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Pesce NA, Plastino F, Reyes-Goya C, Bernd J, Pavone V, Dal Monte M, Kvanta A, Locri F, André H. Mitigation of human iris angiogenesis through uPAR/LRP-1 interaction antagonism in an organotypic ex vivo model. FASEB J 2024; 38:e23533. [PMID: 38451430 DOI: 10.1096/fj.202301892rr] [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: 09/15/2023] [Revised: 02/05/2024] [Accepted: 02/19/2024] [Indexed: 03/08/2024]
Abstract
Rubeosis Iridis (RI) is characterized by an increase in neovascularization and inflammation factors in the iris. During angiogenesis, the urokinase plasminogen activator (uPA) and its receptor (uPAR) play a pivotal role in extracellular matrix remodeling, where uPAR regulates endothelial cell migration and proliferation through assembly with transmembrane receptors. Here, in the context of hypoxia-induced angiogenesis, the uPA/uPAR system blockage was investigated by using UPARANT in a novel ex vivo human iris organotypic angiogenesis assay. The effects of uPA/uPAR system antagonism in the humanized model of ocular pathologic angiogenesis were analyzed by sprouting angiogenesis and protein assays (western, dot blots, and co-immunoprecipitation) and correlated to vascular endothelial growth factor (VEGF) inhibition. Phosphoprotein and co-immunoprecipitation assay illustrated an unidentified antagonism of UPARANT in the interaction of uPAR with the low-density lipoprotein receptor-related protein-1 (LRP-1), resulting in inhibition of β-catenin-mediated angiogenesis in this model. The effects of uPA/uPAR system inhibition were focal to endothelial cells ex vivo. Comparison between human iris endothelial cells and human retinal endothelial revealed an endothelial-specific mechanism of β-catenin-mediated angiogenesis inhibited by uPA/uPAR system blockage and not by VEGF inhibition. Collectively, these findings broaden the understanding of the effects of the uPA/uPAR system antagonism in the context of angiogenesis, revealing non-canonical β-catenin downstream effects mediated by LRP-1/uPAR interaction.
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Affiliation(s)
- Noemi Anna Pesce
- Division of Eye and Vision, Department of Clinical Neuroscience, St Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden
- Department of Biology, University of Pisa, Pisa, Italy
| | - Flavia Plastino
- Division of Eye and Vision, Department of Clinical Neuroscience, St Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden
| | | | - Jonathan Bernd
- Division of Eye and Vision, Department of Clinical Neuroscience, St Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Vincenzo Pavone
- Department of Chemical Sciences, University of Naples Federico II, Naples, Italy
| | | | - Anders Kvanta
- Division of Eye and Vision, Department of Clinical Neuroscience, St Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Filippo Locri
- Division of Eye and Vision, Department of Clinical Neuroscience, St Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Helder André
- Division of Eye and Vision, Department of Clinical Neuroscience, St Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden
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D'Agostino M, Bertuglia G, Rota-Scalabrini D, Belotti A, Morè S, Corradini P, Oliva S, Ledda A, Grasso M, Pavone V, Ronconi S, Vincelli ID, Ballanti S, Velluti C, Cellini C, Gozzetti A, Palmas AD, Gamberi B, Mancuso K, Paris L, Zambello R, Petrucci MT, Bruno B, Musto P, Gay F. Predictors of unsustained measurable residual disease negativity in patients with multiple myeloma. Blood 2024; 143:592-596. [PMID: 38048557 DOI: 10.1182/blood.2023022080] [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: 08/03/2023] [Revised: 11/09/2023] [Accepted: 11/14/2023] [Indexed: 12/06/2023] Open
Abstract
ABSTRACT The prognostic impact of achieving and in particular maintaining measurable residual disease (MRD) negativity in multiple myeloma is now established; therefore, identifying among MRD-negative patients the ones at higher risk of losing MRD negativity is of importance. We analyzed predictors of unsustained MRD negativity in patients enrolled in the FORTE trial (NCT02203643). MRD was performed by multiparameter flow cytometry (sensitivity of 10-5) at premaintenance and every 6 months thereafter. The cumulative incidence (CI) of MRD resurgence and/or progression was analyzed in MRD-negative patients. A total of 306 of 474 (65%) MRD-negative patients were analyzed. After a median follow-up of 50.4 months from MRD negativity, 185 of 306 (60%) patients were still MRD negative and progression free, 118 (39%) lost their MRD-negative status, and 3 patients (1%) died without progression. Amp1q vs normal (4-year CI, 63% vs 34), ≥2 concomitant high-risk cytogenetic abnormalities vs 0 (4-year CI, 59% vs 33%), circulating tumor cells at baseline (high vs low at 4-year CI, 62% vs 32%), and time-to-reach MRD negativity postconsolidation vs preconsolidation (4-year CI, 46% vs 35%) were associated with a higher risk of unsustained MRD negativity in a multivariate Fine-Gray model. During the first 2 years of maintenance, patients receiving carfilzomib-lenalidomide vs lenalidomide alone had a lower risk of unsustained MRD negativity (4-year CI, 20% vs 33%).
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Affiliation(s)
- Mattia D'Agostino
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Turin, Italy
- Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, University of Torino, Turin, Italy
| | - Giuseppe Bertuglia
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Turin, Italy
- Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, University of Torino, Turin, Italy
| | - Delia Rota-Scalabrini
- Medical Oncology Department Candiolo Cancer Institute, Fondazione del Piemonte per l'Oncologia-Istituto di Ricovero e Cura a Carattere Scientifico, Turin, Italy
| | - Angelo Belotti
- Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia, Italy
| | - Sonia Morè
- Clinica di Ematologia Azienda Ospedaliero Universitaria delle Marche, Università Politecnica delle Marche, Ancona, Italy
| | - Paolo Corradini
- University of Milan, Milan, Italy; and Division of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Stefania Oliva
- Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, University of Torino, Turin, Italy
| | - Antonio Ledda
- Ematologia/Centro Trapianti Midollo Osseo, Ospedale A. Businco, Cagliari, Italy
| | | | - Vincenzo Pavone
- Hematology and Bone Marrow Transplant, Hospital Cardinale G. Panico, Tricase, Italy
| | - Sonia Ronconi
- IRCCS Istituto Romagnolo per lo Studio dei Tumori Dino Amadori, Meldola, Italy
| | - Iolanda Donatella Vincelli
- Divisione di Ematologia, Grande Ospedale Metropolitano Bianchi-Melacrino-Morelli, Reggio Calabria, Italy
| | - Stelvio Ballanti
- Sezione di Ematologia e Immunologia Clinica, Ospedale Santa Maria della Misericordia, località Sant'Andrea delle Fratte, Perugia, Italy
| | - Cristina Velluti
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Turin, Italy
| | - Claudia Cellini
- U.O.C. Ematologia, Ospedale Santa Maria delle Croci, Ravenna, Italy
| | - Alessandro Gozzetti
- Department of Medicine, Surgery and Neurosciences, University of Siena, Policlinico S. Maria alle Scotte, Siena, Italy
| | - Angelo D Palmas
- Struttura Complessa Ematologia, Ospedale San Francesco, Azienda Sanitaria Locale Nuoro, Nuoro, Italy
| | | | - Katia Mancuso
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia Seràgnoli, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Laura Paris
- Division of Hematology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Renato Zambello
- Hematology Section, Department of Medicine, Padua University School of Medicine, Padua, Italy
| | - Maria Teresa Petrucci
- Hematology, Department of Translational and Precision Medicine, Azienda Ospedaliera Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Benedetto Bruno
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Turin, Italy
- Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, University of Torino, Turin, Italy
| | - Pellegrino Musto
- Department of Precision and Regenerative Medicine and Ionian Area, Aldo Moro University School of Medicine, Bari, Italy
- Hematology and Stem Cell Transplantation Unit, Azienda Ospedaliero-Universitaria Consorziale Policlinico, Bari, Italy
| | - Francesca Gay
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Turin, Italy
- Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, University of Torino, Turin, Italy
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Ladetto M, Tavarozzi R, Zanni M, Evangelista A, Ferrero S, Tucci A, Botto B, Bolis S, Volpetti S, Zilioli VR, Puccini B, Arcari A, Pavone V, Gaidano G, Corradini P, Tani M, Cavallo F, Milone G, Ghiggi C, Pinto A, Pastore D, Ferreri AJM, Latte G, Patti C, Re F, Benedetti F, Luminari S, Pennese E, Bossi E, Boccomini C, Anastasia A, Bottelli C, Ciccone G, Vitolo U. Radioimmunotherapy versus autologous hematopoietic stem cell transplantation in relapsed/refractory follicular lymphoma: a Fondazione Italiana Linfomi multicenter, randomized, phase III trial. Ann Oncol 2024; 35:118-129. [PMID: 37922989 DOI: 10.1016/j.annonc.2023.10.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/11/2023] [Accepted: 10/03/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Optimal consolidation for young patilents with relapsed/refractory (R/R) follicular lymphoma (FL) remains uncertain in the rituximab era, with an unclear benefit of autologous stem cell transplantation (ASCT). The multicenter, randomized, phase III FLAZ12 (NCT01827605) trial compared anti-CD20 radioimmunotherapy (RIT) with ASCT as consolidation after chemoimmunotherapy, both followed by rituximab maintenance. PATIENTS AND METHODS Patients (age 18-65 years) with R/R FL and without significant comorbidities were enrolled and treated with three courses of conventional, investigator-chosen chemoimmunotherapies. Those experiencing at least a partial response were randomized 1 : 1 to ASCT or RIT before CD34+ collection, and all received postconsolidation rituximab maintenance. Progression-free survival (PFS) was the primary endpoint. The target sample size was 210 (105/group). RESULTS Between August 2012 and September 2019, of 164 screened patients, 159 were enrolled [median age 57 (interquartile range 49-62) years, 55% male, 57% stage IV, 20% bulky disease]. The study was closed prematurely because of low accrual. Data were analyzed on 8 June 2023, on an intention-to-treat basis, with a 77-month median follow-up from enrollment. Of the 141 patients (89%), 70 were randomized to ASCT and 71 to RIT. The estimated 3-year PFS in both groups was 62% (hazard ratio 1.11, 95% confidence interval 0.69-1.80, P = 0.6662). The 3-year overall survival also was similar between the two groups. Rates of grade ≥3 hematological toxicity were 94% with ASCT versus 46% with RIT (P < 0.001), and grade ≥3 neutropenia occurred in 94% versus 41%, respectively (P < 0.001). Second cancers occurred in nine patients after ASCT and three after radioimmunotherapy (P = 0.189). CONCLUSIONS Even if prematurely discontinued, our study did not demonstrate the superiority of ASCT versus RIT. ASCT was more toxic and demanding for patients and health services. Both strategies yielded similar, favorable long-term outcomes, suggesting that consolidation programs milder than ASCT require further investigation in R/R FL.
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Affiliation(s)
- M Ladetto
- Department of Translational Medicine, University of Eastern Piedmont, Novara; SCDU di Ematologia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria.
| | - R Tavarozzi
- Department of Translational Medicine, University of Eastern Piedmont, Novara; SCDU di Ematologia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria
| | - M Zanni
- SCDU di Ematologia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria
| | - A Evangelista
- SSD of Clinical Epidemiology, Universitaria Città della Salute e della Scienza di Torino and Centre for Cancer Prevention Piemonte, Torino
| | - S Ferrero
- Department of Molecular Biotechnologies and Health Sciences, Universitaria Città della Salute e della Scienza di Torino and Centre for Cancer Prevention Piemonte, Torino
| | - A Tucci
- Department of Hematology, Spedali Civili, Brescia
| | - B Botto
- Struttura Complessa Ematologia, AOU Città della salute e della scienza di Torino, Turin
| | - S Bolis
- SC Ematologia ASST-Monza, Monza
| | - S Volpetti
- Division of Hematology, Clinica Ematologica, Centro Trapianti e Terapie Cellulari Carlo Melzi, DISM, Azienda Ospedaliero Universitaria S. M. Misericordia, Udine
| | - V R Zilioli
- Division of Haematology, ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - B Puccini
- Department of Haematology, University of Florence, Firenze
| | - A Arcari
- Hematology Unit, Ospedale Guglielmo da Saliceto, Piacenza
| | - V Pavone
- A. O. C. Panico-U.O.C Ematologia e Trapianto, Tricase, Lecce
| | - G Gaidano
- SCDU di Ematologia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Division of Hematology, Azienda Ospedaliero-Universitaria Maggiore della Carità, Novara
| | - P Corradini
- Division of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, University of Milan, Milano
| | - M Tani
- Hematology Unit, Department of Oncology and Hematology, "Santa Maria delle Croci" Hospital, Ravenna
| | - F Cavallo
- Department of Molecular Biotechnologies and Health Sciences, Universitaria Città della Salute e della Scienza di Torino and Centre for Cancer Prevention Piemonte, Torino
| | - G Milone
- Division of Hematology and Program for Hematopoietic Transplantation, Azienda Ospedaliera Policlinico Vittorio Emanuele, Catania
| | - C Ghiggi
- Hematology Division, IRCCS Azienda Ospedaliera Universitaria San Martino, IST Istituto Nazionale per la Ricerca sul Cancro, Genova
| | - A Pinto
- Department of Hematology, Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico "Fondazione G Pascale", Naples
| | | | - A J M Ferreri
- Onco-Hematology Department, Fondazione Centro San Raffaele, Milano
| | - G Latte
- Unità di Ematologia e Trapianto di Midollo Osseo, San Francesco Hospital, Nuoro
| | - C Patti
- Divisione di Oncoematologia, Azienda Villa Sofia - Cervello, Palermo
| | - F Re
- Department of Hematology, A.O.U. di Parma, Parma
| | - F Benedetti
- Department of Medicine, Section of Hematology and Bone Marrow Transplant Unit, University of Verona, Verona
| | - S Luminari
- Department of Hematology, IRCCS Reggio Emilia, Reggio Emilia
| | - E Pennese
- Lymphoma Unit, Department of Hematology, Ospedale Spirito Santo, Pescara
| | - E Bossi
- SC Ematologia ASST-Monza, Monza
| | - C Boccomini
- Struttura Complessa Ematologia, AOU Città della salute e della scienza di Torino, Turin
| | - A Anastasia
- Department of Hematology, Spedali Civili, Brescia
| | - C Bottelli
- Department of Hematology, Spedali Civili, Brescia
| | - G Ciccone
- SSD of Clinical Epidemiology, Universitaria Città della Salute e della Scienza di Torino and Centre for Cancer Prevention Piemonte, Torino
| | - U Vitolo
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
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4
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Lolli G, Argnani L, Gini G, Casadei B, Pellegrini C, Tani M, Pavone V, Cimminiello M, Bonifazi F, Zinzani PL. Pixantrone as bridging therapy to allogeneic transplantation or in chimeric antigen receptor T-cell pathway in patients with diffuse large B-cell lymphoma. Hematol Oncol 2023; 41:947-950. [PMID: 37442805 DOI: 10.1002/hon.3211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023]
Affiliation(s)
- Ginevra Lolli
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Lisa Argnani
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Guido Gini
- Clinica di Ematologia AOU Ospedali Riuniti, Ancona, Italy
| | - Beatrice Casadei
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Cinzia Pellegrini
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Monica Tani
- U.O.C Ematologia Ospedale Santa Maria delle Croci, Ravenna, Italy
| | - Vincenzo Pavone
- Department of Hematology and Bone Marrow Transplant, Hospital Card. G. Panico, Tricase, Italy
| | - Michele Cimminiello
- Dipartimento Oncologico, U.O.C. di Ematologia-Centro Trapianti di Cellule Staminali, Azienda Ospedaliera Regionale "San Carlo" di Potenza, Potenza, Italy
| | | | - Pier Luigi Zinzani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
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5
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Torre G, Turchetta M, Del Buono A, Pavone V, Papalia R, Mariani PP. Isolated radial tears of the lateral meniscus midbody: a case series of professional athletes treated with outside-in repair. Musculoskelet Surg 2023; 107:447-453. [PMID: 35945416 DOI: 10.1007/s12306-022-00757-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/28/2022] [Indexed: 10/15/2022]
Abstract
PURPOSE The main aim of the study is to assess clinical and functional outcomes of arthroscopic outside-in repair of isolated radial tears of the midbody of lateral meniscus in professional athletes and to evaluate the return to the sport activity after surgery. METHODS A retrospective data collection on professional athletes with isolated complete lesion of the midbody of lateral meniscus, treated with arthroscopic outside-in repair was carried out. Outcome measures included functional assessment, Limb Symmetry Index (LSI) and Hamstring Quadriceps Ratio (HQR) and Lysholm score collected before surgery and at 4-month follow-up. Data on return to sport practice and re-injury were also retrieved. RESULTS Fourteen patients satisfied the selection criteria. Full return to professional sport activity (Tegner 10) was registered in the 86% of the cohort at 4 months after the surgery. Functional testing of the athletes showed a return of the LSI and HQR to the pre-surgical condition, demonstrating a full recovery of the functional ability and muscle strength. Similarly, clinical evaluation through Lysholm score showed an improvement, reaching an average of 97.7 points at 4 months follow-up. CONCLUSION A good functional recovery and a high rate of return to play has been observed in a population of professional athletes, at 4 months after outside-in repair.
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Affiliation(s)
- G Torre
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University Hospital, Via Alvaro del Portillo, 21, 00128, Rome, Italy.
| | - M Turchetta
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico Vittorio Emanuele, University of Catania, Catania, Italy
| | - A Del Buono
- Orthopaedic and Trauma Unit Ospedale Luigi Curto, Polla, Salerno, Italy
| | - V Pavone
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico Vittorio Emanuele, University of Catania, Catania, Italy
| | - R Papalia
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University Hospital, Via Alvaro del Portillo, 21, 00128, Rome, Italy
| | - P P Mariani
- Senior Professor, University of Rome Foro Italico, Rome, Italy
- Villa Stuart Sport Clinic - FIFA Medical Centre of Excellence, Rome, Italy
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6
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Gini G, Tani M, Tucci A, Marcheselli L, Cesaretti M, Bellei M, Pascarella A, Ballerini F, Petrini M, Merli F, Olivieri A, Lanza F, Annibali O, Zilioli VR, Liberati AM, Tisi MC, Arcari A, Marino D, Musuraca G, Pavone V, Fabbri A, Pozzi S, Mannina D, Plenteda C, Celli M, Luminari S. Lenalidomide plus rituximab for the initial treatment of frail older patients with DLBCL: the FIL_ReRi phase 2 study. Blood 2023; 142:1438-1447. [PMID: 37418685 DOI: 10.1182/blood.2022019173] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 06/09/2023] [Accepted: 06/09/2023] [Indexed: 07/09/2023] Open
Abstract
Treatment of diffuse large B-cell lymphoma (DLBCL) in older patients is challenging, especially for those who are not eligible for anthracycline-containing regimens. Fondazione Italiana Linfomi (FIL) started the FIL_ReRi study, a 2-stage single-arm trial to investigate the activity and safety of the chemo-free combination of rituximab and lenalidomide (R2) in ≥70-year-old untreated frail patients with DLBCL. Frailty was prospectively defined using a simplified geriatric assessment tool. Patients were administered a maximum of 6 28-day cycles of 20 mg oral lenalidomide from days 2 to 22 and IV rituximab 375 mg/m2 on day 1, with response assessment after cycles 4 and 6. Patients with partial response or complete response (CR) at cycle 6 were administered lenalidomide 10 mg/d from days 1 to 21 for every 28 cycles for a total of 12 cycles or until progression or unacceptable toxicity. The primary end point was the overall response rate (ORR) after cycle 6; the coprimary end point was the rate of grade 3 or 4 extrahematological toxicity. The ORR was 50.8%, with 27.7% CR. After a median follow-up of 24 months, the median progression-free survival was 14 months, and the 2-year duration of response was 64%. Thirty-four patients experienced extrahematological toxicity according to the National Cancer Institute Common Terminology Criteria for Adverse Events grade ≥3. The activity of the R2 combination was observed in a significant proportion of subjects, warranting further exploration of a chemo-free approach in frail older patients with DLBCL. This trial was registered at EudraCT as #2015-003371-29 and clinicaltrials.gov as #NCT02955823.
