liu.seSök publikationer i DiVA
Ändra sökning
Avgränsa sökresultatet
1 - 25 av 25
RefereraExporteraLänk till träfflistan
Permanent länk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Träffar per sida
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sortering
  • Standard (Relevans)
  • Författare A-Ö
  • Författare Ö-A
  • Titel A-Ö
  • Titel Ö-A
  • Publikationstyp A-Ö
  • Publikationstyp Ö-A
  • Äldst först
  • Nyast först
  • Skapad (Äldst först)
  • Skapad (Nyast först)
  • Senast uppdaterad (Äldst först)
  • Senast uppdaterad (Nyast först)
  • Disputationsdatum (tidigaste först)
  • Disputationsdatum (senaste först)
  • Standard (Relevans)
  • Författare A-Ö
  • Författare Ö-A
  • Titel A-Ö
  • Titel Ö-A
  • Publikationstyp A-Ö
  • Publikationstyp Ö-A
  • Äldst först
  • Nyast först
  • Skapad (Äldst först)
  • Skapad (Nyast först)
  • Senast uppdaterad (Äldst först)
  • Senast uppdaterad (Nyast först)
  • Disputationsdatum (tidigaste först)
  • Disputationsdatum (senaste först)
Markera
Maxantalet träffar du kan exportera från sökgränssnittet är 250. Vid större uttag använd dig av utsökningar.
  • 1.
    Auner, H W.
    et al.
    University of London Imperial Coll Science Technology and Med, England .
    Szydlo, R
    University of London Imperial Coll Science Technology and Med, England .
    van Biezen, A
    Leiden University, Netherlands .
    Iacobelli, S
    University of Roma Tor Vergata, Italy .
    Gahrton, G
    Karolinska Institute, Sweden .
    Milpied, N
    Hop Haut Leveque, France .
    Volin, L
    University of Helsinki, Finland .
    Janssen, J
    Vrije University of Amsterdam, Netherlands .
    Nguyen Quoc, S
    Grp Hospital Pitie Salpetriere, France .
    Michallet, M
    Hop Edouard Herriot, France .
    Schoemans, H
    University Hospital Gasthuisberg, Belgium .
    el Cheikh, J
    Institute J Paoli I Calmettes, France .
    Petersen, E
    University of Medical Centre, Netherlands .
    Guilhot, F
    Hop La Miletrie, France .
    Schoenland, S
    Heidelberg University, Germany .
    Ahlberg, Lucia
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Onkologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Centrum för kirurgi, ortopedi och cancervård, Hematologiska kliniken US.
    Morris, C
    Queens University of Belfast, North Ireland .
    Garderet, L
    Hop St Antoine, France .
    de Witte, T
    Radboud University of Nijmegen, Netherlands .
    Kroeger, N
    University Hospital Eppendorf, Germany .
    Reduced intensity-conditioned allogeneic stem cell transplantation for multiple myeloma relapsing or progressing after autologous transplantation: a study by the European Group for Blood and Marrow Transplantation2013Ingår i: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 48, nr 11, s. 1395-1400Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Outcomes and prognostic factors of reduced intensity-conditioned allo-SCT (RIC allo-SCT) for multiple myeloma (MM) relapsing or progressing after prior autologous (auto)-SCT are not well defined. We performed an analysis of 413 MM patients who received a related or unrelated RIC allo-SCT for the treatment of relapse/progression after prior auto-SCT. Median age at RIC allo-SCT was 54.1 years, and 44.6% of patients had undergone two or more prior auto-SCTs. Median OS and PFS from the time of RIC allo-SCT for the entire population were 24.7 and 9.6 months, respectively. Cumulative non-relapse mortality (NRM) at 1 year was 21.5%. In multivariate analysis, CMV seronegativity of both patient and donor was associated with significantly better PFS, OS and NRM. Patient-donor gender mismatch was associated with better PFS, fewer than two prior auto-SCT was associated with better OS, and shorter time from the first auto-SCT to the RIC allo-SCT was associated with lower NRM. The results of this study identify patient and donor CMV seronegativity as the key prognostic factor for outcome after RIC allo-SCT for MM relapsing or progressing after prior auto-SCT.

  • 2.
    Bergfelt, Emma
    et al.
    Uppsala University, Sweden.
    Kozlowski, Piotr
    University of Örebro, Sweden.
    Ahlberg, Lucia
    Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Hematologiska kliniken US. Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper.
    Hulegardh, Erik
    Sahlgrens University Hospital, Sweden.
    Hagglund, Hans
    Karolinska Institute, Sweden.
    Karlsson, Karin
    Skåne University Hospital, Sweden.
    Markuszewska-Kuczymska, Alicja
    University of Umeå Hospital, Sweden.
    Tomaszewska-Toporska, Beata
    Skåne University Hospital, Sweden.
    Smedmyr, Bengt
    Uppsala University, Sweden.
    Astrom, Maria
    University of Örebro, Sweden.
    Amini, Rose-Marie
    Uppsala University, Sweden.
    Hallbook, Helene
    Uppsala University, Sweden.
    Satisfactory outcome after intensive chemotherapy with pragmatic use of minimal residual disease (MRD) monitoring in older patients with Philadelphia-negative B cell precursor acute lymphoblastic leukaemia: a Swedish registry-based study2015Ingår i: Medical Oncology, ISSN 1357-0560, E-ISSN 1559-131X, Vol. 32, nr 4, s. 135-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The introduction of minimal residual disease (MRD) monitoring, in the Swedish national guidelines for acute lymphoblastic leukaemia, was evaluated in 35 patients aged 46-79 years (median 61), who were diagnosed from 2007 to 2011 and treated with high-intensity, block-based chemotherapy (ABCDV/VABA induction). Both a high complete remission rate (91 %) and acceptable overall survival (OS) rate (47 %) at 5 years were achieved. MRD by flow cytometry was measured in 73 % of the patients reaching complete remission after the first course, but was omitted by the clinicians for eight patients who were either over 70 years of age or already met conventional high-risk criteria. Factors negatively influencing OS were age over 65 years and WHO status greater than= 2. MRD less than 0.1 % after induction had positive impact on continuous complete remission but not on OS. Only five patients were allocated to allogeneic haematopoietic stem cell transplantation in first remission, mainly due to conventional high risk factors. Thus, use of intensive remission induction therapy is effective in a selection of older patients. In a population for whom the possibilities of treatment escalation are limited, the optimal role of MRD monitoring remains to be determined.

  • 3.
    Bergfelt Lennmyr, Emma
    et al.
    Uppsala Univ Hosp, Sweden.
    Kozlowski, Piotr
    Orebro Univ, Sweden.
    Ahlberg, Lucia
    Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Hematologiska kliniken US.
    Bernell, Per
    Karolinska Univ Hosp, Sweden.
    Hulegardh, Erik
    Sahlgrens Univ Hosp, Sweden.
    Izarra, Antonio Santamaria
    Univ Hosp Umeå, Sweden.
    Karlsson, Karin
    Skane Univ Hosp, Sweden.
    Tomaszewska-Toporska, Beata
    Skane Univ Hosp, Sweden.
    Åström, Maria
    Orebro Univ, Sweden.
    Hallbook, Helene
    Uppsala Univ Hosp, Sweden.
    Real-world data on first relapse of acute lymphoblastic leukemia in patients > 55 years2018Ingår i: Leukemia and Lymphoma, ISSN 1042-8194, E-ISSN 1029-2403, Vol. 59, nr 10, s. 2470-2473Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    n/a

