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"Asimakopoulos, John"
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Immunotherapy in Hodgkin Lymphoma: Present Status and Future Strategies
Although classical Hodgkin lymphoma (cHL) is usually curable, 20–30% of the patients experience treatment failure and most of them are typically treated with salvage chemotherapy and autologous stem cell transplantation (autoSCT). However, 45–55% of that subset further relapse or progress despite intensive treatment. At the advanced stage of the disease course, recently developed immunotherapeutic approaches have provided very promising results with prolonged remissions or disease stabilization in many patients. Brentuximab vedotin (BV) has been approved for patients with relapsed/refractory cHL (rr-cHL) who have failed autoSCT, as a consolidation after autoSCT in high-risk patients, as well as for patients who are ineligible for autoSCT or multiagent chemotherapy who have failed ≥ two treatment lines. However, except of the consolidation setting, 90–95% of the patients will progress and require further treatment. In this clinical setting, immune checkpoint inhibitors (CPIs) have produced impressive results. Both nivolumab and pembrolizumab have been approved for rr-cHL after autoSCT and BV failure, while pembrolizumab has also been licensed for transplant ineligible patients after BV failure. Other CPIs, sintilimab and tislelizumab, have been successfully tested in China, albeit in less heavily pretreated populations. Recent data suggest that the efficacy of CPIs may be augmented by hypomethylating agents, such as decitabine. As a result of their success in heavily pretreated disease, BV and CPIs are moving to earlier lines of treatment. BV was recently licensed by the FDA for the first-line treatment of stage III/IV Hodgkin lymphoma (HL) in combination with AVD (only stage IV according to the European Medicines Agency (EMA)). CPIs are currently being evaluated in combination with AVD in phase II trials of first-line treatment. The impact of BV and CPIs was also investigated in the setting of second-line salvage therapy. Finally, combinations of targeted therapies are under evaluation. Based on these exciting results, it appears reasonable to predict that an improvement in survival and a potential increase in the cure rates of cHL will soon become evident.
Journal Article
The political economy of the spectacle and postmodern caste
\"In The Political Economy of the Spectacle and Postmodern Caste, John Asimakopoulos analyzes the political economy of the society of the spectacle, a philosophical concept developed by Guy Debord and Jean Baudrillard. Using the analytical tools of social science, while historicizing, Asimakopoulos reveals that all societies in every epoch have been and continue to be caste systems legitimized by various ideologies. He concludes there is no such thing as capitalism (or socialism) -- only a caste system hidden behind capitalist ideology. Key features of the book include its broad interdisciplinary-nonsectarian approach with quantitative and qualitative data. The Political Economy of the Spectacle and Postmodern Caste is well-written and clear making it accessible to the informed reader\"-- Provided by publisher.
Book
The Political Economy of the Spectacle and Postmodern Caste
In The Political Economy of the Spectacle and Postmodern Caste, John Asimakopoulos analyzes the political economy of the spectacle conceptualized by philosophers like Guy Debord through a broad interdisciplinary-nonsectarian approach concluding every society is a caste system legitimized by ideology.
eBook
Optimizing outcomes in relapsed/refractory Hodgkin lymphoma: a review of current and forthcoming therapeutic strategies
The outcome of patients with relapsed/refractory classical Hodgkin lymphoma (rr-cHL) has improved considerably in recent years owing to the approval of highly active novel agents such as brentuximab vedotin and Programmed Death-1 (PD-1) inhibitors. Although no randomized trials have been conducted to provide formal proof, it is almost undisputable that the survival of these patients has been prolonged. As autologous stem-cell transplantation (SCT) remains the standard of care for second-line therapy of most patients with rr-cHL, optimization of second-line regimens with the use of brentuximab vedotin, or, in the future, checkpoint inhibitors, is promising to increase both the eligibility rate for transplant and the final outcome. The need for subsequent therapy, and especially allogeneic SCT, can be reduced with brentuximab vedotin consolidation for 1 year, while pembrolizumab is also being tested in this setting. Several other drug categories appear to be active in rr-cHL, but their development has been delayed by the appearance of brentuximab vedotin, nivolumab and pembrolizumab, which have dominated the field of rr-cHL treatment in the last 5 years. Combinations of active drugs in chemo-free approaches may further increase efficacy and hopefully reduce toxicity in rr-cHL, but are still under development.
Journal Article
Bone Marrow Iron Stores Are Not Associated with Increased Risk for Invasive Fungal Infections in Patients with Newly Diagnosed Acute Leukemia or Myelodysplastic Syndrome in Transformation: Is There a Relationship?