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Affiliation(s)
- Guido Gini
- Struttura Organizzativa Dipartimentale di Clinica Ematologica, Azienda Ospedaliero Universitaria delle Marche, Università Politecnica delle Marche, Ancona, Italy
| | - Monica Tani
- Unità di Ematologia, Ospedale Santa Maria delle Croci, Ravenna, Italy
| | - Alessandra Tucci
- Unità di Ematologia, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia, Italy
| | - Luigi Marcheselli
- Uffici Studi Fondazione Italiana Linfomi, sede di Modena, Modena, Italy
| | - Marina Cesaretti
- Uffici Studi Fondazione Italiana Linfomi, sede di Modena, Modena, Italy
| | - Monica Bellei
- Uffici Studi Fondazione Italiana Linfomi, sede di Modena, Modena, Italy
| | - Anna Pascarella
- Unità Operativa Complessa di Ematologia, Ospedale dell'Angelo, Venice-Mestre, Italy
| | - Filippo Ballerini
- Clinica Ematologica, IRCCS Ospedale Policlinico San Martino, Università di Genova, Genoa, Italy
| | - Mauro Petrini
- Struttura Organizzativa Dipartimentale di Clinica Ematologica, Azienda Ospedaliero Universitaria delle Marche, Università Politecnica delle Marche, Ancona, Italy
| | - Francesco Merli
- Ematologia, Azienda Unità Sanitaria Locale - IRCCS, Reggio Emilia, Italy
| | - Attilio Olivieri
- Struttura Organizzativa Dipartimentale di Clinica Ematologica, Azienda Ospedaliero Universitaria delle Marche, Università Politecnica delle Marche, Ancona, Italy
| | - Francesco Lanza
- Unità di Ematologia, Ospedale Santa Maria delle Croci, Ravenna, Italy
| | - Ombretta Annibali
- Unità di Ematologia e Trapianto di Cellule Staminali, Università Campus Bio-Medico, Rome, Italy
| | - Vittorio Ruggero Zilioli
- Divisione di Ematologia, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Anna Marina Liberati
- Struttura Complessa di Oncoematologia e Autotrapianto, Azienda Ospedaliera Santa Maria, Università degli Studi di Perugia, Terni, Italy
| | - Maria Chiara Tisi
- Ematologia, Ospedale San Bortolo, Azienda Unità Sanitaria Locale Socio Sanitaria 8 "Berica," Vicenza, Italy
| | - Annalisa Arcari
- Unità di Ematologia, Ospedale Guglielmo da Saliceto, Piacenza, Italy
| | - Dario Marino
- Oncologia 1, Istituto Oncologico Veneto IRCCS, Padua, Italy
| | - Gerardo Musuraca
- Ematologia, IRCCS Istituto Romagnolo per lo Studio dei Tumori, Meldola, Italy
| | - Vincenzo Pavone
- Unità Operativa Complessa di Ematologia e Trapianto, Ospedale Pia Fondazione Cardinale Panico, Tricase, Italy
| | - Alberto Fabbri
- Unità di Ematologia, Azienda Ospedaliero Universitaria Senese, Siena, Italy
| | - Samantha Pozzi
- Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell'Adulto, Università di Modena e Reggio Emilia, Centro Oncologico, Modena, Italy
| | - Donato Mannina
- Dipartimento di Oncoematologia, Ospedale Papardo, Messina, Italy
| | - Caterina Plenteda
- Unità Operativa di Ematologia e Centro Trapianti di Midollo Osseo, Azienda Ospedaliero Universitaria di Parma, Parma, Italy
| | - Melania Celli
- Unità Operativa di Ematologia, Ospedale degli Infermi, Rimini, Italy
| | - Stefano Luminari
- Ematologia, Azienda Unità Sanitaria Locale - IRCCS, Reggio Emilia, Italy
- Dipartimento Chirurgico, Medico, Odontoiatrico e di Scienze Morfologiche con interesse Trapiantologico, Oncologico e di Medicina Rigenerativa, Università di Modena e Reggio Emilia, Reggio Emilia, Italy
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7
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Calogiuri G, Foti C, Congedo M, Nettis E, Paladini L, Greco G, Pavone V, Vacca A. Latent Mastocytosis Triggered by COVID-19 Vaccination: A Case Report. Endocr Metab Immune Disord Drug Targets 2023; 23:EMIDDT-EPUB-135014. [PMID: 37817657 DOI: 10.2174/0118715303241179230927105454] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 07/27/2023] [Accepted: 08/12/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND Hereby, we describe the first case of latent mastocytosis triggered by mRNA-based vaccine to prevent COVID-19 infection. CASE PRESENTATION In a 42-year-old Arabian man affected by slight, undiagnosed mastocytosis, the second dose of the COVID-19 vaccine made more blatant his latent disease. The postvaccination diagnostic iter is illustrated and the potential reasons causing the onset of the cutaneous mastocytosis are discussed. CONCLUSION In certain patients, clinicians should keep a longer follow-up of their patients, following the COVID-19 vaccination, not related to a few hours for the risk of immediate-type adverse events only.
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Affiliation(s)
- Gianfranco Calogiuri
- Pneumology and Respiratory Diseases Department, Civil Hospital Vito Fazzi Lecce, Italy
| | - Caterina Foti
- Section of Dermatology, Department of Biomedical Science and Human Oncology, Bari University "Aldo Moro", Piazza Giulio Cesare, Bari, Italy
| | | | - Eustachio Nettis
- Department of Emergency and Organ Transplantation, School of Allergology and Clinical Immunology, Bari University "Aldo Moro" Bari, Italy
| | - Luigi Paladini
- Pneumology and Respiratory Diseases Department, Civil Hospital Vito Fazzi Lecce, Italy
- Department of Medical and Surgical Sciences, 'Institute of Respiratory Diseases', University Hospital, Foggia, Italy
| | - Giuseppina Greco
- Hematology Department, Cardinale Panico Hospital, Tricase Lecce, Italy
| | - Vincenzo Pavone
- Hematology Department, Cardinale Panico Hospital, Tricase Lecce, Italy
| | - Angelo Vacca
- Department of Biomedical Sciences and Human Oncology, University of Bari 'Aldo Moro', Medical School, Bari, Italy
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8
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Mele G, Di Renzo N, Cascavilla N, Carella AM, Guarini A, Mazza P, Melillo L, Pavone V, Tarantini G, Curci P, Falcone AP, Germano C, Mele A, Merchionne F, Palazzo G, Palumbo G, Quinto AM, Reddiconto G, Rossini B, Spina A, Sgherza N, Specchia G, Musto P, Pastore D. Real-world evidence on the use of daratumumab, bortezomib and dexamethasone (DVd) in lenalidomide-refractory myeloma patients: subgroup analysis of the multicenter retrospective experience by "rete ematologica pugliese". Leuk Lymphoma 2023; 64:1715-1718. [PMID: 37417467 DOI: 10.1080/10428194.2023.2232487] [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: 11/24/2022] [Accepted: 06/24/2023] [Indexed: 07/08/2023]
Affiliation(s)
| | | | - Nicola Cascavilla
- Haematology, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo (Foggia), Italy
| | - Angelo Michele Carella
- Haematology, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo (Foggia), Italy
| | | | | | | | - Vincenzo Pavone
- Haematology, Ospedale Cardinale Panico, Tricase (Lecce), Italy
| | | | - Paola Curci
- Policlinico, University of Bari Medical School, Bari, Italy
| | | | - Candida Germano
- Haematology, Ospedale Monsignor R. Dimiccoli, Barletta (Bari), Italy
| | - Anna Mele
- Haematology, Ospedale Cardinale Panico, Tricase (Lecce), Italy
| | | | | | | | | | - Giovanni Reddiconto
- Haematology, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo (Foggia), Italy
| | | | | | - Nicola Sgherza
- Policlinico, University of Bari Medical School, Bari, Italy
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9
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Tober D, Pavone V, Lafuente-Funes S, Konvalinka N. Eggonomics: Vitrification and bioeconomies of egg donation in the United States and Spain. Med Anthropol Q 2023; 37:248-263. [PMID: 37229598 DOI: 10.1111/maq.12767] [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: 12/10/2020] [Accepted: 03/13/2023] [Indexed: 05/27/2023]
Abstract
Regulations governing assisted reproduction control the degree to which gamete donation is legal and how people providing genetic material are selected and compensated. The United States and Spain are both global leaders in fertility treatment with donor oocytes. Yet both countries take different approaches to how egg donation is regulated. The US model reveals a hierarchically organized form of gendered eugenics. In Spain, the eugenic aspects of donor selection are more subtle. Drawing upon fieldwork in the United States and Spain, this article examines (1) how compensated egg donation operates under two regulatory settings, (2) the implications for egg donors as providers of bioproducts, and (3) how advances in oocyte vitrification enhances the commodity quality of human eggs. By comparing these two reproductive bioeconomies we gain insight into how different cultural, medical, and ethical frameworks intersect with egg donor embodied experiences.
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Affiliation(s)
- Diane Tober
- Department of Anthropology and Institute for Social Science Research, University of Alabama, 19 Ten Hoor Hall, Tuscaloosa, AL, 35487, United States
- Affiliate faculty, Social and Behavioral Sciences University of California, San Francisco
| | - Vincenzo Pavone
- Institute of Public Goods and Policies, Spanish National Research Council, Calle Albesanz, 26-28, Madrid, 28037, Spain
| | - Sara Lafuente-Funes
- Goethe University Frankfurt, Frankfurt, Germany, Theodor-W.-Adorno-Platz 6, 60323, Frankfurt am Main, Frankfurt, Germany
| | - Nancy Konvalinka
- Departamento Antropología Social y Cultural, Universidad Nacional de Educación a Distancia, Calle Senda del Rey, 7, 28040, Madrid, Spain
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10
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Chino M, La Gatta S, Leone L, De Fenza M, Lombardi A, Pavone V, Maglio O. Dye Decolorization by a Miniaturized Peroxidase Fe-MimochromeVI*a. Int J Mol Sci 2023; 24:11070. [PMID: 37446248 DOI: 10.3390/ijms241311070] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 06/23/2023] [Accepted: 07/01/2023] [Indexed: 07/15/2023] Open
Abstract
Oxidases and peroxidases have found application in the field of chlorine-free organic dye degradation in the paper, toothpaste, and detergent industries. Nevertheless, their widespread use is somehow hindered because of their cost, availability, and batch-to-batch reproducibility. Here, we report the catalytic proficiency of a miniaturized synthetic peroxidase, Fe-Mimochrome VI*a, in the decolorization of four organic dyes, as representatives of either the heterocyclic or triarylmethane class of dyes. Fe-Mimochrome VI*a performed over 130 turnovers in less than five minutes in an aqueous buffer at a neutral pH under mild conditions.
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Affiliation(s)
- Marco Chino
- Department of Chemical Sciences, University of Napoli Federico II, Via Cintia, 80126 Napoli, Italy
| | - Salvatore La Gatta
- Department of Chemical Sciences, University of Napoli Federico II, Via Cintia, 80126 Napoli, Italy
| | - Linda Leone
- Department of Chemical Sciences, University of Napoli Federico II, Via Cintia, 80126 Napoli, Italy
| | - Maria De Fenza
- Department of Chemical Sciences, University of Napoli Federico II, Via Cintia, 80126 Napoli, Italy
| | - Angela Lombardi
- Department of Chemical Sciences, University of Napoli Federico II, Via Cintia, 80126 Napoli, Italy
| | - Vincenzo Pavone
- Department of Chemical Sciences, University of Napoli Federico II, Via Cintia, 80126 Napoli, Italy
| | - Ornella Maglio
- Department of Chemical Sciences, University of Napoli Federico II, Via Cintia, 80126 Napoli, Italy
- Institute of Biostructures and Bioimaging (IBB), National Research Council (CNR), Via Pietro Castellino 111, 80131 Napoli, Italy
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11
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Leone L, Muñoz-García AB, D'Alonzo D, Pavone V, Nastri F, Lombardi A. Peptide-based metalloporphyrin catalysts: unveiling the role of the metal ion in indole oxidation. J Inorg Biochem 2023; 246:112298. [PMID: 37379767 DOI: 10.1016/j.jinorgbio.2023.112298] [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: 05/01/2023] [Revised: 06/06/2023] [Accepted: 06/16/2023] [Indexed: 06/30/2023]
Abstract
Over the last decades, much effort has been devoted to the construction of protein and peptide-based metalloporphyrin catalysts capable of promoting difficult transformations with high selectivity. In this context, mechanistic studies are fundamental to elucidate all the factors that contribute to catalytic performances and product selectivity. In our previous work, we selected the synthetic peptide-porphyrin conjugate MnMC6*a as a proficient catalyst for indole oxidation, promoting the formation of a 3-oxindole derivative with unprecedented selectivity. In this work, we have evaluated the role of the metal ion in affecting reaction outcome, by replacing manganese with iron in the MC6*a scaffold. Even though product selectivity is not altered upon metal substitution, FeMC6*a shows a lower substrate conversion and prolonged reaction times with respect to its manganese analogue. Experimental and theoretical studies have enabled us to delineate the reaction free energy profiles for both catalysts, indicating different thermodynamic limiting steps, depending on the nature of the metal ion.
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Affiliation(s)
- Linda Leone
- Department of Chemical Sciences, University of Naples Federico II, Complesso Universitario Monte S. Angelo, via Cintia, 80126 Naples, Italy
| | - Ana Belén Muñoz-García
- Department of Physics "Ettore Pancini", University of Naples Federico II, Complesso Universitario Monte S. Angelo, via Cintia, 80126 Naples, Italy
| | - Daniele D'Alonzo
- Department of Chemical Sciences, University of Naples Federico II, Complesso Universitario Monte S. Angelo, via Cintia, 80126 Naples, Italy
| | - Vincenzo Pavone
- Department of Chemical Sciences, University of Naples Federico II, Complesso Universitario Monte S. Angelo, via Cintia, 80126 Naples, Italy
| | - Flavia Nastri
- Department of Chemical Sciences, University of Naples Federico II, Complesso Universitario Monte S. Angelo, via Cintia, 80126 Naples, Italy.
| | - Angela Lombardi
- Department of Chemical Sciences, University of Naples Federico II, Complesso Universitario Monte S. Angelo, via Cintia, 80126 Naples, Italy.
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12
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D'Alonzo D, De Fenza M, Pavone V, Lombardi A, Nastri F. Selective Oxidation of Halophenols Catalyzed by an Artificial Miniaturized Peroxidase. Int J Mol Sci 2023; 24:ijms24098058. [PMID: 37175773 PMCID: PMC10178546 DOI: 10.3390/ijms24098058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/24/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023] Open
Abstract
The development of artificial enzymes for application in sustainable technologies, such as the transformation of environmental pollutants or biomass, is one of the most challenging goals in metalloenzyme design. In this work, we describe the oxidation of mono-, di-, tri- and penta-halogenated phenols catalyzed by the artificial metalloenzyme Fe-MC6*a. It promoted the dehalogenation of 4-fluorophenol into the corresponding 1,4-benzoquinone, while under the same experimental conditions, 4-chloro, 4-bromo and 4-iodophenol were selectively converted into higher molecular weight compounds. Analysis of the 4-chlorophenol oxidation products clarified that oligomers based on C-O bonds were exclusively formed in this case. All results show that Fe-MC6*a holds intriguing enzymatic properties, as it catalyzes halophenol oxidation with substrate-dependent chemoselectivity.
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Affiliation(s)
- Daniele D'Alonzo
- Department of Chemical Sciences, University of Napoli Federico II, Via Cintia, 80126 Napoli, Italy
| | - Maria De Fenza
- Department of Chemical Sciences, University of Napoli Federico II, Via Cintia, 80126 Napoli, Italy
| | - Vincenzo Pavone
- Department of Chemical Sciences, University of Napoli Federico II, Via Cintia, 80126 Napoli, Italy
| | - Angela Lombardi
- Department of Chemical Sciences, University of Napoli Federico II, Via Cintia, 80126 Napoli, Italy
| | - Flavia Nastri
- Department of Chemical Sciences, University of Napoli Federico II, Via Cintia, 80126 Napoli, Italy
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13
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Chino M, Di Costanzo LF, Leone L, La Gatta S, Famulari A, Chiesa M, Lombardi A, Pavone V. Designed Rubredoxin miniature in a fully artificial electron chain triggered by visible light. Nat Commun 2023; 14:2368. [PMID: 37185349 PMCID: PMC10130062 DOI: 10.1038/s41467-023-37941-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 04/06/2023] [Indexed: 05/17/2023] Open
Abstract
Designing metal sites into de novo proteins has significantly improved, recently. However, identifying the minimal coordination spheres, able to encompass the necessary information for metal binding and activity, still represents a great challenge, today. Here, we test our understanding with a benchmark, nevertheless difficult, case. We assemble into a miniature 28-residue protein, the quintessential elements required to fold properly around a FeCys4 redox center, and to function efficiently in electron-transfer. This study addresses a challenge in de novo protein design, as it reports the crystal structure of a designed tetra-thiolate metal-binding protein in sub-Å agreement with the intended design. This allows us to well correlate structure to spectroscopic and electrochemical properties. Given its high reduction potential compared to natural and designed FeCys4-containing proteins, we exploit it as terminal electron acceptor of a fully artificial chain triggered by visible light.
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Affiliation(s)
- Marco Chino
- Department of Chemical Sciences, University of Naples Federico II, Via Cintia 21, 80126, Napoli, Italy
| | - Luigi Franklin Di Costanzo
- Department of Agricultural Sciences, University of Naples Federico II, Via Università 100, 80055, Portici, Italy
| | - Linda Leone
- Department of Chemical Sciences, University of Naples Federico II, Via Cintia 21, 80126, Napoli, Italy
| | - Salvatore La Gatta
- Department of Chemical Sciences, University of Naples Federico II, Via Cintia 21, 80126, Napoli, Italy
| | - Antonino Famulari
- Department of Chemistry, University of Torino, Via Giuria 9, 10125, Torino, Italy
- Department of Condensed Matter Physics, University of Zaragoza, Calle Pedro Cerbuna 12, 50009, Zaragoza, Spain
| | - Mario Chiesa
- Department of Chemistry, University of Torino, Via Giuria 9, 10125, Torino, Italy
| | - Angela Lombardi
- Department of Chemical Sciences, University of Naples Federico II, Via Cintia 21, 80126, Napoli, Italy.
| | - Vincenzo Pavone
- Department of Chemical Sciences, University of Naples Federico II, Via Cintia 21, 80126, Napoli, Italy.
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14
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Gaudio F, Loseto G, Bozzoli V, Scalzulli PR, Mazzone AM, Tonialini L, Fesce V, Quintana G, De Santis G, Masciopinto P, Arcuti E, Clemente F, Scardino S, Tarantini G, Pastore D, Melillo L, Pavone V, Maggi A, Carella AM, Di Renzo N, Guarini A, Musto P. A real-world analysis of PD1 blockade from the Rete Ematologica Pugliese (REP) in patients with relapse/refractory Hodgkin's lymphoma. Ann Hematol 2023; 102:385-392. [PMID: 36645458 DOI: 10.1007/s00277-023-05100-0] [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: 06/21/2022] [Accepted: 01/05/2023] [Indexed: 01/17/2023]
Abstract
Checkpoint inhibitors have significantly changed the prognosis of patients with relapsing refractory classical Hodgkin's lymphoma (cHL), demonstrating excellent results in heavily pretreated patients. However, there is still limited data on the real-world experience with PD-1 inhibitors in cHL. Within the context of the Apulian hematological network (Rete Ematologica Pugliese, REP), we performed a retrospective, multicenter analysis of 66 patients with relapsing refractory cHL who had received PD-1 inhibitors in the non-trial setting. Forty-three patients (65%) were treated with nivolumab and 23 (35%) with pembrolizumab. Thirty-one (47%) and 8 (12%) patients underwent autologous or allogeneic stem cell transplantation prior to checkpoint inhibitor therapy, respectively. The median number of lines of treatment attempted prior to PD-1 inhibitor therapy was 4 (range, 3 to 7). All patients had received brentuximab vedotin prior to checkpoint inhibitor therapy. The overall response rate to PD-1 inhibitors therapy was 70% (47% complete remission (CR) and 23% partial remission (PR)). Twenty-four immune-related adverse events (19 (80%) grades 1-2; 5 (20%) grades 3-4) were documented (4 gastrointestinal, 4 hepatic, 6 fever, 4 hematological, 3 dermatological, 3 allergic rhinitis). Toxicity resolved in all patients, and there were no deaths attributed to checkpoint inhibitor therapy. After a median follow-up of 26 months (range 3-72 months), 54 patients (82%) are alive, and 12 (18%) died. The cause of death was attributed to disease progression in 9 patients and sepsis in 3 patients. After PD-1 inhibitor therapy, 22 patients (33%) relapsed or progressed. The overall survival and progression-free survival at 5 years were 65% and 54%, respectively. This study confirms the efficacy and tolerability of PD-1 inhibitor therapy in relapsed refractory cHL in a real-world setting, demonstrating similar clinical outcomes and toxicity profiles compared to clinical studies.
