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Mele G, Pastore D, Di Renzo N, Fragasso A, Guarini A, Mazza P, Musto P, Pavone V, Tarantini G, Curci P, Falcone AP, Mele A, Miccolis MR, Palazzo G, Palumbo G, Quinto AM, Reddiconto G, Rizzi R, Cascavilla N, Specchia G, Capalbo SF. Real world Italian experience of pomalidomide plus low-dose dexamethasone in the relapsed and refractory myeloma setting: extended follow-up of a retrospective multicenter study by the 'Rete Ematologica Pugliese E Basilicata'. Leuk Lymphoma 2019; 60:3565-3568. [PMID: 31286780 DOI: 10.1080/10428194.2019.1636989] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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)
- Giuseppe Mele
- Haematology and BMT Unit, Ospedale Antonio Perrino, Brindisi, Italy
| | - Domenico Pastore
- Haematology and BMT Unit, Ospedale Antonio Perrino, Brindisi, Italy
| | | | - Alberto Fragasso
- Haematology and BMT Unit, Ospedale Madonna delle Grazie, Matera, Italy
| | - Attilio Guarini
- Haematology and BMT Unit, Ospedale Giovanni Paolo II, Bari, Italy
| | - Patrizio Mazza
- Haematology and BMT Unit, Ospedale Giuseppe Moscati, Taranto, Italy
| | - Pellegrino Musto
- Haematology and BMT Unit, Centro di Riferimento Oncologico della Basilicata, Rionero in Vulture, Italy
| | - Vincenzo Pavone
- Haematology and BMT Unit, Ospedale Cardinale Panico, Tricase, Italy
| | - Giuseppe Tarantini
- Haematology and BMT Unit, Ospedale Monsignor R. Dimiccoli, Barletta, Italy
| | - Paola Curci
- Haematology and BMT Unit, University of Bari Medical School, Policlinico, Italy
| | - Antonietta Pia Falcone
- Haematology and BMT Unit, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Anna Mele
- Haematology and BMT Unit, Ospedale Cardinale Panico, Tricase, Italy
| | | | - Giulia Palazzo
- Haematology and BMT Unit, Ospedale Giuseppe Moscati, Taranto, Italy
| | - Gaetano Palumbo
- Haematology and BMT Unit, Ospedali Riuniti-Azienda Ospedaliera Universitaria, Foggia, Italy
| | | | | | - Rita Rizzi
- Haematology and BMT Unit, University of Bari Medical School, Policlinico, Italy
| | - Nicola Cascavilla
- Haematology and BMT Unit, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Giorgina Specchia
- Haematology and BMT Unit, University of Bari Medical School, Policlinico, Italy
| | - Silvana Franca Capalbo
- Haematology and BMT Unit, Ospedali Riuniti-Azienda Ospedaliera Universitaria, Foggia, Italy
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Efficace F, Castagnetti F, Martino B, Breccia M, D'Adda M, Angelucci E, Stagno F, Cottone F, Malato A, Trabacchi E, Capalbo SF, Gobbi M, Visani G, Salvucci M, Capodanno I, Tosi P, Tiribelli M, Scortechini AR, Levato L, Maino E, Binotto G, Gugliotta G, Vignetti M, Baccarani M, Rosti G. Health-related quality of life in patients with chronic myeloid leukemia receiving first-line therapy with nilotinib. Cancer 2018; 124:2228-2237. [DOI: 10.1002/cncr.31323] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 12/22/2017] [Accepted: 02/09/2018] [Indexed: 11/12/2022]
Affiliation(s)
- Fabio Efficace
- Data Center and Health Outcomes Research Unit; Italian Group for Adult Hematologic Diseases; Rome Italy
| | - Fausto Castagnetti
- L. and A. Seràgnoli Institute of Hematology, Department of Experimental, Diagnostic, and Specialty Medicine; S. Orsola-Malpighi University Hospital, University of Bologna; Bologna Italy
| | - Bruno Martino
- Hematology Unit; Bianchi-Melacrino-Morelli Azienda Ospedaliera; Reggio Calabria Italy
| | - Massimo Breccia
- Department of Cellular Biotechnologies and Hematology; Sapienza University of Rome; Rome Italy
| | - Mariella D'Adda
- Hematology Unit; Spedali Civili Azienda Ospedaliera; Brescia Italy
| | | | - Fabio Stagno
- Department of Hematology; University of Catania; Catania Italy
| | - Francesco Cottone
- Data Center and Health Outcomes Research Unit; Italian Group for Adult Hematologic Diseases; Rome Italy
| | | | - Elena Trabacchi
- Hematology and Bone Marrow Transplantation Unit, Department of Hematology and Oncology; G. da Saliceto Hospital; Piacenza Italy
