1
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Conconi A, Chiappella A, Ferreri AJM, Stathis A, Botto B, Sassone M, Gaidano G, Balzarotti M, Merli F, Tucci A, Vanazzi A, Tani M, Bruna R, Orsucci L, Cabras MG, Celli M, Annibali O, Liberati AM, Zanni M, Ghiggi C, Pisani F, Pinotti G, Dore F, Esposito F, Pirosa MC, Cesaretti M, Bonomini L, Vitolo U, Zucca E. IELSG30 phase 2 trial: intravenous and intrathecal CNS prophylaxis in primary testicular diffuse large B-cell lymphoma. Blood Adv 2024; 8:1541-1549. [PMID: 38181782 DOI: 10.1182/bloodadvances.2023011251] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 11/30/2023] [Accepted: 12/01/2023] [Indexed: 01/07/2024] Open
Abstract
ABSTRACT Primary testicular diffuse large B-cell lymphoma (PTL) is characterized by high risk of contralateral testis and central nervous system (CNS) relapse. Chemoimmunotherapy with intrathecal (IT) CNS prophylaxis and contralateral testis irradiation eliminates contralateral recurrences and reduces CNS relapses. The IELSG30 phase 2 study investigated feasibility and activity of an intensified IT and IV CNS prophylaxis. Patients with stage I/II PTL who had not received treatment received 2 cycles of IV high-dose methotrexate (MTX) (1.5 g/m2) after 6 cycles of the R-CHOP regimen (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone, every 21 days). IT liposomal cytarabine was administered on day 0 of cycles 2 to 5 of 21-day R-CHOP regimen. Contralateral testis radiotherapy (25-30 Gy) was recommended. Fifty-four patients (median age: 66 years) with stage I (n = 32) or II (n = 22) disease were treated with R-CHOP, 53 received at least 3 doses of IT cytarabine, 48 received at least 1 dose of IV MTX, and 50 received prophylactic radiotherapy. No unexpected toxicity occurred. At a median follow-up of 6 years, there was no CNS relapse; 7 patients progressed, and 8 died, with 5-year progression-free and overall survival rates of 91% (95% confidence interval [CI], 79-96) and 92% (95% CI, 81-97), respectively. Extranodal recurrence was documented in 6 patients (in 2 without nodal involvement). In 4 cases, the relapse occurred >6 years after treatment. Causes of death were lymphoma (n = 4), second primary malignancy (n = 1), cerebral vasculopathy (n = 1), unknown (n = 2). Intensive prophylaxis was feasible and effective in preventing CNS relapses. Late relapses, mainly at extranodal sites, represented the most relevant pattern of failure. This trial was registered at www.clinicaltrials.gov as #NCT00945724.
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Affiliation(s)
| | - Annalisa Chiappella
- Haematology Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Anastasios Stathis
- Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Barbara Botto
- SC Ematologia, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Marianna Sassone
- Lymphoma Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Gianluca Gaidano
- SCDU Ematologia, Department of Translational Medicine, University of Eastern Piedmont and AOU Maggiore della Carità, Novara, Italy
| | - Monica Balzarotti
- UO Ematologia, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Francesco Merli
- Hematology Unit, Azienda USL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Alessandra Tucci
- Division of Hematology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Anna Vanazzi
- Division of Clinical Haemato-Oncology, European Institute of Oncology IRCCS, Milan, Italy
| | - Monica Tani
- UO Ematologia, Dipartimento Oncologia ed Ematologia, Ospedale Santa Maria delle Croci, Ravenna, Italy
| | - Riccardo Bruna
- Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Lorella Orsucci
- Lymphoma Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Melania Celli
- Ospedale degli Infermi, Hematology Unit, Rimini, Italy
| | - Ombretta Annibali
- Area Ematologia Medicina Trasfusionale e Terapia cellulare Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Anna Marina Liberati
- SC Oncoematologia, Azienda Ospedaliera Santa Maria, Università degli studi di Perugia, Terni, Italy
| | - Manuela Zanni
- Antonio e Biagio e Cesare Arrigo Hospital, Hematology Unit, Alessandria, Italy
| | - Chiara Ghiggi
- IRCCS Ospedale Policlinico San Martino UO Ematologia e Terapie Cellulari, Genoa, Italy
| | - Francesco Pisani
- Hematology and Stem Cell Transplantation Unit, IRCCS Istituto Nazionale dei Tumori Regina Elena, Rome, Italy
| | | | | | - Fabiana Esposito
- Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Maria Cristina Pirosa
- Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Institute of Oncology Research, Bellinzona, Switzerland
| | | | | | - Umberto Vitolo
- Medical Oncology, Candiolo Cancer Institute, Fondazione del Piemonte per l'Oncologia-IRCCS, Candiolo, Turin, Italy
| | - Emanuele Zucca
- Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
- Institute of Oncology Research, Bellinzona, Switzerland
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Stathis A, Pirosa MC, Orsucci L, Feugier P, Tani M, Ghesquières H, Musuraca G, Rossi FG, Merli F, Guièze R, Gyan E, Gini G, Marino D, Gressin R, Morschhauser F, Cavallo F, Palombi F, Conconi A, Tessoulin B, Tilly H, Zanni M, Cabras MG, Capochiani E, Califano C, Celli M, Pulsoni A, Angrilli F, Occhini U, Casasnovas RO, Cartron G, Devizzi L, Haioun C, Liberati AM, Houot R, Merli M, Pietrantuono G, Re F, Spina M, Landi F, Cavalli F, Bertoni F, Rossi D, Ielmini N, Borgo E, Luminari S, Zucca E, Thieblemont C. IELSG38: phase II trial of front-line chlorambucil plus subcutaneous rituximab induction and maintenance in mucosa-associated lymphoid tissue lymphoma. Haematologica 2024. [PMID: 38385243 DOI: 10.3324/haematol.2023.283918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Indexed: 02/23/2024] Open
Abstract
The IELSG38 trial was conducted to investigate the effects of subcutaneous (SC) rituximab on the complete remission (CR) rate and the benefits of SC maintenance in patients with extranodal marginal zone lymphoma (MZL) who received frontline treatment with chlorambucil plus rituximab. Study treatment comprised an induction phase with chlorambucil 6 mg/m2/day orally on weeks 1-6, 9-10, 13-14, 17-18, and 21-22, and rituximab 375 mg/m2 intravenously on day 1 of weeks 1-4, and 1400 mg SC on weeks 9, 13, 17, and 21. Then, a maintenance phase followed with rituximab administered at 1400 mg SC every two months for two years. Of the 112 patients enrolled, 109 were evaluated for efficacy. The CR rates increased from 52% at the end of the induction phase to 70% upon completion of the maintenance phase. With a median follow-up of 5.8 years, the 5-year event-free, progression-free, and overall survival rates were 87% (95% CI, 78-92), 84% (95% CI, 75-89), and 93% (95% CI, 86-96), respectively. The most common grade ≥3 toxicities were neutropenia (33%) and lymphocytopenia (16%). Six patients experienced treatment-related serious adverse events, including fever of unknown origin, sepsis, pneumonia, respiratory failure, severe cerebellar ataxia, and fatal acute myeloid leukemia. The trial showed that subcutaneous rituximab did not improve the complete remission rate at the conclusion of the induction phase, which was the main endpoint. Nevertheless, SC maintenance might have facilitated long-term disease control, potentially contributing to enhanced event-free and progression-free survival.
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Affiliation(s)
- Anastasios Stathis
- Oncology Institute of Southern Switzerland, EOC, Bellinzona, Switzerland; Università della Svizzera Italiana, Faculty of Biomedical Sciences, Lugano.
| | - Maria Cristina Pirosa
- Oncology Institute of Southern Switzerland, EOC, Bellinzona, Switzerland; Institute of Oncology Research, Bellinzona
| | - Lorella Orsucci
- S.C. Ematologia, AOU Città della Salute e della Scienza di Torino, Turin
| | - Pierre Feugier
- Department of Clinical Hematology, Nancy University Hospital, INSERM 1256, Nancy
| | - Monica Tani
- U.O. Ematologia, Dipartimento Oncologia e Ematologia, Ospedale Santa Maria delle Croci, Ravenna
| | - Hervé Ghesquières
- Hematology Department, Hospices Civils de Lyon, CHU Lyon-Sud, Pierre-Bénite
| | - Gerardo Musuraca
- Hematology Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola
| | - Francesca Gaia Rossi
- Hematology-BMT Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milano
| | | | - Romain Guièze
- Service d'Hématologie Clinique et de Thérapie Cellulaire, CHU Estaing, Clermont- Ferrand
| | - Emmanuel Gyan
- Hématologie et thérapie cellulaire, CIC Inserm U1415, Centre Hospitalier Universitaire de Tours, Tours
| | - Guido Gini
- Hematology, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona
| | - Dario Marino
- Oncology 1 Unit, Istituto Oncologico Veneto IOV-IRCCS, Padova
| | - Remy Gressin
- Institute for Advanced Biosciences, INSERM U1209/CNRS UMR 5309/Grenoble Alpes University, Grenoble
| | | | - Federica Cavallo
- Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino/AOU Città della Salute e della Scienza di Torino, Turin
| | - Francesca Palombi
- Hematology and Stem Cell Transplant Unit, IRCCS. National Cancer Institute, Istituto Regina Elena, Rome Italy
| | | | - Benoît Tessoulin
- Hématologie Clinique, CHU de Nantes, INSERM CRCINA Nantes-Angers, NeXT Université de Nantes, Nantes
| | - Hervé Tilly
- Department of Hematology and U1245, Centre Henri Becquerel, Rouen
| | - Manuela Zanni
- Hematology Unit, Antonio e Biagio e Cesare Arrigo Hospital, Alessandria
| | | | - Enrico Capochiani
- Hematology Unit, Azienda USL Toscana NordOvest, Center for Translational Medicine, Livorno
| | | | | | - Alessandro Pulsoni
- Department of Translational and Precision Medicine, Sapienza University, Rome
| | - Francesco Angrilli
- Unità Operativa Semplice Dipartimentale Centro Diagnosi e Terapia Linfomi, Presidio Ospedaliero, Pescara
| | - Ubaldo Occhini
- Unità Operativa di Ematologia, Ospedale San Donato, AUSL Toscana Sud-Est, Arezzo
| | | | | | - Liliana Devizzi
- Hematology Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan
| | - Corinne Haioun
- Lymphoid Malignancies Unit, Hôpital Henri Mondor, AP-HP, Créteil
| | - Anna Marina Liberati
- SC Oncoematologia, Azienda Ospedaliera Santa Maria, Università degli studi di Perugia, Terni
| | - Roch Houot
- Department of Clinical Hematology, University Hospital of Rennes, Rennes
| | - Michele Merli
- Division of Hematology, University Hospital Ospedale di Circolo e Fondazione Macchi ASST Sette Laghi, University of Insubria, Varese
| | - Giuseppe Pietrantuono
- Hematology Unit, Centro di Riferimento Oncologico della Basilicata IRCCS Rionero in Vulture
| | - Francesca Re
- Hematology and BMT Center, Azienda Ospedaliera Universitaria, Parma
| | - Michele Spina
- Division of Medical Oncology, Centro di Riferimento Oncologico IRCCS, Aviano
| | | | | | - Francesco Bertoni
- Oncology Institute of Southern Switzerland, EOC, Bellinzona, Switzerland; Università della Svizzera Italiana, Faculty of Biomedical Sciences, Lugano, Switzerland; Institute of Oncology Research, Bellinzona
| | - Davide Rossi
- Oncology Institute of Southern Switzerland, EOC, Bellinzona, Switzerland; Università della Svizzera Italiana, Faculty of Biomedical Sciences, Lugano, Switzerland; Institute of Oncology Research, Bellinzona
| | | | - Elena Borgo
- FIL, Fondazione Italiana Linfomi ONLUS, Alessandria
| | - Stefano Luminari
- AUSL-IRCCS of Reggio Emilia, Reggio Emilia, Italy; CHIMOMO Department, University of Modena and Reggio Emilia, Reggio Emilia
| | - Emanuele Zucca
- Oncology Institute of Southern Switzerland, EOC, Bellinzona, Switzerland; Università della Svizzera Italiana, Faculty of Biomedical Sciences, Lugano, Switzerland; Institute of Oncology Research, Bellinzona, Switzerland; Medical Oncology, University Hospital and University of Bern
| | - Catherine Thieblemont
- APHP - Service d'Hématologie-Oncologie, Hôpital Saint Louis, Université de Paris - Diderot, Paris
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Bommier C, Zucca E, Chevret S, Conconi A, Nowakowski G, Maurer MJ, Cerhan JR, Thieblemont C, Lambert J. Early complete response as a validated surrogate marker in extranodal marginal zone lymphoma systemic therapy. Blood 2024; 143:422-428. [PMID: 37801707 DOI: 10.1182/blood.2023020984] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/31/2023] [Accepted: 08/31/2023] [Indexed: 10/08/2023] Open
Abstract
ABSTRACT Extranodal marginal zone lymphoma (EMZL) has a very indolent course, and the validation of surrogate markers could accelerate novel therapies. Although prognostic markers do exist, no surrogate markers have been validated in EMZL. We hypothesized that time to complete response within 24 months (TTCR24) and complete response (CR) at 24 months (CR24) could be valid surrogate markers of progression-free survival (PFS). The International Extranodal Lymphoma Study Group 19 phase 3 trial showed the advantage of double therapy (rituximab + chlorambucil) over single therapy (rituximab or chlorambucil) on PFS. We used 2 recently published single-trial approaches to assess whether TTCR24 and CR24 were good surrogate markers of 8-year PFS (8y-PFS). Among the 401 patients, 264 (66%) reached a CR in the first 24 months, of which 222 (84%) remained in CR at month 24. The cumulative incidence of CR over time was significantly higher in patients under double therapy (hazard ratio, 1.75; P < .001). The double therapy arm was associated with a higher CR24 rate, a shorter TTCR24, and a longer 8y-PFS. The estimated proportion of treatment effect on 8y-PFS explained by TTCR24 was 95% (95% confidence interval [CI], 0.27-1.87). CR24 was also a strong surrogate marker because it mediated 90% (95% CI, 0.51-2.22) of the treatment effect on PFS and its natural indirect effect was significant throughout the follow-up. We found that TTCR24 predicted 95% and that CR24 mediated 90% of the treatment effect on long-term PFS. Therefore, TTCR24 and CR24 could be used in clinical trials as informative and valid early indicators of treatment effect on PFS. This trial was registered at www.clinicaltrials.gov as #NCT00210353.
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Affiliation(s)
- Côme Bommier
- INSERM U1153, Epidemiology and Clinical Statistics for Trials & Real-world Evidence Research Team, Saint-Louis Hospital, Paris, France
- Université Paris Cité, Paris, France
- Department of Hemato-Oncology, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, Département Médico Universitaire Hématologie et Immunologie, Paris, France
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Emanuele Zucca
- Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Institute of Oncology Research, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Sylvie Chevret
- INSERM U1153, Epidemiology and Clinical Statistics for Trials & Real-world Evidence Research Team, Saint-Louis Hospital, Paris, France
- Biostatistics and Medical Information Department, Saint-Louis Hospital, Paris, France
| | - Annarita Conconi
- Struttura Semplice a Valenza Dipartimentale di Ematologia, Ospedale degli Infermi, Azienda Sanitaria Locale di Biella, Ponderano, Italy
| | - Grzegorz Nowakowski
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN
| | - Matthew J Maurer
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - James R Cerhan
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Catherine Thieblemont
- Université Paris Cité, Paris, France
- Department of Hemato-Oncology, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, Département Médico Universitaire Hématologie et Immunologie, Paris, France
| | - Jérôme Lambert
- INSERM U1153, Epidemiology and Clinical Statistics for Trials & Real-world Evidence Research Team, Saint-Louis Hospital, Paris, France
- Université Paris Cité, Paris, France
- Biostatistics and Medical Information Department, Saint-Louis Hospital, Paris, France
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4
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Nizzoli ME, Manni M, Ghiggi C, Pulsoni A, Musuraca G, Merli M, Califano C, Bari A, Massaia M, Conconi A, Musto P, Mannina D, Perrone T, Re F, Galimberti S, Gini G, Capponi M, Vitolo U, Usai SV, Stefani PM, Ballerini F, Liberati AM, Pennese E, Pastore D, Skrypets T, Catellani H, Marcheselli L, Federico M, Luminari S. Impact of immunochemotherapy with R-bendamustine or R-CHOP for treatment naïve advanced-stage follicular lymphoma: A subset analysis of the FOLL12 trial by Fondazione Italiana Linfomi. Hematol Oncol 2023; 41:655-662. [PMID: 37246287 DOI: 10.1002/hon.3184] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/10/2023] [Accepted: 05/12/2023] [Indexed: 05/30/2023]
Abstract
We conducted a post hoc analysis of the FOLL12 trial to determine the impact of different initial immunochemotherapy (ICT) regimens on patient outcomes. Patients were selected from the FOLL12 trial, which included adults with stage II-IV follicular lymphoma (FL) grade 1-3a and high tumor burden. Patients were randomized 1:1 to receive either standard ICT followed by rituximab maintenance (RM) or the same ICT followed by a response-adapted approach. ICT consisted of rituximab-bendamustine (RB) or rituximab, cyclophosphamide, doxorubicin, and prednisone (R-CHOP), per physician's decision. A total of 786 patients were included in this analysis, 341 of whom received RB and 445 R-CHOP. RB was more frequently prescribed to older subjects, females, patients without bulky disease, and those with grade 1-2 FL. After a median of 56 months of follow-up, R-CHOP and RB had similar progression-free survival (PFS) (Hazard Ratio for RB 1.11, 95% CI 0.87-1.42, p = 0.392). Standard RM was associated with improved PFS compared to response-adapted management both after R-CHOP and RB. Grade 3-4 hematologic adverse events were more frequent with R-CHOP during induction treatment and more frequent with RB during RM. Grade 3-4 infections were more frequent with RB. RB was also associated with a higher incidence of transformed FL. R-CHOP and RB showed similar activity and efficacy, but with different safety profiles and long-term events, suggesting that the treating physician should carefully select the most appropriate chemotherapy regimen for each patient based on patient's individual characteristics, choices, and risk profile.
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Affiliation(s)
- Maria E Nizzoli
- Hematology Unit, Azienda Unitа Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Martina Manni
- Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Chiara Ghiggi
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Alessandro Pulsoni
- Department of Translational and Precision Medicine, Sapienza University - UOC Ematologia, S.M. Goretti Hospital, Latina, Italy
| | - Gerardo Musuraca
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Michele Merli
- Hematology, University Hospital Ospedale di Circolo e Fondazione Macchi-ASST Sette Laghi, University of Insubria, Varese, Italy
| | | | - Alessia Bari
- Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell'Adulto, Università di Modena e Reggio Emilia, Modena, Italy
| | - Massimo Massaia
- SC Ematologia, AO S. Croce e Carle, Cuneo, Italy
- Centro di Biotecnologie Molecolari, University of Torino, Turin, Italy
| | | | - Pellegrino Musto
- Hematology, IRCCS CROB of Rionero in Vulture, Rionero in Vulture, Italy
| | - Donato Mannina
- Azienda Ospedaliera Papardo-UOC di Ematologia, Messina, Italy
| | - Tommasina Perrone
- Unit of Hematology and Stem Cell Transplantation, AOUC Policlinico, Bari, Italy
| | - Francesca Re
- Division od Immuno-Haematology, AOU Parma, Parma, Italy
| | - Sara Galimberti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Guido Gini
- Clinic of Hematology AOU delle Marche- Università Politecnica delle Marche, Ancona, Italy
| | - Monia Capponi
- Department of Hematology, University of Perugia, Perugia, Italy
| | - Umberto Vitolo
- Medical Oncology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - Sara V Usai
- Division of Hematology, Ospedale Oncologico Armando Businco, Cagliari, Italy
| | - Piero M Stefani
- Hematology Unit, General Hospital Ca' Foncello, Treviso, Italy
| | - Filippo Ballerini
- Clinica Ematologica, Ospedale Policlinico San Martino, Genova, Italy
| | - Anna M Liberati
- Oncohematology Unit, University of Perugia, Azienda Ospedaliera S.Maria Terni, Messina, Italy
| | - Elsa Pennese
- Lymphoma Unit, Department of Hematology, Ospedale Spirito Santo, Pescara, Italy
| | | | - Tetiana Skrypets
- Hematology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Hillary Catellani
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Massimo Federico
- Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefano Luminari
- Hematology Unit, Azienda Unitа Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
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5
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Alderuccio JP, Reis IM, Habermann TM, Link BK, Thieblemont C, Conconi A, Larson MC, Cascione L, Zhao W, Cerhan JR, Zucca E, Lossos IS. Revised MALT-IPI: A new predictive model that identifies high-risk patients with extranodal marginal zone lymphoma. Am J Hematol 2022; 97:1529-1537. [PMID: 36057138 PMCID: PMC9847507 DOI: 10.1002/ajh.26715] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/11/2022] [Accepted: 08/29/2022] [Indexed: 01/31/2023]
Abstract
Extranodal marginal zone lymphoma (EMZL) is a heterogeneous disease with a subset of patients exhibiting a more aggressive course. We previously reported that EMZL with multiple mucosal sites (MMS) at diagnosis is characterized by shorter survival. To better recognize patients with different patterns of progression-free survival (PFS) we developed and validated a new prognostic index primarily based on patient's disease characteristics. We derived the "Revised mucosa-associated lymphoid tissue International Prognostic Index" (Revised MALT-IPI) in a large data set (n = 397) by identifying candidate variables that showed highest prognostic association with PFS. The revised MALT-IPI was validated in two independent cohorts, from the University of Iowa/Mayo Clinic (n = 297) and from IELSG-19 study (n = 400). A stepwise Cox regression analysis yielded a model including four independent predictors of shorter PFS. Revised MALT-IPI has scores ranging from 0 to 5, calculated as a sum of one point for each of the following- age >60 years, elevated LDH, and stage III-IV; and two points for MMS. In the training cohort, the Revised MALT-IPI defined four risk groups: low risk (score 0, reference group), low-medium risk (score 1, HR = 1.85, p = .008), medium-high risk (score 2, HR = 3.84, p < .0001), and high risk (score 3+, HR = 8.48, p < .0001). Performance of the Revised MALT-IPI was similar in external validation cohorts. Revised MALT-IPI is a new index centered on disease characteristics that provides robust risk-stratification identifying a group of patients characterized by earlier progression of disease. Revised MALT-IPI can allow a more disease-adjusted management of patients with EMZL in clinical trials and practice.
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Affiliation(s)
| | - Isildinha M. Reis
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
- Biostatistics and Bioinformatics Shared Resource, Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | | | - Brian K. Link
- Division of Hematology, Oncology and Bone and Marrow Transplantation, University of Iowa, Iowa City, IA, USA
| | - Catherine Thieblemont
- APHP, Hôpital Saint-Louis, Service d’hémato-oncologie, DMU DHI, Université de Paris, Paris, France
| | | | - Melissa C. Larson
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Luciano Cascione
- Clinic of Medical Oncology, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Wei Zhao
- Biostatistics and Bioinformatics Shared Resource, Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - James R. Cerhan
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Emanuele Zucca
- Clinic of Medical Oncology, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Institute of Oncology Research, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Bellinzona, Switzerland
- Department of Medical Oncology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Izidore S. Lossos
- Division of Hematology, Sylvester Comprehensive Cancer Center, Miami, FL, USA
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Visco C, Marcheselli L, Mina R, Sassone M, Guidetti A, Penna D, Cattaneo C, Bonuomo V, Busca A, Ferreri AJM, Bruna R, Petrucci L, Cairoli R, Salvini M, Bertù L, Ladetto M, Pilerci S, Pinto A, Ramadan S, Marchesi F, Cavo M, Arcaini L, Coviello E, Romano A, Musto P, Massaia M, Fracchiolla N, Marchetti M, Scattolin A, Tisi MC, Cuneo A, Della Porta M, Trentin L, Turrini M, Gherlinzoni F, Tafuri A, Galimberti S, Bocchia M, Cardinali V, Cilloni D, Corso A, Armiento D, Rigacci L, La Barbera EO, Gambacorti-Passerini C, Visani G, Vallisa D, Venditti A, Selleri C, Conconi A, Tosi P, Lanza F, Candoni A, Krampera M, Corradini P, Passamonti F, Merli F. A prognostic model for patients with lymphoma and COVID-19: a multicentre cohort study. Blood Adv 2022; 6:327-338. [PMID: 34644385 PMCID: PMC8516438 DOI: 10.1182/bloodadvances.2021005691] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [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: 07/06/2021] [Accepted: 09/08/2021] [Indexed: 11/20/2022] Open
Abstract
Lymphoma represents a heterogeneous hematological malignancy (HM), which is characterized by severe immunosuppression. Patients diagnosed of coronavirus disease 2019 (COVID-19) during the course of HM have been described to have poor outcome, with only few reports specifically addressing lymphoma patients. Here, we investigated the clinical behavior and clinical parameters of a large multicenter cohort of adult patients with different lymphoma subtypes, with the aim of identifying predictors of death. The study included 856 patients, of whom 619 were enrolled prospectively in a 1-year frame and were followed-up for a median of 66 days (range 1-395). Patients were managed as outpatient (not-admitted cohort, n = 388) or required hospitalization (n = 468), and median age was 63 years (range 19-94). Overall, the 30- and 100-days mortality was 13% (95% confidence interval (CI), 11% to 15%) and 23% (95% CI, 20% to 27%), respectively. Antilymphoma treatment, including anti-CD20 containing regimens, did not impact survival. Patients with Hodgkin's lymphoma had the more favorable survival, but this was partly related to significantly younger age. The time interval between lymphoma diagnosis and COVID-19 was inversely related to mortality. Multivariable analysis recognized 4 easy-to-use factors (age, gender, lymphocyte, and platelet count) that were associated with risk of death, both in the admitted and in the not-admitted cohort (HR 3.79 and 8.85 for the intermediate- and high-risk group, respectively). Overall, our study shows that patients should not be deprived of the best available treatment of their underlying disease and indicates which patients are at higher risk of death. This study was registered with ClinicalTrials.gov, NCT04352556.
