range 1-13), including, in most cases, rituximab-, fludarabine- and alemtuzumab-based regimens; 13 patients had been allografted. Of 113 adverse events, 28 (29%) were considered to be directly related to ofatumumab. Grade 3-4 toxicities included neutropenia (10%), thrombocytopenia (5%), anemia (3%), pneumonia (17%), and fever (3%). Two heavily pre-treated patients developed progressive multifocal leukoencephalopathy. On an intention-to-treat analysis, the overall response rate was 22% (3 complete response, 1 incomplete complete response). Median progression-free and overall survival times were 5 and 11 months, respectively. This study confirms in a daily-life setting the feasibility and acceptable toxicity of ofatumumab treatment in advanced chronic lymphocytic leukemia. The complete response rate, however, was low. Therefore, treatment with ofatumumab should be moved to earlier phases of the disease. Ideally, this should be done in combination with other agents, as recently approved for ofatumumab plus chlorambucil as front-line treatment for patients unfit for fludarabine. This study is registered at clinicaltrials.gov identifier:01453062.
Assuntos
Anticorpos Monoclonais/uso terapêutico , Antineoplásicos/uso terapêutico , Leucemia Linfocítica Crônica de Células B/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Monoclonais/administração & dosagem , Anticorpos Monoclonais/efeitos adversos , Anticorpos Monoclonais Humanizados , Antineoplásicos/administração & dosagem , Antineoplásicos/efeitos adversos , Esquema de Medicação , Feminino , Humanos , Leucemia Linfocítica Crônica de Células B/diagnóstico , Leucemia Linfocítica Crônica de Células B/mortalidade , Masculino , Pessoa de Meia-Idade , Indução de Remissão , Retratamento , Resultado do TratamentoAssuntos
Adjuvantes Imunológicos/efeitos adversos , Aminoquinolinas/efeitos adversos , Carcinoma de Células Escamosas/induzido quimicamente , Ceratoacantoma/induzido quimicamente , Ceratose/tratamento farmacológico , Neoplasias Cutâneas/induzido quimicamente , Adjuvantes Imunológicos/uso terapêutico , Aminoquinolinas/uso terapêutico , Carcinoma de Células Escamosas/patologia , Humanos , Imiquimode , Ceratoacantoma/patologia , Ceratose/etiologia , Masculino , Pessoa de Meia-Idade , Neoplasias Cutâneas/patologia , Raios Ultravioleta/efeitos adversosRESUMO
We report the case of an 84-year-old white male who underwent vermilionectomy for removal of a tumor, which proved to be squamous cell carcinoma. Chelitis glandularis related to marked actinic damage was noted at a subsequent visit. The presence of chelitis glandularis should be investigated for the presence of neoplasia, immunosuppression, or inflammatory diseases related to extremely poor oral hygiene.
Assuntos
Carcinoma de Células Escamosas/complicações , Queilite/etiologia , Neoplasias Labiais/complicações , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Doença Crônica , Humanos , Queratinócitos/patologia , Neoplasias Labiais/patologia , Neoplasias Labiais/cirurgia , MasculinoAssuntos
Fatores Estimuladores de Colônias/uso terapêutico , Neoplasias Hematológicas/terapia , Transplante de Medula Óssea , Doença Enxerto-Hospedeiro/prevenção & controle , Mobilização de Células-Tronco Hematopoéticas , Humanos , Leucemia/tratamento farmacológico , Linfoma/tratamento farmacológico , Síndromes Mielodisplásicas/tratamento farmacológico , Transplante AutólogoRESUMO
BACKGROUND: "Breaks" in barrier precautions are a definite abrogating influence on the effectiveness of "universal precautions." Dermatologists and dermatologic surgeons are exposed to significant infectious agents on a daily basis, especially due to the high number of minor surgical procedures performed. Backsplash, spray, and eye splash of bodily fluids during these procedures place the surgeon at a high risk of contamination/infection via the conjunctival membranes. The surgical looking glass is a simple utility based on inexpensive equipment already in place in the physician's office which protects the eyes and face during infiltrative anesthesia or incision of cysts and other lesions. OBJECTIVE: To offer a simple and inexpensive utility to assist with protection from and reduction of contamination/infection of the ocular mucous membranes during surgical procedures. METHODS: Utilizing one or two readily available microscope slides overlying the injection site during local infiltrative anesthesia, backsplash or spray can be contained. RESULTS: This utility is effective in containment of backsplash or spray of anesthesia or bodily fluids during even minor surgical procedures. CONCLUSION: The surgical looking glass can enhance safety and promote "universal precautions" during even minor surgical procedures or infiltration of anesthesia into more porous areas or lesions for the practicing dermatologist or dermatologic surgeon. The pragmatic, practical, and inexpensive nature of the surgical looking glass invites its use on a daily basis by the practicing dermatologist.
Assuntos
Anestesia Local/métodos , Procedimentos Cirúrgicos Dermatológicos , Traumatismos Oculares/prevenção & controle , Dispositivos de Proteção dos Olhos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , HumanosRESUMO
Chronic lymphocytic leukaemia (CLL) is a B-cell disorder, which has a median survival of over 10 years from diagnosis for stage A disease. The natural history of stage A disease is generally indolent or only slowly progressive. It is less well known that CLL may undergo spontaneous regression. We report a series of 10 such cases (eight stage A and two stage B) followed at our institutions.