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Bianchi FP, Stefanizzi P, Rizzi D, Signorile N, Cuscianna E, Daleno A, Migliore G, Tafuri S. Burden of COVID-19 disease and vaccine coverages in Apulian splenectomized patients: A retrospective observational study. Br J Haematol 2023. [PMID: 36942786 DOI: 10.1111/bjh.18731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/13/2023] [Accepted: 02/19/2023] [Indexed: 03/23/2023]
Abstract
Splenectomy/asplenia is a condition associated with immune-compromission and specific vaccines are recommended for these patients, including the anti-COVID-19 vaccine. Among the high-risk group for which vaccination was prioritized in Italy, the immunocompromised patients after therapies or treatments were included. The Apulian regional archive of hospital discharge forms was used to define the list of splenectomized Apulian inhabitants, considering data from 2015 through 2020. The overall vaccination status of asplenic patients was assessed via data collected from the Regional Immunization Database. The history of SARS-CoV-2 infection and the infectious disease outcomes were extracted from the Italian Institute of Health platform "Integrated surveillance of COVID-19 cases in Italy". 1219 Apulian splenectomized inhabitants were included; the incidence rate of SARS-CoV-2 infection was 15.0 per 100 persons-year with a proportion of re-infection equal to 6.4%; the proportion of hospitalization was 2.9%, with a case-fatality rate of 2.6%. The vaccine coverage (VC) for the anti-COVID-19 vaccine basal routine was 64.2%, for the first booster dose was 15.4%, and for the second booster dose was 0.6%. A multifactorial approach is needed to increase the vaccination uptake in this sub-group population and to increase the awareness of the asplenia-related risks to patients and health personnel.
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Affiliation(s)
- Francesco Paolo Bianchi
- Department of Interdisciplinary Medicine, Aldo Moro University of Bari, Bari, Italy
- Azienda Ospedaliero Universitaria Policlinico Giovanni XXIII, Bari, Italy
| | - Pasquale Stefanizzi
- Department of Interdisciplinary Medicine, Aldo Moro University of Bari, Bari, Italy
- Azienda Ospedaliero Universitaria Policlinico Giovanni XXIII, Bari, Italy
| | - Donato Rizzi
- Department of Interdisciplinary Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Noemi Signorile
- Department of Interdisciplinary Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Eustachio Cuscianna
- Department of Interdisciplinary Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Antonio Daleno
- Azienda Ospedaliero Universitaria Policlinico Giovanni XXIII, Bari, Italy
| | - Giovanni Migliore
- Azienda Ospedaliero Universitaria Policlinico Giovanni XXIII, Bari, Italy
| | - Silvio Tafuri
- Department of Interdisciplinary Medicine, Aldo Moro University of Bari, Bari, Italy
- Azienda Ospedaliero Universitaria Policlinico Giovanni XXIII, Bari, Italy
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2
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Greco R, Snowden JA, Knelange NS, Tridello G, Cacciatore C, Xhaard A, Ciceri F, Collin M, Ferra C, De Becker A, Averbuch D, Alexander T, Ljungman P, De la Camara R. Outcome of SARS-CoV2 infection in hematopoietic stem cell transplant recipients for autoimmune diseases. J Autoimmun 2023; 136:103024. [PMID: 37001437 PMCID: PMC9977622 DOI: 10.1016/j.jaut.2023.103024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 02/16/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023]
Abstract
Hematopoietic stem cell transplant (HSCT) recipients may be at high risk of mortality from coronavirus disease 2019 (COVID-19). However, specific data on COVID-19 after treatment with HSCT in patients affected by autoimmune diseases (ADs) are still lacking. In this multicenter observational study of the European Society for Blood and Marrow Transplantation (EBMT), clinical data on COVID-19 in 11 patients affected by severe ADs treated with HSCT (n = 3 allogeneic transplant; n = 8 autologous transplant) are reported. All patients were symptomatic during the initial phase of the SARS-CoV-2 infection. At screening, 5 patients reported upper respiratory symptoms, 3 patients had cough without oxygen requirement, and 6 patients exhibited extra-pulmonary symptoms. Four cases developed a lower respiratory tract disease (LRTD). Hospitalization was required in 6 cases, without necessity of intensive care unit (ICU) admission and/or ventilation/supplemental oxygen. Different interventions were adopted: remdesivir (n = 1), nirmatrelvir/ritonavir (n = 1), sotrovimab (n = 1), immunoglobulins (n = 1). At last follow-up, all patients solved the infection and are alive. The current analysis describing the mild-moderate course of COVID-19 in transplant recipients affected by ADs, similar to the course observed in ADs under standard treatments, provides useful information to support the delivery of HSCT programs in this field. Vaccination and new treatments available for SARS-CoV-2 infection may be useful to further minimize the infectious risks.