  • 4.
    Blimark, Cecilie Hveding
    et al.
    Univ Gothenburg, Sweden; Skane Univ Hosp, Sweden.
    Turesson, Ingemar
    Skåne University Hospital, Lund-Malmö, Sweden.
    Genell, Anna
    Western Sweden Hlth Care Reg, Sweden.
    Ahlberg, Lucia
    Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Hematologiska kliniken US.
    Björkstrand, Bo
    Karolinska Inst, Sweden.
    Carlson, Kristina
    Uppsala Univ Hosp, Sweden.
    Forsberg, Karin
    Umeå Univ Hosp, Sweden.
    Juliusson, Gunnar
    Lund Univ, Sweden.
    Linder, Olle
    Örebro Univ Hosp, Sweden.
    Mellqvist, Ulf-Henrik
    Univ Gothenburg, Sweden; Skane Univ Hosp, Sweden; Boras Hosp, Sweden.
    Nahi, Hareth
    Karolinska Univ Hosp, Sweden; Karolinska Inst, Sweden.
    Kristinsson, Sigurdur Y.
    Karolinska Inst, Sweden; Univ Iceland, Iceland; Karolinska Univ Hosp, Sweden.
    Outcome and survival of myeloma patients diagnosed 2008-2015. Real-world data on 4904 patients from the Swedish Myeloma Registry2018Ingår i: Haematologica, ISSN 0390-6078, E-ISSN 1592-8721, Vol. 103, nr 3, s. 506-513Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Epidemiology and outcome of myeloma are mainly reported from large university centers and collaborative groups, and do not represent real-world patients. The Swedish Myeloma Registry is a prospective population-based registry documenting characteristics, treatment and outcome in newly diagnosed myeloma, including asymptomatic and localized forms, with the purpose of improving disease management and outcome. This report presents information on patients diagnosed between 2008 and 2015, including data on first-line treatment in patients diagnosed up to 2014, with a follow up until December 2016. We present age-adjusted incidence, patients characteristics at baseline, treatment, response, and survival. Baseline data were available with a 97% coverage in 4904 patients (median age 71 years, males 70 years, females 73 years; 72% were 65 years or older), and at 1-year follow up in 3558 patients with symptomatic disease (92% of patients initially reported). The age-adjusted incidence was 6.8 myeloma cases per 100,000 inhabi-ants per year. Among initially symptomatic patients (n= 3988), 77% had osteolytic lesions or compression fractures, 49% had anemia, 18% impaired kidney function, and 13% hypercalcemia. High-dose therapy with autologous stem cell transplantation was given to 77% of patients aged up to 66 years, and to 22% of patients aged 66-70 years. In the study period, 68% received bortezomib, thalidomide, and/or lenalidomide as part of the first-line treatment, rising from 31% in 2008 to 81% in 2014. In active myeloma, the median relative survival of patients aged 65 years or under was 7.7 years, and 3.4 years in patients aged 66 years and over. Patients diagnosed with myeloma in more recent years were associated with significantly higher rates of complete or very good partial remission (Pamp;lt;0.05), and with a significantly higher survival, with a Hazard Ratio (HR) of 0.84 (95% CI: 0.77-0.92; Pamp;lt;0.05). There was a small, but significant survival benefit in patients treated at university hospitals (HR 0.93; 95% CI: 0.87-0.99; Pamp;lt;0.05). We report here on a near complete real-world population of myeloma patients during an 8-year period; a period in which newer drugs were implemented into standard practice. The overall incidence and median age were both higher than in most previous studies, indicating a more complete coverage of older patients. Myeloma survival in Sweden is comparable to other large registry studies, and responses and survival improved during the study period.

  • 5. Crawley, C
    et al.
    Lalancette, M
    Szydlo, R
    Gilleece, M
    Peggs, K
    Mackinnon, S
    Juliusson, Gunnar
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Onkologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Hematologiska kliniken US.
    Ahlberg, Lucia
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Onkologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Hematologiska kliniken US.
    Nagler, A
    Shimoni, A
    Sureda, A
    Boiron, JM
    Einsele, H
    Chopra, R
    Carella, A
    Cavenagh, J
    Gratwohl, A
    Garban, F
    Zander, A
    Bjorkstrand, B
    Outcomes for reduced-intensity allogeneic transplantation for multiple myeloma: an analysis of prognostic factors from the Chronic Leukaemia Working Party of the EBMT2005Ingår i: Blood, ISSN 0006-4971, E-ISSN 1528-0020, Vol. 105, nr 11, s. 4532-4539Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We report the outcome of 229 patients who received an allograft for myeloma with reduced-intensity conditioning (RIC) regimens from 33 centers within the European Group for Blood and Marrow Transplantation (EBMT). The median age was 52 years and 64% were male. Conditioning regimens were heterogeneous, but most were fludarabine based and T cell depleted with antithymocyte globulin or alemtuzumab. Transplantation-related mortality (TRIM) at 1 year was 22%. The 3-year overall survival (OS) and progression-free survival (PFS) were 41% and 21 %, respectively. Adverse OS was associated with chemoresistant disease (relative risk [RR], 2.9), more than 1 prior transplantation (RR, 2.0), and male patients with female donors (FIR, 1.45). Adverse PFS was associated with chemoresistance (RR, 2.4) and alemtuzumab (RR, 1.8). TRM was increased with female-to-male donation (RR, 2.5) and transplantation more than 1 year from diagnosis (RR, 2.3). Grades II to IV acute graft-versus-host disease (aGvHD) occurred in 31%. Chronic GvHD was associated with better OS and PFS and were 84% and 46% for limited, 58% and 30% for extensive, and 29% and 12% in its absence suggesting that a graft-versus-myeloma effect is important. While RIC is feasible, heavily pretreated patients and patients with progressive disease do not benefit.

  • 6.
    Delforge, M.
    et al.
    Katholieke University.
    de Samblanx, H.
    ZNA Middelheim.
    Zervas, K.
    Theagene Anticancer Hospital.
    Katodritou, E.
    Theagen Cancer Centre.
    Sargin, D.
    Istanbul University.
    Hulin, C.
    Central Hospital University Nancy Brabois.
    Ahlberg, Lucia
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Onkologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Hematologiska kliniken US.
    de la Rubia, J.
    Hospital La Fe.
    Abdulkadyrov, K.
    Russian Science Research Institute.
    Ganguly, R.
    Johnson & Johnson Pharmaceutical.
    Diels, J.
    Johnson & Johnson Pharmaceutical.
    Dhawan, R.
    Johnson & Johnson Pharmaceutical.
    SURVIVAL ANALYSIS OF PATIENTS WITH RELAPSED/REFRACTORY MULTIPLE MYELOMA: AN INTERIM REPORT FROM AN INTERNATIONAL ELECTRONIC OBSERVATIONAL STUDY OF BORTEZOMIB2009Ingår i: in HAEMATOLOGICA-THE HEMATOLOGY JOURNAL, vol 94, 2009, Vol. 94, s. 0956-Konferensbidrag (Refereegranskat)
    Abstract [en]

