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Conforti F, Pala L, De Pas T, Zattarin E, Catania C, Cocorocchio E, Rossi G, Laszlo D, Colleoni M, Zambelli A, Hortobagyi GN, Cortes J, Piccart MJ, Dowsett M, Gelber RD, Viale G. Fine-Tuning Adjuvant Endocrine Therapy for Early-Stage Breast Cancer: An Expert Consensus on Open Issues for Future Research. Clin Cancer Res 2024; 30:1093-1103. [PMID: 37906083 DOI: 10.1158/1078-0432.ccr-23-1836] [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: 06/19/2023] [Revised: 08/29/2023] [Accepted: 10/19/2023] [Indexed: 11/02/2023]
Abstract
After decades of research, improving the efficacy of adjuvant endocrine therapy (ET) for early-stage breast cancer becomes increasingly difficult. Beyond technological breakthroughs and the availability of new classes of drugs, further improvement of adjuvant ET will require applying a rigorous research approach in poorly investigated areas. We critically discuss some key principles that should inform future research to improve ET efficacy, including identifying specific subgroups of patients who can benefit from escalating or de-escalating approaches, optimizing available and new treatment strategies for different clinical contexts, and dissecting the direct and indirect biological effects of therapeutic interventions. Four main issues regarding adjuvant ET were identified as relevant areas, where a better application of such principles can provide positive results in the near future: (i) tailoring the optimal duration of adjuvant ET, (ii) optimizing ovarian function suppression for premenopausal women, (iii) dissecting the biological effects of estrogen receptor manipulation, and (iv) refining the selection of patients to candidate for treatments escalation.
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Affiliation(s)
- Fabio Conforti
- Department of Medical Oncology, Cliniche Humanitas Gavazzeni, Bergamo, Italy
| | - Laura Pala
- Department of Medical Oncology, Cliniche Humanitas Gavazzeni, Bergamo, Italy
| | - Tommaso De Pas
- Department of Medical Oncology, Cliniche Humanitas Gavazzeni, Bergamo, Italy
| | - Emma Zattarin
- Department of Medical Oncology, Cliniche Humanitas Gavazzeni, Bergamo, Italy
| | - Chiara Catania
- Department of Medical Oncology, Cliniche Humanitas Gavazzeni, Bergamo, Italy
| | - Emilia Cocorocchio
- Department of Medical Oncology, Cliniche Humanitas Gavazzeni, Bergamo, Italy
| | - Giovanna Rossi
- Department of Medical Oncology, Cliniche Humanitas Gavazzeni, Bergamo, Italy
| | - Daniele Laszlo
- Department of Medical Oncology, Cliniche Humanitas Gavazzeni, Bergamo, Italy
| | - Marco Colleoni
- Division of Medical Senology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Alberto Zambelli
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Milan, Italy
| | - Gabriel N Hortobagyi
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Javier Cortes
- International Breast Cancer Center, Pangaea Oncology, Quironsalud Group, Madrid and Barcelona, Spain
- Universidad Europea de Madrid, Faculty of Biomedical and Health Sciences, Department of Medicine, Madrid, Spain
| | - Martine J Piccart
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Mitch Dowsett
- Breast Unit, Royal Marsden Hospital, London, United Kingdom
| | - Richard D Gelber
- Department of Data Science, Division of Biostatistics, Dana-Farber Cancer Institute, Harvard Medical School, Harvard T.H. Chan School of Public Health, and Frontier Science Foundation, Boston, Massachusetts
| | - Giuseppe Viale
- Department of Pathology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
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Pala L, Sala I, Pagan E, De Pas T, Zattarin E, Catania C, Cocorocchio E, Rossi G, Laszlo D, Ceresoli G, Canzian J, Valenzi E, Bagnardi V, Conforti F. "Heterogeneity of treatment effect on patients' long-term outcome according to pathological response type in neoadjuvant RCTs for breast cancer.". Breast 2024; 73:103672. [PMID: 38244459 PMCID: PMC10831306 DOI: 10.1016/j.breast.2024.103672] [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: 08/31/2023] [Revised: 12/02/2023] [Accepted: 01/08/2024] [Indexed: 01/22/2024] Open
Abstract
INTRODUCTION To provide evidence explaining the poor association between pCR and patients' long-term outcome at trial-level in neoadjuvant RCTs for breast cancer (BC), we performed a systematic-review and meta-analysis of all RCTs testing neoadjuvant treatments for early-BC and reporting the hazard ratio of DFS (HRDFS) for the intervention versus control arm stratified by pathological response type (i.e., pCR yes versus no). METHODS The objective was to explore differences of treatment effects on DFS across patients with and without pCR. We calculated the pooled HRDFS in the two strata of pathological response (i.e., pCR yes versus no) using a random-effects model, and assessed the difference between these two estimates using an interaction test. RESULTS Ten RCTs and 8496 patients were included in the analysis. Patients obtaining pCR in the intervention-arm had a higher, although not statistically significant, risk of DFS-event as compared with patients obtaining pCR in the control-arm: the pooled HRDFS for the experimental versus control arm was 1.23 (95%CI, 0.91-1.65). On the opposite, the risk of DFS-event was higher for control as compared with the intervention-arm in the stratum of patients without pCR: the pooled HRDFS was 0.86 (95%CI, 0.78-0.95). Treatment effect on DFS was significantly different according to pathological response type (interaction test p: 0.014). CONCLUSION We reported new evidence that contributes to explaining the poor surrogacy value of pCR at trial-level in neoadjuvant RCTs for early-BC.
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Affiliation(s)
- Laura Pala
- Department of Medical Oncology, Humanitas Gavazzeni, Bergamo, Italy
| | - Isabella Sala
- Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy; Department of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy
| | - Eleonora Pagan
- Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
| | - Tommaso De Pas
- Department of Medical Oncology, Humanitas Gavazzeni, Bergamo, Italy
| | - Emma Zattarin
- Department of Medical Oncology, Humanitas Gavazzeni, Bergamo, Italy
| | - Chiara Catania
- Department of Medical Oncology, Humanitas Gavazzeni, Bergamo, Italy
| | | | - Giovanna Rossi
- Department of Medical Oncology, Humanitas Gavazzeni, Bergamo, Italy
| | - Daniele Laszlo
- Department of Medical Oncology, Humanitas Gavazzeni, Bergamo, Italy
| | | | - Jacopo Canzian
- Department of Medical Oncology, Humanitas Gavazzeni, Bergamo, Italy
| | - Elena Valenzi
- Department of Medical Oncology, Humanitas Gavazzeni, Bergamo, Italy
| | - Vincenzo Bagnardi
- Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
| | - Fabio Conforti
- Department of Medical Oncology, Humanitas Gavazzeni, Bergamo, Italy; Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy.
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Pala L, De Pas T, Stucchi E, Catania C, Cocorocchio E, Zampino MG, Rossi G, Zattarin E, Di Muzio A, Laszlo D, Stucchi S, Conforti F. Immune-checkpoint inhibitors in anal squamous cell carcinoma: a systematic review and meta-analysis. Semin Oncol 2023; 50:140-143. [PMID: 38065801 DOI: 10.1053/j.seminoncol.2023.11.002] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 11/12/2023] [Accepted: 11/13/2023] [Indexed: 04/01/2024]
Abstract
INTRODUCTION Squamous cell carcinoma of the anus (SCCA) is a rare tumor. While most patients with locally advanced disease are cured with chemo-radiotherapy, about a quarter eventually experience metastatic recurrence. Standard treatment for advanced disease is chemotherapy, but recently evidence on the activity of immunotherapy has been reported. We performed a systematic review and meta-analysis of prospective trials testing immune-checkpoint inhibitors (ICIs) in patients with SCCA. OBJECTIVE We aimed to evaluate the overall response rate (ORR) and the disease control rate (DCR) of ICIs in patients with advanced SCCA. METHODS We systematically searched PubMed, Embase, and Scopus, through December 31, 2022, for prospective trials assessing ICIs in patients with advanced SCCA. The primary and secondary endpoints were respectively ORR and DCR. RESULTS Six prospective trials were included in the analysis, one of which was randomized. Overall, seven treatment arms and 347 patients have been analyzed. Five treatment arms tested ICIs as monotherapy and two arms examined ICIs in combination with cetuximab and bevacizumab, respectively. The pooled ORR was 13% (95%CI, 10%-17%), with a DCR of 57% (95%CI, 40%-74%). Results did not change in a sensitivity analysis, which excluded the two treatment arms testing the combination of ICIs with other drugs. CONCLUSIONS The efficacy of ICIs in SCCAs is low. Combination strategies with targeted drugs or chemotherapy might represent a better therapeutic strategy for these patients. Further studies are awaited to identify resistance mechanisms to ICIs and optimize their efficacy.
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Affiliation(s)
- Laura Pala
- Medical Oncology Unit, Humanitas Gavazzeni, Bergamo, Italy.
| | - Tommaso De Pas
- Medical Oncology Unit, Humanitas Gavazzeni, Bergamo, Italy
| | - Erika Stucchi
- Medical Oncology Unit, Humanitas Gavazzeni, Bergamo, Italy; Humanitas University, Rozzano, Italy
| | - Chiara Catania
- Medical Oncology Unit, Humanitas Gavazzeni, Bergamo, Italy
| | | | - Maria Giulia Zampino
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology, IRCCS, Milan, Italy
| | - Giovanna Rossi
- Medical Oncology Unit, Humanitas Gavazzeni, Bergamo, Italy
| | - Emma Zattarin
- Medical Oncology Unit, Humanitas Gavazzeni, Bergamo, Italy
| | | | - Daniele Laszlo
- Medical Oncology Unit, Humanitas Gavazzeni, Bergamo, Italy
| | - Sara Stucchi
- Medical Oncology Unit, Humanitas Gavazzeni, Bergamo, Italy
| | - Fabio Conforti
- Medical Oncology Unit, Humanitas Gavazzeni, Bergamo, Italy
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Digiacomo N, De Pas T, Rossi G, Bossi P, Stucchi E, Conforti F, Cocorocchio E, Laszlo D, Pala L, Zattarin E, Catania C. Exon-18-EGFR Mutated Transformed Small-Cell Lung Cancer: A Case Report and Literature Review. Curr Oncol 2023; 30:3494-3499. [PMID: 36975478 PMCID: PMC10047844 DOI: 10.3390/curroncol30030265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/14/2023] [Accepted: 03/18/2023] [Indexed: 03/29/2023] Open
Abstract
Small-cell lung cancer (SCLC) transformation from EGFR mutant adenocarcinoma is a rare entity that is considered to be a new phenotype of SCLC. While transformation from adenocarcinoma (ADC) with EGFR exon 19 deletions and exon 21 L858R point mutations has been described, to our knowledge, no cases of transformation to SCLC from exon-18-mutated ADC have been reported. We reported a clinical case of a patient with exon-18-EGFR-transformed SCLC, and we performed a systematic review of the literature.
