Selinexor, an oral selective inhibitor of nuclear export, was evaluated in the Phase 2b SADAL study in patients with diffuse large B-cell lymphoma (DLBCL) who previously received two to five prior ...systemic regimens. In post hoc analyses, we analyzed several categories of patient characteristics (age, renal function, DLBCL subtype, absolute lymphocyte count, transplant status, number of prior lines of therapy, refractory status, Ann Arbor disease stage, and lactate dehydrogenase) at baseline, i.e., during screening procedures, to determine their potential contributions to the efficacy (overall response rate ORR, duration of response DOR, overall survival OS) and tolerability of selinexor. Across most categories of characteristics, no significant difference was observed in ORR or DOR. OS was significantly longer for patients < 65 vs. ≥ 65 years, and for those with lymphocyte counts ≥ 1000/µL vs. < 1000/µL or lactate dehydrogenase ≤ ULN vs. > ULN. The most common adverse events (AEs) across the characteristics were thrombocytopenia and nausea, and similar rates of grade 3 AEs and serious AEs were observed. With its oral administration, novel mechanism of action, and consistency in responses in heavily pretreated patients, selinexor may help to address an important unmet clinical need in the treatment of DLBCL.
Background. Sinusoidal obstructive syndrome (SOS) is a potentially fatal complication secondary to hematopoietic stem cell transplant (HSCT) conditioning. Endothelial damage plasma biomarkers such as ...plasminogen activator inhibitor-1 (PAI-1), hyaluronic acid (HA), and vascular adhesion molecule-1 (VCAM1) represent potential diagnostic tools for SOS. Methods. We prospectively collected serial citrated blood samples (baseline, day 0, day 7, and day 14) in all adult patients undergoing HSCT at La Paz Hospital, Madrid. Samples were later analyzed by ELISA (enzyme-linked immunosorbent assay) for HA, VCAM1, and PAI-1 concentrations. Results. During sixteen months, we prospectively recruited 47 patients. Seven patients (14%) were diagnosed with SOS according to the EBMT criteria for SOS/VOD diagnosis and received treatment with defibrotide. Our study showed a statistically significant elevation of HA on day 7 in SOS patients, preceding clinical SOS diagnosis, with a sensitivity of 100%. Furthermore, we observed a significant increase of HA and VCAM1 levels on day 14. Regarding risk factors, we observed a statistically significant association between SOS diagnosis and the fact that patients received 3 or more previous lines of treatment before HSCT. Conclusions. The early significant increase in HA levels observed opens the door to a noninvasive peripheral blood test which could have the potential to improve diagnosis and facilitate prophylactic and therapeutic management of SOS before clinical/histological damage is established.
Han pasado cuatro décadas desde que, en 1983, el sociólogo boliviano Fernando Calderón publicó su estudio inaugural sobre la “política en las calles” para referirse a una forma de política por fuera ...de lo institucional y que implicaba la acción colectiva de actores sociales considerados tradicionalmente “no políticos” (Calderón, 1983) —como el campesinado y el mundo indígena— en la ciudad de Cochabamba durante dos décadas (1950-1970). Cuatro años después, el mismo Calderón publicó, al alero de Clacso, su hoy clásico libro compilado Movimientos sociales ante la crisis (Calderón, 1986), en el que se constata la relevancia de los movimientos sociales en periodos de inestabilidad social y autoritarismo político. Algunos años antes, en Europa, Alain Touraine, junto a un equipo de investigadores asociados al Centro de Análisis y de Intervención Sociológicos (CADIS) en Francia, estudiaron la presencia de los movimientos sociales como actores que producen y disputan la configuración de la sociedad. Allí, Touraine desarrolló una teoría de la acción social que tenía en su centro a lo que después se denominó “nuevos movimientos sociales”, con lo cual se abre a estudiar no solo las clases sociales, sino también las luchas urbanas, estudiantiles, y de mujeres, entre otras.
A través de más de 100 referencias bibliográficas, de distintos países y en distintos idiomas, este artículo pretende 1) clarificar la definición de bullying y de acoso escolar; 2) abordar los roles ...que tienen lugar en el mismo (acosado, acosador, grupo de iguales, escuela, familia y sociedad/políticos/medios de comunicación); 3) presentar datos de la prevalencia del acoso escolar en distintos países y en distintos entornos culturales y, por último, 4) ofrecer un resumen de las propuestas de actuación generales en las que parecen coincidir todos los expertos sobre el tema.
