1
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Foffa I, Janowska A, Fabbri M, Losi P, Ciabatti E, Gabbriellini S, Faita F, Rosa LD, Dini V, Mazzoni A, Romanelli M, Soldani G. Carboxymethyl Cellulose-Based Hydrogel Film Combined with Umbilical Cord Blood Platelet gel as an Innovative Tool for Chronic Wound Management: A Pilot Clinical Study. INT J LOW EXTR WOUND 2022:15347346221138189. [PMID: 36380524 DOI: 10.1177/15347346221138189] [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] [Indexed: 02/17/2024]
Abstract
Treatment of chronic leg ulcers remains a major challenge and it is a substantial financial burden on individuals, families, caregivers, and health care system. There is increasing evidence on using of autologous Platelet-rich-plasma in wound repair but limited clinical data are available on the efficacy and safety of the use of umbilical cord blood platelet gel (CBPG). In our pilot study, for the first time, we aimed to evaluated the safety and efficacy of the use of umbilical CBPG combined with a hydrogel dressing in 10 patients with chronic venous ulcers (VU). The protocol consisted of application of umbilical cord blood platelet-rich plasma (PRP) combined with a Carboxymethyl cellulose (CMC)-based hydrogel dressing once a week for 4 weeks. The 80% of patients after 4 weeks of treatment had a significantly decrease in wound size. Moreover, we obtained an improvement in terms of mean Wound Bed Score (WBS), numeric rating scale (NRS) value and the EQ-5D index score. This pilot study showed that the topically therapeutic administration of umbilical CBPG associated with a CMC-based hydrogel dressing has the potential to accelerate the healing of chronic lesions without adverse reaction. However, additional studies with larger sample size and longer follow-up periods are required to confirm our findings.
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Affiliation(s)
- Ilenia Foffa
- Institute of Clinical Physiology, National Research Council, Massa, Pisa, Italy
| | - Agata Janowska
- Unit of Dermatology, 9310University of Pisa, Pisa, Italy
| | - Marco Fabbri
- Transfusion Medicine and Transplant Biology, 9257Pisa University Hospital, Pisa, Italy
| | - Paola Losi
- Institute of Clinical Physiology, National Research Council, Massa, Pisa, Italy
| | - Elena Ciabatti
- Transfusion Medicine and Transplant Biology, 9257Pisa University Hospital, Pisa, Italy
| | - Sabrina Gabbriellini
- Transfusion Medicine and Transplant Biology, 9257Pisa University Hospital, Pisa, Italy
| | - Francesco Faita
- Institute of Clinical Physiology, National Research Council, Massa, Pisa, Italy
| | - Laura De Rosa
- Institute of Clinical Physiology, National Research Council, Massa, Pisa, Italy
- Department of Information Engineering and Computer Science, University of Trento, Trento, Italy
| | - Valentina Dini
- Unit of Dermatology, 9310University of Pisa, Pisa, Italy
| | - Alessandro Mazzoni
- Transfusion Medicine and Transplant Biology, 9257Pisa University Hospital, Pisa, Italy
| | | | - Giorgio Soldani
- Institute of Clinical Physiology, National Research Council, Massa, Pisa, Italy
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2
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Pulsoni A, Tosti ME, Ferrero S, Luminari S, Dondi A, Liberati AM, Cenfra N, Renzi D, Zanni M, Boccomini C, Ferreri AJ, Rattotti S, Zilioli VR, Bernuzzi P, Bolis S, Musuraca G, Nassi L, Perrone T, Stelitano C, Anastasia A, Corradini P, Partesotti G, Re F, Cencini E, Mannarella C, Mannina D, Molinari AL, Tani M, Annechini G, Assanto GM, Grapulin L, Guarini A, Cavalli M, De Novi LA, Ciabatti E, Mantoan B, Della Starza I, Arcaini L, Ricardi U, Gattei V, Galimberti S, Ladetto M, Foà R, Del Giudice I. UPDATED RESULTS OF THE FIL “MIRO” STUDY, A MULTICENTER PHASE II TRIAL COMBINING LOCAL RADIOTHERAPY AND MRD‐DRIVEN IMMUNOTHERAPY IN EARLY‐STAGE FOLLICULAR LYMPHOMA. Hematol Oncol 2021. [DOI: 10.1002/hon.31_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- A. Pulsoni
- Hematology, Sapienza University Department of Translational and Precision Medicine Roma Italy
| | - M. E. Tosti
- Istituto Superiore di Sanità National Center for Global Health Roma Italy
| | - S. Ferrero
- Hematology Division University of Torino/AOU "Città della Salute e della Scienza di Torino" Department of Molecular Biotechnologies and Health Sciences Torino Italy
| | - S. Luminari
- Hematology Unit Arcispedale S. Maria Nuova, Azienda Unità Sanitaria Locale ‐ IRCCS, University of Modena and Reggio Emilia Reggio Emilia Italy
| | - A. Dondi
- Fondazione Italiana Linfomi Onlus, (FIL) Modena Italy
| | - A. M. Liberati
- A.O. Santa Maria Terni, University of Perugia Perugia Italy
| | - N. Cenfra
- Hematology Unit, S. Maria Goretti Hospital AUSL Latina Latina Italy
| | - D. Renzi
- Hematology and Stem Cells Transplantation Unit IRCCS Istituto Nazionale dei Tumori Regina Elena Roma Italy
| | - M. Zanni
- Division of Hematology, SS. Antonio e Biagio Hospital Alessandria Italy
| | - C. Boccomini
- Hematology Department Città della Salute e della Scienza Torino Italy
| | - A. J. Ferreri
- Lymphoma Unit IRCCS San Raffaele Scientific Institute Department of Onco‐Haematology Milano Italy
| | - S. Rattotti
- Division of Hematology Fondazione IRCCS Policlinico San Matteo Pavia Italy
| | - V. R. Zilioli
- Division of Hematology ASST Grande Ospedale Metropolitano Niguarda Milano Italy
| | - P. Bernuzzi
- Hematology Unit, Guglielmo da Saliceto Hospital Department of Onco‐Hematology Piacenza Italy
| | - S. Bolis
- Hematology Department ASST San Gerardo University Hospital Monza Italy
| | - G. Musuraca
- Hematology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori” Meldola (FC) Italy
| | - L. Nassi
- Division of Hematology University of Eastern Piedmont Department of Translational Medicine Novara Italy
| | - T. Perrone
- Unit of Hematology with Transplantation University of Bari, Dept. of Emergency and Organ Transplantation Bari Italy
| | - C. Stelitano
- Department of Haematology Azienda Ospedaliera Bianchi Melacrino Morelli Reggio Calabria Italy
| | - A. Anastasia
- Hematology, ASST Spedali Civili di Brescia Brescia Italy
| | - P. Corradini
- Division of Hematology Fondazione IRCCS Istituto Nazionale dei Tumori di Milano Milano Italy
| | - G. Partesotti
- Onco‐Hematology Department Nuovo ospedale civile of Sassuolo Sassuolo Italy
| | - F. Re
- Hematology Clinic, A.O.U. di Parma Parma Italy
| | - E. Cencini
- Unit of Hematology Azienda Ospedaliera Universitaria Senese & University of Siena Siena Italy
| | - C. Mannarella
- Hematology Unit "Madonna delle Grazie" Hospital Matera Italy
| | - D. Mannina
- Department of Hematology Azienda Ospedaliera Papardo Messina Italy
| | | | - M. Tani
- Hematology Unit Santa Maria delle Croci Hospital Ravenna Italy
| | - G. Annechini
- Hematology, Sapienza University Department of Translational and Precision Medicine Roma Italy
| | - G. M. Assanto
- Hematology, Sapienza University Department of Translational and Precision Medicine Roma Italy
| | - L. Grapulin
- Department of Radiotherapy Policlinico Umberto I, Sapienza University Roma Italy
| | - A. Guarini
- Hematology, Sapienza University Department of Molecular Medicine Roma Italy
| | - M. Cavalli
- Hematology, Sapienza University Department of Translational and Precision Medicine Roma Italy
| | - L. A. De Novi
- Hematology, Sapienza University Department of Translational and Precision Medicine Roma Italy
| | - E. Ciabatti
- Section of Hematology, University of Pisa Department of Clinical and Experimental Medicine Pisa Italy
| | - B. Mantoan
- Hematology Division University of Torino Department of Molecular Biotechnologies and Health Sciences Torino Italy
| | - I. Della Starza
- Hematology, Sapienza University Department of Translational and Precision Medicine Roma Italy
| | - L. Arcaini
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo University of Pavia, Department of Molecular Medicine Pavia Italy
| | - U. Ricardi
- Radiation Oncology, University of Turin Department of Oncology Torino Italy
| | - V. Gattei
- Clinical and Experimental Onco‐Hematology Unit CRO Aviano National Cancer Institute Aviano Italy
| | - S. Galimberti
- Section of Hematology University of Pisa, Department of Clinical and Experimental Medicine Pisa Italy
| | - M. Ladetto
- Hematology, Az Ospedaliera Santi Antonio e Biagio e Cesare Arrigo Università del Piemonte Orientale Alessandria Italy
| | - R. Foà
- Hematology, Sapienza University Department of Translational and Precision Medicine Roma Italy
| | - I. Del Giudice
- Hematology, Sapienza University Department of Translational and Precision Medicine Roma Italy
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3
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Tavarozzi R, Manzato E, Sammuri P, Ciabatti E, Ciancia E, Carulli G. Eight-year follow up of a case of persistent polyclonal B cell lymphocytosis: Immunophenotypic findings pre- and postsplenectomy. Cytometry B Clin Cytom 2020; 100:687-688. [PMID: 33270977 DOI: 10.1002/cyto.b.21976] [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] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/04/2020] [Accepted: 11/23/2020] [Indexed: 11/07/2022]
Affiliation(s)
- Rita Tavarozzi
- SC of Haematology, AO SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Enrica Manzato
- Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy.,Department of Life Sciences, Sant'Anna School of Advanced Studies, Piazza Martiri della Libertà 33, Pisa, Italy
| | - Paola Sammuri
- Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Elena Ciabatti
- Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Eugenio Ciancia
- Department of Clinical and Experimental Medicine, Second Section of Pathology, University of Pisa, Pisa, Italy
| | - Giovanni Carulli
- Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
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4
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Galimberti S, Petrini M, Baratè C, Ricci F, Balducci S, Grassi S, Guerrini F, Ciabatti E, Mechelli S, Di Paolo A, Baldini C, Baglietto L, Macera L, Spezia PG, Maggi F. Tyrosine Kinase Inhibitors Play an Antiviral Action in Patients Affected by Chronic Myeloid Leukemia: A Possible Model Supporting Their Use in the Fight Against SARS-CoV-2. Front Oncol 2020; 10:1428. [PMID: 33014780 PMCID: PMC7493657 DOI: 10.3389/fonc.2020.01428] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [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: 05/13/2020] [Accepted: 07/06/2020] [Indexed: 12/12/2022] Open
Abstract
SARS-CoV-2 is the viral agent responsible for the pandemic that in the first months of 2020 caused about 400,000 deaths. Among compounds proposed to fight the SARS-CoV-2-related disease (COVID-19), tyrosine kinase inhibitors (TKIs), already effective in Philadelphia-positive acute lymphoblastic leukemia (Ph+ ALL) and chronic myeloid leukemia (CML), have been proposed on the basis of their antiviral action already demonstrated against SARS-CoV-1. Very few cases of COVID-19 have been reported in Ph+ ALL and in CML Italian cohorts; authors suggested that this low rate of infections might depend on the use of TKIs, but the biological causes of this phenomenon remain unknown. In this study, the CML model was used to test if TKIs would sustain or not the viral replication and if they could damage patient immunity. Firstly, the infection and replication rate of torquetenovirus (TTV), whose load is inversely proportional to the host immunological control, have been measured in CML patients receiving nilotinib. A very low percentage of subjects were infected at baseline, and TTV did not replicate or at least showed a low replication rate during the follow-up, with a mean load comparable to the measured one in healthy subjects. Then, after gene expression profiling experiments, we found that several “antiviral” genes, such as CD28 and IFN gamma, were upregulated, while genes with “proviral” action, such as ARG-1, CEACAM1, and FUT4, were less expressed during treatment with imatinib, thus demonstrating that TKIs are not detrimental from the immunological point of view. To sum up, our data could offer some biological explanations to the low COVID-19 occurrence in Ph+ ALL and CML patients and sustain the use of TKIs in COVID-19, as already proposed by several international ongoing studies.
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Affiliation(s)
- Sara Galimberti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Mario Petrini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Federica Ricci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Serena Balducci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Susanna Grassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Francesca Guerrini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Elena Ciabatti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Antonello Di Paolo
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Chiara Baldini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Laura Baglietto
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Lisa Macera
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Pietro Giorgio Spezia
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Fabrizio Maggi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
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5
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Della Starza I, De Novi LA, Cavalli M, Novelli N, Soscia R, Genuardi E, Mantoan B, Drandi D, Ferrante M, Monitillo L, Barbero D, Ciabatti E, Grassi S, Bomben R, Degan M, Gattei V, Galimberti S, Di Rocco A, Martelli M, Cortelazzo S, Guarini A, Foà R, Ladetto M, Ferrero S, Del Giudice I. Immunoglobulin kappa deleting element rearrangements are candidate targets for minimal residual disease evaluation in mantle cell lymphoma. Hematol Oncol 2020; 38:698-704. [PMID: 32816326 DOI: 10.1002/hon.2792] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/14/2020] [Accepted: 08/15/2020] [Indexed: 11/09/2022]
Abstract
Minimal residual disease (MRD) assessment is of high clinical relevance in patients with mantle cell lymphoma (MCL). In mature B-cell malignancies, the presence of somatic hypermutations (SHM) in Variable-Diversity-Joining Heavy chain (VDJH) rearrangements leads to frequent mismatches between primers, probes, and the target, thus impairing tumor cells quantification. Alternative targets, such as immunoglobulin kappa-deleting-element (IGK-Kde) rearrangements, might be suitable for MRD detection. We aimed at evaluating the applicability of IGK-Kde rearrangements for MRD quantification in MCL patients by real-time quantitative polymerase chain reaction (RQ-PCR)/digital-droplet-PCR (ddPCR). IGK screening was performed on bone marrow samples from two cohorts: the first from Turin (22 patients enrolled in the FIL-MCL0208 trial, NCT02354313) and the second from Rome (15 patients). IGK-Kde rearrangements were found in 76% (28/37) of cases, representing the sole molecular marker in 73% (8/11) of IGH-BCL1/IGH negative cases. MRD RQ-PCR monitoring was possible in 57% (16/28) of cases, showing a 100% concordance with the conventional targets. However, the frequent background amplification affected the sensitivity of the assay, that was lower in MCL compared to acute lymphoblastic leukemia and in line with multiple myeloma published results. ddPCR had a good concordance with RQ-PCR and it might help to identify false positive/negative results. From a clinical perspective, we suggest that IGK-Kde can be a candidate target for MRD monitoring and deserves a validation of its predictive value in prospective MCL series.
