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Lanza F, Marconi G. Novel approaches for hematopoietic stem cell mobilisation and collection need to be assessed for qualification and validation to accomplish the proper requirements of their intended purpose. Transfus Apher Sci 2024:103931. [PMID: 38653628 DOI: 10.1016/j.transci.2024.103931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Affiliation(s)
- Francesco Lanza
- Hematology Unit and Romagna Metropolitan Transplant Network, Hospital of Ravenna, Ravenna, University of Bologna, Italy.
| | - Giovanni Marconi
- Hematology Unit and Romagna Metropolitan Transplant Network, Hospital of Ravenna, Ravenna, University of Bologna, Italy
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Griffin M, Eikema DJ, Verheggen I, Kulagin A, Tjon JML, Fattizzo B, Ingram W, Zaidi U, Desnica L, Giammarco S, Drozd-Sokolowska J, Xicoy B, Patriarca A, Loschi M, Szmigielska-Kaplon A, Beier F, Cignetti A, Drexler B, Gavriilaki E, Lanza F, Orvain C, Risitano AM, De la Camara R, De Latour RP. SARS-CoV-2 vaccination in 361 non-transplanted patients with aplastic anemia and/or paroxysmal nocturnal hemoglobinuria. Haematologica 2024; 109:283-286. [PMID: 37584297 PMCID: PMC10772488 DOI: 10.3324/haematol.2023.283863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 08/10/2023] [Indexed: 08/17/2023] Open
Affiliation(s)
| | | | | | - Alexander Kulagin
- RM Gorbacheva Research Institute, Pavlov University, St. Petersburg, Russian Federation
| | | | - Bruno Fattizzo
- SC Ematologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan
| | | | - Uzma Zaidi
- National Institute of Blood Disease and Bone Marrow Transplantation, Karachi
| | | | - Sabrina Giammarco
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome
| | | | - Blanca Xicoy
- Institut Català d'Oncologia-Hospital Universitari Germans Trias i Pujol; Josep Carreras Leukemia Research Institute, Barcelona
| | - Andrea Patriarca
- Azienda Ospedaliero-Universitaria Maggiore della Carità and translational medicine department University of Eastern Piedmont, Novara
| | | | | | - Fabian Beier
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, RWTH Aachen University, Aachen
| | | | | | | | - Francesco Lanza
- Metropolitan Transplant Network, Hospital Santa Maria delle Croci, Ravenna, Italy 21: Centre Hospitalier Universitaire d'Angers, Angers
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Affiliation(s)
- Francesco Lanza
- Hematology Unit, University of Bologna and Hospital of Ravenna, Italy.
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Lanza F, Marchetti M, Zannetti BA. Overview on novel strategies and current guidelines for hematopoietic stem cell mobilisation and collection. Transfus Apher Sci 2023; 62:103830. [PMID: 37867056 DOI: 10.1016/j.transci.2023.103830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
The success of the autologous stem cell transplantation is strictly related to an adequate hematopoietic stem cell mobilization and collection. The minimum threshold for a successful mobilization is currently defined as 2 × 106/kg CD34+ cells. However, the optimal stem cell mobilization strategy is still controversial. The availability of plerixafor, a selective and reversible CXCR4 inhibitor, has been associated with an higher use of chemo-free protocols by many centres. In the near future, it is conceivable that artificial intelligence may became more accurate and comprehensive, possibly guiding clinicians in choosing the optimal mobilisation treatment for the various patients undergoing hematopoietic stem cell transplantation. Machine learning-based scoring models may be the basis for the development of "intelligent" mobilisation algorithms.
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Affiliation(s)
- F Lanza
- Hematology Unit and Romagna Metropolitan Transplant Network, University Hospital, Ravenna & Universty of Bologna, Italy
| | | | - B A Zannetti
- Hematology Unit and Romagna Metropolitan Transplant Network, University Hospital, Ravenna, Italy
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Sanz J, Labopin M, Pabst T, Versluis J, Van Gorkom G, Meijer E, Gedde-Dahl T, Montoro J, Arcese W, Pérez-Simón JA, Schaap N, Maertens J, Vrhovac R, Lanza F, Gorin NC, Mohty M, Ciceri F. Etoposide plus cytarabine versus cyclophosphamide or melphalan in busulfan-based preparative regimens for autologous stem cell transplantation in adults with acute myeloid leukemia in first complete remission: a study from the Acute Leukemia Working Party of the EBMT. Bone Marrow Transplant 2023; 58:1197-1202. [PMID: 37553468 DOI: 10.1038/s41409-023-02075-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/13/2023] [Accepted: 07/25/2023] [Indexed: 08/10/2023]
Abstract
We retrospectively compared the impact of the conditioning regimen in adult patients with acute myeloid leukemia (AML) in first complete remission (CR1) that received high-dose myeloablative chemotherapy followed by autologous stem cell transplantation (ASCT) from 2010 to 2021 with either high-dose cytarabine, etoposide and busulfan (BEA), busulfan with cyclophosphamide (BUCY) or busulfan and high-dose melphalan (BUMEL) registered in the EBMT database. Overall 1560 patients underwent ASCT, of which 156, 1143 and 261 received BEA, BUCY and BUMEL, respectively. Compared to BUCY and BUMEL, BEA patients were younger (p < 0.001) and less frequently had NPM1 mutations (p = 0.03). Transplant outcomes at 5 years with BEA, BUCY and BUMEL were: cumulative incidence of relapse 41.8%, 46.6% and 51.6%; non-relapse mortality (NRM) 1.5%, 5.2% and 7.3%; probability of leukemia-free survival (LFS) 56.7%, 48.2% and 41.1%; and overall survival (OS) 71.3%, 62.3% and 56%, respectively. In multivariable analysis the BEA regimen showed significant improvement in OS compared to BUCY (hazard ratio [HR] 0.65; 95% CI, 0.42-0.83; p = 0.048) and BUMEL (HR 0.59; 95% CI, 0.37-0.94; p = 0.029). In conclusion, high-dose myeloablative combination chemotherapy with BEA offered improved outcomes compared to classical BUCY or BUMEL in patients with AML in CR1 undergoing ASCT.
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Affiliation(s)
- Jaime Sanz
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain.
- CIBERONC, Instituto Carlos III, Madrid, Spain.
| | - Myriam Labopin
- EBMT Paris Office, Hospital Saint Antoine, Paris, France
| | - Thomas Pabst
- Department of Medical Oncology, University Hospital, Inselspital, Bern, Switzerland
| | - Jurjen Versluis
- Erasmus MC Cancer Institute, Department of Hematology, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Gwendolyn Van Gorkom
- Department Internal Med.Hematology/Oncology, University Hospital Maastricht, Maastricht, The Netherlands
| | - Ellen Meijer
- Department of Hematology (Br 250), VU University Medical Center, Amsterdam, The Netherlands
| | - Tobias Gedde-Dahl
- Clinic for Cancer Medicine, Hematology Department, Section for Stem Cell Transplantation, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Juan Montoro
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
- CIBERONC, Instituto Carlos III, Madrid, Spain
| | - William Arcese
- Tor Vergata University of Rome, Stem Cell Transplant Unit, Policlinico Universitario Tor Vergata, Rome, Italy
| | - Jose Antonio Pérez-Simón
- Servicio de Hematologia y Hemoterapia, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS/CISC), Sevilla, Spain
| | - Nicolaas Schaap
- Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Johan Maertens
- Department of Hematology, University Hospital Gasthuisberg, Leuven, Belgium
| | | | - Francesco Lanza
- Hematology Unit, Ravenna Hospital- University of Bologna, Bologna, Italy
| | - Norbert Claude Gorin
- EBMT Paris Office, Hospital Saint Antoine, Paris, France
- Hôpital Saint-Antoine, Sorbonne University, INSERM UMRs 938, Paris, France
| | - Mohamad Mohty
- Hôpital Saint-Antoine, Sorbonne University, INSERM UMRs 938, Paris, France
| | - Fabio Ciceri
- Ospedale San Raffaele s.r.l., Haematology and BMT, Milano, Italy
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Gini G, Tani M, Tucci A, Marcheselli L, Cesaretti M, Bellei M, Pascarella A, Ballerini F, Petrini M, Merli F, Olivieri A, Lanza F, Annibali O, Zilioli VR, Liberati AM, Tisi MC, Arcari A, Marino D, Musuraca G, Pavone V, Fabbri A, Pozzi S, Mannina D, Plenteda C, Celli M, Luminari S. Lenalidomide plus rituximab for the initial treatment of frail older patients with DLBCL: the FIL_ReRi phase 2 study. Blood 2023; 142:1438-1447. [PMID: 37418685 DOI: 10.1182/blood.2022019173] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 06/09/2023] [Accepted: 06/09/2023] [Indexed: 07/09/2023] Open
Abstract
Treatment of diffuse large B-cell lymphoma (DLBCL) in older patients is challenging, especially for those who are not eligible for anthracycline-containing regimens. Fondazione Italiana Linfomi (FIL) started the FIL_ReRi study, a 2-stage single-arm trial to investigate the activity and safety of the chemo-free combination of rituximab and lenalidomide (R2) in ≥70-year-old untreated frail patients with DLBCL. Frailty was prospectively defined using a simplified geriatric assessment tool. Patients were administered a maximum of 6 28-day cycles of 20 mg oral lenalidomide from days 2 to 22 and IV rituximab 375 mg/m2 on day 1, with response assessment after cycles 4 and 6. Patients with partial response or complete response (CR) at cycle 6 were administered lenalidomide 10 mg/d from days 1 to 21 for every 28 cycles for a total of 12 cycles or until progression or unacceptable toxicity. The primary end point was the overall response rate (ORR) after cycle 6; the coprimary end point was the rate of grade 3 or 4 extrahematological toxicity. The ORR was 50.8%, with 27.7% CR. After a median follow-up of 24 months, the median progression-free survival was 14 months, and the 2-year duration of response was 64%. Thirty-four patients experienced extrahematological toxicity according to the National Cancer Institute Common Terminology Criteria for Adverse Events grade ≥3. The activity of the R2 combination was observed in a significant proportion of subjects, warranting further exploration of a chemo-free approach in frail older patients with DLBCL. This trial was registered at EudraCT as #2015-003371-29 and clinicaltrials.gov as #NCT02955823.
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Affiliation(s)
- Guido Gini
- Struttura Organizzativa Dipartimentale di Clinica Ematologica, Azienda Ospedaliero Universitaria delle Marche, Università Politecnica delle Marche, Ancona, Italy
| | - Monica Tani
- Unità di Ematologia, Ospedale Santa Maria delle Croci, Ravenna, Italy
| | - Alessandra Tucci
- Unità di Ematologia, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia, Italy
| | - Luigi Marcheselli
- Uffici Studi Fondazione Italiana Linfomi, sede di Modena, Modena, Italy
| | - Marina Cesaretti
- Uffici Studi Fondazione Italiana Linfomi, sede di Modena, Modena, Italy
| | - Monica Bellei
- Uffici Studi Fondazione Italiana Linfomi, sede di Modena, Modena, Italy
| | - Anna Pascarella
- Unità Operativa Complessa di Ematologia, Ospedale dell'Angelo, Venice-Mestre, Italy
| | - Filippo Ballerini
- Clinica Ematologica, IRCCS Ospedale Policlinico San Martino, Università di Genova, Genoa, Italy
| | - Mauro Petrini
- Struttura Organizzativa Dipartimentale di Clinica Ematologica, Azienda Ospedaliero Universitaria delle Marche, Università Politecnica delle Marche, Ancona, Italy
| | - Francesco Merli
- Ematologia, Azienda Unità Sanitaria Locale - IRCCS, Reggio Emilia, Italy
| | - Attilio Olivieri
- Struttura Organizzativa Dipartimentale di Clinica Ematologica, Azienda Ospedaliero Universitaria delle Marche, Università Politecnica delle Marche, Ancona, Italy
| | - Francesco Lanza
- Unità di Ematologia, Ospedale Santa Maria delle Croci, Ravenna, Italy
| | - Ombretta Annibali
- Unità di Ematologia e Trapianto di Cellule Staminali, Università Campus Bio-Medico, Rome, Italy
| | - Vittorio Ruggero Zilioli
- Divisione di Ematologia, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Anna Marina Liberati
- Struttura Complessa di Oncoematologia e Autotrapianto, Azienda Ospedaliera Santa Maria, Università degli Studi di Perugia, Terni, Italy
| | - Maria Chiara Tisi
- Ematologia, Ospedale San Bortolo, Azienda Unità Sanitaria Locale Socio Sanitaria 8 "Berica," Vicenza, Italy
| | - Annalisa Arcari
- Unità di Ematologia, Ospedale Guglielmo da Saliceto, Piacenza, Italy
| | - Dario Marino
- Oncologia 1, Istituto Oncologico Veneto IRCCS, Padua, Italy
| | - Gerardo Musuraca
- Ematologia, IRCCS Istituto Romagnolo per lo Studio dei Tumori, Meldola, Italy
| | - Vincenzo Pavone
- Unità Operativa Complessa di Ematologia e Trapianto, Ospedale Pia Fondazione Cardinale Panico, Tricase, Italy
| | - Alberto Fabbri
- Unità di Ematologia, Azienda Ospedaliero Universitaria Senese, Siena, Italy
| | - Samantha Pozzi
- Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell'Adulto, Università di Modena e Reggio Emilia, Centro Oncologico, Modena, Italy
| | - Donato Mannina
- Dipartimento di Oncoematologia, Ospedale Papardo, Messina, Italy
| | - Caterina Plenteda
- Unità Operativa di Ematologia e Centro Trapianti di Midollo Osseo, Azienda Ospedaliero Universitaria di Parma, Parma, Italy
| | - Melania Celli
- Unità Operativa di Ematologia, Ospedale degli Infermi, Rimini, Italy
| | - Stefano Luminari
- Ematologia, Azienda Unità Sanitaria Locale - IRCCS, Reggio Emilia, Italy
- Dipartimento Chirurgico, Medico, Odontoiatrico e di Scienze Morfologiche con interesse Trapiantologico, Oncologico e di Medicina Rigenerativa, Università di Modena e Reggio Emilia, Reggio Emilia, Italy
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Ghetti M, Vannini I, Bochicchio MT, Azzali I, Ledda L, Marconi G, Melloni M, Fabbri F, Rondoni M, Chicchi R, Angeli D, Ghelli Luserna di Rorà A, Giannini B, Zacheo I, Biguzzi R, Lanza F, Martinelli G, Simonetti G. Uncovering the expression of circPVT1 in the extracellular vesicles of acute myeloid leukemia patients. Biomed Pharmacother 2023; 165:115235. [PMID: 37536029 DOI: 10.1016/j.biopha.2023.115235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/19/2023] [Accepted: 07/25/2023] [Indexed: 08/05/2023] Open
Abstract
Extracellular vesicles (EVs) act as molecular mediators in the tumor microenvironment, by shuttling information contained within malignant cells and functioning as regulators of the immune system. Circular (circ)RNAs are characterized by a closed loop-like structure that makes them more stable in the extracellular milieu and suitable to be packaged inside EVs. circPVT1 (hsa_circ_0001821) showed an oncogenic role in several cancer types and immunosuppressive properties in myeloid and lymphoid cell subsets. In this study, we characterized EVs from acute myeloid leukemia (AML) patients in terms of size, concentrations, surface markers and circPVT1 cargo. We showed that circPVT1 is overexpressed by primary blast cells from newly-diagnosed AML patients compared with hematopoietic stem-progenitor cells and is released as cell-free RNA in the plasma. We isolated EVs from the plasma of AML patients and healthy subjects by size exclusion chromatography and characterized them by nanoparticle tracking analysis. EVs from patients' plasma are larger compared with those from healthy subjects and their surface profile is characterized by higher levels of the leukemic cell markers CD133, CD105, CD49e and other immune-related epitopes, with differences according to AML molecular profile. Moreover, digital PCR analysis revealed that circPVT1 is more abundant inside EVs from the plasma of AML patients compared with healthy subjects. Our findings provide new insights on the features and content of AML EVs and suggest a role of circPVT1 in the crosstalk between AML cells and the tumor microenvironment.
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Affiliation(s)
- Martina Ghetti
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Ivan Vannini
- Pathology Unit, Morgagni-Pierantoni Hospital, AUSL Romagna, Forlì, Italy
| | - Maria Teresa Bochicchio
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Irene Azzali
- Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Lorenzo Ledda
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Giovanni Marconi
- Hematology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Mattia Melloni
- Laboratory of Biomarkers, Biomolecular Targets and Personalized Medicine in Oncology, Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Francesco Fabbri
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Michela Rondoni
- Hematology Unit & Romagna Transplant Network, Ravenna Hospital, Ravenna, Italy
| | - Roberta Chicchi
- Laboratorio Unico AUSL della Romagna, U.O. Medicina Trasfusionale di Forlì-Cesena e Officina Trasfusionale della Romagna, Pievesestina di Cesena, Italy
| | - Davide Angeli
- Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Andrea Ghelli Luserna di Rorà
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy; Fondazione Pisana per la Scienza ONLUS, San Giuliano Terme, Italy
| | - Barbara Giannini
- Laboratorio Unico AUSL della Romagna, U.O. Genetica Medica, Pievesestina di Cesena, Italy
| | - Irene Zacheo
- Hematology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Rino Biguzzi
- Laboratorio Unico AUSL della Romagna, U.O. Medicina Trasfusionale di Forlì-Cesena e Officina Trasfusionale della Romagna, Pievesestina di Cesena, Italy
| | - Francesco Lanza
- Hematology Unit & Romagna Transplant Network, Ravenna Hospital, Ravenna, Italy
| | - Giovanni Martinelli
- Scientific Directorate, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Giorgia Simonetti
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy.
