ORCID Profile
0000-0003-1615-0540
Current Organisations
Royal Australasian College of Physicians
,
Fiona Stanley Hospital
,
Royal College of Pathologists of Australasia
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Wiley
Date: 09-07-2020
DOI: 10.1111/BJH.16949
Publisher: Wiley
Date: 12-2011
Publisher: American Society of Hematology
Date: 08-07-2019
DOI: 10.1182/BLOODADVANCES.2019000251
Abstract: In advanced-stage diffuse large B-cell lymphoma (DLBCL), the presence of an activated B-cell phenotype or a non–germinal center (GCB) phenotype, coexpression of MYC and BCL2 by immunohistochemistry, and the cooccurrence of MYC and BCL2 or BCL6 rearrangements are associated with inferior outcomes. It is unclear whether these variables remain prognostic in stage I/II patients. In this retrospective study, we evaluated the prognostic impact of cell of origin (COO), as well as dual-expressor (DE) status and molecular double-hit (DH) status, in stage I/II DLBCL by positron emission tomography with computed tomography (PET-CT). A total of 211 patients treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone)–like regimens, with or without radiotherapy, was included. The median follow-up in the entire cohort was 4 years (range, 0.4-9.4), with estimated 4-year progression-free survival (PFS) and overall survival (OS) rates of 85% (95% confidence interval [CI], 79-89) and 88% (95% CI, 83-92), respectively. By univariable analysis, DE (PFS: hazard ratio [HR], 1.27 95% CI, 0.58-2.81, P = .55 and OS: HR, 1.40 95% CI, 0.60-3.30 P = .44), DH (PFS: HR, 1.21 95% CI, 0.27-5.31 P = .80 and OS: HR, 0.61 95% CI, 0.08-4.73 P = .64), and non-GCB status (PFS: HR, 1.59 95% CI, 0.83-3.03 P = .16 and OS: HR, 1.80 95% CI, 0.89-3.67 P = .10) were associated with poorer outcomes. In patients with PET-CT–defined stage I/II DLBCL treated with R-CHOP–like therapy, with or without radiation, COO and DE and DH status were not significantly associated with inferior PFS or OS.
Publisher: American Society of Hematology
Date: 10-02-2022
Abstract: Diffuse large B-cell lymphoma (DLBCL), the most common lymphoma subtype, is localized in 25% to 30% of patients. Prognosis in patients with limited-stage DLBCL (LS-DLBCL) is excellent with 10-year overall survival of at least 70% to 80%. Improved insights into the disease biology, the availability of positron-emission tomography (PET) scans, and recent dedicated clinical trials within this unique population have led to evolving treatment paradigms. However, no standard definition of LS-DLBCL exists, and although generally defined as Ann Arbor stages I to II disease with largest mass size & cm in diameter, variations across studies cause challenges in interpretation. Similar to advanced-stage disease, rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) immunochemotherapy forms the basis of treatment, with combined modality therapy including 3 cycles of systemic treatment and involved-site radiation therapy being a predominant historical standard. Yet the well-described continuous risk of relapse beyond 5 years and established late complications of radiotherapy have challenged previous strategies. More rigorous baseline staging and response assessment with PET may improve decision making. Recent clinical studies have focused on minimizing toxicities while maximizing disease outcomes using strategies such as abbreviated immunochemotherapy alone and PET-adapted radiotherapy delivery. This comprehensive review provides an update of recent literature with recommendations for integration into clinical practice for LS-DLBCL patients.
Publisher: Wiley
Date: 28-12-2022
DOI: 10.1111/EJH.13915
Abstract: Comprehensive clinical characteristics of Australian patients with classical Hodgkin Lymphoma (cHL) have not previously been systematically collected and described. We report real‐world data of 498 eligible patients from the first 5 years of the Lymphoma and Related Diseases Registry (LaRDR), including baseline characteristics, histologic subtype, and treatment patterns in first‐line therapy. Patient demographics and distribution of histopathological subtypes of cHL are similar to reported international cohorts. Doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) was the most common therapy for both early and advanced‐stage disease, and 48% of patients with the early‐stage disease received radiotherapy. Treatment patterns are consistent with international guidelines. In comorbid patients ≥60 years of age with advanced‐stage disease, there is greater variation in treatment. In patients with a recorded response, the objective response rate (ORR) was 96% in early‐stage disease, and 88% in advanced‐stage disease. Early progression‐free survival data suggest Australian patients with cHL have good outcomes, similar to other international studies.