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Affiliation(s)
- Irene Della Starza
- Hematology, Department of Translational and Precision Medicine, "Sapienza" University of Roma, Rome, Italy
| | - Lucia Anna De Novi
- Hematology, Department of Translational and Precision Medicine, "Sapienza" University of Roma, Rome, Italy
| | - Marzia Cavalli
- Hematology, Department of Translational and Precision Medicine, "Sapienza" University of Roma, Rome, Italy
| | - Noemi Novelli
- Hematology, Department of Translational and Precision Medicine, "Sapienza" University of Roma, Rome, Italy
| | - Roberta Soscia
- Hematology, Department of Translational and Precision Medicine, "Sapienza" University of Roma, Rome, Italy
| | - Elisa Genuardi
- Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino, Torino, Italy
| | - Barbara Mantoan
- Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino, Torino, Italy
| | - Daniela Drandi
- Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino, Torino, Italy
| | - Martina Ferrante
- Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino, Torino, Italy
| | - Luigia Monitillo
- Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino, Torino, Italy
| | - Daniela Barbero
- Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino, Torino, Italy
| | - Elena Ciabatti
- Division of Hematology, Department of Oncology, Santa Chiara Hospital, Pisa, Italy
| | - Susanna Grassi
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Riccardo Bomben
- Clinical and Experimental Onco-Haematology Unit, Centro di Riferimento Oncologico, I.R.C.C.S., Aviano, Italy
| | - Massimo Degan
- Clinical and Experimental Onco-Haematology Unit, Centro di Riferimento Oncologico, I.R.C.C.S., Aviano, Italy
| | - Valter Gattei
- Clinical and Experimental Onco-Haematology Unit, Centro di Riferimento Oncologico, I.R.C.C.S., Aviano, Italy
| | - Sara Galimberti
- Division of Hematology, Department of Oncology, Santa Chiara Hospital, Pisa, Italy
| | - Alice Di Rocco
- Hematology, Department of Translational and Precision Medicine, "Sapienza" University of Roma, Rome, Italy
| | - Maurizio Martelli
- Hematology, Department of Translational and Precision Medicine, "Sapienza" University of Roma, Rome, Italy
| | - Sergio Cortelazzo
- Hematology, Medical Oncology and Hematology Division, "Istituto Clinico Humanitas Gavazzeni", Bergamo, Italy
| | - Anna Guarini
- Department of Molecular Medicine, "Sapienza" University of Roma, Rome, Italy
| | - Robin Foà
- Hematology, Department of Translational and Precision Medicine, "Sapienza" University of Roma, Rome, Italy
| | - Marco Ladetto
- Division of Hematology, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Simone Ferrero
- Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino, Torino, Italy.,Division of Hematology, AOU "Città della Salute e della Scienza di Torino", Torino, Italy
| | - Ilaria Del Giudice
- Hematology, Department of Translational and Precision Medicine, "Sapienza" University of Roma, Rome, Italy
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6
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Ricci F, Balducci S, Guerrini F, Grassi S, Ciabatti E, Baratè C, Ferreri MI, Giuliani C, Valetto A, Petrini M, Galimberti S. Sorafenib Induced Complete Cytogenetic and Molecular Response in a Chronic Eosinophilic Leukemia Case with t(12;13) Translocation. Clin Hematol Int 2020; 2:129-131. [PMID: 34595453 PMCID: PMC8432331 DOI: 10.2991/chi.k.200714.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 07/05/2020] [Indexed: 12/01/2022] Open
Affiliation(s)
- Federica Ricci
- Department of Clinical and Experimental Medicine, UO Hematology, University of Pisa, Pisa, Italy
| | - Serena Balducci
- Department of Clinical and Experimental Medicine, UO Hematology, University of Pisa, Pisa, Italy
| | - Francesca Guerrini
- Department of Clinical and Experimental Medicine, UO Hematology, University of Pisa, Pisa, Italy
| | - Susanna Grassi
- Department of Clinical and Experimental Medicine, UO Hematology, University of Pisa, Pisa, Italy
| | - Elena Ciabatti
- Department of Clinical and Experimental Medicine, UO Hematology, University of Pisa, Pisa, Italy
| | - Claudia Baratè
- UO Hematology, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | | | - Cecilia Giuliani
- UO Cytogenetics, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Angelo Valetto
- UO Cytogenetics, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Mario Petrini
- Department of Clinical and Experimental Medicine, UO Hematology, University of Pisa, Pisa, Italy
| | - Sara Galimberti
- Department of Clinical and Experimental Medicine, UO Hematology, University of Pisa, Pisa, Italy
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7
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Grassi S, Guerrini F, Ciabatti E, Puccetti R, Salehzadeh S, Metelli MR, Di Vita A, Domenichini C, Caracciolo F, Orciuolo E, Pelosini M, Mazzantini E, Rossi P, Mazziotta F, Petrini M, Galimberti S. Digital Droplet PCR is a Specific and Sensitive Tool for Detecting IDH2 Mutations in Acute Myeloid LeuKemia Patients. Cancers (Basel) 2020; 12:cancers12071738. [PMID: 32629801 PMCID: PMC7407265 DOI: 10.3390/cancers12071738] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 05/14/2020] [Revised: 06/24/2020] [Accepted: 06/28/2020] [Indexed: 12/19/2022] Open
Abstract
Isocitrate dehydrogenase 1 and 2 (IDH1 and IDH2) interfere with cellular metabolism contributing to oncogenesis. Mutations of IDH2 at R140 and R172 residues are observed in 20% of acute myeloid leukemias (AML), and the availability of the IDH2 inhibitor Enasidenib made IDH2 mutational screening a clinical need. The aim of this study was to set a new quantitative polymerase chain reaction (PCR) technique, the drop-off digital droplet PCR (drop-off ddPCR), as a sensitive and accurate tool for detecting IDH2 mutations. With this technique we tested 60 AML patients. Sanger sequencing identified 8/60 (13.5%) mutated cases, while ddPCR and the amplification refractory mutation system (ARMS) PCR, used as a reference technique, identified mutations in 13/60 (21.6%) cases. When the outcome of IDH2-mutated was compared to that of wild-type patients, no significant difference in terms of quality of response, overall survival, or progression-free survival was observed. Finally, we monitored IDH2 mutations during follow-up in nine cases, finding that IDH2 can be considered a valid marker of minimal residual disease (MRD) in 2/3 of our patients. In conclusion, a rapid screening of IDH2 mutations is now a clinical need well satisfied by ddPCR, but the role of IDH2 as a marker for MRD still remains a matter of debate.
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Affiliation(s)
- Susanna Grassi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (F.G.); (E.C.); (R.P.); (S.S.); (E.M.); (P.R.); (F.M.); (M.P.); (S.G.)
- Correspondence:
| | - Francesca Guerrini
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (F.G.); (E.C.); (R.P.); (S.S.); (E.M.); (P.R.); (F.M.); (M.P.); (S.G.)
| | - Elena Ciabatti
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (F.G.); (E.C.); (R.P.); (S.S.); (E.M.); (P.R.); (F.M.); (M.P.); (S.G.)
| | - Riccardo Puccetti
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (F.G.); (E.C.); (R.P.); (S.S.); (E.M.); (P.R.); (F.M.); (M.P.); (S.G.)
| | - Serena Salehzadeh
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (F.G.); (E.C.); (R.P.); (S.S.); (E.M.); (P.R.); (F.M.); (M.P.); (S.G.)
| | - Maria Rita Metelli
- Hematology, Azienda Ospedaliero Universitaria Pisana (AOUP), 56126 Pisa, Italy; (M.R.M.); (A.D.V.); (C.D.); (F.C.); (E.O.); (M.P.)
| | - Alessia Di Vita
- Hematology, Azienda Ospedaliero Universitaria Pisana (AOUP), 56126 Pisa, Italy; (M.R.M.); (A.D.V.); (C.D.); (F.C.); (E.O.); (M.P.)
| | - Cristiana Domenichini
- Hematology, Azienda Ospedaliero Universitaria Pisana (AOUP), 56126 Pisa, Italy; (M.R.M.); (A.D.V.); (C.D.); (F.C.); (E.O.); (M.P.)
| | - Francesco Caracciolo
- Hematology, Azienda Ospedaliero Universitaria Pisana (AOUP), 56126 Pisa, Italy; (M.R.M.); (A.D.V.); (C.D.); (F.C.); (E.O.); (M.P.)
| | - Enrico Orciuolo
- Hematology, Azienda Ospedaliero Universitaria Pisana (AOUP), 56126 Pisa, Italy; (M.R.M.); (A.D.V.); (C.D.); (F.C.); (E.O.); (M.P.)
| | - Matteo Pelosini
- Hematology, Azienda Ospedaliero Universitaria Pisana (AOUP), 56126 Pisa, Italy; (M.R.M.); (A.D.V.); (C.D.); (F.C.); (E.O.); (M.P.)
| | - Elisa Mazzantini
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (F.G.); (E.C.); (R.P.); (S.S.); (E.M.); (P.R.); (F.M.); (M.P.); (S.G.)
| | - Pietro Rossi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (F.G.); (E.C.); (R.P.); (S.S.); (E.M.); (P.R.); (F.M.); (M.P.); (S.G.)
| | - Francesco Mazziotta
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (F.G.); (E.C.); (R.P.); (S.S.); (E.M.); (P.R.); (F.M.); (M.P.); (S.G.)
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Mario Petrini
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (F.G.); (E.C.); (R.P.); (S.S.); (E.M.); (P.R.); (F.M.); (M.P.); (S.G.)
| | - Sara Galimberti
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (F.G.); (E.C.); (R.P.); (S.S.); (E.M.); (P.R.); (F.M.); (M.P.); (S.G.)
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8
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Tavarozzi R, Carulli G, Manzato E, Sammuri P, Ciabatti E, Petrini M. Large granular lymphocytes (LGL) in primary Sjögren syndrome (pSS): immunophenotype and review on the pathological role of T cells in pSS. Blood Res 2020; 55:120-123. [PMID: 32375464 PMCID: PMC7343554 DOI: 10.5045/br.2020.2020052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 04/07/2020] [Accepted: 04/16/2020] [Indexed: 12/29/2022] Open
Affiliation(s)
- Rita Tavarozzi
- Department of Clinical and Experimental Medicine, Section of Haematology, University of Pisa, Pisa, Italy
| | - Giovanni Carulli
- Department of Clinical and Experimental Medicine, Section of Haematology, University of Pisa, Pisa, Italy
| | - Enrica Manzato
- Department of Clinical and Experimental Medicine, Section of Haematology, University of Pisa, Pisa, Italy
| | - Paola Sammuri
- Department of Clinical and Experimental Medicine, Section of Haematology, University of Pisa, Pisa, Italy
| | - Elena Ciabatti
- Department of Clinical and Experimental Medicine, Section of Haematology, University of Pisa, Pisa, Italy
| | - Mario Petrini
- Department of Clinical and Experimental Medicine, Section of Haematology, University of Pisa, Pisa, Italy
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9
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Della Starza I, Cavalli M, De Novi LA, Genuardi E, Mantoan B, Drandi D, Barbero D, Ciabatti E, Grassi S, Gazzola A, Mannu C, Agostinelli C, Piccaluga PP, Bomben R, Degan M, Gattei V, Guarini A, Foà R, Galimberti S, Ladetto M, Ferrero S, Del Giudice I. Minimal residual disease (MRD) in non‐Hodgkin lymphomas: Interlaboratory reproducibility on marrow samples with very low levels of disease within the FIL (Fondazione Italiana Linfomi) MRD Network. Hematol Oncol 2019; 37:368-374. [PMID: 31325190 DOI: 10.1002/hon.2652] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 07/08/2019] [Accepted: 07/11/2019] [Indexed: 01/08/2023]
Abstract
In 2009, the four laboratories of the Fondazione Italiana Linfomi (FIL) minimal residual disease (MRD) Network started a collaborative effort to harmonize and standardize their methodologies at the national level, performing quality control (QC) rounds for follicular lymphoma (FL) and mantle cell lymphoma (MCL) MRD assessment. In 16 QC rounds between 2010 and 2017, the four laboratories received 208 bone marrow (BM) samples (126 FL; 82 MCL); 187 were analyzed, according to the EuroMRD Consortium guidelines, by both nested (NEST) polymerase chain reaction (PCR) and real-time quantitative (RQ) PCR for BCL2/IGH MBR or IGHV rearrangements. Here, we aimed at analyzing the samples that challenged the interlaboratory reproducibility and data interpretation. Overall, 156/187 BM samples (83%) were concordantly classified as NEST+/RQ+ or NEST-/RQ- by all the four laboratories. The remaining 31 samples (17%) resulted alternatively positive and negative in the interlaboratory evaluations, independently of the method and the type of rearrangement, and were defined "borderline" (brd) samples: 12 proved NEST brd/RQ brd, 7 NEST-/RQ brd, 10 NEST brd/RQ positive not quantifiable (PNQ), and 2 NEST brd/RQ-. Results did not change even increasing the number of replicates/sample. In 6/31 brd samples, droplet digital PCR (ddPCR) was tested and showed no interlaboratory discordance. Despite the high interlaboratory reproducibility in the MRD analysis obtained and maintained by the QC round strategy, samples with the lowest MRD levels can still represent a challenge: 17% (31/187) of our samples showed discordant results in interlaboratory assessments, with 6.4% (12/187) remained brd even applying the two methods. Thus, although representing a minority, brd samples are still problematic, especially when a clinically oriented interpretation of MRD results is required. Alternative, novel methods such as ddPCR and next-generation sequencing have the potential to overcome the current limitations.