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Maffini E, Ngoya M, Galimard JE, Harbi S, Kröger N, Platzbecker U, Sengeloev H, Craddock C, Potter V, Choi G, Chevallier P, Stölzel F, Tholouli E, Maertens J, Ciceri F, Cornelissen J, Sanz J, Spyridonidis A, Lanza F, Nagler A, Mohty M. Allogeneic hematopoietic cell transplantation for patients with AML aged 70 years or older in first remission. A study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT). Bone Marrow Transplant 2023; 58:1033-1041. [PMID: 37386253 DOI: 10.1038/s41409-023-02027-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 06/04/2023] [Accepted: 06/21/2023] [Indexed: 07/01/2023]
Abstract
Accessibility to allogeneic hematopoietic cell transplantation (HCT) programs for older patients is growing constantly. We report on the clinical outcomes of a group of 701 adults aged ≥70 years, with acute myeloid leukemia (AML) in first complete remission (CR1), who received a first HCT, from HLA-matched sibling donors (MSD), 10/10 HLA-matched unrelated donors (UD), 9/10 HLA-mismatched unrelated donors (mUD) or haploidentical (Haplo) donors. The 2-year overall survival (OS) was 48.1%, leukemia-free survival (LFS) 45.3%, relapse incidence (RI) 25.2%, non-relapse mortality (NRM) 29.5% and GVHD-free, relapse-free survival (GRFS), 33.4%. Compared to MSD, patients transplanted from Haplo and UD presented lower RI (HR 0.46, 95% CI 0.25-0.8, p = 0.02 and HR 0.44, 95% CI: 0.28-0.69, p = 0.001, respectively); this translated into prolonged LFS for Haplo (HR 0.62, 95% CI: 0.39-0.99, p = 0.04). Patients transplanted from mUD exhibited the highest NRM incidence (HR 2.33, 95% CI: 1.26-4.31, p = 0.007). HCT in selected adult CR1 AML patients >70 years is feasible and could be associated with good clinical outcomes. Prospective clinical trials are warranted.
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Affiliation(s)
- Enrico Maffini
- IRCCS Azienda Ospedaliero-Universitaria di Bologna; Istituto "L. e A. Seràgnoli", Bologna, Italy.
| | - Maud Ngoya
- EBMT ALWP Statistical Unit, Saint Antoine Hospital, Sorbonne University, Paris, France
| | | | - Samia Harbi
- Programme de Transplantation et Therapie Cellulaire, Centre de Recherche en Cancerologie de Marseille, Institut Paoli Calmettes, Marseille, France
| | - Nicolaus Kröger
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Uwe Platzbecker
- Medical Clinic and Policlinic 1, Hematology and Cellular Therapy, University hospital Leipzig, Leipzig, Germany
| | - Henrik Sengeloev
- Bone Marrow Transplant Unit L 4043, National University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Charles Craddock
- Birmingham Centre for Cellular Therapy and Transplantation, Birmingham, UK
| | - Victoria Potter
- Department of Haematological Medicine, Kings College Hospital, King's Denmark Hill Campus, London, UK
| | - Goda Choi
- University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | | | - Friedrich Stölzel
- University Hospital Dresden, Medizinische Klinik und Poliklinik I, Dresden, TU Dresden, Germany
| | - Eleni Tholouli
- Haematology Department, Manchester Royal Infirmary, Oxford Road, Manchester, UK
| | - Johan Maertens
- Department of Hematology, University Hospital Gasthuisberg, Leuven, Belgium
| | - Fabio Ciceri
- Ospedale San Raffaele s.r.l., Haematology and BMT, Milano, Italy
| | - Jan Cornelissen
- Department of Haematology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jaime Sanz
- Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Alexandros Spyridonidis
- Bone Marrow Transplantation Unit and Institute of Cellular therapy, University of Patras, Patras, Greece
| | - Francesco Lanza
- Hematology Unit, Ravenna Public Hospital and Romagna Transplant Network, Ravenna, Italy
| | - Arnon Nagler
- Sheba Medical Center, Tel-Hashomer, Tel-Aviv University, Ramat-Gan, Israel
| | - Mohamad Mohty
- Clinical Hematology and Cellular Therapy Department, Sorbonne University, Saint Antoine Hospital, INSERM UMRs 938, Paris, France
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Ostuni A, Accorsi P, Mazzoni A, Vacca M, Colpo A, Agostini V, Crovetti G, Iuliani O, Michelotti A, Rondinelli MB, Zanella A, Antozzi C, De Silvestro G, Lanza F, Montanari M, Trinchero M. A report from the SIdEM: Italy. Transfus Apher Sci 2023; 62:103761. [PMID: 37495449 DOI: 10.1016/j.transci.2023.103761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
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10
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Lanza F, Rondoni M, Zannetti BA. New Horizons in Immunology and Immunotherapy of Acute Leukemias and Related Disorders. Cancers (Basel) 2023; 15:cancers15092422. [PMID: 37173889 PMCID: PMC10177104 DOI: 10.3390/cancers15092422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 04/12/2023] [Indexed: 05/15/2023] Open
Abstract
Accumulating data have shown that molecular aberrations have the potential to trigger the development of acute leukemia, and that the routine application of novel molecular biology technologies has facilitated the development of investigational drugs which target driver genetic mutations [...].
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Affiliation(s)
- Francesco Lanza
- Hematology Unit and Metropolitan Romagna Transplant Network, University of Bologna, 40126 Ravenna, Italy
| | - Michela Rondoni
- Hematology Unit and Metropolitan Romagna Transplant Network, University of Bologna, 40126 Ravenna, Italy
| | - Beatrice Anna Zannetti
- Hematology Unit and Metropolitan Romagna Transplant Network, University of Bologna, 40126 Ravenna, Italy
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Todisco E, Papayannidis C, Fracchiolla N, Petracci E, Zingaretti C, Vetro C, Martelli MP, Zappasodi P, Di Renzo N, Gallo S, Audisio E, Griguolo D, Cerchione C, Selleri C, Mattei D, Bernardi M, Fumagalli M, Rizzuto G, Facchini L, Basilico CM, Manfra I, Borlenghi E, Cairoli R, Salutari P, Gottardi M, Molteni A, Martini V, Lunghi M, Fianchi L, Cilloni D, Lanza F, Abruzzese E, Cascavilla N, Rivellini F, Ferrara F, Maurillo L, Nanni J, Romano A, Cardinali V, Gigli F, Roncoroni E, Federico V, Marconi G, Volpi R, Sciumè M, Tarella C, Rossi G, Martinelli G. AVALON: The Italian cohort study on real-life efficacy of hypomethylating agents plus venetoclax in newly diagnosed or relapsed/refractory patients with acute myeloid leukemia. Cancer 2023; 129:992-1004. [PMID: 36692409 DOI: 10.1002/cncr.34608] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 07/19/2022] [Revised: 10/21/2022] [Accepted: 10/29/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Venetoclax in combination with hypomethylating agents (HMA) is revolutionizing the therapy of acute myeloid leukemia (AML). However, evidence on large sets of patients is lacking, especially in relapsed or refractory leukemia. METHODS AVALON is a multicentric cohort study that was conducted in Italy on patients with AML who received venetoclax-based therapies from 2015 to 2020. The study was approved by the ethics committee of the participating institution and was conducted in accordance with the Declaration of Helsinki. The effectiveness and toxicity of venetoclax + HMA in 190 (43 newly diagnosed, 68 refractory, and 79 relapsed) patients with AML are reported here. RESULTS In the newly diagnosed AML, the overall response rate and survival confirmed the brilliant results demonstrated in VIALE-A. In the relapsed or refractory AML, the combination demonstrated a surprisingly complete remission rate (44.1% in refractory and 39.7% in relapsed evaluable patients) and conferred to treated patients a good expectation of survival. Toxicities were overall manageable, and most incidents occurred in the first 60 days of therapy. Infections were confirmed as the most common nonhematologic adverse event. CONCLUSIONS Real-life data show that the combination of venetoclax and HMA offers an expectation of remission and long-term survival to elderly, newly diagnosed patients, and to relapsed or chemoresistant AML, increasing the chance of cure through a different mechanism of action. The venetoclax + HMA combination is expected to constitute the base for triplet combinations and integration of target therapies. Our data contribute to ameliorate the understanding of venetoclax + HMA effectiveness and toxicities in real life.
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Affiliation(s)
- Elisabetta Todisco
- Divisione di Oncoematologia, IRCCS Istituto Europeo di Oncologia, Milano, Italy.,SC Ematologia, Ospedale Busto Arsizio, ASST Valle Olona, Varese, Italy
| | - Cristina Papayannidis
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Nicola Fracchiolla
- UOC Oncoematologia, Fondazione IRCCS "Ca'Granda" Ospedale Maggiore Policlinico, Milano, Italy
| | - Elisabetta Petracci
- Unità di Biostatistica e Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (ISRT) "Dino Amadori", Meldola, Italy
| | - Chiara Zingaretti
- Unità di Biostatistica e Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (ISRT) "Dino Amadori", Meldola, Italy
| | - Calogero Vetro
- Divisione di Ematologia, AOU Policlinico "G. Rodolico-San Marco", Catania, Italy
| | - Maria Paola Martelli
- Dipartimento di Medicina e Chirurgia, Università di Perugia, Ospedale "Santa Maria della Misericordia", Perugia, Italy
| | - Patrizia Zappasodi
- Dipartimento di Oncoematologia, Fondazione IRCCS Policlinico "San Matteo", Pavia, Italy
| | - Nicola Di Renzo
- Unità di Ematologia e TCS, Ospedale "Vito Fazzi", Lecce, Italy
| | - Susanna Gallo
- SCDU di Ematologia e Terapie Cellulari, AO Ordine Mauriziano, Torino, Italy
| | - Ernesta Audisio
- SC Ematologia 2, AOU Città della Salute e della Scienza, Torino, Italy
| | | | - Claudio Cerchione
- Dipartimento di Oncologia ed Ematologia Clinica e Sperimentale, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Carmine Selleri
- UOC Ematologia, AOU "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Daniele Mattei
- SC di Ematologia, AO "Santa Croce e Carle", Cuneo, Italy
| | - Massimo Bernardi
- UO Ematologia e Centro Trapianto di Midollo Osseo, IRCCS Ospedale "San Raffaele", Milano, Italy
| | - Monica Fumagalli
- SC Ematologia, Ospedale "San Gerardo", ASST di Monza, Monza, Italy
| | - Giuliana Rizzuto
- UOC Ematologia e Centro Trapianto di Midollo Osseo, ASST "Papa Giovanni XXIII", Bergamo, Italy
| | - Luca Facchini
- UOC Ematologia, Azienda USL IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Ilenia Manfra
- UO Ematologia, Azienda Ospedaliera "S. G. Moscati", Avellino, Italy
| | - Erika Borlenghi
- UO Ematologia, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Roberto Cairoli
- SC Ematologia, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Prassede Salutari
- UOC Ematologia Clinica, Ospedale Civile "Santo Spirito", Pescara, Italy
| | - Michele Gottardi
- Dipartimento di Oncologia, UOC Oncoematologia, Istituto Oncologico Veneto (IOV) IRCCS, Padova, Italy
| | | | | | - Monia Lunghi
- SCDU Ematologia, AOU "Maggiore della Carità", Novara, Italy
| | - Luana Fianchi
- UOC Ematologia e TCSE, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Roma, Italy
| | - Daniela Cilloni
- Dipartimento di Scienze Cliniche e Biologiche, Università di Torino, Torino, Italy
| | - Francesco Lanza
- UO Ematologia, Ospedale "Santa Maria delle Croci", AUSL Romagna, Ravenna, Italy
| | - Elisabetta Abruzzese
- Dipartimento di Ematologia, Ospedale "S. Eugenio", Università Tor Vergata, Roma, Italy
| | - Nicola Cascavilla
- UO Ematologia, Ospedale "Casa Sollievo della Sofferenza" IRCCS, San Giovanni Rotondo, Italy
| | - Flavia Rivellini
- UOC Oncoematologia, Presidio Ospedaliero "A. Tortora", Pagani, Italy
| | | | - Luca Maurillo
- Dipartimento di Biomedicina e Prevenzione, Università Tor Vergata, Roma, Italy
| | - Jacopo Nanni
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Alessandra Romano
- Divisione di Ematologia, AOU Policlinico "G. Rodolico-San Marco", Catania, Italy
| | - Valeria Cardinali
- Dipartimento di Medicina e Chirurgia, Università di Perugia, Ospedale "Santa Maria della Misericordia", Perugia, Italy
| | - Federica Gigli
- Divisione di Oncoematologia, IRCCS Istituto Europeo di Oncologia, Milano, Italy
| | - Elisa Roncoroni
- Dipartimento di Oncoematologia, Fondazione IRCCS Policlinico "San Matteo", Pavia, Italy
| | | | - Giovanni Marconi
- Dipartimento di Oncologia ed Ematologia Clinica e Sperimentale, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Roberta Volpi
- Unità di Biostatistica e Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (ISRT) "Dino Amadori", Meldola, Italy
| | - Mariarita Sciumè
- UOC Oncoematologia, Fondazione IRCCS "Ca'Granda" Ospedale Maggiore Policlinico, Milano, Italy
| | - Corrado Tarella
- Divisione di Oncoematologia, IRCCS Istituto Europeo di Oncologia, Milano, Italy
| | - Giuseppe Rossi
- UO Ematologia, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Giovanni Martinelli
- Dipartimento di Oncologia ed Ematologia Clinica e Sperimentale, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
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Lanza F, De Giorgio R, Zavagli G. The oldest case of lymphoma? Insights from a XIII century fresco. Br J Haematol 2023; 201:806. [DOI: 10.1111/bjh.18750] [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] [Received: 02/03/2023] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 03/29/2023]
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13
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Lanza F, Monaco F, Ciceri F, Cairoli R, Sacchi MV, Guidetti A, Marchetti M, Massaia M, Arcaini L, Krampera M, Mohamed S, Gherlinzoni F, Mecucci C, Gentile M, Romano I, Venditti A, Ruggeri M, Ferrero D, Coviello E, Fabbri E, Corradini P, Passamonti F. Lack of efficacy of convalescent plasma in COVID-19 patients with concomitant hematological malignancies: An Italian retrospective study. Hematol Oncol 2022; 40:857-863. [PMID: 35932208 PMCID: PMC9538413 DOI: 10.1002/hon.3060] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/27/2022] [Accepted: 07/30/2022] [Indexed: 12/13/2022]
Abstract
A multicenter retrospective study was designed to assess clinical outcome of COVID-19 in patients with hematological malignancies (HM) following treatment with anti-SARS-CoV-2 convalescent plasma (CP) or standard of care therapy. To this aim, a propensity score matching was used to assess the role of non-randomized administration of CP in this high-risk cohort of patients from the Italian Hematology Alliance on COVID-19 (ITA-HEMA-COV) project, now including 2049 untreated control patients. We investigated 30- and 90-day mortality, rate of admission to intensive care unit, proportion of patients requiring mechanical ventilatory support, hospitalization time, and SARS-CoV-2 clearance in 79 CP recipients and compared results with 158 propensity score-matched controls. Results indicated a lack of efficacy of CP in the study group compared with the untreated group, thus confirming the negative results obtained from randomized studies in immunocompetent individuals with COVID-19. In conclusion, this retrospective analysis did not meet the primary and secondary end points in any category of immunocompromized patients affected by HM.
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Affiliation(s)
| | | | - Fabio Ciceri
- IRCCS Ospedale San RaffaeleUniversity Vita‐Salute San RaffaeleMilanoItaly
| | | | - Maria Vittoria Sacchi
- Hematology Unit, SCDU Ematologia ‐ Az Ospedaliera Santi Antonio e Biagio e Cesare ArrigoAlessandriaItaly
| | | | - Monia Marchetti
- Hematology Unit, SCDU Ematologia ‐ Az Ospedaliera Santi Antonio e Biagio e Cesare ArrigoAlessandriaItaly
| | | | - Luca Arcaini
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo and Department of Molecular MedicineUniversity of PaviaPaviaItaly
| | | | - Sara Mohamed
- Hematology UnitAzienda Sanitaria Universitaria Giuliano IsontinaTriesteItaly
| | | | | | | | | | - Adriano Venditti
- Hematology, Department of Biomedicine and PreventionUniversity Tor VergataRomaItaly
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14
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Zappasodi P, Cattaneo C, Valeria Ferretti V, Mina R, José María Ferreri A, Merli F, Oberti M, Krampera M, Romano A, Zerbi C, Ferrari J, Cavo M, Salvini M, Bertù L, Stefano Fracchiolla N, Marchesi F, Massaia M, Marasco V, Cairoli R, Maria Scattolin A, Maria Vannucchi A, Gambacorti‐Passerini C, Musto P, Gherlinzoni F, Cuneo A, Pinto A, Trentin L, Bocchia M, Galimberti S, Coviello E, Chiara Tisi M, Morotti A, Falini B, Turrini M, Tafuri A, Billio A, Gentile M, Massimo Lemoli R, Venditti A, Giovanni Della Porta M, Lanza F, Rigacci L, Tosi P, Mohamed S, Corso A, Luppi M, Giuliani N, Busca A, Pagano L, Bruno R, Antonio Grossi P, Corradini P, Passamonti F, Arcaini L. Secondary infections worsen the outcome of COVID-19 in patients with hematological malignancies: A report from the ITA-HEMA-COV. Hematol Oncol 2022; 40:846-856. [PMID: 35854643 PMCID: PMC9349965 DOI: 10.1002/hon.3048] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 12/13/2022]
Abstract
The impact of secondary infections (SI) on COVID-19 outcome in patients with hematological malignancies (HM) is scarcely documented. To evaluate incidence, clinical characteristics, and outcome of SI, we analyzed the microbiologically documented SI in a large multicenter cohort of adult HM patients with COVID-19. Among 1741 HM patients with COVID-19, 134 (7.7%) had 185 SI, with a 1-month cumulative incidence of 5%. Median time between COVID-19 diagnosis and SI was 16 days (IQR: 5-36). Acute myeloid leukemia (AML) and lymphoma/plasma cell neoplasms (PCN) were more frequent diagnoses in SI patients compared to patients without SI (AML: 14.9% vs. 7.1%; lymphoma/PCN 71.7% vs. 65.3%). Patients with SI were older (median age 70 vs. 66 years, p = 0.002), with more comorbidities (median Charlson Comorbidity Index 5 vs. 4, p < 0.001), higher frequency of critical COVID-19 (19.5% vs. 11.5%, p = 0.046), and more frequently not in complete remission (75% vs. 64.7% p = 0.024). Blood and bronchoalveolar lavage were the main sites of isolation for SI. Etiology of infections was bacterial in 80% (n = 148) of cases, mycotic in 9.7% (n = 18) and viral in 10.3% (n = 19); polymicrobial infections were observed in 24 patients (18%). Escherichia coli represented most of Gram-negative isolates (18.9%), while coagulase-negative Staphylococci were the most frequent among Gram-positive (14.2%). The 30-day mortality of patients with SI was higher when compared to patients without SI (69% vs. 15%, p < 0.001). The occurrence of SI worsened COVID-19 outcome in HM patients. Timely diagnosis and adequate management should be considered to improve their prognosis.