| | | | - Marco Gobbi
- Clinical Hematology, Ospedale Policlinico S. Martino; Istituto di Ricovero e Cura a Carattere Scientifico; Genoa Italy
| | - Giuseppe Visani
- Hematology and Stem Cell Transplantation Unit; Azienda Ospedaliera Ospedali Riuniti Marche Nord; Pesaro Italy
| | - Marzia Salvucci
- Hematology Unit; Santa Maria delle Croci Hospital; Ravenna Italy
| | - Isabella Capodanno
- Hematology Unit, Arcispedale Santa Maria Nuova; Istituto di Ricovero e Cura a Carattere Scientifico; Reggio Emilia Italy
| | - Patrizia Tosi
- Hematology Unit; Infermi Hospital Rimini; Rimini Italy
| | - Mario Tiribelli
- Division of Hematology and Bone Marrow Transplantation, Department of Experimental and Clinical Medical Sciences; Azienda Ospedaliero-Universitaria di Udine; Udine Italy
| | - Anna Rita Scortechini
- Clinical Hematology Laboratory, Department of Molecular and Clinical Sciences; Polytechnic University of Marche; Ancona Italy
| | - Luciano Levato
- Hematology Unit; Pugliese-Ciaccio Hospital; Catanzaro Italy
| | - Elena Maino
- Hematology Unit; Dell'Angelo Hospital; Venezia-Mestre Italy
| | - Gianni Binotto
- Hematology and Clinical Immunology, Department of Medicine; Padua School of Medicine; Padua Italy
| | - Gabriele Gugliotta
- L. and A. Seràgnoli Institute of Hematology, Department of Experimental, Diagnostic, and Specialty Medicine; S. Orsola-Malpighi University Hospital, University of Bologna; Bologna Italy
| | - Marco Vignetti
- Data Center and Health Outcomes Research Unit; Italian Group for Adult Hematologic Diseases; Rome Italy
| | - Michele Baccarani
- L. and A. Seràgnoli Institute of Hematology, Department of Experimental, Diagnostic, and Specialty Medicine; S. Orsola-Malpighi University Hospital, University of Bologna; Bologna Italy
| | - Gianantonio Rosti
- L. and A. Seràgnoli Institute of Hematology, Department of Experimental, Diagnostic, and Specialty Medicine; S. Orsola-Malpighi University Hospital, University of Bologna; Bologna Italy
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Castagnetti F, Breccia M, Gugliotta G, Martino B, D'Adda M, Stagno F, Carella AM, Avanzini P, Tiribelli M, Trabacchi E, Visani G, Gobbi M, Salvucci M, Levato L, Binotto G, Capalbo SF, Bochicchio MT, Soverini S, Cavo M, Martinelli G, Alimena G, Pane F, Saglio G, Rosti G, Baccarani M. Nilotinib 300 mg twice daily: an academic single-arm study of newly diagnosed chronic phase chronic myeloid leukemia patients. Haematologica 2016; 101:1200-1207. [PMID: 27470600 DOI: 10.3324/haematol.2016.144949] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 07/28/2016] [Indexed: 11/09/2022] Open
Abstract
The introduction and the extended clinical use of nilotinib in the first-line treatment of chronic myeloid leukemia have been based on company-sponsored trials. Independent confirmations are extremely important. We report an investigator-sponsored study of nilotinib 300 mg twice daily in 130 chronic myeloid leukemia patients in early chronic phase. A deep molecular response was achieved in 46% (MR4.0) and 17% (MR4.5) of patients at 2 years; 58% of the enrolled patients achieved a MR4.0 at least once, with a sustained MR4.0 in 52% of them. With a median observation of 29 months (range 24-37 months), 77% of patients were still on treatment with nilotinib. The reasons for permanent discontinuation were: 3% progression, 5% failure or suboptimal response, 8% adverse events, 1% treatment-free remission, and 5% other reasons. Thirteen thrombotic arterial events were reported in 12 patients. A prospective evaluation of metabolic effects showed an increase of fasting glucose without significant variations of glycated hemoglobin, an increase of total cholesterol (both low density lipoprotein and high density lipoprotein fractions) and a decrease of triglycerides. This study confirms a high and rapid efficacy of nilotinib 300 mg twice daily and provides detailed information on the type and incidence of non-hematologic and metabolic adverse events (clinicaltrials.gov identifier: 01535391).