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Affiliation(s)
- Irene Della Starza
- Hematology, Department of Translational and Precision Medicine “Sapienza” University of Rome Rome Italy
| | - Marzia Cavalli
- Hematology, Department of Translational and Precision Medicine “Sapienza” University of Rome Rome Italy
| | - Lucia Anna De Novi
- Hematology, Department of Translational and Precision Medicine “Sapienza” University of Rome Rome Italy
| | - Elisa Genuardi
- Department of Molecular Biotechnologies and Health Sciences, Division of Hematology University of Torino Turin Italy
| | - Barbara Mantoan
- Department of Molecular Biotechnologies and Health Sciences, Division of Hematology University of Torino Turin Italy
| | - Daniela Drandi
- Department of Molecular Biotechnologies and Health Sciences, Division of Hematology University of Torino Turin Italy
| | - Daniela Barbero
- Department of Molecular Biotechnologies and Health Sciences, Division of Hematology University of Torino Turin Italy
| | - Elena Ciabatti
- Division of Hematology, Department of Oncology Santa Chiara Hospital Pisa Italy
| | - Susanna Grassi
- Department of Medical Biotechnologies University of Siena Siena Italy
| | - Anna Gazzola
- Hematopathology Section, Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola‐Malpighi Hospital University of Bologna Bologna Italy
| | - Claudia Mannu
- Hematopathology Section, Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola‐Malpighi Hospital University of Bologna Bologna Italy
| | - Claudio Agostinelli
- Hematopathology Section, Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola‐Malpighi Hospital University of Bologna Bologna Italy
| | - Pier Paolo Piccaluga
- Hematopathology Section, Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola‐Malpighi Hospital University of Bologna Bologna Italy
| | - Riccardo Bomben
- Clinical and Experimental Onco‐Haematology Unit Centro di Riferimento Oncologico, I.R.C.C.S. Aviano Italy
| | - Massimo Degan
- Clinical and Experimental Onco‐Haematology Unit Centro di Riferimento Oncologico, I.R.C.C.S. Aviano Italy
| | - Valter Gattei
- Clinical and Experimental Onco‐Haematology Unit Centro di Riferimento Oncologico, I.R.C.C.S. Aviano Italy
| | - Anna Guarini
- Department of Molecular Medicine “Sapienza” University of Rome Rome Italy
| | - Robin Foà
- Hematology, Department of Translational and Precision Medicine “Sapienza” University of Rome Rome Italy
| | - Sara Galimberti
- Division of Hematology, Department of Oncology Santa Chiara Hospital Pisa Italy
| | - Marco Ladetto
- Division of Hematology Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo Alessandria Italy
| | - Simone Ferrero
- Department of Molecular Biotechnologies and Health Sciences, Division of Hematology University of Torino Turin Italy
| | - Ilaria Del Giudice
- Hematology, Department of Translational and Precision Medicine “Sapienza” University of Rome Rome Italy
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10
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Galimberti S, Genuardi E, Mazziotta F, Iovino L, Morabito F, Grassi S, Ciabatti E, Guerrini F, Petrini M. The Minimal Residual Disease in Non-Hodgkin's Lymphomas: From the Laboratory to the Clinical Practice. Front Oncol 2019; 9:528. [PMID: 31293969 PMCID: PMC6606710 DOI: 10.3389/fonc.2019.00528] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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: 01/23/2019] [Accepted: 05/31/2019] [Indexed: 01/05/2023] Open
Abstract
Minimal residual disease (MRD) in non-Hodgkin's lymphomas (NHLs) still represents matter of interest and debate: indeed, the new available treatments offer higher rates of complete responses and MRD negativity than in the past, with a positive impact on the long-term survival. Furthermore, the introduction of more sensitive and accurate molecular techniques, such as digital PCR (ddPCR) and the next generation sequencing techniques (NGS), increased the possibility of identifying molecular targets to be followed after therapy (such as rearrangement of immunoglobulins, fusion genes, or mutations). This review focused on how molecular biology can help to detect MRD in different types of NHLs and how MRD can change the clinical practice in 2019. In follicular lymphoma (FL), contamination of the grafts and molecular disease persistence after transplantation represent a negative prognostic factors. The combination of Rituximab or Obinutuzumab with Bendamustine seems to be the most effective way to clear MRD in FL patients receiving chemo-immunotherapy (further studies are in progress), and also 90Yttrium-Ibritumomab-Tiuxetan offers a deep clearance of molecular disease. Finally, molecular MRD can further stratify PET-negative cases, with subjects both PET- and MRD-negative presenting the best outcome. In aggressive lymphomas, MRD has a relevant prognostic power and can represent the platform for immunotherapy (such as CAR-T). In diffuse large B-cell lymphoma (DLBCL), the assessment of MRD in the plasma (where cell-free DNA and exosomes circulate) seems to be more predictive than the bone marrow analysis or peripheral blood mononuclear cells. Finally, NGS technologies could be more useful than the classical "patient allele-specific PCR" because they can identify any possible clone emerging during the treatment or follow-up, even if different from that identified at diagnosis, thus predicting relapse. After all, the present available molecular approaches can move MRD from the bench side to the clinical practice.
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Affiliation(s)
- Sara Galimberti
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Elisa Genuardi
- Department of Molecular Biotechnologies and Health Sciences, University of Torino, Turin, Italy
| | - Francesco Mazziotta
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.,GeNOMEC School of Doctorate, University of Siena, Siena, Italy
| | - Lorenzo Iovino
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.,Clinical and Translational Sciences School of Doctorate, University of Pisa, Pisa, Italy
| | - Fortunato Morabito
- Hematology Oncology Department, Augusta Victoria Hospital, East Jerusalem, Israel.,Biotechnology Research Unit, Cosenza, Italy
| | - Susanna Grassi
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.,GeNOMEC School of Doctorate, University of Siena, Siena, Italy
| | - Elena Ciabatti
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Francesca Guerrini
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Mario Petrini
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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11
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Grassi S, Palumbo S, Mariotti V, Liberati D, Guerrini F, Ciabatti E, Salehzadeh S, Baratè C, Balducci S, Ricci F, Buda G, Iovino L, Mazziotta F, Ghio F, Ercolano G, Di Paolo A, Cecchettini A, Baldini C, Mattii L, Pellegrini S, Petrini M, Galimberti S. The WNT Pathway Is Relevant for the BCR-ABL1-Independent Resistance in Chronic Myeloid Leukemia. Front Oncol 2019; 9:532. [PMID: 31293972 PMCID: PMC6601352 DOI: 10.3389/fonc.2019.00532] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 01/25/2019] [Accepted: 05/31/2019] [Indexed: 01/08/2023] Open
Abstract
Notwithstanding the introduction of Tyrosine Kinase Inhibitors (TKIs) revolutionized the outcome of Chronic Myeloid Leukemia (CML), one third of patients still suspends treatment for failure response. Recent research demonstrated that several BCR/ABL1-independent mechanisms can sustain resistance, but the relationship between these mechanisms and the outcome has not yet been fully understood. This study was designed to evaluate in a “real-life” setting if a change of expression of several genes involved in the WNT/BETA-CATENIN, JAK-STAT, and POLYCOMB pathways might condition the outcome of CML patients receiving TKIs. Thus, the expression of 255 genes, related to the aforementioned pathways, was measured by quantitative PCR after 6 months of therapy and compared with levels observed at diagnosis in 11 CML patients, in order to find possible correlations with quality of response to treatment and event-free-survival (EFS). These results were then re-analyzed by the principal component method (PCA) for tempting to better cluster resistant cases. After 12 months of therapy, 6 patients achieved an optimal response and 5 were “resistant;” after application of both statistical methods, it was evident that in all pathways a significant overall up-regulation occurred, and that WNT was the pathway mostly responsible for the TKIs resistance. Indeed, 100% of patients with a “low” up-regulation of this pathway achieved an optimal response vs. 33% of those who showed a “high” gene over-expression (p = 0.016). Analogously, the 24-months EFS resulted significantly influenced by the degree of up-regulation of the WNT signaling: all patients with a “low” up-regulation were event-free vs. 33% of those who presented a “high” gene expression (p = 0.05). In particular, the PCA analysis confirmed the role of WNT pathway and showed that the most significantly up-regulated genes with negative prognostic value were DKK, WNT6, WISP1, and FZD8. In conclusion, our results sustain the need of a wide and multitasking approach in order to understand the resistance mechanisms in CML.
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Affiliation(s)
- Susanna Grassi
- Hematology Division, University of Pisa, Pisa, Italy.,Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Sara Palumbo
- Department of Surgical, Medical and Molecular Pathology and Critical Care, University of Pisa, Pisa, Italy
| | - Veronica Mariotti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | | | | | | | | | | | | | - Gabriele Buda
- Hematology Division, University of Pisa, Pisa, Italy
| | | | - Francesco Mazziotta
- Hematology Division, University of Pisa, Pisa, Italy.,Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | | | | | - Antonello Di Paolo
- Department of Clinical and Experimental Medicine, Pharmacology Division, University of Pisa, Pisa, Italy
| | | | - Chiara Baldini
- Department of Clinical and Experimental Medicine, Rheumatology Division, University of Pisa, Pisa, Italy
| | - Letizia Mattii
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Silvia Pellegrini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Mario Petrini
- Hematology Division, University of Pisa, Pisa, Italy
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12
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Salehzadeh S, Guerrini F, Pizzano U, Grassi S, Ciabatti E, Iovino L, Buda G, Caracciolo F, Benedetti E, Orciuolo E, Pelosini M, Consani G, Carulli G, Metelli MR, Martini F, Mazziotta F, Mazzantini E, Rossi P, Tavarozzi R, Ricci F, Petrini M, Galimberti S. The assessment of minimal residual disease versus that of somatic mutations for predicting the outcome of acute myeloid leukemia patients. Cancer Cell Int 2019; 19:83. [PMID: 30992690 PMCID: PMC6449954 DOI: 10.1186/s12935-019-0807-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 12/03/2018] [Accepted: 03/28/2019] [Indexed: 12/22/2022] Open
Abstract
Background In addition to morphological and cytogenetic features, acute myeloid leukemias are characterized by mutations that can be used for target-therapy; also the minimal/measurable residual disease (MRD) could be an important prognostic factor. The purpose of this retrospective study was to investigate if somatic mutations could represent an additional prognostic value in respect of MRD alone. Method At baseline, 98 patients were tested for NPM1, FLT3, and for WT1 expression; 31 for ASXL1, TET2, IDH1, IDH2, N-RAS, WT1, c-KIT, RUNX1, and DNMT3A. The same genes have been also tested after induction and consolidation. Results Overall, 60.2% of our patients resulted mutated: 24.5% carried mutations of FLT3-ITD, 38.7% of NPM1, 48.4% of c-KIT, 25.8% of N-RAS and 19.3% of IDH2. The probability of achieving a complete response (CR) was higher for younger patients, with low ELN risk score, NPM1-mutated, with low WT1 levels, and without FLT3. The presence of additional mutations represented a poor predictive factor: only 19% of these cases achieved CR in comparison to 43% of subjects without any of it. Concerning survival, it was conditioned by a lower ELN risk score, younger age, reduction > 1 log of the NPM1 mutational burden, disappearance of FLT3 mutations and lower WT1 expression. Regarding the role of the additional mutations, they impaired the outcome of 20% of the already MRD-negative patients. Concerning the possibility of predicting relapse, we observed an increase of the NPM1 mutational burden at the time-point immediately preceding the relapse (about 2 months earlier) in 50% of subjects. Similarly concerning WT1, an increase of its expression anticipated disease recurrence in 64% of cases. Conclusions We demonstrated that additional somatic mutations are able to impair outcome of the already MRD-negative subjects. About MRD, we suggest a prognostic role also for the WT1 expression. Finally, we considered as relevant the assessment of NPM1 quantity clearance instead of the presence/absence of mutations alone. Still remains in doubt the utility in terms of long-term prognosis of a baseline more complex mutational screening; we could hypothesize that it would be useful for those patients where other markers are not available or who reached the MRD negativity. Electronic supplementary material The online version of this article (10.1186/s12935-019-0807-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Serena Salehzadeh
- 1Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy.,4University of Rome Tor Vergata, Rome, Italy.,5Ospedale S. Chiara, UO Ematologia, Via Roma, 67, 56126 Pisa, Italy
| | - Francesca Guerrini
- 1Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Umberto Pizzano
- 1Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Susanna Grassi
- 1Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Elena Ciabatti
- 1Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Lorenzo Iovino
- 1Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Gabriele Buda
- 1Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Francesco Caracciolo
- 1Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Edoardo Benedetti
- 1Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Enrico Orciuolo
- 1Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Matteo Pelosini
- 1Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Giovanni Consani
- 1Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Giovanni Carulli
- 1Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | | | - Francesca Martini
- 1Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Francesco Mazziotta
- 1Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy.,2GeNOMEC School of Doctorate, University of Siena, Siena, Italy
| | - Elisa Mazzantini
- 1Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Pietro Rossi
- 1Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Rita Tavarozzi
- 1Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Federica Ricci
- 1Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Mario Petrini
- 1Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Sara Galimberti
- 1Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
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13
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Galimberti S, Grassi S, Baratè C, Guerrini F, Ciabatti E, Perutelli F, Ricci F, Del Genio G, Montali M, Barachini S, Giuliani C, Ferreri MI, Valetto A, Abruzzese E, Ippolito C, Iurlo A, Bocchia M, Sicuranza A, Martino B, Iovino L, Buda G, Salehzadeh S, Petrini M, Di Paolo A, Mattii L. The Polycomb BMI1 Protein Is Co-expressed With CD26+ in Leukemic Stem Cells of Chronic Myeloid Leukemia. Front Oncol 2018; 8:555. [PMID: 30574454 PMCID: PMC6291509 DOI: 10.3389/fonc.2018.00555] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 07/13/2018] [Accepted: 11/08/2018] [Indexed: 11/24/2022] Open
Abstract
The Polycomb gene BMI1 expression exerts a negative predictive impact on several hematological malignancies, such as acute and chronic myeloid leukemia (CML), myelofibrosis, and follicular lymphoma. As already demonstrated in CML, BMI1 is responsible for the resistance to the tyrosine kinase inhibitors (TKIs) in a BCR-ABL1-independent way. Even if, it is unknown where BMI1 in CML is expressed (in progenitors or more mature cells). We decided, therefore, to evaluate if and where the BMI1 protein is located, focusing mainly on the CD34+/CD38-/CD26+ CML progenitors. To begin we measured, by flow cytometry, the proportion of CD34+/CD26+ cells in 31 bone marrow samples from 20 CML patients, at diagnosis and during treatment with imatinib. After that the bone marrow blood smears were stained with antibodies anti-CD26, BCR-ABL1, and BMI1. These smears were observed by a confocal laser microscope and a 3D reconstruction was then performed. At diagnosis, CD34+/CD26+ cells median value/μL was 0.48; this number increased from diagnosis to the third month of therapy and then reduced during treatment with imatinib. The number and behavior of the CD26+ progenitors were independent from the BCR-ABL1 expression, but they summed up what previously observed about the BMI1 expression modulation. In this work we demonstrate for the first time that in CML the BMI1 protein is co-expressed with BCR-ABL1 only in the cytoplasm of the CD26+ precursors; on the contrary, in other hematological malignancies where BMI1 is commonly expressed (follicular lymphoma, essential thrombocytemia, acute myeloid leukemia), it was not co-localized with CD26 or, obviously, with BCR-ABL1. Once translated into the clinical context, if BMI1 is a marker of stemness, our results would suggest the combination of the BMI1 inhibitors with TKIs as an interesting object of research, and, probably, as a promising way to overcome resistance in CML patients.
