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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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2
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Fadda GL, Manca A, Testi F, Itri F, Nicoli P, Moratti G, Cavallo G, Guerrasio A. A Rare Case of Hodgkin Lymphoma of the Maxillary Sinus. Ear Nose Throat J 2021; 102:NP232-NP236. [PMID: 33734885 DOI: 10.1177/0145561321993599] [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: 11/16/2022] Open
Abstract
Hodgkin lymphoma (HL) is an uncommon B-cell malignant disease. It usually presents with mediastinal and/or laterocervical lymph node localization, while primary extranodal HL is a rare entity giving rise to diagnostic and therapeutic challenges. It rarely presents as just extranodal localization, so its presence within the maxillary sinus without any lymphadenopathy is exceptional. Given the rarity of this localization, there is no standard treatment for maxillary sinus HL. We present a case of a patient with extranodal HL of the right maxillary sinus treated with primary surgery followed by adjuvant sequential chemoradiation therapy.
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Affiliation(s)
- Gian Luca Fadda
- Department of Otorhinolaryngology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - Andrea Manca
- FPO IRCCS, Head & Neck Oncology Unit, Candiolo Cancer Institute, Turin, Italy
| | - Francesca Testi
- Department of Otorhinolaryngology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - Federico Itri
- Department of Clinical and Biological Sciences, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - Paolo Nicoli
- Department of Clinical and Biological Sciences, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - Giuseppe Moratti
- Department of Otorhinolaryngology, Galliera Hospital, Genova, Italy
| | - Giovanni Cavallo
- Department of Otorhinolaryngology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - Angelo Guerrasio
- Departement of Clinical and Biological Sciences, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Italy
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3
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Carrà G, Nicoli P, Lingua MF, Maffeo B, Cartellà A, Circosta P, Brancaccio M, Parvis G, Gaidano V, Guerrasio A, Saglio G, Taulli R, Morotti A. Inhibition of bromodomain and extra-terminal proteins increases sensitivity to venetoclax in chronic lymphocytic leukaemia. J Cell Mol Med 2019; 24:1650-1657. [PMID: 31821686 PMCID: PMC6991693 DOI: 10.1111/jcmm.14857] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 11/06/2019] [Accepted: 11/08/2019] [Indexed: 01/03/2023] Open
Abstract
The development of drugs able to target BTK, PI3k‐delta and BCL2 has dramatically improved chronic lymphocytic leukaemia (CLL) therapies. However, drug resistance to these therapies has already been reported due to non‐recurrent changes in oncogenic pathways and genes expression signatures. In this study, we investigated the cooperative role of the BCL2 inhibitor venetoclax and the BRD4 inhibitor JQ1. In particular, we found that JQ1 shows additional activity with venetoclax, in CLL cell lines and in ex vivo isolated primary CD19+ lymphocytes, arguing in favour of combination strategies. Lastly, JQ1 is also effective in venetoclax‐resistant CLL cell lines. Together, our findings indicated that the BET inhibitor JQ1 could be a promising therapy in CLL, both as first‐line therapy in combination with venetoclax and as second‐line therapy, after the emergence of venetoclax‐resistant clones.
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Affiliation(s)
- Giovanna Carrà
- Dept. of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
| | - Paolo Nicoli
- Dept. of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
| | | | - Beatrice Maffeo
- Dept. of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
| | - Antonio Cartellà
- Dept. of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
| | - Paola Circosta
- Dept. of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
| | - Mara Brancaccio
- Dept. of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
| | - Guido Parvis
- Division of Hematology, Ospedale Mauriziano, Torino, Italy
| | | | - Angelo Guerrasio
- Dept. of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
| | - Giuseppe Saglio
- Dept. of Clinical and Biological Sciences, University of Turin, Orbassano, Italy.,Division of Hematology, Ospedale Mauriziano, Torino, Italy
| | | | - Alessandro Morotti
- Dept. of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
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4
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Dragani M, Andreani G, Fava C, Daraio F, Gottardi E, Giugliano E, Nicoli P, Rege-Cambrin G. Philadelphia-positive lymphoblastic lymphoma: a case report and review of the literature. Stem Cell Investig 2019; 6:17. [PMID: 31463310 DOI: 10.21037/sci.2019.06.06] [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: 01/15/2019] [Accepted: 05/08/2019] [Indexed: 11/06/2022]
Abstract
Philadelphia positive acute lymphoblastic leukemia is well documented nowadays but very little is known about Philadelphia positive lymphoblastic lymphoma (LBL). Only two cases are available in literature and both of them died during treatment whereas the patient treated in our center is still alive 3 years after the initial diagnosis. A chemo-free regimen was used in induction with dasatinib plus steroids with local radiotherapy on the mass, and then the patient underwent bone marrow transplant. Philadelphia positive lymphoblastic lymphoma is a difficult diagnosis to make and the management of this extremely rare disease is very challenging.
