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Arcaini L, Bommier C, Alderuccio JP, Merli M, Fabbri N, Nizzoli ME, Maurer MJ, Tarantino V, Ferrero S, Rattotti S, Talami A, Murru R, Khurana A, Mwangi R, Deodato M, Cencini E, Re F, Visco C, Feldman AL, Link BK, Delamain MT, Spina M, Annibali O, Pulsoni A, Ferreri AJ, Stelitano CC, Pennese E, Habermann TM, Marcheselli L, Han S, Reis IM, Paulli M, Lossos IS, Cerhan JR, Luminari S. Marginal zone lymphoma international prognostic index: a unifying prognostic index for marginal zone lymphomas requiring systemic treatment. EClinicalMedicine 2024; 72:102592. [PMID: 38633575 PMCID: PMC11019091 DOI: 10.1016/j.eclinm.2024.102592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 03/21/2024] [Accepted: 03/22/2024] [Indexed: 04/19/2024] Open
Abstract
Background Marginal zone lymphomas (MZL), comprised of three unique but related subtypes, lack a unifying prognostic score applicable to all the patients in need for systemic chemotherapy and/or immunotherapy. Methods Patients from the prospective NF10 study (NCT02904577) with newly diagnosed MZL and receiving frontline systemic therapy at diagnosis or after observation were used to train a prognostic model. The primary endpoint was progression-free survival (PFS) from start of treatment. The model was externally validated in a pooled analysis of two independent cohorts from the University of Iowa and Mayo Clinic Molecular Epidemiology Resource and the University of Miami. Findings We identified 501 eligible patients. After multivariable modeling, lactate dehydrogenase (LDH) above upper normal limit, hemoglobin <12 g/dL, absolute lymphocyte count <1 × 109/L, platelets <100 × 109/L, and MZL subtype (nodal or disseminated) were independently associated with inferior PFS. The proposed MZL International Prognostic index (MZL-IPI) combined these 5 factors, and we defined low (LRG, 0 factors, 27%), intermediate (IRG, 1-2 factors, 57%) and high (HRG, 3+ factors, 16%) risk groups with 5-y PFS of 85%, 66%, and 37%, respectively (c-Harrell = 0.64). Compared to the LRG, the IRG (Hazard Ratio [HR] = 2.30, 95% CI 1.39-3.80) and HRG (HR = 5.41, 95% CI 3.12-9.38) had inferior PFS. Applying the MZL-IPI to the pooled US cohort (N = 353), 94 (27%), 192 (54%), and 67 (19%) patients were classified as LRG, IRG, and HRG, respectively, and the model was validated for PFS (log-rank test p = 0.0018; c-Harrell = 0.578, 95% CI 0.54-0.62). The MZL-IPI was also prognostic for OS in both the training and the external validation sets. Interpretation MZL-IPI is a new prognostic score for use in all patients with MZL considered for systemic treatment. Funding The MER was supported by P50 CA97274 and U01 CA195568.
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Affiliation(s)
- Luca Arcaini
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Côme Bommier
- Hemato-Oncology Department, DMU DHI, Hôpital Saint Louis, Paris, France
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Juan Pablo Alderuccio
- Division of Hematology, Department of Medicine, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Michele Merli
- Division of Hematology, University Hospital Ospedale di Circolo e Fondazione Macchi-ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Nicole Fabbri
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Maria Elena Nizzoli
- Division of Hematology, Azienda Unità Sanitaria Locale – IRCCS, Reggio Emilia, Italy
- Clinical and Experimental Medicine Doctorate School, Università degli Studi di Modena e Reggio Emilia, Italy
| | - Matthew J. Maurer
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Vittoria Tarantino
- Division of Hematology, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy
| | - Simone Ferrero
- Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino, and AOU “Città della Salute e della Scienza di Torino”, Torino, Italy
| | - Sara Rattotti
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Annalisa Talami
- Clinical and Experimental Medicine Doctorate School, Università degli Studi di Modena e Reggio Emilia, Italy
| | - Roberta Murru
- Hematology and Stem Cell Transplantation Unit, Ospedale Oncologico A. Businco, ARNAS G. Brotzu, Cagliari, Italy
| | | | - Raphael Mwangi
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Marina Deodato
- Division of Hematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Emanuele Cencini
- Division of Hematology, Azienda Ospedaliera Universitaria Senese and University of Siena, Siena, Italy
| | - Francesca Re
- Division of Hematology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Carlo Visco
- Division of Hematology, San Bortolo Hospital, AULSS 8 Berica, Vicenza, Italy
| | - Andrew L. Feldman
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Brian K. Link
- Department of Internal Medicine, University of Iowa Hospitals, Iowa City, IA, USA
| | - Marcia Torresan Delamain
- Faculty of Medical of Minas Gerais, Feluma, Brazil for Faculty of Medical of Minas Gerais, Belo Horizonte, Brazil
| | - Michele Spina
- Division of Medical Oncology and Immune-Related Tumors, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Ombretta Annibali
- Division of Hematology, Stem Cell Transplantation, University Campus Bio-Medico, Roma, Italy
| | - Alessandro Pulsoni
- Division of Hematology, Sapienza University – Polo Pontino, Department of Translational and Precision Medicine, S.M. Goretti Hospital, Latina, Italy
| | - Andrés J.M. Ferreri
- Lymphoma Unit, IRCCS San Raffaele Scientific Institute, and University Vita-Salute San Raffaele, Milano, Italy
| | - Caterina Cecilia Stelitano
- Division of Hematology, Grande Ospedale Metropolitano, Bianchi Melacrino Morelli, Reggio Calabria, Reggio Calabria, Italy
| | - Elsa Pennese
- Division of Hematology, Ospedale Spirito Santo, Pescara, Italy
| | | | | | - Sunwoo Han
- Biostatistics and Bioinformatics Shared Resource, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Isildinha M. Reis
- Biostatistics and Bioinformatics Shared Resource, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Marco Paulli
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
- Division of Pathology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Izidore S. Lossos
- Division of Hematology, Department of Medicine, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - James R. Cerhan
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Stefano Luminari
- Division of Hematology, Azienda Unità Sanitaria Locale – IRCCS, Reggio Emilia, Italy
- Department CHIMOMO, University of Modena and Reggio Emilia, Modena, Italy
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Criscuolo M, Tosti ME, Broccoli A, Varettoni M, Maraglino AME, Anastasia A, Cantonetti M, Trentin L, Kovalchuk S, Orsucci L, Deodato M, Spolzino A, Volpetti S, Annibali O, Storti S, Stelitano C, Marchesi F, Morè S, Fianchi L, Falini B, Pulsoni A, Tiacci E, Zinzani PL, Pagano L. Second Neoplasms in Italian Patients with Hairy Cell Leukemia after Treatment with Cladribine: A Multicenter Investigation and Literature Review. Cancers (Basel) 2024; 16:1475. [PMID: 38672557 PMCID: PMC11048584 DOI: 10.3390/cancers16081475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/05/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
Concern has emerged about the prevalence of second cancers among patients with hairy cell leukemia (HCL) treated with purine analogs. We investigated 513 patients with HCL treated with cladribine over the last 30 years at 18 Italian centers and calculated their standardized incidence ratios (SIRs). We identified 24 patients with a second cancer diagnosed at a median time from treatment with cladribine of 59.9 months (range: 9.2-169.7 months). All patients with solid neoplasms presented with a limited-stage disease, except four cases of locally advanced cancer; multiple myeloma patients had a smoldering disease, while lymphoma patients had stage Ie and stage IV diseases. Response to therapy was complete in 19 cases; 1 patient is still receiving treatment for a relapsing bladder disease, while 2 patients progressed during treatment and died. These two patients died from unrelated causes: one from infection and one due to surgery complications. The median OS from HCL was 98.5 months (range: 38.4-409.2 months), while the median OS from second cancer was 27.6 months (range: 1-117.8 months). The SIR was 0.86 (95% CI: 0.54-1.30) for males and 1.13 (95% CI: 0.36-2.73) for females: no statistically significant differences were highlighted. We were not able to demonstrate an excess of second cancer or a significant association with the specific studied neoplasm.
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Affiliation(s)
- Marianna Criscuolo
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (M.C.); (L.F.)
| | | | - Alessandro Broccoli
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy; (A.B.); (P.L.Z.)
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale Università di Bologna, 40126 Bologna, Italy
| | - Marzia Varettoni
- Divisione di Ematologia, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy;
| | | | | | - Maria Cantonetti
- Dipartimento di Oncoematologia Policlinico Tor Vergata, Università Tor Vergata, 00133 Rome, Italy;
| | - Livio Trentin
- Division of Haematology and Clinical Immunology, University of Padova, 35137 Padua, Italy;
| | | | - Lorella Orsucci
- S.C. Ematologia, A.O.U. Città della Salute e della Scienza di Torino, 10126 Turin, Italy;
| | - Marina Deodato
- Divisione di Ematologia, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy;
| | - Angelica Spolzino
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Parma, 43125 Parma, Italy;
- Oncoematologia, Istituto Oncologico Veneto IOV-IRCSS, 31033 Castelfranco Veneto, Italy
| | - Stefano Volpetti
- Clinica Ematologia, Azienda Sanitaria Universitaria Integrata, 33100 Udine, Italy;
| | - Ombretta Annibali
- Hematology and Stem Cell Transplantation Unit, Campus Bio-Medico University, 00128 Rome, Italy;
| | - Sergio Storti
- UOC Oncoematologia Fondazione di Ricerca e Cura Giovanni Paolo II, Campobasso—Università Cattolica del Sacro Cuore, 86100 Campobasso, Italy;
| | - Caterina Stelitano
- Divisione di Ematologia, Azienda Ospedaliera “Bianchi Melacrino Morelli”, 89125 Reggio Calabria, Italy;
| | - Francesco Marchesi
- Haematology and Stem Cell Transplantation Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy;
| | - Sonia Morè
- Clinica di Ematologia, AOU delle Marche, 60126 Ancona, Italy;
| | - Luana Fianchi
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (M.C.); (L.F.)
| | - Brunangelo Falini
- Department of Medicine and Surgery, Institute of Hematology and Center for Hemato-Oncology Research, University of Perugia, Santa Maria della Misericordia Hospital, 06123 Perugia, Italy; (B.F.); (E.T.)
| | - Alessandro Pulsoni
- Divisione di Ematologia, Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy;
| | - Enrico Tiacci
- Department of Medicine and Surgery, Institute of Hematology and Center for Hemato-Oncology Research, University of Perugia, Santa Maria della Misericordia Hospital, 06123 Perugia, Italy; (B.F.); (E.T.)
| | - Pier Luigi Zinzani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy; (A.B.); (P.L.Z.)
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale Università di Bologna, 40126 Bologna, Italy
| | - Livio Pagano
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (M.C.); (L.F.)
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Bruno T, Catena V, Corleone G, Cortile C, Cappelletto MC, Bellei B, De Nicola F, Amadio B, Gumenyuk S, Marchesi F, Annibali O, Blandino G, Fanciulli M, Di Agostino S. Che-1/miR-590-3p/TAZ axis sustains multiple myeloma disease. Leukemia 2024; 38:877-882. [PMID: 38368441 PMCID: PMC10997508 DOI: 10.1038/s41375-024-02168-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 02/01/2024] [Accepted: 02/02/2024] [Indexed: 02/19/2024]
Affiliation(s)
- Tiziana Bruno
- SAFU Laboratory, Department of Research, Advanced Diagnostics, and Technological Innovation, Translational Research Area, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Valeria Catena
- SAFU Laboratory, Department of Research, Advanced Diagnostics, and Technological Innovation, Translational Research Area, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Giacomo Corleone
- SAFU Laboratory, Department of Research, Advanced Diagnostics, and Technological Innovation, Translational Research Area, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Clelia Cortile
- SAFU Laboratory, Department of Research, Advanced Diagnostics, and Technological Innovation, Translational Research Area, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | - Barbara Bellei
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, IRCCS San Gallicano Dermatological Institute, Rome, Italy
| | - Francesca De Nicola
- SAFU Laboratory, Department of Research, Advanced Diagnostics, and Technological Innovation, Translational Research Area, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Bruno Amadio
- SAFU Laboratory, Department of Research, Advanced Diagnostics, and Technological Innovation, Translational Research Area, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Svitlana Gumenyuk
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Ombretta Annibali
- Unit Of Hematology, Stem Cell Transplantation, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Roma, Italy
| | - Giovanni Blandino
- Translational Oncology Research Unit, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53, 00144, Rome, Italy
| | - Maurizio Fanciulli
- SAFU Laboratory, Department of Research, Advanced Diagnostics, and Technological Innovation, Translational Research Area, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
| | - Silvia Di Agostino
- Department of Health Sciences, Magna Græcia University of Catanzaro, 88100, Catanzaro, Italy
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Prisciandaro M, Santinelli E, Tomarchio V, Tafuri MA, Bonchi C, Palazzo G, Nobile C, Marinucci A, Mele M, Annibali O, Rigacci L, Vacca M. Stem Cells Collection and Mobilization in Adult Autologous/Allogeneic Transplantation: Critical Points and Future Challenges. Cells 2024; 13:586. [PMID: 38607025 PMCID: PMC11011310 DOI: 10.3390/cells13070586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/23/2024] [Accepted: 03/26/2024] [Indexed: 04/13/2024] Open
Abstract
Achieving successful hematopoietic stem cell transplantation (HSCT) relies on two fundamental pillars: effective mobilization and efficient collection through apheresis to attain the optimal graft dose. These cornerstones pave the way for enhanced patient outcomes. The primary challenges encountered by the clinical unit and collection facility within a transplant program encompass augmenting mobilization efficiency to optimize the harvest of target cell populations, implementing robust monitoring and predictive strategies for mobilization, streamlining the apheresis procedure to minimize collection duration while ensuring adequate yield, prioritizing patient comfort by reducing the overall collection time, guaranteeing the quality and purity of stem cell products to optimize graft function and transplant success, and facilitating seamless coordination between diverse entities involved in the HSCT process. In this review, we aim to address key questions and provide insights into the critical aspects of mobilizing and collecting hematopoietic stem cells for transplantation purposes.
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Affiliation(s)
- Michele Prisciandaro
- Operative Research Unit of Transfusion Medicine and Cellular Therapy, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy; (C.B.); (G.P.); (C.N.); (A.M.)
| | - Enrico Santinelli
- Operative Research Unit of Hematology and Stem Cell Transplantation, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy; (E.S.); (V.T.); (M.A.T.); (M.M.); (O.A.); (L.R.)
- Program in Immunology, Molecular Medicine and Applied Biotechnologies, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Valeria Tomarchio
- Operative Research Unit of Hematology and Stem Cell Transplantation, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy; (E.S.); (V.T.); (M.A.T.); (M.M.); (O.A.); (L.R.)
| | - Maria Antonietta Tafuri
- Operative Research Unit of Hematology and Stem Cell Transplantation, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy; (E.S.); (V.T.); (M.A.T.); (M.M.); (O.A.); (L.R.)
| | - Cecilia Bonchi
- Operative Research Unit of Transfusion Medicine and Cellular Therapy, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy; (C.B.); (G.P.); (C.N.); (A.M.)
| | - Gloria Palazzo
- Operative Research Unit of Transfusion Medicine and Cellular Therapy, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy; (C.B.); (G.P.); (C.N.); (A.M.)
| | - Carolina Nobile
- Operative Research Unit of Transfusion Medicine and Cellular Therapy, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy; (C.B.); (G.P.); (C.N.); (A.M.)
| | - Alessandra Marinucci
- Operative Research Unit of Transfusion Medicine and Cellular Therapy, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy; (C.B.); (G.P.); (C.N.); (A.M.)
| | - Marcella Mele
- Operative Research Unit of Hematology and Stem Cell Transplantation, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy; (E.S.); (V.T.); (M.A.T.); (M.M.); (O.A.); (L.R.)
| | - Ombretta Annibali
- Operative Research Unit of Hematology and Stem Cell Transplantation, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy; (E.S.); (V.T.); (M.A.T.); (M.M.); (O.A.); (L.R.)
| | - Luigi Rigacci
- Operative Research Unit of Hematology and Stem Cell Transplantation, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy; (E.S.); (V.T.); (M.A.T.); (M.M.); (O.A.); (L.R.)
| | - Michele Vacca
- Operative Research Unit of Transfusion Medicine and Cellular Therapy, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy; (C.B.); (G.P.); (C.N.); (A.M.)
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Conconi A, Chiappella A, Ferreri AJM, Stathis A, Botto B, Sassone M, Gaidano G, Balzarotti M, Merli F, Tucci A, Vanazzi A, Tani M, Bruna R, Orsucci L, Cabras MG, Celli M, Annibali O, Liberati AM, Zanni M, Ghiggi C, Pisani F, Pinotti G, Dore F, Esposito F, Pirosa MC, Cesaretti M, Bonomini L, Vitolo U, Zucca E. IELSG30 phase 2 trial: intravenous and intrathecal CNS prophylaxis in primary testicular diffuse large B-cell lymphoma. Blood Adv 2024; 8:1541-1549. [PMID: 38181782 DOI: 10.1182/bloodadvances.2023011251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 11/30/2023] [Accepted: 12/01/2023] [Indexed: 01/07/2024] Open
Abstract
ABSTRACT Primary testicular diffuse large B-cell lymphoma (PTL) is characterized by high risk of contralateral testis and central nervous system (CNS) relapse. Chemoimmunotherapy with intrathecal (IT) CNS prophylaxis and contralateral testis irradiation eliminates contralateral recurrences and reduces CNS relapses. The IELSG30 phase 2 study investigated feasibility and activity of an intensified IT and IV CNS prophylaxis. Patients with stage I/II PTL who had not received treatment received 2 cycles of IV high-dose methotrexate (MTX) (1.5 g/m2) after 6 cycles of the R-CHOP regimen (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone, every 21 days). IT liposomal cytarabine was administered on day 0 of cycles 2 to 5 of 21-day R-CHOP regimen. Contralateral testis radiotherapy (25-30 Gy) was recommended. Fifty-four patients (median age: 66 years) with stage I (n = 32) or II (n = 22) disease were treated with R-CHOP, 53 received at least 3 doses of IT cytarabine, 48 received at least 1 dose of IV MTX, and 50 received prophylactic radiotherapy. No unexpected toxicity occurred. At a median follow-up of 6 years, there was no CNS relapse; 7 patients progressed, and 8 died, with 5-year progression-free and overall survival rates of 91% (95% confidence interval [CI], 79-96) and 92% (95% CI, 81-97), respectively. Extranodal recurrence was documented in 6 patients (in 2 without nodal involvement). In 4 cases, the relapse occurred >6 years after treatment. Causes of death were lymphoma (n = 4), second primary malignancy (n = 1), cerebral vasculopathy (n = 1), unknown (n = 2). Intensive prophylaxis was feasible and effective in preventing CNS relapses. Late relapses, mainly at extranodal sites, represented the most relevant pattern of failure. This trial was registered at www.clinicaltrials.gov as #NCT00945724.
