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Bossi P, Miceli R, Benasso M, Corvò R, Bacigalupo A, Sanguineti G, Fallai C, Merlano M, Infante G, Dani C, Di Giannantonio V, Licitra L. Individual patient data meta-analysis of the impact of treatment expertise on the outcome of head and neck cancer patients treated within 6 randomized trials. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw340.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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27
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Belgioia L, Bacigalupo A, Chiola I, Blandino G, Lamanna G, Vagge S, Scabini S, Romairone E, Murialdo R, Ballestrero A, Corvò R. EP-1305: Impact of time from neoadjuvant treatment and surgery in rectal cancer: a monoinstitutional report. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32555-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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28
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Merlano M, Vecchio S, Bacigalupo A, Russi E, Denaro N, Ostellino O, Rampino M, Benasso M, Boitano M, Numico G, D'Amico M, Grimaldi A, Blengio F, Licitra L, Pinto C, Aieta M, Bui S, Mattioli R, Bertolini F, Gasparini G, Boni C. The phase III study INTERCEPTOR in locally advanced head and neck cancer (LA-HNC). Preliminary safety report. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv342.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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29
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Merlano M, Vecchio S, Bacigalupo A, Denaro N, Russi E, Benasso M, Vigo V, Ostellino O, Rampino M, Canobbio L, Grimaldi A, Blengio F, Berretta L, Bui S, D'Abbiero N, D'Amico M, Numico G, Bergamini C, Orlandi E, Aieta M. 2821 The phase III study INTERCEPTOR in locally advanced head and neck cancer (LA-HNC). Preliminary safety report. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31564-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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30
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Ringdén O, Labopin M, Ciceri F, Velardi A, Bacigalupo A, Arcese W, Ghavamzadeh A, Hamladji RM, Schmid C, Nagler A, Mohty M. Is there a stronger graft-versus-leukemia effect using HLA-haploidentical donors compared with HLA-identical siblings? Leukemia 2015; 30:447-55. [PMID: 26293645 DOI: 10.1038/leu.2015.232] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 07/13/2015] [Accepted: 07/20/2015] [Indexed: 01/18/2023]
Abstract
Haploidentical hematopoietic stem cell transplants (HSCTs) are increasingly used, but it is unknown whether they have a stronger graft-versus-leukemia (GVL) effect. We analyzed 10 679 acute leukemia patients who underwent HSCT from an HLA-matched sibling donor (MSD, n=9815) or a haploidentical donor (⩾2 HLA-antigen disparity, n=864) between 2007 and 2012, reported to the European Group for Blood and Marrow Transplantation. In a Cox regression model, acute and chronic graft-versus-host disease (GVHD) was added as time-dependent variables. There was no difference in probability of relapse between recipients of haploidentical and MSD grafts. Factors of importance for relapse after T-cell-replete grafts included remission status at HSCT, Karnofsky score ⩽80, acute GVHD of grade II or higher and chronic GVHD (P<10(-5)). Patients with post-transplant cyclophosphamide (n=194) had similar outcome as other T-cell-replete haploidentical transplants (n=369). Non-relapse mortality was significantly higher in the haploidentical group compared with that in MSD patients (P<10(-5)). Leukemia-free survival was superior in the MSD patients receiving T-cell-replete (P<10(-5)) or T-cell-depleted grafts (P=0.0006). The risk of relapse was the same in acute leukemia patients who received haploidentical donor grafts as in those given MSD transplants, suggesting a similar GVL effect.