Publisher: Wiley
Date: 11-03-2021
DOI: 10.1111/BJH.17404
Abstract: Grade 3B follicular lymphoma (G3B FL) is rare, accounting for only 5-10% of FLs. Not only has it been routinely excluded from clinical trials, but data published on diagnosis, outcomes, choice of therapies and role of imaging are conflicting. With the advent of increasingly erse treatment options for low-grade (G1-3A) FL, and the molecular subcategorisation of high-grade B-cell lymphomas, characterisation and treatment of G3B FL is ever more important as extrapolation of data becomes more difficult. New data have emerged exploring unique genetic characteristics, specific features on positron emission tomography imaging, choice of therapy, and outcomes of G3B FL in the current era. The present review will summarise and appraise these new data, and offer recommendations based on current evidence.
Publisher: Informa UK Limited
Date: 03-04-2017
Publisher: Springer Science and Business Media LLC
Date: 11-03-2023
Publisher: Elsevier BV
Date: 03-2019
Publisher: American Society of Clinical Oncology (ASCO)
Date: 10-04-2021
DOI: 10.1200/JCO.20.02465
Abstract: To prospectively validate the use of a simplified geriatric assessment (sGA) at diagnosis and to integrate it into a prognostic score for older patients with diffuse large B-cell lymphoma (DLBCL). We conducted the prospective Elderly Project study on patients with DLBCL older than 64 years who underwent our Fondazione Italiana Linfomi original geriatric assessment (oGA) (age, Cumulative Illness Rating Scale for Geriatrics, activities of daily living, and instrumental activities of daily living) before treatment. Treatment choice was left to the physician's discretion. The primary end point was overall survival (OS) (ClinicalTrials.gov identifier: NCT02364050 ). We analyzed 1,163 patients (median age 76 years), with a 3-year OS of 65% (95% CI, 62 to 68). Because at multivariate analysis on oGA, age 80 years retained an independent correlation with OS, we also developed a new, simplified version of the GA (sGA) that classifies patients as fit (55%), unfit (28%), and frail (18%) with significantly different 3-year OS of 75%, 58%, and 43%, respectively. The sGA groups, International Prognostic Index, and hemoglobin levels were independent predictors of OS and were used to build the Elderly Prognostic Index (EPI). Three risk groups were identified: low (23%), intermediate (48%), and high (29%), with an estimated 3-year OS of 87% (95% CI, 81 to 91), 69% (95% CI, 63 to 73), and 42% (95% CI, 36 to 49), respectively. The EPI was validated using an independent external series of 328 cases. The Elderly Project validates sGA as an objective tool to assess fitness status and defines the new EPI to predict OS of older patients with DLBCL.
Publisher: Wiley
Date: 14-04-2021
DOI: 10.1111/BJH.17436
Abstract: Eligibility criteria for randomised control trials (RCT) in diffuse large B‐cell lymphoma (DLBCL) may be becoming increasingly strict. In this analysis, 42 first‐line phase III RCTs enrolling DLBCL patients since 1990 were identified from PubMed and clinicaltrials.gov . Changes in 31 in idual eligibility criteria were assessed using three pre‐defined eras [(1) 1993–2005 (2) 2006–2013 and (3) 2014–2020]. The presence of 15/31 criteria increased significantly over time, and the total number of criteria per study also increased over time [median Era 1: 14·5, interquartile range (IQR) 12·6–16·4 Era 2: 21, 18·8–23·3 Era 3: 23, 21–25 P 0·001]. When each trial's eligibility criteria were applied to 215 consecutive patients from an institutional database treated between 2010 and 2020, a median of 57% (IQR 47–70) of patients were hypothetically eligible for trial enrolment. The median percentage of patients eligible was 68% (56–91), 54% (37–81) and 47% (38–82) for Era 1, 2 and 3 respectively ( P = 0·004). Phase III front‐line DLBCL trial criteria have become increasingly restrictive over the last three decades, resulting in a diminishing proportion of trial‐eligible patients, with less than 50% of our patients eligible for modern‐era studies. This potentially impacts generalisability of recent trial results and will likely limit recruitment to ongoing studies.
No related grants have been discovered for Allison Barraclough.