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Affiliation(s)
- Nunzio Digiacomo
- Department of Medical Oncology, Cliniche Humanitas Gavazzeni, 24125 Bergamo, Italy
| | - Tommaso De Pas
- Department of Medical Oncology, Cliniche Humanitas Gavazzeni, 24125 Bergamo, Italy
| | - Giovanna Rossi
- Department of Medical Oncology, Cliniche Humanitas Gavazzeni, 24125 Bergamo, Italy
| | - Paola Bossi
- Department of Pathology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Erika Stucchi
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center, IRCCS-Via Manzoni 56, 20089 Rozzano, Italy
| | - Fabio Conforti
- Department of Medical Oncology, Cliniche Humanitas Gavazzeni, 24125 Bergamo, Italy
| | - Emilia Cocorocchio
- Department of Medical Oncology, Cliniche Humanitas Gavazzeni, 24125 Bergamo, Italy
| | - Daniele Laszlo
- Department of Medical Oncology, Cliniche Humanitas Gavazzeni, 24125 Bergamo, Italy
| | - Laura Pala
- Department of Medical Oncology, Cliniche Humanitas Gavazzeni, 24125 Bergamo, Italy
| | - Emma Zattarin
- Department of Medical Oncology, Cliniche Humanitas Gavazzeni, 24125 Bergamo, Italy
| | - Chiara Catania
- Department of Medical Oncology, Cliniche Humanitas Gavazzeni, 24125 Bergamo, Italy
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Pala L, De Pas T, Pagan E, Minucci S, Catania C, Digiacomo N, Cocorocchio E, Laszlo D, Di Muzio A, Barigazzi C, Stucchi E, De Grandi L, Stucchi S, Viale G, Gelber RD, Bagnardi V, Conforti F. Improved outcomes in women with BRAF-mutant melanoma treated with BRAF/MEK-targeted therapy across randomized clinical trials. A systematic review and meta-analysis. Semin Oncol 2023; 50:34-39. [PMID: 36967333 DOI: 10.1053/j.seminoncol.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 03/12/2023] [Accepted: 03/14/2023] [Indexed: 06/05/2023]
Abstract
Available evidence suggests that in patients with advanced BRAF V600-mutant melanoma treated with the combination of BRAF and MEK inhibitors, gender could be associated with survival outcome. We performed a systematic review and meta-analysis of all randomized clinical trials (RCTs) testing the combination of BRAF and MEK inhibitors, to assess the interaction between treatment effect and patients' gender. We searched PubMed, MEDLINE, Embase, and Scopus, for phase II and III RCTs up to January 30, 2022. We included all RCTs that enrolled patients with BRAF V600-mutant advanced cutaneous melanoma and assessed combinations of BRAF and MEK inhibitors versus BRAF inhibitor monotherapy. Our aim was to assess differences if any in treatment efficacy between men and women, measured in terms of the differences in progression-free survival (PFS) and overall survival (OS) log-hazard ratios (log-HRs). We calculated the pooled PFS- and OS-HRs with 95% confidence intervals (CIs) in men and women using a random-effects model and assessed the heterogeneity between the estimates using an interaction test. Five RCTs that enrolled a total of 2,113 patients were included in the analysis. In women, the combination of BRAF and MEK inhibitors halved the risk of progression or death as compared with BRAF inhibitor monotherapy with a pooled PFS-HR of 0.50 (95%CI 0.41-0.61). In men, the benefit obtained with BRAF and MEK inhibitors was smaller with a pooled PFS-HR of 0.63 (95%CI 0.54-0.74), P-heterogeneity = .05. A similar trend was observed for OS where the pooled OS-HR was 0.62 (95%CI 0.48-0.80) in women and only 0.78, (95%CI 0.67-0.92) in men, P-heterogeneity = 0.11. These results support meaningful gender-based heterogeneity of response to combination of BRAF and MEK inhibitors targeted therapy in patients with advanced BRAF-mutant melanoma, that should be considered in future research to improve treatment effectiveness.
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Affiliation(s)
- Laura Pala
- Medical Oncology Unit, Humanitas Gavazzeni, Bergamo, Italy.
| | - Tommaso De Pas
- Medical Oncology Unit, Humanitas Gavazzeni, Bergamo, Italy
| | - Eleonora Pagan
- Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
| | - Saverio Minucci
- Department of Experimental Oncology, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Chiara Catania
- Medical Oncology Unit, Humanitas Gavazzeni, Bergamo, Italy
| | | | | | - Daniele Laszlo
- Medical Oncology Unit, Humanitas Gavazzeni, Bergamo, Italy
| | - Antonio Di Muzio
- Department of Biomedical Sciences, Humanitas University, Rozzano, Italy
| | - Chiara Barigazzi
- Medical Oncology Unit, Humanitas Gavazzeni, Bergamo, Italy; Department of Biomedical Sciences, Humanitas University, Rozzano, Italy
| | - Erika Stucchi
- Medical Oncology Unit, Humanitas Gavazzeni, Bergamo, Italy; Department of Biomedical Sciences, Humanitas University, Rozzano, Italy
| | - Laura De Grandi
- Medical Oncology Unit, Humanitas Gavazzeni, Bergamo, Italy; Department of Biomedical Sciences, Humanitas University, Rozzano, Italy
| | - Sara Stucchi
- Medical Oncology Unit, Humanitas Gavazzeni, Bergamo, Italy
| | - Giuseppe Viale
- Department of Pathology, European Institute of Oncology & University of Milan, Milan, Italy
| | - Richard D Gelber
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard Medical School, Harvard T.H. Chan School of Public Health and Frontier Science & Technology, Research Foundation, Boston, MA, USA
| | - Vincenzo Bagnardi
- Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
| | - Fabio Conforti
- Medical Oncology Unit, Humanitas Gavazzeni, Bergamo, Italy
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Lazzaro C, Castagna L, Lanza F, Laszlo D, Milone G, Pierelli L, Saccardi R. Chemotherapy-based versus chemotherapy-free stem cell mobilization (± plerixafor) in multiple myeloma patients: an Italian cost-effectiveness analysis. Bone Marrow Transplant 2021; 56:1876-1887. [PMID: 33753907 PMCID: PMC8338551 DOI: 10.1038/s41409-021-01251-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 02/03/2021] [Accepted: 02/18/2021] [Indexed: 12/21/2022]
Abstract
Given the availability and efficacy of the mobilizing agent plerixafor in augmenting hematopoietic progenitor cell mobilization with granulocyte colony-stimulating factor (G-CSF), there is a strong case for comparing the cost-effectiveness of mobilization with G-CSF + cyclophosphamide versus G-CSF alone. This study investigated the cost and effectiveness (i.e., successful 4 million-CD34+ collection) of G-CSF alone versus high-dose cyclophosphamide (4 g/m2) + G-CSF mobilization (± on-demand plerixafor) in patients with multiple myeloma (MM) eligible for autograft in Italy. A decision tree-supported cost-effectiveness analysis (CEA) model in MM patients was developed from the societal perspective. The CEA model compared G-CSF alone with cyclophosphamide 4 g/m2 + G-CSF (± on-demand plerixafor) and was populated with demographic, healthcare and non-healthcare resource utilization data collected from a questionnaire administered to six Italian oncohematologists. Costs were expressed in Euro (€) 2019. The CEA model showed that G-CSF alone was strongly dominant versus cyclophosphamide + G-CSF ( ± on-demand plerixafor), with incremental savings of €1198.59 and an incremental probability of a successful 4 million-CD34+ apheresis (+0.052). Sensitivity analyses confirmed the robustness of the base-case results. In conclusion, chemotherapy-free mobilization (± on-demand plerixafor) is a “good value for money” option for MM patients eligible for autograft.
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Affiliation(s)
- Carlo Lazzaro
- Health Economist and Research Director, Studio di Economia Sanitaria, Milan, Italy.
| | - Luca Castagna
- Oncology and Haematology Unit, BMT section, Istituto Clinico Humanitas, Rozzano, Italy
| | - Francesco Lanza
- Hematology Section, Romagna Transplant Network, University Hospital "Santa Maria delle Croci", Ravenna, Italy
| | - Daniele Laszlo
- Stem Cell Mobilization and Collection Unit, IEO IRCCS, Milan, Italy
| | - Giuseppe Milone
- Hematology and BMT Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Luca Pierelli
- Department of Experimental Medicine, University "Sapienza", Rome, Immune-hematology and Transfusion Medicine Unit, Azienda Ospedaliera San Camillo, Rome, Italy
| | - Riccardo Saccardi
- Department of Cellular Therapy and Transfusion Medicine, Careggi University Hospital, Florence, Italy
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Magarò A, Lucchetti B, Caime A, Lionetti MT, Laszlo D. Cost comparison of extracorporeal photopheresis technologies at the European Institute of Oncology. J Clin Apher 2021; 36:364-369. [PMID: 33476456 DOI: 10.1002/jca.21870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 03/11/2020] [Revised: 09/07/2020] [Accepted: 12/18/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND Stem Cell Mobilization and Collection Unit at Istituto Europeo di Oncologia (IEO; Milan, Lombardia) provides extracorporeal photopheresis (ECP) therapy to treat graft-vs-host disease (GvHD) using offline procedures. ECP can be administered via an integrated single device (online procedure). Total cost of performing ECP at IEO vs an integrated device was assessed using a micro-costing approach. METHODS Ten offline ECP procedures for GvHD were monitored using Time-Driven Activity-Based Costing methodology, which utilized costs of resources, and time spent by patients/healthcare personnel with each resource. Details of ECP steps were recorded (pre-/post-treatment clinical evaluations, biological sampling, cannulation, apheresis, irradiation, reinfusion time). Time and cost comparisons between offline (combination of equipment/devices) and online technologies (THERAKOS™ CELLEX™ Photopheresis System) were performed. Cost variables: consumables, personnel, equipment, and laboratory tests. Personnel costs for online procedures were calculated using published time estimates and IEO hourly rates. Costs recorded in 2018 euros. RESULTS Median duration of IEO offline ECP procedures (296 minutes) was greater than that reported for CELLEX ECP delivery (120 minutes). Total cost of offline ECP (€1134.57 [$1314.57]/procedure) was greater than that reported for online delivery (€1063.95 [$1232.74]/procedure). IEO performs ~84 ECP procedures/y, which would require ~412 hours/y vs 168 hours/y for online procedures; suggesting €5932.08 [$6873.72]/y savings with online procedures. CONCLUSIONS This assessment highlights potential resource time savings with online procedures. Time saved could allow increased activity with the same resources, at a department level. Potential non-monetary benefits include reduced time burden on patients, increased availability of hospital staff and improved patient safety.