    n/a

  • 7.
    Dimopoulos, Meletios A
    et al.
    Greek Myeloma Study Group, Greece.
    De Samblanx, Hadewijch M
    AZ Sint-Dimpna, ZNA Middelheim, Antwerp, Belgium.
    Roussou, Maria G
    School of Medicine, University of Athens, Athens, Greece.
    Zervas, Konstantinos
    Greek Myeloma Study Group, Greece.
    Katodritou, Eirini
    Department of Hematology, Theagenion Cancer Center, Thessaloniki, Greece.
    Sargin, Deniz
    Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
    Hulin, Cyrille
    Hematology, Centre Hospitalier of Nancy-Brabois, Vandoeuvre, France.
    Ahlberg, Lucia
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Onkologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Hematologiska kliniken US.
    De La Rubia, Javier
    Hematology, Hospital La Fe, Valencia, Spain.
    Ganguly, Rita
    Johnson & Johnson Pharmaceuticals, Raritan, NJ, USA.
    Diels, Joris K
    Johnson & Johnson Pharmaceuticals, Beerse, Belgium.
    van de Velde, Helgi
    Johnson & Johnson Pharmaceuticals Research & Development, Beerse, Belgium.
    Dhawan, Ravinder
    Johnson & Johnson Pharmaceuticals, Raritan, NJ, USA.
    Spencer, Michael D
    Johnson & Johnson Pharmaceuticals, High Wycombe, United Kingdom.
    Delforge, Michel
    University Hospital Leuven, Leuven, Belgium .
    Efficacy of Bortezomib Plus Dexamethasone Versus Bortezomib Mono therapy In Patients with Relapsed/Refractory Multiple Myeloma An Interim Report from an International Electronic Observational Study2010Ingår i: BLOOD vol 116, issue 21 (ISSN 0006-4971), American Society of Hematology , 2010, Vol. 116, nr 21, s. 1247-1248Konferensbidrag (Refereegranskat)
  • 8.
    Gimsing, Peter
    et al.
    Rigshosp, Copenhagen.
    Carlson, Kristina
    Uppsala University.
    Turesson, Ingemar
    Lund University.
    Fayers, Peter
    University Aberdeen.
    Waage, Anders
    St Olavs University Hospital.
    Vangsted, Annette
    Herlev University Hospital.
    Mylin, Anne
    Rigshosp, Copenhagen.
    Gluud, Christian
    Rigshosp, Copenhagen.
    Juliusson, Gunnar
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Onkologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Hematologiska kliniken US.
    Gregersen, Henrik
    University Hospital Aalborg.
    Hjorth-Hansen, Henrik
    St Olavs University Hospital.
    Nesthus, Ingerid
    Haukeland Hospital.
    Marie S Dahl, Inger
    University Tromso Hospital.
    Westin, Jan
    Sahlgrens University Hospital.
    Lanng Nielsen, Johan
    Arhus University Hospital.
    Meldgaard Knudsen, Lene
    Herlev University Hospital.
    Ahlberg, Lucia
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Onkologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Hematologiska kliniken US.
    Hjorth, Martin
    Lidkoping Hospital.
    Abildgaard, Niels
    Odense University Hospital.
    Frost Andersen, Niels
    Arhus University Hospital.
    Linder, Olle
    Orebro University Hospital.
    Wisloeff, Finn
    Ullevaal University Hospital.
    Effect of pamidronate 30 mg versus 90 mg on physical function in patients with newly diagnosed multiple myeloma (Nordic Myeloma Study Group): a double-blind, randomised controlled trial2010Ingår i: LANCET ONCOLOGY, ISSN 1470-2045, Vol. 11, nr 10, s. 973-982Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Compared with placebo, prophylactic treatment with bisphosphonates reduces risk of skeletal events in patients with multiple myeloma. However, because of toxicity associated with long-term bisphosphonate treatment, establishing the lowest effective dose is important. This study compared the effect of two doses of pamidronate on health-related quality of life and skeletal morbidity in patients with newly diagnosed multiple myeloma. Methods This double-blind, randomised, phase 3 trial was undertaken at 37 clinics in Denmark, Norway, and Sweden. Patients with multiple myeloma who were starting antimyeloma treatment were randomly assigned in a 1:1 ratio to receive one of two doses of pamidronate (30 mg or 90 mg) given by intravenous infusion once a month for at least 3 years. Randomisation was done by use of a central, computerised minimisation system. Primary outcome was physical function after 12 months estimated by the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire (scale 0-100). All patients who returned questionnaires at 12 months and were still on study treatment were included in the analysis of the primary endpoint. This study is registered with ClinicalTrials. gov, number NCT00376883. Findings From January, 2001, until August, 2005, 504 patients were randomly assigned to pamidronate 30 mg or 90 mg (252 in each group). 157 patients in the 90 mg group and 156 in the 30 mg group were included in the primary analysis. Mean physical function at 12 months was 66 points (95% CI 62.9-70.0) in the 90 mg group and 68 points (64.6-71.4) in the 30 mg group (95% CI of difference -6.6 to 3.3; p=0.52). Median time to first skeletal-related event in patients who had such an event was 9.2 months (8.1-10.7) in the 90 mg group and 10-2 months (7.3-14.0) in the 30 mg group (p=0.63). In a retrospective analysis, eight patients in the pamidronate 90 mg group developed osteonecrosis of the jaw compared with two patients in the 30 mg group. Interpretation Monthly infusion of pamidronate 30 mg should be the recommended dose for prevention of bone disease in patients with multiple myeloma.

  • 9. Hedenus, M
    et al.
    Birgegård, G
    Näsman, P
    Ahlberg, Lucia
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Onkologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Hematologiska kliniken US.
    Karlsson, T
    Lauri, B
    Lundin, J
    Lärfars, G
    Österborg, A
    Addition of intravenous iron to epoetin beta increases hemoglobin response and decreases epoetin dose requirement in anemic patients with lymphoproliferative malignancies: A randomized multicenter study2007Ingår i: Leukemia, ISSN 0887-6924, E-ISSN 1476-5551, Vol. 21, nr 4, s. 627-632Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This randomized study assessed if intravenous iron improves hemoglobin (Hb) response and permits decreased epoetin dose in anemic (Hb 9-11,11 g/dl), transfusion-independent patients with stainable iron in the bone marrow and lymphoproliferative malignancies not receiving chemotherapy. Patients (n=67) were randomized to subcutaneous epoetin beta 30 000 IU once weekly for 16 weeks with or without concomitant intravenous iron supplementation. There was a significantly (P25%) lower in the iron group, as was the total epoetin dose (P=0.051). In conclusion, the Hb increase and response rate were significantly greater with the addition of intravenous iron to epoetin treatment in iron-replete patients and a lower dose of epoetin was required.

  • 10.
    Hulegardh, E.
    et al.
    Sahlgrens University Hospital, Sweden .
    Hagglund, H.
    Karolinska University Hospital, Sweden .
    Ahlberg, Lucia
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Centrum för kirurgi, ortopedi och cancervård, Hematologiska kliniken US.
    Karlsson, K.
    Skåne University Hospital, Sweden .
    Karbach, H.
    Umeå University Hospital, Sweden .
    Markuszewska, A.
    Umeå University Hospital, Sweden .
    Persson, I.
    Uppsala University, Sweden .
    Astrom, M.
    Örebro University Hospital, Sweden .
    Hallbook, H.
    Uppsala University, Sweden .
    Outcome after HSCT in Philadelphia chromosome positive acute lymphoblastic leukemia in Sweden: a population-based study2014Ingår i: Medical Oncology, ISSN 1357-0560, E-ISSN 1559-131X, Vol. 31, nr 8, s. 66-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Even in the tyrosine kinase inhibitor era, allogeneic hematopoietic stem cell transplantation (HSCT) is regarded as standard care for adult Philadelphia (Ph) positive acute lymphoblastic leukemia (ALL). In this retrospective national study, we have reviewed the outcome after HSCT in Sweden for adult Ph-positive ALL between 2000 and 2009. In total, 51 patients with median age 42 (range 20-66) years underwent HSCT. Mainly allogeneic HSCT was performed (24 related donor, 24 unrelated donor and one cord blood), and only two patients were treated with an autologous HSCT. The 5-year OS was 51 (37-64) %. The probabilities of morphological relapse and non-relapse mortality (NRM) at 5 years were 36 (23-49) and 18 (9-29) %, respectively. For the allogeneic transplanted, the 5-year OS was for patients less than40 years 70 (50-90) % and for patients greater than= 40 years 34 (16-52) %, p = 0.002. The 5-year probability of NRM was for patients less than40 years 10 (2-28) % compared to 25 (11-42) % for patients greater than= 40 years (p = 0.04). Patients with chronic graft-versus-host disease (GVHD) had a 5-year morphological relapse probability of 20 (6-40) % compared to 59 (35-77) % for patients without chronic GVHD (p = 0.03). Age greater than= 40 years and the absence of chronic GVHD were confirmed as independent negative prognostic factors for relapse and non-relapse mortality in a multivariate analysis although the impact of chronic GVHD was significant only in the older age cohort.

