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Autore F, Visentin A, Deodato M, Vitale C, Galli E, Fresa A, Fazzi R, Sanna A, Olivieri J, Scortechini I, Del Principe MI, Sportoletti P, Schiattone L, Maschio N, Facchinelli D, Marchesi F, Coscia M, Tedeschi A, Trentin L, Innocenti I, Candoni A, Busca A, Pagano L, Laurenti L. Venetoclax infectious risk score to identify patients with chronic lymphocytic leukemia at high infectious risk during venetoclax treatment: A multicenter SEIFEM study. Am J Hematol 2024; 99:982-984. [PMID: 38343033 DOI: 10.1002/ajh.27247] [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: 10/11/2023] [Revised: 01/20/2024] [Accepted: 01/22/2024] [Indexed: 04/09/2024]
Affiliation(s)
- Francesco Autore
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | | | - Marina Deodato
- ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Candida Vitale
- A.O.U. Città della Salute e della Scienza di Torino e Dipartimento di Biotecnologie Molecolari e Scienze per la Salute, Università di Torino, Torino, Italy
| | - Eugenio Galli
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Alberto Fresa
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Rita Fazzi
- Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | | | | | | | | | | | | | - Nilla Maschio
- Oncoematologia Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy
| | | | | | - Marta Coscia
- A.O.U. Città della Salute e della Scienza di Torino e Dipartimento di Biotecnologie Molecolari e Scienze per la Salute, Università di Torino, Torino, Italy
| | | | | | - Idanna Innocenti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Anna Candoni
- Clinica Ematologia di Udine, Udine, Italy
- Università degli Studi di Modena e Reggio Emilia, Modena, Italy
| | - Alessandro Busca
- A.O.U. Città della Salute e della Scienza di Torino e Dipartimento di Biotecnologie Molecolari e Scienze per la Salute, Università di Torino, Torino, Italy
| | - Livio Pagano
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Luca Laurenti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
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2
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Autore F, Bramanti S, Lessi F, Innocenti I, Galli E, Rocchi S, Ribolla R, Derudas D, Oliva S, Stefanoni P, Marcatti M, Schenone A, La Nasa G, Crippa C, Zamagni E, Riva M, Mazza R, Mannina D, Sica S, Bacigalupo A, Laurenti L. What is the best treatment strategy before autologous peripheral blood stem cell transplantation in POEMS syndrome? Haematologica 2024; 109:888-894. [PMID: 37646655 PMCID: PMC10905096 DOI: 10.3324/haematol.2023.283719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/21/2023] [Indexed: 09/01/2023] Open
Abstract
Autologous peripheral blood stem cell transplantation (aPBSCT) provides optimal outcomes in POEMS syndrome but the definition of the best treatment before aPBSCT remains to be defined because of the rarity of the disease and the heterogeneity of published case series. We collected clinical and laboratory data of patients with POEMS syndrome undergoing aPBSCT from 1998 to 2020 in ten Italian centers. The primary endpoint of the study was to evaluate the impact of prior therapies and mobilization regimen on outcome. We divided the patients into three groups: patients who did not receive any treatment before transplant (15 patients, group A: front-line), patients pre-treated with other agents (14 patients, group B) and patients treated with cyclophosphamide as their mobilizing regimen (16 patients, group C). The three groups did not show differences in terms of demographic and clinical characteristics. All 45 patients underwent aPBSCT after a high-dose melphalan conditioning regimen, with a median follow-up of 77 months (range, 37-169 months). The responses were not statistically different between the three groups (P=0.38). Progression-free and overall survival rates at 6 years were: 70% (95% confidence interval: 55-85%) and 91% (95% confidence interval: 82-99) 65%, respectively, and did not differ between the three groups. The cumulative incidence of transplant-related mortality and relapse was 4% and 36%, respectively. In conclusion, in a relatively large number of patients with POEMS syndrome, undergoing an autologous transplant, pre-treatment and disease status at transplant did not appear to have an impact on major transplant outcomes.
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Affiliation(s)
- Francesco Autore
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS.
| | | | | | - Idanna Innocenti
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS
| | - Eugenio Galli
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS
| | - Serena Rocchi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna; Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna
| | | | - Daniele Derudas
- SC di Ematologia e CTMO - Oncologico Oncologico di Riferimento Regionale "A. Businco" - ARNAS "G. Brotzu" - Cagliari
| | | | | | | | - Angelo Schenone
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences (DINOGMI), University of Genoa; IRCCS San Martino Hospital, Genova
| | - Giorgio La Nasa
- SC di Ematologia e CTMO - Oncologico Oncologico di Riferimento Regionale "A. Businco" - ARNAS "G. Brotzu" - Cagliari
| | | | - Elena Zamagni
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna; Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna
| | | | - Rita Mazza
- Istituto Clinico Humanitas IRCCS, Rozzano
| | | | - Simona Sica
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Roma; Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore
| | - Andrea Bacigalupo
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Roma; Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore
| | - Luca Laurenti
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Roma; Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore
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3
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Galli E, Fresa A, Bellesi S, Metafuni E, Maiolo E, Pansini I, Frioni F, Autore F, Limongiello MA, Innocenti I, Giammarco S, Chiusolo P, Zini G, Sorà F. Hematopoiesis and immune reconstitution after CD19 directed chimeric antigen receptor T-cells (CAR-T): A comprehensive review on incidence, risk factors and current management. Eur J Haematol 2024; 112:184-196. [PMID: 37491951 DOI: 10.1111/ejh.14052] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/10/2023] [Accepted: 07/10/2023] [Indexed: 07/27/2023]
Abstract
Impaired function of hematopoiesis after treatment with chimeric antigen T-cells (CAR-T) is a frequent finding and can interest a wide range of patients, regardless of age and underlying disease. Trilinear cytopenias, as well as hypogammaglobulinemia, B-cell aplasia, and T-cell impairment, can severely affect the infectious risk of CAR-T recipients, as well as their quality of life. In this review, we provide an overview of defects in hematopoiesis after CAR-T, starting with a summary of different definitions and thresholds. We then move to summarize the main pathogenetic mechanisms of cytopenias, and we offer insight into cytomorphological aspects, the role of clonal hematopoiesis, and the risk of secondary myeloid malignancies. Subsequently, we expose the major findings and reports on T-cell and B-cell quantitative and functional impairment after CAR-T. Finally, we provide an overview of current recommendations and leading experiences regarding the management of cytopenias and defective B- and T-cell function.
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Affiliation(s)
- Eugenio Galli
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Alberto Fresa
- 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
| | - Silvia Bellesi
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Elisabetta Metafuni
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Elena Maiolo
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Ilaria Pansini
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Filippo Frioni
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Autore
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Maria Assunta Limongiello
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Idanna Innocenti
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Sabrina Giammarco
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Patrizia Chiusolo
- 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
| | - Gina Zini
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Federica Sorà
- 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
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4
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D’Arena G, Vitale C, Pietrantuono G, Villani O, Mansueto G, D’Auria F, Statuto T, D’Agostino S, Sabetta R, Tarasco A, Innocenti I, Autore F, Fresa A, Valvano L, Tomasso A, Cafaro L, Lamorte D, Laurenti L. What Does Atypical Chronic Lymphocytic Leukemia Really Mean? A Retrospective Morphological and Immunophenotypic Study. Cancers (Basel) 2024; 16:469. [PMID: 38275909 PMCID: PMC10814247 DOI: 10.3390/cancers16020469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
Atypical chronic lymphocytic leukemia (CLL) is still defined according to morphological criteria. However, deviance from the typical surface immunological profile suggests an atypical immunological-based CLL. A large cohort of patients with CLL was retrospectively evaluated aiming at assessing morphological (FAB criteria), immunophenotypical (two or more discordances from the typical profile), and clinical-biological features of atypical CLL. Compared to typical cases, morphologically atypical CLL showed a greater percentage of unmutated IgVH and CD38 positivity, and a higher expression of CD20. Immunophenotypically atypical CLL was characterized by more advanced clinical stages, higher expression of CD20, higher rate of FMC7, CD79b and CD49d positivity, and by an intermediate-high expression of membrane surface immunoglobulin, compared to typical cases. When patients were categorized based on immunophenotypic and morphologic concordance or discordance, no difference emerged. Finally, morphological features better discriminated patients' prognosis in terms of time-to-first treatment, while concordant atypical cases showed overall a worse prognosis. Discordant cases by immunophenotype and/or morphology did not identify specific prognostic groups. Whether-in the era of molecular markers used as prognostic indicators-it does make sense to focus on morphology and immunophenotype features in CLL is still matter of debate needing further research.
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Affiliation(s)
- Giovanni D’Arena
- Immuno-Hematology and Transfusion Medicine Unit, “San Luca” Hospital, 84078 Vallo della Lucania, Italy; (R.S.); (A.T.)
| | - Candida Vitale
- A.O.U. Città della Salute e della Scienza di Torino and Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, 10125 Torino, Italy;
| | - Giuseppe Pietrantuono
- Hematology and Stem Cell Transplantation Unit, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy; (G.P.); (O.V.); (G.M.); (S.D.)
| | - Oreste Villani
- Hematology and Stem Cell Transplantation Unit, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy; (G.P.); (O.V.); (G.M.); (S.D.)
| | - Giovanna Mansueto
- Hematology and Stem Cell Transplantation Unit, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy; (G.P.); (O.V.); (G.M.); (S.D.)
| | - Fiorella D’Auria
- Laboratory of Clinical Pathology, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy;
| | - Teodora Statuto
- Laboratory of Clinical Research and Advanced Diagnostics, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy; (T.S.); (L.V.)
| | - Simona D’Agostino
- Hematology and Stem Cell Transplantation Unit, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy; (G.P.); (O.V.); (G.M.); (S.D.)
| | - Rosalaura Sabetta
- Immuno-Hematology and Transfusion Medicine Unit, “San Luca” Hospital, 84078 Vallo della Lucania, Italy; (R.S.); (A.T.)
| | - Angela Tarasco
- Immuno-Hematology and Transfusion Medicine Unit, “San Luca” Hospital, 84078 Vallo della Lucania, Italy; (R.S.); (A.T.)
| | - Idanna Innocenti
- Hematology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (I.I.); (F.A.); (A.F.); (A.T.); (L.L.)
| | - Francesco Autore
- Hematology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (I.I.); (F.A.); (A.F.); (A.T.); (L.L.)
| | - Alberto Fresa
- Hematology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (I.I.); (F.A.); (A.F.); (A.T.); (L.L.)
| | - Luciana Valvano
- Laboratory of Clinical Research and Advanced Diagnostics, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy; (T.S.); (L.V.)
| | - Annamaria Tomasso
- Hematology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (I.I.); (F.A.); (A.F.); (A.T.); (L.L.)
| | - Lorenzo Cafaro
- Immuno-Hematology and Transfusion Medicine Unit, “Immacolata” Hospital, 84073 Sapri, Italy;
| | - Daniela Lamorte
- Laboratory of Preclinical and Translational Research, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Vulture, Italy;
| | - Luca Laurenti
- Hematology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (I.I.); (F.A.); (A.F.); (A.T.); (L.L.)
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5
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Valentini CG, Innocenti I, Pellegrino C, Draisci G, Teofili L. Autologous transfusion requirements in bone marrow harvest: results of the ATREMA study. Blood Transfus 2024; 22:90-92. [PMID: 38276912 PMCID: PMC10812899 DOI: 10.2450/bloodtransfus.669] [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] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 10/16/2023] [Indexed: 01/27/2024]
Affiliation(s)
- Caterina G. Valentini
- Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Idanna Innocenti
- Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Claudio Pellegrino
- Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
- Division of Hematology, Department of Radiological and Hematological Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gaetano Draisci
- Department of Emergency, Anesthesiological and Reanimation Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Department of Basic Biotechnological Sciences, and Intensive and Perioperative Clinics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luciana Teofili
- Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
- Division of Hematology, Department of Radiological and Hematological Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
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6
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Autore F, Innocenti I, Reda G, Visentin A, Vitale C, Piciocchi A, Fresa A, Leone MMA, Farina L, Quaresmini G, Baratè C, Giordano A, Ferrari A, Angeletti I, De Paolis MR, Malerba L, Chiurazzi F, Loseto G, Catania G, Sportoletti P, Scortechini I, Moia R, Gentile M, Rigolin GM, Mattiello V, Gattei V, Coscia M, Trentin L, Foà R, Cuneo A, Laurenti L. Lymphadenopathy as a predictor of progression during venetoclax treatment in chronic lymphocytic leukemia. A campus chronic lymphocytic leukemia study. Hematol Oncol 2023; 41:877-883. [PMID: 37392141 DOI: 10.1002/hon.3199] [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: 04/07/2023] [Revised: 05/30/2023] [Accepted: 06/17/2023] [Indexed: 07/03/2023]
Abstract
Clinical or biological parameters useful to predict progression during treatment in real-life setting with ibrutinib, idelalisib and venetoclax in relapsed/refractory chronic lymphocytic leukemia (CLL) are still debated. We conducted a multi-center retrospective study on CLL patients treated with ibrutinib and/or idelalisib who were switched to venetoclax for progression or due to adverse events to identify any clinical and/or biological parameters useful to predict progression during treatment with venetoclax. Of all the 128 evaluable patients, 81 had received ibrutinib prior to switching to venetoclax, 35 had received idelalisib and 12 both. When comparing the three subgroups, we did not notice any statistical difference in terms of clinical or biological features. No variable at baseline and at different time points during the follow-up (at 6, 12, 18 and 24 months) was found to predict progression nor to have significance for Progression Free Survival (PFS) in the ibrutinib group and in the idelalisib group and in subgroups according to the line of treatment. Analyzing the data of the venetoclax treatment, after a median follow up of 14.3 months, median PFS was not reached and estimated 3-year PFS was 54%. Of the 128 patients treated with venetoclax, 28 (22%) experienced progressive disease. At multivariate analysis for predictive factors for progression, lymph node diameter >56.5 mm before starting treatment emerged as an independent risk factor for progression. The lymph node predictive role for progression during venetoclax treatment could be a new parameter that deserves to be investigate in future studies.
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Affiliation(s)
- Francesco Autore
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Idanna Innocenti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Gianluigi Reda
- Fondazione IRCCS Ca' Granda Ospedale Maggiore, Milano, Italy
| | | | - Candida Vitale
- A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy
| | | | - Alberto Fresa
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | | | - Lucia Farina
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | | | | | | | - Angela Ferrari
- Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy
| | | | | | - Lara Malerba
- A.O. Ospedali San Salvatore di Pesaro, Pesaro, Italy
| | | | | | | | - Paolo Sportoletti
- Centro di Ricerca Emato-Oncologica (CREO), Dipartimento di Medicina e Chirurgia, Università di Perugia, Perugia, Italy
| | | | - Riccardo Moia
- Università del Piemonte Orientale, A.O.U. Maggiore della Carità, Novara, Italy
| | - Massimo Gentile
- AO di Cosenza, Presidio Ospedaliero Annunziata, Cosenza, Italy
| | | | | | - Valter Gattei
- Centro di Riferimento Oncologico di Aviano IRCCS, Aviano, Italy
| | - Marta Coscia
- A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy
| | | | - Robin Foà
- Policlinico Umberto I, Università Sapienza, Roma, Italy
| | - Antonio Cuneo
- A.O.U. Arcispedale S. Anna, Università di Ferrara, Ferrara, Italy
| | - Luca Laurenti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
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7
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Visentin A, Chatzikonstantinou T, Scarfò L, Kapetanakis A, Demosthenous C, Karakatsoulis G, Minga E, Chamou D, Allsup D, Cabrero AA, Andres M, Antic D, Baile M, Baliakas P, Besikli-Dimou S, Bron D, Chatzileontiadou S, Cordoba R, Correa JG, Cuéllar-García C, De Paoli L, De Paolis MR, Delgado J, Dimou M, Donaldson D, Catherwood M, Doubek M, Efstathopoulou M, Eichhorst B, Elashwah S, Enrico A, Espinet B, Farina L, Ferrari A, Foglietta M, Frederiksen H, Fürstenau M, García-Marco JA, García-Serra R, Collado R, Gentile M, Gimeno E, Glenthøj A, da Silva MG, Hakobyan YK, Herishanu Y, Hernández-Rivas JÁ, Herold T, Innocenti I, Itchaki G, Jaksic O, Janssens A, Kalashnikova ОB, Kalicińska E, Kater AP, Kersting S, Labrador J, Lad D, Laurenti L, Levin MD, Lista E, Lopez-Garcia A, Malerba L, Marasca R, Marchetti M, Marquet J, Mattsson M, Mauro FR, Morawska M, Motta M, Munir T, Murru R, Niemann CU, Rodrigues RN, Olivieri J, Orsucci L, Papaioannou M, Pavlovsky MA, Piskunova I, Popov VM, Quaglia FM, Quaresmini G, Qvist K, Rigolin GM, Ruchlemer R, Šimkovič M, Špaček M, Sportoletti P, Stanca O, Tadmor T, Capasso A, Del Poeta G, Gutwein O, Karlsson LK, Milosevic I, Mirás F, Reda G, Saghumyan G, Shrestha A, Te Raa D, Tonino SH, Van Der Spek E, van Gelder M, van Kampen R, Wasik-Szczepanek E, Wróbel T, Segundo LYS, Yassin M, Pocali B, Vandenberghe E, Iyengar S, Varettoni M, Vitale C, Coscia M, Rambaldi A, Montserrat E, Cuneo A, Stavroyianni N, Trentin L, Stamatopoulos K, Ghia P. The evolving landscape of COVID-19 and post-COVID condition in patients with chronic lymphocytic leukemia: A study by ERIC, the European research initiative on CLL. Am J Hematol 2023; 98:1856-1868. [PMID: 37772428 DOI: 10.1002/ajh.27093] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 08/18/2023] [Accepted: 08/23/2023] [Indexed: 09/30/2023]
Abstract
In this retrospective international multicenter study, we describe the clinical characteristics and outcomes of patients with chronic lymphocytic leukemia (CLL) and related disorders (small lymphocytic lymphoma and high-count monoclonal B lymphocytosis) infected by SARS-CoV-2, including the development of post-COVID condition. Data from 1540 patients with CLL infected by SARS-CoV-2 from January 2020 to May 2022 were included in the analysis and assigned to four phases based on cases disposition and SARS-CoV-2 variants emergence. Post-COVID condition was defined according to the WHO criteria. Patients infected during the most recent phases of the pandemic, though carrying a higher comorbidity burden, were less often hospitalized, rarely needed intensive care unit admission, or died compared to patients infected during the initial phases. The 4-month overall survival (OS) improved through the phases, from 68% to 83%, p = .0015. Age, comorbidity, CLL-directed treatment, but not vaccination status, emerged as risk factors for mortality. Among survivors, 6.65% patients had a reinfection, usually milder than the initial one, and 16.5% developed post-COVID condition. The latter was characterized by fatigue, dyspnea, lasting cough, and impaired concentration. Infection severity was the only risk factor for developing post-COVID. The median time to resolution of the post-COVID condition was 4.7 months. OS in patients with CLL improved during the different phases of the pandemic, likely due to the improvement of prophylactic and therapeutic measures against SARS-CoV-2 as well as the emergence of milder variants. However, mortality remained relevant and a significant number of patients developed post-COVID conditions, warranting further investigations.