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Affiliation(s)
- Antonio Magarò
- Stem Cell Mobilization and Collection Unit, Istituto Europeo di Oncologia IRCCS, Milan, Italy
| | - Bruno Lucchetti
- Stem Cell Mobilization and Collection Unit, Istituto Europeo di Oncologia IRCCS, Milan, Italy
| | - Alessandro Caime
- Stem Cell Mobilization and Collection Unit, Istituto Europeo di Oncologia IRCCS, Milan, Italy
| | - Maria T Lionetti
- Stem Cell Mobilization and Collection Unit, Istituto Europeo di Oncologia IRCCS, Milan, Italy
| | - Daniele Laszlo
- Stem Cell Mobilization and Collection Unit, Istituto Europeo di Oncologia IRCCS, Milan, Italy
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Caime A, Piredda A, Lucchetti B, Magarò A, Zencovich C, Clerici M, Laszlo D. Midline catheter as effective device in healthy allogeneic donors and patients without an adequate peripheral venous access for HPC collection by apheresis: Preliminary experience at IEO. Transfus Apher Sci 2020; 59:102740. [DOI: 10.1016/j.transci.2020.102740] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 11/05/2019] [Accepted: 11/05/2019] [Indexed: 01/31/2023]
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Laszlo D, Marcacci GP, Martino M, Radice D, Rabascio C, Lucchetti B, Magarò A, Caime A, Menna S, Lionetti MT, Bertolini F. A comparison of chemo-free strategy with G-CSF plus plerixafor on demand versus intermediate-dose cyclophosphamide and G-CSF as PBSC mobilization in newly diagnosed multiple myeloma patients: An Italian explorative cost Analysis. Transfus Apher Sci 2020; 59:102819. [PMID: 32499108 DOI: 10.1016/j.transci.2020.102819] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 03/26/2020] [Revised: 05/06/2020] [Accepted: 05/07/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Upfront single or tandem ASCT still represents an integral part of treatment for patients with multiple myeloma. The combination of intermediate dose (ID) - cyclophosphamide plus G-CSF, has been considered the standard method as mobilization regimen. No prospective randomized clinical trials have compared efficacy and costs using ID - cyclophosphamide against a chemo-free mobilization strategy with G-CSF and plerixafor on demand. METHODS A prospective single arm of 20 patients enrolled in three Italian Centers mobilized with G-CSF plus plerixafor on demand was compared with a retrospective historical control arm of 30 patients mobilized with ID - cyclophosphamide (4 g/sqm) and G-CSF. Costs of the prospective arm was compared with the ones of the retrospective control arm with the aim to collect ≥4 × 106/kg CD34 + . The exploratory cost analysis was performed using microcosting specific inputs of G-CSF plus plerixafor on demand versus ID - cyclophosphamide + G-CSF considering pre-apheresis, peri-apheresis and post-apheresis session. RESULTS Mobilization with ID - cyclophosphamide and G-CSF resulted in a significantly higher CD34+ peak mean on day 1 yield (119 CD34+ μL vs 67.3; p = 0.06) and in total average CD34+ yield (mean collection 10.6 × 106/kg vs 5.8 × 106/kg; p = 0.004) compared to patients mobilized with G-CSF and plerixafor. There was no significant differences (p = 0.36) in the two groups of patients collecting ≥ 4 million CD34+/Kg with ID - cyclophosphamide and G-CSF (93.3 %) vs G-CSF and plerixafor (90.0 %). None of the patients undergoing G-CSF and plerixafor mobilization had febrile neutropenia compared with 7 patients who received ID - cyclophosphamide and G-CSF (0% vs 23 %, p = 0.03) who had a median of 5 days hospitalization (range 4-6). All patients proceeded to ASCT with a mean of 3.6 CD34+/kg infused for G-CSF and plerixafor arm and 4.4 CD34+/kg for the ID - cyclophosphamide + GCSF group (p = 0.37) with a median time to ANC and PLT engraftment not different in the two groups. Total costs of a mobilizing strategy using a combination of G-CSF and plerixafor on demand was 12.690 euros compared to 16.088 euros with ID - cyclophosphamide and G-CSF (p = 0.07); in particular, mobilization cost components were significantly lower for G-CSF and plerixafor vs G-CSF and ID - cyclophosphamide for hospital stay (3080 euros vs 9653 euros; p < 0.001) whereas for mobilizing agent, there was a significative difference with 5470 euros for G-CSF and plerixafor use due to the cost of plerixafor compared with 1140 euros for ID - cyclophosphamide and G-CSF treatment (P = 0.001). CONCLUSIONS Our data demonstrate that in patients with multiple myeloma eligible for ASCT, a chemo-free mobilization with G-CSF and plerixafor on demand is associated with efficacy in PBSC collection and optimal safety profile with similar average costs when compared to a chemo-mobilization with ID - cyclophosphamide. A prospective randomized multicenter study could address which is the most cost-effective strategy for this setting of patients. CLINICAL TRIAL REGISTRY Eudract Number EudraCT 2013-004690-27.
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Affiliation(s)
- D Laszlo
- Unità Di Mobilizzazione e Raccolta CSE, Divisione Di Laboratorio Di Ematoncologia Clinica, Istituto Europeo Di Oncologia IRCCS- Milano, Italy.
| | - G P Marcacci
- SS UTIE e Trapianto CSE, Dipartimento Ematologico, IRCCS, Istituto Nazionale Dei Tumori Fondazione "Sen G. Pascale" - Napoli, Italy
| | - M Martino
- UOC Centro Trapianti Midollo Osseo, Grande Ospedale BMM - Reggio Calabria, Italy
| | - D Radice
- Divisione Di Epidemiologia e Biostatistica, Italy
| | - C Rabascio
- Unità Di Mobilizzazione e Raccolta CSE, Divisione Di Laboratorio Di Ematoncologia Clinica, Istituto Europeo Di Oncologia IRCCS- Milano, Italy
| | - B Lucchetti
- Unità Di Mobilizzazione e Raccolta CSE, Divisione Di Laboratorio Di Ematoncologia Clinica, Istituto Europeo Di Oncologia IRCCS- Milano, Italy
| | - A Magarò
- Unità Di Mobilizzazione e Raccolta CSE, Divisione Di Laboratorio Di Ematoncologia Clinica, Istituto Europeo Di Oncologia IRCCS- Milano, Italy
| | - A Caime
- Unità Di Mobilizzazione e Raccolta CSE, Divisione Di Laboratorio Di Ematoncologia Clinica, Istituto Europeo Di Oncologia IRCCS- Milano, Italy
| | - S Menna
- Data Management - Istituto Europeo Di Oncologia IRCCS - Milano, Italy
| | - M T Lionetti
- Data Management - Istituto Europeo Di Oncologia IRCCS - Milano, Italy
| | - F Bertolini
- Unità Di Mobilizzazione e Raccolta CSE, Divisione Di Laboratorio Di Ematoncologia Clinica, Istituto Europeo Di Oncologia IRCCS- Milano, Italy
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10
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Shustov A, Cabrera M, Bellei M, Civallero M, Ko Y, Manni M, Horwitz S, Antonio De Souza C, Radford J, Varela S, Prates M, Ferreri A, Chiattone C, Spina M, Vose J, Chiappella A, Laszlo D, Marino D, Stelitano C, Skrypets T, Federico M. ANAPLASTIC LARGE CELL LYMPHOMA, ALK-NEGATIVE: ANALYSIS OF 235 CASES COLLECTED BY THE T-CELL PROJECT. Hematol Oncol 2019. [DOI: 10.1002/hon.93_2630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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. Shustov
- Division of Hematology; University of Washington Medical Center; Seattle United States
| | - M. Cabrera
- Seccion Hematologia; Hospital del Salvador, Universidad de Chile; Santiago Chile
| | - M. Bellei
- Department of Diagnostic; Clinical, and Public Health Medicine, University of Modena and Reggio Emilia; Modena Italy
| | - M. Civallero
- Department of Diagnostic; Clinical, and Public Health Medicine, University of Modena and Reggio Emilia; Modena Italy
| | - Y.H. Ko
- Department of Pathology; Sungkyunkwan University; Seoul Republic of Korea
| | - M. Manni
- Department of Diagnostic; Clinical, and Public Health Medicine, University of Modena and Reggio Emilia; Modena Italy
| | - S.M. Horwitz
- Department of Medical Oncology; Memorial Sloan-Kettering Cancer Ctr; New York United States
| | - C. Antonio De Souza
- Centro de Hematologia e Hemoterapia; University of Campinas; Campinas Brazil
| | - J. Radford
- Manchester Academic Health Science Centre; University of Manchester and the Christie NHS Foundation Trust; Manchester United Kingdom
| | - S.B. Varela
- Hospital Vall D/Hebron; University Hospital Vall D/Hebron; Barcelona Spain
| | - M.V. Prates
- Gatla; Laboratorio Varifarma sa; Buenos Aires Argentina
| | - A. Ferreri
- Unit of Lymphoid Malignancies; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - C. Chiattone
- Hematology Division; Santa Casa Medical School; São Paulo Brazil
| | - M. Spina
- Centro Di Riferimento Oncologico; Aviano Italy
| | - J.M. Vose
- Division of Oncology & Hematology; University of Nebraska Medical Center; Omaha NE United States
| | - A. Chiappella
- Hematology Division; Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino; Turin Italy
| | - D. Laszlo
- Division of Haemato-Oncology; Istituto Europeo di Oncologia; Milan Italy
| | - D. Marino
- Department of Clinical and Experimental Oncology; Veneto Institute of Oncology IOV-IRCCS Padova; Padua Italy
| | - C. Stelitano
- Department of Haematology; Grande Ospedale Metropolitano Bianchi Melacrino Morelli; Reggio Calabria Italy
| | - T. Skrypets
- Department of Diagnostic; Clinical, and Public Health Medicine, University of Modena and Reggio Emilia; Modena Italy
| | - M. Federico
- Department of Diagnostic; Clinical, and Public Health Medicine, University of Modena and Reggio Emilia; Modena Italy
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11
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Rattotti S, Ferretti VV, Rusconi C, Rossi A, Fogazzi S, Baldini L, Pioltelli P, Balzarotti M, Farina L, Ferreri AJM, Laszlo D, Speziale V, Varettoni M, Sciarra R, Morello L, Tedeschi A, Frigeni M, Defrancesco I, Zerbi C, Flospergher E, Nizzoli ME, Morra E, Arcaini L. Lymphomas associated with chronic hepatitis C virus infection: A prospective multicenter cohort study from the Rete Ematologica Lombarda (REL) clinical network. Hematol Oncol 2019; 37:160-167. [PMID: 30726562 DOI: 10.1002/hon.2575] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 10/07/2018] [Revised: 01/21/2019] [Accepted: 01/31/2019] [Indexed: 01/16/2023]
Abstract
Chronic hepatitis C virus (HCV) infection is related with an increased risk of non-Hodgkin lymphomas (NHL). In indolent subtypes, regression of NHL was reported after HCV eradication with antiviral therapy (AT). In 2008 in Lombardy, a region of Northern Italy, the "Rete Ematologica Lombarda" (REL, Hematology Network of Lombardy-Lymphoma Workgroup) started a prospective multicenter observational cohort study on NHL associated with HCV infection, named "Registro Lombardo dei Linfomi HCV-positivi" ("Lombardy Registry of HCV-associated non-Hodgkin lymphomas"). Two hundred fifty patients with a first diagnosis of NHL associated with HCV infection were enrolled; also in our cohort, diffuse large B cell lymphoma (DLBCL) and marginal zone lymphoma (MZL) are the two most frequent HCV-associated lymphomas. Two thirds of patients had HCV-positivity detection before NHL; overall, NHL was diagnosed after a median time of 11 years since HCV survey. Our data on eradication of HCV infection were collected prior the recent introduction of the direct-acting antivirals (DAAs) therapy. Sixteen patients with indolent NHL treated with interferon-based AT as first line anti-lymphoma therapy, because of the absence of criteria for an immediate conventional treatment for lymphoma, had an overall response rate of 90%. After a median follow-up of 7 years, the overall survival (OS) was significantly longer in indolent NHL treated with AT as first line (P = 0.048); this confirms a favorable outcome in this subset. Liver toxicity was an important adverse event after a conventional treatment in 20% of all patients, in particular among DLBCL, in which it is more frequent the coexistence of a more advanced liver disease. Overall, HCV infection should be consider as an important co-pathology in the treatment of lymphomas and an interdisciplinary approach should be always considered, in particular to evaluate the presence of fibrosis or necroinflammatory liver disease.
