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Prisciandaro M, Santinelli E, Tomarchio V, Tafuri MA, Bonchi C, Palazzo G, Nobile C, Marinucci A, Mele M, Annibali O, Rigacci L, Vacca M. Stem Cells Collection and Mobilization in Adult Autologous/Allogeneic Transplantation: Critical Points and Future Challenges. Cells 2024; 13:586. [PMID: 38607025 PMCID: PMC11011310 DOI: 10.3390/cells13070586] [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: 02/05/2024] [Revised: 03/23/2024] [Accepted: 03/26/2024] [Indexed: 04/13/2024] Open
Abstract
Achieving successful hematopoietic stem cell transplantation (HSCT) relies on two fundamental pillars: effective mobilization and efficient collection through apheresis to attain the optimal graft dose. These cornerstones pave the way for enhanced patient outcomes. The primary challenges encountered by the clinical unit and collection facility within a transplant program encompass augmenting mobilization efficiency to optimize the harvest of target cell populations, implementing robust monitoring and predictive strategies for mobilization, streamlining the apheresis procedure to minimize collection duration while ensuring adequate yield, prioritizing patient comfort by reducing the overall collection time, guaranteeing the quality and purity of stem cell products to optimize graft function and transplant success, and facilitating seamless coordination between diverse entities involved in the HSCT process. In this review, we aim to address key questions and provide insights into the critical aspects of mobilizing and collecting hematopoietic stem cells for transplantation purposes.
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Affiliation(s)
- Michele Prisciandaro
- Operative Research Unit of Transfusion Medicine and Cellular Therapy, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy; (C.B.); (G.P.); (C.N.); (A.M.)
| | - Enrico Santinelli
- Operative Research Unit of Hematology and Stem Cell Transplantation, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy; (E.S.); (V.T.); (M.A.T.); (M.M.); (O.A.); (L.R.)
- Program in Immunology, Molecular Medicine and Applied Biotechnologies, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Valeria Tomarchio
- Operative Research Unit of Hematology and Stem Cell Transplantation, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy; (E.S.); (V.T.); (M.A.T.); (M.M.); (O.A.); (L.R.)
| | - Maria Antonietta Tafuri
- Operative Research Unit of Hematology and Stem Cell Transplantation, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy; (E.S.); (V.T.); (M.A.T.); (M.M.); (O.A.); (L.R.)
| | - Cecilia Bonchi
- Operative Research Unit of Transfusion Medicine and Cellular Therapy, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy; (C.B.); (G.P.); (C.N.); (A.M.)
| | - Gloria Palazzo
- Operative Research Unit of Transfusion Medicine and Cellular Therapy, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy; (C.B.); (G.P.); (C.N.); (A.M.)
| | - Carolina Nobile
- Operative Research Unit of Transfusion Medicine and Cellular Therapy, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy; (C.B.); (G.P.); (C.N.); (A.M.)
| | - Alessandra Marinucci
- Operative Research Unit of Transfusion Medicine and Cellular Therapy, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy; (C.B.); (G.P.); (C.N.); (A.M.)
| | - Marcella Mele
- Operative Research Unit of Hematology and Stem Cell Transplantation, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy; (E.S.); (V.T.); (M.A.T.); (M.M.); (O.A.); (L.R.)
| | - Ombretta Annibali
- Operative Research Unit of Hematology and Stem Cell Transplantation, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy; (E.S.); (V.T.); (M.A.T.); (M.M.); (O.A.); (L.R.)
| | - Luigi Rigacci
- Operative Research Unit of Hematology and Stem Cell Transplantation, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy; (E.S.); (V.T.); (M.A.T.); (M.M.); (O.A.); (L.R.)
| | - Michele Vacca
- Operative Research Unit of Transfusion Medicine and Cellular Therapy, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy; (C.B.); (G.P.); (C.N.); (A.M.)
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Annibali O, Altomare A, Tomarchio V, Rocchi G, Mallio CA, Tafuri MA, Zobel BB, Vincenzi B, Guarino MPL, Rigacci L, Avvisati G. Sarcopenia does not impact the outcome of patients with Multiple Mieloma consolidated with autologous Hematopoietic Stem Cell Transplantation. Chemotherapy 2024:000535692. [PMID: 38330935 DOI: 10.1159/000535692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/12/2023] [Indexed: 02/10/2024]
Abstract
Sarcopenia has been associated with chronic diseases and cancer. Aim of this study was to evaluate sarcopenia in Multiple Myeloma patients undergoing autologous stem cell trans-plantation. In 68 eligible patients' measurement of skeletal muscle area (cm2) on computed tomography scans at the level of the L3 vertebra (L3-SMI) was performed. 37(54%) patients were categorized as sarcopenic: 26 males with L3-SMI values < 52.4 cm2/m2, and 11 women with L3-SMI values < 38.9 cm2/m2. The majority of sarcopenic patients included were older than 60 years (69%, p=0.0005), and with BMI <25 (75%; p=0.0000). A significant association was found between sarcopenia and Sorror score value > 1 (p=0.02). The Kaplan Meyer curve showed a median OS of 73.5 months for non-sarcopenic patients vs. 86.5 months for sarcopenic patients, suggesting that sarcopenia is not an independent prognostic factor in this cohort of patients.
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Mallio CA, Bernetti C, Castiello G, Gangemi E, Tomarchio V, Annibali O, Rigacci L, Van Goethem J, Parizel PM, Beomonte Zobel B, Quattrocchi CC. Neuroradiology of acute pathologies in adults with hematologic malignancies: a pictorial review. Quant Imaging Med Surg 2023; 13:7530-7551. [PMID: 37969623 PMCID: PMC10644134 DOI: 10.21037/qims-22-1201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 02/20/2023] [Indexed: 11/17/2023]
Abstract
Hematopoietic and lymphoid tumors are a heterogeneous group of diseases including lymphomas, multiple myeloma (MM), and leukemias. These diseases are associated with systemic involvement and various clinical presentations including acute neurological deficits. Adult patients with hematologic malignancies (HM) are at risk for developing a wide array of acute conditions involving the nervous system. HM in adults may present as tumoral masses responsible for mass effect, possibly resulting in acute neurological signs and symptoms caused by tumor growth with compression of central nervous system (CNS) structures. Moreover, as result of the hematologic disease itself or due to systemic treatments, hematologic patients are at risk for vascular pathologies, such as ischemic, thrombotic, and hemorrhagic disorders due to the abnormal coagulation status. The onset of these disorders is often with acute neurologic signs or symptoms. Lastly, it is well known that patients with HM can have impaired function of the immune system. Thus, CNS involvement due to immune-related diseases such as mycotic, parasitic, bacterial, and viral infections linked to immunodeficiency, together with immune reconstitution inflammatory syndrome, are frequently seen in hematologic patients. Knowledge of the etiology and expected CNS imaging findings in patients with HM is of great importance to reach a fast and correct diagnosis and guide treatment choices. In this manuscript, we review the computed tomography (CT) and magnetic resonance findings of these conditions which can be related to the disease itself and/or to their treatments.
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Affiliation(s)
- Carlo A. Mallio
- Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma, Italy
- Operative Research Unit of Diagnostic Imaging, Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
| | - Caterina Bernetti
- Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma, Italy
- Operative Research Unit of Diagnostic Imaging, Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
| | - Gennaro Castiello
- U.O.S. Diagnostica per Immagini, Azienda Ospedaliera San Camillo Forlanini, Roma, Italy
| | - Emma Gangemi
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Valeria Tomarchio
- Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma, Italy
- Operative Research Unit of Hematology and Stem Cell Transplantation, Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
| | - Ombretta Annibali
- Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma, Italy
- Operative Research Unit of Hematology and Stem Cell Transplantation, Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
| | - Luigi Rigacci
- Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma, Italy
- Operative Research Unit of Hematology and Stem Cell Transplantation, Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
| | - Johan Van Goethem
- Department of Radiology, Antwerp University Hospital, Edegem, Belgium
| | - Paul M. Parizel
- David Hartley Chair of Radiology, Royal Perth Hospital & University of Western Australia, Perth, WA, Australia
| | - Bruno Beomonte Zobel
- Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma, Italy
- Operative Research Unit of Diagnostic Imaging, Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
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Mallio CA, Vaccarino F, Parillo M, Annibali O, Rigacci L, Meduri GM, Pilato F, Beomonte Zobel B, Di Lazzaro V. Artery of Huebner stroke chameleon presenting as central nervous system lymphoma: a case description. Quant Imaging Med Surg 2023; 13:7646-7649. [PMID: 37969621 PMCID: PMC10644133 DOI: 10.21037/qims-23-437] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/02/2023] [Indexed: 11/17/2023]
Affiliation(s)
- Carlo Augusto Mallio
- Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
- Research Unit of Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
| | - Federica Vaccarino
- Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
- Research Unit of Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
| | - Marco Parillo
- Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
- Research Unit of Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
| | - Ombretta Annibali
- Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
- Research Unit of Hematology and Stem Cell Transplantation, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
| | - Luigi Rigacci
- Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
- Research Unit of Hematology and Stem Cell Transplantation, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
| | - Guido M. Meduri
- Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
- Research Unit of Nuclear Medicine, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
| | - Fabio Pilato
- Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
- Research Unit of Neurology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
| | - Bruno Beomonte Zobel
- Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
- Research Unit of Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
| | - Vincenzo Di Lazzaro
- Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
- Research Unit of Neurology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
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Tomarchio V, Rigacci L. Fluorodeoxyglucose-Positron Emission Tomography in Relapsed/Refractory Hodgkin Lymphoma: A Practical Approach. Chemotherapy 2023; 69:1-10. [PMID: 37708879 PMCID: PMC10898808 DOI: 10.1159/000533766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 08/22/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Positron emission tomography (PET) with the use of 18F-fluorodeoxyglucose (FDG), implemented with low-dosage computer tomography, is to be considered as the most important evolution of imaging in the management and assessment of classical Hodgkin lymphoma patients. SUMMARY According to Lugano response criteria, FDG-PET is mandatory to define metabolic response to frontline therapy and moreover it is important in the definition of nonresponders or refractory disease patients. Refractory disease is reported in about 15% of patients, with some variations based on the choice of first-line chemotherapy, and particularly in advanced stages, up to 40% eventually relapse within 3 years. KEY MESSAGES The aim of this review was to highlight a practical way to use FDG-PET in the subset of HL, with some notes of its use in first-line patients, and particularly centered on relapsed or refractory setting with a final focus of the evaluation of response by FDG-PET in the new treatment era of immunocheckpoint inhibitors.
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Affiliation(s)
| | - Luigi Rigacci
- Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
- Department of Medicine and Surgery, Research Unit of Hematology, Università Campus Bio-Medico, Rome, Italy
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Perrone G, Rigacci L, Urru S, Kovalchuk S, Brugia M, Fabbri A, Iovino L, Puccini B, Cencini E, Orciuolo E, Birtolo S, Melosi A, Santini S, Landini I, Roviello G, Santi R, Macciotta A, Ricceri F, Bosi A, Bocchia M, Petrini M, Mini E, Nobili S. Exploratory Genome-Wide Association Analysis to Identify Pharmacogenetic Determinants of Response to R-CHOP in Diffuse Large B-Cell Lymphoma. Cancers (Basel) 2023; 15:2753. [PMID: 37345090 DOI: 10.3390/cancers15102753] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/05/2023] [Accepted: 05/07/2023] [Indexed: 06/23/2023] Open
Abstract
R-CHOP standard chemotherapy is successful in about 60% of diffuse large B-cell lymphoma (DLBCL) patients. Unresponsive patients have a poor prognosis, and predictive biomarkers of response to R-CHOP are lacking. We conducted the first prospective GWAS study aimed at exploring constitutional biomarkers predictive of R-CHOP efficacy and toxicity. Overall, 216 any-stage chemonaïve DLBCL patients candidate to R-CHOP were enrolled. The median age of the 185 eligible patients was 59.2 years, 49.7% were women and 45.4% were stage I-II patients. According to the Revised International Prognostic Index (R-IPI), 14.1%, 56.8% and 29.2% were in the very good, good and poor prognosis groups, respectively. Of the patients, 85.9% produced a complete response. Highly significant associations (i.e., p < 5 × 10-8) were found between progression-free survival (PFS) and six SNPs (i.e., rs116665727, rs1607795, rs75614943, rs77241831, rs117500207, rs78466241). Additionally, five SNPs (i.e., rs74832512, rs117500207, rs35789195, rs11721010, rs12356569) were highly associated with overall survival (OS). Wild-type patients showed a prolonged PFS or OS compared with patients carrying deleterious alleles (p < 0.001). No association with the adequate significant threshold was observed between SNPs and the objective response or toxicity. In the future, these SNPs, alone or in combination, after a proper validation in an independent cohort, could contribute to improving the prediction of R-CHOP response.
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Affiliation(s)
- Gabriele Perrone
- Department of Health Sciences, University of Florence, 50139 Florence, Italy
- DENOTHE Excellence Center, University of Florence, 50139 Florence, Italy
| | - Luigi Rigacci
- Research Unit of Hematology, Department of Medicine and Surgery, Campus Biomedico University, 00128 Roma, Italy
| | - Sara Urru
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
| | - Sofya Kovalchuk
- Unit of Hematology, Careggi University-Hospital, 50134 Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Marco Brugia
- Unit of Medical Oncology, Careggi University-Hospital, 50134 Florence, Italy
| | - Alberto Fabbri
- Unit of Hematology, Azienda Ospedaliera Universitaria Senese, University of Siena, 53100 Siena, Italy
| | - Lorenzo Iovino
- Unit of Hematology, Santa Chiara University Hospital, University of Pisa, 56100 Pisa, Italy
| | - Benedetta Puccini
- Unit of Hematology, Careggi University-Hospital, 50134 Florence, Italy
| | - Emanuele Cencini
- Unit of Hematology, Azienda Ospedaliera Universitaria Senese, University of Siena, 53100 Siena, Italy
| | - Enrico Orciuolo
- Unit of Hematology, Santa Chiara University Hospital, University of Pisa, 56100 Pisa, Italy
| | - Silvia Birtolo
- Unit of Hematology, Ospedale SS. Cosma e Damiano, 51017 Pescia, Italy
| | | | - Simone Santini
- ASL Toscana Centro, Department of Oncology, Oncohematology Unit, Santo Stefano Hospital, 59100 Prato, Italy
| | - Ida Landini
- Department of Health Sciences, University of Florence, 50139 Florence, Italy
- DENOTHE Excellence Center, University of Florence, 50139 Florence, Italy
| | - Giandomenico Roviello
- Department of Health Sciences, University of Florence, 50139 Florence, Italy
- DENOTHE Excellence Center, University of Florence, 50139 Florence, Italy
| | - Raffaella Santi
- Department of Health Sciences, University of Florence, 50139 Florence, Italy
| | - Alessandra Macciotta
- Department of Clinical and Biological Sciences, University of Turin, 10043 Turin, Italy
| | - Fulvio Ricceri
- Department of Clinical and Biological Sciences, University of Turin, 10043 Turin, Italy
| | - Alberto Bosi
- Unit of Hematology, Careggi University-Hospital, 50134 Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Monica Bocchia
- Unit of Hematology, Azienda Ospedaliera Universitaria Senese, University of Siena, 53100 Siena, Italy
| | - Mario Petrini
- Unit of Hematology, Santa Chiara University Hospital, University of Pisa, 56100 Pisa, Italy
| | - Enrico Mini
- Department of Health Sciences, University of Florence, 50139 Florence, Italy
- DENOTHE Excellence Center, University of Florence, 50139 Florence, Italy
| | - Stefania Nobili
- DENOTHE Excellence Center, University of Florence, 50139 Florence, Italy
- Department of Neuroscience, Psychology, Drug Research and Child Health-NEUROFARBA, University of Florence, 50139 Florence, Italy
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Ciccarone M, Cavaceppi P, Tesei C, Brunetti S, Pulsoni A, Annibali O, Gasparoli C, Battistini R, Hohaus S, Pelliccia S, Tafuri A, Cox MC, Cantonetti M, Rigacci L, Abruzzese E. Effects of ABVD chemotherapy on ovarian function: epidemiology, hormonal dosages and ultrasound morphologic analyses in 270 patients with Hodgkin's disease. Front Oncol 2023; 13:1059393. [PMID: 37152067 PMCID: PMC10160490 DOI: 10.3389/fonc.2023.1059393] [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: 10/01/2022] [Accepted: 03/27/2023] [Indexed: 05/09/2023] Open
Abstract
Introduction Classical Hodgkin Lymphoma (HL) is a lymphoproliferative disease typically diagnosed in the young. The excellent results obtained with current treatment lead to long survival with age-related complications affecting patients' survival and quality of life. One issue affecting HL patients is infertility. This problem can be easily overcome in males with seminal liquid cryopreservation, however, in females it is more complex either in terms of the quality of the cryopreserved material or the patients' age at diagnosis. Moreover, not all chemo- or radio-therapies have the same negative impact on fertility.The main objectives of this study was to collect epidemiological information on HL patients involved in fertility preservation counseling and to analyze the impact of ABVD (adriamycin, bleomycin, vinblastine, and dacarbazine), the standard treatment for HL, on ovarian function, hormonal levels and ovarian and uterine tissue morphologies. Patterns of fertility preservation were also reported. Methods Data were obtained from 270 female patients at HL onset who were interested in fertility counseling prior to therapy initiation. Each patient was assessed at HL diagnosis for levels of Anti-Mullerian Hormone (AMH), Follicle Stimulating Hormone (FSH), and 17β-oestradiol (17β-oe), with additional assessments at 6 and 12 months after chemotherapy. Patients were evaluated with ultrasound scans to study the number of ovarian follicles and the degree of uterine thickness at the same timepoints. Results The average patient AMH level showed a statistically significant reduction at 6 months after chemotherapy (p=0.05) and by the 12 month time point returned to near pre-chemotherapy values. FSH and 17β-oe levels did not significantly vary throughout the study period. ABVD chemotherapy was associated with a significant reduction of both ovarian follicles and endometrial thickness at the 6 month time point followed by a recovery at the 12 time point in both ovaries. Different results were observed when patients changed treatment to a more intensive one. Discussion Based on the results from the hormonal measurements and the follicle echography, it appears that the toxic effect of ABVD on fertility is transient, whereas, in contrast, more intensive therapies may potentially be more harmful and long-lasting.
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Affiliation(s)
- Mariavita Ciccarone
- Associazione Gemme Dormienti Organizzazione Non Lucrativa di Utilità Sociale (ONLUS), Rome, Italy
- Gynecologic Unit , San Carlo di Nancy Hospital, Rome, Italy
| | - Paola Cavaceppi
- Associazione Gemme Dormienti Organizzazione Non Lucrativa di Utilità Sociale (ONLUS), Rome, Italy
- LabAurelia, Rome, Italy
| | - Cristiano Tesei
- Associazione Gemme Dormienti Organizzazione Non Lucrativa di Utilità Sociale (ONLUS), Rome, Italy
| | - Stefania Brunetti
- Associazione Gemme Dormienti Organizzazione Non Lucrativa di Utilità Sociale (ONLUS), Rome, Italy
| | - Alessandro Pulsoni
- Department of Cellular Biotechnology and Haematology, Sapienza University, Rome, Italy
| | - Ombretta Annibali
- UOC Haematology Stem Cell Transplantation, University Campus Bio Medico, Rome, Italy
| | | | - Roberta Battistini
- UOC Ematologia e Trapianti CSE, Azienda Ospedaliera (AO) San Camillo Forlanini, Rome, Italy
| | - Stefan Hohaus
- Policlinico Gemelli Foundation, Catholic University of the Sacred Heart, Rome, Italy
| | - Sabrina Pelliccia
- Haematology Unit, Azienda Ospedaliera‐ Universitaria Sant’Andrea, Rome, Italy
| | - Agostino Tafuri
- Haematology Unit, Azienda Ospedaliera‐ Universitaria Sant’Andrea, Rome, Italy
| | | | | | - Luigi Rigacci
- UOC Ematologia e Trapianti CSE, Azienda Ospedaliera (AO) San Camillo Forlanini, Rome, Italy
| | - Elisabetta Abruzzese
- Hematology, S. Eugenio Hospital, Tor Vergata University, ASL Roma2, Rome, Italy
- *Correspondence: Elisabetta Abruzzese,
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Fanelli F, Hohaus S, Cantonetti M, Cimino G, Pennese E, Battistini R, Galli E, Cerretti R, Proia A, Fatone F, Provenzano I, Abruzzese E, Finolezzi E, Pulsoni A, Rigacci L. Impact of Pretransplant Salvage Therapies on Outcome of Hodgkin Lymphoma Patients Performing Allogeneic Transplant. Chemotherapy 2022; 68:131-137. [PMID: 36549287 DOI: 10.1159/000525819] [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: 03/30/2022] [Accepted: 06/17/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Allogeneic transplant is an effective salvage therapy in patients with Hodgkin lymphoma (HL) relapsed or refractory (R/R) to previous treatments. In recent years, immunotherapies (conjugated antibody and checkpoint inhibitors [CPI]) showed interesting results and were used as bridge therapies to allotransplant. AIM The aim of this retrospective study in Lazio region was to evaluate the impact of these new therapies on outcome after allogeneic hematopoietic stem cell transplantation (allo-SCT) in comparison with standard chemotherapies used in the past. METHODS We selected all consecutive patients with diagnosis of HL transplanted in four hematology transplant units, and we collected data obtained from patients' records concerning all the treatments before allo-SCT. RESULTS A total of 56 patients were enrolled in this study. All patients underwent allo-SCT for R/R HL. Seventeen patients (30%) received chemotherapy prior to allo-SCT (group B); they were treated between 2008 and 2015; and 39 patients (70%) received brentuximab vedotin (BV), CPI, or both before allo-SCT as a bridge to transplant (group A); they were treated between 2012 and 2020. Twenty-five patients were treated with BV alone, 2 with CPI alone, and 12 first with BV and then with CPI. No patient received concomitant BV and CPI. At 5 years from allo-SCT, overall survival (OS) was 59% and progression-free survival (PFS) was 65%. No statistical differences in OS or PFS were observed between patients in groups A and B. Relapse was significantly associated with a lower survival. The only factor associated with a reduced risk of relapse was development of any grade acute graft versus host disease (GVHD) (p > 0.02). CONCLUSIONS This regional real-world experience shows the changes that have taken place in the last 10 years in R/R HL using new drugs to render a patient eligible for allo-SCT. This strategy appears to guarantee an impressive disease control with an increased risk of complications, for example, aGVHD, that appear to nullify this advantage at least in part.
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Affiliation(s)
- Fulvia Fanelli
- Haematology Unit and Stem Cell Transplant, AO San Camillo Roma, Rome, Italy
| | - Stefan Hohaus
- Department of Radiological and Hematological Sciences, Università Cattolica del Sacro Cuore Roma, Rome, Italy
- Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Fondazione Policlinico Universitario A. Gemelli, IRCCS Roma, Rome, Italy
| | - Maria Cantonetti
- Dipartimento di Oncoematologia Fondazione Policlinico Tor Vergata Roma, Rome, Italy
| | - Giuseppe Cimino
- UOC Ematologia e Centro Trapianto Ospedale Santa Maria Goretti Latina, Latina, Italy
| | - Elsa Pennese
- UOC Ematologia Clinica Ospedale Civile Pescara, Pescara, Italy
| | - Roberta Battistini
- Haematology Unit and Stem Cell Transplant, AO San Camillo Roma, Rome, Italy
| | - Eugenio Galli
- Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Fondazione Policlinico Universitario A. Gemelli, IRCCS Roma, Rome, Italy
| | - Raffaella Cerretti
- Dipartimento di Oncoematologia Fondazione Policlinico Tor Vergata Roma, Rome, Italy
| | - Anna Proia
- Haematology Unit and Stem Cell Transplant, AO San Camillo Roma, Rome, Italy
| | - Federica Fatone
- Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Fondazione Policlinico Universitario A. Gemelli, IRCCS Roma, Rome, Italy
| | - Ida Provenzano
- Dipartimento di Oncoematologia Fondazione Policlinico Tor Vergata Roma, Rome, Italy
| | | | | | - Alessandro Pulsoni
- Dipartimento di Biotecnologie Cellulari ed Ematologia, Università La Sapienza, Rome, Italy
| | - Luigi Rigacci
- Department of Medicine and Surgery, Università Campus Bio-Medico Roma, Rome, Italy
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9
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Chiattone C, Civallero M, Fischer T, Miranda E, Manni M, Zing NPC, Pileri SA, Montoto S, Horwitz SM, Cabrera ME, De Souza CA, Nagler A, Luminari S, Ferreri AJM, Carson KR, Re A, Rigacci L, Nassi L, Stepanishyna Y, Federico M, Inghirami G. Characteristics and clinical outcomes of patients with ALK-positive anaplastic large cell lymphoma: Report from the prospective international T-cell lymphoma project. Hematol Oncol 2022; 40:953-961. [PMID: 36083035 DOI: 10.1002/hon.3074] [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: 06/23/2022] [Revised: 08/11/2022] [Accepted: 08/15/2022] [Indexed: 12/13/2022]
Abstract
The T-cell Lymphoma Project is an international registry prospective study that enrolled patients with newly diagnosed peripheral T-cell and NK-cell lymphomas (PTCL). The main objective was to define the clinical features and outcomes, establishing a robust benchmark for future clinical trials. Seventy-four institutions from 14 countries in North America, South America, Europe, and Asia collected data on patients diagnosed and treated at their respective centers between September 2006 and February 2018. Among 1553 PTCL patients, 131 (8.4% of the total cohort) were confirmed to have anaplastic large cell lymphoma - kinase positive (ALCL, ALK+). The median age of the patients was 39 years (18-84). Sixty-five patients (66%) had advanced-stage disease, although majority (45 patients, 54%) had a low-risk International Prognostic Index (IPI) score (0-1). Of 97 patients treated with chemotherapy, 97% received anthracycline-containing regimens. The overall response rate was 81%, with 69 patients (70%) achieving complete remission. Estimated OS and PFS at 3 years were 77% (95% CI: 54%-99%) and 68% (95% CI: 46%-90%), respectively, and at 5 years were very similar, 77% of OS (95% CI: 62%-92%) and 64% of PFS (95% CI: 34%-94%). Multivariate analysis for PFS showed advanced stage (hazard ratios [HR]: 4.72, 95% CI: 1.43-23.9, p = 0.015), elevated lactate dehidrogenade (LDH) (HR 4.85; 95% CI: 1.73-13.60, p = 0.001), and Eastern Cooperative Oncology Group Performance Status scale (ECOG-PS) ≥2 (HR: 5.25; 95% CI: 1.68-16.4, p = 0.024). For OS, elevated LDH (HR: 3.77; 95% CI: 1.98-14.17, p = 0.014) and ECOG-PS ≥2 (HR: 4.59; 95% CI: 1.46-14.39, p = 0.004) were identified. In summary, although the outcome of ALK+ ALCL is superior to that of other PTCLs, it remains sufficiently favorable, given the young median age of the patients. Our results confirm the usefulness of both IPI and Prognostic Index for T-cell Lymphoma (PIT) in identifying groups of patients with different outcomes. Clinical Trials ID: NCT01142674.