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Affiliation(s)
- Sara Galimberti
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Susanna Grassi
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.,GeNOMEC School of Doctorate, University of Siena, Siena, Italy
| | - Claudia Baratè
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Francesca Guerrini
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Elena Ciabatti
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Francesca Perutelli
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Federica Ricci
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giada Del Genio
- Unità Operativa Cytogenetics, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Marina Montali
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Serena Barachini
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Cecilia Giuliani
- Unità Operativa Cytogenetics, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | | | - Angelo Valetto
- Unità Operativa Cytogenetics, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | | | - Chiara Ippolito
- Section of Histology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Alessandra Iurlo
- Hematology Division, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Monica Bocchia
- Unità Operativa Ematologia, Università di Siena, Siena, Italy
| | - Anna Sicuranza
- Unità Operativa Ematologia, Università di Siena, Siena, Italy
| | - Bruno Martino
- Unità Operativa Ematologia, Ospedale Binco, Melacrino, Morelli, Reggio Calabria, Italy
| | - Lorenzo Iovino
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gabriele Buda
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Serena Salehzadeh
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Mario Petrini
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Antonello Di Paolo
- Section of Pharmacology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Letizia Mattii
- Section of Histology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Genuardi E, Barbero D, Dogliotti I, Mantoan B, Drandi D, Gambella M, Zaccaria GM, Monitillo L, Della Starza I, Cavalli M, De Novi LA, Ciabatti E, Grassi S, Gazzola A, Mannu C, Del Giudice I, Galimberti S, Agostinelli C, Piccaluga PP, Ladetto M, Ferrero S. Ficoll-hypaque separation vs whole blood lysis: Comparison of efficiency and impact on minimal residual disease analysis. Int J Lab Hematol 2017; 40:201-208. [PMID: 29205868 DOI: 10.1111/ijlh.12766] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 10/26/2017] [Indexed: 12/01/2022]
Abstract
INTRODUCTION The high-throughput era remarkably changed molecular laboratory practice. Actually, the increasing number of processed samples requires to reduce the risk of operator biases, by automating or simplifying as much as possible both the analytical and the pre-analytical phases. Minimal residual disease (MRD) studies in hematology often require a simultaneous processing of many bone marrow and peripheral blood samples from patients enrolled in prospective, multicenter, clinical trials, monitored at several planned time points. METHODS In this study, we demonstrate that red blood cell lysis (RBL) pre-analytical procedure can replace the time-consuming Ficoll stratification as cell recovering step. Here, we show a MRD comparison study using both total white blood cells and mononuclear cells recovered by the 2 procedures from 46 follicular lymphoma (FL), 15 multiple myeloma (MM), and 11 mantle cell lymphoma (MCL) patients enrolled in prospective clinical trials. RESULTS The experiments were performed in the 4 laboratories of the Fondazione Italiana Linfomi (FIL) MRD Network and showed superimposable results, in terms of good correlation (R = 0.87) of the MRD data obtained by recovering blood cells by the 2 approaches. CONCLUSION Based on these results, the FIL MRD Network suggests to optimize the pre-analytical phases introducing RBL approach for cell recovery in the clinical trials including MRD analysis.
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Affiliation(s)
- E. Genuardi
- Department of Molecular Biotechnologies and Health Sciences; Division of Hematology; University of Torino; Torino Italy
| | - D. Barbero
- Department of Molecular Biotechnologies and Health Sciences; Division of Hematology; University of Torino; Torino Italy
| | - I. Dogliotti
- Department of Molecular Biotechnologies and Health Sciences; Division of Hematology; University of Torino; Torino Italy
| | - B. Mantoan
- Department of Molecular Biotechnologies and Health Sciences; Division of Hematology; University of Torino; Torino Italy
| | - D. Drandi
- Department of Molecular Biotechnologies and Health Sciences; Division of Hematology; University of Torino; Torino Italy
| | - M. Gambella
- Department of Molecular Biotechnologies and Health Sciences; Division of Hematology; University of Torino; Torino Italy
| | - G. M. Zaccaria
- Department of Molecular Biotechnologies and Health Sciences; Division of Hematology; University of Torino; Torino Italy
- Division of Hematology; Department of Cellular Biotechnologies and Hematology; “Sapienza” University of Rome; Rome Italy
- Division of Hematology; Department of Oncology; Santa Chiara Hospital; Pisa Italy
- Department of Medical Biotechnologies; University of Siena; Siena Italy
- Hematopathology Section; Department of Experimental, Diagnostic, and Specialty Medicine; S. Orsola-Malpighi Hospital; Bologna University; Bologna Italy. Division of Hematology; Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo; Alessandria Italy. Department of Electronics and Telecommunications; Politecnico di Torino; Torino Italy
| | - L. Monitillo
- Department of Molecular Biotechnologies and Health Sciences; Division of Hematology; University of Torino; Torino Italy
| | - I. Della Starza
- Division of Hematology; Department of Cellular Biotechnologies and Hematology; “Sapienza” University of Rome; Rome Italy
| | - M. Cavalli
- Division of Hematology; Department of Cellular Biotechnologies and Hematology; “Sapienza” University of Rome; Rome Italy
| | - L. A. De Novi
- Division of Hematology; Department of Cellular Biotechnologies and Hematology; “Sapienza” University of Rome; Rome Italy
| | - E. Ciabatti
- Division of Hematology; Department of Oncology; Santa Chiara Hospital; Pisa Italy
| | - S. Grassi
- Division of Hematology; Department of Oncology; Santa Chiara Hospital; Pisa Italy
- Department of Medical Biotechnologies; University of Siena; Siena Italy
| | - A. Gazzola
- Hematopathology Section; Department of Experimental, Diagnostic, and Specialty Medicine; S. Orsola-Malpighi Hospital; Bologna University; Bologna Italy
| | - C. Mannu
- Hematopathology Section; Department of Experimental, Diagnostic, and Specialty Medicine; S. Orsola-Malpighi Hospital; Bologna University; Bologna Italy
| | - I. Del Giudice
- Division of Hematology; Department of Cellular Biotechnologies and Hematology; “Sapienza” University of Rome; Rome Italy
| | - S. Galimberti
- Division of Hematology; Department of Oncology; Santa Chiara Hospital; Pisa Italy
| | - C. Agostinelli
- Hematopathology Section; Department of Experimental, Diagnostic, and Specialty Medicine; S. Orsola-Malpighi Hospital; Bologna University; Bologna Italy
| | - P. P. Piccaluga
- Hematopathology Section; Department of Experimental, Diagnostic, and Specialty Medicine; S. Orsola-Malpighi Hospital; Bologna University; Bologna Italy
| | - M. Ladetto
- Division of Hematology; Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo; Alessandria Italy
| | - S. Ferrero
- Department of Molecular Biotechnologies and Health Sciences; Division of Hematology; University of Torino; Torino Italy
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Tarrini G, Ciabatti E, Pacini S, Galimberti S, Petrini I. GTF2I Mutations Are Common in Thymic Epithelial Tumors But Not in Hematological Malignancies. Anticancer Res 2017; 37:5459-5462. [PMID: 28982856 DOI: 10.21873/anticanres.11974] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 08/04/2017] [Revised: 08/27/2017] [Accepted: 08/28/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Mutation of general transcription factor IIi (GTF2I) (chromosome 7 c.74146970T>A) is common in thymic epithelial tumors and is a candidate driver aberration for cancer growth. To our knowledge, this mutation has not been described in other diseases. We evaluated the presence of GTF2I mutation in hematological malignancies. MATERIALS AND METHODS We sequenced samples from 31 patients with acute leukemia, 29 with chronic leukemia and 12 with myelodysplastic syndrome. The genomic fragment of exon 15 containing the hotspot of mutation was amplified using polymerase chain reaction (PCR) and sequenced. RESULTS We did not identify any GTF2I mutation in patients with hematological malignancies. CONCLUSION Even though our sample size was limited, our data and reports from the literature suggest that GTF2I mutation is not present or is uncommon in these diseases.
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Affiliation(s)
- Giulia Tarrini
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Elena Ciabatti
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Simone Pacini
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sara Galimberti
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Iacopo Petrini
- General Pathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
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16
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Galimberti S, Bucelli C, Arrigoni E, Baratè C, Grassi S, Ricci F, Guerrini F, Ciabatti E, Fava C, D'Avolio A, Fontanelli G, Cambrin GR, Isidori A, Loscocco F, Caocci G, Greco M, Bocchia M, Aprile L, Gozzini A, Scappini B, Cattaneo D, Scortechini AR, La Nasa G, Bosi A, Leoni P, Danesi R, Saglio G, Visani G, Cortelezzi A, Petrini M, Iurlo A, Di Paolo A. The hOCT1 and ABCB1 polymorphisms do not influence the pharmacodynamics of nilotinib in chronic myeloid leukemia. Oncotarget 2017; 8:88021-88033. [PMID: 29152138 PMCID: PMC5675690 DOI: 10.18632/oncotarget.21406] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 06/24/2017] [Accepted: 08/29/2017] [Indexed: 11/25/2022] Open
Abstract
First-line nilotinib in chronic myeloid leukemia is more effective than imatinib to achieve early and deep molecular responses, despite poor tolerability or failure observed in one-third of patients. The toxicity and efficacy of tyrosine kinase inhibitors might depend on the activity of transmembrane transporters. However, the impact of transporters genes polymorphisms in nilotinib setting is still debated. We investigated the possible correlation between single nucleotide polymorphisms of hOCT1 (rs683369 [c.480C>G]) and ABCB1 (rs1128503 [c.1236C>T], rs2032582 [c.2677G>T/A], rs1045642 [c.3435C>T]) and nilotinib efficacy and toxicity in a cohort of 78 patients affected by chronic myeloid leukemia in the context of current clinical practice. The early molecular response was achieved by 81% of patients while 64% of them attained deep molecular response (median time, 26 months). The 36-month event-free survival was 86%, whereas 58% of patients experienced toxicities. Interestingly, hOCT1 and ABCB1 polymorphisms alone or in combination did not influence event-free survival or the adverse events rate. Therefore, in contrast to data obtained in patients treated with imatinib, hOCT1 and ABCB1 polymorphisms do not impact on nilotinib efficacy or toxicity. This could be relevant in the choice of the first-line therapy: patients with polymorphisms that negatively condition imatinib efficacy might thus receive nilotinib as first-line therapy.
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Affiliation(s)
- Sara Galimberti
- Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Cristina Bucelli
- Oncohematology Division, IRCCS Ca' Granda, Maggiore Policlinico Hospital Foundation, University of Milan, Milano, Italy
| | - Elena Arrigoni
- Department of Clinical and Experimental Medicine, Section of Pharmacology, University of Pisa, Pisa, Italy
| | - Claudia Baratè
- Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Susanna Grassi
- Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy.,GeNOMEC, University of Siena, Siena, Italy
| | - Federica Ricci
- Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Francesca Guerrini
- Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Elena Ciabatti
- Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Carmen Fava
- Hematology Division, Ospedale Mauriziano, Torino, Italy
| | - Antonio D'Avolio
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Torino, Torino, Italy
| | - Giulia Fontanelli
- Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Giovanna Rege Cambrin
- Department of Clinical and Biological Sciences, University of Torino, AOU San Luigi Gonzaga, Torino, Italy
| | - Alessandro Isidori
- Hematology and Stem Cell Transplant Center, San Salvatore Hospital, Pesaro, Italy
| | - Federica Loscocco
- Hematology and Stem Cell Transplant Center, San Salvatore Hospital, Pesaro, Italy
| | - Giovanni Caocci
- Department of Medical Sciences, University of Cagliari, Cagliari, Italy
| | - Marianna Greco
- Department of Medical Sciences, University of Cagliari, Cagliari, Italy
| | - Monica Bocchia
- Division of Hematology, Ospedale Le Scotte, University of Siena, Siena, Italy
| | - Lara Aprile
- Division of Hematology, Ospedale Le Scotte, University of Siena, Siena, Italy
| | - Antonella Gozzini
- Division of Hematology, AOU Careggi, University of Florence, Firenze, Italy
| | - Barbara Scappini
- Division of Hematology, AOU Careggi, University of Florence, Firenze, Italy
| | - Daniele Cattaneo
- Oncohematology Division, IRCCS Ca' Granda, Maggiore Policlinico Hospital Foundation, University of Milan, Milano, Italy
| | | | - Giorgio La Nasa
- Department of Medical Sciences, University of Cagliari, Cagliari, Italy
| | - Alberto Bosi
- Division of Hematology, AOU Careggi, University of Florence, Firenze, Italy
| | - Pietro Leoni
- Division of Hematology, Marche Polytechnic University, Ancona, Italy
| | - Romano Danesi
- Department of Clinical and Experimental Medicine, Section of Pharmacology, University of Pisa, Pisa, Italy
| | | | - Giuseppe Visani
- Hematology and Stem Cell Transplant Center, San Salvatore Hospital, Pesaro, Italy
| | - Agostino Cortelezzi
- Oncohematology Division, IRCCS Ca' Granda, Maggiore Policlinico Hospital Foundation, University of Milan, Milano, Italy
| | - Mario Petrini
- Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Alessandra Iurlo
- Oncohematology Division, IRCCS Ca' Granda, Maggiore Policlinico Hospital Foundation, University of Milan, Milano, Italy
| | - Antonello Di Paolo
- Department of Clinical and Experimental Medicine, Section of Pharmacology, University of Pisa, Pisa, Italy
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17
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Galimberti S, Ciabatti E, Ercolano G, Grassi S, Guerrini F, Cecconi N, Rousseau M, Cervetti G, Mazziotta F, Iovino L, Falzetti F, Falcinelli F, Bosi A, Rigacci L, Kovalchuk S, Vallisa D, Macchia L, Ciancia E, Petrini M. The Combination of Rituximab and Bendamustine as First-Line Treatment Is Highly Effective in the Eradicating Minimal Residual Disease in Follicular Lymphoma: An Italian Retrospective Study. Front Pharmacol 2017; 8:413. [PMID: 28706485 PMCID: PMC5489595 DOI: 10.3389/fphar.2017.00413] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 04/28/2017] [Accepted: 06/13/2017] [Indexed: 12/21/2022] Open
Abstract
R-Bendamustine is an effective treatment for follicular lymphoma (FL). Previous large trials demonstrated the prognostic role of the molecular minimal residual disease (MRD) during the most frequently adopted chemotherapeutic regimens, but there are not yet conclusive data about the effect of combination of rituximab (R) and bendamustine in terms of MRD clearance. Thus, the aim of this retrospective study was to assess if and in what extent the combination of rituximab and bendamustine would exert a significant reduction of the molecular disease in 48 previously untreated FL patients. The molecular marker at baseline was found in the 62.5% of cases; no significant differences were observed between patients with or without the molecular marker in respect of the main clinical features. Moreover, the quantization of the baseline molecular tumor burden showed a great variability: the median value was 1.4 × 10-2 copies, ranging from 3 × 10-5 to 4 × 104. The initial molecular tumor burden did not correlate with clinical features and did not impact on the subsequent quality of response. After treatment, 93% of cases became MRD-negative; the median reduction of the BCL2/JH load was 4 logs. The 2-years PFS was 85%; it was significantly longer for patients in complete than for those in partial response (91 vs. 57%; p = 0.002), and for cases with lower FLIPI-2 score (88 vs. 60%; p = 0.004). On the contrary, PFS did not differ between patients with or without the molecular marker at baseline; a molecular tumor burden 15 times higher was observed in the relapsed subgroup in comparison to the relapse-free one, but this difference did not change the PFS length. The 2-years OS was 93.6%; the only variable that significantly impacted on it was the FLIPI-2 score; the presence of the molecular marker at baseline or its behavior after treatment did not impact on survival. This study, even if retrospective and conducted on a small series of patients, would represent a proof of concept that R-bendamustine is able to so efficaciously eradicate MRD that it could be able to by-pass the prognostic significance of MRD already demonstrated for other chemotherapeutic regimens in FL.