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Affiliation(s)
- Sara Rattotti
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Chiara Rusconi
- Division of Hematology, Ospedale Niguarda Ca' Granda, Milan, Italy
| | - Andrea Rossi
- Division of Hematology, Ospedali Riuniti, Bergamo, Italy
| | | | - Luca Baldini
- Division of Hematology, Fondazione IRCCS Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | | | | | - Lucia Farina
- Division of Hematology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Andrés J M Ferreri
- Unit of Lymphoid Malignancies, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Daniele Laszlo
- Division of Hematology, Istituto Europeo di Oncologia, Milan, Italy
| | - Valentina Speziale
- Division of Internal Medicine, Ospedale Civile di Legnano, Legnano, Italy
| | - Marzia Varettoni
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Roberta Sciarra
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Lucia Morello
- Division of Hematology, Humanitas Cancer Center, Milan, Italy
| | | | - Marco Frigeni
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | | | - Caterina Zerbi
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | | | | | - Enrica Morra
- Division of Hematology, Ospedale Niguarda Ca' Granda, Milan, Italy
| | - Luca Arcaini
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Department of Molecular Medicine, University of Pavia, Pavia, Italy
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12
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Lanza F, Saraceni F, Pezzi A, Martino M, Bosi A, Cascavilla N, Musto P, Zuffa E, Tani M, Cellini C, Laszlo D, Bonifazi F. A comparative analysis of biosimilar vs. originator filgrastim in combination with plerixafor for stem cell mobilization in lymphoma and multiple myeloma: a propensity-score weighted multicenter approach. Am J Hematol 2017; 92:E557-E559. [PMID: 28612372 DOI: 10.1002/ajh.24817] [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] [Received: 06/01/2017] [Accepted: 06/02/2017] [Indexed: 11/09/2022]
Affiliation(s)
| | | | | | - Massimo Martino
- Hematology and Stem Cell Transplant Unit; Reggio Calabria Italy
| | | | - Nicola Cascavilla
- Department of Hematology, IRCCS “Casa Sollievo della Sofferenza” Hospital, S. Giovanni Rotondo; Italy
| | | | | | | | | | - Daniele Laszlo
- Stem Cell Mobilization & Collection Unit, Istituto Europeo di Oncologia; Milan Italy
| | - Francesca Bonifazi
- Institute of Hematology “Seràgnoli” University Hospital S. Orsola-Malpighi; Bologna Italy
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13
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Fox C, Bellei M, Manni M, Kim S, Ko Y, Shustov A, Cabrera M, Chiattone C, Horwitz S, Spina M, Advani R, Angrilli F, De Souza C, Dlouhy I, Fernandez-Alvarez R, Gabús R, Hitz F, Laszlo D, Montoto S, Nagler A, Pavlovsky A, Vitolo U, Zoppegno L, Federico M, Kim W. IMPROVED SURVIVAL OUTCOMES FOR PATIENTS WITH EXTRA-NODAL NK/T LYMPHOMA: DATA FROM 140 PATIENTS PROSPECTIVELY REGISTERED IN THE INTERNATIONAL T-CELL PROJECT. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_66] [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: 11/08/2022]
Affiliation(s)
- C.P. Fox
- Nottingham University Hospitals NHS Trust, and Institute of Cancer Sciences, University of Birmingham; Nottingham UK
| | - M. Bellei
- Dept. Diagnostic, Clinical and Public Health Medicine; University of Modena and Reggio Emilia; Modena Italy
| | - M. Manni
- Dept. Diagnostic, Clinical and Public Health Medicine; University of Modena and Reggio Emilia; Modena Italy
| | - S.J. Kim
- Division of Hematology-Oncology; Samsung Medical Center; Seoul Republic of Korea
| | - Y.H. Ko
- Department of Pathology; Sungkyunkwan University; Seoul Republic of Korea
| | - A.R. Shustov
- Division of Hematology, FHCRC; University of Washington Medical Center; Seattle USA
| | - M.E. Cabrera
- Sección Hematología, Hospital del Salvador; Universidad de Chile; Santiago de Chile Chile
| | - C.S. Chiattone
- Departamento de Clínica Médica, FCM da Santa Casa de São Paulo; Centro de Linfomas Núcleo de Oncologia Hospital Samaritano; São Paulo Brazil
| | - S.M. Horwitz
- Dept. Medicine; Memorial Sloan-Kettering Cancer Center; New York USA
| | - M. Spina
- Medical Oncology A; Aviano National Cancer Institute; Aviano Italy
| | - R.H. Advani
- Division of Oncology; Stanford University School of Medicine; Stanford USA
| | - F. Angrilli
- Dip. Ematologia, Medicina Trasfusionale e Biotecnologie; UOSD Centro Diagnosi e Terapia Linfomi; PO Pescara, Pescara Italy
| | - C.A. De Souza
- Departamento de Clínica Médica; Universidade Estadual de Campinas; Campinas Brazil
| | - I. Dlouhy
- Hematology Department; Hospital Clinic; Barcelona Italy
| | | | - R. Gabús
- Service of Hematology and Bone Marrow Transplantation; Hospital Maciel; Montevideo Uruguay
| | - F. Hitz
- Department of Oncology/Haematology; Cantonal Hospital; St Gallen Switzerland
| | - D. Laszlo
- Division of Haemato-Oncology; IEO - Istituto Europeo di Oncologia; Milan Italy
| | - S. Montoto
- Department of Haematology; Barts Health NHS Trust; London Italy
| | - A. Nagler
- Department of Bone Marrow Transplantation; Tel-Aviv University; Tel-Aviv Israel
| | | | - U. Vitolo
- S.C. Ematologia, Dipartimento di Oncologia ed Ematologia, S.C. Ematologia, Dipartimento di Oncologia ed Ematologia; Torino Italy
| | - L. Zoppegno
- Hematologia, Hospital provincial San Martín de La Plata; Buenos Aires Argentina
| | - M. Federico
- Dept. Diagnostic, Clinical and Public Health Medicine; University of Modena and Reggio Emilia; Modena Italy
| | - W.S. Kim
- Division of Hematology-Oncology; Samsung Medical Center; Seoul Republic of Korea
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14
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Taverna C, Martinelli G, Hitz F, Mingrone W, Pabst T, Cevreska L, Del Giglio A, Vanazzi A, Laszlo D, Raats J, Rauch D, Vorobiof DA, Lohri A, Biaggi Rudolf C, Rondeau S, Rusterholz C, Heijnen IAFM, Zucca E, Ghielmini M. Rituximab Maintenance for a Maximum of 5 Years After Single-Agent Rituximab Induction in Follicular Lymphoma: Results of the Randomized Controlled Phase III Trial SAKK 35/03. J Clin Oncol 2015; 34:495-500. [PMID: 26712227 DOI: 10.1200/jco.2015.61.3968] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [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 Rituximab maintenance therapy has been shown to improve progression-free survival in patients with follicular lymphoma; however, the optimal duration of maintenance treatment remains unknown. PATIENTS AND METHODS Two hundred seventy patients with untreated, relapsed, stable, or chemotherapy-resistant follicular lymphoma were treated with four doses of rituximab monotherapy in weekly intervals (375 mg/m(2)). Patients achieving at least a partial response were randomly assigned to receive maintenance therapy with one infusion of rituximab every 2 months, either on a short-term schedule (four administrations) or a long-term schedule (maximum of 5 years or until disease progression or unacceptable toxicity). The primary end point was event-free survival (EFS). Progression-free survival, overall survival (OS), and toxicity were secondary end points. Comparisons between the two arms were performed using the log-rank test for survival end points. RESULTS One hundred sixty-five patients were randomly assigned to the short-term (n = 82) or long-term (n = 83) maintenance arms. Because of the low event rate, the final analysis was performed after 95 events had occurred, which was before the targeted event number of 99 had been reached. At a median follow-up period of 6.4 years, the median EFS was 3.4 years (95% CI, 2.1 to 5.3) in the short-term arm and 5.3 years (95% CI, 3.5 to not available) in the long-term arm (P = .14). Patients in the long-term arm experienced more adverse effects than did those in the short-term arm, with 76% v 50% of patients with at least one adverse event (P < .001), five versus one patient with grade 3 and 4 infections, and three versus zero patients discontinuing treatment because of unacceptable toxicity, respectively. There was no difference in OS between the two groups. CONCLUSION Long-term rituximab maintenance therapy does not improve EFS, which was the primary end point of this trial, or OS, and was associated with increased toxicity.
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Affiliation(s)
- Christian Taverna
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa.