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Affiliation(s)
| | - Annalisa Chiappella
- Haematology Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Anastasios Stathis
- Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Barbara Botto
- SC Ematologia, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Marianna Sassone
- Lymphoma Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Gianluca Gaidano
- SCDU Ematologia, Department of Translational Medicine, University of Eastern Piedmont and AOU Maggiore della Carità, Novara, Italy
| | - Monica Balzarotti
- UO Ematologia, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Francesco Merli
- Hematology Unit, Azienda USL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Alessandra Tucci
- Division of Hematology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Anna Vanazzi
- Division of Clinical Haemato-Oncology, European Institute of Oncology IRCCS, Milan, Italy
| | - Monica Tani
- UO Ematologia, Dipartimento Oncologia ed Ematologia, Ospedale Santa Maria delle Croci, Ravenna, Italy
| | - Riccardo Bruna
- Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Lorella Orsucci
- Lymphoma Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Melania Celli
- Ospedale degli Infermi, Hematology Unit, Rimini, Italy
| | - Ombretta Annibali
- Area Ematologia Medicina Trasfusionale e Terapia cellulare Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Anna Marina Liberati
- SC Oncoematologia, Azienda Ospedaliera Santa Maria, Università degli studi di Perugia, Terni, Italy
| | - Manuela Zanni
- Antonio e Biagio e Cesare Arrigo Hospital, Hematology Unit, Alessandria, Italy
| | - Chiara Ghiggi
- IRCCS Ospedale Policlinico San Martino UO Ematologia e Terapie Cellulari, Genoa, Italy
| | - Francesco Pisani
- Hematology and Stem Cell Transplantation Unit, IRCCS Istituto Nazionale dei Tumori Regina Elena, Rome, Italy
| | | | | | - Fabiana Esposito
- Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Maria Cristina Pirosa
- Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Institute of Oncology Research, Bellinzona, Switzerland
| | | | | | - Umberto Vitolo
- Medical Oncology, Candiolo Cancer Institute, Fondazione del Piemonte per l'Oncologia-IRCCS, Candiolo, Turin, Italy
| | - Emanuele Zucca
- Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
- Institute of Oncology Research, Bellinzona, Switzerland
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Fazio F, Passucci M, Micozzi J, Di Landro F, Fianchi L, Za T, Manieri VM, Annibali O, Cupelli L, Bongarzoni V, Gentili S, De Padua L, Crisanti E, Garzia MG, Rago A, Piciocchi A, Mengarelli A, Morè S, De Stefano V, Bafti MS, Martelli M, Petrucci MT. Effect of daratumumab on stem cell yields in patients with newly diagnosed multiple myeloma: a report from the Multiple Myeloma Group. Bone Marrow Transplant 2024:10.1038/s41409-024-02260-z. [PMID: 38461292 DOI: 10.1038/s41409-024-02260-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/28/2024] [Accepted: 02/29/2024] [Indexed: 03/11/2024]
Affiliation(s)
- F Fazio
- Hematology, Azienda Policlinico Umberto I-Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
| | - M Passucci
- Hematology, Azienda Policlinico Umberto I-Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - J Micozzi
- Hematology, Azienda Policlinico Umberto I-Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - F Di Landro
- Section of Hematology, Department of Radiological and Hematological Sciences, Catholic University, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - L Fianchi
- Section of Hematology, Department of Radiological and Hematological Sciences, Catholic University, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - T Za
- Section of Hematology, Department of Radiological and Hematological Sciences, Catholic University, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - V M Manieri
- Clinica di Ematologia Azienda Ospedaliero-Universitaria delle Marche, Ancona, Italy
| | - O Annibali
- Unit of Hematology, Stem Cell Transplantation, University Campus Bio-Medico, Rome, Italy
| | - L Cupelli
- UOC Hematology, Hospital S. Eugenio, Rome, Italy
| | - V Bongarzoni
- Department of Hematology San Giovanni-Addolorata Hospital, Rome, Italy
| | - S Gentili
- UOSD Ematologia Civitanova Marche AST Macerata, Rome, Italy
| | - L De Padua
- Hematology Unit, Fabrizio Spaziani Hospital, Frosinone, Italy
| | - E Crisanti
- Hematology and Transplant Unit, Santa Maria Goretti Hospital, AUSL, Latina, Italy
| | - M G Garzia
- Department of Hematology, Hematology San Camillo Forlanini Hospital Rome Italy, Rome, Italy
| | - A Rago
- UOSD Ematologia ASL Roma1, Rome, Italy
| | - A Piciocchi
- Italian Group for Adult Hematologic Diseases (GIMEMA) Data Center, Rome, Italy
| | - A Mengarelli
- Hematology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - S Morè
- Clinica di Ematologia Azienda Ospedaliero-Universitaria delle Marche, Ancona, Italy
| | - V De Stefano
- Section of Hematology, Department of Radiological and Hematological Sciences, Catholic University, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - M S Bafti
- Department of Immuno-Hematology and Transfusional Medicine, Policlinico Umberto I, Rome, Italy
| | - M Martelli
- Hematology, Azienda Policlinico Umberto I-Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - M T Petrucci
- Hematology, Azienda Policlinico Umberto I-Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
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Ayto R, Annibali O, Biedermann P, Roset M, Sánchez E, Kotb R. The EASEMENT study: A multicentre, observational, cross-sectional study to evaluate patient preferences, treatment satisfaction, quality of life, and healthcare resource use in patients with multiple myeloma receiving injectable-containing or fully oral therapies. Eur J Haematol 2024. [PMID: 38389468 DOI: 10.1111/ejh.14180] [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: 10/31/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 02/24/2024]
Abstract
OBJECTIVE As multiple myeloma (MM) therapies advance, understanding patients', caregivers', and physicians' perspectives on, and satisfaction with, available treatment options and their impact on quality of life (QoL), is important. METHODS EASEMENT is a real-world, observational, cross-sectional study conducted in 19 sites within the UK, Canada, and Italy using retrospective chart reviews and surveys. Enrolled patients had clinical history available since diagnosis and had received ≥1 cycle of their current line of therapy. Primary objectives were to describe patient/caregiver QoL (EQ-5D-5L questionnaire), patient preference for oral/injectable therapies (single discrete-choice question), and patient satisfaction (TSQM-9 questionnaire). RESULTS Between October 2018 and March 2020, 399 patients were enrolled (n = 192 newly diagnosed multiple myeloma [NDMM], n = 206 relapsed/refractory multiple myeloma [RRMM], n = 1 missing). Among NDMM and RRMM patients, 78%/22% and 42%/58% were receiving injectables/orals, respectively. Both NDMM and RRMM patients significantly preferred orals versus injectables (p < .0001). No significant differences were reported in treatment satisfaction or QoL, but treatment convenience favoured orals over injectables with near significance (p = .053). CONCLUSION MM patients perceived greater convenience and preference for orals versus injectables. Oral treatments are useful for patients who cannot or prefer not to travel to clinics, or cannot perform self-injection within the community.
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Affiliation(s)
- Robert Ayto
- Department of Haematology, Queen Alexandra Hospital, Portsmouth, UK
| | - Ombretta Annibali
- Hematology, Stem Cell Transplantation, Fondazione Policlinico Universitario Campus Bio Medico di Roma, Rome, Italy
| | - Patricia Biedermann
- Medical Affairs, Europe & Canada, Takeda Pharmaceuticals International AG, Zurich, Switzerland
| | | | | | - Rami Kotb
- Medical Oncology & Hematology, CancerCare Manitoba, Winnipeg, Manitoba, Canada
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Annibali O, Altomare A, Tomarchio V, Rocchi G, Mallio CA, Tafuri MA, Zobel BB, Vincenzi B, Guarino MPL, Rigacci L, Avvisati G. Sarcopenia does not impact the outcome of patients with Multiple Mieloma consolidated with autologous Hematopoietic Stem Cell Transplantation. Chemotherapy 2024:000535692. [PMID: 38330935 DOI: 10.1159/000535692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/12/2023] [Indexed: 02/10/2024]
Abstract
Sarcopenia has been associated with chronic diseases and cancer. Aim of this study was to evaluate sarcopenia in Multiple Myeloma patients undergoing autologous stem cell trans-plantation. In 68 eligible patients' measurement of skeletal muscle area (cm2) on computed tomography scans at the level of the L3 vertebra (L3-SMI) was performed. 37(54%) patients were categorized as sarcopenic: 26 males with L3-SMI values < 52.4 cm2/m2, and 11 women with L3-SMI values < 38.9 cm2/m2. The majority of sarcopenic patients included were older than 60 years (69%, p=0.0005), and with BMI <25 (75%; p=0.0000). A significant association was found between sarcopenia and Sorror score value > 1 (p=0.02). The Kaplan Meyer curve showed a median OS of 73.5 months for non-sarcopenic patients vs. 86.5 months for sarcopenic patients, suggesting that sarcopenia is not an independent prognostic factor in this cohort of patients.
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9
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Pelliccia S, Rogges E, Cardoni A, Lopez G, Conte E, Faccini AL, De Vito R, Girardi K, Bianchi A, Annibali O, Fratoni S, Remotti D, De Angelis G, Giordano C, Palumbo G, Scarpino S, Del Porto F, Bianchi MP, Di Gregorio F, Tafuri A, Di Napoli A. The application of a multidisciplinary approach in the diagnosis of Castleman disease and Castleman-like lymphadenopathies: A 20-year retrospective analysis of clinical and pathological features. Br J Haematol 2024; 204:534-547. [PMID: 37953489 DOI: 10.1111/bjh.19171] [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: 07/24/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Castleman disease (CD) comprises a group of rare and heterogeneous haematological disorders, including unicentric (UCD) and multicentric (MCD) forms, the latter further subdivided into HHV8-MCD, POEMS-MCD and idiopathic-MCD (iMCD). However, according to the Castleman Disease Collaborative Network guidelines, the diagnosis of CD can only be achieved through collaboration between clinicians and pathologists. METHODS We applied these clinical and pathological criteria and implement with clonality testing to a retrospective cohort of 48 adult and paediatric Italian patients diagnosed with reactive lymphadenitis with CD-like histological features. RESULTS We confirmed the diagnosis of CD in 60% (29/48) of the cases, including 12 (41%) UCD and 17 (59%; five HHV8-MCD, three POEMS-MCD and nine iMCD) MCD. Of the remaining 19 cases (40%) with multiple lymphadenopathy, 5 (26%) were classified as autoimmune diseases, 1 (5%) as autoimmune lymphoproliferative disorder, 1 (5%) as IgG4-related disease, 11 (83%) as reactive lymphadenitis and 1 (5%) as nodal marginal zone lymphoma. CONCLUSIONS Our study emphasizes the importance of the multidisciplinary approach to reactive lymphadenitis with CD-like features in order to achieve a definitive diagnosis and choose the appropriate treatment.
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Affiliation(s)
- Sabrina Pelliccia
- Haematology Unit, Department of Clinical and Molecular Medicine, Sant'Andrea University Hospital, Sapienza University, Rome, Italy
| | - Evelina Rogges
- Pathology Unit, Department of Clinical and Molecular Medicine, Sant'Andrea University Hospital, Sapienza University, Rome, Italy
| | | | - Gianluca Lopez
- Pathology Unit, Department of Clinical and Molecular Medicine, Sant'Andrea University Hospital, Sapienza University, Rome, Italy
| | - Esmeralda Conte
- Haematology Unit, Department of Clinical and Molecular Medicine, Sant'Andrea University Hospital, Sapienza University, Rome, Italy
| | - Anna Laura Faccini
- Haematology Unit, Department of Clinical and Molecular Medicine, Sant'Andrea University Hospital, Sapienza University, Rome, Italy
| | - Rita De Vito
- Pathology Unit, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - Katia Girardi
- Department of Pediatric Hematology and Oncology and Cell and Gene Therapy, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | | | - Ombretta Annibali
- Haematology Stem Cell Transplantation Unit, Campus Biomedico University Hospital, Campus Bio Medico University, Rome, Italy
| | - Stefano Fratoni
- Surgical Pathology Department, Sant' Eugenio Hospital, Rome, Italy
| | | | | | - Carla Giordano
- Department of Translational and Precision Medicine, A.O.U. Policlinico Umberto I, Sapienza University, Rome, Italy
| | - Giovanna Palumbo
- Haematology Unit, Department of Translational and Precision Medicine, A.O.U Policlinico Umberto I, Sapienza University, Rome, Italy
| | - Stefania Scarpino
- Pathology Unit, Department of Clinical and Molecular Medicine, Sant'Andrea University Hospital, Sapienza University, Rome, Italy
| | - Flavia Del Porto
- Internal Medicine Unit, Department of Clinical and Molecular Medicine, Sant'Andrea University Hospital, Sapienza University, Rome, Italy
| | - Maria Paola Bianchi
- Haematology Unit, Department of Clinical and Molecular Medicine, Sant'Andrea University Hospital, Sapienza University, Rome, Italy
| | - Francesca Di Gregorio
- Radiology Unit, Department of Surgical-Medical Sciences and Translational Medicine, Sant'Andrea University Hospital, Sapienza University, Rome, Italy
| | - Agostino Tafuri
- Haematology Unit, Department of Clinical and Molecular Medicine, Sant'Andrea University Hospital, Sapienza University, Rome, Italy
| | - Arianna Di Napoli
- Pathology Unit, Department of Clinical and Molecular Medicine, Sant'Andrea University Hospital, Sapienza University, Rome, Italy
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Raso S, Lucchesi A, Sardo M, Annibali O, Sucato V, Ciaccio M, Vitale S, Dolce A, Giordano G, Siragusa S, Napolitano M. Global hemostasis assays in acute myeloid leukemia: results of an observational prospective study. Blood Transfus 2024; 22:65-74. [PMID: 37458717 PMCID: PMC10812886 DOI: 10.2450/bloodtransfus.575] [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] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 03/24/2023] [Indexed: 01/27/2024]
Abstract
BACKGROUND Acute myeloid leukemia (AML) is characterized by a complex spectrum of coagulopathy ranging from hemorrhagic to thrombotic symptoms. To date, platelet count (PLT) and conventional coagulation tests (CCTs) cannot predict hemorrhagic events and thrombotic risk. Thromboelastography (TEG) measures the viscoelastic properties of the clot, thus providing information on the entire process of blood coagulation. The primary aim of the study was to assess the hemostatic balance from AML diagnosis to the end of chemotherapy (CHT) by TEG. MATERIAL AND METHODS Here we present the results of a prospective study enrolling newly diagnosed AML patients treated with chemotherapy. Patients had complete blood counts (CBCs), TEG and CCTs performed at three time points: 1) diagnosis (T0); 2) during the first cycle of CHT (T1); and 3) at the end of CHT (T2). An algorithm of TEG indirectly calculated thrombin generation (TG). Patients underwent daily follow-up for bleeding and thrombotic episodes up to the time of hospital discharge or death. RESULTS Eighty consecutive patients were evaluated; forty were eligible for the study, and 21 completed the entire study. At T1, maximum amplitude (MA), TG and K-time were significantly shifted toward a hypocoagulability state compared to T0 (p<0.05), while a hypercoagulable state at T2 was shown by changes in α-angle, MA and TG values. Otherwise, there were no statistically significant differences in CCTs between the evaluated time points. DISCUSSION Overall, TEG revealed complex and dynamic coagulation abnormalities in patients with AML according to both the course of disease and therapy. Further studies are needed to investigate more fully the role of TEG in defining the hemostatic profile in patients with AML.
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Affiliation(s)
- Simona Raso
- University of Palermo, Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), Palermo, Italy
- Department of Hematology and Rare Diseases, V Cervello Hospital, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy
| | - Alessandro Lucchesi
- Hematology Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Mariano Sardo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo and Policlinico Paolo Giaccone, Unit of Hematology, Palermo, Italy
| | | | - Vincenzo Sucato
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo and Policlinico Cardiology Unit, Paolo Giaccone, Palermo, Italy
| | - Marcello Ciaccio
- Department and U.O.C. Laboratory Medicine, “Paolo Giaccone” University Hospital, Palermo, Italy
| | - Silvana Vitale
- Department and U.O.C. Laboratory Medicine, “Paolo Giaccone” University Hospital, Palermo, Italy
| | | | - Giulio Giordano
- Division of Internal Medicine, Hematology Service, Regional Hospital “A. Cardarelli”, Campobasso, Italy
| | - Sergio Siragusa
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo and Policlinico Paolo Giaccone, Unit of Hematology, Palermo, Italy
| | - Mariasanta Napolitano
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo and Policlinico Paolo Giaccone, Unit of Hematology, Palermo, Italy
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Mallio CA, Bernetti C, Castiello G, Gangemi E, Tomarchio V, Annibali O, Rigacci L, Van Goethem J, Parizel PM, Beomonte Zobel B, Quattrocchi CC. Neuroradiology of acute pathologies in adults with hematologic malignancies: a pictorial review. Quant Imaging Med Surg 2023; 13:7530-7551. [PMID: 37969623 PMCID: PMC10644134 DOI: 10.21037/qims-22-1201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 02/20/2023] [Indexed: 11/17/2023]
Abstract
Hematopoietic and lymphoid tumors are a heterogeneous group of diseases including lymphomas, multiple myeloma (MM), and leukemias. These diseases are associated with systemic involvement and various clinical presentations including acute neurological deficits. Adult patients with hematologic malignancies (HM) are at risk for developing a wide array of acute conditions involving the nervous system. HM in adults may present as tumoral masses responsible for mass effect, possibly resulting in acute neurological signs and symptoms caused by tumor growth with compression of central nervous system (CNS) structures. Moreover, as result of the hematologic disease itself or due to systemic treatments, hematologic patients are at risk for vascular pathologies, such as ischemic, thrombotic, and hemorrhagic disorders due to the abnormal coagulation status. The onset of these disorders is often with acute neurologic signs or symptoms. Lastly, it is well known that patients with HM can have impaired function of the immune system. Thus, CNS involvement due to immune-related diseases such as mycotic, parasitic, bacterial, and viral infections linked to immunodeficiency, together with immune reconstitution inflammatory syndrome, are frequently seen in hematologic patients. Knowledge of the etiology and expected CNS imaging findings in patients with HM is of great importance to reach a fast and correct diagnosis and guide treatment choices. In this manuscript, we review the computed tomography (CT) and magnetic resonance findings of these conditions which can be related to the disease itself and/or to their treatments.
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Affiliation(s)
- Carlo A. Mallio
- Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma, Italy
- Operative Research Unit of Diagnostic Imaging, Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
| | - Caterina Bernetti
- Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma, Italy
- Operative Research Unit of Diagnostic Imaging, Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
| | - Gennaro Castiello
- U.O.S. Diagnostica per Immagini, Azienda Ospedaliera San Camillo Forlanini, Roma, Italy
| | - Emma Gangemi
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Valeria Tomarchio
- Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma, Italy
- Operative Research Unit of Hematology and Stem Cell Transplantation, Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
| | - Ombretta Annibali
- Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma, Italy
- Operative Research Unit of Hematology and Stem Cell Transplantation, Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
| | - Luigi Rigacci
- Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma, Italy
- Operative Research Unit of Hematology and Stem Cell Transplantation, Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
| | - Johan Van Goethem
- Department of Radiology, Antwerp University Hospital, Edegem, Belgium
| | - Paul M. Parizel
- David Hartley Chair of Radiology, Royal Perth Hospital & University of Western Australia, Perth, WA, Australia
| | - Bruno Beomonte Zobel
- Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma, Italy
- Operative Research Unit of Diagnostic Imaging, Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
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12
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Mallio CA, Vaccarino F, Parillo M, Annibali O, Rigacci L, Meduri GM, Pilato F, Beomonte Zobel B, Di Lazzaro V. Artery of Huebner stroke chameleon presenting as central nervous system lymphoma: a case description. Quant Imaging Med Surg 2023; 13:7646-7649. [PMID: 37969621 PMCID: PMC10644133 DOI: 10.21037/qims-23-437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/02/2023] [Indexed: 11/17/2023]
Affiliation(s)
- Carlo Augusto Mallio
- Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
- Research Unit of Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
| | - Federica Vaccarino
- Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
- Research Unit of Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
| | - Marco Parillo
- Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
- Research Unit of Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
| | - Ombretta Annibali
- Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
- Research Unit of Hematology and Stem Cell Transplantation, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
| | - Luigi Rigacci
- Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
- Research Unit of Hematology and Stem Cell Transplantation, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
| | - Guido M. Meduri
- Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
- Research Unit of Nuclear Medicine, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
| | - Fabio Pilato
- Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
- Research Unit of Neurology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
| | - Bruno Beomonte Zobel
- Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
- Research Unit of Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
| | - Vincenzo Di Lazzaro
- Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
- Research Unit of Neurology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
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13
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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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14
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Cordone I, Amodeo R, Bellesi S, Bottan F, Buccisano F, De Propris MS, Masi S, Panichi V, Scerpa MC, Annibali O, Bongarzoni V, Caravita di Toritto T, Coppetelli U, Cupelli L, de Fabritiis P, Franceschini L, Garzia M, Fiorini A, Laverde G, Mengarelli A, Za T, Petrucci MT. Consensus for Flow Cytometry Clinical Report on Multiple Myeloma: A Multicenter Harmonization Process Merging Laboratory Experience and Clinical Needs. Cancers (Basel) 2023; 15:cancers15072060. [PMID: 37046720 PMCID: PMC10093543 DOI: 10.3390/cancers15072060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/14/2023] [Accepted: 03/14/2023] [Indexed: 04/03/2023] Open
Abstract
Flow cytometry is a highly sensitive and specific approach for discriminating between normal and clonal plasma cells in multiple myeloma. Uniform response criteria after treatment have been established by the International Myeloma Working Group and the EuroFlow Group; however, the way in which flow cytometry data are reported has suffered from no collaborative or multicentre efforts. This study, involving 8 expert laboratories and 12 clinical hematology units of the Lazio region in Italy, aims to produce a uniform and shared report among the various Centres. From the pre-analytical phase to sample processing, data acquisition, analysis, and evaluation of the potential limitations and pitfalls of the entire process, the study reaches a final conclusion shared by laboratories and clinicians according to the most updated principles and recommendations. The aim was to identify the necessary data to be included in the clinical report by using multiple-choice questionnaires at every single stage of the process. An agreement of more than 75% of the laboratories was considered mandatory for the data to be included in the report. By ensuring the operational autonomy of each laboratory, this study provides a clear report that limits subjective interpretations and highlights possible bias in the process, better supporting clinical decision-making.