  • 11.
    Jakobsen Falk, Ingrid
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Medicinska fakulteten.
    Lund, Johan
    Karolinska Institute, Sweden.
    Green, Henrik
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Medicinska fakulteten. National Board Forens Med, Department Forens Genet and Forens Toxicol, Linkoping, Sweden.
    Gruber, Astrid
    Karolinska Institute, Sweden.
    Alici, Evren
    Karolinska Institute, Sweden.
    Lauri, Birgitta
    Sunderby Hospital, Sweden.
    Blimark, Cecilie
    Sahlgrens University Hospital, Sweden.
    Mellqvist, Ulf-Henrik
    South Elvsborg Hospital, Sweden.
    Swedin, Agneta
    Skåne University Hospital, Sweden.
    Forsberg, Karin
    Norrland University Hospital, Sweden.
    Carlsson, Conny
    Hallands Hospital, Sweden.
    Hardling, Mats
    Uddevalla Central Hospital, Sweden.
    Ahlberg, Lucia
    Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Hematologiska kliniken US.
    Lotfi, Kourosh
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Hematologiska kliniken US.
    Nahi, Hareth
    Karolinska Institute, Sweden.
    Pharmacogenetic study of the impact of ABCB1 single-nucleotide polymorphisms on lenalidomide treatment outcomes in patients with multiple myeloma: results from a phase IV observational study and subsequent phase II clinical trial2018Ingår i: Cancer Chemotherapy and Pharmacology, ISSN 0344-5704, E-ISSN 1432-0843, Vol. 81, nr 1, s. 183-193Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose Despite therapeutic advances, patients with multiple myeloma (MM) continue to experience disease relapse and treatment resistance. The gene ABCB1 encodes the drug transporter P-glycoprotein, which confers resistance through drug extrusion across the cell membrane. Lenalidomide (Len) is excreted mainly via the kidneys, and, given the expression of P-gp in the renal tubuli, single-nucleotide polymorphisms (SNPs) in the ABCB1 gene may influence Len plasma concentrations and, subsequently, the outcome of treatment. We, therefore, investigated the influence of ABCB1 genetic variants on Len treatment outcomes and adverse events (AEs). Methods Ninety patients with relapsed or refractory MM, who received the second-line Len plus dexamethasone in the Rev II trial, were genotyped for the ABCB1 SNPs 1199G amp;gt; A (Ser400Asn, rs2229109), 1236C amp;gt; T (silent, rs1128503), 2677G amp;gt; T/A (Ala893Ser, rs2032582), and 3435C amp;gt; T (silent, rs1045642) using pyrosequencing, and correlations to response parameters, outcomes, and AEs were investigated. Results No significant associations were found between genotype and either best response rates or hematological AEs, and 1236C amp;gt; T, 2677G amp;gt; T or 3435C amp;gt; T genotypes had no impact on survival. There was a trend towards increased time to progression (TTP) in patients carrying the 1199A variant, and a significant difference in TTP between genotypes in patients with standard-risk cytogenetics. Conclusions Our findings show a limited influence of ABCB1 genotype on lenalidomide treatment efficacy and safety. The results suggest that 1199G amp;gt; A may be a marker of TTP following Len treatment in standard-risk patients; however, larger studies are needed to validate and clarify the relationship.

  • 12.
    Kozlowski, Piotr
    et al.
    Örebro University Hospital, Sweden .
    Astrom, Maria
    Örebro University Hospital, Sweden .
    Ahlberg, Lucia
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Centrum för kirurgi, ortopedi och cancervård, Hematologiska kliniken US.
    Bernell, Per
    Karolinska University Hospital, Sweden .
    Hulegardh, Erik
    Sahlgrenska University, Sweden .
    Hagglund, Hans
    Karolinska University Hospital, Sweden .
    Karlsson, Karin
    Skåne University Hospital, Sweden .
    Markuszewska-Kuczymska, Alicja
    University Hospital, Sweden .
    Tomaszewska-Toporska, Beata
    Skåne University Hospital, Sweden .
    Smedmyr, Bengt
    Uppsala University, Sweden .
    Amini, Rose-Marie
    Uppsala University, Sweden .
    Hallbook, Helene
    Uppsala University, Sweden .
    High relapse rate of T cell acute lymphoblastic leukemia in adults treated with Hyper-CVAD chemotherapy in Sweden2014Ingår i: European Journal of Haematology, ISSN 0902-4441, E-ISSN 1600-0609, Vol. 92, nr 5, s. 377-381Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Hyper-CVAD is widely used to treat acute lymphoblastic leukemia (ALL) and aggressive lymphomas. This multicenter, population-based study assessed the efficacy of Hyper-CVAD as first-line therapy in patients with T-cell ALL (T-ALL). Patients and methods Between October 2002 and September 2006, 24 patients were diagnosed with T-ALL in Sweden; 19 were eligible for treatment with the protocol. Results The median age was 32yr (range 18-72yr). Complete remission (CR) was obtained in 17 of 19 (89%) patients, and the treatment was relatively well tolerated. Allogeneic stem cell transplantation (SCT) was recommended in high-risk disease and was performed in four patients upfront. Two- and 5-yr leukemia-free survivals (LFS) in 17 patients with CR achievement were identical, at 29% (95% confidence interval [CI]: 8-51). Two- and 5-yr overall survival (OS) in whole cohort was 63% (95% CI: 42-85) and 47% (95% CI: 26-69), respectively. The 5-yr LFS for 15 patients who did not receive allogeneic SCT upfront were 20% (95% CI: 0-40), although 14 of 15 completed the protocol (eight cycles). Relapse occurred in 2 of 4 upfront-transplanted patients and in 12 of 15 patients treated with chemotherapy alone, six of whom received allogeneic SCT in CR2. Age greater than= 35yr influenced OS negatively in univariate analysis (HR 5.1, 95% CI: 1.55-16.7). Conclusions Hyper-CVAD treatment resulted in a high CR rate and appeared safe, but it showed poor efficacy at preventing relapse. Therefore, this treatment is no longer recommended for adults with T-ALL in Sweden.