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Affiliation(s)
- Raffaella Greco
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy,Corresponding author
| | - John A. Snowden
- Department of Haematology, Sheffield Teaching Hospitals Foundation NHS Trust, Sheffield, United Kingdom
| | | | - Gloria Tridello
- Paediatric Haematology Oncology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Carlotta Cacciatore
- Unité de Médecine Interne (UF04): CRMR MATHEC, Maladies Auto-immunes et Thérapie Cellulaire, Centre de Référence des Maladies Auto-immunes Systémiques Rares D’Ile-de-France, AP-HP, Hôpital St-Louis, F-75010, Paris, France
| | - Alienor Xhaard
- Hôpital Saint-Louis, Department of Hematology - BMT, Paris, France
| | - Fabio Ciceri
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Matthew Collin
- Northern Centre for Bone Marrow Transplantation, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | - Christelle Ferra
- ICO-Hospital Universitari Germans Trias I Pujol, Badalona, Spain
| | | | - Dina Averbuch
- Faculty of Medicine, Hebrew University of Jerusalem, Hadassah Medical Center, Jerusalem, Israel
| | - Tobias Alexander
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, And Berlin Institute of Health, Department of Rheumatology and Clinical Immunology, Berlin, Germany
| | - Per Ljungman
- Department of Cellular Therapy and Allogeneic Stem Cell Transplantation, Karolinska Comprehensive Cancer Center, Karolinska University Hospital Huddinge, Stockholm, Sweden,Division of Hematology, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
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Rescigno M, Agrati C, Salvarani C, Giannarelli D, Costantini M, Mantovani A, Massafra R, Zinzani PL, Morrone A, Notari S, Matusali G, Pinter GL, Uccelli A, Ciliberto G, Baldanti F, Locatelli F, Silvestris N, Sinno V, Turola E, Lupo-Stanghellini MT, Apolone G. Neutralizing antibodies to Omicron after the fourth SARS-CoV-2 mRNA vaccine dose in immunocompromised patients highlight the need of additional boosters. Front Immunol 2023; 14:1104124. [PMID: 36776853 PMCID: PMC9911671 DOI: 10.3389/fimmu.2023.1104124] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/09/2023] [Indexed: 01/28/2023] Open
Abstract
Introduction Immunocompromised patients have been shown to have an impaired immune response to COVID-19 vaccines. Methods Here we compared the B-cell, T-cell and neutralizing antibody response to WT and Omicron BA.2 SARS-CoV-2 virus after the fourth dose of mRNA COVID-19 vaccines in patients with hematological malignancies (HM, n=71), solid tumors (ST, n=39) and immune-rheumatological (IR, n=25) diseases. The humoral and T-cell responses to SARS-CoV-2 vaccination were analyzed by quantifying the anti-RBD antibodies, their neutralization activity and the IFN-γ released after spike specific stimulation. Results We show that the T-cell response is similarly boosted by the fourth dose across the different subgroups, while the antibody response is improved only in patients not receiving B-cell targeted therapies, independent on the pathology. However, 9% of patients with anti-RBD antibodies did not have neutralizing antibodies to either virus variants, while an additional 5.7% did not have neutralizing antibodies to Omicron BA.2, making these patients particularly vulnerable to SARS-CoV-2 infection. The increment of neutralizing antibodies was very similar towards Omicron BA.2 and WT virus after the third or fourth dose of vaccine, suggesting that there is no preferential skewing towards either virus variant with the booster dose. The only limited step is the amount of antibodies that are elicited after vaccination, thus increasing the probability of developing neutralizing antibodies to both variants of virus. Discussion These data support the recommendation of additional booster doses in frail patients to enhance the development of a B-cell response directed against Omicron and/or to enhance the T-cell response in patients treated with anti-CD20.