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Affiliation(s)
- Sara Galimberti
- Section of Hematology, Department of Clinical and Experimental Medicine, University of PisaPisa, Italy
| | - Elena Ciabatti
- Section of Hematology, Department of Clinical and Experimental Medicine, University of PisaPisa, Italy
| | - Giacomo Ercolano
- Section of Hematology, Department of Clinical and Experimental Medicine, University of PisaPisa, Italy
| | - Susanna Grassi
- Section of Hematology, Department of Clinical and Experimental Medicine, University of PisaPisa, Italy
- Doctoral School of Genetics, Oncology and Clinical Medicine (GeNOMEC), University of SienaSiena, Italy
| | - Francesca Guerrini
- Section of Hematology, Department of Clinical and Experimental Medicine, University of PisaPisa, Italy
| | - Nadia Cecconi
- Section of Hematology, Department of Clinical and Experimental Medicine, University of PisaPisa, Italy
| | - Martina Rousseau
- Section of Hematology, Department of Clinical and Experimental Medicine, University of PisaPisa, Italy
| | - Giulia Cervetti
- Section of Hematology, Department of Clinical and Experimental Medicine, University of PisaPisa, Italy
| | - Francesco Mazziotta
- Section of Hematology, Department of Clinical and Experimental Medicine, University of PisaPisa, Italy
| | - Lorenzo Iovino
- Section of Hematology, Department of Clinical and Experimental Medicine, University of PisaPisa, Italy
| | - Franca Falzetti
- Department of Hematology, University of PerugiaPerugia, Italy
| | | | - Alberto Bosi
- Department of Hematology, University of FirenzeFirenze, Italy
| | - Luigi Rigacci
- Department of Hematology, University of FirenzeFirenze, Italy
| | - Sofia Kovalchuk
- Department of Hematology, University of FirenzeFirenze, Italy
| | - Daniele Vallisa
- Department of Hematology and Oncology, Azienda Unità Sanitaria Locale di PiacenzaPiacenza, Italy
| | - Lucia Macchia
- Section of Hematology, Department of Clinical and Experimental Medicine, University of PisaPisa, Italy
| | - Eugenio Ciancia
- Pathology, Azienda Ospedaliero Universitaria PisanaPisa, Italy
| | - Mario Petrini
- Section of Hematology, Department of Clinical and Experimental Medicine, University of PisaPisa, Italy
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18
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Ciabatti E, Valetto A, Bertini V, Ferreri MI, Guazzelli A, Grassi S, Guerrini F, Petrini I, Metelli MR, Caligo MA, Rossi S, Galimberti S. Myelodysplastic syndromes: advantages of a combined cytogenetic and molecular diagnostic workup. Oncotarget 2017; 8:79188-79200. [PMID: 29108298 PMCID: PMC5668031 DOI: 10.18632/oncotarget.16578] [Citation(s) in RCA: 5] [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: 08/23/2016] [Accepted: 03/14/2017] [Indexed: 12/26/2022] Open
Abstract
In this study we present a new diagnostic workup for the myelodysplastic syndromes (MDS) including FISH, aCGH, and somatic mutation assays in addition to the conventional cytogenetics (CC). We analyzed 61 patients by CC, FISH for chromosome 5, 7, 8 and PDGFR rearrangements, aCGH, and PCR for ASXL1, EZH2, TP53, TET2, RUNX1, DNMT3A, SF3B1 somatic mutations. Moreover, we quantified WT1 and RPS14 gene expression levels, in order to find their possible adjunctive value and their possible clinical impact. CC analysis showed 32% of patients with at least one aberration. FISH analysis detected chromosomal aberrations in 24% of patients and recovered 5 cases (13.5%) at normal karyotype (two 5q- syndromes, one del(7) case, two cases with PDGFR rearrangement). The aGCH detected 10 "new" unbalanced cases in respect of the CC, including one with alteration of the ETV6 gene. After mutational analysis, 33 patients (54%) presented at least one mutation and represented the only marker of clonality in 36% of all patients. The statistical analysis confirmed the prognostic role of CC either on overall or on progression-free-survival. In addition, deletions detected by aCGH and WT1 over-expression negatively conditioned survival. In conclusion, our work showed that 1) the addition of FISH (at least for chr. 5 and 7) can improve the definition of the risk score; 2) mutational analysis, especially for the TP53 and SF3B1, could better define the type of MDS and represent a "clinical warning"; 3) the aCGH use could be probably applied to selected cases (with suboptimal response or failure).
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Affiliation(s)
- Elena Ciabatti
- Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy.,GenOMec, University of Siena, Siena, Italy
| | - Angelo Valetto
- Laboratory of Medical Genetics, Azienda Ospedaliero-Universitaria Pisana, S. Chiara Hospital, Pisa, Italy
| | - Veronica Bertini
- Laboratory of Medical Genetics, Azienda Ospedaliero-Universitaria Pisana, S. Chiara Hospital, Pisa, Italy
| | - Maria Immacolata Ferreri
- Laboratory of Medical Genetics, Azienda Ospedaliero-Universitaria Pisana, S. Chiara Hospital, Pisa, Italy
| | - Alice Guazzelli
- Laboratory of Medical Genetics, Azienda Ospedaliero-Universitaria Pisana, S. Chiara Hospital, Pisa, Italy
| | - Susanna Grassi
- Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy.,GenOMec, University of Siena, Siena, Italy
| | - Francesca Guerrini
- Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Iacopo Petrini
- Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - Maria Rita Metelli
- Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Maria Adelaide Caligo
- Laboratory of Medical Genetics, Azienda Ospedaliero-Universitaria Pisana, S. Chiara Hospital, Pisa, Italy
| | - Simona Rossi
- Laboratory of Medical Genetics, Azienda Ospedaliero-Universitaria Pisana, S. Chiara Hospital, Pisa, Italy
| | - Sara Galimberti
- Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
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19
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Guerrini F, Paolicchi M, Ghio F, Ciabatti E, Grassi S, Salehzadeh S, Ercolano G, Metelli MR, Del Re M, Iovino L, Petrini I, Carulli G, Cecconi N, Rousseau M, Cervetti G, Galimberti S. The Droplet Digital PCR: A New Valid Molecular Approach for the Assessment of B-RAF V600E Mutation in Hairy Cell Leukemia. Front Pharmacol 2016; 7:363. [PMID: 27790140 PMCID: PMC5061817 DOI: 10.3389/fphar.2016.00363] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [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: 09/04/2016] [Accepted: 09/20/2016] [Indexed: 12/22/2022] Open
Abstract
Hairy cell leukemia (HCL) is a chronic lymphoproliferative B-cell disorder where the B-RAF V600E mutation has been recently detected, as reported for solid neoplasias but not for other B-cell lymphomas. The digital droplet PCR (dd-PCR) is a molecular technique that, without standard references, is able to accurately quantitate DNA mutations. ddPCR could be an useful instrument for the detection of the B-RAF V600E mutation in HCL, where the minimal residual disease monitoring is fundamental for planning a patients-targeted treatment in the era of new anti-CD20 and anti-RAF compounds. This retrospective study enrolled 47 patients observed at the Hematology Unit of the University of Pisa, Italy, from January 2005 to January 2014: 27 patients were affected by “classic” HCL, two by the variant HCL (vHCL), and 18 by splenic marginal zone lymphoma (SMZL). The aim of the study was to compare dd-PCR to “classic” quantitative PCR (QT-PCR) in terms of sensitivity and specificity and to demonstrate its possible use in HCL. Results showed that: (1) the sensitivity of dd-PCR is about half a logarithm superior to QT-PCR (5 × 10-5 vs. 2.5 × 10-4), (2) the specificity of the dd-PCR is comparable to QT-PCR (no patient with marginal splenic lymphoma or HCL variant resulted mutated), (3) its high sensitivity would allow to use dd-PCR in the monitoring of MRD. At the end of treatment, among patients in complete remission, 33% were still MRD-positive by dd-PCR versus 28% by QT-PCR versus 11% by the evaluation of the B-cell clonality, after 12 months, dd-PCR was comparable to QT-PCR and both detected the B-RAF mutation in 15% of cases defined as MRD-negative by IgH rearrangement. Moreover, (4) the feasibility and the costs of dd-PCR are comparable to those of QT-PCR. In conclusion, our study supports the introduction of dd-PCR in the scenario of HCL, also during the follow-up.
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Affiliation(s)
- Francesca Guerrini
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa Pisa, Italy
| | - Matteo Paolicchi
- UO hematology, Azienda Ospedaliero-Universitaria Pisana Pisa, Italy
| | - Francesco Ghio
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa Pisa, Italy
| | - Elena Ciabatti
- UO hematology, Azienda Ospedaliero-Universitaria Pisana Pisa, Italy
| | - Susanna Grassi
- Section of Hematology, Department of Clinical and Experimental Medicine, University of PisaPisa, Italy; GeNoMEC, University of SienaSiena, Italy
| | - Serena Salehzadeh
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa Pisa, Italy
| | - Giacomo Ercolano
- UO hematology, Azienda Ospedaliero-Universitaria Pisana Pisa, Italy
| | - Maria R Metelli
- UO hematology, Azienda Ospedaliero-Universitaria Pisana Pisa, Italy
| | - Marzia Del Re
- Clinical Pharmacology and Pharmacogenetic Unit, Department of Clinical and Experimental Medicine, University of Pisa Pisa, Italy
| | - Lorenzo Iovino
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa Pisa, Italy
| | - Iacopo Petrini
- Section of Pathology, Department of Translational Medicine and New Technologies, University of Pisa Pisa, Italy
| | - Giovanni Carulli
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa Pisa, Italy
| | - Nadia Cecconi
- UO hematology, Azienda Ospedaliero-Universitaria Pisana Pisa, Italy
| | - Martina Rousseau
- UO hematology, Azienda Ospedaliero-Universitaria Pisana Pisa, Italy
| | - Giulia Cervetti
- UO hematology, Azienda Ospedaliero-Universitaria Pisana Pisa, Italy
| | - Sara Galimberti
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa Pisa, Italy
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20
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Crea F, Di Paolo A, Liu HH, Polillo M, Clermont PL, Guerrini F, Ciabatti E, Ricci F, Baratè C, Fontanelli G, Barsotti S, Morganti R, Danesi R, Wang Y, Petrini M, Galimberti S, Helgason CD. Polycomb genes are associated with response to imatinib in chronic myeloid leukemia. Epigenomics 2015; 7:757-65. [PMID: 26343356 DOI: 10.2217/epi.15.35] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
AIM Imatinib is a tyrosine kinase inhibitor that has revolutionized the treatment of chronic myeloid leukemia (CML). Despite its efficacy, about a third of patients discontinue the treatment due to therapy failure or intolerance. The rational identification of patients less likely to respond to imatinib would be of paramount clinical relevance. We have shown that transmembrane transporter hOCT1 genotyping predicts imatinib activity. In parallel, Polycomb group genes (PcGs) are epigenetic repressors implicated in CML progression and in therapy resistance. PATIENTS & METHODS We measured the expression of eight PcGs in paired pre- and post-imatinib bone marrow samples from 30 CML patients. RESULTS BMI1, PHC3, CBX6 and CBX7 expression was significantly increased during imatinib treatment. Post-treatment levels of CBX6 and CBX7 predicted 3-month response rate. Measurement of post-treatment BMI1 levels improved the predictive power of hOCT1 genotyping. CONCLUSION These results suggest that the expression levels of PcGs might be useful for a more accurate risk stratification of CML patients.
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Affiliation(s)
- Francesco Crea
- Experimental Therapeutics, BCCA Research Centre, 675 W 10th Avenue, Vancouver, BC, V5Z 1L3, Canada.,Vancouver Prostate Centre, Vancouver General Hospital, 2660 Oak Street, Vancouver, BC, V6H 3Z6, Canada.,Department of Life Health & Chemical Sciences, The Open University, UK
| | - Antonello Di Paolo
- Department of Clinical & Experimental Medicine, Section of Pharmacology, University of Pisa, Pisa, Italy
| | - Hui Hsuan Liu
- Experimental Therapeutics, BCCA Research Centre, 675 W 10th Avenue, Vancouver, BC, V5Z 1L3, Canada
| | - Marialuisa Polillo
- Department of Clinical & Experimental Medicine, Section of Pharmacology, University of Pisa, Pisa, Italy
| | - Pier-Luc Clermont
- Experimental Therapeutics, BCCA Research Centre, 675 W 10th Avenue, Vancouver, BC, V5Z 1L3, Canada
| | - Francesca Guerrini
- Department of Clinical & Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Elena Ciabatti
- Department of Clinical & Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Federica Ricci
- Department of Clinical & Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Claudia Baratè
- Department of Clinical & Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Giulia Fontanelli
- Department of Clinical & Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Sara Barsotti
- Department of Clinical & Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Riccardo Morganti
- Department of Clinical & Experimental Medicine, Section of Statistics, University of Pisa, Pisa, Italy
| | - Romano Danesi
- Department of Clinical & Experimental Medicine, Section of Pharmacology, University of Pisa, Pisa, Italy
| | - Yuzhuo Wang
- Experimental Therapeutics, BCCA Research Centre, 675 W 10th Avenue, Vancouver, BC, V5Z 1L3, Canada.,Vancouver Prostate Centre, Vancouver General Hospital, 2660 Oak Street, Vancouver, BC, V6H 3Z6, Canada
| | - Mario Petrini
- Department of Clinical & Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Sara Galimberti
- Department of Clinical & Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Cheryl D Helgason
- Experimental Therapeutics, BCCA Research Centre, 675 W 10th Avenue, Vancouver, BC, V5Z 1L3, Canada
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21
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Fontanelli G, Baratè C, Ciabatti E, Guerrini F, Grassi S, Del Re M, Morganti R, Petrini I, Arici R, Barsotti S, Metelli MR, Danesi R, Galimberti S. Real-Time PCR and Droplet Digital PCR: two techniques for detection of the JAK2(V617F) mutation in Philadelphia-negative chronic myeloproliferative neoplasms. Int J Lab Hematol 2015; 37:766-73. [PMID: 26189968 DOI: 10.1111/ijlh.12404] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Accepted: 06/19/2015] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Philadelphia-negative chronic myeloproliferative neoplasms (MPNs) are clonal disorders that present JAK2(V617F) mutation in 50-95% of cases. The main objective of this study was the comparison of two PCR methods, real-time (qPCR) and droplet digital PCR (DD-PCR) for detection of the JAK2(V617F) mutation, to assess analytic sensitivity, specificity, and feasibility of the two methods. METHODS Ninety-nine patients with MPN of 225 presenting the JAK2(V617F) mutation by qPCR have been evaluated by DD-PCR also. RESULTS We demonstrated an absolute concordance in terms of specificity between the two methods, DD-PCR showing a higher sensitivity (half a log higher than qPCR). As expected, a progressive increase of mutant allele burden was observed from essential thrombocythemia (ET) to polycythemia vera (PV) and primary myelofibrosis (PMF) to secondary myelofibrosis (SMF). CONCLUSION In conclusion, our study showed that DD-PCR could represent a new and promising technological evolution for detection of JAK2 mutation in MPNs.