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Affiliation(s)
- Fausto Castagnetti
- Institute of Hematology "L. and A. Seràgnoli", Department of Experimental, Diagnostic and Specialty Medicine, "S. Orsola-Malpighi" University Hospital, University of Bologna, Italy
| | - Massimo Breccia
- Department of Cellular Biotechnologies and Hematology, "Sapienza" University of Rome, Italy
| | - Gabriele Gugliotta
- Institute of Hematology "L. and A. Seràgnoli", Department of Experimental, Diagnostic and Specialty Medicine, "S. Orsola-Malpighi" University Hospital, University of Bologna, Italy
| | - Bruno Martino
- Hematology Unit, Azienda Ospedaliera "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | - Mariella D'Adda
- Hematology Unit, Azienda Ospedaliera "Spedali Civili", Brescia, Italy
| | - Fabio Stagno
- Chair of Hematology, University of Catania, Italy
| | | | - Paolo Avanzini
- Hematology Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - Mario Tiribelli
- Division of Hematology and BMT, Department of Experimental and Clinical Medical Sciences, Azienda Ospedaliero-Universitaria di Udine, Italy
| | - Elena Trabacchi
- Hematology and Bone Marrow Transplantation Unit, Department of Hematology and Oncology, "G. da Saliceto" Hospital, Piacenza, Italy
| | - Giuseppe Visani
- Hematology and Stem Cell Transplantation Unit, Azienda Ospedaliera Ospedali Riuniti Marche Nord (AORMN), Pesaro, Italy
| | - Marco Gobbi
- Clinical Hematology Unit, IRCCS AOU S. Martino-IST, Genova, Italy
| | - Marzia Salvucci
- Hematology Unit, "Santa Maria delle Croci" Hospital, Ravenna, Italy
| | - Luciano Levato
- Hematology Unit, "Pugliese-Ciaccio" Hospital, Catanzaro, Italy
| | - Gianni Binotto
- Hematology and Clinical Immunology Unit, University of Padova, Padova, Italy
| | | | - Maria Teresa Bochicchio
- Institute of Hematology "L. and A. Seràgnoli", Department of Experimental, Diagnostic and Specialty Medicine, "S. Orsola-Malpighi" University Hospital, University of Bologna, Italy
| | - Simona Soverini
- Institute of Hematology "L. and A. Seràgnoli", Department of Experimental, Diagnostic and Specialty Medicine, "S. Orsola-Malpighi" University Hospital, University of Bologna, Italy
| | - Michele Cavo
- Institute of Hematology "L. and A. Seràgnoli", Department of Experimental, Diagnostic and Specialty Medicine, "S. Orsola-Malpighi" University Hospital, University of Bologna, Italy
| | - Giovanni Martinelli
- Institute of Hematology "L. and A. Seràgnoli", Department of Experimental, Diagnostic and Specialty Medicine, "S. Orsola-Malpighi" University Hospital, University of Bologna, Italy
| | - Giuliana Alimena
- Department of Cellular Biotechnologies and Hematology, "Sapienza" University of Rome, Italy
| | - Fabrizio Pane
- Chair of Hematology, Department of Biochemistry and Medical Biotechnologies, "Federico II" University, Napoli, Italy
| | - Giuseppe Saglio
- Chair of Hematology, Department of Clinical and Biological Sciences, "S. Luigi Gonzaga" University Hospital, University of Torino, Orbassano (TO), Italy
| | - Gianantonio Rosti
- Institute of Hematology "L. and A. Seràgnoli", Department of Experimental, Diagnostic and Specialty Medicine, "S. Orsola-Malpighi" University Hospital, University of Bologna, Italy
| | - Michele Baccarani
- Department of Hematology and Oncology "L. and A. Seràgnoli", University of Bologna, Italy
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Mazza P, Specchia G, Di Renzo N, Cascavilla N, Tarantini G, Capalbo SF, Urbano T, Albano F, Giovannni R, Falcone AP, Santeramo MT, Spinosa G, Pisconti S. Ruxolitinib - better prognostic impact in low-intermediate 1 risk score: evaluation of the 'rete ematologica pugliese' (REP) in primary and secondary myelofibrosis. Leuk Lymphoma 2016; 58:138-144. [PMID: 27263544 DOI: 10.1080/10428194.2016.1189547] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