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Affiliation(s)
- Iole Cordone
- Department of Research, Advanced Diagnostic and Technological Innovation, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
- Correspondence: ; Tel.: +39-065-266-5110
| | - Rachele Amodeo
- Clinical Pathology and Biochemistry Unit, Sant’Andrea University Hospital, 00189 Rome, Italy
| | - Silvia Bellesi
- Department of Diagnostic Imaging, Oncological Radiotherapy and Haematology, IRCCS Foundation A. Gemelli University Hospital, 00168 Rome, Italy
| | - Fiorella Bottan
- Clinical Pathology Unit, San Giovanni Addolorata Hospital, 00184 Rome, Italy
| | - Francesco Buccisano
- Haematology and Stem Cell Transplant Unit, Department of Biomedicine and Prevention, University of Rome ‘Tor Vergata’, 00133 Rome, Italy
| | - Maria Stefania De Propris
- Immunophenotype Laboratory, Department of Translational and Precision Medicine, ‘Sapienza’ University, 00185 Rome, Italy
| | - Serena Masi
- Department of Research, Advanced Diagnostic and Technological Innovation, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Valentina Panichi
- Microbiology and Virology Unit, Department of Oncology and Haematology, Belcolle Central Hospital, 01100 Viterbo, Italy
| | - Maria Cristina Scerpa
- Haematology and Stem Cell Unit, Santa Maria Goretti Hospital, ASL Latina, 04100 Latina, Italy
| | - Ombretta Annibali
- Haematology and Stem Cell Transplant Unit, Campus Bio-Medico University, 00128 Rome, Italy
| | - Velia Bongarzoni
- Haematology Unit, San Giovanni Addolorata Hospital, 00184 Rome, Italy
| | | | - Ugo Coppetelli
- Haematology and Stem Cell Unit, Santa Maria Goretti Hospital, ASL Latina, 04100 Latina, Italy
| | - Luca Cupelli
- Haematology Unit, Sant’Eugenio Hospital, ASL Roma 2, 00144 Rome, Italy
| | | | - Luca Franceschini
- Haematology and Stem Cell Transplant Unit, Department of Biomedicine and Prevention, University of Rome ‘Tor Vergata’, 00133 Rome, Italy
| | - Mariagrazia Garzia
- Haematology and Stem Cell Transplant Unit, San Camillo Forlanini Hospital, 00152 Rome, Italy
| | - Alessia Fiorini
- Department of Oncology and Haematology, Belcolle Central Hospital, 01100 Viterbo, Italy
| | - Giacinto Laverde
- Haematology Unit, Sant’Andrea University Hospital, 00189 Rome, Italy
| | - Andrea Mengarelli
- Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Tommaso Za
- Department of Diagnostic Imaging, Oncological Radiotherapy and Haematology, IRCCS Foundation A. Gemelli University Hospital, 00168 Rome, Italy
| | - Maria Teresa Petrucci
- Haematology Unit, Department of Translational and Precision Medicine, ‘Sapienza’ University, 00185 Rome, Italy
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15
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Margiotta-Casaluci G, Bigliardi S, Cocito F, Meli E, Petrucci L, Nicolosi M, Annibali O, Boccomini C, Bozzoli V, Castellino A, Cattina F, Cenfra N, Ciavarella S, Kovalchuk S, Rotondo F, Fama A, Olivieri J, Zaja F. Comparison of first-line treatment with bendamustine plus rituximab versus R-CHOP for patients with follicular lymphoma grade 3A: Results of a retrospective study from the Fondazione Italiana Linfomi. Front Oncol 2023; 13:1120967. [PMID: 36969038 PMCID: PMC10036382 DOI: 10.3389/fonc.2023.1120967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 02/06/2023] [Indexed: 03/12/2023] Open
Abstract
In the setting of follicular lymphoma (FL), frontline therapy with rituximab, cyclophosphamide, doxorubicin, and prednisone (R-CHOP) has represented for many years the standard of care for patients with symptomatic advanced disease. More recently, the combination of bendamustine plus rituximab (R-B) has emerged as an alternative therapeutic option. We present a retrospective, multicenter, observational study aimed at comparing outcomes and toxicities observed in 145 patients diagnosed with grade 3A FL treated with a first line therapy in 15 Italian Fondazione Italiana Linfomi centers between the 1st of January 2014 and the 30th of May 2018. Seventy patients were treated with R-B and 75 with R-CHOP. In the R-B group, the median age at the time of diagnosis was 67 years compared with 59 years in the R-CHOP group. Patients in R-B group achieved a similar overall response rate (96% vs. 99%) and a better complete remission rate (87% vs. 80%, p=0.035) compared with patients in R-CHOP group. Progression free survival (PFS) was similar between individual treated with R-CHOP and R-B (48- month PFS 77.7% vs. 76.6% respectively, p=0.745). The overall survival was significantly longer with R-CHOP treatment (HR=0.16; 95% IC, 0.04-0.74; p=0.007); however, no statistical significant difference was observed after adjustment for age. With the limitations of the study design, our results suggest that both R-B and R-CHOP seem to be valid first-line treatment options in FL3A.
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Affiliation(s)
- Gloria Margiotta-Casaluci
- Division of Hematology, Department of Translational Medicine, AOU Maggiore della Carità, Novara, Italy
- *Correspondence: Gloria Margiotta-Casaluci,
| | - Sara Bigliardi
- Oncology Unit, Azienda Unità Sanitaria Locale Modena, Area Sud Sede di Sassuolo, Sassuolo, Italy
| | - Federica Cocito
- Department of Hematology, San Gerardo University Hospital, Monza, Italy
| | - Erika Meli
- Department of Hematology, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Luigi Petrucci
- Divisions of Hematology, Department of Translation and Precision Medicine, Policlinico Umberto I, Rome, Italy
| | - Maura Nicolosi
- Hematology Unit, Città della Salute e della Scienza, University and Hospital Torino, Torino, Italy
| | - Ombretta Annibali
- Hematology and Bone Marrow Transplant Unit, University Campus Bio-Medico, Rome, Italy
| | - Carola Boccomini
- Hematology Unit, Città della Salute e della Scienza, University and Hospital Torino, Torino, Italy
| | | | | | | | - Natalia Cenfra
- Department of Hematology, Ospedale Santa Maria Goretti, Latina, Italy
| | - Sabino Ciavarella
- Hematology Unit, Laboratory oh Hematology and Cell Therapy, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | | | | | - Angelo Fama
- Hematology Unit, IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Jacopo Olivieri
- Hematology Unit, Hospital Santa Maria della Misericordia, Udine, Italy
| | - Francesco Zaja
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
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16
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Annibali O, Tomarchio V, Gregorj C, Di Cerbo M, Armiento D, Antonelli L, Vincenzi B, Nobile C, Vacca M, Tirindelli MC, Avvisati G. Circulating Endothelial Cell Kinetic in Patients with Multiple Myeloma Who Receive Autologous Hematopoietic Stem Cell Transplantation. Chemotherapy 2023; 68:138-142. [PMID: 36893739 DOI: 10.1159/000529665] [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: 10/26/2022] [Accepted: 01/02/2023] [Indexed: 03/11/2023]
Abstract
INTRODUCTION Neoangiogenesis has a crucial role in multiple myeloma (MM), and circulating endothelial cells (CECs) contribute to neovascularization by inducing tumor progression and metastasis and by repairing damage to bone marrow vasculature after stem cell transplantation (HSC). We recently proved in a national multicenter study the possibility to reach a high-level standardization in CEC count and analysis based on a polychromatic flow cytometry Lyotube (BD). Our study aimed at assessing the kinetics of CECs in patients with MM undergoing autologous hematopoietic stem cell transplantation (Au-HSCT). METHODS Blood samples for analysis were collected at different time points before (T0, T1) and after (T2, T3, T4) Au-HSCT. For each sample, 20 × 106 leukocytes were processed as already described (Lanuti 2016 e 2018) through a multistep procedure. CECs were eventually identified as 7-ADDneg/Syto16pos/CD45neg/CD34pos/CD146pos. RESULTS Twenty-six MM patients were enrolled in the study. Overall, we observed a constant increase of CECs values from T0 to T3 (day of neutrophil engraftment) followed by decrease at T4 (100 days after transplantation). Using the median value of CECs at T3, we could define a cut-off concentration of 618/mL, with patients with more infective complications having CECs above that value (9/13 vs. 2/13; p = 0.005). CONCLUSION CECs value may be a function of endothelial damage caused by conditioning regimen, as suggested by the increase of their level during the engraftment period. A more severe endothelial damage is reflected by the increase of infective complications in patients with higher CECs value at T3.
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Affiliation(s)
- Ombretta Annibali
- Hematology and Stem Cell Transplantation, Fondazione Policlinico Campus Bio-Medico, Rome, Italy
| | - Valeria Tomarchio
- Hematology and Stem Cell Transplantation, Fondazione Policlinico Campus Bio-Medico, Rome, Italy
| | - Chiara Gregorj
- Hematology and Stem Cell Transplantation, Fondazione Policlinico Campus Bio-Medico, Rome, Italy
| | - Melania Di Cerbo
- Transfusion Medicine and Cell Therapy, Fondazione Policlinico Campus Bio-Medico, Rome, Italy
| | - Daniele Armiento
- Hematology and Stem Cell Transplantation, Fondazione Policlinico Campus Bio-Medico, Rome, Italy
| | - Lara Antonelli
- Hematology and Stem Cell Transplantation, Fondazione Policlinico Campus Bio-Medico, Rome, Italy
| | - Bruno Vincenzi
- Medical Oncology, Department of Medicine, Università Campus Bio-Medico di Roma, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Carolina Nobile
- Transfusion Medicine and Cell Therapy, Fondazione Policlinico Campus Bio-Medico, Rome, Italy
| | - Michele Vacca
- Transfusion Medicine and Cell Therapy, Fondazione Policlinico Campus Bio-Medico, Rome, Italy
| | | | - Giuseppe Avvisati
- Hematology and Stem Cell Transplantation, Fondazione Policlinico Campus Bio-Medico, Rome, Italy
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17
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Ciccarone M, Cavaceppi P, Tesei C, Brunetti S, Pulsoni A, Annibali O, Gasparoli C, Battistini R, Hohaus S, Pelliccia S, Tafuri A, Cox MC, Cantonetti M, Rigacci L, Abruzzese E. Effects of ABVD chemotherapy on ovarian function: epidemiology, hormonal dosages and ultrasound morphologic analyses in 270 patients with Hodgkin's disease. Front Oncol 2023; 13:1059393. [PMID: 37152067 PMCID: PMC10160490 DOI: 10.3389/fonc.2023.1059393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 03/27/2023] [Indexed: 05/09/2023] Open
Abstract
Introduction Classical Hodgkin Lymphoma (HL) is a lymphoproliferative disease typically diagnosed in the young. The excellent results obtained with current treatment lead to long survival with age-related complications affecting patients' survival and quality of life. One issue affecting HL patients is infertility. This problem can be easily overcome in males with seminal liquid cryopreservation, however, in females it is more complex either in terms of the quality of the cryopreserved material or the patients' age at diagnosis. Moreover, not all chemo- or radio-therapies have the same negative impact on fertility.The main objectives of this study was to collect epidemiological information on HL patients involved in fertility preservation counseling and to analyze the impact of ABVD (adriamycin, bleomycin, vinblastine, and dacarbazine), the standard treatment for HL, on ovarian function, hormonal levels and ovarian and uterine tissue morphologies. Patterns of fertility preservation were also reported. Methods Data were obtained from 270 female patients at HL onset who were interested in fertility counseling prior to therapy initiation. Each patient was assessed at HL diagnosis for levels of Anti-Mullerian Hormone (AMH), Follicle Stimulating Hormone (FSH), and 17β-oestradiol (17β-oe), with additional assessments at 6 and 12 months after chemotherapy. Patients were evaluated with ultrasound scans to study the number of ovarian follicles and the degree of uterine thickness at the same timepoints. Results The average patient AMH level showed a statistically significant reduction at 6 months after chemotherapy (p=0.05) and by the 12 month time point returned to near pre-chemotherapy values. FSH and 17β-oe levels did not significantly vary throughout the study period. ABVD chemotherapy was associated with a significant reduction of both ovarian follicles and endometrial thickness at the 6 month time point followed by a recovery at the 12 time point in both ovaries. Different results were observed when patients changed treatment to a more intensive one. Discussion Based on the results from the hormonal measurements and the follicle echography, it appears that the toxic effect of ABVD on fertility is transient, whereas, in contrast, more intensive therapies may potentially be more harmful and long-lasting.
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Affiliation(s)
- Mariavita Ciccarone
- Associazione Gemme Dormienti Organizzazione Non Lucrativa di Utilità Sociale (ONLUS), Rome, Italy
- Gynecologic Unit , San Carlo di Nancy Hospital, Rome, Italy
| | - Paola Cavaceppi
- Associazione Gemme Dormienti Organizzazione Non Lucrativa di Utilità Sociale (ONLUS), Rome, Italy
- LabAurelia, Rome, Italy
| | - Cristiano Tesei
- Associazione Gemme Dormienti Organizzazione Non Lucrativa di Utilità Sociale (ONLUS), Rome, Italy
| | - Stefania Brunetti
- Associazione Gemme Dormienti Organizzazione Non Lucrativa di Utilità Sociale (ONLUS), Rome, Italy
| | - Alessandro Pulsoni
- Department of Cellular Biotechnology and Haematology, Sapienza University, Rome, Italy
| | - Ombretta Annibali
- UOC Haematology Stem Cell Transplantation, University Campus Bio Medico, Rome, Italy
| | | | - Roberta Battistini
- UOC Ematologia e Trapianti CSE, Azienda Ospedaliera (AO) San Camillo Forlanini, Rome, Italy
| | - Stefan Hohaus
- Policlinico Gemelli Foundation, Catholic University of the Sacred Heart, Rome, Italy
| | - Sabrina Pelliccia
- Haematology Unit, Azienda Ospedaliera‐ Universitaria Sant’Andrea, Rome, Italy
| | - Agostino Tafuri
- Haematology Unit, Azienda Ospedaliera‐ Universitaria Sant’Andrea, Rome, Italy
| | | | | | - Luigi Rigacci
- UOC Ematologia e Trapianti CSE, Azienda Ospedaliera (AO) San Camillo Forlanini, Rome, Italy
| | - Elisabetta Abruzzese
- Hematology, S. Eugenio Hospital, Tor Vergata University, ASL Roma2, Rome, Italy
- *Correspondence: Elisabetta Abruzzese,
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18
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Cox MC, Marcheselli L, Scafetta G, Visco C, Hohaus S, Annibali O, Musuraca G, Fabbri A, Cantonetti M, Pelliccia S, Papotti R, Petrucci L, Tani M, Battistini R, Arcari A, Luminari S, Lopez G, Alma E, Pupo L, Carli G, Marchesi F, Re F, Scarpino S, D'amore ESG, Larocca LM, Bianchi A, Pepe G, Natalino F, Anticoli-Borza P, Cenfra N, Andriani A, Abruzzese E, Tesei C, Leoncini L, Asioli S, Ruco L, Di Napoli A. IgM-secreting diffuse large B-cell lymphoma: results of a multicentre clinicopathological and molecular study. Leukemia 2022; 36:2719-2723. [PMID: 36127510 DOI: 10.1038/s41375-022-01706-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 09/07/2022] [Accepted: 09/09/2022] [Indexed: 11/17/2022]
Affiliation(s)
- M Christina Cox
- Fondazione Policlinico Tor Vergata, University Hospital, Rome, Italy.
| | | | - Giorgia Scafetta
- Department of Clinical and Molecular Medicine, Sapienza University, Sant'Andrea University Hospital, Rome, Italy
| | | | - Stefan Hohaus
- Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Roma, Italy
| | | | - Gerardo Musuraca
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy
| | | | - Maria Cantonetti
- Fondazione Policlinico Tor Vergata, University Hospital, Rome, Italy
| | - Sabrina Pelliccia
- Department of Clinical and Molecular Medicine, Sapienza University, Sant'Andrea University Hospital, Rome, Italy
| | - Robel Papotti
- Chimomo department, university of Modena and Reggio Emilia, Modena, Italy
| | | | - Monica Tani
- Ospedale Santa Maria delle Croci, Ravenna, Italy
| | | | | | - Stefano Luminari
- Hematology Ausl IRCCS of Reggio Emilia & Chimomo department, university of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Gianluca Lopez
- Department of Clinical and Molecular Medicine, Sapienza University, Sant'Andrea University Hospital, Rome, Italy
| | - Eleonora Alma
- Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Roma, Italy
| | - Livio Pupo
- Fondazione Policlinico Tor Vergata, University Hospital, Rome, Italy
| | | | | | | | - Stefania Scarpino
- Department of Clinical and Molecular Medicine, Sapienza University, Sant'Andrea University Hospital, Rome, Italy
| | | | - Luigi M Larocca
- Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Roma, Italy
| | | | - Giuseppina Pepe
- Department of Clinical and Molecular Medicine, Sapienza University, Sant'Andrea University Hospital, Rome, Italy
| | | | | | | | | | | | - Cristiano Tesei
- Fondazione Policlinico Tor Vergata, University Hospital, Rome, Italy
| | | | - Silvia Asioli
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy
| | - Luigi Ruco
- Department of Clinical and Molecular Medicine, Sapienza University, Sant'Andrea University Hospital, Rome, Italy
| | - Arianna Di Napoli
- Department of Clinical and Molecular Medicine, Sapienza University, Sant'Andrea University Hospital, Rome, Italy.
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19
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Pagano L, Criscuolo M, Broccoli A, Piciocchi A, Varettoni M, Galli E, Anastasia A, Cantonetti M, Trentin L, Kovalchuk S, Orsucci L, Frustaci A, Spolzino A, Volpetti S, Annibali O, Storti S, Stelitano C, Marchesi F, Offidani M, Casadei B, Nizzoli ME, De Luca ML, Fianchi L, Motta M, Guarnera L, Simonetti E, Visentin A, Vassallo F, Deodato M, Sarlo C, Olivieri A, Falini B, Pulsoni A, Tiacci E, Zinzani PL. Long-term follow-up of cladribine treatment in hairy cell leukemia: 30-year experience in a multicentric Italian study. Blood Cancer J 2022; 12:109. [PMID: 35853850 PMCID: PMC9296486 DOI: 10.1038/s41408-022-00702-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 03/02/2022] [Revised: 06/17/2022] [Accepted: 06/28/2022] [Indexed: 12/16/2022] Open
Abstract
Hairy cell leukemia (HCL) is a rare lymphoproliferative disease with an excellent prognosis after treatment with cladribine (2CDA), although relapse may occur during follow-up. The aim of the study is to review the efficacy, safety, long-term remission rate, and overall survival (OS) in those patients who received 2CDA as first-line treatment. We retrospectively reviewed data of HCL patients treated with 2CDA between March 1991 and May 2019 at 18 Italian Hematological centers: 513 patients were evaluable for study purpose. The median age was 54 years (range 24–88) and ECOG was 0 in 84.9% of cases. A total of 330 (64.3%) patients received 2CDA intravenously and 183 (35.7%) subcutaneously. ORR was 91.8%: CR was obtained in 335 patients (65.3%), PR in 96 (18.7%), and hematological response in 40 (7.8%) patients; in 42 (8.2%) no response was observed. Hemoglobin value (p = 0.044), frequency of circulating hairy cells (p = 0.039), recovery of absolute neutrophil count (p = 0.006), and normalization of spleen (p ≤ 0.001) were associated with CR compared to PR in univariable analysis. At a median follow-up of 6.83 years (range 0.04–28.52), the median time to relapse was 12.2 years. A significant difference in duration of response was identified between patients that obtained a CR and PR (19.4 years versus 4.8 years, p < 0.0001). Non-hematological grade 3 or higher early toxicity was reported in 103 (20.1%) patients. Median OS was not reached: 95.3%, 92.4%, and 81.8% of patients were estimated to be alive at 5, 10, and 15 years, respectively. Forty-nine patients died (9.5%), following an infection in 14 cases (2.7%), natural causes in 14 (2.7%), cardiovascular events in 13 (2.5%), a second neoplasm in 6 (1.2%), and progression of HCL in 2 cases (0.4%). Following treatment of HCL with 2CDA, 80% of patients are estimated to be alive 15 years after diagnosis.
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Affiliation(s)
- Livio Pagano
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Marianna Criscuolo
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.
| | - Alessandro Broccoli
- IRCCS Azienda Ospedaliero-Universitaria di Bologna Istituto di Ematologia "Seràgnoli", Roma, Italy.,Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale Università di Bologna, Bologna, Italy
| | | | - Marzia Varettoni
- Divisione di Ematologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Eugenio Galli
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma, Italy
| | | | - Maria Cantonetti
- Dipartimento di Oncoematologia Policlinico Tor Vergata, Università Tor Vergata, Roma, Italy
| | - Livio Trentin
- Division of Haematology and Clinical Immunology, University of Padova, Padova, Italy
| | | | - Lorella Orsucci
- S.C. Ematologia, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Annamaria Frustaci
- Divisione di Ematologia, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Angelica Spolzino
- Dipartimento di Medicina e Chirurgia, Università degli studi di Parma, Parma, Italy.,Oncoematologia, Istituto Oncologico Veneto IOV-IRCSS, Castelfranco Veneto, Italy
| | - Stefano Volpetti
- Clinica Ematologia, Azienda Sanitaria Universitaria Integrata, Udine, Italy
| | - Ombretta Annibali
- Hematology and Stem Cell Transplantation Unit, Campus Bio-Medico University, Roma, Italy
| | - Sergio Storti
- UOC Oncoematologia Fondazione di Ricerca e Cura Giovanni Paolo II, Campobasso - Università Cattolica del Sacro Cuore, Campobasso, Italy
| | - Caterina Stelitano
- Divisione di Ematologia, Azienda Ospedaliera "Bianchi Melacrino Morelli", Reggio Calabria, Italy
| | - Francesco Marchesi
- Haematology and Stem Cell Transplantation Unit, IRCCS Regina Elena National Cancer Institute, Roma, Italy
| | - Massimo Offidani
- Clinica di Ematologia, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Ancona, Italy
| | - Beatrice Casadei
- IRCCS Azienda Ospedaliero-Universitaria di Bologna Istituto di Ematologia "Seràgnoli", Roma, Italy.,Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale Università di Bologna, Bologna, Italy
| | - Maria Elena Nizzoli
- Divisione di Ematologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Maria Lucia De Luca
- Divisione di Ematologia, Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Luana Fianchi
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Marina Motta
- Department of Hematology, ASST Spedali Civili, Brescia, Italy
| | - Luca Guarnera
- Dipartimento di Oncoematologia Policlinico Tor Vergata, Università Tor Vergata, Roma, Italy
| | - Edoardo Simonetti
- Institute of Hematology and Center for Hemato-Oncology Research, Department of Medicine and Surgery, University and Hospital of Perugia, Perugia, Italy
| | - Andrea Visentin
- Division of Haematology and Clinical Immunology, University of Padova, Padova, Italy
| | - Francesco Vassallo
- S.C. Ematologia, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Marina Deodato
- Divisione di Ematologia, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Chiara Sarlo
- Hematology and Stem Cell Transplantation Unit, Campus Bio-Medico University, Roma, Italy
| | - Attilio Olivieri
- Clinica di Ematologia, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Ancona, Italy
| | - Brunangelo Falini
- Institute of Hematology and Center for Hemato-Oncology Research, Department of Medicine and Surgery, University and Hospital of Perugia, Perugia, Italy
| | - Alessandro Pulsoni
- Divisione di Ematologia, Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Enrico Tiacci
- Institute of Hematology and Center for Hemato-Oncology Research, Department of Medicine and Surgery, University and Hospital of Perugia, Perugia, Italy
| | - Pier Luigi Zinzani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna Istituto di Ematologia "Seràgnoli", Roma, Italy.,Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale Università di Bologna, Bologna, Italy
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20
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Bertamini L, Oliva S, Rota-Scalabrini D, Paris L, Morè S, Corradini P, Ledda A, Gentile M, De Sabbata G, Pietrantuono G, Pascarella A, Tosi P, Curci P, Gilestro M, Capra A, Galieni P, Pisani F, Annibali O, Monaco F, Liberati AM, Palmieri S, Luppi M, Zambello R, Fazio F, Belotti A, Tacchetti P, Musto P, Boccadoro M, Gay F. High Levels of Circulating Tumor Plasma Cells as a Key Hallmark of Aggressive Disease in Transplant-Eligible Patients With Newly Diagnosed Multiple Myeloma. J Clin Oncol 2022; 40:3120-3131. [PMID: 35666982 DOI: 10.1200/jco.21.01393] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
PURPOSE High levels of circulating tumor plasma cells (CTC-high) in patients with multiple myeloma are a marker of aggressive disease. We aimed to confirm the prognostic impact and identify a possible cutoff value of CTC-high for the prediction of progression-free survival (PFS) and overall survival (OS), in the context of concomitant risk features and minimal residual disease (MRD) achievement. METHODS CTC were analyzed at diagnosis with two-tube single-platform flow cytometry (sensitivity 4 × 10-5) in patients enrolled in the multicenter randomized FORTE clinical trial (ClinicalTrials.gov identifier: NCT02203643). MRD was assessed by second-generation multiparameter flow cytometry (sensitivity 10-5). We tested different cutoff values in series of multivariate (MV) Cox proportional hazards regression analyses on PFS outcome and selected the value that maximized the Harrell's C-statistic. We analyzed the impact of CTC on PFS and OS in a MV analysis including baseline features and MRD negativity. RESULTS CTC analysis was performed in 401 patients; the median follow-up was 50 months (interquartile range, 45-54 months). There was a modest correlation between the percentage of CTC and bone marrow plasma cells (r = 0.38). We identified an optimal CTC cutoff of 0.07% (approximately 5 cells/µL, C-index 0.64). In MV analysis, CTC-high versus CTC-low patients had significantly shorter PFS (hazard ratio, 2.61; 95% CI, 1.49 to 2.97, P < .001; 4-year PFS 38% v 69%) and OS (hazard ratio, 2.61; 95% CI, 1.49 to 4.56; P < .001; 4-year OS 68% v 92%). The CTC levels, but not the bone marrow plasma cell levels, affected the outcome. The only factor that reduced the negative impact of CTC-high was the achievement of MRD negativity (interaction P = .039). CONCLUSION In multiple myeloma, increasing levels of CTC above an optimal cutoff represent an easy-to-assess, robust, and independent high-risk factor. The achievement of MRD negativity is the most important factor that modulates their negative prognostic impact.