| | - Giovanni Martinelli
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Felicitas Hitz
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Walter Mingrone
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Thomas Pabst
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Lidija Cevreska
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Auro Del Giglio
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Anna Vanazzi
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Daniele Laszlo
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Johann Raats
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Daniel Rauch
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Daniel A Vorobiof
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Andreas Lohri
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Christine Biaggi Rudolf
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Stéphanie Rondeau
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Corinne Rusterholz
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Ingmar A F M Heijnen
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Emanuele Zucca
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Michele Ghielmini
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
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15
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Necchi A, Miceli R, Bregni M, Bokemeyer C, Berger LA, Oechsle K, Schumacher K, Kanfer E, Bourhis JH, Massard C, Laszlo D, Montoro J, Flechon A, Arpaci F, Secondino S, Wuchter P, Dreger P, Crysandt M, Worel N, Kruger W, Ringhoffer M, Unal A, Nagler A, Campos A, Wahlin A, Michieli M, Sucak G, Donnini I, Schots R, Ifrah N, Badoglio M, Martino M, Raggi D, Giannatempo P, Rosti G, Pedrazzoli P, Lanza F. Prognostic impact of progression to induction chemotherapy and prior paclitaxel therapy in patients with germ cell tumors receiving salvage high-dose chemotherapy in the last 10 years: a study of the European Society for Blood and Marrow Transplantation Solid Tumors Working Party. Bone Marrow Transplant 2015; 51:384-90. [DOI: 10.1038/bmt.2015.300] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 10/21/2015] [Accepted: 10/24/2015] [Indexed: 11/09/2022]
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Giannatempo P, Lo Vullo S, Mariani L, Raggi D, Schumacher K, Massard C, Kanfer E, Oechsle K, Laszlo D, Michieli M, Ifrah N, Crysandt M, Wuchter P, Nagler A, Wahlin A, Badoglio M, Pedrazzoli P, Lanza F, Necchi A. Conventional-dose (CDCT) versus high-dose chemotherapy (HDCT) in the salvage management of relapsed pure seminoma: results from an international database. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv341.04] [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: 11/14/2022] Open
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17
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Andreola G, Labopin M, Beelen D, Chevallier P, Tabrizi R, Bosi A, Michallet M, Santarone S, Ehninger G, Polge E, Laszlo D, Schmid C, Nagler A, Mohty M. Long-term outcome and prognostic factors of second allogeneic hematopoietic stem cell transplant for acute leukemia in patients with a median follow-up of ⩾10 years. Bone Marrow Transplant 2015; 50:1508-12. [DOI: 10.1038/bmt.2015.193] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Revised: 06/23/2015] [Accepted: 07/12/2015] [Indexed: 11/09/2022]
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18
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Necchi A, Lo Vullo S, Giannatempo P, Mariani L, Raggi D, Schumacher K, Massard C, Kanfer E, Oechsle K, Laszlo D, Michieli M, Pflueger KH, Ifrah N, Crysandt MM, Wuchter P, Nagler A, Wahlin A, Badoglio M, Pedrazzoli P, Lanza F. Conventional-dose (CDCT) versus high-dose chemotherapy (HDCT) in the salvage management of relapsed pure seminoma: Results from an international database. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e15559] [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: 11/20/2022] Open
Affiliation(s)
- Andrea Necchi
- Istituto Nazionale Tumori of Milan, Milano, MI, Italy
| | | | | | - Luigi Mariani
- Unit of Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Daniele Raggi
- Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | | | | | - Edward Kanfer
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Karin Oechsle
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | | | | | - Norbert Ifrah
- Hospital University Center of Angers, Angers, France
| | | | - Patrick Wuchter
- Department of Hematology, Oncology, and Rheumatology, Heidelberg University Hospital, Heidelberg, Germany
| | - Arnon Nagler
- Hematology Division, BMT and Cord Blood Bank, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | | | | | - Paolo Pedrazzoli
- Medical Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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Necchi A, Miceli R, Bregni M, Oechsle K, Kanfer E, Massard C, Flechon A, Laszlo D, Arpaci F, Wuchter P, Crysandt MM, Unal A, Nagler A, Wahlin A, Michieli M, Pflueger KH, Ringhoffer M, Badoglio M, Pedrazzoli P, Lanza F. Impact of response to induction chemotherapy (CT) and prior paclitaxel (TXL)-based CT on the outcome of salvage high-dose chemotherapy (HDCT) for relapsed germ-cell tumors (GCT) in the modern era: An EBMT Solid Tumors Working Party study. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.4535] [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: 11/20/2022] Open
Affiliation(s)
- Andrea Necchi
- Istituto Nazionale Tumori of Milan, Milano, MI, Italy
| | - Rosalba Miceli
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Karin Oechsle
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Edward Kanfer
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | | | | | | | - Fikret Arpaci
- Gulhane Faculty of Medicine, Departments of Medical Oncology and Bone Marrow Transplantation Unit, Ankara, Turkey
| | - Patrick Wuchter
- Department of Hematology, Oncology, and Rheumatology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Ali Unal
- Erciyes University, Kayseri, Turkey
| | - Arnon Nagler
- Hematology Division, BMT and Cord Blood Bank, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | | | | | | | | | | | - Paolo Pedrazzoli
- Medical Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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20
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Montoro J, Mattia L, Bertazzoni P, Liptrott S, Colombo N, Civelli M, Preda L, Laszlo D, Martinelli G, Frungillo N. Primary cardiac lymphoma with isolated parenchymal central nervous system relapse: report of two cases and review of the literature. Ecancermedicalscience 2014; 8:474. [PMID: 25374622 PMCID: PMC4217537 DOI: 10.3332/ecancer.2014.474] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Indexed: 12/31/2022] Open
Abstract
Primary cardiac lymphoma (PCL) is a rare subset of non-Hodgkin’s lymphoma involving the heart and/or pericardium with no or minimal evidence of extracardiac involvement at presentation. Distant relapses have infrequently been observed. We report two cases of this disorder that showed isolated central nervous system (CNS) relapse. Diagnosis by endomyocardial biopsy was consistent with diffuse large B-cell lymphoma. After immunochemotherapy they achieved complete remission (CR). Eight and five weeks after, isolated CNS relapses were observed respectively. The first patient was treated with high-dose methotrexate (HD-MTX) and high-dose cytarabine, resulting in a second CR. She then went onto receive autologous stem-cell transplantation but unfortunately died shortly after because of infection. The second patient received systemic CNS prophylaxis with HD-MTX, and later she was treated with an induction chemotherapy strategy with evidencing of progressive disease after two courses of treatment. She was subsequently initiated on a salvage therapy with cytarabine, followed by whole-brain radiotherapy, and autologous stem-cell transplant (ASCT), finally achieving a complete remission. Isolated CNS relapse is a very uncommon pattern in PCL and a standard approach to treatment is not yet well established. Nevertheless, the importance of CNS evaluation, using magnetic resonance imaging (MRI) and lumbar puncture, in patients with PCL should be considered, and further studies are recommended to determine the appropriate management of this complication.
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Affiliation(s)
- Juan Montoro
- Division of Clinical Haematology/Oncology, European Institute of Oncology, Via Ripamonti 435, Milan 20141, Italy
| | - Lucia Mattia
- Division of Clinical Haematology/Oncology, European Institute of Oncology, Via Ripamonti 435, Milan 20141, Italy
| | - Paola Bertazzoni
- Division of Clinical Haematology/Oncology, European Institute of Oncology, Via Ripamonti 435, Milan 20141, Italy
| | - Sarah Liptrott
- Division of Clinical Haematology/Oncology, European Institute of Oncology, Via Ripamonti 435, Milan 20141, Italy
| | - Nicola Colombo
- Division of Cardiology, European Institute of Oncology, Via Ripamonti 435, Milan 20141, Italy
| | - Maurizio Civelli
- Division of Cardiology, European Institute of Oncology, Via Ripamonti 435, Milan 20141, Italy
| | - Lorenzo Preda
- Division of Radiology, European Institute of Oncology, Via Ripamonti 435, Milan 20141, Italy
| | - Daniele Laszlo
- Division of Clinical Haematology/Oncology, European Institute of Oncology, Via Ripamonti 435, Milan 20141, Italy
| | - Giovanni Martinelli
- Division of Clinical Haematology/Oncology, European Institute of Oncology, Via Ripamonti 435, Milan 20141, Italy
| | - Niccolò Frungillo
- Division of Clinical Haematology/Oncology, European Institute of Oncology, Via Ripamonti 435, Milan 20141, Italy
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Abstract
Plerixafor, a hematopoietic stem cell mobilizer, is indicated in combination with G-CSF to mobilize hematopoietic stem cells to the peripheral blood for collection and subsequent autologous transplantation in patients with non-Hodgkin's lymphoma and multiple myeloma. Current evidence suggests that the addition of plerixafor with chemotherapy plus G-CSF is safe and effective in the large majority of the patients with low blood CD34(+) cell count after mobilization and/or poor yield after the first collection. Nevertheless, there are several questions strongly debated, and in this paper, we would like to identify areas of possible future use and development of the drug.
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22
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Necchi A, Miceli R, Berger L, Schumacher K, Bourhis J, Laszlo D, Nicolas-Virelizier E, Arpaci F, Secondino S, Dreger P, Kruger W, Ringhoffer M, Unal A, Nagler A, Campos A, Wahlin A, Donnini I, Badoglio M, Pedrazzoli P, Lanza F. Impact of Response to Induction Chemotherapy in Patients with Germ Cell Tumors (Gct) Receiving Salvage High-Dose Chemotherapy (Hdct): a Study of the Ebmt Solid Tumors Working Party (Stwp). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu337.53] [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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23
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Martinelli G, Montoro J, Vanazzi A, Andreola G, Liptrott S, Radice D, Negri M, Preda L, Pruneri G, Laszlo D. Chlorambucil-rituximab as first-line therapy in patients affected by follicular non-Hodgkin's lymphoma: a retrospective single-centre study. Hematol Oncol 2014; 33:129-35. [DOI: 10.1002/hon.2154] [Citation(s) in RCA: 11] [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] [Received: 02/05/2014] [Revised: 04/30/2014] [Accepted: 06/25/2014] [Indexed: 01/28/2023]
Affiliation(s)
- Giovanni Martinelli
- Division of Clinical Hemato-oncology; European Institute of Oncology; Milan Italy
| | - Juan Montoro
- Division of Clinical Hemato-oncology; European Institute of Oncology; Milan Italy
| | - Anna Vanazzi
- Division of Clinical Hemato-oncology; European Institute of Oncology; Milan Italy
| | - Giovanna Andreola
- Division of Clinical Hemato-oncology; European Institute of Oncology; Milan Italy
| | - Sarah Liptrott
- Division of Clinical Hemato-oncology; European Institute of Oncology; Milan Italy
| | - Davide Radice
- Division of Epidemiology and Biostatistics; European Institute of Oncology; Milan Italy
| | - Mara Negri
- Division of Clinical Hemato-oncology; European Institute of Oncology; Milan Italy
| | - Lorenzo Preda
- Division of Radiology; European Institute of Oncology; Milan Italy
| | | | - Daniele Laszlo
- Division of Clinical Hemato-oncology; European Institute of Oncology; Milan Italy
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Pruneri G, Gigli F, Rafaniello Raviele P, Gardellini A, Raimondi S, De Fiori E, Preda L, Viale G, Martinelli G, Laszlo D. Core needle biopsy as a front line diagnostic approach for lymphoma patients. Hematol Oncol 2014; 33:247-9. [DOI: 10.1002/hon.2150] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 05/20/2014] [Accepted: 05/22/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Giancarlo Pruneri
- European Institute of Oncology; Divisions of Pathology; Milan Italy
- University of Milan; School of Medicine; Milan Italy
| | - Federica Gigli
- European Institute of Oncology; Hemato-Oncology; Milan Italy
| | | | | | - Sara Raimondi
- European Institute of Oncology; Epidemiology and Biostatistics; Milan Italy
| | | | - Lorenzo Preda
- European Institute of Oncology; Radiology; Milan Italy
| | - Giuseppe Viale
- European Institute of Oncology; Divisions of Pathology; Milan Italy
- University of Milan; School of Medicine; Milan Italy
| | | | - Daniele Laszlo
- European Institute of Oncology; Hemato-Oncology; Milan Italy
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25
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Necchi A, Badoglio M, Miceli R, Bourhis JH, Laszlo D, Nicolas-Virelizier E, Wuchter P, Dreger P, Kruger WH, Unal A, Campos A, Montoro J, Raggi D, Giannatempo P, Gianni AM, Pedrazzoli P, Lanza F. Analysis of the contemporary use of high-dose chemotherapy (HDCT) in germ cell tumors (GCT) in Europe: Early findings of an ongoing EBMT-sponsored study. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.e15536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Andrea Necchi
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Rosalba Miceli
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | | | | | - Patrick Wuchter
- Department of Hematology, Oncology, and Rheumatology, Heidelberg University Hospital, Heidelberg, Germany
| | - Peter Dreger
- Department of Hematology, Oncology, and Rheumatology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Ali Unal
- Erciyes University, Kayseri, Turkey
| | | | | | - Daniele Raggi
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Alessandro M. Gianni
- Fondazione IRCCS Istituto Nazionale Tumori and Università degli Studi di Milano, Milan, Italy
| | - Paolo Pedrazzoli
- Medical Oncology, IRCCS San Matteo University Hospital Foundation, Pavia, Italy
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Montoro J, Laszlo D, Zing NPC, Petralia G, Conte G, Colandrea M, Martinelli G, Preda L. Comparison of whole-body diffusion-weighted magnetic resonance and FDG-PET/CT in the assessment of Hodgkin's lymphoma for staging and treatment response. Ecancermedicalscience 2014; 8:429. [PMID: 24963346 PMCID: PMC4027889 DOI: 10.3332/ecancer.2014.429] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Indexed: 11/06/2022] Open
Abstract
Computed tomography (CT), 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), and hybrid FDG-PET/CT are the most commonly used diagnostic tools for the initial staging and treatment response assessment of lymphomas [1]. The aim of this report is to compare the correlations between functional imaging markers derived from FDG-PET/CT and whole-body, diffusion-weighted magnetic resonance imaging (DW-MRI) in a young patient affected by Hodgkin's lymphoma (HL).