We evaluated ruxolitinib in 65 patients with myelofibrosis according to age, sex, time of diagnosis, grade of fibrosis, prognostic score risk, Janus kinase (JAK) status, primary or secondary myelofibrosis, previous treatment, and dosage. Outcome measures were response rate, time to response, duration of response, and event-free survival and survival. Kaplan and Meier curves show a significant difference in event-free survival according to the prognostic score, in favor of patients with low int1 (p = 0.0009). The Cox stepwise model confirmed the result, the int2 high-risk score being the most powerful negative independent parameter (0.001), followed by JAK (0.008); other parameters, such as diagnosis more than 5 years earlier, grade III-IV fibrosis, and ruxolitinib dose have a negligible impact. Time to response was shorter (p = 0.001) in primary myelofibrosis. In conclusion, ruxolitinib is effective, with a better outcome in patients with a low-int1 risk score. This may suggest considering an earlier administration in the disease course.
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Affiliation(s)
- Patrizio Mazza
- a Department of Hematology-Oncology , Complex Operative Unit of Hematology ASL , Taranto , Italy
| | - Giorgina Specchia
- b Department of Emergency and Organ Transplantation , Complex Operative Unit of Hematology , Bari , Italy
| | - Nicola Di Renzo
- c Complex Operative Unit of Hematology - ASL , Lecce , Italy
| | - Nicola Cascavilla
- d Unit of Hematology and Bone Marrow Transplantation 'Casa Sollievo Della Sofferenza' S. Giovanni Rotondo , Foggia , Italy
| | | | | | - Tiziana Urbano
- a Department of Hematology-Oncology , Complex Operative Unit of Hematology ASL , Taranto , Italy
| | - Francesco Albano
- b Department of Emergency and Organ Transplantation , Complex Operative Unit of Hematology , Bari , Italy
| | | | - Antonietta Pia Falcone
- d Unit of Hematology and Bone Marrow Transplantation 'Casa Sollievo Della Sofferenza' S. Giovanni Rotondo , Foggia , Italy
| | | | | | - Salvatore Pisconti
- a Department of Hematology-Oncology , Complex Operative Unit of Hematology ASL , Taranto , Italy
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Breccia M, Graffigna G, Galimberti S, Iurlo A, Pungolino E, Pizzuti M, Maggi A, Falzetti F, Capalbo SF, Intermesoli T, Maffioli M, Elena C, Melosi A, Simonetti F, Capochiani E, Seta RD, Pacilli M, Luppi M, Di Renzo N, Mastrullo L, Trabacchi E, Vallisa D, Rapezzi D, Orlandi EM, Gambacorti-Passerini C, Efficace F, Alimena G. Personal history and quality of life in chronic myeloid leukemia patients: a cross-sectional study using narrative medicine and quantitative analysis. Support Care Cancer 2016; 24:4487-93. [PMID: 27260015 DOI: 10.1007/s00520-016-3286-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 01/31/2016] [Accepted: 05/23/2016] [Indexed: 01/28/2023]
Abstract
BACKGROUND Tyrosine kinase inhibitors (TKIs) drastically changed the outcome of patients diagnosed with chronic myeloid leukemia (CML). Several reports indicated the advantage of continue long-term adherence associated with positive outcome. Therefore, it is important to better understand from the patient's standpoint the experience of living with the disease and the related treatment. OBJECTIVES In this study, quantitative analysis and narrative medicine were combined to get insights on this issue in a population of 257 patients with CML in chronic phase treated with TKIs (43 % men, with a median age of 58 years, 27 % aged 31-50 years), followed for a median time of 5 years. Sixty-one percent of patients enrolled were treated in first line, whereas 37 % were treated in second line. RESULTS The results showed more positive perceptions and acceptance in males compared to females, without impact of disease on relationships. Level of positive acceptance was more evident in elderly compared to younger patients, with a close connection with median time from diagnosis. Overall, female patients reported negative perceptions and an impact of disease on family daily living. The majority of patients understood the importance of continue adherence to treatment, with 27 % resulting less adherent (60 % for forgetfulness), even if well informed and supported by his/her physician. DISCUSSION AND CONCLUSIONS Narrative medicine, in association to quantitative analysis, can help physicians to understand needs of their patients in order to improve communication.
