Nivolumab for relapsed or refractory Hodgkin lymphoma: real-life experience.

Classical Hodgkin lymphoma (cHL) is considered a curable disease; however, in approximately one-third of the responding patients, the disease relapses following completion of therapy. One of the drugs that have been approved for the treatment of relapsed/refractory cHL is nivolumab, an immune check point inhibitor that shows its effects by blocking the programmed death 1 (PD-1) receptor. In this study, we present a retrospective "real-life" analysis of the usage of nivolumab in patients with relapsed/refractory cHL that have joined the named patient program (NPP) for nivolumab, reflecting 4 years of experience in the treatment of relapsed/refractory cHL. We present a retrospective analysis of 87 patients (median age, 30) that participated in the NPP in 24 different centers, who had relapsed/refractory cHL and were consequently treated with nivolumab. The median follow-up was 29 months, and the median number of previous treatments was 5 (2-11). In this study, the best overall response rate was 70% (CR, 36%; PR, 34%). Twenty-eight of the responding patients underwent subsequent stem cell transplantation (SCT). Among 15 patients receiving allogeneic stem cell transplantation, 9 patients underwent transplantation with objective response, of which 8 of them are currently alive with ongoing response. At the time of analysis, 23 patients remained on nivolumab treatment and the rest discontinued therapy. The main reason for discontinuing nivolumab was disease progression (n = 23). The safety profile was acceptable, with only nine patients requiring cessation of nivolumab due to serious adverse events. The 24-month progression-free and overall survival rates were 58.5% (95% CI, 0.47-0.68) and 78.7% (95% CI, 0.68-0.86), respectively. Eighteen patients died during the follow-up and only one of these was regarded to be treatment-related. With its efficacy and its safety profile, PD-1 blockers became an important treatment option in the heavily pretreated cHL patients.

A practical 16-day desensitization protocol in lenalidomide-induced non-immediate hypersensitivity reactions.

BACKGROUND: Desensitization in immediate-type hypersensitivity reactions (HRs) caused by chemotherapeutics is well described and standardized for many drugs. However, there are no standardized protocols in non-immediate HRs. OBJECTIVE: To evaluate the effectiveness of a 16-day desensitization protocol in the non-immediate HRs induced by lenalidomide. METHODS: According to our previously published slow desensitization protocol, we desensitized patients who had experienced non-immediate HRs attributable to lenalidomide. The protocol was started with the 1/100 of the daily-prescribed dose in milligrams of the culprit drug; then the doses were slowly increased to complete the procedure in 16 days. Demographic and clinical features of the patients were further appraised. RESULTS: Ten patients (mean age was 64.7 ± 10.8 years; 7 male) were successfully desensitized to lenalidomide. The mean reaction time was 7.3 ± 3.9 days in the history, and the reaction types were delayed urticaria (n = 4), eczematous rash (n = 3), and maculopapular eruptions (n = 3). The desensitization was successfully completed in 16 days in 9 patients. In 1 patient, maculopapular eruptions developed on the 11th day, and the patient was treated with corticosteroids. We repeated the previous tolerated dose longer and completed with a slower dose increasement, and the targeted dose was achieved in 35 days. CONCLUSION: The 16-day desensitization protocol seemed to be safe and effective in the non-immediate type drug HRs caused by lenalidomide.

Impact of COVID-19 on Outcomes of Patients with Hematologic Malignancies: A Multicenter, Retrospective Study.

Objectives: Patients with hematological malignancies have a high risk of mortality from coronavirus disease 2019 (COVID-19). This study aimed to investigate the impact of COVID-19 on mortality rates in patients with various hematological malignancies and to determine risk factors associated with all-cause mortality. Methods: A multicenter, observational retrospective analysis of patients with hematological malignancies infected with COVID-19 between July 2020 and December 2021 was performed. Demographic data, clinical characteristics, and laboratory parameters were recorded. Patients were grouped as non-survivors and survivors. All-cause mortality was the primary outcome of the study. Results: There were 569 patients with a median age of 59 years. Non-Hodgkin lymphoma (22.0%) and multiple myelomas (18.1%) were the two most frequent hematological malignancies. The all-cause mortality rate was 29.3%. The highest mortality rates were seen in patients with acute myeloid leukemia (44.3%), acute lymphoid leukemia (40.5%), and non-Hodgkin lymphoma (36.8%). The non-survivors were significantly older (p<0.001) and had more comorbidities (p<0.05). In addition, there were significantly more patients with low lymphocyte percentage (p<0.001), thrombocytopenia (p<0.001), and high CRP (p<0.001) in the non-survived patients. Age ≥ 65years (p=0.017), cardiac comorbidities (p=0.041), and continuation of ongoing active therapy for hematological cancer (p<0.001) were the independent risk factors for the prediction of mortality. Conclusions: In patients with hematological malignancies, coexistent COVID-19 leads to a higher mortality rate in elderly patients with more comorbidities. Acute myeloid and lymphoid leukemia and non-Hodgkin lymphoma have the highest mortality rates. Older age, cardiac diseases, and continuation of ongoing active therapy for hematological cancer are the independent risk factors for mortality in hematological malignancy patients with COVID-19.