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Affiliation(s)
- Juan Montoro
- Division of Clinical Haematology/Oncology, European Institute of Oncology, Via Ripamonti 435, Milan 20141, Italy
| | - Daniele Laszlo
- Division of Clinical Haematology/Oncology, European Institute of Oncology, Via Ripamonti 435, Milan 20141, Italy
| | - Natalia Pin Chuen Zing
- Division of Clinical Haematology/Oncology, European Institute of Oncology, Via Ripamonti 435, Milan 20141, Italy
| | - Giuseppe Petralia
- Division of Radiology, European Institute of Oncology, Via Ripamonti 435, Milan 20141, Italy
| | - Giorgio Conte
- Department of Health Science, University of Milan, Milan 20216, Italy
| | - Marzia Colandrea
- Division of Nuclear Medicine, European Institute of Oncology, Via Ripamonti 435, Milan 20141, Italy
| | - Giovanni Martinelli
- Division of Clinical Haematology/Oncology, European Institute of Oncology, Via Ripamonti 435, Milan 20141, Italy
| | - Lorenzo Preda
- Division of Radiology, European Institute of Oncology, Via Ripamonti 435, Milan 20141, Italy
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Montoro J, Andreola G, Gardellini A, Babic A, Negri M, Frungillo N, Martinelli G, Laszlo D. R-ESHAP plus pegfilgrastim as an effective peripheral stem cell mobilization regimen for autologous stem-cell transplantation in patients with relapsed/refractory diffuse large B-cell lymphoma. Transfus Apher Sci 2014; 50:411-4. [PMID: 24751603 DOI: 10.1016/j.transci.2014.03.006] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 03/24/2014] [Indexed: 11/30/2022]
Abstract
Stem cell (SC) mobilization is significantly influenced by the mobilization schedule in patients with lymphoma. We evaluated data from 30 patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) undergoing SC mobilization. All received R-ESHAP plus a single dose of pegfilgrastim. All patients collected ⩾ 2 × 10(6) CD34+cells/kg, 80% of them at least 5 × 10(6) CD34+cells/kg. Adverse effects of the regimen included myelosuppression and neutropenic fever. Herein, our results suggest that R-ESHAP plus pegfilgrastim is a highly effective mobilization strategy in patients affected by DLBCL associated with a low incidence of adverse events.
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Affiliation(s)
- Juan Montoro
- Haematoncology Division, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy.
| | - Giovanna Andreola
- Haematoncology Division, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy
| | - Angelo Gardellini
- Haematoncology Division, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy
| | - Aleksandra Babic
- Haematoncology Division, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy
| | - Mara Negri
- Haematoncology Division, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy
| | - Niccolò Frungillo
- Haematoncology Division, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy
| | - Giovanni Martinelli
- Haematoncology Division, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy
| | - Daniele Laszlo
- Haematoncology Division, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy
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Martino M, Laszlo D, Lanza F. Long-active granulocyte colony-stimulating factor for peripheral blood hematopoietic progenitor cell mobilization. Expert Opin Biol Ther 2014; 14:757-72. [DOI: 10.1517/14712598.2014.895809] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Dallavalle F, Leoncino S, Ferremi Leali P, Marenchino D, Andreola G, Laszlo D, Carlier P, Ravagnani F, Terranova L, Perseghin P, Sormano E, Francisci T, Tassi V. Allogeneic hematopoietic stem cell collection from elderly related donors: a retrospective multicenter study on mobilization and collection efficiency. Drugs Cell Ther Hematol 2013. [DOI: 10.4081/dcth.2013.212] [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: 11/23/2022]
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Dallavalle F, Leoncino S, Ferremi Leali P, Marenchino D, Andreola G, Laszlo D, Carlier P, Ravagnani F, Terranova L, Perseghin P, Sormano E, Francisci T, Tassi V. Allogeneic hematopoietic stem cell collection from elderly related donors: a retrospective multicenter study on mobilization and collection efficiency. Drugs Cell Ther Hematol 2013. [DOI: 10.4081/dcth.2013.37] [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: 11/23/2022]
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31
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Andreola G, Babic A, Perseghin P, Crovetti G, Marson P, Savignano C, Ipsevich F, Lanti A, Laszlo D. Extracorporeal photochemotherapy: an Italian panel perspective on indications, methodologies and clinical results. Drugs Cell Ther Hematol 2013. [DOI: 10.4081/dcth.2013.122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Andreola G, Babic A, Perseghin P, Crovetti G, Marson P, Savignano C, Ipsevich F, Lanti A, Laszlo D. Extracorporeal photochemotherapy: an Italian panel perspective on indications, methodologies and clinical results. Drugs Cell Ther Hematol 2013. [DOI: 10.4081/dcth.2013.23] [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: 11/23/2022]
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Gardellini A, Gigli F, Babic A, Andreola G, Radice D, Sammassimo S, Martinelli G, Laszlo D. Filgrastim XM02 (Tevagrastim®) after autologous stem cell transplantation compared to lenograstim: favourable cost-efficacy analysis. Ecancermedicalscience 2013; 7:327. [PMID: 23818939 PMCID: PMC3694838 DOI: 10.3332/ecancer.2013.327] [Citation(s) in RCA: 5] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Indexed: 11/16/2022] Open
Abstract
PURPOSE Granulocyte colony-stimulating factors (G-CSFs), filgrastim and lenograstim, are recognised to be useful in accelerating engraftment after autologous stem cell transplantation. Several forms of biosimilar non-glycosylated G-CSF have been approved by the European Medicines Agency, with limited published data supporting the clinical equivalence in peripheral blood stem cell mobilisation and recovery after autologous stem cell transplantation. METHOD With the aim of comparing cost-effective strategies in the use of G-CSF after autologous stem cell transplantation, we retrospectively evaluated 32 patients consecutively treated with biosimilar filgrastim XM02 (Tevagrastim) and 26 with lenograstim. All patients received G-CSF (biosimilar or lenograstim) at a dosage of 5 mcg/kg/day subcutaneously from day 5 to absolute neutrophil count of 1500/mmc for three days. RESULTS The median time to absolute neutrophil count engraftment was 11 days for the filgrastim XM02 group and 12 days for the lenograstim group. As for platelets recovery, the median time was 12 days in both groups. The median number of G-CSF vials used for patients was 9.5 for Tevagrastim and 10.5 for lenograstim, reflecting a mean estimated cost of about 556.1 euros for Tevagrastim versus 932.2 euros for lenograstim (p< 0.001). The median days of febrile neutropenia were 1.5 and 1 for filgrastim XM02 and lenograstim, respectively. No adverse event related to the use of XM02 filgrastim was recorded. CONCLUSION In our experience, filgrastim XM02 and lenograstim showed comparable efficacy in shortening the period of neutropenia after cytoreduction and autologous stem cell transplantation, with a favourable cost effect for filgrastim XM02.
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Affiliation(s)
- A Gardellini
- Division of Haematoncology, European Institute of Oncology, Milan, Italy
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Lanza F, Lemoli RM, Olivieri A, Laszlo D, Martino M, Specchia G, Pavone V, Imola M, Pasini A, Milone G, Scortechini I, Todisco E, Guggiari E, Cascavilla N, Martinelli G, Rambaldi A, Bosi A. Factors affecting successful mobilization with plerixafor: an Italian prospective survey in 215 patients with multiple myeloma and lymphoma. Transfusion 2013; 54:331-9. [PMID: 23781769 DOI: 10.1111/trf.12265] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Revised: 02/26/2013] [Accepted: 03/04/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Although the efficacy of plerixafor in peripheral blood stem cell (PBSC) mobilization has been explored in several studies, factors associated with successful plerixafor mobilization after administration of granulocyte-colony-stimulating factor (G-CSF), with or without chemotherapy, have not been investigated. We analyzed data on PBSC mobilization from a large Italian database of lymphoma and myeloma plerixafor-treated patients. STUDY DESIGN AND METHODS Two endpoints were established to define successful mobilization: patients with at least 2 × 10(6) CD34+ cells/kg collected by three leukapheresis procedures and patients achieving a peak count of at least 20 × 10(6) CD34+ cells/L during mobilization. RESULTS Plerixafor achieved successful mobilization in both predicted (n = 64) and proven poor mobilizers (PMs; n = 143), classified according to the Gruppo Italiano Trapianto di Midollo Osseo (GITMO) criteria. Successful mobilization was independent of type of mobilization (steady state or chemotherapy); age; sex; disease; number or type of chemotherapy regimens preceding plerixafor; radiation therapy; prior treatment with melphalan, carmustine, lenalidomide, and radioimmune conjugates; and laboratory variables. Multivariate analysis identified previous fludarabine treatment and premobilization platelet count as predictors of successful mobilization. CONCLUSION This large, prospective, nationwide study confirmed plerixafor efficacy for mobilizing PBSCs when added to G-CSF with or without chemotherapy. Plerixafor can overcome negative effects of most predictors of poor mobilization to achieve satisfactory harvest both in predicted and proven PM.
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Affiliation(s)
- Francesco Lanza
- Section of Hematology and BMT Unit, Cremona Hospital, Cremona, Italy; Department of Hematology and Oncological Sciences, Institute of Hematology "L. & A. Seràgnoli", University of Bologna, Bologna, Italy; Section of Hematology, University Hospital of Ancona, "Ospedali Riuniti", Ancona, Italy; Hemato-Oncology Unit, Istituto Europeo Oncologico, Milan, Italy; Section of Hematology, Reggio Calabria Hospital, Reggio Calabria, Italy; Section of Hematology, University Hospital of Bari, Bari, Italy; Section of Hematology, Tricase Hospital, Tricase, Italy; Section the of Hematology, Rimini Hospital, Rimini, Italy; Section of Hematology, University Hospital Ferrarotto, Policlinico Vittorio Emanuele, Catania, Italy; Section of Hematology, Humanitas Hospital; BMT Unit, S. Raffaele Hospital, Milan, Italy; Section of Hematology, Hospital Casa Sollievo Sofferenza, S. Giovanni Rotondo, Italy; Section of Hematology, Bergamo Hospital, Bergamo, Italy; Section of Hematology and BMT Unit, University Hospital "Careggi", Florence, Italy
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Gigli F, Gardellini A, Babic A, Liptrott SJ, Castagna L, Martinelli G, Laszlo D. Efficacy of photopheresis extracorporeal procedure as single treatment for severe chronic GVHD: a case report. Transfus Apher Sci 2013; 49:205-7. [PMID: 23491865 DOI: 10.1016/j.transci.2013.01.013] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Revised: 10/01/2012] [Accepted: 01/10/2013] [Indexed: 11/18/2022]
Abstract
Allogeneic hematopoietic stem cell transplantation is the only potentially curative therapeutic option for many malignant and nonmalignant hematologic disorders. Despite this, several factors unfavorably affect the outcome of this procedure and in particular chronic graft-versus-host disease (cGVHD) remains the principal cause of morbidity after allogeneic transplantation. Here we present our experience regarding a patient affected by extensive chronic GVHD (cGVHD) treated only with extracorporeal photopheresis procedure (ECP) as first line treatment. The patient, presenting an high risk myelodysplastic syndrome (MDS), underwent an allogeneic peripheral stem cells transplantation. About 2 months after transplantation she experienced a hematological and clinical relapse of MDS. After reinduction therapy with azacitidine she obtained a second complete remission. Because of the risk of relapse related to a strong immunosuppressant therapy and the previous infectious complication, we decided to start a treatment with ECP alone for cGVHD. After six procedure the patient obtained a complete resolution of all signs and symptoms of the cGVHD. This experience may support the possibility to use only an immunomodulant treatment like ECP for the cGVHD, reducing the risk of complications of prolonged immunosuppressant treatment.