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Affiliation(s)
- Andrea Visentin
- Hematology and Clinical Immunology Unit, Department of Medicine, University of Padova, Padova, Italy
| | | | - Lydia Scarfò
- Università Vita-Salute San Raffaele and IRCC Ospedale San Raffaele, Milan, Italy
| | - Anargyros Kapetanakis
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | | | - Georgios Karakatsoulis
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
- Department of Mathematics, University of Ioannina, Ioannina, Greece
| | - Eva Minga
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Dimitra Chamou
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - David Allsup
- Centre for Biomedicine, Hull York Medical School, Hull, UK
| | - Alejandro Alonso Cabrero
- Spanish Society of Hematology and Hemotherapy (SEHH: Sociedad Española de Hematología y hemoterapia), Madrid, Spain
- Hematology Department, Hospital Universitario de La Princesa, Madrid, Spain
| | - Martin Andres
- Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Darko Antic
- University Clinical Center of Serbia, Belgrade, Serbia
- School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Mónica Baile
- Hospital Clinico Universitario de Salamanca (CAUSA/IBSAL), Salamanca, Spain
| | - Panagiotis Baliakas
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
- Department of Clinical Genetics, Uppsala University Hospital, Uppsala, Sweden
| | | | | | - Sofia Chatzileontiadou
- Hematology Unit, 1st Dept of Internal Medicine, AUTH, AHEPA Hospital, Thessaloniki, Greece
| | - Raul Cordoba
- Department of Hematology, Health Research Institute IIS-FJD, Fundacion Jimenez Diaz University Hospital, Madrid, Spain
| | | | | | - Lorenzo De Paoli
- Division of Hematology, Department of Translational Medicine, Università del Piemonte Orientale Amedeo Avogadro, Azienda Ospedaliero-Universitaria Maggiore della Carità Novara, Novara, Italy
| | | | | | - Maria Dimou
- 1st Internal Medicine Department, Propaedeutic, Hematology Clinical Trial Unit, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Michael Doubek
- Department of Internal Medicine-Hematology and Oncology, University Hospital, Brno, Czech Republic
- Faculty of Medicine, Department of Medical Genetics and Genomics, Masaryk University, Brno, Czech Republic
| | - Maria Efstathopoulou
- Department of Haematology, Athens Medical Center-Psychikon Branch, Athens, Greece
| | - Barbara Eichhorst
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Salma Elashwah
- Medical Oncology Unit, Faculty of Medicine, Oncology Center Mansoura University (OCMU), Mansoura, Egypt
| | | | | | - Lucia Farina
- Hematology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Angela Ferrari
- Hematology Unit, Azienda Unità Sanitaria Locale-IRCCS, Reggio Emilia, Italy
| | | | | | - Moritz Fürstenau
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), University Hospital Cologne, University of Cologne, Cologne, Germany
| | - José A García-Marco
- Hematology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Rocío García-Serra
- Department of Hematology, Hospital General Universitario, Valencia, Spain
- Fundaci_on de Investigaci_on del Hospital General Universitario, Valencia, Spain
| | - Rosa Collado
- Department of Hematology, Hospital General Universitario, Valencia, Spain
| | - Massimo Gentile
- Hematology Unit, Azienda Ospedaliera Annunziata, Cosenza, Italy
- Department of Pharmacy, Health and Nutritional Science, University of Calabria, Rende, Italy
| | - Eva Gimeno
- Department of Hematology, Hospital del Mar, Barcelona, Spain
| | - Andreas Glenthøj
- Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | | | | | - Yair Herishanu
- Department of Hematology, Tel Aviv Sourasky Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Tobias Herold
- Department of Medicine III, Laboratory for Leukemia Diagnostics, University Hospital, Munich, Germany
| | - Idanna Innocenti
- Hematology Unit, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Gilad Itchaki
- Meir Medical Center, Kfar-Saba, Israel
- The Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Ozren Jaksic
- Department of Hematology, University Hospital Dubrava, Zagreb, Croatia
| | - Ann Janssens
- Department of Hematology, Universitaire Ziekenhuizen Leuven, Leuven, Belgium
| | - Оlga B Kalashnikova
- Federal State Budgetary Educational Institution of Higher Education Academician I.P. Pavlov First St. Petersburg State Medical University of the Ministry of Healthcare of Russian Federation, St. Petersburg, Russia
| | - Elżbieta Kalicińska
- Department and Clinic of Hematology, Blood Neoplasms and Bone Marrow Transplantation Wroclaw Medical University, Wroclaw, Poland
| | - Arnon P Kater
- Department of Hematology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Sabina Kersting
- Department of Hematology, Haga Teaching Hospital, The Hague, The Netherlands
| | - Jorge Labrador
- Hematology Department, Unit Research, Complejo Asistencial Universitario de Burgos, Burgos, Spain
| | - Deepesh Lad
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Luca Laurenti
- Hematology Unit, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Mark-David Levin
- Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, the Netherlands
| | - Enrico Lista
- Department of Hematology, Santa Chiara Hospital, Trento, Italy
| | - Alberto Lopez-Garcia
- Department of Hematology, Health Research Institute IIS-FJD, Fundacion Jimenez Diaz University Hospital, Madrid, Spain
| | - Lara Malerba
- Hematology and Stem Cell Transplant Center, Marche Nord Hospital, Pesaro, Italy
| | - Roberto Marasca
- Department of Medical Sciences, Section of Hematology, University of Modena and Reggio E., Modena, Italy
| | - Monia Marchetti
- Hematology Unit and BM Transplant Center, AO SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Juan Marquet
- Hematology Department, Ram_on y Cajal University Hospital, Madrid, Spain
| | - Mattias Mattsson
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
- Department of Hematology, Uppsala University Hospital, Uppsala, Sweden
| | - Francesca R Mauro
- Hematology Unit, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Marta Morawska
- Experimental Hematooncology Department, Medical University of Lublin, Lublin, Poland
- Hematology Department, St. John's Cancer Center, Lublin, Poland
| | - Marina Motta
- S.C. Ematologia, ASST Spedali Civili Brescia, Brescia, Italy
| | - Talha Munir
- Consultant Haematologist, St James's Hospital, Leeds, UK
| | - Roberta Murru
- Hematology and Stem Cell Transplantation Unit, Ospedale Oncologico A. Businco, ARNAS "G. Brotzu", Cagliari, Italy
| | - Carsten U Niemann
- Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Jacopo Olivieri
- Hematology Clinic, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Lorella Orsucci
- S.C. Ematologia, Città della Salute e della Scienza di Torino, Turin, Italy
| | - Maria Papaioannou
- Hematology Unit, 1st Dept of Internal Medicine, AUTH, AHEPA Hospital, Thessaloniki, Greece
| | | | - Inga Piskunova
- Consultative Hematology Department with a Day Hospital for Intensive High-Dose Chemotherapy, National Research Center for Hematology, Moscow, Russia
| | - Viola Maria Popov
- HematologyDepartment, Colentina Clinical Hospital, Bucharest, Romania
| | | | - Giulia Quaresmini
- Department of Oncology and Hematology, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII Bergamo, Bergamo, Italy
| | - Kristian Qvist
- Hematologic Section, Department of Internal Medicine, Hospital Union West, Herning, Denmark
| | | | - Rosa Ruchlemer
- Department of Hematology, Shaare-Zedek Medical Center, Affiliated with the Hebrew University Medical School, Jerusalem, Israel
| | - Martin Šimkovič
- Faculty of Medicine in Hradec Králové, 4th Department of Internal Medicine-Haematology, University Hospital and Charles University in Prague, Hradec Kralove, Czech Republic
| | - Martin Špaček
- First Faculty of Medicine, 1st Department of Medicine-Hematology, Charles University and General Hospital in Prague, Prague, Czech Republic
| | - Paolo Sportoletti
- Department of Medicine and Surgery, Institute of Hematology and Center for Hemato-Oncological Research, University of Perugia, Perugia, Italy
| | - Oana Stanca
- Hematology Department, Coltea Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Tamar Tadmor
- Division of Hematology, Bnai-Zion Medical Center, Haifa, Israel
| | | | - Giovanni Del Poeta
- Department of Biomedicine and Prevention Hematology, University Tor Vergata, Rome, Italy
| | - Odit Gutwein
- Department of Hematology, Shamir Medical Center, Zerifin, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Ivana Milosevic
- Faculty of Medicine, Clinical Centre of Vojvodina, University of Novi Sad, Novi Sad, Serbia
| | - Fatima Mirás
- Hematology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Gianluigi Reda
- Hematology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico of Milan, Milan, Italy
| | | | - Amit Shrestha
- Hematology Unit, Nepal Cancer Hospital & Research Centre, Lalitpur, Nepal
| | - Doreen Te Raa
- Department of Hematology, Gelderse Vallei Ede, Ede, the Netherlands
| | - Sanne H Tonino
- Department of Hematology, Lymmcare, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Ellen Van Der Spek
- Department of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands
| | - Michel van Gelder
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
| | | | - Ewa Wasik-Szczepanek
- Department of Hematooncology and Bone Marrow Transplantation, Medical University in Lublin, Lublin, Poland
| | - Tomasz Wróbel
- Department and Clinic of Hematology, Blood Neoplasms and Bone Marrow Transplantation Wroclaw Medical University, Wroclaw, Poland
| | - Lucrecia Yáñez San Segundo
- Hematology Department, University Hospital and Research Institute of Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - Mohamed Yassin
- Hematology Section, Department of Medical Oncology, National Center for Cancer Care and Research, Doha, Qatar
| | | | | | - Sunil Iyengar
- Haemato-oncology Unit, The Royal Marsden Hospital, UK
| | - Marzia Varettoni
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Candida Vitale
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, A.O.U. Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Marta Coscia
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, A.O.U. Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Alessandro Rambaldi
- Department of Medicine and Surgery, Institute of Hematology and Center for Hemato-Oncological Research, University of Perugia, Perugia, Italy
| | | | | | - Niki Stavroyianni
- Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Livio Trentin
- Hematology and Clinical Immunology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Kostas Stamatopoulos
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Paolo Ghia
- Università Vita-Salute San Raffaele and IRCC Ospedale San Raffaele, Milan, Italy
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Marra JD, Galli E, Giammarco S, Chiusolo P, Metafuni E, Sora F, Laurenti L, Innocenti I, Autore F, Limongiello MA, Fresa A, Bacigalupo A, Sica S. Effect of HLA mismatch on post-transplant infections in allogeneic hematopoietic stem cell transplantation with PTCy-based GvHD prophylaxis. Bone Marrow Transplant 2023; 58:1042-1044. [PMID: 37280430 DOI: 10.1038/s41409-023-02010-7] [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: 02/14/2023] [Revised: 05/02/2023] [Accepted: 05/12/2023] [Indexed: 06/08/2023]
Affiliation(s)
- J D Marra
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma, Italy.
| | - E Galli
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma, Italy
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - S Giammarco
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - P Chiusolo
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma, Italy
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - E Metafuni
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - F Sora
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma, Italy
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - L Laurenti
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma, Italy
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - I Innocenti
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - F Autore
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - M A Limongiello
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - A Fresa
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma, Italy
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - A Bacigalupo
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma, Italy
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - S Sica
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma, Italy
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
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Autore F, Ramassone A, Stirparo L, Pagotto S, Fresa A, Innocenti I, Visone R, Laurenti L. Role of microRNAs in Chronic Lymphocytic Leukemia. Int J Mol Sci 2023; 24:12471. [PMID: 37569845 PMCID: PMC10419063 DOI: 10.3390/ijms241512471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/29/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
Chronic Lymphocytic Leukemia (CLL) is the most common form of leukemia in adults, with a highly variable clinical course. Improvement in the knowledge of the molecular pathways behind this disease has led to the development of increasingly specific therapies, such as BCR signaling inhibitors and BCL-2 inhibitors. In this context, the emerging role of microRNAs (miRNAs) in CLL pathophysiology and their possible application in therapy is worth noting. MiRNAs are one of the most important regulatory molecules of gene expression. In CLL, they can act both as oncogenes and tumor suppressor genes, and the deregulation of specific miRNAs has been associated with prognosis, progression, and drug resistance. In this review, we describe the role of the miRNAs that primarily impact the disease, and how these miRNAs could be used as therapeutic tools. Certainly, the use of miRNAs in clinical practice is still limited in CLL. Many issues still need to be solved, particularly regarding their biological and safety profile, even if several studies have suggested their efficacy on the disease, alone or in combination with other drugs.
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Affiliation(s)
- Francesco Autore
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy (A.F.); (I.I.); (L.L.)
| | - Alice Ramassone
- Center for Advanced Studies and Technology (CAST), G. d’Annunzio University, 66100 Chieti, Italy; (A.R.); (S.P.); (R.V.)
| | - Luca Stirparo
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy (A.F.); (I.I.); (L.L.)
| | - Sara Pagotto
- Center for Advanced Studies and Technology (CAST), G. d’Annunzio University, 66100 Chieti, Italy; (A.R.); (S.P.); (R.V.)
- Department of Medical, Oral and Biotechnological Sciences, G. d’Annunzio University, 66100 Chieti, Italy
| | - Alberto Fresa
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy (A.F.); (I.I.); (L.L.)
| | - Idanna Innocenti
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy (A.F.); (I.I.); (L.L.)
| | - Rosa Visone
- Center for Advanced Studies and Technology (CAST), G. d’Annunzio University, 66100 Chieti, Italy; (A.R.); (S.P.); (R.V.)
- Department of Medical, Oral and Biotechnological Sciences, G. d’Annunzio University, 66100 Chieti, Italy
| | - Luca Laurenti
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy (A.F.); (I.I.); (L.L.)
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
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Autore F, Fresa A, Innocenti I, Principe MID, Maglione R, Stefanizzi C, Pelliccia S, Romeo A, Cimino G, Papa E, Padua LD, Andriani A, Mengarelli A, Tafuri A, Ditto C, Mauro FR, Del Poeta G, Laurenti L. Correspondence in reference to the previously published manuscript: Reduction of cycles of bendamustine plus rituximab therapy in the cases with good response for indolent B-cell lymphomas. Hematol Oncol 2023; 41:571-573. [PMID: 35319789 DOI: 10.1002/hon.2989] [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: 11/06/2022]
Abstract
Takezaki et al. analyzed the outcome of 57 patients with indolent lymphomas treated with Bendamustine plus Rituximab (BR) according to the number of cycles received, showing that patients who discontinued BR after four cycles had similar outcomes compared to patients who received five or six cycles. Considering the similarities but also the differences between indolent lymphomas and chronic lymphocytic leukemia (CLL), we enriched the results obtained with a cohort of CLL patients treated with BR starting from the experience of the Lazio region group on CLL. Out of 115 patients, 97 (84%) received 4-6 cycles of BR, while 18 (16%) received 1-3 cycles. The outcome of the group of patients who received at least 4 cycles was superior in terms of response rate (ORR 96% vs. ORR 83%, p = 0.041; CR 58% vs. CR 28%, p = 0.052 respectively) and PFS [median PFS 52.6 (40.3-64.9) versus 26.2 (19.3-33.0) months, p < 0.001]. The number of patients undergoing 4 cycles of BR (4-cycles group) and 5-6 cycles (over-4-cycles group) was 9 and 88, respectively. Compared to analysis conducted by the Japanese group in indolent lymphomas, in CLL we did not observe any difference between the outcome of the 4-cycles group and the over-4-cycles group in terms of ORR (89% vs. 97%, p = 0.268) and in survival [median PFS 40.8 (13.7-67.8) versus 52.6 (38.7-66.5) months, p = 0.117]. Moreover, we observed that patients who achieved a clinical CR showed overlapping outcomes with patients who received more than 4 cycles [CR vs. non-CR median PFS not reached vs. 11.0 months; over-4-cycles group median PFS 52.6 months (40.3-64.9); p < 0.001]. Nowadays chemoimmunotherapy with BR is reserved to fit elderly CLL patients, and there are many chemo-free treatment options available; therefore, discontinuation after 4 cycles may be permissible in patients who obtained a CR in order to limit toxicity as much as possible.