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Affiliation(s)
- Francesco Gaudio
- Unit of Hematology and Stem Cell Transplantation, AOUC Policlinico, Ematologia Con Trapianto, Piazza G. Cesare 11, 70124, Bari, Italy.
| | - Giacomo Loseto
- Hematology Unit, Giovanni Paolo II IRCCS Cancer Institute Oncology Hospital, Bari, Italy
| | - Valentina Bozzoli
- Hematology and Stem Cell Transplant Unit, "Vito Fazzi" Hospital, Lecce, Italy
| | | | - Anna Maria Mazzone
- Hematology Unit, Department of Hematology-Oncology, "Moscati" Hospital, Taranto, Italy
| | - Lorenzo Tonialini
- Hematology and Transplant Unit, "Cardinal Panico" Hospital, Tricase (LE), Italy
| | - Vincenza Fesce
- Hematology Unit, Azienda Ospedaliero Universitaria-Ospedali Riuniti, Foggia, Italy
| | | | | | - Pierluigi Masciopinto
- Department of Emergency and Organ Transplantation, "Aldo Moro" University, Bari, Italy
| | - Elena Arcuti
- Department of Emergency and Organ Transplantation, "Aldo Moro" University, Bari, Italy
| | - Felice Clemente
- Hematology Unit, "Giovanni Paolo II" IRCCS Cancer Institute Oncology Hospital, Bari, Italy
| | - Stefania Scardino
- Hematology and Stem Cell Transplant Unit, "Vito Fazzi" Hospital, Lecce, Italy
| | | | | | - Lorella Melillo
- Hematology Unit, Azienda Ospedaliero Universitaria-Ospedali Riuniti, Foggia, Italy
| | - Vincenzo Pavone
- Hematology and Transplant Unit, "Cardinal Panico" Hospital, Tricase (LE), Italy
| | - Alessandro Maggi
- Hematology Unit, Department of Hematology-Oncology, "Moscati" Hospital, Taranto, Italy
| | - Angelo Michele Carella
- Hematology Unit, IRCCS "Casa Sollievo Della Sofferenza", S. Giovanni Rotondo (FG), Italy
| | - Nicola Di Renzo
- Hematology and Stem Cell Transplant Unit, "Vito Fazzi" Hospital, Lecce, Italy
| | - Attilio Guarini
- Hematology Unit, "Giovanni Paolo II" IRCCS Cancer Institute Oncology Hospital, Bari, Italy
| | - Pellegrino Musto
- Unit of Hematology and Stem Cell Transplantation, AOUC Policlinico, Ematologia Con Trapianto, Piazza G. Cesare 11, 70124, Bari, Italy.,Department of Precision and Translational Medicine With Ionian Area, "Aldo Moro" University School of Medicine, Bari, Italy
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15
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Martino EA, Conticello C, Zamagni E, Pavone V, Palmieri S, Musso M, Tacchetti P, Mele A, Catalano L, Vigna E, Bruzzese A, Mendicino F, Botta C, Vincelli ID, Farina G, Barone M, Cangialosi C, Mancuso K, Rizziello I, Rocchi S, Falcone AP, Mele G, Reddiconto G, Garibaldi B, Iaccino E, Tripepi G, Gamberi B, Di Raimondo F, Musto P, Neri A, Cavo M, Morabito F, Gentile M. Carfilzomib combined with lenalidomide and dexamethasone (KRd) as salvage therapy for multiple myeloma patients: italian, multicenter, retrospective clinical experience with 600 cases outside of controlled clinical trials. Hematol Oncol 2022; 40:1009-1019. [PMID: 35638723 DOI: 10.1002/hon.3035] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 05/23/2022] [Indexed: 12/13/2022]
Abstract
In combination with lenalidomide and dexamethasone (KRd), Carfilzomib has been approved for the treatment of relapsed and refractory multiple myeloma (RRMM) on ASPIRE trial. Efficacy and safety of the triplet are still the object of investigation by many groups to confirm ASPIRE results in the setting of RRMM treated in real-life who don't meet trial restrictive inclusion criteria. Therefore, we report a retrospective multicenter analysis of 600 RRMM patients treated with KRd between December 2015 and December 2018. The median age was 64 years (range 33-85), and the median number of previous therapies was two (range 1-11). After a median of 11 KRd cycles, the overall response rate was 79.9%. The median progression-free survival (PFS) was 22 months, and the 2-year probability of PFS was 47.6%. Creatinine clearance<30 ml/min, >1 line of previous therapy, and high-risk FISH were all associated with a poor prognosis in multivariate analysis. The median overall survival (OS) was 34.8 months; the 2-year probability of OS was 63.5%. At multivariate analysis, creatinine clearance<30 ml/min, >1 line of previous therapy, and high-risk FISH were significantly associated with poor prognosis. After a median follow-up of 16 months (range 1-50), 259 withdrew from therapy. The main discontinuation reason was progressive disease (81.8%). Seventy-four patients (12.3%) discontinued therapy for toxicity. The most frequent side effects were hematological (anemia 49.3%, neutropenia 42.7%, thrombocytopenia 42.5%) and cardiovascular (hypertension 14.5%, heart failure 2.5%, arrhythmias 3.6%). Our study confirms the safety and efficacy of KRd in the real-life setting of RRMM patients and encourages its use in clinical practice.
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Affiliation(s)
| | - Concetta Conticello
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, Catania, Italy
| | - Elena Zamagni
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy.,Dipartimento di Medicina Specialistica, Università di Bologna, Diagnostica e Sperimentale, Bologna, Italy
| | - Vincenzo Pavone
- Department of Hematology and Bone Marrow Transplant, Hospital Card. G. Panico, Tricase (LE), Italy
| | | | - Maurizio Musso
- Dipartimento Oncologico, U.O.C. OncoEmatologia e TMO, La Maddalena, Palermo, Italy
| | - Paola Tacchetti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Anna Mele
- Department of Hematology and Bone Marrow Transplant, Hospital Card. G. Panico, Tricase (LE), Italy
| | | | | | | | | | | | - Iolanda Donatella Vincelli
- Hematology Unit, Department of Hemato-Oncology and Radiotherapy, Great Metropolitan Hospital "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | - Giuliana Farina
- UOC Ematologia a Indirizzo Oncologico, AORN "Sant'Anna e San Sebastiano", Caserta, Italy
| | | | - Clotilde Cangialosi
- U.O.C. Ematologia A. O. Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy
| | - Katia Mancuso
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Ilaria Rizziello
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy.,Dipartimento di Medicina Specialistica, Università di Bologna, Diagnostica e Sperimentale, Bologna, Italy
| | - Serena Rocchi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy.,Dipartimento di Medicina Specialistica, Università di Bologna, Diagnostica e Sperimentale, Bologna, Italy
| | - Antonietta Pia Falcone
- Department of Hematology and Bone Marrow Transplant, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Giuseppe Mele
- Department of Hematology, Hospital Perrino, Brindisi, Italy
| | | | - Bruno Garibaldi
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, Catania, Italy
| | - Enrico Iaccino
- Department of Experimental and Clinical Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Giovanni Tripepi
- Nephrology Center of National Research Institute of Biomedicine and Molecular Immunology, Reggio Calabria, Italy
| | - Barbara Gamberi
- Hematology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Emilia-Romagna, Italy
| | - Francesco Di Raimondo
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, Catania, Italy
| | | | - Antonino Neri
- Scientific Directorate, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy.,Dipartimento di Medicina Specialistica, Università di Bologna, Diagnostica e Sperimentale, Bologna, Italy
| | - Fortunato Morabito
- Biothecnology Research Unit, AO of Cosenza, Cosenza, Italy.,Hematology and Bone Marrow Transplant Unit, Hemato-Oncology Department, Augusta Victoria Hospital, East Jerusalem, Israel
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Ferrero S, Grimaldi D, Genuardi E, Drandi D, Zaccaria GM, Alessandria B, Ghislieri M, Ferrante M, Evangelista A, Mantoan B, De Luca G, Stefani PM, Benedetti F, Casaroli I, Zanni M, Castellino C, Pavone V, Petrini M, Re F, Hohaus S, Musuraca G, Cascavilla N, Ghiggi C, Liberati AM, Cortelazzo S, Ladetto M. Punctual and kinetic MRD analysis from the Fondazione Italiana Linfomi MCL0208 phase 3 trial in mantle cell lymphoma. Blood 2022; 140:1378-1389. [PMID: 35737911 PMCID: PMC9507010 DOI: 10.1182/blood.2021014270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 05/27/2022] [Indexed: 11/20/2022] Open
Abstract
Minimal residual disease (MRD) analysis is a known predictive tool in mantle cell lymphoma (MCL). We describe MRD results from the Fondazione Italiana Linfomi phase 3 MCL0208 prospective clinical trial assessing lenalidomide (LEN) maintenance vs observation after autologous stem cell transplantation (ASCT) in the first prospective comprehensive analysis of different techniques, molecular markers, and tissues (peripheral blood [PB] and bone marrow [BM]), taken at well-defined time points. Among the 300 patients enrolled, a molecular marker was identified in 250 (83%), allowing us to analyze 234 patients and 4351 analytical findings from 10 time points. ASCT induced high rates of molecular remission (91% in PB and 83% in BM, by quantitative real-time polymerase chain reaction [RQ-PCR]). Nevertheless, the number of patients with persistent clinical and molecular remission decreased over time in both arms (up to 30% after 36 months). MRD predicted early progression and long-term outcome, particularly from 6 months after ASCT (6-month time to progression [TTP] hazard ratio [HR], 3.83; P < .001). In single-timepoint analysis, BM outperformed PB, and RQ-PCR was more reliable, while nested PCR appeared applicable to a larger number of patients (234 vs 176). To improve MRD performance, we developed a time-varying kinetic model based on regularly updated MRD results and the MIPI (Mantle Cell Lymphoma International Prognostic Index), showing an area under the ROC (Receiver Operating Characteristic) curve (AUROC) of up to 0.87 using BM. Most notably, PB reached an AUROC of up to 0.81; with kinetic analysis, it was comparable to BM in performance. MRD is a powerful predictor over the entire natural history of MCL and is suitable for models with a continuous adaptation of patient risk. The study can be found in EudraCT N. 2009-012807-25 (https://eudract.ema.europa.eu/).
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Affiliation(s)
- Simone Ferrero
- Department of Molecular Biotechnologies and Health Sciences, University of Torino, Torino, Italy
- AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Daniele Grimaldi
- Department of Molecular Biotechnologies and Health Sciences, University of Torino, Torino, Italy
- Hematology Division, AO S.Croce e Carle, Cuneo, Italy
| | - Elisa Genuardi
- Department of Molecular Biotechnologies and Health Sciences, University of Torino, Torino, Italy
| | - Daniela Drandi
- Department of Molecular Biotechnologies and Health Sciences, University of Torino, Torino, Italy
| | - Gian Maria Zaccaria
- Department of Molecular Biotechnologies and Health Sciences, University of Torino, Torino, Italy
- Hematology and Cell Therapy Unit, IRCCS Istituto Tumori Giovanni Paolo II, Bari, Italy
| | - Beatrice Alessandria
- Department of Molecular Biotechnologies and Health Sciences, University of Torino, Torino, Italy
| | - Marco Ghislieri
- PoliToBIOMed Lab, Politecnico di Torino, Torino, Italy
- Department of Electronics and Telecommunications, Politecnico di Torino, Torino, Italy
| | - Martina Ferrante
- Department of Molecular Biotechnologies and Health Sciences, University of Torino, Torino, Italy
| | - Andrea Evangelista
- Unit of Cancer Epidemiology, CPO, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Barbara Mantoan
- Department of Molecular Biotechnologies and Health Sciences, University of Torino, Torino, Italy
| | - Gabriele De Luca
- Department of Molecular Biotechnologies and Health Sciences, University of Torino, Torino, Italy
| | | | - Fabio Benedetti
- Department of Medicine, Section of Hematology and Bone Marrow Transplant Unit, University of Verona, Verona, Italy
| | | | - Manuela Zanni
- Division of Hematology, Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | | | | | | | - Francesca Re
- Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Stefan Hohaus
- Hematology Unit, Università Cattolica S.Cuore; Roma, Italy
| | - Gerardo Musuraca
- Department of Hematology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS
| | - Nicola Cascavilla
- Hematology, Casa Sollievo della Sofferenza IRCCS Hospital, San Giovanni Rotondo, Italy
| | - Chiara Ghiggi
- Department of Hematology, San Martino Hospital and University, Genova, Italy
| | - Anna Marina Liberati
- Department of Hematology, A.O. Santa Maria Terni, University of Perugia, Perugia, Italy; and
| | | | - Marco Ladetto
- Division of Hematology, Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
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Isidori A, Loscocco F, Visani G, Paolasini S, Scalzulli P, Musto P, Perrone T, Guarini A, Pastore D, Mazza P, Tonialini L, Pavone V, De Santis G, Tarantini G. Real-life efficacy and safety of idelalisib in 55 double-refractory follicular lymphoma patients. Br J Haematol 2022; 199:339-343. [PMID: 36002151 DOI: 10.1111/bjh.18426] [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: 06/02/2022] [Revised: 08/07/2022] [Accepted: 08/12/2022] [Indexed: 11/28/2022]
Abstract
Idelalisib, a reversible inhibitor of PI3Kδ (phosphoinositide-3 kinase delta), showed remarkable activity in the phase II DELTA trial, leading to its approval by the European Medicines Agency (EMA) in patients with relapsed/refractory (R/R) follicular lymphoma (FL). However, real-life data on idelalisib are scarce. We treated 55 double-refractory FL patients with idelalisib in a real-life setting. With a median exposure to idelalisib of 10 months (range 1-43), overall response rate was 73%, the highest ever reported. Non-haematological toxicities were mild and manageable. At 12 months, 80% of patients were alive, and 72% disease-free. The efficacy and safety of idelalisib was confirmed in a real-life setting.
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Affiliation(s)
- Alessandro Isidori
- Hematology and Stem Cell Transplant Center, AORMN Hospital, Pesaro, Italy
| | - Federica Loscocco
- Hematology and Stem Cell Transplant Center, AORMN Hospital, Pesaro, Italy
| | - Giuseppe Visani
- Hematology and Stem Cell Transplant Center, AORMN Hospital, Pesaro, Italy
| | - Sara Paolasini
- Hematology and Stem Cell Transplant Center, AORMN Hospital, Pesaro, Italy
| | - Potito Scalzulli
- UOC di Ematologia San Giovanni Rotondo, San Giovanni Rotondo, Italy
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Morabito F, Zamagni E, Conticello C, Pavone V, Palmieri S, Bringhen S, Galli M, Mangiacavalli S, Derudas D, Rossi E, Ria R, Catalano L, Tacchetti P, Mele G, Vincelli ID, Martino EA, Vigna E, Bruzzese A, Mendicino F, Botta C, Mele A, Pantani L, Rocchi S, Garibaldi B, Cascavilla N, Ballanti S, Tripepi G, Frigeri F, Falcone AP, Cangialosi C, Reddiconto G, Farina G, Barone M, Rizzello I, Iaccino E, Mimmi S, Curci P, Gamberi B, Musto P, De Stefano V, Musso M, Petrucci MT, Offidani M, Di Raimondo F, Boccadoro M, Cavo M, Neri A, Gentile M. Survival Risk Scores for Real-Life Relapsed/Refractory Multiple Myeloma Patients Receiving Elotuzumab or Carfilzomib In Combination With Lenalidomide and Dexamethasone as Salvage Therapy: Analysis of 919 Cases Outside Clinical Trials. Front Oncol 2022; 12:890376. [PMID: 35924160 PMCID: PMC9341470 DOI: 10.3389/fonc.2022.890376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 06/17/2022] [Indexed: 11/20/2022] Open
Abstract
The present study aimed to develop two survival risk scores (RS) for overall survival (OS, SRSKRd/EloRd) and progression-free survival (PFS, PRSKRd/EloRd) in 919 relapsed/refractory multiple myeloma (RRMM) patients who received carfilzomib, lenalidomide, and dexamethasone (KRd)/elotuzumab, lenalidomide, and dexamethasone (EloRd). The median OS was 35.4 months, with no significant difference between the KRd arm versus the EloRd arm. In the multivariate analysis, advanced ISS (HR = 1.31; P = 0.025), interval diagnosis–therapy (HR = 1.46; P = 0.001), number of previous lines of therapies (HR = 1.96; P < 0.0001), older age (HR = 1.72; P < 0.0001), and prior lenalidomide exposure (HR = 1.30; P = 0.026) remained independently associated with death. The median PFS was 20.3 months, with no difference between the two strategies. The multivariate model identified a significant progression/death risk increase for ISS III (HR = 1.37; P = 0.002), >3 previous lines of therapies (HR = 1.67; P < 0.0001), older age (HR = 1.64; P < 0.0001), and prior lenalidomide exposure (HR = 1.35; P = 0.003). Three risk SRSKRd/EloRd categories were generated: low-risk (134 cases, 16.5%), intermediate-risk (467 cases, 57.3%), and high-risk categories (213 cases, 26.2%). The 1- and 2-year OS probability rates were 92.3% and 83.8% for the low-risk (HR = 1, reference category), 81.1% and 60.6% (HR = 2.73; P < 0.0001) for the intermediate-risk, and 65.5% and 42.5% (HR = 4.91; P < 0.0001) for the high-risk groups, respectively. Notably, unlike the low-risk group, which did not cross the median timeline, the OS median values were 36.6 and 18.6 months for the intermediate- and high-risk cases, respectively. Similarly, three PRSKRd/EloRd risk categories were engendered. Based on such grouping, 338 (41.5%) cases were allocated in the low-, 248 (30.5%) in the intermediate-, and 228 (28.0%) in the high-risk groups. The 1- and 2-year PFS probability rates were 71.4% and 54.5% for the low-risk (HR = 1, reference category), 68.9% and 43.7% (HR = 1.95; P < 0.0001) for the intermediate-risk, and 48.0% and 27.1% (HR = 3.73; P < 0.0001) for the high-risk groups, respectively. The PFS median values were 29.0, 21.0, and 11.7 months for the low-, intermediate-, and high-risk cases. This analysis showed 2.7- and 4.9-fold increased risk of death for the intermediate- and high-risk cases treated with KRd/EloRd as salvage therapy. The combined progression/death risks of the two categories were increased 1.3- and 2.2-fold compared to the low-risk group. In conclusion, SRSKRd/EloRd and PRSKRd/EloRd may represent accessible and globally applicable models in daily clinical practice and ultimately represent a prognostic tool for RRMM patients who received KRd or EloRd.