  • 13.
    Kozlowski, Piotr
    et al.
    Örebro University Hospital, Sweden .
    Astrom, Maria
    Örebro University Hospital, Sweden .
    Ahlberg, Lucia
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Onkologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Centrum för kirurgi, ortopedi och cancervård, Hematologiska kliniken US.
    Bernell, Per
    Karolinska University Hospital, Sweden .
    Hulegardh, Erik
    Sahlgrenska University, Sweden .
    Hagglund, Hans
    Karolinska University Hospital, Sweden .
    Karlsson, Karin
    Skåne University Hospital, Sweden .
    Markuszewska-Kuczymska, Alicja
    Umeå University Hospital, Sweden .
    Tomaszewska-Toporska, Beata
    Skåne University Hospital, Sweden .
    Smedmyr, Bengt
    Uppsala University, Sweden .
    Hallbook, Helene
    Uppsala University, Sweden .
    High curability via intensive reinduction chemotherapy and stem cell transplantation in young adults with relapsed acute lymphoblastic leukemia in Sweden 2003-20072012Ingår i: Haematologica, ISSN 0390-6078, E-ISSN 1592-8721, Vol. 97, nr 9, s. 1414-1421Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background less thanbrgreater than less thanbrgreater thanA minority of patients with adult acute lymphoblastic leukemia who relapse are rescued. The aim of this population-based study was to assess the results of reinduction treatment and allogeneic stem cell transplantation in patients in second complete remission. less thanbrgreater than less thanbrgreater thanDesign and Methods less thanbrgreater than less thanbrgreater thanBetween 2003-2007, 76 adults (andlt;66 years) with relapsed acute lymphoblastic leukemia (Burkitts leukemia excluded) were prospectively reported to The Swedish Adult Acute Leukemia Registry and later evaluated. less thanbrgreater than less thanbrgreater thanResults less thanbrgreater than less thanbrgreater thanReinduction with: (i) mitoxantrone, etoposide, and cytarabine (MEA); (ii) fludarabine, cytarabine, pegylated-asparaginase plus granulocyte colony-stimulating factor (FLAG-Asp); and (iii) cytarabine, betamethasone, cyclophosphamide, daunorubicin, and vincristine (ABCDV) resulted in complete remission in 6/9 (67%), 10/16 (63%) and 9/21 (43%) of the patients, respectively. Allogeneic stem cell transplantation was performed during second complete remission in 29 patients. Multivariate analysis regarding overall survival after relapse revealed that age over 35 years at diagnosis and relapse within 18 months were negative prognostic factors. Overall survival rates at 3 and 5 years were 22% (95% CI: 13-32) and 15% (95% CI: 7-24). Of 19 patients less than 35 years at diagnosis who underwent allogeneic stem cell transplantation in second remission, ten (53%) are still alive at a median of 5.5 years (range, 4.2-8.3) after relapse, whereas all patients over 35 years old at diagnosis have died. less thanbrgreater than less thanbrgreater thanConclusions less thanbrgreater than less thanbrgreater thanAllogeneic stem cell transplantation remains the treatment of choice for young adults with relapsed acute lymphoblastic leukemia. Both (i) mitoxantrone, etoposide, and cytarabine and (ii) fludarabine, cytarabine, pegylated-asparaginase plus granulocyte colony-stimulating factor seem effective as reinduction treatments and should be further evaluated. New salvage strategies are needed, especially for patients over 35 years old at diagnosis.

  • 14.
    Kozlowski, Piotr
    et al.
    Örebro University, Sweden.
    Lennmyr, Emma
    Uppsala University, Sweden.
    Ahlberg, Lucia
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Onkologi. Linköpings universitet, Hälsouniversitetet. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Hematologiska kliniken US.
    Bernell, Per
    Karolinska Institute, Sweden.
    Hulegardh, Erik
    Sahlgrens University Hospital, Sweden.
    Karbach, Holger
    University Hospital Umeå, Sweden.
    Karlsson, Karin
    Skåne University Hospital, Sweden.
    Tomaszewska-Toporska, Beata
    Skåne University Hospital, Sweden.
    Åström, Maria
    Örebro University, Sweden.
    Hallbook, Helene
    Uppsala University, Sweden.
    Age but not Philadelphia positivity impairs outcome in older/elderly patients with acute lymphoblastic leukemia in Sweden2017Ingår i: European Journal of Haematology, ISSN 0902-4441, E-ISSN 1600-0609, Vol. 99, nr 2, s. 141-149Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    ObjectivesOlder/elderly patients with acute lymphoblastic leukemia (ALL) are poorly represented in clinical trials. MethodsUsing Swedish national leukemia registries, we investigated disease/patient characteristics, treatment choices, outcome, and the impact of an age-adapted protocol (introduced in 2009) in this population-based study of patients aged 55-85years, diagnosed with ALL 2005-2012. ResultsOf 174 patients, 82% had B-phenotype, 11% Burkitt leukemia (excluded), and 7% T-phenotype. Philadelphia chromosome positivity (Ph+) occurred in 35%. Of the 155 B- and T-ALL patients, 80% were treated with intensive protocols, and 20% with a palliative approach. Higher age and WHO performance status 2 influenced the choice of palliation. Intensive, palliative, and both approaches resulted in complete remission rate 83/16/70% and 3-year overall survival (OS) 32/3/26%. The age-adapted protocol did not improve outcome. With intensive treatment, platelet count 35x10(9)/L and age 75years were adverse prognostic factors for OS, Ph+ was not. Male sex was an adverse prognostic factor in the 55-64 year age-group. ConclusionsWe report a high frequency of Ph+ in older/elderly patients, with no evidence of poorer outcome compared to Ph-negative disease. Overall prognosis for elderly patients with ALL remains dismal, despite the use of age-adapted treatment.

  • 15. Lenhoff, Stig
    et al.
    Hjorth, Martin
    Turesson, Ingemar
    Westin, Jan
    Gimsing, Peter
    Wisloff, Finn
    Ahlberg, Lucia
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Onkologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Hematologiska kliniken US.
    Carlson, Kristina
    Christiansen, Ilse
    Dahl, Inger Marie
    Forsberg, Karin
    Brinch, Lorentz
    Hammerstrom, Jens
    Johnsen, Hans E.
    Knudsen, Lene Me
    Intensive therapy for multiple myeloma in patients younger than 60 years. Long-term results focusing on the effect of the degree of response on survival and relapse pattern after transplantation2006Ingår i: Haematologica, ISSN 0390-6078, E-ISSN 1592-8721, Vol. 91, nr 9, s. 1228-1233Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background and Objectives. From 1994 to 1997 we conducted a population-based, prospective study on intensive therapy in newly diagnosed symptomatic myeloma patients younger than 60 years, comparing their survival to that of a conventionally treated historic population. Long-term results are presented, including the impact of the degree of response on survival and relapse pattern after transplantation. Design and Methods. The prospective population was formed of 397 patients and the historic population of 313 patients. Both populations were calculated to comprise more than 75% of the expected number of new cases. Results. After a median follow-up of 7 years survival was longer in the prospective population than in the historic one (median 60 versus 39 months, p=0.0002). When comparing only patients eligible for intensive therapy the median survival was 63 versus 44 months (p < 0.0001). Attaining a complete response was associated with prolonged event-free survival but not overall survival. The pattern of relapse after transplantation was heterogeneous but could be divided into four major groups, insidious, classical, plasmacytoma form and transformed disease. The median survival after relapse was 29 months. The relapse pattern and time to relapse predicted outcome. Patients relapsing with an insidious or classical form of disease with skeletal events only, or after a long lasting first response were likely to respond well to conventional salvage therapy. In contrast, relapse with multiple symptoms, transformed disease or a short duration of first response implied bad prognosis. Interpretation and conclusions. The relapse pattern after autologous transplantation is heterogeneous and response to salvage therapy is variable. The degree of response and event-free survival after transplantation are not reliable surrogate markers for survival.