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Affiliation(s)
- Luca Bertamini
- SSD Clinical Trial in Oncoematologia e Mieloma Multiplo, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Stefania Oliva
- SSD Clinical Trial in Oncoematologia e Mieloma Multiplo, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Delia Rota-Scalabrini
- Multidisciplinary Oncology Outpatient Clinic, Candiolo Cancer Institute, FPO - IRCCS, Torino, Italy
| | - Laura Paris
- Division of Hematology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Sonia Morè
- Clinica di Ematologia, AOU Ospedali Riuniti di Ancona, Ancona, Italy
| | - Paolo Corradini
- Hematology and Bone Marrow Transplant Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, University of Milan, Milan, Italy
| | - Antonio Ledda
- Ematologia/CTMO, Ospedale "A. Businco," Cagliari, Italy
| | | | - Giovanni De Sabbata
- Ematologia, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Giuseppe Pietrantuono
- Hematology and Stem Cell Transplantation Unit, IRCCS Centro di Riferimento Oncologico della Basilicata, Rionero in Vulture, Italy
| | | | | | - Paola Curci
- Unit of Hematology and Stem Cell Transplantation, AOUC Policlinico, Bari, Italy
| | - Milena Gilestro
- SSD Clinical Trial in Oncoematologia e Mieloma Multiplo, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Andrea Capra
- SSD Clinical Trial in Oncoematologia e Mieloma Multiplo, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Piero Galieni
- UOC Ematologia e Terapia cellulare, Ospedale C. e G. Mazzoni, Ascoli Piceno, Italy
| | - Francesco Pisani
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Ombretta Annibali
- Unit of Hematology, Stem Cell Transplantation, University Campus Bio-Medico, Rome, Italy
| | - Federico Monaco
- SC Ematologia, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Anna Marina Liberati
- Università degli Studi di Perugia, Azienda Ospedaliera Santa Maria, Terni, Italy
| | | | - Mario Luppi
- Dipartimento di Scienze Mediche e Chirurgiche Materno Infantili e dell'Adulto, UNIMORE, UOC Ematologia, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Renato Zambello
- Department of Medicine (DIMED), Hematology and Clinical Immunology Section, Padova University School of Medicine, Padova, Italy
| | - Francesca Fazio
- Hematology, Department of Translational and Precision Medicine, Azienda Ospedaliera Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Angelo Belotti
- Department of Hematology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Paola Tacchetti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Bologna, Italy
| | - Pellegrino Musto
- Unit of Hematology and Stem Cell Transplantation, AOUC Policlinico, Bari, Italy.,Department of Emergency and Organ Transplantation, "Aldo Moro" University School of Medicine, Bari, Italy
| | - Mario Boccadoro
- SSD Clinical Trial in Oncoematologia e Mieloma Multiplo, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Francesca Gay
- SSD Clinical Trial in Oncoematologia e Mieloma Multiplo, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
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21
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Castellino A, Castellino C, Boccomini C, Clerico M, Nicoli P, Vanazzi A, Fanelli F, Perrone T, Marchesi F, Cocito F, Merli M, Bigliardi S, Mecacci B, Bozzoli V, Margiotta-Casaluci G, Meli E, Anastasia A, Farina L, Annibali O, Massaia M. Outcome of follicular lymphoma (FL) patients in maintenance with antiCD20 monoclonal antibodies (MoAb) in SARS-Cov2 era. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e19544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e19544 Background: Maintenance in FL patients (pts) improves progression free survival (PFS). SARS-Cov2 pandemic posed unique challenges for immunocompromised pts. Methods: This is an observational, multicenter, retrospective and prospective study. The aim is to evaluate the outcome of FL pts in maintenance with antiCD20-MoAb during SARS-Cov2 pandemic and how suspension of therapy affected lymphoma outcome and the risk of SARS-Cov2 infection and its morbidity and mortality. Results: 420 pts from 18 Italian Centers were included. Median age was 62 years old (range 27-91), 216 pts (51%) were male. Main clinical characteristics were: histological grade 1-2 vs 3A vs not valuable in 288 (69%) vs 109 (26%) vs 23 (5%), respectively; advanced stage in 361 (86%), high FLIPI score in 192 (46%) pts. All 420 pts were in antiCD20-MoAb maintenance at the time of SARS-Cov2 pandemic onset (March 2020): 333 (79%) were receiving maintenance after a first line, while 87 (21%) after a second line. 342 (81%) pts were receiving Rituximab, while 75 (18%) Obinutuzumab, 3 pts did not start the planned maintenance. Status of disease after induction was complete remission (CR) in 374 (89%), partial response (PR) in 41 (10%), progressive disease (PD) in 1, not evaluated in 4 patients, respectively. At the end of maintenance was CR in 265 (63%), PR in 19 (4%), stable disease (SD) in one and PD in 14 (3%) pts, maintenance is ongoing in 121 (29%) pts. Because of SARS-Cov2 pandemic maintenance treatment was temporary suspended in 122 (29%), definitively interrupted in123 (29%), not changed in 175 (42%). Median number of maintenance treatment administered at March 2020 was 2 (range 1-12), in pts who modified treatment median number of performed vs lost courses was 7 (range 0-11) vs 2 (range 1-12). Patients were divided into two groups according to the approach to maintenance during pandemic: pts who interrupted maintenance (temporary or definitively): groups A (245 (58%) cases) vs pts who did not modified maintenance: group B (175 (42%)). No differences in clinical characteristics, type of therapy and response were observed between the two groups. 29(7%) relapses were observed: 16 (7%) vs 13 (7%) in group A vs B. 70 (17%) pts experienced SARS-Cov2 positivity: 47 (19%) vs 23 (13%) in group A vs B. 53 (76%) pts had symptomatic COVID and 43 (61%) were hospitalized, with no differences between the two groups. Anti-SARS-Cov2 vaccine was administered in 349 patients, serology assessment was done in 46% of cases, showing 21 (13%) reactive vs 138 (87%) not reactive patients, with no differences between the two groups. 21 (30%) pts died because of COVID: 9 (19%) vs 12 (52%) in groups A vs B. Conclusions: Suspension of maintenance during SARS-Cov2 pandemic did not show a protection in terms of SARS-Cov2 positivity and morbidity. A trend in lower mortality is suggested. No differences in terms of relapse rate were observed, but longer follow up is needed.
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Affiliation(s)
| | | | - Carola Boccomini
- Hematology Department, Città della Salute e della Scienza, Torino, Italy
| | | | - Paolo Nicoli
- Hematology Unit, San Luigi Gonzaga Hospital and University, Orbassano, Italy
| | - Anna Vanazzi
- Division of Clinical Haemato-Oncology, Milano, Italy
| | | | - Tommasina Perrone
- Hematology and Stem Cell Transplantation Unit, AOUC Policlinico, Bari, Italy
| | | | | | - Michele Merli
- Hematology, University Hospital “Ospedale di Circolo e Fondazione Macchi"-ASST Sette Laghi, University of Insubria, Varese, Italy
| | | | | | | | - Gloria Margiotta-Casaluci
- Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy
| | - Erika Meli
- ASST Grande Ospedale Metropolitano Niguarda, Dipartimento di Ematologia e Oncologia, S.C. Ematologia, Milan, Italy
| | | | - Lucia Farina
- Fondazione IRCCS Isttuto Nazionale Tumori, Milano, Italy
| | | | - Massimo Massaia
- Sezione di Ematologia, University of Torino, AOU S. Giovanni Battista, Torino, Italy
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22
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Rago A, Annibali O, Tomarchio V, Coppetelli U, Fazio F, Cupelli L, Fiorini A, Piciocchi A, Tafuri A, Caravita di Toritto T. Autologous stem cell transplantation in multiple myeloma patients over 70 years: A GIMEMA Lazio Working Group experience in a retrospective case-control study. Eur J Haematol Suppl 2022; 109:250-256. [PMID: 35617025 DOI: 10.1111/ejh.13804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/20/2022] [Accepted: 05/23/2022] [Indexed: 11/27/2022]
Abstract
High-dose chemotherapy followed by autologous stem cell transplantation (auto-SCT) is the standard treatment for young patient ≤65 years with multiple myeloma (MM). The role of auto-SCT in elderly patients older than 70 years remains controversial in the era of novel agents and especially since the recent introduction of monoclonal antibodies (AbMo). In this study, we evaluated 12 patients with MM over 70 years old undergoing auto-SCT (elderly graft cohort) in seven centers of GIMEMA Working Group Lazio. We compared the baseline characteristics, treatment and outcome with 97 MM elderly patients who did not receive auto-SCT (nontransplant patients) from the same registry who were ≥ 70 years old, but did not undergo auto-SCT. The median progression free survival (PFS) for graft versus no-graft cohort was 56.4 versus 26.1 months, respectively. There was a trend for better PFS among graft compared to nontransplant patient (p = .1). On the other hand, the median overall survival for transplant versus nontransplant cohort was 107.6 versus 49.5 months (p = .02). Despite the small number of patients aged ≥70 years and ≤74 years, it seems that auto-SCT is well tolerated, safe and effective. Therefore, we propose that it should be considered an important treatment option in the era of new drugs in elderly fit patients with MM.
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Affiliation(s)
| | - Ombretta Annibali
- Area di Ematologia, Trapianto di Cellule Staminali, Fondazione Policlinico Campus Bio Medico, Roma, Italy
| | - Valeria Tomarchio
- Area di Ematologia, Trapianto di Cellule Staminali, Fondazione Policlinico Campus Bio Medico, Roma, Italy
| | | | - Francesca Fazio
- Dipartimento di Medicina Traslazionale e di Precisione - Ematologia, Università Sapienza di Roma, Roma, Italy
| | - Luca Cupelli
- Ospedale Sant'Eugenio, UOC Ematologia, Rome, Italy
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23
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Fazio F, Franceschini L, Tomarchio V, Rago A, Garzia MG, Cupelli L, Bongarzoni V, Andriani A, Gumenyuk S, Tafuri A, Siniscalchi A, Piciocchi A, De Fabritiis P, De Rosa L, Caravita di Toritto T, Annibali O, Cantonetti M, Petrucci MT. Daratumumab combined with dexamethasone and lenalidomide or bortezomib in relapsed/refractory multiple myeloma (RRMM) patients: Report from the multiple myeloma GIMEMA Lazio group. eJHaem 2022; 3:121-128. [PMID: 35846211 PMCID: PMC9175681 DOI: 10.1002/jha2.359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/14/2021] [Accepted: 11/18/2021] [Indexed: 11/05/2022]
Affiliation(s)
- Francesca Fazio
- Department of Translational and Precision Medicine, Hematology Azienda Policlinico Umberto I Sapienza University of RomeSapienza Università di Roma
| | | | | | - Angela Rago
- ASL RM/A UOSD Ematologia Asl Roma 1 Rome Italy
| | - Maria Grazia Garzia
- Department of Hematology, Hematology San Camillo Forlanini Hospital Rome Italy
| | - Luca Cupelli
- Department of Hematology, Hematology Ospedale Sant'Eugenio Rome Italy
| | - Velia Bongarzoni
- Department of Hematology San Giovanni‐Addolorata Hospital Rome Italy
| | | | - Svitlana Gumenyuk
- Haematology and Stem Cell Transplant Regina Elena National Cancer Institute Rome Italy
| | | | | | - Alfonso Piciocchi
- Data Center, Italian Group for Adult Hematologic Diseases, (GIMEMA) Rome Italy
| | | | - Luca De Rosa
- Hematology and Bone Marrow Transplantation Unit Azienda Ospedaliera San Camillo‐Forlanini Rome Italy
| | | | - Ombretta Annibali
- Department of Haematology Campus Bio‐Medico University of Rome Rome Italy
| | | | - Maria Teresa Petrucci
- Department of Translational and Precision Medicine, Hematology Azienda Policlinico Umberto I Sapienza University of RomeSapienza Università di Roma
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24
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Gini G, Di Rocco A, Nassi L, Arcari A, Tisi MC, Loseto G, Olivieri A, Gentile M, Annibali O, Cabras MG, Chiappella A, Rusconi C, Ferreri AJM, Balzarotti M. CNS Prophylaxis: How Far Is Routine Practice From the Guidelines? Focus on a Nationwide Survey by the Fondazione Italiana Linfomi (FIL). Front Oncol 2021; 11:730194. [PMID: 34804924 PMCID: PMC8602788 DOI: 10.3389/fonc.2021.730194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 08/27/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- Guido Gini
- Clinic of Hematology, Ospedali Riuniti, Ancona, Italy
| | - Alice Di Rocco
- Department of Traslational and Precision Medicine, Sapienza University, Roma, Italy
| | - Luca Nassi
- Hematology, Department of Translational Medicine, University of Eastern Piedmont and AOU Maggiore della Carità, Novara, Italy
| | - Annalisa Arcari
- Division of Hematology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Maria Chiara Tisi
- Department of Hematology and Cell Therapy, San Bortolo Hospital, Vicenza, Italy
| | - Giacomo Loseto
- Division of Hematology, IRCCS Ospedale Oncologico, Bari, Italy
| | | | - Massimo Gentile
- Department of Onco-Hematology, Hematology Unit, A.O of Cosenza, Cosenza, Italy
| | - Ombretta Annibali
- Unit of Hematology and Stem Cell Transplantation, University "Campus Bio-Medico", Rome, Italy
| | | | - Annalisa Chiappella
- Department of Hematology, Azienda Ospedaliero Universitaria Citta`della Salute e della Scienza di Torino, Torino, Italy
| | - Chiara Rusconi
- Division of Hematology, Ospedale Niguarda Ca' Granda, Milan, Italy
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25
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Rosati S, Gurnari C, Breccia M, Carmosino I, Scalzulli E, Montefusco E, Perrone S, Annibali O, Martini V, Trapè G, Colafigli G, Trawinska M, Minotti C, Cimino G, Tafuri A, Avvisati G, Martelli M, Voso MT, Latagliata R. Acute promyelocytic leukemia (APL) in very old patients: real-life behind protocols. Acta Oncol 2021; 60:1520-1526. [PMID: 34461798 DOI: 10.1080/0284186x.2021.1971291] [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: 10/20/2022]
Abstract
BACKGROUND Acute promyelocytic leukemia (APL) is uncommon among subjects aged ≥ 70 years and the better therapeutic strategy represents an unmet clinical need. MATERIALS AND METHODS This prompted us to explore our real-life data on a retrospective cohort of 45 older APL patients (≥ 70 years) consecutively diagnosed at eight different hematologic institutions in Latium, Italy, from July 1991 to May 2019. RESULTS Two patients (4.4%) died from early hemorrhagic complications before treatment could begin. Twenty-two patients (51.1%) (Group A) were enrolled or treated according to standard clinical protocols, while 21 (48.8%) (Group B) received an ATRA-based personalized approach due to poor performance status. Morphologic complete remission (CR) after induction therapy was achieved in 33 patients (76.7%) with 100% of patients in Group A and 52.3% in Group B (p < 0.001). Molecular CR was documented in 30 patients (69.7%) [20/22 (90.9%) in Group A and 10/21 (47.6%) in Group B (p = 0.002)]. Ten patients (23.2%) died during induction therapy, all in Group B. Five-year overall survival (OS) of the entire cohort was 46.1% (95% CI 28.2-64.0), with 72.6% (95% CI 42.9-100) in Group A vs. 27.2% (95% CI 7.5-46.9) in the Group B (p = 0.001). CONCLUSIONS The present analysis highlights that almost half of the patients received sub-optimal induction treatments and registered dismal outcomes demonstrating the importance of adopting standard therapies instead of modified or reduced personalized approaches also in the setting of frail older patients.
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Affiliation(s)
- Serena Rosati
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Carmelo Gurnari
- Department of Biomedicine and Prevention, PhD in Immunology, Molecular Medicine and Applied Biotechnology, University of Rome Tor Vergata, Rome, Italy
- Translational Hematology and Oncology Research Department, Taussig Cancer Center, Cleveland Clinic, Cleveland, USA
| | - Massimo Breccia
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Ida Carmosino
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Emilia Scalzulli
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | | | - Salvatore Perrone
- Hematology, Polo Universitario Pontino, "Sapienza", Via A. Canova S.M. Goretti Hospital, Latina, Italy
| | - Ombretta Annibali
- Unit of Hematology and Stem Cell Transplantation, Campus Bio-Medico University, Rome, Italy
| | | | | | - Gioia Colafigli
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | | | - Clara Minotti
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Giuseppe Cimino
- Hematology, Polo Universitario Pontino, "Sapienza", Via A. Canova S.M. Goretti Hospital, Latina, Italy
| | - Agostino Tafuri
- Hematology Institute, La Sapienza University of Rome, S. Andrea Hospital, Rome, Italy
| | - Giuseppe Avvisati
- Unit of Hematology and Stem Cell Transplantation, Campus Bio-Medico University, Rome, Italy
| | - Maurizio Martelli
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Maria Teresa Voso
- Laboratorio di Neuro-Oncoematologia, Fondazione Santa Lucia, Rome, Italy
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Roberto Latagliata
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
- Hematology, Belcolle Hospital, Viterbo, Italy
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26
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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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27
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Cicconi L, Testi AM, Montesinos P, Rego E, Zhu HH, Takahashi H, Dworzak M, Estey E, Schwarer A, Esteve J, Annibali O, Castelli R, Mirabile M, Angelini M, Lazarevic V, Kumar J, Avvisati G, Gurnari C, Locatelli F, Voso MT, Sanz MA, Lo-Coco F, Abla O. Characteristics and outcome of acute myeloid leukemia with uncommon retinoic acid receptor-alpha (RARA) fusion variants. Blood Cancer J 2021; 11:167. [PMID: 34657125 PMCID: PMC8520532 DOI: 10.1038/s41408-021-00561-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 06/03/2021] [Accepted: 06/16/2021] [Indexed: 01/09/2023] Open
Affiliation(s)
- Laura Cicconi
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy. .,UOSD Ematologia, ASL Roma 1, Rome, Italy.
| | - Anna Maria Testi
- Department of Translational and Precision Medicine and Hematology, 'Sapienza' University, Rome, Italy
| | - Pau Montesinos
- Department of Hematology, Hospital Universitari i Politècnico la Fe, València, Spain
| | - Eduardo Rego
- Department of Internal Medicine, Medical School of Ribeirao Preto, Ribeirao Preto, Brazil
| | - Hong Hu Zhu
- Department of Hematology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | | | - Michael Dworzak
- Children's Cancer Research Institute and St Anna Children's Hospital, Department of Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Elihu Estey
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Anthony Schwarer
- Department of Hematology and Oncology, Eastern School, Monash University, Melbourne, VIC, Australia
| | - Jordi Esteve
- Servicio de Hematología, Instituto Clínic de Enfermedades Hematológicas y Oncológicas, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Ombretta Annibali
- Hematology and Stem Cells Transplantation Unit, University Campus Bio-Medico, Rome, Italy
| | - Roberto Castelli
- Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Luigi Sacco Hospital, Milano, Italy
| | - Milena Mirabile
- HematologyUnit, Ospedale di Civitanova Marche, Macerata, Italy
| | | | - Vladimir Lazarevic
- Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden
| | - Jeevan Kumar
- Department of Clinical Haematology and BMT Tata Medical Center, Kolkata, India
| | - Giuseppe Avvisati
- Hematology and Stem Cells Transplantation Unit, University Campus Bio-Medico, Rome, Italy
| | - Carmelo Gurnari
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
| | - Franco Locatelli
- Department of Pediatric Hematology/Oncology, IRCCS Ospedale Pediatrico Bambino Gesu, Rome, Italy.,Department of Pediatrics, Sapienza, University of Rome, Rome, Italy
| | - Maria Teresa Voso
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
| | - Miguel Angel Sanz
- Department of Hematology, Hospital Universitari i Politècnico la Fe, València, Spain
| | - Francesco Lo-Coco
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
| | - Oussama Abla
- Division of Hematology/Oncology, Department of Pediatrics, the Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
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28
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Venanzi A, Rossi R, Martino G, Annibali O, Avvisati G, Mameli MG, Sportoletti P, Tiacci E, Falini B, Martelli MP. A Curious Novel Combination of Nucleophosmin ( NPM1) Gene Mutations Leading to Aberrant Cytoplasmic Dislocation of NPM1 in Acute Myeloid Leukemia (AML). Genes (Basel) 2021; 12:genes12091426. [PMID: 34573408 PMCID: PMC8468273 DOI: 10.3390/genes12091426] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/12/2021] [Accepted: 09/14/2021] [Indexed: 11/16/2022] Open
Abstract
Nucleophosmin (NPM1) mutations occurring in acute myeloid leukemia (AML) (about 50 so far identified) cluster almost exclusively in exon 12 and lead to common changes at the NPM1 mutants C-terminus, i.e., loss of tryptophans 288 and 290 (or 290 alone) and creation of a new nuclear export signal (NES), at the bases of exportin-1(XPO1)-mediated aberrant cytoplasmic NPM1. Immunohistochemistry (IHC) detects cytoplasmic NPM1 and is predictive of the molecular alteration. Besides IHC and molecular sequencing, Western blotting (WB) with anti-NPM1 mutant specific antibodies is another approach to identify NPM1-mutated AML. Here, we show that among 382 AML cases with NPM1 exon 12 mutations, one was not recognized by WB, and describe the discovery of a novel combination of two mutations involving exon 12. This appeared as a conventional mutation A with the known TCTG nucleotides insertion/duplication accompanied by a second event (i.e., an 8-nucleotide deletion occurring 15 nucleotides downstream of the TCTG insertion), resulting in a new C-terminal protein sequence. Strikingly, the sequence included a functional NES ensuring cytoplasmic relocation of the new mutant supporting the role of cytoplasmic NPM1 as critical in AML leukemogenesis.
