To define prognostic impact of EpsteinBarr virus (EBV) infection in diffuse large

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Key Points• Nilotinib plus multiagent chemotherapy was feasible and showed a comparable outcome to previous results with imatinib for Ph-pos ALL.• The achievement of deep MR with nilotinib at postremission correlated well with the clinical outcomes for Ph-pos ALL.We investigated the effects of nilotinib plus multiagent chemotherapy, followed by consolidation/maintenance or allogeneic hematopoietic cell transplantation (allo-HCT) for adult patients with newly diagnosed Philadelphia-positive (Ph-pos) acute lymphoblastic leukemia (ALL). Study subjects received induction treatment that comprised concurrent vincristine, daunorubicin, prednisolone, and nilotinib. After achieving complete hematologic remission (HCR), subjects received either 5 courses of consolidation, followed by 2-year maintenance with nilotinib, or allo-HCT. Minimal residual disease (MRD) was assessed at HCR, and every 3 months thereafter. The molecular responses (MRs) were defined as MR3 for BCR-ABL1/G6PDH ratios £10 23 and MR5 for ratios <10 25. Ninety evaluable subjects, ages 17 to 71 years, were enrolled in 17 centers. The HCR rate was 91%; 57 subjects received allo-HCT. The cumulative MR5 rate was 94%; the 2-year hematologic relapse-free survival (HRFS) rate was 72% for 82 subjects that achieved HCR, and the 2-year overall survival rate was 72%. Subjects that failed to achieve MR3 or MR5 were 9.1 times (P 5 .004) or 6.3 times (P 5 .001) more prone to hematologic relapse, respectively, than those that achieved MR3 or MR5. MRD statuses just before allo-HCT and at 3 months after allo-HCT were predictive of 2-year HRFS. Adverse events occurred mainly during induction, and most were reversible with dose reduction or transient interruption of nilotinib. The combination of nilotinib with high-dose cytotoxic drugs was feasible, and it effectively achieved high cumulative complete molecular remission and HRFS rates. The MRD status at early postremission time was predictive of the HRFS. This trial was registered at www.clinicaltrials.gov as #NCT00844298. (Blood. 2015;126(6):746-756)

EPSCC was identified in various sites, with the most common primary site being the uterine cervix. Regardless of the primary site or disease stage, EPSCC of sites other than cervix was usually a fatal disease with a discouraging outcome for various treatment modalities.

Although this entity of lymphoma appears to have a good prognosis, further clinical experience and long-term follow-up are needed to identify prognostic factors.

To achieve successful therapeutic outcomes in chronic myeloid leukemia (CML), continuous and adequate imatinib (Gleevec(®), Glivec(®), Novartis Pharmaceuticals, Basel, Switzerland) dosing is essential. Here, we report a patient counseling program ("Care club", "Happy club" in Korea) performed to improve patient compliance with imatinib. From January 2006 to December 2008, patients diagnosed with chronic phase CML and taking imatinb were eligible for this retrospective study. A total of 114 patients from 4 centers in Korea were recruited at a 50:50 ratio for Happy club group versus non-Happy club group at each center. During 36-month follow-up, persistency (the number of days of imatinib prescribed versus 1 year) was higher in the Happy club group (98.2 ± 0.03%) than in the non-Happy club group (79.3 ± 0.16%, P = 0.001), whereas dose compliance (miligrams of imatinib that were actually taken versus miligrams that should have been taken) was not different between two groups; 96.5 ± 0.6% and 96.6 ± 0.7% in the Happy club and non-Happy club (P = 0.958). Overall compliance (the product of persistency and dose compliance) improved in the Happy club group (93.0 ± 2.3%) compared with the non-Happy club group (76.2 ± 7.4%, P = 0.001). The patient counseling program was efficient especially in patients who needed high-dose imatinib (>400 mg/day), and overall compliance was 87.8 ± 6.0% in the Happy club group versus 65.5 ± 16.1% in the non-Happy club group (P = 0.017). In conclusion, the patient counseling program was effective in persisting imatinib medication, resulting in the improvement of overall compliance.