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Affiliation(s)
- Patrizia Zappasodi
- Division of Hematology, Fondazione IRCCS Policlinico San MatteoPaviaItaly
| | - Chiara Cattaneo
- Division of HematologyAzienda Socio‐Sanitaria Territoriale‐Spedali CiviliBresciaItaly
| | | | - Roberto Mina
- SSD Clinical Trial in Oncoematologia e Mieloma MultiploDivision of HematologyUniversity of TorinoAzienda Ospedaliero‐Universitaria Città della Salute e della Scienza di TorinoTorinoItaly
| | - Andrés José María Ferreri
- Division of HematologyIstituto di Ricovero e Cura a Carattere Scientifico San Raffaele Scientific InstituteMilanItaly
| | - Francesco Merli
- Division of Hematology, AUSL‐IRCCS Reggio EmiliaReggio EmiliaItaly
| | - Margherita Oberti
- Division of Hematology and Transplant UnitASST Spedali CiviliBresciaItaly
| | - Mauro Krampera
- Division of HematologyAzienda Ospedaliera Integrata di VeronaVeronaItaly
| | - Alessandra Romano
- Division of Hematology and Bone Marrow TransplantationAzienda Ospedaliera Universitaria Policlinico “G. Rodolico—San Marco”CataniaItaly
| | - Caterina Zerbi
- Department of Molecular MedicineUniversity of PaviaPaviaItaly
| | | | - Michele Cavo
- Division of HematologyAzienda Ospedaliero‐Universitaria Policlinico S. Orsola‐MalpighiBolognaItaly
| | - Marco Salvini
- UOC Ematologia, Azienda Socio‐Sanitaria Territoriale Sette Laghi, Ospedale di Circolo of VareseVareseItaly,Department of Medicine and SurgeryUniversity of InsubriaVareseItaly
| | - Lorenza Bertù
- UOC Ematologia, Azienda Socio‐Sanitaria Territoriale Sette Laghi, Ospedale di Circolo of VareseVareseItaly,Department of Medicine and SurgeryUniversity of InsubriaVareseItaly
| | | | | | | | - Vincenzo Marasco
- Division of HematologyFondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei TumoriUniversity of MilanMilanItaly
| | - Roberto Cairoli
- HematologyAzienda Socio‐Sanitaria Territoriale Grande Ospedale Metropolitano NiguardaMilanItaly
| | - Anna Maria Scattolin
- Division of HematologyAzienda Unità Locale Socio‐Sanitaria 3 SerenissimaOspedale dell'AngeloVenezia‐MestreVeniceItaly
| | | | | | - Pellegrino Musto
- Department of Emergency and Organ Transplantation“Aldo Moro” University School of Medicine and Unit of Hematology and Stem Cell Transplantation, AOUC PoliclinicoBariItaly
| | | | - Antonio Cuneo
- Division of HematologyAzienda Ospedaliero Universitaria Arcispedale S. AnnaFerraraItaly
| | - Antonello Pinto
- Hematology, Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico “Fondazione G Pascale,” NaplesNaplesItaly
| | - Livio Trentin
- Division of HematologyAzienda Ospedaliera di PadovaPadovaItaly
| | - Monica Bocchia
- Division of HematologyPoliclinico Santa Maria alle ScotteSienaItaly
| | - Sara Galimberti
- Division of HematologyAzienda Ospedaliera Universitaria Pisana‐ Santa ChiaraPisaItaly
| | - Elisa Coviello
- Ematologia e terapie cellulari. IRCCS Ospedale Policlinico San MartinoGenovaItaly
| | | | - Alessandro Morotti
- Department of Clinical and Biological SciencesUniversity of TorinoOrbassanoItaly
| | - Brunangelo Falini
- Division of Hematology and Transplant UnitAzienda Ospedaliera di PerugiaPerugiaItaly
| | | | - Agostino Tafuri
- Division of HematologyUniversity Hospital Sant'AndreaSapienzaRomeItaly
| | - Atto Billio
- Division of Hematology and Transplant UnitOspedale di BolzanoBolzanoItaly
| | - Massimo Gentile
- Division of HematologyAzienda Ospedaliera di CosenzaCosenzaItaly
| | - Roberto Massimo Lemoli
- Department of Internal Medicine (DiMI)Clinic of Hematology, University of GenoaGenoaItaly,IRCCS‐ San Martino HospitalGenoaItaly
| | - Adriano Venditti
- Department of Biomedicine and PreventionUniversity Tor Vergata RomeRomeItaly
| | - Matteo Giovanni Della Porta
- Division of Hematology, Humanitas Clinical and Research Hospital Istituto di Ricovero e Cura a Carattere Scientifico and Department of Biomedical SciencesHumanitas UniversityMilanItaly
| | - Francesco Lanza
- Division of HematologyOspedale Santa Maria delle CrociRavennaItaly
| | - Luigi Rigacci
- Division of Hematology and Transplant Unit, Azienda Ospedaliera S. Camillo‐ForlaniniRomeItaly
| | - Patrizia Tosi
- Division of HematologyOspedale degli InfermiRiminiItaly
| | - Sara Mohamed
- SC EmatologiaAzienda Sanitaria Universitaria Giuliano IsontinaTriesteItaly
| | | | - Mario Luppi
- Department of Medical and Surgical SciencesUNIMORE. Division of Hematology Azienda Ospedaliero Universitaria ModenaModenaItaly
| | - Nicola Giuliani
- Division of Hematology and Transplant UnitAzienda Ospedaliero‐Universitaria di ParmaSItaly
| | - Alessandro Busca
- SSD Clinical Trial in Oncoematologia e Mieloma MultiploDivision of HematologyUniversity of TorinoAzienda Ospedaliero‐Universitaria Città della Salute e della Scienza di TorinoTorinoItaly
| | - Livio Pagano
- Division of HematologyFondazione Policlinico Universitario Agostino Gemelli ‐ Istituto di Ricovero e Cura a Carattere ScientificoRomeItaly,Hematology, Università Cattolica del Sacro CuoreRomeItaly
| | - Raffaele Bruno
- Division of Infectious and Tropical DiseasesFondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San MatteoPaviaItaly,Department of ClinicalSurgical, Diagnostic, and Paediatric SciencesUniversity of PaviaPaviaItaly
| | - Paolo Antonio Grossi
- Department of Medicine and SurgeryUniversity of InsubriaVareseItaly,Division of Infectious and Tropical DiseasesAzienda Socio‐Sanitaria Territoriale Sette Laghi, Ospedale di Circolo of VareseVareseItaly
| | - Paolo Corradini
- Division of HematologyFondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei TumoriUniversity of MilanMilanItaly
| | - Francesco Passamonti
- UOC Ematologia, Azienda Socio‐Sanitaria Territoriale Sette Laghi, Ospedale di Circolo of VareseVareseItaly,Department of Medicine and SurgeryUniversity of InsubriaVareseItaly
| | - Luca Arcaini
- Division of Hematology, Fondazione IRCCS Policlinico San MatteoPaviaItaly,Department of Molecular MedicineUniversity of PaviaPaviaItaly
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Nagler A, Galimard J, Labopin M, Blaise D, Arcese W, Trisolini SM, Wu D, Pigneux A, Van Gorkom G, Rubio M, Gedde‐Dahl T, Huynh A, Lanza F, Gorin N, Mohty M. Autologous stem cell transplantation (ASCT) for acute myeloid leukemia in patients in first complete remission after one versus two induction courses: A study from the ALWP of the EBMT. Cancer Med 2022; 12:1482-1491. [PMID: 35891608 PMCID: PMC9883552 DOI: 10.1002/cam4.5039] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 06/19/2022] [Accepted: 07/07/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Achieving complete remission (CR) is the main goal in AML treatment and a prerequisite for successful autologous stem cell transplantation (ACT). METHODS Comparing results of peripheral blood ACT in patients with AML in CR1 attained following 1 versus 2 chemotherapy courses transplanted in 2000-2019. RESULTS Patients 1532 (84%) with one and 293 (16%) patients with two induction chemotherapies courses (a total of 1825 patients) were included in the study. Follow-up was 7.9 (95% CI: 7.4-8.4) and 7.7 (95% CI: 7.0-8.6) years (p = 0.8). Time from diagnosis to ACT was 4.7 (range, 3.9-5.8) versus 5.7 (range, 4.7-7.1) months (p < 0.001), respectively. Leukemia free survival (LFS) and overall survival (OS) at 5 years were inferior for patients achieving CR1 with 2 versus 1 course of chemotherapy: 26.6% versus 41.7% (HR = 1.42 [95% CI: 1.22-1.66], p < 0.001) and 36.2% versus 53.3%, (HR = 1.48 [95% CI: 1.25-1.75], p < 0.001), and 5-year relapse incidence (RI) was higher: 67.2% versus 52.3%, (HR = 1.46 [95% CI: 1.25-1.72], p < 0.001). Five-year non-relapse mortality (NRM) was 6.2% versus 6.0% for patients with 2 versus 1 chemotherapy courses, and did not differ significantly (HR = 1.31 [95% CI: 0.81-2.10], p = 0.27). CONCLUSIONS LFS and OS were inferior and relapse rate was higher in AML patients who received two inductions chemotherapy courses to reach CR1 before being autografted. AML patients who required 2 induction courses to achieve remission, may be offered allogeneic transplantation rather than an autologous one in an attempt to reduce their high RI and improve outcomes.
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Affiliation(s)
- Arnon Nagler
- Division of HematologySheba Medical CenterTel HashomerIsrael
| | | | - Myriam Labopin
- EBMT Statistical UnitParisFrance,Department of Clinical Hematology and Cellular Therapy, Saint‐Antoine Hospital, AP‐HPSorbonne UniversityParisFrance,Sorbonne University, INSERM, Saint‐Antoine Research CentreParisFrance
| | - Didier Blaise
- Programme de Transplantation & Therapie Cellulaire; Centre de Recherche en Cancérologie de MarseilleInstitut Paoli CalmettesMarseilleFrance
| | | | - Silvia Maria Trisolini
- Hematology, Department of Translational and Precision MedicineSapienza UniversityRomeItaly
| | - Depei Wu
- First Affiliated Hospital of Soochow University, Department of HematologySuzhouChina
| | - Arnaud Pigneux
- Service d'Hématologie et Thérapie Cellulaire, CHU BordeauxBordeauxFrance
| | - Gwendolyn Van Gorkom
- University Hospital Maastricht, Department of Internal Medicine Hematology/OncologyMaastrichtThe Netherlands
| | - Marie‐Thérèse Rubio
- Department of Hematology, Brabois HospitalCentre Hospitalier Régional Universitaire (CHRU)NancyFrance
| | - Tobias Gedde‐Dahl
- Department of Hematology, Institute of Clinical MedicineUniversity of Oslo and Oslo University Hospital‐RikshospitaletOsloNorway
| | - Anne Huynh
- Hematology DepartmentInstitut Universitaire du Cancer Toulouse‐OncopoleToulouseFrance
| | | | - Norbert‐Claude Gorin
- Department of Clinical Hematology and Cellular Therapy, Saint‐Antoine Hospital, AP‐HPSorbonne UniversityParisFrance,Sorbonne University, INSERM, Saint‐Antoine Research CentreParisFrance
| | - Mohamad Mohty
- Department of Clinical Hematology and Cellular Therapy, Saint‐Antoine Hospital, AP‐HPSorbonne UniversityParisFrance,Sorbonne University, INSERM, Saint‐Antoine Research CentreParisFrance
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16
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Seghatchian J, Pereira P, Lanza F. Spotlights on the latest opinions on identification, prevention, and management of newer CoV-2 variants: a roundup appraisal on innovative ideas and designer vaccines for Omicron. Transfus Apher Sci 2022; 61:103499. [PMID: 35811273 PMCID: PMC9250817 DOI: 10.1016/j.transci.2022.103499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 05/02/2022] [Accepted: 06/30/2022] [Indexed: 10/24/2022]
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Visco C, Marcheselli L, Mina R, Sassone M, Guidetti A, Penna D, Cattaneo C, Bonuomo V, Busca A, Ferreri AJM, Bruna R, Petrucci L, Cairoli R, Salvini M, Bertù L, Ladetto M, Pilerci S, Pinto A, Ramadan S, Marchesi F, Cavo M, Arcaini L, Coviello E, Romano A, Musto P, Massaia M, Fracchiolla N, Marchetti M, Scattolin A, Tisi MC, Cuneo A, Della Porta M, Trentin L, Turrini M, Gherlinzoni F, Tafuri A, Galimberti S, Bocchia M, Cardinali V, Cilloni D, Corso A, Armiento D, Rigacci L, La Barbera EO, Gambacorti-Passerini C, Visani G, Vallisa D, Venditti A, Selleri C, Conconi A, Tosi P, Lanza F, Candoni A, Krampera M, Corradini P, Passamonti F, Merli F. A prognostic model for patients with lymphoma and COVID-19: a multicentre cohort study. Blood Adv 2022; 6:327-338. [PMID: 34644385 PMCID: PMC8516438 DOI: 10.1182/bloodadvances.2021005691] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 09/08/2021] [Indexed: 11/20/2022] Open
Abstract
Lymphoma represents a heterogeneous hematological malignancy (HM), which is characterized by severe immunosuppression. Patients diagnosed of coronavirus disease 2019 (COVID-19) during the course of HM have been described to have poor outcome, with only few reports specifically addressing lymphoma patients. Here, we investigated the clinical behavior and clinical parameters of a large multicenter cohort of adult patients with different lymphoma subtypes, with the aim of identifying predictors of death. The study included 856 patients, of whom 619 were enrolled prospectively in a 1-year frame and were followed-up for a median of 66 days (range 1-395). Patients were managed as outpatient (not-admitted cohort, n = 388) or required hospitalization (n = 468), and median age was 63 years (range 19-94). Overall, the 30- and 100-days mortality was 13% (95% confidence interval (CI), 11% to 15%) and 23% (95% CI, 20% to 27%), respectively. Antilymphoma treatment, including anti-CD20 containing regimens, did not impact survival. Patients with Hodgkin's lymphoma had the more favorable survival, but this was partly related to significantly younger age. The time interval between lymphoma diagnosis and COVID-19 was inversely related to mortality. Multivariable analysis recognized 4 easy-to-use factors (age, gender, lymphocyte, and platelet count) that were associated with risk of death, both in the admitted and in the not-admitted cohort (HR 3.79 and 8.85 for the intermediate- and high-risk group, respectively). Overall, our study shows that patients should not be deprived of the best available treatment of their underlying disease and indicates which patients are at higher risk of death. This study was registered with ClinicalTrials.gov, NCT04352556.