Assessment of Genotoxic Effects of Pendimethalin in Chinese Hamster Over Cells by the Single Cell Gel Electrophoresis (Comet) Assay.

OBJECTIVES: Pendimethalin (N-(1-ethylpropyl)-3,4-dimethyl-2,6-dinitrobenzeneamine) is a dinitroaniline herbicide compound which selectively controls weeds. It is a cell division and growth inhibitor. It descends plants in a short time after seedling. It is a soil and water pollutant due to the widespread use of formulations in Turkey and around the world. Pendimethalin is manufactured in and imported by Turkey. Pendimethalin is a slightly toxic compound that is classified in toxicity class 3 by the United States Environmental Protection Agency (USEPA). Even though it is classified as group C (human possible carcinogen) compound by the USEPA, there are limited number of studies about its genotoxic effects. The aim of this study was to evaluate in vitro genotoxic effects of different concentrations of pendimethalin in Chinese hamster over (CHO) cells by the single cell gel electrophoresis (comet) assay. MATERIALS AND METHODS: The cells are incubated with 1, 10, 100, 1000 and 10000 µM concentrations of pendimethalin for 30 min at 37°C and DNA damage was compared with CHO cells untreated with pendimethalin. 50 µM hydrogen peroxide was used as positive control. RESULTS: No significant cytotoxic effects were observed within the concentration ranges studied. The DNA damage in CHO cells was significantly increased in the pendimethalin concentrations of 1, 100, 1000 and 10000 µM, however, a significant decrease was observed in 10 µM pendimethalin concentration. CONCLUSION: Our results show that 1-10000 µM concentrations of pendimethalin induce DNA damage in CHO cells, which was assessed by comet assay.

Degradation of a textile dye, Rhodamine 6G (Rh6G), by heterogeneous sonophotoFenton process in the presence of Fe-containing TiO2 catalysts.

In this study, degradation of Rhodamine 6G (Rh6G) was investigated with ultrasound-assisted heterogeneous photoFenton process by iron-containing TiO2 catalysts. The catalysts were prepared by incipient wetness impregnation method and characterized by XRD, SEM, FT-IR, nitrogen adsorption, and ICP-AES measurements. Almost complete color removal (99.9 %) was achieved after a reaction time of 90 min while chemical oxygen demand (COD) could be removed by 24 % only with the 1 wt% iron-containing TiO2 catalyst. Initial color removal after 15 min of reaction and total COD abatement after 90 min of reaction decreased with increasing calcination temperature of the catalyst from 573 to 973 K. This indicated that the catalytic activity of the catalyst depend on the percentage of anatase phase in the TiO2, which was decreased with increasing calcination temperature.

The relationship between serum adiponectin and resistin levels, insulin resistance and colorectal adenomas.

BACKGROUND/AIMS: The relationship between adipocytokines and the development of colorectal cancer is well-documented. Our aim was to assess the relationship among serum adiponectin and resistin levels, insulin resistance, and colorectal adenoma to evaluate whether these parameters can be used as biomarkers to predict the development of colorectal adenoma. MATERIALS AND METHODS: This is a cross-sectional case-control study conducted in 32 patients with colorectal adenoma and 30 control subjects. Serum adiponectin and resistin levels, body mass index values, waist and hip circumferences and Homeostasis Model Assessment scores were measured. RESULTS: Resistin levels were slightly higher and adiponectin was slightly lower in patients with colorectal adenoma compared with controls; however, the differences in both parameters failed to reach statistical significance. The body mass index values and waist circumference of the patient group were significantly higher than controls (p=0.003 and p=0.002, respectively). Fasting serum insulin levels and Homeostasis Model Assessment scores of patients with colorectal adenoma were significantly higher than those of controls (p=0.02 and p=0.02, respectively). There was no relation between the number of colorectal adenomas and serum adiponectin or resistin levels. CONCLUSION: Our data indicate that obesity and insulin resistance may contribute to the development of colorectal adenoma and that serum adiponectin levels and insulin resistance may not have a substantial predictive value for colorectal adenoma.