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Affiliation(s)
- Matteo Dragani
- Azienda Ospedaliero Universitaria San Luigi Gonzaga, Università di Torino, Torino, Italy
| | - Giacomo Andreani
- Azienda Ospedaliero Universitaria San Luigi Gonzaga, Università di Torino, Torino, Italy
| | - Carmen Fava
- Azienda Ospedaliero Universitaria San Luigi Gonzaga, Università di Torino, Torino, Italy
| | - Filomena Daraio
- Azienda Ospedaliero Universitaria San Luigi Gonzaga, Università di Torino, Torino, Italy
| | - Enrico Gottardi
- Azienda Ospedaliero Universitaria San Luigi Gonzaga, Università di Torino, Torino, Italy
| | - Emilia Giugliano
- Azienda Ospedaliero Universitaria San Luigi Gonzaga, Università di Torino, Torino, Italy
| | - Paolo Nicoli
- Azienda Ospedaliero Universitaria San Luigi Gonzaga, Università di Torino, Torino, Italy
| | - Giovanna Rege-Cambrin
- Azienda Ospedaliero Universitaria San Luigi Gonzaga, Università di Torino, Torino, Italy
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5
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Andreani G, Dragani M, Serra A, Nicoli P, De Gobbi M, Cilloni D. Venetoclax plus decitabine induced complete remission with molecular response in acute myeloid leukemia relapsed after hematopoietic stem cell transplantation. Am J Hematol 2019; 94:E48-E50. [PMID: 30431666 DOI: 10.1002/ajh.25352] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 11/07/2018] [Accepted: 11/12/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Giacomo Andreani
- Department of Clinical and Biological Sciences; University of Turin; Turin Italy
| | - Matteo Dragani
- Department of Clinical and Biological Sciences; University of Turin; Turin Italy
| | - Anna Serra
- Department of Clinical and Biological Sciences; University of Turin; Turin Italy
| | - Paolo Nicoli
- Department of Clinical and Biological Sciences; University of Turin; Turin Italy
| | - Marco De Gobbi
- Department of Clinical and Biological Sciences; University of Turin; Turin Italy
| | - Daniela Cilloni
- Department of Clinical and Biological Sciences; University of Turin; Turin Italy
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6
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Carturan S, Petiti J, Rosso V, Calabrese C, Signorino E, Bot-Sartor G, Nicoli P, Gallo D, Bracco E, Morotti A, Panuzzo C, Gottardi E, Frassoni F, Saglio G, Cilloni D. Variable but consistent pattern of Meningioma 1 gene (MN1) expression in different genetic subsets of acute myelogenous leukaemia and its potential use as a marker for minimal residual disease detection. Oncotarget 2018; 7:74082-74096. [PMID: 27765915 PMCID: PMC5342037 DOI: 10.18632/oncotarget.12269] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 09/14/2016] [Indexed: 11/25/2022] Open
Abstract
Meningioma 1 (MN1) gene overexpression has been reported in acute myeloid leukaemia (AML) patients and identified as a negative prognostic factor. In order to characterize patients presenting gene overexpression and to verify if MN1 transcript could be a useful marker for minimal residual disease detection, MN1 was quantified in 136 AML patients with different cytogenetic risk and in 50 normal controls. In 20 patients bearing a fusion gene transcript suitable for minimal residual disease quantitative assessment and in 8 patients with NPM1 mutation, we performed a simultaneous analysis of MN1 and the fusion-gene transcript or NPM1 mutation during follow-up. Sequential MN1 and WT1 analysis was also performed in 13 AML patients lacking other molecular markers. The data obtained show that normal cells consistently express low levels of MN1 transcript. In contrast, high levels of MN1 expression are present in 47% of patients with normal karyotype and in all cases with inv(16). MN1 levels during follow-up were found to follow the pattern of other molecular markers (fusion gene transcripts, NPM1 and WT1). Increased MN1 expression in the BM during follow up was always found to be predictive of an impending hematological relapse.