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Affiliation(s)
- Carlo Visco
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | | | - Roberto Mina
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliera Universitaria Citta’della Salute e della Scienza, Turin, Italy
| | - Marianna Sassone
- Lymphoma Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Anna Guidetti
- Hematology and Bone Marrow Transplantation, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, University of Milano, Milano, Italy
| | - Domenico Penna
- Hematology, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Reggio Emilia, Reggio Emilia, Italy
| | - Chiara Cattaneo
- Hematology, Azienda Socio-Sanitaria Territoriale-Spedali Civili, Brescia, Italy
| | - Valentina Bonuomo
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Alessandro Busca
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliera Universitaria Citta’della Salute e della Scienza, Turin, Italy
| | - Andrés José María Ferreri
- Lymphoma Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Riccardo Bruna
- Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont and Ospedale Maggiore della Carità, Novara, Italy
| | - Luigi Petrucci
- Hematology, Department of Translational and Precision Medicine, Sapienza, University of Rome, Rome, Italy
| | - Roberto Cairoli
- Hematology, Azienda Socio-Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Marco Salvini
- Department of Medicine and Surgery, University of Insubria and Azienda Socio-Sanitaria Territoriale Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Lorenza Bertù
- Department of Medicine and Surgery, University of Insubria and Azienda Socio-Sanitaria Territoriale Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Marco Ladetto
- Hematology, Azienda Ospedaliera Santissimi Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Sofia Pilerci
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Antonello Pinto
- Hematology, Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico “Fondazione G Pascale,” Naples, Italy
| | - Safaa Ramadan
- Division of Onco-Hematology, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, Istituto di Ricovero e Cura a Carattere Scientifico Regina Elena National Cancer Institute, Rome, Italy
| | - Michele Cavo
- Seràgnoli Institute of Hematology, Department of Experimental, Diagnostic and Specialty Medicine, Bologna University School of Medicine, Bologna, Italy
| | - Luca Arcaini
- Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo & Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Elisa Coviello
- Hematology and bone marrow transplant, Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genova, Italy
| | - Alessandra Romano
- Hematology, Dipartimento di Chirurgia e Specialità Medico Chirurgiche, Università degli Studi di Catania, Catania, Italy
| | - Pellegrino Musto
- Department of Emergency and Organ Transplantation, Aldo Moro” University School of Medicine and Unit of Hematology and Stem Cell Transplantation, Azienda Ospedaliera Universitaria Consorziale Policlinico, Bari, Italy
| | | | - Nicola Fracchiolla
- Oncoematologia, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milano, Italy
| | - Monia Marchetti
- Hematology, Azienda Ospedaliera Santissimi Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | | | | | - Antonio Cuneo
- Hematology, Azienda Ospedaliero Universitaria Sant’Anna, Ferrara, Italy
| | - Matteo Della Porta
- Humanitas Clinical and Research Hospital Istituto di Ricovero e Cura a Carattere Scientifico and Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Livio Trentin
- Hematology and Clinical Immunology Unit, Department of Medicine, University of Padua, Padua, Italy
| | | | | | - Agostino Tafuri
- Hematology, University Hospital Sant’Andrea, Sapienza, Rome, Italy
| | - Sara Galimberti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Monica Bocchia
- Hematology Unit, University of Siena, Azienda Ospedaliero Universitaria Senese, Siena, Italy
| | | | - Daniela Cilloni
- Department of Clinical and Biological Sciences, University of Turin, San Luigi Hospital, Turin, Italy
| | | | - Daniele Armiento
- Unit of Hematology, Stem Cell Transplantation, University Campus Bio-Medico, Rome, Italy
| | | | - Elettra Ortu La Barbera
- Unità Operativa Complessa Ematologia con Trapianto, Ospedale Santa Maria Goretti, Latina, Italy
| | | | - Giuseppe Visani
- Dipartimento di OncoEmatologia, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
| | | | - Adriano Venditti
- Department of Biomedicine and Prevention, University Tor Vergata Rome, Rome, Italy
| | - Carmine Selleri
- Department of Medicine, Hematology, University of Salerno, Ospedale San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | | | - Patrizia Tosi
- Hematology, Ospedale degli Infermi di Rimini, Rimini, Italy
| | | | - Anna Candoni
- Hematology and Stem Cell Transplant Unit, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Mauro Krampera
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Paolo Corradini
- Hematology and Bone Marrow Transplantation, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, University of Milano, Milano, Italy
| | - Francesco Passamonti
- Department of Medicine and Surgery, University of Insubria and Azienda Socio-Sanitaria Territoriale Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Francesco Merli
- Hematology, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Reggio Emilia, Reggio Emilia, Italy
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18
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Lanza F, Agostini V, Monaco F, Passamonti F, Seghatchian J. Therapeutic Use of Convalescent Plasma in COVID-19 Infected Patients with Concomitant Hematological Disorders. Clin Hematol Int 2021; 3:77-82. [PMID: 34820612 PMCID: PMC8486975 DOI: 10.2991/chi.k.210403.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 02/11/2021] [Accepted: 03/17/2021] [Indexed: 12/27/2022] Open
Abstract
The use of convalescent plasma (CP) from individuals recovered from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a promising therapeutic modality for the coronavirus disease 2019 (COVID-19). CP has been in use for at least a century to provide passive immunity against a number of diseases, and was recently proposed by the World Health Organization for human Ebola virus infection. Only a few small studies have so far been published on patients with COVID-19 and concomitant hematological malignancies (HM). The Italian Hematology Alliance on HM and COVID-19 has found that HM patients with COVID-19 clinically perform more poorly than those with either HM or COVID-19 alone. A COVID-19 infection in patients with B-cell lymphoma is associated with impaired generation of neutralizing antibody titers and lowered clearance of SARS-CoV-2. Treatment with CP was seen to increase antibody titers in all patients and to improve clinical response in 80% of patients examined. However, a recent study has reported impaired production of SARS-CoV-2-neutralizing antibodies in an immunosuppressed individual treated with CP, possibly supporting the notion of virus escape, particularly in immunocompromised individuals where prolonged viral replication occurs. This may limit the efficacy of CP treatment in at least some HM patients. More recently, it has been shown that CP may provide a neutralising effect against B.1.1.7 and other SARS-CoV-2 variants, thus expanding its application in clinical practice. More extensive studies are needed to further assess the use of CP in COVID-19-infected HM patients.
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Affiliation(s)
- Francesco Lanza
- Hematology Unit & Romagna Transplant Network, Ravenna, Italy
| | - Vanessa Agostini
- Transfusion Medicine Department, IRCCS- Ospedale Policlinico San Martino, Genova, Italy
| | - Federica Monaco
- Hematology Unit & Romagna Transplant Network, Ravenna, Italy
| | | | - Jerard Seghatchian
- International Consultancy in Innovative Manufacturing and Quality/Safety of Blood-Derived Bioproducts, London, England, UK
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19
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Preynat-Seauve O, Lanza F, Brioudes E, Modarressi A, Vuagnat H, Boehncke W, Krause K, Brembilla N. 369 An Adipose-derived Stem Cell-engineered matrix represents a promising treatment for chronic wounds. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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20
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Lanza F, Bazarbachi A. Targeted Therapies and Druggable Genetic Anomalies in Acute Myeloid Leukemia: From Diagnostic Tools to Therapeutic Interventions. Cancers (Basel) 2021; 13:4698. [PMID: 34572925 PMCID: PMC8466687 DOI: 10.3390/cancers13184698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 09/14/2021] [Indexed: 12/25/2022] Open
Abstract
Acute myeloid leukemia (AML) is a clonal disorder resulting from acquired somatic mutations in hematopoietic progenitor cells that lead to the dysregulation of differentiation and the proliferation of hematopoietic cells [...].
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Affiliation(s)
- Francesco Lanza
- Hematology Service and Romagna Transplant Network for HSCT, 48121 Ravenna, Italy
| | - Ali Bazarbachi
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut 1107-2020, Lebanon
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21
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Gottardi M, Simonetti G, Sperotto A, Nappi D, Ghelli Luserna di Rorà A, Padella A, Norata M, Giannini MB, Musuraca G, Lanza F, Cerchione C, Martinelli G. Therapeutic Targeting of Acute Myeloid Leukemia by Gemtuzumab Ozogamicin. Cancers (Basel) 2021; 13:cancers13184566. [PMID: 34572794 PMCID: PMC8469571 DOI: 10.3390/cancers13184566] [Citation(s) in RCA: 9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/08/2021] [Accepted: 09/10/2021] [Indexed: 11/16/2022] Open
Abstract
Acute myeloid leukemia (AML) is a complex hematological malignancy characterized by genetic and clinical heterogeneity and high mortality. Despite the recent introduction of novel pharmaceutical agents in hemato-oncology, few advancements have been made in AML for decades. In the last years, the therapeutic options have rapidly changed, with the approval of innovative compounds that provide new opportunities, together with new challenges for clinicians: among them, on 1 September, 2017 the Food and Drug Administration granted approval for Gemtuzumab Ozogamicin (GO) in combination with daunorubicin and cytarabine for the treatment of adult patients affected by newly diagnosed CD33+ AML. Benefits of GO-based regimens were also reported in the pre- and post-transplantation settings. Moreover, several biomarkers of GO response have been suggested, including expression of CD33 and multidrug resistance genes, cytogenetic and molecular profiles, minimal residual disease and stemness signatures. Among them, elevated CD33 expression on blast cells and non-adverse cytogenetic or molecular risk represent largely validated predictors of good response.
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Affiliation(s)
- Michele Gottardi
- Onco Hematology, Department of Oncology, Veneto Institute of Oncology IOV, IRCCS, 31033 Padua, Italy
| | - Giorgia Simonetti
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", 47014 Meldola (FC), Italy
| | - Alessandra Sperotto
- Hematology and Transplant Center Unit, Dipartimento di Area Medica (DAME), Udine University Hospital, 33100 Udine, Italy
| | - Davide Nappi
- Department of Hematology and Cell Bone Marrow Transplantation (CBMT), Ospedale di Bolzano, 39100 Bolzano, Italy
| | - Andrea Ghelli Luserna di Rorà
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", 47014 Meldola (FC), Italy
| | - Antonella Padella
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", 47014 Meldola (FC), Italy
| | - Marianna Norata
- Hematology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", 47014 Meldola (FC), Italy
| | - Maria Benedetta Giannini
- Hematology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", 47014 Meldola (FC), Italy
| | - Gerardo Musuraca
- Hematology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", 47014 Meldola (FC), Italy
| | - Francesco Lanza
- Hematology Unit & Romagna Transplant Network, Ravenna Hospital, 48121 Ravenna, Italy
| | - Claudio Cerchione
- Hematology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", 47014 Meldola (FC), Italy
| | - Giovanni Martinelli
- Scientific Directorate, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", 47014 Meldola (FC), Italy
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22
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Affiliation(s)
- Francesco Lanza
- Hematology Unit and Romagna Transplant Network, Ravenna & Ferrara University, Italy
| | - Enrico Maffini
- Hematology Unit and Romagna Transplant Network, Ravenna & Ferrara University, Italy
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23
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Passamonti F, Romano A, Salvini M, Merli F, Porta MGD, Bruna R, Coviello E, Romano I, Cairoli R, Lemoli R, Farina F, Venditti A, Busca A, Ladetto M, Massaia M, Pinto A, Arcaini L, Tafuri A, Marchesi F, Fracchiolla N, Bocchia M, Armiento D, Candoni A, Krampera M, Luppi M, Cardinali V, Galimberti S, Cattaneo C, La Barbera EO, Mina R, Lanza F, Visani G, Musto P, Petrucci L, Zaja F, Grossi PA, Bertù L, Pagano L, Corradini P. COVID-19 elicits an impaired antibody response against SARS-CoV-2 in patients with haematological malignancies. Br J Haematol 2021; 195:371-377. [PMID: 34272724 PMCID: PMC8444788 DOI: 10.1111/bjh.17704] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [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: 05/25/2021] [Accepted: 06/25/2021] [Indexed: 12/13/2022]
Abstract
COVID‐19 is associated with high mortality in patients with haematological malignancies (HM) and rate of seroconversion is unknown. The ITA‐HEMA‐COV project (NCT04352556) investigated patterns of seroconversion for SARS‐CoV‐2 IgG in patients with HMs. A total of 237 patients, SARS‐CoV‐2 PCR‐positive with at least one SARS‐CoV‐2 IgG test performed during their care, entered the analysis. Among these, 62 (26·2%) had myeloid, 121 (51·1%) lymphoid and 54 (22·8%) plasma cell neoplasms. Overall, 69% of patients (164 of 237) had detectable IgG SARS‐CoV‐2 serum antibodies. Serologically negative patients (31%, 73 of 237) were evenly distributed across patients with myeloid, lymphoid and plasma cell neoplasms. In the multivariable logistic regression, chemoimmunotherapy [odds ratio (OR), 3·42; 95% confidence interval (CI), 1·04–11·21; P = 0·04] was associated with a lower rate of seroconversion. This effect did not decline after 180 days from treatment withdrawal (OR, 0·35; 95% CI: 0·11–1·13; P = 0·08). This study demonstrates a low rate of seroconversion in HM patients and indicates that treatment‐mediated immune dysfunction is the main driver. As a consequence, we expect a low rate of seroconversion after vaccination and thus we suggest testing the efficacy of seroconversion in HM patients.
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Affiliation(s)
- Francesco Passamonti
- Dipartimento di Medicina e Chirurgia, Università dell'Insubria, Varese, Italy.,ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | | | - Marco Salvini
- ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | | | - Matteo G Della Porta
- Department of Biomedical Sciences, Humanitas Clinical and Research Hospital - IRCCS, Humanitas University, Milano, Italy
| | - Riccardo Bruna
- Department of Translational Medicine, University of Eastern Piedmont and Ospedale Maggiore della Carità, Novara, Italy
| | | | - Ilaria Romano
- University of Florence and AOU Careggi, Firenze, Italy
| | | | | | | | - Adriano Venditti
- Ematologia, Dipartimento di Biomedicina e Prevenzione, Università Tor Vergata, Roma, Italy
| | - Alessandro Busca
- Stem Cell Transplant Center, AOU Citta' della Salute e della Scienza of Torino, Torino, Italy
| | - Marco Ladetto
- Dip di Medicina Traslazionale, Università del Piemonte Orientale ed AO SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | | | - Antonio Pinto
- Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Luca Arcaini
- Division of Hematology, Department of Molecular Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Agostino Tafuri
- Department of Clinical and Molecular Medicine, Sapienza, University Hospital Sant'Andrea, University of Rome, Roma, Italy
| | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Nicola Fracchiolla
- Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Monica Bocchia
- Azienda Ospedaliera Universitaria Senese, University of Siena, Siena, Italy
| | - Daniele Armiento
- Unit of Hematology, Stem Cell Transplantation, University Campus Bio-Medico, Rome, Italy
| | - Anna Candoni
- Division of Hematology, University Hospital of Udine -ASUFC, Udine, Italy
| | - Mauro Krampera
- Department of Medicine, University of Verona, Verona, Italy
| | - Mario Luppi
- Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | | | | | | | | | - Roberto Mina
- Università di Torino, Azienda Ospedaliera Città della Salute e della Scienza, Alessandria, Italy
| | | | - Giuseppe Visani
- Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
| | - Pellegrino Musto
- Department of Emergency and Organ Transplantation, Unit of Hematology and Stem Cell Transplantation, "Aldo Moro" University School of Medicine, AOU Consorziale Policlinico, Bari, Italy
| | - Luigi Petrucci
- Division of Hematology, Department of Translational and Precison Medicine, Sapienza University of Rome, Rome, Italy
| | | | - Paolo A Grossi
- Dipartimento di Medicina e Chirurgia, Università dell'Insubria, Varese, Italy.,ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Lorenza Bertù
- ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Livio Pagano
- University Cattolica del Sacro Cuore, Roma, Italy
| | - Paolo Corradini
- University of Milan, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
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24
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Greinix HT, Eikema DJ, Koster L, Penack O, Yakoub-Agha I, Montoto S, Chabannon C, Styczynski J, Nagler A, Robin M, Robinson S, Chalandon Y, Mikulska M, Schönland S, Peric Z, Ruggeri A, Lanza F, De Wreede LC, Mohty M, Basak GW, Kröger N. Improved outcome of patients with graft-versus-host disease after allogeneic hematopoietic cell transplantation for hematologic malignancies over time: an EBMT mega-file study. Haematologica 2021; 107:1054-1063. [PMID: 34162176 PMCID: PMC9052930 DOI: 10.3324/haematol.2020.265769] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Indexed: 11/27/2022] Open
Abstract
Acute graft-versus-host disease (aGvHD) remains a major threat to successful outcome following allogeneic hematopoietic cell transplantation though advances in prophylaxis and supportive care have been made. The aim of this study is to test whether the incidence and mortality of aGvHD have decreased over time. 102,557 patients with a median age of 47.6 years and with malignancies after first allogeneic sibling or unrelated donor (URD) transplant were studied in the following periods: 1990-1995, 1996-2000, 2001-2005, 2006-2010 and 2011-2015. Findings: 100-day incidences of aGvHD grades II-IV decreased from 40% to 38%, 32%, 29% and 28%, respectively, over calendar time (P<0.001). In multivariate analysis URD, not in complete remission (CR) at transplant or untreated, and female donor for male recipient were factors associated with increased risk whereas the use of ATG/alemtuzumab decreased aGvHD incidence. Median follow-up was 214, 169, 127, 81 and 30 months, respectively, for the periods analyzed. Three-year-survival after aGvHD grades II-IV increased significantly from 38% to 40%, 43%, 44%, and 45%, respectively. In multivariate analysis URD, not in CR at transplant, peripheral blood as stem cell source, female donor for male recipient, and the use of ATG/alemtuzumab were associated with increased mortality whereas reduced-intensity conditioning was linked to lower mortality. Mortality increased with increasing patient age but decreased in the recent cohorts. Our analysis demonstrates that aGvHD has decreased over recent decades and also that the survival rates of patients affected with aGvHD has improved.