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Affiliation(s)
- Alessandra Venanzi
- Hematology and Clinical Immunology, Centro di Ricerche Emato-Oncologiche (CREO), University of Perugia, 06132 Perugia, Italy; (A.V.); (R.R.); (P.S.); (E.T.); (B.F.)
- Hematology Section, “Santa Maria della Misericordia” Hospital of Perugia, 06132 Perugia, Italy;
| | - Roberta Rossi
- Hematology and Clinical Immunology, Centro di Ricerche Emato-Oncologiche (CREO), University of Perugia, 06132 Perugia, Italy; (A.V.); (R.R.); (P.S.); (E.T.); (B.F.)
| | - Giovanni Martino
- Pathology Unit, Azienda Ospedaliera Santa Maria di Terni, University of Perugia, 05100 Terni, Italy;
- Department of Pathology, AOU Cagliari, University of Cagliari, 09042 Cagliari, Italy
| | - Ombretta Annibali
- Hematology and Stem Cell Transplant Unit, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (O.A.); (G.A.)
| | - Giuseppe Avvisati
- Hematology and Stem Cell Transplant Unit, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (O.A.); (G.A.)
| | - Maria Grazia Mameli
- Hematology Section, “Santa Maria della Misericordia” Hospital of Perugia, 06132 Perugia, Italy;
| | - Paolo Sportoletti
- Hematology and Clinical Immunology, Centro di Ricerche Emato-Oncologiche (CREO), University of Perugia, 06132 Perugia, Italy; (A.V.); (R.R.); (P.S.); (E.T.); (B.F.)
- Hematology Section, “Santa Maria della Misericordia” Hospital of Perugia, 06132 Perugia, Italy;
| | - Enrico Tiacci
- Hematology and Clinical Immunology, Centro di Ricerche Emato-Oncologiche (CREO), University of Perugia, 06132 Perugia, Italy; (A.V.); (R.R.); (P.S.); (E.T.); (B.F.)
- Hematology Section, “Santa Maria della Misericordia” Hospital of Perugia, 06132 Perugia, Italy;
| | - Brunangelo Falini
- Hematology and Clinical Immunology, Centro di Ricerche Emato-Oncologiche (CREO), University of Perugia, 06132 Perugia, Italy; (A.V.); (R.R.); (P.S.); (E.T.); (B.F.)
- Hematology Section, “Santa Maria della Misericordia” Hospital of Perugia, 06132 Perugia, Italy;
| | - Maria Paola Martelli
- Hematology and Clinical Immunology, Centro di Ricerche Emato-Oncologiche (CREO), University of Perugia, 06132 Perugia, Italy; (A.V.); (R.R.); (P.S.); (E.T.); (B.F.)
- Hematology Section, “Santa Maria della Misericordia” Hospital of Perugia, 06132 Perugia, Italy;
- Correspondence:
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29
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Rinaldi F, Marchesi F, Palombi F, Pelosi A, Di Pace AL, Sacconi A, Terrenato I, Annibali O, Tomarchio V, Marino M, Cantonetti M, Vaccarini S, Papa E, Moretta L, Bertoni F, Mengarelli A, Regazzo G, Rizzo MG. MiR-22, a serum predictor of poor outcome and therapy response in diffuse large B-cell lymphoma patients. Br J Haematol 2021; 195:399-404. [PMID: 34318932 DOI: 10.1111/bjh.17734] [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] [Received: 05/19/2021] [Accepted: 07/13/2021] [Indexed: 11/30/2022]
Abstract
Diffuse large B-cell lymphoma (DLBCL) is an aggressive, heterogeneous neoplasm where prognostication and therapeutic decision are challenging. The available prognostic tools are not able to identify all patients refractory to treatment. MicroRNAs, small RNAs frequently deregulated in cancer, stably circulate in biofluids, representing interesting candidates for non-invasive biomarkers. Here we validated serum miR-22, an evolutionarily conserved microRNA, as a prognostic/predictive biomarker in DLBCL. Moreover, we found that its expression and release from DLBCL cells are related to therapy response and adversely affect cell proliferation. These results suggest that miR-22 is a promising complementary or even independent non-invasive biomarker for DLBCL management.
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Affiliation(s)
- Federica Rinaldi
- Department of Research, Advanced Diagnostics and Technological Innovation, Oncogenomic and Epigenetic Unit, Translational Research Area, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Francesco Marchesi
- Department of Clinical and Experimental Oncology, Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Francesca Palombi
- Department of Clinical and Experimental Oncology, Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Andrea Pelosi
- Immunology Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | | | - Andrea Sacconi
- Department of Research, Advanced Diagnostics and Technological Innovation, Clinical Trial Center, Biostatistics and Bioinformatics Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Irene Terrenato
- Department of Research, Advanced Diagnostics and Technological Innovation, Clinical Trial Center, Biostatistics and Bioinformatics Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Ombretta Annibali
- Hematology and Stem Cell Transplantation Unit, University Campus Bio-Medico, Rome, Italy
| | - Valeria Tomarchio
- Hematology and Stem Cell Transplantation Unit, University Campus Bio-Medico, Rome, Italy
| | - Mirella Marino
- Department of Research, Advanced Diagnostics and Technological Innovation, Pathology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Maria Cantonetti
- Hematology Unit of Lymphoproliferative Disorders, Policlinico Tor Vergata (PTV) Foundation, Rome, Italy
| | - Sara Vaccarini
- Hematology Unit of Lymphoproliferative Disorders, Policlinico Tor Vergata (PTV) Foundation, Rome, Italy
| | - Elena Papa
- Department of Clinical and Experimental Oncology, Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Lorenzo Moretta
- Immunology Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Francesco Bertoni
- Faculty of Biomedical Sciences, Institute of Oncology Research, USI, Bellinzona, Switzerland.,Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Andrea Mengarelli
- Department of Clinical and Experimental Oncology, Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Giulia Regazzo
- Department of Research, Advanced Diagnostics and Technological Innovation, Oncogenomic and Epigenetic Unit, Translational Research Area, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Maria G Rizzo
- Department of Research, Advanced Diagnostics and Technological Innovation, Oncogenomic and Epigenetic Unit, Translational Research Area, IRCCS Regina Elena National Cancer Institute, Rome, Italy
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30
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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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31
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Fabiani E, Cicconi L, Nardozza AM, Cristiano A, Rossi M, Ottone T, Falconi G, Divona M, Testi AM, Annibali O, Castelli R, Lazarevic V, Rego E, Montesinos P, Esteve J, Venditti A, Della Porta M, Arcese W, Lo-Coco F, Voso MT. Mutational profile of ZBTB16-RARA-positive acute myeloid leukemia. Cancer Med 2021; 10:3839-3847. [PMID: 34042280 PMCID: PMC8209618 DOI: 10.1002/cam4.3904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 03/02/2021] [Accepted: 03/28/2021] [Indexed: 12/31/2022] Open
Abstract
Background The ZBTB16‐RARA fusion gene, resulting from the reciprocal translocation between ZBTB16 on chromosome 11 and RARA genes on chromosome 17 [t(11;17)(q23;q21)], is rarely observed in acute myeloid leukemia (AML), and accounts for about 1% of retinoic acid receptor‐α (RARA) rearrangements. AML with this rare translocation shows unusual bone marrow (BM) morphology, with intermediate aspects between acute promyelocytic leukemia (APL) and AML with maturation. Patients may have a high incidence of disseminated intravascular coagulation at diagnosis, are poorly responsive to all‐trans retinoic acid (ATRA) and arsenic tryoxyde, and are reported to have an overall poor prognosis. Aims The mutational profile of ZBTB16‐RARA rearranged AML has not been described so far. Materials and methods We performed targeted next‐generation sequencing of 24 myeloid genes in BM diagnostic samples from seven ZBTB16‐RARA+AML, 103 non‐RARA rearranged AML, and 46 APL. The seven ZBTB16‐RARA‐positive patients were then screened for additional mutations using whole exome sequencing (n = 3) or an extended cancer panel including 409 genes (n = 4). Results ZBTB16‐RARA+AML showed an intermediate number of mutations per patient and involvement of different genes, as compared to APL and other AMLs. In particular, we found a high incidence of ARID1A mutations in ZBTB16‐RARA+AML (five of seven cases, 71%). Mutations in ARID2 and SMARCA4, other tumor suppressor genes also belonging to SWI/SNF chromatin remodeling complexes, were also identified in one case (14%). Discussion and conclusion Our data suggest the association of mutations of the ARID1A gene and of the other members of the SWI/SNF chromatin remodeling complexes with ZBTB16‐RARA+AMLs, where they may support the peculiar disease phenotype.
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Affiliation(s)
- Emiliano Fabiani
- Department of Biomedicine and Prevention, University Tor Vergata Rome, Rome, Italy.,UniCamillus-Saint Camillus International University of Health Sciences, Rome, Italy
| | - Laura Cicconi
- Unit of Hematology, Santo Spirito Hospital, Rome, Italy
| | - Anna Maria Nardozza
- Department of Biomedicine and Prevention, University Tor Vergata Rome, Rome, Italy
| | - Antonio Cristiano
- Department of Biomedicine and Prevention, University Tor Vergata Rome, Rome, Italy
| | - Marianna Rossi
- Cancer Center - IRCCS Humanitas Clinical & Research Hospital and Humanitas University, Milan, Italy
| | - Tiziana Ottone
- Department of Biomedicine and Prevention, University Tor Vergata Rome, Rome, Italy
| | - Giulia Falconi
- Department of Biomedicine and Prevention, University Tor Vergata Rome, Rome, Italy
| | - Mariadomenica Divona
- Department of Biomedicine and Prevention, University Tor Vergata Rome, Rome, Italy
| | - Anna Maria Testi
- Department of Translational and Precision Medicine and Hematology, Sapienza University, Rome, Italy
| | - Ombretta Annibali
- Hematology and Stem Cell Transplantation Unit, University Campus Biomedico, Rome, Italy
| | - Roberto Castelli
- Department of Biomedical and Clinical Sciences, Luigi Sacco Hospital, Milan, Italy
| | - Vladimir Lazarevic
- Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden
| | - Eduardo Rego
- Department of Internal Medicine, Medical School of Ribeirao Preto, Sau Paulo, Brazil
| | - Pau Montesinos
- Hematology Department, Hospital Universitari i Politècnico la Fe, Valencia, Spain
| | - Jordi Esteve
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Adriano Venditti
- Department of Biomedicine and Prevention, University Tor Vergata Rome, Rome, Italy
| | - Matteo Della Porta
- Cancer Center - IRCCS Humanitas Clinical & Research Hospital and Humanitas University, Milan, Italy
| | - William Arcese
- Department of Biomedicine and Prevention, University Tor Vergata Rome, Rome, Italy
| | - Francesco Lo-Coco
- Department of Biomedicine and Prevention, University Tor Vergata Rome, Rome, Italy
| | - Maria Teresa Voso
- Department of Biomedicine and Prevention, University Tor Vergata Rome, Rome, Italy
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Palladini G, Paiva B, Wechalekar A, Massa M, Milani P, Lasa M, Ravichandran S, Krsnik I, Basset M, Burgos L, Nuvolone M, Lecumberri R, Foli A, Puig N, Sesta MA, Bozzola M, Cascino P, Nevone A, Ripepi J, Berti P, Casarini S, Annibali O, Orfao A, San-Miguel J, Merlini G. Minimal residual disease negativity by next-generation flow cytometry is associated with improved organ response in AL amyloidosis. Blood Cancer J 2021; 11:34. [PMID: 33594045 PMCID: PMC7887224 DOI: 10.1038/s41408-021-00428-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/17/2020] [Accepted: 11/02/2020] [Indexed: 12/30/2022] Open
Abstract
Light chain (AL) amyloidosis is caused by a small B-cell clone producing light chains that form amyloid deposits and cause organ dysfunction. Chemotherapy aims at suppressing the production of the toxic light chain (LC) and restore organ function. However, even complete hematologic response (CR), defined as negative serum and urine immunofixation and normalized free LC ratio, does not always translate into organ response. Next-generation flow (NGF) cytometry is used to detect minimal residual disease (MRD) in multiple myeloma. We evaluated MRD by NGF in 92 AL amyloidosis patients in CR. Fifty-four percent had persistent MRD (median 0.03% abnormal plasma cells). There were no differences in baseline clinical variables in patients with or without detectable MRD. Undetectable MRD was associated with higher rates of renal (90% vs 62%, p = 0.006) and cardiac response (95% vs 75%, p = 0.023). Hematologic progression was more frequent in MRD positive (0 vs 25% at 1 year, p = 0.001). Altogether, NGF can detect MRD in approximately half the AL amyloidosis patients in CR, and persistent MRD can explain persistent organ dysfunction. Thus, this study supports testing MRD in CR patients, especially if not accompanied by organ response. In case MRD persists, further treatment could be considered, carefully balancing residual organ damage, patient frailty, and possible toxicity.
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Affiliation(s)
- Giovanni Palladini
- Amyloidosis Research and Treatment Center, "Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo", Pavia, Italy. .,Biochemistry, Biotechnology and Advanced Diagnostics Laboratory, "Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo", Pavia, Italy. .,Department of Molecular Medicine, University of Pavia, Pavia, Italy.
| | - Bruno Paiva
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), IDISNA, CIBERONC CB16/12/00369 Pamplona, Pamplona, Spain
| | - Ashutosh Wechalekar
- National Amyloidosis Centre, University College London (Royal Free Campus), London, UK.,Department of Haematology, University College London Hospitals, London, UK
| | - Margherita Massa
- Biochemistry, Biotechnology and Advanced Diagnostics Laboratory, "Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo", Pavia, Italy
| | - Paolo Milani
- Amyloidosis Research and Treatment Center, "Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo", Pavia, Italy.,Biochemistry, Biotechnology and Advanced Diagnostics Laboratory, "Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo", Pavia, Italy
| | - Marta Lasa
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), IDISNA, CIBERONC CB16/12/00369 Pamplona, Pamplona, Spain
| | - Sriram Ravichandran
- National Amyloidosis Centre, University College London (Royal Free Campus), London, UK
| | - Isabel Krsnik
- Hospital Universitario Puerta del Hierro, Madrid, Spain
| | - Marco Basset
- Amyloidosis Research and Treatment Center, "Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo", Pavia, Italy.,Biochemistry, Biotechnology and Advanced Diagnostics Laboratory, "Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo", Pavia, Italy.,Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Leire Burgos
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), IDISNA, CIBERONC CB16/12/00369 Pamplona, Pamplona, Spain
| | - Mario Nuvolone
- Amyloidosis Research and Treatment Center, "Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo", Pavia, Italy.,Biochemistry, Biotechnology and Advanced Diagnostics Laboratory, "Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo", Pavia, Italy.,Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Ramón Lecumberri
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), IDISNA, CIBERONC CB16/12/00369 Pamplona, Pamplona, Spain
| | - Andrea Foli
- Amyloidosis Research and Treatment Center, "Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo", Pavia, Italy.,Biochemistry, Biotechnology and Advanced Diagnostics Laboratory, "Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo", Pavia, Italy
| | - Noemi Puig
- Servicio General de Citometría, Universidad de Salamanca, IBSAL, and IBMCC CSIC-USAL, CIBERONC, Salamanca, Spain
| | - Melania Antonietta Sesta
- Amyloidosis Research and Treatment Center, "Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo", Pavia, Italy.,Biochemistry, Biotechnology and Advanced Diagnostics Laboratory, "Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo", Pavia, Italy.,Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Margherita Bozzola
- Amyloidosis Research and Treatment Center, "Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo", Pavia, Italy.,Biochemistry, Biotechnology and Advanced Diagnostics Laboratory, "Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo", Pavia, Italy.,Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Pasquale Cascino
- Amyloidosis Research and Treatment Center, "Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo", Pavia, Italy.,Biochemistry, Biotechnology and Advanced Diagnostics Laboratory, "Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo", Pavia, Italy.,Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Alice Nevone
- Amyloidosis Research and Treatment Center, "Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo", Pavia, Italy.,Biochemistry, Biotechnology and Advanced Diagnostics Laboratory, "Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo", Pavia, Italy.,Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Jessica Ripepi
- Amyloidosis Research and Treatment Center, "Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo", Pavia, Italy.,Biochemistry, Biotechnology and Advanced Diagnostics Laboratory, "Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo", Pavia, Italy.,Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Pierpaolo Berti
- Immunohematology and Transfusion Medicine Unit, Department of Laboratories, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - Simona Casarini
- Amyloidosis Research and Treatment Center, "Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo", Pavia, Italy.,Biochemistry, Biotechnology and Advanced Diagnostics Laboratory, "Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo", Pavia, Italy
| | - Ombretta Annibali
- Hematology and Stem Cell Transplantation Unit, University Campus Bio-medico, Rome, Italy
| | - Alberto Orfao
- Servicio General de Citometría, Universidad de Salamanca, IBSAL, and IBMCC CSIC-USAL, CIBERONC, Salamanca, Spain
| | - Jesus San-Miguel
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), IDISNA, CIBERONC CB16/12/00369 Pamplona, Pamplona, Spain
| | - Giampaolo Merlini
- Amyloidosis Research and Treatment Center, "Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo", Pavia, Italy.,Biochemistry, Biotechnology and Advanced Diagnostics Laboratory, "Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo", Pavia, Italy.,Department of Molecular Medicine, University of Pavia, Pavia, Italy
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Perriello VM, Gionfriddo I, Rossi R, Milano F, Mezzasoma F, Marra A, Spinelli O, Rambaldi A, Annibali O, Avvisati G, Di Raimondo F, Ascani S, Falini B, Martelli MP, Brunetti L. CD123 Is Consistently Expressed on NPM1-Mutated AML Cells. Cancers (Basel) 2021; 13:cancers13030496. [PMID: 33525388 PMCID: PMC7865228 DOI: 10.3390/cancers13030496] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 01/20/2021] [Accepted: 01/22/2021] [Indexed: 12/14/2022] Open
Abstract
Simple Summary One-third of adult acute myeloid leukemia (AML) harbors NPM1 mutations. A deep knowledge of the distribution of selected antigens on the surface of NPM1-mutated AML cells may help optimizing new therapies for this frequent AML subtype. CD123 is known to be expressed on leukemic cells but also on healthy hematopoietic and endothelial cells, although at lower levels. Differences in antigen densities between AML and healthy cells may enlighten therapeutic windows, where targeting CD123 could be effective without triggering “on-target off-tumor” toxicities. Here, we perform a thorough analysis of CD123 expression demonstrating high expression of this antigen on both NPM1-mutated bulk leukemic cells and CD34+CD38− cells. Abstract NPM1-mutated (NPM1mut) acute myeloid leukemia (AML) comprises about 30% of newly diagnosed AML in adults. Despite notable advances in the treatment of this frequent AML subtype, about 50% of NPM1mut AML patients treated with conventional treatment die due to disease progression. CD123 has been identified as potential target for immunotherapy in AML, and several anti-CD123 therapeutic approaches have been developed for AML resistant to conventional therapies. As this antigen has been previously reported to be expressed by NPM1mut cells, we performed a deep flow cytometry analysis of CD123 expression in a large cohort of NPM1mut and wild-type samples, examining the whole blastic population, as well as CD34+CD38− leukemic cells. We demonstrate that CD123 is highly expressed on NPM1mut cells, with particularly high expression levels showed by CD34+CD38− leukemic cells. Additionally, CD123 expression was further enhanced by FLT3 mutations, which frequently co-occur with NPM1 mutations. Our results identify NPM1-mutated and particularly NPM1/FLT3 double-mutated AML as disease subsets that may benefit from anti-CD123 targeted therapies.