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Affiliation(s)
- Sonia Carturan
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Jessica Petiti
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Valentina Rosso
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Chiara Calabrese
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Elisabetta Signorino
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Giada Bot-Sartor
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Paolo Nicoli
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Daniela Gallo
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Enrico Bracco
- Department of Oncology, University of Turin, Turin, Italy
| | - Alessandro Morotti
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Cristina Panuzzo
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Enrico Gottardi
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Francesco Frassoni
- Department of Pediatric Hemato-Oncology and Stem Cell and Cellular Therapy Laboratory, Institute G. Gaslini, Genova, Italy
| | - Giuseppe Saglio
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Daniela Cilloni
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
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7
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Messa E, Biale L, Castiglione A, Lunghi M, Bonferroni M, Salvi F, Allione B, Ferrero D, Calabrese C, De Gobbi M, Nicoli P, Gioia D, Levis A, Saglio G, Cilloni D. Erythroid response during iron chelation therapy in a cohort of patients affected by hematologic malignancies and aplastic anemia with transfusion requirement and iron overload: a FISM Italian multicenter retrospective study. Leuk Lymphoma 2017; 58:2752-2754. [DOI: 10.1080/10428194.2017.1312385] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Lucia Biale
- AOU Città della Salute e della Scienza di Torino – Presidio Ospedaliero Molinette – SC Banca del Sangue e del plasma, Turin, Italy
| | - Anna Castiglione
- Unit of Cancer Epidemiology and CPO Piedmont, S. Giovanni Battista Hospital, Torino, Italy
| | - Monia Lunghi
- Division of Haematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Italy, Novara, Italy
| | | | - Flavia Salvi
- Department of Hematology, AO SS Antonio e Biagio e C. Arrigo, Alessandria, Italy
| | - Bernardino Allione
- Division of Hematology, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Dario Ferrero
- Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
| | - Chiara Calabrese
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
| | - Marco De Gobbi
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
| | - Paolo Nicoli
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
| | - Daniela Gioia
- FISM Registry, SS Antonio e Biagio e C. Arrigo Hospital, Alessandria, Tuscany, Italy
| | - Alessandro Levis
- Department of Hematology, AO SS Antonio e Biagio e C. Arrigo, Alessandria, Italy
| | - Giuseppe Saglio
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
| | - Daniela Cilloni
- Department of Clinical and Biological Sciences, Division of Hematology, University of Turin, Turin, Italy
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8
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Maselli F, Ciuro A, Mastrosimone R, Cannone M, Nicoli P, Signori A, Testa M. Low back pain among Italian rowers: A cross-sectional survey. J Back Musculoskelet Rehabil 2016; 28:365-76. [PMID: 25271199 DOI: 10.3233/bmr-140529] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Low Back Pain is commonly reported to be a very frequent disorder in rowing, but it is still unclear if its prevalence is higher than in other sports or even in a non-athletes group. OBJECTIVES To determine prevalence of low back pain (LBP) with and without irradiated pain and possibly related risk factors in a group of elite Italian rowers. METHODS The study was conducted during the 2010 Italian Indoor Rowing Championship held in Bari from 30th to 31st January. All the 415 rowers who qualified for the national championship were asked to complete a three-page questionnaire on LBP, assisted by a physiotherapist. RESULTS One hundred and thirty-three athletes (32%) completed the assessment. LBP was very common, with a lifetime and 1 year prevalence of 64.7% and 40.6% respectively. During the last episode, the LBP intensity, measured by a numeric rating scale (NRS), presented a median value of 6/10, and 40% of rowers reported some limitation in daily living activities (ADL). Odds ratio (OR) to suffer from LBP was 2.62 in males compared to females; athletes who row both in sculling and sweep or only sweep showed an OR of 4.43 and 3.32 respectively. CONCLUSIONS The prevalence of low back pain among rowers seems to be comparable to the one of the general population, even if the recovery appears to be faster. The risk of developing LBP is associated with the rowing typology and the gender, but a prospective study with an adequate sample size is necessary to clearly identify risk factors for LBP in rowers and to implement effective prevention strategies.
