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Introducing Network Intervention Analysis to Investigate Sequential, Symptom-Specific Treatment Effects: A Demonstration in Co-Occurring Insomnia and Depression
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Gemcitabine-based salvage therapy is considered an effective treatment for relapsed and refractory Non-Hodgkin's lymphoma (NHL). We analyzed the outcome of 41 consecutive NHL patients treated with gemcitabine-based regimens between January 2007 and October 2015. Twenty-eight males and 13 females (median age 66.4 years) were included. The median follow-up from gemcitabine initiation was 7.3 months. Thirty patients (73%) had B-cell, and eleven (27%) had T-cell, lymphoma. All patients received a median of 2 prior regimens, of which at least 1 was anthracycline based. Twenty-eight patients (78%) received full-dose while 9 (22%) received reduced-dose regimens. The overall response rate was 37%, with 24% (n = 10) complete response, 12% (n = 5) partial response, and 63% (n = 22) progressive disease or stable disease. The median progression-free survival (PFS) was 47 days (range 12-1,318), the median overall survival (OS) was 1.9 years. Twenty patients (49%) died during follow-up. Grade 3-4 hematological toxicity was reported in 21 patients (51%). Relapsed vs. refractory disease, as well as a response to gemcitabine, predicted better PFS and OS. Use of a full-dose regimen predicted a better OS. Compared to previously published data, we observed less favorable outcomes. The administration of gemcitabine-based therapy as a salvage regimen for patients with relapsed or refractory NHL had limited success. Innovative therapies for these patients are an unmet need.
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“network intervention analysis, an approach proposed by Blanken et al. (2019), extends symptom network models to examine treatment-induced changes in symptoms and their association over time.”
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Metadata
- Authors
- Blanken, T. F., Van Der Zweerde, T., Van Straten, A., Van Someren, E. J. W., Borsboom, D., & Lancee, J.
- Affiliations
- Netherlands Institute for Neuroscience (NL)
- University of Amsterdam (NL)
- Venue
- Psychotherapy and Psychosomatics
- Publisher
- S. Karger AG
- Published
- 2019
- Volume
- 88
- Issue
- 1
- Pages
- 52-54
- ISSN
- 0033-3190 (ISSN-L)
- 1423-0348
- PMC
- PMC6469840
- OpenAlex
- W2910954829
- Cited by
- 187
- References
- 10
- Citations by year
- 2026: 23 · 2025: 33 · 2024: 29 · 2023: 18 · 2022: 16 · 2021: 31 · 2020: 20 · 2019: 17
- FWCI
- 24.76
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Psychotherapy and Psychosomatics (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion, cc-by)
- KNAW Research Portal (The Royal Netherlands Academy of Arts and Sciences) (publishedVersion, other-oa)
- VU Research Portal (publishedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- UvA-DARE (University of Amsterdam) (submittedVersion, cc-by-nc-nd)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (submittedVersion, other-oa)
- Funders
- Vrije Universiteit Amsterdam
- H2020 European Research Council (671084)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- insomnia, depression, progression-free survival, overall survival, hematologic toxicity
- MeSH terms
- Adult, Data Interpretation, Statistical, Depressive Disorder, Humans, Sleep Initiation and Maintenance Disorders, Severity of Illness Index, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Outcome Assessment, Health Care
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