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Affiliation(s)
- Hildegard T Greinix
- Department of Medicine, Division of Haematology, Medical University of Graz, Graz.
| | | | | | - Olaf Penack
- Medical Department of Hematology, Oncology and Tumor Immunology, Charité Universitaetsmedizin Berlin, Berlin
| | - Ibrahim Yakoub-Agha
- Department of Haematology, CHU de Lille, University Lille, INSERM U1286, Infinite, 59000 Lille
| | - Silvia Montoto
- St. Bartholomew`s hospital, Barts Health NHS Trust, London
| | | | - Jan Styczynski
- Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz
| | - Arnon Nagler
- Hematology and BMT Division, Chaim Sheba Medical Center, Tel-Hashomer, Tel-Aviv University, Ramat-Gan
| | - Marie Robin
- Hematology / Transplantation, Hôpital Saint-Louis, Paris Cedex 10
| | | | - Yves Chalandon
- Département d'Oncologie, Service d'Hématologie, Hôpitaux Universitaires de Genève and Faculty of Medicine, University of Geneva, Geneva
| | - Malgorzata Mikulska
- Division of Infectious Diseases, University of Genova, Ospedale Policlinico San Martino, Genova
| | | | | | - Annalisa Ruggeri
- Hematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan
| | | | | | | | - Grzegorz W Basak
- Department of Hematology, Oncology and Internal Medicine, Medical University of Warsaw, Warsaw
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Barcellini W, Fattizzo B, Giannotta JA, Quattrocchi L, Aydin S, Barone F, Carbone C, Pomponi F, Metafuni E, Beggiato E, Sica S, Di Bona E, Lanza F, Notaro R, Iori AP. COVID-19 in patients with paroxysmal nocturnal haemoglobinuria: an Italian multicentre survey. Br J Haematol 2021; 194:854-856. [PMID: 34036575 PMCID: PMC8239635 DOI: 10.1111/bjh.17558] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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] [Indexed: 11/29/2022]
Affiliation(s)
- Wilma Barcellini
- UOC Ematologia, Fondazione IRCCS Ca' Grande Ospedale Maggiore Policlinico, Milan, Italy
| | - Bruno Fattizzo
- UOC Ematologia, Fondazione IRCCS Ca' Grande Ospedale Maggiore Policlinico, Milan, Italy.,Department of Oncology and Oncohematology, University of Milan, Milan, Italy
| | - Juri A Giannotta
- UOC Ematologia, Fondazione IRCCS Ca' Grande Ospedale Maggiore Policlinico, Milan, Italy
| | - Luisa Quattrocchi
- Ematologia, Dipartimento di Ematologia, Oncologia e Dermatologia, AOU Policlinico Umberto I, Università Sapienza, Rome, Italy
| | - Semra Aydin
- Department of Oncology and Hematology, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | - Federica Barone
- Core Research Laboratory, Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy.,Doctorate School GenOMeC, University of Siena, Siena, Italy
| | - Cecilia Carbone
- Department of Hematology, ASST Spedali Civili di Brescia, Brescia, Italy
| | | | - Elisabetta Metafuni
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Eloise Beggiato
- Department of Oncology and Hematology, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | - Simona Sica
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Eros Di Bona
- Hematology, San Bortolo Hospital, Vicenza, Italy
| | - Francesco Lanza
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy.,Hematology Unit, Romagna Transplant Network, Ravenna, Italy
| | - Rosario Notaro
- Core Research Laboratory, Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy
| | - Anna P Iori
- Ematologia, Dipartimento di Ematologia, Oncologia e Dermatologia, AOU Policlinico Umberto I, Università Sapienza, Rome, Italy
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De Lima MJ, Kebriaei P, Lanza F, Cho C, Giralt S, Popradi G, Hemmer MT, Zhang X, Shah R, Welch VL, Vandendries E, Stelljes M, Marks DI, Saber W. A registry-based, observational safety study of inotuzumab ozogamicin (InO) treatment in patients (pts) with B-cell precursor acute lymphoblastic leukemia (ALL) who proceeded to hematopoietic stem cell transplant (HSCT). J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.7017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7017 Background: InO is a CD22-directed antibody-drug conjugate indicated for treatment of relapsed/refractory (R/R) ALL. InO has been associated with hepatotoxicity and hepatic veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS), particularly post-HSCT. Registry data (Center for International Blood and Marrow Transplant Research [CIBMTR]) was analyzed to assess toxicity in pts with ALL who received InO prior to HSCT. Methods: CIBMTR patient data are being collected for a 5-year period after US approval of InO (Aug 2017 – Aug 2022). Data from US pts age ≥18 y treated with InO who proceeded to allogeneic HSCT were included. Using interim data at 3 y, we evaluated post-HSCT outcomes, including clinical status, overall survival, transplant-related (non-relapse) mortality (NRM), relapse, death after relapse (time from HSCT to death after the first 28 d from any cause with prior relapse/progression post-HSCT), and investigator-defined adverse events, including hepatic VOD/SOS. All statistical analyses are descriptive. Results: Data accrued from 18 Aug 2017 to 17 Aug 2020 for 131 adult pts (median age 40 y) who proceeded to first allogeneic HSCT: 31% in first complete remission (CR1), 46% in CR2, 13% in ≥CR3, 5% in 1st relapse, 2% in ≥3rd relapse, and 3% in primary induction failure. A majority (70%) had transplants from peripheral blood stem cells, and 47% involved an HLA-identical sibling or other related donor. Nearly half received myeloablative conditioning regimens. Before HSCT, 36% of pts received 1 cycle of InO, 46% had 2 cycles, and 17% had ≥3 cycles. Half (48%) received InO as a single agent. Median time from last dose of InO to HSCT was 2.0 mo (range: 0.4–26.2). At time of data-lock (11 Nov 2020), post-transplant data were available for 131 pts. Outcomes for these pts are shown in the Table. Among a subgroup of adults with active R/R ALL (n = 91) at time of HSCT (median of 4 lines prior therapy), VOD/SOS incidence within 100 d of HSCT was 18%. Conclusions: Incidence of VOD/SOS after first HSCT in InO-treated pts with R/R ALL in this study was similar to the 18–19% reported in pooled analyses of 2 clinical trials among InO-treated pts with R/R ALL (Marks et al, Biol Blood Marrow Transplant 2019) and in the INOVATE study (Kantarjian et al, Lancet Haematol 2017). The NRM at 1 y of 21% (23% R/R ALL) is lower than the NRM at 1 y of 38% reported in the pooled analyses of R/R ALL InO recipients.[Table: see text]
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Affiliation(s)
| | - Partow Kebriaei
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Christina Cho
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Sergio Giralt
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Michael T Hemmer
- Center for International Blood and Marrow Transplant Research (CIBMTR), Medical College of Wisconsin, Milwaukee, WI
| | | | | | | | | | | | | | - Wael Saber
- Center for International Blood and Marrow Transplant Research (CIBMTR), Medical College of Wisconsin, Milwaukee, WI
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Seidita V, Lanza F, Pipitone A, Chella A. Robots as intelligent assistants to face COVID-19 pandemic. Brief Bioinform 2021; 22:823-831. [PMID: 33326994 PMCID: PMC7799200 DOI: 10.1093/bib/bbaa361] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 10/10/2020] [Accepted: 11/09/2020] [Indexed: 01/24/2023] Open
Abstract
MOTIVATION The epidemic at the beginning of this year, due to a new virus in the coronavirus family, is causing many deaths and is bringing the world economy to its knees. Moreover, situations of this kind are historically cyclical. The symptoms and treatment of infected patients are, for better or worse even for new viruses, always the same: more or less severe flu symptoms, isolation and full hygiene. By now man has learned how to manage epidemic situations, but deaths and negative effects continue to occur. What about technology? What effect has the actual technological progress we have achieved? In this review, we wonder about the role of robotics in the fight against COVID. It presents the analysis of scientific articles, industrial initiatives and project calls for applications from March to now highlighting how much robotics was ready to face this situation, what is expected from robots and what remains to do. RESULTS The analysis was made by focusing on what research groups offer as a means of support for therapies and prevention actions. We then reported some remarks on what we think is the state of maturity of robotics in dealing with situations like COVID-19.
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Lazzaro C, Castagna L, Lanza F, Laszlo D, Milone G, Pierelli L, Saccardi R. Chemotherapy-based versus chemotherapy-free stem cell mobilization (± plerixafor) in multiple myeloma patients: an Italian cost-effectiveness analysis. Bone Marrow Transplant 2021; 56:1876-1887. [PMID: 33753907 PMCID: PMC8338551 DOI: 10.1038/s41409-021-01251-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 02/03/2021] [Accepted: 02/18/2021] [Indexed: 12/21/2022]
Abstract
Given the availability and efficacy of the mobilizing agent plerixafor in augmenting hematopoietic progenitor cell mobilization with granulocyte colony-stimulating factor (G-CSF), there is a strong case for comparing the cost-effectiveness of mobilization with G-CSF + cyclophosphamide versus G-CSF alone. This study investigated the cost and effectiveness (i.e., successful 4 million-CD34+ collection) of G-CSF alone versus high-dose cyclophosphamide (4 g/m2) + G-CSF mobilization (± on-demand plerixafor) in patients with multiple myeloma (MM) eligible for autograft in Italy. A decision tree-supported cost-effectiveness analysis (CEA) model in MM patients was developed from the societal perspective. The CEA model compared G-CSF alone with cyclophosphamide 4 g/m2 + G-CSF (± on-demand plerixafor) and was populated with demographic, healthcare and non-healthcare resource utilization data collected from a questionnaire administered to six Italian oncohematologists. Costs were expressed in Euro (€) 2019. The CEA model showed that G-CSF alone was strongly dominant versus cyclophosphamide + G-CSF ( ± on-demand plerixafor), with incremental savings of €1198.59 and an incremental probability of a successful 4 million-CD34+ apheresis (+0.052). Sensitivity analyses confirmed the robustness of the base-case results. In conclusion, chemotherapy-free mobilization (± on-demand plerixafor) is a “good value for money” option for MM patients eligible for autograft.
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Affiliation(s)
- Carlo Lazzaro
- Health Economist and Research Director, Studio di Economia Sanitaria, Milan, Italy.
| | - Luca Castagna
- Oncology and Haematology Unit, BMT section, Istituto Clinico Humanitas, Rozzano, Italy
| | - Francesco Lanza
- Hematology Section, Romagna Transplant Network, University Hospital "Santa Maria delle Croci", Ravenna, Italy
| | - Daniele Laszlo
- Stem Cell Mobilization and Collection Unit, IEO IRCCS, Milan, Italy
| | - Giuseppe Milone
- Hematology and BMT Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Luca Pierelli
- Department of Experimental Medicine, University "Sapienza", Rome, Immune-hematology and Transfusion Medicine Unit, Azienda Ospedaliera San Camillo, Rome, Italy
| | - Riccardo Saccardi
- Department of Cellular Therapy and Transfusion Medicine, Careggi University Hospital, Florence, Italy
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Benevolo G, Elli EM, Bartoletti D, Latagliata R, Tiribelli M, Heidel FH, Cavazzini F, Bonifacio M, Crugnola M, Binotto G, D'Addio A, Tieghi A, Bergamaschi M, Caocci G, Polverelli N, Bossi E, Auteri G, Carmosino I, Catani L, Cuneo A, Krampera M, Lanza F, Lemoli RM, Vianelli N, Breccia M, Palumbo GA, Cavo M, Palandri F. Impact of comorbidities and body mass index on the outcome of polycythemia vera patients. Hematol Oncol 2021; 39:409-418. [PMID: 33590502 DOI: 10.1002/hon.2843] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 01/12/2021] [Accepted: 02/08/2021] [Indexed: 11/10/2022]
Abstract
In 816 patients with 2016 World Health Organization-defined polycythemia vera (PV) enrolled in a multicenter retrospective study, we investigated the predictive value of Charlson comorbidity index (CCI) and body mass index (BMI) on thrombosis, progression to post-PV myelofibrosis (PPV-MF) and survival. Patients were subgrouped according to CCI = 0 (58.1%, no comorbidities) or CCI ≥ 1 (41.9%) and according to normal/underweight (BMI < 25, 54.5%) or overweight/obesity (BMI ≥ 25, 45.5%) at PV diagnosis. BMI was available for 529 patients. Patients with CCI ≥ 1 were older and more frequently presented cardiovascular risk factors compared to patients with CCI = 0 (p < 0.001), while overweight/obese patients were more frequently males (p < 0.001). Cumulative incidence of thromboses with death as competing risk was 13.3% at 10 years. Multivariable analysis with death as competing risk showed that previous thromboses (subdistribution hazard ratio [SHR]: 2.1, p = 0.01) and hypertension (SHR: 1.77, p = 0.04) were significantly associated with a higher thrombotic risk, while BMI ≥ 25 lost statistical significance (SHR: 1.69, p = 0.05) and CCI ≥ 1 was excluded after evaluation of goodness of fit. After a median follow-up of 6.1 years, progression to PPV-MF occurred in 44 patients, and 75 patients died. BMI ≥ 25 was associated with a lower probability of progression to PPV-MF (SHR: 0.38, CI95%: 0.15-0.94, p = 0.04) and better survival (hazard ratio [HR]: 0.42, CI95%: 0.18-0.97, p = 0.04). CCI ≥ 1 did not affect progression to PPV-MF (p = 0.44) or survival (p = 0.71). The evaluation of CCI and BMI may improve the prognostic definition of PV. In patients with hypertension an accurate evaluation of thrombotic risk is warranted.
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Affiliation(s)
- Giulia Benevolo
- Division of Hematology, Città della Salute e della Scienza Hospital, Torino, Italy
| | - Elena M Elli
- Hematology Division, San Gerardo Hospital, ASST Monza, Monza, Italy
| | - Daniela Bartoletti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy.,Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna Bologna, Italy
| | - Roberto Latagliata
- Division of Cellular Biotechnologies and Hematology, University Sapienza, Rome, Italy
| | - Mario Tiribelli
- Division of Hematology and BMT, Azienda Sanitaria Universitaria Integrata di Udine, Italy
| | - Florian H Heidel
- Department of Hematology and Oncology, Friedrich-Schiller-University Medical Center, Jena, Germany
| | | | | | - Monica Crugnola
- Division of Hematology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Gianni Binotto
- Unit of Hematology and Clinical Immunology, University of Padova, Padova, Italy
| | - Alessandra D'Addio
- Division of Hematology, Onco-Hematologic Department, AUSL della Romagna, Ravenna, Italy
| | - Alessia Tieghi
- Department of Hematology, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Micaela Bergamaschi
- Department of Internal Medicine (DiMI), Clinic of Hematology, University of Genoa, Genova, Italy
| | - Giovanni Caocci
- Hematology Unit, Department of Medical Sciences, University of Cagliari, Cagliari, Italy
| | - Nicola Polverelli
- Unit of Blood Diseases and Stem Cell Transplantation, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Elisa Bossi
- Hematology Division, San Gerardo Hospital, ASST Monza, Monza, Italy
| | - Giuseppe Auteri
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy.,Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna Bologna, Italy
| | - Ida Carmosino
- Division of Cellular Biotechnologies and Hematology, University Sapienza, Rome, Italy
| | - Lucia Catani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Antonio Cuneo
- Division of Hematology, University of Ferrara, Ferrara, Italy
| | - Mauro Krampera
- Department of Hematology, University of Verona, Verona, Italy
| | - Francesco Lanza
- Division of Hematology, Onco-Hematologic Department, AUSL della Romagna, Ravenna, Italy
| | - Roberto M Lemoli
- Department of Internal Medicine (DiMI), Clinic of Hematology, University of Genoa, Genova, Italy.,IRCCS Policlinico San Martino, Genova, Italy
| | - Nicola Vianelli
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Massimo Breccia
- Division of Cellular Biotechnologies and Hematology, University Sapienza, Rome, Italy
| | - Giuseppe A Palumbo
- Department of Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", University of Catania, Catania, Italy
| | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Francesca Palandri
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
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Maffini E, Labopin M, Beelen DW, Kroeger N, Arat M, Wilson KM, Bay JO, Ganser A, Martin H, Passweg J, Carpenter B, Yakoub-Agha I, Porras RP, Wagner EM, Lanza F, Mohty M, Nagler A. MRD Status Impact on Secondary Acute Myeloid Leukemia Outcomes after Allogeneic Hematopoietic Cell Transplantation. A Study from the Acute Leukemia Working Party (ALWP) of the European Society for Blood and Marrow Transplantation (EBMT). Transplant Cell Ther 2021. [DOI: 10.1016/s2666-6367(21)00171-8] [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: 10/22/2022]
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31
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Gambacorti-Passerini C, Ruggeri M, Aroldi A, Piazza R, Mazzi A, De Silvestro G, Krampera M, Lanza F. Transfusion of blood products derived from SARS-CoV-2+ donors to patients with hematological malignancies. Transfus Apher Sci 2021; 60:103105. [PMID: 33637468 PMCID: PMC7896506 DOI: 10.1016/j.transci.2021.103105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 02/15/2021] [Accepted: 02/17/2021] [Indexed: 11/06/2022]
Affiliation(s)
| | - Marco Ruggeri
- Division of Hematology, San Bortolo Hospital, Vicenza, Italy
| | - Andrea Aroldi
- University of Milano-Bicocca, Monza, Italy; Hematology Division, ASST Monza, Italy
| | - Rocco Piazza
- University of Milano-Bicocca, Monza, Italy; Hematology Division, ASST Monza, Italy
| | - Angela Mazzi
- Transfusion Medicine Unit, Azienda USL-IRCCS, Reggio Emilia, Italy
| | | | - Mauro Krampera
- Section of Hematology, Department of Medicine, University of Verona, Policlinico G.B. Rossi, Verona, Italy
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Strassel C, Lanza F, Gachet C. Plaquettes sanguines de culture : état de l’art. Bulletin de l'Académie Nationale de Médecine 2020; 204:971-980. [PMID: 33078027 PMCID: PMC7556249 DOI: 10.1016/j.banm.2020.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 10/03/2020] [Indexed: 11/09/2022]
Abstract
Les plaquettes sanguines sont des éléments anucléés du sang. D’un diamètre de 2 à 3 μm, ce sont les plus petits éléments figurés du sang. Alors que leur rôle principal est d’arrêter ou prévenir les saignements, elles sont également impliquées dans d’autres fonctions, comme l’immunité, l’inflammation ou la progression tumorale. L’essor des biotechnologies et les connaissances acquises sur les mécanismes qui régulent la biogénèse des plaquettes permettent aujourd’hui d’envisager la production de plaquettes de culture. Dès lors, ce type de produit pourrait avoir sa place pour relever un certain nombre de défis transfusionnels comme l’allo-immunisation ou les états réfractaires. Cependant les rendements de culture restent faibles et de nombreux obstacles doivent encore être franchis avant d’envisager une application en transfusion. Cet article recense les arguments qui motivent la production de plaquettes de culture à visée transfusionnelle et récapitule les principales avancées dans le domaine tout en soulignant ses limites.
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Lanza F, Seghatchian J. Trends and targets of various types of stem cell derived transfusable RBC substitution therapy: Obstacles that need to be converted to opportunity. Transfus Apher Sci 2020; 59:102941. [PMID: 32958397 PMCID: PMC7474814 DOI: 10.1016/j.transci.2020.102941] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A shortage of blood during the pandemic outbreak of COVID-19 is a typical example in which the maintenance of a safe and adequate blood supply becomes difficult and highly demanding. So far, human RBCs have been produced in vitro using diverse sources: hematopoietic stem cells (SCs), embryonic SCs and induced pluripotent SCs. The existing, even safest core of conventional cellular bioproducts destined for transfusion have some shortcoming in respects to: donor -dependency variability in terms of hematological /immunological and process/ storage period issues. SCs-derived transfusable RBC bioproducts, as one blood group type for all, were highly complex to work out. Moreover, the strategies for their successful production are often dependent upon the right selection of starting source materials and the composition and the stability of the right expansion media and the strict compliance to GMP regulatory processes. In this mini-review we highlight some model studies, which showed that the efficiency and the functionality of RBCs that could be produced by the various types of SCs, in relation to the in-vitro culture procedures are such that they may, potentially, be used at an industrial level. However, all cultured products do not have an unlimited life due to the critical metabolic pathways or the metabolites produced. New bioreactors are needed to remove these shortcomings and the development of a new mouse model is required. Modern clinical trials based on the employment of regenerative medicine approaches in combination with novel large-scale bioengineering tools, could overcome the current obstacles in artificial RBC substitution, possibly allowing an efficient RBC industrial production.