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Affiliation(s)
- G Fontanelli
- U.O. Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - C Baratè
- U.O. Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - E Ciabatti
- U.O. Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.,GenOMEC, University of Siena, Siena, Italy
| | - F Guerrini
- U.O. Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - S Grassi
- U.O. Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - M Del Re
- U.O. Pharmacology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - R Morganti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - I Petrini
- Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - R Arici
- U.O. Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - S Barsotti
- U.O. Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - M R Metelli
- U.O. Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - R Danesi
- U.O. Pharmacology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - S Galimberti
- U.O. Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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22
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Carulli G, Ottaviano V, Sammuri P, Domenichini C, Guerri V, Rousseau M, Ciancia EM, Ciabatti E, Petrini M. Kinetics of hematogones in bone marrow samples from patients with non-Hodgkin lymphomas treated with rituximab-containing regimens: a flow cytometric study. Int J Hematol 2015; 102:59-66. [PMID: 25953308 DOI: 10.1007/s12185-015-1798-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 04/13/2015] [Accepted: 04/13/2015] [Indexed: 01/17/2023]
Abstract
Treatment with rituximab, either alone or in combination with antiblastic drugs, causes significant depletion of circulating B-lymphocytes and modifications of B cell maturation in the bone marrow. In the present study, we analyzed the kinetics of hematogones in bone marrow samples from 55 patients suffering from non-Hodgkin lymphomas and treated with rituximab-containing regimens. Maturation arrest at the level of stage 2 hematogones, along with complete depletion of naïve, mature B-lymphocytes, was observed as short-term effects (2 months after completion of chemo-immunotherapy). Further bone marrow samples, obtained 12 months after the last rituximab infusion in 21 patients undergoing long-term follow-up and treated with rituximab maintenance therapy, showed complete normalization of B-lymphocyte ontogeny. Hypogammaglobulinemia developed in 26 patients, and was still observed in nine of the 21 patients undergoing long-term follow-up. Our study provides novel data on hematogone kinetics in the setting of patients with non-Hodgkin lymphomas treated with chemo-immunotherapy containing rituximab and with rituximab maintenance. Our observations show that hypogammaglobulinemia can persist in a significant percentage of patients, despite complete recovery of B-lymphocyte ontogeny.
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Affiliation(s)
- Giovanni Carulli
- Division of Hematology, Department of Clinical and Experimental Medicine, Santa Chiara Hospital, University of Pisa, 56126, Pisa, Italy,
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23
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Ciabatti E, Ferreri M, Valetto A, Bertini V, Guazzelli A, Azzarà A, Petrini I, Guerrini F, Grassi S, Metelli M, Simi P, Petrini M, Galimberti S. 95 MDS: AN INTEGRATED WORKUP FOR A CORRECT DIAGNOSIS. Leuk Res 2015. [DOI: 10.1016/s0145-2126(15)30096-5] [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: 10/23/2022]
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24
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Grassi S, Ciabatti E, Rousseau M, Guerrini F, Cecconi N, Cervetti G, Musto P, Rocca FL, Cilloni D, Gaidano V, Petrini I, Poloni A, Palumbo G, Petrini M, Galimberti S. 149 LOW RPS14 EXPRESSION IS FREQUENTLY FOUND IN NON-5Q-MYELODYSPLASTIC SYNDROMES. Leuk Res 2015. [DOI: 10.1016/s0145-2126(15)30150-8] [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: 10/23/2022]
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25
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Rossi D, Bruscaggin A, La Cava P, Galimberti S, Ciabatti E, Luminari S, Rigacci L, Tucci A, Pulsoni A, Bertoldero G, Vallisa D, Rusconi C, Spina M, Arcaini L, Angrilli F, Stelitano C, Merli F, Gaidano G, Federico M, Palumbo GA. The genotype of MLH1 identifies a subgroup of follicular lymphoma patients who do not benefit from doxorubicin: FIL-FOLL study. Haematologica 2015; 100:517-24. [PMID: 25596266 DOI: 10.3324/haematol.2014.108183] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Though most follicular lymphoma biomarkers rely on tumor features, the host genetic background may also be relevant for outcome. Here we aimed at verifying the contribution of candidate polymorphisms of FCγ receptor, DNA repair and detoxification genes to prognostic stratification of follicular lymphoma treated with immunochemotherapy. The study was based on 428 patients enrolled in the FOLL05 prospective trial that compared three standard-of-care regimens (rituximab-cyclophosphamide-vincristine-prednisone versus rituximab-cyclophosphamide-doxorubicin-vincristine-prednisone versus rituximab-fludarabine-mitoxantrone) for the first line therapy of advanced follicular lymphoma. Polymorphisms were genotyped on peripheral blood DNA samples. The primary endpoint was time to treatment failure. Polymorphisms of FCGR2A and FCGR3A, which have been suggested to influence the activity of rituximab as a single agent, did not affect time to treatment failure in the pooled analysis of the three FOLL05 treatment arms that combined rituximab with chemotherapy (P=0.742, P=0.252, respectively). These results were consistent even when the analysis was conducted by intention to treat, indicating that different chemotherapy regimens and loads did not interact differentially with the FCGR2A and FCGR3A genotypes. The genotype of MLH1, which regulates the genotoxic effect of doxorubicin, significantly affected time to treatment failure in patients in the rituximab-cyclophosphamide-doxorubicin-vincristine-prednisone arm (P=0.001; q<0.1), but not in arms in which patients did not receive doxorubicin (i.e., the rituximab-cyclophosphamide-vincristine-prednisone and rituximab-fludarabine-mitoxantrone arms). The impact of MLH1 on time to treatment failure was independent after adjusting for the Follicular Lymphoma International Prognostic Index and other potential confounding variables by multivariate analysis. These data indicate that MLH1 genotype is a predictor of failure to benefit from rituximab-cyclophosphamide-doxorubicin-vincristine-prednisone treatment in advanced follicular lymphoma and confirm that FCGR2A and FCGR3A polymorphisms have no impact when follicular lymphoma is treated with rituximab plus chemotherapy (clinicaltrials.gov identifier: NCT00774826).
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Affiliation(s)
- Davide Rossi
- Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara
| | - Alessio Bruscaggin
- Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara
| | - Piera La Cava
- Division of Hematology, AOU "Policlinico V. Emanuele", Catania
| | - Sara Galimberti
- Department of Oncology, Transplants and Advanced Technologies, Section of Haematology, University of Pisa
| | - Elena Ciabatti
- Department of Oncology, Transplants and Advanced Technologies, Section of Haematology, University of Pisa
| | - Stefano Luminari
- Department of Oncology and Hematology, University of Modena and Reggio Emilia, Modena
| | - Luigi Rigacci
- Division of Hematology, Azienda Ospedaliero Universitaria Careggi, Florence
| | - Alessandra Tucci
- Division of Hematology, Spedali Civili Hospital and University, Brescia
| | - Alessandro Pulsoni
- Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome
| | | | | | - Chiara Rusconi
- Division of Hematology, Department of Hematology and Oncology, Niguarda Hospital, Milan
| | - Michele Spina
- Division of Medical Oncology A, National Cancer Institute, Aviano
| | - Luca Arcaini
- Divisions of Hematology, Fondazione IRCCS Policlinico San Matteo, University of Pavia
| | | | | | - Francesco Merli
- Hematology Unit, Arcispedale Santa Maria Nuova, Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy
| | - Gianluca Gaidano
- Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara
| | - Massimo Federico
- Department of Oncology and Hematology, University of Modena and Reggio Emilia, Modena
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26
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Galimberti S, Luminari S, Ciabatti E, Grassi S, Guerrini F, Dondi A, Marcheselli L, Ladetto M, Piccaluga PP, Gazzola A, Mannu C, Monitillo L, Mantoan B, Del Giudice I, Della Starza I, Cavalli M, Arcaini L, Tucci A, Palumbo GA, Rigacci L, Pulsoni A, Vitolo U, Boccomini C, Vallisa D, Bertoldero G, Gaidano G, Musto P, Petrini M, Federico M. Minimal residual disease after conventional treatment significantly impacts on progression-free survival of patients with follicular lymphoma: the FIL FOLL05 trial. Clin Cancer Res 2014; 20:6398-405. [PMID: 25316810 DOI: 10.1158/1078-0432.ccr-14-0407] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The role of the minimal residual disease (MRD) in follicular lymphoma is still debated. In this study, we assessed whether the BCL2/IGH rearrangement could have a prognostic role in patients receiving R-CHOP, R-FM, or R-CVP. EXPERIMENTAL DESIGN DNAs from 415 patients among the 504 cases enrolled in the FOLL05 trial (NCT00774826) were centralized and assessed for the BCL2/IGH at diagnosis, at the end of treatment, and after 12 and 24 months. RESULTS At diagnosis, the molecular marker was detected in 53% of cases. Patients without molecular marker or with a low molecular tumor burden (<1 × 10(-4) copies) showed higher complete remission (CR) rate and longer progression-free survival (PFS; 3-year PFS 80% vs. 59%; P = 0.015). PFS was significantly conditioned by the PCR status at 12 and 24 months, with 3-year PFS of 66% for MRD(-) cases versus 41% for those MRD(+) at 12 months (P = 0.015), and 84% versus 50% at 24 months (P = 0.014). The MRD negativity at 12 and 24 months resulted in an improved PFS both in CR and in partial remission (PR) patients (3-year PFS = 72% for cases CR/PCR(-) vs. 32% for those CR/PCR(+) vs. 62% for those PR/PCR(-) and 25% for patients in PR/PCR(+); P = 0.001). The prognostic value of MRD at 12 and 24 months of follow-up was confirmed also in multivariate analysis. CONCLUSIONS In this study, standardized molecular techniques have been adopted and applied on bone marrow samples from a large cohort. Data reported show that the MRD detection is a powerful independent predictor of PFS in patients with follicular lymphoma receiving conventional chemoimmunotherapy.
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Affiliation(s)
- Sara Galimberti
- Department of Clinical and Experimental Medicine - University of Pisa, Pisa, Italy.
| | - Stefano Luminari
- Department of Diagnostic, Clinics and Public Health, University of Modena and Reggio Emilia, Modena, Italy
| | - Elena Ciabatti
- Department of Clinical and Experimental Medicine - University of Pisa, Pisa, Italy. GenOMec School of University of Siena, Italy
| | - Susanna Grassi
- Department of Clinical and Experimental Medicine - University of Pisa, Pisa, Italy
| | - Francesca Guerrini
- Department of Clinical and Experimental Medicine - University of Pisa, Pisa, Italy
| | - Alessandra Dondi
- Department of Diagnostic, Clinics and Public Health, University of Modena and Reggio Emilia, Modena, Italy
| | - Luigi Marcheselli
- Department of Diagnostic, Clinics and Public Health, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Pier Paolo Piccaluga
- Department of Experimental, Diagnostic, and Speciality Medicine, Bologna University, Bologna, Italy
| | - Anna Gazzola
- Department of Experimental, Diagnostic, and Speciality Medicine, Bologna University, Bologna, Italy
| | - Claudia Mannu
- Department of Experimental, Diagnostic, and Speciality Medicine, Bologna University, Bologna, Italy
| | | | | | - Ilaria Del Giudice
- Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
| | - Irene Della Starza
- Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
| | - Marzia Cavalli
- Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
| | - Luca Arcaini
- Department of Oncology and Hematology, IRCSS "San Matteo", University of Pavia, Italy
| | | | | | | | - Alessandro Pulsoni
- Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
| | | | | | | | | | - Gianluca Gaidano
- SCDU Hematology, Department of Translational Medicine, University of East Piedmont, Novara, Italy
| | - Pellegrino Musto
- Scientific Direction, IECCS, Referral Cancer Center of basilicata, Rionero In vulture (Pz), Italy
| | - Mario Petrini
- Department of Clinical and Experimental Medicine - University of Pisa, Pisa, Italy
| | - Massimo Federico
- Department of Diagnostic, Clinics and Public Health, University of Modena and Reggio Emilia, Modena, Italy
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27
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Mannu C, Gazzola A, Ciabatti E, Fuligni F, Cavalli M, Della Starza I, Genuardi E, Mantoan B, Monitillo L, Del Giudice I, Ladetto M, Gaidano G, Sabattini E, Pileri SA, Galimberti S, Piccaluga PP. Comparison of different DNA extraction methods from peripheral blood cells: advice from the Fondazione Italiana Linfomi Minimal Residual Disease Network. Leuk Lymphoma 2014; 57:400-410. [PMID: 25115509 DOI: 10.3109/10428194.2014.914199] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Genomic DNA extraction is a primary component of genomic research and diagnostic routine analysis. Recently, the importance of this process has been highlighted by the necessity to standardize the diagnostic procedure. In this regard, the Minimal Residual Disease (MRD) Network of the Fondazione Italiana Linfomi (FIL MRD Network) has performed a comparative study of four different commercially available kits for DNA extraction, applying them on a panel of cellular pellets, with the aim of defining possible technical recommendations in order to harmonize and standardize diagnostic procedures in the clinical setting. Overall, all four kits usually allowed the recovery of a significant quantity of high-quality DNA (in most conditions), although specific indications could be addressed for cellular pellets of different sizes.
