Auris Huen

Myelosuppression and Serotonin Syndrome Associated with Concurrent Use of Linezolid and Selective Serotonin Reuptake Inhibitors in Bone Marrow Transplant Recipients

We report 2 cases of serotonin syndrome and myelosuppression in bone marrow transplant recipients who received linezolid in combination with a selective serotonin reuptake inhibitor (SSRI). Given the risks to patients in this high-risk group, we recommend that this combination of medications be avoided if alternative antibiotic therapy is possible. If no alternative therapy is possible, prescribers should discontinue SSRI therapy and monitor these patients closely for evidence of serotonin syndrome or the development of hematological toxicity.

Hydrochlorothiazide and cutaneous T cell lymphoma: Prospective analysis and case series

Mycosis fungoides (MF) and leukemic Sézary syndrome (SS) are the most common cutaneous T cell lymphomas (CTCL), but their etiology remains unknown. After patients were observed with hydrochlorothiazide (HCTZ)‐associated CTCL, HCTZ was examined as a putative chronic antigen in a cohort of prospectively staged patients.

Incidence and risk factors of venous Thromboembolic events in lymphoma

BACKGROUND Cancer patients are at increased risk of venous thromboembolism; however, the incidence and risk factors for venous thromboembolism in lymphoma patients are not well defined. METHODS Medical records of 422 newly referred lymphoma patients at our institution were reviewed over 2-year follow-up for all venous thromboembolism events and potential risk factors. Multivariate logistic regression model was used to identify risk factors predictive of venous thromboembolism. RESULTS Among 422 patients, 72 (17.1 %) had 80 new episodes of venous thromboembolism: 59 had deep vein thrombosis, 17 had pulmonary embolism, and 4 had combined deep vein thrombosis and pulmonary embolism. Only 18 of 422 patients (4.3%) were on thromboprophylaxis at baseline. Interestingly, 64% (51/80) of the episodes occurred by the third cycle of chemotherapy. By multivariate logistic regression, female sex (odds ratio [OR] 3.51, P=.001), high hemoglobin (OR 1.26, P=.020), high serum creatinine (OR 3.23, P=.009), and doxorubicin- or methotrexate-based chemotherapy (OR 3.47, P=0.003) were important risk factors for new venous thromboembolism. CONCLUSIONS Lymphoma patients are at high risk for venous thromboembolism in the initial cycles of chemotherapy; the risk was higher for women, patients with elevated hemoglobin or creatinine, or those receiving doxorubicin or methotrexate. Future studies might focus on validation of these risk factors to identify the high-risk cohort and the potential role of thromboprophylaxis, particularly during initial cycles of chemotherapy.

Brentuximab Vedotin for Patients With Refractory Lymphomatoid Papulosis: An Analysis of Phase 2 Results

Importance Brentuximab vedotin is a monomethyl auristatin E–conjugated monoclonal antibody directed against CD30. It represents a potential treatment for the CD30+ lymphoproliferative disorder lymphomatoid papulosis (LyP), which currently has no approved treatment. Objective To assess the efficacy and safety of brentuximab vedotin for the treatment of LyP. Design, Setting, and Participants In this study conducted at The University of Texas MD Anderson Cancer Center from May 10, 2011, to March 31, 2017, a total of 12 patients with LyP received brentuximab vedotin. All patients were 18 years or older with a diagnosis of LyP and were also required to have scarring, more than 10 lesions, or active lesions on the face, hands, or feet. Nine patients were enrolled in a physician-initiated, open-label, single-center, phase 2 clinical trial of brentuximab vedotin for CD30+ cutaneous T-cell lymphomas and LyP from 2011 to 2013. Three patients were later treated outside of the trial from 2013 to 2017. Five patients continued to be followed up as of March 2017. Interventions Intravenous brentuximab vedotin 1.8 mg/kg infused over 30 minutes every 21 days. Main Outcomes and Measures The primary end point was the overall response rate. Complete response was defined as zero lesions, and partial response was defined as a 50% or greater reduction in lesion count from baseline. A relapse was defined as loss of partial response. Results All 12 patients (8 men and 4 women; median age, 46 years) responded to brentuximab vedotin, and 7 exhibited a complete response. Time to response was 3 weeks in all patients. The median duration of response was 20 weeks (range, 6-103 weeks). For 5 patients who relapsed, the median time to relapse was 12 weeks (range, 6-41 weeks). One patient who relapsed was retreated and has remained in partial response for more than 23 months. Grade 1 to 2 neuropathy occurred in 10 patients but resolved in 5. Adverse events of grade 3 or higher were neutropenia (n = 2) and dizziness/vertigo (n = 1). Three patients withdrew owing to adverse events. Conclusions and Relevance Brentuximab vedotin is effective in treating LyP (overall response rate, 100%; complete response rate, 58%), but its use should be reserved for patients with truly severe and refractory LyP. More work is needed to optimize its dosing to minimize adverse events, such as peripheral neuropathy. Trial Registration clinicaltrials.gov Identifier: NCT01352520

Aerosolized Ribavirin—Induced Reversible Hepatotoxicity in a Hematopoietic Stem Cell Transplant Recipient with Hodgkin Lymphoma

We describe a case of acute hepatic toxicity associated with aerosolized ribavirin in a bone marrow transplant recipient with documented respiratory syncytial virus infection. The temporal relationship with drug administration and the liver biopsy results suggested drug-induced hepatic injury. As the use of aerosolized ribavirin to treat respiratory syncytial virus infections continues, it is imperative that careful attention be paid to possible adverse effects of therapy in the high-risk population of immunosuppressed patients.

Quality of Life in Cutaneous T-cell Lymphoma Patients Treated with the Anti-CCR4 Monoclonal Antibody Mogamulizumab versus Vorinostat: Results from MAVORIC

NHL-265 Quality of Life in Cutaneous T-cell Lymphoma Patients Treated with the Anti-CCR4 Monoclonal Antibody Mogamulizumab versus Vorinostat: Results from MAVORIC Auris Huen , Pierluigi Porcu, Stacie Hudgens, Pietro Quaglino, Richard Cowan, Lysbeth Floden, Athanasios Tsianakas, Mollie Leoni, Stephen Dale, Madeline Duvic MD Anderson Cancer Center, Houston, Texas, United States; Thomas Jefferson University, Philadelphia, Pennsylvania, United States; Clinical Outcomes Solutions, Tucson, Arizona, United States; University of Turin, Turin, Italy; Christie Hospital Foundation, Manchester, United Kingdom; Specialist Clinic Bad Bentheim, Bad Bentheim, Germany; Kyowa Kirin Pharmaceutical Development, Inc., Princeton, New Jersey, United States