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Affiliation(s)
- Francesco Autore
- Dipartimento di Diagnostica per Immagini, Hematology Unit, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Alberto Fresa
- Institute of Hematology, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Idanna Innocenti
- Dipartimento di Diagnostica per Immagini, Hematology Unit, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Maria Ilaria Del Principe
- Department of Biomedicine and Prevention, Hematology Unit, University tor Vergata of Rome, Rome, Italy
| | - Raffaele Maglione
- Department of Cellular Biotechnologies and Hematology, Hematology Unit, Sapienza University, Rome, Italy
| | | | - Sabrina Pelliccia
- Hematology Unit, Azienda Ospedaliera-Universitaria Sant'Andrea, Rome, Italy
| | - Azzurra Romeo
- Hematology Unit, Ospedale Santa Maria Goretti, Latina, Italy
| | - Giuseppe Cimino
- Hematology Unit, Ospedale Santa Maria Goretti, Latina, Italy
| | - Elena Papa
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Laura De Padua
- Hematology Unit, Fabrizio Spaziani Hospital, Frosinone, Italy
| | | | - Andrea Mengarelli
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Agostino Tafuri
- Hematology Unit, Azienda Ospedaliera-Universitaria Sant'Andrea, Rome, Italy
| | - Concetta Ditto
- Division of Hematology, Ospedale Belcolle, Viterbo, Italy
| | - Francesca Romana Mauro
- Department of Cellular Biotechnologies and Hematology, Hematology Unit, Sapienza University, Rome, Italy
| | - Giovanni Del Poeta
- Department of Biomedicine and Prevention, Hematology Unit, University tor Vergata of Rome, Rome, Italy
| | - Luca Laurenti
- Dipartimento di Diagnostica per Immagini, Hematology Unit, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Institute of Hematology, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
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11
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Innocenti I, Benintende G, Tomasso A, Fresa A, Autore F, Larocca LM, Laurenti L. Richter transformation in Chronic Lymphocytic Leukemia. Hematol Oncol 2023; 41:293-300. [PMID: 36433773 DOI: 10.1002/hon.3106] [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: 07/29/2022] [Revised: 11/10/2022] [Accepted: 11/19/2022] [Indexed: 11/28/2022]
Abstract
Chronic lymphocytic leukemia can evolve to an aggressive lymphoma-in most of the cases diffuse large B cells lymphoma, rarely Hodgkin lymphoma-and this complication is defined Richter syndrome (RS). Immunogenotypic features that characterize RS include unmutated IgHV status with high prevalence of IgHV4-39/D6-13/J5 sequence; deletion of chromosome 17p or 11q; activation of oncogenes as NOTCH1 and c-MYC; inactivation of onco-suppressors as TP53 and CDKN2A; high expression of CD38 in lymph-nodes. The prognosis of this condition is very poor: patients experience a rapid clinical deterioration with frequent therapeutic failure since the current options include suboptimal strategies as standard chemo-immunotherapy followed by hematopoietic stem cells transplantation or enrollment in clinical trials which investigate the efficacy of target drugs. Understanding the biology of such a heterogeneous condition is crucial to personalize the treatment and improve patient's survival.
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Affiliation(s)
- Idanna Innocenti
- Sezione di Ematologia, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario a. Gemelli IRCCS, Rome, Italy
| | - Giulia Benintende
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Annamaria Tomasso
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alberto Fresa
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Autore
- Sezione di Ematologia, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario a. Gemelli IRCCS, Rome, Italy
| | | | - Luca Laurenti
- Sezione di Ematologia, 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
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12
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Benintende G, Innocenti I, Fresa A, Autore F, Tomasso A, Piciocchi A, Vuono F, Stirparo L, Mosca A, Bacigalupo A, Gattei V, Efremov D, Sangiorgi E, Laurenti L. Clinical and molecular features of familial chronic lymphocytic leukemia: a pilot monocentric study. Haematologica 2023; 108:2240-2243. [PMID: 36546426 PMCID: PMC10388279 DOI: 10.3324/haematol.2022.282268] [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: 10/14/2022] [Indexed: 08/02/2023] Open
Abstract
Not available.
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Affiliation(s)
- Giulia Benintende
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome.
| | - Idanna Innocenti
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome
| | - Alberto Fresa
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome
| | - Francesco Autore
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome
| | - Annamaria Tomasso
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome
| | - Alfonso Piciocchi
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Disease (GIMEMA), Rome
| | - Florenzia Vuono
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome
| | - Luca Stirparo
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome
| | - Antonio Mosca
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome
| | - Andrea Bacigalupo
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome
| | - Valter Gattei
- Clinical Experimental Onco-Haematology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano
| | - Dimitar Efremov
- Molecular Hematology, International Centre for Genetic Engineering and Biotechnology, Località Padriciano 99 Street, 34149 Trieste
| | - Eugenio Sangiorgi
- Sezione di Medicina Genomica, Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore - Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome
| | - Luca Laurenti
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome
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13
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Metafuni E, Cingolani A, Fantoni M, Chiusolo P, Giammarco S, Sorà F, Galli E, Hohaus S, D’Alò F, Bellesi S, Maiolo E, Alma E, Laurenti L, Innocenti I, Autore F, Limongiello MA, Santangelo R, Marchetti S, Ricci R, Sica S. Safety and efficacy of SARS-Cov2 neutralizing monoclonal antibodies after stem cell transplant or CAR-T cell infusion. Hematol Oncol 2023; 41:563-566. [PMID: 36575607 PMCID: PMC9880699 DOI: 10.1002/hon.3119] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Elisabetta Metafuni
- Dipartimento di Diagnostica per ImmaginiRadioterapia Oncologica e EmatologiaFondazione Policlinico Universitario Agostino GemelliIRCCSRomeItaly
| | - Antonella Cingolani
- Dipartimento Scienze di Laboratorio e InfettivologicheFondazione Policlinico Universitario Agostino Gemelli IRCCSRomeItaly
- Dipartimento di Sicurezza e BioeticaSezione Malattie InfettiveUniversità Cattolica del Sacro CuoreRomeItaly
| | - Massimo Fantoni
- Dipartimento Scienze di Laboratorio e InfettivologicheFondazione Policlinico Universitario Agostino Gemelli IRCCSRomeItaly
- Dipartimento di Sicurezza e BioeticaSezione Malattie InfettiveUniversità Cattolica del Sacro CuoreRomeItaly
| | - Patrizia Chiusolo
- Dipartimento di Diagnostica per ImmaginiRadioterapia Oncologica e EmatologiaFondazione Policlinico Universitario Agostino GemelliIRCCSRomeItaly
- Dipartimento di Scienze Radiologiche ed EmatologicheSezione di EmatologiaUniversità Cattolica del Sacro CuoreRomeItaly
| | - Sabrina Giammarco
- Dipartimento di Diagnostica per ImmaginiRadioterapia Oncologica e EmatologiaFondazione Policlinico Universitario Agostino GemelliIRCCSRomeItaly
| | - Federica Sorà
- Dipartimento di Diagnostica per ImmaginiRadioterapia Oncologica e EmatologiaFondazione Policlinico Universitario Agostino GemelliIRCCSRomeItaly
| | - Eugenio Galli
- Dipartimento di Diagnostica per ImmaginiRadioterapia Oncologica e EmatologiaFondazione Policlinico Universitario Agostino GemelliIRCCSRomeItaly
| | - Stefan Hohaus
- Dipartimento di Diagnostica per ImmaginiRadioterapia Oncologica e EmatologiaFondazione Policlinico Universitario Agostino GemelliIRCCSRomeItaly
- Dipartimento di Scienze Radiologiche ed EmatologicheSezione di EmatologiaUniversità Cattolica del Sacro CuoreRomeItaly
| | - Francesco D’Alò
- Dipartimento di Diagnostica per ImmaginiRadioterapia Oncologica e EmatologiaFondazione Policlinico Universitario Agostino GemelliIRCCSRomeItaly
| | - Silvia Bellesi
- Dipartimento di Diagnostica per ImmaginiRadioterapia Oncologica e EmatologiaFondazione Policlinico Universitario Agostino GemelliIRCCSRomeItaly
| | - Elena Maiolo
- Dipartimento di Diagnostica per ImmaginiRadioterapia Oncologica e EmatologiaFondazione Policlinico Universitario Agostino GemelliIRCCSRomeItaly
| | - Eleonora Alma
- Dipartimento di Diagnostica per ImmaginiRadioterapia Oncologica e EmatologiaFondazione Policlinico Universitario Agostino GemelliIRCCSRomeItaly
| | - Luca Laurenti
- Dipartimento di Diagnostica per ImmaginiRadioterapia Oncologica e EmatologiaFondazione Policlinico Universitario Agostino GemelliIRCCSRomeItaly
- Dipartimento di Scienze Radiologiche ed EmatologicheSezione di EmatologiaUniversità Cattolica del Sacro CuoreRomeItaly
| | - Idanna Innocenti
- Dipartimento di Diagnostica per ImmaginiRadioterapia Oncologica e EmatologiaFondazione Policlinico Universitario Agostino GemelliIRCCSRomeItaly
| | - Francesco Autore
- Dipartimento di Diagnostica per ImmaginiRadioterapia Oncologica e EmatologiaFondazione Policlinico Universitario Agostino GemelliIRCCSRomeItaly
| | - Maria Assunta Limongiello
- Dipartimento di Diagnostica per ImmaginiRadioterapia Oncologica e EmatologiaFondazione Policlinico Universitario Agostino GemelliIRCCSRomeItaly
| | - Rosaria Santangelo
- Dipartimento Scienze di Laboratorio e InfettivologicheFondazione Policlinico Universitario Agostino Gemelli IRCCSRomeItaly
| | - Simona Marchetti
- Dipartimento Scienze di Laboratorio e InfettivologicheFondazione Policlinico Universitario Agostino Gemelli IRCCSRomeItaly
| | - Rosalba Ricci
- Dipartimento Scienze di Laboratorio e InfettivologicheFondazione Policlinico Universitario Agostino Gemelli IRCCSRomeItaly
| | - Simona Sica
- Dipartimento di Diagnostica per ImmaginiRadioterapia Oncologica e EmatologiaFondazione Policlinico Universitario Agostino GemelliIRCCSRomeItaly
- Dipartimento di Scienze Radiologiche ed EmatologicheSezione di EmatologiaUniversità Cattolica del Sacro CuoreRomeItaly
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14
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Benintende G, Pozzo F, Innocenti I, Autore F, Fresa A, D’Arena G, Gattei V, Lurenti L. Measurable residual disease in chronic lymphocytic leukemia. Front Oncol 2023; 13:1112616. [PMID: 36865804 PMCID: PMC9971803 DOI: 10.3389/fonc.2023.1112616] [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: 11/30/2022] [Accepted: 01/24/2023] [Indexed: 02/16/2023] Open
Abstract
Measurable residual disease (MRD) is defined as the presence of residual cancer cells after treatment in patients with clinically undetectable disease, who would otherwise be considered in complete remission. It is a highly sensitive parameter which indicates the disease burden and predicts survival in this setting of patients. In recent years, MRD has gained a role in many hematological malignancies as a surrogate endpoint for clinical trials: undetectable MRD has been correlated to longer progression free survival (PFS) and overall survival (OS). New drugs and combinations have been developed with the aim to achieve MRD negativity, which would indicate favorable prognosis. Different methods to measure MRD have also been devised, which include flow cytometry, polymerase chain reaction (PCR) and next generation sequencing (NGS), with different sensitivity and accuracy in evaluating deep remission after treatment. In this review, we will analyze the current recommendations for the detection of MRD, with particular focus on its role in Chronic Lymphocytic Leukemia (CLL), as well as the different detection methods. Moreover, we will discuss the results of clinical trials and the role of MRD in new therapeutic schemes with inhibitors and monoclonal antibodies. MRD is not currently used in the clinical practice to evaluate response to treatment, due to technical and economical limitations, but it's gaining more and more interest in trials settings, especially since the introduction of venetoclax. The use of MRD in trials will likely be followed by a broader practical application in the future. The aim of this work is to provide a reader-friendly summary of the state of art in the field, as MRD will soon become an accessible tool to evaluate our patients, predict their survival and guide physician's therapeutic choices and preferences.
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Affiliation(s)
- Giulia Benintende
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy,*Correspondence: Giulia Benintende,
| | - Federico Pozzo
- Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico di Aviano (CRO) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Idanna Innocenti
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Francesco Autore
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Alberto Fresa
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Giovanni D’Arena
- “San Luca” Hospital, Azienda Sanitaria Locale (ASL) Salerno, Salerno, Italy
| | - Valter Gattei
- Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico di Aviano (CRO) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Luca Lurenti
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
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15
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Galli E, Sorà F, Hohaus S, Fresa A, Pansini I, Autore F, Metafuni E, Innocenti I, Limongiello M, Giammarco S, Laurenti L, Bacigalupo A, Chiusolo P, De Stefano V, Sica S. Endothelial activation predicts disseminated intravascular coagulopathy, cytokine release syndrome and prognosis in patients treated with
anti‐CD19 CAR‐T
cells. Br J Haematol 2022; 201:86-94. [PMID: 36503182 DOI: 10.1111/bjh.18596] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/23/2022] [Accepted: 11/27/2022] [Indexed: 12/14/2022]
Abstract
Cytokine release syndrome (CRS) and consumptive coagulopathy can complicate the treatment with chimeric antigen receptor T (CAR-T) cells. The modified version of the Endothelial Activation and Stress Index (mEASIX), a score derived from haematopoietic stem cell transplantation, combines platelets, C-reactive protein (CRP), and lactate dehydrogenase (LDH) and has been correlated with CRS and endothelial biomarkers. In 38 consecutive patients with aggressive lymphoproliferative disease we measured a coagulative laboratory panel at baseline and early after infusion of anti-CD19 CAR-T. The panel was investigated also in the presence of CRS graded 2 or higher, or immune effector cell-associated neurotoxicity syndrome (ICANS). Moreover, we examined the relationship between mEASIX, coagulation biomarkers, and toxicities of CAR-T cells. During CRS grade 2 or higher, we found increased prothrombin time (PT) and activated partial thromboplastin time (aPTT), fibrinogen, D-dimer, factor VIII (FVIII), and von Willebrand factor (vWF) antigen levels, and decreased platelet count and antithrombin levels. The occurrence of immune effector cell-associated neurotoxicity syndrome was associated with higher PT values, D-dimer, FVIII, and vWF levels, and decreased fibrinogen levels and platelet count. A higher mEASIX score correlated with increased aPTT values, fibrinogen, D-dimer, FVIII and vWF levels, and decreased antithrombin levels. Baseline mEASIX was predictive for consumptive coagulopathy and CRS graded 2 or higher, and for progression-free survival and overall survival.
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Affiliation(s)
- Eugenio Galli
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche Università Cattolica del Sacro Cuore Rome Italy
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
| | - Federica Sorà
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche Università Cattolica del Sacro Cuore Rome Italy
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
| | - Stefan Hohaus
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche Università Cattolica del Sacro Cuore Rome Italy
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
| | - Alberto Fresa
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche Università Cattolica del Sacro Cuore Rome Italy
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
| | - Ilaria Pansini
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche Università Cattolica del Sacro Cuore Rome Italy
| | - Francesco Autore
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
| | - Elisabetta Metafuni
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
| | - Idanna Innocenti
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
| | - Maria Assunta Limongiello
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
| | - Sabrina Giammarco
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
| | - Luca Laurenti
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche Università Cattolica del Sacro Cuore Rome Italy
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
| | - Andrea Bacigalupo
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche Università Cattolica del Sacro Cuore Rome Italy
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
| | - Patrizia Chiusolo
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche Università Cattolica del Sacro Cuore Rome Italy
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
| | - Valerio De Stefano
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche Università Cattolica del Sacro Cuore Rome Italy
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
| | - Simona Sica
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche Università Cattolica del Sacro Cuore Rome Italy
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
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16
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Autore F, Stirparo L, Innocenti I, Papa E, Marchesi F, Togni C, Mariani S, Torrieri L, Salvatori M, Fazio F, Metafuni E, Giammarco S, Sora F, Falcucci P, Ferrari A, Trisolini SM, Capria S, Tafuri A, Chiusolo P, Sica S, Laurenti L. Immunogenicity of SARS-CoV-2 vaccination in patients undergoing autologous stem cell transplantation. A multicentric experience. Front Oncol 2022; 12:897937. [PMID: 36531008 PMCID: PMC9755510 DOI: 10.3389/fonc.2022.897937] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 11/14/2022] [Indexed: 11/10/2023] Open
Abstract
COVID-19 disease has a strong impact on hematological patients; those receiving autologous hematopoietic stem cell transplantation (aHSCT) represent a particularly vulnerable group, in which the effectiveness of vaccination is very variable. Chiarucci et al. showed that patients affected by non-Hodgkin lymphoma (NHL) and treated with rituximab experienced a lower rate of immunization against SARS-CoV-2 (54%), as well as significantly lower IgG antibody titers. In our multicenter retrospective observational study, we included 82 patients who underwent aHSCT, divided into two groups: 58 patients vaccinated after aHSCT (group A) and 24 vaccinated before getting transplantation (group B). In group A, 39 (67%) patients had positive serology, and the rate of positivity increased with time after aHSCT. In the subgroup of patients with NHL, the administration of rituximab predicted negative serology, particularly when administered in the 6 months before vaccination (13% response rate). Patients affected by plasma cells had a higher rate of positivity (83% overall), independently of the time to aHSCT. In group B, no patient who initially showed positive serology became negative after transplantation, so the aHSCT did not affect the response to the vaccination. Our study confirmed the role of rituximab as a negative predictor of response to SARS-CoV-2 vaccination, whereas the conditioning and transplantation procedure itself seemed to be less important.