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Affiliation(s)
- Carlo Visco
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | | | - Roberto Mina
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliera Universitaria Citta’della Salute e della Scienza, Turin, Italy
| | - Marianna Sassone
- Lymphoma Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Anna Guidetti
- Hematology and Bone Marrow Transplantation, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, University of Milano, Milano, Italy
| | - Domenico Penna
- Hematology, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Reggio Emilia, Reggio Emilia, Italy
| | - Chiara Cattaneo
- Hematology, Azienda Socio-Sanitaria Territoriale-Spedali Civili, Brescia, Italy
| | - Valentina Bonuomo
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Alessandro Busca
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliera Universitaria Citta’della Salute e della Scienza, Turin, Italy
| | - Andrés José María Ferreri
- Lymphoma Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Riccardo Bruna
- Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont and Ospedale Maggiore della Carità, Novara, Italy
| | - Luigi Petrucci
- Hematology, Department of Translational and Precision Medicine, Sapienza, University of Rome, Rome, Italy
| | - Roberto Cairoli
- Hematology, Azienda Socio-Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Marco Salvini
- Department of Medicine and Surgery, University of Insubria and Azienda Socio-Sanitaria Territoriale Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Lorenza Bertù
- Department of Medicine and Surgery, University of Insubria and Azienda Socio-Sanitaria Territoriale Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Marco Ladetto
- Hematology, Azienda Ospedaliera Santissimi Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Sofia Pilerci
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Antonello Pinto
- Hematology, Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico “Fondazione G Pascale,” Naples, Italy
| | - Safaa Ramadan
- Division of Onco-Hematology, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, Istituto di Ricovero e Cura a Carattere Scientifico Regina Elena National Cancer Institute, Rome, Italy
| | - Michele Cavo
- Seràgnoli Institute of Hematology, Department of Experimental, Diagnostic and Specialty Medicine, Bologna University School of Medicine, Bologna, Italy
| | - Luca Arcaini
- Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo & Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Elisa Coviello
- Hematology and bone marrow transplant, Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genova, Italy
| | - Alessandra Romano
- Hematology, Dipartimento di Chirurgia e Specialità Medico Chirurgiche, Università degli Studi di Catania, Catania, Italy
| | - Pellegrino Musto
- Department of Emergency and Organ Transplantation, Aldo Moro” University School of Medicine and Unit of Hematology and Stem Cell Transplantation, Azienda Ospedaliera Universitaria Consorziale Policlinico, Bari, Italy
| | | | - Nicola Fracchiolla
- Oncoematologia, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milano, Italy
| | - Monia Marchetti
- Hematology, Azienda Ospedaliera Santissimi Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | | | | | - Antonio Cuneo
- Hematology, Azienda Ospedaliero Universitaria Sant’Anna, Ferrara, Italy
| | - Matteo Della Porta
- Humanitas Clinical and Research Hospital Istituto di Ricovero e Cura a Carattere Scientifico and Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Livio Trentin
- Hematology and Clinical Immunology Unit, Department of Medicine, University of Padua, Padua, Italy
| | | | | | - Agostino Tafuri
- Hematology, University Hospital Sant’Andrea, Sapienza, Rome, Italy
| | - Sara Galimberti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Monica Bocchia
- Hematology Unit, University of Siena, Azienda Ospedaliero Universitaria Senese, Siena, Italy
| | | | - Daniela Cilloni
- Department of Clinical and Biological Sciences, University of Turin, San Luigi Hospital, Turin, Italy
| | | | - Daniele Armiento
- Unit of Hematology, Stem Cell Transplantation, University Campus Bio-Medico, Rome, Italy
| | | | - Elettra Ortu La Barbera
- Unità Operativa Complessa Ematologia con Trapianto, Ospedale Santa Maria Goretti, Latina, Italy
| | | | - Giuseppe Visani
- Dipartimento di OncoEmatologia, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
| | | | - Adriano Venditti
- Department of Biomedicine and Prevention, University Tor Vergata Rome, Rome, Italy
| | - Carmine Selleri
- Department of Medicine, Hematology, University of Salerno, Ospedale San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | | | - Patrizia Tosi
- Hematology, Ospedale degli Infermi di Rimini, Rimini, Italy
| | | | - Anna Candoni
- Hematology and Stem Cell Transplant Unit, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Mauro Krampera
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Paolo Corradini
- Hematology and Bone Marrow Transplantation, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, University of Milano, Milano, Italy
| | - Francesco Passamonti
- Department of Medicine and Surgery, University of Insubria and Azienda Socio-Sanitaria Territoriale Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Francesco Merli
- Hematology, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Reggio Emilia, Reggio Emilia, Italy
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7
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Conconi A, Chiappella A, Orsucci L, Gaidano G, Ferreri AJ, Balzarotti M, Tucci A, Botto B, Moccia A, Vanazzi A, Merli F, Tani M, Esposito F, Bonomini L, Vitolo U, Zucca E. INTENSIFIED (INTRAVENOUS AND INTRATHECAL) CNS PROPHYLAXIS IN PRIMARY TESTICULAR DIFFUSE LARGE B‐CELL LYMPHOMA: 5‐YEAR RESULTS OF THE IELSG30 TRIAL. Hematol Oncol 2021. [DOI: 10.1002/hon.48_2879] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- A. Conconi
- Azienda sanitaria locale Biella Ospedale degli Infermi ‐ Ematologia Biella Italy
| | - A. Chiappella
- A.O.U Città della Salute e della Scienza di Torino Dipartimento di Oncologia ed Ematologia Torino Italy
| | - L. Orsucci
- A.O.U Città della Salute e della Scienza di Torino Dipartimento di Oncologia ed Ematologia Torino Italy
| | - G. Gaidano
- Azienda Ospedaliera "Maggiore della Carità" Ematologia Novara Italy
| | - Andrés J.M. Ferreri
- IRCCS San Raffaele Scientific Institute Unità Operativa di Oncologia Medica Milano Italy
| | - M. Balzarotti
- Istituto Clinico Humanitas U.O. Oncologia Medica ed Ematologia Milano Rozzano Italy
| | - A. Tucci
- Spedali Civili, SC Ematologia Brescia Italy
| | - B. Botto
- A.O.U Città della Salute e della Scienza di Torino Dipartimento di Oncologia ed Ematologia Torino Italy
| | - A. Moccia
- Oncology Institute of Southern Switzerland Medical Oncology Clinic Bellinzona Switzerland
| | - A. Vanazzi
- Istituto Europeo di Oncologia Oncoematologia Milano Italy
| | - F. Merli
- Azienda Ospedaliera di Reggio Emilia Arcispedale Santa Maria Nuova ‐ Ematologia Reggio Emilia Italy
| | - M. Tani
- Ospedale Santa Maria delle Croci Dipartimento di Oncologia ed Ematologia Ravenna Italy
| | - F. Esposito
- Foundation for the Institute of Oncology Research (IOR) International Extranodal Lymphoma Study Group Oncology Institute of Southern Switzerland Medical Oncology Clinic Bellinzona Switzerland
| | - L. Bonomini
- Foundation for the Institute of Oncology Research (IOR) International Extranodal Lymphoma Study Group Bellinzona Switzerland
| | - U. Vitolo
- Candiolo Cancer Institute FPO‐IRCCS Oncologia Medica Candiolo Italy
| | - E. Zucca
- Foundation for the Institute of Oncology Research (IOR) International Extranodal Lymphoma Study Group Oncology Institute of Southern Switzerland Medical Oncology Clinic Bellinzona Switzerland
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8
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Luminari S, Galimberti S, Versari A, Tucci A, Boccomini C, Farina L, Zaja F, Marcheselli L, Ferrero S, Arcaini L, Pulsoni A, Musuraca G, Califano C, Merli M, Bari A, Conconi A, Giudice ID, Re F, Stefani PM, Usai SV, Perrone T, Gini G, Falini B, Gattei V, Manni M, Ladetto M, Mannina D, Federico M. RESPONSE ADAPTED POST INDUCTION THERAPY IN FOLLICULAR LYMPHOMA: UPDATED RESULTS OF THE FOLL12 TRIAL BY THE FONDAZIONE ITALIANA LINFOMI (FIL). Hematol Oncol 2021. [DOI: 10.1002/hon.80_2879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- S. Luminari
- Azienda Unità Sanitaria Locale IRCCS Arcispedale Santa Maria Nuova IRCCS Hematology Unit and University of Modena and Reggio Emilia Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine Reggio Emilia Italy
| | - S. Galimberti
- University of Pisa Department of Clinical and Experimental Medicine Pisa Italy
| | - A. Versari
- Azienda Unità Sanitaria Locale‐IRCCS ‐ Arcispedale Santa Maria Nuova Medicina Nucleare Reggio Emilia Italy
| | - A. Tucci
- ASST Spedali Civili di Brescia SC Ematologia Brescia Italy
| | - C. Boccomini
- A.O.U. Città della Salute e della Scienza di Torino SC Ematologia Torino Italy
| | - L. Farina
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano Division of Hematology Milano Italy
| | - F. Zaja
- Università degli Studi di Trieste Dipartimento Clinico di Scienze mediche, chirurgiche e della salute and, Azienda Sanitaria Universitaria Giuliano Isontina SC Ematologia Trieste Italy
| | | | - S. Ferrero
- University of Torino, Hematology Department of Molecular Biotechnologies and Health Sciences and AOU “Città della Salute e della Scienza di Torino” Hematology 1 Torino Italy
| | - L. Arcaini
- Fondazione IRCCS Policlinico San Matteo di Pavia Division of Hematology and University of Pavia Department of Molecular Medicine Pavia Italy
| | - A. Pulsoni
- Sapienza Università di Roma Dipartimento di Biotecnologie Cellulari ed Ematologia Roma Italy
| | - G. Musuraca
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori" Department of Hematology Meldola Italy
| | - C. Califano
- Ospedale Umberto I, U.O Medicina‐Oncoematologia Nocera Inferiore Italy
| | - M. Merli
- University Hospital Ospedale di Circolo e Fondazione Macchi ASST Settelaghi Varese Italy
| | - A. Bari
- Università di Modena e Reggio Emilia Dipartimento di Scienze Mediche e Chirurgiche Materno‐Infantili e dell'Adulto Modena Italy
| | - A. Conconi
- Ospedale degli Infermi Unit of Hematology Biella Italy
| | - I. del Giudice
- Policlinico Umberto I ‐ Università "La Sapienza" ‐ Istituto Ematologia Dipartimento di Medicina Traslazionale e di Precisione Roma Italy
| | - F. Re
- Azienda Ospedaliero Universitaria di Parma UO Ematologia e CTMO Parma Italy
| | - P. M. Stefani
- General Hospital Ca' Foncello Hematology Treviso Italy
| | - S. V. Usai
- Ospedale Oncologico Armando Businco Division of Hematology Cagliari Italy
| | - T. Perrone
- University of Bari Hematology Bari Italy
| | - G. Gini
- Marche Polytechnic University Department of Clinical and Molecular Sciences, Hematology Ancona Italy
| | - B. Falini
- Ospedale S. Maria della Misericordia University of Perugia Institute of Hematology and CREO (Center for Hemato‐Oncological Research) Perugia Italy
| | - V. Gattei
- Centro di Riferimento Oncologico di Aviano (CRO) IRCCS Clinical and Experimental Onco‐Hematology Unit Aviano Italy
| | - M. Manni
- University of Modena and Reggio Emilia Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine Modena Italy
| | - M. Ladetto
- Università del Piemonte Orientale Dipartimento di Medicina Traslazionale and AO SS Antonio e Biagio e Cesare Arrigo SC Ematologia Alessandria Italy
| | - D. Mannina
- Azienda Ospedaliera Papardo UOC di Ematologia Messina Italy
| | - M. Federico
- University of Modena and Reggio Emilia Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine Modena Italy
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Conconi A, Vannata B, Janikova A, Ramirez A, Bodoni CL, Nowakowski G, Mian M, Ferreri AJ, Ryan G, Pangalis GA, Cabrera ME, Luminari S, Montoto S, Tsang R, Aurer I, Visco C, Mazzucchelli L, Trneny M, Gaidano G, Federico M, Lopez‐Guillermo A, Pro B, Zucca E. PRIMARY EXTRANODAL FOLLICULAR LYMPHOMA IN A LARGE RETROSPECTIVE SURVEY OF THE INTERNATIONAL EXTRANODAL LYMPHOMA STUDY GROUP (IELSG31). Hematol Oncol 2021. [DOI: 10.1002/hon.78_2879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- A. Conconi
- Azienda sanitaria locale Biella Ospedale degli Infermi ‐ Ematologia Biella Italy
| | - B. Vannata
- Oncology Institute of Southern Switzerland Medical Oncology Clinic Bellinzona Switzerland
| | - A. Janikova
- University Hospital Brno Department of Hematology and Oncology Brno Czech Republic
| | - A. Ramirez
- Instituto Nacional de Cancerologia Hematology Department Mexico City Mexico
| | - C. Lobetti Bodoni
- Oncology Institute of Southern Switzerland Medical Oncology Clinic Bellinzona Switzerland
| | - G. Nowakowski
- Mayo Clinic Division of Hematology Rochester Minnesota USA
| | - M. Mian
- Ospedale di Bolzano Ematologia e Centro Trapianto Midollo Osseo Bolzano Italy
| | - Andrés J.M. Ferreri
- IRCCS San Raffaele Scientific Institute Unità Operativa di Oncologia Medica Milano Italy
| | - G. Ryan
- Peter MacCallum Cancer Institute Deptment of Radiation Oncology Melbourne Australia
| | - G. A. Pangalis
- Athens Medical Center‐Psychikon Branch Hematology Department Athens Greece
| | - M. E. Cabrera
- Hospital del Salvador Facultad de Medicina Santiago Chile
| | - S. Luminari
- Arcispedale Santa Maria Nuova Servizio di Ematologia Reggio Emilia Italy
| | - S. Montoto
- St. Bartholomew’s Hospital Department of Medical Oncology London UK
| | - R. Tsang
- University Health Network Princess Margaret Hospital Toronto Canada
| | - I. Aurer
- University Hospital Centre Zagreb Division of Hematology Zagreb Croatia
| | - C. Visco
- University of Verona Departmento of Medicine ‐ Section of Hematology Verona Italy
| | | | - M. Trneny
- Charles University General Hospital Prague First Faculty of Medicine Prague Czech Republic
| | - G. Gaidano
- Azienda Ospedaliera "Maggiore della Carità" Ematologia Novara Italy
| | - M. Federico
- Università degli Studi di Modena e Reggio Emilia Centro Oncologico Modenese Modena Italy
| | | | - B. Pro
- Northwestern Medicine Hematology and Medical Oncology Chicago Illinois USA
| | - E. Zucca
- Foundation for the Institute of Oncology Research (IOR) International Extranodal Lymphoma Study Group Oncology Institute of Southern Switzerland Medical Oncology Clinic Bellinzona Switzerland
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Conconi A, Thieblemont C, Cascione L, Torri V, Kiesewetter B, Casaluci GM, Gaidano G, Raderer M, Cavalli F, Guillermo AL, Johnson PW, Zucca E. Early progression of disease predicts shorter survival in MALT lymphoma patients receiving systemic treatment. Haematologica 2020; 105:2592-2597. [PMID: 33131248 PMCID: PMC7604574 DOI: 10.3324/haematol.2019.237990] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [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: 09/11/2019] [Accepted: 01/02/2020] [Indexed: 11/13/2022] Open
Abstract
Early progression of disease (POD) within two years from diagnosis is linked with poor overall survival (OS) in follicular lymphoma but its prognostic role is less clear in extranodal marginal zone B-cell lymphoma (EMZL). We sought to identify prognostic factors associated with early POD and to determine whether is associated with inferior OS. We analyzed the impact of early POD in the IELSG19 clinical trial dataset (training set of 401 patients randomly assigned to chlorambucil or rituximab or chlorambucil plus rituximab). Reproducibility was examined in a validation set of 287 patients who received systemic treatment. In both sets, we excluded from the analysis the patients who, within 24 months from treatment start, died without progression or were lost to follow-up without prior progression. OS was calculated from progression in patients with early POD and from 24 months after start of treatment in those without (reference group). Early POD was observed in 69 of the 384 (18%) evaluable patients of the IELSG19 study. Patients with high-risk MALT-IPI were more likely to have early POD (p=0.006). The 10-year OS rate was 64% in the early POD group and 85% in the reference group (HR= 2.42, 95%CI, 1.35-4.34; log-rank P=0.002). This prognostic impact was confirmed in the validation set, in which early POD was observed in 64 out of 224 (29%) evaluable patients with 10-year OS rate of 48% in the early POD group and 71% in the reference group (HR= 2.15, 95%CI, 1.19-3.90; log-rank P=0.009). In patients with EMZL who received front-line systemic treatment, early POD is associated with poorer survival and may represent a useful endpoint in future prospective clinical trials.
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Affiliation(s)
| | | | | | - Valter Torri
- Clinical Research Methodology Laboratory, IRCCS–Mario Negri Institute, Milan, Italy
| | - Barbara Kiesewetter
- Division of Oncology, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - Gloria Margiotta Casaluci
- Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Gianluca Gaidano
- Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Markus Raderer
- Division of Oncology, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | | | | | - Peter W. Johnson
- Cancer Research UK Centre Southampton General Hospital, Southampton, UK
| | - Emanuele Zucca
- Institute of Oncology Research, Bellinzona, Switzerland
- Division of Medical Oncology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
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11
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Passamonti F, Cattaneo C, Arcaini L, Bruna R, Cavo M, Merli F, Angelucci E, Krampera M, Cairoli R, Della Porta MG, Fracchiolla N, Ladetto M, Gambacorti Passerini C, Salvini M, Marchetti M, Lemoli R, Molteni A, Busca A, Cuneo A, Romano A, Giuliani N, Galimberti S, Corso A, Morotti A, Falini B, Billio A, Gherlinzoni F, Visani G, Tisi MC, Tafuri A, Tosi P, Lanza F, Massaia M, Turrini M, Ferrara F, Gurrieri C, Vallisa D, Martelli M, Derenzini E, Guarini A, Conconi A, Cuccaro A, Cudillo L, Russo D, Ciambelli F, Scattolin AM, Luppi M, Selleri C, Ortu La Barbera E, Ferrandina C, Di Renzo N, Olivieri A, Bocchia M, Gentile M, Marchesi F, Musto P, Federici AB, Candoni A, Venditti A, Fava C, Pinto A, Galieni P, Rigacci L, Armiento D, Pane F, Oberti M, Zappasodi P, Visco C, Franchi M, Grossi PA, Bertù L, Corrao G, Pagano L, Corradini P. Clinical characteristics and risk factors associated with COVID-19 severity in patients with haematological malignancies in Italy: a retrospective, multicentre, cohort study. Lancet Haematol 2020; 7:e737-e745. [PMID: 32798473 PMCID: PMC7426107 DOI: 10.1016/s2352-3026(20)30251-9] [Citation(s) in RCA: 372] [Impact Index Per Article: 93.0] [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: 06/09/2020] [Revised: 07/19/2020] [Accepted: 07/21/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Several small studies on patients with COVID-19 and haematological malignancies are available showing a high mortality in this population. The Italian Hematology Alliance on COVID-19 aimed to collect data from adult patients with haematological malignancies who required hospitalisation for COVID-19. METHODS This multicentre, retrospective, cohort study included adult patients (aged ≥18 years) with diagnosis of a WHO-defined haematological malignancy admitted to 66 Italian hospitals between Feb 25 and May 18, 2020, with laboratory-confirmed and symptomatic COVID-19. Data cutoff for this analysis was June 22, 2020. The primary outcome was mortality and evaluation of potential predictive parameters of mortality. We calculated standardised mortality ratios between observed death in the study cohort and expected death by applying stratum-specific mortality rates of the Italian population with COVID-19 and an Italian cohort of 31 993 patients with haematological malignancies without COVID-19 (data up to March 1, 2019). Multivariable Cox proportional hazards model was used to identify factors associated with overall survival. This study is registered with ClinicalTrials.gov, NCT04352556, and the prospective part of the study is ongoing. FINDINGS We enrolled 536 patients with a median follow-up of 20 days (IQR 10-34) at data cutoff, 85 (16%) of whom were managed as outpatients. 440 (98%) of 451 hospitalised patients completed their hospital course (were either discharged alive or died). 198 (37%) of 536 patients died. When compared with the general Italian population with COVID-19, the standardised mortality ratio was 2·04 (95% CI 1·77-2·34) in our whole study cohort and 3·72 (2·86-4·64) in individuals younger than 70 years. When compared with the non-COVID-19 cohort with haematological malignancies, the standardised mortality ratio was 41·3 (38·1-44·9). Older age (hazard ratio 1·03, 95% CI 1·01-1·05); progressive disease status (2·10, 1·41-3·12); diagnosis of acute myeloid leukaemia (3·49, 1·56-7·81), indolent non-Hodgin lymphoma (2·19, 1·07-4·48), aggressive non-Hodgkin lymphoma (2·56, 1·34-4·89), or plasma cell neoplasms (2·48, 1·31-4·69), and severe or critical COVID-19 (4·08, 2·73-6·09) were associated with worse overall survival. INTERPRETATION This study adds to the evidence that patients with haematological malignancies have worse outcomes than both the general population with COVID-19 and patients with haematological malignancies without COVID-19. The high mortality among patients with haematological malignancies hospitalised with COVID-19 highlights the need for aggressive infection prevention strategies, at least until effective vaccination or treatment strategies are available. FUNDING Associazione italiana contro le leucemie, linfomi e mieloma-Varese Onlus.