  • 16.
    Lennmyr, Emma
    et al.
    Uppsala Univ, Sweden.
    Karlsson, Karin
    Skane Univ Hosp, Sweden.
    Ahlberg, Lucia
    Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Hematologiska kliniken US.
    Garelius, Hege
    Sahlgrens Univ Hosp, Sweden.
    Hulegardh, Erik
    Sahlgrens Univ Hosp, Sweden.
    Izarra, Antonio S.
    Univ Hosp Umea, Sweden.
    Joelsson, Joel
    Karolinska Inst, Sweden.
    Kozlowski, Piotr
    Orebro Univ, Sweden.
    Moicean, Andreea
    Cent Hosp Skovde, Sweden.
    Tomaszewska-Toporska, Beata
    Skane Univ Hosp, Sweden.
    Lubking, Anna
    Skane Univ Hosp, Sweden.
    Hallbook, Helene
    Uppsala Univ, Sweden.
    Survival in adult acute lymphoblastic leukaemia (ALL): A report from the Swedish ALL Registry2019Ingår i: European Journal of Haematology, ISSN 0902-4441, E-ISSN 1600-0609, Vol. 103, nr 2, s. 88-98Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives As new, effective therapies emerge for acute lymphoblastic leukaemia (ALL), the results of clinical trials need to relate to standard of care. Methods We used the population-based Swedish ALL Registry to evaluate characteristics, treatment and long-term outcome in 933 patients with diagnosis between 1997 and 2015. Results The median age was 53 years. The frequency of Philadelphia (Ph)-positive leukaemia was 34% of examined B-ALL with a peak incidence at 50-59 years. Five-year overall survival (OS) improved between 1997-2006 and 2007-2015; in patients 18-45 years from 50% (95% CI 43-57) to 65% (95% CI 58-72), 46-65 years from 25% (95% CI 18-32) to 46% (95% CI 37-55) and amp;gt;65 years from 7% (95% CI 2.6-11) to 11% (95% CI 5.9-16) (P amp;lt; 0.05). Men with Ph-neg B-ALL 46-65 years had inferior OS compared with women (P amp;lt; 0.01). Standardised mortality ratio was 5.7 (95% CI 5.0-6.3) for patients who survived 5 years from diagnosis. In multivariable analysis, Ph-positive disease was not associated with impaired prognosis but with lower risk of death in 2007-2015. Conclusions In a population-based cohort, OS has improved in adult ALL, especially for Ph-positive disease but for middle-aged men with Ph-negative B-ALL outcome was poor. Cure without late toxicity or relapse is still desired.

  • 17.
    Lund, Johan
    et al.
    Karolinska Univ Hosp, Sweden.
    Gruber, Astrid
    Karolinska Univ Hosp, Sweden.
    Lauri, Birgitta
    Sunderby Hosp, Sweden.
    Duru, Adil Doganay
    Karolinska Univ Hosp, Sweden; NSU, FL USA.
    Blimark, Cecilie
    Sahlgrens Univ Hosp, Sweden.
    Swedin, Agneta
    Skane Univ Hosp, Sweden.
    Hansson, Markus
    Skane Univ Hosp, Sweden.
    Forsberg, Karin
    Norrland Univ Hosp, Sweden.
    Ahlberg, Lucia
    Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Hematologiska kliniken US.
    Carlsson, Conny
    Hallands Hosp, Sweden.
    Waage, Anders
    Norwegian Univ Sci and Technol, Norway.
    Gimsing, Peter
    Rigshosp, Denmark.
    Vangsted, Annette Juul
    Rigshosp, Denmark; Zealand Univ, Denmark.
    Frolund, Ulf
    Zealand Univ, Denmark.
    Holmberg, Erik
    Inst Clin Sci, Sweden.
    Gahrton, Gösta
    Karolinska Univ Hosp, Sweden.
    Alici, Evren
    Karolinska Univ Hosp, Sweden.
    Hardling, Mats
    Uddevalla Cent Hosp, Sweden.
    Mellqvist, Ulf-Henrik
    Sahlgrens Univ Hosp, Sweden.
    Nahi, Hareth
    Karolinska Univ Hosp, Sweden.
    Lenalidomide versus lenalidomide plus dexamethasone prolonged treatment after second-line lenalidomide plus dexamethasone induction in multiple myeloma2018Ingår i: Cancer Medicine, ISSN 2045-7634, E-ISSN 2045-7634, Vol. 7, nr 6, s. 2256-2268Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Lenalidomide (Len) plus dexamethasone (Dex) is approved for the treatment of relapsed or refractory multiple myeloma (RRMM). It is possible that single-agent Len may be effective as prolonged treatment regimen in RRMM once patients demonstrate an initial response to Len+Dex induction. Patients with RRMM who responded to first-line Len+Dex in an observational study (NCT01430546) received up to 24 cycles of either Len (25mg/day) or Len+Dex (25mg/day and 40mg/week) as prolonged treatment in a subsequent phase 2 clinical trial (NCT01450215). In the observational study (N = 133), median time to response was 1.7 (range 0.6-9.6) months. A complete response to all treatments received in both studies was observed in 11% of patients; very good partial response and partial response rates were 31% and 38%, respectively. Corresponding response rates in the subgroup of patients who did not enter the phase 2 trial (n = 71) were 3%, 18%, and 39%, respectively. Rates of disease progression at 2years in the phase 2 trial were 47% versus 31% for Len versus Len+Dex (P = 0.14). After 36months median follow-up in surviving patients, median time to progression was not reached with Len+Dex and was 24.9months (95% confidence interval 12.5-not calculable, P amp;lt; 0.001) with Len. Three-year OS among the total observational study population was 61% (95% CI, 52-69%). The corresponding rate among patients who entered the phase 2 clinical trial was 73% (95% CI, 60-83%) and was significantly lower among those patients who achieved PR but did not proceed into the phase 2 trial (55%; P = 0.01). In the phase 2 trial, OS was 73% in both treatment arms (P = 0.70). Neutropenia and thrombocytopenia were more common with prolonged (phase 2 trial) versus short-term (observational study) Len administration but remained manageable. Prolonged treatment with Len with or without Dex provides sustained, clinically relevant responses and demonstrates an acceptable safety profile.

  • 18.
    Mellqvist, Ulf-Henrik
    et al.
    Sahlgrens University Hospital, Sweden .
    Gimsing, Peter
    Rigshosp, Denmark .
    Hjertner, Oyvind
    Norwegian University of Science and Technology, Norway .
    Lenhoff, Stig
    Skåne University Hospital, Sweden .
    Laane, Edward
    North Estonian Regional Hospital, Estonia .
    Remes, Kari
    Turku University, Finland .
    Steingrimsdottir, Hlif
    Landspitali University Hospital, Iceland .
    Abildgaard, Niels
    Odense University Hospital, Denmark .
    Ahlberg, Lucia
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Onkologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Centrum för kirurgi, ortopedi och cancervård, Hematologiska kliniken US.
    Blimark, Cecilie
    Sahlgrens University Hospital, Sweden .
    Dahl, Inger Marie
    University of North Norway, Norway .
    Forsberg, Karin
    Norrlands University Hospital, Sweden .
    Gedde-Dahl, Tobias
    Oslo University Hospital, Norway .
    Gregersen, Henrik
    Aalborg Hospital, Denmark .
    Gruber, Astrid
    Karolinska Institute, Sweden .
    Guldbrandsen, Nina
    Oslo University Hospital, Norway .
    Haukas, Einar
    Stavanger University Hospital, Norway .
    Carlson, Kristina
    Akad University Hospital, Sweden .
    Kvam, Ann Kristin
    Oslo University Hospital, Norway .
    Nahi, Hareth
    Karolinska Institute, Sweden .
    Lindas, Roald
    Haukeland Hospital, Norway .
    Frost Andersen, Niels
    Aarhus University Hospital, Denmark .
    Turesson, Ingemar
    Skåne University Hospital, Sweden .
    Waage, Anders
    Norwegian University of Science and Technology, Norway .
    Westin, Jan
    Sahlgrens University Hospital, Sweden .
    Bortezomib consolidation after autologous stem cell transplantation in multiple myeloma: a Nordic Myeloma Study Group randomized phase 3 trial2013Ingår i: Blood, ISSN 0006-4971, E-ISSN 1528-0020, Vol. 121, nr 23, s. 4647-4654Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The Nordic Myeloma Study Group conducted an open randomized trial to compare bortezomib as consolidation therapy given after high-dose therapy and autologous stem cell transplantation (ASCT) with no consolidation in bortezomib-naive patients with newly diagnosed multiple myeloma. Overall, 370 patients were centrally randomly assigned 3 months after ASCT to receive 20 doses of bortezomib given during 21 weeks or no consolidation. The hypothesis was that consolidation therapy would prolong progression-free survival (PFS). The PFS after randomization was 27 months for the bortezomib group compared with 20 months for the control group (P = .05). Fifty-one of 90 patients in the treatment group compared with 32 of 90 controls improved their response after randomization (P = .007). No difference in overall survival was seen. Fatigue was reported more commonly by the bortezomib-treated patients in self-reported quality-of-life (QOL) questionnaires, whereas no other major differences in QOL were recorded between the groups. Consolidation therapy seemed to be beneficial for patients not achieving at least a very good partial response (VGPR) but not for patients in the andgt;= VGPR category at randomization. Consolidation with bortezomib after ASCT in bortezomib-naive patients improves PFS without interfering with QOL. This trial was registered at www.clinicaltrials.gov as #NCT00417911.