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Affiliation(s)
- Maria Rescigno
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.,Mucosal Immunology and Microbiota Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Rozzano, Milano, Italy
| | - Chiara Agrati
- Cellular Immunology Laboratory, National Institute for Infectious Diseases (INMI) L Spallanzani - Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.,Department of Hematology and Oncology and Cell and Gene Therapy, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Bambino Gesù Children Hospital , Roma, Italy
| | - Carlo Salvarani
- Unità di Reumatologia, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) di Reggio Emilia, Reggio Emilia, Italy.,Unità di Reumatologia, Università degli Studi di Modena e Reggio Emilia, Reggio Emilia, Italy
| | - Diana Giannarelli
- Facility di Epidemiologia e Biostatistica, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Roma, Italy
| | - Massimo Costantini
- Scientific Directorate, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Alberto Mantovani
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.,Humanitas Scientific Directorate, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Rozzano, Milan, Italy.,William Harvey Research Institute, Queen Mary University, London, United Kingdom
| | - Raffaella Massafra
- Vice Scientific Directorate, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Pier Luigi Zinzani
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy.,Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Aldo Morrone
- Scientific Directorate, San Gallicano Dermatological Institute Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Roma, Italy
| | - Stefania Notari
- Cellular Immunology Laboratory, National Institute for Infectious Diseases (INMI) L Spallanzani - Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Giulia Matusali
- Virology Laboratory, INMI L Spallanzani - Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Roma, Italy
| | - Giuseppe Lauria Pinter
- Scientific Directorate, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milano, Italy.,Department of Medical Biotechnology and Translational Medicine, University of Milan, Milano, Italy
| | - Antonio Uccelli
- Scientific Directorate, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Policlinico San Martino, Genoa, Italy.,Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Gennaro Ciliberto
- Scientific Directorate, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Regina Elena, National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Roma, Italy
| | - Fausto Baldanti
- Microbiology and Virology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia, Italy.,Department of Clinical, Surgical, Diagnostics and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Franco Locatelli
- Department of Hematology and Oncology and Cell and Gene Therapy, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Bambino Gesù Children Hospital , Roma, Italy.,Department of Pediatrics, Catholic University of the Sacred Heart, Roma, Italy
| | - Nicola Silvestris
- Medical Oncology Unit, Department of Human Pathology "G. Barresi", University of Messina, Messina, Italy
| | - Valentina Sinno
- Department of Oncology and Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Elena Turola
- Infrastruttura Ricerca e Statistica, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) di Reggio Emilia, Reggio Emilia, Italy
| | - Maria Teresa Lupo-Stanghellini
- Hematology and BMT Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale San Raffaele, Milano, Italy
| | - Giovanni Apolone
- Scientific Directorate, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Nazionale dei Tumori di Milano, Milano, Italy
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Fiorino F, Ciabattini A, Sicuranza A, Pastore G, Santoni A, Simoncelli M, Polvere J, Galimberti S, Baratè C, Sammartano V, Montagnani F, Bocchia M, Medaglini D. The third dose of mRNA SARS-CoV-2 vaccines enhances the spike-specific antibody and memory B cell response in myelofibrosis patients. Front Immunol 2022; 13:1017863. [PMID: 36248803 PMCID: PMC9556722 DOI: 10.3389/fimmu.2022.1017863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 09/06/2022] [Indexed: 11/13/2022] Open
Abstract