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Affiliation(s)
- Francesco Passamonti
- Department of Medicine and Surgery, University of Insubria and ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy.
| | | | - Luca Arcaini
- Department of Molecular Medicine, University of Pavia, Pavia, Italy; Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Riccardo Bruna
- Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont and Ospedale Maggiore della Carità, Novara, Italy
| | - Michele Cavo
- Seràgnoli Institute of Hematology, Department of Experimental, Diagnostic and Specialty Medicine, Bologna University School of Medicine, Bologna, Italy
| | - Francesco Merli
- Hematology, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | | | - Mauro Krampera
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Roberto Cairoli
- Hematology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Matteo Giovanni Della Porta
- Humanitas Clinical and Research Hospital-IRCCS and Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | | | - Marco Ladetto
- Hematology, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | | | - Marco Salvini
- Department of Medicine and Surgery, University of Insubria and ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Monia Marchetti
- Hematology, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Roberto Lemoli
- Dipartimento di Medicina interna e Specialità mediche, University of Genoa, Genoa, Italy
| | | | - Alessandro Busca
- Stem Cell Transplant Center, AOU Citta' della Salute e della Scienza, Turin, Italy
| | - Antonio Cuneo
- Hematology, Azienda Ospedaliero Universitaria Sant'Anna, Ferrara, Italy
| | - Alessandra Romano
- Hematology, Dipartimento di Chirurgia e Specialità Medico Chirurgiche, Università degli Studi di Catania, Catania, Italy
| | - Nicola Giuliani
- Dipartimento di Medicina e Chirurgia, University of Parma, Parma, Italy
| | - Sara Galimberti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Alessandro Morotti
- Department of Clinical and Biological Sciences, Università di Torino, Turin, Italy
| | | | | | | | - Giuseppe Visani
- Dipartimento di Onco- Ematologia, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
| | | | - Agostino Tafuri
- Hematology, University Hospital Sant'Andrea, Sapienza, Rome, Italy; Department of Clinical and Molecular Medicine, Sapienza, University of Rome, Rome, Italy
| | - Patrizia Tosi
- Hematology, Ospedale degli Infermi di Rimini, Rimini, Italy
| | | | | | | | | | - Carmela Gurrieri
- Dipartimento Strutturale Aziendale Medicina, University of Padova, Padova, Italy
| | | | - Maurizio Martelli
- Hematology, Department of Translational and Precision Medicine, Sapienza, University of Rome, Rome, Italy
| | | | | | | | | | - Laura Cudillo
- Hematology, San Giovanni Addolorata Hospital, Rome, Italy
| | - Domenico Russo
- Dipartimento di Scienze Cliniche e Sperimentali, University of Brescia, Brescia, Italy
| | | | | | - Mario Luppi
- Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell'Adulto, University of Modena and Reggio Emilia, Azienda Ospedaliera Universitaria, Modena, Italy
| | - Carmine Selleri
- Hematology, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy
| | - Elettra Ortu La Barbera
- UOC Ematologia con Trapianto, Ospedale Santa Maria Goretti, Latina, Italy; Hematology, Ospedale Santa Maria Goretti, Latina, Italy
| | - Celestino Ferrandina
- Hematology, Ospedali Riuniti Azienda Ospedaliera Universitaria di Foggia, Foggia, Italy
| | - Nicola Di Renzo
- Hematology and Transplant Unit, Ospedale Vito Fazzi, Lecce, Italy
| | | | - Monica Bocchia
- Hematology Unit, University of Siena, Azienda Ospedaliero Universitaria Senese, Siena, Italy
| | | | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Pellegrino Musto
- Department of Emergency and Organ Transplantation, "Aldo Moro" University School of Medicine and Unit of Hematology and Stem Cell Transplantation, AOU Consorziale Policlinico, Bari, Italy
| | | | - Anna Candoni
- Dipartimento di Medicina Specialistica, University of Udine, Udine, Italy
| | | | - Carmen Fava
- Department of Clinical and Biological Sciences, Università di Torino, Turin, Italy
| | - Antonio Pinto
- Hematology, Istituto Nazionale Tumori IRCCS "Fondazione G Pascale", Naples, Italy
| | | | | | - Daniele Armiento
- Unit of Hematology, Stem Cell Transplantation, University Campus Bio-Medico, Rome, Italy
| | - Fabrizio Pane
- Department of Clinical Medicine and Surgery, Federico II Hospital, Naples, Italy
| | | | - Patrizia Zappasodi
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Carlo Visco
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Matteo Franchi
- Laboratory of Healthcare Research & Pharmacoepidemiology, Department of Statistics and Quantitative Methods, Università degli Studi di Milano-Bicocca, Milan, Italy; National Centre for Healthcare Research and Pharmacoepidemiology, Milan, Italy
| | - Paolo Antonio Grossi
- Department of Medicine and Surgery, University of Insubria and ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Lorenza Bertù
- Department of Medicine and Surgery, University of Insubria and ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Giovanni Corrao
- Laboratory of Healthcare Research & Pharmacoepidemiology, Department of Statistics and Quantitative Methods, Università degli Studi di Milano-Bicocca, Milan, Italy; National Centre for Healthcare Research and Pharmacoepidemiology, Milan, Italy
| | - Livio Pagano
- Dipartimento di Scienze Radiologiche ed Ematologiche, Fondazione Policlinico Universitario A Gemelli-IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy
| | - Paolo Corradini
- Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, University of Milano
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Rodgers T, Luigi Zinzani P, Marino D, Frezzato M, Maria Barbui A, Castellino C, Meli E, Conconi A, Cascavilla N, Cavallo F, H Fowler N, Feinberg B, Tillmanns S, Parche S, Fingerle-Rowson G, Winderlich M, Ambarkhane S, Salles G, Nowakowski G. ABCL-135: RE-MIND: A Comparison of Tafasitamab (MOR208) + Lenalidomide (L-MIND) Versus Lenalidomide Monotherapy (Real-World Data) in Transplant-Ineligible Patients with Relapsed/Refractory Diffuse Large B-Cell Lymphoma. Clinical Lymphoma Myeloma and Leukemia 2020. [DOI: 10.1016/s2152-2650(20)30874-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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13
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Vannata B, Conconi A, Winkler J, Cascione L, Margiotta Casaluci G, Nassi L, Moia R, Pirosa MC, Moccia AA, Stathis A, Rossi D, Gaidano G, Zucca E. Late relapse in patients with diffuse large B-cell lymphoma: impact of rituximab on their incidence and outcome. Br J Haematol 2019; 187:478-487. [PMID: 31385291 DOI: 10.1111/bjh.16106] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 05/21/2019] [Indexed: 12/14/2022]
Abstract
Diffuse large B-cell lymphoma (DLBCL) constitutes 25-35% of all non-Hodgkin lymphomas in Western countries. Approximately two thirds of the patients can be cured with standard immuno-chemotherapy. Most relapses occur within 1-2 years from diagnosis, however, the occurrence of relapses after 5 years or more has been described. We aimed at defining the incidence and clinical features of late relapses. Data of 1113 DLBCL patients were analysed. Among the 196 patients relapsing after a first complete remission, 36 (18% of relapses and 3% of all DLBCLs) experienced a recurrence more than 5 years from diagnosis. Late relapsing patients, in comparison with those relapsing earlier, showed a more favourable risk profile at presentation: normal lactate dehydrogenase levels (P = 0·002), early Ann Arbor stage (P = 0·006) and low International Prognostic Index (P = 0·003). The risk of late relapse was lowered by the introduction of rituximab as part of the front-line treatment (P < 0·001). Cause-specific survival (CSS) from the time of relapse was significantly better for late relapsing patients compared to those relapsing early: 5-year CSS rates were 53% and 31%, respectively (P = 0·033). A trend toward a better overall survival was also observed, with 5-year rates after relapse of 47% and 25%, respectively (P = 0·054).
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Affiliation(s)
- Barbara Vannata
- Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland
| | - Annarita Conconi
- Division of Haematology, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy
| | - Jonas Winkler
- Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland
| | | | - Gloria Margiotta Casaluci
- Division of Haematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont and AOU Maggiore della Carità, Novara, Italy
| | - Luca Nassi
- Division of Haematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont and AOU Maggiore della Carità, Novara, Italy
| | - Riccardo Moia
- Division of Haematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont and AOU Maggiore della Carità, Novara, Italy
| | | | - Alden A Moccia
- Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland
| | - Anastasios Stathis
- Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland
| | - Davide Rossi
- Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland.,Institute of Oncology Research (IOR), Bellinzona, Switzerland
| | - Gianluca Gaidano
- Division of Haematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont and AOU Maggiore della Carità, Novara, Italy
| | - Emanuele Zucca
- Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland.,Institute of Oncology Research (IOR), Bellinzona, Switzerland
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14
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Merli F, Cavallo F, Salvi F, Tucci A, Musuraca G, Nassi L, Merli M, Tani M, Gini G, Ferrari A, Molinari AL, Liberati AM, Conconi A, Matteucci P, Bari A, Scalone R, Ferrero S, Zanni M, Mammi C, Luminari S. Obinutuzumab and miniCHOP for unfit patients with diffuse large B-cell lymphoma. A phase II study by Fondazione Italiana Linfomi. J Geriatr Oncol 2019; 11:37-40. [PMID: 31296461 DOI: 10.1016/j.jgo.2019.06.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 01/03/2019] [Revised: 06/05/2019] [Accepted: 06/27/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To evaluate activity and safety of obinutuzumab-miniCHOP (Ga101-miniCHOP) combination in older patients with Diffuse Large B-Cell Lymphoma (DLBCL) unfit to receive full dose immunochemotherapy. MATERIALS AND METHODS We conducted a Simon's two-stage phase II multicenter trial to investigate response rate (primary endpoint) and safety of six courses of Ga101-miniCHOP in older patients with DLBCL (≥65 years), prospectively defined as unfit according to a simplified Comprehensive Geriatric Assessment (sCGA). RESULTS Overall, 34 patients were enrolled (median age 82 years; range 68-89), with 27 out of the 33 eligible patients completing all six planned courses. Complete Remission (CR) rate was reported in fourteen patients (42%). After a median follow-up of sixteen months, the two-year Progression Free and Overall Survival (PFS and OS) were 49% (95% Confidence Interval (CI), 28 to 67) and 68% (95% CI, 49 to 81), respectively. The most frequent grade 3-4 adverse event was neutropenia in thirteen patients (26%). CONCLUSIONS Based on the observed CR rate, study accrual was interrupted due to the very low probability of demonstrating the initial study hypothesis that Ga101-miniCHOP could improve results of historical data obtained with R-miniCHOP in this group of patients. Nonetheless, results achieved with the 33 treated patients confirm activity and good tolerability of the Ga101-miniCHOP regimen for older unfit adult patients with DLBCL.
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Affiliation(s)
- Francesco Merli
- Hematology Unit, Arcispedale S.Maria Nuova, Azienda Unità Sanitaria Locale - IRCCS, Reggio Emilia, Italy.
| | - Federica Cavallo
- Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino/AOU "Città della Salute e della Scienza di Torino", Torino, Italy
| | - Flavia Salvi
- Hematology Unit, Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | | | - Gerardo Musuraca
- Hematology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Luca Nassi
- Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Azienda Ospedaliero-Universitaria Maggiore della Carità Novara, Italy
| | - Michele Merli
- Division of Hematology, University Hospital Ospedale di Circolo e Fondazione Macchi - ASST Sette Laghi, Varese, Italy
| | - Monica Tani
- Hematology Unit, Santa Maria delle Croci Hospital, Ravenna, Italy
| | - Guido Gini
- Division of Hematology, Ospedali Riuniti, Ancona, Italy
| | - Angela Ferrari
- Hematology Unit, Arcispedale S.Maria Nuova, Azienda Unità Sanitaria Locale - IRCCS, Reggio Emilia, Italy
| | | | - Anna Marina Liberati
- Division of Onco-Hematology, S.Maria Terni Hospital, Department of Surgery and Medical Sciences, University of Perugia, Terni, Italy
| | - Annarita Conconi
- Unit of Hematology, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy
| | - Paola Matteucci
- Haematology and Bone Marrow Transplantation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Alessia Bari
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Renato Scalone
- Division of Hematology, La Maddalena Hospital, Palermo, Italy
| | - Simone Ferrero
- Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino/AOU "Città della Salute e della Scienza di Torino", Torino, Italy
| | - Manuela Zanni
- Hematology Unit, Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Caterina Mammi
- Gruppo Amici dell'Ematologia GRADE- Onlus Foundation, Reggio Emilia, Italy
| | - Stefano Luminari
- Hematology Unit, Arcispedale S.Maria Nuova, Azienda Unità Sanitaria Locale - IRCCS, Reggio Emilia, Italy; Dipartimento Chirurgico, Medico, Odontoiatrico e di Scienze Morfologiche con interesse Trapiantologico, Oncologico e di Medicina Rigenerativa, University of Modena and Reggio Emilia, Reggio Emilia, Italy
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15
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Conconi A, Thieblemont C, Cascione L, Torri V, Kiesewetter B, Margiotta-Casaluci G, Gaidano G, Raderer M, Cavalli F, Lopez Guillermo A, Johnson P, Zucca E. EARLY PROGRESSION OF DISEASE (POD24) PREDICTS SHORTER SURVIVAL IN MALT LYMPHOMA PATIENTS RECEIVING SYSTEMIC TREATMENT. Hematol Oncol 2019. [DOI: 10.1002/hon.136_2629] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- A. Conconi
- Division of Hematology; Ospedale degli Infermi; Ponderano Italy
| | - C. Thieblemont
- Hemato-Oncology Department; Saint Louis Hospital; Paris France
| | - L. Cascione
- IOR; Institute of Oncology Research; Bellinzona Switzerland
| | - V. Torri
- Clinical Research Methodology Laboratory; IRCCS-Mario Negri Institute; Milan Italy
| | - B. Kiesewetter
- Division of Oncology; Department of Internal Medicine I, Medical University of Vienna; Vienna Austria
| | - G. Margiotta-Casaluci
- Division of Hematology, Department of Translational Medicine; University of Eastern Piedmont; Novara Italy
| | - G. Gaidano
- Division of Hematology, Department of Translational Medicine; University of Eastern Piedmont; Novara Italy
| | - M. Raderer
- Division of Oncology; Department of Internal Medicine I, Medical University of Vienna; Vienna Austria
| | - F. Cavalli
- IOR; Institute of Oncology Research; Bellinzona Switzerland
| | | | - P.W. Johnson
- Cancer Research UK Center; Southampton General Hospital; Southampton United Kingdom
| | - E. Zucca
- Division of Medical Oncology; Oncology Institute of Southern Switzerland; Bellinzona Switzerland
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16
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Conconi A, Thieblemont C, Cascione L, Torri V, Kiesewetter B, Margiotta-Casaluci G, Gaidano G, Raderer M, Cavalli F, Lopez-Guillermo A, Johnson PWM, Zucca E. Early progression of disease (POD24) as survival predictor in MALT lymphoma. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.7548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7548 Background: Progression of disease within two years from start of therapy (POD24) is linked with poor outcome in follicular lymphoma. It is less clear whether POD24 affects overall survival (OS) also in extranodal marginal zone B-cell lymphoma of mucosa associated lymphoid tissue (MALT lymphoma). Methods: We analyzed the dataset of the IELSG19 clinical trial (training set) to determine whether POD24 is associated with inferior OS. The study population included 401 EMZL patients (131 randomly assigned to chlorambucil treatment, 138 to rituximab and 132 to chlorambucil plus rituximab). Reproducibility was analyzed in an independent cohort (validation set) of 218 patients who received systemic treatment (chemotherapy, immunotherapy or both). In both, training and validation sets, we excluded from the analysis the patients who, within 24 months from treatment start, died without progression or were lost to follow-up without progression. Overall survival (OS) was calculated from disease progression in patients with POD24 and from 24 months after start of treatment in those without POD24 (reference group). Results: POD24 was observed in 69 of 401 patients of the IELSG19 study and 58 of 218 patients in the validation cohort. In the training set, the 10-year OS rates were 64% in the POD24 group and 85% in the reference group (HR = 2.42, 95%CI, 1.35-4.34; log-rank P = 0.002) and POD24 predicted poor outcome regardless of treatment type (multivariable Cox model, P = 0.003). The prognostic impact of POD24 was confirmed in the validation set, with 10-year OS rates of 48% in the POD24 group and 71% in the reference group (HR = 2.17, 95%CI, 1.20-3.93; log-rank P = 0.009). Conclusions: In patients with EMZL who received front-line systemic treatment, POD24 is associated with poorer survival and may represent a useful endpoint in future prospective clinical trial.
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Affiliation(s)
| | | | | | - Valter Torri
- IRCCS Istituto Di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Barbara Kiesewetter
- Medical University Vienna, Department of Medicine I, Clinical Division of Oncology and Comprehensive Cancer Center, Vienna, Austria
| | - Gloria Margiotta-Casaluci
- Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy
| | - Gianluca Gaidano
- Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy
| | - Markus Raderer
- Medical University Vienna, Department of Medicine I, Clinical Division of Oncology and Comprehensive Cancer Center, Vienna, Austria
| | - Franco Cavalli
- Università della Svizzera italiana, Institute of Oncology Research, Oncology Institute of Southern Switzerland, International Extranodal Lymphoma Study Group, IELSG, Bellinzona, Switzerland
| | | | | | - Emanuele Zucca
- Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
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17
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Broccoli A, Casadei B, Chiappella A, Visco C, Tani M, Cascavilla N, Conconi A, Balzarotti M, Cox MC, Marino D, Goldaniga MC, Marasca R, Tecchio C, Patti C, Musuraca G, Devizzi L, Monaco F, Romano A, Fama A, Zancanella M, Paolini R, Rigacci L, Castellino C, Gaudio F, Argnani L, Zinzani PL. Lenalidomide in Pretreated Patients with Diffuse Large B-Cell Lymphoma: An Italian Observational Multicenter Retrospective Study in Daily Clinical Practice. Oncologist 2019; 24:1246-1252. [PMID: 30940746 DOI: 10.1634/theoncologist.2018-0603] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 03/04/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma subtype, and approximately 50% of the patients are >60 years of age. Patients with relapsed/refractory (rr) disease have a poor prognosis with currently available treatments. Lenalidomide is available in Italy for patients with rrDLBCL based on a local disposition of the Italian Drug Agency. SUBJECTS, MATERIALS, AND METHODS An observational retrospective study was conducted in 24 Italian hematology centers with the aim to improve information on effectiveness and safety of lenalidomide use for rrDLBCL in real practice. RESULTS One hundred fifty-three patients received lenalidomide for 21/28 days with a median of four cycles. At the end of therapy, there were 36 complete responses (23.5%) and 9 partial responses with an overall response rate (ORR) of 29.4%. In the elderly (>65 years) subset, the ORR was 33.6%. With a median follow-up of 36 months, median overall survival was reached at 12 months and median disease-free survival was not reached at 62 months. At the latest available follow-up, 29 patients are still in response out of therapy. Median progression-free survivals differ significantly according to age (2.5 months vs. 9.5 in the younger vs. elderly group, respectively) and to disease status at the latest previous therapy (15 months for relapsed patients vs. 3.5 for refractory subjects). Toxicities were manageable, even if 30 of them led to an early drug discontinuation. CONCLUSION Lenalidomide therapy for patients with rrDLBCL is effective and tolerable even in a real-life context, especially for elderly patients. IMPLICATIONS FOR PRACTICE Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma, and approximately 50% of the patients are >60 years of age. Patients with relapsed/refractory (rr) disease have a poor prognosis, reflected by the remarkably short life expectancy of 12 months with currently available treatments. The rrDLBCL therapeutic algorithm is not so well established because data in the everyday clinical practice are still poor. Lenalidomide for patients with rrDLBCL is effective and tolerable even in a real-life context, especially for elderly patients.
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Affiliation(s)
| | | | - Annalisa Chiappella
- Hematology, Città della Salute e della Scienza Hospital and University, Torino, Italy
| | - Carlo Visco
- Department of Cell Therapy and Hematology, San Bortolo Hospital, Vicenza, Italy
| | - Monica Tani
- Hematology Unit, S. Maria delle Croci Hospital, Ravenna, Italy
| | - Nicola Cascavilla
- Hematology Department, "Casa Sollievo della Sofferenza" Hospital, IRCCS - Italy
| | - Annarita Conconi
- Hematology Division, Ospedale degli Infermi di Biella, Ponderano, Italy
| | - Monica Balzarotti
- Departmento of Medical Oncology and Hematology Humanitas Cancer Center, Rozzano-Milan, Italy
| | | | - Dario Marino
- Dipartimento di Oncologia Clinica e Sperimentale, Oncologia Medica 1, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy
| | | | - Roberto Marasca
- Department of Medical Sciences, Section of Hematology, University of Modena and Reggio Emilia, Modena, Italy
| | - Cristina Tecchio
- Hematology and Bone Marrow Transplant Unit, Verona University, Verona, Italy
| | - Caterina Patti
- Department of Hematology Azienda Ospedali Riuniti Villa Sofia- Cervello, Palermo, Italy
| | - Gerardo Musuraca
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Liliana Devizzi
- Division of Hematology, IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Federico Monaco
- Hematology Unit, SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Alessandra Romano
- Division of Hematology, AOU Policlinico-OVE, Department of Surgery and Medical Specialties, University of Catania, Catania, Italy
| | | | | | | | - Luigi Rigacci
- Hematology, AOU Careggi, Firenze, Italy
- Hematology Azienda San Camillo Forlanini, Rome, Italy
| | - Claudia Castellino
- Azienda Ospedaliera S. Croce e Carle - Hematology Department and BMT Unit, Cuneo, Italy
| | - Francesco Gaudio
- Unit of Hematology with Transplantation Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Lisa Argnani
- Institute of Hematology, University of Bologna, Bologna, Italy
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18
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Conconi A, Zucca E, Margiotta-Casaluci G, Darling K, Hasse B, Battegay M, Staehelin C, Novak U, Schmid P, Scherrer A, Dirnhofer S, Kwee I, Nassi L, Cavalli F, Gaidano G, Bertoni F, Bernasconi E. Population-based outcome analysis of diffuse large B-cell lymphoma in people living with HIV infection and competent individuals. Hematol Oncol 2018; 36:757-764. [PMID: 30113708 DOI: 10.1002/hon.2536] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 02/28/2018] [Revised: 05/01/2018] [Accepted: 06/15/2018] [Indexed: 11/11/2022]
Abstract
The prognostic factors and outcome of 58 acquired immunodeficiency syndrome-related diffuse large B-cell lymphoma (AR-DLBCL) patients from the Swiss HIV Cohort Study, diagnosed from 2004 to 2011, were compared with those of 326 immunocompetent (IC)-DLBCL from the Hematology Division of the Amedeo Avogadro University (Italy) and the Oncology Institute of Southern Switzerland. Median follow-up was 6 years; 5-year overall survival (OS) was 68% (95% CI: 63%-73%) in IC-DLBCL and 63% (95% CI: 49%-75%) in AR-DLBCL (P = .220). The acquired immunodeficiency syndrome-related lymphoma international prognostic index predicted OS in AR-DLBCL. Among 148 patients younger than 61 years (40 AR-DLBCL and 108 IC-DLBCL) treated with RCHOP/RCHOP-like regimens, 20 IC-DLBCL and 9 AR-DLBCL patients died and OS was not significantly different. A higher proportion of early deaths occurred in the AR-DLBCL: indeed, 1-year OS was 94% (95% CI: 87%-97%) in IC-DLBCL and 82% (95% CI: 66%-91%) in AR-DLBCL patients. After rituximab and active antiretroviral therapy introduction, AR-DLBCL and IC-DLBCL patients treated with curative intent have similar long-term survival.
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Affiliation(s)
- Annarita Conconi
- Division of Hematology, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy
| | - Emanuele Zucca
- IOSI Oncology Institute of Southern Switzerland, Bellinzona, Switzerland.,Foundation for the Institute of Oncology Research (IOR), Bellinzona, Switzerland
| | - Gloria Margiotta-Casaluci
- Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont and AOU Maggiore della Carità, Novara, Italy
| | - Katharine Darling
- Infectious Disease Service, Lausanne University Hospital, Lausanne, Switzerland
| | - Barbara Hasse
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital, Zurich, University of Zurich, Zurich, Switzerland
| | - Manuel Battegay
- Division of Infectious Diseases, University Hospital, Basel, Switzerland
| | - Cornelia Staehelin
- Department of Infectious Diseases, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Urban Novak
- Department of Medical Oncology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Patrick Schmid
- Division of Infectious Diseases, Cantonal Hospital, St Gallen, St Gallen, Switzerland
| | - Alexandra Scherrer
- Swiss HIV Cohort Study Data Center, University Hospital and University of Zurich, Zurich, Switzerland
| | | | - Ivo Kwee
- Università della Svizzera italiana, Institute of Oncology Research, Bellinzona, Switzerland.,Dalle Molle Institute for Artificial Intelligence (IDSIA), Manno, Switzerland.,SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Luca Nassi
- Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont and AOU Maggiore della Carità, Novara, Italy
| | - Franco Cavalli
- IOSI Oncology Institute of Southern Switzerland, Bellinzona, Switzerland.,Foundation for the Institute of Oncology Research (IOR), Bellinzona, Switzerland
| | - Gianluca Gaidano
- Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont and AOU Maggiore della Carità, Novara, Italy
| | - Francesco Bertoni
- Università della Svizzera italiana, Institute of Oncology Research, Bellinzona, Switzerland
| | - Enos Bernasconi
- Division of Infectious Diseases, Ospedale Regionale di Lugano, Lugano, Switzerland
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19
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Ceriani L, Milan L, Martelli M, Ferreri AJM, Cascione L, Zinzani PL, Di Rocco A, Conconi A, Stathis A, Cavalli F, Bellei M, Cozens K, Porro E, Giovanella L, Johnson PW, Zucca E. Metabolic heterogeneity on baseline 18FDG-PET/CT scan is a predictor of outcome in primary mediastinal B-cell lymphoma. Blood 2018; 132:179-186. [PMID: 29720487 DOI: 10.1182/blood-2018-01-826958] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 04/05/2018] [Indexed: 12/19/2022] Open
Abstract
An important unmet need in the management of primary mediastinal B-cell lymphoma (PMBCL) is to identify the patients for whom first-line therapy will fail to intervene before the lymphoma becomes refractory. High heterogeneity of intratumoral 18F-fluorodeoxyglucose (18FDG) uptake distribution on positron emission tomography/computed tomography (PET/CT) scans has been suggested as a possible marker of chemoresistance in solid tumors. In the present study, we investigated the prognostic value of metabolic heterogeneity (MH) in 103 patients with PMBCL prospectively enrolled in the International Extranodal Lymphoma Study Group (IELSG) 26 study, aimed at clarifying the role of PET in this lymphoma subtype. MH was estimated using the area under curve of cumulative standardized uptake value-volume histogram (AUC-CSH) method. Progression-free survival at 5 years was 94% vs 73% in low- and high-MH groups, respectively (P = .0001). In a Cox model of progression-free survival including dichotomized MH, metabolic tumor volume, total lesion glycolysis (TLG), international prognostic index, and tumor bulk (mediastinal mass > 10 cm), as well as age as a continuous variable, only TLG (P < .001) and MH (P < .001) retained statistical significance. Using these 2 features to construct a simple prognostic model resulted in early and accurate (positive predictive value, 89%; negative predictive value, ≥90%) identification of patients at high risk for progression at a point that would allow the use of risk-adapted treatments. This may provide an important opportunity for the design of future trials aimed at helping the minority of patients who harbor chemorefractory PMBCL. The study is registered at ClinicalTrials.gov as NCT00944567.