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Affiliation(s)
- Carlos Chiattone
- Santa Casa Medical School of Sao Paulo, Samaritano Hospital, São Paulo, Brazil
| | - Monica Civallero
- Department of CHIMOMO, University of Modena and Reggio Emilia, Modena, Italy
| | - Thais Fischer
- Santa Casa Medical School of Sao Paulo, Samaritano Hospital, São Paulo, Brazil
| | - Eliana Miranda
- Hematology and Hemotherapy Center, University of Campinas, São Paulo, Brazil
| | - Martina Manni
- Department of CHIMOMO, University of Modena and Reggio Emilia, Modena, Italy
| | - Natalia P C Zing
- Santa Casa Medical School of Sao Paulo, Samaritano Hospital, São Paulo, Brazil
| | - Stefano A Pileri
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Milan, Italy
| | - Silvia Montoto
- Department of Haemato-Oncology, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | - Steven M Horwitz
- Department Medicine,, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
| | - Maria Elena Cabrera
- Sección Hematología, Hospital del Salvador, Universidad de Chile, Santiago de Chile, Chile
| | - Carmino A De Souza
- Hematology and Hemotherapy Center, University of Campinas, São Paulo, Brazil
| | - Arnon Nagler
- Hematology Division, BMT and Cord Blood Bank, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | | | - Andrés J M Ferreri
- Lymphoma Unit, Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Kenneth R Carson
- Oncology, Internal Medicine, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Alessandro Re
- UO Ematologia A.O. Spedali Civili di Brescia, Brescia, Italy
| | - Luigi Rigacci
- S.O.D. Ematologia Dipartimento Area Critica Medico Chirurgica A.O.U. Careggi, Firenze, Italy
| | - Luca Nassi
- Department of Translational Medicine, AOU Maggiore della Carità and University of Eastern Piedmont, Novara, Italy
| | | | - Massimo Federico
- Department of CHIMOMO, University of Modena and Reggio Emilia, Modena, Italy
| | - Giorgio Inghirami
- W Pathology and Laboratory Medicine, New York Presbyterian Hospital, Weill Cornell Medicine, Weill Cornell Medical College, New York, New York, USA
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10
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Zappasodi P, Cattaneo C, Valeria Ferretti V, Mina R, José María Ferreri A, Merli F, Oberti M, Krampera M, Romano A, Zerbi C, Ferrari J, Cavo M, Salvini M, Bertù L, Stefano Fracchiolla N, Marchesi F, Massaia M, Marasco V, Cairoli R, Maria Scattolin A, Maria Vannucchi A, Gambacorti‐Passerini C, Musto P, Gherlinzoni F, Cuneo A, Pinto A, Trentin L, Bocchia M, Galimberti S, Coviello E, Chiara Tisi M, Morotti A, Falini B, Turrini M, Tafuri A, Billio A, Gentile M, Massimo Lemoli R, Venditti A, Giovanni Della Porta M, Lanza F, Rigacci L, Tosi P, Mohamed S, Corso A, Luppi M, Giuliani N, Busca A, Pagano L, Bruno R, Antonio Grossi P, Corradini P, Passamonti F, Arcaini L. Secondary infections worsen the outcome of COVID-19 in patients with hematological malignancies: A report from the ITA-HEMA-COV. Hematol Oncol 2022; 40:846-856. [PMID: 35854643 PMCID: PMC9349965 DOI: 10.1002/hon.3048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 12/13/2022]
Abstract
The impact of secondary infections (SI) on COVID-19 outcome in patients with hematological malignancies (HM) is scarcely documented. To evaluate incidence, clinical characteristics, and outcome of SI, we analyzed the microbiologically documented SI in a large multicenter cohort of adult HM patients with COVID-19. Among 1741 HM patients with COVID-19, 134 (7.7%) had 185 SI, with a 1-month cumulative incidence of 5%. Median time between COVID-19 diagnosis and SI was 16 days (IQR: 5-36). Acute myeloid leukemia (AML) and lymphoma/plasma cell neoplasms (PCN) were more frequent diagnoses in SI patients compared to patients without SI (AML: 14.9% vs. 7.1%; lymphoma/PCN 71.7% vs. 65.3%). Patients with SI were older (median age 70 vs. 66 years, p = 0.002), with more comorbidities (median Charlson Comorbidity Index 5 vs. 4, p < 0.001), higher frequency of critical COVID-19 (19.5% vs. 11.5%, p = 0.046), and more frequently not in complete remission (75% vs. 64.7% p = 0.024). Blood and bronchoalveolar lavage were the main sites of isolation for SI. Etiology of infections was bacterial in 80% (n = 148) of cases, mycotic in 9.7% (n = 18) and viral in 10.3% (n = 19); polymicrobial infections were observed in 24 patients (18%). Escherichia coli represented most of Gram-negative isolates (18.9%), while coagulase-negative Staphylococci were the most frequent among Gram-positive (14.2%). The 30-day mortality of patients with SI was higher when compared to patients without SI (69% vs. 15%, p < 0.001). The occurrence of SI worsened COVID-19 outcome in HM patients. Timely diagnosis and adequate management should be considered to improve their prognosis.
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Affiliation(s)
- Patrizia Zappasodi
- Division of Hematology, Fondazione IRCCS Policlinico San MatteoPaviaItaly
| | - Chiara Cattaneo
- Division of HematologyAzienda Socio‐Sanitaria Territoriale‐Spedali CiviliBresciaItaly
| | | | - Roberto Mina
- SSD Clinical Trial in Oncoematologia e Mieloma MultiploDivision of HematologyUniversity of TorinoAzienda Ospedaliero‐Universitaria Città della Salute e della Scienza di TorinoTorinoItaly
| | - Andrés José María Ferreri
- Division of HematologyIstituto di Ricovero e Cura a Carattere Scientifico San Raffaele Scientific InstituteMilanItaly
| | - Francesco Merli
- Division of Hematology, AUSL‐IRCCS Reggio EmiliaReggio EmiliaItaly
| | - Margherita Oberti
- Division of Hematology and Transplant UnitASST Spedali CiviliBresciaItaly
| | - Mauro Krampera
- Division of HematologyAzienda Ospedaliera Integrata di VeronaVeronaItaly
| | - Alessandra Romano
- Division of Hematology and Bone Marrow TransplantationAzienda Ospedaliera Universitaria Policlinico “G. Rodolico—San Marco”CataniaItaly
| | - Caterina Zerbi
- Department of Molecular MedicineUniversity of PaviaPaviaItaly
| | | | - Michele Cavo
- Division of HematologyAzienda Ospedaliero‐Universitaria Policlinico S. Orsola‐MalpighiBolognaItaly
| | - Marco Salvini
- UOC Ematologia, Azienda Socio‐Sanitaria Territoriale Sette Laghi, Ospedale di Circolo of VareseVareseItaly,Department of Medicine and SurgeryUniversity of InsubriaVareseItaly
| | - Lorenza Bertù
- UOC Ematologia, Azienda Socio‐Sanitaria Territoriale Sette Laghi, Ospedale di Circolo of VareseVareseItaly,Department of Medicine and SurgeryUniversity of InsubriaVareseItaly
| | | | | | | | - Vincenzo Marasco
- Division of HematologyFondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei TumoriUniversity of MilanMilanItaly
| | - Roberto Cairoli
- HematologyAzienda Socio‐Sanitaria Territoriale Grande Ospedale Metropolitano NiguardaMilanItaly
| | - Anna Maria Scattolin
- Division of HematologyAzienda Unità Locale Socio‐Sanitaria 3 SerenissimaOspedale dell'AngeloVenezia‐MestreVeniceItaly
| | | | | | - Pellegrino Musto
- Department of Emergency and Organ Transplantation“Aldo Moro” University School of Medicine and Unit of Hematology and Stem Cell Transplantation, AOUC PoliclinicoBariItaly
| | | | - Antonio Cuneo
- Division of HematologyAzienda Ospedaliero Universitaria Arcispedale S. AnnaFerraraItaly
| | - Antonello Pinto
- Hematology, Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico “Fondazione G Pascale,” NaplesNaplesItaly
| | - Livio Trentin
- Division of HematologyAzienda Ospedaliera di PadovaPadovaItaly
| | - Monica Bocchia
- Division of HematologyPoliclinico Santa Maria alle ScotteSienaItaly
| | - Sara Galimberti
- Division of HematologyAzienda Ospedaliera Universitaria Pisana‐ Santa ChiaraPisaItaly
| | - Elisa Coviello
- Ematologia e terapie cellulari. IRCCS Ospedale Policlinico San MartinoGenovaItaly
| | | | - Alessandro Morotti
- Department of Clinical and Biological SciencesUniversity of TorinoOrbassanoItaly
| | - Brunangelo Falini
- Division of Hematology and Transplant UnitAzienda Ospedaliera di PerugiaPerugiaItaly
| | | | - Agostino Tafuri
- Division of HematologyUniversity Hospital Sant'AndreaSapienzaRomeItaly
| | - Atto Billio
- Division of Hematology and Transplant UnitOspedale di BolzanoBolzanoItaly
| | - Massimo Gentile
- Division of HematologyAzienda Ospedaliera di CosenzaCosenzaItaly
| | - Roberto Massimo Lemoli
- Department of Internal Medicine (DiMI)Clinic of Hematology, University of GenoaGenoaItaly,IRCCS‐ San Martino HospitalGenoaItaly
| | - Adriano Venditti
- Department of Biomedicine and PreventionUniversity Tor Vergata RomeRomeItaly
| | - Matteo Giovanni Della Porta
- Division of Hematology, Humanitas Clinical and Research Hospital Istituto di Ricovero e Cura a Carattere Scientifico and Department of Biomedical SciencesHumanitas UniversityMilanItaly
| | - Francesco Lanza
- Division of HematologyOspedale Santa Maria delle CrociRavennaItaly
| | - Luigi Rigacci
- Division of Hematology and Transplant Unit, Azienda Ospedaliera S. Camillo‐ForlaniniRomeItaly
| | - Patrizia Tosi
- Division of HematologyOspedale degli InfermiRiminiItaly
| | - Sara Mohamed
- SC EmatologiaAzienda Sanitaria Universitaria Giuliano IsontinaTriesteItaly
| | | | - Mario Luppi
- Department of Medical and Surgical SciencesUNIMORE. Division of Hematology Azienda Ospedaliero Universitaria ModenaModenaItaly
| | - Nicola Giuliani
- Division of Hematology and Transplant UnitAzienda Ospedaliero‐Universitaria di ParmaSItaly
| | - Alessandro Busca
- SSD Clinical Trial in Oncoematologia e Mieloma MultiploDivision of HematologyUniversity of TorinoAzienda Ospedaliero‐Universitaria Città della Salute e della Scienza di TorinoTorinoItaly
| | - Livio Pagano
- Division of HematologyFondazione Policlinico Universitario Agostino Gemelli ‐ Istituto di Ricovero e Cura a Carattere ScientificoRomeItaly,Hematology, Università Cattolica del Sacro CuoreRomeItaly
| | - Raffaele Bruno
- Division of Infectious and Tropical DiseasesFondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San MatteoPaviaItaly,Department of ClinicalSurgical, Diagnostic, and Paediatric SciencesUniversity of PaviaPaviaItaly
| | - Paolo Antonio Grossi
- Department of Medicine and SurgeryUniversity of InsubriaVareseItaly,Division of Infectious and Tropical DiseasesAzienda Socio‐Sanitaria Territoriale Sette Laghi, Ospedale di Circolo of VareseVareseItaly
| | - Paolo Corradini
- Division of HematologyFondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei TumoriUniversity of MilanMilanItaly
| | - Francesco Passamonti
- UOC Ematologia, Azienda Socio‐Sanitaria Territoriale Sette Laghi, Ospedale di Circolo of VareseVareseItaly,Department of Medicine and SurgeryUniversity of InsubriaVareseItaly
| | - Luca Arcaini
- Division of Hematology, Fondazione IRCCS Policlinico San MatteoPaviaItaly,Department of Molecular MedicineUniversity of PaviaPaviaItaly
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11
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Rigacci L, Battistini R, Kovalchuk S, Zoli V, Puccini B, Evangelista A, Arcaini L, Flenghi L, Visco C, Mian M, Di Rocco A, Peracchio C, Gotti M, Tisi MC, Palombi F, Pozzi S, Gioia D, Viero P, Martelli M. OBINUTUZUMAB DOES NOT IMPROVE COMPLETE METHABOLIC RESPONSE BUT DOES NOT COMPROMISE MOBILIZATION OR ENGRAFTMENT OF AUTOLOGOUS PERIPHERAL BLOOD STEM CELLS IN DIFFUSE LARGE B CELL LYMPHOMA: RESULTS FROM A FIL PROSPECTIVE PHASE II STUDY (THE GIOTTO STUDY). Hematol Oncol 2022; 40:609-616. [PMID: 35612350 DOI: 10.1002/hon.3028] [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: 03/13/2022] [Revised: 05/03/2022] [Accepted: 05/05/2022] [Indexed: 11/06/2022]
Abstract
Salvage immunochemotherapy and transplant consolidation is the standard treatment for relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL). We tested a combination of Obinutuzumab and DHAP for treating R/R DLBCL. The primary end point was the rate of complete metabolic response (CMR). Secondary end points were stem cell mobilization, stem cell engraftment, overall survival, and feasibility. In this prospective, phase-2, single-arm trial (EudraCT 2014-004014-17) patients received the standard three doses of Obinutuzumab for the first cycle, and then one dose. Patients with CMR were consolidated with an autologous stem cell transplantation (ASCT). An interim analysis was provided after the first 29 patients to confirm the initial null hypothesis that at least 10/29 patients would achieve CMR. Among the 29 patients evaluated for the first stage only 6 patients (6/29, 21%) achieved CMR, thus, study enrollment was stopped. Nine patients exhibited extra-hematologic toxicities ≥grade 3. Among the 19 patients that started stem cell mobilization, one failed (5%) and 18 achieved mobilization (95%). Of these 18 patients, 9 were reinfused. Mobilization was observed in 16 patients (89%) after 1 or 2 apheresis rounds. The mean number of CD34+ cells mobilized was 5.8 x 106 /Kg (median: 5.5, IQR: 5 - 6.75). The mean number of reinfused CD34+ cells in the 9 patients was 4.1 x 106 /Kg (median: 4.1, IQR: 3.5 - 5). Obinutuzumab combined with DHAP did not compromise stem cell mobilization or engraftment after ASCT in patients with DLBCL. However, Obinutuzumab+DHAP provided a lower CMR rate than expected. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Luigi Rigacci
- UOC Hematology and Stem Cell Transplantation, AO San Camillo Forlanini, Roma.,SOD Hematology, AOU Careggi, Firenze
| | - Roberta Battistini
- UOC Hematology and Stem Cell Transplantation, AO San Camillo Forlanini, Roma
| | | | - Valerio Zoli
- UOC Hematology and Stem Cell Transplantation, AO San Camillo Forlanini, Roma
| | | | - Andrea Evangelista
- Unit of Clinical Epidemiology, CPO Piemonte, AOU Città della Salute e della Scienza di Tori, no, Torino
| | - Luca Arcaini
- Policlinico San Matteo Pavia Fondazione IRCCS, Pavi, a.,Departement of Molecular Medicine, University of Pav, i, a
| | - Leonardo Flenghi
- Institute of Hematology, University of Perugia, Ospedale S. Maria della Misericordia, Perugi, a
| | | | - Michael Mian
- Division of Hematology and BMT, General Hospital of Bolza, no
| | - Alice Di Rocco
- Hematology Unit, Department of Cellular Biotechnologies and Hematology, "Sapienza" University of Rome, Rom, e
| | | | - Manuel Gotti
- Policlinico San Matteo Pavia Fondazione IRCCS, Pavi, a
| | | | - Francesca Palombi
- UOSD Ematologia e Trapianti, Istituto Nazionale Tumori Regina Elena IFO, Rom, a
| | - Samantha Pozzi
- UOC Ematologia, Azienda Ospedaliero Universitaria Mode, n, a
| | | | - Piera Viero
- UOC Ematologia dell'Ospedale dell'Angelo, Venezi, a
| | - Maurizio Martelli
- Hematology Unit, Department of Cellular Biotechnologies and Hematology, "Sapienza" University of Rome, Rom, e
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12
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Bisceglia I, Camilli M, Mistrulli R, Cartoni D, Matera S, Canale M, Battistini R, Rigacci L, Petrolati S. P140 EFFICACY AND SAFETY OF CHEMOTHERAPY CONTAINING NON–PEGYLATED LIPOSOMAL DOXORUBICIN IN PATIENTS AT HIGH CARDIOVASCULAR RISK: A SINGLE–CENTER EXPERIENCE. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Anthracyclines represent the most effective chemotherapeutic agent in the treatment of non–Hodgkin‘s lymphoma (NHL), although their use is limited due to the risk of cardiac toxicity. This occurs mainly in elderly patients, those with a history of cardiovascular (CV) disease and/or multiple concomitant risk factors. Liposomal doxorubicin has been shown to reduce this toxicity. The aim of this retrospective study is to investigate the use of non–pegylated liposomal doxorubicin in high–risk patients in terms of haematological response rate and CV events. In a single centre, 15 patients undergoing R–COMP regimen (Rituximab, Prednisone, Cyclophosphamide, Vincristine, Myocet liposomal doxorubicin) were consecutively collected from January 2020 to December 2021. The mean age of patients was 73.9 years and 60% were male. The baseline mean left ventricular ejection fraction (LVEF) was 55.9%; four patients had a baseline FE of < 50%, two of them had a severe reduction in LVEF. Among all patients, 86.7% had systemic hypertension, 40% diabetes mellitus, 46.7% dyslipidaemia and 20% a family history of CV disease. Moreover, 46.7% of patients had at least two concomitant risk factors and 20% at least three. 20% had a history of ischemic heart disease, 13.3% had previous exposure to anthracyclines and 20% with mediastinal radiotherapy; 26.7% had moderate to severe aortic valvulopathy. According to the joint Cardio–Oncology evaluation, 100% of patients had been considered unsuitable for conventional doxorubicin.. More than 85% of the cases were already on cardioactive therapy at baseline evaluation and 66.7% required titration or modification during chemotherapy. With R–COMP, the whole population was able to finish treatment achieved complete haematological remission. The mean LVEF at the end of treatment was 55.8% (p = 0.814).
Conclusions
Our results support the efficacy and safety of R–COMP in a population at high risk for cardiac events, otherwise excluded from anthracycline–containing therapy. Liposomal formulatio reduces doxorubicin cardiomyocyte accumulation and thus toxicity, providing the best possible treatment for the majority of the onco–haematological population.
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Affiliation(s)
- I Bisceglia
- OSPEDALE SAN CAMILLO, ROMA; FONDAZIONE POLICLINICO UNIV. A. GEMELLI, ROMA; OSPEDALE SANT‘ANDREA DI ROMA, ROMA; OSPEDALE S. MARIA GORETTI, LATINA; NUOVO OSPEDALE VERSILIA, LIDO DI CAMAIORE; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO– FORLANINI, ROMA
| | - M Camilli
- OSPEDALE SAN CAMILLO, ROMA; FONDAZIONE POLICLINICO UNIV. A. GEMELLI, ROMA; OSPEDALE SANT‘ANDREA DI ROMA, ROMA; OSPEDALE S. MARIA GORETTI, LATINA; NUOVO OSPEDALE VERSILIA, LIDO DI CAMAIORE; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO– FORLANINI, ROMA
| | - R Mistrulli
- OSPEDALE SAN CAMILLO, ROMA; FONDAZIONE POLICLINICO UNIV. A. GEMELLI, ROMA; OSPEDALE SANT‘ANDREA DI ROMA, ROMA; OSPEDALE S. MARIA GORETTI, LATINA; NUOVO OSPEDALE VERSILIA, LIDO DI CAMAIORE; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO– FORLANINI, ROMA
| | - D Cartoni
- OSPEDALE SAN CAMILLO, ROMA; FONDAZIONE POLICLINICO UNIV. A. GEMELLI, ROMA; OSPEDALE SANT‘ANDREA DI ROMA, ROMA; OSPEDALE S. MARIA GORETTI, LATINA; NUOVO OSPEDALE VERSILIA, LIDO DI CAMAIORE; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO– FORLANINI, ROMA
| | - S Matera
- OSPEDALE SAN CAMILLO, ROMA; FONDAZIONE POLICLINICO UNIV. A. GEMELLI, ROMA; OSPEDALE SANT‘ANDREA DI ROMA, ROMA; OSPEDALE S. MARIA GORETTI, LATINA; NUOVO OSPEDALE VERSILIA, LIDO DI CAMAIORE; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO– FORLANINI, ROMA
| | - M Canale
- OSPEDALE SAN CAMILLO, ROMA; FONDAZIONE POLICLINICO UNIV. A. GEMELLI, ROMA; OSPEDALE SANT‘ANDREA DI ROMA, ROMA; OSPEDALE S. MARIA GORETTI, LATINA; NUOVO OSPEDALE VERSILIA, LIDO DI CAMAIORE; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO– FORLANINI, ROMA
| | - R Battistini
- OSPEDALE SAN CAMILLO, ROMA; FONDAZIONE POLICLINICO UNIV. A. GEMELLI, ROMA; OSPEDALE SANT‘ANDREA DI ROMA, ROMA; OSPEDALE S. MARIA GORETTI, LATINA; NUOVO OSPEDALE VERSILIA, LIDO DI CAMAIORE; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO– FORLANINI, ROMA
| | - L Rigacci
- OSPEDALE SAN CAMILLO, ROMA; FONDAZIONE POLICLINICO UNIV. A. GEMELLI, ROMA; OSPEDALE SANT‘ANDREA DI ROMA, ROMA; OSPEDALE S. MARIA GORETTI, LATINA; NUOVO OSPEDALE VERSILIA, LIDO DI CAMAIORE; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO– FORLANINI, ROMA
| | - S Petrolati
- OSPEDALE SAN CAMILLO, ROMA; FONDAZIONE POLICLINICO UNIV. A. GEMELLI, ROMA; OSPEDALE SANT‘ANDREA DI ROMA, ROMA; OSPEDALE S. MARIA GORETTI, LATINA; NUOVO OSPEDALE VERSILIA, LIDO DI CAMAIORE; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO– FORLANINI, ROMA
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13
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Bisceglia I, Mistrulli R, Cartoni D, Buffa V, Battistini R, Proia A, Rigacci L, Petrolati S. C50 CARDIO–ONCO–HAEMATOLOGY IN CLINICAL PRACTICE. A “CHANGELING” CASE: MORE THAN PARADOXICAL BUBBLES. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac011.049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
39–year–old female, without cardiovascular risk factors. At the end of pregnancy she complained of progressive dyspnoea and so she was admitted to the emergency room. Blood tests showed elevated D–dimer and LDH values. A chest CT scan was performed showing a mediastinal mass of about 15 cm encompassing the ascending aorta, the left brachiocephalic trunk and the superior vena cava, both of which appeared thrombosed. Therapy with low molecular weight heparin was started. The patient underwent a mediastinal biopsy, which documented a primary mediastinal non–Hodgkin‘s lymphoma. The baseline cardiological evaluation showed a preserved ejection fraction (60%) at echocardiogram (ECHO). The first cycle of chemotherapy with R–CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine) was started. After an episode of hypoesthesia of the left upper limb, that regressed spontaneously within a few hours, she performed MRI that showed multiple areolas compatible with ischemic disease. Following these results the patient was submitted to an ECHO with saline solution injected through the right brachial vein that documented evidence of early opacification of the left atrium and subsequent opacification of the right sections (after 3 cardiac cycles) (Fig. 1–2). This finding suggested a right–to–left shunting, via the bronchial lower district to the left atrium (pulmonary veins). This suspicion was confirmed by CT angiography, which showed occlusion of the superior vena cava with passage of contrast into azygos and early opacification of peribronchial venous circles (Fig. 3). A patency of foramen ovale was ruled out by injection of saline solution through the femoral vein. After the second cycle of chemotherapy, ECHO showed diffuse hypokinesia and reduced EF to 50%. It was then decided to proceed with the third cycle according to the intensified R–DAEPOCH scheme, except for doxorubicin, because of the cardiotoxicity developed by the patient. A cardioprotective therapy was also started with bisoprolol and ramipril with rapid titration. At subsequent radiological controls, a progressive reduction of the mediastinal mass was found and after just one month, the echocardiogram showed a complete recovery of the EF. Contrast injection confirmed presence of a veno–venous shunt. Cardio–oncology is an intriguing and complex discipline that requires the development of local multidisciplinary teams for challenging situations that patients with cancer may ask us to address.