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Affiliation(s)
- Francesco Autore
- Dipartimento di Diagnostica per Immagini Radioterapia Oncologica ed Ematologia Fondazione Policlinico, Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Luca Stirparo
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Idanna Innocenti
- Dipartimento di Diagnostica per Immagini Radioterapia Oncologica ed Ematologia Fondazione Policlinico, Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Elena Papa
- Hematology and Stem Cell Transplant Unit, Regina Elena National Cancer Institute IRCCS, Rome, Italy
| | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, Regina Elena National Cancer Institute IRCCS, Rome, Italy
| | - Chiara Togni
- Hematology Unit, Azienda Ospedaliera Universitaria Sant’Andrea, Sapienza University, Rome, Italy
| | - Sabrina Mariani
- Hematology Unit, Azienda Ospedaliera Universitaria Sant’Andrea, Sapienza University, Rome, Italy
| | - Lorenzo Torrieri
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Martina Salvatori
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Francesca Fazio
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Elisabetta Metafuni
- Dipartimento di Diagnostica per Immagini Radioterapia Oncologica ed Ematologia Fondazione Policlinico, Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Sabrina Giammarco
- Dipartimento di Diagnostica per Immagini Radioterapia Oncologica ed Ematologia Fondazione Policlinico, Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Federica Sora
- Dipartimento di Diagnostica per Immagini Radioterapia Oncologica ed Ematologia Fondazione Policlinico, Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Paolo Falcucci
- Hematology and Stem Cell Transplant Unit, Regina Elena National Cancer Institute IRCCS, Rome, Italy
| | - Antonella Ferrari
- Hematology Unit, Azienda Ospedaliera Universitaria Sant’Andrea, Sapienza University, Rome, Italy
| | - Silvia Maria Trisolini
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Saveria Capria
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Agostino Tafuri
- Hematology Unit, Azienda Ospedaliera Universitaria Sant’Andrea, Sapienza University, Rome, Italy
| | - Patrizia Chiusolo
- Dipartimento di Diagnostica per Immagini Radioterapia Oncologica ed Ematologia Fondazione Policlinico, Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Simona Sica
- Dipartimento di Diagnostica per Immagini Radioterapia Oncologica ed Ematologia Fondazione Policlinico, Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luca Laurenti
- Dipartimento di Diagnostica per Immagini Radioterapia Oncologica ed Ematologia Fondazione Policlinico, Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
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17
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Innocenti I, Reda G, Visentin A, Coscia M, Motta M, Murru R, Moia R, Gentile M, Pennese E, Quaglia FM, Albano F, Cassin R, Deodato M, Ielo C, Frustaci AM, Piciocchi A, Rughini A, Arena V, Di Sevo D, Tomasso A, Autore F, Del Poeta G, Scarfò L, Mauro FR, Tedeschi A, Trentin L, Pompili M, Foà R, Ghia P, Cuneo A, Laurenti L. Risk of hepatitis B virus reactivation in chronic lymphocytic leukemia patients receiving ibrutinib with or without antiviral prophylaxis. A retrospective multicentric GIMEMA study. Haematologica 2022; 107:1470-1473. [PMID: 35199505 PMCID: PMC9152973 DOI: 10.3324/haematol.2021.280325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 02/11/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Idanna Innocenti
- Sezione di Ematologia, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma
| | - Gianluigi Reda
- U.O.C. Ematologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano
| | - Andrea Visentin
- Department of Medicine, Hematology and Clinical Immunology Branch, University of Padova, Padova
| | - Marta Coscia
- Division of Hematology, A.O.U. Città della Salute e della Scienza di Torino, Torino
| | | | - Roberta Murru
- Hematology and Stem Cell Transplantation Unit, Ospedale A. Businco, ARNAS "G.Brotzu", Cagliari
| | - Riccardo Moia
- Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara
| | - Massimo Gentile
- UOC Ematologia AO di Cosenza, Presidio Ospedaliero Annunziata, Cosenza
| | - Elsa Pennese
- U.O.S.D. Centro Diagnosi e Terapia dei Linfomi, Dipartimento Oncologico-Ematologico, Presidio Ospedaliero "Spirito Santo", Pescara
| | | | - Francesco Albano
- Department of Emergency and Organ Transplantation (D.E.T.O.), Hematology Section, University of Bari "Aldo Moro", Bari
| | - Ramona Cassin
- U.O.C. Ematologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano
| | - Marina Deodato
- ASST Grande Ospedale Metropolitano Niguarda Hospital, Milano
| | - Claudia Ielo
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Policlinico Umberto I, Roma
| | | | | | | | | | | | - Annamaria Tomasso
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma
| | - Francesco Autore
- Sezione di Ematologia, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma
| | - Giovanni Del Poeta
- UOC Unit of Hematology and Stem Cell Transplantation, AOU Policlinico Tor Vergata Roma, Roma
| | - Lydia Scarfò
- Strategic Research Program on CLL, Università Vita Salute and IRCSS Ospedale San Raffaele, Milano
| | - Francesca Romana Mauro
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Policlinico Umberto I, Roma
| | | | - Livio Trentin
- Department of Medicine, Hematology and Clinical Immunology Branch, University of Padova, Padova
| | - Maurizio Pompili
- Dipartimento di Medicina Interna e Gastroenterologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma
| | - Robin Foà
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Policlinico Umberto I, Roma
| | - Paolo Ghia
- Strategic Research Program on CLL, Università Vita Salute and IRCSS Ospedale San Raffaele, Milano
| | - Antonio Cuneo
- Hematology section, Department of Medical Sciences, University of Ferrara, Ferrara
| | - Luca Laurenti
- Sezione di Ematologia, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma.
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18
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Innocenti I, Benintende G, Stirparo L, Tomasso A, Mosca A, Fresa A, Galli E, Autore F, Laurenti L. PB1872: ANTIBODY RESPONSES AFTER COVID-19 VACCINATION IN PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKAEMIA, EITHER TREATED OR NAÏVE. A MONOCENTRIC EXPERIENCE. Hemasphere 2022. [PMCID: PMC9431519 DOI: 10.1097/01.hs9.0000850340.86517.a4] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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19
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Innocenti I, Tomasso A, Benintende G, Autore F, Fresa A, Vuono F, Stirparo L, Galli E, D’Arena G, Sorà F, Efremov D, Laurenti L. SUBCUTANEOUS IMMUNOGLOBULINS IN CHRONIC LYMPHOCYTIC LEUKAEMIA WITH SECONDARY ANTIBODY DEFICIENCY. A MONOCENTRIC EXPERIENCE DURING COVID‐19 PANDEMICS. Hematol Oncol 2022; 40:469-474. [PMID: 35076123 PMCID: PMC9015622 DOI: 10.1002/hon.2966] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Secondary antibody deficiency (SAD) is a frequent manifestation of chronic lymphocytic leukemia (CLL) that increases the risk of infections. However, no formal guideline are available regarding the eligibility for prophylaxis or the delivery method, dosage, frequency of administration and duration of immunoglobulin replacement therapy (IgRT). The aim of this study was to assess the efficacy and safety of subcutaneous IgRT (SCIg) and its impact on quality of life (QoL) of CLL pts in the Covid‐19 era. Ten CLL pts with SAD were treated with subcutaneous IgRT (SCIg) at our institution between October 2019 and December 2020. Median age was 66 years and five patients had comorbidities. Seven patients were receiving therapy for CLL when treatment with SCIg was initiated. All pts received 10 g total dose hyaluronidase‐free SCIg independently from body weight. The IgG level and CD4/CD8, CD19 and CD16/56 lymphocytes subset were recorded at baseline and every 3 months. No patient experienced infectious events nor Covid‐19 mediated interstitial pneumonia while on SCIg therapy. All patients tolerated well the therapy and experienced an increase of IgG levels, which was then stable in time. We conclude that SCIg administration in CLL pts with SAD is efficacious and safe as infectious prophylaxis. This route of administration appears particularly advantageous in the Covid‐19 era, because of the self‐administration at home which results in improvement in the QoL and reduced treatment expenditures.
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Affiliation(s)
- Idanna Innocenti
- Sezione di Ematologia, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed EmatologiaFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
| | - Annamaria Tomasso
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed EmatologicheUniversità Cattolica del Sacro CuoreRomeItaly
| | - Giulia Benintende
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed EmatologicheUniversità Cattolica del Sacro CuoreRomeItaly
| | - Francesco Autore
- Sezione di Ematologia, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed EmatologiaFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
| | - Alberto Fresa
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed EmatologicheUniversità Cattolica del Sacro CuoreRomeItaly
| | - Florenzia Vuono
- Sezione di Ematologia, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed EmatologiaFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
| | - Luca Stirparo
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed EmatologicheUniversità Cattolica del Sacro CuoreRomeItaly
| | - Eugenio Galli
- Sezione di Ematologia, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed EmatologiaFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
| | - Giovanni D’Arena
- UO di Ematologia e Trapianto di cellule staminaliIRCCS Centro di riferimento Oncologico della BasilicataRionero in VultureItaly
| | - Federica Sorà
- Sezione di Ematologia, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCSUniversità Cattolica del Sacro CuoreRomeItaly
| | - Dimitar Efremov
- Molecular HematologyInternational Center for Genetic Engineering and BiotechnologyTriesteItaly
| | - Luca Laurenti
- Sezione di Ematologia, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCSUniversità Cattolica del Sacro CuoreRomeItaly
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20
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Del Poeta G, Biagi A, Laurenti L, Chiarenza A, Pozzo F, Innocenti I, Postorino M, Rossi FM, Del Principe MI, Bomben R, de Fabritiis P, Bruno A, Cantonetti M, Di Raimondo F, Zucchetto A, Gattei V. Impaired nodal shrinkage and apoptosis define the independent adverse outcome of NOTCH1 mutated patients under ibrutinib therapy in chronic lymphocytic leukaemia. Haematologica 2021; 106:2345-2353. [PMID: 32732360 PMCID: PMC8409042 DOI: 10.3324/haematol.2020.251488] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Indexed: 12/18/2022] Open
Abstract
The introduction of agents inhibiting the B-cell receptor-associated kinases such as ibrutinib has dramatically changed treatments algorithms of chronic lymphocytic leukemia (CLL) as well as the role of different adverse prognosticators. We evaluated the efficacy of ibrutinib as a single agent, in a real-life context, in 180 patients with CLL mostly pretreated, recruited from three independent cohorts from Italy. Patients received 420 mg oral ibrutinib once daily until progression or occurrence of unacceptable side effects. Seventy-three patients discontinued ibrutinib for progression or for adverse events. NOTCH1 mutations (NOTCH1 M) were correlated with a reduced redistribution lymphocytosis, calculated at 3 months on ibrutinib (P=0.022). Moreover, NOTCH1 M patients showed inferior nodal response at 6 months on ibrutinib compared to NOTCH1 wild-type patients (P<0.0001). Significant shorter progression free survival (PFS) and overall survival (OS) were observed in NOTCH1 M patients (P=0.00002 and P=0.001). Interestingly, NOTCH1 M plus a lower BAX/BCL-2 ratio identified a CLL subset showing the worst PFS and OS (P=0.0002 and P=0.005). In multivariate analysis of PFS and OS, NOTCH1 M were confirmed an independent prognosticator (P=0.00006 and P=0.0039). In conclusion, NOTCH1 M are strongly associated with a lower BAX/BCL-2 ratio, consistent with defective apoptosis, lower redistribution lymphocytosis and lower nodal shrinkage under ibrutinib treatment, this last paramter being responsible for partial responses, subsequent relapses, as well as shorter PFS and OS. Either new small molecule combination approaches or antibodies targeting NOTCH1 could be future therapeutic options for NOTCH1 M patients.
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Affiliation(s)
- Giovanni Del Poeta
- Hematology, Dept of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
| | - Annalisa Biagi
- Hematology, Dept of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
| | - Luca Laurenti
- Division of Hematology, Universita' Cattolica del Sacro Cuore, Rome, Italy
| | | | - Federico Pozzo
- Cinical and Experimental Hematology Unit, CRO, IRCCS, Aviano (PN), Italy
| | - Idanna Innocenti
- Division of Hematology, Universita' Cattolica del Sacro Cuore, Rome, Italy
| | | | | | | | - Riccardo Bomben
- Cinical and Experimental Hematology Unit, CRO, IRCCS, Aviano (PN), Italy
| | - Paolo de Fabritiis
- Hematology, Dept of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
| | - Antonio Bruno
- Hematology, Dept of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
| | - Maria Cantonetti
- Hematology, Dept of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
| | | | | | - Valter Gattei
- Cinical and Experimental Hematology Unit, CRO, IRCCS, Aviano (PN), Italy
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21
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Autore F, Chiusolo P, Sorà F, Giammarco S, Laurenti L, Innocenti I, Metafuni E, Piccirillo N, Pagano L, Sica S. Efficacy and Tolerability of First Line Arsenic Trioxide in Combination With All-Trans Retinoic Acid in Patients With Acute Promyelocytic Leukemia: Real Life Experience. Front Oncol 2021; 11:614721. [PMID: 34336637 PMCID: PMC8323479 DOI: 10.3389/fonc.2021.614721] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 06/28/2021] [Indexed: 12/03/2022] Open
Abstract
Acute promyelocytic leukemia is a variant of acute myeloid leukemia characterized by t(15;17) and PML/RAR alfa fusion gene. The discovery of the molecular pathogenesis has led to entitle all-trans retinoic acid (ATRA) as the first targeted therapy for acute leukemia. It is usually associated to anthracycline-based chemotherapy with high response rates, but potential long-term sequelae including therapy-related malignancies have been observed. Arsenic trioxide (ATO) was added to obviate these complications and investigational trials aimed to a new strategy with the incorporation of arsenic trioxide (ATO) into initial therapy instead of chemotherapy in selected patients. ATRA plus ATO without chemotherapy was the first attempt to treat low and intermediate-risk patients with APL. Our study aims to describe a monocentric cohort of patients with newly diagnosed APL effectively treated with ATO plus ATRA underlying its efficacy together with the high grade of tolerability of this association. From January 2009 to December 2019 23 APL patients were diagnosed and treated with ATO plus ATRA regimen: 14 males and 9 females patients with a median age of 45 years (range 18-72), for the majority intermediate risk (15 patients, 65%). The treatment was well tolerated and all patients achieved molecular remission after a median time of 3 months (range 1-6 months). All patients proceeded to consolidation phase as outpatients, they maintained complete molecular response at a median time of 44 months (range 15-127) except for 1 patient. All but one patient are alive and in response at a median follow-up of 48 months (range 9-141) without late effects. ATO plus ATRA regimen shows advantages in comparison to chemotherapy; in fact it allowed to treat patients in which chemotherapy could even not be applicable and it did not show secondary hematological diseases. The association of ATO to ATRA as chemo-free regimen enabled to treat APL even without chemotherapy.
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Affiliation(s)
- Francesco Autore
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Patrizia Chiusolo
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Federica Sorà
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Sabrina Giammarco
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Luca Laurenti
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Idanna Innocenti
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Elisabetta Metafuni
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Nicola Piccirillo
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Livio Pagano
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Simona Sica
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma, Italy
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22
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Sora F, Annunziata M, Laurenti L, Giammarco S, Chiusolo P, Innocenti I, Autore F, Metafuni E, Galli E, Bacigalupo A, Ferrara F, Sica S. Blinatumomab as a successful and safe therapy in Down syndrome patients with relapsed/refractory b-precursor acute lymphoblastic leukaemia: Case reports and literature review. Pediatr Blood Cancer 2021; 68:e29044. [PMID: 33844429 DOI: 10.1002/pbc.29044] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Federica Sora
- 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
| | | | - Luca Laurenti
- 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
| | - Sabrina Giammarco
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Patrizia Chiusolo
- 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
| | - Idanna Innocenti
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Autore
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Elisabetta Metafuni
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Eugenio Galli
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Andrea Bacigalupo
- 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
| | | | - 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
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23
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Bacigalupo A, Innocenti I, Rossi E, Sora F, Galli E, Autore F, Metafuni E, Chiusolo P, Giammarco S, Laurenti L, Benintende G, Sica S, De Stefano V. Allogeneic Hemopoietic Stem Cell Transplantation for Myelofibrosis: 2021. Front Immunol 2021; 12:637512. [PMID: 34017327 PMCID: PMC8129535 DOI: 10.3389/fimmu.2021.637512] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 04/13/2021] [Indexed: 11/13/2022] Open
Abstract
The aim of this review is to update the current status of allogeneic hemopoietic stem cell transplants (HSCT) for patients with myelofibrosis (MF). We have first summarized the issue of an indication for allogeneic HSCT, discussing several prognostic scoring systems, developed to predict the outcome of MF, and therefore to identify patients who will benefit of an allogeneic HSCT. Patients with low risk MF are usually not selected for a transplant, whereas patients with intermediate or high risk MF are eligible. A separate issue, is how to predict the outcome of HSCT: we will outline a clinical molecular myelofibrosis transplant scoring system (MTSS), which predicts overall survival, ranging from 90% for low risk patients, to 20% for very high risk patients. We will also discuss transfusion burden and spleen size, as predictors of transplant outcome. The choice of a transplant platform including the conditioning regimen, the stem cell source and GvHD prophylaxis, are crucial for a successful program in MF, and will be outlined. Complications such as poor graft function, graft failure, GvHD and relapse of the disease, will also be reviewed. Finally we discuss monitoring the disease after HSCT with donor chimerism, driver mutations and hematologic data. We have made an effort to make this review as comprehensive and up to date as possible, and we hope it will provide some useful data for the clinicians.