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Affiliation(s)
- Luca Ceriani
- Nuclear Medicine and PET/CT Centre, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Lisa Milan
- Nuclear Medicine and PET/CT Centre, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Maurizio Martelli
- Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
| | - Andrés J M Ferreri
- Department of Onco-Hematology, Unit of Lymphoid Malignancies, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Pier Luigi Zinzani
- Institute of Hematology "Seràgnoli", University of Bologna, Bologna Italy
| | - Alice Di Rocco
- Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
| | | | - Anastasios Stathis
- Division of Medical Oncology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | | | - Monica Bellei
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Elena Porro
- Institute of Oncology Research, Bellinzona, Switzerland
| | - Luca Giovanella
- Nuclear Medicine and PET/CT Centre, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Peter W Johnson
- Cancer Research UK Centre, University of Southampton, Southampton, United Kingdom; and
| | - Emanuele Zucca
- Institute of Oncology Research, Bellinzona, Switzerland
- Division of Medical Oncology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
- Medical Oncology, University of Bern, Bern, Switzerland
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20
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Avivi I, Arcaini L, Ferretti VV, Boumendil A, Finel H, Milone G, Zaja F, Liliana D, Musso M, Didier B, Bachy E, Wattad M, Nicolas-Virelizier E, Gramatzki M, Bourhis JH, Caillot D, Haenel A, Held G, Thieblemont C, Jindra P, Pohlreich D, Guilhot F, Kroschinsky F, Wahlin B, Scheid C, Ifrah N, Berthou C, Dreger P, Montoto S, Conconi A. High-dose therapy and autologous stem cell transplantation in marginal zone lymphomas: a retrospective study by the EBMT Lymphoma Working Party and FIL-GITMO. Br J Haematol 2018; 182:807-815. [PMID: 29984825 DOI: 10.1111/bjh.15454] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 01/12/2018] [Accepted: 04/18/2018] [Indexed: 12/26/2022]
Abstract
The role of autologous stem cell transplantation (ASCT) in patients with marginal zone lymphoma (MZL) is debatable. This study investigated the outcome and prognostic factors affecting the outcome of patients undergoing ASCT for MZL. Eligible patients had non-transformed nodal, extra-nodal (MALT) or splenic MZL (SMZL), aged ≥18 years, who underwent a first ASCT between1994 and 2013 and were reported to the European Society for Blood and Marrow Transplantation, Fondazione Italiana Linfomi or Gruppo Italiano Trapianto Di Midollo Osseo registries. The study included 199 patients, [111 MALT lymphoma, 55 nodal MZL (NMZL) and 33 SMZL]. Median age at transplantation was 56 years. The median number of prior therapies was 2 (range 1-8), including rituximab in 71%. 95% had chemosensitive disease. 89% received a chemotherapy-based high-dose regimen. There were no significant differences in patient and transplant characteristics between the 3 histological subtypes except for a lower percentage of patients previously treated with rituximab in the MALT sub-group and more transplants performed in recent years in the other sub-groups. After a median follow-up of 5 years, 5-year cumulative incidence of relapse/progression and non-relapse mortality were 38% and 9%, respectively. Five-year event-free survival (EFS) and overall survival (OS) were 53% and 73%, respectively. Five-year cumulative incidence of second malignancies was 6%. Multivariate analysis revealed age ≥65 years was associated with a shorter EFS and OS. In addition, patients with SMZL had a shorter OS than those with MALT. ASCT may provide clinical benefit in MZL patients who have failed multiple lines of chemoimmunotherapy.
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Affiliation(s)
- Irit Avivi
- Tel Aviv Sourasky Medical Centre, Tel-Aviv, Israel
| | - Luca Arcaini
- Universita Di Pavia, IRCCS Fondazione San Matteo, Pavia, Italy
| | | | | | - Hervé Finel
- EBMT LWP Paris Office, Hôpital Saint-Antoine, Paris, France
| | - Giuseppe Milone
- Institute of Hematology, University of Catania, Catania, Italy
| | | | - Devizzi Liliana
- Division of Medical Oncology, Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Blaise Didier
- Département d'Onco-Hématologie, Institut Paoli-Calmettes, Marseille, France
| | - Emmanuel Bachy
- National Institutes of Health, National Cancer Institute, Bethesda, MD, USA
| | | | | | - Martin Gramatzki
- University Hospital Schleswig-Holstein, Kiel, Germany.,University of Kiel, Kiel, Germany
| | | | | | | | - Gerhard Held
- Department of Internal Medicine I, Saarland University Medical School, Homburg/Saar, Germany.,University Hospital of Saarland, Homburg, Germany
| | - Catherine Thieblemont
- APHP - INSERM U 728 - Institut Universitaire d'Hematologie, Hopital Saint-Louis, Paris, France
| | | | | | | | - Frank Kroschinsky
- Midizinische Klinik und Poliklinik I, Universitaetsklinikum Dresden, Dresden, Germany
| | - Björn Wahlin
- Department of Medicine, Huddinge (MedH), H7, Unit for Hematology, M 54, Karolinska Universitetssjukhuset Huddinge, Stockholm, Sweden
| | | | | | | | - Peter Dreger
- EBMT LWP Paris Office, Hôpital Saint-Antoine, Paris, France.,University of Heidelberg, Heidelberg, Germany
| | - Silvia Montoto
- Department of Haemato-Oncology, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK
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21
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Minoia C, Zucca E, Conconi A. Novel acquisitions on biology and management of transformed follicular lymphoma. Hematol Oncol 2018; 36:617-623. [PMID: 29602222 DOI: 10.1002/hon.2508] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 11/28/2017] [Revised: 02/07/2018] [Accepted: 02/08/2018] [Indexed: 11/07/2022]
Abstract
Follicular lymphoma (FL) generally has an indolent clinical course, but in some patients, a histological transformation (HT) into aggressive entities may take place and often lead to a poorer survival. The rituximab era has seen an improved outcome of FL, including those with HT. The current treatment strategies for transformed FL are based on immunochemotherapy for the cases with HT at the time of diagnosis or as the first event after watchful waiting. Patients transforming after prior treatment of FL usually benefit from autologous stem cell transplant. Unfortunately, early assessment of the transformation risk remains elusive. Recent studies delved the mechanisms of HT, showing that this is a complex process, resulting from a number of epigenetic and genetic lesions occurring in the tumour cell population as well as progressive changes in the tumour microenvironment. This novel knowledge has prompted clinical investigations on a variety of new therapeutic strategies.
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Affiliation(s)
- Carla Minoia
- Hematology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy.,Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland
| | - Emanuele Zucca
- Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland.,Institute of Oncology Research (IOR), Bellinzona, Switzerland
| | - Annarita Conconi
- Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland.,Hematology Division, Ospedale degli Infermi, Biella, Italy
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22
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Castelli A, Mosca-Siez ML, Riccomagno P, Patriarca A, Liscia D, Conconi A. Efficacy and safety of decitabine against cutaneous granuloblastic sarcoma: a case report. Ann Hematol 2018; 97:1485-1486. [PMID: 29600420 DOI: 10.1007/s00277-018-3314-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 03/19/2018] [Indexed: 10/17/2022]
Affiliation(s)
- Andrea Castelli
- Division of Hematology, Ospedale degli Infermi, Biella, Italy.
| | - M L Mosca-Siez
- Division of Hematology, Ospedale degli Infermi, Biella, Italy
| | - P Riccomagno
- Division of Hematology, Ospedale degli Infermi, Biella, Italy
| | - A Patriarca
- Department of Hematology, Ospedale Maggiore della Carità, Novara, Italy
| | - D Liscia
- Pathology Service, Ospedale degli Infermi, Biella, Italy
| | - A Conconi
- Division of Hematology, Ospedale degli Infermi, Biella, Italy
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23
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Gobba S, Moccia AA, Gulden-Sala W, Conconi A, Diem S, Cascione L, Iacoboni G, Margiotta-Casaluci G, Aprile von Hohenstaufen K, Stathis A, Hitz F, Pinotti G, Gaidano G, Zucca E. Outcome of patients older than 80 years with diffuse large B-cell lymphoma (DLBCL) treated with “standard” immunochemotherapy: A large retrospective study from 4 institutions. Hematol Oncol 2017. [DOI: 10.1002/hon.2447] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Stefania Gobba
- ASST Sette Laghi; Ospedale di Circolo e Fondazione Macchi; Varese Italy
| | - Alden A. Moccia
- Istituto Oncologico della Svizzera Italiana; Bellinzona Switzerland
| | | | - Annarita Conconi
- SCDU Ematologia, Dipartimento di Medicina Traslazionale; Università degli Studi del Piemonte Orientale; Novara Italy
- Unit of Hematology; Ospedale degli Infermi; Biella Italy
| | - Stefan Diem
- Klinik für Onkologie und Hämatologie; Kantonsspital St Gallen; St Gallen Switzerland
| | - Luciano Cascione
- Istituto Oncologico della Svizzera Italiana; Bellinzona Switzerland
- Lymphoma and Genomics Research Program; Institute of Oncology Research (IOR); Bellinzona Switzerland
| | - Gloria Iacoboni
- Istituto Oncologico della Svizzera Italiana; Bellinzona Switzerland
| | - Gloria Margiotta-Casaluci
- SCDU Ematologia, Dipartimento di Medicina Traslazionale; Università degli Studi del Piemonte Orientale; Novara Italy
| | | | | | - Felicitas Hitz
- Klinik für Onkologie und Hämatologie; Kantonsspital St Gallen; St Gallen Switzerland
| | - Graziella Pinotti
- ASST Sette Laghi; Ospedale di Circolo e Fondazione Macchi; Varese Italy
| | - Gianluca Gaidano
- SCDU Ematologia, Dipartimento di Medicina Traslazionale; Università degli Studi del Piemonte Orientale; Novara Italy
| | - Emanuele Zucca
- Istituto Oncologico della Svizzera Italiana; Bellinzona Switzerland
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24
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Zucca E, Conconi A, Martinelli G, Bouabdallah R, Tucci A, Vitolo U, Martelli M, Pettengell R, Salles G, Sebban C, Guillermo AL, Pinotti G, Devizzi L, Morschhauser F, Tilly H, Torri V, Hohaus S, Ferreri AJM, Zachée P, Bosly A, Haioun C, Stelitano C, Bellei M, Ponzoni M, Moreau A, Jack A, Campo E, Mazzucchelli L, Cavalli F, Johnson P, Thieblemont C. Final Results of the IELSG-19 Randomized Trial of Mucosa-Associated Lymphoid Tissue Lymphoma: Improved Event-Free and Progression-Free Survival With Rituximab Plus Chlorambucil Versus Either Chlorambucil or Rituximab Monotherapy. J Clin Oncol 2017; 35:1905-1912. [PMID: 28355112 DOI: 10.1200/jco.2016.70.6994] [Citation(s) in RCA: 108] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Purpose There is no consensus on the optimal systemic treatment of patients with extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue. The IELSG-19 phase III study, to our knowledge, was the first such study to address the question of first-line treatment in a randomized trial. Patients and Methods Eligible patients were initially randomly assigned (1:1 ratio) to receive either chlorambucil monotherapy (6 mg/m2/d orally on weeks 1 to 6, 9 to 10, 13 to 14, 17 to 18, and 21 to 22) or a combination of chlorambucil (same schedule as above) and rituximab (375 mg/m2 intravenously on day 1 of weeks 1, 2, 3, 4, 9, 13, 17, and 21). After the planned enrollment of 252 patients, the protocol was amended to continue with a three-arm design (1:1:6 ratio), with a new arm that included rituximab alone (same schedule as the combination arm) and with a final sample size of 454 patients. The main end point was event-free survival (EFS). Analysis of chlorambucil versus the combination arm was performed and reported separately before any analysis of the third arm. Results At a median follow-up of 7.4 years, addition of rituximab to chlorambucil led to significantly better EFS (hazard ratio, 0.54; 95% CI, 0.38 to 0.77). EFS at 5 years was 51% (95% CI, 42 to 60) with chlorambucil alone, 50% (95% CI, 42 to 59) with rituximab alone, and 68% (95% CI, 60 to 76) with the combination ( P = .0009). Progression-free survival was also significantly better with the combination ( P = .0119). Five-year overall survival was approximately 90% in each arm. All treatments were well tolerated. No unexpected toxicities were recorded. Conclusion Rituximab in combination with chlorambucil demonstrated superior efficacy in mucosa-associated lymphoid tissue lymphoma; however, improvements in EFS and progression-free survival did not translate into longer overall survival.
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Affiliation(s)
- Emanuele Zucca
- Emanuele Zucca and Franco Cavalli, Oncology Institute of Southern Switzerland, Bellinzona; Luca Mazzucchelli, Cantonal Institute of Pathology, Locarno, Switzerland; Annarita Conconi, Ospedale degli Infermi, Biella; Giovanni Martinelli, European Institute of Oncology; Liliana Devizzi, Fondazione Istituto Nazionale Tumori; Valter Torri, Mario Negri Institute; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Maurilio Ponzoni, San Raffaele Hospital, Milan; Alessandra Tucci, Spedali Civili, Brescia; Umberto Vitolo, University-Hospital Città della Salute e della Scienza, Turin; Maurizio Martelli, Sapienza University; Stefan Hohaus, Catholic University of the Sacred Heart, Rome; Graziella Pinotti, Fondazione Macchi Hospital, Varese; Caterina Stelitano, Bianchi-Melacrino-Morelli Hospitals, Reggio Calabria; Monica Bellei, University of Modena and Reggio Emilia, Modena, Italy; Reda Bouabdallah, Institut Paoli-Calmettes, Marseille; Gilles Salles, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre-Benite; Catherine Sebban, Centre Léon Bérard, Lyon; Franck Morschhauser, Claude Huriez Hospital, Lille; Anne Moreau, University Hospital of Nantes, Nantes; Hervé Tilly, Centre Henri Becquerel, Rouen; Corinne Haioun, Henri-Mondor Hospital, Paris Créteil; Corinne Haioun, UPEC, Assistance Publique-Hopitaux de Paris; Catherine Thieblemont, Assistance Publique-Hopitaux de Paris, Hôpital-Saint-Louis, Hematooncology-Université Paris Diderot, Sorbonne Paris-Cité, Paris, France; Ruth Pettengell, St George's University of London, London; Andrew Jack, St James's University Hospital, Leeds; Peter Johnson, Southampton General Hospital, Southampton, United Kingdom; Armando Lopez Guillermo and Elias Campo, Hospital Clinic, Barcelona, Spain; Pierre Zachée, ZNA Stuivenberg, Antwerp; and André Bosly, Mont-Godinne UCL, Yvoir, Belgium
| | - Annarita Conconi
- Emanuele Zucca and Franco Cavalli, Oncology Institute of Southern Switzerland, Bellinzona; Luca Mazzucchelli, Cantonal Institute of Pathology, Locarno, Switzerland; Annarita Conconi, Ospedale degli Infermi, Biella; Giovanni Martinelli, European Institute of Oncology; Liliana Devizzi, Fondazione Istituto Nazionale Tumori; Valter Torri, Mario Negri Institute; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Maurilio Ponzoni, San Raffaele Hospital, Milan; Alessandra Tucci, Spedali Civili, Brescia; Umberto Vitolo, University-Hospital Città della Salute e della Scienza, Turin; Maurizio Martelli, Sapienza University; Stefan Hohaus, Catholic University of the Sacred Heart, Rome; Graziella Pinotti, Fondazione Macchi Hospital, Varese; Caterina Stelitano, Bianchi-Melacrino-Morelli Hospitals, Reggio Calabria; Monica Bellei, University of Modena and Reggio Emilia, Modena, Italy; Reda Bouabdallah, Institut Paoli-Calmettes, Marseille; Gilles Salles, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre-Benite; Catherine Sebban, Centre Léon Bérard, Lyon; Franck Morschhauser, Claude Huriez Hospital, Lille; Anne Moreau, University Hospital of Nantes, Nantes; Hervé Tilly, Centre Henri Becquerel, Rouen; Corinne Haioun, Henri-Mondor Hospital, Paris Créteil; Corinne Haioun, UPEC, Assistance Publique-Hopitaux de Paris; Catherine Thieblemont, Assistance Publique-Hopitaux de Paris, Hôpital-Saint-Louis, Hematooncology-Université Paris Diderot, Sorbonne Paris-Cité, Paris, France; Ruth Pettengell, St George's University of London, London; Andrew Jack, St James's University Hospital, Leeds; Peter Johnson, Southampton General Hospital, Southampton, United Kingdom; Armando Lopez Guillermo and Elias Campo, Hospital Clinic, Barcelona, Spain; Pierre Zachée, ZNA Stuivenberg, Antwerp; and André Bosly, Mont-Godinne UCL, Yvoir, Belgium
| | - Giovanni Martinelli
- Emanuele Zucca and Franco Cavalli, Oncology Institute of Southern Switzerland, Bellinzona; Luca Mazzucchelli, Cantonal Institute of Pathology, Locarno, Switzerland; Annarita Conconi, Ospedale degli Infermi, Biella; Giovanni Martinelli, European Institute of Oncology; Liliana Devizzi, Fondazione Istituto Nazionale Tumori; Valter Torri, Mario Negri Institute; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Maurilio Ponzoni, San Raffaele Hospital, Milan; Alessandra Tucci, Spedali Civili, Brescia; Umberto Vitolo, University-Hospital Città della Salute e della Scienza, Turin; Maurizio Martelli, Sapienza University; Stefan Hohaus, Catholic University of the Sacred Heart, Rome; Graziella Pinotti, Fondazione Macchi Hospital, Varese; Caterina Stelitano, Bianchi-Melacrino-Morelli Hospitals, Reggio Calabria; Monica Bellei, University of Modena and Reggio Emilia, Modena, Italy; Reda Bouabdallah, Institut Paoli-Calmettes, Marseille; Gilles Salles, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre-Benite; Catherine Sebban, Centre Léon Bérard, Lyon; Franck Morschhauser, Claude Huriez Hospital, Lille; Anne Moreau, University Hospital of Nantes, Nantes; Hervé Tilly, Centre Henri Becquerel, Rouen; Corinne Haioun, Henri-Mondor Hospital, Paris Créteil; Corinne Haioun, UPEC, Assistance Publique-Hopitaux de Paris; Catherine Thieblemont, Assistance Publique-Hopitaux de Paris, Hôpital-Saint-Louis, Hematooncology-Université Paris Diderot, Sorbonne Paris-Cité, Paris, France; Ruth Pettengell, St George's University of London, London; Andrew Jack, St James's University Hospital, Leeds; Peter Johnson, Southampton General Hospital, Southampton, United Kingdom; Armando Lopez Guillermo and Elias Campo, Hospital Clinic, Barcelona, Spain; Pierre Zachée, ZNA Stuivenberg, Antwerp; and André Bosly, Mont-Godinne UCL, Yvoir, Belgium
| | - Reda Bouabdallah
- Emanuele Zucca and Franco Cavalli, Oncology Institute of Southern Switzerland, Bellinzona; Luca Mazzucchelli, Cantonal Institute of Pathology, Locarno, Switzerland; Annarita Conconi, Ospedale degli Infermi, Biella; Giovanni Martinelli, European Institute of Oncology; Liliana Devizzi, Fondazione Istituto Nazionale Tumori; Valter Torri, Mario Negri Institute; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Maurilio Ponzoni, San Raffaele Hospital, Milan; Alessandra Tucci, Spedali Civili, Brescia; Umberto Vitolo, University-Hospital Città della Salute e della Scienza, Turin; Maurizio Martelli, Sapienza University; Stefan Hohaus, Catholic University of the Sacred Heart, Rome; Graziella Pinotti, Fondazione Macchi Hospital, Varese; Caterina Stelitano, Bianchi-Melacrino-Morelli Hospitals, Reggio Calabria; Monica Bellei, University of Modena and Reggio Emilia, Modena, Italy; Reda Bouabdallah, Institut Paoli-Calmettes, Marseille; Gilles Salles, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre-Benite; Catherine Sebban, Centre Léon Bérard, Lyon; Franck Morschhauser, Claude Huriez Hospital, Lille; Anne Moreau, University Hospital of Nantes, Nantes; Hervé Tilly, Centre Henri Becquerel, Rouen; Corinne Haioun, Henri-Mondor Hospital, Paris Créteil; Corinne Haioun, UPEC, Assistance Publique-Hopitaux de Paris; Catherine Thieblemont, Assistance Publique-Hopitaux de Paris, Hôpital-Saint-Louis, Hematooncology-Université Paris Diderot, Sorbonne Paris-Cité, Paris, France; Ruth Pettengell, St George's University of London, London; Andrew Jack, St James's University Hospital, Leeds; Peter Johnson, Southampton General Hospital, Southampton, United Kingdom; Armando Lopez Guillermo and Elias Campo, Hospital Clinic, Barcelona, Spain; Pierre Zachée, ZNA Stuivenberg, Antwerp; and André Bosly, Mont-Godinne UCL, Yvoir, Belgium
| | - Alessandra Tucci
- Emanuele Zucca and Franco Cavalli, Oncology Institute of Southern Switzerland, Bellinzona; Luca Mazzucchelli, Cantonal Institute of Pathology, Locarno, Switzerland; Annarita Conconi, Ospedale degli Infermi, Biella; Giovanni Martinelli, European Institute of Oncology; Liliana Devizzi, Fondazione Istituto Nazionale Tumori; Valter Torri, Mario Negri Institute; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Maurilio Ponzoni, San Raffaele Hospital, Milan; Alessandra Tucci, Spedali Civili, Brescia; Umberto Vitolo, University-Hospital Città della Salute e della Scienza, Turin; Maurizio Martelli, Sapienza University; Stefan Hohaus, Catholic University of the Sacred Heart, Rome; Graziella Pinotti, Fondazione Macchi Hospital, Varese; Caterina Stelitano, Bianchi-Melacrino-Morelli Hospitals, Reggio Calabria; Monica Bellei, University of Modena and Reggio Emilia, Modena, Italy; Reda Bouabdallah, Institut Paoli-Calmettes, Marseille; Gilles Salles, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre-Benite; Catherine Sebban, Centre Léon Bérard, Lyon; Franck Morschhauser, Claude Huriez Hospital, Lille; Anne Moreau, University Hospital of Nantes, Nantes; Hervé Tilly, Centre Henri Becquerel, Rouen; Corinne Haioun, Henri-Mondor Hospital, Paris Créteil; Corinne Haioun, UPEC, Assistance Publique-Hopitaux de Paris; Catherine Thieblemont, Assistance Publique-Hopitaux de Paris, Hôpital-Saint-Louis, Hematooncology-Université Paris Diderot, Sorbonne Paris-Cité, Paris, France; Ruth Pettengell, St George's University of London, London; Andrew Jack, St James's University Hospital, Leeds; Peter Johnson, Southampton General Hospital, Southampton, United Kingdom; Armando Lopez Guillermo and Elias Campo, Hospital Clinic, Barcelona, Spain; Pierre Zachée, ZNA Stuivenberg, Antwerp; and André Bosly, Mont-Godinne UCL, Yvoir, Belgium
| | - Umberto Vitolo
- Emanuele Zucca and Franco Cavalli, Oncology Institute of Southern Switzerland, Bellinzona; Luca Mazzucchelli, Cantonal Institute of Pathology, Locarno, Switzerland; Annarita Conconi, Ospedale degli Infermi, Biella; Giovanni Martinelli, European Institute of Oncology; Liliana Devizzi, Fondazione Istituto Nazionale Tumori; Valter Torri, Mario Negri Institute; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Maurilio Ponzoni, San Raffaele Hospital, Milan; Alessandra Tucci, Spedali Civili, Brescia; Umberto Vitolo, University-Hospital Città della Salute e della Scienza, Turin; Maurizio Martelli, Sapienza University; Stefan Hohaus, Catholic University of the Sacred Heart, Rome; Graziella Pinotti, Fondazione Macchi Hospital, Varese; Caterina Stelitano, Bianchi-Melacrino-Morelli Hospitals, Reggio Calabria; Monica Bellei, University of Modena and Reggio Emilia, Modena, Italy; Reda Bouabdallah, Institut Paoli-Calmettes, Marseille; Gilles Salles, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre-Benite; Catherine Sebban, Centre Léon Bérard, Lyon; Franck Morschhauser, Claude Huriez Hospital, Lille; Anne Moreau, University Hospital of Nantes, Nantes; Hervé Tilly, Centre Henri Becquerel, Rouen; Corinne Haioun, Henri-Mondor Hospital, Paris Créteil; Corinne Haioun, UPEC, Assistance Publique-Hopitaux de Paris; Catherine Thieblemont, Assistance Publique-Hopitaux de Paris, Hôpital-Saint-Louis, Hematooncology-Université Paris Diderot, Sorbonne Paris-Cité, Paris, France; Ruth Pettengell, St George's University of London, London; Andrew Jack, St James's University Hospital, Leeds; Peter Johnson, Southampton General Hospital, Southampton, United Kingdom; Armando Lopez Guillermo and Elias Campo, Hospital Clinic, Barcelona, Spain; Pierre Zachée, ZNA Stuivenberg, Antwerp; and André Bosly, Mont-Godinne UCL, Yvoir, Belgium
| | - Maurizio Martelli