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Affiliation(s)
- F Maselli
- Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University ofGenova, Campus of Savona, Italy
| | - A Ciuro
- Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University ofGenova, Campus of Savona, Italy
| | - R Mastrosimone
- Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University ofGenova, Campus of Savona, Italy
| | - M Cannone
- "Fondazione Padre Pio" Rehabilitation Centre, Foggia, Italy
| | - P Nicoli
- Nursing Home "Domus Salutis", Brescia, Italy
| | - A Signori
- Department of Health Sciences, Section of Biostatistics, University of Genova, Italy
| | - M Testa
- Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University ofGenova, Campus of Savona, Italy
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9
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Gallo D, Nicoli P, Calabrese C, Gaidano V, Petiti J, Rosso V, Signorino E, Carturan S, Bot-Sartor G, Volpe G, Frassoni F, Saglio G, Cilloni D. The Wilms' tumor (WT1) gene expression correlates with the International Prognostic Scoring System (IPSS) score in patients with myelofibrosis and it is a marker of response to therapy. Cancer Med 2016; 5:1650-3. [PMID: 27167495 PMCID: PMC4867666 DOI: 10.1002/cam4.735] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 05/05/1993] [Accepted: 03/18/2016] [Indexed: 11/06/2022] Open
Abstract
The Wilms tumor gene WT1 is a useful marker of clonal hematopoiesis and it has been shown to be a good marker of residual disease and it reflects the response to therapy. Although myelofibrosis is characterized by mutations of JAK2 and calreticulin (CALR), these mutations are not useful to monitor response to therapy. In this study we demonstrated that in patients affected by myelofibrosis WT1 correlates with the International Prognostic Scoring System (IPSS) score at diagnosis. Furthermore WT1 is a good marker of response to JAK2 inhibitors especially for patients without blasts and for patients who develop anemia or thrombocytopenia not for progression but as therapy related toxicity. Finally, WT1 transcript reduction can mirror a benefit of therapy on the disease burden. This study demonstrated that WT1 is a good marker for monitoring the response to therapy in patients affected by myelofibrosis.
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Affiliation(s)
- Daniela Gallo
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Paolo Nicoli
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Chiara Calabrese
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Valentina Gaidano
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Jessica Petiti
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Valentina Rosso
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Elisabetta Signorino
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Sonia Carturan
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Giada Bot-Sartor
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Gisella Volpe
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Francesco Frassoni
- Department of Pediatric Hemato-Oncology and Stem Cell and Cellular Therapy Laboratory, Institute G. Gaslini, Largo G Gaslini, Genova
| | - Giuseppe Saglio
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Daniela Cilloni
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
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10
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Di Savino A, Gaidano V, Palmieri A, Crasto F, Volpengo A, Lorenzatti R, Scaravaglio P, Manello A, Nicoli P, Gottardi E, Saglio G, Cilloni D, De Gobbi M. Clinical significance of TFR2 and EPOR expression in bone marrow cells in myelodysplastic syndromes. Br J Haematol 2016; 176:491-495. [PMID: 26914246 DOI: 10.1111/bjh.13968] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Augusta Di Savino
- Dipartimento di Scienze Cliniche e Biologiche, AOU San Luigi Gonzaga, Università di Torino, Orbassano, Italy
| | - Valentina Gaidano
- SCDU Medicina Interna II ad indirizzo ematologico, AOU San Luigi Gonzaga, Orbassano, Italy
| | - Antonietta Palmieri
- Dipartimento di Scienze Cliniche e Biologiche, AOU San Luigi Gonzaga, Università di Torino, Orbassano, Italy
| | - Francesca Crasto
- Dipartimento di Scienze Cliniche e Biologiche, AOU San Luigi Gonzaga, Università di Torino, Orbassano, Italy
| | - Alessandro Volpengo
- Dipartimento di Scienze Cliniche e Biologiche, AOU San Luigi Gonzaga, Università di Torino, Orbassano, Italy
| | - Roberta Lorenzatti
- Dipartimento di Scienze Cliniche e Biologiche, AOU San Luigi Gonzaga, Università di Torino, Orbassano, Italy
| | - Patrizia Scaravaglio
- SCDU Medicina Interna II ad indirizzo ematologico, AOU San Luigi Gonzaga, Orbassano, Italy
| | - Alessandro Manello
- Dipartimento di Economia e Statistica, Università di Torino, Torino, Italy
| | - Paolo Nicoli
- SCDU Medicina Interna II ad indirizzo ematologico, AOU San Luigi Gonzaga, Orbassano, Italy
| | - Enrico Gottardi
- SCDU Medicina Interna II ad indirizzo ematologico, AOU San Luigi Gonzaga, Orbassano, Italy
| | - Giuseppe Saglio
- Dipartimento di Scienze Cliniche e Biologiche, AOU San Luigi Gonzaga, Università di Torino, Orbassano, Italy.,SCDU Medicina Interna II ad indirizzo ematologico, AOU San Luigi Gonzaga, Orbassano, Italy