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Affiliation(s)
- Andrea Bacigalupo
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Idanna Innocenti
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Elena Rossi
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Federica Sora
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Eugenio Galli
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Francesco Autore
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Elisabetta Metafuni
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Patrizia Chiusolo
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Sabrina Giammarco
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Luca Laurenti
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Giulia Benintende
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Simona Sica
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Valerio De Stefano
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma, Italy
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24
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Fresa A, Autore F, Innocenti I, Piciocchi A, Tomasso A, Morelli F, Sorà F, Sica S, De Stefano V, Laurenti L. Non-overt disseminated intravascular coagulopathy associated with the first obinutuzumab administration in patients with chronic lymphocytic leukemia. Hematol Oncol 2021; 39:423-427. [PMID: 33462837 DOI: 10.1002/hon.2837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Infusion-related reactions are among the worst complications of obinutuzumab (G) administration and occur predominantly during the first infusion. We reported another adverse event related to the first G infusion, a subclinical coagulopathy. We retrospectively analyzed a cohort of 13 pts with chronic lymphocytic leukemia treated with a frontline G-chlorambucil regimen. Six pts developed non-overt disseminated intravascular coagulopathy (DIC) (46%) after the first administration of G. The coagulopathy was subclinical and self-limited in all pts, not requiring any intervention apart from the suspension of anticoagulant therapy in one pt. We observed a drop in the platelet count, an elevation of D-dimer levels, and an elongation of activated partial thromboplastin time. We found a significant difference in the platelet count between the pts with DIC and those withouts; in fact, all the six pts with non-overt DIC had a platelet count greater than 100 × 109 /L, while in the other group only one (p = 0.019). A trend towards a lower lymphocyte count and a higher CD20 expression was found in the pts with DIC. No other correlation between the DIC complication and the clinical or laboratory characteristics of the patients was found. The pathogenesis of the G-related non-overt DIC could be related to the consumption of the platelets after the lysis of lymphocytes, probably triggered by the damage associated molecular patterns. Despite its limitations, this study describes a new adverse event and identifies a specific subgroup of patients whose clinical management at the time of the infusion of G may need to be refined.
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Affiliation(s)
- Alberto Fresa
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Autore
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Idanna Innocenti
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Annamaria Tomasso
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesca Morelli
- Haematology Unit, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy
| | - Federica Sorà
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy.,Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Simona Sica
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy.,Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Valerio De Stefano
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy.,Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Luca Laurenti
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy.,Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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25
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Giammarco S, Raiola AM, Di Grazia C, Bregante S, Gualandi F, Varaldo R, Chiusolo P, Sora F, Sica S, Laurenti L, Metafuni E, Innocenti I, Autore F, Murgia B, Bacigalupo A, Angelucci E. Second haploidentical stem cell transplantation for primary graft failure. Bone Marrow Transplant 2020; 56:1291-1296. [PMID: 33328569 DOI: 10.1038/s41409-020-01183-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 11/11/2020] [Accepted: 11/30/2020] [Indexed: 01/04/2023]
Abstract
We report the outcome of 19 patients who experienced primary graft failure (PrGF) after a haploidentical (HAPLO), unmanipulated bone marrow transplant. The median age of patients was 52 years; the conditioning regimen of the first HAPLO transplant was either full dose total body irradiation (TBI) or fludarabine, busulfan, and thiotepa (TBF); PTCY was given to all patients together with cyclosporine and mycophenolate. All 19 patients with PrGF received a second HAPLO graft, at a median interval of 42 days (34-82) after HSCT, using the Baltimore protocol and G-CSF mobilized PB from the same (n = 13) or another HAPLO family donor (n = 6). GvHD prophylaxis was again PTCY-based; 14/19 patients had trilineage recovery (74%) and 1-year survival was 66%. Engraftment at second HAPLO was seen in 7/8 patient with, and in 5/7 patients without donor-specific antibodies (DSA). In a multivariate logistic regression analysis on the original group of 503 patients, there was a trend for a reduced dose of busulfan, to increase the risk of PrGF (p = 0.1). In conclusion, patients with PrGF following a HAPLO transplant, can be rescued with a second early HAPLO transplant, using the same or a different donor.
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Affiliation(s)
- Sabrina Giammarco
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.
| | | | | | | | | | | | - Patrizia Chiusolo
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Federica Sora
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Simona Sica
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Luca Laurenti
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Elisabetta Metafuni
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Idanna Innocenti
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Francesco Autore
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Barbara Murgia
- Italian Bone Marrow Donor Registry (IBMDR), Ospedale Galliera, Genova, Italy
| | - Andrea Bacigalupo
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma, Italy
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26
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Sorà F, Chiusolo P, Laurenti L, Innocenti I, Autore F, Alma E, Viscovo M, Fusco D, Maresca M, Tumbarello M, Sica S. SARS CoV 2 infection in chronic myelogenous leukemia: Severe hematological presentation. Transfus Apher Sci 2020; 59:102881. [PMID: 32828694 PMCID: PMC7377729 DOI: 10.1016/j.transci.2020.102881] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 07/14/2020] [Accepted: 07/14/2020] [Indexed: 11/15/2022]
Abstract
Infection with SARS-CoV-2, the cause of coronavirus infectious disease-19 (COVID-19), has caused a pandemic. Few data are available about the risk of COVID-19 infection in persons with hematological cancer, but controversy whether these persons have the same clinical signs and outcomes. We describe a case of life-threatening COVID-19 infection complicated by severe anemia in patients affected also by chronic myelogenous leukemia. The screening for RBC antibodies and the direct antiglobulin test (DAT) turned positive. The identification of the antibodies, showed the presence of an alloantibody with anti-Lewis b specificity, which was reactive at room temperature, in the anti-human globulin phase (AGH) and with papain-treated red blood cells. At the same time hemophagocytic lymphohistiocytosis (HLH), on the basis of major laboratory findings including hyperferritnemia, increase of triglicerides levels and according to the HLH score was suspected. Patients received antiviral therapy, steroids and intravenous immunoglobulins. Hemolysis resolved and ferritin dramatically decreased after administration of Ig and a Afull recovery was achieved after viral infection resolution.This case highlights the novel and multifaceted hematological findings during sever COVID 19 infection. COVID 19-related pneumonia is mediated by hyper activation of effector T cells and excessive production of inflammatory cytokines, such as IL-6, IL-1, interferon-gamma, and TNF. This inflammatory process called "cytokine storm" is a life-threatening complication of COVID 19 infection. In this case severe immunohematological consequences are reported for the first time and recognition of this complications are probably underestimated.
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MESH Headings
- COVID-19/blood
- COVID-19/diagnostic imaging
- COVID-19/therapy
- Cytokines/blood
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/blood
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnostic imaging
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy
- Lymphohistiocytosis, Hemophagocytic/blood
- Lymphohistiocytosis, Hemophagocytic/diagnostic imaging
- Lymphohistiocytosis, Hemophagocytic/therapy
- Male
- Middle Aged
- SARS-CoV-2/metabolism
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Affiliation(s)
- Federica Sorà
- Istituto di Ematologia, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy; Universita' Cattolica del Sacro Cuore, Rome, Italy; Clinica di Malattie Infettive, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy.
| | - Patrizia Chiusolo
- Istituto di Ematologia, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy; Universita' Cattolica del Sacro Cuore, Rome, Italy; Clinica di Malattie Infettive, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Luca Laurenti
- Istituto di Ematologia, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy; Universita' Cattolica del Sacro Cuore, Rome, Italy; Clinica di Malattie Infettive, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Idanna Innocenti
- Istituto di Ematologia, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy; Clinica di Malattie Infettive, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Francesco Autore
- Istituto di Ematologia, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy; Clinica di Malattie Infettive, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Eleonora Alma
- Istituto di Ematologia, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy; Clinica di Malattie Infettive, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Marcello Viscovo
- Universita' Cattolica del Sacro Cuore, Rome, Italy; Clinica di Malattie Infettive, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Domernico Fusco
- Istituto di Ematologia, Policlinico "A. Gemelli", Università Cattolica S.Cuore, Largo Gemelli, 8, 00168, Roma, Italy; Clinica di Malattie Infettive, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Maddalena Maresca
- Istituto di Ematologia, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy; Clinica di Malattie Infettive, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Mario Tumbarello
- Universita' Cattolica del Sacro Cuore, Rome, Italy; Istituto di Ematologia, Policlinico "A. Gemelli", Università Cattolica S.Cuore, Largo Gemelli, 8, 00168, Roma, Italy; Clinica di Malattie Infettive, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Simona Sica
- Istituto di Ematologia, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy; Universita' Cattolica del Sacro Cuore, Rome, Italy; Clinica di Malattie Infettive, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
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27
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Innocenti I, Sora F, Autore F, Chiusolo P, Giammarco S, Metafuni E, Bacigalupo A, Sica S, Laurenti L. Efficacy of ibrutinib in late relapse chronic lymphocytic leukemia after allogeneic hematopoietic stem cell transplantation. Hematol Oncol 2020; 39:267-269. [PMID: 33150962 DOI: 10.1002/hon.2826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/09/2020] [Accepted: 10/06/2020] [Indexed: 12/29/2022]
Affiliation(s)
- Idanna Innocenti
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Federica Sora
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Dipartimento di Scienze Radiologiche ed Ematologiche, Sezione di Ematologia, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Francesco Autore
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Patrizia Chiusolo
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Dipartimento di Scienze Radiologiche ed Ematologiche, Sezione di Ematologia, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Sabrina Giammarco
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Elisabetta Metafuni
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Andrea Bacigalupo
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Dipartimento di Scienze Radiologiche ed Ematologiche, Sezione di Ematologia, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Simona Sica
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Dipartimento di Scienze Radiologiche ed Ematologiche, Sezione di Ematologia, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Luca Laurenti
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Dipartimento di Scienze Radiologiche ed Ematologiche, Sezione di Ematologia, Università Cattolica del Sacro Cuore, Roma, Italy
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28
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Corbingi A, Innocenti I, Tomasso A, Pasquale R, Visentin A, Varettoni M, Flospergher E, Autore F, Morelli F, Trentin L, Reda G, Efremov DG, Laurenti L. Monoclonal gammopathy and serum immunoglobulin levels as prognostic factors in chronic lymphocytic leukaemia. Br J Haematol 2020; 190:901-908. [PMID: 32712965 DOI: 10.1111/bjh.16975] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 05/31/2020] [Indexed: 12/17/2022]
Abstract
The relationship between chronic lymphocytic leukaemia (CLL) and qualitative/quantitative gammaglobulin abnormalities is well established. Nevertheless, in order to better understand this kind of connection, we examined 1505 patients with CLL and divided them into four subgroups on the basis of immunoglobulin (Ig) aberrations at diagnosis. A total of 73 (4·8%), 149 (10%), 200 (13·2%) and 1083 (72%) patients were identified with IgM monoclonal gammopathy (IgM/CLL), IgG monoclonal gammopathy (IgG/CLL), hypogammaglobulinaemia (hypo-γ) and normal Ig levels (γ-normal) respectively. IgM paraprotein was significantly associated with a more advanced Binet/Rai stage and del(17p)/TP53 mutation, while IgG abnormalities correlated with a higher occurrence of trisomy 12. Patients with any type of Ig abnormality had shorter treatment-free survival (TFS) but no significant impact affecting overall survival (OS) compared to those with normal Ig levels.
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Affiliation(s)
- Andrea Corbingi
- Department of Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Idanna Innocenti
- Department of Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Annamaria Tomasso
- Department of Hematology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Raffaella Pasquale
- Department of Hematology, Fondazione IRCCS Ca'Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Visentin
- Hematology and Clinical Immunology Unit, Department of Medicine, Università degli Studi di Padova, Padova, Italy
| | - Marzia Varettoni
- Department of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Elena Flospergher
- Department of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Francesco Autore
- Department of Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Francesca Morelli
- Department of Hematology, Università degli Studi di Firenze, Florence, Italy
| | - Livio Trentin
- Hematology and Clinical Immunology Unit, Department of Medicine, Università degli Studi di Padova, Padova, Italy
| | - Gianluigi Reda
- Department of Hematology, Fondazione IRCCS Ca'Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Dimitar G Efremov
- Molecular Haematology, International Centre for Genetic Engineering and Biotechnology, Trieste, Italy
| | - Luca Laurenti
- Department of Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Department of Hematology, Università Cattolica del Sacro Cuore, Rome, Italy
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29
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Autore F, Innocenti I, Corrente F, Del Principe MI, Rosati S, Falcucci P, Fresa A, Conte E, Limongiello MA, Renzi D, De Padua L, Andriani A, Pisani F, Cimino G, Tafuri A, Montanaro M, Mauro FR, Del Poeta G, Laurenti L. Front-Line Therapy for Elderly Chronic Lymphocytic Leukemia Patients: Bendamustine Plus Rituximab or Chlorambucil Plus Rituximab? Real-Life Retrospective Multicenter Study in the Lazio Region. Front Oncol 2020; 10:848. [PMID: 32587827 PMCID: PMC7298101 DOI: 10.3389/fonc.2020.00848] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 04/29/2020] [Indexed: 11/18/2022] Open
Abstract
Previous studies investigated the efficacy and the safety of bendamustine (B) vs. chlorambucil (Chl) associated with rituximab (R) in fludarabine-ineligible patients with treated and untreated chronic lymphocytic leukemia (CLL). We conducted a retrospective multicenter study in the Lazio region to further evaluate and compare the efficacy and the toxicity of Chl-R and B-R regimen in CLL patients over the age of 65. We enrolled 192 untreated CLL patients: 111 treated with B-R and 81 with Chl-R. The overall response rates (ORR; 93.6% in B-R and 86.5% in Chl-R) were not statistically different between the two groups, such as progression-free survival (PFS), time to retreatment (TTR), and overall survival (OS). The B-R group showed a higher hematological (p = 0.007) and extra-hematological (p = 0.008) toxicity. When comparing the toxicities according to age, we noted that the extra-hematological toxicity was higher in patients over the age of 75 who were treated with B-R than those treated with Chl-R (p = 0.03). This retrospective study confirms the feasibility of B-R and Chl-R in elderly untreated CLL patients. Currently, patients who are over 75 and unfit are usually treated with Chl-R. This scheme allows achieving the same ORR, PFS, TTR, and OS when compared with B-R because of hematological and extra-hematological toxicities due to B, in which a greater dose reduction has been shown in comparison to Chl.
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Affiliation(s)
- Francesco Autore
- Institute of Hematology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Idanna Innocenti
- Institute of Hematology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Francesco Corrente
- Institute of Hematology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Maria Ilaria Del Principe
- Hematology Unit, Department of Biomedicine and Prevention, University tor Vergata of Rome, Rome, Italy
| | - Serena Rosati
- Hematology Unit, Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
| | - Paolo Falcucci
- Division of Hematology, Ospedale Belcolle, Viterbo, Italy
| | - Alberto Fresa
- Institute of Hematology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Esmeralda Conte
- Hematology Unit, Azienda Ospedaliera-Universitaria Sant'Andrea, Rome, Italy
| | | | - Daniela Renzi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Laura De Padua
- Hematology Unit, Fabrizio Spaziani Hospital, Frosinone, Italy
| | | | - Francesco Pisani
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Giuseppe Cimino
- Hematology Unit, Ospedale Santa Maria Goretti, Latina, Italy
| | - Agostino Tafuri
- Hematology Unit, Azienda Ospedaliera-Universitaria Sant'Andrea, Rome, Italy
| | | | - Francesca Romana Mauro
- Hematology Unit, Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
| | - Giovanni Del Poeta
- Hematology Unit, Department of Biomedicine and Prevention, University tor Vergata of Rome, Rome, Italy
| | - Luca Laurenti
- Institute of Hematology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,Institute of Hematology, Università Cattolica del Sacro Cuore, Rome, Italy
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30
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Autore F, Innocenti I, Fresa A, Paolini A, Sora F, Sica S, Zini G, Laurenti L. The concomitance of lymphoma and breast carcinoma in the bone. Ann Hematol 2020; 99:1403-1404. [PMID: 32382767 DOI: 10.1007/s00277-020-04041-2] [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: 03/30/2020] [Accepted: 04/11/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Francesco Autore
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy.
| | - Idanna Innocenti
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Alberto Fresa
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Federica Sora
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Simona Sica
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gina Zini
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luca Laurenti
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
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31
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Ramassone A, D'Argenio A, Veronese A, Basti A, Soliman SHA, Volinia S, Bassi C, Pagotto S, Ferracin M, Lupini L, Saccenti E, Balatti V, Pepe F, Rassenti LZ, Innocenti I, Autore F, Marzetti L, Mariani-Costantini R, Kipps TJ, Negrini M, Laurenti L, Visone R. Genetic dynamics in untreated CLL patients with either stable or progressive disease: a longitudinal study. J Hematol Oncol 2019; 12:114. [PMID: 31744508 PMCID: PMC6862808 DOI: 10.1186/s13045-019-0802-x] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 10/09/2019] [Indexed: 01/30/2023] Open
Abstract
Clonal evolution of chronic lymphocytic leukemia (CLL) often follows chemotherapy and is associated with adverse outcome, but also occurs in untreated patients, in which case its predictive role is debated. We investigated whether the selection and expansion of CLL clone(s) precede an aggressive disease shift. We found that clonal evolution occurs in all CLL patients, irrespective of the clinical outcome, but is faster during disease progression. In particular, changes in the frequency of nucleotide variants (NVs) in specific CLL-related genes may represent an indicator of poor clinical outcome.