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Affiliation(s)
- Claudia Mannu
- a Hematopathology Section, Department of Experimental , Diagnostic, and Specialty Medicine, S. Orsola-Malpighi Hospital, Bologna University , Bologna , Italy
| | - Anna Gazzola
- a Hematopathology Section, Department of Experimental , Diagnostic, and Specialty Medicine, S. Orsola-Malpighi Hospital, Bologna University , Bologna , Italy
| | - Elena Ciabatti
- b Division of Hematology, Department of Oncology , Santa Chiara Hospital , Pisa , Italy
| | - Fabio Fuligni
- a Hematopathology Section, Department of Experimental , Diagnostic, and Specialty Medicine, S. Orsola-Malpighi Hospital, Bologna University , Bologna , Italy
| | - Marzia Cavalli
- c Hematology Section, Department of Cellular Biotechnologies and Hematology , "Sapienza" University of Rome , Rome , Italy
| | - Irene Della Starza
- c Hematology Section, Department of Cellular Biotechnologies and Hematology , "Sapienza" University of Rome , Rome , Italy
| | - Elisa Genuardi
- d University Division of Hematology, Hospital S. Giovanni Battista , Turin , Italy
| | - Barbara Mantoan
- d University Division of Hematology, Hospital S. Giovanni Battista , Turin , Italy
| | - Luigia Monitillo
- d University Division of Hematology, Hospital S. Giovanni Battista , Turin , Italy
| | - Ilaria Del Giudice
- c Hematology Section, Department of Cellular Biotechnologies and Hematology , "Sapienza" University of Rome , Rome , Italy
| | - Marco Ladetto
- d University Division of Hematology, Hospital S. Giovanni Battista , Turin , Italy
| | - Gianluca Gaidano
- e Division of Hematology, Department of Translational Medicine , Amedeo Avogadro University of Eastern Piedmont , Novara , Italy
| | - Elena Sabattini
- a Hematopathology Section, Department of Experimental , Diagnostic, and Specialty Medicine, S. Orsola-Malpighi Hospital, Bologna University , Bologna , Italy
| | - Stefano A Pileri
- a Hematopathology Section, Department of Experimental , Diagnostic, and Specialty Medicine, S. Orsola-Malpighi Hospital, Bologna University , Bologna , Italy
| | - Sara Galimberti
- b Division of Hematology, Department of Oncology , Santa Chiara Hospital , Pisa , Italy
| | - Pier Paolo Piccaluga
- a Hematopathology Section, Department of Experimental , Diagnostic, and Specialty Medicine, S. Orsola-Malpighi Hospital, Bologna University , Bologna , Italy
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28
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Carulli G, Ciancia EM, Azzarà A, Ottaviano V, Grassi S, Ciabatti E, Ferreri MI, Rocco M, Marini A, Petrini M. Simultaneous presentation of Waldenström macroglobulinemia and multiple myeloma: multidisciplinary diagnosis, treatment and 30-month follow-up. J Clin Exp Hematop 2014; 53:29-36. [PMID: 23801131 DOI: 10.3960/jslrt.53.29] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Waldenström macroglobulinemia and multiple myeloma are mature B-cell neoplasms deriving from post-germinal cells at different stages of differentiation. The simultaneous presentation of Waldenström macroglobulinemia and multiple myeloma in the same patient is a very rare phenomenon and, so far, only two cases have been described. We report the case of a 75-year Caucasian female patient, with a silent clinical history, who presented with anemia and two different monoclonal proteins (IgMκ and IgGκ). The trephine biopsy showed the presence of a dual population, represented by small lymphoplasmacytoid cells and by plasma cells, which infiltrated the bone marrow with a clearly different pattern. Both immunohistochemistry and flow cytometry demonstrated the biclonal origin such neoplastic cells, since lymphoplasmacytoid cells resulted IgMκ while plasma cells were IgGκ. This biclonal pattern was further confirmed by the demonstration of a different IgH gene rearrangement of the two neoplasms. The patient was treated with bortezomib, dexamethasone and rituximab, achieving partial remission of both Waldenström macroglobulinemia and multiple myeloma. After a 30-month follow-up, she is in stable disease. Multiple myeloma has been described in association with other indolent B-cell neoplasms, mostly chronic lymphocytic leukemia, while Waldenström macroglobulinemia can be followed by diffuse large B-cell lymphoma in some instances, after chemotherapy. The association of Waldenström macroglobulinemia and multiple myeloma seems to be very rare. Our study shows that an integrated diagnostic work-up is very useful in such cases, with an interesting role for flow cytometry. [J Clin Exp Hematop 53(1): 29-36, 2013].
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Affiliation(s)
- Giovanni Carulli
- Division of Hematology, Department of Clinical and Experimental Medicine, University of Pisa
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29
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Di Paolo A, Polillo M, Capecchi M, Cervetti G, Baratè C, Angelini S, Guerrini F, Fontanelli G, Arici R, Ciabatti E, Grassi S, Bocci G, Hrelia P, Danesi R, Petrini M, Galimberti S. The c.480C>G polymorphism of hOCT1 influences imatinib clearance in patients affected by chronic myeloid leukemia. Pharmacogenomics J 2014; 14:328-35. [PMID: 24589908 DOI: 10.1038/tpj.2014.7] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Revised: 01/17/2014] [Accepted: 01/31/2014] [Indexed: 12/30/2022]
Abstract
The aim of the study was to investigate any possible influence of polymorphisms of transmembrane transporters human organic cation transporter 1 (hOCT1), ABCB1, ABCG2 on imatinib pharmacokinetics in 33 men and 27 women (median age and range, 56 and 27-79 years, respectively) affected by chronic myeloid leukemia. A population pharmacokinetic analysis was performed to investigate imatinib disposition in every patient and the role of transporter polymorphisms. Results showed that the α1-acid glycoprotein and the c.480C>G genotype of hOCT1 had a significant effect on apparent drug clearance (CL/F) being responsible, respectively, for a 20% and 10% decrease in interindividual variability (IIV) of CL/F (from 50.1 up to 19.6%). Interestingly, 25 patients carrying at least one polymorphic c.480 G allele had a significant lower CL/F value with respect to the 35 c.480CC individuals (mean±s.d., 9.6±1.6 vs 12.1±2.3 l h(-1), respectively; P<0.001). In conclusion, the hOCT1 c.480C>G SNP may significantly influence imatinib pharmacokinetics, supporting further analyses in larger groups of patients.
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Affiliation(s)
- A Di Paolo
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 55, Pisa, Italy
| | - M Polillo
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 55, Pisa, Italy
| | - M Capecchi
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 55, Pisa, Italy
| | - G Cervetti
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 55, Pisa, Italy
| | - C Baratè
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 55, Pisa, Italy
| | - S Angelini
- Department of Pharmacy and Biotechnology, University of Bologna, Via Irnerio 48, Bologna, Italy
| | - F Guerrini
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 55, Pisa, Italy
| | - G Fontanelli
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 55, Pisa, Italy
| | - R Arici
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 55, Pisa, Italy
| | - E Ciabatti
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 55, Pisa, Italy
| | - S Grassi
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 55, Pisa, Italy
| | - G Bocci
- 1] Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 55, Pisa, Italy [2] Istituto Toscano Tumori, Via Alderotti 86/N, Florence, Italy
| | - P Hrelia
- Department of Pharmacy and Biotechnology, University of Bologna, Via Irnerio 48, Bologna, Italy
| | - R Danesi
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 55, Pisa, Italy
| | - M Petrini
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 55, Pisa, Italy
| | - S Galimberti
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 55, Pisa, Italy
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Danti S, Ciofani G, Pertici G, Moscato S, D'Alessandro D, Ciabatti E, Chiellini F, D'Acunto M, Mattoli V, Berrettini S. Boron nitride nanotube-functionalised myoblast/microfibre constructs: a nanotech-assisted tissue-engineered platform for muscle stimulation. J Tissue Eng Regen Med 2014; 9:847-51. [DOI: 10.1002/term.1878] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Revised: 12/15/2013] [Accepted: 01/14/2014] [Indexed: 11/09/2022]
Affiliation(s)
- Serena Danti
- Department of Surgical, Medical and Molecular Pathology and Emergency Medicine; University of Pisa; Italy
| | - Gianni Ciofani
- Istituto Italiano di Tecnologia (IIT); Centre for Micro-BioRobotics@SSSA; Pontedera PI Italy
| | - Gianni Pertici
- Department of Innovative Technologies; University of Applied Sciences and Arts of Southern Switzerland (SUPSI); Manno Switzerland
| | - Stefania Moscato
- Department of Clinical and Experimental Medicine; University of Pisa; Italy
| | - Delfo D'Alessandro
- Department of Surgical, Medical and Molecular Pathology and Emergency Medicine; University of Pisa; Italy
| | - Elena Ciabatti
- Department of Clinical and Experimental Medicine; University of Pisa; Italy
| | - Federica Chiellini
- Department of Chemistry and Industrial Chemistry; University of Pisa; Italy
| | - Mario D'Acunto
- Institute of Matter Structure; Tor Vergata Research Area, CNR; Rome Italy
| | - Virgilio Mattoli
- Istituto Italiano di Tecnologia (IIT); Centre for Micro-BioRobotics@SSSA; Pontedera PI Italy
| | - Stefano Berrettini
- Department of Surgical, Medical and Molecular Pathology and Emergency Medicine; University of Pisa; Italy
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Ibatici A, Pica GM, Nati S, Vitolo U, Botto B, Ciochetto C, Petrini M, Galimberti S, Ciabatti E, Orciuolo E, Zinzani PL, Cascavilla N, Guolo F, Fraternali Orcioni G, Carella AM. Safety and efficacy of90Yttrium-Ibritumomab-Tiuxetan for untreated follicular lymphoma patients. An Italian cooperative study. Br J Haematol 2013; 164:710-6. [DOI: 10.1111/bjh.12695] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Accepted: 10/13/2013] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Sandro Nati
- U.O. Ematologia 1; IRCCS AOU San Martino-IST; Genova Italy
| | - Umberto Vitolo
- Ematologia 2; A.O. San Giovanni Battista Hospital and University; Torino Italy
| | - Barbara Botto
- Ematologia 2; A.O. San Giovanni Battista Hospital and University; Torino Italy
| | - Chiara Ciochetto
- Ematologia 2; A.O. San Giovanni Battista Hospital and University; Torino Italy
| | - Mario Petrini
- Divisione di Ematologia; A.O. Pisana Santa Chiara; Pisa Italy
| | - Sara Galimberti
- Divisione di Ematologia; A.O. Pisana Santa Chiara; Pisa Italy
| | - Elena Ciabatti
- Divisione di Ematologia; A.O. Pisana Santa Chiara; Pisa Italy
| | - Enrico Orciuolo
- Divisione di Ematologia; A.O. Pisana Santa Chiara; Pisa Italy
| | | | - Nicola Cascavilla
- Divisione di Ematologia; Casa Sollievo della Sofferenza; San Giovanni Rotondo Italy
| | - Fabio Guolo
- U.O. Ematologia 1; IRCCS AOU San Martino-IST; Genova Italy
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Danti S, Ciofani G, Moscato S, D'Alessandro D, Ciabatti E, Nesti C, Brescia R, Bertoni G, Pietrabissa A, Lisanti M, Petrini M, Mattoli V, Berrettini S. Boron nitride nanotubes and primary human osteoblasts: in vitro compatibility and biological interactions under low frequency ultrasound stimulation. Nanotechnology 2013; 24:465102. [PMID: 24150892 DOI: 10.1088/0957-4484/24/46/465102] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
In this paper we investigated a novel and non-invasive approach for an endogenous osteoblast stimulation mediated by boron nitride nanotubes (BNNTs). Specifically, following the cellular uptake of the piezoelectric nanotubes, cultures of primary human osteoblasts (hOBs) were irradiated with low frequency ultrasound (US), as a simple method to apply a mechanical input to the cells loaded with BNNTs. This in vitro study was aimed at investigating the main interactions between hOBs and BNNTs and to study the effects of the 'BNNTs + US' stimulatory method on the osteoblastic function and maturation.A non-cytotoxic BNNT concentration to be used in vitro with hOB cultures was established. Moreover, investigation with transmission electron microscopy/electron energy loss spectroscopy (TEM/EELS) confirmed that BNNTs were internalized in membranal vesicles. The panel of investigated osteoblastic markers disclosed that BNNTs were capable of fostering the expression of late-stage bone proteins in vitro, without using any mineralizing culture supplements. In our samples, the maximal osteopontin expression, with the highest osteocalcin and Ca(2+) production, in the presence of mineral matrix with nodular morphology, was observed in the samples treated with BNNTs + US. In this group was also shown a significantly enhanced synthesis of TGF-β1, a molecule sensitive to electric stimulation in bone. Finally, gene deregulations of the analyzed osteoblastic genes leading to depletive cellular effects were not detected. Due to their piezoelectricity, BNNT-based therapies might disclose advancements in the treatment of bone diseases.
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Affiliation(s)
- Serena Danti
- Department of Surgical, Medical, Molecular Pathology and Emergency Medicine, University of Pisa, via Paradisa 2, I-56124 Pisa, Italy. Center for the Clinical Use of Stem Cells-Regional Network of Regenerative Medicine 'CUCCS-RRMR', University of Pisa, via Roma 55, I-56126 Pisa, Italy
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Della Starza I, Cavalli M, Del Giudice I, Barbero D, Mantoan B, Genuardi E, Urbano M, Mannu C, Gazzola A, Ciabatti E, Guarini A, Foà R, Galimberti S, Piccaluga P, Gaidano G, Ladetto M, Monitillo L. Comparison of two real-time quantitative polymerase chain reaction strategies for minimal residual disease evaluation in lymphoproliferative disorders: correlation between immunoglobulin gene mutation load and real-time quantitative polymerase chain reaction performance. Hematol Oncol 2013; 32:133-8. [PMID: 24254547 DOI: 10.1002/hon.2095] [Citation(s) in RCA: 8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 08/12/2013] [Indexed: 11/07/2022]
Abstract
We compared two strategies for minimal residual disease evaluation of B-cell lymphoproliferative disorders characterized by a variable immunoglobulin heavy chain (IGH) genes mutation load. Twenty-five samples from chronic lymphocytic leukaemia (n = 18) or mantle cell lymphoma (n = 7) patients were analyzed. Based on IGH variable region genes, 22/25 samples carried > 2% mutations, 20/25 > 5%. In the IGH joining region genes, 23/25 samples carried > 2% mutations, 18/25 > 5%. Real-time quantitative polymerase chain reaction was performed on IGH genes using two strategies: method A utilizes two patient-specific primers, whereas method B employs one patient-specific and one germline primer, with different positions on the variable, diversity and joining regions. Twenty-three samples (92%) resulted evaluable using method A, only six (24%) by method B. Method B poor performance was specifically evident among mutated IGH variable/joining region cases, although no specific mutation load above, which the real-time quantitative polymerase chain reaction failed was found. The molecular strategies for minimal residual disease evaluation should be adapted to the B-cell receptor features of the disease investigated.