Vaccination against SARS-CoV-2 using mRNA-based vaccines has been highly recommended for fragile subjects, including myelofibrosis patients (MF). Available data on the immune responsiveness of MF patients to mRNA SARS-CoV-2 vaccination, and the impact of the therapy with the JAK inhibitor ruxolitinib, are still fragmented. Here, we profile the spike-specific IgG and memory B-cell response in MF patients, treated or not with ruxolitinib, after the second and the third dose of SARS-CoV-2 BNT162b2 (BioNTech) and mRNA-1273 (Moderna) vaccines. Plasma and peripheral blood mononuclear cells samples were collected before vaccination, post the second and the third doses and tested for spike-specific antibodies, ACE2/RBD antibody inhibition binding activity and spike-specific B cells. The third vaccine dose significantly increased the spike-specific IgG titers in both ruxolitinib-treated and untreated patients, and strongly enhanced the percentage of subjects with antibodies capable of in vitro blocking ACE2/RBD interaction, from 50% up to 80%. While a very low frequency of spike-specific B cells was measured in blood 7 days after the second vaccination dose, a strong and significant increase was elicited by the third dose administration, generating a B cell response similar to the one detected in healthy controls. Despite the overall positive impact of the third dose in MF patients, two patients that were under active concomitant immunosuppressive treatment at the time of vaccination, and a patient that received lymphodepleting therapies in the past, remained low responders. The third mRNA vaccine dose strongly increases the SARS-CoV-2 specific humoral and B cell responses in MF patients, promoting a reactivation of the immune response similar to the one observed in healthy controls.
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Affiliation(s)
- Fabio Fiorino
- Laboratory of Molecular Microbiology and Biotechnology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Annalisa Ciabattini
- Laboratory of Molecular Microbiology and Biotechnology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Anna Sicuranza
- Hematology Unit, Department of Medical Science, Surgery and Neuroscience, Azienda Ospedaliero Universitaria Senese, University of Siena, Siena, Italy
| | - Gabiria Pastore
- Laboratory of Molecular Microbiology and Biotechnology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Adele Santoni
- Hematology Unit, Department of Medical Science, Surgery and Neuroscience, Azienda Ospedaliero Universitaria Senese, University of Siena, Siena, Italy
| | - Martina Simoncelli
- Hematology Unit, Department of Medical Science, Surgery and Neuroscience, Azienda Ospedaliero Universitaria Senese, University of Siena, Siena, Italy
| | - Jacopo Polvere
- Laboratory of Molecular Microbiology and Biotechnology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Sara Galimberti
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Claudia Baratè
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Vincenzo Sammartano
- Hematology Unit, Department of Medical Science, Surgery and Neuroscience, Azienda Ospedaliero Universitaria Senese, University of Siena, Siena, Italy
| | - Francesca Montagnani
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
- Department of Medical Sciences, Infectious and Tropical Diseases Unit, Azienda Ospedaliero Universitaria Senese, University Hospital of Siena, Siena, Italy
| | - Monica Bocchia
- Hematology Unit, Department of Medical Science, Surgery and Neuroscience, Azienda Ospedaliero Universitaria Senese, University of Siena, Siena, Italy
- *Correspondence: Donata Medaglini, ; Monica Bocchia,
| | - Donata Medaglini
- Laboratory of Molecular Microbiology and Biotechnology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
- *Correspondence: Donata Medaglini, ; Monica Bocchia,
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5
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Di Cosimo S, Lupo-Stanghellini MT, Costantini M, Mantegazza R, Ciceri F, Salvarani C, Zinzani PL, Mantovani A, Ciliberto G, Uccelli A, Baldanti F, Apolone G, Delcuratolo S, Morrone A, Locatelli F, Agrati C, Silvestris N. Safety of third dose of COVID-19 vaccination in frail patients: Results from the prospective Italian VAX4FRAIL study. Front Oncol 2022; 12:1002168. [PMID: 36338743 PMCID: PMC9631315 DOI: 10.3389/fonc.2022.1002168] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 09/29/2022] [Indexed: 02/05/2023] Open
Abstract