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Affiliation(s)
- Vincenzo Maria Perriello
- Department of Medicine and Surgery, University of Perugia, 06131 Perugia, Italy; (V.M.P.); (I.G.); (R.R.); (F.M.); (F.M.); (A.M.); (S.A.); (B.F.)
| | - Ilaria Gionfriddo
- Department of Medicine and Surgery, University of Perugia, 06131 Perugia, Italy; (V.M.P.); (I.G.); (R.R.); (F.M.); (F.M.); (A.M.); (S.A.); (B.F.)
| | - Roberta Rossi
- Department of Medicine and Surgery, University of Perugia, 06131 Perugia, Italy; (V.M.P.); (I.G.); (R.R.); (F.M.); (F.M.); (A.M.); (S.A.); (B.F.)
| | - Francesca Milano
- Department of Medicine and Surgery, University of Perugia, 06131 Perugia, Italy; (V.M.P.); (I.G.); (R.R.); (F.M.); (F.M.); (A.M.); (S.A.); (B.F.)
| | - Federica Mezzasoma
- Department of Medicine and Surgery, University of Perugia, 06131 Perugia, Italy; (V.M.P.); (I.G.); (R.R.); (F.M.); (F.M.); (A.M.); (S.A.); (B.F.)
| | - Andrea Marra
- Department of Medicine and Surgery, University of Perugia, 06131 Perugia, Italy; (V.M.P.); (I.G.); (R.R.); (F.M.); (F.M.); (A.M.); (S.A.); (B.F.)
| | - Orietta Spinelli
- Azienda Socio-Sanitaria Territoriale Papa Giovanni XXIII, 24127 Bergamo, Italy; (O.S.); (A.R.)
| | - Alessandro Rambaldi
- Azienda Socio-Sanitaria Territoriale Papa Giovanni XXIII, 24127 Bergamo, Italy; (O.S.); (A.R.)
- Department of Oncology and Hematology, University of Milan, 20122 Milan, Italy
| | - Ombretta Annibali
- Hematology and Stem Cell Transplant Unit, Campus Biomedico University Hospital, 00128 Rome, Italy; (O.A.); (G.A.)
| | - Giuseppe Avvisati
- Hematology and Stem Cell Transplant Unit, Campus Biomedico University Hospital, 00128 Rome, Italy; (O.A.); (G.A.)
| | - Francesco Di Raimondo
- Hematology and Bone Marrow Transplant Unit, Catania University Hospital, 95125 Catania, Italy;
| | - Stefano Ascani
- Department of Medicine and Surgery, University of Perugia, 06131 Perugia, Italy; (V.M.P.); (I.G.); (R.R.); (F.M.); (F.M.); (A.M.); (S.A.); (B.F.)
- Hematology and Bone Marrow Transplant Unit, Santa Maria della Misericordia Hospital, 06131 Perugia, Italy
- Pathology, Santa Maria Hospital, 05100 Terni, Italy
| | - Brunangelo Falini
- Department of Medicine and Surgery, University of Perugia, 06131 Perugia, Italy; (V.M.P.); (I.G.); (R.R.); (F.M.); (F.M.); (A.M.); (S.A.); (B.F.)
- Hematology and Bone Marrow Transplant Unit, Santa Maria della Misericordia Hospital, 06131 Perugia, Italy
| | - Maria Paola Martelli
- Department of Medicine and Surgery, University of Perugia, 06131 Perugia, Italy; (V.M.P.); (I.G.); (R.R.); (F.M.); (F.M.); (A.M.); (S.A.); (B.F.)
- Hematology and Bone Marrow Transplant Unit, Santa Maria della Misericordia Hospital, 06131 Perugia, Italy
- Correspondence: (M.P.M.); (L.B.)
| | - Lorenzo Brunetti
- Department of Medicine and Surgery, University of Perugia, 06131 Perugia, Italy; (V.M.P.); (I.G.); (R.R.); (F.M.); (F.M.); (A.M.); (S.A.); (B.F.)
- Hematology and Bone Marrow Transplant Unit, Santa Maria della Misericordia Hospital, 06131 Perugia, Italy
- Correspondence: (M.P.M.); (L.B.)
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Santopietro M, Kovalchuk S, Battistini R, Puccini B, Annibali O, Romano I, Zoli V, Avvisati G, Bosi A, Rigacci L. Treatment and prognosis of primary pulmonary lymphoma: A long-term follow-up study. Eur J Haematol 2020; 106:49-57. [PMID: 32779796 DOI: 10.1111/ejh.13507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 08/07/2020] [Accepted: 08/07/2020] [Indexed: 11/27/2022]
Abstract
Primary pulmonary lymphoma (PPL) is a rare disease with not well-defined optimal treatment. Outcomes and follow-up are variable in published data. OBJECTIVES To define the outcome and optimal treatment strategies in PPL. METHODS We reviewed the medical records of 49 patients with PPL treated in three Italian Hematological Institutions between 2002 and 2018. RESULTS Thirty-eight (77.5%) cases were indolent PPL, and 11 (22.5%) cases were aggressive PPL. The majority of patients were asymptomatic at diagnosis, early stages (stages IE-IIE), normal serum LDH, no bone marrow involvement, and low or low-intermediate risks of IPI. Local therapy ± immunotherapy or immuno-chemotherapy was possible in 18/49 (37%) patients. Twenty-eight (57%) patients were treated with immuno-chemotherapy after biopsy. Waiting and watching were reported in 3 (6%) patients. Overall, the CR and ORR were 83.7% and 95.9%. With a median follow-up of 62.5 months (range 0.8-199 months), the estimated 5- and 10-year OS rates were 85% and 72.3% for all patients, 89.2% and 80.3% for indolent PPL, and 70.7% and 47.1% for aggressive PPL. Aggressive PPL tended to have a high risk of progression in the first months (P = .056). No advantages were found for indolent PPL who received immuno-chemotherapy or more conservative approaches. CONCLUSION Our studies confirm the epidemiological and favorable survival of patients with PPL, suggesting a very conservative approach, particularly in indolent subtypes.
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Affiliation(s)
- Michelina Santopietro
- Haematology and Haematopoietic Stem Cells Transplant Unit, AO San Camillo-Forlanini, Rome, Italy
| | | | - Roberta Battistini
- Haematology and Haematopoietic Stem Cells Transplant Unit, AO San Camillo-Forlanini, Rome, Italy
| | | | - Ombretta Annibali
- Unit of Haematology and Stem Cell Transplantation, Campus Bio-Medico University, Rome, Italy
| | | | - Valerio Zoli
- Haematology and Haematopoietic Stem Cells Transplant Unit, AO San Camillo-Forlanini, Rome, Italy
| | - Giuseppe Avvisati
- Unit of Haematology and Stem Cell Transplantation, Campus Bio-Medico University, Rome, Italy
| | - Alberto Bosi
- Unit of Haematology, AOU Careggi, Florence, Italy
| | - Luigi Rigacci
- Haematology and Haematopoietic Stem Cells Transplant Unit, AO San Camillo-Forlanini, Rome, Italy.,Unit of Haematology, AOU Careggi, Florence, Italy
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Sommer K, Vignetti M, Cottone F, Breccia M, Annibali O, Luppi M, Intermesoli T, Borlenghi E, Carluccio P, Rodeghiero F, Fabbiano F, Romani C, Sborgia M, Martino B, Crugnola M, Efficace F. Acute promyelocytic leukaemia long-term survivors: higher fatigue and greater overall symptom burden. BMJ Support Palliat Care 2020; 12:182-186. [DOI: 10.1136/bmjspcare-2020-002281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/19/2020] [Accepted: 06/02/2020] [Indexed: 12/27/2022]
Abstract
ObjectiveWe aimed to investigate the association of fatigue with severity of other key cancer symptoms, as well as symptom interference with daily activities and outlook on life, in long-term survivors of acute promyelocytic leukaemia (APL).MethodsThe study sample consisted of APL survivors (n=244), with a median time from diagnosis of 14.3 years (IQR=11.1–16.9 years), previously enrolled in a long-term follow-up study. Symptom severity and symptom interference were assessed using the well-validated MD Anderson Symptom Inventory (MDASI). Fatigue was evaluated with the Functional Assessment of Chronic Illness Therapy-Fatigue questionnaire.ResultsHigher fatigue burden was associated with increased affective symptoms, memory problems, drowsiness, sleep disturbances, shortness of breath and pain. Higher levels of fatigue were also associated with higher scores across all interference items of the MDASI. Overall, symptoms interfered most with mood, but among APL survivors with high levels of fatigue, symptoms interfered most with enjoyment of life. Multivariable regression analysis confirmed the independent association between fatigue and all symptom severity items of the MDASI.ConclusionsThe current findings show that long-term APL survivors who report higher fatigue also experience a greater overall symptom burden and a substantial impact on performance of daily activities. Further studies are needed to examine whether interventions aimed at reducing fatigue could also reduce overall symptom burden.
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Rigacci L, Annibali O, Kovalchuk S, Bonifacio E, Pregnolato F, Angrilli F, Vitolo U, Pozzi S, Broggi S, Luminari S, Merli F, Spina M, Bolis S, Margiotta-Casaluci G, Scalzulli R, Cox C, Mamusa AM, Santoro A, Zinzani PL, Ferrari S, Gini G, Vigliotti ML, Mulè A, Flenghi L. Nonpeghylated liposomal doxorubicin combination regimen (R-COMP) for the treatment of lymphoma patients with advanced age or cardiac comorbidity. Hematol Oncol 2020; 38:478-486. [PMID: 32542788 PMCID: PMC7689940 DOI: 10.1002/hon.2764] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 06/06/2020] [Accepted: 06/09/2020] [Indexed: 11/30/2022]
Abstract
Doxorubicin is the most effective single agent in the treatment of non‐Hodgkin's lymphoma (NHL). Its use is limited because of the cardiac toxicity primarily in elderly patients (pts) and in pts with history of cardiac disease. Liposomal doxorubicin has been proven to reduce cardiotoxicity. The aim of this retrospective study was the use of nonpeghylated liposomal doxorubicin (NPLD) in term of efficacy, response rate and incidence of cardiac events. We retrospectively collected the experience of 33 Hematological Italian Centers in using NPLD. Nine hundred and forty‐six consecutive pts treated with R‐COMP (doxorubicin was substituted with NPLD, Myocet) were collected. Median age was 74 years, the reasons for use of NPLD were: age (466 pts), cardiac disease (298 pts), uncontrolled hypertension (126 pts), other reasons (56 pts). According to clinicians' evaluation, 49.9% of pts would not have used standard doxorubicin for different situations (age, cardiomyopathy, previous use of doxorubicin, and uncontrolled hypertension). Overall 687 pts (72.6%) obtained a complete remission (CR). About 5% (n = 51) of subjects developed major cardiotoxic events including heart failure (N = 31), ischemic heart disease (N = 16), acute heart attack (N = 3), and acute pulmonary oedema (N = 1). After a median follow‐up of 32 months, 651 pts were alive and the overall survival (OS) was 72%. After a median observation period of 23 months disease free survival (DFS) was 58%. Either in univariate or in multivariate analysis OS and DFS were not significantly affected by age or cardiac disease. Our findings strongly support that including R‐COMP is effective and safe when the population is at high risk of cardiac events and negatively selected. Moreover, the use of this NPLD permitted that about half of our population had the opportunity to receive the best available treatment.
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Affiliation(s)
- Luigi Rigacci
- UOC Ematologia e Centro Trapianto Cellule Staminali, AO San Camillo Forlanini Roma, Roma, Italy.,SOD C Ematologia, AOU Careggi, Firenze, Italy
| | - Ombretta Annibali
- Ematologia, Trapianto Cellule Staminali, Medicina Trasfusionale, Policlinico Universitario Campus Biomedico, Roma, Italy
| | | | - Elisabetta Bonifacio
- Ematologia e Trapianto Midollo Osseo, Ospedale Santa Maria della Misericordia, Azienda Ospedaliera Perugia, Perugia, Italy
| | - Francesca Pregnolato
- Istituto Auxologico Italiano (IRCCS) Experimental Laboratory of Immunorheumatology, Cusano Milanino, Milanino, Italy
| | - Francesco Angrilli
- Unità Operativa Semplice Dipartimentale Centro Diagnosi e Terapia Linfomi, Presidio Ospedaliero, Pescara, Italy
| | - Umberto Vitolo
- SC di Ematologia, AOU Città della Salute e delle Scienze di Torino, Torino, Italy
| | - Samantha Pozzi
- Dipartimento Onco-ematologico, Policlinico di Modena, Univesrità di Modena e Reggio Emilia, Modena, Italy
| | - Serena Broggi
- Ematologia e Trapianto Midollo Osseo, Ospedale Santa Maria della Misericordia, Azienda Ospedaliera Perugia, Perugia, Italy
| | - Stefano Luminari
- Dipartimento Onco-ematologico, Policlinico di Modena, Univesrità di Modena e Reggio Emilia, Modena, Italy.,Unità Operativa di Ematologia, Arcispedale S. Maria Nuova Reggio Emilia, Emilia, Italy
| | - Francesco Merli
- Unità Operativa di Ematologia, Arcispedale S. Maria Nuova Reggio Emilia, Emilia, Italy
| | - Michele Spina
- Centro di Riferimento Oncologico di Aviano, IRCCS, Aviano, Italy
| | - Silvia Bolis
- Ematologia, Ospedale San Gerardo Monza, Monza, Italy
| | | | - Rosario Scalzulli
- Ematologia Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | | | - Angela Maria Mamusa
- Ematologia e Centro Trapianto Midollo Osseo, Ospedale Businco Cagliari, Cagliari, Italy
| | - Armando Santoro
- Department of Biomedical Sciences Milano, Ematologia, Humanitas Clinical and Research Center - IRCCS, Humanitas University, Rozzano, Italy
| | | | - Samantha Ferrari
- Unità Operativa di Ematologia, Spedali Civili di Brescia, Brescia, Italy
| | - Guido Gini
- SOD Clinca Ematologica, AOU Ospedali Riuniti Ancona, Ancona, Italy
| | | | - Antonino Mulè
- UOC Ematologia e Talassemia PO Sant'Elia Caltanissetta, Caltanissetta, Italy
| | - Leonardo Flenghi
- Ematologia e Trapianto Midollo Osseo, Ospedale Santa Maria della Misericordia, Azienda Ospedaliera Perugia, Perugia, Italy
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Breccia M, Vignetti M, Annibali O, Cottone F, Luppi M, Borlenghi E, Rodeghiero F, Efficace F. Younger age at diagnosis of acute promyelocytic leukaemia is associated with better long‐term cognitive functioning. Br J Haematol 2020; 190:e304-e307. [DOI: 10.1111/bjh.16877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Massimo Breccia
- Department of Cellular Biotechnologies and Hematology “Sapienza” University of Rome Rome Italy
| | - Marco Vignetti
- Italian Group for Adult Hematologic Diseases (GIMEMA) Data Center and Health Outcomes Research Unit Rome Italy
| | - Ombretta Annibali
- Hematology and Stem Cell Transplantation Unit University Campus Bio‐Medico Rome Italy
| | - Francesco Cottone
- Italian Group for Adult Hematologic Diseases (GIMEMA) Data Center and Health Outcomes Research Unit Rome Italy
| | - Mario Luppi
- Department of Medical and Surgical Sciences Chair of Hematology University of Modena and Reggio EmiliaAOU Modena Modena Italy
| | | | - Francesco Rodeghiero
- Haematology Project Foundation Affiliated to the Department of Haematology S. Bortolo Hospital Vicenza Italy
| | - Fabio Efficace
- Italian Group for Adult Hematologic Diseases (GIMEMA) Data Center and Health Outcomes Research Unit Rome Italy
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Arcese W, Cerretti R, Sarmati L, Cudillo L, De Angelis G, Mariotti B, Bruno A, Mangione I, Rapanotti C, Andreani M, De Fabritiis P, Dentamaro T, Cupelli L, Mengarelli A, Marchesi F, Tirindelli MC, Annibali O, Tafuri A, Ferrari A, Cedrone M, Anaclerico B, Adorno G, Miccichè S, Andreoni M, Picardi A. Matched-Pair Analysis of Transplant from Haploidentical, Unmanipulated Bone Marrow Donor versus HLA Identical Sibling for Patients with Hematologic Malignancies. Biol Blood Marrow Transplant 2020; 26:1113-1118. [PMID: 32068095 DOI: 10.1016/j.bbmt.2020.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 01/22/2020] [Accepted: 02/03/2020] [Indexed: 12/19/2022]
Abstract
A matched-pair analysis of transplant-related outcomes was carried out in 116 of 255 consecutive patients who received transplants from an HLA identical sibling (n = 58) or haploidentical related donor (n = 58). The 2 patient series were matched with 9 variables: period of transplant, patient and donor age, sex, diagnosis, disease phase, conditioning regimen, donor-recipient sex, and cytomegalovirus (CMV) status combinations. As graft-versus-host disease (GVHD) prophylaxis, all patients received the standard cyclosporine and methotrexate association with the addition of anti-thymocyte globulins, mycophenolate mofetil, and basiliximab in haploidentical, unmanipulated bone marrow recipients. Anti-infectious management, transfusion policy, and supportive care were identical for all patients. By comparing the 2 patient series, no statistically significant difference was observed for the cumulative incidence of advanced acute and extensive chronic GVHD, transplant-related mortality, and relapse. With a median follow-up of 3.5 years, the 5-year disease-free survival was 37% ± 6% and 36% ± 6% for HLA identical sibling and haploidentical recipients, respectively. The results of transplant from HLA identical siblings and haploidentical donors are comparable. Regardless of the HLA matching, other factors known to affect the transplant outcomes, such as donor-recipient age, sex, and CMV status combinations, might drive the search for the best donor.
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Affiliation(s)
- William Arcese
- Hematology, Stem Cell Transplant Unit, University Tor Vergata, Rome, Italy.
| | - Raffaella Cerretti
- Hematology, Stem Cell Transplant Unit, University Tor Vergata, Rome, Italy.
| | - Loredana Sarmati
- Clinical Infectious Diseases, University Tor Vergata, Rome, Italy.
| | - Laura Cudillo
- Hematology, Stem Cell Transplant Unit, University Tor Vergata, Rome, Italy.
| | | | - Benedetta Mariotti
- Hematology, Stem Cell Transplant Unit, University Tor Vergata, Rome, Italy.
| | - Antoine Bruno
- Hematology, Stem Cell Transplant Unit, University Tor Vergata, Rome, Italy.
| | - Ilaria Mangione
- Hematology, Stem Cell Transplant Unit, University Tor Vergata, Rome, Italy.
| | - Cristina Rapanotti
- Hematology, Stem Cell Transplant Unit, University Tor Vergata, Rome, Italy.
| | - Marco Andreani
- Laboratory of Immunogenetics and Transplant Biology, Bambino Gesù Hospital.
| | | | | | | | | | | | | | | | | | | | | | | | | | - Silvia Miccichè
- Hematology, Stem Cell Transplant Unit, University Tor Vergata, Rome, Italy.
| | - Massimo Andreoni
- Clinical Infectious Diseases, University Tor Vergata, Rome, Italy.
| | - Alessandra Picardi
- Hematology, Stem Cell Transplant Unit, University Tor Vergata, Rome, Italy.
