Medicine (St Vincent's) - Research Publications

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    COVID-19 vaccination in haematology patients: an Australian and New Zealand consensus position statement
    McCaughan, G ; Di Ciaccio, P ; Ananda-Rajah, M ; Gilroy, N ; MacIntyre, R ; Teh, B ; Weinkove, R ; Curnow, J ; Szer, J ; Enjeti, AK ; Ross, DM ; Mulligan, S ; Trotman, J ; Dickinson, M ; Quach, H ; Choi, P ; Polizzotto, MN ; Tam, CS ; Ho, PJ ; Ku, M ; Gregory, G ; Gangatharan, S ; Hapgood, G ; Cochrane, T ; Cheah, C ; Gibbs, S ; Wei, A ; Johnston, A ; Greenwood, M ; Prince, HM ; Latimer, M ; Berkahn, L ; Wight, J ; Armytage, T ; Hamad, N (WILEY, 2021-05-01)
    Australia and New Zealand have achieved excellent community control of COVID-19 infection. In light of the imminent COVID-19 vaccination roll out in both countries, representatives from the Haematology Society of Australia and New Zealand and infectious diseases specialists have collaborated on this consensus position statement regarding COVID-19 vaccination in patients with haematological disorders. It is our recommendation that patients with haematological malignancies, and some benign haematological disorders, should have expedited access to high-efficacy COVID-19 vaccines, given that these patients are at high risk of morbidity and mortality from COVID-19 infection. Vaccination should not replace other public health measures in these patients, given that the effectiveness of COVID-19 vaccination, specifically in patients with haematological malignancies, is not known. Given the limited available data, prospective collection of safety and efficacy data of COVID-19 vaccination in this patient group is a priority.
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    Australian and New Zealand consensus statement on the management of lymphoma, chronic lymphocytic leukaemia and myeloma during the COVID-19 pandemic
    Di Ciaccio, P ; McCaughan, G ; Trotman, J ; Ho, PJ ; Cheah, CY ; Gangatharan, S ; Wight, J ; Ku, M ; Quach, H ; Gasiorowski, R ; Polizzotto, MN ; Prince, HM ; Mulligan, S ; Tam, CS ; Gregory, G ; Hapgood, G ; Spencer, A ; Dickinson, M ; Latimer, M ; Johnston, A ; Armytage, T ; Lee, C ; Cochrane, T ; Berkhahn, L ; Weinkove, R ; Doocey, R ; Harrison, SJ ; Webber, N ; Lee, H-P ; Chapman, S ; Campbell, BA ; Gibbs, SDJ ; Hamad, N (WILEY, 2020-05-15)
    The COVID-19 pandemic poses a unique challenge to the care of patients with haematological malignancies. Viral pneumonia is known to cause disproportionately severe disease in patients with cancer, and patients with lymphoma, myeloma and chronic lymphocytic leukaemia are likely to be at particular risk of severe disease related to COVID-19. This statement has been developed by consensus among authors from Australia and New Zealand. We aim to provide supportive guidance to clinicians making individual patient decisions during the COVID-19 pandemic, in particular during periods that access to healthcare resources may be limited. General recommendations include those to minimise patient exposure to COVID-19, including the use of telehealth, avoidance of non-essential visits and minimisation of time spent by patients in infusion suites and other clinical areas. This statement also provides recommendations where appropriate in assessing indications for therapy, reducing therapy-associated immunosuppression and reducing healthcare utilisation in patients with specific haematological malignancies during the COVID-19 pandemic. Specific decisions regarding therapy of haematological malignancies will need to be individualised, based on disease risk, risks of immunosuppression, rates of community transmission of COVID-19 and available local healthcare resources.
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    Zanubrutinib (BGB-3111) plus obinutuzumab in patients with chronic lymphocytic leukemia and follicular lymphoma
    Tam, CS ; Quach, H ; Nicol, A ; Badoux, X ; Rose, H ; Prince, HM ; Leahy, MF ; Eek, R ; Wickham, N ; Patil, SS ; Huang, J ; Prathikanti, R ; Cohen, A ; Elstrom, R ; Reed, W ; Schneider, J ; Flinn, IW (ELSEVIER, 2020-10-13)
    Zanubrutinib (BGB-3111) is a next-generation Bruton tyrosine kinase inhibitor designed to be more selective with fewer off-target effects. We conducted a phase 1 study to assess the safety of its combination with obinutuzumab and evaluate early efficacy in 81 patients with chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) or relapsed/refractory (R/R) follicular lymphoma (FL). In this phase 1b study, zanubrutinib was tolerable at 160 mg twice daily or 320 mg once daily combined with IV obinutuzumab in patients with CLL/SLL (n = 45) and FL (n = 36). Common adverse events (AEs) included upper respiratory tract infection (51%; n = 23), neutropenia (44%; n = 20), contusion (33%; n = 15), cough, diarrhea, or fatigue (27%; n = 12 each), and pyrexia (22%; n = 10) in CLL/SLL patients and upper respiratory tract infection (39%; n = 14), contusion (28%; n = 10), fatigue (25%; n = 9), and cough (22%; n = 8) in FL patients. Neutropenia was the most common grade 3/4 AE (CLL/SLL, 31% [n = 14]; FL, 14% [n = 5]). Five patients required temporary dose reductions, and 5 discontinued the study drug because of AEs. Overall response rate (ORR) was 100% (n = 20) in treatment-naïve CLL patients and 92% (n = 23) in R/R CLL patients. ORR in 36 R/R FL patients was 72% (n = 26), with 14 complete and 12 partial responses. Median follow-up was 29 months (range, 8-37) for CLL patients and 20 months (range, 2-37) for FL patients. Zanubrutinib and obinutuzumab combination therapy was generally well tolerated. This trial was registered at www.clinicaltrials.gov as #NCT02569476.