IMPORTANCE Despite people with impaired immune competence due to an underlying disease or ongoing therapy, hereinafter frail patients, are (likely to be) the first to be vaccinated, they were usually excluded from clinical trials. OBJECTIVE To report adverse reactions of frail patients after receipt of the third dose (booster) administered after completion of a two-dose mRNA vaccination and to compare with those reported after the receipt of the first two doses. DESIGN A multicenter, observational, prospective study aimed at evaluating both the safety profile and the immune response of Pfizer-BioNTech or Moderna vaccines in frail patients. SETTING National Project on Vaccines, COVID-19 and Frail Patients (VAX4FRAIL). PARTICIPANTS People consenting and included in the VAX4FRAIL trial. EXPOSURE A series of three doses of COVID-19 mRNA vaccination from the same manufacturer. MAIN OUTCOMES AND MEASURES Evaluation of a self-assessment questionnaire addressing a predefined list of eight symptoms on a five-item Likert scale. Symptoms were classified as severe if the patient rated them as severe or overwhelming. RESULTS Among 320 VAX4FRAIL participants diagnosed/treated for hematological malignancies (N=105; 32.8%), solid tumors (N=48; 15.0%), immune-rheumatological diseases (N=60; 18.8%), neurological diseases (N=107; 33.4%), and receiving the booster dose, 70.3% reported at least one loco-regional or systemic reactions. Adverse events were mostly mild or moderate, none being life-threatening. Only six of the 320 (1.9%) patients had their treatment postponed due to the vaccine. The safety profile of the booster compared to previously administered two doses showed a stable prevalence of patients with one or more adverse events (73.5%, 79.7% and 73.9% respectively), and a slightly increment of patients with one or more severe adverse events (13.4%, 13.9% and 19.2% respectively). CONCLUSIONS AND RELEVANCE The booster of the mRNA COVID-19 vaccine was safely administered in the largest prospective cohort of frail patients reported so far. VAX4FRAIL will continue to monitor the safety of additional vaccine doses, especially systemic adverse events that can be easily prevented to avoid interruption of continuity of care. CLINICAL TRIAL REGISTRATION https://clinicaltrials.gov/ct2/show/NCT04848493, identifier NCT04848493.
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Affiliation(s)
- Serena Di Cosimo
- Department of Applied Research and Technological Development, Fondazione Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Nazionale dei Tumori, Milano, Italy
| | - Maria Teresa Lupo-Stanghellini
- Hematology and Bone Marrow Transplantation Unit, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milano, Italy
| | - Massimo Costantini
- Scientific Directorate, Fondazione Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Renato Mantegazza
- Neuromuscular Diseases and Neuroimmunology Unit, Fondazione Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milano, Italy
| | - Fabio Ciceri
- Hematology and Bone Marrow Transplantation Unit, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milano, Italy
- University Vita-Salute San Raffaele, Milano, Italy
| | - Carlo Salvarani
- Unità di Reumatologia, Azienda Unità Sanitaria Locale (USL)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Reggio Emilia, Italy
- Unità di Reumatologia, Università degli Studi di Modena e Reggio Emilia, Modena, Italy
| | - Pier Luigi Zinzani
- Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Alberto Mantovani
- Humanitas Scientific Directorate, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- William Harvey Research Institute, Queen Mary University, London, United Kingdom
| | - Gennaro Ciliberto
- Scientific Directorate Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Regina Elena, National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Antonio Uccelli
- Biotherapy Unit, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Fausto Baldanti
- Molecular Virology Unit, Fondazione Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia, Italy
- Department of Clinical, Surgical, Diagnostics and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Giovanni Apolone
- Scientific Directorate, Fondazione Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Sabina Delcuratolo
- Scientific Directorate, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Aldo Morrone
- Scientific Directorate, San Gallicano Dermatological Institute Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Franco Locatelli
- Department of Pediatric Hematology and Oncology and Cell and Gene Therapy, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Pediatrico Bambino Gesù, Roma, Italy
- Department of Gynecology-Obstetrics and Pediatrics, University “La Sapienza”, Roma, Italy
| | - Chiara Agrati
- Cellular Immunology Laboratory, National Institute for Infectious Diseases L Spallanzani – Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Nicola Silvestris
- Medical Oncology Unit, Department of Human Pathology “G. Barresi”, University of Messina, Messina, Italy
- *Correspondence: Nicola Silvestris,
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