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Affiliation(s)
- Francesco Lanza
- Romagna Transplant Network, Hematology Unit, Ravenna Hospital & University of Ferrara-Italy, Via Randi 5, Ravenna, Italy.
| | - Jerard Seghatchian
- International Consultancy in Strategic Safety/Quality Innovations of Blood-Derived Bioproducts and Quality Audit/ Inspection, London, England, UK.
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34
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Passamonti F, Cattaneo C, Arcaini L, Bruna R, Cavo M, Merli F, Angelucci E, Krampera M, Cairoli R, Della Porta MG, Fracchiolla N, Ladetto M, Gambacorti Passerini C, Salvini M, Marchetti M, Lemoli R, Molteni A, Busca A, Cuneo A, Romano A, Giuliani N, Galimberti S, Corso A, Morotti A, Falini B, Billio A, Gherlinzoni F, Visani G, Tisi MC, Tafuri A, Tosi P, Lanza F, Massaia M, Turrini M, Ferrara F, Gurrieri C, Vallisa D, Martelli M, Derenzini E, Guarini A, Conconi A, Cuccaro A, Cudillo L, Russo D, Ciambelli F, Scattolin AM, Luppi M, Selleri C, Ortu La Barbera E, Ferrandina C, Di Renzo N, Olivieri A, Bocchia M, Gentile M, Marchesi F, Musto P, Federici AB, Candoni A, Venditti A, Fava C, Pinto A, Galieni P, Rigacci L, Armiento D, Pane F, Oberti M, Zappasodi P, Visco C, Franchi M, Grossi PA, Bertù L, Corrao G, Pagano L, Corradini P. Clinical characteristics and risk factors associated with COVID-19 severity in patients with haematological malignancies in Italy: a retrospective, multicentre, cohort study. Lancet Haematol 2020; 7:e737-e745. [PMID: 32798473 PMCID: PMC7426107 DOI: 10.1016/s2352-3026(20)30251-9] [Citation(s) in RCA: 372] [Impact Index Per Article: 93.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/19/2020] [Accepted: 07/21/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Several small studies on patients with COVID-19 and haematological malignancies are available showing a high mortality in this population. The Italian Hematology Alliance on COVID-19 aimed to collect data from adult patients with haematological malignancies who required hospitalisation for COVID-19. METHODS This multicentre, retrospective, cohort study included adult patients (aged ≥18 years) with diagnosis of a WHO-defined haematological malignancy admitted to 66 Italian hospitals between Feb 25 and May 18, 2020, with laboratory-confirmed and symptomatic COVID-19. Data cutoff for this analysis was June 22, 2020. The primary outcome was mortality and evaluation of potential predictive parameters of mortality. We calculated standardised mortality ratios between observed death in the study cohort and expected death by applying stratum-specific mortality rates of the Italian population with COVID-19 and an Italian cohort of 31 993 patients with haematological malignancies without COVID-19 (data up to March 1, 2019). Multivariable Cox proportional hazards model was used to identify factors associated with overall survival. This study is registered with ClinicalTrials.gov, NCT04352556, and the prospective part of the study is ongoing. FINDINGS We enrolled 536 patients with a median follow-up of 20 days (IQR 10-34) at data cutoff, 85 (16%) of whom were managed as outpatients. 440 (98%) of 451 hospitalised patients completed their hospital course (were either discharged alive or died). 198 (37%) of 536 patients died. When compared with the general Italian population with COVID-19, the standardised mortality ratio was 2·04 (95% CI 1·77-2·34) in our whole study cohort and 3·72 (2·86-4·64) in individuals younger than 70 years. When compared with the non-COVID-19 cohort with haematological malignancies, the standardised mortality ratio was 41·3 (38·1-44·9). Older age (hazard ratio 1·03, 95% CI 1·01-1·05); progressive disease status (2·10, 1·41-3·12); diagnosis of acute myeloid leukaemia (3·49, 1·56-7·81), indolent non-Hodgin lymphoma (2·19, 1·07-4·48), aggressive non-Hodgkin lymphoma (2·56, 1·34-4·89), or plasma cell neoplasms (2·48, 1·31-4·69), and severe or critical COVID-19 (4·08, 2·73-6·09) were associated with worse overall survival. INTERPRETATION This study adds to the evidence that patients with haematological malignancies have worse outcomes than both the general population with COVID-19 and patients with haematological malignancies without COVID-19. The high mortality among patients with haematological malignancies hospitalised with COVID-19 highlights the need for aggressive infection prevention strategies, at least until effective vaccination or treatment strategies are available. FUNDING Associazione italiana contro le leucemie, linfomi e mieloma-Varese Onlus.
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Affiliation(s)
- Francesco Passamonti
- Department of Medicine and Surgery, University of Insubria and ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy.
| | | | - Luca Arcaini
- Department of Molecular Medicine, University of Pavia, Pavia, Italy; Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Riccardo Bruna
- Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont and Ospedale Maggiore della Carità, Novara, Italy
| | - Michele Cavo
- Seràgnoli Institute of Hematology, Department of Experimental, Diagnostic and Specialty Medicine, Bologna University School of Medicine, Bologna, Italy
| | - Francesco Merli
- Hematology, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | | | - Mauro Krampera
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Roberto Cairoli
- Hematology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Matteo Giovanni Della Porta
- Humanitas Clinical and Research Hospital-IRCCS and Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | | | - Marco Ladetto
- Hematology, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | | | - Marco Salvini
- Department of Medicine and Surgery, University of Insubria and ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Monia Marchetti
- Hematology, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Roberto Lemoli
- Dipartimento di Medicina interna e Specialità mediche, University of Genoa, Genoa, Italy
| | | | - Alessandro Busca
- Stem Cell Transplant Center, AOU Citta' della Salute e della Scienza, Turin, Italy
| | - Antonio Cuneo
- Hematology, Azienda Ospedaliero Universitaria Sant'Anna, Ferrara, Italy
| | - Alessandra Romano
- Hematology, Dipartimento di Chirurgia e Specialità Medico Chirurgiche, Università degli Studi di Catania, Catania, Italy
| | - Nicola Giuliani
- Dipartimento di Medicina e Chirurgia, University of Parma, Parma, Italy
| | - Sara Galimberti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Alessandro Morotti
- Department of Clinical and Biological Sciences, Università di Torino, Turin, Italy
| | | | | | | | - Giuseppe Visani
- Dipartimento di Onco- Ematologia, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
| | | | - Agostino Tafuri
- Hematology, University Hospital Sant'Andrea, Sapienza, Rome, Italy; Department of Clinical and Molecular Medicine, Sapienza, University of Rome, Rome, Italy
| | - Patrizia Tosi
- Hematology, Ospedale degli Infermi di Rimini, Rimini, Italy
| | | | | | | | | | - Carmela Gurrieri
- Dipartimento Strutturale Aziendale Medicina, University of Padova, Padova, Italy
| | | | - Maurizio Martelli
- Hematology, Department of Translational and Precision Medicine, Sapienza, University of Rome, Rome, Italy
| | | | | | | | | | - Laura Cudillo
- Hematology, San Giovanni Addolorata Hospital, Rome, Italy
| | - Domenico Russo
- Dipartimento di Scienze Cliniche e Sperimentali, University of Brescia, Brescia, Italy
| | | | | | - Mario Luppi
- Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell'Adulto, University of Modena and Reggio Emilia, Azienda Ospedaliera Universitaria, Modena, Italy
| | - Carmine Selleri
- Hematology, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy
| | - Elettra Ortu La Barbera
- UOC Ematologia con Trapianto, Ospedale Santa Maria Goretti, Latina, Italy; Hematology, Ospedale Santa Maria Goretti, Latina, Italy
| | - Celestino Ferrandina
- Hematology, Ospedali Riuniti Azienda Ospedaliera Universitaria di Foggia, Foggia, Italy
| | - Nicola Di Renzo
- Hematology and Transplant Unit, Ospedale Vito Fazzi, Lecce, Italy
| | | | - Monica Bocchia
- Hematology Unit, University of Siena, Azienda Ospedaliero Universitaria Senese, Siena, Italy
| | | | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Pellegrino Musto
- Department of Emergency and Organ Transplantation, "Aldo Moro" University School of Medicine and Unit of Hematology and Stem Cell Transplantation, AOU Consorziale Policlinico, Bari, Italy
| | | | - Anna Candoni
- Dipartimento di Medicina Specialistica, University of Udine, Udine, Italy
| | | | - Carmen Fava
- Department of Clinical and Biological Sciences, Università di Torino, Turin, Italy
| | - Antonio Pinto
- Hematology, Istituto Nazionale Tumori IRCCS "Fondazione G Pascale", Naples, Italy
| | | | | | - Daniele Armiento
- Unit of Hematology, Stem Cell Transplantation, University Campus Bio-Medico, Rome, Italy
| | - Fabrizio Pane
- Department of Clinical Medicine and Surgery, Federico II Hospital, Naples, Italy
| | | | - Patrizia Zappasodi
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Carlo Visco
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Matteo Franchi
- Laboratory of Healthcare Research & Pharmacoepidemiology, Department of Statistics and Quantitative Methods, Università degli Studi di Milano-Bicocca, Milan, Italy; National Centre for Healthcare Research and Pharmacoepidemiology, Milan, Italy
| | - Paolo Antonio Grossi
- Department of Medicine and Surgery, University of Insubria and ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Lorenza Bertù
- Department of Medicine and Surgery, University of Insubria and ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Giovanni Corrao
- Laboratory of Healthcare Research & Pharmacoepidemiology, Department of Statistics and Quantitative Methods, Università degli Studi di Milano-Bicocca, Milan, Italy; National Centre for Healthcare Research and Pharmacoepidemiology, Milan, Italy
| | - Livio Pagano
- Dipartimento di Scienze Radiologiche ed Ematologiche, Fondazione Policlinico Universitario A Gemelli-IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy
| | - Paolo Corradini
- Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, University of Milano
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Lanza F, Maffini E, Saraceni F, Massari E, Rondoni M, Daghia G, Olivieri A, Cerchione C, Martinelli G. New monoclonal antibodies and tyrosine kinase inhibitors in B-cell acute lymphoblastic leukemia. Minerva Med 2020; 111:478-490. [PMID: 32955830 DOI: 10.23736/s0026-4806.20.07031-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Patients with acute lymphoblastic leukemia (ALL) are characterized by an unfavorable outcome in the majority of adult cases. Several clinical trials have confirmed the usefulness of a pediatric-type therapy applied to adult patients. Adults present with higher risk features at diagnosis that predispose them to chemotherapy resistance and disease relapse after an initial achievement of complete remission. The recent introduction of novel immune-targeted therapies, including monoclonal antibodies (MoAbs) targeting B cell-associated antigens such as CD19 (blinatumumab) and CD22 (inotuzumab), tyrosine kinase inhibitors targeting BCR-ABL1 tyrosine kinase, bispecific antibodies and chimeric antigen receptor T- cell therapy (CAR-T), circumvent B-ALL cell chemo-refractoriness through novel mechanisms of action, potentially eradicating minimal residual disease (MRD) and enabling more patients to receive allogeneic hematopoietic stem cell transplantation and to achieve a better clinical outcome.
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Affiliation(s)
- Francesco Lanza
- Hematology Unit and Romagna Transplant Network, "Santa Maria delle Croci" Hospital, Ravenna, Italy -
| | - Enrico Maffini
- Hematology Unit and Romagna Transplant Network, "Santa Maria delle Croci" Hospital, Ravenna, Italy
| | | | | | - Michela Rondoni
- Hematology Unit and Romagna Transplant Network, "Santa Maria delle Croci" Hospital, Ravenna, Italy
| | - Giulia Daghia
- Hematology Unit and Romagna Transplant Network, "Santa Maria delle Croci" Hospital, Ravenna, Italy
| | | | - Claudio Cerchione
- Unit of Hematology, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Meldola, Forlì-Cesena, Italy
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Lanza F, Seghatchian J. An Overview of Current Position on Cell Therapy in Transfusion Science and Medicine: From Fictional Promises to Factual and Perspectives from Red Cell Substitution to Stem Cell Therapy. Transfus Apher Sci 2020; 59:102940. [PMID: 32950375 DOI: 10.1016/j.transci.2020.102940] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 01/17/2023]
Abstract
Stem cell therapy is a relatively novel field of investigation, in which either differentiated cells or stem cells capable of differentiation are transplanted into an individual with the objective of yielding specific cell types in the damaged tissue and consequently restoring its function. The most successful example of cell therapy is hematopoietic stem cell transplantation, leading to regeneration of a patient's blood cells, now a widely established procedure for many oncologic and non-oncologic diseases. Innovative cell-based therapies are being developed to replace, regenerate or repair injured, absent, or diseased tissues and organs. However, cell therapy bioproducts are based on their inherent biological features such as proliferation, migratory, capability, plasticity, and capacity of self-renewal, posing serious challenges during such bioproduct development. The extraordinary promise of stem cells for future treatments of otherwise intractable diseases has raised great hope and expectations in patients, advocates, physicians, and researchers alike. However, despite thousands of scientific publications and research programs, increased efforts need to be put into the identification of the factors involved, biological mechanisms and materials that affect safety/ efficacy, and into the design of cost-effective methods for the harvesting, expansion, manipulation and purification of the cells.
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Affiliation(s)
- Francesco Lanza
- Romagna Transplant Network, Hematology Unit, Ravenna, Via Randi 5, Ravenna, Italy.
| | - Jerard Seghatchian
- International Consultancy in Strategic Safety/Quality Innovations of Blood- Derived Bioproducts and Quality Audit/Inspection, London, England, UK.
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Lanza F, Seidita V, Chella A. Agents and robots for collaborating and supporting physicians in healthcare scenarios. J Biomed Inform 2020; 108:103483. [PMID: 32603793 PMCID: PMC7320857 DOI: 10.1016/j.jbi.2020.103483] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 06/01/2020] [Accepted: 06/08/2020] [Indexed: 11/20/2022]
Abstract
Monitoring patients through robotics telehealth systems is an interesting scenario where patients' conditions, and their environment, are dynamic and unknown variables. We propose to improve telehealth systems' features to include the ability to serve patients with their needs, operating as human caregivers. The objective is to support the independent living of patients at home without losing the opportunity to monitor their health status. Application scenarios are several, and they spread from simple clinical assisting scenarios to an emergency one. For instance, in the case of a nursing home, the system would support in continuously monitoring the elderly patients. In contrast, in the case of an epidemic diffusion, such as COVID-19 pandemic, the system may help in all the early triage phases, significantly reducing the risk of contagion. However, the system has to let medical assistants perform actions remotely such as changing therapies or interacting with patients that need support. The paper proposes and describes a multi-agent architecture for intelligent medical care. We propose to use the beliefs-desires-intentions agent architecture, part of it is devised to be deployed in a robot. The result is an intelligent system that may allow robots the ability to select the most useful plan for unhandled situations and to communicate the choice to the physician for his validation and permission.
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Affiliation(s)
- Francesco Lanza
- Dipartimento di Ingegneria, Università degli Studi di Palermo, 90128 Viale delle Scienze, Palermo, Italy.
| | - Valeria Seidita
- Dipartimento di Ingegneria, Università degli Studi di Palermo, 90128 Viale delle Scienze, Palermo, Italy; Istituto di Calcolo e Reti ad Alte Prestazioni (ICAR), Consiglio Nazionale delle Ricerche, 90146, Via Ugo La Malfa, 153 Palermo, Italy.
| | - Antonio Chella
- Dipartimento di Ingegneria, Università degli Studi di Palermo, 90128 Viale delle Scienze, Palermo, Italy; Istituto di Calcolo e Reti ad Alte Prestazioni (ICAR), Consiglio Nazionale delle Ricerche, 90146, Via Ugo La Malfa, 153 Palermo, Italy.
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Maffini E, Labopin M, Blaise D, Ciceri F, Gülbas Z, Deconinck E, Leblond V, Chevallier P, Sociè G, Araujo MC, Koc Y, Savani BN, Gorin NC, Lanza F, Nagler A, Mohty M. CD34+ cell dose effects on clinical outcomes after T-cell replete haploidentical allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia using peripheral blood stem cells. A study from the acute leukemia working Party of the European Society for blood and marrow transplantation (EBMT). Am J Hematol 2020; 95:892-899. [PMID: 32303111 DOI: 10.1002/ajh.25826] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 03/23/2020] [Accepted: 04/08/2020] [Indexed: 12/15/2022]
Abstract
Previous observations have reported controversial conclusions regarding cell dose and survival endpoints after allogeneic hematopoietic stem cell transplantation (HSCT). We conducted a retrospective analysis on 414 adult patients (median age 54 years, range, 18-74 years) with acute myeloid leukemia (AML) in first and second complete remission. They received a T-cell replete allogeneic HSCT from haploidentical donors, using peripheral blood stem cells, between 2006-2018. Median number of infused CD34+ was 6.58 × 106 /kg (range, 2.2-31.2 × 106 /kg). Graft-vs-host disease (GVHD) prophylaxis was post-transplant cyclophosphamide in 293 patients and anti-lymphocyte serum in 121 patients. Conditioning was myeloablative in 179 patients and reduced-intensity in 235 patients. After a median follow-up of 23.3 months (range, 12.1-41.8 months), 2-year overall survival (OS) was 64.5% (95% CI 59.3%-69.7%) with leukemia-free survival (LFS) of 57.3% (95% CI 51.8%-62.7%) and non-relapse mortality (NRM) of 23.3% (95% CI 19%-27.7%). Grades III-IV acute GVHD day+100 incidence was 14.6% while extensive chronic GVHD was 14.4% at 2-years. Thirteen (3.2%) patients experienced graft failure. We found the optimal CD34+/kg threshold defining high (n = 334) vs low cell dose (n = 80) at 4.96 × 106 . Recipients of >4.96 × 106 /kg CD34+ cells experienced less NRM (Hazard ratio [HR] 0.48; 95% CI 0.30-0.76) and prolonged LFS (HR 0.63; 95% CI 0.43-0.91) and OS (HR 0.60; 95% CI 0.40-0.88) compared to those in the lower cell dose cohort. Larger cohort studies are needed to confirm these findings.