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Affiliation(s)
- Fortunato Morabito
- Biotechnology Research Unit, AO of Cosenza, Cosenza, Italy
- Hematology and Bone Marrow Transplant Unit, Hemato-Oncology Department, Augusta Victoria Hospital, East Jerusalem, Israel
- *Correspondence: Fortunato Morabito, ; Massimo Gentile, ; Antonino Neri,
| | - Elena Zamagni
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Concetta Conticello
- Division of Hematology, Azienda Policlinico-S. Marco, University of Catania, Catania, Italy
| | - Vincenzo Pavone
- Department of Hematology and Bone Marrow Transplant, Hospital Card. G. Panico, Tricase, Italy
| | | | - Sara Bringhen
- Division of Hematology, AOU Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy
| | - Monica Galli
- Hematology and Bone Marrow Transplant Unit, Azienda Socio-Sanitaria Territoriale-Papa Giovanni XXIII, Bergamo, Italy
| | - Silvia Mangiacavalli
- Hematology Division, Department of Hematology-Oncology, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | | | - Elena Rossi
- Istituto di Ematologia, Università Cattolica, Fondazione Policlinico Gemelli IRCCS, Roma, Italy
| | - Roberto Ria
- Department of Biomedical Science, Internal Medicine “G. Baccelli”, Policlinico, University of Bari “Aldo Moro” Medical School, Bari, Italy
| | | | - Paola Tacchetti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
| | - Giuseppe Mele
- Department of Hematology, Hospital Perrino, Brindisi, Italy
| | - Iolanda Donatella Vincelli
- Hematology Unit, Department of Hemato-Oncology and Radiotherapy, Great Metropolitan Hospital “Bianchi-Melacrino-Morelli”, Reggio Calabria, Italy
| | | | - Ernesto Vigna
- Department of Onco-Hematology, Hematology Unit AO of Cosenza, Cosenza, Italy
| | - Antonella Bruzzese
- Department of Onco-Hematology, Hematology Unit AO of Cosenza, Cosenza, Italy
| | - Francesco Mendicino
- Department of Onco-Hematology, Hematology Unit AO of Cosenza, Cosenza, Italy
| | - Cirino Botta
- Department of Onco-Hematology, Hematology Unit AO of Cosenza, Cosenza, Italy
| | - Anna Mele
- Department of Hematology and Bone Marrow Transplant, Hospital Card. G. Panico, Tricase, Italy
| | - Lucia Pantani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
| | - Serena Rocchi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Bruno Garibaldi
- Division of Hematology, Azienda Policlinico-S. Marco, University of Catania, Catania, Italy
| | - Nicola Cascavilla
- Department of Hematology and Bone Marrow Transplant, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Stelvio Ballanti
- Institute of Haematology and Stem Cell transplantation, Ospedale Santa Maria della Misericordia, University of Perugia, Perugia, Italy
| | - Giovanni Tripepi
- Department of Internal Medicine, Nephrology Center of National Research Institute of Biomedicine and Molecular Immunology, Reggio Calabria, Italy
| | - Ferdinando Frigeri
- UOC Ematologia a Indirizzo Oncologico, AORN “Sant’Anna e San Sebastiano”, Caserta, Italy
| | - Antonetta Pia Falcone
- Department of Hematology and Bone Marrow Transplant, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Clotilde Cangialosi
- U.O.C. Ematologia A. O. Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy
| | | | - Giuliana Farina
- UOC Ematologia a Indirizzo Oncologico, AORN “Sant’Anna e San Sebastiano”, Caserta, Italy
| | | | - Ilaria Rizzello
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Enrico Iaccino
- Department of Experimental and Clinical Medicine, University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Selena Mimmi
- Department of Experimental and Clinical Medicine, University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Paola Curci
- Department of Emergency and Organ Transplantation, “Aldo Moro” University School of Medicine and Unit of Hematology and Stem Cell Transplantation, AOUC Policlinico, Bari, Italy
| | - Barbara Gamberi
- Division of Hematology, Azienda USL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Pellegrino Musto
- Department of Emergency and Organ Transplantation, “Aldo Moro” University School of Medicine and Unit of Hematology and Stem Cell Transplantation, AOUC Policlinico, Bari, Italy
| | - Valerio De Stefano
- Istituto di Ematologia, Università Cattolica, Fondazione Policlinico Gemelli IRCCS, Roma, Italy
| | - Maurizio Musso
- U.O.C. OncoEmatologia e TMO, Dipartimento Oncologico, Palermo, Italy
| | - Maria Teresa Petrucci
- Department of Cellular Biotechnologies and Hematology, Sapienza University of Rome, Roma, Italy
| | | | - Francesco Di Raimondo
- Division of Hematology, Azienda Policlinico-S. Marco, University of Catania, Catania, Italy
| | - Mario Boccadoro
- Division of Hematology, AOU Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy
| | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Antonino Neri
- Scientific Directorate, Azienda USL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
- *Correspondence: Fortunato Morabito, ; Massimo Gentile, ; Antonino Neri,
| | - Massimo Gentile
- Department of Onco-Hematology, Hematology Unit AO of Cosenza, Cosenza, Italy
- *Correspondence: Fortunato Morabito, ; Massimo Gentile, ; Antonino Neri,
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Mele A, Prete E, Citiso S, Mele G, Pastore D, Sgherza N, Curci P, Musto P, Falcone AP, Cascavilla N, Germano C, Giuseppe T, Reddiconto G, Di Renzo N, Palazzo G, Mazza P, Rossini B, Guarini A, Palumbo G, Melillo LMA, Pavone V. PB2016: COMPARISON BETWEEN DRD VS KRD AS SALVAGE THERAPY FOR MULTIPLE MYELOMA PATIENTS IN FIRST RELAPSE: THE REAL LIFE EXPERIENCE OF RETE EMATOLOGICA PUGLIESE (REP). Hemasphere 2022. [PMCID: PMC9431550 DOI: 10.1097/01.hs9.0000850896.11254.d1] [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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Mele G, Cascavilla N, Di Renzo N, Guarini A, Mazza P, Melillo L, Pavone V, Tarantini G, Curci P, Falcone AP, Germano C, Mele A, Palazzo G, Palumbo G, Reddiconto G, Rossini B, Specchia G, Musto P, Pastore D. Daratumumab plus bortezomib or daratumumab plus lenalidomide as salvage therapy for patients with myeloma: initial follow-up of an Italian multicentre retrospective clinical experience by 'Rete Ematologica Pugliese'. Ann Hematol 2022; 101:1727-1739. [PMID: 35587825 DOI: 10.1007/s00277-022-04857-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 04/24/2022] [Indexed: 12/01/2022]
Abstract
We report herein a multicentre retrospective analysis of 192 consecutive patients with symptomatic refractory/relapsed multiple myeloma (RRMM) treated with daratumumab in combination with bortezomib or lenalidomide as salvage therapy at 9 haematological centres in Puglia. Choice of both regimens was based on previous treatment and/or physicians' preference. Considering the under-representation of older patients (very old patient ≥ 80 years) in clinical trials and the prognostic and predictive importance and value of frailty status, here, we further characterised the patient cohort by age. The overall response rate (ORR) was generally lower than what was previously reported in the CASTOR (ORR 72.6% vs 85%) and POLLUX (ORR 86.5% vs 93%) trials. The lower ORR in our analysis compared to the CASTOR and POLLUX trials could be related to a less selected population. Similarly, amongst very old patients, the ORR was encouraging: ORR to treatment with DVd (daratumumab + bortezomib + dexamethasone) was 66.7%, and ORR to treatment with DRd (daratumumab + lenalidomide + dexamethasone) was 92.3%. Median TTP (time to progression) was 10.8 months (1-year TTP: 44.7%; 2-year TTP: 25.3%) in the DVd group; median TTP was not reached in the DRd group (1-year TTP: 82.7%; 2-year TTP: 71.4%). Median OS (overall survival) was not reached either in the DRd group (1-year OS: 85.9%; 2-year OS: 73.7%) or the DVd group (1-year OS: 70.2%; 2-year OS: 58.9%).
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Affiliation(s)
- G Mele
- Haematology and BMT Unit, Ospedale A. Perrino, SS 7 per Mesagne, 72100, Brindisi, Italy.
| | - N Cascavilla
- Haematology, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - N Di Renzo
- Haematology, Ospedale V. Fazzi, Lecce, Italy
| | - A Guarini
- Haematology, Ospedale Giovanni Paolo II°, Bari, Italy
| | - P Mazza
- Haematology, Ospedale G. Moscati, Taranto, Italy
| | - L Melillo
- Haematology, Ospedali Riuniti, Foggia, Italy
| | - V Pavone
- Haematology, Ospedale Cardinale Panico, Tricase, Lecce, Italy
| | - G Tarantini
- Haematology, Ospedale Monsignor R. Dimiccoli, Barletta, Bari, Italy
| | - P Curci
- University of Bari Medical School, Policlinico, Bari, Italy
| | - A P Falcone
- Haematology, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - C Germano
- Haematology, Ospedale Monsignor R. Dimiccoli, Barletta, Bari, Italy
| | - A Mele
- Haematology, Ospedale Cardinale Panico, Tricase, Lecce, Italy
| | - G Palazzo
- Haematology, Ospedale G. Moscati, Taranto, Italy
| | - G Palumbo
- Haematology, Ospedali Riuniti, Foggia, Italy
| | | | - B Rossini
- Haematology, Ospedale Giovanni Paolo II°, Bari, Italy
| | - G Specchia
- University of Bari Medical School, Policlinico, Bari, Italy
| | - P Musto
- University of Bari Medical School, Policlinico, Bari, Italy
| | - D Pastore
- Haematology and BMT Unit, Ospedale A. Perrino, SS 7 per Mesagne, 72100, Brindisi, Italy
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Zambrano G, Sekretareva A, D'Alonzo D, Leone L, Pavone V, Lombardi A, Nastri F. Oxidative dehalogenation of trichlorophenol catalyzed by a promiscuous artificial heme-enzyme. RSC Adv 2022; 12:12947-12956. [PMID: 35527726 PMCID: PMC9067433 DOI: 10.1039/d2ra00811d] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/13/2022] [Indexed: 01/21/2023] Open
Abstract
The miniaturized metalloenzyme Fe(iii)-mimochrome VI*a (Fe(iii)-MC6*a) acts as an excellent biocatalyst in the H2O2-mediated oxidative dehalogenation of the well-known pesticide and biocide 2,4,6-trichlorophenol (TCP). The artificial enzyme can oxidize TCP with a catalytic efficiency (kcat/KTCPm = 150 000 mM−1 s−1) up to 1500-fold higher than the most active natural metalloenzyme horseradish peroxidase (HRP). UV-visible and EPR spectroscopies were used to provide indications of the catalytic mechanism. One equivalent of H2O2 fully converts Fe(iii)-MC6*a into the oxoferryl-porphyrin radical cation intermediate [(Fe(iv)
Created by potrace 1.16, written by Peter Selinger 2001-2019
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O)por˙+], similarly to peroxidase compound I (Cpd I). Addition of TCP to Cpd I rapidly leads to the formation of the corresponding quinone, while Cpd I decays back to the ferric resting state in the absence of substrate. EPR data suggest a catalytic mechanism involving two consecutive one-electron reactions. All results highlight the value of the miniaturization strategy for the development of chemically stable, highly efficient artificial metalloenzymes as powerful catalysts for the oxidative degradation of toxic pollutants. The artificial metalloenzyme FeMC6*a is able to perform the H2O2-mediated dechlorination of 2,4,6-trichlorophenol with unrivalled catalytic efficiency, highlighting its potential application for the removal of toxic pollutants.![]()
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Affiliation(s)
- Gerardo Zambrano
- Department of Chemical Sciences, University of Napoli Federico II, Via Cintia, 80126 Napoli, Italy
| | - Alina Sekretareva
- Department of Chemistry – Ångström, Uppsala University, Lägerhyddsvägen 1, 75120 Uppsala, Sweden
| | - Daniele D'Alonzo
- Department of Chemical Sciences, University of Napoli Federico II, Via Cintia, 80126 Napoli, Italy
| | - Linda Leone
- Department of Chemical Sciences, University of Napoli Federico II, Via Cintia, 80126 Napoli, Italy
| | - Vincenzo Pavone
- Department of Chemical Sciences, University of Napoli Federico II, Via Cintia, 80126 Napoli, Italy
| | - Angela Lombardi
- Department of Chemical Sciences, University of Napoli Federico II, Via Cintia, 80126 Napoli, Italy
| | - Flavia Nastri
- Department of Chemical Sciences, University of Napoli Federico II, Via Cintia, 80126 Napoli, Italy
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22
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Malagola M, Polverelli N, Rubini V, Martino M, Patriarca F, Bruno B, Giaccone L, Grillo G, Bramanti S, Bernasconi P, De Gobbi M, Natale A, Terruzzi E, Olivieri A, Chiusolo P, Carella AM, Casini M, Nozzoli C, Mazza P, Bassi S, Onida F, Vacca A, Falcioni S, Luppi M, Iori AP, Pavone V, Skert C, Carluccio P, Borghero C, Proia A, Selleri C, Sacchi N, Mammoliti S, Oldani E, Ciceri F, Russo D, Bonifazi F. GITMO Registry Study on Allogeneic Transplantation in Patients Aged ≥60 Years from 2000 to 2017: Improvements and Criticisms. Transplant Cell Ther 2021; 28:96.e1-96.e11. [PMID: 34818581 DOI: 10.1016/j.jtct.2021.11.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 10/13/2021] [Accepted: 11/15/2021] [Indexed: 12/18/2022]
Abstract
Today, allogeneic stem cell transplantation (allo-SCT) can be offered to patients up to age 70 to 72 years and represents one of the most effective curative treatments for many hematologic malignancies. The primary objective of the study was to collect data from the allo-SCTs performed in Italy between 2000 and 2017 in patients aged ≥60 years to evaluate the changes in safety and efficacy outcomes, as well as their distribution and characteristics over time. The Italian Group for Bone Marrow Transplantation, Hematopoietic Stem Cells and Cell Therapy (GITMO) AlloEld study (ClinicalTrials.gov identifier NCT04469985) is a retrospective analysis of allo-SCTs performed at 30 Italian transplantation centers in older patients (age ≥60 years) between 2000 and 2017 (n = 1996). For the purpose of this analysis, patients were grouped into 3 time periods: time A, 2000 to 2005 (n = 256; 12%); time B, 2006 to 2011 (n = 584; 29%); and time C, 2012 to 2017 (n = 1156; 59%). After a median follow-up of 5.6 years, the 5-year nonrelapse mortality (NRM) remained stable (time A, 32.8%; time B, 36.2%; and time C, 35.0%; P = .5), overall survival improved (time A, 28.4%; time B, 31.8%; and time C, 37.3%; P = .012), and the cumulative incidence of relapse was reduced (time A, 45.3%; time B, 38.2%; time C, 30.0%; P < .0001). The 2-year incidence of extensive chronic graft-versus-host disease was reduced significantly (time A, 17.2%; time B, 15.8%; time C, 12.2%; P = .004). Considering times A and B together (2000 to 2011), the 2-year NRM was positively correlated with the Hematopoietic Cell Transplantation Comorbidity Index (HCT-CI) score; NRM was 25.2% in patients with an HCT-CI score of 0, 33.9% in those with a score of 1 or 2, and 36.1% in those with a score of 3 (P < .001). However, after 2012, the HCT-CI score was not significantly predictive of NRM. This study shows that the transplantation procedure in elderly patients became more effective over time. Relapse incidence remains the major problem, and strategies to prevent it are currently under investigation (eg, post-transplantation maintenance). The selection of patients aged ≥60 could be improved by combining HCT-CI and frailty assessment to better predict NRM.
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Affiliation(s)
- Michele Malagola
- Blood Diseases and Cell Therapies Unit, Bone Marrow Transplant Unit, "ASST-Spedali Civili" Hospital of Brescia; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
| | - Nicola Polverelli
- Blood Diseases and Cell Therapies Unit, Bone Marrow Transplant Unit, "ASST-Spedali Civili" Hospital of Brescia; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Vicky Rubini
- Blood Diseases and Cell Therapies Unit, Bone Marrow Transplant Unit, "ASST-Spedali Civili" Hospital of Brescia; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Massimo Martino
- Stem Cell Transplant and Cellular Therapies Unit, "BMM" Hospital, Reggio Calabria, Italy
| | - Francesca Patriarca
- Hematologic Clinic and Transplant Center, University Hospital of Central Friuli, DAME, University of Udine, Udine, Italy
| | - Benedetto Bruno
- Department of Oncology, SSD Allogeneic Stem Cell Transplantation, "Città della Salute e della Scienza", Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Turin, Turin, Italy
| | - Luisa Giaccone
- Department of Oncology, SSD Allogeneic Stem Cell Transplantation, "Città della Salute e della Scienza", Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Turin, Turin, Italy
| | - Giovanni Grillo
- Division of Hematology and Marrow Transplant, Niguarda Hospital, Milan, Italy
| | | | - Paolo Bernasconi
- Transplant Center, Unit of Hematology, Foundation IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marco De Gobbi
- Department of Clinical and Biological Sciences, University of Turin, Internal Medicine and Hematology Division, San Luigi University Hospital - Orbassano (Turin), Italy
| | - Annalisa Natale
- Hematologic Intensive Care, Pescara Hospital, Pescara, Italy
| | | | - Attilio Olivieri
- Haematology Clinic, "Ospedali Riuniti," University Hospital of Ancona, Ancona, Italy
| | - Patrizia Chiusolo
- Department of Medical Imaging, Radiotherapy, Oncology, and Hematology, "A. Gemelli IRCCS" University Teaching Hospital Foundation, Hematology Division, Department of Radiological and Hematological Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Angelo Michele Carella
- SSD Hematologic Intensive Care and Cell Therapy Unit; Department of Medical Sciences, "Casa Sollievo della Sofferenza" Foundation, San Giovanni Rotondo, Italy
| | - Marco Casini
- Hematology and Bone Marrow Transplantation, Bolzano Hospital, Bolzano, Italy
| | - Chiara Nozzoli
- Cell Therapy and Ttransfusion Medicine, "Careggi" University Hospital, Florence, Italy
| | - Patrizio Mazza
- PO San Giuseppe Moscati, Department of Hematology with Transplant Division, ASL Taranto, Italy
| | - Simona Bassi
- Hematology Unit, "G. da Saliceto" Hospital, Piacenza, Italy
| | - Francesco Onida
- IRCCS Foundation "Ospedale Maggiore Ca' Granda Policlinico," University of Milan, Milan, Italy
| | - Adriana Vacca
- Hematology Unit, CTMO PO, "A. Businco", ARNAS Brotzu, Cagliari, Italy
| | - Sadia Falcioni
- Unit of Hematology and Cellular Therapy, "C. e G. Mazzoni" Hospital, Ascoli Piceno, Italy
| | - Mario Luppi
- Department of Medical and Surgical Sciences, UNIMORE, Division of Hematology, Azienda Ospedaliera Universitaria di Modena, Modena, Italy
| | - Anna Paola Iori
- Department of Hematology, Oncology, and Dermatology, "Umberto I" University Hospital, Roma Sapienza University, Rome, Italy
| | - Vincenzo Pavone
- Department of Hematology and Bone Marrow Transplantation, "Card. G. Panico" Hospital, Tricase, Italy
| | - Cristina Skert
- Unit of Hematology/Bone Marrow Transplantation, Unit "Ospedale dell'Angelo" Venice, Mestre, Italy
| | - Paola Carluccio
- Hematology and Stem Cell Transplantation Unit, Department of Emergency and Organ Transplantation, "Aldo Moro" University of Bari, Bari, Italy
| | - Carlo Borghero
- Hematology Department, "San Bortolo" Hospital, Vicenza, Italy
| | - Anna Proia
- Unit of Hematology and Stem Cell Transplant Center, "San Camillo" Hospital, Rome, Italy
| | - Carmine Selleri
- "San Giovanni di Dio e Ruggi d'Aragona" University Hospital, Salerno, Italy
| | - Nicoletta Sacchi
- Italian Bone Marrow Donor Registry, E. O. Galliera Hospitals, Genoa, Italy
| | | | - Elena Oldani
- Hematology Unit, "ASST Papa Giovanni XXIII," Bergamo, Italy
| | - Fabio Ciceri
- Department of Onco-Hematology, Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Milan, Italy
| | - Domenico Russo
- Blood Diseases and Cell Therapies Unit, Bone Marrow Transplant Unit, "ASST-Spedali Civili" Hospital of Brescia; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
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23
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Morabito F, Zamagni E, Conticello C, Pavone V, Palmieri S, Bringhen S, Galli M, Mangiacavalli S, Derudas D, Rossi E, Ria R, Catalano L, Tacchetti P, Mele G, Donatella Vincelli I, Antonia Martino E, Vigna E, Botta C, Bruzzese A, Mele A, Pantani L, Rocchi S, Garibaldi B, Cascavilla N, Ballanti S, Tripepi G, Frigeri F, Pia Falcone A, Cangialosi C, Reddiconto G, Farina G, Barone M, Rizzello I, Musto P, De Stefano V, Musso M, Teresa Petrucci M, Offidani M, Neri A, Di Renzo N, Di Raimondo F, Boccadoro M, Cavo M, Gentile M. Adjusted comparison between elotuzumab and carfilzomib in combination with lenalidomide and dexamethasone as salvage therapy for multiple myeloma patients. Eur J Haematol 2021; 108:178-189. [PMID: 34716957 DOI: 10.1111/ejh.13723] [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] [Received: 06/08/2021] [Revised: 10/16/2021] [Accepted: 10/25/2021] [Indexed: 11/29/2022]
Abstract
The lack of a randomized trial comparing carfilzomib (K) versus elotuzumab (Elo) associated with lenalidomide and dexamethasone (Rd) prompted us to assess the relative usefulness of one triplet over the other. Five independent retrospective cohorts of 883 relapsed/refractory multiple myeloma (RRMM) patients, including 300 EloRd and 583 KRd cases, outside clinical trials, entered this non-randomized comparison. KRd cohort accounted for a higher incidence of younger patients, cases with ≥3 lines of therapy, already exposed to lenalidomide, International Staging System (ISS) stage III, and abnormal lactic dehydrogenase (LDH) level compared with EloRd cohort. Moreover, cytogenetic risk categories, detected in roughly one-third of cases, were equally distributed between the two therapy arms. The probability of CR+VGPR response was significantly higher in KRd (n = 314, 53.9%) than in EloRd patients (n = 111, 37.0%). Likewise, the cumulative incidence function of CR+VGPR, taking into account the competitive risk of death, was significantly higher in KRd arm patients than those in the EloRd arm (p = .003). Moreover, KRd treatment significantly reduced the progression or death risk by 46% in an adjusted multivariate analysis (HR: 0.54, 95% CI 0.42-0.69, p < .0001). Finally, in an adjusted illness-progression/death model, the effect of KRd versus EloRd was of higher magnitude among those who achieved CR+VGPR (-39% hazard ratio reduction, p = .02) than among those who achieved < VGPR (-29% hazard ratio reduction, p = .007). With limitations characteristic to any retrospective analysis, this current clinical practice study's overall results demonstrated potential benefits of KRd therapy compared with EloRd. This observation may help the daily clinical practice.