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Affiliation(s)
- I Bisceglia
- OSPEDALE SAN CAMILLO, ROMA; OSPEDALE SANT‘ANDREA ROMA; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO–FORLANINI, ROMA
| | - R Mistrulli
- OSPEDALE SAN CAMILLO, ROMA; OSPEDALE SANT‘ANDREA ROMA; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO–FORLANINI, ROMA
| | - D Cartoni
- OSPEDALE SAN CAMILLO, ROMA; OSPEDALE SANT‘ANDREA ROMA; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO–FORLANINI, ROMA
| | - V Buffa
- OSPEDALE SAN CAMILLO, ROMA; OSPEDALE SANT‘ANDREA ROMA; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO–FORLANINI, ROMA
| | - R Battistini
- OSPEDALE SAN CAMILLO, ROMA; OSPEDALE SANT‘ANDREA ROMA; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO–FORLANINI, ROMA
| | - A Proia
- OSPEDALE SAN CAMILLO, ROMA; OSPEDALE SANT‘ANDREA ROMA; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO–FORLANINI, ROMA
| | - L Rigacci
- OSPEDALE SAN CAMILLO, ROMA; OSPEDALE SANT‘ANDREA ROMA; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO–FORLANINI, ROMA
| | - S Petrolati
- OSPEDALE SAN CAMILLO, ROMA; OSPEDALE SANT‘ANDREA ROMA; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO–FORLANINI, ROMA
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14
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Canale ML, Turazza F, Lestuzzi C, Parrini I, Camerini A, Russo G, Colivicchi F, Gabrielli D, Gulizia MM, Oliva S, Tarantini L, Maurea N, Rigacci L, Petrolati S, Casolo G, Bisceglia I. Corrigendum: Portrait of Italian Cardio-Oncology: Results of a Nationwide Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) Survey. Front Cardiovasc Med 2022; 9:920605. [PMID: 35620512 PMCID: PMC9127951 DOI: 10.3389/fcvm.2022.920605] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 04/19/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- Maria Laura Canale
- Division of Cardiology, Azienda USL Toscana Nord-Ovest, Versilia Hospital, Lido di Camaiore, Italy
- *Correspondence: Maria Laura Canale
| | - Fabio Turazza
- Cardiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Chiara Lestuzzi
- Cardiology Unit, Oncology Department, CRO National Cancer Institute, Aviano, Italy
| | - Iris Parrini
- Divisione di Cardiologia, Ospedale Mauriziano, Turin, Italy
| | - Andrea Camerini
- Medical Oncology, Azienda USL Toscana Nord-Ovest, Versilia Hospital, Lido di Camaiore, Italy
| | - Giulia Russo
- SC Centro Cardiovascolare Ospedale Maggiore, Trieste, Italy
| | - Furio Colivicchi
- Division of Cardiology, San Filippo Neri Hospital, ASL Roma 1, Rome, Italy
| | - Domenico Gabrielli
- Division of Cardiology, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy
| | | | - Stefano Oliva
- UOSD Cardiologia di Interesse Oncologico - IRCCS Istituto Tumori “GIOVANNI Paolo II” Bari, Bari, Italy
| | - Luigi Tarantini
- Division of Cardiology, Arcispedale S. Maria Nuova, Azienda USL – IRCCS di Reggio-Emilia, Reggio-Emilia, Italy
| | - Nicola Maurea
- S.C. Cardiologia, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Napoli, Italy
| | - Luigi Rigacci
- UOC Ematologia, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy
| | - Sandro Petrolati
- Servizi Cardiologici Integrati, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy
| | - Giancarlo Casolo
- Division of Cardiology, Azienda USL Toscana Nord-Ovest, Versilia Hospital, Lido di Camaiore, Italy
| | - Irma Bisceglia
- Servizi Cardiologici Integrati, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy
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15
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Di Giosaffatte N, Bottillo I, Laino L, Iaquinta G, Ferraris A, Garzia M, Bargiacchi S, Mulargia C, Angelitti MR, Palumbo F, Grammatico B, Bartolelli C, Salerno MG, Rigacci L, Grammatico P. Discordant cfDNA-NIPT result unraveling a trisomy 12 chronic lymphocytic leukemia in a 37 years old pregnant woman. Prenat Diagn 2022; 42:1000-1003. [PMID: 35506546 PMCID: PMC9546086 DOI: 10.1002/pd.6158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 11/07/2022]
Abstract
What's already known about this topic?
Discordant NIPT results can rarely unravel maternal malignancies, especially when multiple chromosomal imbalances are reported. Both solid and hematological neoplasms have been described.
What does this study add?
This is the first case of a discordant NIPT result due to Chronic Lymphocytic Leukemia associated with trisomy of the chromosome 12. Putative maternal malignancy should be considered and investigated through sensitive techniques even in presence of a single chromosomal anomaly. This must be considered especially when the imbalance is known to recur in hematological neoplasms.
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Affiliation(s)
- Niccolò Di Giosaffatte
- Department of Molecular Medicine, Laboratory of Medical Genetics, Sapienza University, San Camillo-Forlanini Hospital, Rome, Italy
| | - Irene Bottillo
- Department of Molecular Medicine, Laboratory of Medical Genetics, Sapienza University, San Camillo-Forlanini Hospital, Rome, Italy
| | - Luigi Laino
- Department of Molecular Medicine, Laboratory of Medical Genetics, Sapienza University, San Camillo-Forlanini Hospital, Rome, Italy
| | - Giovanni Iaquinta
- Department of Molecular Medicine, Laboratory of Medical Genetics, Sapienza University, San Camillo-Forlanini Hospital, Rome, Italy
| | - Alessandro Ferraris
- Department of Molecular Medicine, Laboratory of Medical Genetics, Sapienza University, San Camillo-Forlanini Hospital, Rome, Italy
| | - Mariagrazia Garzia
- Haematology and Stem Cell Transplantation Unit, San Camillo-Forlanini Hospital, Rome, Italy
| | - Simone Bargiacchi
- Department of Molecular Medicine, Laboratory of Medical Genetics, Sapienza University, San Camillo-Forlanini Hospital, Rome, Italy
| | - Claudia Mulargia
- Department of Molecular Medicine, Laboratory of Medical Genetics, Sapienza University, San Camillo-Forlanini Hospital, Rome, Italy
| | - Maria Rosaria Angelitti
- Department of Molecular Medicine, Laboratory of Medical Genetics, Sapienza University, San Camillo-Forlanini Hospital, Rome, Italy
| | - Fabiana Palumbo
- Haematology and Stem Cell Transplantation Unit, San Camillo-Forlanini Hospital, Rome, Italy
| | - Barbara Grammatico
- Department of Molecular Medicine, Laboratory of Medical Genetics, Sapienza University, San Camillo-Forlanini Hospital, Rome, Italy
| | - Cinzia Bartolelli
- Obstetrics and Gynecology Unit, San Camillo-Forlanini Hospital, Rome, Italy
| | | | - Luigi Rigacci
- Haematology and Stem Cell Transplantation Unit, San Camillo-Forlanini Hospital, Rome, Italy
| | - Paola Grammatico
- Department of Molecular Medicine, Laboratory of Medical Genetics, Sapienza University, San Camillo-Forlanini Hospital, Rome, Italy
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16
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Bocchia M, Carella AM, Mulè A, Rizzo L, Turrini M, Abbenante MC, Cairoli R, Calafiore V, Defina M, Gardellini A, Luzi G, Patti C, Pinazzi MB, Riva M, Rossi G, Sammartano V, Rigacci L. Therapeutic Management of Patients with FLT3 + Acute Myeloid Leukemia: Case Reports and Focus on Gilteritinib Monotherapy. Pharmgenomics Pers Med 2022; 15:393-407. [PMID: 35496349 PMCID: PMC9041600 DOI: 10.2147/pgpm.s346688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 04/04/2022] [Indexed: 12/26/2022] Open
Abstract
Acute myeloid leukemia is a malignant disorder of the bone marrow, characterized by differentiation, clonal expansion, and uncontrolled proliferation of malignant myeloid progenitor cells and by several molecular and genetic abnormalities. A mutation of FMS-like tyrosine kinase 3 gene can be observed in about one-third of cases of acute myeloid leukemia. Two FLT3 inhibitors are actually approved for FLT3 mutated acute myeloid leukemia: midostaurin, a multikinase first generation inhibitor with lower affinity for FLT3 binding, and gilteritinib fumarate, a potent second-generation inhibitor of both FLT3-ITD and TKD. Gilteritinib is a new effective and well-tolerated drug for patients with relapsing or refractory FLT3-positive acute myeloid leukemia. Thanks to its efficacy, low toxicity, its good manageability (oral formulation), this drug is suitable for all the patients, including elderly frail patient with concomitant therapies or pre-existing or underlying diseases, and can be used also in the outpatient setting, reducing risks and costs related to the hospitalization. We report and discuss seven cases of different patients with FLT3 positive acute myeloid leukemia successfully managed with gilteritinib in the real clinical practice.
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Affiliation(s)
- Monica Bocchia
- Hematology Unit, Azienda Ospedaliera Universitaria Senese, University of Siena, Siena, Italy
| | - Angelo Michele Carella
- Division of Hematology with Hematologic Intensive Care Unit and Cellular Therapies, Department of Medical Science, Fondazione IRCCS Casa Sollievo Della Sofferenza, Foggia, Italy
- Correspondence: Angelo Michele Carella, Division of Hematology with Hematologic Intensive Care Unit and Cellular Therapies, Department of Medical Science, Fondazione IRCCS Casa Sollievo della Sofferenza, Viale Cappuccini, San Giovanni Rotondo, Foggia, 71013, Italy, Tel +390882410054, Fax +390882410322, Email
| | - Antonino Mulè
- UOC Hematology and Oncology, Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy
| | - Lorenzo Rizzo
- Department of Haematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Mauro Turrini
- Division of Hematology, Valduce Hospital, Como, Italy
| | - Maria Chiara Abbenante
- Division of Hematology with Hematologic Intensive Care Unit and Cellular Therapies, Department of Medical Science, Fondazione IRCCS Casa Sollievo Della Sofferenza, Foggia, Italy
| | - Roberto Cairoli
- Department of Haematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Valeria Calafiore
- UOC Hematology and Oncology, Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy
| | - Marzia Defina
- Hematology Unit, Azienda Ospedaliera Universitaria Senese, University of Siena, Siena, Italy
| | | | - Giovanni Luzi
- UOC Hematology and Stem Cell Transplant Unit, Ospedale S, Camillo, Rome, Italy
| | - Caterina Patti
- UOC Hematology and Oncology, Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy
| | | | - Marta Riva
- Department of Haematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Giovanni Rossi
- Division of Hematology with Hematologic Intensive Care Unit and Cellular Therapies, Department of Medical Science, Fondazione IRCCS Casa Sollievo Della Sofferenza, Foggia, Italy
| | - Vincenzo Sammartano
- Hematology Unit, Azienda Ospedaliera Universitaria Senese, University of Siena, Siena, Italy
| | - Luigi Rigacci
- UOC Hematology and Stem Cell Transplant Unit, Ospedale S, Camillo, Rome, Italy
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17
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Efficace F, Patriarca A, Luppi M, Potenza L, Caocci G, Tafuri A, Fazio F, Cartoni C, Petrucci MT, Carmosino I, Moia R, Margiotta Casaluci G, Boggione P, Colaci E, Giusti D, Pioli V, Sparano F, Cottone F, De Fabritiis P, Ardu NR, Niscola P, Capodanno I, Leporace AP, Pelliccia S, Lugli E, La Sala E, Rigacci L, Santopietro M, Fozza C, Siragusa S, Breccia M, Fazi P, Vignetti M. Physicians’ Perceptions of Clinical Utility of a Digital Health Tool for Electronic Patient-Reported Outcome Monitoring in Real-Life Hematology Practice. Evidence From the GIMEMA-ALLIANCE Platform. Front Oncol 2022; 12:826040. [PMID: 35372079 PMCID: PMC8968922 DOI: 10.3389/fonc.2022.826040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 11/30/2021] [Accepted: 02/03/2022] [Indexed: 12/19/2022] Open
Abstract
Digital health tools are increasingly being used in cancer care and may include electronic patient-reported outcome (ePRO) monitoring systems. We examined physicians’ perceptions of usability and clinical utility of a digital health tool (GIMEMA-ALLIANCE platform) for ePRO monitoring in the real-life practice of patients with hematologic malignancies. This tool allows for the collection and assessment of ePROs with real-time graphical presentation of results to medical staff. Based on a predefined algorithm, automated alerts are sent to medical staff. Participating hematologists completed an online survey on their experience with the platform. Of the 201 patients invited to participate between December 2020 and June 2021 (cut-off date for current analysis), 180 (90%) agreed to enter the platform and had a median age of 57 years. Twenty-three hematologists with a median age of 42 years and an average of 17 years of experience in clinical practice were surveyed. All hematologists agreed or strongly agreed that the platform was easy to use, and 87%, agreed or strongly agreed that ePROs data were useful to enhance communication with their patients. The majority of physicians (78%) accessed the platform at least once per month to consult the symptom and health status profile of their patients. The frequency of access was independent of physician sex (p=0.393) and years of experience in clinical practice (p=0.404). In conclusion, our preliminary results support the clinical utility, from the perspective of the treating hematologist, of integrating ePROs into the routine cancer care of patients with hematologic malignancies.
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Affiliation(s)
- Fabio Efficace
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Rome, Italy
- *Correspondence: Fabio Efficace,
| | - Andrea Patriarca
- Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Mario Luppi
- Hematology Unit and Chair, Azienda Ospedaliera Universitaria di Modena, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Leonardo Potenza
- Hematology Unit and Chair, Azienda Ospedaliera Universitaria di Modena, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Giovanni Caocci
- Department of Medical Sciences and Public Health, Businco Hospital, University of Cagliari, Cagliari, Italy
| | | | - Francesca Fazio
- Hematology, Department of Translational and Precision Medicine, Azienda Ospedaliera Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Claudio Cartoni
- Hematology, Department of Translational and Precision Medicine, Azienda Ospedaliera Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Maria Teresa Petrucci
- Hematology, Department of Translational and Precision Medicine, Azienda Ospedaliera Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Ida Carmosino
- Hematology, Department of Translational and Precision Medicine, Azienda Ospedaliera Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Riccardo Moia
- Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Gloria Margiotta Casaluci
- Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Paola Boggione
- Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Elisabetta Colaci
- Hematology Unit and Chair, Azienda Ospedaliera Universitaria di Modena, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Davide Giusti
- Hematology Unit and Chair, Azienda Ospedaliera Universitaria di Modena, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Valeria Pioli
- Hematology Unit and Chair, Azienda Ospedaliera Universitaria di Modena, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Francesco Sparano
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Rome, Italy
| | - Francesco Cottone
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Rome, Italy
| | | | | | | | - Isabella Capodanno
- Hematology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | | | - Elisabetta Lugli
- Hematology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Edoardo La Sala
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Rome, Italy
| | - Luigi Rigacci
- U.O. di Ematologia e Trapianti di cellule Staminali. A.O.S. S. Camillo-Forlanini, Rome, Italy
| | - Michelina Santopietro
- U.O. di Ematologia e Trapianti di cellule Staminali. A.O.S. S. Camillo-Forlanini, Rome, Italy
| | - Claudio Fozza
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Sergio Siragusa
- Policlinico Paolo Giaccone, Unit of Haematology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo, Palermo, Italy
| | - Massimo Breccia
- Hematology, Department of Translational and Precision Medicine, Azienda Ospedaliera Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Paola Fazi
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Rome, Italy
| | - Marco Vignetti
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Rome, Italy
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18
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Visco C, Marcheselli L, Mina R, Sassone M, Guidetti A, Penna D, Cattaneo C, Bonuomo V, Busca A, Ferreri AJM, Bruna R, Petrucci L, Cairoli R, Salvini M, Bertù L, Ladetto M, Pilerci S, Pinto A, Ramadan S, Marchesi F, Cavo M, Arcaini L, Coviello E, Romano A, Musto P, Massaia M, Fracchiolla N, Marchetti M, Scattolin A, Tisi MC, Cuneo A, Della Porta M, Trentin L, Turrini M, Gherlinzoni F, Tafuri A, Galimberti S, Bocchia M, Cardinali V, Cilloni D, Corso A, Armiento D, Rigacci L, La Barbera EO, Gambacorti-Passerini C, Visani G, Vallisa D, Venditti A, Selleri C, Conconi A, Tosi P, Lanza F, Candoni A, Krampera M, Corradini P, Passamonti F, Merli F. A prognostic model for patients with lymphoma and COVID-19: a multicentre cohort study. Blood Adv 2022; 6:327-338. [PMID: 34644385 PMCID: PMC8516438 DOI: 10.1182/bloodadvances.2021005691] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 09/08/2021] [Indexed: 11/20/2022] Open
Abstract
Lymphoma represents a heterogeneous hematological malignancy (HM), which is characterized by severe immunosuppression. Patients diagnosed of coronavirus disease 2019 (COVID-19) during the course of HM have been described to have poor outcome, with only few reports specifically addressing lymphoma patients. Here, we investigated the clinical behavior and clinical parameters of a large multicenter cohort of adult patients with different lymphoma subtypes, with the aim of identifying predictors of death. The study included 856 patients, of whom 619 were enrolled prospectively in a 1-year frame and were followed-up for a median of 66 days (range 1-395). Patients were managed as outpatient (not-admitted cohort, n = 388) or required hospitalization (n = 468), and median age was 63 years (range 19-94). Overall, the 30- and 100-days mortality was 13% (95% confidence interval (CI), 11% to 15%) and 23% (95% CI, 20% to 27%), respectively. Antilymphoma treatment, including anti-CD20 containing regimens, did not impact survival. Patients with Hodgkin's lymphoma had the more favorable survival, but this was partly related to significantly younger age. The time interval between lymphoma diagnosis and COVID-19 was inversely related to mortality. Multivariable analysis recognized 4 easy-to-use factors (age, gender, lymphocyte, and platelet count) that were associated with risk of death, both in the admitted and in the not-admitted cohort (HR 3.79 and 8.85 for the intermediate- and high-risk group, respectively). Overall, our study shows that patients should not be deprived of the best available treatment of their underlying disease and indicates which patients are at higher risk of death. This study was registered with ClinicalTrials.gov, NCT04352556.
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Affiliation(s)
- Carlo Visco
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | | | - Roberto Mina
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliera Universitaria Citta’della Salute e della Scienza, Turin, Italy
| | - Marianna Sassone
- Lymphoma Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Anna Guidetti
- Hematology and Bone Marrow Transplantation, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, University of Milano, Milano, Italy
| | - Domenico Penna
- Hematology, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Reggio Emilia, Reggio Emilia, Italy
| | - Chiara Cattaneo
- Hematology, Azienda Socio-Sanitaria Territoriale-Spedali Civili, Brescia, Italy
| | - Valentina Bonuomo
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Alessandro Busca
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliera Universitaria Citta’della Salute e della Scienza, Turin, Italy
| | - Andrés José María Ferreri
- Lymphoma Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Riccardo Bruna
- Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont and Ospedale Maggiore della Carità, Novara, Italy
| | - Luigi Petrucci
- Hematology, Department of Translational and Precision Medicine, Sapienza, University of Rome, Rome, Italy
| | - Roberto Cairoli
- Hematology, Azienda Socio-Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Marco Salvini
- Department of Medicine and Surgery, University of Insubria and Azienda Socio-Sanitaria Territoriale Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Lorenza Bertù
- Department of Medicine and Surgery, University of Insubria and Azienda Socio-Sanitaria Territoriale Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Marco Ladetto
- Hematology, Azienda Ospedaliera Santissimi Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Sofia Pilerci
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Antonello Pinto
- Hematology, Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico “Fondazione G Pascale,” Naples, Italy
| | - Safaa Ramadan
- Division of Onco-Hematology, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, Istituto di Ricovero e Cura a Carattere Scientifico Regina Elena National Cancer Institute, Rome, Italy
| | - Michele Cavo
- Seràgnoli Institute of Hematology, Department of Experimental, Diagnostic and Specialty Medicine, Bologna University School of Medicine, Bologna, Italy
| | - Luca Arcaini
- Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo & Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Elisa Coviello
- Hematology and bone marrow transplant, Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genova, Italy
| | - Alessandra Romano
- Hematology, Dipartimento di Chirurgia e Specialità Medico Chirurgiche, Università degli Studi di Catania, Catania, Italy
| | - Pellegrino Musto
- Department of Emergency and Organ Transplantation, Aldo Moro” University School of Medicine and Unit of Hematology and Stem Cell Transplantation, Azienda Ospedaliera Universitaria Consorziale Policlinico, Bari, Italy
| | | | - Nicola Fracchiolla
- Oncoematologia, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milano, Italy
| | - Monia Marchetti
- Hematology, Azienda Ospedaliera Santissimi Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | | | | | - Antonio Cuneo
- Hematology, Azienda Ospedaliero Universitaria Sant’Anna, Ferrara, Italy
| | - Matteo Della Porta
- Humanitas Clinical and Research Hospital Istituto di Ricovero e Cura a Carattere Scientifico and Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Livio Trentin
- Hematology and Clinical Immunology Unit, Department of Medicine, University of Padua, Padua, Italy
| | | | | | - Agostino Tafuri
- Hematology, University Hospital Sant’Andrea, Sapienza, Rome, Italy
| | - Sara Galimberti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Monica Bocchia
- Hematology Unit, University of Siena, Azienda Ospedaliero Universitaria Senese, Siena, Italy
| | | | - Daniela Cilloni
- Department of Clinical and Biological Sciences, University of Turin, San Luigi Hospital, Turin, Italy
| | | | - Daniele Armiento
- Unit of Hematology, Stem Cell Transplantation, University Campus Bio-Medico, Rome, Italy
| | | | - Elettra Ortu La Barbera
- Unità Operativa Complessa Ematologia con Trapianto, Ospedale Santa Maria Goretti, Latina, Italy
| | | | - Giuseppe Visani
- Dipartimento di OncoEmatologia, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
| | | | - Adriano Venditti
- Department of Biomedicine and Prevention, University Tor Vergata Rome, Rome, Italy
| | - Carmine Selleri
- Department of Medicine, Hematology, University of Salerno, Ospedale San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | | | - Patrizia Tosi
- Hematology, Ospedale degli Infermi di Rimini, Rimini, Italy
| | | | - Anna Candoni
- Hematology and Stem Cell Transplant Unit, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Mauro Krampera
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Paolo Corradini
- Hematology and Bone Marrow Transplantation, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, University of Milano, Milano, Italy
| | - Francesco Passamonti
- Department of Medicine and Surgery, University of Insubria and Azienda Socio-Sanitaria Territoriale Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Francesco Merli
- Hematology, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Reggio Emilia, Reggio Emilia, Italy
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Moretti M, Liberati AM, Rigacci L, Puccini B, Pulsoni A, Gini G, Galieni P, Fabbri A, Cantonetti M, Pavone V, Bolis S, Botto B, Renzi D, Falchi L. Brentuximab Vedotin and Bendamustine Produce Long-Term Clinical Benefit in Patients With Relapsed or Refractory Classical Hodgkin Lymphoma: A Multicenter Real-Life Experience. Clin Lymphoma Myeloma Leuk 2021; 22:198-204. [PMID: 34690088 PMCID: PMC9531864 DOI: 10.1016/j.clml.2021.09.018] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 09/24/2021] [Indexed: 12/02/2022]
Abstract
In the real-life setting, the combination of brentuximab vedotin and bendamustine was well tolerated and produced an ORR of 75%, CR 50% and a median PFS of 26 months. A significant proportion of heavily pretreated cHL patients may be cured with this approach.