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Balleari E, Salvetti C, Del Corso L, Filiberti R, Bacigalupo A, Bellodi A, Beltrami G, Bergamaschi M, Berisso G, Calzamiglia T, Carella A, Cavalleri M, Da Col A, Favorini S, Forni G, Goretti R, Miglino M, Mitscheuning L, Molinari E, Racchi O, Scudeletti M, Tassara R, Gobbi M, Lemoli R, Clavio M. Age and comorbidities deeply impact on clinical outcome of patients with myelodysplastic syndromes. Leuk Res 2015; 39:846-52. [DOI: 10.1016/j.leukres.2015.05.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 05/11/2015] [Accepted: 05/17/2015] [Indexed: 11/16/2022]
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32
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Ruggeri A, Labopin M, Sanz G, Piemontese S, Arcese W, Bacigalupo A, Blaise D, Bosi A, Huang H, Karakasis D, Koc Y, Michallet M, Picardi A, Sanz J, Santarone S, Sengelov H, Sierra J, Vincent L, Volt F, Nagler A, Gluckman E, Ciceri F, Rocha V, Mohty M. Comparison of outcomes after unrelated cord blood and unmanipulated haploidentical stem cell transplantation in adults with acute leukemia. Leukemia 2015; 29:1891-900. [PMID: 25882700 DOI: 10.1038/leu.2015.98] [Citation(s) in RCA: 174] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 04/01/2015] [Accepted: 04/07/2015] [Indexed: 12/27/2022]
Abstract
Outcomes after unmanipulated haploidentical stem cell transplantation (Haplo) and after unrelated cord blood transplantation (UCBT) are encouraging and have become alternative options to treat patients with high-risk acute leukemia without human leukocyte antigen (HLA) matched donor. We compared outcomes after UCBT and Haplo in adults with de novo acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL). Median follow-up was 24 months. Analysis was performed separately for patients with AML, n=918 (Haplo=360, UCBT=558) and ALL, n=528 (Haplo=158 and UCBT=370). UCBT was associated with delayed engraftment and higher graft failure in both AML and ALL recipients. In multivariate analysis, UCBT was associated with lower incidence of chronic graft-vs-host disease both in the AML group (hazard ratio (HR)=0.63, P=0.008) and in the ALL group (HR=0.58, P=0.01). Not statistically significant differences were observed between Haplo and UCBT for relapse incidence (HR=0.95, P=0.76 for AML and HR=0.82, P=0.31 for ALL), non-relapse mortality (HR=1.16, P=0.47 for AML and HR=1.23, P=0.23 for ALL) and leukemia-free survival (HR 0.78, P=0.78 for AML and HR=1.00, P=0.84 for ALL). There were no statistically differences on main outcomes after unmanipulated Haplo and UCBT, and both approaches are valid for acute leukemia patients lacking a HLA matched donor. Both strategies expand the donor pool for patients in need.
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Belgioia L, Vagge S, Agnese A, Garelli S, Murialdo R, Fornarini G, Chiara S, Bacigalupo A, Corvò R. EP-1208: Accelerated Intensity Modulated Radiotherapy with SIB in anal cancer: outcomes of a retrospective trial. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41200-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Del Corso L, Bacigalupo A, Balleari E, Bellodi A, Calzamiglia T, Da Col A, D'elia P, Dominietto A, Favorini S, Forni G, Galimberti S, Ghio M, Ghio R, Salvetti C, Ubezio G, Vignolo L, Molinari E, Ghiso A, Drousseau M, Simonetti F, Goretti R, Tassara R, Racchi O, Scudeletti M, Arboscello E, Gianluca F. 301 IRON OVERLOAD AND IRON CHELATION THERAPY WITH DEFERASIROX IN TRANSFUSION-DEPENDENT PATIENTS WITH MYELODYSPLASTIC SYNDROMES. Leuk Res 2015. [DOI: 10.1016/s0145-2126(15)30302-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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35
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Bacigalupo A, Belgioia L, Vecchio S, Marcenaro M, Vagge S, Agnese D, Agostinelli S, Corvò R. PO-060: Long term results with intensified intensity modulated radiotherapy for nasopharyngeal cancer treatment. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)34820-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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36
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Belgioia L, Agnese D, Bacigalupo A, Marcenaro M, Pupillo F, Morbelli S, Corvò R. PO-113: Role of 18F-FDG PET/CT in chemo-radiotherapy response of nasopharyngeal cancer. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)34873-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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37
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Piemontese S, Ciceri F, Labopin M, Bacigalupo A, Huang H, Santarone S, Gorin NC, Koc Y, Wu D, Beelen D, Tischer J, Ehninger G, Arcese W, Nagler A, Mohty M. A survey on unmanipulated haploidentical hematopoietic stem cell transplantation in adults with acute leukemia. Leukemia 2014; 29:1069-75. [PMID: 25434302 DOI: 10.1038/leu.2014.336] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 10/16/2014] [Accepted: 10/27/2014] [Indexed: 01/28/2023]
Abstract
The use of unmanipulated graft is increasingly adopted in the setting of allogeneic hematopoietic stem cell transplantation from haploidentical family donors (haplo-SCT) in acute leukemia (AL). We analyzed the outcome of 229 adult patients with de novo AL, who received an unmanipulated haploidentical transplant as their first allo-SCT between 2007 and 2011. Median follow-up was 30 months. Disease status at transplant was: first complete remission (CR1) for 77, second CR (CR2) for 56, and advanced for 96 patients. One hundred and seventy-one patients received in vivo T-cell depletion by monoclonal antibodies (75%). The 60-day cumulative incidence (CI) of engraftment was 93±2%. The 100-day CI of acute graft-versus-host disease (GvHD) was 32±3% for grade II-IV, 12±3% for grade III-IV. The 3-year CI of chronic GvHD was 34±3%. The 3-year CI of non-relapse mortality was 31±4% with in vivo T-cell depletion and 17±5% without. At 3 years, for patients transplanted in CR1, CR2 or advanced disease leukemia-free survival was 44±6, 42±7 and 12±3%, overall survival was 55±6, 51±7 and 14±4% and CI of relapse was 32±6, 24±6 and 61±5%, respectively. These data suggest that unmanipulated haplo-SCT is a valid treatment option for adult AL patients in complete remission lacking a matched donor.