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Affiliation(s)
- Fortunato Morabito
- Biothecnology Research Unit, AO of Cosenza, Cosenza, Italy.,Hematology and Bone Marrow Transplant Unit, Hemato-Oncology Department, Augusta Victoria Hospital, East Jerusalem, Israel
| | - Elena Zamagni
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy.,Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Concetta Conticello
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, Catania, Italy
| | - Vincenzo Pavone
- Department of Hematology and Bone Marrow Transplant, Hospital Card. G. Panico, Tricase (LE), Italy
| | | | - Sara Bringhen
- Division of Hematology, University of Torino, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Monica Galli
- Hematology and Bone Marrow Transplant Unit, Azienda Socio-Sanitaria Territoriale-Papa Giovanni XXIII, Bergamo, Italy
| | - Silvia Mangiacavalli
- Hematology Division, Department of Hematology-Oncology, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | | | - Elena Rossi
- Istituto di Ematologia, Università Cattolica, Fondazione Policlinico Gemelli IRCCS, Roma, Italy
| | - Roberto Ria
- Department of Biomedical Science, University of Bari "Aldo Moro" Medical School, Internal Medicine "G. Baccelli", Policlinico, Bari, Italy
| | | | - Paola Tacchetti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Giuseppe Mele
- Department of Hematology, Hospital Perrino, Brindisi, Italy
| | - Iolanda Donatella Vincelli
- Hematology Unit, Department of Hemato-Oncology and Radiotherapy, Great Metropolitan Hospital "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | | | | | | | | | - Anna Mele
- Department of Hematology and Bone Marrow Transplant, Hospital Card. G. Panico, Tricase (LE), Italy
| | - Lucia Pantani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Serena Rocchi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy.,Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Bruno Garibaldi
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, Catania, Italy
| | - Nicola Cascavilla
- Department of Hematology and Bone Marrow Transplant, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Stelvio Ballanti
- Institute of Haematology and Stem Cell transplantation, Ospedale Santa Maria della Misericordia, University of Perugia, Perugia, Italy
| | - Giovanni Tripepi
- Nephrology Center of National Research Institute of Biomedicine and Molecular Immunology, Reggio Calabria, Italy
| | - Ferdinando Frigeri
- UOC Ematologia a Indirizzo Oncologico, AORN "Sant'Anna e San Sebastiano", Caserta, Italy
| | - Antonetta Pia Falcone
- Department of Hematology and Bone Marrow Transplant, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Clotilde Cangialosi
- U.O.C. Ematologia A. O. Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy
| | | | - Giuliana Farina
- UOC Ematologia a Indirizzo Oncologico, AORN "Sant'Anna e San Sebastiano", Caserta, Italy
| | | | - Ilaria Rizzello
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy.,Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | | | - Valerio De Stefano
- Istituto di Ematologia, Università Cattolica, Fondazione Policlinico Gemelli IRCCS, Roma, Italy
| | - Maurizio Musso
- U.O.C. OncoEmatologia e TMO, Dipartimento Oncologico, La Maddalena, Palermo, Italy
| | - Maria Teresa Petrucci
- Department of Cellular Biotechnologies and Hematology, Sapienza University of Rome, Rome, Italy
| | | | - Antonino Neri
- Hematology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Francesco Di Raimondo
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, Catania, Italy
| | - Mario Boccadoro
- Division of Hematology, University of Torino, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy.,Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
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24
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Luminari S, Manni M, Galimberti S, Versari A, Tucci A, Boccomini C, Farina L, Olivieri J, Marcheselli L, Guerra L, Ferrero S, Arcaini L, Cavallo F, Kovalchuk S, Skrypets T, Del Giudice I, Chauvie S, Patti C, Stelitano C, Ricci F, Pinto A, Margiotta Casaluci G, Zilioli VR, Merli A, Ladetto M, Bolis S, Pavone V, Chiarenza A, Arcari A, Anastasia A, Dondi A, Mannina D, Federico M. Response-Adapted Postinduction Strategy in Patients With Advanced-Stage Follicular Lymphoma: The FOLL12 Study. J Clin Oncol 2021; 40:729-739. [PMID: 34709880 DOI: 10.1200/jco.21.01234] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
PURPOSE We compared 2 years of rituximab maintenance (RM) with a response-adapted postinduction approach in patients with follicular lymphoma who responded to induction immunochemotherapy. METHODS We randomly assigned treatment-naïve, advanced-stage, high-tumor burden follicular lymphoma patients to receive standard RM or a response-adapted postinduction approach on the basis of metabolic response and molecular assessment of minimal residual disease (MRD). The experimental arm used three types of postinduction therapies: for complete metabolic response (CMR) and MRD-negative patients, observation; for CMR and MRD-positive (end of induction or follow-up) patients, four doses of rituximab (one per week, maximum three courses) until MRD-negative; and for non-CMR patients, one dose of ibritumomab tiuxetan followed by standard RM. The study was designed as noninferiority trial with progression-free survival (PFS) as the primary end point. RESULTS Overall, 807 patients were randomly assigned. After a median follow-up of 53 months (range 1-92 months), patients in the standard arm had a significantly better PFS than those in the experimental arm (3-year PFS 86% v 72%; P < .001). The better PFS of the standard vs experimental arm was confirmed in all the study subgroups except non-CMR patients (n = 65; P = .274). The 3-year overall survival was 98% (95% CI, 96 to 99) and 97% (95% CI, 95 to 99) in the reference and experimental arms, respectively (P = .238). CONCLUSION A metabolic and molecular response-adapted therapy as assessed in the FOLL12 study was associated with significantly inferior PFS compared with 2-year RM. The better efficacy of standard RM was confirmed in the subgroup analysis and particularly for patients achieving both CMR and MRD-negative.
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Affiliation(s)
- 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.,Azienda Unitа Sanitaria Locale-IRCCS, Arcispedale Santa Maria Nuova-Ematologia, Reggio Emilia, 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
| | - Sara Galimberti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Annibale Versari
- Nuclear Medicine Division, Azienda USL IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | | | - Carola Boccomini
- A.O.U. Città della Salute e della Scienza di Torino-SC Ematologia, Torino, Italy
| | - Lucia Farina
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Division of Hematology, Milano, Italy
| | - Jacopo Olivieri
- Azienda Sanitaria Universitaria Friuli Centrale (ASU FC), SOC Clinica Ematologica, Udine, Italy
| | | | - Luca Guerra
- School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy.,Nuclear Medicine, San Gerardo Hospital, ASST Monza, Italy
| | - Simone Ferrero
- A.O.U. Città della Salute e della Scienza di Torino, Ematologia Universitaria, Torino, Italy
| | - Luca Arcaini
- IRCCS Policlinico S. Matteo di Pavia, Div di Ematologia, Pavia, Italy
| | - Federica Cavallo
- A.O.U. Città della Salute e della Scienza di Torino, Ematologia Universitaria, Torino, Italy
| | - Sofya Kovalchuk
- Azienda Ospedaliera Universitaria Careggi, Unità funzionale di Ematologia, Firenze, Italy
| | - Tetiana Skrypets
- Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy.,Clinical and Experimental Medicine (CEM), University of Modena and Reggio Emilia, Modena, Italy
| | - Ilaria Del Giudice
- Policlinico Umberto I, Università "La Sapienza," Istituto Ematologia, Dipartimento di Medicina Traslazionale e di Precisione, Roma, Italy
| | - Stephane Chauvie
- Medical Physics Division, Santa Croce e Carle Hospital, Cuneo, Italy
| | - Caterina Patti
- A.O. Ospedali Riuniti Villa Sofia-Cervello, Div di Ematologia, Palermo, Italy
| | - Caterina Stelitano
- Grande Ospedale Metropolitano Bianchi Melacrino Morelli-Ematologia, Reggio Calabria, Italy
| | | | - Antonello Pinto
- Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, UOC Ematologia Oncologica, Napoli, Italy
| | | | - Vittorio R Zilioli
- ASST Grande Ospedale Metropolitano Niguarda, SC Ematologia, Milano, Italy
| | - Anna Merli
- Ospedale degli Infermi di Rimini, U.O. di Ematologia, Rimini, Italy
| | - Marco Ladetto
- Dipartimento di Medicina Traslazionale Università del Piemonte Orientale, Alessandria, Italy.,SC Ematologia, AO SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | | | - Vincenzo Pavone
- A.O. C. Panico, U.O.C Ematologia e Trapianto, Tricase, Italy
| | - Annalisa Chiarenza
- A.O.O. Policlinico "G. Rodolico-S. Marco," U.O.C. Ematologia, Catania, Italy
| | - Annalisa Arcari
- Ospedale Guglielmo da Saliceto, U.O.Ematologia, Piacenza, Italy
| | | | | | - Donato Mannina
- Azienda Ospedaliera Papardo-UOC di Ematologia, Messina, 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
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25
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Massaro F, Pavone V, Stefani PM, Botto B, Pulsoni A, Patti C, Cantonetti M, Visentin A, Scalzulli PR, Rossi A, Galimberti S, Cimminiello M, Gini G, Musso M, Sorio M, Arcari A, Zilioli VR, Luppi M, Mannina D, Fabbri A, Pietrantuono G, Annibali O, Tafuri A, Prete E, Mulè A, Barbolini E, Marcheselli L, Luminari S, Merli F. Brentuximab vedotin consolidation after autologous stem cell transplantation for Hodgkin lymphoma: A Fondazione Italiana Linfomi real-life experience. Hematol Oncol 2021; 40:31-39. [PMID: 34694649 PMCID: PMC9298220 DOI: 10.1002/hon.2939] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 08/31/2021] [Revised: 10/17/2021] [Accepted: 10/18/2021] [Indexed: 11/09/2022]
Abstract
The standard management for relapsed or refractory classical Hodgkin lymphoma (cHL) is salvage therapy followed by autologous stem cell transplantation (ASCT). This strategy allows almost 50% of patients to be cured. Post-ASCT maintenance treatment with brentuximab vedotin (BV) confers improved progression-free survival (PFS) to cHL patients at high risk of relapse. We investigated the outcome of 105 cHL patients receiving post-ASCT BV maintenance in the real-life setting of 23 Italian hematology centers. This population included naïve patients and those previously exposed to BV. Median follow-up was 20 months. Patients presented a median of two lines of treatment pre-ASCT, with 51% receiving BV. Twenty-nine percent of patients had at least two high-risk factors (refractory disease, complete response [CR] less than 12 months, extranodal disease at relapse), while 16% presented none. At PET-CT, a Deauville score (DS) of 1-3 was reported in 75% and 78% of pre- and post-ASCT evaluations, respectively. Grade 3-4 adverse events (AEs), mainly peripheral neuropathy, were observed in 16% of patients. Three-year PFS and overall survival (OS) were 62% and 86%, respectively. According to BV exposure, 3-year PFS and OS were 54% and 71%, respectively, for naïve and 77% and 96%, respectively, for previously exposed patients. Refractory disease (hazard ratio [HR] 4.46; p = 0.003) and post-ASCT DS 4-5 (HR 3.14; p = 0.005) were the only two factors significantly associated with PFS reduction in multivariable analysis. Post-ASCT BV maintenance is an effective, safe treatment option for cHL naïve patients and those previously exposed to BV.
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Affiliation(s)
- Fulvio Massaro
- PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy.,Hematology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Vincenzo Pavone
- Department of Hematology and Bone Marrow Transplant, Hospital Card. G. Panico, Tricase, Italy
| | | | - Barbara Botto
- Division of Hematology, Città della Salute e della Scienza Hospital and University, Torino, Italy
| | - Alessandro Pulsoni
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Caterina Patti
- Division of Onco-Hematology, Azienda Villa Sofia-Cervello, Palermo, Italy
| | - Maria Cantonetti
- Unit of Lymphoproliferative Disorders, Policlinico Tor Vergata, Rome, Italy
| | - Andrea Visentin
- Hematology and Clinical Immunology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | | | - Andrea Rossi
- Hematology, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | - Sara Galimberti
- Division of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | | | - Guido Gini
- Division of Hematology, Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy
| | - Maurizio Musso
- Department of Oncology, Hematology and BMT Unit, Casa di Cura La Maddalena, Palermo, Italy
| | - Marco Sorio
- Department of Clinical and Experimental Medicine, Hematology and Bone Marrow Transplant Unit, University of Verona, Verona, Italy
| | - Annalisa Arcari
- Hematology Unit, Ospedale Guglielmo da Saliceto, Piacenza, Italy
| | | | - Mario Luppi
- Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Donato Mannina
- Unit of Haematology, Azienda Ospedaliera Papardo, Messina, Italy
| | - Alberto Fabbri
- Hematology, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
| | - Giuseppe Pietrantuono
- Hematology and Stem Cell Transplantation Unit, IRCCS Centro di Riferimento Oncologico della Basilicata, Rionero in Vulture, Italy
| | - Ombretta Annibali
- Unit of Haematology and Stem Cell Transplantation, Campus Bio-Medico University, Rome, Italy
| | - Agostino Tafuri
- Department of Clinical and Molecular Medicine and Hematology, Sant'Andrea - University Hospital - Sapienza, University of Rome, Rome, Italy
| | - Eleonora Prete
- Department of Hematology and Bone Marrow Transplant, Hospital Card. G. Panico, Tricase, Italy
| | - Antonino Mulè
- Division of Onco-Hematology, Azienda Villa Sofia-Cervello, Palermo, Italy
| | - Elisa Barbolini
- Gruppo Amici dell'Ematologia GRADE-Onlus Foundation, Reggio Emilia, Italy
| | | | - Stefano Luminari
- Hematology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Merli
- Hematology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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26
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D’Agostino M, Belotti A, Zamagni E, Auclair D, Zambello R, Arigoni M, Spadano A, Cea M, Pescosta N, Ronconi S, Olivero M, Musolino C, Genuardi E, Molica S, Pavone V, Patriarca F, Fabritiis PD, Gamberi B, Calogero RA, Offidani M, Galli M, Musto P, Boccadoro M, Gay F. OAB-055: Gain and amplification of 1q induce transcriptome deregulation and worsen the outcome of newly diagnosed Multiple Myeloma patients. Clinical Lymphoma Myeloma and Leukemia 2021. [DOI: 10.1016/s2152-2650(21)02127-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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27
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Moretti M, Liberati AM, Rigacci L, Puccini B, Pulsoni A, Gini G, Galieni P, Fabbri A, Cantonetti M, Pavone V, Bolis S, Botto B, Renzi D, Falchi L. Brentuximab Vedotin and Bendamustine Produce Long-Term Clinical Benefit in Patients With Relapsed or Refractory Classical Hodgkin Lymphoma: A Multicenter Real-Life Experience. Clin Lymphoma Myeloma Leuk 2021; 22:198-204. [PMID: 34690088 PMCID: PMC9531864 DOI: 10.1016/j.clml.2021.09.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 09/24/2021] [Indexed: 12/02/2022]
Abstract
In the real-life setting, the combination of brentuximab vedotin and bendamustine was well tolerated and produced an ORR of 75%, CR 50% and a median PFS of 26 months. A significant proportion of heavily pretreated cHL patients may be cured with this approach.
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Affiliation(s)
| | | | - Luigi Rigacci
- Hematology and Stem Cell Transplant, AziendaOspedalieraSan Camillo Forlanini Roma
| | - Benedetta Puccini
- Hematology Department, Azienda Ospedaliero Universitaria Careggi, Firenze
| | - Alessandro Pulsoni
- Hematology Unit, Department of Translational and Precision Medicine, Sapienza University of Roma
| | - Guido Gini
- HematologyDepartment, Azienda Ospedaliero Universitaria Ospedali Riuniti di Ancona Politecnica delle Marche
| | - Piero Galieni
- Hematology and Cell Therapy Unit, Ospedale C. e G. Mazzoni Ascoli Piceno
| | - Alberto Fabbri
- Hematology Unit, Azienda Ospedaliero Universitaria Senese
| | - Maria Cantonetti
- Onco-Hematology Department, Policlinico Ospedaliero Universitario "Tor Vergata" Roma
| | - Vincenzo Pavone
- Hematology and Bone Marrow Transplant, Azienda Ospedaliera Cardinale G. Panico Tricase
| | - Silvia Bolis
- Hematology Department, Azienda Ospedaliera San Gerardo Monza
| | - Barbara Botto
- Hematology Department, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza Torino
| | - Daniela Renzi
- Hematology and Stem Cell Transplantation Unit, IRCCS Istituto Nazionale Tumori Regina Elena Roma
| | - Lorenzo Falchi
- Lymphoma service, Memorial Sloan Kettering Cancer Center, New York.
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28
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Guglielmelli P, Palandri F, Selleri C, Cilloni D, Mendicino F, Mazza P, Pastore D, Palumbo GA, Santoro M, Pavone V, Impera S, Morelli M, Coco P, Valsecchi D, Passamonti F, Breccia M. Adherence to ruxolitinib, an oral JAK1/2 inhibitor, in patients with myelofibrosis: interim analysis from an Italian, prospective cohort study (ROMEI). Leuk Lymphoma 2021; 63:189-198. [PMID: 34521299 DOI: 10.1080/10428194.2021.1969388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
ROMEI, a prospective, observational study in patients with myelofibrosis receiving the oral JAK1/2 inhibitor ruxolitinib in real-world practice, assesses treatment adherence based on the 8-item Morisky Medication Adherence Scale (MMAS-8). Here, we present MMAS-8 results at week 24. Overall, 101 of 188 evaluable patients completed the questionnaire at every visit (full completers). Mean (±standard deviation) total MMAS-8 scores remained stable from week 4 to week 24 in the overall population (7.54 ± 0.77 and 7.67 ± 0.70, respectively) and full completers (7.53 ± 0.79 and 7.67 ± 0.73, respectively). Rates of low (MMAS-8 ˂6) or medium (MMAS-8 ≥ 6 to ˂8) adherence were 25-40% and 26-36%, respectively. Fifty-five full completers (54%) reported ≥1 change in adherence category (improvement and/or worsening), most of which were associated with unintentional behavior. The data suggest that one-third of patients receiving ruxolitinib may be undertreated due to non-adherence, potentially undermining disease control, and indicate a need for better interventions addressing noncompliance to oral therapies.