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Cicconi L, Platzbecker U, Avvisati G, Paoloni F, Thiede C, Vignetti M, Fazi P, Ferrara F, Divona M, Albano F, Efficace F, Sborgia M, Di Bona E, Breccia M, Borlenghi E, Cairoli R, Rambaldi A, Melillo L, La Nasa G, Fiedler W, Brossart P, Hertenstein B, Salih HR, Annibali O, Wattad M, Lubbert M, Brandts CH, Hanel M, Rollig C, Schmitz N, Link H, Frairia C, Fozza C, Maria D'Arco A, Di Renzo N, Cortelezzi A, Fabbiano F, Dohner K, Ganser A, Dohner H, Amadori S, Mandelli F, Voso MT, Ehninger G, Schlenk RF, Lo-Coco F. Long-term results of all-trans retinoic acid and arsenic trioxide in non-high-risk acute promyelocytic leukemia: update of the APL0406 Italian-German randomized trial. Leukemia 2019; 34:914-918. [PMID: 31611624 DOI: 10.1038/s41375-019-0589-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 07/31/2019] [Accepted: 08/13/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Laura Cicconi
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
| | | | - Giuseppe Avvisati
- Ematologia e Trapianto di cellule staminali, Università Campus Bio-Medico, Rome, Italy
| | | | - Christian Thiede
- Universitätsklinikum Carl Gustav Carus der Technischen Universität, Dresden, Germany
| | | | | | - Felicetto Ferrara
- Dipartimento di Ematologia e Trapianto di Cellule Staminali, Ospedale Cardarelli, Napoli, Italy
| | | | | | | | | | - Eros Di Bona
- Dipartimento di Terapie cellulari ed Ematologia, Unità Operativa di Ematologia, Ospedale S. Bortolo, Vicenza, Italy
| | - Massimo Breccia
- Dipartimento di Biotecnologie Cellulari ed Ematologia, Università La Sapienza, Rome, Italy
| | | | - Roberto Cairoli
- Grande Ospedale Metropolitano Niguarda, SC Ematologia, Milan, Italy
| | | | - Lorella Melillo
- Casa Sollievo della Sofferenza Hospital, IRCCS, San Giovanni Rotondo, Italy
| | - Giorgio La Nasa
- Centro Trapianti Midollo Osseo, Ospedale R. Binaghi, Università di Cagliari, Cagliari, Italy
| | | | - Peter Brossart
- Department of Oncology, Hematology, Immuno-Oncology and Rheumatology, University Hospital Bonn, CIO Bonn, Bonn, Germany
| | | | | | - Ombretta Annibali
- Ematologia e Trapianto di cellule staminali, Università Campus Bio-Medico, Rome, Italy
| | | | | | | | | | - Christoph Rollig
- Universitätsklinikum Carl Gustav Carus der Technischen Universität, Dresden, Germany
| | | | - Hartmut Link
- Klinik für Innere Medizin I, Westpfalz-Klinikum, Kaiserslautern, Germany
| | - Chiara Frairia
- Città della Salute e della Scienza, Hematology, Torino, Italy
| | | | - Alfonso Maria D'Arco
- U.O. Medicina Interna e Onco-Ematologica P.O. Umberto I, Nocera Inferiore, Nocera Inferiore, Italy
| | | | - Agostino Cortelezzi
- Foundation Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico and University of Milan, Milan, Italy
| | - Francesco Fabbiano
- Divisione di Ematologia e Unità di Trapianti di Midollo Osseo, Ospedale Riuniti Villa Sofia-Cervello, Palermo, Italy
| | | | | | | | | | | | - Maria Teresa Voso
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy. .,Fondazione Santa Lucia, Laboratorio di Neuro-Oncoematologia, Roma, Italy.
| | - Gerhard Ehninger
- Universitätsklinikum Carl Gustav Carus der Technischen Universität, Dresden, Germany
| | - Richard F Schlenk
- NCT Trial Center, National Center for Tumor Diseases Heidelberg, Heidelberg, Germany
| | - Francesco Lo-Coco
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy.,Fondazione Santa Lucia, Laboratorio di Neuro-Oncoematologia, Roma, Italy
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40
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Ciccarone M, Hohaus S, Pulsoni A, Cavaceppi P, Franzò S, Fabbri R, Cudillo L, Battistini R, Di Rocco A, Annibali O, Cox MC, Provenzano I, Abruzzese E, Renzi D, Tesei C, Anticoli Borza P, Cuccaro A, Andriani A, D'Elia GM, Facchiano A, Marchetti P, Cantonetti M. Preliminary results of a counselling programme for fertility preservation in female cancer patients: The experience of the GEMME DORMIENTI network. Eur J Cancer Care (Engl) 2019; 29:e13174. [PMID: 31571303 DOI: 10.1111/ecc.13174] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 08/09/2019] [Accepted: 09/04/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To describe a population of patients referred for fertility preservation (FP), how to efficiently provide FP care, and how FP care changed over time. METHODS This longitudinal observational study enrolled 281 female cancer patients referred between 2013 and 2016 to the non-profit organisation Gemme Dormienti ONLUS (GD) for FP care. All patients underwent the same battery of instrumental and laboratory diagnostic tests. GnRHa therapy was started at least seven days before CTh treatment. RESULTS From 2013 to 2016, we observed a progressive increase in the number of patients referred for FP care. Out of 251 eligible patients, 135 patients were treated with GnRHa only, and 72 patients underwent GnRHa therapy and cryopreservation. The median time from GD referral to oocyte and ovarian tissue cryopreservation was 11 and 5 days respectively. Tissue cryopreservation requests increased during our study period (from four cases in 2013 to 17 cases in 2016). During follow-up, 17β-estradiol and FSH levels were significantly increased (p < .0001), and AMH levels were significantly decreased (p < .0001). CONCLUSION The rapid increase in the number of patients who requested FP care and in the complexity of FP procedures overtime reflects the need to improve quality of life for cancer patients.
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Affiliation(s)
- Mariavita Ciccarone
- Department of Gynaecology, San Carlo di Nancy Hospital, Rome, Italy.,Gemme Dormienti Association ONLUS, Rome, Italy
| | - Stefan Hohaus
- Policlinico Gemelli Foundation, Catholic University of the Sacred Heart, Rome, Italy
| | - Alessandro Pulsoni
- Department of Cellular Biotechnology and Haematology, Sapienza University, Rome, Italy
| | | | | | - Raffaella Fabbri
- Gynaecology and Physiopathology of Human Reproduction Unit, Department of Medical and Surgical Sciences, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Laura Cudillo
- Haematology and Stem Cell Transplant Unit, Tor Vergata University, Roma, Italy
| | - Roberta Battistini
- A.O. San Camillo Forlanini U.O.C. Ematologia e Trapianti CSE, Rome, Italy
| | - Alice Di Rocco
- Department of Cellular Biotechnology and Haematology, Sapienza University, Rome, Italy
| | - Ombretta Annibali
- UOC Haematology Stem Cell Transplantation, University Campus Bio Medico, Rome, Italy
| | - Maria Christina Cox
- Haematology Unit, Azienda Ospedaliera-Universitaria Sant'Andrea, Rome, Italy
| | - Ida Provenzano
- UOC Oncoematologia Fondazione Policlinico Tor Vergata, Rome, Italy
| | | | - Daniela Renzi
- Haematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | | | - Annarosa Cuccaro
- Policlinico Gemelli Foundation, Catholic University of the Sacred Heart, Rome, Italy
| | - Alessandro Andriani
- UOSD di Ematologia, Rome, Italy.,UOC di Ematologia, Osp. F. Spaziani, ASL Frosinone, Rome, Italy
| | - Gianna Maria D'Elia
- Department of Cellular Biotechnology and Haematology, Sapienza University, Rome, Italy
| | | | - Paolo Marchetti
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University, Rome, Italy
| | - Maria Cantonetti
- UOC Oncoematologia Fondazione Policlinico Tor Vergata, Rome, Italy
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41
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Piredda M, Biagioli V, Gargiulo G, Annibali O, Tirindelli M, Pignatelli A, Marchesi F, Mauroni M, Soave S, Del Giudice E, Ponticelli E, Clari M, Cavallero S, Monni P, Ottani L, Sica S, Cioce M, Cappucciati L, Alvaro R, De Marinis M. Factors influencing the level of emotional support from nurses perceived by patients undergoing haematopoietic stem cell transplantation in protective isolation. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz275.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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42
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Biagioli V, Piredda M, Annibali O, Tirindelli MC, Pignatelli A, Marchesi F, Mauroni MR, Soave S, Del Giudice E, Ponticelli E, Clari M, Cavallero S, Monni P, Ottani L, Sica S, Cioce M, Cappucciati L, Bonifazi F, Alvaro R, De Marinis MG, Gargiulo G. Factors influencing the perception of protective isolation in patients undergoing haematopoietic stem cell transplantation: A multicentre prospective study. Eur J Cancer Care (Engl) 2019; 28:e13148. [PMID: 31429155 DOI: 10.1111/ecc.13148] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 05/04/2019] [Accepted: 08/01/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To identify which factors can influence the patients' perception of protective isolation following Haematopoietic Stem Cell Transplantation (HSCT). METHODS This is a prospective study conducted in 10 Italian centres, members of the Italian Group of stem cell transplant (GITMO). Patients' perception of protective isolation was assessed using the ISOLA scale between 7 and 9 days post-transplant. Statistical linear regression analysis was performed. RESULTS The participants were 182 adult patients receiving autologous (48%) or allogeneic (52%) HSCT in protective isolation. Male sex (β = .152), education level (β = -.245), double room (β = .186), satisfaction with visiting hours (β = -.174) and emotional support from nurses (β = -.169) were independently associated with isolation-related suffering. Significant predictors of the relationship with oneself included body temperature (β = -.179), fatigue (β = -.192) and emotional support from nurses (β = -.292). Factors independently associated with the relationship with others were education (β = -.230), chemotherapy cycles (β = -.218), pain (β = .150) and satisfaction with visiting hours (β = -.162). CONCLUSION Healthcare providers should pay greater attention in caring for those patients who are at risk for a negative isolation experience. Nurses should provide emotional support.
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Affiliation(s)
- Valentina Biagioli
- Department of Biomedicine and Prevention, Faculty of Medicine, School of Nursing, Tor Vergata University, Rome, Italy
| | - Michela Piredda
- Research Unit Nursing Science, Campus Bio-Medico di Roma University, Rome, Italy
| | - Ombretta Annibali
- Haematology, Stem Cell Transplantation, Transfusion Medicine and Cellular Therapy Unit, Campus Bio-Medico di Roma University, Rome, Italy
| | - Maria Cristina Tirindelli
- Haematology, Stem Cell Transplantation, Transfusion Medicine and Cellular Therapy Unit, Campus Bio-Medico di Roma University, Rome, Italy
| | | | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, Regina Elena National Cancer Institute, Rome, Italy
| | | | - Sonia Soave
- Stem Cell Transplant Unit, Fondazione Policlinico Tor Vergata, Rome, Italy
| | | | - Elena Ponticelli
- Department of Oncology, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - Marco Clari
- Department of Public Health and Paediatrics, University of Turin, Turin, Italy
| | | | - Pierina Monni
- Haematology/Oncology and Specialised Medicine Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Ottani
- Bone Marrow Transplant Centre, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Simona Sica
- Institute of Haematology, Cattolica del Sacro Cuore University, Rome, Italy
| | - Marco Cioce
- Haematology Unit, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | | | - Francesca Bonifazi
- Institute of Hematology and Medical Oncology "Seràgnoli", S. Orsola-Malpighi University Hospital, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, Faculty of Medicine, School of Nursing, Tor Vergata University, Rome, Italy
| | | | - Gianpaolo Gargiulo
- Haematology and Haematopoietic Stem Cell Transplantation Unit, Federico II University Hospital, Naples, Italy
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Annibali O, Hohaus S, Marchesi F, Cantonetti M, Di Rocco A, Tomarchio V, Di Napoli A, Pelliccia S, Battistini R, Anticoli Borza P, Abruzzese E, Cenfra N, Andriani A, Tesei C, Alma E, Palombi F, Pupo L, Petrucci L, Becilli M, Maiolo E, Bellesi S, Cuccaro A, D'Alò F, Cox MC. The neutrophil/lymphocyte ratio ≥3.5 is a prognostic marker in diffuse large B-cell lymphoma: a retrospective analysis from the database of the Italian regional network 'Rete Ematologica del Lazio per i Linfomi' (RELLI). Leuk Lymphoma 2019; 60:3386-3394. [PMID: 31259651 DOI: 10.1080/10428194.2019.1633628] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In solid tumors and lymphomas, the neutrophil/lymphocyte (N/L) ratio at diagnosis has been shown to be a prognostic factor. The aim of our study was to validate the originally reported N/L ratio cut-point of 3.5 in patients with diffuse large B-cell lymphoma (DLBCL) registered in an Italian real-life database. The prognostic role of the N/L ratio at diagnosis on event-free survival (EFS) and overall survival (OS) was assessed in 505 patients with DLBCL. Patients with an N/L ratio <3.5 (n = 249) had a 4-year EFS probability of 76% and OS probability of 86%, significantly higher than the 4 year EFS rate of 48% and OS rate of 64% in patients with N/L ratio ≥3.5 (n = 256, both p<.0001). The N/L ratio was an independent prognostic factor in the multivariate analysis including the IPI score, and could separate patients with a low/intermediate risk IPI (IPI <3).
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Affiliation(s)
- Ombretta Annibali
- Ematologia, Trapianto di cellule staminali, Università Campus Bio Medico di Roma, Rome, Italy
| | - Stefan Hohaus
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Istituto di Ematologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Marchesi
- UO di Ematologia e Trapianto di Cellule Staminali, IRCCS Istituto Nazionale Tumori Regina Elena, Rome, Italy
| | | | - Alice Di Rocco
- Dipartimento di Biotecnologie Cellulari e Ematologia, Università Sapienza Roma, Rome, Italy
| | - Valeria Tomarchio
- Ematologia, Trapianto di cellule staminali, Università Campus Bio Medico di Roma, Rome, Italy
| | - Arianna Di Napoli
- Anatomia Patologica, Azienza Ospedaliera Universitaria, Sant'Andrea, Rome, Italy
| | - Sabrina Pelliccia
- Ematologia, Azienza Ospedaliera Universitaria, Sant'Andrea, Rome, Italy
| | - Roberta Battistini
- U.O.C Ematologia e Trapianti CSE - A.O. San Camillo Forlanini, Rome, Italy
| | - Paola Anticoli Borza
- S.C. Ematologia e Trapianto di Cellule Staminali, Ospedale San Giovanni Addolorata, Rome, Italy
| | | | | | | | - Cristiano Tesei
- Ematologia, Azienza Ospedaliera Universitaria, Sant'Andrea, Rome, Italy
| | - Eleonora Alma
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Istituto di Ematologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesca Palombi
- UO di Ematologia e Trapianto di Cellule Staminali, IRCCS Istituto Nazionale Tumori Regina Elena, Rome, Italy
| | - Livio Pupo
- UO Ematologia, Policlinico Tor Vergata Roma, Rome, Italy
| | - Luigi Petrucci
- Dipartimento di Biotecnologie Cellulari e Ematologia, Università Sapienza Roma, Rome, Italy
| | - Marco Becilli
- Ematologia, Trapianto di cellule staminali, Università Campus Bio Medico di Roma, Rome, Italy
| | - Elena Maiolo
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Istituto di Ematologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Silvia Bellesi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Istituto di Ematologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Annarosa Cuccaro
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Istituto di Ematologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco D'Alò
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Istituto di Ematologia, Università Cattolica del Sacro Cuore, Rome, Italy
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Gini G, Tani M, Bassan R, Tucci A, Ballerini F, Sampaolo M, Merli F, Re F, Annibali O, Liberati A, Visco C, Arcari A, Storti S, Fabbri A, Musuraca G, Zilioli V, Cox M, Luminari S. LENALIDOMIDE AND RITUXIMAB (ReRi) AS FRONT LINE THERAPY OF ELDERLY FRAIL PATIENTS WITH DIFFUSE LARGE B-CELLS LYMPHOMA. FIRST PLANNED INTERIM ANALYSIS OF A PHASE II STUDY OF THE FONDAZIONE ITALIANA LINFOMI (FIL). Hematol Oncol 2019. [DOI: 10.1002/hon.99_2631] [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: 11/07/2022]
Affiliation(s)
- G. Gini
- Clinica di Ematologia; AOU Ospedali Riuniti Ancona; Ancona Italy
| | - M. Tani
- U.O.C. Ematologia; Ospedale Santa Maria delle Croci; Ravenna Italy
| | - R. Bassan
- U.O.C. Ematologia; Ospedale dell'Angelo; Mestre Italy
| | - A. Tucci
- Ematologia; ASST-Spedali Civili; Brescia Italy
| | - F. Ballerini
- Clinica di Ematologia; IRCCS Ospedale Policlinico San Martino Università di Genova; Genova Italy
| | - M. Sampaolo
- Clinica di Ematologia; AOU Ospedali Riuniti Ancona; Ancona Italy
| | - F. Merli
- Hematology; Arcispedale Santa Maria Nuova; Reggio Emilia Italy
| | - F. Re
- Hematology Clinic; AOU di Parma; Parma Italy
| | - O. Annibali
- Unità complessa di Ematologia trapianto di cellule Staminali; Università Campus Bio Medico; Roma Italy
| | - A. Liberati
- SC di Oncoematologia; AO Santa Maria di Terni; Terni Italy
| | - C. Visco
- Department of Hematology and Cell Therapy; Ospedale San Bartolo; Vicenza Italy
| | - A. Arcari
- Hematology Unit; Ospedale Guglielmo da Saliceto; Piacenza Italy
| | - S. Storti
- Oncoematologia; Fondazione di Ricerca e Cura Giovanni Paolo II; Campobasso Italy
| | - A. Fabbri
- U.O.C. Ematologia; A.O.U. Senese; Siena Italy
| | - G. Musuraca
- IRST; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori; Meldola Italy
| | - V. Zilioli
- Divisione di Ematologia; ASST Grande Ospedale Metropolitano Niguarda; Milano Italy
| | - M. Cox
- Haematology Unit; AOU Sant'Andrea; Roma Italy
| | - S. Luminari
- Hematology; Arcispedale Santa Maria Nuova; Reggio Emilia Italy
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45
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Gini G, Annibali O, Lupasco D, Bocci C, Tomarchio V, Sampaolo M, Trappolini S, Tafuri MA, Cacciagiù S, Ciccarone M, Barucca A, Sarlo C, Vincenzi B, Avvisati G, Leoni P, Olivieri A. Gonadal Function Recovery and Fertility in Women Treated with Chemo- and/or Radiotherapy for Hodgkin's and Non-Hodgkin Lymphoma. Chemotherapy 2019; 64:36-41. [PMID: 31117081 DOI: 10.1159/000499535] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 03/12/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Fertility and gonadal function represent one of the most important aspects for long-term lymphoma survivors. AIMS The aim of our study was to determine possible risk factors, such as age at treatment, chemotherapeutic regimen, protection with oral contraceptives (OCs), and gonadotropin-releasing hormone (GnRH) analogues in female patients treated for Hodgkin's lymphoma (HL) or non-Hodgkin lymphoma (NHL) at a reproductive age. METHODS Patients between the age of 16 and 50 years at the time of HL or NHL diagnosis were selected. Eligible patients were requested to respond to a questionnaire by phone interview about fertility, menstrual status, sexual aspects, and treatment with OCs or GnRH analogues during chemotherapy. RESULTS The resumption of menstrual activity was associated with the use of the OCs and GnRH analogues during chemotherapy (p = 0.008 and 0.034, respectively). At univariate analysis, the use of OCs during chemotherapy was associated with a lower risk of amenorrhea (prevalence ratio [PR] = 0.37; 95% CI 0.17-0.82). A higher age at the time of treatment correlated positively with therapy-induced amenorrhea, with a difference of 12.8 years between the mean age at diagnosis of the women with therapy-induced amenorrhea and those who resumed their menses. Amenorrhea was significantly higher in women receiving R-CHOP than in women treated with ABVD (PR = 6.00; 95% CI 2.32-15.54). Moreover, NHL had an infertility PR of 1.51 (95% CI 0.86-2.45) at multivariate analysis compared to HL. CONCLUSIONS This study suggests a possible role of pharmacological prophylaxis with OCs and GnRH analogues.
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Affiliation(s)
- Guido Gini
- Unit of Hematology, AUO Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy
| | - Ombretta Annibali
- Unit of Hematology and Stem Cell Transplantation, Campus Bio-Medico University, Rome, Italy,
| | - Diana Lupasco
- Unit of Hematology, AUO Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy
| | - Caterina Bocci
- Unit of Hematology, AUO Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy
| | - Valeria Tomarchio
- Unit of Hematology and Stem Cell Transplantation, Campus Bio-Medico University, Rome, Italy
| | - Michela Sampaolo
- Unit of Hematology, AUO Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy
| | - Silvia Trappolini
- Unit of Hematology, AUO Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy
| | | | - Sonia Cacciagiù
- Unit of Hematology, AUO Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy
| | - Mariavita Ciccarone
- Unit of Gynecology, Ospedale San Carlo di Nancy, Rome, Italy.,Associazione Gemme Dormienti ONLUS, Rome, Italy
| | - Alessandra Barucca
- Unit of Hematology, AUO Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy
| | - Chiara Sarlo
- Unit of Hematology and Stem Cell Transplantation, Campus Bio-Medico University, Rome, Italy
| | - Bruno Vincenzi
- Medical Oncology, University Campus Bio Medico, Rome, Italy
| | - Giuseppe Avvisati
- Unit of Hematology and Stem Cell Transplantation, Campus Bio-Medico University, Rome, Italy
| | - Pietro Leoni
- Unit of Hematology, AUO Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy
| | - Attilio Olivieri
- Unit of Hematology, AUO Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy
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Minotti G, Menna P, Calabrese V, Greco C, Armento G, Annibali O, Marchesi F, Salvatorelli E, Reggiardo G. Pharmacology of Ranolazine versus Common Cardiovascular Drugs in Patients with Early Diastolic Dysfunction Induced by Anthracyclines or Nonanthracycline Chemotherapeutics: A Phase 2b Minitrial. J Pharmacol Exp Ther 2019; 370:197-205. [PMID: 31101682 DOI: 10.1124/jpet.119.258178] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 05/15/2019] [Indexed: 12/12/2022] Open
Abstract
We have reported that anthracyclines and nonanthracycline chemotherapeutics caused diastolic dysfunction in cancer patients without cardiovascular risk factors. Diastolic dysfunction occurred as early as 1 week after the last chemotherapy cycle and manifested as impaired myocardial relaxation at echocardiography or persistent elevations of B-type natriuretic peptide (BNP) or troponin. The antianginal drug ranolazine shows cardiac relaxant effects that we considered of value to treat early diastolic dysfunction induced by cancer drugs; therefore, 24 low-risk patients with post-chemotherapy diastolic dysfunction were randomized (1:1) to ranolazine or the investigator's choice of common cardiovascular drugs, such as β-blockers and/or angiotensin-converting enzyme inhibitors or loop diuretics (best standard therapy, BST). After 5 weeks, 12 of 12 patients on ranolazine recovered from diastolic dysfunction, whereas 3 of 12 patients on BST did not improve; however, adverse events (not serious) were apparently more frequent for ranolazine than for BST (4/12 vs. 1/12). Ranolazine did not lower blood pressure, whereas BST reduced systolic pressure and caused a trend toward a reduced diastolic pressure. Most patients at randomization showed tachycardia resulting from chemotherapy-related anemia. Hemoglobin recovery contributed to normalizing heart rate in these patients; however, some patients in the ranolazine arm developed tachycardia through chronotropic effects of high BNP levels and returned to a normal heart rate through the effects of ranolazine on decreasing BNP levels. This minitrial describes the potential effects of ranolazine on relieving chemotherapy-related diastolic dysfunction; however, clinical implications of these findings need to be characterized by studies with an adequate sample size. SIGNIFICANCE STATEMENT: The antianginal drug ranolazine causes cardiac relaxant effects that might relieve diastolic dysfunction. In a clinical pharmacology study, 24 patients were randomized (1:1) to receive ranolazine or common cardiovascular drugs to treat early diastolic dysfunction induced by anthracycline-based or nonanthracycline chemotherapy. Ranolazine relieved diastolic dysfunction in these patients. The safety profile of ranolazine in cancer patients is similar to that of the general population. Compared with common cardiovascular drugs, ranolazine relieved diastolic dysfunction without lowering blood pressure. The sample size of this study was nonetheless too small to permit considerations about the potential clinical value of ranolazine for oncologic patients with early diastolic dysfunction induced by anthracyclines or nonanthracycline chemotherapeutics. This information should be obtained by studies with an adequate sample size.
