WBLDCT at effective doses lower than previously reported, is superior to SS at detecting osteolytic lesions and at determining overall stage of multiple myeloma, and provides complementary information to WBMRI.
Standard teicoplanin dosing regimens should be used with caution in patients with haematological malignancy. Bodyweight, CLCR and serum albumin concentration are important considerations for appropriate dosing.
19Objectives: To describe the population pharmacokinetics of teicoplanin in adult haematological 20 malignancy patients receiving higher than standard doses and to perform Monte Carlo simulations 21 to determine dosing regimens associated with optimal teicoplanin concentrations. 22Methods: This was a hospital-based clinical trial (EudraCT 2013-004535-72). Nine blood samples 23 were collected on Day 3, plus single trough samples on Days 7 and 10, and 24 and 48 h post last 24 dose. Teicoplanin minimum inhibitory concentrations were determined for Gram-positive isolates 25 from study patients. Population pharmacokinetic analyses and Monte Carlo dosing simulations were 26 undertaken using Pmetrics®. 27Results: Thirty adult haematological malignancy patients were recruited with a mean (SD) loading 28 dose, age, total body weight and creatinine clearance of 9.5 (1.9) mg/kg, 63 (12) that administering five loading doses 12-h, stratified by total body weight and creatinine clearance, 36 increased the probability of achieving target concentrations within 72 h. 37Conclusions: To increase the number of patients achieving optimal teicoplanin concentrations an 38 individualised dosing approach, based on body weight and creatinine clearance, is recommended. 39 40
SummaryThis retrospective analysis assessed the response, safety and duration of response to standard dose rituximab 375 mg/m 2 weekly for four weeks as therapy for patients with primary or secondary warm autoimmune haemolytic anaemia (WAIHA), who had failed initial treatment. Thirty-four patients received rituximab for WAIHA in seven centres in the Republic of Ireland. The overall response rate was 70Á6% (24/34) with 26Á5% (9/34) achieving a complete response (CR). The time to response was 1 month post-initiation of rituximab in 87Á5% (21/24) and 3 months in 12Á5% (3/24) of patients. The median duration of follow-up was 36 months (range 6-90 months). Of the patients who responded, 50% (12/24) relapsed during follow up with a median time to next treatment of 16Á5 months (range 6-60 months). Three patients were re-treated with rituximab 375 mg/m2 weekly for four weeks at relapse and responded.There was a single episode of neutropenic sepsis. Rituximab is an effective and safe treatment for WAIHA but a significant number of patients will relapse in the first two years post treatment. Re-treatment was effective in a small number of patients, suggesting that intermittent pulse treatment or maintenance treatment may improve long-term response.
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