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Affiliation(s)
| | | | - Luigi Rigacci
- Hematology and Stem Cell Transplant, AziendaOspedalieraSan Camillo Forlanini Roma
| | - Benedetta Puccini
- Hematology Department, Azienda Ospedaliero Universitaria Careggi, Firenze
| | - Alessandro Pulsoni
- Hematology Unit, Department of Translational and Precision Medicine, Sapienza University of Roma
| | - Guido Gini
- HematologyDepartment, Azienda Ospedaliero Universitaria Ospedali Riuniti di Ancona Politecnica delle Marche
| | - Piero Galieni
- Hematology and Cell Therapy Unit, Ospedale C. e G. Mazzoni Ascoli Piceno
| | - Alberto Fabbri
- Hematology Unit, Azienda Ospedaliero Universitaria Senese
| | - Maria Cantonetti
- Onco-Hematology Department, Policlinico Ospedaliero Universitario "Tor Vergata" Roma
| | - Vincenzo Pavone
- Hematology and Bone Marrow Transplant, Azienda Ospedaliera Cardinale G. Panico Tricase
| | - Silvia Bolis
- Hematology Department, Azienda Ospedaliera San Gerardo Monza
| | - Barbara Botto
- Hematology Department, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza Torino
| | - Daniela Renzi
- Hematology and Stem Cell Transplantation Unit, IRCCS Istituto Nazionale Tumori Regina Elena Roma
| | - Lorenzo Falchi
- Lymphoma service, Memorial Sloan Kettering Cancer Center, New York.
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20
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Canale ML, Turazza F, Lestuzzi C, Parrini I, Camerini A, Russo G, Colivicchi F, Gabrielli D, Gulizia MM, Oliva S, Tarantini L, Maurea N, Rigacci L, Petrolati S, Casolo G, Bisceglia I. Portrait of Italian Cardio-Oncology: Results of a Nationwide Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) Survey. Front Cardiovasc Med 2021; 8:677544. [PMID: 34222373 PMCID: PMC8242580 DOI: 10.3389/fcvm.2021.677544] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 04/26/2021] [Indexed: 11/13/2022] Open
Abstract
Aims: Cardio-oncology has achieved a pivotal role in science, but real world data on its clinical impact are still limited. Methods: A questionnaire was sent out to all cardio-oncology services across Italy (n = 120). The questionnaire was made up of 28 questions divided into four blocks: (A) general information on hospitals and service, (B) the inner organization of cardio-oncology and its relationships with out-of-hospital cardiologists and general practitioners, (C) educational needs and referral guidelines, and (D) activities/specific workload. Results: Ninety-six out of 120 (80%) completed the questionnaire; 9.4% were cancer centers while 90.6% were general hospitals. A cardio-oncology team was present in 56% of the cancer centers and in 20% only of general hospitals, and a cardio-oncology pathway was active in 55% of cancer centers and in just 14% of the general hospitals. Relationships with out-of-hospital cardiologists and general practitioners were lacking. The guidelines of reference were ESC and ANMCO/AIOM. Patients receiving anthracycline chemotherapy underwent scheduled monitoring by means of echocardiography in 58% of cases. Routine use of cardiac damage biomarkers was overall low, ranging from 22 to 33% while the use of global longitudinal strain reached 44%. Conclusions: Italian cardio-oncology showed a growing influence on clinical practice but still has room for improvement. Cardio-oncology teams are still scarce, and the application of dedicated paths is poor. The need for specific training has been highlighted.
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Affiliation(s)
- Maria Laura Canale
- Division of Cardiology, Azienda USL Toscana Nord-Ovest, Versilia Hospital, Lido di Camaiore, Italy
| | - Fabio Turazza
- Cardiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Chiara Lestuzzi
- Cardiology Unit, Oncology Department, CRO National Cancer Institute, Aviano, Italy
| | - Iris Parrini
- Divisione di Cardiologia, Ospedale Mauriziano, Turin, Italy
| | - Andrea Camerini
- Medical Oncology, Azienda USL Toscana Nord-Ovest, Versilia Hospital, Lido di Camaiore, Italy
| | - Giulia Russo
- SC Centro Cardiovascolare Ospedale Maggiore, Trieste, Italy
| | - Furio Colivicchi
- Division of Cardiology, San Filippo Neri Hospital, ASL Roma 1, Rome, Italy
| | - Domenico Gabrielli
- Division of Cardiology, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy
| | | | - Stefano Oliva
- Division of Cardiology, Istituto Tumori Giovanni Paolo II, Bari, Italy
| | - Luigi Tarantini
- Divisione di Cardiologia, Arcispedale S. Maria Nuova, Reggio-Emilia, Italy
| | - Nicola Maurea
- S.C. Cardiologia, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Napoli, Italy
| | - Luigi Rigacci
- UOC Ematologia, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy
| | - Sandro Petrolati
- Servizi Cardiologici Integrati, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy
| | - Giancarlo Casolo
- Division of Cardiology, Azienda USL Toscana Nord-Ovest, Versilia Hospital, Lido di Camaiore, Italy
| | - Irma Bisceglia
- Servizi Cardiologici Integrati, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy
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21
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Merli F, Tucci A, Arcari A, Rigacci L, Cavallo F, Cabras G, Alvarez I, Fabbri A, Re A, Ferrero S, Puccini B, Usai SV, Ferrari A, Cencini E, Pennese E, Zilioli VR, Marino D, Balzarotti M, Cox MC, Zanni M, Rocco A, Lleshi A, Botto B, Hohaus S, Merli M, Sartori R, Gini G, Nassi L, Musuraca G, Tani M, Bottelli C, Kovalchuk S, Re F, Flenghi L, Molinari A, Tarantini G, Chimienti E, Marcheselli L, Mammi C, Luminari S, Spina M. THE ELDERLY PROGNOSTIC INDEX (EPI) PREDICTS EARLY MORTALITY IN OLDER PATIENTS WITH DLBCL. A SUBSTUDY OF THE ELDERLY PROJECT BY THE FONDAZIONE ITALIANA LINFOMI (FIL). Hematol Oncol 2021. [DOI: 10.1002/hon.85_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Pellicelli A, Giannelli V, Zoli V, Regine G, Cortese A, Ettorre GM, Carmenini E, Pellicelli V, Rigacci L. Resolution of primary hepatic marginal zone lymphoma in a hepatitis C virus-infected patient treated with a direct-acting antiviral. Oxf Med Case Reports 2021; 2021:omab022. [PMID: 34055359 PMCID: PMC8143661 DOI: 10.1093/omcr/omab022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 02/05/2021] [Accepted: 02/18/2021] [Indexed: 11/24/2022] Open
Abstract
The favorable impact of antiviral therapy on low-grade hepatitis C virus (HCV)-related non-Hodgkin lymphoma manifesting as marginal zone lymphoma (MZL) has been reported in some clinical studies. However, primary HCV-related marginal zone lymphomas (MZLs) confined to the liver have not been described in the literature nor have the resolution of liver lymphoma through anti-HCV eradication treatment. The authors report a genotype 1b HCV-positive patient with chronic hepatitis who exhibited lesions involving both hepatic lobes resembling hepatocellular carcinoma. Liver biopsy revealed an MZL of the liver. Antiviral treatment using sofosbuvir associated with simeprevir as unique treatment was started and resulted in complete haematological response. In HCV-related MZL isolated to the liver, antiviral treatment has led to the eradication of viral infection and a complete haematological response. Antiviral therapy should be considered as a first-line treatment for HCV-related primary MZLs of the liver.
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Affiliation(s)
- Adriano Pellicelli
- Liver Unit, Department of Liver Transplant, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
| | - Valerio Giannelli
- Liver Unit, Department of Liver Transplant, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
| | - Valerio Zoli
- Hematology Unit, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
| | - Giovanni Regine
- Department of Radiology, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
| | - Andrea Cortese
- Department of Radiology, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
| | - Giuseppe M Ettorre
- Division of General Surgery and Liver Transplantation, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
| | - Enrico Carmenini
- Liver Unit, Department of Liver Transplant, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
| | - Valeria Pellicelli
- Internal Medicine, Azienda Ospedaliera Sant'Andrea Università degli Studi "La Sapienza", Rome, Italy
| | - Luigi Rigacci
- Hematology Unit, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
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23
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Tiacci E, De Carolis L, Simonetti E, Capponi M, Ambrosetti A, Lucia E, Antolino A, Pulsoni A, Ferrari S, Zinzani PL, Ascani S, Perriello VM, Rigacci L, Gaidano G, Della Seta R, Frattarelli N, Falcucci P, Foà R, Visani G, Zaja F, Falini B. Vemurafenib plus Rituximab in Refractory or Relapsed Hairy-Cell Leukemia. N Engl J Med 2021; 384:1810-1823. [PMID: 33979489 DOI: 10.1056/nejmoa2031298] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Hairy-cell leukemia (HCL) is a CD20+ indolent B-cell cancer in which a BRAF V600E kinase-activating mutation plays a pathogenetic role. In clinical trials involving patients with refractory or relapsed HCL, the targeting of BRAF V600E with the oral BRAF inhibitor vemurafenib led to a response in 91% of the patients; 35% of the patients had a complete response. However, the median relapse-free survival was only 9 months after treatment was stopped. METHODS In a phase 2, single-center, academic trial involving patients with refractory or relapsed HCL, we assessed the safety and efficacy of vemurafenib (960 mg, administered twice daily for 8 weeks) plus concurrent and sequential rituximab (375 mg per square meter of body-surface area, administered for 8 doses over a period of 18 weeks). The primary end point was a complete response at the end of planned treatment. RESULTS Among the 30 enrolled patients with HCL, the median number of previous therapies was 3. A complete response was observed in 26 patients (87%) in the intention-to-treat population. All the patients who had HCL that had been refractory to chemotherapy (10 patients) or rituximab (5) and all those who had previously been treated with BRAF inhibitors (7) had a complete response. Thrombocytopenia resolved after a median of 2 weeks, and neutropenia after a median of 4 weeks. Of the 26 patients with a complete response, 17 (65%) were cleared of minimal residual disease (MRD). Progression-free survival among all 30 patients was 78% at a median follow-up of 37 months; relapse-free survival among the 26 patients with a response was 85% at a median follow-up of 34 months. In post hoc analyses, MRD negativity and no previous BRAF inhibitor treatment correlated with longer relapse-free survival. Toxic effects, mostly of grade 1 or 2, were those that had previously been noted for these agents. CONCLUSIONS In this small study, a short, chemotherapy-free, nonmyelotoxic regimen of vemurafenib plus rituximab was associated with a durable complete response in most patients with refractory or relapsed HCL. (Funded by the European Research Council and others; HCL-PG03 EudraCT number, 2014-003046-27.).
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Affiliation(s)
- Enrico Tiacci
- From the Institute of Hematology, Ospedale S. Maria della Misericordia, and the Department of Medicine, University of Perugia, Perugia (E.T., L.D.C., E.S., M.C., S.A., V.M.P., B.F.), the Department of Medicine, Section of Hematology, University of Verona, Verona (A. Ambrosetti), the Hematology Unit, Ospedale di Cosenza, Cosenza (E.L.), the Hematology Unit, Department of Transfusional Medicine-SIMMT, Maria Paternò-Arezzo Hospital, Ragusa (A. Antolino), the Hematology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome (A.P., R.F.), and the Hematology and Stem Cell Transplant Unit, A.O. San Camillo Forlanini (L.R.), Rome, the Department of Hematology, Spedali Civili di Brescia, Brescia (S.F.), IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli" and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), the Department of Translational Medicine, Division of Hematology, Amedeo Avogadro University of Eastern Piedmont, Novara (G.G.), the Hematology Unit, Ospedale di Carrara, Carrara (R.D.S.), the Hematology Unit, Ospedale di Frosinone, Frosinone (N.F.), the Hematology Unit, Ospedale di Ronciglione, Viterbo (P.F.), the Hematology Unit, Ospedale di Pesaro, Pesaro (G.V.), and the Hematology Unit, Azienda Sanitaria Universitaria Integrata-Ospedale Maggiore, Trieste (F.Z.) - all in Italy
| | - Luca De Carolis
- From the Institute of Hematology, Ospedale S. Maria della Misericordia, and the Department of Medicine, University of Perugia, Perugia (E.T., L.D.C., E.S., M.C., S.A., V.M.P., B.F.), the Department of Medicine, Section of Hematology, University of Verona, Verona (A. Ambrosetti), the Hematology Unit, Ospedale di Cosenza, Cosenza (E.L.), the Hematology Unit, Department of Transfusional Medicine-SIMMT, Maria Paternò-Arezzo Hospital, Ragusa (A. Antolino), the Hematology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome (A.P., R.F.), and the Hematology and Stem Cell Transplant Unit, A.O. San Camillo Forlanini (L.R.), Rome, the Department of Hematology, Spedali Civili di Brescia, Brescia (S.F.), IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli" and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), the Department of Translational Medicine, Division of Hematology, Amedeo Avogadro University of Eastern Piedmont, Novara (G.G.), the Hematology Unit, Ospedale di Carrara, Carrara (R.D.S.), the Hematology Unit, Ospedale di Frosinone, Frosinone (N.F.), the Hematology Unit, Ospedale di Ronciglione, Viterbo (P.F.), the Hematology Unit, Ospedale di Pesaro, Pesaro (G.V.), and the Hematology Unit, Azienda Sanitaria Universitaria Integrata-Ospedale Maggiore, Trieste (F.Z.) - all in Italy
| | - Edoardo Simonetti
- From the Institute of Hematology, Ospedale S. Maria della Misericordia, and the Department of Medicine, University of Perugia, Perugia (E.T., L.D.C., E.S., M.C., S.A., V.M.P., B.F.), the Department of Medicine, Section of Hematology, University of Verona, Verona (A. Ambrosetti), the Hematology Unit, Ospedale di Cosenza, Cosenza (E.L.), the Hematology Unit, Department of Transfusional Medicine-SIMMT, Maria Paternò-Arezzo Hospital, Ragusa (A. Antolino), the Hematology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome (A.P., R.F.), and the Hematology and Stem Cell Transplant Unit, A.O. San Camillo Forlanini (L.R.), Rome, the Department of Hematology, Spedali Civili di Brescia, Brescia (S.F.), IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli" and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), the Department of Translational Medicine, Division of Hematology, Amedeo Avogadro University of Eastern Piedmont, Novara (G.G.), the Hematology Unit, Ospedale di Carrara, Carrara (R.D.S.), the Hematology Unit, Ospedale di Frosinone, Frosinone (N.F.), the Hematology Unit, Ospedale di Ronciglione, Viterbo (P.F.), the Hematology Unit, Ospedale di Pesaro, Pesaro (G.V.), and the Hematology Unit, Azienda Sanitaria Universitaria Integrata-Ospedale Maggiore, Trieste (F.Z.) - all in Italy
| | - Monia Capponi
- From the Institute of Hematology, Ospedale S. Maria della Misericordia, and the Department of Medicine, University of Perugia, Perugia (E.T., L.D.C., E.S., M.C., S.A., V.M.P., B.F.), the Department of Medicine, Section of Hematology, University of Verona, Verona (A. Ambrosetti), the Hematology Unit, Ospedale di Cosenza, Cosenza (E.L.), the Hematology Unit, Department of Transfusional Medicine-SIMMT, Maria Paternò-Arezzo Hospital, Ragusa (A. Antolino), the Hematology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome (A.P., R.F.), and the Hematology and Stem Cell Transplant Unit, A.O. San Camillo Forlanini (L.R.), Rome, the Department of Hematology, Spedali Civili di Brescia, Brescia (S.F.), IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli" and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), the Department of Translational Medicine, Division of Hematology, Amedeo Avogadro University of Eastern Piedmont, Novara (G.G.), the Hematology Unit, Ospedale di Carrara, Carrara (R.D.S.), the Hematology Unit, Ospedale di Frosinone, Frosinone (N.F.), the Hematology Unit, Ospedale di Ronciglione, Viterbo (P.F.), the Hematology Unit, Ospedale di Pesaro, Pesaro (G.V.), and the Hematology Unit, Azienda Sanitaria Universitaria Integrata-Ospedale Maggiore, Trieste (F.Z.) - all in Italy
| | - Achille Ambrosetti
- From the Institute of Hematology, Ospedale S. Maria della Misericordia, and the Department of Medicine, University of Perugia, Perugia (E.T., L.D.C., E.S., M.C., S.A., V.M.P., B.F.), the Department of Medicine, Section of Hematology, University of Verona, Verona (A. Ambrosetti), the Hematology Unit, Ospedale di Cosenza, Cosenza (E.L.), the Hematology Unit, Department of Transfusional Medicine-SIMMT, Maria Paternò-Arezzo Hospital, Ragusa (A. Antolino), the Hematology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome (A.P., R.F.), and the Hematology and Stem Cell Transplant Unit, A.O. San Camillo Forlanini (L.R.), Rome, the Department of Hematology, Spedali Civili di Brescia, Brescia (S.F.), IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli" and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), the Department of Translational Medicine, Division of Hematology, Amedeo Avogadro University of Eastern Piedmont, Novara (G.G.), the Hematology Unit, Ospedale di Carrara, Carrara (R.D.S.), the Hematology Unit, Ospedale di Frosinone, Frosinone (N.F.), the Hematology Unit, Ospedale di Ronciglione, Viterbo (P.F.), the Hematology Unit, Ospedale di Pesaro, Pesaro (G.V.), and the Hematology Unit, Azienda Sanitaria Universitaria Integrata-Ospedale Maggiore, Trieste (F.Z.) - all in Italy
| | - Eugenio Lucia
- From the Institute of Hematology, Ospedale S. Maria della Misericordia, and the Department of Medicine, University of Perugia, Perugia (E.T., L.D.C., E.S., M.C., S.A., V.M.P., B.F.), the Department of Medicine, Section of Hematology, University of Verona, Verona (A. Ambrosetti), the Hematology Unit, Ospedale di Cosenza, Cosenza (E.L.), the Hematology Unit, Department of Transfusional Medicine-SIMMT, Maria Paternò-Arezzo Hospital, Ragusa (A. Antolino), the Hematology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome (A.P., R.F.), and the Hematology and Stem Cell Transplant Unit, A.O. San Camillo Forlanini (L.R.), Rome, the Department of Hematology, Spedali Civili di Brescia, Brescia (S.F.), IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli" and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), the Department of Translational Medicine, Division of Hematology, Amedeo Avogadro University of Eastern Piedmont, Novara (G.G.), the Hematology Unit, Ospedale di Carrara, Carrara (R.D.S.), the Hematology Unit, Ospedale di Frosinone, Frosinone (N.F.), the Hematology Unit, Ospedale di Ronciglione, Viterbo (P.F.), the Hematology Unit, Ospedale di Pesaro, Pesaro (G.V.), and the Hematology Unit, Azienda Sanitaria Universitaria Integrata-Ospedale Maggiore, Trieste (F.Z.) - all in Italy
| | - Agostino Antolino
- From the Institute of Hematology, Ospedale S. Maria della Misericordia, and the Department of Medicine, University of Perugia, Perugia (E.T., L.D.C., E.S., M.C., S.A., V.M.P., B.F.), the Department of Medicine, Section of Hematology, University of Verona, Verona (A. Ambrosetti), the Hematology Unit, Ospedale di Cosenza, Cosenza (E.L.), the Hematology Unit, Department of Transfusional Medicine-SIMMT, Maria Paternò-Arezzo Hospital, Ragusa (A. Antolino), the Hematology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome (A.P., R.F.), and the Hematology and Stem Cell Transplant Unit, A.O. San Camillo Forlanini (L.R.), Rome, the Department of Hematology, Spedali Civili di Brescia, Brescia (S.F.), IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli" and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), the Department of Translational Medicine, Division of Hematology, Amedeo Avogadro University of Eastern Piedmont, Novara (G.G.), the Hematology Unit, Ospedale di Carrara, Carrara (R.D.S.), the Hematology Unit, Ospedale di Frosinone, Frosinone (N.F.), the Hematology Unit, Ospedale di Ronciglione, Viterbo (P.F.), the Hematology Unit, Ospedale di Pesaro, Pesaro (G.V.), and the Hematology Unit, Azienda Sanitaria Universitaria Integrata-Ospedale Maggiore, Trieste (F.Z.) - all in Italy
| | - Alessandro Pulsoni
- From the Institute of Hematology, Ospedale S. Maria della Misericordia, and the Department of Medicine, University of Perugia, Perugia (E.T., L.D.C., E.S., M.C., S.A., V.M.P., B.F.), the Department of Medicine, Section of Hematology, University of Verona, Verona (A. Ambrosetti), the Hematology Unit, Ospedale di Cosenza, Cosenza (E.L.), the Hematology Unit, Department of Transfusional Medicine-SIMMT, Maria Paternò-Arezzo Hospital, Ragusa (A. Antolino), the Hematology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome (A.P., R.F.), and the Hematology and Stem Cell Transplant Unit, A.O. San Camillo Forlanini (L.R.), Rome, the Department of Hematology, Spedali Civili di Brescia, Brescia (S.F.), IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli" and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), the Department of Translational Medicine, Division of Hematology, Amedeo Avogadro University of Eastern Piedmont, Novara (G.G.), the Hematology Unit, Ospedale di Carrara, Carrara (R.D.S.), the Hematology Unit, Ospedale di Frosinone, Frosinone (N.F.), the Hematology Unit, Ospedale di Ronciglione, Viterbo (P.F.), the Hematology Unit, Ospedale di Pesaro, Pesaro (G.V.), and the Hematology Unit, Azienda Sanitaria Universitaria Integrata-Ospedale Maggiore, Trieste (F.Z.) - all in Italy
| | - Samantha Ferrari
- From the Institute of Hematology, Ospedale S. Maria della Misericordia, and the Department of Medicine, University of Perugia, Perugia (E.T., L.D.C., E.S., M.C., S.A., V.M.P., B.F.), the Department of Medicine, Section of Hematology, University of Verona, Verona (A. Ambrosetti), the Hematology Unit, Ospedale di Cosenza, Cosenza (E.L.), the Hematology Unit, Department of Transfusional Medicine-SIMMT, Maria Paternò-Arezzo Hospital, Ragusa (A. Antolino), the Hematology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome (A.P., R.F.), and the Hematology and Stem Cell Transplant Unit, A.O. San Camillo Forlanini (L.R.), Rome, the Department of Hematology, Spedali Civili di Brescia, Brescia (S.F.), IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli" and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), the Department of Translational Medicine, Division of Hematology, Amedeo Avogadro University of Eastern Piedmont, Novara (G.G.), the Hematology Unit, Ospedale di Carrara, Carrara (R.D.S.), the Hematology Unit, Ospedale di Frosinone, Frosinone (N.F.), the Hematology Unit, Ospedale di Ronciglione, Viterbo (P.F.), the Hematology Unit, Ospedale di Pesaro, Pesaro (G.V.), and the Hematology Unit, Azienda Sanitaria Universitaria Integrata-Ospedale Maggiore, Trieste (F.Z.) - all in Italy
| | - Pier L Zinzani
- From the Institute of Hematology, Ospedale S. Maria della Misericordia, and the Department of Medicine, University of Perugia, Perugia (E.T., L.D.C., E.S., M.C., S.A., V.M.P., B.F.), the Department of Medicine, Section of Hematology, University of Verona, Verona (A. Ambrosetti), the Hematology Unit, Ospedale di Cosenza, Cosenza (E.L.), the Hematology Unit, Department of Transfusional Medicine-SIMMT, Maria Paternò-Arezzo Hospital, Ragusa (A. Antolino), the Hematology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome (A.P., R.F.), and the Hematology and Stem Cell Transplant Unit, A.O. San Camillo Forlanini (L.R.), Rome, the Department of Hematology, Spedali Civili di Brescia, Brescia (S.F.), IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli" and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), the Department of Translational Medicine, Division of Hematology, Amedeo Avogadro University of Eastern Piedmont, Novara (G.G.), the Hematology Unit, Ospedale di Carrara, Carrara (R.D.S.), the Hematology Unit, Ospedale di Frosinone, Frosinone (N.F.), the Hematology Unit, Ospedale di Ronciglione, Viterbo (P.F.), the Hematology Unit, Ospedale di Pesaro, Pesaro (G.V.), and the Hematology Unit, Azienda Sanitaria Universitaria Integrata-Ospedale Maggiore, Trieste (F.Z.) - all in Italy
| | - Stefano Ascani
- From the Institute of Hematology, Ospedale S. Maria della Misericordia, and the Department of Medicine, University of Perugia, Perugia (E.T., L.D.C., E.S., M.C., S.A., V.M.P., B.F.), the Department of Medicine, Section of Hematology, University of Verona, Verona (A. Ambrosetti), the Hematology Unit, Ospedale di Cosenza, Cosenza (E.L.), the Hematology Unit, Department of Transfusional Medicine-SIMMT, Maria Paternò-Arezzo Hospital, Ragusa (A. Antolino), the Hematology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome (A.P., R.F.), and the Hematology and Stem Cell Transplant Unit, A.O. San Camillo Forlanini (L.R.), Rome, the Department of Hematology, Spedali Civili di Brescia, Brescia (S.F.), IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli" and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), the Department of Translational Medicine, Division of Hematology, Amedeo Avogadro University of Eastern Piedmont, Novara (G.G.), the Hematology Unit, Ospedale di Carrara, Carrara (R.D.S.), the Hematology Unit, Ospedale di Frosinone, Frosinone (N.F.), the Hematology Unit, Ospedale di Ronciglione, Viterbo (P.F.), the Hematology Unit, Ospedale di Pesaro, Pesaro (G.V.), and the Hematology Unit, Azienda Sanitaria Universitaria Integrata-Ospedale Maggiore, Trieste (F.Z.) - all in Italy
| | - Vincenzo M Perriello
- From the Institute of Hematology, Ospedale S. Maria della Misericordia, and the Department of Medicine, University of Perugia, Perugia (E.T., L.D.C., E.S., M.C., S.A., V.M.P., B.F.), the Department of Medicine, Section of Hematology, University of Verona, Verona (A. Ambrosetti), the Hematology Unit, Ospedale di Cosenza, Cosenza (E.L.), the Hematology Unit, Department of Transfusional Medicine-SIMMT, Maria Paternò-Arezzo Hospital, Ragusa (A. Antolino), the Hematology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome (A.P., R.F.), and the Hematology and Stem Cell Transplant Unit, A.O. San Camillo Forlanini (L.R.), Rome, the Department of Hematology, Spedali Civili di Brescia, Brescia (S.F.), IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli" and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), the Department of Translational Medicine, Division of Hematology, Amedeo Avogadro University of Eastern Piedmont, Novara (G.G.), the Hematology Unit, Ospedale di Carrara, Carrara (R.D.S.), the Hematology Unit, Ospedale di Frosinone, Frosinone (N.F.), the Hematology Unit, Ospedale di Ronciglione, Viterbo (P.F.), the Hematology Unit, Ospedale di Pesaro, Pesaro (G.V.), and the Hematology Unit, Azienda Sanitaria Universitaria Integrata-Ospedale Maggiore, Trieste (F.Z.) - all in Italy
| | - Luigi Rigacci
- From the Institute of Hematology, Ospedale S. Maria della Misericordia, and the Department of Medicine, University of Perugia, Perugia (E.T., L.D.C., E.S., M.C., S.A., V.M.P., B.F.), the Department of Medicine, Section of Hematology, University of Verona, Verona (A. Ambrosetti), the Hematology Unit, Ospedale di Cosenza, Cosenza (E.L.), the Hematology Unit, Department of Transfusional Medicine-SIMMT, Maria Paternò-Arezzo Hospital, Ragusa (A. Antolino), the Hematology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome (A.P., R.F.), and the Hematology and Stem Cell Transplant Unit, A.O. San Camillo Forlanini (L.R.), Rome, the Department of Hematology, Spedali Civili di Brescia, Brescia (S.F.), IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli" and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), the Department of Translational Medicine, Division of Hematology, Amedeo Avogadro University of Eastern Piedmont, Novara (G.G.), the Hematology Unit, Ospedale di Carrara, Carrara (R.D.S.), the Hematology Unit, Ospedale di Frosinone, Frosinone (N.F.), the Hematology Unit, Ospedale di Ronciglione, Viterbo (P.F.), the Hematology Unit, Ospedale di Pesaro, Pesaro (G.V.), and the Hematology Unit, Azienda Sanitaria Universitaria Integrata-Ospedale Maggiore, Trieste (F.Z.) - all in Italy
| | - Gianluca Gaidano
- From the Institute of Hematology, Ospedale S. Maria della Misericordia, and the Department of Medicine, University of Perugia, Perugia (E.T., L.D.C., E.S., M.C., S.A., V.M.P., B.F.), the Department of Medicine, Section of Hematology, University of Verona, Verona (A. Ambrosetti), the Hematology Unit, Ospedale di Cosenza, Cosenza (E.L.), the Hematology Unit, Department of Transfusional Medicine-SIMMT, Maria Paternò-Arezzo Hospital, Ragusa (A. Antolino), the Hematology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome (A.P., R.F.), and the Hematology and Stem Cell Transplant Unit, A.O. San Camillo Forlanini (L.R.), Rome, the Department of Hematology, Spedali Civili di Brescia, Brescia (S.F.), IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli" and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), the Department of Translational Medicine, Division of Hematology, Amedeo Avogadro University of Eastern Piedmont, Novara (G.G.), the Hematology Unit, Ospedale di Carrara, Carrara (R.D.S.), the Hematology Unit, Ospedale di Frosinone, Frosinone (N.F.), the Hematology Unit, Ospedale di Ronciglione, Viterbo (P.F.), the Hematology Unit, Ospedale di Pesaro, Pesaro (G.V.), and the Hematology Unit, Azienda Sanitaria Universitaria Integrata-Ospedale Maggiore, Trieste (F.Z.) - all in Italy
| | - Roberta Della Seta
- From the Institute of Hematology, Ospedale S. Maria della Misericordia, and the Department of Medicine, University of Perugia, Perugia (E.T., L.D.C., E.S., M.C., S.A., V.M.P., B.F.), the Department of Medicine, Section of Hematology, University of Verona, Verona (A. Ambrosetti), the Hematology Unit, Ospedale di Cosenza, Cosenza (E.L.), the Hematology Unit, Department of Transfusional Medicine-SIMMT, Maria Paternò-Arezzo Hospital, Ragusa (A. Antolino), the Hematology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome (A.P., R.F.), and the Hematology and Stem Cell Transplant Unit, A.O. San Camillo Forlanini (L.R.), Rome, the Department of Hematology, Spedali Civili di Brescia, Brescia (S.F.), IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli" and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), the Department of Translational Medicine, Division of Hematology, Amedeo Avogadro University of Eastern Piedmont, Novara (G.G.), the Hematology Unit, Ospedale di Carrara, Carrara (R.D.S.), the Hematology Unit, Ospedale di Frosinone, Frosinone (N.F.), the Hematology Unit, Ospedale di Ronciglione, Viterbo (P.F.), the Hematology Unit, Ospedale di Pesaro, Pesaro (G.V.), and the Hematology Unit, Azienda Sanitaria Universitaria Integrata-Ospedale Maggiore, Trieste (F.Z.) - all in Italy
| | - Natalia Frattarelli
- From the Institute of Hematology, Ospedale S. Maria della Misericordia, and the Department of Medicine, University of Perugia, Perugia (E.T., L.D.C., E.S., M.C., S.A., V.M.P., B.F.), the Department of Medicine, Section of Hematology, University of Verona, Verona (A. Ambrosetti), the Hematology Unit, Ospedale di Cosenza, Cosenza (E.L.), the Hematology Unit, Department of Transfusional Medicine-SIMMT, Maria Paternò-Arezzo Hospital, Ragusa (A. Antolino), the Hematology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome (A.P., R.F.), and the Hematology and Stem Cell Transplant Unit, A.O. San Camillo Forlanini (L.R.), Rome, the Department of Hematology, Spedali Civili di Brescia, Brescia (S.F.), IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli" and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), the Department of Translational Medicine, Division of Hematology, Amedeo Avogadro University of Eastern Piedmont, Novara (G.G.), the Hematology Unit, Ospedale di Carrara, Carrara (R.D.S.), the Hematology Unit, Ospedale di Frosinone, Frosinone (N.F.), the Hematology Unit, Ospedale di Ronciglione, Viterbo (P.F.), the Hematology Unit, Ospedale di Pesaro, Pesaro (G.V.), and the Hematology Unit, Azienda Sanitaria Universitaria Integrata-Ospedale Maggiore, Trieste (F.Z.) - all in Italy
| | - Paolo Falcucci
- From the Institute of Hematology, Ospedale S. Maria della Misericordia, and the Department of Medicine, University of Perugia, Perugia (E.T., L.D.C., E.S., M.C., S.A., V.M.P., B.F.), the Department of Medicine, Section of Hematology, University of Verona, Verona (A. Ambrosetti), the Hematology Unit, Ospedale di Cosenza, Cosenza (E.L.), the Hematology Unit, Department of Transfusional Medicine-SIMMT, Maria Paternò-Arezzo Hospital, Ragusa (A. Antolino), the Hematology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome (A.P., R.F.), and the Hematology and Stem Cell Transplant Unit, A.O. San Camillo Forlanini (L.R.), Rome, the Department of Hematology, Spedali Civili di Brescia, Brescia (S.F.), IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli" and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), the Department of Translational Medicine, Division of Hematology, Amedeo Avogadro University of Eastern Piedmont, Novara (G.G.), the Hematology Unit, Ospedale di Carrara, Carrara (R.D.S.), the Hematology Unit, Ospedale di Frosinone, Frosinone (N.F.), the Hematology Unit, Ospedale di Ronciglione, Viterbo (P.F.), the Hematology Unit, Ospedale di Pesaro, Pesaro (G.V.), and the Hematology Unit, Azienda Sanitaria Universitaria Integrata-Ospedale Maggiore, Trieste (F.Z.) - all in Italy
| | - Robin Foà
- From the Institute of Hematology, Ospedale S. Maria della Misericordia, and the Department of Medicine, University of Perugia, Perugia (E.T., L.D.C., E.S., M.C., S.A., V.M.P., B.F.), the Department of Medicine, Section of Hematology, University of Verona, Verona (A. Ambrosetti), the Hematology Unit, Ospedale di Cosenza, Cosenza (E.L.), the Hematology Unit, Department of Transfusional Medicine-SIMMT, Maria Paternò-Arezzo Hospital, Ragusa (A. Antolino), the Hematology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome (A.P., R.F.), and the Hematology and Stem Cell Transplant Unit, A.O. San Camillo Forlanini (L.R.), Rome, the Department of Hematology, Spedali Civili di Brescia, Brescia (S.F.), IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli" and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), the Department of Translational Medicine, Division of Hematology, Amedeo Avogadro University of Eastern Piedmont, Novara (G.G.), the Hematology Unit, Ospedale di Carrara, Carrara (R.D.S.), the Hematology Unit, Ospedale di Frosinone, Frosinone (N.F.), the Hematology Unit, Ospedale di Ronciglione, Viterbo (P.F.), the Hematology Unit, Ospedale di Pesaro, Pesaro (G.V.), and the Hematology Unit, Azienda Sanitaria Universitaria Integrata-Ospedale Maggiore, Trieste (F.Z.) - all in Italy
| | - Giuseppe Visani
- From the Institute of Hematology, Ospedale S. Maria della Misericordia, and the Department of Medicine, University of Perugia, Perugia (E.T., L.D.C., E.S., M.C., S.A., V.M.P., B.F.), the Department of Medicine, Section of Hematology, University of Verona, Verona (A. Ambrosetti), the Hematology Unit, Ospedale di Cosenza, Cosenza (E.L.), the Hematology Unit, Department of Transfusional Medicine-SIMMT, Maria Paternò-Arezzo Hospital, Ragusa (A. Antolino), the Hematology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome (A.P., R.F.), and the Hematology and Stem Cell Transplant Unit, A.O. San Camillo Forlanini (L.R.), Rome, the Department of Hematology, Spedali Civili di Brescia, Brescia (S.F.), IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli" and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), the Department of Translational Medicine, Division of Hematology, Amedeo Avogadro University of Eastern Piedmont, Novara (G.G.), the Hematology Unit, Ospedale di Carrara, Carrara (R.D.S.), the Hematology Unit, Ospedale di Frosinone, Frosinone (N.F.), the Hematology Unit, Ospedale di Ronciglione, Viterbo (P.F.), the Hematology Unit, Ospedale di Pesaro, Pesaro (G.V.), and the Hematology Unit, Azienda Sanitaria Universitaria Integrata-Ospedale Maggiore, Trieste (F.Z.) - all in Italy
| | - Francesco Zaja
- From the Institute of Hematology, Ospedale S. Maria della Misericordia, and the Department of Medicine, University of Perugia, Perugia (E.T., L.D.C., E.S., M.C., S.A., V.M.P., B.F.), the Department of Medicine, Section of Hematology, University of Verona, Verona (A. Ambrosetti), the Hematology Unit, Ospedale di Cosenza, Cosenza (E.L.), the Hematology Unit, Department of Transfusional Medicine-SIMMT, Maria Paternò-Arezzo Hospital, Ragusa (A. Antolino), the Hematology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome (A.P., R.F.), and the Hematology and Stem Cell Transplant Unit, A.O. San Camillo Forlanini (L.R.), Rome, the Department of Hematology, Spedali Civili di Brescia, Brescia (S.F.), IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli" and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), the Department of Translational Medicine, Division of Hematology, Amedeo Avogadro University of Eastern Piedmont, Novara (G.G.), the Hematology Unit, Ospedale di Carrara, Carrara (R.D.S.), the Hematology Unit, Ospedale di Frosinone, Frosinone (N.F.), the Hematology Unit, Ospedale di Ronciglione, Viterbo (P.F.), the Hematology Unit, Ospedale di Pesaro, Pesaro (G.V.), and the Hematology Unit, Azienda Sanitaria Universitaria Integrata-Ospedale Maggiore, Trieste (F.Z.) - all in Italy
| | - Brunangelo Falini
- From the Institute of Hematology, Ospedale S. Maria della Misericordia, and the Department of Medicine, University of Perugia, Perugia (E.T., L.D.C., E.S., M.C., S.A., V.M.P., B.F.), the Department of Medicine, Section of Hematology, University of Verona, Verona (A. Ambrosetti), the Hematology Unit, Ospedale di Cosenza, Cosenza (E.L.), the Hematology Unit, Department of Transfusional Medicine-SIMMT, Maria Paternò-Arezzo Hospital, Ragusa (A. Antolino), the Hematology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome (A.P., R.F.), and the Hematology and Stem Cell Transplant Unit, A.O. San Camillo Forlanini (L.R.), Rome, the Department of Hematology, Spedali Civili di Brescia, Brescia (S.F.), IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli" and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), the Department of Translational Medicine, Division of Hematology, Amedeo Avogadro University of Eastern Piedmont, Novara (G.G.), the Hematology Unit, Ospedale di Carrara, Carrara (R.D.S.), the Hematology Unit, Ospedale di Frosinone, Frosinone (N.F.), the Hematology Unit, Ospedale di Ronciglione, Viterbo (P.F.), the Hematology Unit, Ospedale di Pesaro, Pesaro (G.V.), and the Hematology Unit, Azienda Sanitaria Universitaria Integrata-Ospedale Maggiore, Trieste (F.Z.) - all in Italy
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Solves P, Lozano M, Zhiburt E, Anguita Velasco J, Maria Pérez-Corral A, Monsalvo-Saornil S, Yamazaki S, Okazaki H, Selleng K, Aurich K, Krüger W, Buser A, Holbro A, Infanti L, Stehle G, Pierelli L, Matteocci A, Rigacci L, De Vooght KMK, Kuball JHE, Fielding KL, Westerman DA, Wood EM, Cohn CS, Johnson A, Koh MBC, Qadir D, Cserti-Gazdewich C, Daguindau E, Angelot-Delettre F, Tiberghien P, Wendel-Neto S, Fachini RM, Morton S, Craddock C, Lumley M, Antoniewicz-Papis J, Hałaburda K, Łętowska M, Dunbar N. International Forum on Transfusion Practices in Haematopoietic Stem-Cell Transplantation: Summary. Vox Sang 2021; 116:609-612. [PMID: 33866564 DOI: 10.1111/vox.13061] [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: 09/30/2020] [Accepted: 12/02/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Pilar Solves
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Nancy Dunbar
- Dartmouth-Hitchcock Medical Center - Pathology, Lebanon, NH, USA
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Solves P, Lozano M, Zhiburt E, Anguita Velasco J, Maria Pérez-Corral A, Monsalvo-Saornil S, Yamazaki S, Okazaki H, Selleng K, Aurich K, Krüger W, Buser A, Holbro A, Infanti L, Stehle G, Pierelli L, Matteocci A, Rigacci L, De Vooght KMK, Kuball JHE, Fielding KL, Westerman DA, Wood EM, Cohn CS, Johnson A, Koh MBC, Qadir D, Cserti-Gazdewich C, Daguindau E, Angelot-Delettre F, Tiberghien P, Wendel-Neto S, Fachini RM, Morton S, Craddock C, Lumley M, Antoniewicz-Papis J, Hałaburda K, Łętowska M, Dunbar N. International Forum on Transfusion Practices in Haematopoietic Stem-Cell Transplantation: Responses. Vox Sang 2021; 116:e25-e43. [PMID: 33866580 DOI: 10.1111/vox.13021] [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: 09/24/2020] [Accepted: 10/01/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Pilar Solves
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | | - Eugene Zhiburt
- Pirogov National Medical Surgical Center, Moscow, Russia
| | | | | | | | | | | | - Kathleen Selleng
- Institut für Immunologie und Transfusionsmedizin, Greifswald, Germany
| | - Konstanze Aurich
- Institut für Immunologie und Transfusionsmedizin, Greifswald, Germany
| | - William Krüger
- Klinik für Hämatologie und Onkologie, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Andreas Buser
- Regional Blood Transfusion Service, Swiss Red Cross, Basel, Switzerland
| | - Andreas Holbro
- Regional Blood Transfusion Service, Swiss Red Cross, Basel, Switzerland
| | - Laura Infanti
- Regional Blood Transfusion Service, Swiss Red Cross, Basel, Switzerland
| | - Gregor Stehle
- Regional Blood Transfusion Service, Swiss Red Cross, Basel, Switzerland
| | - Luca Pierelli
- Sapienza University, Rome, Italy.,San Camillo Forlanini Hospital, Rome, Italy
| | | | | | | | | | - Katherine L Fielding
- Royal Melbourne Hospital and Peter MacCallum Cancer Centre, Parkville, Vic, Australia
| | | | - Erica M Wood
- Peter MacCallum Cancer Centre, Parkville, Vic, Australia
| | | | | | | | - Dara Qadir
- St George's University Hospital, London, UK
| | | | | | | | | | | | | | | | - Charles Craddock
- University Hospitals Birmingham NHS Foundation Trust, Sutton Coldfield, UK
| | - Matthew Lumley
- University Hospitals Birmingham NHS Foundation Trust, Sutton Coldfield, UK
| | | | | | | | - Nancy Dunbar
- Dartmouth-Hitchcock Medical Center - Pathology, Lebanon, NH, USA
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26
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Merli F, Luminari S, Tucci A, Arcari A, Rigacci L, Hawkes E, Chiattone CS, Cavallo F, Cabras G, Alvarez I, Fabbri A, Re A, Puccini B, Barraclough A, Delamain MT, Ferrero S, Usai SV, Ferrari A, Cencini E, Pennese E, Zilioli VR, Marino D, Balzarotti M, Cox MC, Zanni M, Di Rocco A, Lleshi A, Botto B, Hohaus S, Merli M, Sartori R, Gini G, Nassi L, Musuraca G, Tani M, Bottelli C, Kovalchuk S, Re F, Flenghi L, Molinari A, Tarantini G, Chimienti E, Marcheselli L, Mammi C, Spina M. Simplified Geriatric Assessment in Older Patients With Diffuse Large B-Cell Lymphoma: The Prospective Elderly Project of the Fondazione Italiana Linfomi. J Clin Oncol 2021; 39:1214-1222. [PMID: 33577377 DOI: 10.1200/jco.20.02465] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To prospectively validate the use of a simplified geriatric assessment (sGA) at diagnosis and to integrate it into a prognostic score for older patients with diffuse large B-cell lymphoma (DLBCL). METHODS We conducted the prospective Elderly Project study on patients with DLBCL older than 64 years who underwent our Fondazione Italiana Linfomi original geriatric assessment (oGA) (age, Cumulative Illness Rating Scale for Geriatrics, activities of daily living, and instrumental activities of daily living) before treatment. Treatment choice was left to the physician's discretion. The primary end point was overall survival (OS) (ClinicalTrials.gov identifier: NCT02364050). RESULTS We analyzed 1,163 patients (median age 76 years), with a 3-year OS of 65% (95% CI, 62 to 68). Because at multivariate analysis on oGA, age > 80 years retained an independent correlation with OS, we also developed a new, simplified version of the GA (sGA) that classifies patients as fit (55%), unfit (28%), and frail (18%) with significantly different 3-year OS of 75%, 58%, and 43%, respectively. The sGA groups, International Prognostic Index, and hemoglobin levels were independent predictors of OS and were used to build the Elderly Prognostic Index (EPI). Three risk groups were identified: low (23%), intermediate (48%), and high (29%), with an estimated 3-year OS of 87% (95% CI, 81 to 91), 69% (95% CI, 63 to 73), and 42% (95% CI, 36 to 49), respectively. The EPI was validated using an independent external series of 328 cases. CONCLUSION The Elderly Project validates sGA as an objective tool to assess fitness status and defines the new EPI to predict OS of older patients with DLBCL.
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Affiliation(s)
- Francesco Merli
- Hematology Unit, Azienda Unità Sanitaria Locale-IRCCS, Reggio Emilia, Italy
| | - Stefano Luminari
- Hematology Unit, Azienda Unità Sanitaria Locale-IRCCS, Reggio Emilia, Italy.,Department CHIMOMO, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Alessandra Tucci
- Hematology Division, ASST Spedali Civili Brescia, Brescia, Italy
| | - Annalisa Arcari
- Hematology Unit, Ospedale Guglielmo da Saliceto, Piacenza, Italy
| | - Luigi Rigacci
- Haematology Unit, Careggi University Hospital, Firenze, Italy
| | - Eliza Hawkes
- Department of Oncology and Clinical Haematology, Olivia Newton-John Cancer Research Institute at Austin Health, Heidelberg, Melbourne, Australia
| | - Carlos S Chiattone
- Santa Casa Medical School, Sao Paulo, Brazil.,Samaritano Hospital, Sao Paulo, Brazil
| | - Federica Cavallo
- Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino/AOU "Città della Salute e della Scienza di Torino," Torino, Italy
| | - Giuseppina Cabras
- Division of Hematology, Ospedale Oncologico Armando Businco, Cagliari, Italy
| | - Isabel Alvarez
- Hematology Unit, Azienda Unità Sanitaria Locale-IRCCS, Reggio Emilia, Italy
| | - Alberto Fabbri
- Unit of Hematology, Azienda Ospedaliera Universitaria Senese and University of Siena, Siena, Italy
| | - Alessandro Re
- Hematology Division, ASST Spedali Civili Brescia, Brescia, Italy
| | | | | | | | - Simone Ferrero
- Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino/AOU "Città della Salute e della Scienza di Torino," Torino, Italy
| | - Sara Veronica Usai
- Division of Hematology, Ospedale Oncologico Armando Businco, Cagliari, Italy
| | - Angela Ferrari
- Hematology Unit, Azienda Unità Sanitaria Locale-IRCCS, Reggio Emilia, Italy
| | - Emanuele Cencini
- Unit of Hematology, Azienda Ospedaliera Universitaria Senese and University of Siena, Siena, Italy
| | - Elsa Pennese
- Lymphoma Unit, Department of Hematology, Ospedale Spirito Santo, Pescara, Italy
| | | | - Dario Marino
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Monica Balzarotti
- Department of Medical Oncology and Hematology, Humanitas Clinical Research Hospital-IRCCS, Rozzano (MI), Italy
| | | | - Manuela Zanni
- Hematology Unit, Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Alice Di Rocco
- Institute of Hematology, Department of Translational and Precision Medicine "Sapienza," University of Roma, Roma, Italy
| | - Arben Lleshi
- Division of Medical Oncology and Immune-related Tumors, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano (PN), Italy
| | - Barbara Botto
- Division of Hematology, Città della Salute e della Scienza Hospital and University, Torino, Italy
| | - Stefan Hohaus
- University Policlinico Gemelli Foundation-IRCCS, Catholic University of the Sacred Heart, Roma, Italy
| | - Michele Merli
- Division of Hematology, Ospedale di Circolo e Fondazione Macchi-ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Roberto Sartori
- Department of Clinical and Experimental Oncology, Oncohematology Unit, Veneto Institute of Oncology, IOV-IRCCS, Castelfranco Veneto (TV), Italy
| | - Guido Gini
- Division of Hematology, Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy
| | - Luca Nassi
- Hematology, AOU Maggiore della Carità and University of Eastern Piedmont, Novara, Italy
| | - Gerardo Musuraca
- Hematology Unit, IRCCS-Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) SRL, Meldola (FC), Italy
| | - Monica Tani
- Hematology Unit, Santa Maria delle Croci Hospital, Ravenna, Italy
| | - Chiara Bottelli
- Hematology Division, ASST Spedali Civili Brescia, Brescia, Italy
| | - Sofia Kovalchuk
- Haematology Unit, Careggi University Hospital, Firenze, Italy
| | - Francesca Re
- Hematology and BMT Center, Azienda Ospedaliera Universitaria, Parma, Italy
| | - Leonardo Flenghi
- Hematology, Santa Maria della Misericordia Hospital, Perugia, Italy
| | | | - Giuseppe Tarantini
- Haematology and BMT Unit, Ospedale Monsignor R. Dimiccoli, Barletta, Italy
| | - Emanuela Chimienti
- Division of Medical Oncology and Immune-related Tumors, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano (PN), Italy
| | | | - Caterina Mammi
- Gruppo Amici dell'Ematologia GRADE-Onlus Foundation, Reggio Emilia, Italy
| | - Michele Spina
- Division of Medical Oncology and Immune-related Tumors, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano (PN), Italy
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Boccomini C, Ladetto M, Rigacci L, Puccini B, Rattotti S, Volpetti S, Ferrero S, Chiarenza A, Freilone R, Novo M, Corradini P, Nassi L, Rusconi C, Stelitano C, Bolis S, Marina Liberati A, Tucci A, Baldini L, Balzarotti M, Evangelista A, Ciccone G, Vitolo U. A brief rituximab, bendamustine, mitoxantrone (R-BM) induction followed by rituximab consolidation in elderly patients with advanced follicular lymphoma: a phase II study by the Fondazione Italiana Linfomi (FIL). Br J Haematol 2021; 193:280-289. [PMID: 33476434 DOI: 10.1111/bjh.17283] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 11/24/2020] [Indexed: 11/29/2022]
Abstract
Treatment for follicular lymphoma (FL) in the elderly is not well standardized. A phase II, multicentre, single arm trial was conducted in this setting with a brief chemoimmunotherapy regimen. Treatment consisted in four monthly courses of rituximab, bendamustine and mitoxantrone (R-BM) followed by 4 weekly rituximab as consolidation; rituximab maintenance was not applied because the drug was not licensed at the time of enrolment. The primary endpoint was the complete remission rate (CR). Seventy-six treatment-naive FL patients (aged 65-80 and a "FIT" score, according to the Comprehensive Geriatric Assessment) were enrolled. CR was documented in 59/76 patients (78%), partial remission in 12 (16%) and stable/progressive disease in five (6%) with an overall response rate in 71/76 (94%). Median follow-up was 44 months with 3-year progression-free-survival (PFS) and overall-survival of 67% and 92% respectively. Nine deaths occurred, three of progressive disease. The regimen was well tolerated and the most frequent severe toxicity was neutropenia (18% of the cycles). Bcl-2/IGH rearrangement was found in 40/75 (53%) of evaluated patients. R-BM was highly effective in clearing polymerase chain reaction-detectable disease: 29/31 (96%) evaluated patients converted to bcl-2/IGH negativity at the end of treatment. A brief R-BM regimen plus rituximab consolidation is effective and safe in "FIT" elderly, treatment-naïve, FL patients, inducing high CR and molecular remission rates with prolonged PFS.
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Affiliation(s)
- Carola Boccomini
- SC Ematologia AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Marco Ladetto
- SC Ematologia Azienda Ospedaliera Santi Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Luigi Rigacci
- UOC Ematologia e Trapianto Cellule Staminali, AO San Camillo Forlanini, Roma, Italy.,Hematology Department, Universisty of Florence and AOU Careggi, Firenze, Italy
| | - Benedetta Puccini
- Hematology Department, Universisty of Florence and AOU Careggi, Firenze, Italy
| | - Sara Rattotti
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Stefano Volpetti
- Clinica Ematologia e Trapianto Midollo osseo, AOU Santa Maria della Misericordia, Udine, Italy
| | - Simone Ferrero
- Department of Molecular Biotechnologies and Health Sciences, Division of Hematology, University of Torino/Hematology 1, AOU "Città della Salute e della Scienza di Torino", Torino, Italy
| | - Annalisa Chiarenza
- Ematologia e Trapianto di Midollo Osseo, AOU Policlinico Vittorio Emanuele, PO Ferrarotto Alessi, Catania, Italy
| | | | - Mattia Novo
- Multidisciplinary Oncology Outpatient Clinic, Candiolo Cancer Institute, FPO-IRCCS, Candiolo (Torino), Italy
| | - Paolo Corradini
- Division of Hematology and Stem Cell Transplantation Fondazione, IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Luca Nassi
- Hematology, AOU Maggiore della Carità and University of Eastern Piedmont, Novara, Italy
| | - Chiara Rusconi
- Division of Hematology and Stem Cell Transplantation Fondazione, IRCCS Istituto Nazionale dei Tumori, Milano, Italy.,SC Ematologia, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Caterina Stelitano
- UOC Ematologia, Grande Ospedale Metropolitano Bianchi-Melacrino-Morelli, Reggio Calabria, Italy
| | | | | | | | - Luca Baldini
- UOC Ematologia Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Università degli Studi, Milano, Italy
| | - Monica Balzarotti
- UO Ematologia, Humanitas Clinical and Research Center - IRCCS, Rozzano (Milano), Italy
| | - Andrea Evangelista
- Unit of Clinical Epidemiology, CPO Piemonte, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Giovannino Ciccone
- Unit of Clinical Epidemiology, CPO Piemonte, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Umberto Vitolo
- SC Ematologia AOU Città della Salute e della Scienza di Torino, Torino, Italy
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Fabbri A, Cencini E, Congiu AG, Miglino M, Rigacci L, Bocchia M. Ibrutinib in association with venetoclax for the treatment of mantle-cell lymphoma: a multicenter case series. Am J Blood Res 2020; 10:355-359. [PMID: 33489445 PMCID: PMC7811909] [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] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 12/10/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Mantle-cell lymphoma (MCL) with relapsed/refractory (R/R) disease after intensive chemotherapy have few effective treatment options. Ibrutinib showed a promising median progression-free survival (PFS) with manageable toxicity. The BCL2 inhibitor venetoclax showed encouraging results in R/R MCL patients and preclinical models suggest a potential synergistic effect of dual BTK and BCL2 inhibition. Ibrutinib in association with venetoclax was successfully investigated in a phase II trial. CASE REPORT We have retrospectively analyzed 4 patients with R/R MCL receiving daily oral ibrutinib in association with venetoclax. All patients received oral ibrutinib 560 mg per day as monotherapy and subsequently added venetoclax with an initial dose of 50 mg per day, with weekly rump-up until a full dose of 400 mg per day until disease progression. All patients achieved a response, the CR rate was 50%. The aim was to perform an allogeneic SCT (allo-SCT). One patient experienced an early relapse and died because of PD. Allo-SCT was successfully performed in the other 3 patients; ibrutinib and venetoclax were discontinued before allo-SCT. One patient died because of transplant-related complications, while the other 2 cases are alive and in CR. No tumor lysis syndrome occurred. DISCUSSION Ibrutinib plus venetoclax represents a promising and feasible treatment option for R/R MCL patients outside clinical trials.
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Affiliation(s)
- Alberto Fabbri
- Hematology Unit, Azienda Ospedaliera Universitaria Senese, University of SienaItaly
| | - Emanuele Cencini
- Hematology Unit, Azienda Ospedaliera Universitaria Senese, University of SienaItaly
| | - Angela Giovanna Congiu
- Unit of Hematology, IRCCS Azienda Ospedaliera Universitaria San Martino - IST Istituto Nazionale per la Ricerca sul CancroGenova, Italy
| | - Maurizio Miglino
- Clinic of Hematology, Department of Internal Medicine (DiMI), University of Genoa, Policlinico San Martino, IRCCS per l’OncologiaGenova, Italy
| | - Luigi Rigacci
- Unit of Hematology, Azienda San Camillo ForlaniniRome, Italy
| | - Monica Bocchia
- Hematology Unit, Azienda Ospedaliera Universitaria Senese, University of SienaItaly
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Santopietro M, Kovalchuk S, Battistini R, Puccini B, Annibali O, Romano I, Zoli V, Avvisati G, Bosi A, Rigacci L. Treatment and prognosis of primary pulmonary lymphoma: A long-term follow-up study. Eur J Haematol 2020; 106:49-57. [PMID: 32779796 DOI: 10.1111/ejh.13507] [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: 06/23/2020] [Revised: 08/07/2020] [Accepted: 08/07/2020] [Indexed: 11/27/2022]
Abstract
Primary pulmonary lymphoma (PPL) is a rare disease with not well-defined optimal treatment. Outcomes and follow-up are variable in published data. OBJECTIVES To define the outcome and optimal treatment strategies in PPL. METHODS We reviewed the medical records of 49 patients with PPL treated in three Italian Hematological Institutions between 2002 and 2018. RESULTS Thirty-eight (77.5%) cases were indolent PPL, and 11 (22.5%) cases were aggressive PPL. The majority of patients were asymptomatic at diagnosis, early stages (stages IE-IIE), normal serum LDH, no bone marrow involvement, and low or low-intermediate risks of IPI. Local therapy ± immunotherapy or immuno-chemotherapy was possible in 18/49 (37%) patients. Twenty-eight (57%) patients were treated with immuno-chemotherapy after biopsy. Waiting and watching were reported in 3 (6%) patients. Overall, the CR and ORR were 83.7% and 95.9%. With a median follow-up of 62.5 months (range 0.8-199 months), the estimated 5- and 10-year OS rates were 85% and 72.3% for all patients, 89.2% and 80.3% for indolent PPL, and 70.7% and 47.1% for aggressive PPL. Aggressive PPL tended to have a high risk of progression in the first months (P = .056). No advantages were found for indolent PPL who received immuno-chemotherapy or more conservative approaches. CONCLUSION Our studies confirm the epidemiological and favorable survival of patients with PPL, suggesting a very conservative approach, particularly in indolent subtypes.
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Affiliation(s)
- Michelina Santopietro
- Haematology and Haematopoietic Stem Cells Transplant Unit, AO San Camillo-Forlanini, Rome, Italy
| | | | - Roberta Battistini
- Haematology and Haematopoietic Stem Cells Transplant Unit, AO San Camillo-Forlanini, Rome, Italy
| | | | - Ombretta Annibali
- Unit of Haematology and Stem Cell Transplantation, Campus Bio-Medico University, Rome, Italy
| | | | - Valerio Zoli
- Haematology and Haematopoietic Stem Cells Transplant Unit, AO San Camillo-Forlanini, Rome, Italy
| | - Giuseppe Avvisati
- Unit of Haematology and Stem Cell Transplantation, Campus Bio-Medico University, Rome, Italy
| | - Alberto Bosi
- Unit of Haematology, AOU Careggi, Florence, Italy
| | - Luigi Rigacci
- Haematology and Haematopoietic Stem Cells Transplant Unit, AO San Camillo-Forlanini, Rome, Italy.,Unit of Haematology, AOU Careggi, Florence, Italy
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30
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Ferreri AJM, Cattaneo C, Lleshi A, Verga L, Allione B, Facchetti F, Ponzoni M, Foppoli M, Ferrari D, Rigacci L, Pecciarini L, Donadoni G, Fumagalli L, Sassone M, Calimeri T, Rossi G, Spina M, Re A. A dose-dense short-term therapy for human immunodeficiency virus/acquired immunodeficiency syndrome patients with high-risk Burkitt lymphoma or high-grade B-cell lymphoma: safety and efficacy results of the "CARMEN" phase II trial. Br J Haematol 2020; 192:119-128. [PMID: 33085777 DOI: 10.1111/bjh.17188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 09/02/2020] [Indexed: 12/14/2022]
Abstract
A few prospective trials in HIV-positive patients with Burkitt lymphoma (BL) or high-grade B-cell lymphoma (HGBL) have been reported. Investigated therapies have shown good efficacy but relevant safety problems, with high rates of interruptions, severe mucositis, septic complications, and fungal infections. Here, we report the results of a multicentre phase II trial addressing a new dose-dense, short-term therapy aimed at maintaining efficacy and improving tolerability. The experimental programme included a 36-day polychemotherapy induction followed by high-dose cytarabine-based consolidation and response-tailored BEAM (carmustine, etoposide, cyatarabine, and melphalan)- conditioned autologous stem cell transplantation (ASCT). This therapy would be considered active if ≥11 complete remissions (CR) after induction (primary endpoint) were recorded among 20 assessable patients. HIV-positive adults (median age 42, range 26-58; 16 males) with untreated BL (n = 16), HGBL (n = 3) or double-hit lymphoma (n = 1) were enrolled. All patients had high-risk features, with meningeal and bone marrow infiltration in five and nine patients respectively. The experimental programme was safe and active in a multicentre setting, with only two episodes of grade 4 non-haematological toxicity (hepatotoxicity and mucositis), and no cases of systemic fungal infections; two patients died of toxicity (bacterial infections). Response after induction (median duration: 47 days; interquartile range 41-54), was complete in 13 patients and partial in five [overall response rate = 90%; 95% confidence interval (CI) = 77-100]. All responders received consolidation, and five required autologous stem cell transplant. At a median follow-up of 55 (41-89) months, 14 patients are relapse-free and 15 are alive, with a five-year progression-free survival and an overall survival of 70% (95% CI = 60-80%) and 75% (95% CI = 66-84) respectively. No patient with cerebrospinal fluid (CSF)/meningeal lymphoma experienced central nervous system recurrence. With respect to previously reported regimens, this programme was delivered in a shorter period, and achieved the main goal of maintaining efficacy and improving tolerability.
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Affiliation(s)
- Andrés J M Ferreri
- Lymphoma Unit, Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Cattaneo
- Division of Hematology, Ospedali Civili di Brescia, Brescia, Italy
| | - Arben Lleshi
- Division of Medical Oncology and Immune-related tumors, IRCCS Centro di Riferimento Oncologico (CRO), Aviano (PN), Italy
| | - Luisa Verga
- Division of Hematology, Azienda Ospedaliera San Gerardo, Monza, Italy
| | | | | | - Maurilio Ponzoni
- Pathology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milano, Italy
| | - Marco Foppoli
- Lymphoma Unit, Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Daris Ferrari
- Division of Medical Oncology, Azienda Ospedaliera San Paolo, Milan, Italy
| | - Luigi Rigacci
- Division of Hematology, Ospedale Careggi, Florence, Italy
| | | | - Giovanni Donadoni
- Lymphoma Unit, Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Luca Fumagalli
- Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Marianna Sassone
- Lymphoma Unit, Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Teresa Calimeri
- Lymphoma Unit, Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giuseppe Rossi
- Division of Hematology, Ospedali Civili di Brescia, Brescia, Italy
| | - Michele Spina
- Division of Medical Oncology and Immune-related tumors, IRCCS Centro di Riferimento Oncologico (CRO), Aviano (PN), Italy
| | - Alessandro Re
- Division of Hematology, Ospedali Civili di Brescia, Brescia, Italy
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Passamonti F, Cattaneo C, Arcaini L, Bruna R, Cavo M, Merli F, Angelucci E, Krampera M, Cairoli R, Della Porta MG, Fracchiolla N, Ladetto M, Gambacorti Passerini C, Salvini M, Marchetti M, Lemoli R, Molteni A, Busca A, Cuneo A, Romano A, Giuliani N, Galimberti S, Corso A, Morotti A, Falini B, Billio A, Gherlinzoni F, Visani G, Tisi MC, Tafuri A, Tosi P, Lanza F, Massaia M, Turrini M, Ferrara F, Gurrieri C, Vallisa D, Martelli M, Derenzini E, Guarini A, Conconi A, Cuccaro A, Cudillo L, Russo D, Ciambelli F, Scattolin AM, Luppi M, Selleri C, Ortu La Barbera E, Ferrandina C, Di Renzo N, Olivieri A, Bocchia M, Gentile M, Marchesi F, Musto P, Federici AB, Candoni A, Venditti A, Fava C, Pinto A, Galieni P, Rigacci L, Armiento D, Pane F, Oberti M, Zappasodi P, Visco C, Franchi M, Grossi PA, Bertù L, Corrao G, Pagano L, Corradini P. Clinical characteristics and risk factors associated with COVID-19 severity in patients with haematological malignancies in Italy: a retrospective, multicentre, cohort study. Lancet Haematol 2020; 7:e737-e745. [PMID: 32798473 PMCID: PMC7426107 DOI: 10.1016/s2352-3026(20)30251-9] [Citation(s) in RCA: 372] [Impact Index Per Article: 93.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/19/2020] [Accepted: 07/21/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Several small studies on patients with COVID-19 and haematological malignancies are available showing a high mortality in this population. The Italian Hematology Alliance on COVID-19 aimed to collect data from adult patients with haematological malignancies who required hospitalisation for COVID-19. METHODS This multicentre, retrospective, cohort study included adult patients (aged ≥18 years) with diagnosis of a WHO-defined haematological malignancy admitted to 66 Italian hospitals between Feb 25 and May 18, 2020, with laboratory-confirmed and symptomatic COVID-19. Data cutoff for this analysis was June 22, 2020. The primary outcome was mortality and evaluation of potential predictive parameters of mortality. We calculated standardised mortality ratios between observed death in the study cohort and expected death by applying stratum-specific mortality rates of the Italian population with COVID-19 and an Italian cohort of 31 993 patients with haematological malignancies without COVID-19 (data up to March 1, 2019). Multivariable Cox proportional hazards model was used to identify factors associated with overall survival. This study is registered with ClinicalTrials.gov, NCT04352556, and the prospective part of the study is ongoing. FINDINGS We enrolled 536 patients with a median follow-up of 20 days (IQR 10-34) at data cutoff, 85 (16%) of whom were managed as outpatients. 440 (98%) of 451 hospitalised patients completed their hospital course (were either discharged alive or died). 198 (37%) of 536 patients died. When compared with the general Italian population with COVID-19, the standardised mortality ratio was 2·04 (95% CI 1·77-2·34) in our whole study cohort and 3·72 (2·86-4·64) in individuals younger than 70 years. When compared with the non-COVID-19 cohort with haematological malignancies, the standardised mortality ratio was 41·3 (38·1-44·9). Older age (hazard ratio 1·03, 95% CI 1·01-1·05); progressive disease status (2·10, 1·41-3·12); diagnosis of acute myeloid leukaemia (3·49, 1·56-7·81), indolent non-Hodgin lymphoma (2·19, 1·07-4·48), aggressive non-Hodgkin lymphoma (2·56, 1·34-4·89), or plasma cell neoplasms (2·48, 1·31-4·69), and severe or critical COVID-19 (4·08, 2·73-6·09) were associated with worse overall survival. INTERPRETATION This study adds to the evidence that patients with haematological malignancies have worse outcomes than both the general population with COVID-19 and patients with haematological malignancies without COVID-19. The high mortality among patients with haematological malignancies hospitalised with COVID-19 highlights the need for aggressive infection prevention strategies, at least until effective vaccination or treatment strategies are available. FUNDING Associazione italiana contro le leucemie, linfomi e mieloma-Varese Onlus.
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Affiliation(s)
- Francesco Passamonti
- Department of Medicine and Surgery, University of Insubria and ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy.
| | | | - Luca Arcaini
- Department of Molecular Medicine, University of Pavia, Pavia, Italy; Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Riccardo Bruna
- Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont and Ospedale Maggiore della Carità, Novara, Italy
| | - Michele Cavo
- Seràgnoli Institute of Hematology, Department of Experimental, Diagnostic and Specialty Medicine, Bologna University School of Medicine, Bologna, Italy
| | - Francesco Merli
- Hematology, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | | | - Mauro Krampera
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Roberto Cairoli
- Hematology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Matteo Giovanni Della Porta
- Humanitas Clinical and Research Hospital-IRCCS and Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | | | - Marco Ladetto
- Hematology, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | | | - Marco Salvini
- Department of Medicine and Surgery, University of Insubria and ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Monia Marchetti
- Hematology, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Roberto Lemoli
- Dipartimento di Medicina interna e Specialità mediche, University of Genoa, Genoa, Italy
| | | | - Alessandro Busca
- Stem Cell Transplant Center, AOU Citta' della Salute e della Scienza, Turin, Italy
| | - Antonio Cuneo
- Hematology, Azienda Ospedaliero Universitaria Sant'Anna, Ferrara, Italy
| | - Alessandra Romano
- Hematology, Dipartimento di Chirurgia e Specialità Medico Chirurgiche, Università degli Studi di Catania, Catania, Italy
| | - Nicola Giuliani
- Dipartimento di Medicina e Chirurgia, University of Parma, Parma, Italy
| | - Sara Galimberti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Alessandro Morotti
- Department of Clinical and Biological Sciences, Università di Torino, Turin, Italy
| | | | | | | | - Giuseppe Visani
- Dipartimento di Onco- Ematologia, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
| | | | - Agostino Tafuri
- Hematology, University Hospital Sant'Andrea, Sapienza, Rome, Italy; Department of Clinical and Molecular Medicine, Sapienza, University of Rome, Rome, Italy
| | - Patrizia Tosi
- Hematology, Ospedale degli Infermi di Rimini, Rimini, Italy
| | | | | | | | | | - Carmela Gurrieri
- Dipartimento Strutturale Aziendale Medicina, University of Padova, Padova, Italy
| | | | - Maurizio Martelli
- Hematology, Department of Translational and Precision Medicine, Sapienza, University of Rome, Rome, Italy
| | | | | | | | | | - Laura Cudillo
- Hematology, San Giovanni Addolorata Hospital, Rome, Italy
| | - Domenico Russo
- Dipartimento di Scienze Cliniche e Sperimentali, University of Brescia, Brescia, Italy
| | | | | | - Mario Luppi
- Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell'Adulto, University of Modena and Reggio Emilia, Azienda Ospedaliera Universitaria, Modena, Italy
| | - Carmine Selleri
- Hematology, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy
| | - Elettra Ortu La Barbera
- UOC Ematologia con Trapianto, Ospedale Santa Maria Goretti, Latina, Italy; Hematology, Ospedale Santa Maria Goretti, Latina, Italy
| | - Celestino Ferrandina
- Hematology, Ospedali Riuniti Azienda Ospedaliera Universitaria di Foggia, Foggia, Italy
| | - Nicola Di Renzo
- Hematology and Transplant Unit, Ospedale Vito Fazzi, Lecce, Italy
| | | | - Monica Bocchia
- Hematology Unit, University of Siena, Azienda Ospedaliero Universitaria Senese, Siena, Italy
| | | | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Pellegrino Musto
- Department of Emergency and Organ Transplantation, "Aldo Moro" University School of Medicine and Unit of Hematology and Stem Cell Transplantation, AOU Consorziale Policlinico, Bari, Italy
| | | | - Anna Candoni
- Dipartimento di Medicina Specialistica, University of Udine, Udine, Italy
| | | | - Carmen Fava
- Department of Clinical and Biological Sciences, Università di Torino, Turin, Italy
| | - Antonio Pinto
- Hematology, Istituto Nazionale Tumori IRCCS "Fondazione G Pascale", Naples, Italy
| | | | | | - Daniele Armiento
- Unit of Hematology, Stem Cell Transplantation, University Campus Bio-Medico, Rome, Italy
| | - Fabrizio Pane
- Department of Clinical Medicine and Surgery, Federico II Hospital, Naples, Italy
| | | | - Patrizia Zappasodi
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Carlo Visco
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Matteo Franchi
- Laboratory of Healthcare Research & Pharmacoepidemiology, Department of Statistics and Quantitative Methods, Università degli Studi di Milano-Bicocca, Milan, Italy; National Centre for Healthcare Research and Pharmacoepidemiology, Milan, Italy
| | - Paolo Antonio Grossi
- Department of Medicine and Surgery, University of Insubria and ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Lorenza Bertù
- Department of Medicine and Surgery, University of Insubria and ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Giovanni Corrao
- Laboratory of Healthcare Research & Pharmacoepidemiology, Department of Statistics and Quantitative Methods, Università degli Studi di Milano-Bicocca, Milan, Italy; National Centre for Healthcare Research and Pharmacoepidemiology, Milan, Italy
| | - Livio Pagano
- Dipartimento di Scienze Radiologiche ed Ematologiche, Fondazione Policlinico Universitario A Gemelli-IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy
| | - Paolo Corradini
- Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, University of Milano
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Rigacci L, Annibali O, Kovalchuk S, Bonifacio E, Pregnolato F, Angrilli F, Vitolo U, Pozzi S, Broggi S, Luminari S, Merli F, Spina M, Bolis S, Margiotta-Casaluci G, Scalzulli R, Cox C, Mamusa AM, Santoro A, Zinzani PL, Ferrari S, Gini G, Vigliotti ML, Mulè A, Flenghi L. Nonpeghylated liposomal doxorubicin combination regimen (R-COMP) for the treatment of lymphoma patients with advanced age or cardiac comorbidity. Hematol Oncol 2020; 38:478-486. [PMID: 32542788 PMCID: PMC7689940 DOI: 10.1002/hon.2764] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 03/12/2020] [Revised: 06/06/2020] [Accepted: 06/09/2020] [Indexed: 11/30/2022]
Abstract
Doxorubicin is the most effective single agent in the treatment of non‐Hodgkin's lymphoma (NHL). Its use is limited because of the cardiac toxicity primarily in elderly patients (pts) and in pts with history of cardiac disease. Liposomal doxorubicin has been proven to reduce cardiotoxicity. The aim of this retrospective study was the use of nonpeghylated liposomal doxorubicin (NPLD) in term of efficacy, response rate and incidence of cardiac events. We retrospectively collected the experience of 33 Hematological Italian Centers in using NPLD. Nine hundred and forty‐six consecutive pts treated with R‐COMP (doxorubicin was substituted with NPLD, Myocet) were collected. Median age was 74 years, the reasons for use of NPLD were: age (466 pts), cardiac disease (298 pts), uncontrolled hypertension (126 pts), other reasons (56 pts). According to clinicians' evaluation, 49.9% of pts would not have used standard doxorubicin for different situations (age, cardiomyopathy, previous use of doxorubicin, and uncontrolled hypertension). Overall 687 pts (72.6%) obtained a complete remission (CR). About 5% (n = 51) of subjects developed major cardiotoxic events including heart failure (N = 31), ischemic heart disease (N = 16), acute heart attack (N = 3), and acute pulmonary oedema (N = 1). After a median follow‐up of 32 months, 651 pts were alive and the overall survival (OS) was 72%. After a median observation period of 23 months disease free survival (DFS) was 58%. Either in univariate or in multivariate analysis OS and DFS were not significantly affected by age or cardiac disease. Our findings strongly support that including R‐COMP is effective and safe when the population is at high risk of cardiac events and negatively selected. Moreover, the use of this NPLD permitted that about half of our population had the opportunity to receive the best available treatment.
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Affiliation(s)
- Luigi Rigacci
- UOC Ematologia e Centro Trapianto Cellule Staminali, AO San Camillo Forlanini Roma, Roma, Italy.,SOD C Ematologia, AOU Careggi, Firenze, Italy
| | - Ombretta Annibali
- Ematologia, Trapianto Cellule Staminali, Medicina Trasfusionale, Policlinico Universitario Campus Biomedico, Roma, Italy
| | | | - Elisabetta Bonifacio
- Ematologia e Trapianto Midollo Osseo, Ospedale Santa Maria della Misericordia, Azienda Ospedaliera Perugia, Perugia, Italy
| | - Francesca Pregnolato
- Istituto Auxologico Italiano (IRCCS) Experimental Laboratory of Immunorheumatology, Cusano Milanino, Milanino, Italy
| | - Francesco Angrilli
- Unità Operativa Semplice Dipartimentale Centro Diagnosi e Terapia Linfomi, Presidio Ospedaliero, Pescara, Italy
| | - Umberto Vitolo
- SC di Ematologia, AOU Città della Salute e delle Scienze di Torino, Torino, Italy
| | - Samantha Pozzi
- Dipartimento Onco-ematologico, Policlinico di Modena, Univesrità di Modena e Reggio Emilia, Modena, Italy
| | - Serena Broggi
- Ematologia e Trapianto Midollo Osseo, Ospedale Santa Maria della Misericordia, Azienda Ospedaliera Perugia, Perugia, Italy
| | - Stefano Luminari
- Dipartimento Onco-ematologico, Policlinico di Modena, Univesrità di Modena e Reggio Emilia, Modena, Italy.,Unità Operativa di Ematologia, Arcispedale S. Maria Nuova Reggio Emilia, Emilia, Italy
| | - Francesco Merli
- Unità Operativa di Ematologia, Arcispedale S. Maria Nuova Reggio Emilia, Emilia, Italy
| | - Michele Spina
- Centro di Riferimento Oncologico di Aviano, IRCCS, Aviano, Italy
| | - Silvia Bolis
- Ematologia, Ospedale San Gerardo Monza, Monza, Italy
| | | | - Rosario Scalzulli
- Ematologia Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | | | - Angela Maria Mamusa
- Ematologia e Centro Trapianto Midollo Osseo, Ospedale Businco Cagliari, Cagliari, Italy
| | - Armando Santoro
- Department of Biomedical Sciences Milano, Ematologia, Humanitas Clinical and Research Center - IRCCS, Humanitas University, Rozzano, Italy
| | | | - Samantha Ferrari
- Unità Operativa di Ematologia, Spedali Civili di Brescia, Brescia, Italy
| | - Guido Gini
- SOD Clinca Ematologica, AOU Ospedali Riuniti Ancona, Ancona, Italy
| | | | - Antonino Mulè
- UOC Ematologia e Talassemia PO Sant'Elia Caltanissetta, Caltanissetta, Italy
| | - Leonardo Flenghi
- Ematologia e Trapianto Midollo Osseo, Ospedale Santa Maria della Misericordia, Azienda Ospedaliera Perugia, Perugia, Italy
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Di Renzo N, Gaudio F, Carlo Stella C, Oppi S, Pelosini M, Sorasio R, Stelitano C, Rigacci L. Relapsing/refractory HL after autotransplantation: which treatment? Acta Biomed 2020; 91:30-40. [PMID: 32525132 PMCID: PMC7944654 DOI: 10.23750/abm.v91is-5.9912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 05/25/2020] [Indexed: 11/23/2022]
Abstract
For advanced-stage Hodgkin lymphoma (HL), front-line chemotherapy, alone or in combination with radiotherapy, leads to 5-year progression-free survival (PFS) rates and freedom-from-treatment failure (FFTF) rates of 70-85%, regardless of the chemotherapy regimen applied. Patients with HL experiencing disease progression during or within 3 months of front-line therapy (primary refractory) and patients whose disease relapses after a complete response have a second chance of treatment. The standard of care for relapsed or refractory HL is second-line chemotherapy followed by autologous stem cell transplantation (ASCT), which can induce long-term remission in approximately 40-50% of patients. However, HL recurrence occurs in about 50% of patients after ASCT, usually within the first year, and represents a significant therapeutic challenge. Allogeneic transplantation from HLA-matched donors represents the standard of care for patients with HL relapsing after- or refractory to ASCT.
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Affiliation(s)
- Nicola Di Renzo
- Department of Hematology and Stem Cell Transplant, Presidio Ospedaliero Vito Fazzi, Lecce, Italy.
| | - Francesco Gaudio
- Department of Emergency and Transplantation, Hematology Section, University of Bari Medical School, Italy.
| | - Carmelo Carlo Stella
- Department of Hematology and Oncology, Humanitas Cancer Center, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy; Department of Biomedical Sciences, Humanitas University, Rozzano, Milano, Italy.
| | - Sara Oppi
- Bone Marrow Transplant Center, R. Binaghi Hospital, ASL 8, Cagliari, Italy.
| | | | - Roberto Sorasio
- Division of Hematology, A.O. Santi Croce e Carle, Cuneo, Italy.
| | - Caterina Stelitano
- Division of Hematology, Azienda Ospedaliera "Bianchi Melacrino Morelli", Reggio Calabria, Italy.
| | - Luigi Rigacci
- Haematology Unit and Bone Marrow Transplant Unit, San Camillo Forlanini Hospital, Rome, Italy.
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Rigacci L, Puccini B, Broccoli A, Dona M, Gotti M, Evangelista A, Santoro A, Bonfichi M, Re A, Spina M, Botto B, Pulsoni A, Pagani C, Stelitano C, Salvi F, Nassi L, Mannelli L, Kovalchuk S, Gioia D, Zinzani PL. Clinical characteristics of interim-PET negative patients with a positive end PET from the prospective HD08-01 FIL study. Ann Hematol 2019; 99:283-291. [PMID: 31872361 DOI: 10.1007/s00277-019-03889-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 12/06/2019] [Indexed: 11/28/2022]
Abstract
FDG-positron emission tomography (PET) performed early during therapy in advanced Hodgkin lymphoma patients has been confirmed as being important for progression-free survival. A group of patients with a negative interim-PET (i-PET) showed a positive end induction PET (e-PET). The aim of this study was to evaluate the clinical characteristics of patients with a positive e-PET as a secondary end point of the HD0801 study. A total of 519 patients with advanced-stage de novo Hodgkin lymphoma received initial treatment and underwent an i-PET. Patients with negative results continued the standard treatment. i-PET negative patients were then evaluated for response with an e-PET and those patients found to have a positive one were also then given a salvage therapy. Among 409 i-PET negative, 16 interrupted the therapy, 393 patients were evaluated with an e-PET, and 39 were positive. Sixteen out of 39 underwent a diagnostic biopsy and 15 were confirmed as HD. Seventeen out of 39 e-PET were reviewed according to the Deauville Score and, in sixteen, it was confirmed positive (10 DS 5, 6 DS 4). With the exception of high LDH value at diagnosis (p = 0.01; HR 95% CI 1.18-4.89), no clinical characteristics were significantly different in comparison with e-PET negative patients. Positive e-PET after a negative i-PET has a worse outcome when compared with i-PET positive patients salvaged with therapy intensification. It was not possible to identify clinical characteristics associated with a positive e-PET.
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Affiliation(s)
- Luigi Rigacci
- Department of Hematology, AOU Careggi, Florence, Italy. .,Hematology Unit and Bone Marrow Transplant Unit, AO San Camillo Forlanini, Rome, Italy.
| | | | - Alessandro Broccoli
- Institute of Hematology "L. e A. Seràgnoli", University of Bologna, Bologna, Italy
| | - Manjola Dona
- Department of Nuclear Medicine, Ospedale Santo Stefano, Prato, Italy
| | - Manuel Gotti
- Policlinico San Matteo Pavia Fondazione, IRCCS, Pavia, Italy
| | - Andrea Evangelista
- Unit of Cancer Epidemiology, AO Città della Salute e della Scienza di Torino and FIL Secretary, Turin, Italy
| | | | | | - Alessandro Re
- Department of Hematology, Spedali Civili, Brescia, Italy
| | | | - Barbara Botto
- Hematology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | | | - Chiara Pagani
- Department of Hematology, Spedali Civili, Brescia, Italy
| | | | - Flavia Salvi
- Division of Hematology, A.O. SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Luca Nassi
- Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Lara Mannelli
- Department of Hematology, AOU Careggi, Florence, Italy
| | | | - Daniela Gioia
- Unit of Cancer Epidemiology, AO Città della Salute e della Scienza di Torino and FIL Secretary, Turin, Italy
| | - Pier Luigi Zinzani
- Institute of Hematology "L. e A. Seràgnoli", University of Bologna, Bologna, Italy
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Schmidt-Hieber M, Engelhard D, Ullmann A, Ljungman P, Maertens J, Martino R, Rovira M, Shaw PJ, Robin C, Faraci M, Byrne J, Schäfer-Eckart K, Einsele H, Faber E, Rigacci L, Saccardi R, Balaguer-Rosello A, Isaksson C, Christopeit M, Tridello G, Wang J, Knelange N, Mikulska M, Cesaro S, Styczynski J. Central nervous system disorders after hematopoietic stem cell transplantation: a prospective study of the Infectious Diseases Working Party of EBMT. J Neurol 2019; 267:430-439. [PMID: 31664549 DOI: 10.1007/s00415-019-09578-5] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 09/28/2019] [Accepted: 10/10/2019] [Indexed: 12/18/2022]
Abstract
We performed a prospective study to evaluate the types and characteristics of central nervous system (CNS) disorders in patients after hematopoietic stem cell transplantation. The study included 163 episodes of CNS disorders of which 58 (36%) were infections. Proven or probable infections were documented in 34 patients and included fungi (n = 10, 29%), viruses (n = 12, 35%), Toxoplasma spp. (n = 9, 27%) and bacteria (n = 3, 9%). Non-infectious neurological disorders (n = 105, 64%) frequently encompassed metabolic/drug-induced abnormalities (n = 28, 27%) or cerebral vascular events (n = 22, 21%). Median onset times were later for infectious (day + 101) vs non-infectious neurological disorders (day + 50, p = 0.009). An unremarkable cranial CT scan was found in 33% of infection episodes. Absence of cerebrospinal fluid pleocytosis despite a normal or increased peripheral blood white blood cell count occurred in 26% of infections. Day-30 mortality rates were significantly higher for fungal (87%) vs non-fungal infections (40%, p < 0.001). Significantly higher mortality rates were also documented for cerebral vascular events than for other non-infectious disorders (86% vs 34%, p < 0.001). Our prospective study shows that diagnostic findings in CNS infections might differ between hematopoietic stem cell transplant recipients and immunocompetent hosts. Special awareness and timely initiation of adequate diagnostics are crucial to improve the prognosis of these patients.
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Affiliation(s)
- Martin Schmidt-Hieber
- Clinic for Hematology and Oncology, Carl-Thiem-Klinikum, Thiemstr. 111, 03048, Cottbus, Germany.
| | - Dan Engelhard
- Department of Pediatrics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Andrew Ullmann
- Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
| | - Per Ljungman
- Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
| | - Johan Maertens
- Department of Microbiology, Immunology, and Transplantation, KU Leuven, Leuven, Belgium
| | - Rodrigo Martino
- Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Barcelona, Spain
| | - Montserrat Rovira
- Department of Hematology, Institute of Hematology and Oncology, IDIBAPS, Hospital Clinic, University of Barcelona, Josep Carreras Leukemia Research Institute, Barcelona, Spain
| | - Peter J Shaw
- The Children's Hospital at Westmead, Sydney, Australia
| | - Christine Robin
- Assistance Publique-Hopitaux de Paris, Henri Mondor University Hospital, Hematology Department and UPEC, Créteil France Hôspital Henri Mondor, Créteil, France
| | - Maura Faraci
- Hematopoietic Stem Cell Unit Transplantation, IRCCS Instituto G. Gaslini, Genova, Italy
| | - Jenny Byrne
- Nottingham University Hospital, Nottingham, UK
| | - Kerstin Schäfer-Eckart
- Clinic for Hematology and Oncology, Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität, Nürnberg, Germany
| | - Hermann Einsele
- Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
| | - Edgar Faber
- Department of Hemato-Oncology, Faculty Hospital Olomouc, Faculty of Medicine and Dentistry Palacky University, Olomouc, Czech Republic
| | | | | | | | | | - Maximilian Christopeit
- Department of Stem Cell Transplantation, University Medical Center Eppendorf, Hamburg, Germany
| | - Gloria Tridello
- Pediatric Hematology Oncology, Mother and Child Hospital, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.,EBMT Data Office, Leiden, The Netherlands
| | | | | | - Malgorzata Mikulska
- Division of Infectious Diseases, University of Genova, DISSAL, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Simone Cesaro
- Pediatric Hematology Oncology, Mother and Child Hospital, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Jan Styczynski
- Department of Pediatric Hematology and Oncology, Collegium Medicum UMK, Bydgoszcz, Poland
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Luminari S, Donati B, Casali M, Valli R, Santi R, Puccini B, Kovalchuk S, Ruffini A, Fama A, Berti V, Fragliasso V, Zanelli M, Vergoni F, Versari A, Rigacci L, Merli F, Ciarrocchi A. A Gene Expression-based Model to Predict Metabolic Response After Two Courses of ABVD in Hodgkin Lymphoma Patients. Clin Cancer Res 2019; 26:373-383. [PMID: 31645353 DOI: 10.1158/1078-0432.ccr-19-2356] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 09/12/2019] [Accepted: 10/15/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE Early response to ABVD, assessed with interim FDG-PET (iPET), is prognostic for classical Hodgkin lymphoma (cHL) and supports the use of response adapted therapy. The aim of this study was to identify a gene-expression profile on diagnostic biopsy to predict iPET positivity (iPET+). EXPERIMENTAL DESIGN Consecutive untreated patients with stage I-IV cHL who underwent iPET after two cycles of ABVD were identified. Expression of 770 immune-related genes was analyzed by digital expression profiling (NanoString Technology). iPET was centrally reviewed according to the five-point Deauville scale (DS 1-5). An iPET+ predictive model was derived by multivariate regression analysis and assessed in a validation set identified using the same inclusion criteria. RESULTS A training set of 121 and a validation set of 117 patients were identified, with 23 iPET+ cases in each group. Sixty-three (52.1%), 19 (15.7%), and 39 (32.2%) patients had stage I-II, III, and IV, respectively. Diagnostic biopsy of iPET+ cHLs showed transcriptional profile distinct from iPET-. Thirteen genes were stringently associated with iPET+. This signature comprises two functionally stromal-related nodes. Lymphocytes/monocytes ratio (LMR) was also associated to iPET+. In the training cohort a 5-gene/LMR integrated score predicted iPET+ [AUC, 0.88; 95% confidence interval (CI), 0.80-0.96]. The score achieved a 100% sensitivity to identify DS5 cases. Model performance was confirmed in the validation set (AUC, 0.68; 95% CI, 0.52-0.84). Finally, iPET score was higher in patients with event versus those without. CONCLUSIONS In cHL, iPET is associated with a genetic signature and can be predicted by applying an integrated gene-based model on the diagnostic biopsy.
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Affiliation(s)
- Stefano Luminari
- Hematology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
- Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Benedetta Donati
- Laboratory of Translational Research, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Riccardo Valli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | | | | | - Alessia Ruffini
- Hematology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Gruppo Amici Dell'Ematologia Foundation_GrADE, Reggio Emilia, Italy
| | - Angelo Fama
- Hematology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Valentina Fragliasso
- Laboratory of Translational Research, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Magda Zanelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Annibale Versari
- Nuclear Medicine, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Luigi Rigacci
- Hematology and Stem Cell Transplant AO San Camillo Forlanini, Roma, Italy
| | - Francesco Merli
- Hematology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Alessia Ciarrocchi
- Laboratory of Translational Research, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
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Cozzi D, Dini C, Mungai F, Puccini B, Rigacci L, Miele V. Primary pulmonary lymphoma: imaging findings in 30 cases. Radiol Med 2019; 124:1262-1269. [PMID: 31583557 DOI: 10.1007/s11547-019-01091-z] [Citation(s) in RCA: 16] [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: 07/12/2019] [Accepted: 09/25/2019] [Indexed: 12/17/2022]
Abstract
PURPOSE To present our experience of cases of primary pulmonary lymphoma (PPL) found between January 2002 and July 2018, focusing on the radiological features and the differential diagnosis in order to contribute to the difficult role of the radiologist in the disease identification and to help the clinicians to reach the diagnosis. MATERIALS AND METHODS CT scans of 30 patients (14 men and 16 women, aged 58-86, mean age 72 years) with PPL were retrospectively reviewed. All patients had a histopathological confirmation of the disease: MALT lymphoma (23 patients, 76.6%); diffuse large B-cell lymphoma-DLBCL (seven patients, 23.4%). All the staging CT scans were evaluated by three experienced radiologists dedicated to thoracic disease in order to radiologically define the predominant pattern of presentation. RESULTS The following parenchymal patterns were observed: 11 patients with single/multiple nodules, five with masses/mass-like consolidations, 14 with consolidations with air bronchogram, 16 with ground-glass opacity, ten with angiogram sign, 22 with perilymphatic and/or peribronchovascular spread, 15 with associated lymphadenopathies, and 13 with pleural/chest wall involvement. The main characteristics of PPLs were the presence of consolidations and ground-glass opacities, with perilymphatic and/or bronchovascular spread. CONCLUSION All the characteristics of the work should alert the radiologist to consider lymphoma among the possible differential diagnoses, always correlating the results of the CT examination with appropriate clinical laboratory evaluations.
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Affiliation(s)
- Diletta Cozzi
- Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50123, Florence, Italy
| | - Catia Dini
- Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50123, Florence, Italy
| | - Francesco Mungai
- Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50123, Florence, Italy
| | - Benedetta Puccini
- Haematology Unit - Department of Oncology, University Hospital Careggi, Florence, Italy
| | - Luigi Rigacci
- Haematology Unit and Bone Marrow Transplant Unit, San Camillo Forlanini Hospital, Rome, Italy
| | - Vittorio Miele
- Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50123, Florence, Italy.
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Tiacci E, De Carolis L, Simonetti E, Zaja F, Capponi M, Ambrosetti A, Lucia E, Antolino A, Pulsoni A, Ferrari S, Zinzani P, Rigacci L, Gaidano G, Della Seta R, Frattarelli N, Falcucci P, Visani G, Foà R, Falini B. THE BRAF INHIBITOR VEMURAFENIB PLUS RITUXIMAB PRODUCES A HIGH RATE OF DEEP AND DURABLE RESPONSES IN RELAPSED/REFRACTORY HAIRY CELL LEUKEMIA: UPDATED RESULTS OF A PHASE-2 TRIAL. Hematol Oncol 2019. [DOI: 10.1002/hon.72_2629] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- E. Tiacci
- Institute of Hematology and Center for Hemato-Oncology Research; University and Hospital of Perugia; Perugia Italy
| | - L. De Carolis
- Institute of Hematology and Center for Hemato-Oncology Research; University and Hospital of Perugia; Perugia Italy
| | - E. Simonetti
- Institute of Hematology and Center for Hemato-Oncology Research; University and Hospital of Perugia; Perugia Italy
| | - F. Zaja
- Hematology Unit; Azienda Sanitaria Universitaria Integrata-Ospedale Maggiore; Trieste Italy
| | - M. Capponi
- Institute of Hematology and Center for Hemato-Oncology Research; University and Hospital of Perugia; Perugia Italy
| | - A. Ambrosetti
- Department of Medicine; Section of Hematology; Verona Italy
| | - E. Lucia
- Hematology Unit; Ospedale di Cosenza; Cosenza Italy
| | - A. Antolino
- Hematology Unit, Department of Transfusional Medicine - SIMMT; Maria Paternò-Arezzo Hospital; Ragusa Italy
| | - A. Pulsoni
- Hematology Unit, Department of Translational and Precision Medicine; "Sapienza" University of Rome; Roma Italy
| | - S. Ferrari
- Department of Hematology; Spedali Civili di Brescia; Brescia Italy
| | - P. Zinzani
- Institute of Hematology, Policlinico Sant'Orsola-Malpighi; University of Bologna; Bologna Italy
| | - L. Rigacci
- Hematology and Stem Cell Transplant Unit; AO San Camillo Forlanini; Roma Italy
| | - G. Gaidano
- Department of Translational Medicine, Division of Hematology; Amedeo Avogadro University of Eastern Piedmont; Novara Italy
| | | | | | - P. Falcucci
- Hematology Unit; Ospedale di Ronciglione; Viterbo Italy
| | - G. Visani
- Hematology Unit; Ospedale di Pesaro; Pesaro Italy
| | - R. Foà
- Hematology Unit, Department of Translational and Precision Medicine; "Sapienza" University of Rome; Roma Italy
| | - B. Falini
- Institute of Hematology and Center for Hemato-Oncology Research; University and Hospital of Perugia; Perugia Italy
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Morbelli S, Capitanio S, Guerra L, Rigacci L. Predictive value of pre-treatment FDG PET in patients with non-Hodgkin lymphoma treated with radioimmunotherapy: a systematic review. Clin Transl Imaging 2019. [DOI: 10.1007/s40336-019-00330-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Donati B, Casali M, Fama A, Puccini B, Zanelli M, Valli R, Santi R, Vergoni F, Ruffini A, Berti V, Rigacci L, Merli F, Ciarrocchi A, Luminari S. A GENE EXPRESSION-BASED SCORE TO PREDICT INTERIM PET POSITIVITY IN HODGKIN LYMPHOMA PATIENTS TREATED WITH ABVD. Hematol Oncol 2019. [DOI: 10.1002/hon.17_2629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- B. Donati
- Laboratory of Translational Research; AUSL IRCCS; Reggio Emilia Italy
| | - M. Casali
- Nuclear Medicine; AUSL IRCCS; Reggio Emilia Italy
| | - A. Fama
- Hematology; AUSL IRCCS; Reggio Emilia Italy
| | - B. Puccini
- Hematology; Azienda Ospedaliero Universitaria Careggi; Firenze Italy
| | - M. Zanelli
- Pathology; AUSL IRCCS; Reggio Emilia Italy
| | - R. Valli
- Pathology; AUSL IRCCS; Reggio Emilia Italy
| | - R. Santi
- Pathological Histology and Molecular Diagnostics; Azienda Ospedaliero Universitaria Careggi; Firenze Italy
| | - F. Vergoni
- Pathological Histology and Molecular Diagnostics; Azienda Ospedaliero Universitaria Careggi; Firenze Italy
| | - A. Ruffini
- Hematology; GRuppo Amici dell'Ematologia Foundation_GrADE; Reggio Emilia Italy
| | - V. Berti
- Nuclear Medicine; University of Firenze; Firenze Italy
| | - L. Rigacci
- Hematology and Stem Cell Transplant; AO San Camillo Forlanini, Roma and Hematology of Azienda Ospedaliero Universitaria Careggi; Firenze Italy
| | - F. Merli
- Hematology; AUSL IRCCS; Reggio Emilia Italy
| | - A. Ciarrocchi
- Laboratory of Translational Research; AUSL IRCCS; Reggio Emilia Italy
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Guerra L, Bergesio F, Versari A, Franceschetto A, Peano S, Fallanca F, Storto G, Luminari S, Rigacci L, Gallamini A, Federico M, Chauvie S. INTERIM ANALYSIS OF CENTRAL REVIEW OF END-OF-THERAPY PET IN FOLL12 TRIAL FOR FOLLICULAR LYMPHOMA. Hematol Oncol 2019. [DOI: 10.1002/hon.62_2631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- L. Guerra
- Nuclear Medicine; San Gerardo Hospital - ASST Monza; Monza Italy
| | - F. Bergesio
- Medical Physics; Azienda Ospedaliera S. Croce e Carle; Cuneo Italy
| | - A. Versari
- Nuclear Medicine; AUSL-IRCCS of Reggio Emilia; Reggio Emilia Italy
| | - A. Franceschetto
- Nuclear Medicine; University of Modena and Reggio Emilia; Modena Italy
| | - S. Peano
- Nuclear Medicine; Azienda Ospedaliera S. Croce e Carle; Cuneo Italy
| | - F. Fallanca
- Nuclear Medicine; San Raffaele Scientific Institute; Milano Italy
| | - G. Storto
- Nuclear Medicine; IRCCS-CROB Referral Cancer Center of Basilicata; Rionero in Vulture Italy
| | - S. Luminari
- Department of Diagnostic Medicine; Clinical and Public Health, University of Modena and Reggio Emilia; Modena Italy
| | - L. Rigacci
- Haematology and Stem Cells Transplantation Unit; San Camillo Forlanini Hospital; Roma Italy
| | - A. Gallamini
- Research and Clinical Innovation; Antoine Lacassagne Cancer Center; Nice France
| | - M. Federico
- CHIMOMO; University of Modena and Reggio Emilia; Modena Italy
| | - S. Chauvie
- Medical Physics; Azienda Ospedaliera S. Croce e Carle; Cuneo Italy
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Broccoli A, Casadei B, Chiappella A, Visco C, Tani M, Cascavilla N, Conconi A, Balzarotti M, Cox MC, Marino D, Goldaniga MC, Marasca R, Tecchio C, Patti C, Musuraca G, Devizzi L, Monaco F, Romano A, Fama A, Zancanella M, Paolini R, Rigacci L, Castellino C, Gaudio F, Argnani L, Zinzani PL. Lenalidomide in Pretreated Patients with Diffuse Large B-Cell Lymphoma: An Italian Observational Multicenter Retrospective Study in Daily Clinical Practice. Oncologist 2019; 24:1246-1252. [PMID: 30940746 DOI: 10.1634/theoncologist.2018-0603] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 03/04/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma subtype, and approximately 50% of the patients are >60 years of age. Patients with relapsed/refractory (rr) disease have a poor prognosis with currently available treatments. Lenalidomide is available in Italy for patients with rrDLBCL based on a local disposition of the Italian Drug Agency. SUBJECTS, MATERIALS, AND METHODS An observational retrospective study was conducted in 24 Italian hematology centers with the aim to improve information on effectiveness and safety of lenalidomide use for rrDLBCL in real practice. RESULTS One hundred fifty-three patients received lenalidomide for 21/28 days with a median of four cycles. At the end of therapy, there were 36 complete responses (23.5%) and 9 partial responses with an overall response rate (ORR) of 29.4%. In the elderly (>65 years) subset, the ORR was 33.6%. With a median follow-up of 36 months, median overall survival was reached at 12 months and median disease-free survival was not reached at 62 months. At the latest available follow-up, 29 patients are still in response out of therapy. Median progression-free survivals differ significantly according to age (2.5 months vs. 9.5 in the younger vs. elderly group, respectively) and to disease status at the latest previous therapy (15 months for relapsed patients vs. 3.5 for refractory subjects). Toxicities were manageable, even if 30 of them led to an early drug discontinuation. CONCLUSION Lenalidomide therapy for patients with rrDLBCL is effective and tolerable even in a real-life context, especially for elderly patients. IMPLICATIONS FOR PRACTICE Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma, and approximately 50% of the patients are >60 years of age. Patients with relapsed/refractory (rr) disease have a poor prognosis, reflected by the remarkably short life expectancy of 12 months with currently available treatments. The rrDLBCL therapeutic algorithm is not so well established because data in the everyday clinical practice are still poor. Lenalidomide for patients with rrDLBCL is effective and tolerable even in a real-life context, especially for elderly patients.
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Affiliation(s)
| | | | - Annalisa Chiappella
- Hematology, Città della Salute e della Scienza Hospital and University, Torino, Italy
| | - Carlo Visco
- Department of Cell Therapy and Hematology, San Bortolo Hospital, Vicenza, Italy
| | - Monica Tani
- Hematology Unit, S. Maria delle Croci Hospital, Ravenna, Italy
| | - Nicola Cascavilla
- Hematology Department, "Casa Sollievo della Sofferenza" Hospital, IRCCS - Italy
| | - Annarita Conconi
- Hematology Division, Ospedale degli Infermi di Biella, Ponderano, Italy
| | - Monica Balzarotti
- Departmento of Medical Oncology and Hematology Humanitas Cancer Center, Rozzano-Milan, Italy
| | | | - Dario Marino
- Dipartimento di Oncologia Clinica e Sperimentale, Oncologia Medica 1, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy
| | | | - Roberto Marasca
- Department of Medical Sciences, Section of Hematology, University of Modena and Reggio Emilia, Modena, Italy
| | - Cristina Tecchio
- Hematology and Bone Marrow Transplant Unit, Verona University, Verona, Italy
| | - Caterina Patti
- Department of Hematology Azienda Ospedali Riuniti Villa Sofia- Cervello, Palermo, Italy
| | - Gerardo Musuraca
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Liliana Devizzi
- Division of Hematology, IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Federico Monaco
- Hematology Unit, SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Alessandra Romano
- Division of Hematology, AOU Policlinico-OVE, Department of Surgery and Medical Specialties, University of Catania, Catania, Italy
| | | | | | | | - Luigi Rigacci
- Hematology, AOU Careggi, Firenze, Italy
- Hematology Azienda San Camillo Forlanini, Rome, Italy
| | - Claudia Castellino
- Azienda Ospedaliera S. Croce e Carle - Hematology Department and BMT Unit, Cuneo, Italy
| | - Francesco Gaudio
- Unit of Hematology with Transplantation Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Lisa Argnani
- Institute of Hematology, University of Bologna, Bologna, Italy
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Ricardi U, Levis M, Evangelista A, Gioia D, Rigacci L, Botto B, Simontacchi G, Franzone P, Rossi G, Buglione M, Pavone V, Bonfichi M, Rusconi C, Freilone R, Pulsoni A, De Sanctis V, Gaidano G, Stelitano C, Tani M, Castagnoli A, Ciccone G, Zaja F, Santoro A, Zinzani P. OC-0502 Role of consolidation RT to bulky lesions of advanced Hodgkin lymphoma: results of FIL HD0801 trial. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30922-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Innocenti R, Rigacci L, Restelli U, Scappini B, Gianfaldoni G, Fanci R, Mannelli F, Scolari F, Croce D, Bonizzoni E, Perrone T, Bosi A. Lenograstim and filgrastim in the febrile neutropenia prophylaxis of hospitalized patients: efficacy and cost of the prophylaxis in a retrospective survey. J Blood Med 2018; 10:21-27. [PMID: 30643475 PMCID: PMC6312059 DOI: 10.2147/jbm.s186786] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose We conducted a retrospective study to evaluate the efficacy and related costs of using two different molecules of granulocyte-colony stimulating factor (G-CSF) (lenograstim - LENO or filgrastim - FIL) as primary prophylaxis of chemotherapy-induced neutropenia in a hematological inpatient setting. Methods The primary endpoints of the analysis were the efficacy of the two G-CSFs in terms of the level of white blood cells, hemoglobin and platelets at the end of the treatment and the per capita direct medical costs related to G-CSF prophylaxis. Results Two hundred twelve patients (96 LENO, 116 FIL) have been evaluated. The following statistically significant differences have been observed between FIL and LENO: the use of a higher number of vials (11 vs 7; P<0.03) to fully recover bone marrow, a higher grade 3-4 neutropenia at the time of G-CSF discontinuation (29.3% vs 16.7%; P=0.031) and an increased number of days of hospitalization (8 vs 5; P<0.005). A longer hospital stay before discharge was necessary (12 vs 10), which reflects the higher final costs per patient (median treatment cost per cycle 10.706 € for LENO, compared to 12.623 € for FIL). Conclusion The use of LENO has been associated with a lower number of days of hospitalization, number of vials and less incidence of grade 3-4 neutropenia at the time of G-CSF discontinuation. LENO seems to be cost-saving when compared with FIL (-15.2%).
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Affiliation(s)
- Rolando Innocenti
- Hematology Department, University of Florence and AOU Careggi, Florence, Italy,
| | - Luigi Rigacci
- Hematology Department, University of Florence and AOU Careggi, Florence, Italy, .,Hematology Unit and Bone Marrow Transplant Unit, San Camillo Forlanini Hospital, Rome, Italy,
| | - Umberto Restelli
- Center for Health Economics, Social and Health Care Management, LIUC - Università Cattaneo, Castellanza (VA), Italy.,School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Barbara Scappini
- Hematology Department, University of Florence and AOU Careggi, Florence, Italy,
| | - Giacomo Gianfaldoni
- Hematology Department, University of Florence and AOU Careggi, Florence, Italy,
| | - Rosa Fanci
- Hematology Department, University of Florence and AOU Careggi, Florence, Italy,
| | - Francesco Mannelli
- Hematology Department, University of Florence and AOU Careggi, Florence, Italy,
| | - Francesca Scolari
- Center for Health Economics, Social and Health Care Management, LIUC - Università Cattaneo, Castellanza (VA), Italy
| | - Davide Croce
- Center for Health Economics, Social and Health Care Management, LIUC - Università Cattaneo, Castellanza (VA), Italy.,School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Erminio Bonizzoni
- Section of Medical Statistics and Biometry "GA Maccacaro", Department of Clinical Science and Community, University of Milan, Milan, Italy
| | - Tania Perrone
- Medical Affairs Department, Italfarmaco SpA, Milan, Italy
| | - Alberto Bosi
- Hematology Department, University of Florence and AOU Careggi, Florence, Italy,
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Cencini E, Sicuranza A, Fabbri A, Ferrigno I, Rigacci L, Cox MC, Raspadori D, Bocchia M. Study of gene polymorphisms as predictors of treatment efficacy and toxicity in patients with indolent non-hodgkin lymphomas and mantle cell lymphoma receiving bendamustine and rituximab. Br J Haematol 2018; 184:223-231. [PMID: 30203425 DOI: 10.1111/bjh.15582] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 07/24/2018] [Indexed: 12/11/2022]
Abstract
Bendamustine is used in combination with rituximab (BR) to treat indolent non-Hodgkin lymphomas (iNHL) and mantle cell lymphoma (MCL). The variability in treatment efficacy and toxicity could be related to single nucleotide polymorphisms (SNPs) in immune response genes. We would like to show a correlation between SNPs and treatment outcome in iNHL and MCL patients receiving BR. We investigated some SNPs that had already been associated with NHL outcome. Samples were genotyped for the IL2 (rs2069762), IL10 (rs1800890, rs10494879), VEGFA (rs3025039), IL8 (rs4073), CFH (rs1065489) and MTHFR (rs1801131) SNPs by allelic discrimination assays. We enrolled 70 patients that received rituximab 375 mg/m2 and bendamustine 90 mg/m2 every 28 days, both as first-line treatment and ≥ second-line regimens. Overall response rate was 97·1% (complete response [CR] rate 73·9%). Treatment toxicity included grade 3-4 neutropenia (24/70 patients), infections (21/70 patients; 1/70 grade 3), skin rash (26/70 patients; 2/70 grade 3). After a median follow-up of 24 months we did find any correlation between the analysed SNPs, CR rate and PFS. However, we demonstrated an association between the SNP in IL2 (rs2069762) and the onset of skin rash (P = 0·0001). Our study suggests a role for cytokine SNPs in bendamustine-related toxicity, which could represent a promising research field.
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Affiliation(s)
- Emanuele Cencini
- Unit of Haematology, Azienda Ospedaliera Universitaria Senese, Siena, Italy.,University of Siena, Siena, Italy
| | - Anna Sicuranza
- Unit of Haematology, Azienda Ospedaliera Universitaria Senese, Siena, Italy.,University of Siena, Siena, Italy
| | - Alberto Fabbri
- Unit of Haematology, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Ilaria Ferrigno
- Unit of Haematology, Azienda Ospedaliera Universitaria Senese, Siena, Italy.,University of Siena, Siena, Italy
| | - Luigi Rigacci
- Haematology Department, University of Florence, Florence, Italy
| | - Maria C Cox
- Haematology Department, Ospedale S. Andrea, Roma, Italy
| | | | - Monica Bocchia
- Unit of Haematology, Azienda Ospedaliera Universitaria Senese, Siena, Italy.,University of Siena, Siena, Italy
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Rigacci L, Kovalchuk S, Berti V, Puccini B, Mannelli L, Benelli G, Dini C, Pupi A, Bosi A. The use of Deauville 5-point score could reduce the risk of false-positive fluorodeoxyglucose-positron emission tomography in the posttherapy evaluation of patients with primary bone lymphomas. World J Nucl Med 2018; 17:157-165. [PMID: 30034279 PMCID: PMC6034538 DOI: 10.4103/wjnm.wjnm_42_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Primary bone lymphoma (PBL) is a rare disease. Little is reported about response evaluation procedures in these patients. Our aim was to evaluate response to therapy according to fluorodeoxyglucose-positron emission tomography (FDG-PET) results, and in particular to test the Deauville 5-point scale as compared to the visual evaluation of FDG-PET scans in PBL. In this single-center study, we diagnosed 31 consecutive patients with PBL, of which 24 were evaluated with end-of-treatment FDG-PET. Patients' ages ranged from 19 to 82 years. Six patients were treated with chemotherapy, 24 with chemotherapy and radiotherapy, and one patient with radiotherapy alone. Six patients were affected by a pathological fracture. Four patients died within the range of 3 to 36 months after diagnosis. The average follow-up of the remaining patients was 70 (24–173) months. Overall survival was 87% at 5 years. The only positive prognostic factor was complete remission after chemotherapy. According to visual criteria, end-of-treatment FDG-PET was evaluated in 24 patients and it was positive in 11 (46%) and negative in 13 patients. We organized a retrospective central-blinded revision of end-of-therapy FDG-PET scans using the 5-point Deauville Score (DS). We reviewed 17 out of 24 patients and obtained the following results: at the end of therapy, 12 patients with DS score 2, three patients with DS score 3, one patient with DS score 4, and none with DS score 5. Considering that all the 24 patients achieved complete remission after treatment, visual interpretation produced 11/24 false-positive results, and DS interpretation produced 1/17 false-positive results, thus significantly reducing the number of false positives. In PBL, the final evaluation at the end of therapy with FDG-PET should be evaluated using Deauville 5-point scale in order to significantly reduce the risk of false-positive scans.
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Affiliation(s)
- Luigi Rigacci
- Department of Hematology, University of Florence, Florence, Italy
| | - Sofia Kovalchuk
- Department of Hematology, University of Florence, Florence, Italy
| | - Valentina Berti
- Department of Biomedical, Experimental and Clinical Sciences, Nuclear Medicine Unit, University of Florence, Florence, Italy
| | | | - Lara Mannelli
- Department of Hematology, University of Florence, Florence, Italy
| | - Gemma Benelli
- Department of Hematology, University of Florence, Florence, Italy
| | - Catia Dini
- Department of Radiology, AOU Careggi, Florence, Italy
| | - Alberto Pupi
- Department of Biomedical, Experimental and Clinical Sciences, Nuclear Medicine Unit, University of Florence, Florence, Italy
| | - Alberto Bosi
- Department of Hematology, University of Florence, Florence, Italy
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Ambrosio MR, Lazzi S, Bello GL, Santi R, Porro LD, de Santi MM, Guazzo R, Mundo L, Rigacci L, Kovalchuck S, Onyango N, Fabbri A, Cencini E, Zinzani PL, Zaja F, Angrilli F, Stelitano C, Cabras MG, Spataro G, Bob R, Menter T, Granai M, Cevenini G, Naresh KN, Stein H, Sabattini E, Leoncini L. MYC protein expression scoring and its impact on the prognosis of aggressive B-cell lymphoma patients. Haematologica 2018; 104:e25-e28. [PMID: 29954940 DOI: 10.3324/haematol.2018.195958] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Affiliation(s)
- Maria R Ambrosio
- Department of Medical Biotechnologies, University of Siena, Italy
| | - Stefano Lazzi
- Department of Medical Biotechnologies, University of Siena, Italy
| | | | - Raffaella Santi
- Division of Pathological Anatomy, University of Florence, Italy
| | | | | | - Raffaella Guazzo
- Department of Medical Biotechnologies, University of Siena, Italy
| | - Lucia Mundo
- Department of Medical Biotechnologies, University of Siena, Italy
| | - Luigi Rigacci
- Hematology Division, AOU Careggi, University of Firenze, Italy
| | | | - Noel Onyango
- Department of Clinical Medicine and Therapeutics, Unit of Medical Oncology, University of Nairobi, Kenya
| | - Alberto Fabbri
- Haematology Unit, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Emanuele Cencini
- Haematology Unit, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Pier Luigi Zinzani
- Institute of Hematology "L. e A. Seràgnoli", University of Bologna, Italy
| | - Francesco Zaja
- Clinica Ematologica ed Unità di Terapie Cellulari "Carlo Melzi", DAME, University of Udine, Italy
| | | | | | | | - Giuseppe Spataro
- Post Graduate School of Public Health, University of Siena, Italy
| | | | - Thomas Menter
- Institute of Pathology and Medical Genetics, University Hospital of Basel, Switzerland.,Department of Cellular and Molecular Pathology, Hammersmith Hospital Campus, Imperial College Healthcare NHS Trust, London, UK
| | - Massimo Granai
- Department of Medical Biotechnologies, University of Siena, Italy
| | | | - Kikkeri N Naresh
- Department of Cellular and Molecular Pathology, Hammersmith Hospital Campus, Imperial College Healthcare NHS Trust, London, UK
| | | | - Elena Sabattini
- Unit of Haemolymphopathology, Department of Hematology and Oncology, University Hospital of Bologna, Italy
| | - Lorenzo Leoncini
- Department of Medical Biotechnologies, University of Siena, Italy
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48
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Witzig T, Tobinai K, Rigacci L, Ikeda T, Vanazzi A, Hino M, Shi Y, Mayer J, Costa L, Bermudez Silva C, Zhu J, Belada D, Bouabdallah K, Kattan J, Kuruvilla J, Kim W, Larouche JF, Ogura M, Ozcan M, Fayad L, Wu C, Fan J, Louveau AL, Voi M, Cavalli F. Adjuvant everolimus in high-risk diffuse large B-cell lymphoma: final results from the PILLAR-2 randomized phase III trial. Ann Oncol 2018; 29:707-714. [DOI: 10.1093/annonc/mdx764] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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49
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Bomben R, Ferrero S, D'Agaro T, Dal Bo M, Re A, Evangelista A, Carella AM, Zamò A, Vitolo U, Omedè P, Rusconi C, Arcaini L, Rigacci L, Luminari S, Piccin A, Liu D, Wiestner A, Gaidano G, Cortelazzo S, Ladetto M, Gattei V. A B-cell receptor-related gene signature predicts survival in mantle cell lymphoma: results from the Fondazione Italiana Linfomi MCL-0208 trial. Haematologica 2018; 103:849-856. [PMID: 29472356 PMCID: PMC5927985 DOI: 10.3324/haematol.2017.184325] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 11/10/2017] [Accepted: 02/14/2018] [Indexed: 12/22/2022] Open
Abstract
Mantle cell lymphoma patients have variable clinical courses, ranging from indolent cases that do not require immediate treatment to aggressive, rapidly progressing diseases. Thus, diagnostic tools capable of stratifying patients according to their risk of relapse and death are needed. This study included 83 samples from the Fondazione Italiana Linfomi MCL-0208 clinical trial. Through gene expression profiling and quantitative real-time PCR we analyzed 46 peripheral blood and 43 formalin-fixed paraffin-embedded lymph node samples. A prediction model to classify patients was developed. By analyzing the transcriptome of 27 peripheral blood samples, two subgroups characterized by a differential expression of genes from the B-cell receptor pathway (B-cell receptorlow and B-cell receptorhigh) were identified. The prediction model based on the quantitative real-time PCR values of six representative genes (AKT3, BCL2, BTK, CD79B, PIK3CD, and SYK), was used to classify the 83 cases (43 B-cell receptorlow and 40 B-cell receptorhigh). The B-cell receptorhigh signature associated with shorter progression-free survival (P=0.0074), selected the mantle cell lymphoma subgroup with the shortest progression-free survival and overall survival (P=0.0014 and P=0.029, respectively) in combination with high (>30%) Ki-67 staining, and was an independent predictor of short progression- free survival along with the Mantle Cell Lymphoma International Prognostic Index-combined score. Moreover, the clinical impact of the 6- gene signature related to the B-cell receptor pathway identified a mantle cell lymphoma subset with shorter progression-free survival intervals also in an external independent mantle cell lymphoma cohort homogenously treated with different schedules. In conclusion, this 6-gene signature associates with a poor clinical response in the context of the MCL- 0208 clinical trial. (clinicaltrials.gov identifier: 02354313).
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Affiliation(s)
- Riccardo Bomben
- Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico, IRCCS, Aviano (PN), Italy
| | - Simone Ferrero
- Department of Molecular Biotechnologies and Health Sciences, Hematology Division 1, University of Torino, Italy.,Hematology Division 1, AOU "Città della Salute e della Scienza di Torino" University-Hospital, Italy
| | - Tiziana D'Agaro
- Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico, IRCCS, Aviano (PN), Italy
| | - Michele Dal Bo
- Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico, IRCCS, Aviano (PN), Italy
| | | | - Andrea Evangelista
- Unit of Cancer Epidemiology, AOU "Città della Salute e della Scienza di Torino" University-Hospital, Italy
| | | | - Alberto Zamò
- Department of Diagnostics and Public Health, University of Verona, Italy
| | - Umberto Vitolo
- Hematology Division 1, AOU "Città della Salute e della Scienza di Torino" University-Hospital, Italy
| | - Paola Omedè
- Hematology Division 1, AOU "Città della Salute e della Scienza di Torino" University-Hospital, Italy
| | - Chiara Rusconi
- Hematology Division, "Niguarda Ca' Granda" Hospital, Milano, Italy
| | - Luca Arcaini
- Hematology Division, Department of Molecular Medicine, IRCCS Fondazione San Matteo, Pavia, Italy
| | - Luigi Rigacci
- Hematology Division, AOU "Careggi", University of Firenze, Italy
| | - Stefano Luminari
- Hematology, Azienda Sanitaria Locale IRCCS, Reggio Emilia, Italy.,Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Andrea Piccin
- Department of Hematology and BMT Unit, Bolzano/Bozen Regional Hospital, Italy
| | - Delong Liu
- Hematology Branch, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD, USA
| | - Adrian Wiestner
- Hematology Branch, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD, USA
| | - Gianluca Gaidano
- Division of Haematology, Department of Translational Medicine -University of Eastern Piedmont, Novara, Italy
| | - Sergio Cortelazzo
- Hematology, Medical Oncology and Hematology Division, "Istituto Clinico Humanitas Gavazzeni", Bergamo, Italy
| | - Marco Ladetto
- Department of Molecular Biotechnologies and Health Sciences, Hematology Division 1, University of Torino, Italy.,SC Ematologia Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Valter Gattei
- Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico, IRCCS, Aviano (PN), Italy
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50
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Calistri L, Puccini B, Berti V, Grazzini G, Nardi C, Rigacci L, Colagrande S. Diffusion-Weighted and Perfusion-Weighted MRI to Evaluate Therapeutic Response in Lymphoma: A Comparison with FDG-PET/CT. Acta Haematol 2018; 139:74-76. [PMID: 29393082 DOI: 10.1159/000485548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 11/18/2017] [Indexed: 11/19/2022]
Affiliation(s)
- Linda Calistri
- Radiodiagnostic Unit No. 2, Department of Experimental and Clinical Biomedical Sciences, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
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