- Emanuele Zucca and Franco Cavalli, Oncology Institute of Southern Switzerland, Bellinzona; Luca Mazzucchelli, Cantonal Institute of Pathology, Locarno, Switzerland; Annarita Conconi, Ospedale degli Infermi, Biella; Giovanni Martinelli, European Institute of Oncology; Liliana Devizzi, Fondazione Istituto Nazionale Tumori; Valter Torri, Mario Negri Institute; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Maurilio Ponzoni, San Raffaele Hospital, Milan; Alessandra Tucci, Spedali Civili, Brescia; Umberto Vitolo, University-Hospital Città della Salute e della Scienza, Turin; Maurizio Martelli, Sapienza University; Stefan Hohaus, Catholic University of the Sacred Heart, Rome; Graziella Pinotti, Fondazione Macchi Hospital, Varese; Caterina Stelitano, Bianchi-Melacrino-Morelli Hospitals, Reggio Calabria; Monica Bellei, University of Modena and Reggio Emilia, Modena, Italy; Reda Bouabdallah, Institut Paoli-Calmettes, Marseille; Gilles Salles, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre-Benite; Catherine Sebban, Centre Léon Bérard, Lyon; Franck Morschhauser, Claude Huriez Hospital, Lille; Anne Moreau, University Hospital of Nantes, Nantes; Hervé Tilly, Centre Henri Becquerel, Rouen; Corinne Haioun, Henri-Mondor Hospital, Paris Créteil; Corinne Haioun, UPEC, Assistance Publique-Hopitaux de Paris; Catherine Thieblemont, Assistance Publique-Hopitaux de Paris, Hôpital-Saint-Louis, Hematooncology-Université Paris Diderot, Sorbonne Paris-Cité, Paris, France; Ruth Pettengell, St George's University of London, London; Andrew Jack, St James's University Hospital, Leeds; Peter Johnson, Southampton General Hospital, Southampton, United Kingdom; Armando Lopez Guillermo and Elias Campo, Hospital Clinic, Barcelona, Spain; Pierre Zachée, ZNA Stuivenberg, Antwerp; and André Bosly, Mont-Godinne UCL, Yvoir, Belgium
| | - Ruth Pettengell
- Emanuele Zucca and Franco Cavalli, Oncology Institute of Southern Switzerland, Bellinzona; Luca Mazzucchelli, Cantonal Institute of Pathology, Locarno, Switzerland; Annarita Conconi, Ospedale degli Infermi, Biella; Giovanni Martinelli, European Institute of Oncology; Liliana Devizzi, Fondazione Istituto Nazionale Tumori; Valter Torri, Mario Negri Institute; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Maurilio Ponzoni, San Raffaele Hospital, Milan; Alessandra Tucci, Spedali Civili, Brescia; Umberto Vitolo, University-Hospital Città della Salute e della Scienza, Turin; Maurizio Martelli, Sapienza University; Stefan Hohaus, Catholic University of the Sacred Heart, Rome; Graziella Pinotti, Fondazione Macchi Hospital, Varese; Caterina Stelitano, Bianchi-Melacrino-Morelli Hospitals, Reggio Calabria; Monica Bellei, University of Modena and Reggio Emilia, Modena, Italy; Reda Bouabdallah, Institut Paoli-Calmettes, Marseille; Gilles Salles, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre-Benite; Catherine Sebban, Centre Léon Bérard, Lyon; Franck Morschhauser, Claude Huriez Hospital, Lille; Anne Moreau, University Hospital of Nantes, Nantes; Hervé Tilly, Centre Henri Becquerel, Rouen; Corinne Haioun, Henri-Mondor Hospital, Paris Créteil; Corinne Haioun, UPEC, Assistance Publique-Hopitaux de Paris; Catherine Thieblemont, Assistance Publique-Hopitaux de Paris, Hôpital-Saint-Louis, Hematooncology-Université Paris Diderot, Sorbonne Paris-Cité, Paris, France; Ruth Pettengell, St George's University of London, London; Andrew Jack, St James's University Hospital, Leeds; Peter Johnson, Southampton General Hospital, Southampton, United Kingdom; Armando Lopez Guillermo and Elias Campo, Hospital Clinic, Barcelona, Spain; Pierre Zachée, ZNA Stuivenberg, Antwerp; and André Bosly, Mont-Godinne UCL, Yvoir, Belgium
| | - Gilles Salles
- Emanuele Zucca and Franco Cavalli, Oncology Institute of Southern Switzerland, Bellinzona; Luca Mazzucchelli, Cantonal Institute of Pathology, Locarno, Switzerland; Annarita Conconi, Ospedale degli Infermi, Biella; Giovanni Martinelli, European Institute of Oncology; Liliana Devizzi, Fondazione Istituto Nazionale Tumori; Valter Torri, Mario Negri Institute; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Maurilio Ponzoni, San Raffaele Hospital, Milan; Alessandra Tucci, Spedali Civili, Brescia; Umberto Vitolo, University-Hospital Città della Salute e della Scienza, Turin; Maurizio Martelli, Sapienza University; Stefan Hohaus, Catholic University of the Sacred Heart, Rome; Graziella Pinotti, Fondazione Macchi Hospital, Varese; Caterina Stelitano, Bianchi-Melacrino-Morelli Hospitals, Reggio Calabria; Monica Bellei, University of Modena and Reggio Emilia, Modena, Italy; Reda Bouabdallah, Institut Paoli-Calmettes, Marseille; Gilles Salles, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre-Benite; Catherine Sebban, Centre Léon Bérard, Lyon; Franck Morschhauser, Claude Huriez Hospital, Lille; Anne Moreau, University Hospital of Nantes, Nantes; Hervé Tilly, Centre Henri Becquerel, Rouen; Corinne Haioun, Henri-Mondor Hospital, Paris Créteil; Corinne Haioun, UPEC, Assistance Publique-Hopitaux de Paris; Catherine Thieblemont, Assistance Publique-Hopitaux de Paris, Hôpital-Saint-Louis, Hematooncology-Université Paris Diderot, Sorbonne Paris-Cité, Paris, France; Ruth Pettengell, St George's University of London, London; Andrew Jack, St James's University Hospital, Leeds; Peter Johnson, Southampton General Hospital, Southampton, United Kingdom; Armando Lopez Guillermo and Elias Campo, Hospital Clinic, Barcelona, Spain; Pierre Zachée, ZNA Stuivenberg, Antwerp; and André Bosly, Mont-Godinne UCL, Yvoir, Belgium
| | - Catherine Sebban
- Emanuele Zucca and Franco Cavalli, Oncology Institute of Southern Switzerland, Bellinzona; Luca Mazzucchelli, Cantonal Institute of Pathology, Locarno, Switzerland; Annarita Conconi, Ospedale degli Infermi, Biella; Giovanni Martinelli, European Institute of Oncology; Liliana Devizzi, Fondazione Istituto Nazionale Tumori; Valter Torri, Mario Negri Institute; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Maurilio Ponzoni, San Raffaele Hospital, Milan; Alessandra Tucci, Spedali Civili, Brescia; Umberto Vitolo, University-Hospital Città della Salute e della Scienza, Turin; Maurizio Martelli, Sapienza University; Stefan Hohaus, Catholic University of the Sacred Heart, Rome; Graziella Pinotti, Fondazione Macchi Hospital, Varese; Caterina Stelitano, Bianchi-Melacrino-Morelli Hospitals, Reggio Calabria; Monica Bellei, University of Modena and Reggio Emilia, Modena, Italy; Reda Bouabdallah, Institut Paoli-Calmettes, Marseille; Gilles Salles, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre-Benite; Catherine Sebban, Centre Léon Bérard, Lyon; Franck Morschhauser, Claude Huriez Hospital, Lille; Anne Moreau, University Hospital of Nantes, Nantes; Hervé Tilly, Centre Henri Becquerel, Rouen; Corinne Haioun, Henri-Mondor Hospital, Paris Créteil; Corinne Haioun, UPEC, Assistance Publique-Hopitaux de Paris; Catherine Thieblemont, Assistance Publique-Hopitaux de Paris, Hôpital-Saint-Louis, Hematooncology-Université Paris Diderot, Sorbonne Paris-Cité, Paris, France; Ruth Pettengell, St George's University of London, London; Andrew Jack, St James's University Hospital, Leeds; Peter Johnson, Southampton General Hospital, Southampton, United Kingdom; Armando Lopez Guillermo and Elias Campo, Hospital Clinic, Barcelona, Spain; Pierre Zachée, ZNA Stuivenberg, Antwerp; and André Bosly, Mont-Godinne UCL, Yvoir, Belgium
| | - Armando Lopez Guillermo
- Emanuele Zucca and Franco Cavalli, Oncology Institute of Southern Switzerland, Bellinzona; Luca Mazzucchelli, Cantonal Institute of Pathology, Locarno, Switzerland; Annarita Conconi, Ospedale degli Infermi, Biella; Giovanni Martinelli, European Institute of Oncology; Liliana Devizzi, Fondazione Istituto Nazionale Tumori; Valter Torri, Mario Negri Institute; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Maurilio Ponzoni, San Raffaele Hospital, Milan; Alessandra Tucci, Spedali Civili, Brescia; Umberto Vitolo, University-Hospital Città della Salute e della Scienza, Turin; Maurizio Martelli, Sapienza University; Stefan Hohaus, Catholic University of the Sacred Heart, Rome; Graziella Pinotti, Fondazione Macchi Hospital, Varese; Caterina Stelitano, Bianchi-Melacrino-Morelli Hospitals, Reggio Calabria; Monica Bellei, University of Modena and Reggio Emilia, Modena, Italy; Reda Bouabdallah, Institut Paoli-Calmettes, Marseille; Gilles Salles, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre-Benite; Catherine Sebban, Centre Léon Bérard, Lyon; Franck Morschhauser, Claude Huriez Hospital, Lille; Anne Moreau, University Hospital of Nantes, Nantes; Hervé Tilly, Centre Henri Becquerel, Rouen; Corinne Haioun, Henri-Mondor Hospital, Paris Créteil; Corinne Haioun, UPEC, Assistance Publique-Hopitaux de Paris; Catherine Thieblemont, Assistance Publique-Hopitaux de Paris, Hôpital-Saint-Louis, Hematooncology-Université Paris Diderot, Sorbonne Paris-Cité, Paris, France; Ruth Pettengell, St George's University of London, London; Andrew Jack, St James's University Hospital, Leeds; Peter Johnson, Southampton General Hospital, Southampton, United Kingdom; Armando Lopez Guillermo and Elias Campo, Hospital Clinic, Barcelona, Spain; Pierre Zachée, ZNA Stuivenberg, Antwerp; and André Bosly, Mont-Godinne UCL, Yvoir, Belgium
| | - Graziella Pinotti
- Emanuele Zucca and Franco Cavalli, Oncology Institute of Southern Switzerland, Bellinzona; Luca Mazzucchelli, Cantonal Institute of Pathology, Locarno, Switzerland; Annarita Conconi, Ospedale degli Infermi, Biella; Giovanni Martinelli, European Institute of Oncology; Liliana Devizzi, Fondazione Istituto Nazionale Tumori; Valter Torri, Mario Negri Institute; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Maurilio Ponzoni, San Raffaele Hospital, Milan; Alessandra Tucci, Spedali Civili, Brescia; Umberto Vitolo, University-Hospital Città della Salute e della Scienza, Turin; Maurizio Martelli, Sapienza University; Stefan Hohaus, Catholic University of the Sacred Heart, Rome; Graziella Pinotti, Fondazione Macchi Hospital, Varese; Caterina Stelitano, Bianchi-Melacrino-Morelli Hospitals, Reggio Calabria; Monica Bellei, University of Modena and Reggio Emilia, Modena, Italy; Reda Bouabdallah, Institut Paoli-Calmettes, Marseille; Gilles Salles, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre-Benite; Catherine Sebban, Centre Léon Bérard, Lyon; Franck Morschhauser, Claude Huriez Hospital, Lille; Anne Moreau, University Hospital of Nantes, Nantes; Hervé Tilly, Centre Henri Becquerel, Rouen; Corinne Haioun, Henri-Mondor Hospital, Paris Créteil; Corinne Haioun, UPEC, Assistance Publique-Hopitaux de Paris; Catherine Thieblemont, Assistance Publique-Hopitaux de Paris, Hôpital-Saint-Louis, Hematooncology-Université Paris Diderot, Sorbonne Paris-Cité, Paris, France; Ruth Pettengell, St George's University of London, London; Andrew Jack, St James's University Hospital, Leeds; Peter Johnson, Southampton General Hospital, Southampton, United Kingdom; Armando Lopez Guillermo and Elias Campo, Hospital Clinic, Barcelona, Spain; Pierre Zachée, ZNA Stuivenberg, Antwerp; and André Bosly, Mont-Godinne UCL, Yvoir, Belgium
| | - Liliana Devizzi
- Emanuele Zucca and Franco Cavalli, Oncology Institute of Southern Switzerland, Bellinzona; Luca Mazzucchelli, Cantonal Institute of Pathology, Locarno, Switzerland; Annarita Conconi, Ospedale degli Infermi, Biella; Giovanni Martinelli, European Institute of Oncology; Liliana Devizzi, Fondazione Istituto Nazionale Tumori; Valter Torri, Mario Negri Institute; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Maurilio Ponzoni, San Raffaele Hospital, Milan; Alessandra Tucci, Spedali Civili, Brescia; Umberto Vitolo, University-Hospital Città della Salute e della Scienza, Turin; Maurizio Martelli, Sapienza University; Stefan Hohaus, Catholic University of the Sacred Heart, Rome; Graziella Pinotti, Fondazione Macchi Hospital, Varese; Caterina Stelitano, Bianchi-Melacrino-Morelli Hospitals, Reggio Calabria; Monica Bellei, University of Modena and Reggio Emilia, Modena, Italy; Reda Bouabdallah, Institut Paoli-Calmettes, Marseille; Gilles Salles, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre-Benite; Catherine Sebban, Centre Léon Bérard, Lyon; Franck Morschhauser, Claude Huriez Hospital, Lille; Anne Moreau, University Hospital of Nantes, Nantes; Hervé Tilly, Centre Henri Becquerel, Rouen; Corinne Haioun, Henri-Mondor Hospital, Paris Créteil; Corinne Haioun, UPEC, Assistance Publique-Hopitaux de Paris; Catherine Thieblemont, Assistance Publique-Hopitaux de Paris, Hôpital-Saint-Louis, Hematooncology-Université Paris Diderot, Sorbonne Paris-Cité, Paris, France; Ruth Pettengell, St George's University of London, London; Andrew Jack, St James's University Hospital, Leeds; Peter Johnson, Southampton General Hospital, Southampton, United Kingdom; Armando Lopez Guillermo and Elias Campo, Hospital Clinic, Barcelona, Spain; Pierre Zachée, ZNA Stuivenberg, Antwerp; and André Bosly, Mont-Godinne UCL, Yvoir, Belgium
| | - Franck Morschhauser
- Emanuele Zucca and Franco Cavalli, Oncology Institute of Southern Switzerland, Bellinzona; Luca Mazzucchelli, Cantonal Institute of Pathology, Locarno, Switzerland; Annarita Conconi, Ospedale degli Infermi, Biella; Giovanni Martinelli, European Institute of Oncology; Liliana Devizzi, Fondazione Istituto Nazionale Tumori; Valter Torri, Mario Negri Institute; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Maurilio Ponzoni, San Raffaele Hospital, Milan; Alessandra Tucci, Spedali Civili, Brescia; Umberto Vitolo, University-Hospital Città della Salute e della Scienza, Turin; Maurizio Martelli, Sapienza University; Stefan Hohaus, Catholic University of the Sacred Heart, Rome; Graziella Pinotti, Fondazione Macchi Hospital, Varese; Caterina Stelitano, Bianchi-Melacrino-Morelli Hospitals, Reggio Calabria; Monica Bellei, University of Modena and Reggio Emilia, Modena, Italy; Reda Bouabdallah, Institut Paoli-Calmettes, Marseille; Gilles Salles, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre-Benite; Catherine Sebban, Centre Léon Bérard, Lyon; Franck Morschhauser, Claude Huriez Hospital, Lille; Anne Moreau, University Hospital of Nantes, Nantes; Hervé Tilly, Centre Henri Becquerel, Rouen; Corinne Haioun, Henri-Mondor Hospital, Paris Créteil; Corinne Haioun, UPEC, Assistance Publique-Hopitaux de Paris; Catherine Thieblemont, Assistance Publique-Hopitaux de Paris, Hôpital-Saint-Louis, Hematooncology-Université Paris Diderot, Sorbonne Paris-Cité, Paris, France; Ruth Pettengell, St George's University of London, London; Andrew Jack, St James's University Hospital, Leeds; Peter Johnson, Southampton General Hospital, Southampton, United Kingdom; Armando Lopez Guillermo and Elias Campo, Hospital Clinic, Barcelona, Spain; Pierre Zachée, ZNA Stuivenberg, Antwerp; and André Bosly, Mont-Godinne UCL, Yvoir, Belgium
| | - Hervé Tilly
- Emanuele Zucca and Franco Cavalli, Oncology Institute of Southern Switzerland, Bellinzona; Luca Mazzucchelli, Cantonal Institute of Pathology, Locarno, Switzerland; Annarita Conconi, Ospedale degli Infermi, Biella; Giovanni Martinelli, European Institute of Oncology; Liliana Devizzi, Fondazione Istituto Nazionale Tumori; Valter Torri, Mario Negri Institute; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Maurilio Ponzoni, San Raffaele Hospital, Milan; Alessandra Tucci, Spedali Civili, Brescia; Umberto Vitolo, University-Hospital Città della Salute e della Scienza, Turin; Maurizio Martelli, Sapienza University; Stefan Hohaus, Catholic University of the Sacred Heart, Rome; Graziella Pinotti, Fondazione Macchi Hospital, Varese; Caterina Stelitano, Bianchi-Melacrino-Morelli Hospitals, Reggio Calabria; Monica Bellei, University of Modena and Reggio Emilia, Modena, Italy; Reda Bouabdallah, Institut Paoli-Calmettes, Marseille; Gilles Salles, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre-Benite; Catherine Sebban, Centre Léon Bérard, Lyon; Franck Morschhauser, Claude Huriez Hospital, Lille; Anne Moreau, University Hospital of Nantes, Nantes; Hervé Tilly, Centre Henri Becquerel, Rouen; Corinne Haioun, Henri-Mondor Hospital, Paris Créteil; Corinne Haioun, UPEC, Assistance Publique-Hopitaux de Paris; Catherine Thieblemont, Assistance Publique-Hopitaux de Paris, Hôpital-Saint-Louis, Hematooncology-Université Paris Diderot, Sorbonne Paris-Cité, Paris, France; Ruth Pettengell, St George's University of London, London; Andrew Jack, St James's University Hospital, Leeds; Peter Johnson, Southampton General Hospital, Southampton, United Kingdom; Armando Lopez Guillermo and Elias Campo, Hospital Clinic, Barcelona, Spain; Pierre Zachée, ZNA Stuivenberg, Antwerp; and André Bosly, Mont-Godinne UCL, Yvoir, Belgium
| | - Valter Torri
- Emanuele Zucca and Franco Cavalli, Oncology Institute of Southern Switzerland, Bellinzona; Luca Mazzucchelli, Cantonal Institute of Pathology, Locarno, Switzerland; Annarita Conconi, Ospedale degli Infermi, Biella; Giovanni Martinelli, European Institute of Oncology; Liliana Devizzi, Fondazione Istituto Nazionale Tumori; Valter Torri, Mario Negri Institute; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Maurilio Ponzoni, San Raffaele Hospital, Milan; Alessandra Tucci, Spedali Civili, Brescia; Umberto Vitolo, University-Hospital Città della Salute e della Scienza, Turin; Maurizio Martelli, Sapienza University; Stefan Hohaus, Catholic University of the Sacred Heart, Rome; Graziella Pinotti, Fondazione Macchi Hospital, Varese; Caterina Stelitano, Bianchi-Melacrino-Morelli Hospitals, Reggio Calabria; Monica Bellei, University of Modena and Reggio Emilia, Modena, Italy; Reda Bouabdallah, Institut Paoli-Calmettes, Marseille; Gilles Salles, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre-Benite; Catherine Sebban, Centre Léon Bérard, Lyon; Franck Morschhauser, Claude Huriez Hospital, Lille; Anne Moreau, University Hospital of Nantes, Nantes; Hervé Tilly, Centre Henri Becquerel, Rouen; Corinne Haioun, Henri-Mondor Hospital, Paris Créteil; Corinne Haioun, UPEC, Assistance Publique-Hopitaux de Paris; Catherine Thieblemont, Assistance Publique-Hopitaux de Paris, Hôpital-Saint-Louis, Hematooncology-Université Paris Diderot, Sorbonne Paris-Cité, Paris, France; Ruth Pettengell, St George's University of London, London; Andrew Jack, St James's University Hospital, Leeds; Peter Johnson, Southampton General Hospital, Southampton, United Kingdom; Armando Lopez Guillermo and Elias Campo, Hospital Clinic, Barcelona, Spain; Pierre Zachée, ZNA Stuivenberg, Antwerp; and André Bosly, Mont-Godinne UCL, Yvoir, Belgium
| | - Stefan Hohaus
- Emanuele Zucca and Franco Cavalli, Oncology Institute of Southern Switzerland, Bellinzona; Luca Mazzucchelli, Cantonal Institute of Pathology, Locarno, Switzerland; Annarita Conconi, Ospedale degli Infermi, Biella; Giovanni Martinelli, European Institute of Oncology; Liliana Devizzi, Fondazione Istituto Nazionale Tumori; Valter Torri, Mario Negri Institute; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Maurilio Ponzoni, San Raffaele Hospital, Milan; Alessandra Tucci, Spedali Civili, Brescia; Umberto Vitolo, University-Hospital Città della Salute e della Scienza, Turin; Maurizio Martelli, Sapienza University; Stefan Hohaus, Catholic University of the Sacred Heart, Rome; Graziella Pinotti, Fondazione Macchi Hospital, Varese; Caterina Stelitano, Bianchi-Melacrino-Morelli Hospitals, Reggio Calabria; Monica Bellei, University of Modena and Reggio Emilia, Modena, Italy; Reda Bouabdallah, Institut Paoli-Calmettes, Marseille; Gilles Salles, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre-Benite; Catherine Sebban, Centre Léon Bérard, Lyon; Franck Morschhauser, Claude Huriez Hospital, Lille; Anne Moreau, University Hospital of Nantes, Nantes; Hervé Tilly, Centre Henri Becquerel, Rouen; Corinne Haioun, Henri-Mondor Hospital, Paris Créteil; Corinne Haioun, UPEC, Assistance Publique-Hopitaux de Paris; Catherine Thieblemont, Assistance Publique-Hopitaux de Paris, Hôpital-Saint-Louis, Hematooncology-Université Paris Diderot, Sorbonne Paris-Cité, Paris, France; Ruth Pettengell, St George's University of London, London; Andrew Jack, St James's University Hospital, Leeds; Peter Johnson, Southampton General Hospital, Southampton, United Kingdom; Armando Lopez Guillermo and Elias Campo, Hospital Clinic, Barcelona, Spain; Pierre Zachée, ZNA Stuivenberg, Antwerp; and André Bosly, Mont-Godinne UCL, Yvoir, Belgium
| | - Andrés J M Ferreri
- Emanuele Zucca and Franco Cavalli, Oncology Institute of Southern Switzerland, Bellinzona; Luca Mazzucchelli, Cantonal Institute of Pathology, Locarno, Switzerland; Annarita Conconi, Ospedale degli Infermi, Biella; Giovanni Martinelli, European Institute of Oncology; Liliana Devizzi, Fondazione Istituto Nazionale Tumori; Valter Torri, Mario Negri Institute; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Maurilio Ponzoni, San Raffaele Hospital, Milan; Alessandra Tucci, Spedali Civili, Brescia; Umberto Vitolo, University-Hospital Città della Salute e della Scienza, Turin; Maurizio Martelli, Sapienza University; Stefan Hohaus, Catholic University of the Sacred Heart, Rome; Graziella Pinotti, Fondazione Macchi Hospital, Varese; Caterina Stelitano, Bianchi-Melacrino-Morelli Hospitals, Reggio Calabria; Monica Bellei, University of Modena and Reggio Emilia, Modena, Italy; Reda Bouabdallah, Institut Paoli-Calmettes, Marseille; Gilles Salles, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre-Benite; Catherine Sebban, Centre Léon Bérard, Lyon; Franck Morschhauser, Claude Huriez Hospital, Lille; Anne Moreau, University Hospital of Nantes, Nantes; Hervé Tilly, Centre Henri Becquerel, Rouen; Corinne Haioun, Henri-Mondor Hospital, Paris Créteil; Corinne Haioun, UPEC, Assistance Publique-Hopitaux de Paris; Catherine Thieblemont, Assistance Publique-Hopitaux de Paris, Hôpital-Saint-Louis, Hematooncology-Université Paris Diderot, Sorbonne Paris-Cité, Paris, France; Ruth Pettengell, St George's University of London, London; Andrew Jack, St James's University Hospital, Leeds; Peter Johnson, Southampton General Hospital, Southampton, United Kingdom; Armando Lopez Guillermo and Elias Campo, Hospital Clinic, Barcelona, Spain; Pierre Zachée, ZNA Stuivenberg, Antwerp; and André Bosly, Mont-Godinne UCL, Yvoir, Belgium
| | - Pierre Zachée
- Emanuele Zucca and Franco Cavalli, Oncology Institute of Southern Switzerland, Bellinzona; Luca Mazzucchelli, Cantonal Institute of Pathology, Locarno, Switzerland; Annarita Conconi, Ospedale degli Infermi, Biella; Giovanni Martinelli, European Institute of Oncology; Liliana Devizzi, Fondazione Istituto Nazionale Tumori; Valter Torri, Mario Negri Institute; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Maurilio Ponzoni, San Raffaele Hospital, Milan; Alessandra Tucci, Spedali Civili, Brescia; Umberto Vitolo, University-Hospital Città della Salute e della Scienza, Turin; Maurizio Martelli, Sapienza University; Stefan Hohaus, Catholic University of the Sacred Heart, Rome; Graziella Pinotti, Fondazione Macchi Hospital, Varese; Caterina Stelitano, Bianchi-Melacrino-Morelli Hospitals, Reggio Calabria; Monica Bellei, University of Modena and Reggio Emilia, Modena, Italy; Reda Bouabdallah, Institut Paoli-Calmettes, Marseille; Gilles Salles, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre-Benite; Catherine Sebban, Centre Léon Bérard, Lyon; Franck Morschhauser, Claude Huriez Hospital, Lille; Anne Moreau, University Hospital of Nantes, Nantes; Hervé Tilly, Centre Henri Becquerel, Rouen; Corinne Haioun, Henri-Mondor Hospital, Paris Créteil; Corinne Haioun, UPEC, Assistance Publique-Hopitaux de Paris; Catherine Thieblemont, Assistance Publique-Hopitaux de Paris, Hôpital-Saint-Louis, Hematooncology-Université Paris Diderot, Sorbonne Paris-Cité, Paris, France; Ruth Pettengell, St George's University of London, London; Andrew Jack, St James's University Hospital, Leeds; Peter Johnson, Southampton General Hospital, Southampton, United Kingdom; Armando Lopez Guillermo and Elias Campo, Hospital Clinic, Barcelona, Spain; Pierre Zachée, ZNA Stuivenberg, Antwerp; and André Bosly, Mont-Godinne UCL, Yvoir, Belgium
| | - André Bosly
- Emanuele Zucca and Franco Cavalli, Oncology Institute of Southern Switzerland, Bellinzona; Luca Mazzucchelli, Cantonal Institute of Pathology, Locarno, Switzerland; Annarita Conconi, Ospedale degli Infermi, Biella; Giovanni Martinelli, European Institute of Oncology; Liliana Devizzi, Fondazione Istituto Nazionale Tumori; Valter Torri, Mario Negri Institute; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Maurilio Ponzoni, San Raffaele Hospital, Milan; Alessandra Tucci, Spedali Civili, Brescia; Umberto Vitolo, University-Hospital Città della Salute e della Scienza, Turin; Maurizio Martelli, Sapienza University; Stefan Hohaus, Catholic University of the Sacred Heart, Rome; Graziella Pinotti, Fondazione Macchi Hospital, Varese; Caterina Stelitano, Bianchi-Melacrino-Morelli Hospitals, Reggio Calabria; Monica Bellei, University of Modena and Reggio Emilia, Modena, Italy; Reda Bouabdallah, Institut Paoli-Calmettes, Marseille; Gilles Salles, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre-Benite; Catherine Sebban, Centre Léon Bérard, Lyon; Franck Morschhauser, Claude Huriez Hospital, Lille; Anne Moreau, University Hospital of Nantes, Nantes; Hervé Tilly, Centre Henri Becquerel, Rouen; Corinne Haioun, Henri-Mondor Hospital, Paris Créteil; Corinne Haioun, UPEC, Assistance Publique-Hopitaux de Paris; Catherine Thieblemont, Assistance Publique-Hopitaux de Paris, Hôpital-Saint-Louis, Hematooncology-Université Paris Diderot, Sorbonne Paris-Cité, Paris, France; Ruth Pettengell, St George's University of London, London; Andrew Jack, St James's University Hospital, Leeds; Peter Johnson, Southampton General Hospital, Southampton, United Kingdom; Armando Lopez Guillermo and Elias Campo, Hospital Clinic, Barcelona, Spain; Pierre Zachée, ZNA Stuivenberg, Antwerp; and André Bosly, Mont-Godinne UCL, Yvoir, Belgium