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Mikulska M, Nicolini L, Signori A, Rivoli G, Del Bono V, Raiola A, Di Grazia C, Dominietto A, Varaldo R, Ghiso A, Bacigalupo A, Viscoli C. Hepatitis B reactivation in HBsAg-negative/HBcAb-positive allogeneic haematopoietic stem cell transplant recipients: risk factors and outcome. Clin Microbiol Infect 2014; 20:O694-701. [DOI: 10.1111/1469-0691.12611] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 02/04/2014] [Accepted: 02/21/2014] [Indexed: 12/13/2022]
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Ruutu T, Gratwohl A, de Witte T, Afanasyev B, Apperley J, Bacigalupo A, Dazzi F, Dreger P, Duarte R, Finke J, Garderet L, Greinix H, Holler E, Kröger N, Lawitschka A, Mohty M, Nagler A, Passweg J, Ringdén O, Socié G, Sierra J, Sureda A, Wiktor-Jedrzejczak W, Madrigal A, Niederwieser D. Erratum: Prophylaxis and treatment of GVHD: EBMT–ELN working group recommendations for a standardized practice. Bone Marrow Transplant 2013. [DOI: 10.1038/bmt.2013.210] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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40
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Ruutu T, Gratwohl A, de Witte T, Afanasyev B, Apperley J, Bacigalupo A, Dazzi F, Dreger P, Duarte R, Finke J, Garderet L, Greinix H, Holler E, Kröger N, Lawitschka A, Mohty M, Nagler A, Passweg J, Ringdén O, Socié G, Sierra J, Sureda A, Wiktor-Jedrzejczak W, Madrigal A, Niederwieser D. Prophylaxis and treatment of GVHD: EBMT–ELN working group recommendations for a standardized practice. Bone Marrow Transplant 2013; 49:168-73. [DOI: 10.1038/bmt.2013.107] [Citation(s) in RCA: 200] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Revised: 05/16/2013] [Accepted: 05/18/2013] [Indexed: 11/09/2022]
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41
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Perseghin P, Marchetti M, Messina C, Mazzoni A, Carlier P, Perotti C, Salvaneschi L, Risso M, Fanin R, Olivieri A, Accorsi P, Locatelli F, Bacigalupo A, Pierelli L, Bosi A. Best practice recommendations in: (1) Peripheral blood stem cell mobilization and collection and (2) acute and chronic GvHD treatment using extracorporeal photopheresis. A joint effort from SIdEM (Società Italiana di Emaferesi e Manipolazione Cellulare) and GITMO (Gruppo Italiano Trapianto di Midollo Osseo). Transfus Apher Sci 2013; 48:195-6. [DOI: 10.1016/j.transci.2013.02.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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42
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Garelli S, Raso R, Scalco E, Vagge S, Bacigalupo A, Salvetti C, Passoni P, Broggi S, Rizzo G, Fiorino C. EP-1257: Rectal motion during radio-chemotherapy of rectal cancer assessed by daily MVCTs and 3D local shift measurements. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)33563-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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43
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Timon G, Bacigalupo A, Vagge S, Belgioia L, Garelli S, Corvò R. PO-0699: IMRT with SIB in the treatment of anal cancer: a mono-institutional experience. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)33005-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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44
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Mikulska M, Furfaro E, Del Bono V, Raiola AM, Di Grazia C, Bacigalupo A, Viscoli C. (1-3)- -D-Glucan in Cerebrospinal Fluid Is Useful for the Diagnosis of Central Nervous System Fungal Infections. Clin Infect Dis 2013; 56:1511-2. [DOI: 10.1093/cid/cit073] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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45
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Belgioia L, Timon G, Bacigalupo A, Vagge S, Pupillo F, Marcenaro M, Vecchio S, Corvò R. PO-056: Early-Outcome and Toxicity of RT/CT in the Management of Unknown HN Primary Site with Helical Tomotherapy. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)34675-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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46