  • 19.
    Mellqvist, Ulf-Henrik
    et al.
    Sahlgrens University Hospital.
    Westin, Jan
    Rigshosp, Copenhagen, Denmark .
    Hjertner, Oyvind
    St Olavs Hospital.
    Lenhoff, Stig
    Lund University Hospital.
    Laane, Edward
    North Estonian Regional Hospital.
    Remes, Kari
    Turku University.
    Steingrimsdottir, Hlif
    Landspitali University Hospital.
    Abildgaard, Niels
    Odense University Hospital.
    Ahlberg, Lucia
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Onkologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Hematologiska kliniken US.
    Carlsson, Kristina
    University of North Norway.
    Forsberg, Karin
    Norrlands University Hospital.
    Gedde-Dahl, Tobias
    University Hospital, Rikshosp, Oslo, Norway .
    Gregersen, Henrik
    Aalborg Hospital.
    Gruber, Astrid
    Karolinska Institute.
    Guldbrandsen, Nina
    Ullevaal University Hospital.
    Haukas, Einar
    Stavanger University Hospital.
    Linder, Olle
    Orebro University Hospital.
    Nahi, Hareth
    Karolinska University Hospital.
    Nesthus, Ingerid
    Haukeland Hospital.
    Toffner-Clausen, Nilsaage
    Amtsygehuset Herlev, Copenhagen, Denmark .
    Silvennoinen, Raija
    Tampere University Hospital.
    Frost Andersen, Niels
    Aarhus University Hospital.
    Turesson, Ingemar
    Malmö University Hospital.
    Waage, Anders
    St Olavs University Hospital.
    Improved Response Rate with Bortezomib Consolidation After High Dose Melphalan: First Results of a Nordic Myeloma Study Group Randomized Phase III Trial in BLOOD, vol 114, issue 22, pp 221-2212009Ingår i: BLOOD, American Society of Hematology , 2009, Vol. 114, nr 22, s. 221-221Konferensbidrag (Refereegranskat)
    Abstract [en]

    n/a

  • 20.
    Mylin, Anne K.
    et al.
    University of Copenhagen, Denmark.
    Goetze, Jens P.
    University of Copenhagen, Denmark.
    Heickendorff, Lene
    Aarhus University Hospital, Denmark.
    Ahlberg, Lucia
    Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Hematologiska kliniken US. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten.
    Marie Dahl, Inger
    University of Tromso Hospital, Norway.
    Abildgaard, Niels
    Odense University Hospital, Denmark.
    Gimsing, Peter
    University of Copenhagen, Denmark.
    N-terminal pro-C-type natriuretic peptide in serum associated with bone destruction in patients with multiple myeloma2015Ingår i: Biomarkers in Medicine, ISSN 1752-0363, E-ISSN 1752-0371, Vol. 9, nr 7, s. 679-689Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To examine whether N-terminal proCNP concentrations in serum is associated with bone destruction in patients with multiple myeloma. Materials and methods: N-terminal proCNP and biochemical bone markers were measured in 153 patients. Radiographic bone disease and skeletal-related events were evaluated at specific time-points. Results: N-terminal proCNP concentrations increased with age. High N-terminal proCNP concentrations were associated with high-risk disease and renal impairment. Renal function explained 22% of the variation. N-terminal proCNP concentrations correlated with serum bone ALP and serum PINP, but lacked association with bone resorption markers, radiographic bone disease and skeletal-related events. Conclusion: Serum N-terminal proCNP are associated with bone formation activity in patients with multiple myeloma, but should be interpreted with caution in patients with renal impairment.

  • 21.
    Rosengren, S
    et al.
    Uppsala University Hospital.
    Ahlberg, Lucia
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Onkologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Hematologiska kliniken US.
    Forsberg, K
    Umeå University Hospital.
    Lenhoff, S
    Lund University Hospital.
    Mellqvist, U
    Sahlgrenska University Hospital.
    Nahi, H
    Karolinska University Hospital.
    Carlson, K
    OUTCOME OF AUTOLOGOUS STEM CELL TRANSPLANTATION FOR AL-AMYLOIDOSIS IN SWEDEN in HAEMATOLOGICA-THE HEMATOLOGY JOURNAL, vol 95, issue , pp 393-3932010Ingår i: HAEMATOLOGICA-THE HEMATOLOGY JOURNAL, Pensiero Scientifico / Ferrata Storti Foundation , 2010, Vol. 95, s. 393-393Konferensbidrag (Refereegranskat)
    Abstract [en]

    n/a

  • 22.
    Rosengren, S.
    et al.
    University of Uppsala Hospital, Sweden.
    Mellqvist, U-H
    South Elvsborg Hospital, Sweden.
    Nahi, H.
    Karolinska Institute, Sweden.
    Forsberg, K.
    Norrlands University Hospital, Sweden.
    Lenhoff, S.
    Skåne University Hospital, Sweden.
    Strömberg, O.
    Karolinska Institute, Sweden.
    Ahlberg, Lucia
    Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Hematologiska kliniken US.
    Linder, O.
    Örebro University Hospital, Sweden.
    Carlson, K.
    University of Uppsala Hospital, Sweden.
    Outcome of AL amyloidosis after high-dose melphalan and autologous stem cell transplantation in Sweden, long-term results from all patients treated in 1994-20092016Ingår i: BONE MARROW TRANSPLANTATION, ISSN 0268-3369, Vol. 51, nr 12, s. 1569-1572Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    High-dose melphalan and autologous stem cell transplantation (HDM/ASCT) is widely used in immunoglobulin light chain (AL) amyloidosis, but the benefit is debated mainly because of the high treatment-related mortality (24% in a randomised study comparing HDM/ASCT with oral melphalan/dexamethasone). We report here on the long-term outcome of all patients treated with HDM/ASCT for AL amyloidosis in Sweden between 1994 and 2009. Seventy-two patients were treated at eight Swedish centres. Median follow-up was 67.5 months. At least partial response (organ or haematological) was seen in 64% of the patients. Median overall survival was 98 months or 8.2 years, with 5-year survival 63.9% and 10-year survival 43.4%. In patients with cardiac involvement or multiple organ involvement, survival was significantly shorter, median overall survival 49 and 56 months, respectively. All mortality within 100 days from ASCT was 12.5% for all patients and 17.2% in the patients with cardiac involvement. For patients treated in the earlier time period (1994-2001), 100-day mortality was 23.8% compared with 7.8% in the later period (2002-2009). In conclusion, long survival times can be achieved in patients with AL amyloidosis treated with HDM/ ASCT, also in smaller centres. Early mortality is high, but with a decreasing trend over time.