| | - Corinne Haioun
- Emanuele Zucca and Franco Cavalli, Oncology Institute of Southern Switzerland, Bellinzona; Luca Mazzucchelli, Cantonal Institute of Pathology, Locarno, Switzerland; Annarita Conconi, Ospedale degli Infermi, Biella; Giovanni Martinelli, European Institute of Oncology; Liliana Devizzi, Fondazione Istituto Nazionale Tumori; Valter Torri, Mario Negri Institute; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Maurilio Ponzoni, San Raffaele Hospital, Milan; Alessandra Tucci, Spedali Civili, Brescia; Umberto Vitolo, University-Hospital Città della Salute e della Scienza, Turin; Maurizio Martelli, Sapienza University; Stefan Hohaus, Catholic University of the Sacred Heart, Rome; Graziella Pinotti, Fondazione Macchi Hospital, Varese; Caterina Stelitano, Bianchi-Melacrino-Morelli Hospitals, Reggio Calabria; Monica Bellei, University of Modena and Reggio Emilia, Modena, Italy; Reda Bouabdallah, Institut Paoli-Calmettes, Marseille; Gilles Salles, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre-Benite; Catherine Sebban, Centre Léon Bérard, Lyon; Franck Morschhauser, Claude Huriez Hospital, Lille; Anne Moreau, University Hospital of Nantes, Nantes; Hervé Tilly, Centre Henri Becquerel, Rouen; Corinne Haioun, Henri-Mondor Hospital, Paris Créteil; Corinne Haioun, UPEC, Assistance Publique-Hopitaux de Paris; Catherine Thieblemont, Assistance Publique-Hopitaux de Paris, Hôpital-Saint-Louis, Hematooncology-Université Paris Diderot, Sorbonne Paris-Cité, Paris, France; Ruth Pettengell, St George's University of London, London; Andrew Jack, St James's University Hospital, Leeds; Peter Johnson, Southampton General Hospital, Southampton, United Kingdom; Armando Lopez Guillermo and Elias Campo, Hospital Clinic, Barcelona, Spain; Pierre Zachée, ZNA Stuivenberg, Antwerp; and André Bosly, Mont-Godinne UCL, Yvoir, Belgium
| | - Caterina Stelitano
- Emanuele Zucca and Franco Cavalli, Oncology Institute of Southern Switzerland, Bellinzona; Luca Mazzucchelli, Cantonal Institute of Pathology, Locarno, Switzerland; Annarita Conconi, Ospedale degli Infermi, Biella; Giovanni Martinelli, European Institute of Oncology; Liliana Devizzi, Fondazione Istituto Nazionale Tumori; Valter Torri, Mario Negri Institute; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Maurilio Ponzoni, San Raffaele Hospital, Milan; Alessandra Tucci, Spedali Civili, Brescia; Umberto Vitolo, University-Hospital Città della Salute e della Scienza, Turin; Maurizio Martelli, Sapienza University; Stefan Hohaus, Catholic University of the Sacred Heart, Rome; Graziella Pinotti, Fondazione Macchi Hospital, Varese; Caterina Stelitano, Bianchi-Melacrino-Morelli Hospitals, Reggio Calabria; Monica Bellei, University of Modena and Reggio Emilia, Modena, Italy; Reda Bouabdallah, Institut Paoli-Calmettes, Marseille; Gilles Salles, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre-Benite; Catherine Sebban, Centre Léon Bérard, Lyon; Franck Morschhauser, Claude Huriez Hospital, Lille; Anne Moreau, University Hospital of Nantes, Nantes; Hervé Tilly, Centre Henri Becquerel, Rouen; Corinne Haioun, Henri-Mondor Hospital, Paris Créteil; Corinne Haioun, UPEC, Assistance Publique-Hopitaux de Paris; Catherine Thieblemont, Assistance Publique-Hopitaux de Paris, Hôpital-Saint-Louis, Hematooncology-Université Paris Diderot, Sorbonne Paris-Cité, Paris, France; Ruth Pettengell, St George's University of London, London; Andrew Jack, St James's University Hospital, Leeds; Peter Johnson, Southampton General Hospital, Southampton, United Kingdom; Armando Lopez Guillermo and Elias Campo, Hospital Clinic, Barcelona, Spain; Pierre Zachée, ZNA Stuivenberg, Antwerp; and André Bosly, Mont-Godinne UCL, Yvoir, Belgium
| | - Monica Bellei
- Emanuele Zucca and Franco Cavalli, Oncology Institute of Southern Switzerland, Bellinzona; Luca Mazzucchelli, Cantonal Institute of Pathology, Locarno, Switzerland; Annarita Conconi, Ospedale degli Infermi, Biella; Giovanni Martinelli, European Institute of Oncology; Liliana Devizzi, Fondazione Istituto Nazionale Tumori; Valter Torri, Mario Negri Institute; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Maurilio Ponzoni, San Raffaele Hospital, Milan; Alessandra Tucci, Spedali Civili, Brescia; Umberto Vitolo, University-Hospital Città della Salute e della Scienza, Turin; Maurizio Martelli, Sapienza University; Stefan Hohaus, Catholic University of the Sacred Heart, Rome; Graziella Pinotti, Fondazione Macchi Hospital, Varese; Caterina Stelitano, Bianchi-Melacrino-Morelli Hospitals, Reggio Calabria; Monica Bellei, University of Modena and Reggio Emilia, Modena, Italy; Reda Bouabdallah, Institut Paoli-Calmettes, Marseille; Gilles Salles, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre-Benite; Catherine Sebban, Centre Léon Bérard, Lyon; Franck Morschhauser, Claude Huriez Hospital, Lille; Anne Moreau, University Hospital of Nantes, Nantes; Hervé Tilly, Centre Henri Becquerel, Rouen; Corinne Haioun, Henri-Mondor Hospital, Paris Créteil; Corinne Haioun, UPEC, Assistance Publique-Hopitaux de Paris; Catherine Thieblemont, Assistance Publique-Hopitaux de Paris, Hôpital-Saint-Louis, Hematooncology-Université Paris Diderot, Sorbonne Paris-Cité, Paris, France; Ruth Pettengell, St George's University of London, London; Andrew Jack, St James's University Hospital, Leeds; Peter Johnson, Southampton General Hospital, Southampton, United Kingdom; Armando Lopez Guillermo and Elias Campo, Hospital Clinic, Barcelona, Spain; Pierre Zachée, ZNA Stuivenberg, Antwerp; and André Bosly, Mont-Godinne UCL, Yvoir, Belgium
| | - Maurilio Ponzoni
- Emanuele Zucca and Franco Cavalli, Oncology Institute of Southern Switzerland, Bellinzona; Luca Mazzucchelli, Cantonal Institute of Pathology, Locarno, Switzerland; Annarita Conconi, Ospedale degli Infermi, Biella; Giovanni Martinelli, European Institute of Oncology; Liliana Devizzi, Fondazione Istituto Nazionale Tumori; Valter Torri, Mario Negri Institute; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Maurilio Ponzoni, San Raffaele Hospital, Milan; Alessandra Tucci, Spedali Civili, Brescia; Umberto Vitolo, University-Hospital Città della Salute e della Scienza, Turin; Maurizio Martelli, Sapienza University; Stefan Hohaus, Catholic University of the Sacred Heart, Rome; Graziella Pinotti, Fondazione Macchi Hospital, Varese; Caterina Stelitano, Bianchi-Melacrino-Morelli Hospitals, Reggio Calabria; Monica Bellei, University of Modena and Reggio Emilia, Modena, Italy; Reda Bouabdallah, Institut Paoli-Calmettes, Marseille; Gilles Salles, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre-Benite; Catherine Sebban, Centre Léon Bérard, Lyon; Franck Morschhauser, Claude Huriez Hospital, Lille; Anne Moreau, University Hospital of Nantes, Nantes; Hervé Tilly, Centre Henri Becquerel, Rouen; Corinne Haioun, Henri-Mondor Hospital, Paris Créteil; Corinne Haioun, UPEC, Assistance Publique-Hopitaux de Paris; Catherine Thieblemont, Assistance Publique-Hopitaux de Paris, Hôpital-Saint-Louis, Hematooncology-Université Paris Diderot, Sorbonne Paris-Cité, Paris, France; Ruth Pettengell, St George's University of London, London; Andrew Jack, St James's University Hospital, Leeds; Peter Johnson, Southampton General Hospital, Southampton, United Kingdom; Armando Lopez Guillermo and Elias Campo, Hospital Clinic, Barcelona, Spain; Pierre Zachée, ZNA Stuivenberg, Antwerp; and André Bosly, Mont-Godinne UCL, Yvoir, Belgium
| | - Anne Moreau
- Emanuele Zucca and Franco Cavalli, Oncology Institute of Southern Switzerland, Bellinzona; Luca Mazzucchelli, Cantonal Institute of Pathology, Locarno, Switzerland; Annarita Conconi, Ospedale degli Infermi, Biella; Giovanni Martinelli, European Institute of Oncology; Liliana Devizzi, Fondazione Istituto Nazionale Tumori; Valter Torri, Mario Negri Institute; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Maurilio Ponzoni, San Raffaele Hospital, Milan; Alessandra Tucci, Spedali Civili, Brescia; Umberto Vitolo, University-Hospital Città della Salute e della Scienza, Turin; Maurizio Martelli, Sapienza University; Stefan Hohaus, Catholic University of the Sacred Heart, Rome; Graziella Pinotti, Fondazione Macchi Hospital, Varese; Caterina Stelitano, Bianchi-Melacrino-Morelli Hospitals, Reggio Calabria; Monica Bellei, University of Modena and Reggio Emilia, Modena, Italy; Reda Bouabdallah, Institut Paoli-Calmettes, Marseille; Gilles Salles, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre-Benite; Catherine Sebban, Centre Léon Bérard, Lyon; Franck Morschhauser, Claude Huriez Hospital, Lille; Anne Moreau, University Hospital of Nantes, Nantes; Hervé Tilly, Centre Henri Becquerel, Rouen; Corinne Haioun, Henri-Mondor Hospital, Paris Créteil; Corinne Haioun, UPEC, Assistance Publique-Hopitaux de Paris; Catherine Thieblemont, Assistance Publique-Hopitaux de Paris, Hôpital-Saint-Louis, Hematooncology-Université Paris Diderot, Sorbonne Paris-Cité, Paris, France; Ruth Pettengell, St George's University of London, London; Andrew Jack, St James's University Hospital, Leeds; Peter Johnson, Southampton General Hospital, Southampton, United Kingdom; Armando Lopez Guillermo and Elias Campo, Hospital Clinic, Barcelona, Spain; Pierre Zachée, ZNA Stuivenberg, Antwerp; and André Bosly, Mont-Godinne UCL, Yvoir, Belgium
| | - Andrew Jack
- Emanuele Zucca and Franco Cavalli, Oncology Institute of Southern Switzerland, Bellinzona; Luca Mazzucchelli, Cantonal Institute of Pathology, Locarno, Switzerland; Annarita Conconi, Ospedale degli Infermi, Biella; Giovanni Martinelli, European Institute of Oncology; Liliana Devizzi, Fondazione Istituto Nazionale Tumori; Valter Torri, Mario Negri Institute; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Maurilio Ponzoni, San Raffaele Hospital, Milan; Alessandra Tucci, Spedali Civili, Brescia; Umberto Vitolo, University-Hospital Città della Salute e della Scienza, Turin; Maurizio Martelli, Sapienza University; Stefan Hohaus, Catholic University of the Sacred Heart, Rome; Graziella Pinotti, Fondazione Macchi Hospital, Varese; Caterina Stelitano, Bianchi-Melacrino-Morelli Hospitals, Reggio Calabria; Monica Bellei, University of Modena and Reggio Emilia, Modena, Italy; Reda Bouabdallah, Institut Paoli-Calmettes, Marseille; Gilles Salles, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre-Benite; Catherine Sebban, Centre Léon Bérard, Lyon; Franck Morschhauser, Claude Huriez Hospital, Lille; Anne Moreau, University Hospital of Nantes, Nantes; Hervé Tilly, Centre Henri Becquerel, Rouen; Corinne Haioun, Henri-Mondor Hospital, Paris Créteil; Corinne Haioun, UPEC, Assistance Publique-Hopitaux de Paris; Catherine Thieblemont, Assistance Publique-Hopitaux de Paris, Hôpital-Saint-Louis, Hematooncology-Université Paris Diderot, Sorbonne Paris-Cité, Paris, France; Ruth Pettengell, St George's University of London, London; Andrew Jack, St James's University Hospital, Leeds; Peter Johnson, Southampton General Hospital, Southampton, United Kingdom; Armando Lopez Guillermo and Elias Campo, Hospital Clinic, Barcelona, Spain; Pierre Zachée, ZNA Stuivenberg, Antwerp; and André Bosly, Mont-Godinne UCL, Yvoir, Belgium
| | - Elias Campo
- Emanuele Zucca and Franco Cavalli, Oncology Institute of Southern Switzerland, Bellinzona; Luca Mazzucchelli, Cantonal Institute of Pathology, Locarno, Switzerland; Annarita Conconi, Ospedale degli Infermi, Biella; Giovanni Martinelli, European Institute of Oncology; Liliana Devizzi, Fondazione Istituto Nazionale Tumori; Valter Torri, Mario Negri Institute; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Maurilio Ponzoni, San Raffaele Hospital, Milan; Alessandra Tucci, Spedali Civili, Brescia; Umberto Vitolo, University-Hospital Città della Salute e della Scienza, Turin; Maurizio Martelli, Sapienza University; Stefan Hohaus, Catholic University of the Sacred Heart, Rome; Graziella Pinotti, Fondazione Macchi Hospital, Varese; Caterina Stelitano, Bianchi-Melacrino-Morelli Hospitals, Reggio Calabria; Monica Bellei, University of Modena and Reggio Emilia, Modena, Italy; Reda Bouabdallah, Institut Paoli-Calmettes, Marseille; Gilles Salles, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre-Benite; Catherine Sebban, Centre Léon Bérard, Lyon; Franck Morschhauser, Claude Huriez Hospital, Lille; Anne Moreau, University Hospital of Nantes, Nantes; Hervé Tilly, Centre Henri Becquerel, Rouen; Corinne Haioun, Henri-Mondor Hospital, Paris Créteil; Corinne Haioun, UPEC, Assistance Publique-Hopitaux de Paris; Catherine Thieblemont, Assistance Publique-Hopitaux de Paris, Hôpital-Saint-Louis, Hematooncology-Université Paris Diderot, Sorbonne Paris-Cité, Paris, France; Ruth Pettengell, St George's University of London, London; Andrew Jack, St James's University Hospital, Leeds; Peter Johnson, Southampton General Hospital, Southampton, United Kingdom; Armando Lopez Guillermo and Elias Campo, Hospital Clinic, Barcelona, Spain; Pierre Zachée, ZNA Stuivenberg, Antwerp; and André Bosly, Mont-Godinne UCL, Yvoir, Belgium
| | - Luca Mazzucchelli
- Emanuele Zucca and Franco Cavalli, Oncology Institute of Southern Switzerland, Bellinzona; Luca Mazzucchelli, Cantonal Institute of Pathology, Locarno, Switzerland; Annarita Conconi, Ospedale degli Infermi, Biella; Giovanni Martinelli, European Institute of Oncology; Liliana Devizzi, Fondazione Istituto Nazionale Tumori; Valter Torri, Mario Negri Institute; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Maurilio Ponzoni, San Raffaele Hospital, Milan; Alessandra Tucci, Spedali Civili, Brescia; Umberto Vitolo, University-Hospital Città della Salute e della Scienza, Turin; Maurizio Martelli, Sapienza University; Stefan Hohaus, Catholic University of the Sacred Heart, Rome; Graziella Pinotti, Fondazione Macchi Hospital, Varese; Caterina Stelitano, Bianchi-Melacrino-Morelli Hospitals, Reggio Calabria; Monica Bellei, University of Modena and Reggio Emilia, Modena, Italy; Reda Bouabdallah, Institut Paoli-Calmettes, Marseille; Gilles Salles, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre-Benite; Catherine Sebban, Centre Léon Bérard, Lyon; Franck Morschhauser, Claude Huriez Hospital, Lille; Anne Moreau, University Hospital of Nantes, Nantes; Hervé Tilly, Centre Henri Becquerel, Rouen; Corinne Haioun, Henri-Mondor Hospital, Paris Créteil; Corinne Haioun, UPEC, Assistance Publique-Hopitaux de Paris; Catherine Thieblemont, Assistance Publique-Hopitaux de Paris, Hôpital-Saint-Louis, Hematooncology-Université Paris Diderot, Sorbonne Paris-Cité, Paris, France; Ruth Pettengell, St George's University of London, London; Andrew Jack, St James's University Hospital, Leeds; Peter Johnson, Southampton General Hospital, Southampton, United Kingdom; Armando Lopez Guillermo and Elias Campo, Hospital Clinic, Barcelona, Spain; Pierre Zachée, ZNA Stuivenberg, Antwerp; and André Bosly, Mont-Godinne UCL, Yvoir, Belgium
| | - Franco Cavalli
- Emanuele Zucca and Franco Cavalli, Oncology Institute of Southern Switzerland, Bellinzona; Luca Mazzucchelli, Cantonal Institute of Pathology, Locarno, Switzerland; Annarita Conconi, Ospedale degli Infermi, Biella; Giovanni Martinelli, European Institute of Oncology; Liliana Devizzi, Fondazione Istituto Nazionale Tumori; Valter Torri, Mario Negri Institute; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Maurilio Ponzoni, San Raffaele Hospital, Milan; Alessandra Tucci, Spedali Civili, Brescia; Umberto Vitolo, University-Hospital Città della Salute e della Scienza, Turin; Maurizio Martelli, Sapienza University; Stefan Hohaus, Catholic University of the Sacred Heart, Rome; Graziella Pinotti, Fondazione Macchi Hospital, Varese; Caterina Stelitano, Bianchi-Melacrino-Morelli Hospitals, Reggio Calabria; Monica Bellei, University of Modena and Reggio Emilia, Modena, Italy; Reda Bouabdallah, Institut Paoli-Calmettes, Marseille; Gilles Salles, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre-Benite; Catherine Sebban, Centre Léon Bérard, Lyon; Franck Morschhauser, Claude Huriez Hospital, Lille; Anne Moreau, University Hospital of Nantes, Nantes; Hervé Tilly, Centre Henri Becquerel, Rouen; Corinne Haioun, Henri-Mondor Hospital, Paris Créteil; Corinne Haioun, UPEC, Assistance Publique-Hopitaux de Paris; Catherine Thieblemont, Assistance Publique-Hopitaux de Paris, Hôpital-Saint-Louis, Hematooncology-Université Paris Diderot, Sorbonne Paris-Cité, Paris, France; Ruth Pettengell, St George's University of London, London; Andrew Jack, St James's University Hospital, Leeds; Peter Johnson, Southampton General Hospital, Southampton, United Kingdom; Armando Lopez Guillermo and Elias Campo, Hospital Clinic, Barcelona, Spain; Pierre Zachée, ZNA Stuivenberg, Antwerp; and André Bosly, Mont-Godinne UCL, Yvoir, Belgium
| | - Peter Johnson
- Emanuele Zucca and Franco Cavalli, Oncology Institute of Southern Switzerland, Bellinzona; Luca Mazzucchelli, Cantonal Institute of Pathology, Locarno, Switzerland; Annarita Conconi, Ospedale degli Infermi, Biella; Giovanni Martinelli, European Institute of Oncology; Liliana Devizzi, Fondazione Istituto Nazionale Tumori; Valter Torri, Mario Negri Institute; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Maurilio Ponzoni, San Raffaele Hospital, Milan; Alessandra Tucci, Spedali Civili, Brescia; Umberto Vitolo, University-Hospital Città della Salute e della Scienza, Turin; Maurizio Martelli, Sapienza University; Stefan Hohaus, Catholic University of the Sacred Heart, Rome; Graziella Pinotti, Fondazione Macchi Hospital, Varese; Caterina Stelitano, Bianchi-Melacrino-Morelli Hospitals, Reggio Calabria; Monica Bellei, University of Modena and Reggio Emilia, Modena, Italy; Reda Bouabdallah, Institut Paoli-Calmettes, Marseille; Gilles Salles, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre-Benite; Catherine Sebban, Centre Léon Bérard, Lyon; Franck Morschhauser, Claude Huriez Hospital, Lille; Anne Moreau, University Hospital of Nantes, Nantes; Hervé Tilly, Centre Henri Becquerel, Rouen; Corinne Haioun, Henri-Mondor Hospital, Paris Créteil; Corinne Haioun, UPEC, Assistance Publique-Hopitaux de Paris; Catherine Thieblemont, Assistance Publique-Hopitaux de Paris, Hôpital-Saint-Louis, Hematooncology-Université Paris Diderot, Sorbonne Paris-Cité, Paris, France; Ruth Pettengell, St George's University of London, London; Andrew Jack, St James's University Hospital, Leeds; Peter Johnson, Southampton General Hospital, Southampton, United Kingdom; Armando Lopez Guillermo and Elias Campo, Hospital Clinic, Barcelona, Spain; Pierre Zachée, ZNA Stuivenberg, Antwerp; and André Bosly, Mont-Godinne UCL, Yvoir, Belgium
| | - Catherine Thieblemont
- Emanuele Zucca and Franco Cavalli, Oncology Institute of Southern Switzerland, Bellinzona; Luca Mazzucchelli, Cantonal Institute of Pathology, Locarno, Switzerland; Annarita Conconi, Ospedale degli Infermi, Biella; Giovanni Martinelli, European Institute of Oncology; Liliana Devizzi, Fondazione Istituto Nazionale Tumori; Valter Torri, Mario Negri Institute; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Maurilio Ponzoni, San Raffaele Hospital, Milan; Alessandra Tucci, Spedali Civili, Brescia; Umberto Vitolo, University-Hospital Città della Salute e della Scienza, Turin; Maurizio Martelli, Sapienza University; Stefan Hohaus, Catholic University of the Sacred Heart, Rome; Graziella Pinotti, Fondazione Macchi Hospital, Varese; Caterina Stelitano, Bianchi-Melacrino-Morelli Hospitals, Reggio Calabria; Monica Bellei, University of Modena and Reggio Emilia, Modena, Italy; Reda Bouabdallah, Institut Paoli-Calmettes, Marseille; Gilles Salles, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre-Benite; Catherine Sebban, Centre Léon Bérard, Lyon; Franck Morschhauser, Claude Huriez Hospital, Lille; Anne Moreau, University Hospital of Nantes, Nantes; Hervé Tilly, Centre Henri Becquerel, Rouen; Corinne Haioun, Henri-Mondor Hospital, Paris Créteil; Corinne Haioun, UPEC, Assistance Publique-Hopitaux de Paris; Catherine Thieblemont, Assistance Publique-Hopitaux de Paris, Hôpital-Saint-Louis, Hematooncology-Université Paris Diderot, Sorbonne Paris-Cité, Paris, France; Ruth Pettengell, St George's University of London, London; Andrew Jack, St James's University Hospital, Leeds; Peter Johnson, Southampton General Hospital, Southampton, United Kingdom; Armando Lopez Guillermo and Elias Campo, Hospital Clinic, Barcelona, Spain; Pierre Zachée, ZNA Stuivenberg, Antwerp; and André Bosly, Mont-Godinne UCL, Yvoir, Belgium
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25
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Merli F, Luminari S, Salvi F, Cavallo F, Gini G, Musuraca G, Gaidano G, Cellini C, Merli M, Ferrari A, Molinari A, Liberati A, Conconi A, Matteucci P, Pozzi S, Musso M, Mammi C, Monaco F, Ferrero S, Tucci A. OBINUTUZUMAB-MINICHOP FOR THE TREATMENT OF ELDERLY UNFIT PATIENTS WITH DIFFUSE LARGE B-CELL LYMPHOMA. A STUDY OF THE FONDAZIONE ITALIANA LINFOMI. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- F. Merli
- Hematology; Arcispedale Santa Maria Nuova-IRCCS; Reggio Emilia Italy
| | - S. Luminari
- Hematology; Arcispedale Santa Maria Nuova-IRCCS and University of Modena and Reggio Emilia; Reggio Emilia Italy
| | - F. Salvi
- Hematology Unit; Antonio e Biagio e Cesare Arrigo Hospital; Alessandria Italy
| | - F. Cavallo
- Division of Hematology; University of Torino; Torino Italy
| | - G. Gini
- Division of Hematology; Ospedali Riuniti; Ancona Italy
| | - G. Musuraca
- Hematology Unit; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS; Meldola (FC) Italy
| | - G. Gaidano
- Division of Hematology, Department of Translational Medicine; Amedeo Avogadro University of Eastern Piedmont; Novara Italy
| | - C. Cellini
- Hematology Unit; Santa Maria delle Croci Hospital; Ravenna Italy
| | - M. Merli
- Division of Hematology; University Hospital “Ospedale di Circolo e Fondazione Macchi-ASST Sette Laghi”; Varese Italy
| | - A. Ferrari
- Hematology; Arcispedale Santa Maria Nuova-IRCCS; Reggio Emilia Italy
| | - A. Molinari
- Hematology; Ospedale degli Infermi; Rimini (FC) Italy
| | - A.M. Liberati
- Department of Oncohematology; S.Maria Hospital; Terni Italy
| | - A. Conconi
- Unit of Hematology; Department of Internal Medicine, Ospedale degli Infermi; Ponderano (BI) Italy
| | - P. Matteucci
- Haematology and Bone Marrow Transplantation Unit; Fondazione IRCCS Istituto Nazionale dei Tumori; Milan Italy
| | - S. Pozzi
- Department of Diagnostic, Clinical and Public Health Medicine; University of Modena and Reggio Emilia; Modena Italy
| | - M. Musso
- Division of Hematology; La Maddalena Hospital; Palermo Italy
| | - C. Mammi
- GRADE onlus; Gruppo Amici dell'Ematologia; Reggio Emilia Italy
| | - F. Monaco
- Hematology Unit; Antonio e Biagio e Cesare Arrigo Hospital; Alessandria Italy
| | - S. Ferrero
- Division of Hematology; University of Torino; Torino Italy
| | - A. Tucci
- Hematology; Spedali Civili Hospital; Brescia Italy
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Ceriani L, Martelli M, Conconi A, Zinzani PL, Ferreri AJM, Botto B, Stelitano C, Gotti M, Cabras MG, Rigacci L, Giovanella L, Zucca E, Johnson PWM. Prognostic models for primary mediastinal (thymic) B-cell lymphoma derived from 18-FDG PET/CT quantitative parameters in the International Extranodal Lymphoma Study Group (IELSG) 26 study. Br J Haematol 2017; 178:588-591. [PMID: 28485042 DOI: 10.1111/bjh.14728] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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: 01/24/2017] [Accepted: 03/06/2017] [Indexed: 11/26/2022]
Abstract
The International Extranodal Lymphoma Study Group-26 study evaluated the prognostic role of 18-fluorodeoxyglucose positron-emission tomography (PET) in primary mediastinal large B-cell lymphoma. We assessed quantitative PET parameters at diagnosis and post-treatment in 100 patients. The end-of-therapy total lesion glycolysis (TLG) was the best individual outcome predictor, but the combination of baseline TLG and end-of-therapy visual analysis with Deauville Score (DS) showed a better positive predictive value. A model in which baseline TLG is combined with interim DS might identify patients with shorter progression-free survival. PET metrics combined with interim DS may allow early risk assessment and warrants further studies.