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Affiliation(s)
- Massimo Breccia
- Department of Cellular Biotechnologies and Hematology, Sapienza University, Via Benevento 6, 00161, Rome, Italy.
| | | | | | - Alessandra Iurlo
- Oncoematologia, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | | | | | | | - Franca Falzetti
- Hematology, Santa Maria della Misericordia Hospital, Perugia, Italy
| | | | | | | | | | | | | | | | | | | | - Mario Luppi
- Hematology, University of Modena, Modena, Italy
| | - Nicola Di Renzo
- Hematology and Stem Cell Transplant, Fazzi Hospital, Lecce, Italy
| | | | | | | | | | | | | | | | - Giuliana Alimena
- Department of Cellular Biotechnologies and Hematology, Sapienza University, Via Benevento 6, 00161, Rome, Italy
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Montrone D, Correale M, Franzese MG, Ieva R, Di Biase M, Capalbo SF. Pulmonary arterial hypertension in a chronic lymphocytic leukemia patient in treatment with rituximab. J Cardiovasc Med (Hagerstown) 2015; 16 Suppl 1:S65. [PMID: 25643063 DOI: 10.2459/jcm.0b013e3283621adf] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [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]
Affiliation(s)
- Deodata Montrone
- aDepartment of Cardiology bDepartment of Hematology, University of Foggia, Foggia, Italy
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7
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Nosari AM, Caira M, Pioltelli ML, Fanci R, Bonini A, Cattaneo C, Castagnola C, Capalbo SF, De Fabritiis P, Mettivier V, Morselli M, Pastore D, Aversa F, Rossi G, Pagano L. Hema e-Chart registry of invasive fungal infections in haematological patients: improved outcome in recent years in mould infections. Clin Microbiol Infect 2012; 19:757-62. [PMID: 23279327 DOI: 10.1111/1469-0691.12014] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The electronic surveillance system Hema e-Chart allowed us to prospectively collect data and to perform an analysis of invasive fungal infections (IFI) diagnosed in febrile patients as well as the procedures allowing their diagnosis and outcome according to the treatment given. Every patient admitted to 26 Italian Haematology Units with a new diagnosis of haematological malignancy and who was a candidate for chemotherapy was consecutively registered between March 2007 and March 2009. In all, 147 haematological patients with mycoses were identified. Yeasts were found in 23 infections; moulds were diagnosed in 17 proven, 35 probable and 72 possible mycoses. Galactomannan (GM) antigen was the most important test to diagnose probable mould infection; it was positive (cut-off >0.5) in 27 (77%) probable and in nine (53%) proven mould infections. Among patients with probable/proven mould infection who received no prophylaxis or non-mould-active prophylaxis with fluconazole, more patients (n = 26, 78.8%) had GM antigen positivity compared with patients (n = 10, 52.6%) given prophylaxis with mould-active drugs (p <0.05). First-line antifungal therapy was effective in 11/23 (48%) yeast infections and in 37/52 (71.2%) proven/probable mould infections. Twenty patients (14%) died within 12 weeks. The fungal attributable mortality was 30.4% and 17.3% in yeast and proven/probable mould infections, respectively. Among risk factors only age was independently associated (p 0.013) with mortality; sex, underlying haematological malignancy, previous prophylaxis and presence of neutropenia at diagnosis were not significant. A diagnosis of mould infection seemed to have a trend for a better outcome than the diagnosis of yeast infection (p 0.064).
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Affiliation(s)
- A M Nosari
- Divisione di Ematologia e Centro Trapianti Midollo, Ospedale Niguarda Ca' Granda, Milano, Italy.
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Franzese MG, Ieva R, Correale M, Palumbo G, Capalbo SF, Di Biase M. An extramedullary lesion in multiple myeloma: voluminous pericardial mass. Clin Cardiol 2009; 32:E73. [PMID: 19455706 DOI: 10.1002/clc.20397] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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