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Affiliation(s)
- Giorgio Minotti
- Clinical Pharmacology Unit (G.M., P.M.) and Cardio Center (V.C.), Campus Bio-Medico University Hospital, Rome; Units of Drug Sciences (G.M., E.S.), Radiation Oncology (C.G.), Oncology (G.A.), and Hematology (O.A.), Department of Medicine and Center for Integrated Research, University Campus Bio-Medico, Rome; Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome (F.M.); and Mediservice S.r.l., Agrate Brianza (Monza) (G.R.), Italy
| | - Pierantonio Menna
- Clinical Pharmacology Unit (G.M., P.M.) and Cardio Center (V.C.), Campus Bio-Medico University Hospital, Rome; Units of Drug Sciences (G.M., E.S.), Radiation Oncology (C.G.), Oncology (G.A.), and Hematology (O.A.), Department of Medicine and Center for Integrated Research, University Campus Bio-Medico, Rome; Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome (F.M.); and Mediservice S.r.l., Agrate Brianza (Monza) (G.R.), Italy
| | - Vito Calabrese
- Clinical Pharmacology Unit (G.M., P.M.) and Cardio Center (V.C.), Campus Bio-Medico University Hospital, Rome; Units of Drug Sciences (G.M., E.S.), Radiation Oncology (C.G.), Oncology (G.A.), and Hematology (O.A.), Department of Medicine and Center for Integrated Research, University Campus Bio-Medico, Rome; Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome (F.M.); and Mediservice S.r.l., Agrate Brianza (Monza) (G.R.), Italy
| | - Carlo Greco
- Clinical Pharmacology Unit (G.M., P.M.) and Cardio Center (V.C.), Campus Bio-Medico University Hospital, Rome; Units of Drug Sciences (G.M., E.S.), Radiation Oncology (C.G.), Oncology (G.A.), and Hematology (O.A.), Department of Medicine and Center for Integrated Research, University Campus Bio-Medico, Rome; Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome (F.M.); and Mediservice S.r.l., Agrate Brianza (Monza) (G.R.), Italy
| | - Grazia Armento
- Clinical Pharmacology Unit (G.M., P.M.) and Cardio Center (V.C.), Campus Bio-Medico University Hospital, Rome; Units of Drug Sciences (G.M., E.S.), Radiation Oncology (C.G.), Oncology (G.A.), and Hematology (O.A.), Department of Medicine and Center for Integrated Research, University Campus Bio-Medico, Rome; Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome (F.M.); and Mediservice S.r.l., Agrate Brianza (Monza) (G.R.), Italy
| | - Ombretta Annibali
- Clinical Pharmacology Unit (G.M., P.M.) and Cardio Center (V.C.), Campus Bio-Medico University Hospital, Rome; Units of Drug Sciences (G.M., E.S.), Radiation Oncology (C.G.), Oncology (G.A.), and Hematology (O.A.), Department of Medicine and Center for Integrated Research, University Campus Bio-Medico, Rome; Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome (F.M.); and Mediservice S.r.l., Agrate Brianza (Monza) (G.R.), Italy
| | - Francesco Marchesi
- Clinical Pharmacology Unit (G.M., P.M.) and Cardio Center (V.C.), Campus Bio-Medico University Hospital, Rome; Units of Drug Sciences (G.M., E.S.), Radiation Oncology (C.G.), Oncology (G.A.), and Hematology (O.A.), Department of Medicine and Center for Integrated Research, University Campus Bio-Medico, Rome; Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome (F.M.); and Mediservice S.r.l., Agrate Brianza (Monza) (G.R.), Italy
| | - Emanuela Salvatorelli
- Clinical Pharmacology Unit (G.M., P.M.) and Cardio Center (V.C.), Campus Bio-Medico University Hospital, Rome; Units of Drug Sciences (G.M., E.S.), Radiation Oncology (C.G.), Oncology (G.A.), and Hematology (O.A.), Department of Medicine and Center for Integrated Research, University Campus Bio-Medico, Rome; Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome (F.M.); and Mediservice S.r.l., Agrate Brianza (Monza) (G.R.), Italy
| | - Giorgio Reggiardo
- Clinical Pharmacology Unit (G.M., P.M.) and Cardio Center (V.C.), Campus Bio-Medico University Hospital, Rome; Units of Drug Sciences (G.M., E.S.), Radiation Oncology (C.G.), Oncology (G.A.), and Hematology (O.A.), Department of Medicine and Center for Integrated Research, University Campus Bio-Medico, Rome; Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome (F.M.); and Mediservice S.r.l., Agrate Brianza (Monza) (G.R.), Italy
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Del Principe MI, Dragonetti G, Verga L, Candoni A, Marchesi F, Cattaneo C, Delia M, Potenza L, Farina F, Ballanti S, Decembrino N, Castagnola C, Nadali G, Fanci R, Orciulo E, Veggia B, Offidani M, Melillo L, Manetta S, Tumbarello M, Venditti A, Busca A, Aversa F, Pagano L, Pepa RD, Ferrari A, Piedimonte M, Andrea OS, Fracchiolla NS, Sciumè M, Lessi F, Prezioso L, Spolzino A, Rambaldi B, Russo D, di Ematologia C, Maracci L, Sarlo C, Annibali O, Cefalo M, Zizzari A, Blasi RD, Zama D, Mancini V, Salutari P, Cesaro S, Garzia MG, Vacca A, Dargenio M, Invernizzi R, Perruccio K, Quinto AM, Chierichini A, Spadea A. ‘Real-life’ analysis of the role of antifungal prophylaxis in preventing invasive aspergillosis in AML patients undergoing consolidation therapy: Sorveglianza Epidemiologica Infezioni nelle Emopatie (SEIFEM) 2016 study. J Antimicrob Chemother 2019; 74:1062-1068. [DOI: 10.1093/jac/dky550] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 11/23/2018] [Accepted: 11/30/2018] [Indexed: 12/17/2022] Open
Affiliation(s)
- Maria Ilaria Del Principe
- Cattedra di Ematologia, Dipartimento di Biomedicina e Prevenzione, Università degli Studi di Roma ‘Tor Vergata’, Roma, Italy
| | - Giulia Dragonetti
- Istituto di Ematologia, Fondazione Policlinico Universitario A. Gemelli-IRCCS-Università Cattolica del Sacro Cuore, Roma, Italy
| | - Luisa Verga
- Clinica Ematologica, Ospedale San Gerardo, ASST Monza, Università Milano Bicocca, Milano, Italy
| | - Anna Candoni
- Clinica di Ematologia e Unità di terapie Cellulari ‘Carlo Melzi’-Azienda Sanitaria-Universitaria, Integrata, Udine, Italy
| | - Francesco Marchesi
- Haematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Roma, Italy
| | - Chiara Cattaneo
- Divisione di Ematologia, ASST-Spedali Civili di Brescia, Brescia, Italy
| | - Mario Delia
- Sezione di Ematologia, Dipartimento dell'Emergenza e dei Trapianti d'Organo-Università di Bari, Bari, Italy
| | - Leonardo Potenza
- UOC Ematologia, Dipartimento di Scienze Mediche e Chirurgiche Materno infantili e dell’Adulto, Università di Modena e Reggio Emilia, Modena, Italy
| | | | | | - Nunzia Decembrino
- UOC Oncoematologia Pediatrica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Carlo Castagnola
- Dipartimento Onco-Ematologico Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Gianpaolo Nadali
- Unità Operativa Complessa di Ematologia, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Rosa Fanci
- Unità Funzionale di Ematologia, Azienda Ospedaliero-Universitaria Careggi e Università di Firenze, Firenze, Italy
| | - Enrico Orciulo
- Dipartimento di Oncologia, Trapianti e Tecnologie Avanzate, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | | | - Massimo Offidani
- Clinica di Ematologia, Azienda Ospedaliero-Universitaria, Ospedali Riunti di Ancona, Ancona, Italy
| | - Lorella Melillo
- Divisione di Ematologia, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Sara Manetta
- Stem Cell Transplant Centre, AOU Citta’ della Salute e della Scienza, Torino, Italy
| | - Mario Tumbarello
- Istituto di Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli-IRCCS-Università Cattolica del Sacro Cuore, Roma, Italy
| | - Adriano Venditti
- Cattedra di Ematologia, Dipartimento di Biomedicina e Prevenzione, Università degli Studi di Roma ‘Tor Vergata’, Roma, Italy
| | - Alessandro Busca
- Stem Cell Transplant Centre, AOU Citta’ della Salute e della Scienza, Torino, Italy
| | - Franco Aversa
- Dipartimento di Medicina Interna, Università di Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Livio Pagano
- Istituto di Ematologia, Fondazione Policlinico Universitario A. Gemelli-IRCCS-Università Cattolica del Sacro Cuore, Roma, Italy
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Tendas A, Marchesi F, Mengarelli A, Annibali O, Tomarchio V, Saltarelli D, Chierichini A, Di Venanzio M, Sollazzo F, Piedimonte M, Cupelli L, Bruno A, De Angelis G, Delbono L, Niscola P, Perrotti AP, de Fabritiis P, Arcese W. Prevention of chemotherapy-induced nausea and vomiting after high-dose melphalan and stem cell transplantation: review of the evidence and suggestions. Support Care Cancer 2018; 27:793-803. [PMID: 30564934 DOI: 10.1007/s00520-018-4594-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 12/06/2018] [Indexed: 11/26/2022]
Abstract
INTRODUCTION High-dose melphalan (HDMel) is the most common conditioning chemotherapy regimen for autologous stem cell transplantation (SCT) in patients affected by multiple myeloma (MM). No consensus exists for the emetogenicity or prophylaxis of chemotherapy-induced nausea and vomiting (CINV) in this regimen. METHODS Data on the incidence and efficacy/safety of CINV prophylaxis among patients affected by MM undergoing autologous SCT with the HDMel regimen was extracted from electronic databases and analyzed. RESULTS Eleven studies involving multiple CINV prophylaxis regimens were identified and included. No consensus on HDMel emetogenicity was reached, but most studies summarized the emetogenicity as moderate-high risk. An aprepitant-based three-drug regimen (aprepitant + serotonin receptor antagonist (5HT3RA) + dexamethasone) showed better efficacy than a two-drug regimen (5HT3RA + dexamethasone) for CINV prevention without increasing the frequency in adverse events. CONCLUSIONS The aprepitant-based three-drug regimen should be the regimen of choice for CINV prophylaxis for MM patients undergoing autologous SCT with HDMel conditioning.
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Affiliation(s)
- Andrea Tendas
- Hematology Division, S. Eugenio Hospital, Piazzale dell'Umanesimo 10, 00144, Rome, Italy.
| | | | | | - Ombretta Annibali
- Hematology and Stem Cell Transplantation Unit, University Campus Bio-medico, Rome, Italy
| | - Valeria Tomarchio
- Hematology and Stem Cell Transplantation Unit, University Campus Bio-medico, Rome, Italy
| | | | | | | | | | | | - Luca Cupelli
- Hematology Division, S. Eugenio Hospital, Piazzale dell'Umanesimo 10, 00144, Rome, Italy
| | - Antoine Bruno
- Hematology, Rome Transplant Network, Department of Hematology, Stem Cell Transplant Unit, Tor Vergata University, Rome, Italy
| | - Gottardo De Angelis
- Hematology, Rome Transplant Network, Department of Hematology, Stem Cell Transplant Unit, Tor Vergata University, Rome, Italy
| | - Luciano Delbono
- Wake Forest University School of Medicine, Winston Salem, NC, USA
| | - Pasquale Niscola
- Hematology Division, S. Eugenio Hospital, Piazzale dell'Umanesimo 10, 00144, Rome, Italy
| | - Alessio Pio Perrotti
- Hematology Division, S. Eugenio Hospital, Piazzale dell'Umanesimo 10, 00144, Rome, Italy
| | - Paolo de Fabritiis
- Hematology Division, S. Eugenio Hospital, Piazzale dell'Umanesimo 10, 00144, Rome, Italy
| | - William Arcese
- Hematology, Rome Transplant Network, Department of Hematology, Stem Cell Transplant Unit, Tor Vergata University, Rome, Italy
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Biagioli V, Piredda M, Annibali O, Tirindelli MC, Pignatelli A, Marchesi F, Mauroni MR, Soave S, Del Giudice E, Ponticelli E, Clari M, Cavallero S, Monni P, Ottani L, Sica S, Cioce M, Cappucciati L, Bonifazi F, Alvaro R, De Marinis MG, Gargiulo G. Development and initial validation of a questionnaire to assess patients’ perception of protective isolation following haematopoietic stem cell transplantation. Eur J Cancer Care (Engl) 2018; 28:e12955. [DOI: 10.1111/ecc.12955] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 06/22/2018] [Accepted: 09/24/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Valentina Biagioli
- Faculty of Medicine, Department of Biomedicine and Prevention, School of Nursing; Tor Vergata University; Rome Italy
| | - Michela Piredda
- Research Unit Nursing Science; Campus Bio-Medico di Roma University; Rome Italy
| | - Ombretta Annibali
- Haematology, Stem Cell Transplantation, Transfusion Medicine and Cellular Therapy Unit; Campus Bio-Medico di Roma University; Rome Italy
| | - Maria Cristina Tirindelli
- Haematology, Stem Cell Transplantation, Transfusion Medicine and Cellular Therapy Unit; Campus Bio-Medico di Roma University; Rome Italy
| | | | - Francesco Marchesi
- Haematology and Stem Cell Transplant Unit; Regina Elena National Cancer Institute; Rome Italy
| | | | - Sonia Soave
- Stem Cell Transplant Unit; Fondazione Policlinico Tor Vergata; Rome Italy
| | | | - Elena Ponticelli
- Department of Oncology; Città della Salute e della Scienza University Hospital; Turin Italy
| | - Marco Clari
- Department of Quality and Safety of Care; Città della Salute e della Scienza University Hospital; Turin Italy
| | | | - Pierina Monni
- Haematology/Oncology and Specialised Medicine Unit; Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico; Milan Italy
| | - Laura Ottani
- Bone Marrow Transplant Centre; Fondazione IRCCS Ca' Granda; Milan Italy
| | - Simona Sica
- Institute of Haematology; Cattolica del Sacro Cuore University; Rome Italy
| | - Marco Cioce
- Haematology Unit; Fondazione Policlinico Universitario Agostino Gemelli; Rome Italy
| | | | - Francesca Bonifazi
- Alma Mater Studiorum University of Bologna; Bologna Italy
- Institute of Hematology and Medical Oncology ‘Seràgnoli’; S. Orsola-Malpighi University Hospital; Bologna Italy
| | - Rosaria Alvaro
- Faculty of Medicine, Department of Biomedicine and Prevention, School of Nursing; Tor Vergata University; Rome Italy
| | | | - Gianpaolo Gargiulo
- Haematology and Haematopoietic Stem Cell Transplantation Unit; Federico II University Hospital; Naples Italy
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50
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Menna P, Salvatorelli E, Armento G, Annibali O, Greco C, Marchesi F, Calabrese V, Reggiardo G, Minotti G. The Endogenous Lusitropic and Chronotropic Agent, B-Type Natriuretic Peptide, Limits Cardiac Troponin Release in Cancer Patients with an Early Impairment of Myocardial Relaxation Induced by Anthracyclines. J Pharmacol Exp Ther 2018; 367:518-527. [PMID: 30275150 DOI: 10.1124/jpet.118.253104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 09/27/2018] [Indexed: 11/22/2022] Open
Abstract
We have reported that cancer patients treated with anthracycline-based or nonanthracycline chemotherapy developed an early impairment of myocardial relaxation at echocardiography or persistent elevations of the cardiac hormone B-type natriuretic peptide (BNP). Post-hoc pharmacologic analyses showed that BNP elevations were induced by impaired relaxation and caused positive lusitropic effects that maintained normal relaxation. High BNP levels and impaired relaxation were therefore characterized as mutually exclusive manifestations of diastolic dysfunction, but high BNP levels resulted in positive chronotropism and inappropriate tachycardia. Some patients developed increased circulating levels of cardiac troponin I isoform (cTnI), a marker of cardiomyocyte necrosis. Here we have characterized whether cTnI elevations correlated with diastolic dysfunction that manifested as impaired relaxation or a high level of BNP. The effects of high BNP levels on cTnI elevations were also characterized. We show that impaired relaxation or high BNP levels were significantly more frequent in patients with cTnI elevations. High BNP levels diminished the plasma peak and area under the curve of cTnI, but this result was accompanied by inappropriate tachycardia. cTnI elevations occurred only in patients treated with anthracyclines; moreover, the association of impaired relaxation or high BNP levels with cTnI elevations was significantly more frequent in doxorubicin-treated patients compared with patients treated with its analog, epirubicin. These findings describe cause-and-effect relations between impaired relaxation and cardiomyocyte necrosis, illuminate the role of anthracycline analogs, denote that the beneficial effects of BNP in relieving impaired relaxation and cardiomyocyte necrosis are counterbalanced by inappropriate tachycardia. Patients showing troponin elevations and impaired relaxation or high BNP levels should be treated with lusitropic drugs that lack a positive chronotropism.
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Affiliation(s)
- Pierantonio Menna
- Units of Drug Sciences (P.M., E.S., G.M.), Oncology (G.A.), Hematology (O.A.), Radiation Oncology (C.G.), and Cardiovascular Sciences (V.C.), Department of Medicine and Center for Integrated Research, University Campus Bio-Medico, Rome; Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome (F.M.); and Mediservice S.r.l., Agrate Brianza (Monza), Italy (G.R.)
| | - Emanuela Salvatorelli
- Units of Drug Sciences (P.M., E.S., G.M.), Oncology (G.A.), Hematology (O.A.), Radiation Oncology (C.G.), and Cardiovascular Sciences (V.C.), Department of Medicine and Center for Integrated Research, University Campus Bio-Medico, Rome; Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome (F.M.); and Mediservice S.r.l., Agrate Brianza (Monza), Italy (G.R.)
| | - Grazia Armento
- Units of Drug Sciences (P.M., E.S., G.M.), Oncology (G.A.), Hematology (O.A.), Radiation Oncology (C.G.), and Cardiovascular Sciences (V.C.), Department of Medicine and Center for Integrated Research, University Campus Bio-Medico, Rome; Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome (F.M.); and Mediservice S.r.l., Agrate Brianza (Monza), Italy (G.R.)
| | - Ombretta Annibali
- Units of Drug Sciences (P.M., E.S., G.M.), Oncology (G.A.), Hematology (O.A.), Radiation Oncology (C.G.), and Cardiovascular Sciences (V.C.), Department of Medicine and Center for Integrated Research, University Campus Bio-Medico, Rome; Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome (F.M.); and Mediservice S.r.l., Agrate Brianza (Monza), Italy (G.R.)
| | - Carlo Greco
- Units of Drug Sciences (P.M., E.S., G.M.), Oncology (G.A.), Hematology (O.A.), Radiation Oncology (C.G.), and Cardiovascular Sciences (V.C.), Department of Medicine and Center for Integrated Research, University Campus Bio-Medico, Rome; Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome (F.M.); and Mediservice S.r.l., Agrate Brianza (Monza), Italy (G.R.)
| | - Francesco Marchesi
- Units of Drug Sciences (P.M., E.S., G.M.), Oncology (G.A.), Hematology (O.A.), Radiation Oncology (C.G.), and Cardiovascular Sciences (V.C.), Department of Medicine and Center for Integrated Research, University Campus Bio-Medico, Rome; Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome (F.M.); and Mediservice S.r.l., Agrate Brianza (Monza), Italy (G.R.)
| | - Vito Calabrese
- Units of Drug Sciences (P.M., E.S., G.M.), Oncology (G.A.), Hematology (O.A.), Radiation Oncology (C.G.), and Cardiovascular Sciences (V.C.), Department of Medicine and Center for Integrated Research, University Campus Bio-Medico, Rome; Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome (F.M.); and Mediservice S.r.l., Agrate Brianza (Monza), Italy (G.R.)
| | - Giorgio Reggiardo
- Units of Drug Sciences (P.M., E.S., G.M.), Oncology (G.A.), Hematology (O.A.), Radiation Oncology (C.G.), and Cardiovascular Sciences (V.C.), Department of Medicine and Center for Integrated Research, University Campus Bio-Medico, Rome; Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome (F.M.); and Mediservice S.r.l., Agrate Brianza (Monza), Italy (G.R.)
| | - Giorgio Minotti
- Units of Drug Sciences (P.M., E.S., G.M.), Oncology (G.A.), Hematology (O.A.), Radiation Oncology (C.G.), and Cardiovascular Sciences (V.C.), Department of Medicine and Center for Integrated Research, University Campus Bio-Medico, Rome; Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome (F.M.); and Mediservice S.r.l., Agrate Brianza (Monza), Italy (G.R.)
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