Iron plays an important role in the pathogenesis of infections, including invasive fungal infections (IFIs). Studies suggested that iron overload might represent an additional risk factor for IFIs among patients with hematological malignancies. We conducted a prospective, multi-center study amongst adult patients with newly diagnosed acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) in transformation to determine whether baseline iron overload as measured using the bone marrow iron store (BMIS) score is an independent risk factor for the development of IFIs. We also measured baseline serum iron and ferritin levels. A total of 98 patients were enrolled (76 with AML) and were followed for 12 months. Twenty-two patients developed IFI during the follow-up period (invasive aspergillosis n = 16, candidemia n = 5, mucormycosis n = 1). A baseline BMIS score ≥ 3 indicated that iron overload was relatively common (38/98 patients, 38%), and its frequency was comparable between patients with no IFIs (31/76, 40.7%) and in those with IFIs (8/22, 36.4%). Univariate analysis showed that only the presence of AML was associated with increased risk for IFIs [OR (95% CI) 7.40 (1.05–325.42)]. Both univariate and multivariate analyses showed that an increased BMIS score (≥3) at baseline was not an independent risk factor for IFIs. Similarly, there was no difference in serum iron and ferritin between the two groups that had similar demographic characteristics. Indices of iron overload were not independent risk factors for IFIs in our cohort of Greek patients with newly diagnosed AML/MDS in transformation.
Journal Article
Venetoclax–Rituximab and Emerging Treatment Strategies After c-BTKi Exposure in Relapsed/Refractory CLL: A Real-World Cohort and Literature Overview
Background: Fixed-duration venetoclax plus rituximab (VR) is a standard therapy for relapsed/refractory (R/R) chronic lymphocytic leukemia (CLL). However, evidence supporting its use after covalent BTK inhibitor (c-BTKi) therapy is scarce in clinical trials and limited in real-world settings. Objectives: To assess the efficacy and safety of VR in a real-world cohort of patients with R/R CLL, including cBTKi-pretreated individuals, and to contextualize outcomes alongside published real-world studies and registrational trials of alternative therapies. Methods: We retrospectively analyzed 37 patients with R/R CLL treated with VR at our center between April 2018 and November 2024. Baseline characteristics, treatment responses, minimal residual disease (MRD), and adverse events were recorded. Survival was estimated using the Kaplan–Meier method. A structured review of relevant real-world evidence and pirtobrutinib clinical trials was also conducted. Results: Median age was 67 years; 35.1% had prior cBTKi exposure. The overall response rate (ORR) was 91.7% (22/24 evaluable patients), with 66.7% achieving complete remission (CR). Among evaluable c-BTKi-pretreated patients, the ORR was 87.5% (7/8) and the CR rate was 62.5%. Undetectable MRD (uMRD) rates were 78.6% in peripheral blood and 71.4% in bone marrow. Thirty-month progression-free survival (PFS), time to next treatment (TTNT), and overall survival (OS) were >90% for the whole cohort and for c-BTKi-pretreated patients. The most frequent adverse event was neutropenia grade ≥ 3, especially during combination therapy, which is easily managed with GCSF support. Conclusions: Our real-world evidence shows that VR is an effective and well-tolerated option even after c-BTKi therapy in R/R CLL. These data complement evidence from emerging therapies and inform post-c-BTKi treatment selection in clinical practice.
Journal Article
Optimally Delivered R-da-EPOCH Versus R-CHOP-21 in Primary Mediastinal Large B-Cell Lymphoma: A Real-Life Comparison in a Single Academic Center
Background/Objectives: The National Cancer Institute introduced the intensified R-da-EPOCH regimen in primary mediastinal large B-cell lymphoma (PMLBCL) to improve outcomes while minimizing radiotherapy use. However, there is no randomized comparison of R-da-EPOCH vs. R-CHOP-21. The objective of this study was to compare R-da-EPOCH with R-CHOP-21 in consecutive patients with PMLBCL of a single, large referral center, where the R-da-EPOCH escalation schedule was strictly followed. Methods: We retrospectively analyzed all 35 consecutive patients who received R-da-EPOCH (2017–2022) compared to 35 consecutive patients treated with R-CHOP-21 arm at the same Department, starting from the most recent patient and going backwards (2005–2017). Results: R-da-EPOCH was given strictly in 33/35 (94%) patients. The 5-year freedom from progression (FFP) was 91% vs. 69% (p = 0.027). The 5-year event-free survival (EFS) was 84% vs. 69% (p = 0.124). The 5-year overall survival (OS) was 97% vs. 80% (p = 0.063). Among R-CHOP-21-responders, 20/29 (69%) received RT compared to 2/34 (6%) R-da-EPOCH-responders. In multivariate analysis, R-da-EPOCH remained better than R-CHOP-21 in terms of FFP [hazard ratios (HRs) 0.21–0.26, all p < 0.05] and was associated with very favorable HR for EFS and OS. Conclusions: Optimally delivered R-da-EPOCH minimized the use of RT in a real-life setting and provided superior outcomes than R-CHOP-21.
Journal Article
Against Capital in the Twenty-First Century
The problems of capitalism have been studied from Karl Marx to Thomas Piketty.The latter has recently confirmed that the system of capital is deeply bound up in ever-growing inequality without challenging the continuance of that system.
eBook
No such thing as Capitalism or Socialism:All societies have always been and continue to be caste systems
Using the analytical tools of social science and statistical data while historicizing, I document that all societies in every epoch have been and continue to be caste systems legitimized by various ideologies. There is no such thing as capitalism (or socialism)—only a caste system hidden behind capitalist ideology. KEYWORDS: Stratification, Class, Caste, Capitalism, Political Theory, Inequality, History, Income, Wealth, Distribution, Statitics, Data
Journal Article