En 1977 ve la luz el primer número de la revista Cuadernos de Sociología, promovida desde la Facultad de Sociología de la Universidad Santo Tomás. Hasta el 2011, la Revista se publicó ...ininterrumpidamente, excepto en 1996, 1997 y 1998. Bajo el amparo metodológico de un estudio de caso, antecedido por un trabajo de archivo y recuperación documental, se realizó un ejercicio de sistematización de la información de la Revista, con la que se generó una base de datos de 592 registros, que facilitó el análisis del contenido de los documentos. Para completar la recolección de información, se realizó una entrevista en profundidad a su fundador, Guillermo Páez Morales.Como resultados de la investigación, se obtuvo información acerca del contexto y las motivaciones del nacimiento de la Revista, su desarrollo (reflexiones publicadas, eventos, autores y autoras, y temas abordados) y las circunstancias que causaron que dejara de publicarse. Se destaca la fuerte participación femenina, tanto en la redacción de artículos, como en el proceso editorial. Más de la mitad de los artículos publicados corresponden al tipo reflexión, con énfasis en aspectos antropológicos y filosóficos, perspectivas políticas, reflexiones teóricas, reflexiones disciplinares o profundización en temas coyunturales. Temáticamente, hay un énfasis en la sociología política, la sociología urbana, el conflicto armado, la sociología de la familia y los estudios culturales.Como conclusiones, se plantean la importancia de la revista como herramienta para la generación de comunidad académica; su carácter divulgativo, según el cual priman los artículos de reflexión y, dentro de estos, los de reflexión sobre la sociología como ciencia social; la pertinencia de profundizar en los contenidos de la Revista desde un análisis hermenéutico, para trazar un paralelismo entre estos y el proceso de institucionalización de la sociología en Colombia; la relevancia de esta y otras revistas ya desaparecidas para hacer “sociología de la sociología”; y una propuesta para rescatar en las publicaciones y en los procesos de investigación el dinamismo, la creatividad y la espontaneidad que siempre ha acompañado a la sociología colombiana.
Mantle cell lymphoma (MCL) is considered a distinct type of B-cell lymphoma genetically characterized by the t(11;14) translocation and cyclin D1 overexpression. There is also a small subset of ...tumors negative for cyclin D1 expression that are morphologically and immunophenotypically indistinguishable from conventional MCL. Although in the last decades, the median overall survival of patients with MCL has improved significantly, it is still considered as one of the poorest prognoses diseases among B-cell lymphomas. Election of treatment for patients with MCL is complex due to the scarcity of solid evidence. Current available data shows that conventional chemotherapy does not yield satisfactory results as in other types of B-cell lymphomas. However, the role of other approaches such as autologous or allogenic stem cell transplantation, immunotherapy, the administration of consolidation or maintenance schedules, or the use of targeted therapies still lack clear indications. In view of this situation, the Spanish Group of Lymphomas/Autologous Bone Marrow Transplantation has conducted a series of reviews on different aspects of MCL, namely its diagnosis, prognosis, first-line and salvage treatment (both in young and elderly patients), new targeted therapies, and detection of minimal residual disease. On the basis of the available evidence, a series of recommendations have been issued with the intention of providing guidance to clinicians on the diagnosis, treatment, and monitoring of patients with MCL.
1 Complejo Hospitalario de Zamora
2 Hospital Marqués de Valdecilla, Santander
3 Hospital Duran i Reynals, LHospitalet de Llobregat
4 Hospital La Paz, Madrid
5 Hospital Juan Canalejo, La Coruña
6 ...Hospital Germans Trias i Pujol, Badalona
7 Hospital Dr. Peset, Valencia
8 Hospital del Mar, Barcelona
9 Hospital Clínico de Madrid
10 Hospital Universitario de Salamanca
11 Hospital Universitario de Getafe
12 Hospital Severo Ochoa, Leganés
13 Hospital General de Castellón
14 Hospital Virgen del Puerto, Plasencia
15 Hospital General de Jerez, Jerez de la Frontera
16 Hospital Carlos Haya, Málaga
17 Hospital Doce de Octubre, Madrid, Spain
Correspondence: Alejandro Martín, MD, PhD, Department of Hematology, Complejo Hospitalario de Zamora, Avenida de Requejo 35, Zamora 49022, Spain. E-mail: amartingar{at}aehh.org
Background: The role of re-treatment with rituximab in aggressive B-cell lymphomas still needs to be defined. This study evaluated the influence of prior exposure to rituximab on response rates and survival in patients with diffuse large B-cell lymphoma treated with rituximab plus etoposide, cytarabine, cisplatinum and methylprednisolone (R-ESHAP).
Design and Methods: We retrospectively analyzed 163 patients with relapsed or refractory diffuse large B-cell lymphoma who received R-ESHAP as salvage therapy with a curative purpose. Patients were divided into two groups according to whether rituximab had been administered (n=94, "R+" group) or not (n=69, "R-" group) prior to R-ESHAP.
Results: Response rates were significantly higher in the R- group in the univariate but not in the multivariate analysis. In the analysis restricted to the R+ group, we observed very low complete remission and overall response rates in patients with primary refractory disease (8% and 33%, respectively), as compared to those in patients who were in first partial remission (41% and 86%) or who had relapsed disease (50% and 75%) ( p <0.01 in both cases). Overall, 60% and 65% of patients in the R+ and R- groups, respectively, underwent stem-cell transplantation after the salvage therapy. With a median follow-up of 29 months (range, 6–84), patients in the R+ group had significantly worse progression-free survival (17% vs. 57% at 3 years, p <0.0001) and overall survival (38% v 67% at 3 years, p =0.0005) than patients in the R- group. Prior exposure to rituximab was also an independent adverse prognostic factor for both progression-free survival (RR: 2.0; 95% CI: 1.2–3.3, p =0.008) and overall survival (RR: 2.2; 95% CI: 1.3–3.9, p =0.004).
Conclusions: R-ESHAP was associated with a high response rate in patients who were not refractory to upfront rituximab-based chemotherapy. However, the survival outcome was poor for patients previously exposed to rituximab, as compared to in those who had not previously been treated with rituximab.
Key words: R-ESHAP, salvage therapy, diffuse large B-cell lymphoma, rituximab.
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