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Affiliation(s)
- Paola Guglielmelli
- CRIMM, Center for Research and Innovation of Myeloproliferative Neoplasms, AOU Careggi, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Francesca Palandri
- Policlinico S.Orsola-Malpighi, Dipartimento di Oncologia e di Ematologia, Azienda Ospedaliero-Universitaria di Bologna, IRCCS Istituto di Ricovero e Cura a Carattere Scientifico, Bologna, Italy
| | - Carmine Selleri
- UOC di Ematologia e Trapianti di Cellule Staminali Emopoietiche, Dipartimento di Medicina, Università di Salerno, AOU San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy
| | - Daniela Cilloni
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | | | - Patrizio Mazza
- C/O Ospedale Moscati, Department of Hematology-Oncology, Taranto, Italy
| | | | - Giuseppe A Palumbo
- Dipartimento di Scienze Mediche Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", Unità Operativa di Ematologia con TMO AOU "Policlinico - San Marco", Università degli Studi di Catania, Catania, Italy
| | - Marco Santoro
- Dipartimento di Chirurgia, Stomatologia e Oncologia Sperimentale (DiChirOnS), Università degli Studi di Palermo, Palermo, Italy
| | | | | | - Mara Morelli
- Novartis Oncology, Novartis Farma SpA, Varese, Italy
| | - Paola Coco
- Novartis Oncology, Novartis Farma SpA, Varese, Italy
| | | | - Francesco Passamonti
- Università degli Studi dell'Insubria, Ospedale di Circolo - ASST Sette Laghi, Varese, Italy
| | - Massimo Breccia
- Hematology, Department of Translational and Precision Medicine, Azienda Policlinico Umberto I, Sapienza University, Rome, Italy
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29
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Makieva S, Scotti GM, Lazarevic D, Giacomini E, Ottolina J, Bartiromo L, Schimberni M, Alteri A, Pavone V, Minetto S, Papaleo E, Morelli M, Tonon G, Viganò P. P-240 Human extracellular vesicles (EVs) secreted by aneuploid embryos potentiate development of non-invasive PGT-A RNA biomarkers and stimulate MUC1 up-regulation in primary endometrial stromal cells (ESCs). Hum Reprod 2021. [DOI: 10.1093/humrep/deab127.067] [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: 11/14/2022] Open
Abstract
Abstract
Study question
Could EVs secreted by aneuploid embryos a) serve for development of RNA biomarkers for PGT-A and b) elicit a relevant transcriptomic response in decidualised ESCs?
Summary answer
Aneuploid embryo EVs a) contain PPM1J, LINC00561, ANKRD34C and TMED10 in differential abundance from euploid EVs and b) induce up-regulation of MUC1 in decidualised ESCs.
What is known already
Embryo aneuploidy accounts for approximately 50% of all recurrent implantation failures in women >35 years old. PGT-A identifies euploid embryos to increase implantation probability but the technology is controversial as it requires an invasive embryo biopsy with an elusive long-term biosafety. The development of non-invasive methods to screen out aneuploid embryos is paramount. It is also critical to decode the embryo-endometrial dialog underlying implantation failure. We have previously reported that IVF embryos secrete EVs that can be internalised by ESCs, conceptualising that successful implantation to the endometrium is facilitated by EVs, which may additionally serve as biomarkers of ploidy status.
Study design, size, duration
Embryos destined for biopsy on days 5-7 for PGT-A were grown under standard conditions. Spent media (30μl) were collected from euploid (n = 175) and aneuploid embryos (n = 145) at both cleavage (days 1-3) and blastocyst (days 3-5) stage. Media samples from n = 35 cleavage embryos were pooled in order to obtain five euploid and four aneuploidy pools. Blastocyst media were pooled to create one euploid and one aneuploid pool. ESCs were obtained from five women undergoing diagnostic laparoscopy.
Participants/materials, setting, methods
The study was realised at a research hospital. EVs were isolated from euploid and aneuploid Day3 pools with differential ultracentrifugation and EV-RNA sequencing was performed following the SMARTer Stranded Total RNA-Seq approach. ESCs were decidualised (E2:10nM, P4:1uM, cAMP:0.5 mM twice every 48 hours) and treated for 24 hours with 50 ng/ml euploid or aneuploid EVs extracted from blastocyst media. RNA sequencing was performed on ESCs following the Truseq RNAseq protocol.
Main results and the role of chance
Aneuploid cleavage stage embryos (n = 4) secreted EVs that were less abundant in RNA fragments originating from the genes PPM1J (log2fc=-5.13, p = 0.011), LINC00561 (log2fc=-7.87, p = 0.010) and ANKRD34C (log2fc=-7.30, p = 0.017) and more abundant in TMED10 (log2fc=1.63 p = 0.025) compared to EVs (n = 5) from euploid embryos. Decidualisation per se induced downregulation of MUC1 (log2FC=-0.54, p = 0.0028) in ESCs as prerequisite for the establishment of receptive endometrium. The expression of MUC1 transcript in decidualised ESCs was significantly increased following treatment with aneuploid compared to euploid embryo-secreted EVs (log2FC=0.85, p = 0.0201).
Limitations, reasons for caution
The findings of the study may require validation utilising a second cohort of EVs samples.
Wider implications of the findings
This discovery that the RNA cargo of EVs secreted from aneuploid cleavage stage embryos is diverse from that of euploid embryos potentiates the development of non-invasive methodology for PGT-A. The upregulation of MUC1 in decidualised ESCs following aneuploid embryo EV treatment proposes a new mechanism underlying implantation failure.
Trial registration number
NA
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Affiliation(s)
- S Makieva
- IRCCS San Raffaele Scientific Institute, Reproductive Sciences Laboratory, Milan, Italy
| | - G M Scotti
- IRCCS San Raffaele Scientific Institute, Center for Omics Sciences, Milan, Italy
| | - D Lazarevic
- IRCCS San Raffaele Scientific Institute, Center for Omics Sciences, Milan, Italy
| | - E Giacomini
- IRCCS San Raffaele Scientific Institute, Reproductive Sciences Laboratory, Milan, Italy
| | - J Ottolina
- IRCCS San Raffaele Scientific Institute, Centro Scienze della Natalità, Milan, Italy
| | - L Bartiromo
- IRCCS San Raffaele Scientific Institute, Department of Obstetrics and Gynecology, Milan, Italy
| | - M Schimberni
- IRCCS San Raffaele Scientific Institute, Department of Obstetrics and Gynecology, Milan, Italy
| | - A Alteri
- IRCCS San Raffaele Scientific Institute, Centro Scienze della Natalità, Milan, Italy
| | - V Pavone
- IRCCS San Raffaele Scientific Institute, Reproductive Sciences Laboratory, Milan, Italy
| | - S Minetto
- IRCCS San Raffaele Scientific Institute, Centro Scienze della Natalità, Milan, Italy
| | - E Papaleo
- IRCCS San Raffaele Scientific Institute, Centro Scienze della Natalità, Milan, Italy
| | - M Morelli
- IRCCS San Raffaele Scientific Institute, Center for Omics Sciences, Milan, Italy
| | - G Tonon
- IRCCS San Raffaele Scientific Institute, Center for Omics Sciences, Milan, Italy
| | - P Viganò
- IRCCS San Raffaele Scientific Institute, Reproductive Sciences Laboratory, Milan, Italy
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30
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Jacxsens L, Coveney C, Culley L, Herbrand C, Lafuente-Funes S, Pavone V, Pennings G, Weis C, Hudson N, Provoost V. O-097 The presentation of medical risks and incentives in egg donation: an analysis of Belgian, Spanish and UK fertility clinic websites. Hum Reprod 2021. [DOI: 10.1093/humrep/deab125.033] [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: 11/12/2022] Open
Abstract
Abstract
Study question
How do fertility clinics’ websites of the UK, Belgium and Spain present the medical risks of egg donation and incentives?
Summary answer
Spanish and UK websites typically included more incentives to recruit egg donors compared to the Belgian websites. OHSS was overall the most discussed risk.
What is known already
People commonly turn to the internet for initial information. Primary presentations of information of a subject co-determine how an individual interprets the topic and thus influence later decisions. Considering the growing demand and clinics’ dependency on egg donors, some scholars have expressed concerns that clinics might (initially) misrepresent risks to recruit more egg donors. Offering appealing incentives may also encourage potential donors to dismiss possible risks and side-effects.
Therefore, it is important to see how incentives (both monetary and non-monetary rewards) and risks are presented on the websites of fertility clinics, the first source of information for egg donors.
Study design, size, duration
This study is part of the EDNA-project, a multi-phased comparative study (2017-2021), that aims to explore the social, political, economic and moral configuration of egg donation in the United Kingdom, Belgium and Spain. In this study, we only focused on the medical risks of egg donation and incentives presented on the fertility clinics’ websites of the three countries.
Participants/materials, setting, methods
We analysed the websites of all Belgian fertility clinics (n = 18), and a maximum variation sample in the UK (n = 21) and Spain (n = 23). The sampling was based on the geographical location of the clinic, size/number of cycles performed each year, the clinic’s status (independent or part of a larger clinical group) and whether the clinic was public or privately funded in the UK. Frame analysis and content analysis were used for analysis in Nvivo12.
Main results and the role of chance
No misrepresentation of risks was found. There was an extensive variety in the representation of risks. There were differences between the websites of the three countries (e.g. the risks of having acne was only discussed on Spanish websites), but also remarkable differences within the websites of a particular country (of the 40 risks, 13 were one-off mentions, each found on a single website). A description of a risk was generally accompanied by a minimization or normalization of the risk, or a statement about the fertility clinic’s excellent care for their egg donors. These three approaches were often combined.
Our analysis differentiated between incentives (i.e. external rewards) and emotional appeals. An appeal to emotions (e.g. empathy) can also motivate behavioural action (e.g. donation) but was not considered as an incentive since there is no external reward.
While Belgian websites used almost no incentives, Spanish and UK websites used gratitude and a rewarding experience as incentives. However, only Spanish websites used free medical tests as incentives, while UK websites were the only ones that used discounts received with egg sharing as an incentive. All countries’ websites used emotional appeals by enticing feelings of empathy for the recipients.
Limitations, reasons for caution
Not all UK and Spanish fertility clinics’ websites were analysed. However, our international team of researchers applied a maximum variation sampling strategy. This generated samples of clinics per country that were as diversified as possible.
Wider implications of the findings
The study shows that incentives are more often used on the UK and Spanish websites than on the Belgian websites. All three countries’ websites used emotional appeals. It should be studied how effective these incentives and emotional appeals are, and if there is a correlation with the potential donors’ risk-perceptions.
Trial registration number
not applicable
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Affiliation(s)
- L Jacxsens
- UGent, Bioethics Institute Ghent, Ghent, Belgium
| | - C Coveney
- Loughborough University, Social and Policy Studies- School of Social Sciences and Humanities, Loughborough, United Kingdom
| | - L Culley
- De Montfort University, Centre for Reproduction Research, Leicester, United Kingdom
| | - C Herbrand
- De Montfort University, Centre for Reproduction Research, Leicester, United Kingdom
| | - S Lafuente-Funes
- Goethe-Universität Frankfurt am Main, Institut für Soziologie, Frankfurt am Main, Germany
| | - V Pavone
- Consejo Superior de Investigaciones Cientificas, Institute of Public Goods and Policies, Madrid, Spain
| | - G Pennings
- UGent, Bioethics Institute Ghent, Ghent, Belgium
| | - C Weis
- De Montfort University, Centre for Reproduction Research, Leicester, United Kingdom
| | - N Hudson
- De Montfort University, Centre for Reproduction Research, Leicester, United Kingdom
| | - V Provoost
- UGent, Bioethics Institute Ghent, Ghent, Belgium
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31
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Makieva S, Scotti GM, Lazarevic D, Giacomini E, Ottolina J, Bartiromo L, Schimberni M, Alteri A, Pavone V, Minetto S, Papaleo E, Morelli M, Tonon G, Viganò P. P–240 Human extracellular vesicles (EVs) secreted by aneuploid embryos potentiate development of non-invasive PGT-A RNA biomarkers and stimulate MUC1 up-regulation in primary endometrial stromal cells (ESCs). Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Could EVs secreted by aneuploid embryos a) serve for development of RNA biomarkers for PGT-A and b) elicit a relevant transcriptomic response in decidualised ESCs?
Summary answer
Aneuploid embryo EVs a) contain PPM1J, LINC00561, ANKRD34C and TMED10 in differential abundance from euploid EVs and b) induce up-regulation of MUC1 in decidualised ESCs.
What is known already
Embryo aneuploidy accounts for approximately 50% of all recurrent implantation failures in women >35 years old. PGT-A identifies euploid embryos to increase implantation probability but the technology is controversial as it requires an invasive embryo biopsy with an elusive long-term biosafety. The development of non-invasive methods to screen out aneuploid embryos is paramount. It is also critical to decode the embryo-endometrial dialog underlying implantation failure. We have previously reported that IVF embryos secrete EVs that can be internalised by ESCs, conceptualising that successful implantation to the endometrium is facilitated by EVs, which may additionally serve as biomarkers of ploidy status.
Study design, size, duration
Embryos destined for biopsy on days 5–7 for PGT-A were grown under standard conditions. Spent media (30μl) were collected from euploid (n = 175) and aneuploid embryos (n = 145) at both cleavage (days 1–3) and blastocyst (days 3–5) stage. Media samples from n = 35 cleavage embryos were pooled in order to obtain five euploid and four aneuploidy pools. Blastocyst media were pooled to create one euploid and one aneuploid pool. ESCs were obtained from five women undergoing diagnostic laparoscopy.
Participants/materials, setting, methods
The study was realised at a research hospital. EVs were isolated from euploid and aneuploid Day3 pools with differential ultracentrifugation and EV-RNA sequencing was performed following the SMARTer Stranded Total RNA-Seq approach. ESCs were decidualised (E2:10nM, P4:1uM, cAMP:0.5 mM twice every 48 hours) and treated for 24 hours with 50 ng/ml euploid or aneuploid EVs extracted from blastocyst media. RNA sequencing was performed on ESCs following the Truseq RNAseq protocol.
Main results and the role of chance
Aneuploid cleavage stage embryos (n = 4) secreted EVs that were less abundant in RNA fragments originating from the genes PPM1J (log2fc=–5.13, p = 0.011), LINC00561 (log2fc=–7.87, p = 0.010) and ANKRD34C (log2fc=–7.30, p = 0.017) and more abundant in TMED10 (log2fc=1.63 p = 0.025) compared to EVs (n = 5) from euploid embryos. Decidualisation per se induced downregulation of MUC1 (log2FC=–0.54, p = 0.0028) in ESCs as prerequisite for the establishment of receptive endometrium. The expression of MUC1 transcript in decidualised ESCs was significantly increased following treatment with aneuploid compared to euploid embryo-secreted EVs (log2FC=0.85, p = 0.0201).
Limitations, reasons for caution
The findings of the study may require validation utilising a second cohort of EVs samples.
Wider implications of the findings: This discovery that the RNA cargo of EVs secreted from aneuploid cleavage stage embryos is diverse from that of euploid embryos potentiates the development of non-invasive methodology for PGT-A. The upregulation of MUC1 in decidualised ESCs following aneuploid embryo EV treatment proposes a new mechanism underlying implantation failure.