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Affiliation(s)
- Federica Gigli
- European Institute of Oncology, Hematoncology Divisione, Milan, Italy; Humanitas Cancer Center, Istituto Clinico Humanitas, Istituto Di Ricovero e Cura a Carattere Scientifico, Rozzano, Milan, Italy.
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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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Laszlo D. Introduction of the JACIE standard in the PBPC collection facility. Drugs Cell Ther Hematol 2012. [DOI: 10.4081/dcth.2012.17] [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: 11/22/2022]
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38
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Laszlo D. Introduction of the JACIE standard in the PBPC collection facility. Drugs Cell Ther Hematol 2012. [DOI: 10.4081/dcth.2012.1s.89] [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: 11/23/2022]
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39
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Cannella L, Babic A, Andreola G, Elezi R, Rabascio C, Negri M, Calabrese L, Lionetti M, Laszlo D. O-26 G-CSF AND PLERIXAFOR AS NON-TOXIC AND EFFECTIVE FIRST-LINE MOBILIZING APPROACH IN PATIENTS WITH MULTIPLE MYELOMA CANDIDATE TO ASCT. Transfus Apher Sci 2012. [DOI: 10.1016/s1473-0502(12)70027-7] [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: 10/27/2022]
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40
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Andreola G, Vanazzi A, Radice D, Babic A, Rabascio C, Negri M, Martinelli G, Laszlo D. Who should be really considered as a poor mobilizer in the plerixafor era? Transfus Apher Sci 2012; 47:27-32. [PMID: 22480954 DOI: 10.1016/j.transci.2012.03.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Revised: 01/20/2012] [Accepted: 03/12/2012] [Indexed: 10/28/2022]
Abstract
Patients with a number of peripheral CD34+ cells ≥20/μL have recently been defined in the literature as "poor mobilizers". We retrospectively reviewed medical records from a total of 248 patients affected by hematological malignancies or solid tumors undergoing peripheral blood stem cell collection following chemotherapy plus G-CSF. On the basis of the CD34+ cell peak in peripheral blood following mobilization therapy, patients were defined as good mobilizers (group A, CD34+ cells ≥20/μL), relative poor mobilizers (group B, CD34+ cells <20 and ≥8/μL) and absolute poor mobilizers (group C, CD34+ cells <8/μL). One hundred and seventy-seven (71%) patients resulted good mobilizers, 35 (14%) patients relative poor mobilizers and 36 (15%) patients absolute poor mobilizers. Target of stem cell collection was ≥2.0×10(6) CD34+cells/kg for each transplantation procedure. All patients in group A, 20 patients in group B (57%) and 1 patient in group C (2.7%) were able to collect ≥2.0×10(6) CD34+cells/kg. The multivariate analysis confirmed that more than three lines of previous chemotherapy and a previous autologous PBSC transplantation negatively affect mobilization of CD34+ cells in peripheral blood. Our data suggest that a number of CD34+ cells ≥20/μL does not always result in a failed stem cell collection and in fact in our patient series more than 70% of the patients defined as poor mobilizers have indeed collected the minimum number of 2.0×10(6) CD34+cells/kg required for a successful transplantation. The use of new agent such as CXCR4 antagonist plerixafor might further improve mobilization efficacy in such patients.
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Affiliation(s)
- Giovanna Andreola
- Stem Cell Collection Unit, European Institute of Oncology, Milan, Italy
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41
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Andreola G, Babic A, Rabascio C, Negri M, Martinelli G, Laszlo D. Plerixafor and Filgrastim XM02 (Tevagastrim®) as a first line peripheral blood stem cell mobilisation strategy in patients with multiple myeloma and lymphoma candidated to autologous bone marrow transplantation. Eur J Haematol 2011; 88:154-8. [DOI: 10.1111/j.1600-0609.2011.01719.x] [Citation(s) in RCA: 13] [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: 11/27/2022]
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42
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Arcaini L, Laszlo D, Rizzi S, Balzarotti M, Antoniazzi F, Zilioli VR, Guggiari E, Farina L, Todisco E, Bonfichi M, Alamos SM, Rossi G, Martinelli G, Morra E. Plerixafor and G-CSF for PBSC mobilization in patients with lymphoma who failed previous attempts with G-CSF and chemotherapy: A REL (Rete Ematologica Lombarda) experience. Leuk Res 2011; 35:712-4. [DOI: 10.1016/j.leukres.2010.12.036] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2010] [Revised: 12/28/2010] [Accepted: 12/31/2010] [Indexed: 11/30/2022]
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43
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Laszlo D, Andreola G, Rigacci L, Fabbri A, Rabascio C, Pinto A, Negri M, Martinelli G. Rituximab and Subcutaneous 2-Chloro-2′-Deoxyadenosine as Therapy in Untreated and Relapsed Waldenström's Macroglobulinemia. Clinical Lymphoma Myeloma and Leukemia 2011; 11:130-2. [DOI: 10.3816/clml.2011.n.029] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Bertazzoni P, Rabascio C, Gigli F, Calabrese L, Radice D, Calleri A, Gregato G, Negri M, Liptrott SJ, Bassi S, Nassi L, Sammassimo S, Laszlo D, Preda L, Pruneri G, Orlando L, Martinelli G. Rituximab and subcutaneous cladribine in chronic lymphocytic leukemia for newly diagnosed and relapsed patients. Leuk Lymphoma 2010; 51:1485-93. [PMID: 20578816 DOI: 10.3109/10428194.2010.495799] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [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
The aim of this study was to investigate the efficacy of combined treatment with rituximab and subcutaneous cladribine in patients with newly diagnosed and relapsed chronic lymphocytic leukemia (CLL). Forty-three patients with active CLL or small lymphocytic lymphoma received rituximab 375 mg/m(2) on day 1 and cladribine 0.1 mg/kg subcutaneously on days 2-6. The treatment was repeated every 4 weeks for a total of four cycles. Sixteen patients were pretreated. The overall response rate was 88% (50% complete remission and 38% partial remission). The median time to treatment failure was 37.9 months. Grade 4 neutropenia developed in 5% of patients. The data indicate that combination therapy with rituximab and cladribine is a valuable and safe treatment for patients with CLL.
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Affiliation(s)
- Paola Bertazzoni
- Hematoncology Division, European Institute of Oncology, Milan, Italy.
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Laszlo D, Andreola G, Rigacci L, Fabbri A, Rabascio C, Mancuso P, Pruneri G, Radice D, Pinto A, Frigeri F, Calabrese L, Billio A, Bertolini F, Martinelli G. Rituximab and Subcutaneous 2-Chloro-2′-Deoxyadenosine Combination Treatment for Patients With Waldenström Macroglobulinemia: Clinical and Biologic Results of a Phase II Multicenter Study. J Clin Oncol 2010; 28:2233-8. [DOI: 10.1200/jco.2009.23.6315] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [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 To assess the efficacy of 2-chloro-2′-deoxyadenosine (2-CdA) given subcutaneously (SC) in combination with rituximab in the treatment of newly diagnosed/pretreated patients with Waldenström macroglobulinemia (WM) and to correlate the response to treatment with biologic findings (immunophenotypic and pharmacogenomic analysis). Patients and Methods From December 2003 to February 2007, 29 patients were enrolled. Intended therapy consisted of a combination of rituximab (375 mg/m2) on day 1 followed by 2-CdA 0.1 mg/kg (SC injection) for 5 consecutive days, administered monthly for four cycles. Anemia (n = 16), neurologic symptoms (n = 6), symptomatic cryoglobulinemia (n = 4), and thrombocytopenia (n = 3) represented the reasons for starting treatment. The expression of ζ chain–associated protein kinase 70 (Zap-70) and of seven genes involved in 2-CdA metabolism as markers of response to the combination treatment was evaluated. Results With a median follow-up of 43 months, the overall response rate observed was 89.6%, with seven complete responses (CR), 16 partial responses, and three minor response, without any difference between newly or pretreated patients (P = .522). The therapy was well tolerated, except for transitory cardiac toxicity (n = 2) and intolerance to rituximab (n = 2). No major infections were observed despite the lack of antimicrobial prophylaxis. No patients developed transformation to high-grade non-Hodgkin's lymphoma nor myelodysplasia. Low expression levels of human concentrative nucleoside transporter 1 (hCNT1) were correlated with the failure to achieve a CR (P = .024), whereas no association with Zap-70 expression was found. Conclusion The combination of rituximab and SC 2-CdA is safe and effective in patients with WM requiring treatment. The pharmacogenomic analysis associated with the study suggests hCNT1 might be beneficial in predicting clinical response to such a combination treatment.
