@article{ProetelPletschLausekeretal.2014, author = {Proetel, Ulrike and Pletsch, Nadine and Lauseker, Michael and M{\"u}ller, Martin C. and Hanfstein, Benjamin and Krause, Stefan W. and Kalmanti, Lida and Schreiber, Annette and Heim, Dominik and Baerlocher, Gabriela M. and Hofmann, Wolf-Karsten and Lange, Elisabeth and Einsele, Hermann and Wernli, Martin and Kremers, Stephan and Schlag, Rudolf and M{\"u}ller, Lothar and H{\"a}nel, Mathias and Link, Hartmut and Hertenstein, Bernd and Pfirrmann, Markus and Hochhaus, Andreas and Hasford, Joerg and Hehlmann, R{\"u}diger and Saußele, Susanne}, title = {Older patients with chronic myeloid leukemia (≥65 years) profit more from higher imatinib doses than younger patients: a subanalysis of the randomized CML-Study IV}, series = {Annals of Hematology}, volume = {93}, journal = {Annals of Hematology}, number = {7}, issn = {0939-5555}, doi = {10.1007/s00277-014-2041-0}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-121574}, pages = {1167-76}, year = {2014}, abstract = {The impact of imatinib dose on response rates and survival in older patients with chronic myeloid leukemia in chronic phase has not been studied well. We analyzed data from the German CML-Study IV, a randomized five-arm treatment optimization study in newly diagnosed BCR-ABL-positive chronic myeloid leukemia in chronic phase. Patients randomized to imatinib 400 mg/day (IM400) or imatinib 800 mg/day (IM800) and stratified according to age (≥65 years vs. <65 years) were compared regarding dose, response, adverse events, rates of progression, and survival. The full 800 mg dose was given after a 6-week run-in period with imatinib 400 mg/day. The dose could then be reduced according to tolerability. A total of 828 patients were randomized to IM400 or IM800. Seven hundred eighty-four patients were evaluable (IM400, 382; IM800, 402). One hundred ten patients (29 \%) on IM400 and 83 (21 \%) on IM800 were ≥65 years. The median dose per day was lower for patients ≥65 years on IM800, with the highest median dose in the first year (466 mg/day for patients ≥65 years vs. 630 mg/day for patients <65 years). Older patients on IM800 achieved major molecular remission and deep molecular remission as fast as younger patients, in contrast to standard dose imatinib with which older patients achieved remissions much later than younger patients. Grades 3 and 4 adverse events were similar in both age groups. Five-year relative survival for older patients was comparable to that of younger patients. We suggest that the optimal dose for older patients is higher than 400 mg/day. ClinicalTrials.gov identifier: NCT00055874}, language = {en} } @article{TrudzinskiMinkoRappetal.2016, author = {Trudzinski, Franziska C. and Minko, Peter and Rapp, Daniel and F{\"a}hndrich, Sebastian and Haake, Hendrik and Haab, Myriam and Bohle, Rainer M. and Flaig, Monika and Kaestner, Franziska and Bals, Robert and Wilkens, Heinrike and Muellenbach, Ralf M. and Link, Andreas and Groesdonk, Heinrich V. and Lensch, Christian and Langer, Frank and Lepper, Philipp M.}, title = {Runtime and aPTT predict venous thrombosis and thromboembolism in patients on extracorporeal membrane oxygenation: a retrospective analysis}, series = {Annals of Intensive Care}, volume = {6}, journal = {Annals of Intensive Care}, doi = {10.1186/s13613-016-0172-2}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-164455}, pages = {66}, year = {2016}, abstract = {Background Even though bleeding and thromboembolic events are major complications of extracorporeal membrane oxygenation (ECMO), data on the incidence of venous thrombosis (VT) and thromboembolism (VTE) under ECMO are scarce. This study analyzes the incidence and predictors of VTE in patients treated with ECMO due to respiratory failure. Methods Retrospective analysis of patients treated on ECMO in our center from 04/2010 to 11/2015. Patients with thromboembolic events prior to admission were excluded. Diagnosis was made by imaging in survivors and postmortem examination in deceased patients. Results Out of 102 screened cases, 42 survivors and 21 autopsy cases [mean age 46.0 ± 14.4 years; 37 (58.7 \%) males] fulfilling the above-mentioned criteria were included. Thirty-four patients (54.0 \%) underwent ECMO therapy due to ARDS, and 29 patients (46.0 \%) with chronic organ failure were bridged to lung transplantation. Despite systemic anticoagulation at a mean PTT of 50.6 ± 12.8 s, [VT/VTE 47.0 ± 12.3 s and no VT/VTE 53.63 ± 12.51 s (p = 0.037)], VT and/or VTE was observed in 29 cases (46.1 \%). The rate of V. cava thrombosis was 15/29 (51.7 \%). Diagnosis of pulmonary embolism prevailed in deceased patients [5/21 (23.8 \%) vs. 2/42 (4.8 \%) (p = 0.036)]. In a multivariable analysis, only aPTT and time on ECMO predicted VT/VTE. There was no difference in the incidence of clinically diagnosed VT in ECMO survivors and autopsy findings. Conclusions Venous thrombosis and thromboembolism following ECMO therapy are frequent. Quality of anticoagulation and ECMO runtime predicted thromboembolic events. "}, language = {en} }