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Affiliation(s)
| | - Myriam Labopin
- Acute Leukemia Working Party OfficeHospital Saint Antoine Paris France
- Assistance Publique‐Hopitaux de ParisHospital Saint Antoine Paris France
- University Pierre et Marie Curie Paris France
- Institut National de la Santè et de la Recherche Médicale Unitè Mixte de Recherche en Santè Paris France
| | - Didier Blaise
- Programme de Transplantation & Therapie CellulaireCentre de Recherche en Cancérologie de Marseille, Institut Paoli Calmettes Marseille France
| | - Fabio Ciceri
- Ospedale San RaffaeleHaematology and BMT Milan Italy
| | - Zafer Gülbas
- Anadolu Medical Center HospitalBone Marrow Transplantation Department Kocaeli Turkey
| | - Eric Deconinck
- Hopital Jean MinjozService d'Hématologie Besancon France
| | - Veronique Leblond
- Universite Paris IVHopital la Pitié‐Salpêtrière, Hematologie Clinique Paris France
| | - Patrick Chevallier
- Centre Hospitalier Universitaire NantesDept. D'Hematologie Nantes France
| | - Gerard Sociè
- Hopital Saint‐LouisService d'Hematologie – BMT Paris France
| | - Mercedes C. Araujo
- Hospital U. Marqués de ValdecillaServicio de Hematología‐Hemoterapia Santander Spain
| | - Yener Koc
- Medical Park HospitalsStem Cell Transplant Unit Antalya Turkey
| | - Bipin N. Savani
- Division of Hematology and Medical OncologyVanderbilt University Medical Center Nashville Tennessee USA
| | | | | | - Arnon Nagler
- Hematology and Bone Marrow Transplantation DivisionChaim Sheba Medical Center Tel‐Hashomer Israel
- Sackler School of MedicineTel Aviv University Tel Aviv Israel
| | - Mohamad Mohty
- Saint‐Antoine Hospital Paris France
- Sorbonne University Paris France
- INSERM UMRs 938 Paris France
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Nagler A, Baron F, Labopin M, Polge E, Esteve J, Bazarbachi A, Brissot E, Bug G, Ciceri F, Giebel S, Gilleece MH, Gorin NC, Lanza F, Peric Z, Ruggeri A, Sanz J, Savani BN, Schmid C, Shouval R, Spyridonidis A, Versluis J, Mohty M. Measurable residual disease (MRD) testing for acute leukemia in EBMT transplant centers: a survey on behalf of the ALWP of the EBMT. Bone Marrow Transplant 2020; 56:218-224. [PMID: 32724200 DOI: 10.1038/s41409-020-01005-y] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 07/07/2020] [Accepted: 07/16/2020] [Indexed: 12/21/2022]
Abstract
Detectable measurable residual disease (MRD) is a key prognostic factor in both acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) patients. Thus, we conducted a survey in EBMT transplant centers focusing on pre- and post-allo-HCT MRD. One hundred and six centers from 29 countries responded. One hundred had a formal strategy for routine MRD assessment, 91 for both ALL and AML. For ALL (n = 95), assessing MRD has been routine practice starting from 2010 (range, 1990-2019). Techniques used for MRD assessment consisted of PCR techniques alone (n = 27), multiparameter flow cytometry (MFC, n = 16), both techniques (n = 43), next-generation sequencing (NGS) + PCR (n = 2), or PCR + MFC + NGS (n = 7). The majority of centers assessed MRD every 2-3 months for 2 (range, 1-until relapse) years. For AML, assessing MRD was routine in 92 centers starting in 2010 (range 1990-2019). Assessment of MRD was by PCR (n = 23), MFC (n = 13), both PCR and MFC (n = 39), both PCR and NGS (n = 3), and by all three techniques (n = 14). The majority assesses MRD for AML every 2-3 months for 2 (range, 1-until relapse) years. This survey is the first step in the aim to include MRD status as a routine registry capture parameter in acute leukemia.
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Affiliation(s)
- Arnon Nagler
- Chaim Sheba Medical Center, Tel Aviv University, Tel-Hashomer, Tel Aviv, Israel. .,EBMT ALWP Office, Saint Antoine Hospital, Paris, France.
| | - Frédéric Baron
- Department of Hematology, University of Liège, Liège, Belgium
| | - Myriam Labopin
- EBMT Paris Study Office/CEREST-TC, Paris, France.,Department of Haematology, Saint Antoine Hospital, Paris, France.,INSERM UMR 938, Paris, France.,Sorbonne University, Paris, France
| | | | - Jordi Esteve
- Hematology Department, Hospital Clinic, Barcelona, Spain
| | - Ali Bazarbachi
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Eolia Brissot
- Department of Haematology, Saint Antoine Hospital, Paris, France.,INSERM UMR 938, Paris, France.,Sorbonne University, Paris, France
| | - Gesine Bug
- Medizinische Klinik II, Hämatologie, Medizinische Onkologie, Goethe-Universitaet, Frankfurt, Germany
| | - Fabio Ciceri
- Ospedale San Raffaele S.r.l., Haematology and BMT, Milan, Italy
| | - Sebastian Giebel
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Institute, Oncology Center, Gliwice, Poland
| | - Maria H Gilleece
- Yorkshire Blood and Marrow Transplant Programme, Haematology Department, St James's Institute of Oncology, Leeds, UK
| | | | | | - Zinaida Peric
- Bone Marrow Transplant Unit, University Hospital Center Rebro, Zagreb, Croatia
| | | | - Jaime Sanz
- Hematology Department, University Hospital La Fe, Valencia, Spain
| | - Bipin N Savani
- Department of Hematology-Oncology, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Roni Shouval
- Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Division of Hematology and Bone Marrow Transplantation, Sheba Medical Center, Ramat Gan, Israel
| | | | - Jurjen Versluis
- Erasmus University Medical Center Cancer Institute, Rotterdam, The Netherlands
| | - Mohamad Mohty
- EBMT Paris Study Office/CEREST-TC, Paris, France.,Department of Haematology, Saint Antoine Hospital, Paris, France.,INSERM UMR 938, Paris, France.,Sorbonne University, Paris, France
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Lanza F, Seghatchian J. Reflection on passive immunotherapy in those who need most: some novel strategic arguments for obtaining safer therapeutic plasma or autologous antibodies from recovered COVID-19 infected patients. Br J Haematol 2020; 190:e27-e29. [PMID: 32407543 PMCID: PMC7272917 DOI: 10.1111/bjh.16814] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 05/12/2020] [Indexed: 12/28/2022]
Affiliation(s)
- Francesco Lanza
- Hematology Unit, Romagna Transplant Network, Ravenna Hospital & University of Ferrara-I, London, UK
| | - Jerard Seghatchian
- International Consultancy in Strategic Advices on Safety Improvements of Blood-Derived Bioproducts and Suppliers Quality Audit/Inspection, London, UK
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Bazarbachi A, Bug G, Baron F, Brissot E, Ciceri F, Dalle IA, Döhner H, Esteve J, Floisand Y, Giebel S, Gilleece M, Gorin NC, Jabbour E, Aljurf M, Kantarjian H, Kharfan-Dabaja M, Labopin M, Lanza F, Malard F, Peric Z, Prebet T, Ravandi F, Ruggeri A, Sanz J, Schmid C, Shouval R, Spyridonidis A, Versluis J, Vey N, Savani BN, Nagler A, Mohty M. Clinical practice recommendation on hematopoietic stem cell transplantation for acute myeloid leukemia patients with FLT3-internal tandem duplication: a position statement from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation. Haematologica 2020; 105:1507-1516. [PMID: 32241850 PMCID: PMC7271578 DOI: 10.3324/haematol.2019.243410] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 03/19/2020] [Indexed: 12/13/2022] Open
Abstract
The FMS-like tyrosine kinase 3 (FLT3) gene is mutated in 25-30% of patients with acute myeloid leukemia (AML). Because of the poor prognosis associated with FLT3-internal tandem duplication mutated AML, allogeneic hematopoietic stem-cell transplantation (SCT) was commonly performed in first complete remission. Remarkable progress has been made in frontline treatments with the incorporation of FLT3 inhibitors and the development of highly sensitive minimal/measurable residual disease assays. Similarly, recent progress in allogeneic hematopoietic SCT includes improvement of transplant techniques, the use of haploidentical donors in patients lacking an HLA matched donor, and the introduction of FLT3 inhibitors as post-transplant maintenance therapy. Nevertheless, current transplant strategies vary between centers and differ in terms of transplant indications based on the internal tandem duplication allelic ratio and concomitant nucleophos-min-1 mutation, as well as in terms of post-transplant maintenance/consolidation. This review generated by international leukemia or transplant experts, mostly from the European Society for Blood and Marrow Transplantation, attempts to develop a position statement on best approaches for allogeneic hematopoietic SCT for AML with FLT3-internal tandem duplication including indications for and modalities of such transplants and on the potential optimization of post-transplant maintenance with FLT inhibitors.
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Affiliation(s)
- Ali Bazarbachi
- Bone Marrow Transplantation Program, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Department of Anatomy, Cell Biology, and Physiological Sciences, American University of Beirut, Beirut, Lebanon
| | - Gesine Bug
- Department of Medicine 2, Hematology and Oncology, University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany
| | | | - Eolia Brissot
- Sorbonne Universités, UPMC University of Paris 06, INSERM, Centre de Recherche Saint-Antoine (CRSA), Hematology Department, AP-HP, Saint Antoine Hospital, Paris, France
| | - Fabio Ciceri
- Vita-Salute San Raffaele University of Milan, Milan, ItalyHematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Iman Abou Dalle
- Bone Marrow Transplantation Program, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hartmut Döhner
- Department of Internal Medicine III, Ulm University Hospital, Ulm, Germany
| | - Jordi Esteve
- Hematology Department, Hospital Clínic of Barcelona, IDIBAPS, University of Barcelona, Barcellona, Spain
| | - Yngvar Floisand
- Department of Hematology, Oslo University Hospital - Rikshospitalet, Oslo, Norway
- Center for Cancer Cell Reprogramming, Institute for Cancer Research, Oslo University Hospital, Montebello, Oslo, Norway
| | - Sebastian Giebel
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Institute - Oncology Center, Gliwice Branch, Gliwice, Poland
| | - Maria Gilleece
- Department of Haematology, Leeds Teaching Hospitals Trust, Leeds, UK
| | - Norbert-Claude Gorin
- Department of Hematology and Cell Therapy, European Society for Blood and Marrow Transplantation, Paris Office, Hopital Saint-Antoine, Paris, France
| | - Elias Jabbour
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mahmoud Aljurf
- Department of Hematology King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Hagop Kantarjian
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mohamed Kharfan-Dabaja
- Division of Hematology-Oncology and Blood and Marrow Transplantation and Cellular Therapies Program, Mayo Clinic, Jacksonville, FL, USA
| | - Myriam Labopin
- Acute Leukemia Working Party, Paris Study Office, European Society for Blood and Marrow Transplantation, Paris, France
- Sorbonne Universités, UPMC University of Paris 06, INSERM, Centre de Recherche Saint-Antoine (CRSA), Hematology Department, AP-HP, Saint Antoine Hospital, Paris, France
| | | | - Florent Malard
- Sorbonne Universités, UPMC University of Paris 06, INSERM, Centre de Recherche Saint-Antoine (CRSA), Hematology Department, AP-HP, Saint Antoine Hospital, Paris, France
| | - Zinaida Peric
- University Hospital Center Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Thomas Prebet
- Section of Hematology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Farhad Ravandi
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Annalisa Ruggeri
- Department of Pediatric Hematology and Oncology, IRCCS Bambino Gesù Children's Hospital, Roma, ItalyEurocord, Hôpital Saint Louis, Paris, France
| | - Jaime Sanz
- Hematology Department, Hospital Universitari i Politecnic La Fe. Instituto de Investigación Sanitaria La Fe, Valencia, CIBERONC, Instituto Carlos III, Madrid, Spain
| | - Christoph Schmid
- Department of Hematology and Oncology, Augsburg University Hospital, Augsburg, Germany
| | - Roni Shouval
- Adult Bone Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Jurjen Versluis
- Erasmus University Medical Center Cancer Institute, Rotterdam, the Netherlands
| | - Norbert Vey
- Department of Hematology, Institut Paoli-Calmettes, Marseille, France
| | - Bipin N Savani
- Department of Hematology-Oncology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Arnon Nagler
- Hematology and Bone Marrow Transplantation Division, Chaim Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel Aviv University, Israel
| | - Mohamad Mohty
- Sorbonne Universités, UPMC University of Paris 06, INSERM, Centre de Recherche Saint-Antoine (CRSA), Hematology Department, AP-HP, Saint Antoine Hospital, Paris, France
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Seghatchian J, Lanza F. Convalescent plasma, an apheresis research project targeting and motivating the fully recovered COVID 19 patients: A rousing message of clinical benefit to both donors and recipients alike. Transfus Apher Sci 2020; 59:102794. [PMID: 32448638 PMCID: PMC7177094 DOI: 10.1016/j.transci.2020.102794] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- J Seghatchian
- International Consultancy in Strategic Advice on Safety Improvements of Blood-Derived Bioproducts and Suppliers Quality Audit / Inspection, London, UK.
| | - F Lanza
- Romagna Transplant Network, Hematology Unit, Ravenna-I, Italy
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Seghatchian J, Lanza F. WITHDRAWN: Convalescent plasma, an apheresis research project targeting and motivating the fully recovered COVID 19 patients: A rousing message of clinical benefit to both donors and recipients alike. Transfus Apher Sci 2020:102792. [PMID: 32417123 PMCID: PMC7194513 DOI: 10.1016/j.transci.2020.102792] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The Publisher regrets that this article is an accidental duplication of an article that has already been published, https://doi.org/10.1016/j.transci.2020.102794. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.
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Affiliation(s)
- J Seghatchian
- International Consultancy in Strategic Safety Improvements of Blood-Derived Bioproducts and Suppliers Quality Audit / Inspection, London, UK.
| | - F Lanza
- Romagna Transplant Network, Hematology Unit, Ravenna-I, Italy
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Lanza F, Saccardi R, Seghatchian J. NEW HORIZONS ON STEM CELL CRYOPRESERVATION THROUGH THE ARTIFICIAL EYES OF CD 34+, USING MODERN FLOW CYTOMETRY TOOLS. Transfus Apher Sci 2020; 59:102785. [PMID: 32340812 DOI: 10.1016/j.transci.2020.102785] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Hematopoietic stem cell (HSC) cryopreservation is a critical step in autologous and cord blood transplantation (CBT). In most circumstances, cryopreservation is performed in a mixture containing dimethyl sulfoxide (DMSO), since DMSO is necessary to secure cell viability. Most centers use a controlled rate (slow) freezing before the long-term storage at vapor phase liquid nitrogen (LN2) temperatures (≤ -160 °C). The primary objectives for laboratories supporting HSCT programs are to provide secure storage for leukapheresis and cord blood products, and to adequately characterize the functional properties of the grafts before their infusion. In the autologous setting, the large majority of the published results dealt with the assessment of the graft before cryopreservation. On the contrary, in CBT, before a CB unit is released, a sample obtained from a contiguous segment of that CB unit needs to be tested to verify HLA type and cell viability. The effects of graft handling, cryopreservation, storage and thawing on the recovery of CD34+ cells needs to be carefully analyzed and standardized on a global level. Some technical unresolved issues still limit the application of the ISHAGE derived single platform flow cytometry protocol for the assessment of the thawed material; based on these considerations, an adaptation of both the acquisition setting and the gating strategyis necessary for reliable measurement of CD34-expressing HSC in cryopreserved grafts. Artificial intelligence applied to "big data" may provide a new tool for improving advanced processing procedures and quality management guidelines in this area of investigation.
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Affiliation(s)
- F Lanza
- Romagna Transplant Network, Hematology Unit, Ravenna Hospital & Univrsity of Ferrara- I.
| | - R Saccardi
- Cellular Therapy and Transfusion Medicine Unit, Florence-I
| | - J Seghatchian
- International Consultancy in Strategic Safety/Quality Improvements of Blood-Derived Bioproducts and Suppliers Quality Audit / Inspection, London, UK
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Lanza F, Mangianti S, Accorsi P, Lombardini L, Martino M, Saccardi R, Vassanelli A, Ostuni A, Ciceri F. Manipulation, and cryopreservation of autologous peripheral blood stem cell products in Italy: A survey by GITMO, SIDEM and GIIMA societies. Transfus Apher Sci 2020; 59:102753. [PMID: 32305212 DOI: 10.1016/j.transci.2020.102753] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
There is considerable heterogeneity in manipulation and cryopreservation of hematopoietic stem cells (HSC) for autologous HSC transplantation across Europe and Italy. To better address this point, three Italian Scientific Societies (GITMO- Gruppo Italiano per il Trapianto di Midollo Osseo; SIDEM- Società Italiana Emaferesi e Manipolazione Cellulare; and GIIMA- Gruppo Italiano Interdisciplinare Manipolazione e Aferesi per Terapie Cellulari), in collaboration with the Competent Authority "National Transplant Center" (CNT) sent to 85 Italian transplant centers (TC) a survey, which included 12 questions related to the most critical elements in graft processing. Fifty-nine centers (70 %) responded to the questionnaire. Overall, this survey demonstrates that the majority (>90 %) of responding TC used standardized procedures for HSC processing; however, an intercenter heterogeneity was clearly documented in several standard operating procedures adopted by different TC. These results seem to suggest that further standardization and efforts are needed to provide recommendations and guidelines on HSC manipulation, cryopreservation and functional assessment of cryopreserved material for autologous HSCT.