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Affiliation(s)
- Luca Ceriani
- Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland
| | - Maurizio Martelli
- Department of Cellular Biotechnologies and Haematology, La Sapienza University, Rome, Italy
| | | | - Pier L Zinzani
- Institute of Haematology and Medical Oncology, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - Andrés J M Ferreri
- Department of Oncology, Unit of Lymphoid Malignancies, San Raffaele Hospital, Milan, Italy
| | - Barbara Botto
- Haematology, Azienda Ospedaliera Città della Salute e della Scienza, Turin, Italy
| | - Caterina Stelitano
- Haematology, Azienda Ospedaliera Bianchi-Melacrino-Morelli, Reggio Calabria, Italy
| | - Manuel Gotti
- Department of Haematology Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | | | - Luca Giovanella
- Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland
| | - Emanuele Zucca
- Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland
| | - Peter W M Johnson
- Cancer Research UK Centre, Southampton General Hospital, Southampton, United Kingdom
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Conconi A, Montoto S, Montserrat E, Zucca E. Reply to the letter to the editor ‘Survival in young adults diagnosed with follicular lymphoma’ by Calvo et al. Ann Oncol 2016; 27:1173. [DOI: 10.1093/annonc/mdw058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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28
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Conconi A, Lobetti-Bodoni C, Montoto S, Lopez-Guillermo A, Coutinho R, Matthews J, Franceschetti S, Bertoni F, Moccia A, Rancoita P, Gribben J, Cavalli F, Gaidano G, Lister T, Montserrat E, Ghielmini M, Zucca E. Life expectancy of young adults with follicular lymphoma. Ann Oncol 2015; 26:2317-22. [DOI: 10.1093/annonc/mdv376] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Accepted: 09/07/2015] [Indexed: 11/13/2022] Open
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29
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Conconi A, Franceschetti S, Aprile von Hohenstaufen K, Margiotta-Casaluci G, Stathis A, Moccia A, Bertoni F, Ramponi A, Mazzucchelli L, Cavalli F, Gaidano G, Zucca E. Histologic transformation in marginal zone lymphomas. Ann Oncol 2015; 26:2329-35. [DOI: 10.1093/annonc/mdv368] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 08/26/2015] [Indexed: 01/14/2023] Open
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30
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Gobba S, Moccia A, Conconi A, Diem S, Cascione L, Aprile von Hohenstaufen K, Gulden-Sala W, Stathis A, Hitz F, Gaidano G, Zucca E, Pinotti G. Survival and prognostic factors in very elderly patients (pts) with diffuse large B-cell lymphoma (DLBCL): a retrospective analysis of 281 patients over 80 years. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv348.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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31
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Jackson AE, Mian M, Kalpadakis C, Pangalis GA, Stathis A, Porro E, Conconi A, Cortelazzo S, Gaidano G, Lopez Guillermo A, Johnson PW, Martelli M, Martinelli G, Thieblemont C, McPhail ED, Copie-Bergman C, Pileri SA, Jack A, Campo E, Mazzucchelli L, Ristow K, Habermann TM, Cavalli F, Nowakowski GS, Zucca E. Extranodal Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue of the Salivary Glands: A Multicenter, International Experience of 248 Patients (IELSG 41). Oncologist 2015; 20:1149-53. [PMID: 26268740 DOI: 10.1634/theoncologist.2015-0180] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 06/09/2015] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The salivary gland is one of the most common sites involved by nongastric, extranodal marginal zone lymphomas of mucosa-associated lymphoid tissue (MALT). A large series of patients with long-term follow-up has not been documented. This multicenter, international study sought to characterize the clinical characteristics, treatment, and natural history of salivary gland MALT lymphoma. METHODS Patients with biopsy-confirmed salivary gland MALT lymphoma were identified from multiple international sites. Risk factors, treatment, and long-term outcomes were evaluated. RESULTS A total of 247 patients were evaluated; 76% presented with limited-stage disease. There was a history of autoimmune disorder in 41%, with Sjögren disease being the most common (83%). Fifty-seven percent of patients were initially treated with local therapy with surgery, radiation, or both; 37 of patients were treated with systemic therapy initially, with 47% of those receiving rituximab; and 6% of patients were observed. The median overall survival (OS) was 18.3 years. The median progression-free survival (PFS) following primary therapy was 9.3 years. There was no difference in the outcomes between patients receiving local or systemic therapy in first-line management. On multivariate analysis, age <60 years and low to intermediate international prognostic index were associated with improved OS and PFS; Sjögren disease was associated with improved OS. CONCLUSION Salivary gland MALT lymphoma has an excellent prognosis regardless of initial treatment, and patients with Sjögren disease have improved survival. Risks for long-term complications must be weighed when determining initial therapy.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Chemotherapy, Adjuvant
- Disease-Free Survival
- Female
- Humans
- Lymphoma, B-Cell, Marginal Zone/complications
- Lymphoma, B-Cell, Marginal Zone/mortality
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymphoma, B-Cell, Marginal Zone/therapy
- Male
- Middle Aged
- Prognosis
- Rituximab/therapeutic use
- Salivary Gland Neoplasms/mortality
- Salivary Gland Neoplasms/pathology
- Salivary Gland Neoplasms/therapy
- Sjogren's Syndrome/complications
- Treatment Outcome
- Young Adult
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Affiliation(s)
- Amie E Jackson
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Michael Mian
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Christina Kalpadakis
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Gerassimos A Pangalis
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Anastasios Stathis
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Elena Porro
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Annarita Conconi
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Sergio Cortelazzo
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Gianluca Gaidano
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | | | - Peter W Johnson
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Maurizio Martelli
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Giovanni Martinelli
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Catherine Thieblemont
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Ellen D McPhail
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Christiane Copie-Bergman
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Stefano A Pileri
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Andrew Jack
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Elias Campo
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Luca Mazzucchelli
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Kay Ristow
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Thomas M Habermann
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Franco Cavalli
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Grzegorz S Nowakowski
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Emanuele Zucca
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
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Conconi A, Raderer M, Franceschetti S, Devizzi L, Ferreri AJM, Magagnoli M, Arcaini L, Zinzani PL, Martinelli G, Vitolo U, Kiesewetter B, Porro E, Stathis A, Gaidano G, Cavalli F, Zucca E. Clinical activity of everolimus in relapsed/refractory marginal zone B-cell lymphomas: results of a phase II study of the International Extranodal Lymphoma Study Group. Br J Haematol 2014; 166:69-76. [DOI: 10.1111/bjh.12845] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Accepted: 01/27/2014] [Indexed: 12/29/2022]
Affiliation(s)
- Annarita Conconi
- Division of Haematology; Department of Translational Medicine; Amedeo Avogadro University of Eastern Piedmont; AOU Maggiore della Carità; Novara Italy
- Haematology Unit; Department of Internal Medicine; Ospedale degli Infermi; Biella Italy
| | - Markus Raderer
- Division of Oncology; Department of Internal Medicine I; Medical University of Vienna; Vienna Austria
| | - Silvia Franceschetti
- Division of Haematology; Department of Translational Medicine; Amedeo Avogadro University of Eastern Piedmont; AOU Maggiore della Carità; Novara Italy
| | - Liliana Devizzi
- Medical Oncology; Fondazione IRCCS Istituto Nazionale Tumori; Milan Italy
| | - Andrés J. M. Ferreri
- Unit of Lymphoid Malignancies; Department of Onco-Haematology; San Raffaele Scientific Institute; Milan Italy
| | - Massimo Magagnoli
- Department of Medical Oncology and Haematology; Istituto Clinico Humanitas; Rozzano Milan Italy
| | - Luca Arcaini
- Department of Molecular Medicine; University of Pavia; Pavia Italy
- Department of Haematology Oncology; Fondazione IRCCS Policlinico San Matteo; Pavia Italy
| | - Pier Luigi Zinzani
- Institute of Haematology “L. e A. Seràgnoli”; University of Bologna; Bologna Italy
| | | | - Umberto Vitolo
- Haematology 2; San Giovanni Battista Hospital and University; Torino Italy
| | - Barbara Kiesewetter
- Division of Oncology; Department of Internal Medicine I; Medical University of Vienna; Vienna Austria
| | - Elena Porro
- Lymphoma Unit; IOSI - Oncology Institute of Southern Switzerland; Ospedale San Giovanni; Bellinzona Switzerland
| | - Anastasios Stathis
- Lymphoma Unit; IOSI - Oncology Institute of Southern Switzerland; Ospedale San Giovanni; Bellinzona Switzerland
| | - Gianluca Gaidano
- Division of Haematology; Department of Translational Medicine; Amedeo Avogadro University of Eastern Piedmont; AOU Maggiore della Carità; Novara Italy
| | - Franco Cavalli
- Lymphoma Unit; IOSI - Oncology Institute of Southern Switzerland; Ospedale San Giovanni; Bellinzona Switzerland
| | - Emanuele Zucca
- Lymphoma Unit; IOSI - Oncology Institute of Southern Switzerland; Ospedale San Giovanni; Bellinzona Switzerland
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von Hohenstaufen KA, Conconi A, de Campos CP, Zucca E. Prognostic impact of monocyte count at presentation in mantle cell lymphoma - response to George et al. Br J Haematol 2013; 164:893-4. [PMID: 24251543 DOI: 10.1111/bjh.12680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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von Hohenstaufen KA, Conconi A, de Campos CP, Franceschetti S, Bertoni F, Margiotta Casaluci G, Stathis A, Ghielmini M, Stussi G, Cavalli F, Gaidano G, Zucca E. Prognostic impact of monocyte count at presentation in mantle cell lymphoma. Br J Haematol 2013; 162:465-73. [PMID: 23808798 DOI: 10.1111/bjh.12409] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [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: 01/15/2013] [Accepted: 05/02/2013] [Indexed: 11/29/2022]
Abstract
An increased number of circulating monocytes at presentation has recently been associated with shorter survival in Hodgkin lymphoma, follicular lymphoma and diffuse large B cell lymphoma. This study aimed to assess the prognostic impact of the absolute monocyte count (AMC) at diagnosis in mantle cell lymphoma (MCL). AMC at diagnosis was available in 97 MCL cases recorded in the databases of the Oncology Institute of Southern Switzerland in Bellinzona (Switzerland) and the Division of Haematology of the Amedeo Avogadro University of Eastern Piedmont in Novara (Italy). With a median follow up of 7 years, the 5-year overall survival was 29% for patients with AMC >0·50 × 10(9) /l and 62% for patients with AMC ≤0·50 × 10(9) /l (P = 0·008). Elevated AMC and beta-2 microglobulin at diagnosis remained independent outcome predictors at multivariate analysis, controlling for the MCL International Prognostic Index (MIPI), and have been used to build a simple prognostic scoring system. In this relatively small and heterogeneous series an increased AMC identified poor-risk patients. Our results suggest that AMC together with the beta-2 microglobulin level might provide an inexpensive way to stratify MCL patient risk as a complement to the MIPI, which was confirmed to be a very powerful prognostic tool.
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Conconi A, Franceschetti S, Lobetti-Bodoni C, Stathis A, Margiotta-Casaluci G, Ramponi A, Mazzucchelli L, Bertoni F, Ghielmini M, Gaidano G, Cavalli F, Zucca E. Risk factors of central nervous system relapse in mantle cell lymphoma. Leuk Lymphoma 2013; 54:1908-14. [DOI: 10.3109/10428194.2013.767454] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Zucca E, Conconi A, Laszlo D, López-Guillermo A, Bouabdallah R, Coiffier B, Sebban C, Jardin F, Vitolo U, Morschhauser F, Pileri SA, Copie-Bergman C, Campo E, Jack A, Floriani I, Johnson P, Martelli M, Cavalli F, Martinelli G, Thieblemont C. Addition of rituximab to chlorambucil produces superior event-free survival in the treatment of patients with extranodal marginal-zone B-cell lymphoma: 5-year analysis of the IELSG-19 Randomized Study. J Clin Oncol 2013; 31:565-72. [PMID: 23295789 DOI: 10.1200/jco.2011.40.6272] [Citation(s) in RCA: 175] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Apart from localized gastric disease, there is no consensus on standard initial treatment of mucosa-associated lymphoid tissue lymphoma. The IELSG-19 study (Randomized Trial of Chlorambucil Versus Chlorambucil Plus Rituximab Versus Rituximab in MALT Lymphoma) was launched to compare chlorambucil alone versus chlorambucil plus rituximab in patients not previously given systemic anticancer therapy. PATIENTS AND METHODS Patients not responding to or not suitable for local therapy were eligible. In arm A, chlorambucil was given daily 6 mg/m(2) orally (PO) for 6 weeks. Responding patients and those with stable disease continued to be given daily chlorambucil 6 mg/m(2) PO for 14 consecutive days every 28 days for four cycles. In arm B, intravenous rituximab 375 mg/m(2) per day was added on days 1, 8, 15, 22, 56, 84, 112, and 140. After completion of the planned accrual, the protocol was amended to introduce a third arm with rituximab alone. We report the planned final analysis of the first two arms (113 patients in arm A and 114 in arm B). RESULTS At a median follow-up of 62 months, the 5-year event-free survival (EFS) was significantly better for the patients treated in arm B (68% v 50%; P = .002) who, despite similar overall response rates (90% v 87%), achieved a higher complete remission rate (78% v 65%; P = .025). Progression-free survival was also improved but it did not reach statistical significance (P = .057). Five-year overall survival (OS) was 89% in both arms. Both treatments were well tolerated without unexpected toxicities. CONCLUSION Both treatments were active; the better response rate and EFS obtained with the addition of rituximab did not translate into improved OS.
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Affiliation(s)
- Emanuele Zucca
- Oncology Institute of Southern Switzerland, Ospedale San Giovanni, 6500 Bellinzona, Switzerland.
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Copie-Bergman C, Wotherspoon AC, Capella C, Motta T, Pedrinis E, Pileri SA, Bertoni F, Conconi A, Zucca E, Ponzoni M, Ferreri AJM. Gela histological scoring system for post-treatment biopsies of patients with gastric MALT lymphoma is feasible and reliable in routine practice. Br J Haematol 2012; 160:47-52. [PMID: 23043300 DOI: 10.1111/bjh.12078] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Accepted: 07/31/2012] [Indexed: 12/30/2022]
Abstract
The International Extranodal Lymphoma Study Group (IELSG) promoted this study to determine the inter-observer agreement in the application of the Groupe d' Etude des Lymphomes de l' Adulte (GELA) histological scoring system for evaluating residual disease in post-treatment gastric biopsies of patients with gastric Mucosa-Associated Lymphoid Tissue (MALT) lymphoma (GML). Twenty-one patients with Helicobacter pylori -associated GML and treated with anti-H. pylori therapies were considered. A total of 154 biopsy sets from follow-up endoscopic procedures after H. pylori eradication were examined independently by seven pathologists from four European countries, following histological criteria suggested by the GELA scoring system. The overall concordance rate was 83% with a kappa value of 0·64, indicating a significant agreement among the seven observers. Most non-concordant responses clustered across the border of complete remission (CR) and probable minimal residual disease (pMRD), a distinction that does not imply critical clinical impact. Accordingly, when the analysis considered CR/pMRD as a single entity, the responses showed an overall concordance rate of 89% with kappa value of 0·83, thus indicating a high degree of inter-observer agreement. This study provides additional validation of the GELA histological grading system. This scheme can therefore be recommended in routine practice and deserves to be used in prospective clinical trials.
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Mian M, Ferreri AJM, Rossi A, Conconi A, Tsang R, Gospodarowicz MK, Oldani E, Federico M, Luminari S, Pogliani EM, Rossini F, Cabrera ME, Martelli M, Gutierrez-Garcia G, Busetto M, Cavalli F, Zucca E, Rambaldi A, Cortelazzo S. Role of radiotherapy in patients with early-stage diffuse large B-cell lymphoma of Waldeyer's ring in remission after anthracycline-containing chemotherapy. Leuk Lymphoma 2012; 54:62-8. [DOI: 10.3109/10428194.2012.710907] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Vecchio D, Mittino D, Terazzi E, Nassi L, Luca N, Conconi A, Monaco F. A case of cranial multinevritis: from the onset to the diagnosis of primary neurolymphomatosis. BMJ Case Rep 2012; 2012:bcr.06.2011.4299. [PMID: 22707692 DOI: 10.1136/bcr.06.2011.4299] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Neurolymphomatosis (NL) is a rare peripheral or cranial neuropathy caused by non-Hodgkin's lymphoma (NHL). Diagnosis is often delayed and prognosis is poor. The authors described a woman in her 70s with a facial left peripheral palsy, complete right abducent palsy, left hypoacusia and balance deficit. Then she presented with low progressive hyposthenia at four limbs and cognitive impairment, sudden facial right peripheral palsy and complete left abducent palsy. The authors performed brain and spinal MRI, cerebrospinal fluid (CSF) analysis and extensive haematological examinations for infections, autoimmune and neoplastic diseases. All the results were not diagnostic. Only repeating for the third time a spinal tap, CSF presented neoplastic B cells suggestive for large B-NHL. The authors diagnosed primary NL. The patient was treated with R-CHOP but she died 2 months later. In front of rapidly progressive neuropathy, a NL has to be considered performing different examinations, especially and repeating them after a short period.
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Affiliation(s)
- Domizia Vecchio
- Neurological Clinic, University of Eastern Piedmont and ‘Maggiore della Carità’ Hospital, Novara, Italy
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Conconi A, Ponzio C, Lobetti-Bodoni C, Motta M, Rancoita PM, Stathis A, Moccia AA, Mazzucchelli L, Bertoni F, Ghielmini M, Cavalli F, Zucca E. Incidence, risk factors and outcome of histological transformation in follicular lymphoma. Br J Haematol 2012; 157:188-96. [DOI: 10.1111/j.1365-2141.2012.09054.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Accepted: 12/12/2011] [Indexed: 12/24/2022]
Affiliation(s)
- Annarita Conconi
- Oncology Institute of Southern Switzerland (IOSI); Bellinzona; Switzerland
| | - Carlotta Ponzio
- Oncology Institute of Southern Switzerland (IOSI); Bellinzona; Switzerland
| | | | - Maddalena Motta
- Oncology Institute of Southern Switzerland (IOSI); Bellinzona; Switzerland
| | | | - Anastasios Stathis
- Oncology Institute of Southern Switzerland (IOSI); Bellinzona; Switzerland
| | - Alden A. Moccia
- Oncology Institute of Southern Switzerland (IOSI); Bellinzona; Switzerland
| | | | - Francesco Bertoni
- Oncology Institute of Southern Switzerland (IOSI); Bellinzona; Switzerland
| | - Michele Ghielmini
- Oncology Institute of Southern Switzerland (IOSI); Bellinzona; Switzerland
| | - Franco Cavalli
- Oncology Institute of Southern Switzerland (IOSI); Bellinzona; Switzerland
| | - Emanuele Zucca
- Oncology Institute of Southern Switzerland (IOSI); Bellinzona; Switzerland
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Nicolosi Guidicelli S, Lopez-Guillermo A, Falcone U, Conconi A, Christinat A, Rodriguez-Abreu D, Grisanti S, Lobetti-Bodoni C, Piffaretti JC, Johnson PW, Mombelli G, Cerny A, Montserrat E, Cavalli F, Zucca E. Hepatitis C virus and GBV-C virus prevalence among patients with B-cell lymphoma in different European regions: a case-control study of the International Extranodal Lymphoma Study Group. Hematol Oncol 2011; 30:137-42. [PMID: 22105737 DOI: 10.1002/hon.1015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2011] [Revised: 08/18/2011] [Accepted: 08/21/2011] [Indexed: 12/24/2022]
Abstract
Hepatitis C virus (HCV) infection is associated with some B-cell non-Hodgkin lymphoma (B cell-NHLs). Patients with HCV infection frequently show co-infections with GB virus C (GBV-C, formerly known as hepatitis G virus), and some studies have suggested a higher incidence of GBV-C infection in patients with B cell-NHLs. The aim of this study was to prospectively evaluate the association between HCV and/or GBV-C infection and B cell-NHLs in different geographic areas. One hundred thirty-seven lymphoma cases and 125 non-lymphoma matched controls were enrolled in an international case-control study conducted in Switzerland (Bellinzona), Spain (Barcelona) and England (Southampton) on samples collected from 2001 to 2002. In Bellinzona (41 cases and 81 controls), the overall prevalence of HCV was 3.3% (4.9% in NHLs), and the overall prevalence of GBV-C was 24% (22% in NHLs). In Barcelona (46 cases and 44 controls), the prevalence of HCV was 10% (8.7% in NHLs) and the prevalence of GBV-C 20% (13% in NHLs). There was no statistically significant difference in the frequency of both infections between patients with NHL and controls. In Southampton, 50 NHL cases were analysed, none of them was found to be HCV-positive; therefore, no control group was analysed and GBV-C analysis was not performed, too. Both in Bellinzona and in Barcelona, the seropositivity rate was significantly lower for HCV than for GBV-C, suggesting that their transmission can be independent. The incidence of HCV was significantly higher in Barcelona than that in Bellinzona. This study confirmed the existence of marked geographic differences in the prevalence of HCV in NHL but cannot provide any significant evidence for an association between HCV and/or GBV-C and B-cell NHLs.