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Affiliation(s)
- Irene Della Starza
- Department of Cellular Biotechnologies and Hematology, "Sapienza" University, Rome, Italy
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Galimberti S, Grassi S, Rocco M, Mingrone T, Ciabatti E, Guerrini F, Azzara' A, Petrini M. P-135 Low RPS14 expression negatively conditions the prognosis of patients affected by not 5q- myelodysplastic syndromes during azacitidine treatment. Leuk Res 2013. [DOI: 10.1016/s0145-2126(13)70183-8] [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: 10/26/2022]
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Carulli G, Marini A, Ciancia EM, Bruno J, Vignati S, Lambelet P, Cannizzo E, Ottaviano V, Galimberti S, Caracciolo F, Ferreri MI, Ciabatti E, Petrini M. Discordant lymphoma consisting of splenic mantle cell lymphoma and marginal zone lymphoma involving the bone marrow and peripheral blood: a case report. J Med Case Rep 2011; 5:476. [PMID: 21943040 PMCID: PMC3189904 DOI: 10.1186/1752-1947-5-476] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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: 12/28/2010] [Accepted: 09/23/2011] [Indexed: 11/13/2022] Open
Abstract
Introduction Discordant lymphomas are rare entities characterized by the simultaneous presence of two distinct types of lymphomas in different anatomic sites. We describe a very rare case of simultaneous occurrence of splenic mantle cell lymphoma and marginal zone lymphoma involving the bone marrow and peripheral blood. Case presentation We report the case of a 60-year-old asymptomatic Caucasian woman in whom discordant lymphomas were discovered when a slight lymphocytosis and a conspicuous splenomegaly were observed. The different morphological, immunophenotypical and immunohistochemical features found in the different pathologic samples obtained from peripheral blood, bone marrow and spleen sections made it possible to differentiate two types of non-Hodgkin B-cell lymphomas: a mantle cell lymphoma infiltrating the spleen and a marginal zone lymphoma involving both the bone marrow and peripheral blood. Since a similar IgH gene rearrangement was found both in the bone marrow and in the spleen, the hypothesis of a common origin, followed by a different clonal selection of the neoplastic lymphocytes may be taken into consideration. Conclusion Our case emphasizes the usefulness of investigating simultaneous specimens from different anatomic sites from the same patient and the relevant diagnostic role of splenectomy.
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Affiliation(s)
- Giovanni Carulli
- Department of Oncology, Transplants and New Technologies in Medicine, Division of Hematology and Section of Flow Cytometry, University of Pisa, Pisa, Italy.
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Galimberti S, Ghio F, Guerrini F, Ciabatti E, Grassi S, Ferreri MI, Petrini M. WT1 expression levels at diagnosis could predict long-term time-to-progression in adult patients affected by acute myeloid leukaemia and myelodysplastic syndromes. Br J Haematol 2010; 149:451-4. [PMID: 20085581 DOI: 10.1111/j.1365-2141.2009.08063.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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37
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Galimberti S, Nagy B, Benedetti E, Pacini S, Brizzi S, Caracciolo F, Papineschi F, Ciabatti E, Guerrini F, Fazzi R, Canestraro M, Petrini M. Evaluation of the MDR1, ABCG2, Topoisomerases IIalpha and GSTpi gene expression in patients affected by aggressive mantle cell lymphoma treated by the R-Hyper-CVAD regimen. Leuk Lymphoma 2007; 48:1502-9. [PMID: 17701580 DOI: 10.1080/10428190701402895] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The genomic profile of mantle cell lymphoma (MCL) has been reported to be significantly different from that of other indolent lymphoproliferative disorders, Topoisomerase IIalpha, glutathione-s-transferasepi (GSTpi) and ABCG2 (BCRP) chemoresistance genes being over-expressed in MCL. In our study, expression levels of the above mentioned genes plus MDR1 were tested on bone marrow samples from 20 patients treated with Rituximab plus hyper-CVAD regimen, in order to evaluate a possible impact of the chemoresistance phenomenon on this promising treatment regimen. All patients expressed ABCG2 and MDR1 genes; 85% of cases expressed GSTpi and topoisomerase IIalpha. Only ABCG2 were over-expressed in comparison both with marrow from healthy donors and tonsilar CD5+/CD20+ lymphocytes (adopted as normal counterpart of the neoplastic population). The overall response rate of the entire series was 87.5%, with 44% of complete responses. Fifty-seven percent of patients achieved the clearance of minimal residual disease. Levels of tested genes did not condition either quality of clinical response or PFS (76% at 24 months). Nevertheless, an ABCG2 higher expression appeared associated with a worse PFS and levels of this gene paralleled the status of minimal residual disease. A further evaluation of ABCG2 expression in larger series of MCL patients would be suitable.
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MESH Headings
- ATP Binding Cassette Transporter, Subfamily B
- ATP Binding Cassette Transporter, Subfamily B, Member 1/genetics
- ATP Binding Cassette Transporter, Subfamily G, Member 2
- ATP-Binding Cassette Transporters/genetics
- Adult
- Aged
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Murine-Derived
- Antigens, Neoplasm/genetics
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/genetics
- Case-Control Studies
- Cyclophosphamide/therapeutic use
- DNA Topoisomerases, Type II/genetics
- DNA-Binding Proteins/genetics
- Dexamethasone/therapeutic use
- Doxorubicin/therapeutic use
- Drug Resistance, Multiple
- Drug Resistance, Neoplasm
- Female
- Gene Expression Regulation, Neoplastic
- Glutathione S-Transferase pi/genetics
- Humans
- Lymphoma, Mantle-Cell/drug therapy
- Lymphoma, Mantle-Cell/genetics
- Lymphoma, Mantle-Cell/metabolism
- Male
- Middle Aged
- Neoplasm Proteins/genetics
- Prognosis
- Rituximab
- Survival Rate
- Treatment Outcome
- Vincristine/therapeutic use
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Affiliation(s)
- Sara Galimberti
- Department of Oncology, Transplants and Advances in Medicine, Hematology Section, University of Pisa, Italy.
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38
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Galimberti S, Palumbo GA, Caracciolo F, Benedetti E, Pelosini M, Brizzi S, Ciabatti E, Fazzi R, Stelitano C, Quintana G, Conte E, Tibullo D, Di Raimondo F, Petrini M. The efficacy of rituximab plus Hyper-CVAD regimen in mantle cell lymphoma is independent of FCgammaRIIIa and FCgammaRIIa polymorphisms. J Chemother 2007; 19:315-21. [PMID: 17594928 DOI: 10.1179/joc.2007.19.3.315] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Mantle cell lymphoma (MCL) accounts for 3-10% of all non-Hodgkin's lymphomas, with median overall survival not exceeding 3-4 years. Rituximab in combination with the Hyper-CVAD regimen appears the most promising regimen; thus, we adopted it as a first-line treatment strategy in a series of 24 patients. In addition to evaluation of clinical success of the regimen, we investigated a possible role of polymorphism in IgG Fc receptors, FCgammaRIIIa and FCgammaRIIa. The frequencies of FCgammaRIIIa-158 were as follows: V/V=4/24 (17%); V/F=16/24 (66%); F/F=4/24 (17%). Those of the FCgammaRIIa-131 polymorphism were H/H=11/24 (46%), H/R=9/24 (37%), R/R=4/24 (17%). The overall response rate was 62.5%, with 33% of complete responses (CRs) after four cycles of R-Hyper-CVAD. Two-year progression-free survival (PFS) was 78% for 158V/V patients vs 75% for cases carrying phenylalanine (p=0.88). When the FCgammaRIIa polymorphism was assessed, the 2-year PFS was 82% for 131H/H patients vs 75% for those carrying arginine (p=0.26). Eighty-three percent of cases achieved Polymerase Chain Reaction (PCR)-negativity: the progression rate was significantly influenced by the minimal residual disease clearance, with 12% progression in the subgroup of PCR-negative cases versus 67% progression in PCR-positive cases (p=0.008). The achievement of PCRnegativity was not significantly influenced by FCgammaR polymorphisms. Results confirm that rituximab plus Hyper-CVAD is an effective regimen for the induction of prolonged remission in patients with aggressive MCL and suggest that rituximab efficacy is independent of the FCgammaR polymorphisms.
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Affiliation(s)
- S Galimberti
- Department of Oncology, Section of Hematology, University of Pisa, Pisa, Italy.
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Guerrini F, Galimberti S, Ciabatti E, Brizzi S, Testi R, Pollastrini A, Falini B, Petrini M. Molecular detection of GNNK− and GNNK+ c-kit isoforms: a new tool for risk stratification in adult acute myeloid leukaemia. Leukemia 2007; 21:2056-8. [PMID: 17554388 DOI: 10.1038/sj.leu.2404726] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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40
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Galimberti S, Ciabatti E, Ottimo F, Rossi A, Trombi L, Carulli G, Cervetti G, Matti L, Bianchi G, Petrini M. Cell clonality in hypereosinophilic syndrome: what pathogenetic role? Clin Exp Rheumatol 2007; 25:17-22. [PMID: 17417985] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
OBJECTIVE Idiopathic hypereosinophilic syndrome (HES) is a heterogeneous disorder, including either a myeloproliferative or a lymphoproliferative variant (l-HES). In l-HES, T-lymphocytes could be involved in the pathogenesis through several cytokines, including IL5. METHODS We assayed both TCR Beta- and delta-rearrangements by fluorescent PCR, characterizing 14 patients affected by HES. Lyn activation (a src-kinase involved in the IL5 pathway) was also tested in 6 cases. RESULTS FIP1L1-PDGFRa was detected in 4 cases (28.6%); a clonal TCR was found in 10 cases (71.4%), including cases FIP1L1-PDGFRalpha-positive; four cases did not show any molecular marker. In this series, levels of IL5, IL4, IL2 and gammaIFN were measured, without any significant difference among different subgroups. All pathological samples tested did not show Lyn activation. Immunophenotype was also characterized: only one case showed an atypical CD3-/CD4+ population in the bone marrow. CONCLUSION This study would suggest that a real distinction between m- and l-HES is not wholly convincing and that clonal T-cell expansion could not be the "primum movens" but an epiphenomenon in HES.
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Affiliation(s)
- S Galimberti
- Department of Oncology, Transplant and Advances in Medicine, Section of Hematology, University of Pisa, Ospedale S. Chiara, Pisa Italy.
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41
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Galimberti S, Benedetti E, Morabito F, Petrini I, Battolla B, Papineschi F, Fazzi R, Ciabatti E, Martino M, Cuzzola M, Console G, Iacopino P, Petrini M. Different gamma/delta T clones sustain GVM and GVH effects in multiple myeloma patients after non-myeloablative transplantation. Leuk Res 2005; 30:529-35. [PMID: 16249028 DOI: 10.1016/j.leukres.2005.09.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2005] [Revised: 08/31/2005] [Accepted: 09/05/2005] [Indexed: 11/17/2022]
Abstract
TCR gamma/delta profiles were analyzed in 13 multiple myeloma patients after allogeneic non-myeloablative transplantation. Results show that both aGVHD and minimal residual disease (MRD) eradication did significantly affect TCR gamma/delta profile. During follow-up, six patients developed an aGVHD episode; in five of them, this event fitted with a modification of the TCR profile. Eleven patients achieved PCR-negativity during follow-up. In the 90% of them, the appearance of a new predominant TCR peak was concomitant to the disappearance of the IgH clone. These results suggest that different T gamma/delta populations would sustain GVM and GVH effects after non-myeloablative allogeneic transplant.
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MESH Headings
- Adult
- Aged
- Clone Cells
- Female
- Follow-Up Studies
- Graft vs Host Disease/genetics
- Graft vs Host Disease/immunology
- Graft vs Host Disease/therapy
- Graft vs Tumor Effect/genetics
- Graft vs Tumor Effect/immunology
- Humans
- Immunoglobulin Heavy Chains/genetics
- Male
- Middle Aged
- Multiple Myeloma/genetics
- Multiple Myeloma/immunology
- Multiple Myeloma/therapy
- Neoplasm, Residual/genetics
- Neoplasm, Residual/immunology
- Neoplasm, Residual/therapy
- Peripheral Blood Stem Cell Transplantation/adverse effects
- Peripheral Blood Stem Cell Transplantation/methods
- Receptors, Antigen, T-Cell, gamma-delta/analysis
- Receptors, Antigen, T-Cell, gamma-delta/genetics
- Transplantation, Homologous
- Treatment Outcome
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Affiliation(s)
- Sara Galimberti
- Department of Oncology, Transplant and Advances in Medicine, Section of Hematology, University of Pisa, Ospedale S. Chiara, Via Roma, 56, 56100 PISA, Italy.
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42
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Galimberti S, Benedetti E, Morabito F, Papineschi F, Callea V, Fazzi R, Stelitano C, Andreazzoli F, Guerrini F, Ciabatti E, Martino M, Nobile F, Iacopino P, Petrini M. Prognostic role of minimal residual disease in multiple myeloma patients after non-myeloablative allogeneic transplantation. Leuk Res 2005; 29:961-6. [PMID: 15978948 DOI: 10.1016/j.leukres.2005.01.017] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [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: 09/27/2004] [Accepted: 01/22/2005] [Indexed: 10/25/2022]
Abstract
This study evaluates the prognostic value of molecular monitoring of minimal residual disease (MRD) in 20 patients with multiple myeloma (MM) following autologous (peripheral blood stem cell transplantation, PBSCT) and non-myeloablative allogeneic (NMT) transplant. All patients completed their program, with a treatment-related mortality (TRM) of 20% and a 2-year progression-free survival (PFS) of 51%. After PBSCT, only 3 patients (15%) achieved PCR-negativity, versus 12 (60%) after NMT. The eradication of MRD had a favorable impact on 2-year OS. In fact, 76% of patients with no detectable MRD was still alive versus 34% of persistently IgH-positive cases (p=0.03). PCR status did not correlate with chimerism percentage: Seventy-five percent of patients achieved full donor chimerism, which was more frequently observed in cases presenting cGHVD (p=0.01). These data sustain the relevant role of molecular monitoring in MM patients undergoing NMT. MRD monitoring would assist physicians in making additional therapeutic decisions to better control this hematological malignancy.
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Affiliation(s)
- Sara Galimberti
- Department of Oncology, Transplant and Advances in Medicine, Section of Hematology, University of Pisa, Ospedale S. Chiara-Via Roma, 56-56100 Pisa, Italy.
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