  • 23.
    Terpos, Evangelos
    et al.
    Univ Athens, Greece.
    Katodritou, Eirini
    Theagen Canc Ctr, Greece.
    de la Rubia, Javier
    Univ Catolica Valencia, Spain.
    Hungria, Vania
    Theagen Canc Ctr, Greece; Ctr Estudos Hemoctr Santa Casa Sao Paolo, Brazil.
    Hulin, Cyrille
    CHU Bordeaux, France.
    Roussou, Maria
    Univ Athens, Greece.
    Delforge, Michel
    Univ Hosp Leuven, Belgium.
    Bries, Greet
    AZ Turnhout, Belgium.
    Stoppa, Anne-Marie
    Inst Paoli Calmettes, France.
    Aagesen, Jesper
    Ryhov Cty Hosp, Sweden.
    Sargin, Deniz
    Istanbul Univ, Turkey.
    Belch, Andrew
    Cross Canc Inst, Canada.
    Ahlberg, Lucia
    Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Hematologiska kliniken US.
    Diels, Joris
    Janssen Res and Dev, Belgium.
    Olie, Robert A.
    Janssen Cilag AG, Switzerland.
    Robinson, Don Jr.
    Janssen Global Serv, NJ USA.
    Spencer, Mike
    Janssen Cilag UK, England.
    Potamianou, Anna
    Janssen Cilag Pharmaceut SACI, Greece.
    van de Velde, Helgi
    Janssen Res and Dev, Belgium; Millennium Pharmaceut Inc, MA USA.
    Dimopoulos, Meletios A.
    Univ Athens, Greece.
    Bortezomib-based therapy for relapsed/refractory multiple myeloma in real-world medical practice2018Ingår i: European Journal of Haematology, ISSN 0902-4441, E-ISSN 1600-0609, Vol. 101, nr 4, s. 556-565Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The efficacy and safety of bortezomib-based therapy for relapsed/refractory multiple myeloma (RRMM) in clinical trials may differ from the oncology practice experience. The electronic VELCADE (R) OBservational Study was designed to prospectively evaluate bortezomib for multiple myeloma (MM) in real-world medical practice. Method: Patients scheduled to receive intravenous bortezomib for MM were eligible. The primary objective was to evaluate clinical outcomes, including response, time to response, time to next therapy, treatment-free interval, progression-free survival (PFS), and overall survival (OS). Secondary objectives included safety and healthcare resource utilization. Results: In total, 873 patients with a median of two therapy lines prior to initiating bortezomib were included. The overall response rate (amp;gt;= partial response) was 69%, including 37% complete response/near-complete response. Median time to response was 1.8 months, median time to next therapy was 9.7 months, and median treatment-free interval was 7.9 months. After 22.6 months median follow-up, median PFS was 12.0 months and median OS was 36.1 months. The most common adverse events (AEs) were neuropathy not otherwise specified (19%), diarrhea NOS, and thrombocytopenia (each 17%); 230 (26%) patients discontinued bortezomib due to AEs. Of 689 (79%) patients without baseline peripheral neuropathy (PN), the rate of new-onset any-grade PN increased to 51% (12% grade 3/4) by cycle 8. Overall, 244 (28%) patients were hospitalized, 372 (43%) attended an outpatient visit, and 341 (39%) underwent a diagnostic/therapeutic procedure during bortezomib treatment. Conclusion: These prospective real-world data demonstrate the effectiveness and safety of bortezomib-based therapy for RRMM and confirm high response rates and long OS for this population.

  • 24.
    Waage, Anders
    et al.
    NTNU.
    Gimsing, Peter
    Rigshospital, Copenhagen.
    Fayers, Peter
    Norwegian University Science and Technology.
    Abildgaard, Niels
    Odense University Hospital.
    Ahlberg, Lucia
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Onkologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Hematologiska kliniken US.
    Bjorkstrand, Bo
    Karolinska University Hospital.
    Carlson, Kristina
    University Uppsala Hospital.
    Dahl, Inger Marie
    University Tromso Hospital.
    Forsberg, Karin
    Norrland University Hospital.
    Gulbrandsen, Nina
    University of Oslo.
    Haukas, Einar
    Stavanger University Hospital.
    Hjertner, Oyvind
    Norwegian University Science and Technology.
    Hjorth, Martin
    Lidkoping Hospital.
    Karlsson, Torbjorn
    Capio Sankt Gorans Hospital.
    Meldgaard Knudsen, Lene
    Herlev Hospital.
    Lanng Nielsen, Johan
    Aarhus University Hospital.
    Linder, Olle
    Orebro University Hospital.
    Mellqvist, Ulf-Henrik
    Sahlgrens University Hospital.
    Nesthus, Ingerid
    Haukeland Hospital.
    Rolke, Jurgen
    Kristiansand Hospital.
    Strandberg, Maria
    Sundsvalls Hospital.
    Wisloff, Finn
    University of Oslo.
    Juliusson, Gunnar
    Lund University Hospital.
    Turesson, Ingemar
    Malmo University Hospital.
    Melphalan and prednisone plus thalidomide or placebo in elderly patients with multiple myeloma2010Ingår i: BLOOD, ISSN 0006-4971, Vol. 116, nr 9, s. 1405-1412Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In this double-blind, placebo-controlled study, 363 patients with untreated multiple myeloma were randomized to receive either melphalan-prednisone and thalidomide (MPT) or melphalan-prednisone and placebo (MP). The dose of melphalan was 0.25 mg/kg and prednisone was 100 mg given daily for 4 days every 6 weeks until plateau phase. The dose of thalidomide/placebo was escalated to 400 mg daily until plateau phase and thereafter reduced to 200 mg daily until progression. A total of 357 patients were analyzed. Partial response was 34% and 33%, and very good partial response or better was 23% and 7% in the MPT and MP arms, respectively (P andlt; .001). There was no significant difference in progression-free or overall survival, with median survival being 29 months in the MPT arm and 32 months in the MP arm. Most quality of life outcomes improved equally in both arms, apart from constipation, which was markedly increased in the MPT arm. Constipation, neuropathy, non-neuropathy neurologic toxicity, and skin reactions were significantly more frequent in the MPT arm. The number of thromboembolic events was equal in the 2 treatment arms. In conclusion, MPT had a significant antimyeloma effect, but this did not translate into improved survival. This trial was registered at www.clinicaltrials.gov as #NCT00218855.

  • 25.
    Zervas, K.
    et al.
    Theagene Anticancer Hospital.
    Katodritou, E.
    Theagen Cancer Centre.
    Delforge, M.
    University Hospital Leuven.
    de Samblanx, H.
    ZNA Middelheim.
    Sargin, D.
    Istanbul University.
    Hulin, C.
    University Nancy Brabois.
    Ahlberg, Lucia
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Onkologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Hematologiska kliniken US.
    de la Rubia, J.
    Hospital La Fe.
    Abdulkadyrov, K.
    Russian Science Research Institute.
    Ganguly, R.
    Johnson & Johnson Pharmaceutical.
    Diels, J.
    Johnson & Johnson Pharmaceutical.
    Dhawan, R.
    Johnson & Johnson Pharmaceutical.
    PATIENT RESPONSE TO BORTEZOMIB IN RELAPSED/REFRACTORY MULTIPLE MYELOMA: INTERIM RESULTS FROM AN OBSERVATIONAL STUDY2009Ingår i: in HAEMATOLOGICA-THE HEMATOLOGY JOURNAL, vol 94, 2009, Vol. 94, s. 1591-Konferensbidrag (Refereegranskat)
    Abstract [en]

    n/a

1 - 25 av 25
RefereraExporteraLänk till träfflistan
Permanent länk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf