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Arcaini L, Bommier C, Alderuccio JP, Merli M, Fabbri N, Nizzoli ME, Maurer MJ, Tarantino V, Ferrero S, Rattotti S, Talami A, Murru R, Khurana A, Mwangi R, Deodato M, Cencini E, Re F, Visco C, Feldman AL, Link BK, Delamain MT, Spina M, Annibali O, Pulsoni A, Ferreri AJ, Stelitano CC, Pennese E, Habermann TM, Marcheselli L, Han S, Reis IM, Paulli M, Lossos IS, Cerhan JR, Luminari S. Marginal zone lymphoma international prognostic index: a unifying prognostic index for marginal zone lymphomas requiring systemic treatment. EClinicalMedicine 2024; 72:102592. [PMID: 38633575 PMCID: PMC11019091 DOI: 10.1016/j.eclinm.2024.102592] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 03/21/2024] [Accepted: 03/22/2024] [Indexed: 04/19/2024] Open
Abstract
Background Marginal zone lymphomas (MZL), comprised of three unique but related subtypes, lack a unifying prognostic score applicable to all the patients in need for systemic chemotherapy and/or immunotherapy. Methods Patients from the prospective NF10 study (NCT02904577) with newly diagnosed MZL and receiving frontline systemic therapy at diagnosis or after observation were used to train a prognostic model. The primary endpoint was progression-free survival (PFS) from start of treatment. The model was externally validated in a pooled analysis of two independent cohorts from the University of Iowa and Mayo Clinic Molecular Epidemiology Resource and the University of Miami. Findings We identified 501 eligible patients. After multivariable modeling, lactate dehydrogenase (LDH) above upper normal limit, hemoglobin <12 g/dL, absolute lymphocyte count <1 × 109/L, platelets <100 × 109/L, and MZL subtype (nodal or disseminated) were independently associated with inferior PFS. The proposed MZL International Prognostic index (MZL-IPI) combined these 5 factors, and we defined low (LRG, 0 factors, 27%), intermediate (IRG, 1-2 factors, 57%) and high (HRG, 3+ factors, 16%) risk groups with 5-y PFS of 85%, 66%, and 37%, respectively (c-Harrell = 0.64). Compared to the LRG, the IRG (Hazard Ratio [HR] = 2.30, 95% CI 1.39-3.80) and HRG (HR = 5.41, 95% CI 3.12-9.38) had inferior PFS. Applying the MZL-IPI to the pooled US cohort (N = 353), 94 (27%), 192 (54%), and 67 (19%) patients were classified as LRG, IRG, and HRG, respectively, and the model was validated for PFS (log-rank test p = 0.0018; c-Harrell = 0.578, 95% CI 0.54-0.62). The MZL-IPI was also prognostic for OS in both the training and the external validation sets. Interpretation MZL-IPI is a new prognostic score for use in all patients with MZL considered for systemic treatment. Funding The MER was supported by P50 CA97274 and U01 CA195568.
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Affiliation(s)
- Luca Arcaini
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Côme Bommier
- Hemato-Oncology Department, DMU DHI, Hôpital Saint Louis, Paris, France
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Juan Pablo Alderuccio
- Division of Hematology, Department of Medicine, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Michele Merli
- Division of Hematology, University Hospital Ospedale di Circolo e Fondazione Macchi-ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Nicole Fabbri
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Maria Elena Nizzoli
- Division of Hematology, Azienda Unità Sanitaria Locale – IRCCS, Reggio Emilia, Italy
- Clinical and Experimental Medicine Doctorate School, Università degli Studi di Modena e Reggio Emilia, Italy
| | - Matthew J. Maurer
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Vittoria Tarantino
- Division of Hematology, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy
| | - Simone Ferrero
- Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino, and AOU “Città della Salute e della Scienza di Torino”, Torino, Italy
| | - Sara Rattotti
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Annalisa Talami
- Clinical and Experimental Medicine Doctorate School, Università degli Studi di Modena e Reggio Emilia, Italy
| | - Roberta Murru
- Hematology and Stem Cell Transplantation Unit, Ospedale Oncologico A. Businco, ARNAS G. Brotzu, Cagliari, Italy
| | | | - Raphael Mwangi
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Marina Deodato
- Division of Hematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Emanuele Cencini
- Division of Hematology, Azienda Ospedaliera Universitaria Senese and University of Siena, Siena, Italy
| | - Francesca Re
- Division of Hematology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Carlo Visco
- Division of Hematology, San Bortolo Hospital, AULSS 8 Berica, Vicenza, Italy
| | - Andrew L. Feldman
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Brian K. Link
- Department of Internal Medicine, University of Iowa Hospitals, Iowa City, IA, USA
| | - Marcia Torresan Delamain
- Faculty of Medical of Minas Gerais, Feluma, Brazil for Faculty of Medical of Minas Gerais, Belo Horizonte, Brazil
| | - Michele Spina
- Division of Medical Oncology and Immune-Related Tumors, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Ombretta Annibali
- Division of Hematology, Stem Cell Transplantation, University Campus Bio-Medico, Roma, Italy
| | - Alessandro Pulsoni
- Division of Hematology, Sapienza University – Polo Pontino, Department of Translational and Precision Medicine, S.M. Goretti Hospital, Latina, Italy
| | - Andrés J.M. Ferreri
- Lymphoma Unit, IRCCS San Raffaele Scientific Institute, and University Vita-Salute San Raffaele, Milano, Italy
| | - Caterina Cecilia Stelitano
- Division of Hematology, Grande Ospedale Metropolitano, Bianchi Melacrino Morelli, Reggio Calabria, Reggio Calabria, Italy
| | - Elsa Pennese
- Division of Hematology, Ospedale Spirito Santo, Pescara, Italy
| | | | | | - Sunwoo Han
- Biostatistics and Bioinformatics Shared Resource, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Isildinha M. Reis
- Biostatistics and Bioinformatics Shared Resource, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Marco Paulli
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
- Division of Pathology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Izidore S. Lossos
- Division of Hematology, Department of Medicine, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - James R. Cerhan
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Stefano Luminari
- Division of Hematology, Azienda Unità Sanitaria Locale – IRCCS, Reggio Emilia, Italy
- Department CHIMOMO, University of Modena and Reggio Emilia, Modena, Italy
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Zilioli VR, Cencini E, Lorenzo SD, Pezzullo L, Merli M, Rivellini F, Muzi C, Emiliano B, Marcheselli L, Luminari S. Real-life study on the use of response adapted therapy in patients with Hodgkin Lymphoma: Results from a multicenter experience. Hematol Oncol 2024; 42:e3273. [PMID: 38661120 DOI: 10.1002/hon.3273] [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: 02/13/2024] [Revised: 04/11/2024] [Accepted: 04/13/2024] [Indexed: 04/26/2024]
Abstract
Few data are known regarding the use of interim positron emission tomography (iPET) after the first two cycles (iPET2) of chemotherapy in treatment-naïve classical Hodgkin lymphoma (cHL) in routine clinical practice, and about the real-life adoption of intensification strategies for iPET positive patients. We conducted a multicenter retrospective study on cHL to investigate the use of iPET in the real-life setting, its prognostic role and outcomes of patients early shifted to intensification. Six hundreds and forty-one patients were enrolled (62% had advanced stage). iPET2 was positive in 89 patients (14%) including 8.7% and 17% early and advanced stage patients, respectively (p = 0.003). Among iPET 2 positive cases treatment was immediately modified in 19 cases; in 14 cases treatment was modified after an additional positive iPET4. Overall 56 iPET2 positive patients never received intensified therapies. Most frequently used intensified therapy was autologous stem cell transplantation followed by BEACOPP. After a median follow-up of 72 months, the 5-year progression-free survival (PFS) was 82% with iPET2 positive patients showing a worse PFS compared with iPET2 negative cases: 31% versus 85%. Focusing on advanced stage patients with a positive iPET2, the 5-year PFS was 59% for patients shifted to intensified therapy at any time point versus 61% for patients who never received intensified therapy. Our study confirmed the higher curability of naïve cHL patients in a real-world setting, and the prognostic role of iPET2 in this setting. A poor adherence to response-adapted strategy which however did not translate into a difference in patient outcomes.
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Affiliation(s)
| | - Emanuele Cencini
- Hematology, Azienda Ospedaliera Universitaria Senese & University of Siena, Siena, Italy
| | - Sonya De Lorenzo
- U.O.C. Ematologia e T.M.O., AORN "S.G. Moscati", Avellino, Italy
| | - Luca Pezzullo
- U.O.C. di Ematologia con Trapianto di Midollo Osseo, A.U.O. "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Michele Merli
- Ospedale di Circolo e Fondazione Macchi, Varese, Italy
- Hematology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - Flavia Rivellini
- U.O.C. Ematologia e T.M.O., AORN "S.G. Moscati", Avellino, Italy
| | - Cristina Muzi
- Division of Hematology, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Barbieri Emiliano
- Doctorate School of Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Stefano Luminari
- Hematology Unit, Arcispedale S. Maria Nuova, Azienda Unità Sanitaria Locale - IRCCS, University of Modena and Reggio Emilia, Reggio Emilia, Italy
- Chimomo Department, University of Modena and Reggio Emilia, Reggio Emilia, Italy
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Merli M, Costantini A, Tafuri S, Bavaro DF, Minoia C, Meli E, Luminari S, Gini G. Management of vaccinations in patients with non-Hodgkin lymphoma. Br J Haematol 2024; 204:1617-1634. [PMID: 38532527 DOI: 10.1111/bjh.19422] [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: 12/19/2023] [Revised: 03/07/2024] [Accepted: 03/13/2024] [Indexed: 03/28/2024]
Abstract
Vaccinations are fundamental tools in preventing infectious diseases, especially in immunocompromised patients like those affected by non-Hodgkin lymphomas (NHLs). The COVID-19 pandemic made clinicians increasingly aware of the importance of vaccinations in preventing potential life-threatening SARS-CoV-2-related complications in NHL patients. However, several studies have confirmed a significant reduction in vaccine-induced immune responses after anti-CD20 monoclonal antibody treatment, thus underscoring the need for refined immunization strategies in NHL patients. In this review, we summarize the existing data about COVID-19 and other vaccine's efficacy in patients with NHL and propose multidisciplinary team-based recommendations for the management of vaccines in this specific group of patients.
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Affiliation(s)
- Michele Merli
- Division of Hematology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Costantini
- Clinical Immunology Unit, Azienda Ospedaliero Universitaria delle Marche - Università Politecnica delle Marche, Ancona, Italy
| | - Silvio Tafuri
- Department of Biomedical Sciences and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Davide Fiore Bavaro
- Department of Biomedical Sciences and Human Oncology, Clinic of Infectious Diseases, Aldo Moro University of Bari, Bari, Italy
| | - Carla Minoia
- Hematology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Erika Meli
- Division of Hematology, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - 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, Modena, Italy
| | - Guido Gini
- Clinic of Hematology, Azienda Ospedaliero Universitaria Delle Marche - Università Politecnica Delle Marche, Ancona, Italy
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Iannitto E, Ferrero S, Bommier C, Drandi D, Ferrante M, Bouabdallah K, Carras S, Gini G, Camus V, Mancuso S, Marcheselli L, Ferrari A, Merli M, Tessoulin B, Stelitano C, Beldjord K, Roti G, Jardin F, Castagnari B, Palombi F, Baseggio L, Traverse-Glehen A, Tripodo C, Liberati AM, Parolini M, Usai S, Patti C, Federico M, Musso M, Ladetto M, Zucca E, Thieblemont C. Bendamustine and rituximab as first-line treatment for symptomatic splenic marginal zone lymphoma: long-term outcome and impact of early unmeasurable minimal residual disease attainment from the BRISMA/IELSG36 phase II study. Haematologica 2024. [PMID: 38497158 DOI: 10.3324/haematol.2023.284109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Indexed: 03/19/2024] Open
Abstract
Not available.
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Affiliation(s)
- Emilio Iannitto
- La Maddalena Department of Oncology, Onco-Hematology and Bone Marrow Transplantation Unit, Palemo, Italy; Tumor Immunology Unit Department of Health Sciences University of Palermo School of Medicine. Istituto di Patologia Generale, Palermo
| | - Simone Ferrero
- Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino
| | - Côme Bommier
- Universitè Paris Citè; AP-HP, Hôpital Saint-Louis, Hemato-oncologie, Paris
| | - Daniela Drandi
- Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino
| | - Martina Ferrante
- Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino
| | - Krimo Bouabdallah
- CHU de Bordeaux - Hôpital Haut Lèvêque and Centre François Magendie, Service d'Hématologie Clinique et Thérapie Cellulaire, Pessac
| | - Sylvain Carras
- Univ. Grenoble Alpes. Institute For Advanced Biosciences (INSERM U1209, CNRS UMR 5309). University Hospital, Molecular Biology and Hematology departments, Grenoble
| | | | - Vincent Camus
- Department of Hematology, Centre Henri Becquerel, Rouen
| | - Salvatrice Mancuso
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), Hematology Unit, University of Palermo
| | | | - Angela Ferrari
- Azienda Unità Sanitaria Locale-IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia
| | - Michele Merli
- Hematology, Ospedale di Circolo e Fondazione Macchi - ASST Sette Laghi, Varese
| | | | | | | | - Giovanni Roti
- Dipartimento di Medicina e Chirurgia, Università di Parma, AOU di Parma
| | | | | | | | - Lucile Baseggio
- Laboratoire d'Hèmatologie Biologique, Groupement Hospitalier Lyon-Sud/Hospices Civils de Lyon
| | | | - Claudio Tripodo
- Tumor Immunology Unit Department of Health Sciences University of Palermo School of Medicine. Istituto di Patologia Generale, Palermo
| | | | - Margherita Parolini
- Ematologia Istituto Romagnolo Per Lo studio dei Tumori Dino Amadori, Meldola
| | - Sara Usai
- Ospedale Oncologico A. Businco, Cagliari
| | - Caterina Patti
- U.O.C. di Oncoematologia Ospedali Riuniti Villa Sofia - Cervello, Palermo
| | | | - Maurizio Musso
- La Maddalena Department of Oncology, Onco-Hematology and Bone Marrow Transplantation Unit, Palemo
| | - Marco Ladetto
- University of Eastern Piedmont Amedeo Avogadro S.S. Antonio and Biagio and Cesaro Arrigo Hospital, Alessandria
| | - Emanuele Zucca
- IOSI, Oncology Institute of Southern Switzerland and IOR: Institute of Oncology Research IELSG International Extranodal Lymphoma Study, Bellinzona, Switzerland
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Sciarra R, Merli M, Cristinelli C, Lucioni M, Zibellini S, Riboni R, Furlan D, Uccella S, Zerbi C, Bianchi B, Gotti M, Ferretti VV, Varraso C, Fraticelli S, Lazic T, Defrancesco I, Mora B, Libera L, Mazzacane A, Carpi F, Berliner M, Neri G, Rizzo E, De Paoli F, Sessa F, Passamonti F, Paulli M, Arcaini L. Molecular characterization of diffuse large B-cell lymphomas associated with hepatitis C virus infection. Br J Haematol 2024. [PMID: 38442902 DOI: 10.1111/bjh.19378] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 02/18/2024] [Accepted: 02/21/2024] [Indexed: 03/07/2024]
Abstract
Hepatitis C virus (HCV)-associated diffuse large B-cell lymphoma (DLBCL) displays peculiar clinicopathological characteristics, but its molecular landscape is not fully elucidated. In this study, we investigated the clinicopathological and molecular features of 54 patients with HCV-associated DLBCL. The median age was 71 years. An underlying marginal zone lymphoma component was detected in 14.8% of cases. FISH analysis showed rearrangements involving BCL6 in 50.9% of cases, MYC in 11.3% and BCL2 in 3.7%. Lymph2Cx-based assay was successful in 38 cases, recognizing 16 cases (42.1%) as ABC and 16 cases as GCB subtypes, while six resulted unclassified. ABC cases exhibited a higher lymphoma-related mortality (LRM). Next-generation sequencing analysis showed mutations in 158/184 evaluated genes. The most frequently mutated genes were KMT2D (42.6%), SETD1B (33.3%), RERE (29.4%), FAS and PIM1 (27.8%) and TBL1XR1 (25.9%). A mutation in the NOTCH pathway was detected in 25.9% of cases and was associated with worst LRM. Cluster analysis by LymphGen classified 29/54 cases within definite groups, including BN2 in 14 (48.2%), ST2 in seven (24.2%) and MCD and EZB in four each (13.8%). Overall, these results indicate a preferential marginal zone origin for a consistent subgroup of HCV-associated DLBCL cases and suggest potential implications for molecularly targeted therapies.
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Affiliation(s)
- Roberta Sciarra
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Michele Merli
- Division of Hematology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Marco Lucioni
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
- Anatomic Pathology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Silvia Zibellini
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Roberta Riboni
- Anatomic Pathology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Daniela Furlan
- Anatomic Pathology Unit, University of Insubria, Ospedale di Circolo, Varese, Italy
| | - Silvia Uccella
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Pathology Service, IRCCS, Humanitas Research Hospital, Milan, Italy
| | - Caterina Zerbi
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Benedetta Bianchi
- Division of Hematology, University Hospital Ospedale di Circolo e Fondazione Macchi-ASST Sette Laghi, Varese, Italy
| | - Manuel Gotti
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Chiara Varraso
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Sara Fraticelli
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
- Anatomic Pathology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Tanja Lazic
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Irene Defrancesco
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Medical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Barbara Mora
- Division of Hematology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Libera
- Anatomic Pathology Unit, University of Insubria, Ospedale di Circolo, Varese, Italy
| | | | - Federico Carpi
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Martha Berliner
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Giuseppe Neri
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | | | | | - Fausto Sessa
- Anatomic Pathology Unit, University of Insubria, Ospedale di Circolo, Varese, Italy
| | - Francesco Passamonti
- Division of Hematology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
- University of Milan, Milan, Italy
| | - Marco Paulli
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
- Anatomic Pathology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Luca Arcaini
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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6
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Salvini M, Grossi PA, Cacioppo A, Merli M, Pellegrini G, Brociner M, Passamonti F. Efficacy of Tixagevimab-Cilgavimab as Immunoprophylaxis in Patients With Hematologic Cancer. JAMA Oncol 2024; 10:405-407. [PMID: 38270961 PMCID: PMC10811587 DOI: 10.1001/jamaoncol.2023.6446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 11/04/2023] [Indexed: 01/26/2024]
Abstract
This cohort study compares outcomes for patients with hematologic malignant tumors who prophylactically received tixagevimab-cilgavimab against SARS-CoV-2 with those who did not.
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Affiliation(s)
- Marco Salvini
- ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Paolo Antonio Grossi
- ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | | | - Michele Merli
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Giacomo Pellegrini
- ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Marco Brociner
- ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Francesco Passamonti
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy
- Department of Medicine and Surgery, Università degli Studi di Milano, Milano, Italy
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7
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Stathis A, Pirosa MC, Orsucci L, Feugier P, Tani M, Ghesquières H, Musuraca G, Rossi FG, Merli F, Guièze R, Gyan E, Gini G, Marino D, Gressin R, Morschhauser F, Cavallo F, Palombi F, Conconi A, Tessoulin B, Tilly H, Zanni M, Cabras MG, Capochiani E, Califano C, Celli M, Pulsoni A, Angrilli F, Occhini U, Casasnovas RO, Cartron G, Devizzi L, Haioun C, Liberati AM, Houot R, Merli M, Pietrantuono G, Re F, Spina M, Landi F, Cavalli F, Bertoni F, Rossi D, Ielmini N, Borgo E, Luminari S, Zucca E, Thieblemont C. IELSG38: phase II trial of front-line chlorambucil plus subcutaneous rituximab induction and maintenance in mucosa-associated lymphoid tissue lymphoma. Haematologica 2024. [PMID: 38385243 DOI: 10.3324/haematol.2023.283918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Indexed: 02/23/2024] Open
Abstract
The IELSG38 trial was conducted to investigate the effects of subcutaneous (SC) rituximab on the complete remission (CR) rate and the benefits of SC maintenance in patients with extranodal marginal zone lymphoma (MZL) who received frontline treatment with chlorambucil plus rituximab. Study treatment comprised an induction phase with chlorambucil 6 mg/m2/day orally on weeks 1-6, 9-10, 13-14, 17-18, and 21-22, and rituximab 375 mg/m2 intravenously on day 1 of weeks 1-4, and 1400 mg SC on weeks 9, 13, 17, and 21. Then, a maintenance phase followed with rituximab administered at 1400 mg SC every two months for two years. Of the 112 patients enrolled, 109 were evaluated for efficacy. The CR rates increased from 52% at the end of the induction phase to 70% upon completion of the maintenance phase. With a median follow-up of 5.8 years, the 5-year event-free, progression-free, and overall survival rates were 87% (95% CI, 78-92), 84% (95% CI, 75-89), and 93% (95% CI, 86-96), respectively. The most common grade ≥3 toxicities were neutropenia (33%) and lymphocytopenia (16%). Six patients experienced treatment-related serious adverse events, including fever of unknown origin, sepsis, pneumonia, respiratory failure, severe cerebellar ataxia, and fatal acute myeloid leukemia. The trial showed that subcutaneous rituximab did not improve the complete remission rate at the conclusion of the induction phase, which was the main endpoint. Nevertheless, SC maintenance might have facilitated long-term disease control, potentially contributing to enhanced event-free and progression-free survival.
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Affiliation(s)
- Anastasios Stathis
- Oncology Institute of Southern Switzerland, EOC, Bellinzona, Switzerland; Università della Svizzera Italiana, Faculty of Biomedical Sciences, Lugano.
| | - Maria Cristina Pirosa
- Oncology Institute of Southern Switzerland, EOC, Bellinzona, Switzerland; Institute of Oncology Research, Bellinzona
| | - Lorella Orsucci
- S.C. Ematologia, AOU Città della Salute e della Scienza di Torino, Turin
| | - Pierre Feugier
- Department of Clinical Hematology, Nancy University Hospital, INSERM 1256, Nancy
| | - Monica Tani
- U.O. Ematologia, Dipartimento Oncologia e Ematologia, Ospedale Santa Maria delle Croci, Ravenna
| | - Hervé Ghesquières
- Hematology Department, Hospices Civils de Lyon, CHU Lyon-Sud, Pierre-Bénite
| | - Gerardo Musuraca
- Hematology Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola
| | - Francesca Gaia Rossi
- Hematology-BMT Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milano
| | | | - Romain Guièze
- Service d'Hématologie Clinique et de Thérapie Cellulaire, CHU Estaing, Clermont- Ferrand
| | - Emmanuel Gyan
- Hématologie et thérapie cellulaire, CIC Inserm U1415, Centre Hospitalier Universitaire de Tours, Tours
| | - Guido Gini
- Hematology, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona
| | - Dario Marino
- Oncology 1 Unit, Istituto Oncologico Veneto IOV-IRCCS, Padova
| | - Remy Gressin
- Institute for Advanced Biosciences, INSERM U1209/CNRS UMR 5309/Grenoble Alpes University, Grenoble
| | | | - Federica Cavallo
- Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino/AOU Città della Salute e della Scienza di Torino, Turin
| | - Francesca Palombi
- Hematology and Stem Cell Transplant Unit, IRCCS. National Cancer Institute, Istituto Regina Elena, Rome Italy
| | | | - Benoît Tessoulin
- Hématologie Clinique, CHU de Nantes, INSERM CRCINA Nantes-Angers, NeXT Université de Nantes, Nantes
| | - Hervé Tilly
- Department of Hematology and U1245, Centre Henri Becquerel, Rouen
| | - Manuela Zanni
- Hematology Unit, Antonio e Biagio e Cesare Arrigo Hospital, Alessandria
| | | | - Enrico Capochiani
- Hematology Unit, Azienda USL Toscana NordOvest, Center for Translational Medicine, Livorno
| | | | | | - Alessandro Pulsoni
- Department of Translational and Precision Medicine, Sapienza University, Rome
| | - Francesco Angrilli
- Unità Operativa Semplice Dipartimentale Centro Diagnosi e Terapia Linfomi, Presidio Ospedaliero, Pescara
| | - Ubaldo Occhini
- Unità Operativa di Ematologia, Ospedale San Donato, AUSL Toscana Sud-Est, Arezzo
| | | | | | - Liliana Devizzi
- Hematology Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan
| | - Corinne Haioun
- Lymphoid Malignancies Unit, Hôpital Henri Mondor, AP-HP, Créteil
| | - Anna Marina Liberati
- SC Oncoematologia, Azienda Ospedaliera Santa Maria, Università degli studi di Perugia, Terni
| | - Roch Houot
- Department of Clinical Hematology, University Hospital of Rennes, Rennes
| | - Michele Merli
- Division of Hematology, University Hospital Ospedale di Circolo e Fondazione Macchi ASST Sette Laghi, University of Insubria, Varese
| | - Giuseppe Pietrantuono
- Hematology Unit, Centro di Riferimento Oncologico della Basilicata IRCCS Rionero in Vulture
| | - Francesca Re
- Hematology and BMT Center, Azienda Ospedaliera Universitaria, Parma
| | - Michele Spina
- Division of Medical Oncology, Centro di Riferimento Oncologico IRCCS, Aviano
| | | | | | - Francesco Bertoni
- Oncology Institute of Southern Switzerland, EOC, Bellinzona, Switzerland; Università della Svizzera Italiana, Faculty of Biomedical Sciences, Lugano, Switzerland; Institute of Oncology Research, Bellinzona
| | - Davide Rossi
- Oncology Institute of Southern Switzerland, EOC, Bellinzona, Switzerland; Università della Svizzera Italiana, Faculty of Biomedical Sciences, Lugano, Switzerland; Institute of Oncology Research, Bellinzona
| | | | - Elena Borgo
- FIL, Fondazione Italiana Linfomi ONLUS, Alessandria
| | - Stefano Luminari
- AUSL-IRCCS of Reggio Emilia, Reggio Emilia, Italy; CHIMOMO Department, University of Modena and Reggio Emilia, Reggio Emilia
| | - Emanuele Zucca
- Oncology Institute of Southern Switzerland, EOC, Bellinzona, Switzerland; Università della Svizzera Italiana, Faculty of Biomedical Sciences, Lugano, Switzerland; Institute of Oncology Research, Bellinzona, Switzerland; Medical Oncology, University Hospital and University of Bern
| | - Catherine Thieblemont
- APHP - Service d'Hématologie-Oncologie, Hôpital Saint Louis, Université de Paris - Diderot, Paris
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Zinzani PL, Mayer J, Flowers CR, Bijou F, De Oliveira AC, Song Y, Zhang Q, Merli M, Bouabdallah K, Ganly P, Zhang H, Johnson R, Martín García-Sancho A, Provencio Pulla M, Trněný M, Yuen S, Tilly H, Kingsley E, Tumyan G, Assouline SE, Auer R, Ivanova E, Kim P, Huang S, Delarue R, Trotman J. ROSEWOOD: A Phase II Randomized Study of Zanubrutinib Plus Obinutuzumab Versus Obinutuzumab Monotherapy in Patients With Relapsed or Refractory Follicular Lymphoma. J Clin Oncol 2023; 41:5107-5117. [PMID: 37506346 DOI: 10.1200/jco.23.00775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 07/10/2023] [Accepted: 07/21/2023] [Indexed: 07/30/2023] Open
Abstract
PURPOSE The combination of zanubrutinib plus obinutuzumab (ZO) was found to be well tolerated with an early signal of efficacy in a phase Ib study. ROSEWOOD is a phase II, randomized study that assessed the efficacy and safety of ZO versus obinutuzumab in patients with relapsed/refractory (R/R) follicular lymphoma (FL). METHODS Patients with R/R FL who had received ≥2 lines of therapy, including an anti-CD20 antibody and an alkylating agent, were randomly assigned 2:1 to receive ZO or obinutuzumab (O). The primary end point was overall response rate (ORR) by independent central review (ICR). Secondary end points included duration of response (DOR), progression-free survival (PFS), overall survival, and safety. RESULTS A total of 217 patients were randomized (ZO, 145; O, 72). Median study follow-up was 20.2 months. The study met its primary end point: ORR by ICR was 69% (ZO) versus 46% (O; P = .001). Complete response rate was 39% (ZO) versus 19% (O); 18-month DOR rate was 69% (ZO) versus 42% (O). Median PFS was 28.0 months (ZO) versus 10.4 months (O; hazard ratio, 0.50 [95% CI, 0.33 to 0.75]; P < .001). The most common adverse events with ZO were thrombocytopenia, neutropenia, diarrhea, and fatigue; incidences of atrial fibrillation and major hemorrhage were 3% and 1%, respectively. CONCLUSION The combination of ZO met its primary end point of a superior ORR versus O, and demonstrated meaningful activity and a manageable safety profile in patients with R/R FL. ZO had a favorable benefit-risk profile compared with O, and represents a potential combination therapy for patients with R/R FL.
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Affiliation(s)
- Pier Luigi Zinzani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna Istituto di Ematologia "Seràgnoli" and Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Jiří Mayer
- Department of Internal Medicine-Hematology and Oncology, Masaryk University and University Hospital, Brno, Czech Republic
| | | | | | - Ana C De Oliveira
- Institut Catala d'Oncologia (ICO) Hospital Duran I Reynals, Hospital, Barcelana, Spain
| | - Yuqin Song
- Peking University Cancer Hospital and Institute, Beijing, China
| | - Qingyuan Zhang
- Harbin Medical University Cancer Hospital, Harbin, China
| | - Michele Merli
- Hematology, University Hospital "Ospedale di Circolo e Fondazione Macchi"-ASST Sette Laghi, University of Insubria, Varese, Italy
| | | | - Peter Ganly
- Department of Haematology, Christchurch Hospital, Christchurch, New Zealand
| | - Huilai Zhang
- Tianjin Medical University Cancer Institute & Hospital, Tianjin, China
| | - Roderick Johnson
- The Leeds Teaching Hospitals NHS Trust, St James's University Hospital, Leeds, United Kingdom
| | | | | | - Marek Trněný
- Vseobecna fakultní nemocnice v Praze, Nové Město, Czech Republic
| | - Sam Yuen
- Calvary Mater Newcastle, Waratah, NSW, Australia
| | | | | | - Gayane Tumyan
- N.N. Blokhin Russian Cancer Research Center, Moscow, Russia
| | | | - Rebecca Auer
- St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom
| | | | - Pil Kim
- BeiGene USA, Inc, San Mateo, CA
| | - Sha Huang
- BeiGene (Shanghai) Co, Ltd, Shanghai, China
| | | | - Judith Trotman
- Concord Repatriation General Hospital, University of Sydney, Concord, NSW, Australia
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Merli M, Passamonti F, Arcaini L. Deciphering molecular complexity of HCV-associated lymphoproliferation. Br J Haematol 2023; 203:154-157. [PMID: 37592432 DOI: 10.1111/bjh.19043] [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: 08/01/2023] [Accepted: 08/03/2023] [Indexed: 08/19/2023]
Abstract
Recent clinical studies demonstrated the achievement of lymphoma responses in patients with Hepatitis C virus-associated indolent lymphoproliferative disorders (LPD) receiving direct-acting antivirals (DAAs) as their sole treatment. However, the molecular mechanisms underlying LPD responses to DAAs are still poorly understood. In their paper the authors provide new molecular insights on this issue, reporting intraclonal diversification and persistence of B-cell clones in most cases, despite viral eradication and beneficial clinical outcome. These provocative data suggest that the achievement of molecular response is probably not required for a 'functional cure' of these patients. Further comprehensive immunogenetic and mutational studies would be fundamental to dissect this biological puzzle and, ultimately, to refine improved treatment strategies in this setting. Commentary on: Mazzaro et al. Persistence of monoclonal B-cell expansion and intraclonal diversification despite virus eradication in patients affected by hepatitis C virus-associated lymphoproliferative disorders. Br J Haematol 2023;203:237-243.
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Affiliation(s)
- Michele Merli
- Division of Hematology, University Hospital "Ospedale di Circolo e Fondazione Macchi - ASST Sette Laghi", Varese, Italy
| | - Francesco Passamonti
- Division of Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Università degli Studi di Milano, Milan, Italy
| | - Luca Arcaini
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
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Nizzoli ME, Manni M, Ghiggi C, Pulsoni A, Musuraca G, Merli M, Califano C, Bari A, Massaia M, Conconi A, Musto P, Mannina D, Perrone T, Re F, Galimberti S, Gini G, Capponi M, Vitolo U, Usai SV, Stefani PM, Ballerini F, Liberati AM, Pennese E, Pastore D, Skrypets T, Catellani H, Marcheselli L, Federico M, Luminari S. Impact of immunochemotherapy with R-bendamustine or R-CHOP for treatment naïve advanced-stage follicular lymphoma: A subset analysis of the FOLL12 trial by Fondazione Italiana Linfomi. Hematol Oncol 2023; 41:655-662. [PMID: 37246287 DOI: 10.1002/hon.3184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/10/2023] [Accepted: 05/12/2023] [Indexed: 05/30/2023]
Abstract
We conducted a post hoc analysis of the FOLL12 trial to determine the impact of different initial immunochemotherapy (ICT) regimens on patient outcomes. Patients were selected from the FOLL12 trial, which included adults with stage II-IV follicular lymphoma (FL) grade 1-3a and high tumor burden. Patients were randomized 1:1 to receive either standard ICT followed by rituximab maintenance (RM) or the same ICT followed by a response-adapted approach. ICT consisted of rituximab-bendamustine (RB) or rituximab, cyclophosphamide, doxorubicin, and prednisone (R-CHOP), per physician's decision. A total of 786 patients were included in this analysis, 341 of whom received RB and 445 R-CHOP. RB was more frequently prescribed to older subjects, females, patients without bulky disease, and those with grade 1-2 FL. After a median of 56 months of follow-up, R-CHOP and RB had similar progression-free survival (PFS) (Hazard Ratio for RB 1.11, 95% CI 0.87-1.42, p = 0.392). Standard RM was associated with improved PFS compared to response-adapted management both after R-CHOP and RB. Grade 3-4 hematologic adverse events were more frequent with R-CHOP during induction treatment and more frequent with RB during RM. Grade 3-4 infections were more frequent with RB. RB was also associated with a higher incidence of transformed FL. R-CHOP and RB showed similar activity and efficacy, but with different safety profiles and long-term events, suggesting that the treating physician should carefully select the most appropriate chemotherapy regimen for each patient based on patient's individual characteristics, choices, and risk profile.
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Affiliation(s)
- Maria E Nizzoli
- Hematology Unit, Azienda Unitа Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Martina Manni
- Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Chiara Ghiggi
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Alessandro Pulsoni
- Department of Translational and Precision Medicine, Sapienza University - UOC Ematologia, S.M. Goretti Hospital, Latina, Italy
| | - Gerardo Musuraca
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Michele Merli
- Hematology, University Hospital Ospedale di Circolo e Fondazione Macchi-ASST Sette Laghi, University of Insubria, Varese, Italy
| | | | - Alessia Bari
- Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell'Adulto, Università di Modena e Reggio Emilia, Modena, Italy
| | - Massimo Massaia
- SC Ematologia, AO S. Croce e Carle, Cuneo, Italy
- Centro di Biotecnologie Molecolari, University of Torino, Turin, Italy
| | | | - Pellegrino Musto
- Hematology, IRCCS CROB of Rionero in Vulture, Rionero in Vulture, Italy
| | - Donato Mannina
- Azienda Ospedaliera Papardo-UOC di Ematologia, Messina, Italy
| | - Tommasina Perrone
- Unit of Hematology and Stem Cell Transplantation, AOUC Policlinico, Bari, Italy
| | - Francesca Re
- Division od Immuno-Haematology, AOU Parma, Parma, Italy
| | - Sara Galimberti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Guido Gini
- Clinic of Hematology AOU delle Marche- Università Politecnica delle Marche, Ancona, Italy
| | - Monia Capponi
- Department of Hematology, University of Perugia, Perugia, Italy
| | - Umberto Vitolo
- Medical Oncology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - Sara V Usai
- Division of Hematology, Ospedale Oncologico Armando Businco, Cagliari, Italy
| | - Piero M Stefani
- Hematology Unit, General Hospital Ca' Foncello, Treviso, Italy
| | - Filippo Ballerini
- Clinica Ematologica, Ospedale Policlinico San Martino, Genova, Italy
| | - Anna M Liberati
- Oncohematology Unit, University of Perugia, Azienda Ospedaliera S.Maria Terni, Messina, Italy
| | - Elsa Pennese
- Lymphoma Unit, Department of Hematology, Ospedale Spirito Santo, Pescara, Italy
| | | | - Tetiana Skrypets
- Hematology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Hillary Catellani
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Massimo Federico
- Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefano Luminari
- Hematology Unit, Azienda Unitа Sanitaria Locale-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, Modena, Italy
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Arcari A, Rigacci L, Tucci A, Puccini B, Usai SV, Cavallo F, Fabbri A, Balzarotti M, Pelliccia S, Luminari S, Pennese E, Zilioli VR, Mahmoud AM, Musuraca G, Marino D, Sartori R, Botto B, Gini G, Zanni M, Hohaus S, Tarantini G, Flenghi L, Tani M, Di Rocco A, Merli M, Vallisa D, Pagani C, Nassi L, Dessì D, Ferrero S, Cencini E, Bernuzzi P, Mammi C, Marcheselli L, Tabanelli V, Spina M, Merli F. A Fondazione Italiana Linfomi cohort study of R-COMP vs R-CHOP in older patients with diffuse large B-cell lymphoma. Blood Adv 2023; 7:4160-4169. [PMID: 37276080 PMCID: PMC10407138 DOI: 10.1182/bloodadvances.2023009839] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 05/11/2023] [Accepted: 05/14/2023] [Indexed: 06/07/2023] Open
Abstract
Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) is the most commonly used regimen for the upfront treatment of diffuse large B-cell lymphoma (DLBCL). However, it is associated with cardiotoxicity, especially in older patients. Substituting doxorubicin with non-PEGylated liposomal doxorubicin (R-COMP) may reduce the risk of cardiac events, but its efficacy has never been demonstrated in prospective trials. We describe the characteristics and outcome of patients with DLBCL aged ≥65 years prospectively enrolled in the Elderly Project by the Fondazione Italiana Linfomi and treated with full doses of R-CHOP or R-COMP per local practice. Starting from 1163 patients, 383 (55%) were treated with R-CHOP and 308 (45%) with R-COMP. Patients treated with R-COMP were older (median age, 76 vs 71 years), less frequently fit at simplified geriatric assessment (61% vs 88%; P < .001), and had a more frequent baseline cardiac disorders (grade >1, 32% vs 8%; P < .001). Three-year progression-free survival (PFS) was similar between R-CHOP and R-COMP (70% and 64%); 3-year overall survival was 77%, and 71% respectively. R-CHOP was associated with better PFS vs R-COMP only in the Elderly Prognostic Index (EPI) low-risk group. The two groups had similar rates of treatment interruptions due to toxicities or of cardiac events (P = 1.00). We suggest R-COMP is a potentially curative treatment for older patients with intermediate- or high-risk EPI, even in the presence of a baseline cardiopathy. R-CHOP is confirmed as the standard therapy for low risk patients.
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Affiliation(s)
- Annalisa Arcari
- Hematology Unit, Ospedale Guglielmo da Saliceto, Piacenza, Italy
| | - Lugi Rigacci
- UOC Hematology and Stem Cell Transplantation, AO San Camillo Forlanini, Roma, Italy
| | - Alessandra Tucci
- Hematology Division, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Benedetta Puccini
- Lymphoma Unit, Hematology Department, Careggi Hospital and University of Florence, Firenze, Italy
| | - Sara Veronica Usai
- Division of Hematology, Ospedale Oncologico Armando Businco, Cagliari, Italy
| | - 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
| | - Alberto Fabbri
- Unit of Hematology, Azienda Ospedaliera Universitaria Senese and University of Siena, Siena, Italy
| | - Monica Balzarotti
- Department of Medical Oncology and Hematology, Humanitas Clinical Research Hospital Istituto di Ricovero e Cura a Carattere Scientifico, Rozzano, Milan, Italy
| | - Sabrina Pelliccia
- Hematology, Department of Clinical and Molecular Medicine, University Hospital Sant’Andrea, Sapienza University of Rome, Rome, Italy
| | - Stefano Luminari
- Hematology Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Department CHIMOMO, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Elsa Pennese
- Lymphoma Unit, Department of Hematology, Ospedale Spirito Santo, Pescara, Italy
| | | | | | - Gerardo Musuraca
- Hematology, IRCCS Istituto Scientifico Romagnolo per lo Studio dei Tumori “Dino Amadori,” Meldola, Forlì-Cesena, Italy
| | - Dario Marino
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Padova, Italy
| | - Roberto Sartori
- Oncohematology Unit, Veneto Institute of Oncology, Veneto Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Castelfranco Veneto, Treviso, Italy
| | - Barbara Botto
- Division of Hematology, Città della Salute e della Scienza Hospital and University, Torino, Italy
| | - Guido Gini
- Division of Hematology, Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy
| | - Manuela Zanni
- Hematology Unit, Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Stefan Hohaus
- University Policlinico Gemelli Foundation Istituto di Ricovero e Cura a Carattere Scientifico, Catholic University of the Sacred Heart, Roma, Italy
| | - Giuseppe Tarantini
- Haematology and Bone Marrow Transplant Unit, Ospedale Monsignor R. Dimiccoli, Barletta, Italy
| | - Leonardo Flenghi
- Hematology, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Monica Tani
- Hematology Unit, Santa Maria delle Croci Hospital, Ravenna, Italy
| | - Alice Di Rocco
- Institute of Hematology, Department of Translational and Precision Medicine “Sapienza,” University of Roma, Roma, Italy
| | - Michele Merli
- Division of Hematology, Ospedale di Circolo e Fondazione Macchi ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Daniele Vallisa
- Hematology Unit, Ospedale Guglielmo da Saliceto, Piacenza, Italy
| | - Chiara Pagani
- Hematology Division, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Luca Nassi
- Lymphoma Unit, Hematology Department, Careggi Hospital and University of Florence, Firenze, Italy
| | - Daniela Dessì
- Division of Hematology, Ospedale Oncologico Armando Businco, Cagliari, 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
| | - Emanuele Cencini
- Unit of Hematology, Azienda Ospedaliera Universitaria Senese and University of Siena, Siena, Italy
| | | | - Caterina Mammi
- Gruppo Amici dell'Ematologia GRADE Onlus Foundation, Reggio Emilia, Italy
| | | | - Valentina Tabanelli
- Division of Haematopathology, European Institute of Oncology IRCCS, Milan, Italy
| | - Michele Spina
- Division of Medical Oncology and Immune-related Tumors, Centro di Riferimento Oncologico di Aviano IRCCS, Aviano, Pordenone, Italy
| | - Francesco Merli
- Hematology Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Varettoni M, Zibellini S, Merli M, Drandi D, Jiménez C, Furlan D, Ferretti VV, Fabbri N, Dogliotti I, Varraso C, Ferrante M, Cappello E, Peri V, Cavalloni C, Borriero M, Facchetti GV, Ferrero S, Arcaini L, Garcia-Sanz R. Molecular remission is an independent predictor of progression-free survival in patients with Waldenström macroglobulinemia treated with chemo-immunotherapy: Results from the FIL_BIOWM study. Hematol Oncol 2023; 41:574-577. [PMID: 36218059 DOI: 10.1002/hon.3082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Marzia Varettoni
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Silvia Zibellini
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Michele Merli
- Department of Hematology, University Hospital "Ospedale di Circolo e Fondazione Macchi - ASST Sette Laghi", Varese, Italy
| | - Daniela Drandi
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Cristina Jiménez
- Department of Hematology, University Hospital of Salamanca (HUS/IBSAL), CIBERONC and Cancer Research Institute of Salamanca-IBMCC (USAL-CSIC), Salamanca, Spain
| | - Daniela Furlan
- Unit of Anatomic Pathology, University of Insubria, Varese, Italy
| | | | - Nicole Fabbri
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Irene Dogliotti
- Hematology, A.O.U. Città della Salute e della Scienza, University of Torino, Torino, Italy
| | - Chiara Varraso
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Martina Ferrante
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Emilia Cappello
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Veronica Peri
- Hematology, A.O.U. Città della Salute e della Scienza, University of Torino, Torino, Italy
| | - Chiara Cavalloni
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Michela Borriero
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | | | - Simone Ferrero
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
- Hematology, A.O.U. Città della Salute e della Scienza, University of Torino, Torino, Italy
| | - Luca Arcaini
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Ramon Garcia-Sanz
- Department of Hematology, University Hospital of Salamanca (HUS/IBSAL), CIBERONC and Cancer Research Institute of Salamanca-IBMCC (USAL-CSIC), Salamanca, Spain
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13
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Fraticelli S, Lucioni M, Neri G, Marchiori D, Cristinelli C, Merli M, Monaco R, Borra T, Lazzaro A, Uccella S, Arcaini L, Paulli M. T-Cells Subsets in Castleman Disease: Analysis of 28 Cases Including Unicentric, Multicentric and HHV8-Related Clinical Forms. Int J Mol Sci 2023; 24:ijms24097813. [PMID: 37175521 PMCID: PMC10178230 DOI: 10.3390/ijms24097813] [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: 01/27/2023] [Revised: 04/14/2023] [Accepted: 04/19/2023] [Indexed: 05/15/2023] Open
Abstract
Castleman disease (CD) is a rare lymphoproliferative disorder that includes various clinico-pathological subtypes. According to clinical course, CD is divided into unicentric CD (UCD) and multicentric CD (MCD). MCD is further distinguished based on the etiological driver in herpes virus-8-related MCD (that can occur in the setting of HIV); in MCD associated with POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes); and idiopathic MCD (iMCD). The latter can also be divided in iMCD-TAFRO (thrombocytopenia, anasarca, fever, myelofibrosis, organomegaly) and iMCD not otherwise specified. To date, CD pathogenesis is still uncertain, but CD may represent the histological and clinical result of heterogeneous pathomechanisms. Transcriptome investigations in CD lymph nodes have documented the expression and up-regulation of different cytokines; furthermore, few recent studies have shown alterations of different T-cell subsets in CD patients, suggesting a possible role of the nodal microenvironment in CD development. On this basis, our study aimed to investigate the distribution of T-cell subsets in the clinico-pathological spectrum of CD. We evaluated the CD4/CD8 ratio and the number of T-regulatory (T-reg) FOXP3+ cells in 28 CD cases. In total, 32% of cases showed a decreased CD4/CD8 ratio due to increased CD8+ T-cells, including both UCD, iMCD, and HHV8+ MCD cases. The T-reg subset analysis revealed a statistically significant (p < 0.0001) lower mean number of FOXP3+ T-reg cells in CD cases when compared with non-specific reactive lymph nodes. We did not find statistically significant differences in T-reg numbers between the different CD subtypes. These findings may suggest that alterations in T-cell subpopulations that can lead to disruption of immune system control may contribute to the numerous changes in different cellular compartments that characterize CD.
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Affiliation(s)
- Sara Fraticelli
- Department of Molecular Medicine, University of Pavia, 27100 Pavia, Italy
| | - Marco Lucioni
- Department of Molecular Medicine, University of Pavia, 27100 Pavia, Italy
- Pathology Unit, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy
| | - Giuseppe Neri
- Department of Molecular Medicine, University of Pavia, 27100 Pavia, Italy
| | - Deborah Marchiori
- Pathology Unit, Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy
| | | | - Michele Merli
- Division of Hematology, Ospedale di Circolo e Fondazione Macchi, 21100 Varese, Italy
| | - Rodolfo Monaco
- Pathology Unit, Ospedale Guglielmo da Saliceto, 29121 Piacenza, Italy
| | - Tiziana Borra
- Department of Pathology, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Antonio Lazzaro
- Division of Hematology and Bone Marrow Transplant Center, Ospedale Guglielmo da Saliceto, 29121 Piacenza, Italy
| | - Silvia Uccella
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
- Pathology Service, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Luca Arcaini
- Department of Molecular Medicine, University of Pavia, 27100 Pavia, Italy
- Division of Hematology, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy
| | - Marco Paulli
- Department of Molecular Medicine, University of Pavia, 27100 Pavia, Italy
- Pathology Unit, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy
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14
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Peracchi F, Merli M, Rogati C, Ravano E, Puoti M, Cairoli R, Travi G. Dual antiviral therapy in haematological patients with protracted SARS-CoV-2 infection. Br J Haematol 2023. [PMID: 37085972 DOI: 10.1111/bjh.18827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/06/2023] [Accepted: 04/12/2023] [Indexed: 04/23/2023]
Affiliation(s)
- F Peracchi
- Division of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - M Merli
- Division of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - C Rogati
- Division of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - E Ravano
- Department of Hematology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - M Puoti
- Division of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - R Cairoli
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Department of Hematology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - G Travi
- Division of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
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15
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Gotti M, Sciarra R, Pulsoni A, Merli F, Luminari S, Zerbi C, Trentin L, Re A, Rusconi C, Viviani S, Rossi A, Cocito F, Botto B, Meli E, Pinto A, Dogliotti I, Gini G, Puccini B, Ricci F, Nassi L, Fabbri A, Liberati AM, Merli M, Filippi AR, Bonfichi M, Zoboli V, Tartaglia G, Annechini G, D’Elia GM, Del Giudice I, Alvarez I, Visentin A, Pravato S, Dalceggio D, Pagani C, Ferrari S, Cristinelli C, Lazic T, Ferretti VV, Ricardi U, Arcaini L. Role of Rituximab Addition to First-line Chemotherapy Regimens in Nodular Lymphocyte-predominant Hodgkin Lymphoma: A Study by Fondazione Italiana Linfomi. Hemasphere 2023; 7:e837. [PMID: 37034003 PMCID: PMC10079338 DOI: 10.1097/hs9.0000000000000837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 12/29/2022] [Indexed: 04/08/2023] Open
Abstract
Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare entity whose neoplastic cells retain a B-cell phenotype with expression of CD20. Radiotherapy is recommended for favorable stage IA disease while for other stages guidelines suggest therapeutic strategies similar to those used for classic HL. The role of rituximab, although quite widespread, is not completely elucidated. We retrospectively analyzed baseline characteristics of 308 consecutive patients with NLPHL diagnosed in 19 Italian centers from 2000 to 2018. With a median follow-up of 8.4 years (interquartile range: 4.5–12.4) for treated patients, median overall survival (OS) was not reached and estimated 5-year OS was 97.8% and 5-year progression-free survival (PFS) was 84.5%. Five-year cumulative incidence of histological transformation was 1.4%, 95% confidence interval (CI), 0.5%-3.8%. After adjusting for lymphocyte count, splenic involvement, bulky disease and B symptoms (fever, drenching night sweats, unintentional loss >10% of body weight within the preceding 6 months), patients with stage II or more showed superior PFS with immunochemotherapy in comparison to chemotherapy alone (hazard ratio = 0.4, 95% CI, 0.2-0.8; P = 0.015). Our data suggest an advantage of the use of rituximab combined with chemotherapy ± radiotherapy in the treatment of stage II–III–IV NLPHL.
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Affiliation(s)
- Manuel Gotti
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Roberta Sciarra
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Molecular Medicine, University of Pavia, Italy
| | - Alessandro Pulsoni
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
| | - Francesco Merli
- Division of Hematology, Azienda USL-IRCCS of Reggio Emilia, Italy
| | - Stefano Luminari
- Division of Hematology, Azienda USL-IRCCS of Reggio Emilia, Italy
- Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Italy
| | - Caterina Zerbi
- Department of Molecular Medicine, University of Pavia, Italy
| | - Livio Trentin
- Hematology Unit, Department of Medicine - DIMED, University of Padova, Italy
| | - Alessandro Re
- Division of Hematology, Spedali Civili, Brescia, Italy
| | - Chiara Rusconi
- Division of Hematology and Blood Marrow Transplantation, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Simonetta Viviani
- Division of Hematology and Blood Marrow Transplantation, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Andrea Rossi
- Hematology and Bone Marrow Transplant Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Federica Cocito
- Division of Hematology, ASST Monza, Ospedale S. Gerardo, Monza, Italy
| | - Barbara Botto
- Division of Hematology, Azienda Ospedale Città della Salute e della Scienza, Torino, Italy
| | - Erika Meli
- Division of Hematology, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Antonello Pinto
- Hematology-Oncology and Stem-Cell Transplantation Unit, Department of Hematology and Developmental Therapeutics, Istituto Nazionale Tumori, Fondazione G. Pascale, IRCCS, Napoli, Italy
| | - Irene Dogliotti
- Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino, Italy
| | - Guido Gini
- Department of Hematology, Ospedali Riuniti, Ancona, Italy
| | | | - Francesca Ricci
- Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy
| | - Luca Nassi
- Hematology, Department of Translational Medicine, AOU Maggiore della Carità and University of Eastern Piedmont, Novara, Italy
| | - Alberto Fabbri
- Division of Hematology, Azienda Ospedaliero- Universitaria Senese, Siena, Italy
| | - Anna Marina Liberati
- Division of Hematology, Azienda Ospedalaliera S. Maria di terni – Università degli Studi di Perugia, Italy
| | - Michele Merli
- Division of Hematology, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Andrea Riccardo Filippi
- Radiation Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Italy
| | - Maurizio Bonfichi
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Valentina Zoboli
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Germana Tartaglia
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
| | - Giorgia Annechini
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
| | - Gianna Maria D’Elia
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
| | - Ilaria Del Giudice
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
| | - Isabel Alvarez
- Division of Hematology, Azienda USL-IRCCS of Reggio Emilia, Italy
| | - Andrea Visentin
- Hematology Unit, Department of Medicine - DIMED, University of Padova, Italy
| | - Stefano Pravato
- Hematology Unit, Department of Medicine - DIMED, University of Padova, Italy
| | | | - Chiara Pagani
- Division of Hematology, Spedali Civili, Brescia, Italy
| | - Silvia Ferrari
- Hematology and Bone Marrow Transplant Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | - Tanja Lazic
- Department of Molecular Medicine, University of Pavia, Italy
| | - Virginia Valeria Ferretti
- Service of Clinical Epidemiology and Biometry, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Umberto Ricardi
- Radiation Oncology, Department of Oncology, University of Turin, Italy
| | - Luca Arcaini
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Molecular Medicine, University of Pavia, Italy
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Magnoli F, Marchiori D, Facchi S, Martin V, Campiotti L, Merli M, Sessa F, Tibiletti MG, Uccella S. High frequency of BCL2 gene rearrangement-negative follicular lymphoma in northwestern Italy. Cancer Genet 2023; 274-275:1-9. [PMID: 36917896 DOI: 10.1016/j.cancergen.2023.03.001] [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: 06/13/2022] [Revised: 02/10/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023]
Abstract
BCL2 rearrangement is reported to be an early pathogenetic event in follicular lymphoma (FL) and it is considered as a reliable marker in the follow up of the disease. We aimed to investigate the frequency of BCL2 rearrangement in FLs from northwestern Italy, to evaluate their clinicopathological features, and to investigate alternative genetic aberrations in BCL2-negative FLs. We collected a series of 76 consecutive FLs diagnosed between 2013 and 2016. All lymphomas underwent histopathological review. Interphasic fluorescent in situ hybridization (FISH) was performed with break apart probes targeting BCL2, IGH, BCL6 and MYC on paraffin embedded (PE) and fresh frozen (FF) specimens. 1p36 region and p53 locus in BLC2-negative cases were investigated using dual color probes. Karyotype analysis was available in a subset of cases. BCL2 rearrangements were detected in 39 cases (51,3%). Of the remaining 37, 6 showed IGH rearrangement, and were further tested: 1 showed variant BCL2 translocation, 1 had BCL6 rearrangement, and the other 4 were negative for further gene rearrangements. FISH on FF specimens detected small BCL2+ clones in cases otherwise categorized as BCL2-. 1p36 and p53 deletion were observed in 1 and 8 BCL2- FLs, respectively. Karyotype analysis documented 3q, 1p and BCL6 alternative abnormalities in 3 cases. In conclusion, BCL2 rearrangement is not a constant finding in FL, its frequency being probably affected by geographical factors. Thus, it should not be considered as a reliable molecular marker in the follow up of the disease, unless it is found to be present at the initial diagnosis of FL. Alternative genetic aberrations exist in BCL2-negative cases.
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Affiliation(s)
| | - Deborah Marchiori
- Unit of Pathology, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Sofia Facchi
- Unit of Pathology, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Vittoria Martin
- Institute of Pathology, Ente Ospedaliero Cantonale (EOC), Locarno, Switzerland
| | - Leonardo Campiotti
- Unit of Internal Medicine, Department of Medicine and Surgery, Università degli Studi dell'Insubria, Varese, Italy
| | - Michele Merli
- Unit of Hematology, ASST dei Sette Laghi, Varese, Italy
| | - Fausto Sessa
- Unit of Pathology, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | | | - Silvia Uccella
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanule, Milan, Italy; Pathology Service, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, Milan 20089, Italy.
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17
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de Lima M, Castillo J, Merli M, Garcia-Gutierrez V. Editorial: Epidemiological trends in hematological malignancies. Front Oncol 2023; 13:1151774. [PMID: 36865813 PMCID: PMC9972218 DOI: 10.3389/fonc.2023.1151774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 01/31/2023] [Indexed: 02/16/2023] Open
Affiliation(s)
- Marcos de Lima
- Division of Hematology, The Ohio State University, Columbus, OH, United States,*Correspondence: Marcos de Lima,
| | - Jorge Castillo
- Harvard School of Medicine, Dana–Farber Cancer Institute, Boston, MA, United States
| | - Michele Merli
- Division of Hematology, University Hospital Ospedale di Circolo e Fondazione Macchi - ASST Sette Laghi, University of Insubria, Varese, Italy
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18
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Arcari A, Tabanelli V, Merli F, Marcheselli L, Merli M, Balzarotti M, Zilioli VR, Fabbri A, Cavallo F, Casaluci GM, Tucci A, Puccini B, Pennese E, Di Rocco A, Zanni M, Flenghi L, Gini G, Sartori R, Chiappella A, Usai SV, Tani M, Marino D, Arcaini L, Vallisa D, Spina M. Biological features and outcome of diffuse large B-cell lymphoma associated with hepatitis C virus in elderly patients: Results of the prospective 'Elderly Project' by the Fondazione Italiana Linfomi. Br J Haematol 2023; 201:653-662. [PMID: 36733229 DOI: 10.1111/bjh.18678] [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: 10/21/2022] [Revised: 12/23/2022] [Accepted: 01/18/2023] [Indexed: 02/04/2023]
Abstract
Up to 10%-15% of diffuse large B-cell lymphoma (DLBCL) are related to hepatitis C virus (HCV) infection, in particular in elderly patients. The Fondazione Italiana Linfomi has recently published a multicentre prospective observational study, the 'Elderly Project', on the outcome of DLBCL in patients aged ≥65 years, evaluated using a simplified comprehensive geriatric assessment. The aim of this study was to compare biological and clinical features of HCV positive (HCV+) with HCV negative (HCV-) cases. A total of 89 HCV+ patients were identified out of 1095 evaluated for HCV serology (8.1%). The HCV+ patients were older, less fit, and had frequent extranodal involvement. The cell-of-origin determination by Nanostring showed that HCV+ cases less frequently had an activated B-cell profile compared to HCV- patients (18% vs. 43%). In all, 86% of HCV+ patients received rituximab-cyclophosphamide, doxorubicin, vincristine (Oncovin) and prednisone (R-CHOP)-like immunochemotherapy. Grade 3-4 liver toxicity occurred in 3% of cases. Among centrally reviewed cases confirmed as DLBCL, the 3-year overall survival of HCV+ patients was very similar to HCV- (63% vs. 61%, p = 0.926). In all, 20 HCV+ patients were treated with direct-acting antiviral agents (DAAs), with good tolerance and sustained virological response in all cases. The 3-year progression-free survival for this subgroup was excellent (77%), suggesting DAAs' possible role in reducing the risk of relapse by eliminating the viral trigger.
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Affiliation(s)
- Annalisa Arcari
- Hematology Unit, Ospedale Guglielmo da Saliceto, Piacenza, Italy
| | - Valentina Tabanelli
- Division of Haematopathology, European Institute of Oncology IRCCS, Milan, Italy
| | - Francesco Merli
- Hematology Unit, Azienda Unità Sanitaria Locale-IRCCS, Reggio Emilia, Italy
| | | | - Michele Merli
- Division of Hematology, Ospedale di Circolo and Fondazione Macchi, University of Insubria, Varese, Italy
| | - Monica Balzarotti
- Department of Medical Oncology and Hematology, IRCCS Humanitas Research Hospital, Milan, Italy
| | | | - Alberto Fabbri
- Unit of Hematology, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - 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
| | - Gloria Margiotta Casaluci
- Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | | | - Benedetta Puccini
- Hematology Department, University of Florence and AOU Careggi, Florence, Italy
| | - Elsa Pennese
- Lymphoma Unit, Department of Hematology, Ospedale Spirito Santo, Pescara, Italy
| | - Alice Di Rocco
- Department of Traslational and Precision Medicine, Sapienza University, Rome, Italy
| | - Manuela Zanni
- Division of Hematology, A.O. SS Antonio e Biagio and Cesare Arrigo, Alessandria, Italy
| | - Leonardo Flenghi
- Division of Hematology, S. Maria della Misericordia Hospital, Perugia, Italy
| | - Guido Gini
- Clinic of Hematology, Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy
| | - Roberto Sartori
- Onco Hematology Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | | | - Sara Veronica Usai
- Division of Hematology, Ospedale Oncologico Armando Businco, Cagliari, Italy
| | - Monica Tani
- Hematology Unit, Santa Maria delle Croci Hospital, Ravenna, Italy
| | - Dario Marino
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS Padova, Padova, Italy
| | - Luca Arcaini
- Department of Molecular Medicine, University of Pavia and Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Daniele Vallisa
- Hematology Unit, Ospedale Guglielmo da Saliceto, Piacenza, Italy
| | - Michele Spina
- Division of Medical Oncology and Immunerelated tumors, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
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19
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Cencini E, Tucci A, Puccini B, Cavallo F, Luminari S, Usai SV, Fabbri A, Pennese E, Marino D, Zilioli VR, Balzarotti M, Petrucci L, Tafuri A, Arcari A, Botto B, Zanni M, Hohaus S, Sartori R, Merli M, Gini G, Al Essa W, Musurca G, Tani M, Nassi L, Daffini R, Mammi C, Marcheselli L, Bocchia M, Spina M, Merli F. The elderly prognostic index predicts early mortality in older patients with diffuse large B-cell lymphoma. An ad hoc analysis of the elderly project by the Fondazione Italiana Linfomi. Hematol Oncol 2023; 41:78-87. [PMID: 36177902 DOI: 10.1002/hon.3081] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/09/2022] [Accepted: 09/17/2022] [Indexed: 02/03/2023]
Abstract
The Elderly Prognostic Index (EPI) is based on the integration of a simplified geriatric assessment, hemoglobin levels and International Prognostic Index and has been validated to predict overall survival in older patients with diffuse large B-cell lymphoma (DLBCL). In this study, we evaluated the ability of EPI to predict the risk of early mortality. This study included all patients registered in the Elderly Project for whom treatment details and a minimum follow-up of 3 months were available. Three main treatment groups were identified based on the anthracycline amount administered: cases receiving >70% of the theoretical anthracyclines dose (Full Dose [FD] group), ≤70% (Reduced Dose [RD]) and palliative therapy (PT; no anthracyclines). The primary endpoint was early mortality rate, defined as death for any cause occurring within 90 days from diagnosis. We identified 1150 patients with a median age of 76 years (range 65-94). Overall, 69 early deaths were observed, accounting for 19% of all reported deaths. The cumulative rate of early mortality at 90 days was 6.0%. Comparing early with delayed deaths, we observed a lower frequency of deaths due to lymphoma progression (42% vs. 75%; p < 0.001) and a higher frequency due to toxicity and infections (22% vs. 4%, p < 0.001, and 22% vs. 3%, p < 0.001, respectively) for early events. A multivariable logistic analysis on 931 patients (excluding PT) confirmed an independent association of high-risk EPI (odds ratio [OR] 3.60; 95% confidence interval [CI] 1.15-11.2) and bulky disease (OR 2.08; 95% CI 1.09-3.97) with the risk of early mortality. The cumulative incidence of early mortality for older patients with DLBCL is not negligible and is mainly associated with non-lymphoma related events. For patients receiving anthracyclines, high-risk EPI and bulky disease are associated with a higher probability of early mortality.
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Affiliation(s)
- Emanuele Cencini
- Unit of Hematology, Azienda Ospedaliera Universitaria Senese and University of Siena, Siena, Italy
| | - Alessandra Tucci
- Hematology Division, ASST Spedali Civili Brescia, Brescia, Italy
| | - Benedetta Puccini
- Hematology Department, Careggi Hospital and University of Florence, Firenze, Italy
| | - 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
| | - Stefano Luminari
- Hematology, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Department CHIMOMO, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Sara Veronica Usai
- Division of Hematology, Ospedale Oncologico Armando Businco, Cagliari, Italy
| | - Alberto Fabbri
- 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
- Oncology 1 Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | | | - Monica Balzarotti
- Department of Medical Oncology and Hematology, IRCCS Humanitas Research Hospital, Milano, Italy
| | - Luigi Petrucci
- Insitute of Hematology, Department of Tanslational and Precision Medicine "La Sapienza", University of Roma, Roma, Italy
| | - Agostino Tafuri
- Hematology, University Hospital S.Andrea-Sapienza, Roma, Italy
| | - Annalisa Arcari
- Hematology Unit, Ospedale Guglielmo da Saliceto, Piacenza, Italy
| | - Barbara Botto
- Division of Hematology, Città della Salute e della Scienza Hospital and University, Torino, Italy
| | - Manuela Zanni
- Hematology Unit, Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Stefan Hohaus
- University Policlinico Gemelli Foundation-IRCCS, Catholic University of Sacred Heart, Roma, Italy
| | - Roberto Sartori
- Oncohematology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padova, Italy
| | - Michele Merli
- Division of Hematology, Ospedale di Circolo e Fondazione Macchi - ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Guido Gini
- Clinic of Hematology AOU Ospedali Riuniti Ancona, Università Politecnica delle Marche, Ancona, Italy
| | - Wael Al Essa
- Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, and Azienda Ospedaliero-Universitaria Maggiore della Carità Novara, Novara, Italy
| | - Gerardo Musurca
- Hematology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Monica Tani
- Hematology Unit, Santa Maria delle Croci Hospital, Ravenna, Italy
| | - Luca Nassi
- Hematology Department, Careggi Hospital and University of Florence, Firenze, Italy
| | - Rosa Daffini
- Hematology Division, ASST Spedali Civili Brescia, Brescia, Italy
| | - Caterina Mammi
- Gruppo Amici dell'Ematologia GRADE-Onlus Foundation, Reggio Emilia, Italy
| | | | - Monica Bocchia
- Unit of Hematology, Azienda Ospedaliera Universitaria Senese and University of Siena, Siena, Italy
| | - Michele Spina
- Division of Medical Oncology and Immunerelated Tumors, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Francesco Merli
- Hematology, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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20
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Pirosa MC, Sassone M, Kiesewetter B, Guillermo AL, Devizzi L, Domènech ED, Tucci A, Mannina D, Merli M, Salar A, Visco C, Esposito F, Bonomini L, Zucca E, Ferreri AJM, Raderer M. IELSG40/CLEO phase II trial of clarithromycin and lenalidomide in relapsed/refractory extranodal marginal zone lymphoma. Haematologica 2022. [DOI: 10.3324/haematol.2022.281963] [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: 08/18/2022] [Indexed: 12/24/2022] Open
Abstract
Not available.
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21
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Merli M, Rattotti S, Spina M, Re F, Motta M, Piazza F, Orsucci L, Ferreri AJ, Perbellini O, Dodero A, Vallisa D, Pulsoni A, Santoro A, Sacchi P, Zuccaro V, Chimienti E, Russo F, Visco C, Zignego AL, Marcheselli L, Passamonti F, Luminari S, Paulli M, Bruno R, Arcaini L. Direct-Acting Antivirals as Primary Treatment for Hepatitis C Virus-Associated Indolent Non-Hodgkin Lymphomas: The BArT Study of the Fondazione Italiana Linfomi. J Clin Oncol 2022; 40:4060-4070. [PMID: 35714311 PMCID: PMC9746784 DOI: 10.1200/jco.22.00668] [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] [Indexed: 12/24/2022] Open
Abstract
PURPOSE We prospectively treated patients with hepatitis C virus (HCV)-associated indolent lymphomas with genotype-appropriate direct-acting antivirals (DAAs) with the aim to evaluate virologic and hematologic outcomes. No prospective studies in this setting have been published so far. METHODS FIL_BArT is a prospective, multicenter, phase II trial that evaluated genotype-appropriate DAAs in untreated HCV-positive patients with indolent lymphomas without criteria for immediate conventional antilymphoma treatment. The primary objective was sustained virologic response, whereas the main secondary objectives were overall response rate of lymphoma and progression-free survival. RESULTS Forty patients were enrolled, including 27 with marginal zone lymphoma. Median age was 68 years. Extranodal sites were involved in 14 cases (35%). Main genotypes were 1 in 16 patients and 2 in 21 patients. All patients received genotype-guided DAAs: 17 ledipasvir/sofosbuvir, eight sofosbuvir plus ribavirin, and 15 sofosbuvir/velpatasvir. All patients achieved sustained virologic response (100%). DAAs were well tolerated, with only two grade 3-4 adverse events. Overall response rate of lymphoma was 45%, including eight patients (20%) achieving complete response and 10 (25%) partial response, whereas 16 exhibited stable disease and six progressed. With a median follow-up of 37 months, two patients died (3-year overall survival 93%; 95% CI, 74 to 98) and three additional patients progressed, with a 3-year progression-free survival of 76% (95% CI, 57 to 87). CONCLUSION HCV eradication by DAAs was achieved in 100% of HCV-positive patients with indolent lymphomas not requiring immediate conventional treatment and resulted in non-negligible rate of lymphoma responses. Treatment with DAAs should be considered as the first-line therapy in this setting.
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Affiliation(s)
- Michele Merli
- Division of Hematology, University Hospital Ospedale di Circolo e Fondazione Macchi, ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Sara Rattotti
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Michele Spina
- Division of Medical Oncology and Immune-related Tumors, Centro di Riferimento Oncologico IRCCS, Aviano, Italy
| | - Francesca Re
- Division of Hematology and BMT Center, Azienda Ospedaliera Universitaria, Parma, Italy
| | - Marina Motta
- Division of Hematology, ASST Spedali Civili, Brescia, Italy
| | - Francesco Piazza
- Hematology and Clinical Immunology Unit, Department of Medicine—DIMED, University of Padova, Padova, Italy
| | - Lorella Orsucci
- Division of Hematology, Città della Salute e della Scienza di Torino, Torino, Italy
| | | | - Omar Perbellini
- Division of Hematology, San Bortolo Hospital, Vicenza, Italy
| | - Anna Dodero
- Division of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Daniele Vallisa
- Division of Hematology, Ospedale Guglielmo da Saliceto, Piacenza, Italy
| | - Alessandro Pulsoni
- Department of Translational and Precision Medicine, Sapienza University of Roma, Roma, Italy
| | - Armando Santoro
- Department of Biomedical Sciences, Humanitas University, IRCCS Humanitas Research Hospital-Humanitas Cancer Center, Milano, Italy
| | - Paolo Sacchi
- Division of Infectious and Tropical Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Valentina Zuccaro
- Division of Infectious and Tropical Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Emanuela Chimienti
- Division of Medical Oncology and Immune-related Tumors, Centro di Riferimento Oncologico IRCCS, Aviano, Italy
| | - Filomena Russo
- Division of Hematology and BMT Center, Azienda Ospedaliera Universitaria, Parma, Italy
| | - Carlo Visco
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Anna Linda Zignego
- Department of Clinical and Experimental Medicine, Interdepartmental Hepatology Center MASVE, University of Firenze, Firenze, Italy
| | | | - Francesco Passamonti
- Division of Hematology, University Hospital Ospedale di Circolo e Fondazione Macchi, ASST Sette Laghi, University of Insubria, Varese, Italy,Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Stefano Luminari
- Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy,Division of Hematology, Azienda Unità Sanitaria Locale-IRCCS, Reggio Emilia, Italy
| | - Marco Paulli
- Unit of Anatomic Pathology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy,Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Raffaele Bruno
- Division of Infectious and Tropical Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy,Department of Clinical, Surgical, Diagnostic, and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - Luca Arcaini
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy,Department of Molecular Medicine, University of Pavia, Pavia, Italy,Luca Arcaini, MD, Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100 Pavia, Italy; e-mail:
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22
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Merli M, Arcaini L. Management of marginal zone lymphomas. Hematology Am Soc Hematol Educ Program 2022; 2022:676-687. [PMID: 36485086 PMCID: PMC9901419 DOI: 10.1182/hematology.2022000362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Marginal zone lymphomas (MZLs) represent about 7% of B-cell non-Hodgkin lymphomas and include 3 different subtypes-namely, extranodal (EMZL), nodal, and splenic (SMZL). The initial assessment requires specific diagnostic and staging procedures depending on organ-related peculiarities. In particular, although positron emission tomography/computed tomography was not initially recommended, recent data have reassessed its role in the routine staging of MZL, especially when only localized treatment is planned or there is a suspicion of histologic transformation. Recent findings have improved the risk stratification of MZL patients, highlighting the association of early progression after frontline therapy with worse overall survival. A significant fraction of MZL cases may be related to specific bacterial (ie, Helicobacter pylori in gastric EMZL) or viral infections (hepatis C virus), and in the earlier phases of disease, a variable percentage of patients may respond to anti-infective therapy. Involved-site radiotherapy has a central role in the management of localized EMZL not amenable to or not responding to anti-infective therapy. Although rituximab-based treatments (bendamustine- rituximab in advanced EMZL or rituximab monotherapy in SMZL) have demonstrated favorable results, the current therapeutic scenario is predicted to rapidly change as emerging novel agents, especially Bruton's tyrosine kinase inhibitors, have demonstrated promising efficacy and safety profiles, leading to their approval in the relapsed setting. Moreover, a large variety of novel agents (phosphatidylinositol 3-kinase inhibitors, chimeric antigen receptor T-cells, bispecific antibodies) are being tested in MZL patients with encouraging preliminary results.
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Affiliation(s)
- Michele Merli
- Division of Hematology, University Hospital Ospedale di Circolo e Fondazione Macchi, ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Luca Arcaini
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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23
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Macagno N, Mastorino L, Rubatto M, Avallone G, Merli M, Agostini A, Fava P, Ribero S, Quaglino P. Primary cutaneous lymphoma patients seen at a referral dermatological centre in 1 year: A single-centre observational retrospective cohort study of the diagnoses and staging, comorbidities and associated symptoms, treatment performed and clinical course. J Eur Acad Dermatol Venereol 2022; 36:2388-2392. [PMID: 35881645 PMCID: PMC9804410 DOI: 10.1111/jdv.18469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 06/24/2022] [Indexed: 01/05/2023]
Abstract
IMPORTANCE Primary cutaneous lymphomas (PCL) are rare diseases, but the indolent course makes their prevalence high. Although there are many treatment options, no hierarchy is recommended. OBJECTIVE To identify the burden of PCL and describe clinical-pathologic features; associated comorbidities; analyse treatment approaches in real-life and the parameters associated with the achievement of complete response (CR). DESIGN, SETTING AND PARTICIPANTS In this study, all the PCL patients (384 patients) consecutively seen at the Dermatologic Clinic of the University of Turin from January 1, 2019 to December 31, 2019, with follow-up updated to December 2020, were included. MAIN OUTCOMES AND MEASURES Subtype of PCL, demographic data, time elapsed between first lesions and diagnosis, associated symptoms, comorbidities, staging at diagnosis, high-grade transformation, blood involvement, stage progression, therapies used and response were assessed. RESULTS 247 were cutaneous T-cell lymphomas (CTCL, 64.3%), 137 cutaneous B-cell lymphomas (CBCL, 35.7%) and the most frequent subtype was MF (48.4%). 62.3% of CTCL patients showed at least one comorbidity, mainly cardiovascular (28.7%), 20.2% show other not cutaneous neoplasms. The main approaches were skin-directed therapies (topical steroids 65.6%; phototherapy 50.2%). 39.3% patients achieved a CR during the disease course. Pruritus, the presence of comorbidities and high-grade transformation were factors associated with failure to achieve CR, whereas stage IA of MF was associated with greater achievement of CR. CONCLUSIONS AND RELEVANCE The Th2 cytokine related development of pruritus could justify increased resistance to treatment, while the presence of associated comorbidities could reduce treatment options as well as treatment compliance.
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Affiliation(s)
- N. Macagno
- Department of Medical Sciences, Dermatologic ClinicUniversity of TurinTurinItaly
| | - L. Mastorino
- Department of Medical Sciences, Dermatologic ClinicUniversity of TurinTurinItaly
| | - M. Rubatto
- Department of Medical Sciences, Dermatologic ClinicUniversity of TurinTurinItaly
| | - G. Avallone
- Department of Medical Sciences, Dermatologic ClinicUniversity of TurinTurinItaly
| | - M. Merli
- Department of Medical Sciences, Dermatologic ClinicUniversity of TurinTurinItaly
| | - A. Agostini
- Department of Medical Sciences, Dermatologic ClinicUniversity of TurinTurinItaly
| | - P. Fava
- Department of Medical Sciences, Dermatologic ClinicUniversity of TurinTurinItaly
| | - S. Ribero
- Department of Medical Sciences, Dermatologic ClinicUniversity of TurinTurinItaly
| | - P. Quaglino
- Department of Medical Sciences, Dermatologic ClinicUniversity of TurinTurinItaly
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24
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Forestieri G, Terzi di Bergamo L, Deodato M, Frustaci AM, Moia R, Deambrogi C, Rasi S, Autore F, Merli M, Mattarucchi R, Fahrni G, Scarfo' L, Gussetti D, Bulian P, Zanatta A, Spina V, Bruscaggin A, Pini K, Piffaretti D, Pirosa MC, Salehi M, Marques de Almeida J, Passweg J, Cavalli F, Zucca E, Gerber B, Stussi G, Gattei V, Ghia P, Gregor M, Passamonti F, Laurenti L, Gaidano G, Tedeschi A, Rossi D, Condoluci A. Ibrutinib dose intensity in high-risk chronic lymphocytic leukemia. Hematol Oncol 2022; 40:1100-1104. [PMID: 35613703 DOI: 10.1002/hon.3032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Gabriela Forestieri
- Laboratory of Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | | | - Marina Deodato
- Department of Hematology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Anna Maria Frustaci
- Department of Hematology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Riccardo Moia
- Department of Translational Medicine, Division of Hematology, University of Eastern Piedmont, Novara, Italy
| | - Clara Deambrogi
- Department of Translational Medicine, Division of Hematology, University of Eastern Piedmont, Novara, Italy
| | - Silvia Rasi
- Department of Translational Medicine, Division of Hematology, University of Eastern Piedmont, Novara, Italy
| | - Francesco Autore
- Hematology Institute, Catholic University of the Sacred Hearth, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - Michele Merli
- Ospedale di Circolo of Varese & Department of Medicine and Surgery, Hematology, ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Roberta Mattarucchi
- Ospedale di Circolo of Varese & Department of Medicine and Surgery, Hematology, ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Gaby Fahrni
- Division of Hematology, Cantonal Hospital of Lucerne, Lucerne, Switzerland
| | - Lydia Scarfo'
- Strategic Research Program on CLL, Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Milan, Italy
| | - Daniela Gussetti
- Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Pietro Bulian
- Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Annagiulia Zanatta
- Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Valeria Spina
- Laboratory of Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | - Alessio Bruscaggin
- Laboratory of Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | - Katia Pini
- Laboratory of Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | - Deborah Piffaretti
- Laboratory of Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | - Maria Cristina Pirosa
- Laboratory of Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | - Matin Salehi
- Laboratory of Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | | | - Jakob Passweg
- Clinic of Haematology, University Hospital Basel, Basel, Switzerland
| | | | - Emanuele Zucca
- Clinic of Oncology, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Bernhard Gerber
- Clinic of Hematology, Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Georg Stussi
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland.,Clinic of Hematology, Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Valter Gattei
- Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Paolo Ghia
- Strategic Research Program on CLL, Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Milan, Italy
| | - Michael Gregor
- Division of Hematology, Cantonal Hospital of Lucerne, Lucerne, Switzerland
| | - Francesco Passamonti
- Ospedale di Circolo of Varese & Department of Medicine and Surgery, Hematology, ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Luca Laurenti
- Hematology Institute, Catholic University of the Sacred Hearth, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - Gianluca Gaidano
- Department of Translational Medicine, Division of Hematology, University of Eastern Piedmont, Novara, Italy
| | - Alessandra Tedeschi
- Department of Hematology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Davide Rossi
- Laboratory of Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland.,Clinic of Hematology, Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Adalgisa Condoluci
- Laboratory of Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland.,Clinic of Hematology, Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
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25
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Condoluci A, Milan L, Forestieri G, Terzi di Bergamo L, Spina V, Bruscaggin A, Deambrogi C, Moia R, Deodato M, Fahrni G, Mattarucchi R, Merli M, Gerber B, Stussi G, Passamonti F, Gregor M, Tedeschi A, Gaidano G, Rossi D, Ceriani L. Anatomical heterogeneity of residual disease in chronic lymphocytic leukemia treated with ibrutinib. Hematol Oncol 2022; 40:1105-1108. [PMID: 35656838 DOI: 10.1002/hon.3039] [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: 01/27/2023]
Affiliation(s)
- Adalgisa Condoluci
- Clinic of Hematology, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.,Laboratory of Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | - Lisa Milan
- Clinic for Nuclear Medicine and Molecular Imaging, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Gabriela Forestieri
- Laboratory of Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | | | - Valeria Spina
- Laboratory of Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | - Alessio Bruscaggin
- Laboratory of Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | - Clara Deambrogi
- Department of Translational Medicine, Division of Hematology, University of Eastern Piedmont, Novara, Italy
| | - Riccardo Moia
- Department of Translational Medicine, Division of Hematology, University of Eastern Piedmont, Novara, Italy
| | - Marina Deodato
- Department of Hematology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Gaby Fahrni
- Division of Hematology, Cantonal Hospital of Lucerne, Lucerne, Switzerland
| | - Roberta Mattarucchi
- Ospedale di Circolo of Varese & Department of Medicine and Surgery, Hematology, University of Insubria, Varese, Italy
| | - Michele Merli
- Ospedale di Circolo of Varese & Department of Medicine and Surgery, Hematology, University of Insubria, Varese, Italy
| | - Bernhard Gerber
- Clinic of Hematology, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Georg Stussi
- Clinic of Hematology, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Francesco Passamonti
- Ospedale di Circolo of Varese & Department of Medicine and Surgery, Hematology, University of Insubria, Varese, Italy
| | - Michael Gregor
- Division of Hematology, Cantonal Hospital of Lucerne, Lucerne, Switzerland
| | - Alessandra Tedeschi
- Department of Hematology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Gianluca Gaidano
- Department of Translational Medicine, Division of Hematology, University of Eastern Piedmont, Novara, Italy
| | - Davide Rossi
- Clinic of Hematology, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.,Laboratory of Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Luca Ceriani
- Clinic for Nuclear Medicine and Molecular Imaging, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
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26
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Tucci A, Merli F, Fabbri A, Marcheselli L, Pagani C, Puccini B, Marino D, Zanni M, Pennese E, Flenghi L, Arcari A, Botto B, Celli M, Mammi C, Re A, Campostrini G, Tafuri A, Zilioli VR, Cencini E, Sartori R, Bottelli C, Merli M, Petrucci L, Gini G, Balzarotti M, Cavallo F, Musuraca G, Luminari S, Rossi G, Spina M. Diffuse large B-cell lymphoma in octogenarians aged 85 and older can benefit from treatment with curative intent: a report on 129 patients prospectively registered in the Elderly Project of the Fondazione Italiana Linfomi (FIL). Haematologica 2022; 108:1083-1091. [PMID: 36384247 PMCID: PMC10071130 DOI: 10.3324/haematol.2022.281407] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Indexed: 11/18/2022] Open
Abstract
Octogenarian patients with diffuse large B-cell lymphoma are managed mainly with palliation, but recent improvement in their overall condition makes potentially curative treatment a possibility. Studies have shown that half of selected octogenarians may be cured using reduced-dose anthracycline chemoimmunotherapy. However, patients aged >85 (late octogenarians–LO) were underrepresented, and selection criteria were poorly defined. We analyzed the clinical characteristics and outcomes of LO enrolled in the FIL Elderly Project (EP) in terms of the treatment received (palliative vs curative) and of their simplified geriatric assessment (sGA), then compared them with early octogenarians (EO) aged 80-84 and with those aged 65-79 classified as UNFIT or FRAIL according to sGA enrolled in the same study. Of the 1163 patients, 370 were >80 and 129 LO. Clinical characteristics were similar between LO and EO, but LO more frequently received palliation (50% vs 23%: P=0.001) and had worse 2-year overall survival (OS) (48% vs 63%: P=0.001) and 2-year progression-free survival (PFS) (43% vs 56%: P=0.01). Patients receiving anthracycline did better than patients receiving palliation (P
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Affiliation(s)
| | - Francesco Merli
- Hematology Unit, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia
| | - Alberto Fabbri
- Hematology Unit, Azienda Ospedaliera Universitaria Senese and University of Siena, Siena
| | | | - Chiara Pagani
- Hematology Division, ASST Spedali Civili of Brescia, Brescia
| | | | - Dario Marino
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Padova
| | - Manuela Zanni
- Hematology Unit, Antonio e Biagio e Cesare Arrigo Hospital Alessandria
| | - Elsa Pennese
- Lymphoma Unit, Departement of Hematology, Spirito Santo Hospital, Lymphoma Diagnosis and Therapy Center, Pescara
| | - Leonardo Flenghi
- Hematology Unit, Santa Maria della Misericordia Hospital, Perugia
| | | | - Barbara Botto
- Hematology Division, Città della Salute e della Scienza Hospital and University, Torino
| | | | - Caterina Mammi
- Gruppo Amici dell'Ematologia GRADE-Onlus Foundation, Reggio Emilia
| | - Alessandro Re
- Hematology Division, ASST Spedali Civili of Brescia, Brescia
| | | | | | - Vittorio R Zilioli
- Hematology Division, ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - Emanuele Cencini
- Hematology Unit, Azienda Ospedaliera Universitaria Senese and University of Siena, Siena
| | - Roberto Sartori
- Department of Clinical and Experimental Oncology, Oncohematology Unit, Veneto Institute of Oncology, IOV-IRCCS, Castelfranco Veneto (TV)
| | - Chiara Bottelli
- Hematology Division, ASST Spedali Civili of Brescia, Brescia
| | - Michele Merli
- Hematology Division, Ospedale di Circolo e Fondazione Macchi-ASST Sette Laghi, University of Insubria, Varese
| | - Luigi Petrucci
- Hematology Institute, Department of Translational and Precision Medicine "Sapienza", University of Roma, Roma
| | - Guido Gini
- Hematology Division, Ospedali Riuniti Hospital and University, Ancona
| | - Monica Balzarotti
- Medical Oncology and Hematology Department, Humanitas Clinical Research Hospital-IRCCS, Rozzano (MI)
| | - Federica Cavallo
- Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino, Citta della Salute e della `Scienza di Torino," Hospital, Torino
| | - Gerardo Musuraca
- Hematology Unit, IRCCS-Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) SRL, Meldola (FC)
| | - Stefano Luminari
- Hematology Unit, Azienda USL-IRCCS 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, Modena
| | - Giuseppe Rossi
- Hematology Division, ASST Spedali Civili of Brescia, Brescia
| | - Michele Spina
- Division of Medical Oncology and Immune-related Tumors, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano (PN)
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27
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Merli M, Ferrarini I, Merli F, Busca A, Mina R, Falini B, Bruna R, Cairoli R, Marchetti M, Romano A, Cavo M, Arcaini L, Trentin L, Cattaneo C, Derenzini E, Fracchiolla NS, Marchesi F, Scattolin A, Billio A, Bocchia M, Massaia M, Gambacorti‐Passerini C, Mauro FR, Gentile M, Mohamed S, Della Porta MG, Coviello E, Cilloni D, Visani G, Federici AB, Tisi MC, Cudillo L, Galimberti S, Gherlinzoni F, Pagano L, Guidetti A, Bertù L, Corradini P, Passamonti F, Visco C. SARS-CoV-2 infection in patients with chronic lymphocytic leukemia: The Italian Hematology Alliance on COVID-19 cohort. Hematol Oncol 2022; 41:128-138. [PMID: 36265128 PMCID: PMC9874469 DOI: 10.1002/hon.3092] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 10/15/2022] [Accepted: 10/17/2022] [Indexed: 02/03/2023]
Abstract
COVID-19, the disease caused by SARS-CoV-2, is still afflicting thousands of people across the globe. Few studies on COVID-19 in chronic lymphocytic leukemia (CLL) are available. Here, we analyzed data from the CLL cohort of the Italian Hematology Alliance on COVID-19 (NCT04352556), which included 256 CLL patients enrolled between 25 February 2020 and 1 February 2021. Median age was 70 years (range 38-94) with male preponderance (60.1%). Approximately half of patients (n = 127) had received at least one line of therapy for CLL, including 108 (83.7%) who were on active treatment at the time of COVID-19 or received their last therapy within 12 months. Most patients (230/256, 89.9%) were symptomatic at COVID-19 diagnosis and the majority required hospitalization (n = 176). Overall, after a median follow-up of 42 days (IQR 24-96), case fatality rate was 30.1%, and it was 37.5% and 24.4% in the first (25 February 2020-22 June 2020) and second wave (23 June 2020-1 February 2021), respectively (p = 0.03). At multivariate analysis, male sex (HR 1.82, 95% CI 1.03-3.24, p = 0.04), age over than 70 years (HR 2.23, 95% CI 1.23-4.05, p = 0.01), any treatment for CLL given in the last 12 months (HR 1.72, 95% CI 1.04-2.84, p = 0.04) and COVID-19 severity (severe: HR 5.66, 95% CI 2.62-12.33, p < 0.0001; critical: HR 15.99, 95% CI 6.93-36.90, p < 0.0001) were independently associated with poor survival. In summary, we report a dismal COVID-related outcome in a significant fraction of CLL patients, that can be nicely predicted by clinical parameters.
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Affiliation(s)
- Michele Merli
- Division of HematologyUniversity Hospital Ospedale di Circolo e Fondazione Macchi ‐ASST Sette LaghiUniversity of InsubriaVareseItaly
| | - Isacco Ferrarini
- Department of MedicineSection of HematologyUniversity of VeronaVeronaItaly
| | - Francesco Merli
- HematologyAzienda Unità Sanitaria Locale‐Istituto di Ricovero e Cura a Carattere Scientifico Reggio EmiliaReggio EmiliaItaly
| | - Alessandro Busca
- Stem Cell Transplant CenterAzienda Ospedaliera Universitaria Citta’ della Salute e della ScienzaTurinItaly
| | - Roberto Mina
- Myeloma UnitDivision of HematologyUniversity of TurinAzienda Ospedaliera Universitaria Citta’ della Salute e della ScienzaTurinItaly
| | | | - Riccardo Bruna
- Division of HematologyDepartment of Translational MedicineUniversity of Eastern Piedmont and Ospedale Maggiore della CaritàNovaraItaly
| | - Roberto Cairoli
- HematologyAzienda Socio‐Sanitaria Territoriale Grande Ospedale Metropolitano NiguardaMilanItaly
| | - Monia Marchetti
- HematologyAzienda Ospedaliera Santissimi Antonio e Biagio e Cesare ArrigoAlessandriaItaly
| | - Alessandra Romano
- HematologyDipartimento di Chirurgia e Specialità Medico ChirurgicheUniversità degli Studi di CataniaCataniaItaly
| | - Michele Cavo
- IRCCS Azienda Ospedaliero‐Universitaria di BolognaSeràgnoli Institute of HematologyDepartment of Experimental, Diagnostic and Specialty MedicineBologna University School of MedicineBolognaItaly
| | - Luca Arcaini
- Department of Molecular MedicineUniversity of Pavia & Division of HematologyFondazione IRCCS Policlinico San MatteoPaviaItaly
| | - Livio Trentin
- Hematology and Clinical Immunology UnitDepartment of MedicineUniversity of PaduaPaduaItaly
| | - Chiara Cattaneo
- HematologyAzienda Socio‐Sanitaria Territoriale‐Spedali CiviliBresciaItaly
| | - Enrico Derenzini
- Onco‐Hematology DivisionIEO European Institute of Oncology IRCCS & Department of Health SciencesUniversity of MilanMilanItaly
| | | | - Francesco Marchesi
- Hematology and Stem Cell Transplant UnitIstituto di Ricovero e Cura a Carattere Scientifico Regina Elena National Cancer InstituteRomeItaly
| | | | - Atto Billio
- Division of Hematology and BMTHospital S. MaurizioBolzanoItaly
| | - Monica Bocchia
- Hematology UnitUniversity of SienaAzienda Ospedaliero Universitaria SeneseSienaItaly
| | | | | | - Francesca Romana Mauro
- HematologyDepartment of Translational and Precision MedicineSapienza University of RomeRomeItaly
| | - Massimo Gentile
- Hematology UnitDepartment of Hemato‐Oncology, Ospedale AnnunziataCosenzaItaly
| | - Sara Mohamed
- UCO EmatologiaAzienda Sanitaria Universitaria Giuliano IsontinaTriesteItaly
| | - Matteo Giovanni Della Porta
- Humanitas Clinical and Research Hospital Istituto di Ricovero e Cura a Carattere Scientifico and Department of Biomedical SciencesHumanitas UniversityMilanItaly
| | - Elisa Coviello
- Hematology and Bone Marrow TransplantIstituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San MartinoGenovaItaly
| | - Daniela Cilloni
- Department of Clinical and Biological SciencesUniversity of TurinSan Luigi HospitalTurinItaly
| | - Giuseppe Visani
- Dipartimento di Onco‐EmatologiaAzienda Ospedaliera Ospedali Riuniti Marche NordPesaroItaly
| | | | | | | | - Sara Galimberti
- Department of Clinical and Experimental MedicineUniversity of PisaPisaItaly
| | | | - Livio Pagano
- Dipartimento di Scienze Radiologiche ed EmatologicheFondazione Policlinico Universitario A Gemelli–IRCCS–Università Cattolica del Sacro CuoreRomeItaly
| | - Anna Guidetti
- Hematology and Bone Marrow TransplantationFondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei TumoriUniversity of MilanMilanItaly
| | - Lorenza Bertù
- Division of HematologyUniversity Hospital Ospedale di Circolo e Fondazione Macchi ‐ASST Sette LaghiUniversity of InsubriaVareseItaly
| | - Paolo Corradini
- Hematology and Bone Marrow TransplantationFondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei TumoriUniversity of MilanMilanItaly
| | - Francesco Passamonti
- Division of HematologyUniversity Hospital Ospedale di Circolo e Fondazione Macchi ‐ASST Sette LaghiUniversity of InsubriaVareseItaly
| | - Carlo Visco
- Department of MedicineSection of HematologyUniversity of VeronaVeronaItaly
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28
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Salvini M, Damonte C, Mortara L, Maggi F, Bruno A, Pellegrini G, Mora B, Brociner M, Ingrassia A, Mattarucchi R, Bianchi B, Sirocchi D, Agnoli S, Rumi E, Merli M, Fossati A, Bassi S, Bombelli R, Gallazzi M, Borsani O, Baj A, Franchi M, Grossi PA, Passamonti F. Immunogenicity and clinical efficacy of anti-SARS-CoV-2 vaccination in patients with hematological malignancies: Results of a prospective cohort study of 365 patients. Am J Hematol 2022; 97:E321-E324. [PMID: 35702859 PMCID: PMC9349729 DOI: 10.1002/ajh.26629] [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: 05/06/2022] [Revised: 05/22/2022] [Accepted: 05/26/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Marco Salvini
- ASST Sette Laghi, Ospedale di Circolo, Varese, Italy
| | - Camilla Damonte
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Lorenzo Mortara
- Laboratory of Immunology and General Pathology, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Fabrizio Maggi
- ASST Sette Laghi, Ospedale di Circolo, Varese, Italy.,Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Antonino Bruno
- Laboratory of Immunology and General Pathology, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy.,IRCCS MultiMedica, Milan, Italy
| | - Giacomo Pellegrini
- ASST Sette Laghi, Ospedale di Circolo, Varese, Italy.,National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
| | - Barbara Mora
- ASST Sette Laghi, Ospedale di Circolo, Varese, Italy.,Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | | | | | | | | | | | | | - Elisa Rumi
- Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Michele Merli
- ASST Sette Laghi, Ospedale di Circolo, Varese, Italy
| | | | - Susanna Bassi
- ASST Sette Laghi, Ospedale di Circolo, Varese, Italy
| | - Raffaella Bombelli
- Laboratory of Immunology and General Pathology, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Matteo Gallazzi
- Laboratory of Immunology and General Pathology, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Oscar Borsani
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Andreina Baj
- ASST Sette Laghi, Ospedale di Circolo, Varese, Italy.,Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Matteo Franchi
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy.,Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - Paolo A Grossi
- ASST Sette Laghi, Ospedale di Circolo, Varese, Italy.,Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Francesco Passamonti
- ASST Sette Laghi, Ospedale di Circolo, Varese, Italy.,Department of Medicine and Surgery, University of Insubria, Varese, Italy
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29
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Mora B, Guglielmelli P, Kuykendall A, Maffioli M, Rotunno G, Komrokji RS, Palandri F, Kiladjian JJ, Iurlo A, Auteri G, Cattaneo D, De Stefano V, Salmoiraghi S, Devos T, Cervantes F, Merli M, Campagna A, Benevolo G, Brociner M, Albano F, Gotlib J, Caramella M, Ruggeri M, Ross DM, Orsini F, Pessina C, Colugnat I, Pallotti F, Barbui T, Bertù L, Della Porta MG, Vannucchi AM, Passamonti F. P995: MYELOID NEOPLASMS-ASSOCIATED GENE VARIANTS IN 639 PATIENTS WITH POST-POLYCYTHEMIA VERA AND POST-ESSENTIAL THROMBOCYTHEMIA MYELOFIBROSIS: AN ANALYSIS OF THE MYSEC COHORT. Hemasphere 2022. [PMCID: PMC9430043 DOI: 10.1097/01.hs9.0000846848.27311.c7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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30
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Castellino A, Castellino C, Boccomini C, Clerico M, Nicoli P, Vanazzi A, Fanelli F, Perrone T, Marchesi F, Cocito F, Merli M, Bigliardi S, Mecacci B, Bozzoli V, Margiotta-Casaluci G, Meli E, Anastasia A, Farina L, Annibali O, Massaia M. Outcome of follicular lymphoma (FL) patients in maintenance with antiCD20 monoclonal antibodies (MoAb) in SARS-Cov2 era. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e19544] [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: 11/20/2022] Open
Abstract
e19544 Background: Maintenance in FL patients (pts) improves progression free survival (PFS). SARS-Cov2 pandemic posed unique challenges for immunocompromised pts. Methods: This is an observational, multicenter, retrospective and prospective study. The aim is to evaluate the outcome of FL pts in maintenance with antiCD20-MoAb during SARS-Cov2 pandemic and how suspension of therapy affected lymphoma outcome and the risk of SARS-Cov2 infection and its morbidity and mortality. Results: 420 pts from 18 Italian Centers were included. Median age was 62 years old (range 27-91), 216 pts (51%) were male. Main clinical characteristics were: histological grade 1-2 vs 3A vs not valuable in 288 (69%) vs 109 (26%) vs 23 (5%), respectively; advanced stage in 361 (86%), high FLIPI score in 192 (46%) pts. All 420 pts were in antiCD20-MoAb maintenance at the time of SARS-Cov2 pandemic onset (March 2020): 333 (79%) were receiving maintenance after a first line, while 87 (21%) after a second line. 342 (81%) pts were receiving Rituximab, while 75 (18%) Obinutuzumab, 3 pts did not start the planned maintenance. Status of disease after induction was complete remission (CR) in 374 (89%), partial response (PR) in 41 (10%), progressive disease (PD) in 1, not evaluated in 4 patients, respectively. At the end of maintenance was CR in 265 (63%), PR in 19 (4%), stable disease (SD) in one and PD in 14 (3%) pts, maintenance is ongoing in 121 (29%) pts. Because of SARS-Cov2 pandemic maintenance treatment was temporary suspended in 122 (29%), definitively interrupted in123 (29%), not changed in 175 (42%). Median number of maintenance treatment administered at March 2020 was 2 (range 1-12), in pts who modified treatment median number of performed vs lost courses was 7 (range 0-11) vs 2 (range 1-12). Patients were divided into two groups according to the approach to maintenance during pandemic: pts who interrupted maintenance (temporary or definitively): groups A (245 (58%) cases) vs pts who did not modified maintenance: group B (175 (42%)). No differences in clinical characteristics, type of therapy and response were observed between the two groups. 29(7%) relapses were observed: 16 (7%) vs 13 (7%) in group A vs B. 70 (17%) pts experienced SARS-Cov2 positivity: 47 (19%) vs 23 (13%) in group A vs B. 53 (76%) pts had symptomatic COVID and 43 (61%) were hospitalized, with no differences between the two groups. Anti-SARS-Cov2 vaccine was administered in 349 patients, serology assessment was done in 46% of cases, showing 21 (13%) reactive vs 138 (87%) not reactive patients, with no differences between the two groups. 21 (30%) pts died because of COVID: 9 (19%) vs 12 (52%) in groups A vs B. Conclusions: Suspension of maintenance during SARS-Cov2 pandemic did not show a protection in terms of SARS-Cov2 positivity and morbidity. A trend in lower mortality is suggested. No differences in terms of relapse rate were observed, but longer follow up is needed.
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Affiliation(s)
| | | | - Carola Boccomini
- Hematology Department, Città della Salute e della Scienza, Torino, Italy
| | | | - Paolo Nicoli
- Hematology Unit, San Luigi Gonzaga Hospital and University, Orbassano, Italy
| | - Anna Vanazzi
- Division of Clinical Haemato-Oncology, Milano, Italy
| | | | - Tommasina Perrone
- Hematology and Stem Cell Transplantation Unit, AOUC Policlinico, Bari, Italy
| | | | | | - Michele Merli
- Hematology, University Hospital “Ospedale di Circolo e Fondazione Macchi"-ASST Sette Laghi, University of Insubria, Varese, Italy
| | | | | | | | - Gloria Margiotta-Casaluci
- Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy
| | - Erika Meli
- ASST Grande Ospedale Metropolitano Niguarda, Dipartimento di Ematologia e Oncologia, S.C. Ematologia, Milan, Italy
| | | | - Lucia Farina
- Fondazione IRCCS Isttuto Nazionale Tumori, Milano, Italy
| | | | - Massimo Massaia
- Sezione di Ematologia, University of Torino, AOU S. Giovanni Battista, Torino, Italy
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31
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Zinzani PL, Mayer J, Auer R, Bijou F, de Oliveira AC, Flowers C, Merli M, Bouabdallah K, Ganly PS, Johnson R, Yuen S, Kingsley E, Tumyan G, Assouline SE, Ivanova E, Kim P, Huang J, Delarue R, Trotman J. Zanubrutinib plus obinutuzumab (ZO) versus obinutuzumab (O) monotherapy in patients (pts) with relapsed or refractory (R/R) follicular lymphoma (FL): Primary analysis of the phase 2 randomized ROSEWOOD trial. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.7510] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7510 Background: FL is the most common type of indolent non-Hodgkin lymphoma. Approved treatment options are limited for pts with R/R FL. In a phase 1b trial ( Blood Adv. 2020;4(19):4802-4811), ZO was found to be tolerable and associated with early signal of efficacy. ROSEWOOD (BGB-3111-212) is a phase 2, randomized study designed to assess efficacy and safety of ZO vs O in pts with R/R FL. Methods: Pts with R/R FL who received ≥2 lines of therapy, including an anti-CD20 antibody and an alkylating agent, were randomized 2:1 to receive either ZO or O. O was given in both arms on Days 1, 8, and 15 of Cycle 1, Day 1 of Cycles 2-6, and then every 8 weeks up to 20 doses maximum. Z (160 mg twice daily) was given until progressive disease (PD) or unacceptable toxicity; Pts with confirmed PD in the O arm were allowed to crossover to ZO. Primary endpoint was overall response rate (ORR) by independent central review. Secondary endpoints included complete response rate (CRR), duration of response (DOR), progression-free survival (PFS), overall survival (OS), and safety. Exploratory endpoint included ORR by investigator after crossover. Primary analysis cutoff was October 8, 2021. Results: A total of 217 pts were randomized to ZO (n = 145) or O (n = 72). Median study follow-up was 12.5 mo; median age was 64 yrs. Incidence of high FL International Prognostic Index score was 53% (ZO) and 51% (O). Pts received a median of 3 prior lines of therapy, with 28% (ZO) and 25% (O) of pts receiving > 3 lines. Proportion of pts refractory to rituximab, refractory to the most recent line of therapy, or with PD within 24 mo of initiation of first-line immunochemotherapy was 54%, 32% and 28% with ZO and 50%, 40% and 32% with O, respectively. The study met its primary endpoint: ORR was 68.3% with ZO vs 45.8% with O ( p= 0.0017). CRR was 37.2% (ZO) vs 19.4% (O); 18-mo DOR rate was 70.9% (ZO) vs 54.6% (O); and median PFS was 27.4 mo (ZO) vs 11.2 mo (O; hazard ratio [HR], 0.51 [95% CI, 0.32-0.81], p= 0.0040). Median time to new anti-lymphoma therapy or crossover was not evaluable (NE; ZO) vs 12.1 mo (O; HR, 0.37 [95% CI, 0.23-0.60], p< 0.0001). ORR for 29 pts who crossed over to ZO was 24.1%. Median OS was NE; 18-mo OS probability was 85.4% (ZO) vs 72.6% (O). Most common any grade AEs in the ZO arm were thrombocytopenia (34.3%), neutropenia (27.3%), diarrhea (16.1%), fatigue (14.0%), constipation (13.3%), cough (11.9%), pyrexia (11.2%), and dyspnea (10.5%). Grade ≥3 AEs with incidence > 5% with ZO were neutropenia (22.4%) and thrombocytopenia (14.0%); incidence of atrial fibrillation was 0.7% and major bleeding was 1.4%. Incidence of treatment-emergent AEs leading to death was 5.6% (ZO) and 9.9% (O). Conclusions: ZO demonstrated superior efficacy to O in treatment of pts with R/R FL. ZO had a favorable benefit-risk profile and represents a potential combination therapy for pts with R/R FL. Clinical trial information: NCT03332017.
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Affiliation(s)
- Pier Luigi Zinzani
- Institute of Hematology “Seràgnoli”, University of Bologna, Bologna, Italy
| | - Jiří Mayer
- Department of Internal Medicine-Hematology and Oncology, Masaryk University and University Hospital, Brno, Czech Republic
| | - Rebecca Auer
- St. Bartholomew’s Hospital, Barts Health NHS Trust, London, United Kingdom
| | | | - Ana C. de Oliveira
- Institut Catala d'Oncologia (ICO) Hospital Duran I Reynals Hospital, Barcelona, Spain
| | | | - Michele Merli
- Hematology, University Hospital "Ospedale di Circolo e Fondazione Macchi"-ASST Sette Laghi, University of Insubria, Varese, Italy
| | | | - Peter S. Ganly
- Department of Haematology, Christchurch Hospital, Christchurch, New Zealand
| | | | - Sam Yuen
- Calvary Mater Newcastle, Waratah, NSW, Australia
| | - Ed Kingsley
- Comprehensive Cancer Centers of Nevada, Las Vegas, NV
| | - Gayane Tumyan
- Department of Chemotherapy of Hemoblastosis, Blokhin Russian Cancer Research Center, Moscow, Russian Federation
| | | | | | - Pil Kim
- BeiGene Co., Ltd.; BeiGene, Inc., San Mateo, CA
| | - Jane Huang
- BeiGene Co., Ltd.; BeiGene, Inc., San Mateo, CA
| | | | - Judith Trotman
- Concord Repatriation General Hospital, Department of Haemotology, University of Sydney, Concord, NSW, Australia
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Calabretta E, Guidetti A, Ricci F, Di Trani M, Monfrini C, Magagnoli M, Bramanti S, Maspero D, Morello L, Merli M, Di Rocco A, Graudenzi A, Derenzini E, Antoniotti M, Rossi D, Corradini P, Santoro A, Carlo-Stella C. Chemotherapy after PD-1 inhibitors in relapsed/refractory Hodgkin lymphoma: Outcomes and clonal evolution dynamics. Br J Haematol 2022; 198:82-92. [PMID: 35468225 PMCID: PMC9321573 DOI: 10.1111/bjh.18183] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [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: 01/26/2022] [Revised: 03/20/2022] [Accepted: 03/22/2022] [Indexed: 11/27/2022]
Abstract
Checkpoint inhibitors (CPIs) are routinely employed in relapsed/refractory classical Hodgkin lymphoma. Nonetheless, persistent long-term responses are uncommon, and one-third of patients are refractory. Several reports have suggested that treatment with CPIs may re-sensitize patients to chemotherapy, however there is no consensus on the optimal chemotherapy regimen and subsequent consolidation strategy. In this retrospective study we analysed the response to rechallenge with chemotherapy after CPI failure. Furthermore, we exploratively characterized the clonal evolution profile of a small sample of patients (n = 5) by employing the CALDER approach. Among the 28 patients included in the study, 17 (71%) were primary refractory and 26 (92%) were refractory to the last chemotherapy prior to CPIs. Following rechallenge with chemotherapy, response was recorded in 23 (82%) patients experiencing complete remission and 3 (11%) patients experiencing partial remission. The tumour evolution of the patients inferred by CALDER seemingly occurred prior to the first cycle of therapy and was characterized either by linear or branching evolution patterns. Twenty-five patients proceeded to allogeneic stem cell transplantation. At a median follow-up of 21 months, median PFS and OS were not reached. In conclusion, patients who fail CPIs can be effectively rescued by salvage chemotherapy and bridged to allo-SCT/auto-SCT.
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Affiliation(s)
- Eleonora Calabretta
- Department of Biomedical Sciences, Humanitas University, Milan, Italy.,Department of Oncology and Hematology, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Anna Guidetti
- Division of Hematology and Bone Marrow Transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,University of Milano, Milan, Italy
| | - Francesca Ricci
- Department of Oncology and Hematology, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Martina Di Trani
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Chiara Monfrini
- Division of Hematology and Bone Marrow Transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Massimo Magagnoli
- Department of Oncology and Hematology, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Stefania Bramanti
- Department of Oncology and Hematology, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Davide Maspero
- Dipartimento di Informatica, Sistemistica e Comunicazione, Università degli Studi di Milano-Bicocca, Milan, Italy.,Institute of Molecular Bioimaging and Physiology, Consiglio Nazionale delle Ricerche (IBFM-CNR), Segrate, Milan, Italy
| | - Lucia Morello
- Department of Oncology and Hematology, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Michele Merli
- Department of Hematology, University Hospital "Ospedale di Circolo e Fondazione Macchi - ASST Sette Laghi", University of Insubria, Varese, Italy
| | - Alice Di Rocco
- Department of Translational and Precision Medicine, La Sapienza University, Rome, Italy
| | - Alex Graudenzi
- Institute of Molecular Bioimaging and Physiology, Consiglio Nazionale delle Ricerche (IBFM-CNR), Segrate, Milan, Italy.,Bicocca Bioinformatics, Biostatistics and Bioimaging Centre (B4), Università degli Studi di Milano-Bicocca, Milan, Italy
| | - Enrico Derenzini
- IEO European Institute of Oncology IRCCS, Milan, Italy.,Department of Health Sciences, University of Milan, Italy
| | - Marco Antoniotti
- Dipartimento di Informatica, Sistemistica e Comunicazione, Università degli Studi di Milano-Bicocca, Milan, Italy.,Bicocca Bioinformatics, Biostatistics and Bioimaging Centre (B4), Università degli Studi di Milano-Bicocca, Milan, Italy
| | - Davide Rossi
- Clinic of Hematology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland.,Institute of Oncology Research, Bellinzona, Switzerland.,Faculty of Biomedical Sciences, USI, Lugano, Switzerland
| | - Paolo Corradini
- Division of Hematology and Bone Marrow Transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,University of Milano, Milan, Italy
| | - Armando Santoro
- Department of Biomedical Sciences, Humanitas University, Milan, Italy.,Department of Oncology and Hematology, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Carmelo Carlo-Stella
- Department of Biomedical Sciences, Humanitas University, Milan, Italy.,Department of Oncology and Hematology, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Milan, Italy
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33
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Bonfiglio F, Bruscaggin A, Guidetti F, Terzi di Bergamo L, Faderl M, Spina V, Condoluci A, Bonomini L, Forestieri G, Koch R, Piffaretti D, Pini K, Pirosa MC, Cittone MG, Arribas A, Lucioni M, Ghilardi G, Wu W, Arcaini L, Baptista MJ, Bastidas G, Bea S, Boldorini R, Broccoli A, Buehler MM, Canzonieri V, Cascione L, Ceriani L, Cogliatti S, Corradini P, Derenzini E, Devizzi L, Dietrich S, Elia AR, Facchetti F, Gaidano G, Garcia JF, Gerber B, Ghia P, Gomes da Silva M, Gritti G, Guidetti A, Hitz F, Inghirami G, Ladetto M, Lopez-Guillermo A, Lucchini E, Maiorana A, Marasca R, Matutes E, Meignin V, Merli M, Moccia A, Mollejo M, Montalban C, Novak U, Oscier DG, Passamonti F, Piazza F, Pizzolitto S, Rambaldi A, Sabattini E, Salles G, Santambrogio E, Scarfò L, Stathis A, Stüssi G, Geyer JT, Tapia G, Tarella C, Thieblemont C, Tousseyn T, Tucci A, Vanini G, Visco C, Vitolo U, Walewska R, Zaja F, Zenz T, Zinzani PL, Khiabanian H, Calcinotto A, Bertoni F, Bhagat G, Campo E, De Leval L, Dirnhofer S, Pileri SA, Piris MA, Traverse-Glehen A, Tzankov A, Paulli M, Ponzoni M, Mazzucchelli L, Cavalli F, Zucca E, Rossi D. Genetic and phenotypic attributes of splenic marginal zone lymphoma. Blood 2022; 139:732-747. [PMID: 34653238 DOI: 10.1182/blood.2021012386] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 09/14/2021] [Indexed: 11/20/2022] Open
Abstract
Splenic marginal zone B-cell lymphoma (SMZL) is a heterogeneous clinico-biological entity. The clinical course is variable, multiple genes are mutated with no unifying mechanism, and essential regulatory pathways and surrounding microenvironments are diverse. We sought to clarify the heterogeneity of SMZL by resolving different subgroups and their underlying genomic abnormalities, pathway signatures, and microenvironment compositions to uncover biomarkers and therapeutic vulnerabilities. We studied 303 SMZL spleen samples collected through the IELSG46 multicenter international study (NCT02945319) by using a multiplatform approach. We carried out genetic and phenotypic analyses, defined self-organized signatures, validated the findings in independent primary tumor metadata and in genetically modified mouse models, and determined correlations with outcome data. We identified 2 prominent genetic clusters in SMZL, termed NNK (58% of cases, harboring NF-κB, NOTCH, and KLF2 modules) and DMT (32% of cases, with DNA-damage response, MAPK, and TLR modules). Genetic aberrations in multiple genes as well as cytogenetic and immunogenetic features distinguished NNK- from DMT-SMZLs. These genetic clusters not only have distinct underpinning biology, as judged by differences in gene-expression signatures, but also different outcomes, with inferior survival in NNK-SMZLs. Digital cytometry and in situ profiling segregated 2 basic types of SMZL immune microenvironments termed immune-suppressive SMZL (50% of cases, associated with inflammatory cells and immune checkpoint activation) and immune-silent SMZL (50% of cases, associated with an immune-excluded phenotype) with distinct mutational and clinical connotations. In summary, we propose a nosology of SMZL that can implement its classification and also aid in the development of rationally targeted treatments.
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Affiliation(s)
- Ferdinando Bonfiglio
- Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | - Alessio Bruscaggin
- Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | - Francesca Guidetti
- Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | | | - Martin Faderl
- Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | - Valeria Spina
- Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | - Adalgisa Condoluci
- Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
- Division of Hematology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Luisella Bonomini
- International Extranodal Lymphoma Study Group, Bellinzona, Switzerland
| | - Gabriela Forestieri
- Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | - Ricardo Koch
- Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | - Deborah Piffaretti
- Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | - Katia Pini
- Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | - Maria Cristina Pirosa
- Division of Hematology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Micol Giulia Cittone
- Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
- Division of Hematology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Alberto Arribas
- Lymphoma Genomics, Institute of Oncology Research, Bellinzona, Switzerland
| | - Marco Lucioni
- Unit of Anatomic Pathology, Department of Molecular Medicine, Fondazione IRCCS Policlinico San Matteo and Università degli Studi di Pavia, Pavia, Italy
| | - Guido Ghilardi
- Division of Hematology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Wei Wu
- Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | - Luca Arcaini
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo and Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Maria Joao Baptista
- Lymphoid Neoplasms Group, Josep Carreras Leukaemia Research Institute, Badalona, Spain
| | - Gabriela Bastidas
- Division of Hematology, Hospital Clínic i Provincial de Barcelona, Barcelona, Spain
| | - Silvia Bea
- Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS)
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) 28029, Madrid, Spain
- Pathology Department, Hospital Clínic, Barcelona University, Barcelona, Spain
| | - Renzo Boldorini
- Division of Pathology, University of Eastern Piedmont, Novara, Italy
| | - Alessandro Broccoli
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia Seràgnoli, Bologna, Italy
| | - Marco Matteo Buehler
- Department of Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland
| | - Vincenzo Canzonieri
- Pathology Unit, CRO Aviano National Cancer Institute, Aviano, Italy
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Luciano Cascione
- Lymphoma Genomics, Institute of Oncology Research, Bellinzona, Switzerland
| | - Luca Ceriani
- Clinic of Nuclear Medicine and PET-CT Centre, Imaging Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Sergio Cogliatti
- Institute of Pathology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - Paolo Corradini
- Division of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Enrico Derenzini
- Onco-hematology Division, European Institute of Oncology (IEO) IRCCS, Milan, Italy
| | - Liliana Devizzi
- Division of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Sascha Dietrich
- Division of Hematology, University Hospital Heidelberg, Heidelberg, Germany
| | - Angela Rita Elia
- Cancer Immunotherapy, Institute of Oncology Research, Bellinzona, Switzerland
| | - Fabio Facchetti
- Department of Molecular and Translational Medicine, Pathology Unit, Spedali Civili, Brescia, Italy
| | - Gianluca Gaidano
- Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | | | - Bernhard Gerber
- Division of Hematology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
- Department of Hematology and Oncology, University of Zurich, Zurich, Switzerland
| | - Paolo Ghia
- Strategic Research Program on Chronic Lymphocytic Leukemia (CLL), IRCCS Ospedale San Raffaele and Università Vita-Salute San Raffaele, Milan, Italy
| | - Maria Gomes da Silva
- Division of Hematology, Instituto Português de Oncologia de Lisboa, Lisbon, Portugal
| | - Giuseppe Gritti
- Division of Hematology, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - Anna Guidetti
- Division of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Felicitas Hitz
- Division of Hematology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - Giorgio Inghirami
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY
| | - Marco Ladetto
- Division of Hematology, Azienda Ospedaliera SS Antonio e Biagio, Alessandria, Italy
- Dipartimento di Medicina Traslazionale, University of Eastern Piedmont, Alessandria, Italy
| | | | - Elisa Lucchini
- Division of Hematology, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Antonino Maiorana
- Division of Pathology, Universitá degli Studi di Modena e Reggio Emilia, Modena, Italy
| | - Roberto Marasca
- Hematology Unit, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Estella Matutes
- Haematopathology Unit, Hospital Clínic i Provincial de Barcelona, Barcelona, Spain
| | | | - Michele Merli
- Division of Hematology, University of Insubria and ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Alden Moccia
- Clinic of Medical Oncology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Manuela Mollejo
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) 28029, Madrid, Spain
- Division of Pathology, Hospital Virgen de la Salud, Toledo, Spain
| | - Carlos Montalban
- Division of Hematology, MD Anderson Cancer Center, Madrid, Spain
| | - Urban Novak
- Department of Medical Oncology and University Cancer Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - David Graham Oscier
- Division of Hematology, University Hospitals Dorset, Bournemouth, United Kingdom
| | - Francesco Passamonti
- Department of Medicine and Surgery, University of Insubria and ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Francesco Piazza
- Division of Hematology, Ospedale Universitario di Padova, Padova, Italy
| | - Stefano Pizzolitto
- Division of Pathology, General Hospital S Maria della Misericordia, Udine, Italy
| | - Alessandro Rambaldi
- Division of Hematology, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - Elena Sabattini
- Haematopathology Unit, Department of Experimental Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Gilles Salles
- Faculté de Médecine et de Maïeutique Lyon Sud, Université de Lyon, Lyon, France
| | | | - Lydia Scarfò
- Strategic Research Program on Chronic Lymphocytic Leukemia (CLL), IRCCS Ospedale San Raffaele and Università Vita-Salute San Raffaele, Milan, Italy
| | - Anastasios Stathis
- Clinic of Medical Oncology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Georg Stüssi
- Division of Hematology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
| | - Julia T Geyer
- Division of Anatomic Pathology and Clinical Pathology, Weill Cornell Medical College, New York, NY
| | - Gustavo Tapia
- Division of Pathology, Hospital Germans Trias I Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Corrado Tarella
- Onco-hematology Division, European Institute of Oncology (IEO) IRCCS, Milan, Italy
| | - Catherine Thieblemont
- Assistance Publique-Hôpitaux de Paris, Hopital Saint-Louis, Hemato-Oncology Unit; Université de Paris, Paris, France
| | - Thomas Tousseyn
- Department of Haematology, University Hospitals Leuven, Leuven, Belgium
| | | | - Giorgio Vanini
- Department of Medical Oncology and University Cancer Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Carlo Visco
- Department of Medicine, Section of Hematology, University of Verona, Italy
| | - Umberto Vitolo
- Candiolo Cancer Institute (FPO-IRCCS), Candiolo, Turin, Italy
| | - Renata Walewska
- Division of Hematology, University Hospitals Dorset, Bournemouth, United Kingdom
| | - Francesco Zaja
- Division of Hematology, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Thorsten Zenz
- Department of Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland
| | - Pier Luigi Zinzani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia Seràgnoli, Bologna, Italy
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Hossein Khiabanian
- Center for Systems and Computational Biology, Rutgers University, New Brunswick, NJ
| | - Arianna Calcinotto
- Cancer Immunotherapy, Institute of Oncology Research, Bellinzona, Switzerland
| | - Francesco Bertoni
- Lymphoma Genomics, Institute of Oncology Research, Bellinzona, Switzerland
- Clinic of Medical Oncology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
| | - Govind Bhagat
- Department of Pathology and Cell Biology, Columbia University, New York, NY
| | - Elias Campo
- Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS)
- Pathology Department, Hospital Clínic, Barcelona University, Barcelona, Spain
| | - Laurence De Leval
- Division of Pathology, Institut Universitaire de Pathologie, Lausanne, Switzerland
| | - Stefan Dirnhofer
- Institute of Pathology and Medical Genetics, University Hospital Basel, Basel, Switzerland
| | - Stefano A Pileri
- Haematopathology Division, European Institute of Oncology IRCCS, Milan, Italy
| | - Miguel A Piris
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) 28029, Madrid, Spain
- Pathology Service, Fundación Jiménez Díaz, Madrid, Spain
| | | | - Alexander Tzankov
- Institute of Pathology and Medical Genetics, University Hospital Basel, Basel, Switzerland
| | - Marco Paulli
- Unit of Anatomic Pathology, Department of Molecular Medicine, Fondazione IRCCS Policlinico San Matteo and Università degli Studi di Pavia, Pavia, Italy
| | - Maurilio Ponzoni
- Ateneo Vita-Salute San Raffaele University and Pathology Unit San Raffaele Scientific Institute, Milan, Italy
| | - Luca Mazzucchelli
- Division of Pathology, Cantonal Institute of Pathology, Locarno, Switzerland
| | - Franco Cavalli
- Institute of Oncology Research, Bellinzona, Switzerland; and
| | - Emanuele Zucca
- International Extranodal Lymphoma Study Group, Bellinzona, Switzerland
- Clinic of Medical Oncology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
- Department of Medical Oncology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Davide Rossi
- Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
- Division of Hematology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
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34
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Avallone G, Giordano S, Astrua C, Merli M, Senetta R, Conforti C, Ribero S, Marzano AV, Quaglino P. Reply to “The first dose of COVID‐19 vaccine may trigger pemphigus and bullous pemphigoid flares: is the second dose therefore contraindicated?” by Damiani G et al. J Eur Acad Dermatol Venereol 2022; 36:e433-e435. [DOI: 10.1111/jdv.17959] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 12/13/2021] [Accepted: 01/18/2022] [Indexed: 11/28/2022]
Affiliation(s)
- G Avallone
- Dermatology Clinic Department of Medical Sciences University of Turin Turin Italy
| | - S Giordano
- Dermatology Clinic Department of Medical Sciences University of Turin Turin Italy
| | - C Astrua
- Dermatology Clinic Department of Medical Sciences University of Turin Turin Italy
| | - M Merli
- Dermatology Clinic Department of Medical Sciences University of Turin Turin Italy
| | - R Senetta
- Department of Oncology, Pathology Unit University of Turin Turin Italy
| | - C Conforti
- Dermatology Clinic Maggiore Hospital Trieste Italy
| | - S Ribero
- Dermatology Clinic Department of Medical Sciences University of Turin Turin Italy
| | - AV Marzano
- Dermatology Unit Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milan Italy
- Department of Pathophysiology and Transplantation Università degli Studi di Milano Milan Italy
| | - P Quaglino
- Dermatology Clinic Department of Medical Sciences University of Turin Turin Italy
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35
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Ballotta L, Zinzani PL, Pileri S, Bruna R, Tani M, Casadei B, Tabanelli V, Volpetti S, Luminari S, Corradini P, Lucchini E, Tisi MC, Merli M, Re A, Varettoni M, Pesce EA, Zaja F. Venetoclax Shows Low Therapeutic Activity in BCL2-Positive Relapsed/Refractory Peripheral T-Cell Lymphoma: A Phase 2 Study of the Fondazione Italiana Linfomi. Front Oncol 2021; 11:789891. [PMID: 34938664 PMCID: PMC8685372 DOI: 10.3389/fonc.2021.789891] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 11/15/2021] [Indexed: 01/05/2023] Open
Abstract
Patients with relapsed/refractory (R/R) peripheral T-cell lymphoma (PTCL) have a poor prognosis, with an expected survival of less than 1 year using standard salvage therapies. Recent advances in our understanding of the biology of PTCL have led to identifying B-Cell Lymphoma 2 (BCL2) protein as a potential therapeutic target. BLC2 inhibitor venetoclax was investigated in a prospective phase II trial in patients with BCL2-positive R/R PTCL after at least one previous standard line of treatment (NCT03552692). Venetoclax given alone at a dosage of 800 mg/day resulted in one complete response (CR) and two stable diseases (SDs) among 17 enrolled patients. The majority of patients (88.2%) interrupted the treatment due to disease progression. No relationship with BCL2 expression was documented. At a median follow-up of 8 months, two patients are currently still on treatment (one CR and one SD). No case of tumor lysis syndrome was registered. Therefore, venetoclax monotherapy shows activity in a minority of patients whose biological characteristics have not yet been identified. Clinical Trial Registration www.clinicaltrials.gov (NCT03552692, EudraCT number 2017-004630-29).
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Affiliation(s)
- Laura Ballotta
- Dipartimento Clinico di Scienze Mediche, Chirurgiche e della Salute, Università degli Studi di Trieste, Trieste, Italy.,Struttura Complessa (SC) Ematologia, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Pier Luigi Zinzani
- Istituti di Ricovero e Cura a Carattere Scientifico (IRCSS) Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seragnoli", Bologna, Italy.,Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università degli Studi di Bologna, Bologna, Italy
| | - Stefano Pileri
- Divisione di Emolinfopatologia, Istituto Europeo di Oncologia Istituti di Ricovero e Cura a Carattere Scientifico (IRCSS), Milano, Italy
| | - Riccardo Bruna
- Divisione di Ematologia, Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale e Azienda Ospedaliera Universitaria (AOU) Maggiore della Carità, Novara, Italy
| | - Monica Tani
- Unità Operativa Complessa (UOC) Ematologia, Ospedale Santa Maria delle Croci, Ravenna, Italy
| | - Beatrice Casadei
- Istituti di Ricovero e Cura a Carattere Scientifico (IRCSS) Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seragnoli", Bologna, Italy.,Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università degli Studi di Bologna, Bologna, Italy
| | - Valentina Tabanelli
- Divisione di Emolinfopatologia, Istituto Europeo di Oncologia Istituti di Ricovero e Cura a Carattere Scientifico (IRCSS), Milano, Italy
| | - Stefano Volpetti
- Clinica Ematologica, Azienda Sanitaria Universitaria (AOU) Friuli Centrale, Udine, Italy
| | - Stefano Luminari
- Ematologia, Azienda Unita Sanitaria Locale Istituti di Ricovero e Cura a Carattere Scientifico (IRCSS) Reggio Emilia, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.,Dipartimento Chirurgico Medico Odontoiatrico e di Scienze Morfologiche con interesse Trapiantologico Oncologico e di Medicina Rigenerativa (CHIMOMO), Università di Modena e Reggio Emilia, Modena, Italy
| | - Paolo Corradini
- Struttura Complessa (SC) Ematologia, Fondazione Istituti di Ricovero e Cura a Carattere Scientifico (IRCSS) Istituto Nazionale dei Tumori, Milano, Italy
| | - Elisa Lucchini
- Struttura Complessa (SC) Ematologia, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | | | - Michele Merli
- Ematologia "Ospedale di Circolo e Fondazione Macchi-Azienda Socio Sanitaria Territoriale (ASST) Sette Laghi", Varese, Italy
| | - Alessandro Re
- Ematologia, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili di Brescia, Brescia, Italy
| | - Marzia Varettoni
- Divisione di Ematologia, Fondazione Istituti di Ricovero e Cura a Carattere Scientifico (IRCSS) Policlinico San Matteo, Pavia, Italy
| | | | - Francesco Zaja
- Dipartimento Clinico di Scienze Mediche, Chirurgiche e della Salute, Università degli Studi di Trieste, Trieste, Italy.,Struttura Complessa (SC) Ematologia, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
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36
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Cariti C, Dapavo P, Mastorino L, Ortoncelli M, Siliquini N, Merli M, Avallone G, Giordano S, Fabrizio R, Susca S, Verrone A, Stroppiana E, Quaglino P, Ribero S. Comparison of Secukinumab and Ixekizumab in psoriasis: a real-life cohort study on the efficacy and drug survival of 445 patients. J Eur Acad Dermatol Venereol 2021; 36:e233-e235. [PMID: 34672026 DOI: 10.1111/jdv.17766] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 09/13/2021] [Accepted: 10/15/2021] [Indexed: 12/01/2022]
Affiliation(s)
- C Cariti
- Department of Medical Sciences, Section of Dermatology, University of Turin, C.so Dogliotti, Turin, 14 - 10126, Italy
| | - P Dapavo
- Department of Medical Sciences, Section of Dermatology, University of Turin, C.so Dogliotti, Turin, 14 - 10126, Italy
| | - L Mastorino
- Department of Medical Sciences, Section of Dermatology, University of Turin, C.so Dogliotti, Turin, 14 - 10126, Italy
| | - M Ortoncelli
- Department of Medical Sciences, Section of Dermatology, University of Turin, C.so Dogliotti, Turin, 14 - 10126, Italy
| | - N Siliquini
- Department of Medical Sciences, Section of Dermatology, University of Turin, C.so Dogliotti, Turin, 14 - 10126, Italy
| | - M Merli
- Department of Medical Sciences, Section of Dermatology, University of Turin, C.so Dogliotti, Turin, 14 - 10126, Italy
| | - G Avallone
- Department of Medical Sciences, Section of Dermatology, University of Turin, C.so Dogliotti, Turin, 14 - 10126, Italy
| | - S Giordano
- Department of Medical Sciences, Section of Dermatology, University of Turin, C.so Dogliotti, Turin, 14 - 10126, Italy
| | - R Fabrizio
- Department of Medical Sciences, Section of Dermatology, University of Turin, C.so Dogliotti, Turin, 14 - 10126, Italy
| | - S Susca
- Department of Medical Sciences, Section of Dermatology, University of Turin, C.so Dogliotti, Turin, 14 - 10126, Italy
| | - A Verrone
- Department of Medical Sciences, Section of Dermatology, University of Turin, C.so Dogliotti, Turin, 14 - 10126, Italy
| | - E Stroppiana
- Department of Medical Sciences, Section of Dermatology, University of Turin, C.so Dogliotti, Turin, 14 - 10126, Italy
| | - P Quaglino
- Department of Medical Sciences, Section of Dermatology, University of Turin, C.so Dogliotti, Turin, 14 - 10126, Italy
| | - S Ribero
- Department of Medical Sciences, Section of Dermatology, University of Turin, C.so Dogliotti, Turin, 14 - 10126, Italy
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37
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Arcari A, Morello L, Vallisa D, Marcheselli L, Tecchio C, Quaglia FM, Tisi MC, Zilioli VR, Di Rocco A, Perrone T, Gini G, Dogliotti I, Bianchetti N, Bozzoli V, De Philippis C, Alvarez De Celis MI, Chiappella A, Fabbri A, Pelosini M, Merli M, Molinari AL, Sciarra R, Volpetti S, Hohaus S, Nassi L, Visco C. Allogeneic stem cell transplantation in patients with mantle cell lymphoma: results from the MANTLE-FIRST study on behalf of Fondazione Italiana Linfomi. Leuk Lymphoma 2021; 62:3474-3483. [PMID: 34625013 DOI: 10.1080/10428194.2021.1961238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The role of allogeneic stem cell transplantation (allo-SCT) in mantle cell lymphoma (MCL) is uncertain, even more in the era of bruton's tyrosine kinase inhibitors (BTKi) and chimeric antigen receptor T-cells. We retrospectively analyzed 55 patients who underwent allo-SCT for MCL relapsed or refractory (r/r) after rituximab and high-dose cytarabine within the MANTLE-FIRST project. With a median follow-up of 3.7 years, non-relapse mortality (NRM), progression-free survival, and overall survival were 23%, 53%, and 56%, respectively. NRM was significantly higher in the case of acute graft-versus-host disease, > 2 prior lines of therapy, age > 60 years. The outcome was similar for patients with early (≤24 months) and late progression of disease. The use of BTKi as a bridge to allo-SCT did not increase the toxicity and allowed a good control of disease. Our real-life experience confirms that allo-SCT still represents an option in MCL patients, especially if young and early-relapsed.
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Affiliation(s)
- Annalisa Arcari
- Unit of Hematology and Bone Marrow Transplantation, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Lucia Morello
- Department of Medical Oncology and Hematology, IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Rozzano, Italy
| | - Daniele Vallisa
- Unit of Hematology and Bone Marrow Transplantation, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | | | - Cristina Tecchio
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | | | | | | | - Alice Di Rocco
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | | | - Guido Gini
- Hematology, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
| | - Irene Dogliotti
- Stem Cell Transplant Unit, A.O.U. "Città della Salute e della Scienza di Torino", Turin, Italy
| | | | | | - Chiara De Philippis
- Department of Medical Oncology and Hematology, IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Rozzano, Italy
| | | | - Annalisa Chiappella
- Hematology and Bone Marrow Transplantation, IRCCS Istituto Nazionale Tumori, Milan, Italy.,Hematology, "Città della Salute e della Scienza di Torino" University Hospital, Turin, Italy
| | - Alberto Fabbri
- Hematology, Azienda Ospedaliero-Universitaria Senese and University of Siena, Siena, Italy
| | | | - Michele Merli
- Hematology, University Hospital Ospedale di Circolo e Fondazione Macchi-ASST Sette Laghi, University of Insubria, Varese, Italy
| | | | - Roberta Sciarra
- Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Stefano Volpetti
- Department of Hematology, Azienda Sanitaria Universitaria Integrata, Udine, Italy
| | - Stefan Hohaus
- Hematology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luca Nassi
- Hematology, Azienda Ospedaliero-Universitaria Maggiore della Carità, Novara, Italy
| | - Carlo Visco
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
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38
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Lazzari L, Farina F, Lupo Stanghellini MT, Piemontese S, Marktel S, Mazzi B, Vago L, Milani R, Ferrario A, Bianchi B, Merli M, Ferreri AJM, Corti C, Peccatori J, Ruggeri A, Ciceri F. Graft-versus-lymphoma effect inside the central nervous system in a patient with extranodal natural killer/T-cell lymphoma, nasal type. Curr Res Transl Med 2021; 69:103313. [PMID: 34598023 DOI: 10.1016/j.retram.2021.103313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/30/2021] [Accepted: 09/18/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Lorenzo Lazzari
- Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele, Milano, Italy.
| | - Francesca Farina
- Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele, Milano, Italy
| | | | - Simona Piemontese
- Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Sarah Marktel
- Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Benedetta Mazzi
- Immunohematology and Transfusion Medicine Unit, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Luca Vago
- Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele, Milano, Italy; Immunohematology and Transfusion Medicine Unit, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Raffaella Milani
- Immunohematology and Transfusion Medicine Unit, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Andrea Ferrario
- Division of Hematology, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Benedetta Bianchi
- Division of Hematology, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Michele Merli
- Division of Hematology, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | | | - Consuelo Corti
- Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Jacopo Peccatori
- Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Annalisa Ruggeri
- Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Fabio Ciceri
- Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele, Milano, Italy
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39
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Merli M, Passamonti F, Arcaini L. The double significance of idelalisib immune-related toxicity. Leuk Lymphoma 2021; 62:2815-2817. [PMID: 34586008 DOI: 10.1080/10428194.2021.1983569] [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: 10/20/2022]
Affiliation(s)
- Michele Merli
- Department of Hematology, University Hospital "Ospedale di Circolo e Fondazione Macchi - ASST Sette Laghi", Varese, Italy
| | - Francesco Passamonti
- Department of Hematology, University Hospital "Ospedale di Circolo e Fondazione Macchi - ASST Sette Laghi", Varese, Italy.,Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Luca Arcaini
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Departement of Molecular Medicine, University of Pavia, Pavia, Italy
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40
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Merli M, Rattotti S, Spina M, Re F, Motta M, Piazza F, Orsucci L, Ferreri AJ, Perbellini O, Dodero A, Vallisa D, Pulsoni A, Santoro A, Zuccaro V, Chimienti E, Russo F, Visco C, Zignego AL, Marcheselli L, Luminari S, Paulli M, Bruno R, Arcaini L. DIRECT‐ACTING ANTIVIRALS AS PRIMARY TREATMENT FOR HCV‐ASSOCIATED INDOLENT NON‐HODGKIN LYMPHOMAS: THE PROSPECTIVE BART STUDY OF THE
FONDAZIONE ITALIANA LINFOMI. Hematol Oncol 2021. [DOI: 10.1002/hon.77_2879] [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]
Affiliation(s)
- M. Merli
- University Hospital "Ospedale di Circolo e Fondazione Macchi" ‐ ASST Sette Laghi University of Insubria Hematology Varese Italy
| | - S. Rattotti
- Fondazione IRCCS Policlinico San Matteo Hematology Pavia Italy
| | - M. Spina
- Centro di Riferimento Oncologico IRCCS Medical Oncology and Immune‐related Tumors Aviano (PN) Italy
| | - F. Re
- Azienda Ospedaliera Universitaria Hematology and BMT Center Parma Italy
| | - M. Motta
- ASST Spedali Civili Brescia Hematology Brescia Italy
| | - F. Piazza
- Azienda Ospedaliera‐Universitaria University of Padova Medicine, Hematology Padova Italy
| | - L. Orsucci
- Città della Salute e della Scienza di Torino Hematology Torino Italy
| | | | | | - A. Dodero
- Fondazione IRCCS Istituto Nazionale dei Tumori Hematology Milano Italy
| | - D. Vallisa
- Ospedale Guglielmo da Saliceto Hematology Piacenza Italy
| | - A. Pulsoni
- Sapienza University of Rome Translational and Precision Medicine Roma Italy
| | - A. Santoro
- Humanitas Research Hospital Medical Oncology and Hematology Unit Rozzano Milan Italy
| | - V. Zuccaro
- Fondazione IRCCS Policlinico San Matteo University of Pavia Infectious and Tropical Diseases Pavia Italy
| | - E. Chimienti
- Centro di Riferimento Oncologico IRCCS Medical Oncology and Immune‐related Tumors Aviano (PN) Italy
| | - F. Russo
- Azienda Ospedaliera Universitaria Hematology and BMT Center Parma Italy
| | - C. Visco
- University of Verona Medicine, Section of Hematology Verona Italy
| | - A. L. Zignego
- University of Florence Clinical and Experimental Medicine Interdepartmental Hepatology Center MASVE Florence Italy
| | | | - S. Luminari
- AUSL ‐ IRCCS Reggio Emilia University of Modena and Reggio Emilia Hematology Reggo Emilia Italy
| | - M. Paulli
- Fondazione IRCCS Policlinico San Matteo University of Pavia Anatomic Pathology Unit Pavia Italy
| | - R. Bruno
- Fondazione IRCCS Policlinico San Matteo University of Pavia Infectious and Tropical Diseases Pavia Italy
| | - L. Arcaini
- University of Pavia Molecular Medicine Pavia Italy
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41
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Condoluci A, Terzi‐di‐Bergamo L, Forestieri G, Moia R, Deambrogi C, Deodato M, Frustaci AM, Merli M, Mattarucchi R, Autore F, Fahrni G, Scarfò L, Gussetti D, Bulian P, Zanatta A, Spina V, Faderl MR, Bruscaggin A, Pini K, Piffaretti D, Koch R, Pirosa MC, Cittone MG, Passweg J, Cavalli F, Zucca E, Gerber B, Gillessen S, Stüssi G, Gattei V, Ghia P, Gregor M, Laurenti L, Passamonti F, Tedeschi A, Gaidano G, Rossi D. IBRUTINIB TOLERABILITY AND OUTCOME IN PATIENTS WITH HIGH‐RISK CHRONIC LYMPHOCYTIC LEUKEMIA. Hematol Oncol 2021. [DOI: 10.1002/hon.45_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: 11/09/2022]
Affiliation(s)
- A. Condoluci
- Oncology Institute of Southern Switzerland Clinic of Hematology Bellinzona Switzerland
| | - L. Terzi‐di‐Bergamo
- Institute of Oncology Research Laboratory of Experimental Hematology Bellinzona Switzerland
| | - G. Forestieri
- Institute of Oncology Research Laboratory of Experimental Hematology Bellinzona Switzerland
| | - R. Moia
- University of Eastern Piedmont Department of Translational Medicine, , Division of Hematology Novara Italy
| | - C. Deambrogi
- University of Eastern Piedmont Department of Translational Medicine, , Division of Hematology Novara Italy
| | - M. Deodato
- ASST Grande Ospedale Metropolitano Niguarda Niguarda Cancer Center, Department of Hematology Milan Italy
| | - A. M. Frustaci
- ASST Grande Ospedale Metropolitano Niguarda Niguarda Cancer Center, Department of Hematology Milan Italy
| | - M. Merli
- University of Insubria Ospedale di Circolo e Fondazione Macchi, Department of Hematology Varese Italy
| | - R. Mattarucchi
- University of Insubria Ospedale di Circolo e Fondazione Macchi, Department of Hematology Varese Italy
| | - F. Autore
- Fondazione Policlinico Universitario A. Gemelli, Catholic University of the Sacred Hearth, Hematology Institute Rome Italy
| | - G. Fahrni
- Cantonal Hospital Lucerne Division of Haematology and Central Haematology Laboratory Lucerne Switzerland
| | - L. Scarfò
- IRCCS San Raffaele Scientific Institute and Vita‐Salute San Raffaele University Strategic Research Program on CLL, Division of Experimental Oncology Milan Italy
| | - D. Gussetti
- Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Clinical and Experimental Onco‐Hematology Unit Aviano Italy
| | - P. Bulian
- Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Clinical and Experimental Onco‐Hematology Unit Aviano Italy
| | - A. Zanatta
- Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Clinical and Experimental Onco‐Hematology Unit Aviano Italy
| | - V. Spina
- Institute of Oncology Research Laboratory of Experimental Hematology Bellinzona Switzerland
| | - M. R. Faderl
- Oncology Institute of Southern Switzerland Clinic of Hematology Bellinzona Switzerland
| | - A. Bruscaggin
- Institute of Oncology Research Laboratory of Experimental Hematology Bellinzona Switzerland
| | - K. Pini
- Institute of Oncology Research Laboratory of Experimental Hematology Bellinzona Switzerland
| | - D. Piffaretti
- Institute of Oncology Research Laboratory of Experimental Hematology Bellinzona Switzerland
| | - R. Koch
- Institute of Oncology Research Laboratory of Experimental Hematology Bellinzona Switzerland
| | - M. C. Pirosa
- Oncology Institute of Southern Switzerland Clinic of Hematology Bellinzona Switzerland
| | - M. G. Cittone
- Oncology Institute of Southern Switzerland Clinic of Hematology Bellinzona Switzerland
| | - J. Passweg
- University Hospital Basel Department of Haematology Basel Switzerland
| | - F. Cavalli
- Università della Svizzera Italiana Institute of Oncology Research Bellinzona Switzerland
| | - E. Zucca
- Oncology Institute of Southern Switzerland Clinic of Oncology Bellinzona Switzerland
| | - B. Gerber
- Oncology Institute of Southern Switzerland Clinic of Hematology Bellinzona Switzerland
| | - S. Gillessen
- Oncology Institute of Southern Switzerland Clinic of Oncology Bellinzona Switzerland
| | - G. Stüssi
- Oncology Institute of Southern Switzerland Clinic of Hematology Bellinzona Switzerland
| | - V. Gattei
- Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Clinical and Experimental Onco‐Hematology Unit Aviano Italy
| | - P. Ghia
- IRCCS San Raffaele Scientific Institute and Vita‐Salute San Raffaele University Strategic Research Program on CLL, Division of Experimental Oncology Milan Italy
| | - M. Gregor
- Cantonal Hospital Lucerne Division of Haematology and Central Haematology Laboratory Lucerne Switzerland
| | - L. Laurenti
- Fondazione Policlinico Universitario A. Gemelli, Catholic University of the Sacred Hearth, Hematology Institute Rome Italy
| | - F. Passamonti
- University of Insubria Ospedale di Circolo e Fondazione Macchi, Department of Hematology Varese Italy
| | - A. Tedeschi
- ASST Grande Ospedale Metropolitano Niguarda Niguarda Cancer Center, Department of Hematology Milan Italy
| | - G. Gaidano
- University of Eastern Piedmont Department of Translational Medicine, , Division of Hematology Novara Italy
| | - D. Rossi
- Oncology Institute of Southern Switzerland Clinic of Hematology Bellinzona Switzerland
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Bonfiglio F, Bruscaggin A, Guidetti F, Terzi di Bergamo L, Faderl M, Spina V, Condoluci A, Bonomini L, Forestieri G, Koch R, Piffaretti D, Pini K, Pirosa MC, Cittone MG, Arribas A, Lucioni M, Ghilardi G, Wu W, Arcaini L, Baptista MJ, Bastidas G, Bea S, Boldorini R, Broccoli A, Canzonieri V, Cascione L, Ceriani L, Cogliatti S, Derenzini E, Devizzi L, Dietrich S, Elia AR, Facchetti F, Gaidano G, Garcia JF, Gerber B, Ghia P, Silva MG, Gritti G, Guidetti A, Hitz F, Inghirami G, Ladetto M, Lopez‐Guillermo A, Lucchini E, Maiorana A, Marasca R, Matutes E, Meignin V, Merli M, Moccia A, Mollejo M, Montalban C, Novak U, Oscier DG, Passamonti F, Piazza F, Pizzolitto S, Sabattini E, Salles G, Santambrogio E, Scarfó L, Stathis A, Stüssi G, Geyer JT, Tapia G, Thieblemont C, Tousseyn T, Tucci A, Visco C, Vitolo U, Zenz T, Zinzani PL, Khiabanian H, Calcinotto A, Bertoni F, Bhagat G, Campo E, Leval L, Dirnhofer S, Pileri SA, Piris MÁ, Traverse‐Glehen A, Tzankov A, Paulli M, Ponzoni M, Mazzucchelli L, Cavalli F, Zucca E, Rossi D. GENETIC AND PHENOTYPIC ATTRIBUTES OF SPLENIC MARGINAL ZONE LYMPHOMA. Hematol Oncol 2021. [DOI: 10.1002/hon.43_2879] [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: 11/05/2022]
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43
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Terzi di Bergamo L, Forestieri G, Loh JW, Singh A, Spina V, Zucchetto A, Condoluci A, Faderl M, Koch R, Bruscaggin A, Pini K, Wu W, Piffaretti D, Bittolo T, Tissino E, Paoli L, Deambrogi C, Frustaci AM, Autore F, Merli M, Scarfò L, Rasi S, Passweg J, Moia R, Martines C, Ghia P, Cavalli F, Zucca E, Gerber B, Gillessen S, Stüssi G, Montillo M, Passamonti F, Gregor M, Laurenti L, Tedeschi A, Gaidano G, Efremov D, Gattei V, Khiabanian H, Rossi D. ADAPTATION OF CHRONIC LYMPHOCYTIC LEUKEMIA TO IBRUTINIB IS MEDIATED BY EPIGENETIC PLASTICITY OF RESIDUAL DISEASE AND BY‐PASS SIGNALING VIA MAPK PATHWAY. Hematol Oncol 2021. [DOI: 10.1002/hon.29_2879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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44
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Luminari S, Galimberti S, Versari A, Tucci A, Boccomini C, Farina L, Zaja F, Marcheselli L, Ferrero S, Arcaini L, Pulsoni A, Musuraca G, Califano C, Merli M, Bari A, Conconi A, Giudice ID, Re F, Stefani PM, Usai SV, Perrone T, Gini G, Falini B, Gattei V, Manni M, Ladetto M, Mannina D, Federico M. RESPONSE ADAPTED POST INDUCTION THERAPY IN FOLLICULAR LYMPHOMA: UPDATED RESULTS OF THE FOLL12 TRIAL BY THE FONDAZIONE ITALIANA LINFOMI (FIL). Hematol Oncol 2021. [DOI: 10.1002/hon.80_2879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- S. Luminari
- Azienda Unità Sanitaria Locale IRCCS Arcispedale Santa Maria Nuova IRCCS Hematology Unit and University of Modena and Reggio Emilia Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine Reggio Emilia Italy
| | - S. Galimberti
- University of Pisa Department of Clinical and Experimental Medicine Pisa Italy
| | - A. Versari
- Azienda Unità Sanitaria Locale‐IRCCS ‐ Arcispedale Santa Maria Nuova Medicina Nucleare Reggio Emilia Italy
| | - A. Tucci
- ASST Spedali Civili di Brescia SC Ematologia Brescia Italy
| | - C. Boccomini
- A.O.U. Città della Salute e della Scienza di Torino SC Ematologia Torino Italy
| | - L. Farina
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano Division of Hematology Milano Italy
| | - F. Zaja
- Università degli Studi di Trieste Dipartimento Clinico di Scienze mediche, chirurgiche e della salute and, Azienda Sanitaria Universitaria Giuliano Isontina SC Ematologia Trieste Italy
| | | | - S. Ferrero
- University of Torino, Hematology Department of Molecular Biotechnologies and Health Sciences and AOU “Città della Salute e della Scienza di Torino” Hematology 1 Torino Italy
| | - L. Arcaini
- Fondazione IRCCS Policlinico San Matteo di Pavia Division of Hematology and University of Pavia Department of Molecular Medicine Pavia Italy
| | - A. Pulsoni
- Sapienza Università di Roma Dipartimento di Biotecnologie Cellulari ed Ematologia Roma Italy
| | - G. Musuraca
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori" Department of Hematology Meldola Italy
| | - C. Califano
- Ospedale Umberto I, U.O Medicina‐Oncoematologia Nocera Inferiore Italy
| | - M. Merli
- University Hospital Ospedale di Circolo e Fondazione Macchi ASST Settelaghi Varese Italy
| | - A. Bari
- Università di Modena e Reggio Emilia Dipartimento di Scienze Mediche e Chirurgiche Materno‐Infantili e dell'Adulto Modena Italy
| | - A. Conconi
- Ospedale degli Infermi Unit of Hematology Biella Italy
| | - I. del Giudice
- Policlinico Umberto I ‐ Università "La Sapienza" ‐ Istituto Ematologia Dipartimento di Medicina Traslazionale e di Precisione Roma Italy
| | - F. Re
- Azienda Ospedaliero Universitaria di Parma UO Ematologia e CTMO Parma Italy
| | - P. M. Stefani
- General Hospital Ca' Foncello Hematology Treviso Italy
| | - S. V. Usai
- Ospedale Oncologico Armando Businco Division of Hematology Cagliari Italy
| | - T. Perrone
- University of Bari Hematology Bari Italy
| | - G. Gini
- Marche Polytechnic University Department of Clinical and Molecular Sciences, Hematology Ancona Italy
| | - B. Falini
- Ospedale S. Maria della Misericordia University of Perugia Institute of Hematology and CREO (Center for Hemato‐Oncological Research) Perugia Italy
| | - V. Gattei
- Centro di Riferimento Oncologico di Aviano (CRO) IRCCS Clinical and Experimental Onco‐Hematology Unit Aviano Italy
| | - M. Manni
- University of Modena and Reggio Emilia Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine Modena Italy
| | - M. Ladetto
- Università del Piemonte Orientale Dipartimento di Medicina Traslazionale and AO SS Antonio e Biagio e Cesare Arrigo SC Ematologia Alessandria Italy
| | - D. Mannina
- Azienda Ospedaliera Papardo UOC di Ematologia Messina Italy
| | - M. Federico
- University of Modena and Reggio Emilia Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine Modena Italy
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Defrancesco I, Visentini M, Zibellini S, Minafò YA, Rattotti S, Ferretti VV, Rizzo E, Varettoni M, Frigeni M, Pulsoni A, Casato M, Colantuono S, Rossi M, Candido C, Zerbi C, Bergamini F, Cristinelli C, Fabbri N, Merli M, Zuccaro V, Bruno R, Paulli M, Arcaini L. Mutational and immunogenetic landscape of HCV-associated B-cell lymphoproliferative disorders. Am J Hematol 2021; 96:E210-E214. [PMID: 33755245 PMCID: PMC8252412 DOI: 10.1002/ajh.26167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 03/15/2021] [Indexed: 11/23/2022]
Affiliation(s)
- Irene Defrancesco
- Department of Medical, Surgical, Diagnostic and Pediatric Sciences University of Pavia Pavia Italy
- Division of Hematology Fondazione IRCCS Policlinico San Matteo Pavia Italy
| | - Marcella Visentini
- Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
- Laboratory affiliated to Istituto Pasteur Italia ‐ Fondazione Cenci Bolognetti Sapienza University of Rome Rome Italy
| | - Silvia Zibellini
- Division of Hematology Fondazione IRCCS Policlinico San Matteo Pavia Italy
| | - Ylenia Aura Minafò
- Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
- Department of Molecular Medicine Sapienza University of Rome Rome Italy
- Now at Istituto Dermopatico dell'Immacolata, IDI‐IRCCS Rome Italy
| | - Sara Rattotti
- Division of Hematology Fondazione IRCCS Policlinico San Matteo Pavia Italy
| | | | | | - Marzia Varettoni
- Division of Hematology Fondazione IRCCS Policlinico San Matteo Pavia Italy
| | - Marco Frigeni
- Division of Hematology Fondazione IRCCS Policlinico San Matteo Pavia Italy
- Now at Division of Hematology, Azienda Socio‐Sanitaria Territoriale Papa Giovanni XXIII Bergamo Italy
| | - Alessandro Pulsoni
- Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - Milvia Casato
- Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - Stefania Colantuono
- Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - Marianna Rossi
- Division of Hematology Fondazione IRCCS Policlinico San Matteo Pavia Italy
| | - Chiara Candido
- Division of Hematology Fondazione IRCCS Policlinico San Matteo Pavia Italy
| | - Caterina Zerbi
- Department of Molecular Medicine University of Pavia Pavia Italy
| | - Fabio Bergamini
- Department of Molecular Medicine University of Pavia Pavia Italy
| | | | - Nicole Fabbri
- Department of Molecular Medicine University of Pavia Pavia Italy
| | - Michele Merli
- Division of Hematology, University Hospital "Ospedale di Circolo e Fondazione Macchi"‐ASST Sette Laghi University of Insubria Varese Italy
| | - Valentina Zuccaro
- Division of Infectious Diseases Fondazione IRCCS Policlinico San Matteo Pavia Italy
| | - Raffaele Bruno
- Department of Medical, Surgical, Diagnostic and Pediatric Sciences University of Pavia Pavia Italy
- Division of Infectious Diseases Fondazione IRCCS Policlinico San Matteo Pavia Italy
| | - Marco Paulli
- Department of Molecular Medicine University of Pavia Pavia Italy
- Division of Anatomic Pathology Fondazione IRCCS Policlinico San Matteo Pavia Italy
| | - Luca Arcaini
- Division of Hematology Fondazione IRCCS Policlinico San Matteo Pavia Italy
- Department of Molecular Medicine University of Pavia Pavia Italy
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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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Luminari S, Guerra L, Durmo R, Chauvie S, Peano S, Franceschetto A, Fallanca F, Tarantino V, Pinto A, Ghiggi C, Pulsoni A, Merli M, Farina L, Tani M, Botto B, Musuraca G, Falini B, Ballerini F, Stefani PM, Bolis S, Pietrantuono G, Manni M, Marcheselli L, Federico M, Versari A. EARLY METABOLIC RESPONSE IN FOLLICULAR LYMPHOMA: A SUBSET ANALYSIS OF THE FOLL12 TRIAL BY THE FONDAZIONE ITALIANA LINFOMI (FIL). Hematol Oncol 2021. [DOI: 10.1002/hon.33_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: 11/09/2022]
Affiliation(s)
- S. Luminari
- Azienda Unità Sanitaria Locale IRCCS Arcispedale Santa Maria Nuova IRCCS, Hematology Unit and University of Modena and Reggio Emilia Surgical, Medical and Dental Department of Morphological Sciences related to Transplant Oncology and Regenerative Medicine Reggio Emilia Italy
| | - L. Guerra
- S. Gerardo Hospital University of Milano‐Bicocca, Nuclear Medicine and , University of Milano Bicocca School of Medicine and Surgery Monza Italy
| | - R. Durmo
- Azienda USL‐IRCCS di Reggio Emilia Nuclear Medicine Reggio Emilia Italy
| | - S. Chauvie
- Santa Croce e Carle Hospital Department of Medical Physics Cuneo Italy
| | - S. Peano
- ASO S. Croce e Carle S.C. Medicina Nucleare Cuneo Italy
| | - A. Franceschetto
- Modena Cancer Center University of Modena and Reggio Emilia Department of Oncology and Hematology Unit of Nuclear Medicine Modena Italy
| | - F. Fallanca
- IRCCS San Raffaele Scientific Institute Nuclear Medicine Unit Milano Italy
| | - V. Tarantino
- University of Modena and Reggio Emilia PhD program in Clinical and Experimental Medicine (CEM) Modena Italy
| | - A. Pinto
- National Cancer Institute Fondazione "G. Pascale" IRCCS Hematology‐Oncology and Stem Cell Transplantation Unit Napoli Italy
| | - C. Ghiggi
- IRCCS San Martino Hospital Hematology and Transplant Center Division Genoa Italy
| | - A. Pulsoni
- Sapienza Università di Roma Dipartimento di Biotecnologie Cellulari ed Ematologia Roma Italy
| | - M. Merli
- University Hospital Ospedale di Circolo e Fondazione Macchi ASST Settelaghi Varese Italy
| | - L. Farina
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano Division of Hematology Milano Italy
| | - M. Tani
- Ospedale Civile S Maria delle Croci Azienda Unità Sanitaria Locale (AUSL) Ravenna Italy
| | - B. Botto
- A.O.U. Città della Salute e della Scienza di Torino SC Ematologia Torino Italy
| | - G. Musuraca
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori" Department of Hematology Meldola Italy
| | - B. Falini
- University of Perugia, Institute of Hematology and CREO (Center for Hemato‐Oncological Research) Ospedale S. Maria della Misericordia Perugia Italy
| | - F. Ballerini
- IRCCS Ospedale Policlinico San Martino University of Genoa Clinica Ematologica Genova Italy
| | - P. M. Stefani
- General Hospital Ca' Foncello Hematology Treviso Italy
| | - S. Bolis
- ASST MONZA, SC di Ematologia Monza Italy
| | - G. Pietrantuono
- IRCCS Centro di Riferimento Oncologico della Basilicata Hematology and Stem Cell Transplantation Unit Rionero in Vulture Italy
| | - M. Manni
- University of Modena and Reggio Emilia Surgical, Medical and Dental Department of Morphological Sciences related to Transplant Oncology and Regenerative Medicine Modena Italy
| | | | - M. Federico
- University of Modena and Reggio Emilia Surgical, Medical and Dental Department of Morphological Sciences related to Transplant Oncology and Regenerative Medicine Modena Italy
| | - A. Versari
- Azienda USL‐IRCCS di Reggio Emilia Nuclear Medicine Reggio Emilia Italy
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Ferrante M, Furlan D, Zibellini S, Borriero M, Candido C, Sahnane N, Uccella S, Genuardi E, Alessandria B, Bianchi B, Mora B, Grimaldi D, Defrancesco I, Jiménez C, Cavallo F, Ferrero D, Dogliotti I, Merli M, Varettoni M, Ferrero S, Drandi D. MYD88 L265P Detection in IgM Monoclonal Gammopathies: Methodological Considerations for Routine Implementation. Diagnostics (Basel) 2021; 11:diagnostics11050779. [PMID: 33926007 PMCID: PMC8146978 DOI: 10.3390/diagnostics11050779] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/17/2021] [Accepted: 04/23/2021] [Indexed: 12/19/2022] Open
Abstract
In IgM monoclonal gammopathies MYD88L265P is a prognostic and predictive biomarker of therapy response. MYD88L265P detection is mainly performed by allele-specific quantitative PCR (ASqPCR), however recently, droplet digital PCR (ddPCR) has been proved to be suitable for MYD88L265P screening and minimal residual disease monitoring (MRD). This study compared ASqPCR and ddPCR to define the most sensitive method for MYD88L265P detection in bone marrow (BM), peripheral blood (PB) sorted or unsorted CD19+ cells, and in plasma cell-free DNA (cfDNA). Overall, the analysis showed a good concordance rate (74%) between the two methods, especially in BM samples, while discordances (26%) were mostly in favor of ddPCR (ddPCR+ vs. ASqPCR-) and were particularly evident in samples with low mutational burden, such as PB and cfDNA. This study highlights ddPCR as a feasible approach for MYD88L265P detection across different specimen types (including cfDNA). Interestingly, its high sensitivity makes CD19+ selection dispensable. On the other hand, our results showed that MYD88L265P detection on PB samples, especially with ASqPCR, is suboptimal for screening and MRD analysis. Finally, significantly different MYD88L265P mutational levels observed between Waldenström Macroglobulinemia and IgM monoclonal gammopathy of undetermined significance patients suggest the need for further studies in order to identify possible correlations between mutational levels and risk of progression to Waldenström.
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Affiliation(s)
- Martina Ferrante
- Department of Molecular Biotechnology and Health Sciences, Hematology Division, University of Torino, 10100 Torino, Italy; (M.F.); (M.B.); (E.G.); (B.A.); (D.G.); (F.C.); (D.F.); (D.D.)
| | - Daniela Furlan
- Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy; (D.F.); (S.U.)
| | - Silvia Zibellini
- Division of Hematology, IRCCS Foundation, Policlinico San Matteo, 27100 Pavia, Italy; (S.Z.); (C.C.); (I.D.); (M.V.)
| | - Michela Borriero
- Department of Molecular Biotechnology and Health Sciences, Hematology Division, University of Torino, 10100 Torino, Italy; (M.F.); (M.B.); (E.G.); (B.A.); (D.G.); (F.C.); (D.F.); (D.D.)
| | - Chiara Candido
- Division of Hematology, IRCCS Foundation, Policlinico San Matteo, 27100 Pavia, Italy; (S.Z.); (C.C.); (I.D.); (M.V.)
| | - Nora Sahnane
- University Hospital “Ospedale di Circolo e Fondazione Macchi”-ASST Sette Laghi, University of Insubria, 21100 Varese, Italy; (N.S.); (B.B.); (B.M.); (M.M.)
| | - Silvia Uccella
- Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy; (D.F.); (S.U.)
| | - Elisa Genuardi
- Department of Molecular Biotechnology and Health Sciences, Hematology Division, University of Torino, 10100 Torino, Italy; (M.F.); (M.B.); (E.G.); (B.A.); (D.G.); (F.C.); (D.F.); (D.D.)
| | - Beatrice Alessandria
- Department of Molecular Biotechnology and Health Sciences, Hematology Division, University of Torino, 10100 Torino, Italy; (M.F.); (M.B.); (E.G.); (B.A.); (D.G.); (F.C.); (D.F.); (D.D.)
| | - Benedetta Bianchi
- University Hospital “Ospedale di Circolo e Fondazione Macchi”-ASST Sette Laghi, University of Insubria, 21100 Varese, Italy; (N.S.); (B.B.); (B.M.); (M.M.)
| | - Barbara Mora
- University Hospital “Ospedale di Circolo e Fondazione Macchi”-ASST Sette Laghi, University of Insubria, 21100 Varese, Italy; (N.S.); (B.B.); (B.M.); (M.M.)
| | - Daniele Grimaldi
- Department of Molecular Biotechnology and Health Sciences, Hematology Division, University of Torino, 10100 Torino, Italy; (M.F.); (M.B.); (E.G.); (B.A.); (D.G.); (F.C.); (D.F.); (D.D.)
| | - Irene Defrancesco
- Division of Hematology, IRCCS Foundation, Policlinico San Matteo, 27100 Pavia, Italy; (S.Z.); (C.C.); (I.D.); (M.V.)
| | - Cristina Jiménez
- Hematology Department, University Hospital of Salamanca, Research Biomedical Institute of Salamanca (IBSAL), CIBERONC and Center for Cancer Research-IBMCC (USAL-CSIC), 37001 Salamanca, Spain;
| | - Federica Cavallo
- Department of Molecular Biotechnology and Health Sciences, Hematology Division, University of Torino, 10100 Torino, Italy; (M.F.); (M.B.); (E.G.); (B.A.); (D.G.); (F.C.); (D.F.); (D.D.)
- Hematology, A.O.U. Città della Salute e della Scienza, University of Torino, 10100 Torino, Italy
| | - Dario Ferrero
- Department of Molecular Biotechnology and Health Sciences, Hematology Division, University of Torino, 10100 Torino, Italy; (M.F.); (M.B.); (E.G.); (B.A.); (D.G.); (F.C.); (D.F.); (D.D.)
- Hematology, A.O.U. Città della Salute e della Scienza, University of Torino, 10100 Torino, Italy
| | - Irene Dogliotti
- Stem Cell Transplant Unit, University Hospital AOU Città della Salute e della Scienza, 10100 Torino, Italy;
| | - Michele Merli
- University Hospital “Ospedale di Circolo e Fondazione Macchi”-ASST Sette Laghi, University of Insubria, 21100 Varese, Italy; (N.S.); (B.B.); (B.M.); (M.M.)
| | - Marzia Varettoni
- Division of Hematology, IRCCS Foundation, Policlinico San Matteo, 27100 Pavia, Italy; (S.Z.); (C.C.); (I.D.); (M.V.)
| | - Simone Ferrero
- Department of Molecular Biotechnology and Health Sciences, Hematology Division, University of Torino, 10100 Torino, Italy; (M.F.); (M.B.); (E.G.); (B.A.); (D.G.); (F.C.); (D.F.); (D.D.)
- Hematology, A.O.U. Città della Salute e della Scienza, University of Torino, 10100 Torino, Italy
- Correspondence: ; Tel.: +39-388-064-3900
| | - Daniela Drandi
- Department of Molecular Biotechnology and Health Sciences, Hematology Division, University of Torino, 10100 Torino, Italy; (M.F.); (M.B.); (E.G.); (B.A.); (D.G.); (F.C.); (D.F.); (D.D.)
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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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50
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Varettoni M, Ferrari A, Frustaci AM, Ferretti VV, Rizzi R, Motta M, Piazza F, Merli M, Benevolo G, Visco C, Laurenti L, Ferrero S, Gentile M, Del Fabro V, Abbadessa A, Klersy C, Musto P, Fabbri N, Deodato M, Dogliotti I, Greco C, Corbingi A, Luminari S, Arcaini L. Younger patients with Waldenström Macroglobulinemia exhibit low risk profile and excellent outcomes in the era of immunotherapy and targeted therapies. Am J Hematol 2020; 95:1473-1478. [PMID: 32780514 DOI: 10.1002/ajh.25961] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 08/06/2020] [Indexed: 12/13/2022]
Abstract
We analyzed 160 young Waldenström Macroglobulinemia (WM) patients with a median age of 49 years (range 23-55 years), diagnosed between January 2000 and January 2019 in 14 Italian centers. At diagnosis, 70% of patients were asymptomatic. With a median follow-up of 5.6 years, 57% have been treated. As initial therapy 79% of patients received chemo-immunotherapy, 13% a chemo-free induction and 8% chemotherapy only. At relapse or progression, 6% underwent an autologous stem cell transplantation. Overall, 19% of patients received ibrutinib during the course of the disease. According to IPSSWM, 63% were classified as low risk, 27% as intermediate risk and 10% as high risk. Five-year OS was shorter in high-risk as compared with low or intermediate risk patients (92.9% vs 100% P = .002). According to revised IPSSWM, 92% were classified as very low or low risk and 8% as intermediate risk, with a shorter 5-year OS in the latter group (87.5% vs 100%, P = .028). The OS of young WM patients was not significantly reduced as compared with age-matched, sex-matched and calendar year-matched general population. Early diagnosis, absence of high-risk features in symptomatic patients and high efficacy of modern treatments are the main determinants of the excellent outcome of young WM patients.
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Affiliation(s)
- Marzia Varettoni
- Division of Hematology Fondazione IRCCS Policlinico San Matteo Pavia Italy
| | - Angela Ferrari
- Hematology Unit Azienda USL IRCCS di Reggio Emilia Reggio Emilia Italy
| | - Anna M. Frustaci
- Department of Hematology Niguarda Cancer Center, Niguarda Hospital Milan Italy
| | - Virginia V. Ferretti
- Service of Biometry and Clinical Epidemiology Fondazione IRCCS Policlinico San Matteo Pavia Italy
| | - Rita Rizzi
- 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
| | - Marina Motta
- Department of Hematology ASST‐Spedali Civili Brescia Italy
| | - Francesco Piazza
- Department of Medicine (DIMED), Haematology and Clinical Immunology Section Padua University School of Medicine Padua Italy
| | - Michele Merli
- Division of Hematology Ospedale di Circolo e Fondazione Macchi ‐ ASST Sette Laghi Varese Italy
| | - Giulia Benevolo
- Department of Hematology Cittaʼ della Salute e della Scienza Torino Italy
| | - Carlo Visco
- Medicine, Section of Hematology University of Verona Verona Italy
| | - Luca Laurenti
- Dipartimento Universitario di Scienze Radiologiche ed Ematologiche Fondazione Policlinico Universitario Agostino Gemelli, IRCCS Roma Italy
| | - Simone Ferrero
- Division of Hematology, Department of Molecular Biotechnologies and Health Sciences University of Torino, Italy/AOU “Città della Salute e della Scienza di Torino” Torino Italy
| | | | - Vittorio Del Fabro
- Division of Hematology Azienda Policlinico‐OVE, University of Catania Catania Italy
| | | | - Catherine Klersy
- Service of Biometry and Clinical Epidemiology Fondazione IRCCS Policlinico San Matteo Pavia 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
| | - Nicole Fabbri
- Department of Molecular Medicine University of Pavia Pavia Italy
| | - Marina Deodato
- Department of Hematology Niguarda Cancer Center, Niguarda Hospital Milan Italy
| | - Irene Dogliotti
- Division of Hematology, Department of Molecular Biotechnologies and Health Sciences University of Torino, Italy/AOU “Città della Salute e della Scienza di Torino” Torino Italy
| | | | - Andrea Corbingi
- Dipartimento Universitario di Scienze Radiologiche ed Ematologiche Fondazione Policlinico Universitario Agostino Gemelli, IRCCS Roma Italy
| | - Stefano Luminari
- Hematology Unit Azienda USL IRCCS di Reggio Emilia Reggio Emilia Italy
- Department CHIMOMO University of Modena and Reggio Emilia Reggio Emilia Italy
| | - Luca Arcaini
- Division of Hematology Fondazione IRCCS Policlinico San Matteo Pavia Italy
- Department of Molecular Medicine University of Pavia Pavia Italy
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