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Vitolo U, Chiappella A, Ferreri AJ, Martelli M, Baldi I, Balzarotti M, Bottelli C, Conconi A, Gomez H, Lopez-Guillermo A, Martinelli G, Merli F, Novero D, Orsucci L, Pavone V, Ricardi U, Storti S, Gospodarowicz MK, Cavalli F, Sarris AH, Zucca E. First-Line Treatment for Primary Testicular Diffuse Large B-Cell Lymphoma With Rituximab-CHOP, CNS Prophylaxis, and Contralateral Testis Irradiation: Final Results of an International Phase II Trial. J Clin Oncol 2011; 29:2766-72. [DOI: 10.1200/jco.2010.31.4187] [Citation(s) in RCA: 144] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Primary testicular lymphoma (PTL) has poor prognosis with failures in contralateral testis, CNS, and extranodal sites. To prevent these events, we designed an international phase II trial (International Extranodal Lymphoma Study Group 10 [IELSG-10]) that addressed feasibility and activity of conventional chemoimmunotherapy associated with CNS prophylaxis and contralateral testis irradiation. The trial was conducted by the IELSG and the Italian Lymphoma Foundation. Patients and Methods Fifty-three patients (age 22 to 79 years) with untreated stage I or II PTL were treated with six to eight courses of rituximab added to cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) every 21 days (R-CHOP21); four doses of intrathecal methotrexate (IT-MTX) and radiotherapy (RT) to the contralateral testis (30 Gy) for all patients and to regional lymph nodes (30 to 36 Gy) for stage II disease. Results All patients received R-CHOP21, 50 received CNS prophylaxis, and 47 received testicular RT. With a median follow-up of 65 months, 5-year progression-free survival and overall survival rates were 74% (95% CI, 59% to 84%) and 85% (95% CI, 71% to 92%), respectively. Ten patients relapsed or progressed: two in lymph nodes, five in extranodal organs, and three in the CNS. The 5-year cumulative incidence of CNS relapse was 6% (95% CI, 0% to 12%). No contralateral testis relapses occurred. Ten patients died: lymphoma (n = 6), secondary leukemia (n = 2), heart failure (n = 1), and gastric cancer (n = 1). Grade 3 to 4 toxicities were neutropenia, 28%; infections, 4%; and neurologic, 13%. No deaths occurred as a result of toxicity. Conclusion This international prospective trial shows that combined treatment with R-CHOP21, IT-MTX, and testicular RT was associated with a good outcome in patients with PTL. RT avoided contralateral testis relapses, but CNS prophylaxis deserves further investigation.
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Affiliation(s)
- Umberto Vitolo
- Umberto Vitolo, Annalisa Chiappella, Ileana Baldi, Domenico Novero, Lorella Orsucci, Umberto Ricardi, San Giovanni Battista Hospital and University, Turin; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Monica Balzarotti, Humanitas Institute, Rozzano (Milan); Giovanni Martinelli, European Institute of Oncology, Milan; Maurizio Martelli, University La Sapienza of Rome, Rome; Chiara Bottelli, Spedali Civil Hospital, Brescia; Annarita Conconi, Hospital Maggiore della Carità, “Amedeo Avogadro”
| | - Annalisa Chiappella
- Umberto Vitolo, Annalisa Chiappella, Ileana Baldi, Domenico Novero, Lorella Orsucci, Umberto Ricardi, San Giovanni Battista Hospital and University, Turin; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Monica Balzarotti, Humanitas Institute, Rozzano (Milan); Giovanni Martinelli, European Institute of Oncology, Milan; Maurizio Martelli, University La Sapienza of Rome, Rome; Chiara Bottelli, Spedali Civil Hospital, Brescia; Annarita Conconi, Hospital Maggiore della Carità, “Amedeo Avogadro”
| | - Andrés J.M. Ferreri
- Umberto Vitolo, Annalisa Chiappella, Ileana Baldi, Domenico Novero, Lorella Orsucci, Umberto Ricardi, San Giovanni Battista Hospital and University, Turin; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Monica Balzarotti, Humanitas Institute, Rozzano (Milan); Giovanni Martinelli, European Institute of Oncology, Milan; Maurizio Martelli, University La Sapienza of Rome, Rome; Chiara Bottelli, Spedali Civil Hospital, Brescia; Annarita Conconi, Hospital Maggiore della Carità, “Amedeo Avogadro”
| | - Maurizio Martelli
- Umberto Vitolo, Annalisa Chiappella, Ileana Baldi, Domenico Novero, Lorella Orsucci, Umberto Ricardi, San Giovanni Battista Hospital and University, Turin; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Monica Balzarotti, Humanitas Institute, Rozzano (Milan); Giovanni Martinelli, European Institute of Oncology, Milan; Maurizio Martelli, University La Sapienza of Rome, Rome; Chiara Bottelli, Spedali Civil Hospital, Brescia; Annarita Conconi, Hospital Maggiore della Carità, “Amedeo Avogadro”
| | - Ileana Baldi
- Umberto Vitolo, Annalisa Chiappella, Ileana Baldi, Domenico Novero, Lorella Orsucci, Umberto Ricardi, San Giovanni Battista Hospital and University, Turin; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Monica Balzarotti, Humanitas Institute, Rozzano (Milan); Giovanni Martinelli, European Institute of Oncology, Milan; Maurizio Martelli, University La Sapienza of Rome, Rome; Chiara Bottelli, Spedali Civil Hospital, Brescia; Annarita Conconi, Hospital Maggiore della Carità, “Amedeo Avogadro”
| | - Monica Balzarotti
- Umberto Vitolo, Annalisa Chiappella, Ileana Baldi, Domenico Novero, Lorella Orsucci, Umberto Ricardi, San Giovanni Battista Hospital and University, Turin; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Monica Balzarotti, Humanitas Institute, Rozzano (Milan); Giovanni Martinelli, European Institute of Oncology, Milan; Maurizio Martelli, University La Sapienza of Rome, Rome; Chiara Bottelli, Spedali Civil Hospital, Brescia; Annarita Conconi, Hospital Maggiore della Carità, “Amedeo Avogadro”
| | - Chiara Bottelli
- Umberto Vitolo, Annalisa Chiappella, Ileana Baldi, Domenico Novero, Lorella Orsucci, Umberto Ricardi, San Giovanni Battista Hospital and University, Turin; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Monica Balzarotti, Humanitas Institute, Rozzano (Milan); Giovanni Martinelli, European Institute of Oncology, Milan; Maurizio Martelli, University La Sapienza of Rome, Rome; Chiara Bottelli, Spedali Civil Hospital, Brescia; Annarita Conconi, Hospital Maggiore della Carità, “Amedeo Avogadro”
| | - Annarita Conconi
- Umberto Vitolo, Annalisa Chiappella, Ileana Baldi, Domenico Novero, Lorella Orsucci, Umberto Ricardi, San Giovanni Battista Hospital and University, Turin; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Monica Balzarotti, Humanitas Institute, Rozzano (Milan); Giovanni Martinelli, European Institute of Oncology, Milan; Maurizio Martelli, University La Sapienza of Rome, Rome; Chiara Bottelli, Spedali Civil Hospital, Brescia; Annarita Conconi, Hospital Maggiore della Carità, “Amedeo Avogadro”
| | - Henry Gomez
- Umberto Vitolo, Annalisa Chiappella, Ileana Baldi, Domenico Novero, Lorella Orsucci, Umberto Ricardi, San Giovanni Battista Hospital and University, Turin; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Monica Balzarotti, Humanitas Institute, Rozzano (Milan); Giovanni Martinelli, European Institute of Oncology, Milan; Maurizio Martelli, University La Sapienza of Rome, Rome; Chiara Bottelli, Spedali Civil Hospital, Brescia; Annarita Conconi, Hospital Maggiore della Carità, “Amedeo Avogadro”
| | - Armando Lopez-Guillermo
- Umberto Vitolo, Annalisa Chiappella, Ileana Baldi, Domenico Novero, Lorella Orsucci, Umberto Ricardi, San Giovanni Battista Hospital and University, Turin; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Monica Balzarotti, Humanitas Institute, Rozzano (Milan); Giovanni Martinelli, European Institute of Oncology, Milan; Maurizio Martelli, University La Sapienza of Rome, Rome; Chiara Bottelli, Spedali Civil Hospital, Brescia; Annarita Conconi, Hospital Maggiore della Carità, “Amedeo Avogadro”
| | - Giovanni Martinelli
- Umberto Vitolo, Annalisa Chiappella, Ileana Baldi, Domenico Novero, Lorella Orsucci, Umberto Ricardi, San Giovanni Battista Hospital and University, Turin; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Monica Balzarotti, Humanitas Institute, Rozzano (Milan); Giovanni Martinelli, European Institute of Oncology, Milan; Maurizio Martelli, University La Sapienza of Rome, Rome; Chiara Bottelli, Spedali Civil Hospital, Brescia; Annarita Conconi, Hospital Maggiore della Carità, “Amedeo Avogadro”
| | - Francesco Merli
- Umberto Vitolo, Annalisa Chiappella, Ileana Baldi, Domenico Novero, Lorella Orsucci, Umberto Ricardi, San Giovanni Battista Hospital and University, Turin; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Monica Balzarotti, Humanitas Institute, Rozzano (Milan); Giovanni Martinelli, European Institute of Oncology, Milan; Maurizio Martelli, University La Sapienza of Rome, Rome; Chiara Bottelli, Spedali Civil Hospital, Brescia; Annarita Conconi, Hospital Maggiore della Carità, “Amedeo Avogadro”
| | - Domenico Novero
- Umberto Vitolo, Annalisa Chiappella, Ileana Baldi, Domenico Novero, Lorella Orsucci, Umberto Ricardi, San Giovanni Battista Hospital and University, Turin; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Monica Balzarotti, Humanitas Institute, Rozzano (Milan); Giovanni Martinelli, European Institute of Oncology, Milan; Maurizio Martelli, University La Sapienza of Rome, Rome; Chiara Bottelli, Spedali Civil Hospital, Brescia; Annarita Conconi, Hospital Maggiore della Carità, “Amedeo Avogadro”
| | - Lorella Orsucci
- Umberto Vitolo, Annalisa Chiappella, Ileana Baldi, Domenico Novero, Lorella Orsucci, Umberto Ricardi, San Giovanni Battista Hospital and University, Turin; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Monica Balzarotti, Humanitas Institute, Rozzano (Milan); Giovanni Martinelli, European Institute of Oncology, Milan; Maurizio Martelli, University La Sapienza of Rome, Rome; Chiara Bottelli, Spedali Civil Hospital, Brescia; Annarita Conconi, Hospital Maggiore della Carità, “Amedeo Avogadro”
| | - Vincenzo Pavone
- Umberto Vitolo, Annalisa Chiappella, Ileana Baldi, Domenico Novero, Lorella Orsucci, Umberto Ricardi, San Giovanni Battista Hospital and University, Turin; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Monica Balzarotti, Humanitas Institute, Rozzano (Milan); Giovanni Martinelli, European Institute of Oncology, Milan; Maurizio Martelli, University La Sapienza of Rome, Rome; Chiara Bottelli, Spedali Civil Hospital, Brescia; Annarita Conconi, Hospital Maggiore della Carità, “Amedeo Avogadro”
| | - Umberto Ricardi
- Umberto Vitolo, Annalisa Chiappella, Ileana Baldi, Domenico Novero, Lorella Orsucci, Umberto Ricardi, San Giovanni Battista Hospital and University, Turin; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Monica Balzarotti, Humanitas Institute, Rozzano (Milan); Giovanni Martinelli, European Institute of Oncology, Milan; Maurizio Martelli, University La Sapienza of Rome, Rome; Chiara Bottelli, Spedali Civil Hospital, Brescia; Annarita Conconi, Hospital Maggiore della Carità, “Amedeo Avogadro”
| | - Sergio Storti
- Umberto Vitolo, Annalisa Chiappella, Ileana Baldi, Domenico Novero, Lorella Orsucci, Umberto Ricardi, San Giovanni Battista Hospital and University, Turin; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Monica Balzarotti, Humanitas Institute, Rozzano (Milan); Giovanni Martinelli, European Institute of Oncology, Milan; Maurizio Martelli, University La Sapienza of Rome, Rome; Chiara Bottelli, Spedali Civil Hospital, Brescia; Annarita Conconi, Hospital Maggiore della Carità, “Amedeo Avogadro”
| | - Mary K. Gospodarowicz
- Umberto Vitolo, Annalisa Chiappella, Ileana Baldi, Domenico Novero, Lorella Orsucci, Umberto Ricardi, San Giovanni Battista Hospital and University, Turin; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Monica Balzarotti, Humanitas Institute, Rozzano (Milan); Giovanni Martinelli, European Institute of Oncology, Milan; Maurizio Martelli, University La Sapienza of Rome, Rome; Chiara Bottelli, Spedali Civil Hospital, Brescia; Annarita Conconi, Hospital Maggiore della Carità, “Amedeo Avogadro”
| | - Franco Cavalli
- Umberto Vitolo, Annalisa Chiappella, Ileana Baldi, Domenico Novero, Lorella Orsucci, Umberto Ricardi, San Giovanni Battista Hospital and University, Turin; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Monica Balzarotti, Humanitas Institute, Rozzano (Milan); Giovanni Martinelli, European Institute of Oncology, Milan; Maurizio Martelli, University La Sapienza of Rome, Rome; Chiara Bottelli, Spedali Civil Hospital, Brescia; Annarita Conconi, Hospital Maggiore della Carità, “Amedeo Avogadro”
| | - Andreas H. Sarris
- Umberto Vitolo, Annalisa Chiappella, Ileana Baldi, Domenico Novero, Lorella Orsucci, Umberto Ricardi, San Giovanni Battista Hospital and University, Turin; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Monica Balzarotti, Humanitas Institute, Rozzano (Milan); Giovanni Martinelli, European Institute of Oncology, Milan; Maurizio Martelli, University La Sapienza of Rome, Rome; Chiara Bottelli, Spedali Civil Hospital, Brescia; Annarita Conconi, Hospital Maggiore della Carità, “Amedeo Avogadro”
| | - Emanuele Zucca
- Umberto Vitolo, Annalisa Chiappella, Ileana Baldi, Domenico Novero, Lorella Orsucci, Umberto Ricardi, San Giovanni Battista Hospital and University, Turin; Andrés J.M. Ferreri, San Raffaele Scientific Institute; Monica Balzarotti, Humanitas Institute, Rozzano (Milan); Giovanni Martinelli, European Institute of Oncology, Milan; Maurizio Martelli, University La Sapienza of Rome, Rome; Chiara Bottelli, Spedali Civil Hospital, Brescia; Annarita Conconi, Hospital Maggiore della Carità, “Amedeo Avogadro”
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Ripellino P, Comi C, Mula M, Varrasi C, Conconi A, Stecco A, Brustia D, Nasuelli N, Savio K, De Paoli L, Cantello R, Gaidano G, Monaco F. Progressive multifocal leucoencephalopathy after autologous bone marrow transplantation: a treatment option. BMJ Case Rep 2011; 2011:2011/apr15_1/bcr1120103549. [PMID: 22701032 DOI: 10.1136/bcr.11.2010.3549] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A patient with multiple myeloma was treated with high-dose chemotherapy followed by two autologous bone marrow transplantations (ABMTs). Nine months after the second ABMT the patient complained of severe left hemiparesis, paraesthesias, left homonymous visual field defects and gait ataxia. She was diagnosed with progressive multifocal leucoencephalopathy (PML) confirmed by detection of JC virus (JCV) DNA and prescribed cidofovir every other week and mirtazapine daily. Her symptoms and signs remained stable and after 6 months the JCV DNA was undetectable in the cerebrospinal fluid. Repeated MRI scans demonstrated the stabilisation of demyelinating lesion volume; after more than 2 years of follow-up the patient's neurological examination does not show significant variations. Combination of cidofovir and mirtazapine may be helpful in the treatment of PML in HIV-negative patients.
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Affiliation(s)
- P Ripellino
- Department of Neurology, University of Turin, Turin, Italy.
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Mian M, Gaidano G, Conconi A, Tsang R, Gospodarowicz MK, Rambaldi A, Rossi A, Oldani E, Federico M, Luminari S, Bellei M, Pogliani EM, Rossini F, Cabrera ME, Martelli M, Lopez-Guillermo A, Busetto M, Cavalli F, Zucca E, Cortelazzo S. High response rate and improvement of long-term survival with combined treatment modalities in patients with poor-risk primary thyroid diffuse large B-cell lymphoma: an International Extranodal Lymphoma Study Group and Intergruppo Italiano Linfomi study. Leuk Lymphoma 2011; 52:823-32. [PMID: 21338283 DOI: 10.3109/10428194.2011.555888] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The impact of different treatment modalities and prognostic factors on the clinical course of primary thyroid diffuse large B-cell lymphoma (PTDLBCL) is still the subject of research. This study was conducted to clarify these clinical aspects of this disorder. The clinical parameters of 48 patients with PTDLBCL at time of diagnosis were comparable to those of previous studies. Patients underwent either radiotherapy (RT) ± surgery (SX), chemotherapy (CHT) alone or in combination with local treatments (RT or SX), or SX followed by CHT and RT. A 90% complete remission (CR) rate was observed among patients who underwent combined treatment modalities (CTM), compared to 76% among the others. The 5-year progression-free survival differed significantly between both groups (p = 0.028). Poor performance status and advanced age correlated with decreased survival. PTDLBCL is a curable disease prevalent in elderly patients. Combined treatment modalities were able to induce an elevated rate of CR, improving long-term survival in younger patients. However, the outcome in elderly patients still remains unsatisfactory.
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Affiliation(s)
- Michael Mian
- Division of Hematology, Azienda Ospedaliera S. Maurizio, Bolzano/Bozen, Italy.
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Conconi A, Motta M, Bertoni F, Piona C, Stathis A, Wannesson L, Gracia E, Filho VB, Abreu DR, Mian M, Froesch P, Mazzucchelli L, Ghielmini M, Cavalli F, Zucca E. Patterns of survival of follicular lymphomas at a single institution through three decades. Leuk Lymphoma 2010; 51:1028-34. [PMID: 20536347 DOI: 10.3109/10428191003743460] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Follicular lymphoma (FL) is considered an indolent but incurable disease. It remains to be clarified whether the outcome has changed after the recent introduction of novel treatment modalities. We retrospectively analyzed the outcome of 281 patients with FL treated at the Oncology Institute of Southern Switzerland from 1979 to 2007. Three diagnostic eras were considered, according to the major therapeutic changes: before 1989 ('alkylating agents era', n = 73), 1990 to 1999 ('aggressive regimens and G-CSF era', n = 119), and 2000 to 2007 ('rituximab era', n = 89). The distribution of prognostic factors was similar in the three eras. A significant improvement in cause-specific survival (CSS) was observed over time (p = 0.0088), but not in overall survival. Median CSS was 12.5 years for patients with FL diagnosed before 1989, but was not reached in the more recent groups. The estimated CSS rate at 5 years in the three eras was 80%, 86%, and 91%, respectively. The CSS of patients with FL treated at our institution has improved over the last 25 years. This improvement, already evident before the wide introduction of rituximab in clinical practice, may be a result of the sequential application of effective therapies and improved supportive care.
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Affiliation(s)
- Annarita Conconi
- IOSI - Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
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46
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Conconi A, Martinelli G, Lopez-Guillermo A, Zinzani PL, Ferreri AJM, Rigacci L, Devizzi L, Vitolo U, Luminari S, Cavalli F, Zucca E. Clinical activity of bortezomib in relapsed/refractory MALT lymphomas: results of a phase II study of the International Extranodal Lymphoma Study Group (IELSG). Ann Oncol 2010; 22:689-695. [PMID: 20810546 DOI: 10.1093/annonc/mdq416] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The nuclear factor-kappa B activation in mucosa-associated lymphoid tissue (MALT) lymphoma pathogenesis provided the rationale for the evaluation of bortezomib in this malignancy. PATIENTS AND METHODS Thirty-two patients with relapsed/refractory MALT lymphoma were enrolled. Thirty-one patients received bortezomib 1.3 mg/m(2) i.v., on days 1, 4, 8, and 11, for up to six 21-day cycles. RESULTS Median age was 63 years (range, 37-82 years). Median number of prior therapies was 2 (range, 1-4). Nine patients had Ann Arbor stage I, 7 patients had stage II, and 16 patients had stage IV. Primary lymphoma localization was the stomach in 14 patients; multiple extranodal sites were present in 10 patients. Among the 29 patients assessable for response, the overall response rate was 48% [95% confidence interval (CI) 29% to 67%], with 9 complete and 5 partial responses. Nine patients experienced stable disease and six had disease progression during therapy. The most relevant adverse events were fatigue, thrombocytopenia, neutropenia, and peripheral neuropathy. After a median follow-up of 24 months, the median duration of response was not reached yet. Five deaths were reported, in two patients due to disease progression. CONCLUSION Bortezomib is active in relapsed MALT lymphomas. Further investigations to identify optimal bortezomib dose, schedule, and combination regimens are needed since the frequent detection of dose-limiting peripheral neuropathy.
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Affiliation(s)
- A Conconi
- Department of Clinical and Experimental Medicine, Division of Hematology, AOU Maggiore della Carità, Amedeo Avogadro University of Eastern Piedmont, Novara.
| | - G Martinelli
- Division of Hematology-Oncology, European Institute of Oncology, Milan, Italy
| | | | - P L Zinzani
- Institute of Hematology and Medical Oncology 'L. e A. Seràgnoli', University of Bologna, Bologna
| | - A J M Ferreri
- Unit of Lymphoid Malignancies, Medical Oncology Unit, Department of Oncology, San Raffaele H Scientific Institute, Milan
| | - L Rigacci
- Department of Hematology, Careggi Hospital and University of Florence, Florence
| | - L Devizzi
- Cristina Gandini Medical Oncology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milan
| | - U Vitolo
- SC Ematologia II, Azienda Ospedaliera e Universitaria San Giovanni Battista, Turin
| | - S Luminari
- Department of Oncology and Hematology, University of Modena and Reggio Emilia, Modena, Italy
| | - F Cavalli
- IOSI-Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - E Zucca
- IOSI-Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
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Pinto V, Castelli A, Gaidano G, Conconi A. Safe and effective use of plerixafor plus G-CSF in dialysis-dependent renal failure. Am J Hematol 2010; 85:461-2. [PMID: 20513130 DOI: 10.1002/ajh.21712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Lunghi M, Riccomagno P, De Paoli L, Vendramin C, Conconi A, Gaidano G, Rossi D. Monitoring of cytomegalovirus reactivation during induction and nontransplant consolidation of acute leukemia. Am J Hematol 2009; 84:697-8. [PMID: 19691101 DOI: 10.1002/ajh.21494] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Toso A, Aluffi P, Capello D, Conconi A, Gaidano G, Pia F. Clinical and molecular features of mucosa-associated lymphoid tissue (MALT) lymphomas of salivary glands. Head Neck 2009; 31:1181-7. [DOI: 10.1002/hed.21087] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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50
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Cavalli F, Conconi A, Motta M, Stathis A, Abreu DR, Gracia E, Filho VB, Wannesson L, Ghielmini M, Zucca E. 9216 Incidence and outcome of histological transformation in a single-institution cohort of patients with follicular lymphoma. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71907-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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