Trial registration number
NA
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Affiliation(s)
- S Makieva
- IRCCS San Raffaele Scientific Institute, Reproductive Sciences Laboratory, Milan, Italy
| | - G M Scotti
- IRCCS San Raffaele Scientific Institute, Center for Omics Sciences, Milan, Italy
| | - D Lazarevic
- IRCCS San Raffaele Scientific Institute, Center for Omics Sciences, Milan, Italy
| | - E Giacomini
- IRCCS San Raffaele Scientific Institute, Reproductive Sciences Laboratory, Milan, Italy
| | - J Ottolina
- IRCCS San Raffaele Scientific Institute, Centro Scienze della Natalità, Milan, Italy
| | - L Bartiromo
- IRCCS San Raffaele Scientific Institute, Department of Obstetrics and Gynecology, Milan, Italy
| | - M Schimberni
- IRCCS San Raffaele Scientific Institute, Department of Obstetrics and Gynecology, Milan, Italy
| | - A Alteri
- IRCCS San Raffaele Scientific Institute, Centro Scienze della Natalità, Milan, Italy
| | - V Pavone
- IRCCS San Raffaele Scientific Institute, Reproductive Sciences Laboratory, Milan, Italy
| | - S Minetto
- IRCCS San Raffaele Scientific Institute, Centro Scienze della Natalità, Milan, Italy
| | - E Papaleo
- IRCCS San Raffaele Scientific Institute, Centro Scienze della Natalità, Milan, Italy
| | - M Morelli
- IRCCS San Raffaele Scientific Institute, Center for Omics Sciences, Milan, Italy
| | - G Tonon
- IRCCS San Raffaele Scientific Institute, Center for Omics Sciences, Milan, Italy
| | - P Viganò
- IRCCS San Raffaele Scientific Institute, Reproductive Sciences Laboratory, Milan, Italy
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32
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Leone L, D’Alonzo D, Maglio O, Pavone V, Nastri F, Lombardi A. Highly Selective Indole Oxidation Catalyzed by a Mn-Containing Artificial Mini-Enzyme. ACS Catal 2021. [DOI: 10.1021/acscatal.1c01985] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Linda Leone
- Department of Chemical Sciences, University of Napoli Federico II, Via Cintia 21, Napoli 80126, Italy
| | - Daniele D’Alonzo
- Department of Chemical Sciences, University of Napoli Federico II, Via Cintia 21, Napoli 80126, Italy
| | - Ornella Maglio
- Department of Chemical Sciences, University of Napoli Federico II, Via Cintia 21, Napoli 80126, Italy
- Institute of Biostructures and Bioimages—National Research Council, Via Mezzocannone 16, Napoli 80134, Italy
| | - Vincenzo Pavone
- Department of Chemical Sciences, University of Napoli Federico II, Via Cintia 21, Napoli 80126, Italy
| | - Flavia Nastri
- Department of Chemical Sciences, University of Napoli Federico II, Via Cintia 21, Napoli 80126, Italy
| | - Angela Lombardi
- Department of Chemical Sciences, University of Napoli Federico II, Via Cintia 21, Napoli 80126, Italy
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33
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Massaro F, Pavone V, Stefani PM, Botto B, Pulsoni A, Patti C, Cantonetti M, Visentin A, Scalzulli PR, Rossi A, Galimberti S, Cimminiello M, Gini G, Musso M, Sorio M, Arcari A, Zilioli VR, Bari A, Mannina D, Fabbri A, Pietrantuono G, Annibali O, Tafuri A, Prete E, Mulè A, Barbolini E, Marcheselli L, Luminari S, Merli F. BRENTUXIMAB VEDOTIN CONSOLIDATION AFTER AUTOLOGOUS STEM CELLS TRANSPLANTATION FOR HODGKIN LYMPHOMA: A REAL‐LIFE EXPERIENCE BY FONDAZIONE ITALIANA LINFOMI (FIL). Hematol Oncol 2021. [DOI: 10.1002/hon.65_2881] [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: 11/12/2022]
Affiliation(s)
- F. Massaro
- PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia Modena Italy
| | - V. Pavone
- Department of Hematology and Bone Marrow Transplant Hospital Card. G. Panico Tricase Italy
| | - P. M. Stefani
- Hematology Unit, General Hospital Ca' Foncello Treviso Italy
| | - B. Botto
- Division of Hematology, Città della Salute e della Scienza Hospital and University Turin Italy
| | - A. Pulsoni
- Hematology Unit, Department of Translational and Precision Medicine, Sapienza University Rome Italy
| | - C. Patti
- Division of Hematology, Azienda Villa Sofia‐Cervello Palermo Italy
| | - M. Cantonetti
- Unit of Lymphoproliferative Disorders, Policlinico Tor Vergata Rome Italy
| | - A. Visentin
- Hematology and Clinical Immunology Unit, Department of Medicine (DIMED) University of Padua Padua Italy
| | - P. R. Scalzulli
- Department of Hematology Casa Sollievo della Sofferenza San Giovanni Rotondo Italy
| | - A. Rossi
- Hematology Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII Bergamo Italy
| | - S. Galimberti
- Division of Hematology, Department of Clinical and Experimental Medicine, University of Pisa Pisa Italy
| | | | - G. Gini
- Division of Hematology, Azienda Ospedaliera Universitaria Ospedali Riuniti Ancona Italy
| | - M. Musso
- Department of Oncology, Hematology and BMT Unit Casa di Cura La Maddalena Palermo Italy
| | - M. Sorio
- Department of Clinical and Experimental Medicine, Hematology and Bone Marrow Transplant Unit Verona Italy
| | - A. Arcari
- Hematology Unit, Ospedale Guglielmo da Saliceto Piacenza Italy
| | - V. R. Zilioli
- Division of Hematology ASST Grande Ospedale Metropolitano Niguarda Milan Italy
| | - A. Bari
- Dipartimento di Scienze Mediche e Chirurgiche Materno‐Infantili e dell'Adulto Università di Modena e Reggio Emilia Modena Italy
| | - D. Mannina
- Unit of Haematology Azienda Ospedaliera Papardo Messina Italy
| | - A. Fabbri
- Hematology Unit Azienda Ospedaliero‐Universitaria Senese Siena Italy
| | - G. Pietrantuono
- Hematology and Stem Cell Transplantation Unit IRCCS Centro di Riferimento Oncologico della Basilicata Rionero in Vulture Italy
| | - O. Annibali
- Unit of Haematology and Stem Cell Transplantation Campus Bio‐Medico University Rome Italy
| | - A. Tafuri
- University Hospital Sant'Andrea, Sapienza University of Rome Rome Italy
| | - E. Prete
- Department of Hematology and Bone Marrow Transplant Hospital Card. G. Panico Tricase Italy
| | - A. Mulè
- Division of Hematology, Azienda Villa Sofia‐Cervello Palermo Italy
| | - E. Barbolini
- Gruppo Amici dell'Ematologia GRADE Onlus Foundation Reggio Emilia Italy
| | | | - S. Luminari
- Hematology Unit Azienda Unità Sanitaria Locale ‐ IRCCS Reggio Emilia Italy
| | - F. Merli
- Hematology Unit Azienda Unità Sanitaria Locale ‐ IRCCS Reggio Emilia Italy
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Ferrero S, Moia R, Cascione L, Zaccaria GM, Rinaldi A, Alessandria B, Grimaldi D, Favini C, Evangelista A, Schipani M, Narni F, Stelitano C, Stefani PM, Benedetti F, Mian M, Casaroli I, Zanni M, Castellino C, Pavone V, Galimberti S, Re F, Rossi D, Cortelazzo S, Gaidano G, Ladetto M, Bertoni F. A COMPLETELY GENETIC PROGNOSTIC MODEL OVERCOMES CLINICAL PROGNOSTICATORS IN MANTLE CELL LYMPHOMA: RESULTS FROM THE MCL0208 TRIAL FROM THE FONDAZIONE ITALIANA LINFOMI (FIL). Hematol Oncol 2021. [DOI: 10.1002/hon.59_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: 11/08/2022]
Affiliation(s)
- S. Ferrero
- Hematology Department of Molecular Biotechnologies and Health Sciences University of Torino Hematology 1, AOU "Città della salute e della scienza di Torino" Torino Italy
| | - R. Moia
- Division of Hematology Department of Translational Medicine Università del Piemonte Orientale Novara Italy
| | - L. Cascione
- Institute of Oncology Research Faculty of Biomedical Sciences USI, Bellinzona SIB Swiss Institute of Bioinformatics Lausanne Switzerland
| | - G. M. Zaccaria
- Hematology and Cell Therapy Unit IRCCS Istituto Tumori 'Giovanni Paolo II' Bari Italy
| | - A. Rinaldi
- Institute of Oncology Research Faculty of Biomedical Sciences USI Bellinzona Switzerland
| | - B. Alessandria
- Hematology Department of Molecular Biotechnologies and Health Sciences University of Torino Torino Italy
| | - D. Grimaldi
- Hematology Department of Molecular Biotechnologies and Health Sciences University of Torino Torino Italy
| | - C. Favini
- Division of Hematology Department of Translational Medicine Università del Piemonte Orientale Novara Italy
| | - A. Evangelista
- Unit of Cancer Epidemiology CPO Piemonte A.O.U. Città della Salute e della Scienza di Torino Torino Italy
| | - M. Schipani
- Division of Hematology Department of Translational Medicine Università del Piemonte Orientale Novara Italy
| | - F. Narni
- Department of Medical and Surgical Sciences Section of Hematology University of Modena and Reggio Emilia Azienda Ospedaliero Universitaria Policlinico Modena Italy
| | - C. Stelitano
- Hematology Department AO "Bianchi‐Melacrino‐Morelli" Reggio Calabria Italy
| | - P. M. Stefani
- Hematology Unit General Hospital Ca' Foncello Treviso Italy
| | - F. Benedetti
- Hematology University Division Verona Hospital Verona Italy
| | - M. Mian
- Department of Haematology and CBMT Bolzano Hospital Bolzano Italy
| | - I. Casaroli
- Haematology Unit ASST Monza San Gerardo Monza Italy
| | - M. Zanni
- Hematology Unit Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo Alessandria Italy
| | - C. Castellino
- Department of Hematology S. Croce e Carle Hospital Cuneo Italy
| | - V. Pavone
- UOC Ematologia e Trapianto Az. Osp. C. Panico Tricase Italy
| | - S. Galimberti
- Section of Hematology Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - F. Re
- Haematology and Bone Marrow Transplant Unit Parma General Hospital Parma Italy
| | - D. Rossi
- Institute of Oncology Research Faculty of Biomedical Sciences USI, Bellinzona, Switzerland Oncology Institute of Southern Switzerland (IOSI) Bellinzona,Bellinzona Switzerland
| | - S. Cortelazzo
- Oncology Unit Italy Medical & Center Hospital Humanitas Gavazzeni and Castelli Bergamo Italy
| | - G. Gaidano
- Division of Hematology Department of Translational Medicine Università del Piemonte Orientale Novara Italy
| | - M. Ladetto
- Division of Hematology Department of Translational Medicine Università del Piemonte Orientale Novara, Division of Hematology Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo Alessandria Italy
| | - F. Bertoni
- Institute of Oncology Research Faculty of Biomedical Sciences USI, Bellinzona, Switzerland Oncology Institute of Southern Switzerland (IOSI) Bellinzona,Bellinzona Switzerland
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35
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Greco A, Tonialini L, Scalzulli PR, De Santis G, Prete E, La Rosa E, Cascavilla N, Tarantini G, Pavone V. PIXANTRONE (PIX) IN RELAPSED/REFRACTORY DIFFUSE LARGE B‐CELL LYMPHOMA (R/R DLBCL). REAL LIFE EXPERIENCE IN 27 PATIENTS. Hematol Oncol 2021. [DOI: 10.1002/hon.41_2881] [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: 11/11/2022]
Affiliation(s)
- A Greco
- Pia Fondazione Card. G. Panico Hospital, Unit of Hematology Tricase Italy
| | - L Tonialini
- Pia Fondazione Card. G. Panico Hospital, Unit of Hematology Tricase Italy
| | - P. R Scalzulli
- Casa Sollievo della Sofferenza Hospital, Unit of Hematology San Giovanni Rotondo Italy
| | - G De Santis
- Monsignor Raffaele Dimiccoli Hospital, Unit of Hematology Barletta Italy
| | - E Prete
- Pia Fondazione Card. G. Panico Hospital, Unit of Hematology Tricase Italy
| | - E La Rosa
- Pia Fondazione Card. G. Panico Hospital, Unit of Hematology Tricase Italy
| | - N Cascavilla
- Casa Sollievo della Sofferenza Hospital, Unit of Hematology San Giovanni Rotondo Italy
| | - G Tarantini
- Monsignor Raffaele Dimiccoli Hospital, Unit of Hematology Barletta Italy
| | - V Pavone
- Pia Fondazione Card. G. Panico Hospital, Unit of Hematology Tricase Italy
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36
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Maglio O, Chino M, Vicari C, Pavone V, Louro RO, Lombardi A. Histidine orientation in artificial peroxidase regioisomers as determined by paramagnetic NMR shifts. Chem Commun (Camb) 2021; 57:990-993. [PMID: 33399143 DOI: 10.1039/d0cc06676a] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Fe-Mimochrome VI*a is a synthetic peroxidase and peroxygenase, featuring two different peptides that are covalently-linked to deuteroheme. To perform a systematic structure/function correlation, we purposely shortened the distance between the distal peptide and the heme, allowing for the separation and characterization of two regioisomers. They differ in both His axial-ligand orientation, as determined by paramagnetic NMR shifts, and activity. These findings highlight that synthetic metalloenzymes may provide an efficient tool for disentangling the role of axial ligand orientation over peroxidase activity.
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Affiliation(s)
- Ornella Maglio
- Department of Chemical Sciences, University Federico II of Naples, Via Cintia 21, Naples, 80126, Italy. and IBB-CNR, Via Mezzocannone 16, Naples, 80134, Italy
| | - Marco Chino
- Department of Chemical Sciences, University Federico II of Naples, Via Cintia 21, Naples, 80126, Italy.
| | - Claudia Vicari
- Department of Chemical Sciences, University Federico II of Naples, Via Cintia 21, Naples, 80126, Italy.
| | - Vincenzo Pavone
- Department of Chemical Sciences, University Federico II of Naples, Via Cintia 21, Naples, 80126, Italy.
| | - Ricardo O Louro
- ITQB-UNL, Av. da Republica (EAN), Oeiras 2780-157, Portugal.
| | - Angela Lombardi
- Department of Chemical Sciences, University Federico II of Naples, Via Cintia 21, Naples, 80126, Italy.
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37
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Locri F, Pesce NA, Aronsson M, Cammalleri M, De Rosa M, Pavone V, Bagnoli P, Kvanta A, Dal Monte M, André H. Gaining insight on mitigation of rubeosis iridis by UPARANT in a mouse model associated with proliferative retinopathy. J Mol Med (Berl) 2020; 98:1629-1638. [PMID: 32940719 PMCID: PMC7591405 DOI: 10.1007/s00109-020-01979-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/04/2020] [Accepted: 09/10/2020] [Indexed: 12/29/2022]
Abstract
Proliferative retinopathies (PR) lead to an increase in neovascularization and inflammation factors, at times culminating in pathologic rubeosis iridis (RI). In mice, uveal puncture combined with injection of hypoxia-conditioned media mimics RI associated with proliferative retinopathies. Here, we investigated the effects of the urokinase plasminogen activator receptor (uPAR) antagonist-UPARANT-on the angiogenic and inflammatory processes that are dysregulated in this model. In addition, the effects of UPARANT were compared with those of anti-vascular endothelial growth factor (VEGF) therapies. Administration of UPARANT promptly decreased iris vasculature, while anti-VEGF effects were slower and less pronounced. Immunoblot and qPCR analysis suggested that UPARANT acts predominantly by reducing the upregulated inflammatory and extracellular matrix degradation responses. UPARANT appears to be more effective in comparison to anti-VEGF in the treatment of RI associated with PR in the murine model, by modulating multiple uPAR-associated signaling pathways. Furthermore, UPARANT effectiveness was maintained when systemically administered, which could open to novel improved therapies for proliferative ocular diseases, particularly those associated with PR. KEY MESSAGES: • Further evidence of UPARANT effectiveness in normalizing pathological iris neovascularization. • Both systemic and local administration of UPARANT reduce iris neovascularization in a model associated with proliferative retinopathies. • In the mouse models of rubeosis iridis associated with proliferative retinopathy, UPARANT displays stronger effects when compared with anti-vascular endothelial growth factor regimen.
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Affiliation(s)
- Filippo Locri
- Department of Clinical Neuroscience, Division of Eye and Vision, St Erik Eye Hospital, Karolinska Institutet, Polhemsgatan 50, 112 82, Stockholm, Sweden
| | - Noemi A Pesce
- Department of Clinical Neuroscience, Division of Eye and Vision, St Erik Eye Hospital, Karolinska Institutet, Polhemsgatan 50, 112 82, Stockholm, Sweden.,Department of Biology, University of Pisa, Pisa, Italy
| | - Monica Aronsson
- Department of Clinical Neuroscience, Division of Eye and Vision, St Erik Eye Hospital, Karolinska Institutet, Polhemsgatan 50, 112 82, Stockholm, Sweden
| | | | - Mario De Rosa
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Vincenzo Pavone
- Department of Chemical Sciences, University of Naples Federico II, Naples, Italy
| | - Paola Bagnoli
- Department of Biology, University of Pisa, Pisa, Italy
| | - Anders Kvanta
- Department of Clinical Neuroscience, Division of Eye and Vision, St Erik Eye Hospital, Karolinska Institutet, Polhemsgatan 50, 112 82, Stockholm, Sweden
| | | | - Helder André
- Department of Clinical Neuroscience, Division of Eye and Vision, St Erik Eye Hospital, Karolinska Institutet, Polhemsgatan 50, 112 82, Stockholm, Sweden.
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38
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Hudson N, Culley L, Herbrand C, Pavone V, Pennings G, Provoost V, Coveney C, Funes SL. Reframing egg donation in Europe: new regulatory challenges for a shifting landscape. Health Policy and Technology 2020. [DOI: 10.1016/j.hlpt.2020.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abstract
Previous studies have suggested that various A-gliadin-derived peptides actively agglutinate K562CS) cells. These active peptides showed the following common sequences: pro-ser-gln-gln and gln-gln-gln-pro. In this study, we have synthesised and tested the following toxic fragments: the peptide with the 31–55 amino acid sequence, which contains both the toxic sequences, and the peptides 31–43 and 44–55, which contain the sequences gln-gln-gln-pro, and pro-ser-gln-gln, respectively. Both the peptides with either the gln-gln-gln-pro or pro-ser-gln-gln sequences were active in agglutinating all cells. However, the peptide 44–55 agglutinated 100% of the cells at a concentration two times greater than the peptide 31–43. This suggests a relationship between the gln-gln-gln-pro and pro-ser-gln-gln sequences and the damaging effect of gliadins on the coeliac small intestine in individuals affected by coeliac disease. Moreover mannan and oligomers of N-acetylglucosamine were found to be able to prevent the cell-agglutinating activity of the active peptides.
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Affiliation(s)
- Massimo De Vincenzi
- Laboratorio di Metabolismo e Biochimica Patologica, Istituto Superiore di Sanità, viale Regina Elena 299, 00161 Roma, Italy
| | - Maria Rita Dessi
- Istituto di Biochimica, Facoltà di Farmacia, Università degli Studi, viale della Pineta 77, 09100 Cagliari, Italy
| | - Claudio Giovannini
- Laboratorio di Metabolismo e Biochimica Patologica, Istituto Superiore di Sanità, viale Regina Elena 299, 00161 Roma, Italy
| | - Alfredo Cantafora
- Laboratorio di Metabolismo e Biochimica Patologica, Istituto Superiore di Sanità, viale Regina Elena 299, 00161 Roma, Italy
| | - Vincenzo Pavone
- Dipartimento di Chimica, Università degli Studi, via S. Panzini 5, 80131 Napoli, Italy
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40
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Leone L, Chino M, Nastri F, Maglio O, Pavone V, Lombardi A. Mimochrome, a metalloporphyrin‐based catalytic Swiss knife†. Biotechnol Appl Biochem 2020; 67:495-515. [DOI: 10.1002/bab.1985] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 07/09/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Linda Leone
- Department of Chemical Sciences University of Napoli “Federico II” Napoli Italy
| | - Marco Chino
- Department of Chemical Sciences University of Napoli “Federico II” Napoli Italy
| | - Flavia Nastri
- Department of Chemical Sciences University of Napoli “Federico II” Napoli Italy
| | - Ornella Maglio
- Department of Chemical Sciences University of Napoli “Federico II” Napoli Italy
- IBB ‐ National Research Council Napoli Italy
| | - Vincenzo Pavone
- Department of Chemical Sciences University of Napoli “Federico II” Napoli Italy
| | - Angela Lombardi
- Department of Chemical Sciences University of Napoli “Federico II” Napoli Italy
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41
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Martínez C, Boumendil A, Romejko-Jarosinska J, Anagnostopoulos A, Faber E, Poiré X, Yakoub-Agha I, Akhtar S, Gurman G, Pavone V, Halaburda K, Sousa AB, Ghesquières H, Finel H, Khvedelidze I, Montoto S, Sureda A. Second autologous stem cell transplantation for relapsed/refractory Hodgkin lymphoma after a previous autograft: a study of the lymphoma working party of the EBMT. Leuk Lymphoma 2020; 61:2915-2922. [PMID: 32654552 DOI: 10.1080/10428194.2020.1789624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The purpose of this study was to analyze the results of second autologous hematopoietic stem cell transplantation (ASCT2) for patients with relapsed/refractory Hodgkin lymphoma (HL) after a first transplantation (ASCT1). Outcomes for 56 patients receiving an ASCT2 registered in the EBMT database were analyzed. The 4-year cumulative incidences of non-relapse mortality and disease relapse/progression were 5% and 67%, respectively. The 4-year overall survival (OS) and progression-free survival (PFS) were 62% and 28%. In univariate analysis, relapse of HL within 12 months of ASCT1 was associated with a worse OS (35% versus 76%, p = 0.01) and PFS (19% versus 29%, p = 0.059). Chemosensitivity at ASCT2 predicted better outcomes (4-year OS 72% versus 29%, p = 0.002; PFS 31% versus 12%, p = 0.015). This series shows that ASCT2 is a safe procedure and a relatively effective option for patients with late relapses after ASCT1 and with chemosensitive disease who are not eligible for an allogeneic transplant.
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Affiliation(s)
- Carmen Martínez
- Department of Hematology, Institute of Hematology and Oncology, Hospital Clínic, Barcelona, Spain
| | | | | | | | - Edgar Faber
- University Hospital, Olomouc, Czech Republic
| | - Xavier Poiré
- Cliniques Universitaires St. Luc, Brussels, Belgium
| | | | - Saad Akhtar
- King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Gunhan Gurman
- Faculty of Medicine, Ankara University, Ankara, Turkey
| | | | | | | | | | - Hervé Finel
- EBMT LWP Paris Office Hopital Saint-Antoine, Paris, France
| | | | - Silvia Montoto
- Department of Haemato-Oncology, St. Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | - Anna Sureda
- Department of Haematology, Institut Catala d'Oncologia, Hospital Duran I Reynals, Barcelona, Spain
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42
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Zambrano G, Nastri F, Pavone V, Lombardi A, Chino M. Use of an Artificial Miniaturized Enzyme in Hydrogen Peroxide Detection by Chemiluminescence. Sensors (Basel) 2020; 20:E3793. [PMID: 32640736 PMCID: PMC7374304 DOI: 10.3390/s20133793] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/25/2020] [Accepted: 07/03/2020] [Indexed: 11/16/2022]
Abstract
Advanced oxidation processes represent a viable alternative in water reclamation for potable reuse. Sensing methods of hydrogen peroxide are, therefore, needed to test both process progress and final quality of the produced water. Several bio-based assays have been developed so far, mainly relying on peroxidase enzymes, which have the advantage of being fast, efficient, reusable, and environmentally safe. However, their production/purification and, most of all, batch-to-batch consistency may inherently prevent their standardization. Here, we provide evidence that a synthetic de novo miniaturized designed heme-enzyme, namely Mimochrome VI*a, can be proficiently used in hydrogen peroxide assays. Furthermore, a fast and automated assay has been developed by using a lab-bench microplate reader. Under the best working conditions, the assay showed a linear response in the 10.0-120 μM range, together with a second linearity range between 120 and 500 μM for higher hydrogen peroxide concentrations. The detection limit was 4.6 μM and quantitation limits for the two datasets were 15.5 and 186 μM, respectively. In perspective, Mimochrome VI*a could be used as an active biological sensing unit in different sensor configurations.