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Bacigalupo A, Timon G, Vagge S, Belgioia L, Bellini A, Marcenaro M, Vecchio S, Corvò R. PO-057: SIB-IMRT Delivered By Helical Tomotherapy for Patients with Nasopharyngeal Carcinoma. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)34676-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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47
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Bacigalupo A, Marsh JCW. Unrelated donor search and unrelated donor transplantation in the adult aplastic anaemia patient aged 18-40 years without an HLA-identical sibling and failing immunosuppression. Bone Marrow Transplant 2012. [PMID: 23178545 DOI: 10.1038/bmt.2012.233] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Currently at least 75% of patients with severe aplastic anaemia can be successfully transplanted using a matched unrelated donor (UD) haematopoietic SCT (HSCT). For children, outcomes are similar to matched sibling donor (MSD) HSCT. This improvement in outcome over time is likely due to improved HLA tissue typing to identify better matched donors, improvements in the conditioning regimen, particularly fludarabine-based regimens, and improved supportive care. Graft rejection occurs in ∼15% of adults, but is less frequent in children. Chronic GVHD remains a concern but may be reduced by using Alemtuzumab instead of ATG. UD HSCT should be considered early after failure to respond to one course of immunosuppressive therapy, but for children who lack a MSD up front matched UD HSCT may be considered.
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Dufour C, Svahn J, Bacigalupo A. Front-line immunosuppressive treatment of acquired aplastic anemia. Bone Marrow Transplant 2012; 48:174-7. [DOI: 10.1038/bmt.2012.222] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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49
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Mikulska M, Del Bono V, Raiola AM, Signori A, Prinapori R, Ghiso A, Bacigalupo A, Viscoli C. Enterococcal Bloodstream Infection After Hematopoietic Stem Cell Transplant: Experience of a Center With a Low Prevalence of Vancomycin-Resistant Enterococci. Clin Infect Dis 2012; 55:1744. [DOI: 10.1093/cid/cis765] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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50
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Giebel S, Labopin M, Mohty M, Mufti GJ, Niederwieser D, Cornelissen JJ, Janssen JJWM, Milpied N, Vindelov L, Petersen E, Arnold R, Bacigalupo A, Blaise D, Craddock C, Nagler A, Frassoni F, Sadus-Wojciechowska M, Rocha V. The impact of center experience on results of reduced intensity: allogeneic hematopoietic SCT for AML. An analysis from the Acute Leukemia Working Party of the EBMT. Bone Marrow Transplant 2012; 48:238-42. [PMID: 22773125 DOI: 10.1038/bmt.2012.131] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Allogeneic hematopoietic SCT with reduced-intensity conditioning (RIC-HSCT) is increasingly adopted for the treatment of older adults with AML. Our goal was to verify for the first time, if center experience influences outcome of RIC-HSCT. Results of 1413 transplantations from HLA-matched related or unrelated donors for adult patients with AML in first CR were analyzed according to the level of center activity. Transplants were performed in 203 European centers between 2001 and 2007. The 2-year probability of leukemia-free survival (LFS) after RIC-HSCT performed in centers with the lowest activity (< or =15 procedures/7 years) was 43±3% compared with 55±2% in the remainder (P<0.001). The incidence of non-relapse mortality (NRM) was 24±3% and 15±1% (P=0.004), whilst relapse rate was 33±3% and 31±1% (P=0.33), respectively. In a multivariate model, adjusted for other prognostic factors, low RIC-HSCT activity was associated with decreased chance of LFS (hazard ratio (HR)=0.64; P<0.001) and increased risk of NRM (HR=1.47, P=0.04) and relapse (HR=1.41, P=0.01). Center experience is a very important predictor of outcome and should be considered in future analyses evaluating the results of RIC-HSCT. The reasons why centers with low RIC-HSCT activity have worse outcomes should be further investigated.
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