• International exchange programs professional development and benefits to oncology nursing practice

      Turner, Lorraine; Lau, Vicki; Neeson, Susan M; Davies, Michelle; Christie National Health Service Foundation Trust, Manchester (2019)
      The benefits of international immersion programs are multifactorial. These programs not only allow the sharing of nursing best practices and models of care and education, but they also increase collaborative opportunities to develop shared research ideas and innovation. This article presents the practicalities and considerations when undertaking an immersion program, with exemplars from the authors' experience and the unique and invaluable outcomes that were achieved.
    • Safe navigation of CARs in a changing landscape

      Davies, Michelle; Dolan, Evelyn; Neeson, Susan M; Blowers, Elaine; Linton, Kim M; Thistlethwaite, Fiona C; The National Institute for Health Research (NIHR) Manchester Clinical Research Facility, The Christie NHS Foundation Trust, Manchester, UK (2018)
    • A study to investigate dose escalation of doxorubicin in ABVD chemotherapy for Hodgkin lymphoma incorporating biomarkers of response and toxicity.

      Gibb, Adam; Greystoke, Alastair; Ranson, Malcolm R; Linton, Kim M; Neeson, Susan M; Hampson, G; Illidge, Timothy M; Smith, Ed; Dive, Caroline; Pettitt, A; et al. (2013-11-12)
      Background:Myelotoxicity during initial cycles of chemotherapy for Hodgkin lymphoma is associated with better outcome, supporting the concept of individualised dosing based on pharmacodynamic end points to optimise results. This study was performed to identify the maximum tolerated dose (MTD) of doxorubicin within cycles 1-3 ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine). Circulating biomarkers of response (nucleosomal DNA, nDNA) and epithelial toxicity (Cytokeratin 18, CK18) were also measured.Methods:Dose escalation of doxorubicin in cycles 1-3 ABVD supported by pegfilgrastim was performed on a six-patient cohort basis (35, 45 and 55 mg m(-2)) with doxorubicin reduced to 25 mg m(-2) or omitted in cycles 4-6 to maintain cumulative exposure of 103-130% standard ABVD. BVD was given at standard doses throughout. Six additional subjects were recruited at the MTD.Results:Twenty-four subjects were recruited. Dose-limiting toxicities (DLTs) of grade 3 neuropathy, pneumonitis, palmar-plantar erythema and neutropenic infection were observed at 55 mg m(-2), so 45 mg m(-2) was declared the MTD. In patients who subsequently experienced DLT at any time, large increases in CK18 were seen on day 3 of cycle 1 ABVD.Conclusion:Escalated ABVD incorporating doxorubicin at 45 mg m(-2) in cycles 1-3 can be delivered safely with pegfilgrastim support. Circulating cell death biomarkers may assist in the development of future individualised dosing strategies.
    • Weekly versus twice weekly bortezomib given in conjunction with rituximab, in patients with recurrent follicular lymphoma, mantle cell lymphoma and Waldenström macroglobulinaemia.

      Agathocleous, A; Rohatiner, A; Rule, S; Hunter, H; Kerr, J; Neeson, Susan M; Matthews, J; Strauss, S; Montoto, S; Johnson, P; et al. (2010-11)
      The combination of bortezomib and rituximab was evaluated in patients with mantle cell lymphoma (MCL), follicular lymphoma (FL) and Waldenström macroglobulinaemia (WM), in a Phase I and later, a randomized Phase II study. In the randomized study, 42 patients with recurrent/refractory disease received either: bortezomib 1·3 mg/m(2) on days 1, 4, 8 and 11 of a 3-week cycle with rituximab 375 mg/m(2) on day 1 (21 patients) or: bortezomib 1·6 mg/m(2) and rituximab on days 1, 8, 15 and 22 of a 5-week cycle (with rituximab being given only in cycles 1 and 4).Twenty-eight patients were withdrawn (toxicity 16, progression 7, and 'patient choice' 5). The main toxicities were neurological, gastro-intestinal and haematological. The overall response rate was 28/42(67%) and by histology: MCL 11/19, FL 8/15, and WM 9/10. Ten of 28 responding patients remained progression-free at 1-3·5 years. Toxicity and efficacy were equivalent between the two groups. The combination has significant toxicity but is effective, particularly in patients with WM.