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Affiliation(s)
- Alice Ramassone
- Unit of General Pathology, Center for Advanced Studies and Technology (CAST), University G. d'Annunzio Chieti-Pescara, Chieti, Italy.,Department of Medicine and Aging Sciences, University G. d'Annunzio Chieti-Pescara, Chieti, Italy
| | - Andrea D'Argenio
- Unit of General Pathology, Center for Advanced Studies and Technology (CAST), University G. d'Annunzio Chieti-Pescara, Chieti, Italy
| | - Angelo Veronese
- Unit of General Pathology, Center for Advanced Studies and Technology (CAST), University G. d'Annunzio Chieti-Pescara, Chieti, Italy.,Department of Medicine and Aging Sciences, University G. d'Annunzio Chieti-Pescara, Chieti, Italy
| | - Alessio Basti
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio Chieti-Pescara, Chieti, Italy.,Institute for Advanced Biomedical Technologies (ITAB), University G. d'Annunzio Chieti-Pescara, Chieti, Italy
| | - Shimaa Hassan AbdelAziz Soliman
- Unit of General Pathology, Center for Advanced Studies and Technology (CAST), University G. d'Annunzio Chieti-Pescara, Chieti, Italy.,Department of Medicine and Aging Sciences, University G. d'Annunzio Chieti-Pescara, Chieti, Italy
| | - Stefano Volinia
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Cristian Bassi
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Sara Pagotto
- Unit of General Pathology, Center for Advanced Studies and Technology (CAST), University G. d'Annunzio Chieti-Pescara, Chieti, Italy.,Department of Medical, Oral and Biotechnological Sciences, University G. d'Annunzio Chieti-Pescara, Chieti, Italy
| | - Manuela Ferracin
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Laura Lupini
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Elena Saccenti
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Veronica Balatti
- Department of Cancer Biology and Genetics and Comprehensive Cancer Center at the Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Felice Pepe
- Unit of General Pathology, Center for Advanced Studies and Technology (CAST), University G. d'Annunzio Chieti-Pescara, Chieti, Italy.,Department of Medical, Oral and Biotechnological Sciences, University G. d'Annunzio Chieti-Pescara, Chieti, Italy
| | - Laura Z Rassenti
- Department of Medicine, Moores Cancer Center, University of California at San Diego, La Jolla, CA, USA.,Chronic Lymphocytic Leukemia Research Consortium, San Diego, CA, USA
| | - Idanna Innocenti
- Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Francesco Autore
- Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Laura Marzetti
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio Chieti-Pescara, Chieti, Italy.,Institute for Advanced Biomedical Technologies (ITAB), University G. d'Annunzio Chieti-Pescara, Chieti, Italy
| | - Renato Mariani-Costantini
- Unit of General Pathology, Center for Advanced Studies and Technology (CAST), University G. d'Annunzio Chieti-Pescara, Chieti, Italy.,Department of Medical, Oral and Biotechnological Sciences, University G. d'Annunzio Chieti-Pescara, Chieti, Italy
| | - Thomas J Kipps
- Department of Medicine, Moores Cancer Center, University of California at San Diego, La Jolla, CA, USA.,Chronic Lymphocytic Leukemia Research Consortium, San Diego, CA, USA
| | - Massimo Negrini
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Luca Laurenti
- Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Rosa Visone
- Unit of General Pathology, Center for Advanced Studies and Technology (CAST), University G. d'Annunzio Chieti-Pescara, Chieti, Italy. .,Department of Medical, Oral and Biotechnological Sciences, University G. d'Annunzio Chieti-Pescara, Chieti, Italy.
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32
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Autore F, Fresa A, Innocenti I, Tomasso A, Morelli F, Corbingi A, Sorà F, Laurenti L. Purging with chlorambucil to prevent infusion-related reaction before obinutuzumab administration: A monocentric pilot experience. Hematol Oncol 2019; 37:641-643. [PMID: 31604368 DOI: 10.1002/hon.2684] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 10/03/2019] [Accepted: 10/04/2019] [Indexed: 11/07/2022]
Affiliation(s)
- Francesco Autore
- Institute of Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Alberto Fresa
- Institute of Hematology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Idanna Innocenti
- Institute of Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Annamaria Tomasso
- Institute of Hematology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesca Morelli
- Institute of Hematology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Andrea Corbingi
- Institute of Hematology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Federica Sorà
- Institute of Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Luca Laurenti
- Institute of Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Institute of Hematology, Università Cattolica del Sacro Cuore, Rome, Italy
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33
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Cohen JA, Rossi FM, Zucchetto A, Bomben R, Terzi-di-Bergamo L, Rabe KG, Degan M, Steffan A, Polesel J, Santinelli E, Innocenti I, Cutrona G, D'Arena G, Pozzato G, Zaja F, Chiarenza A, Rossi D, Di Raimondo F, Laurenti L, Gentile M, Morabito F, Neri A, Ferrarini M, Fegan CD, Pepper CJ, Del Poeta G, Parikh SA, Kay NE, Gattei V. A laboratory-based scoring system predicts early treatment in Rai 0 chronic lymphocytic leukemia. Haematologica 2019; 105:1613-1620. [PMID: 31582547 PMCID: PMC7271568 DOI: 10.3324/haematol.2019.228171] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 10/02/2019] [Indexed: 11/09/2022] Open
Abstract
We present a laboratory-based prognostic calculator (designated CRO score) to risk stratify treatment-free survival in early stage (Rai 0) chronic lymphocytic leukemia (CLL) developed using a training-validation model in a series of 1,879 cases from Italy, the United Kingdom and the United States. By means of regression analysis, we identified five prognostic variables with weighting as follows: deletion of the short arm of chromosome 17 and unmutated immunoglobulin heavy chain gene status, 2 points; deletion of the long arm of chromosome 11, trisomy of chromosome 12, and white blood cell count >32.0x103/microliter, 1 point. Low-, intermediate- and high-risk categories were established by recursive partitioning in a training cohort of 478 cases, and then validated in four independent cohorts of 144 / 395 / 540 / 322 cases, as well as in the composite validation cohort. Concordance indices were 0.75 in the training cohort and ranged from 0.63 to 0.74 in the four validation cohorts (0.69 in the composite validation cohort). These findings advocate potential application of our novel prognostic calculator to better stratify early-stage CLL, and aid case selection in risk-adapted treatment for early disease. Furthermore, they support immunocytogenetic analysis in Rai 0 CLL being performed at the time of diagnosis to aid prognosis and treatment, particularly in today's chemofree era.
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Affiliation(s)
- Jared A Cohen
- Clinical and Experimental Onco-Haematology Unit, Centro di Riferimento Oncologico, I.R.C.C.S., Aviano (PN), Italy
| | - Francesca Maria Rossi
- Clinical and Experimental Onco-Haematology Unit, Centro di Riferimento Oncologico, I.R.C.C.S., Aviano (PN), Italy
| | - Antonella Zucchetto
- Clinical and Experimental Onco-Haematology Unit, Centro di Riferimento Oncologico, I.R.C.C.S., Aviano (PN), Italy
| | - Riccardo Bomben
- Clinical and Experimental Onco-Haematology Unit, Centro di Riferimento Oncologico, I.R.C.C.S., Aviano (PN), Italy
| | | | - Kari G Rabe
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Massimo Degan
- Clinical and Experimental Onco-Haematology Unit, Centro di Riferimento Oncologico, I.R.C.C.S., Aviano (PN), Italy
| | - Agostino Steffan
- Immunopathology and Cancer Biomarkers, Centro di RiferimentoOncologico, I.R.C.C.S., Aviano (PN), Italy
| | - Jerry Polesel
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico, I.R.C.C.S., Aviano (PN), Italy
| | - Enrico Santinelli
- Division of Haematology, S. Eugenio Hospital and University of Tor Vergata, Rome, Italy
| | - Idanna Innocenti
- Hematology Institute, Catholic University of the Sacred Heart, Fondazione Policlinico A. Gemelli, Rome, Italy
| | - Giovanna Cutrona
- UO Molecular Pathology, Ospedale Policlinico San Martino IRCCS, Genova, Italy
| | - Giovanni D'Arena
- Onco-Haematology Department, Centro di Riferimento Oncologico della Basilicata, I.R.C.C.S., Rionero in Vulture, Italy
| | - Gabriele Pozzato
- Department of Internal Medicine and Haematology, Maggiore General Hospital, University of Trieste, Trieste, Italy
| | - Francesco Zaja
- Department of Internal Medicine and Haematology, Maggiore General Hospital, University of Trieste, Trieste, Italy
| | | | - Davide Rossi
- Hematology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland.,Universita' della Svizzera Italiana, Lugano, Switzerland
| | | | - Luca Laurenti
- Hematology Institute, Catholic University of the Sacred Heart, Fondazione Policlinico A. Gemelli, Rome, Italy
| | - Massimo Gentile
- Hematology Unit, AO, Cosenza, Italy.,Biotechnology Research Unit, Aprigliano, Cosenza, Italy
| | - Fortunato Morabito
- Biotechnology Research Unit, Aprigliano, Cosenza, Italy.,Hematogy Department and Bone Marrow Transplant Unit, Cancer Care Center, Augusta Victoria Hospital, East Jerusalem, Israel
| | - Antonino Neri
- Hematology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico and University of Milan, Milan, Italy
| | - Manlio Ferrarini
- Department of Experimental Medicine, University of Genova, Genova, Italy
| | - Christopher D Fegan
- Division of Cancer and Genetics, Cardiff University, School of Medicine, Heath Park, Cardiff, UK
| | - Christopher J Pepper
- Division of Cancer and Genetics, Cardiff University, School of Medicine, Heath Park, Cardiff, UK.,University of Sussex, Brighton and Sussex Medical School, Brighton, UK
| | - Giovanni Del Poeta
- Division of Haematology, S. Eugenio Hospital and University of Tor Vergata, Rome, Italy
| | - Sameer A Parikh
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Neil E Kay
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Valter Gattei
- Clinical and Experimental Onco-Haematology Unit, Centro di Riferimento Oncologico, I.R.C.C.S., Aviano (PN), Italy
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34
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Dalla Villa P, Migliaccio P, Innocenti I, Nardoia M, Lafiandra D. Companion Animals Welfare in Non-Epidemic Emergencies: The Case of Central Italy, Post-Earthquake 2016/2017. ACTA ACUST UNITED AC 2019. [DOI: 10.1163/25889567-12340012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract
Among the several factors affecting animal welfare, non-epidemic emergencies are very stressful events. In the aftermath of earthquakes or during flooding, snowstorms and wildfires, companion animals are subject to injuries and deep stress, abandonment or loss resulting in the overcrowding of animal shelters, or in emergent free-roaming populations representing a potential public health threat to the affected communities. The loss of animals often also results in significant psychological trauma for their guardians. For these reasons in all phases of calamities, the care of companion animals becomes essential. This paper describes the activities that were carried out for the veterinary care of dogs and cats affected by the earthquakes that occurred in central Italy from August 2016 to January 2017. These disasters provided an opportunity to test an integrated emergency management system in which several actors participated to aid, assist and accommodate the companion animals, whether owned or strays, affected by the catastrophic events.
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Affiliation(s)
- P. Dalla Villa
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise Campo Boario, 64100, Teramo (TE) Italy
| | - P. Migliaccio
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise Campo Boario, 64100, Teramo (TE) Italy
| | - I. Innocenti
- Lega Antivivisezione Viale Regina Margherita, 177-00198 Roma (RM) Italy
| | - M. Nardoia
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise Campo Boario, 64100, Teramo (TE) Italy
| | - D.C. Lafiandra
- Azienda Sanitaria Locale Rieti, Dipartimento di Prevenzione Via del Terminillo, 02100, Rieti (RI) Italy
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35
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Teofili L, Valentini CG, Bianchi M, Pellegrino C, Bellesi S, Chiusolo P, Laurenti L, Innocenti I, De Stefano V, Bacigalupo A. Preoperative autologous blood donation in adult bone marrow donors: reappraisal of a single-centre experience. Vox Sang 2019; 114:762-768. [PMID: 31402471 DOI: 10.1111/vox.12834] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 06/22/2019] [Accepted: 07/14/2019] [Indexed: 11/27/2022]
Abstract
To avoid risk for allogeneic transfusions in healthy bone marrow (BM) donors, 1-2 preoperative autologous blood donations (PAD) are usually collected before the BM harvest. We analysed the haematological parameters in BM donors before and after the harvest, to assess the efficacy of this practice in limiting the postharvest anaemia. Overall, 102 consecutive donors underwent BM harvest preceded by one (26 cases) or two PAD (76 cases), which were infused during BM collection. We analysed the parameters related to donors, PAD timing and BM graft characteristics. PAD induced a significant decrease in Hb (from 14·6 g/dl, IQ range 13·3-15·5 to12·9 g/dl, IQ range 11·8-13·9; P < 0·0001) in all donors, with a median Hb loss at day -1 of 10·9% (IQ range 6·8-14·2). The PAD-related Hb decrease was independent of sex or number of PAD, and was inversely related to the time elapsed from first or last PAD. In comparison with values recorded at day-1, BM harvest produced an additional Hb decrease, accounting for a median Hb loss of 18·9% (IQ range 14·9-24·4). Overall, in comparison with pre-PAD values, Hb levels at day +1 were reduced of 28·9% (IQ range 23·6-32·2), independently if donors had 1 or 2 PAD reinfused. In conclusion, these data show that two PAD do not carry any advantage over one PAD. An eventual benefit of PAD can be achieved only if an adequate interval between PAD and BM harvest elapses. Prospective randomized studies could be worth to establish if any role for PAD does exist in BM donors.
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Affiliation(s)
- Luciana Teofili
- Fondazione Policlinico A. Gemelli IRCCS, Roma, Italy.,Università Cattolica del Sacro Cuore, Roma, Italy
| | | | - Maria Bianchi
- Fondazione Policlinico A. Gemelli IRCCS, Roma, Italy
| | | | | | - Patrizia Chiusolo
- Fondazione Policlinico A. Gemelli IRCCS, Roma, Italy.,Università Cattolica del Sacro Cuore, Roma, Italy
| | - Luca Laurenti
- Fondazione Policlinico A. Gemelli IRCCS, Roma, Italy.,Università Cattolica del Sacro Cuore, Roma, Italy
| | | | - Valerio De Stefano
- Fondazione Policlinico A. Gemelli IRCCS, Roma, Italy.,Università Cattolica del Sacro Cuore, Roma, Italy
| | - Andrea Bacigalupo
- Fondazione Policlinico A. Gemelli IRCCS, Roma, Italy.,Università Cattolica del Sacro Cuore, Roma, Italy
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Innocenti I, Morelli F, Autore F, Piciocchi A, Frustaci A, Mauro FR, Schiattone L, Trentin L, Del Poeta G, Reda G, Rigolin GM, Ibatici A, Ciolli S, Coscia M, Sportoletti P, Murru R, Levato L, Gentile M, D'Arena G, Efremov DG, Tedeschi A, Scarfò L, Cuneo A, Foà R, Laurenti L. Venetoclax in CLL patients who progress after B-cell Receptor inhibitor treatment: a retrospective multi-centre Italian experience. Br J Haematol 2019; 187:e8-e11. [PMID: 31364153 DOI: 10.1111/bjh.16123] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Idanna Innocenti
- Institute of Haematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Francesca Morelli
- Institute of Haematology, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Francesco Autore
- Institute of Haematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Alfonso Piciocchi
- Italian Group for Adult Haematological Diseases (GIMEMA), Data Centre, Roma, Italy
| | - Annamaria Frustaci
- Haematology, Niguarda Cancer Centre, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Francesca R Mauro
- Haematology, Department of Translational and Precision Medicine, Sapienza University, Roma, Italy
| | - Luana Schiattone
- Division of Experimental Oncology, IRCCS Istituto Scientifico San Raffaele and Università Vita-Salute San Raffaele, Milano, Italy
| | - Livio Trentin
- Haematology and Clinical Immunology, Department of Medicine, Padova, Italy
| | - Giovanni Del Poeta
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Roma, Italy
| | - Gianluigi Reda
- IRCCS Ca' Granda - Università degli Studi, Milano, Italy
| | - Gian M Rigolin
- Haematology section - University of Ferrara, Ferrara, Italy
| | - Adalberto Ibatici
- Division of Haematology and Bone Marrow Transplant, IRCCS San Martino-IST, Genova, Italy
| | | | - Marta Coscia
- Division of Haematology, A.O.U. Città della Salute e della Scienza di Torino and Department of Molecular Biotechnology and Health Sciences, University of Torino, Turin, Italy
| | - Paolo Sportoletti
- Haematology and Clinical Immunology, University of Perugia, Perugia, Italy
| | - Roberta Murru
- Haematology and Stem Cell Transplantation Unit, Ospedale Oncologico A. Businco, AO Brotzu, Cagliari, Italy
| | - Luciano Levato
- Haematology Unit, A. Pugliese Hospital, Azienda Ospedaliera Pugliese Ciaccio, Catanzaro, Italy
| | | | - Giovanni D'Arena
- Haematology and Stem cell Transplantation Unit, IRCCSCROB, Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Dimitar G Efremov
- Molecular Haematology, International Centre for Genetic Engineering and Biotechnology, Trieste, Italy
| | - Alessandra Tedeschi
- Haematology, Niguarda Cancer Centre, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Lydia Scarfò
- Division of Experimental Oncology, IRCCS Istituto Scientifico San Raffaele and Università Vita-Salute San Raffaele, Milano, Italy
| | - Antonio Cuneo
- Haematology section - University of Ferrara, Ferrara, Italy
| | - Robin Foà
- Haematology, Department of Translational and Precision Medicine, Sapienza University, Roma, Italy
| | - Luca Laurenti
- Institute of Haematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Institute of Haematology, Università Cattolica del Sacro Cuore, Roma, Italy
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37
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Autore F, Strati P, Innocenti I, Corrente F, Trentin L, Cortelezzi A, Visco C, Coscia M, Cuneo A, Gozzetti A, Mauro FR, Frustaci AM, Gentile M, Morabito F, Molica S, Falcucci P, D'Arena G, Murru R, Vincelli D, Efremov DG, Ferretti A, Rigolin GM, Vitale C, Tisi MC, Reda G, Visentin A, Sica S, Foà R, Ferrajoli A, Laurenti L. Elevated Lactate Dehydrogenase Has Prognostic Relevance in Treatment-Naïve Patients Affected by Chronic Lymphocytic Leukemia with Trisomy 12. Cancers (Basel) 2019; 11:cancers11070896. [PMID: 31248056 PMCID: PMC6678692 DOI: 10.3390/cancers11070896] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 05/30/2019] [Revised: 06/16/2019] [Accepted: 06/18/2019] [Indexed: 12/14/2022] Open
Abstract
Chronic Lymphocytic Leukemia (CLL) patients with +12 have been reported to have specific clinical and biologic features. We performed an analysis of the association between demographic; clinical; laboratory; biologic features and outcome in CLL patients with +12 to identify parameters predictive of disease progression; time to treatment; and survival. The study included 487 treatment-naive CLL patients with +12 from 15 academic centers; diagnosed between January 2000 and July 2016; and 816 treatment-naïve patients with absence of Fluorescence In Situ Hybridization (FISH) abnormalities. A cohort of 250 patients with +12 CLL followed at a single US institution was used for external validation. In patients with +12; parameters associated with worse prognosis in the multivariate model were high Lactate DeHydrogenase (LDH) and β-2-microglobulin and unmutated immunoglobulin heavy-chain variable region gene (IGHV). CLL patients with +12 and high LDH levels showed a shorter Progression-Free-Survival (PFS) (30 months vs. 65 months; p < 0.001), Treatment-Free-Survival (TFS) (33 months vs. 69 months; p < 0.001), Overall Survival (OS) (131 months vs. 181 months; p < 0.001) and greater CLL-related mortality (29% vs. 11% at 10 years; p < 0.001) when compared with +12 CLL patients with normal LDH levels. The same differences were observed in the validation cohort. These data suggest that serum LDH levels can predict PFS; TFS; OS and CLL-specific survival in CLL patients with +12.