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Affiliation(s)
- Daniele Laszlo
- From the Department of Hematology, Department of Epidemiology and Biostatistics, and Division of Pathology, European Institute of Oncology, Milan; Department of Hematology, University of Florence, Firenze; Department of Hematology, University of Siena, Siena; Department of Hematology, Istituto Nazionale dei Tumori, Naples; and Central Hospital, Bolzano, Italy
| | - Giovanna Andreola
- From the Department of Hematology, Department of Epidemiology and Biostatistics, and Division of Pathology, European Institute of Oncology, Milan; Department of Hematology, University of Florence, Firenze; Department of Hematology, University of Siena, Siena; Department of Hematology, Istituto Nazionale dei Tumori, Naples; and Central Hospital, Bolzano, Italy
| | - Luigi Rigacci
- From the Department of Hematology, Department of Epidemiology and Biostatistics, and Division of Pathology, European Institute of Oncology, Milan; Department of Hematology, University of Florence, Firenze; Department of Hematology, University of Siena, Siena; Department of Hematology, Istituto Nazionale dei Tumori, Naples; and Central Hospital, Bolzano, Italy
| | - Alberto Fabbri
- From the Department of Hematology, Department of Epidemiology and Biostatistics, and Division of Pathology, European Institute of Oncology, Milan; Department of Hematology, University of Florence, Firenze; Department of Hematology, University of Siena, Siena; Department of Hematology, Istituto Nazionale dei Tumori, Naples; and Central Hospital, Bolzano, Italy
| | - Cristina Rabascio
- From the Department of Hematology, Department of Epidemiology and Biostatistics, and Division of Pathology, European Institute of Oncology, Milan; Department of Hematology, University of Florence, Firenze; Department of Hematology, University of Siena, Siena; Department of Hematology, Istituto Nazionale dei Tumori, Naples; and Central Hospital, Bolzano, Italy
| | - Patrizia Mancuso
- From the Department of Hematology, Department of Epidemiology and Biostatistics, and Division of Pathology, European Institute of Oncology, Milan; Department of Hematology, University of Florence, Firenze; Department of Hematology, University of Siena, Siena; Department of Hematology, Istituto Nazionale dei Tumori, Naples; and Central Hospital, Bolzano, Italy
| | - Giancarlo Pruneri
- From the Department of Hematology, Department of Epidemiology and Biostatistics, and Division of Pathology, European Institute of Oncology, Milan; Department of Hematology, University of Florence, Firenze; Department of Hematology, University of Siena, Siena; Department of Hematology, Istituto Nazionale dei Tumori, Naples; and Central Hospital, Bolzano, Italy
| | - Davide Radice
- From the Department of Hematology, Department of Epidemiology and Biostatistics, and Division of Pathology, European Institute of Oncology, Milan; Department of Hematology, University of Florence, Firenze; Department of Hematology, University of Siena, Siena; Department of Hematology, Istituto Nazionale dei Tumori, Naples; and Central Hospital, Bolzano, Italy
| | - Antonello Pinto
- From the Department of Hematology, Department of Epidemiology and Biostatistics, and Division of Pathology, European Institute of Oncology, Milan; Department of Hematology, University of Florence, Firenze; Department of Hematology, University of Siena, Siena; Department of Hematology, Istituto Nazionale dei Tumori, Naples; and Central Hospital, Bolzano, Italy
| | - Ferdinando Frigeri
- From the Department of Hematology, Department of Epidemiology and Biostatistics, and Division of Pathology, European Institute of Oncology, Milan; Department of Hematology, University of Florence, Firenze; Department of Hematology, University of Siena, Siena; Department of Hematology, Istituto Nazionale dei Tumori, Naples; and Central Hospital, Bolzano, Italy
| | - Liliana Calabrese
- From the Department of Hematology, Department of Epidemiology and Biostatistics, and Division of Pathology, European Institute of Oncology, Milan; Department of Hematology, University of Florence, Firenze; Department of Hematology, University of Siena, Siena; Department of Hematology, Istituto Nazionale dei Tumori, Naples; and Central Hospital, Bolzano, Italy
| | - Atto Billio
- From the Department of Hematology, Department of Epidemiology and Biostatistics, and Division of Pathology, European Institute of Oncology, Milan; Department of Hematology, University of Florence, Firenze; Department of Hematology, University of Siena, Siena; Department of Hematology, Istituto Nazionale dei Tumori, Naples; and Central Hospital, Bolzano, Italy
| | - Francesco Bertolini
- From the Department of Hematology, Department of Epidemiology and Biostatistics, and Division of Pathology, European Institute of Oncology, Milan; Department of Hematology, University of Florence, Firenze; Department of Hematology, University of Siena, Siena; Department of Hematology, Istituto Nazionale dei Tumori, Naples; and Central Hospital, Bolzano, Italy
| | - Giovanni Martinelli
- From the Department of Hematology, Department of Epidemiology and Biostatistics, and Division of Pathology, European Institute of Oncology, Milan; Department of Hematology, University of Florence, Firenze; Department of Hematology, University of Siena, Siena; Department of Hematology, Istituto Nazionale dei Tumori, Naples; and Central Hospital, Bolzano, Italy
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Agazzi A, Sammassimo S, Laszlo D, Liptrott SJ, Cascio R, Alietti A, Rabascio C, Mancuso P, Pruneri G, Martinelli G. Is there a role for 'modified VAD' in the treatment of multiple myeloma? Ecancermedicalscience 2010; 3:136. [PMID: 22276003 PMCID: PMC3223996 DOI: 10.3332/ecancer.2009.136] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2009] [Indexed: 11/06/2022] Open
Abstract
VAD, (Vincristine, Doxorubicin and Dexamethasone) was initially proposed as a salvage therapy for myeloma patients in whom prior alkylating agent therapy failed, although in recent years VAD has been surpassed by novel combination therapies with new biological agents such as thalidomide (and its derivative, lenalidomide) and bortezomib. After the excellent results obtained by the novel agents, VAD can no longer be proposed in preparation to autologous transplantation, although there are still indications that VAD remains useful and clinically relevant in the initial treatment of symptomatic multiple myeloma.
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Affiliation(s)
- A Agazzi
- Haematoncology Division, European Institute of Oncology, Via Ripamonti 435, Milan, 20141, Italy
| | - S Sammassimo
- Haematoncology Division, European Institute of Oncology, Via Ripamonti 435, Milan, 20141, Italy
- Correspondence to S Sammassimo.
| | - D Laszlo
- Haematoncology Division, European Institute of Oncology, Via Ripamonti 435, Milan, 20141, Italy
| | - SJ Liptrott
- Haematoncology Division, European Institute of Oncology, Via Ripamonti 435, Milan, 20141, Italy
| | - R Cascio
- Haematoncology Division, European Institute of Oncology, Via Ripamonti 435, Milan, 20141, Italy
| | - A Alietti
- Haematoncology Division, European Institute of Oncology, Via Ripamonti 435, Milan, 20141, Italy
| | - C Rabascio
- Anatomopathology Division, European Institute of Oncology, Via Ripamonti 435, Milan, 20141, Italy
| | - P Mancuso
- Anatomopathology Division, European Institute of Oncology, Via Ripamonti 435, Milan, 20141, Italy
| | - G Pruneri
- Anatomopathology Division, European Institute of Oncology, Via Ripamonti 435, Milan, 20141, Italy
| | - G Martinelli
- Haematoncology Division, European Institute of Oncology, Via Ripamonti 435, Milan, 20141, Italy
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47
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Laszlo D, Pruneri G, Andreola G, Radice D, Calabrese L, Rafaniello PR, Nassi L, Sammassimo S, Alietti A, Agazzi A, Vanazzi A, Martinelli G. Tissue microarrays in diffuse large B-cell lymphomas: are they really able to identify distinct prognostic groups in lymphomas of both nodal and extranodal origin? Int J Surg Pathol 2009; 19:417-24. [PMID: 19793830 DOI: 10.1177/1066896909345596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS Diffuse large B-cell lymphomas (DLBCL) can be divided into different subgroups (germinal center B-cell-like [GCB] and non-GCB) according to their gene expression profiles. Immunohistochemistry has been proposed as a surrogate for identifying these subgroups, but data about its efficacy in providing prognostic information are conflicting. METHODS AND RESULTS This study retrospectively analyzed a series of 105 DLBCL, defined as GCB and non-GCB according to CD10, bcl-6, and MUM1 expression. All patients received a first-line anthracycline-based (CHOP-like) chemotherapy. A total of 50 patients (48%) were identified as GCB and 55 (52%) as non-GCB. The overall response rate was 89% (94/105), with 62 (59%) complete response. Disease progressions were equally distributed between the 2 subgroups and were not significantly different (P = .756) considering the primary site of involvement (nodal or extranodal). The median follow-up was 62 months (range 5-126 months). Overall survival at 5 years was not significantly different between the groups (P = .3468) and was 72.3% and 66.6% for GCB and non-GCB, respectively. CONCLUSION The results do not support the prognostic value of GCB and non-GCB immunohistochemical categories in DLBCL of both nodal and extranodal origin. Furthermore, a limited number of antigens may be not sufficient to identify the same patterns defined by cDNA microarray. Prospective studies are warranted to address this issue.
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Affiliation(s)
- D Laszlo
- European Institute of Oncology, Milan, Italy.
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48
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Rabascio C, Laszlo D, Andreola G, Saronni L, Radice D, Rigacci L, Fabbri A, Frigeri F, Calabrese L, Billio A, Bertolini F, Martinelli G. Expression of the human concentrative nucleotide transporter 1 (hCNT1) gene correlates with clinical response in patients affected by Waldenström's Macroglobulinemia (WM) and small lymphocytic lymphoma (SLL) undergoing a combination treatment with 2-chloro-2'-deoxyadenosine (2-CdA) and Rituximab. Leuk Res 2009; 34:454-7. [PMID: 19647871 DOI: 10.1016/j.leukres.2009.07.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2009] [Revised: 06/25/2009] [Accepted: 07/02/2009] [Indexed: 11/18/2022]
Abstract
PURPOSE Resistance to nucleoside analogues agents is likely to be multifactorial and could involve a number of mechanisms affecting drug penetration, metabolism and targeting. In vitro studies of resistant human cell lines have confirmed that human concentrative nucleoside transporter 1 (hCNT1)-deficient cells display resistance. EXPERIMENTAL DESIGN We applied real-time PCR method to assess the mRNA expression of equilibrative and concentrative nucleoside transporter (hENT1, hCNT1), deoxycytidine and deoxyguanosine kinase (dCK, dGK), 5'-nucleotidase (5'-NT), ribonucleotide reductase catalytic and regulatory (RR1, RR2) subunits in bone marrow cells from 32 patients with Waldenström's Macroglobulinemia (WM) and small lymphocytic lymphoma (SLL) who received 2CdA-based chemotherapy. Responses to chemotherapy, were then correlated to the expression of these markers. RESULTS All 32 patients enrolled expressed lower levels of hCNT1 as compared to healthy donors. In univariate analysis, lower expression level of hCNT1 (p=0.0021) and RR2 (p=0.02) correlated with response to chemotherapy. In particular, patients with low levels of hCNT1 achieved inferior clinical response. No significant correlation between these genes expression and age, stage of disease was found. This study suggests that nucleotidase expression levels can be used to identify subgroups of WM and SLL patients who will likely respond differently to a 2CdA-based therapy.
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MESH Headings
- Adult
- Aged
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal, Murine-Derived
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/genetics
- Cladribine/administration & dosage
- Female
- Gene Expression Regulation, Neoplastic/drug effects
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Male
- Membrane Transport Proteins/genetics
- Middle Aged
- Models, Biological
- Prognosis
- Rituximab
- Treatment Outcome
- Waldenstrom Macroglobulinemia/diagnosis
- Waldenstrom Macroglobulinemia/drug therapy
- Waldenstrom Macroglobulinemia/genetics
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Affiliation(s)
- C Rabascio
- Dept of Haematology, European Institute of Oncology, via Ripamonti 435, 20141 Milano, Italy.
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49
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Laszlo D, Rabascio C, Andreola G, Pruneri G, Raia V, Calabrese L, Radice D, Saronni L, Martinelli G. Chlorambucil – rituximab as first line combination therapy in follicular non-Hodgkin's lymphoma: A clinical and biological analysis. Leuk Lymphoma 2009; 48:437-8. [PMID: 17325914 DOI: 10.1080/10428190601078134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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50
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Pruneri G, Alietti A, Agnelli L, Morabito F, Laszlo D, Calabrese L, Fabris S, Bertolini F, Agazzi A, Bottiglieri L, Raviele PR, Baldini L, Pileri S, Sabattini E, Bosari S, Maisonneuve P, Lambertenghi-Deliliers G, Bertoni F, Martinelli G, Viale G, Neri A. Immunoreactivity for cyclin D1 is a reliable marker of gene aberration in plasma cell myeloma but does not specify patients prognosis. Leuk Res 2008; 32:1628-32. [PMID: 18355918 DOI: 10.1016/j.leukres.2008.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2008] [Revised: 02/05/2008] [Accepted: 02/06/2008] [Indexed: 11/15/2022]
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