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Affiliation(s)
| | | | | | | | - Marco Chino
- Department of Chemical Sciences, University of Naples “Federico II”. Via Cintia, 80126 Napoli, Italy; (G.Z.); (F.N.); (V.P.); (A.L.)
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43
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Zambrano G, Chino M, Renzi E, Di Girolamo R, Maglio O, Pavone V, Lombardi A, Nastri F. Clickable artificial heme-peroxidases for the development of functional nanomaterials. Biotechnol Appl Biochem 2020; 67:549-562. [PMID: 33463759 DOI: 10.1002/bab.1969] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 06/06/2020] [Indexed: 11/08/2022]
Abstract
Artificial metalloenzymes as catalysts are promising candidates for their use in different technologies, such as bioremediation, biomass transformation, or biosensing. Despite this, their practical exploitation is still at an early stage. Immobilized natural enzymes have been proposed to enhance their applicability. Immobilization may offer several advantages: (i) catalyst reuse; (ii) easy separation of the enzyme from the reaction medium; (iii) better tolerance to harsh temperature and pH conditions. Here, we report an easy immobilization procedure of an artificial peroxidase on different surfaces, by means of click chemistry. FeMC6*a, a recently developed peroxidase mimic, has been functionalized with a pegylated aza-dibenzocyclooctyne to afford a "clickable" biocatalyst, namely FeMC6*a-PEG4@DBCO, which easily reacts with azide-functionalized molecules and/or nanomaterials to afford functional bioconjugates. The clicked biocatalyst retains its structural and, to some extent, its functional behaviors, thus housing high potential for biotechnological applications.
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Affiliation(s)
- Gerardo Zambrano
- Department of Chemical Sciences, University of Napoli "Federico II," Via Cintia, Napoli, Italy
| | - Marco Chino
- Department of Chemical Sciences, University of Napoli "Federico II," Via Cintia, Napoli, Italy
| | - Emilia Renzi
- Department of Chemical Sciences, University of Napoli "Federico II," Via Cintia, Napoli, Italy
| | - Rocco Di Girolamo
- Department of Chemical Sciences, University of Napoli "Federico II," Via Cintia, Napoli, Italy
| | - Ornella Maglio
- Department of Chemical Sciences, University of Napoli "Federico II," Via Cintia, Napoli, Italy.,Istituto di Biostrutture e Bioimmagini, CNR, Napoli, Italy
| | - Vincenzo Pavone
- Department of Chemical Sciences, University of Napoli "Federico II," Via Cintia, Napoli, Italy
| | - Angela Lombardi
- Department of Chemical Sciences, University of Napoli "Federico II," Via Cintia, Napoli, Italy
| | - Flavia Nastri
- Department of Chemical Sciences, University of Napoli "Federico II," Via Cintia, Napoli, Italy
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44
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D'Alonzo D, De Fenza M, Pavone V. COVID-19 and pneumonia: a role for the uPA/uPAR system. Drug Discov Today 2020; 25:1528-1534. [PMID: 32562843 PMCID: PMC7299864 DOI: 10.1016/j.drudis.2020.06.013] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [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: 04/11/2020] [Revised: 05/14/2020] [Accepted: 06/11/2020] [Indexed: 12/29/2022]
Abstract
Here, we highlight recent findings on the urokinase plasminogen activator (uPA)/uPA receptor (uPAR) system that suggest its potential role as a main orchestrator of fatal progression to pulmonary, kidney, and heart failure in patients with coronavirus. Patients with prolonged background inflammation can present aberrant inflammatory reactions, well recognized as the main factors that can result in death and probably sustained by a dysregulated uPA/uPAR system. SuPAR, the soluble form of uPAR, represents a biomarker of disease progression, and its levels correlate well with comorbidities associated with the death of patients with coronavirus. New drugs that regulate the uPA/uPAR system could help treat the severe complications of highly pathogenic human coronaviruses (hCoVs), including pandemic coronavirus 2019 (COVID-19).
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Affiliation(s)
- Daniele D'Alonzo
- University of Naples 'Federico II', Department of Chemical Sciences, Complesso Universitario di Monte Sant'Angelo, Via Cintia 46, 80126 Naples, Italy
| | - Maria De Fenza
- University of Naples 'Federico II', Department of Chemical Sciences, Complesso Universitario di Monte Sant'Angelo, Via Cintia 46, 80126 Naples, Italy
| | - Vincenzo Pavone
- University of Naples 'Federico II', Department of Chemical Sciences, Complesso Universitario di Monte Sant'Angelo, Via Cintia 46, 80126 Naples, Italy.
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45
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Merli F, Ballerini F, Botto B, Gotti M, Pavone V, Pulsoni A, Stefani PM, Massaro F, Viviani S. Hodgkin's lymphoma: post- autologous transplantation consolidation therapy. Acta Biomed 2020; 91:23-29. [PMID: 32525131 PMCID: PMC7944651 DOI: 10.23750/abm.v91is-5.9914] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 05/25/2020] [Indexed: 11/23/2022]
Abstract
A first-line chemotherapy program based on the ABVD regimen is currently considered the golden standard by most hematologists, being able to achieve a cure without any need of subsequent therapies in >70% of patients with advanced-stage Hodgkin's lymphoma (HL). To increase this percentage, efforts in recent decades focused on the development of new therapeutic strategies. A first major effort was the introduction of the BEACOPP chemotherapy regimen, which is able to increase the response rate and to reduce the need of salvage therapies. However, this result did not demonstrate an advantage in terms of overall survival compared to ABVD, mainly due to an excess of non lymphoma-related events in the follow-up phase. Here we describe three clinical cases of young HL patients who had relapsed/refractory disease after the induction chemotherapy. These three clinical cases provide practical and real world evidence in favor of the use of BV in monotherapy as consolidation treatment after autologous stem cells transplantation in patients with relapsed/refractory HL.
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Affiliation(s)
- Francesco Merli
- Hematology Unit, Azienda Unità Sanitaria Locale - IRCCS, Reggio Emilia, Italy.
| | - Filippo Ballerini
- Clinic of Hematology, Department of Internal Medicine (DiMI), University of Genoa, Italy; S. Martino Hospital IRCCS, Genoa, Italy .
| | - Barbara Botto
- Dipartimento di Oncologia ed Ematologia, A.O Città della Salute e della Scienza di Torino, San Giovanni Battista. Torino, Italy .
| | - Manuel Gotti
- Department of Hematology Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
| | - Vincenzo Pavone
- Dept. of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
| | - Alessandro Pulsoni
- Department of Cellular Biotechnologies and Hematology, La Sapienza University, Rome, Italy.
| | | | - Fulvio Massaro
- Hematology Unit, Azienda Unità Sanitaria Locale - IRCCS, Reggio Emilia, Italy.
| | - Simonetta Viviani
- Onco-Hematology Division, IEO, European Institute of Oncology, IRCCS, Milan, Italy.
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46
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Bari A, Marcheselli R, Sacchi S, Re A, Pagani C, Tucci A, Botto B, Vitolo U, Molinari AL, Puccini B, Pulsoni A, Santoro A, Tani M, Nassi L, Meli E, Pavone V, Bonfichi M, Evangelista A, Gioia D, Levis A, Zinzani P. The classic prognostic factors in advanced Hodgkin's lymphoma patients are losing their meaning at the time of Pet-guided treatments. Ann Hematol 2019; 99:277-282. [PMID: 31872362 PMCID: PMC6976582 DOI: 10.1007/s00277-019-03893-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 12/06/2019] [Indexed: 11/30/2022]
Abstract
The International Prognostic Score (IPS) is the most commonly used risk stratification tool for patients with advanced Hodgkin lymphoma (HL). It incorporates seven clinical parameters independently associated with a poorer outcome: male sex, age, stage IV, hemoglobin level, white blood cell and lymphocyte counts, and albumin level. Since the development of the IPS, there have been significant advances in therapy and supportive care. Recent studies suggest that the IPS is less discriminating due to improved outcomes with ABVD therapy. The aim of the present study was to asses if classic prognostic factors maintain their prognostic meaning at the time of response-adapted treatment based on interim PET scans. We evaluated the prognostic significance of IPS in the 520 advanced stage HL patients enrolled in the PET-guided, HD0801 trial in which PET2-positive patients underwent a more intense treatment with an early stem-cell transplantation after 2 cycles of ABVD. We observed that in these patients, the IPS completely loses its prognostic value together with all the single parameters that contribute to the IPS. Furthermore, neutrophils, monocytes, lymphocytes, and the ratio among them also no longer had any predictive value. We believe that the substantial improvement in survival outcomes in PET2-positive patients treated with early autologous transplantation could explain the complete disappearance of the residual prognostic significance of the IPS.
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Affiliation(s)
- Alessia Bari
- UO Terapie Mirate in Oncoematologia ed Osteoncologia, Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell'Adulto, Universita' di Modena e Reggio Emilia, Modena, Italy
| | | | - Stefano Sacchi
- UO Terapie Mirate in Oncoematologia ed Osteoncologia, Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell'Adulto, Universita' di Modena e Reggio Emilia, Modena, Italy.
| | | | | | | | - Barbara Botto
- Struttura Complessa Ematologia, AOU Città della salute e della scienza di Torino, Turin, Italy
| | - Umberto Vitolo
- Struttura Complessa Ematologia, AOU Città della salute e della scienza di Torino, Turin, Italy
| | - Anna Lia Molinari
- Unità Operativa di Ematologia, Ospedale degli Infermi di Rimini, Rimini, Italy
| | | | - Alessandro Pulsoni
- Dipartimento di Biotecnologie Cellulari ed Ematologia, Sapienza Università di Roma, Rome, Italy
| | - Armando Santoro
- Humanitas Clinical and Research Center - IRCCS, Humanitas Cancer Center, via Manzoni 56, 20089, Rozzano, Milan, Italy.,Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele - Milan, Italy
| | - Monica Tani
- U.O.C di Ematologia Ospedale Santa Maria delle Croci, Ravenna, Italy
| | - Luca Nassi
- Department of Translational Medicine, Università del Piemonte Orientale Amedeo Avogadro, Azienda Ospedaliero-Universitaria Maggiore della Carità, 28100, Novara, Italy
| | - Erika Meli
- Ematologia, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Vincenzo Pavone
- A.O. C. Panico-U.O.C Ematologia e Trapianto, Tricase, Lecce, Italy
| | - Maurizio Bonfichi
- Div. di Ematologia, IRCCS Policlinico S. Matteo di Pavia, Pavia, Italy
| | - Andrea Evangelista
- Unit of Clinical Epidemiology, AOU Citta' della Salute e della Scienza di Torino and CPO Piemonte, Turin, Italy
| | - Daniela Gioia
- Fondazione Italiana Linfomi, Onlus, Alessandria, Italy
| | | | - Pierluigi Zinzani
- Policlinico S.Orsola-Malpighi, Istituto di Ematologia "Seragnoli", Bologna, Italy
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Di Renzo N, Melillo L, Porretto F, Dargenio M, Pavone V, Pastore D, Mazza P, Mannina D, Merenda A, Cascavilla N, Greco G, Matera R, Bonizzoni E, Celio L, Musso M. Every-other-day palonosetron plus aprepitant for prevention of emesis following induction chemotherapy for acute myeloid leukemia: A randomized, controlled study from the "Rete Ematologica Pugliese". Cancer Med 2019; 9:170-178. [PMID: 31725196 PMCID: PMC6943081 DOI: 10.1002/cam4.2628] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 07/08/2019] [Revised: 10/06/2019] [Accepted: 10/09/2019] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Compared with older 5-HT3 receptor antagonists, palonosetron requires fewer drug administrations to prevent chemotherapy-induced nausea and vomiting (CINV) following multiple-day chemotherapy. We conducted a phase II multicenter study comparing palonosetron plus aprepitant to palonosetron alone in patients undergoing a range of induction chemotherapy regimens for acute myeloid leukemia (AML). METHODS Patients were randomized to palonosetron (0.25 mg) every other day until the last dose of chemotherapy alone or with aprepitant on days 1-3. Patients mainly received an anthracycline on days 1-3 plus cytarabine administered for 5-10 days. The primary end point was complete response (CR; no emesis and no rescue medication) over the whole study period (days of chemotherapy plus two additional days). Unplanned analysis of time to anti-emetic treatment failure (TTF) was also performed. RESULTS Of the 134 patients enrolled in the study, 130 were evaluable: 68 subjects received palonosetron plus aprepitant and 62 received palonosetron alone. Although the primary end point of CR was similar between the treatment arms (72% vs 69%; P = .55), a higher proportion of patients treated with palonosetron plus aprepitant were free from nausea during the whole study period (43% vs 27%; P = .03). There was also a significant difference in favor of the two-drug regimens in TTF (median: 5 days vs 3 days; P = .03). CONCLUSIONS The study suggests that every-other-day palonosetron plus 3-day aprepitant can add clinical benefit to the control of CINV caused by multiple-day, corticosteroid-free chemotherapy for AML. In this challenging setting of CINV, further investigations of palonosetron in combination with aprepitant administered with an expanded schedule are warranted. ClinicalTrial.gov identifier: NCT02205164.
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Affiliation(s)
- Nicola Di Renzo
- Department of Hematology and Stem Cell Transplant, Presidio Ospedaliero Vito Fazzi, Lecce, Italy
| | - Lorella Melillo
- Hematology Unit, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | | | - Michela Dargenio
- Department of Hematology and Stem Cell Transplant, Presidio Ospedaliero Vito Fazzi, Lecce, Italy
| | - Vincenzo Pavone
- Hematology Unit, Ospedale Cardinale G. Panico, Tricase, Italy
| | | | | | - Donato Mannina
- Hematology Unit, A.O. Ospedali Riuniti Papardo-Piemonte, Messina, Italy
| | | | - Nicola Cascavilla
- Hematology Unit, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | | | - Rosella Matera
- Department of Hematology and Stem Cell Transplant, Presidio Ospedaliero Vito Fazzi, Lecce, Italy
| | - Erminio Bonizzoni
- Section of Medical Statistics, Biometry and Epidemiology, University of Milan, Milan, Italy
| | - Luigi Celio
- Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Maurizio Musso
- Hematology Unit, Casa di Cura La Maddalena, Palermo, Italy
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Bringhen S, D'Agostino M, Paris L, Ballanti S, Pescosta N, Spada S, Pezzatti S, Grasso M, Rota-Scalabrini D, De Rosa L, Pavone V, Gazzera G, Aquino S, Poggiu M, Santoro A, Gentile M, Baldini L, Petrucci MT, Tosi P, Marasca R, Cellini C, Palumbo A, Falco P, Hájek R, Boccadoro M, Larocca A. Lenalidomide-based induction and maintenance in elderly newly diagnosed multiple myeloma patients: updated results of the EMN01 randomized trial. Haematologica 2019; 105:1937-1947. [PMID: 31582542 PMCID: PMC7327625 DOI: 10.3324/haematol.2019.226407] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 09/26/2019] [Indexed: 01/01/2023] Open
Abstract
n the EMN01 trial, the addition of an alkylator (melphalan or cyclophosphamide) to lenalidomide-steroid induction therapy was prospectively evaluated in transplant-ineligible patients with multiple myeloma. After induction, patients were randomly assigned to maintenance treatment with lenalidomide alone or with prednisone continuously. The analysis presented here (median follow-up of 71 months) is focused on maintenance treatment and on subgroup analyses defined according to the International Myeloma Working Group Frailty Score. Of the 654 evaluable patients, 217 were in the lenalidomide-dexamethasone arm, 217 in the melphalan-prednisone-lenalidomide arm and 220 in the cyclophosphamide-prednisone-lenalidomide arm. With regards to the Frailty Score, 284 (43%) patients were fit, 205 (31%) were intermediate-fit and 165 (25%) were frail. After induction, 402 patients were eligible for maintenance therapy (lenalidomide arm, n=204; lenalidomide-prednisone arm, n=198). After a median duration of maintenance of 22.0 months, progression-free survival from the start of maintenance was 22.2 months with lenalidomide-prednisone vs. 18.6 months with lenalidomide (hazard ratio 0.85, P=0.14), with no differences across frailty subgroups. The most frequent grade ≥3 toxicity was neutropenia (10% of lenalidomide-prednisone and 21% of lenalidomide patients; P=0.001). Grade ≥3 non-hematologic adverse events were rare (<15%). In fit patients, melphalan-prednisone-lenalidomide significantly prolonged progression-free survival compared to cyclophosphamide-prednisone-lenalidomide (hazard ratio 0.72, P=0.05) and lenalidomide-dexamethasone (hazard ratio 0.72, P=0.04). Likewise, a trend towards a better overall survival was noted for patients treated with melphalan-prednisone-lenalidomide or cyclophosphamide-prednisone-lenalidomide, as compared to lenalidomide-dexamethasone. No differences were observed in intermediate-fit and frail patients. This analysis showed positive outcomes of maintenance with lenalidomide-based regimens, with a good safety profile. For the first time, we showed that fit patients benefit from a full-dose triplet regimen, while intermediate-fit and frail patients benefit from gentler regimens. ClinicalTrials.gov registration number: NCT01093196.
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Affiliation(s)
- Sara Bringhen
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Mattia D'Agostino
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Laura Paris
- Hematology and Bone Marrow Transplant Unit, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | - Stelvio Ballanti
- Sezione di Ematologia e Immunologia Clinica, Ospedale Santa Maria della Misericordia, località Sant'Andrea delle Fratte, Perugia, Italy
| | - Norbert Pescosta
- Reparto Ematologia e Centro TMO, Ospedale Centrale, Bolzano, Italy
| | - Stefano Spada
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Sara Pezzatti
- Divisione di Ematologia, Ospedale S. Gerardo, Monza, Italy
| | | | | | - Luca De Rosa
- Hematology and Stem Cell Transplantation Unit, Az. Osp. S. Camillo-Forlanini, Rome, Italy
| | - Vincenzo Pavone
- UOC Ematologia e Trapianto, Az. Osp. C. Panico, Tricase (Lecce), Italy
| | - Giulia Gazzera
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Sara Aquino
- Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Marco Poggiu
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Armando Santoro
- Istituto Clinico Humanitas, Humanitas University, Rozzano-Milano, Italy
| | | | - Luca Baldini
- UOC Ematologia, Università degli Studi di Milano, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | | | - Patrizia Tosi
- UO Ematologia, Ospedale di Rimini, AUSL della Romagna, Rimini, Italy
| | - Roberto Marasca
- Hematology Unit, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Claudia Cellini
- U.O. Ematologia, Ospedale Santa Maria delle Croci, Ravenna, Italy
| | - Antonio Palumbo
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Patrizia Falco
- SSD Ematologia, ASLTO4, Ospedali di Chivasso Cirié Ivrea, Italy
| | - Roman Hájek
- Department of Hematooncology, University Hospital Ostrava, Ostrava, Czech Republic.,Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Mario Boccadoro
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Alessandra Larocca
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
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Chisari E, Pavone V, Sessa G, Ravalli S, Musumeci G. Electromyostimulation and whole-body vibration effects in elder sarcopenic patients. Muscles Ligaments Tendons J 2019. [DOI: 10.32098/mltj.03.2019.18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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)
- E. Chisari
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopedics and Traumatology, AOU Policlinico-Vittorio Emanuele, University of Catania, 95100 Catania, Italy
| | - V. Pavone
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopedics and Traumatology, AOU Policlinico-Vittorio Emanuele, University of Catania, 95100 Catania, Italy
| | - G. Sessa
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopedics and Traumatology, AOU Policlinico-Vittorio Emanuele, University of Catania, 95100 Catania, Italy
| | - S. Ravalli
- Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, University of Catania, Via S. Sofia n°87, Catania, Italy
| | - G. Musumeci
- Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, University of Catania, Via S. Sofia n°87, Catania, Italy
- Research Center on Motor Activities (CRAM), University of Catania, Catania 95123, Italy
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50
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Degli Esposti S, Pavone V. Corrigendum to “Oocyte provision as a (quasi) social market: Insights from Spain” [Soc. Sci. Med. 234 (2019) 112381]. Soc Sci Med 2019; 235:112402. [DOI: 10.1016/j.socscimed.2019.112402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Indexed: 10/26/2022]
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