The addition of polatuzumab vedotin to bendamustine and rituximab (Pola-BR) has been shown to improve overall survival (OS) in stem cell transplant (SCT)-ineligible patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL). It is also increasingly used as bridging to CAR T-cell therapy (CAR-T). We retrospectively analysed the efficacy of Pola-BR in 133 patients at 28 UK institutions. Treatment intent was bridging to CAR-T for N=40, re-induction with planned SCT for N=13 and stand-alone treatment for N=78. The overall response rate (ORR) was 57.0% (complete response (CR) 32.8%). After median 7.7 months follow-up, median PFS and OS were 4.8 months and 8.2 months respectively. For stand-alone treatment shortened PFS was associated with bulk disease (>7.5cm) (HR 2.32 (95% CI 1.23-4.38), p=0.009), >1 prior treatment (HR 2.17 (95% CI 1.19-3.95), p=0.01) and refractoriness to the last treatment (HR 3.48 (95% CI 1.79-6.76), p<0.001). For CAR-T bridging the ORR was 42.1% (CR 18.4%) and for treatment after CAR-T failure the ORR was 43.8% (CR 18.8%). These data demonstrate efficacy for Pola-BR as a treatment for SCT-ineligible patients with R/R DLBCL, help to delineate which patients may benefit most, and provide preliminary evidence of efficacy as bridging to CAR-T and after CAR-T failure.
The objective of this study was to evaluate maternal temperature, heart rate, leukocyte count and C-reactive protein in the prediction of fetal bacteraemia and positive amniotic fluid cultures in 75 pregnancies complicated by preterm prelabor amniorrhexis. Cordocentesis and amniocentesis were performed and fetal blood and amniotic fluid were cultured for aerobic and anaerobic bacteria. Amniotic fluid was also cultured for Ureaplasma urealyticum and Mycoplasma hominis. Patients were classified into 3 groups: negative fetal blood and amniotic fluid cultures (group 1, n = 45); negative fetal blood but positive amniotic fluid cultures (group 2, n = 18), and positive fetal blood cultures (group 3, n = 12). In the groups with intrauterine infection compared to the non infected group, the median maternal temperature, leukocyte count and C-reactive protein were significantly higher. In groups 1, 2 and 3 the respective incidences of maternal pyrexia were 0, 7 and 16% and raised C-reactive protein 13, 28 and 33%. In pregnancies complicated by preterm prelabor amniorrhexis, maternal temperature, heart rate, leukocyte count and C-reactive protein do not provide sensitive prediction of intrauterine infection.
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