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Affiliation(s)
- F Lanza
- Romagna Transplant Network, Ravenna, Italy.
| | - S Mangianti
- Cell Processing Laboratory- PS-Cesena, Italy
| | - P Accorsi
- Dept Onco-hematology-Transfusion Service, Italy
| | | | - M Martino
- Transplantation Unit, Reggio Calabria, Italy
| | | | | | - A Ostuni
- Transfusion Service, Bari, Italy
| | - F Ciceri
- IRCCS San Raffaele University Hospital- Milan, Italy
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Gaipa G, Erba E, Danova M, Mazzini G, Venditti A, Buldini B, Specchia G, Maglia O, Kunkl A, Ciriello MM, Arpinati M, Mannelli F, Lanza F, Riccioni R, Pistotti V, Apolone G. Health technology assessment-based approach to flow cytometric immunophenotyping of acute leukemias: a literature classification. Tumori 2020; 106:300891620904412. [PMID: 32056511 DOI: 10.1177/0300891620904412] [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: 11/17/2022]
Abstract
OBJECTIVE Acute leukemia (AL) is a broad, heterogeneous group of malignant diseases. The diagnostic workup of AL is based on several clinical and laboratory findings, including flow cytometric immunophenotyping. However, the role of this assay in the diagnosis of AL has not been systematically investigated. The aim of this study was to determine the accuracy and utility of flow cytometric immunophenotyping in the identification, characterization, and staging of AL. METHODS We performed a systematic selection and classification of the literature since 1980, focused on flow cytometric immunophenotyping of AL. We applied a 6-variables model to cover both the technical capabilities and the clinical value of flow cytometric immunophenotyping in the diagnosis of AL. RESULTS Using 3 key words (acute leukemia, immunophenotyping, flow cytometry), we screened the literature from January 1985 to April 2015 in PubMed and Embase databases and found 1010 articles. A total of 363 were selected and submitted to the expert panel, which selected a final data set of 248 articles to be analyzed. Of these, 160 were focused on clinical and biological issues, 55 were technical articles, and 31 were reviews. These 248 articles were then analyzed according to the 6-variables model and definitively classified. CONCLUSIONS We assessed the literature on flow cytometric immunophenotyping of AL over 3 decades as the first step toward an evidence-based analysis of the impact of this technology on the clinical management of patients with AL.
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Affiliation(s)
- Giuseppe Gaipa
- M. Tettamanti Research Center, Pediatric Clinic, University of Milano Bicocca, Monza, Italy
| | - Eugenio Erba
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Dipartimento di Oncologia, Milan, Italy
| | - Marco Danova
- Department of Internal Medicine and Oncology, ASST of Pavia, Pavia, Italy
| | - Giuliano Mazzini
- Molecular Genetics Institute, National Research Council and Biology and Biotechnology, Department "L. Spallanzani," University of Pavia, Pavia, Italy
| | - Adriano Venditti
- Hematology, Department of Biomedicine and Prevention, University of Rome "Tor Vergata," Rome, Italy
| | - Barbara Buldini
- Laboratory of Hematology-Oncology, Department of Woman and Child Health, University of Padova, Padova, Italy
| | - Giorgina Specchia
- Department of Emergency and Organ Transplantation (D.E.T.O.), Hematology Section, University of Bari, Bari, Italy
| | - Oscar Maglia
- M. Tettamanti Research Center, Pediatric Clinic, University of Milano Bicocca, Monza, Italy
| | - Annalisa Kunkl
- Clinical Flow Cytometry Unit, Anatomic Pathology Department, IRCCS San Martino Polyclinic University Hospital, Genoa, Italy
| | | | - Mario Arpinati
- Department of Experimental, Diagnostic, and Specialty Medicine, Hematopathology & Hematology Sections, Molecular Pathology Laboratory, S. Orsola-Malpighi Hospital, Bologna University, Bologna, Italy
| | - Francesco Mannelli
- Anna Meyer Children's University Hospital, Department of Hematology, Florence, Italy
| | | | - Roberta Riccioni
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - Vanna Pistotti
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Dipartimento di Oncologia, Milan, Italy
| | - Giovanni Apolone
- Fondazione IRCCS Istituto Nazionale dei Tumori, Direzione Scientifica, Milan, Italy
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Lanza F, Maffini E, Rondoni M, Massari E, Faini AC, Malavasi F. CD22 Expression in B-Cell Acute Lymphoblastic Leukemia: Biological Significance and Implications for Inotuzumab Therapy in Adults. Cancers (Basel) 2020; 12:E303. [PMID: 32012891 PMCID: PMC7072635 DOI: 10.3390/cancers12020303] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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: 12/23/2019] [Revised: 01/22/2020] [Accepted: 01/24/2020] [Indexed: 12/11/2022] Open
Abstract
CD22 is a surface molecule expressed early during the ontogeny of B cells in the bone marrow and spleen, and can be found on B cells isolated from the different lymphoid compartments in humans. CD22 is expressed by most blasts from the majority (60-90%) of B-cell acute lymphoblastic leukemia (B-ALL). Current therapies in adults with newly diagnosed B-ALL are associated with complete remission (CR) rates of 50-90%. However, 30-60% of these patients relapse, and only 25-40% achieve disease-free survival of three years or more. Chemotherapy regimens for patients with refractory/relapsed B-ALL are associated with CR rates ranging from 31% to 44%. Novel immune-targeted therapies, such as blinatumomab and inotuzumab (a humanized anti-CD22 monoclonal antibody conjugated to the cytotoxic antibiotic agent calicheamicin), provide potential means of circumventing chemo-refractory B-ALL cells through novel mechanisms of action. Eighty percent of inotuzumab-treated B-ALL patients may achieve a CR state. This review is focused on the biological and clinical activities of CD22 antibodies in B-ALL, and provides evidence about the potential role played by qualitative and quantitative analysis of the CD22 molecule on individual B-ALL blasts in predicting the depletion of leukemic cells, and, ultimately, leading to better clinical response rates.
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Affiliation(s)
- Francesco Lanza
- Hematology Unit & Romagna Transplant Network, Ravenna Hospital, 48121 Ravenna, Italy; (E.M.); (M.R.)
| | - Enrico Maffini
- Hematology Unit & Romagna Transplant Network, Ravenna Hospital, 48121 Ravenna, Italy; (E.M.); (M.R.)
| | - Michela Rondoni
- Hematology Unit & Romagna Transplant Network, Ravenna Hospital, 48121 Ravenna, Italy; (E.M.); (M.R.)
| | - Evita Massari
- Clinical Pathology Unit, Hub Laboratory, Romagna Transplant Network, 47522 Cesena (FC), Italy;
| | - Angelo Corso Faini
- Department of Medical Science, University of Torino and Fondazione Ricerca Molinette, 10126 Torino, Italy; (A.C.F.); (F.M.)
| | - Fabio Malavasi
- Department of Medical Science, University of Torino and Fondazione Ricerca Molinette, 10126 Torino, Italy; (A.C.F.); (F.M.)
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Passweg JR, Labopin M, Christopeit M, Cornelissen J, Pabst T, Socié G, Russel N, Yakoub-Agha I, Blaise D, Gedde-Dahl T, Labussière-Wallet H, Malladi R, Forcade E, Maury S, Polge E, Lanza F, Gorin NC, Mohty M, Nagler A. Postremission Consolidation by Autologous Hematopoietic Cell Transplantation (HCT) for Acute Myeloid Leukemia in First Complete Remission (CR) and Negative Implications for Subsequent Allogeneic HCT in Second CR: A Study by the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT). Biol Blood Marrow Transplant 2019; 26:659-664. [PMID: 31759159 DOI: 10.1016/j.bbmt.2019.11.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 11/02/2019] [Accepted: 11/15/2019] [Indexed: 11/29/2022]
Abstract
After autologous hematopoietic cell transplantation (HCT) in the first complete remission (CR1), patients with acute myeloid leukemia (AML) may relapse and undergo allogeneic HCT in the second complete remission (CR2). The aim of this study was to analyze the outcome of allogeneic HCT performed in CR2 comparing patients with prior consolidation by autologous HCT versus patients with chemotherapy consolidation. Included were 2619 adults with allogeneic HCT in CR2 from 2000 to 2017 with (n = 417) or without (n = 2202) prior autologous HCT. Patient groups were not entirely comparable; patients with prior autologous HCT were younger, had less often a favorable cytogenetic profile, had more commonly donors other than matched siblings, and more often received reduced-intensity conditioning. In multivariate analysis, nonrelapse mortality risks in patients with prior autologous HCT were 1.34 (1.07 to 1.67; P = .01) after adjustment for age, cytogenetic risk, transplant year, donor, conditioning intensity, sex matching, interval diagnosis-relapse, and relapse-allogeneic HCT as compared with chemotherapy consolidation. Similarly, risks of events in leukemia-free survival and graft-versus-host disease, relapse-free survival were higher with prior autologous HCT, 1.17 (1.01 to 1.35), P = .03 and 1.18 (1.03 to 1.35), P = .02, respectively. Risk of death was also higher, 1.13 (0.97 to 1.32), P = .1, but this was not significant. Postremission consolidation with autologous HCT for AML in CR1 increases toxicity of subsequent allogeneic HCT in CR2.
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Affiliation(s)
- J R Passweg
- Division of Hematology, University Hospital Basel, Basel, Switzerland.
| | - M Labopin
- Department of Hematology and Cell Therapy, Institut National de la Santé et de la Recherche Médicale (INSERM) UMRs 938, Hopital Saint Antoine Assistance Publique-Hopitaux de Paris, Paris Sorbonne University, Paris, France
| | - M Christopeit
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J Cornelissen
- Department of Hematology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, Netherlands
| | - T Pabst
- Department of Medical Oncology, University Hospital, Bern, Switzerland
| | - G Socié
- Department of Hematology-BMT, Hopital St. Louis, Paris France
| | - N Russel
- Department of Haematology, Nottingham City Hospital, Nottingham University, Nottingham, UK
| | - I Yakoub-Agha
- CHU de Lille, LIRIC, INSERM U995, université de Lille, Lille, France
| | - D Blaise
- Programme de Transplantation & Therapie Cellulaire Centre de Recherche en Cancérologie de Marseille Institut Paoli Calmettes, Marseille, France
| | - T Gedde-Dahl
- Department of Hematology, Oslo University Hospital, Rikshospitalet, and Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - R Malladi
- Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK
| | - E Forcade
- CHU Bordeaux, Hôpital Haut-Leveque, Pessac, France
| | - S Maury
- Service d'Hématologie, Hôpital Henri Mondor, Creteil, France
| | - E Polge
- Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT), Paris, France
| | - F Lanza
- Romagna Transplant Network, Ravenna, Italy
| | - N C Gorin
- Department of Hematology and Cell Therapy, Institut National de la Santé et de la Recherche Médicale (INSERM) UMRs 938, Hopital Saint Antoine Assistance Publique-Hopitaux de Paris, Paris Sorbonne University, Paris, France
| | - M Mohty
- Department of Hematology and Cell Therapy, Institut National de la Santé et de la Recherche Médicale (INSERM) UMRs 938, Hopital Saint Antoine Assistance Publique-Hopitaux de Paris, Paris Sorbonne University, Paris, France
| | - A Nagler
- Division of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel-Hashomer and Sackler School of Medicine, Ramat Gan, Israel
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Comoli P, Chabannon C, Koehl U, Lanza F, Urbano-Ispizua A, Hudecek M, Ruggeri A, Secondino S, Bonini C, Pedrazzoli P. Development of adaptive immune effector therapies in solid tumors. Ann Oncol 2019; 30:1740-1750. [PMID: 31435646 DOI: 10.1093/annonc/mdz285] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
State-of-the-art treatment strategies have drastically ameliorated the outcome of patients affected by cancer. However, resistant and recurrent solid tumors are generally nonresponsive to conventional therapies. A central factor in the sequence of events that lead to cancer is an alteration in antitumor immune surveillance, which results in failure to recognize and eliminate the transformed tumor cell. A greater understanding of the dysregulation and evasion of the immune system in the evolution and progression of cancer provides the basis for improved therapies. Targeted strategies, such as T-cell therapy, not only generally spare normal tissues, but also use alternative antineoplastic mechanisms that synergize with other therapeutics. Despite encouraging success in hematologic malignancies, adaptive cellular therapies for solid tumors face unique challenges because of the immunosuppressive tumor microenvironment, and the hurdle of T-cell trafficking within scarcely accessible tumor sites. This review provides a brief overview of current cellular therapeutic strategies for solid tumors, research carried out to increase efficacy and safety, and results from ongoing clinical trials.
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Affiliation(s)
- P Comoli
- Cell Factory and Pediatric Hematology Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - C Chabannon
- Institut Paoli-Calmettes, Aix-Marseille University, INSERM CBT 1409, Centre for Clinical Investigation in Biotherapy, Marseille, France
| | - U Koehl
- Institute of Clinical Immunology, University of Leipzig and Fraunhofer Institute for Cell Therapy and Immunology, Leipzig; Institute of Cellular Therapeutics, Hannover Medical School, Hannover, Germany
| | - F Lanza
- Hematology and Stem Cell Transplant, Romagna Transplant Network, Ravenna, Italy
| | - A Urbano-Ispizua
- Department of Hematology, IDIBAPS, Institute of Research Josep Carreras, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - M Hudecek
- Department of Medicine II, University Hospital Würzburg, Würzburg, Germany
| | - A Ruggeri
- Department of Pediatric Hematology and Oncology, Bambino Gesù Children's Hospital, Rome
| | - S Secondino
- Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia
| | - C Bonini
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, University Vita-Salute San Raffaele and Ospedale San Raffaele Scientific Institute, Milan, Italy
| | - P Pedrazzoli
- Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia.
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Angiolillo DJ, Bhatt DL, Lanza F, Cryer B, Dong J, Jeske W, Von Chong E, Prats J, Deliargyris E, Marathi U. P1935Pharmacokinetic and pharmacodynamic assessment of a lipid-based aspirin formulation: results of a prospective, randomised, crossover study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objectives
Aspirin, or acetylsalicylic acid (ASA), can lead to gastrointestinal mucosal injury through disruption of its protective phospholipid bilayer, underscoring the need for ASA formulations with a more favorable safety profile while maintaining an effective pharmacologic profile. A liquid formulation using a novel pharmaceutical lipid aspirin complex (PL-ASA) has been designed to prevent the disruption of the protective mucosal bilayer. We sought to determine the pharmacokinetic (PK)/pharmacodynamic (PD) characteristics of PL-ASA compared with traditional, immediate release aspirin (IR-ASA).
Methods
In this active-control crossover study, 16 healthy volunteers were randomized to receive a single dose of either IR-ASA 325 mg or PL-ASA 325 mg in a sequential fashion with a 2-week washout period between treatment assignments. The primary objectives of the study were to assess PK (i.e., plasma salicylic acid levels) and PD (i.e., serum thromboxane B2 levels) bioequivalence over a 24–hour period after drug administration, of PL-ASA and IR-ASA using established criteria.
Results
The PK parameter values were similar for PL-ASA and IR-ASA, with median AUC 0-t and Cmax values nominally higher for PL-ASA. Log-transformed PK parameters meeting FDA-criteria for bioequivalence (80% to 125%) are provided in the Table. Serum thromboxane B2 levels were similar for PL-ASA and IR-ASA, with Cmin values below 3.1 ng/mL (cut-off associated with decreased cardiovascular events) for both drugs. Both drugs also showed >99% inhibition of serum thromboxane B2 levels (≥95% inhibition represents the cut-off to define aspirin responders). Several secondary PK/PD parameters showed similarities between the two drugs (data not shown). Overall, these findings support functional and clinical equivalence between PL-ASA and IR-ASA.
PK Results Parameter Ratio (PL-ASA/IR-ASA) 90% Confidence Interval AUC0-t 96.51 89.24, 104.37 Cmax 103.73 92.06, 116.89
Conclusions
PL-ASA's novel liquid formulation has similar PK and PD performance compared with IR-ASA. The improved endoscopic safety profile of PL-ASA coupled with its pharmacologic efficacy equivalent to IR-ASA may result in an improved benefit-risk performance, warranting evaluation in future trials.
Acknowledgement/Funding
PLx Pharma, Inc.
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Affiliation(s)
- D J Angiolillo
- University of Florida College of Medicine-Jacksonville, Cardiology, Jacksonville, United States of America
| | - D L Bhatt
- Brigham and Womens Hospital, Interventional Cardiovascular Programs, Boston, United States of America
| | - F Lanza
- Houston Institute for Clinical Research, Houston, United States of America
| | - B Cryer
- University of Texas Southwestern Medical School, Dallas, United States of America
| | - J Dong
- University of Washington, Hematology Division, Medicine, Seattle, United States of America
| | - W Jeske
- Loyola University, Cardiovascular Research Institute, Chicago Health Sciences Division, Chicago, United States of America
| | - E Von Chong
- PLx Pharma, Inc., Houston, United States of America
| | - J Prats
- Elysis, LLC., Carlisle, United States of America
| | | | - U Marathi
- 7 Hills Pharma and PLx Pharma, Houston, United States of America
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