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Affiliation(s)
- Francesco Autore
- Institute of Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy.
| | - Paolo Strati
- Departments of Leukemia, MD Anderson Cancer Centre, 77030 Houston, USA.
| | - Idanna Innocenti
- Institute of Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy.
| | - Francesco Corrente
- Institute of Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy.
| | - Livio Trentin
- Hematology and Clinical Immunology Unit, Department of Medicine, Università di Padova, 35122 Padova, Italy.
| | - Agostino Cortelezzi
- Hematology Unit, IRCCS Ca' Granda Policlinico-Università degli Studi, 55031 Milano, Italy.
| | - Carlo Visco
- Division of Hematology, Ospedale San Bortolo di Vicenza, 36100 Vicenza, Italy.
| | - Marta Coscia
- Department of Molecular Biotechnology and Health Sciences, University of Torino, 10126 Torino, Italy.
- Division of Hematology, A.O.U. Città della Salute e della Scienza di Torino, 10126 Torino, Italy.
| | - Antonio Cuneo
- Hematology section, Department of Medical Sciences, Azienda Ospedaliero Universitaria Arcispedale S. Anna, 44124 Ferrara, Italy.
| | - Alessandro Gozzetti
- Hematology Unit, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy.
| | | | | | - Massimo Gentile
- Biothecnology Research Unit, Azienda Ospedaliera di Cosenza, 87100 Cosenza, Italy.
| | - Fortunato Morabito
- Biothecnology Research Unit, Azienda Ospedaliera di Cosenza, 87100 Cosenza, Italy.
| | - Stefano Molica
- Department of Hematology-Oncology, Ospedale Pugliese-Ciacco, 88100 Catanzaro, Italy.
| | - Paolo Falcucci
- Division of Hematology, Ospedale Belcolle, 01100 Viterbo, Italy.
| | - Giovanni D'Arena
- Hematology and Stem cell Transplantation Unit, IRCCS Centro di Riferimento Oncologico della Basilicata, 85028 Rionero in Vulture, Italy.
| | - Roberta Murru
- Hematology and Stem Cell Transplantation Unit, Ospedale A. Businco, 09121 Cagliari, Italy.
| | - Donatella Vincelli
- Department of Hematology, Azienda Ospedaliera Bianchi-Melacrino-Morelli, 89124 Reggio Calabria, Italy.
| | - Dimitar G Efremov
- Molecular Hematology, International Centre for Genetic Engineering and Biotechnology, 34149 Trieste, Italy.
| | - Antonietta Ferretti
- Hematology division, Policlinico Umberto I, Università Sapienza, 00161 Roma, Italy.
| | - Gian Matteo Rigolin
- Hematology section, Department of Medical Sciences, Azienda Ospedaliero Universitaria Arcispedale S. Anna, 44124 Ferrara, Italy.
| | - Candida Vitale
- Department of Molecular Biotechnology and Health Sciences, University of Torino, 10126 Torino, Italy.
- Division of Hematology, A.O.U. Città della Salute e della Scienza di Torino, 10126 Torino, Italy.
| | - Maria Chiara Tisi
- Division of Hematology, Ospedale San Bortolo di Vicenza, 36100 Vicenza, Italy.
| | - Gianluigi Reda
- Hematology Unit, IRCCS Ca' Granda Policlinico-Università degli Studi, 55031 Milano, Italy.
| | - Andrea Visentin
- Hematology and Clinical Immunology Unit, Department of Medicine, Università di Padova, 35122 Padova, Italy.
| | - Simona Sica
- Institute of Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy.
- Institute of Hematology, Università Cattolica del Sacro Cuore, 00168 Roma, Italy.
| | - Robin Foà
- Hematology division, Policlinico Umberto I, Università Sapienza, 00161 Roma, Italy.
| | | | - Luca Laurenti
- Institute of Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy.
- Institute of Hematology, Università Cattolica del Sacro Cuore, 00168 Roma, Italy.
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Innocenti I, Morelli F, Autore F, Tomasso A, Corbingi A, Bellesi S, Za T, De Stefano V, Laurenti L. Remission of acquired von Willebrand syndrome in a patient with chronic lymphocytic leukemia treated with venetoclax. Leuk Lymphoma 2019; 60:3078-3080. [PMID: 31106622 DOI: 10.1080/10428194.2019.1612063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Idanna Innocenti
- Institute of Hematology, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Francesca Morelli
- Institute of Hematology, Universita Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Autore
- Institute of Hematology, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Annamaria Tomasso
- Institute of Hematology, Universita Cattolica del Sacro Cuore, Rome, Italy
| | - Andrea Corbingi
- Institute of Hematology, Universita Cattolica del Sacro Cuore, Rome, Italy
| | - Silvia Bellesi
- Institute of Hematology, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Tommaso Za
- Institute of Hematology, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Valerio De Stefano
- Institute of Hematology, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy.,Institute of Hematology, Universita Cattolica del Sacro Cuore, Rome, Italy
| | - Luca Laurenti
- Institute of Hematology, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy.,Institute of Hematology, Universita Cattolica del Sacro Cuore, Rome, Italy
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Autore F, Innocenti I, Morelli F, Sorà F, Corbingi A, Fianchi L, Criscuolo M, Pagano L, Sica S, Laurenti L. Risk of infectious complications in patients with chronic lymphocytic leukemia in the era of BCR inhibitors: a retrospective single institution experience. Hematol Oncol 2019; 37:496-497. [PMID: 31017684 DOI: 10.1002/hon.2623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/17/2019] [Accepted: 04/18/2019] [Indexed: 11/07/2022]
Affiliation(s)
- Francesco Autore
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Idanna Innocenti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Francesca Morelli
- Istituto di Ematologia, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Federica Sorà
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Istituto di Ematologia, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Andrea Corbingi
- Istituto di Ematologia, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Luana Fianchi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | | | - Livio Pagano
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Istituto di Ematologia, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Simona Sica
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Istituto di Ematologia, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Luca Laurenti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Istituto di Ematologia, Università Cattolica del Sacro Cuore, Roma, Italy
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40
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Pagotto S, Veronese A, Soranno A, Balatti V, Ramassone A, Guanciali-Franchi PE, Palka G, Innocenti I, Autore F, Rassenti LZ, Kipps TJ, Mariani-Costantini R, Laurenti L, Croce CM, Visone R. HNRNPL Restrains miR-155 Targeting of BUB1 to Stabilize Aberrant Karyotypes of Transformed Cells in Chronic Lymphocytic Leukemia. Cancers (Basel) 2019; 11:cancers11040575. [PMID: 31018621 PMCID: PMC6520824 DOI: 10.3390/cancers11040575] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 04/15/2019] [Accepted: 04/19/2019] [Indexed: 11/18/2022] Open
Abstract
Aneuploidy and overexpression of hsa-miR-155-5p (miR-155) characterize most solid and hematological malignancies. We recently demonstrated that miR-155 sustains aneuploidy at early stages of in vitro cellular transformation. During in vitro transformation of normal human fibroblast, upregulation of miR-155 downregulates spindle checkpoint proteins as the mitotic checkpoint serine/threonine kinase budding uninhibited by benzimidazoles 1 (BUB1), the centromere protein F (CENPF) and the zw10 kinetochore protein (ZW10), compromising the chromosome alignment at the metaphase plate and leading to aneuploidy in daughter cells. Here we show that the heterogeneous nuclear ribonucleoprotein L (HNRNPL) binds to the polymorphic marker D2S1888 at the 3′UTR of BUB1 gene, impairs the miR-155 targeting, and restores BUB1 expression in chronic lymphocytic leukemia. This mechanism occurs at advanced passages of cell transformation and allows the expansion of more favorable clones. Our findings have revealed, at least in part, the molecular mechanisms behind the chromosomal stabilization of cell lines and the concept that, to survive, tumor cells cannot continuously change their genetic heritage but need to stabilize the most suitable karyotype.
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Affiliation(s)
- Sara Pagotto
- Ageing Research Center and Translational medicine-CeSI-MeT, 66100 Chieti, Italy.
- Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University Chieti-Pescara, 66100 Chieti, Italy.
| | - Angelo Veronese
- Ageing Research Center and Translational medicine-CeSI-MeT, 66100 Chieti, Italy.
- Department of Medicine and Aging Sciences, "G. d'Annunzio" University Chieti-Pescara, 66100 Chieti, Italy.
| | - Alessandra Soranno
- Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University Chieti-Pescara, 66100 Chieti, Italy.
| | - Veronica Balatti
- Department of Cancer Biology and Genetics, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA.
| | - Alice Ramassone
- Ageing Research Center and Translational medicine-CeSI-MeT, 66100 Chieti, Italy.
- Department of Medicine and Aging Sciences, "G. d'Annunzio" University Chieti-Pescara, 66100 Chieti, Italy.
| | - Paolo E Guanciali-Franchi
- Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University Chieti-Pescara, 66100 Chieti, Italy.
| | - Giandomenico Palka
- Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University Chieti-Pescara, 66100 Chieti, Italy.
| | - Idanna Innocenti
- Institute of Hematology, Catholic University of the Sacred Heart, 00168 Rome, Italy.
| | - Francesco Autore
- Institute of Hematology, Catholic University of the Sacred Heart, 00168 Rome, Italy.
| | - Laura Z Rassenti
- Department of Medicine, Moores Cancer Center, University of California at San Diego, La Jolla, CA 92093, USA.
- Chronic Lymphocytic Leukemia Research Consortium, San Diego, CA 92093, USA.
| | - Thomas J Kipps
- Department of Medicine, Moores Cancer Center, University of California at San Diego, La Jolla, CA 92093, USA.
- Chronic Lymphocytic Leukemia Research Consortium, San Diego, CA 92093, USA.
| | - Renato Mariani-Costantini
- Ageing Research Center and Translational medicine-CeSI-MeT, 66100 Chieti, Italy.
- Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University Chieti-Pescara, 66100 Chieti, Italy.
| | - Luca Laurenti
- Institute of Hematology, Catholic University of the Sacred Heart, 00168 Rome, Italy.
| | - Carlo M Croce
- Department of Cancer Biology and Genetics, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA.
- Chronic Lymphocytic Leukemia Research Consortium, San Diego, CA 92093, USA.
| | - Rosa Visone
- Ageing Research Center and Translational medicine-CeSI-MeT, 66100 Chieti, Italy.
- Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University Chieti-Pescara, 66100 Chieti, Italy.
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Innocenti I, Morelli F, Autore F, Corbingi A, Pasquale R, Sorà F, Pompili M, Laurenti L. HBV reactivation in CLL patients with occult HBV infection treated with ibrutinib without viral prophylaxis. Leuk Lymphoma 2019; 60:1340-1342. [PMID: 30730231 DOI: 10.1080/10428194.2018.1523401] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Idanna Innocenti
- a Institute of Hematology , Università Cattolica del Sacro Cuore , Roma , Italy
| | - Francesca Morelli
- b Institute of Hematology , Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore , Roma , Italy.,c Institute of Internal Medicine , Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore , Roma , Italy
| | - Francesco Autore
- b Institute of Hematology , Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore , Roma , Italy.,c Institute of Internal Medicine , Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore , Roma , Italy
| | - Andrea Corbingi
- a Institute of Hematology , Università Cattolica del Sacro Cuore , Roma , Italy
| | - Raffaella Pasquale
- d Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico , Institute of Hematology , Milano , Italy
| | - Federica Sorà
- a Institute of Hematology , Università Cattolica del Sacro Cuore , Roma , Italy
| | - Maurizio Pompili
- e Institute of Internal Medicine , Università Cattolica del Sacro Cuore , Roma , Italy
| | - Luca Laurenti
- a Institute of Hematology , Università Cattolica del Sacro Cuore , Roma , Italy
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Bacigalupo A, Sica S, Laurenti L, Sora' F, Giammarco S, Metafuni E, Innocenti I, Autore F, Teofili L, Bianchi M, Chiusolo P. Unrelated cord blood transplantation and post-transplant cyclophosphamide. Haematologica 2018; 104:e77-e78. [PMID: 30573505 DOI: 10.3324/haematol.2018.202598] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Andrea Bacigalupo
- Istituto di Ematologia, Fondazione Policlinico Universitario A Gemelli IRCCS, Universita' Cattolica, Rome, Italy
| | - Simona Sica
- Istituto di Ematologia, Fondazione Policlinico Universitario A Gemelli IRCCS, Universita' Cattolica, Rome, Italy
| | - Luca Laurenti
- Istituto di Ematologia, Fondazione Policlinico Universitario A Gemelli IRCCS, Universita' Cattolica, Rome, Italy
| | - Federica Sora'
- Istituto di Ematologia, Fondazione Policlinico Universitario A Gemelli IRCCS, Universita' Cattolica, Rome, Italy
| | - Sabrina Giammarco
- Istituto di Ematologia, Fondazione Policlinico Universitario A Gemelli IRCCS, Universita' Cattolica, Rome, Italy
| | - Elisabetta Metafuni
- Istituto di Ematologia, Fondazione Policlinico Universitario A Gemelli IRCCS, Universita' Cattolica, Rome, Italy
| | - Idanna Innocenti
- Istituto di Ematologia, Fondazione Policlinico Universitario A Gemelli IRCCS, Universita' Cattolica, Rome, Italy
| | - Francesco Autore
- Istituto di Ematologia, Fondazione Policlinico Universitario A Gemelli IRCCS, Universita' Cattolica, Rome, Italy
| | - Luciana Teofili
- Istituto di Ematologia, Fondazione Policlinico Universitario A Gemelli IRCCS, Universita' Cattolica, Rome, Italy
| | - Maria Bianchi
- Istituto di Ematologia, Fondazione Policlinico Universitario A Gemelli IRCCS, Universita' Cattolica, Rome, Italy
| | - Patrizia Chiusolo
- Istituto di Ematologia, Fondazione Policlinico Universitario A Gemelli IRCCS, Universita' Cattolica, Rome, Italy
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Autore F, Chiusolo P, Sorà F, Giammarco S, Laurenti L, Innocenti I, Metafuni E, Piccirillo N, Pagano L, Bacigalupo A, Leone G, Sica S. Reduction of hospitalization and transfusion support in patients with acute promyelocytic leukemia treated with arsenic trioxide plus all-trans retinoic acid compared to chemotherapy plus all-trans retinoic acid. Leuk Lymphoma 2018; 60:1328-1330. [PMID: 30526180 DOI: 10.1080/10428194.2018.1522436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Francesco Autore
- a UOC Ematologia, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia , Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome, Italy
| | - Patrizia Chiusolo
- a UOC Ematologia, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia , Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome, Italy.,b UOC Ematologia, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia , Istituto di Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore , Rome , Italy
| | - Federica Sorà
- a UOC Ematologia, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia , Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome, Italy.,b UOC Ematologia, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia , Istituto di Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore , Rome , Italy
| | - Sabrina Giammarco
- a UOC Ematologia, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia , Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome, Italy
| | - Luca Laurenti
- a UOC Ematologia, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia , Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome, Italy.,b UOC Ematologia, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia , Istituto di Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore , Rome , Italy
| | - Idanna Innocenti
- a UOC Ematologia, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia , Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome, Italy
| | - Elisabetta Metafuni
- a UOC Ematologia, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia , Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome, Italy
| | - Nicola Piccirillo
- a UOC Ematologia, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia , Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome, Italy.,b UOC Ematologia, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia , Istituto di Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore , Rome , Italy
| | - Livio Pagano
- a UOC Ematologia, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia , Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome, Italy.,b UOC Ematologia, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia , Istituto di Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore , Rome , Italy
| | - Andrea Bacigalupo
- a UOC Ematologia, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia , Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome, Italy.,b UOC Ematologia, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia , Istituto di Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore , Rome , Italy
| | - Giuseppe Leone
- a UOC Ematologia, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia , Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome, Italy.,b UOC Ematologia, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia , Istituto di Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore , Rome , Italy
| | - Simona Sica
- a UOC Ematologia, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia , Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome, Italy.,b UOC Ematologia, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia , Istituto di Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore , Rome , Italy
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Gentile M, Shanafelt TD, Mauro FR, Reda G, Rossi D, Laurenti L, Del Principe MI, Cutrona G, Angeletti I, Coscia M, Herishanu Y, Chiarenza A, Molica S, Ciolli S, Goldschmidt N, Angrilli F, Giordano A, Rago A, Bairey O, Tripepi G, Chaffee KG, Sameer PA, Vigna E, Zirlik K, Shvidel L, Innocenti I, Recchia AG, Di Raimondo F, Del Poeta G, Cortelezzi A, Neri A, Ferrarini M, Gaidano G, Kay NE, Polliack A, Foà R, Morabito F. Predictive value of the CLL-IPI in CLL patients receiving chemo-immunotherapy as first-line treatment. Eur J Haematol 2018; 101:703-706. [PMID: 30039576 DOI: 10.1111/ejh.13149] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | - Tait D Shanafelt
- Department of Medicine, Division of Hematology, Stanford University, Stanford, California
| | | | - Gianluigi Reda
- Unità di Ematologia, Fondazione Ca' Granda IRCCS, Ospedale Maggiore Policlinico, Università di Milano, Milan, Italy
| | - Davide Rossi
- Oncology Institute of Southern Switzerland, Institute of Oncology Research, Bellinzona, Switzerland
| | - Luca Laurenti
- Dipartimento di Ematologia, Università Cattolica "A. Gemelli" Rome, Rome, Italy
| | - Maria Ilaria Del Principe
- Ematologia, Dipartimento di Biomedicina e Prevenzione, Università degli Studi di Roma "Tor Vergata," Rome, Rome, Italy
| | | | - Ilaria Angeletti
- Reparto di Oncoematologia Azienda Ospedaliera Santa Maria di Terni, Terni, Italy
| | - Marta Coscia
- Divisione di Ematologia, Università di Torino, A.O. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Yair Herishanu
- Department of Hematology, Tel-Aviv Sourasky Medical and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Annalisa Chiarenza
- Divisione di Ematologia, Ospedale Ferrarotto, Università di Catania, Catania, Italy
| | - Stefano Molica
- Dipartimento di Onco-ematologia, Azienda Ospedaliera Pugliese-Ciaccio, Catanzaro, Italy
| | | | - Neta Goldschmidt
- Department of Hematology, Hadassah Medical Center, Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | | | - Annamaria Giordano
- Ematologia-Azienda Ospedaliero-Universitaria, Policlinico consorziale di Bari, Bari, Italy
| | - Angela Rago
- UOC Ematologia Ospedale Santa Maria Goretti, Latina, Italy
| | - Osnat Bairey
- Department of Hematology, Rabin Medical Center, Petah Tikva and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Giovanni Tripepi
- Consiglio Nazionale delle Ricerche, Istituto di Biomedicina ed Immunologia Molecolare, Reggio Calabria, Italy
| | - Kari G Chaffee
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
| | - Parikh A Sameer
- Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, Minnesota
| | | | - Katja Zirlik
- Department of Haematology and Oncology, University Medical Centre Freiburg, Freiburg, Germany
| | - Lev Shvidel
- Department of Hematology Kaplan Medical Center, Rehovot and Hadassah Medical Center, Jerusalem, Israel
- Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Idanna Innocenti
- Dipartimento di Ematologia, Università Cattolica "A. Gemelli" Rome, Rome, Italy
| | - Anna Grazia Recchia
- Unità di Ricerca Biotecnologica, Azienda Sanitaria Provinciale di Cosenza, Aprigliano (CS), Italy
| | | | - Giovanni Del Poeta
- Ematologia, Dipartimento di Biomedicina e Prevenzione, Università degli Studi di Roma "Tor Vergata," Rome, Rome, Italy
| | - Agostino Cortelezzi
- Unità di Ematologia, Fondazione Ca' Granda IRCCS, Ospedale Maggiore Policlinico, Università di Milano, Milan, Italy
| | - Antonino Neri
- Unità di Ematologia, Fondazione Ca' Granda IRCCS, Ospedale Maggiore Policlinico, Università di Milano, Milan, Italy
| | | | - Gianluca Gaidano
- Division of Haematology, Department of Translational Medicine, UPO, Novara, Italy
| | - Neil E Kay
- Department of Medicine, Division of Hematology, Stanford University, Stanford, California
| | - Aaron Polliack
- Department of Hematology, Hadassah Medical Center, Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Robin Foà
- Ematologia, Università Sapienza, Roma, Italy
| | - Fortunato Morabito
- Unità di Ricerca Biotecnologica, Azienda Sanitaria Provinciale di Cosenza, Aprigliano (CS), Italy
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45
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Alberelli M, Innocenti I, Autore F, Sica S, Laurenti L, De Candia E. Clinical and laboratory characterization of platelet dysfunction caused by ibrutinib treatment in patients with chronic lymphocytic leukemia. Thromb Res 2018. [DOI: 10.1016/j.thromres.2018.02.026] [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: 11/16/2022]
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46
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D'Arena G, Vitale C, Rossi G, Coscia M, Omedè P, D'Auria F, Statuto T, Valvano L, Ciolli S, Gilestro M, Molica S, Bellesi S, Topini G, Panichi V, Autore F, Innocenti I, Musto P, Deaglio S, Laurenti L, Del Vecchio L. CD200 included in a 4-marker modified Matutes score provides optimal sensitivity and specificity for the diagnosis of chronic lymphocytic leukaemia. Hematol Oncol 2018; 36:543-546. [PMID: 29602219 DOI: 10.1002/hon.2510] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 01/26/2018] [Accepted: 03/05/2018] [Indexed: 12/27/2022]
Abstract
CD200, a transmembrane type Ia glycoprotein belonging to the immunoglobulin superfamily, has been shown to have a differential expression in B-cell neoplasms. Here, we retrospectively assessed the diagnostic relevance of CD200 on 427 patients with B-cell chronic neoplasms in leukemic phase (median age, 69 y; range, 35-97 y). The final diagnosis based on the investigator's assessment was chronic lymphocytic leukaemia (CLL) in 75% of cases and non-CLL in 25% of cases. Sensitivity and specificity for the diagnosis of CLL (vs non-CLL) were calculated for the following markers: CD200, CD5, CD22, CD23, CD79b, FMC7, and SmIg. CD23 was the only marker without a statistically significant difference between the investigator assessment and the flowcytometric analysis. The other markers were unable-when individually evaluated-to discriminate between CLL and non-CLL, requiring the integration into a scoring system. The modified score no. 1 (addition of CD200) showed superimposable sensitivity and specificity compared with the Matutes score. The substitution of CD79b (modified score no. 2), surface membrane immunoglobulins (SmIg) (modified score no. 3), and CD79b and FMC7 (modified score no. 4) with CD200 showed that only the modified score no. 4 had both higher sensitivity and higher specificity compared with standard Matutes score. In conclusion, this work defines a simplified score, compared with the classical Matutes score, for the differential diagnosis of chronic B-cell leukaemia-which only requires 4 markers instead of 5 (CD5, CD23, CD200, and SmIg).
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Affiliation(s)
- Giovanni D'Arena
- Hematology and Stem Cell Transplantation Unit, IRCCS Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Candida Vitale
- Division of Hematology, University of Torino, Torino, Italy
| | - Giovanni Rossi
- Hematology Unit and Stem Cell Transplantation, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Italy
| | - Marta Coscia
- Division of Hematology, University of Torino, Torino, Italy
| | - Paola Omedè
- Division of Hematology, University of Torino, Torino, Italy
| | - Fiorella D'Auria
- Laboratory of Clinical Research and Advances Diagnostics, IRCCS Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Teodora Statuto
- Laboratory of Clinical Research and Advances Diagnostics, IRCCS Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Luciana Valvano
- Laboratory of Clinical Research and Advances Diagnostics, IRCCS Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | | | | | - Stefano Molica
- Hematology Unit, "Pugliese e Ciaccio" Hospital, Catanzaro, Italy
| | - Silvia Bellesi
- Hematology Unit, Catholic University of "Sacred Hearth", Rome, Italy
| | - Giuseppe Topini
- Department of Onco-Hematology, Belcolle Hospital, Viterbo, Italy
| | | | - Francesco Autore
- Hematology Unit, Catholic University of "Sacred Hearth", Rome, Italy
| | - Idanna Innocenti
- Hematology Unit, Catholic University of "Sacred Hearth", Rome, Italy
| | - Pellegrino Musto
- Scientific Direction, IRCCS Cancer Referral Center of Basilicata, Rionero in Vulture, Italy
| | - Silvia Deaglio
- Italian Institute for Genomic Medicine (IIGM), University of Torino, Turin, Italy
| | - Luca Laurenti
- Hematology Unit, Catholic University of "Sacred Hearth", Rome, Italy
| | - Luigi Del Vecchio
- CEINGE-Biotecnologie Avanzate s.c.a.r.l., "Federico II" University, Naples, Italy
- Department of Molecular Medicine and Medical Biotechnology, "Federico II" University, Naples, Italy
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47
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Innocenti I, Rossi D, Trapè G, Autore F, Larocca LM, Gomes V, Cerri M, Falcucci P, Sica S, Gaidano G, Laurenti L. Clinical, pathological, and biological characterization of Richter syndrome developing after ibrutinib treatment for relapsed chronic lymphocytic leukemia. Hematol Oncol 2018; 36:600-603. [PMID: 29484684 DOI: 10.1002/hon.2502] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 01/22/2018] [Accepted: 01/23/2018] [Indexed: 01/22/2023]
Abstract
Richter syndrome, a transformation of chronic lymphocytic leukemia (CLL) into a diffuse large B-cell lymphoma, is a rare complication of patients treated with chemo-immunotherapy. Richter syndrome might be both clonally related or unrelated to the underlying CLL and often showed mutations of the TP53 and NOTCH1 genes. Recently, ibrutinib was approved for patients with relapsed/refractory CLL or for untreated CLL patients with del 17p or TP53 mutation. The clinical picture, pathology, and genetics of Richter transformation after IBR treatment are largely unknown. Here, we report 2 cases of Richter transformation after Ibrutinib treatment. As just reported by previous report, Richter syndrome developing after ibrutinib therapy lacked resistance mutations of the BTK and PLCG2 genes, which are clonally related to the pre-existent CLL phase representing transformation from CLL. Richter syndrome after ibrutinib seems to have some peculiar clinical findings as the bone marrow predilection, severe hypercalcemia, and a more aggressive outcome.
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Affiliation(s)
- Idanna Innocenti
- Institue of Hematology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Davide Rossi
- Institute of Oncology Research and Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Giulio Trapè
- Division of Hematology, Ospedale Belcolle, Viterbo, Italy
| | - Francesco Autore
- Institue of Hematology, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | | | - Michaela Cerri
- Division of Hematology, Department of Translational Medicine, Amedeo Avogadro, University of Eastern Piedmont, Novara, Italy
| | - Paolo Falcucci
- Division of Hematology, Ospedale Belcolle, Viterbo, Italy
| | - Simona Sica
- Institue of Hematology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gianluca Gaidano
- Division of Hematology, Department of Translational Medicine, Amedeo Avogadro, University of Eastern Piedmont, Novara, Italy
| | - Luca Laurenti
- Institue of Hematology, Università Cattolica del Sacro Cuore, Rome, Italy
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Gentile M, Shanafelt TD, Mauro FR, Laurenti L, Rossi D, Molica S, Vincelli I, Cutrona G, Uccello G, Pepe S, Vigna E, Tripepi G, Chaffee KG, Parikh SA, Bossio S, Recchia AG, Innocenti I, Pasquale R, Neri A, Ferrarini M, Gaidano G, Foà R, Morabito F. Comparison between the CLL-IPI and the Barcelona-Brno prognostic model: Analysis of 1299 newly diagnosed cases. Am J Hematol 2018; 93:E35-E37. [PMID: 29098721 DOI: 10.1002/ajh.24960] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Accepted: 10/31/2017] [Indexed: 12/31/2022]
Affiliation(s)
- Massimo Gentile
- Department of Onco-hematology, Hematology Unit; AO of Cosenza; Italy
| | - Tait D. Shanafelt
- Department of Internal Medicine; Mayo Clinic; Rochester Minnesota
- Division of Hematology; Mayo Clinic; Rochester Minnesota
| | - Francesca R. Mauro
- Department of Cellular Biotechnologies and Hematology; Sapienza University; Rome Italy
| | - Luca Laurenti
- Department of Hematology; Catholic University Hospital, Agostino Gemelli; Rome Italy
| | - Davide Rossi
- Department of Oncology and Hematology; Oncology Institute of Southern Switzerland and Institute of Oncology Research; Bellinzona Switzerland
| | - Stefano Molica
- Department of Oncology and Haematology; Pugliese-Ciaccio Hospital; Catanzaro Italy
| | - Iolanda Vincelli
- Department of Oncology and Hematology; Hematology Unit of Reggio; Calabria Italy
| | - Giovanna Cutrona
- Department of Oncology and Hematology; UO Molecular Pathology, Ospedale Policlinico, San Martino, IRCCS; Genova Italy
| | | | - Sara Pepe
- Department of Cellular Biotechnologies and Hematology; Sapienza University; Rome Italy
| | - Ernesto Vigna
- Department of Onco-hematology, Hematology Unit; AO of Cosenza; Italy
| | - Giovanni Tripepi
- Consiglio Nazionale delle Ricerche, Istituto di Biomedicina ed Immunologia Molecolare; Reggio Calabria Italy
| | - Kari G. Chaffee
- Division of Biomedical Statistics and Informatics; Mayo Clinic; Rochester Minnesota
| | - Sameer A. Parikh
- Department of Internal Medicine; Mayo Clinic; Rochester Minnesota
| | - Sabrina Bossio
- Biotechnology Research Unit; Department of Oncology and Hematology; Azienda Sanitaria Provinciale di Cosenza; Aprigliano (CS) Italy
| | - Anna Grazia Recchia
- Biotechnology Research Unit; Department of Oncology and Hematology; Azienda Sanitaria Provinciale di Cosenza; Aprigliano (CS) Italy
| | - Idanna Innocenti
- Department of Hematology; Catholic University Hospital, Agostino Gemelli; Rome Italy
| | - Raffaella Pasquale
- Department of Hematology; Catholic University Hospital, Agostino Gemelli; Rome Italy
| | - Antonino Neri
- Department of Oncology and Hemato-oncology; University of Milano and Hematology CTMO, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico; Milano Italy
| | - Manlio Ferrarini
- Department of Oncology and Hematology; Direzione Scientifica, Ospedale Policlinico, San Martino, IRCCS; Genova Italy
| | - Gianluca Gaidano
- Division of Haematology; Università del Piemonte Orientale; Novara Italy
- Department of Translational Medicine; Università del Piemonte Orientale; Novara Italy
| | - Robin Foà
- Department of Cellular Biotechnologies and Hematology; Sapienza University; Rome Italy
| | - Fortunato Morabito
- Biotechnology Research Unit; Department of Oncology and Hematology; Azienda Sanitaria Provinciale di Cosenza; Aprigliano (CS) Italy
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49
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Alberelli MA, Innocenti I, Autore F, Laurenti L, De Candia E. Ibrutinib does not affect ristocetin-induced platelet aggregation evaluated by light transmission aggregometry in chronic lymphocytic leukemia patients. Haematologica 2017; 103:e119-e122. [PMID: 29242303 DOI: 10.3324/haematol.2017.179044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Affiliation(s)
- Maria Adele Alberelli
- Servizio Malattie Emorragiche e Trombotiche, Polo Oncologia ed Ematologia, Istituto di Medicina Interna, Rome, Italy
| | - Idanna Innocenti
- Dipartimento di Ematologia, Polo Oncologia e Ematologia, Istituto di Ematologia, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - Francesco Autore
- Dipartimento di Ematologia, Polo Oncologia e Ematologia, Istituto di Ematologia, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - Luca Laurenti
- Dipartimento di Ematologia, Polo Oncologia e Ematologia, Istituto di Ematologia, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - Erica De Candia
- Servizio Malattie Emorragiche e Trombotiche, Polo Oncologia ed Ematologia, Istituto di Medicina Interna, Rome, Italy
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50
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Innocenti I, Autore F, Pasquale R, Morelli F, Efremov DG, Laurenti L. Treatment approach for elderly and unfit patients with chronic lymphocytic leukemia. Expert Rev Hematol 2017; 10:1069-1076. [DOI: 10.1080/17474086.2017.1398642] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Idanna Innocenti
- Institute of Hematology Università Cattolica del Sacro Cuore, Roma, Italy
| | - Francesco Autore
- Institute of Hematology Università Cattolica del Sacro Cuore, Roma, Italy
| | - Raffaella Pasquale
- Institute of Hematology Università Cattolica del Sacro Cuore, Roma, Italy
| | - Francesca Morelli
- Institute of Hematology Università Cattolica del Sacro Cuore, Roma, Italy
| | - Dimitar G Efremov
- International Centre For Genetic Engineering and Biotechnology, Trieste, Italy
| | - Luca Laurenti
- Institute of Hematology Università Cattolica del Sacro Cuore, Roma, Italy
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