| | - Daniela Cilloni
- Dipartimento di Scienze Cliniche e Biologiche, AOU San Luigi Gonzaga, Università di Torino, Orbassano, Italy.,SCDU Medicina Interna II ad indirizzo ematologico, AOU San Luigi Gonzaga, Orbassano, Italy
| | - Marco De Gobbi
- Dipartimento di Scienze Cliniche e Biologiche, AOU San Luigi Gonzaga, Università di Torino, Orbassano, Italy.,SCDU Medicina Interna II ad indirizzo ematologico, AOU San Luigi Gonzaga, Orbassano, Italy
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Nicoli P, Calabrese C, Pellegrino RM, Rosso V, Bracco E, Signorino E, Carturan S, Petiti J, Gallo D, Gaidano V, De Gobbi M, Roetto A, Saglio G, Cilloni D. Development of cellular and humoral response against WT1 protein vaccination in mice. Am J Hematol 2015; 90:E193-4. [PMID: 26088411 PMCID: PMC5054933 DOI: 10.1002/ajh.24092] [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: 06/12/2015] [Accepted: 06/17/2015] [Indexed: 12/03/2022]
Affiliation(s)
- Paolo Nicoli
- Department of Clinical and Biological SciencesUniversity of TurinTurin Italy
| | - Chiara Calabrese
- Department of Clinical and Biological SciencesUniversity of TurinTurin Italy
| | | | - Valentina Rosso
- Department of Clinical and Biological SciencesUniversity of TurinTurin Italy
| | - Enrico Bracco
- Department of OncologyUniversity of TurinTurin Italy
| | | | - Sonia Carturan
- Department of Clinical and Biological SciencesUniversity of TurinTurin Italy
| | - Jessica Petiti
- Department of Clinical and Biological SciencesUniversity of TurinTurin Italy
| | - Daniela Gallo
- Department of Clinical and Biological SciencesUniversity of TurinTurin Italy
| | - Valentina Gaidano
- Department of Clinical and Biological SciencesUniversity of TurinTurin Italy
| | - Marco De Gobbi
- Department of Clinical and Biological SciencesUniversity of TurinTurin Italy
| | - Antonella Roetto
- Department of Clinical and Biological SciencesUniversity of TurinTurin Italy
| | - Giuseppe Saglio
- Department of Clinical and Biological SciencesUniversity of TurinTurin Italy
| | - Daniela Cilloni
- Department of Clinical and Biological SciencesUniversity of TurinTurin Italy
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12
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Rosso V, Bracco E, Pedrola R, Carturan S, Signorino E, Petiti J, Calabrese C, Nicoli P, De Gobbi M, Gaidano V, Gallo D, Ulisciani S, Fava C, Rege-Cambrin G, Frassoni F, Saglio G, Cilloni D. Detection of BCR-ABL T315I mutation by peptide nucleic acid directed PCR clamping and by peptide nucleic acid FISH. Biomark Res 2015; 3:15. [PMID: 26146560 PMCID: PMC4490729 DOI: 10.1186/s40364-015-0039-y] [Citation(s) in RCA: 6] [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: 06/13/2015] [Accepted: 06/15/2015] [Indexed: 01/10/2023] Open
Abstract
Background Mutations of the BCR-ABL1 fusion gene represent a well established cause of resistance to tyrosine kinase inhibitors. Among the different mutations identified T315I is of particular concern since it is not effectively targeted by the majority of Tyrosine Kinase Inhibitors so far available. We developed a novel assay based on peptide nucleic acid (PNA) technology coupled to immunofluorescence microscopy (PNA-FISH) for the specific detection at a single cell level of BCR-ABLT315I mutation thus improving both, diagnostic resolution and the study of clonal prevalence. Furthermore we developed an additional method based on PNA directed PCR-clamping for the fast and easy detection of the mutation. Results The PNA directed PCR clamping allows to detect an amount of mutated template as low as 0.5 %. This method is highly sensitive, specific and cheap and could be applied even in laboratory not equipped for more sophisticated analysis. Furthermore, the PNA FISH method allows to identify a small amount of progenitor cells still present after therapy with specific inhibitors. Conclusions We present here two different methods based on PNA for the detection of T315I useful for different purposes. PNA-FISH can be used to study clonal evolution. In addition, this method could help in the study of compound mutations being able to identify two different mutations in a single cell. PNA directed PCR clamping although not superior to sequencing can be applied worldwide even in laboratory not equipped to search for mutations.
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Affiliation(s)
- Valentina Rosso
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Enrico Bracco
- Department of Oncology, University of Turin, Turin, Italy
| | - Roberto Pedrola
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Sonia Carturan
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Elisabetta Signorino
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Jessica Petiti
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Chiara Calabrese
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Paolo Nicoli
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Marco De Gobbi
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Valentina Gaidano
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Daniela Gallo
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Stefano Ulisciani
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Carmen Fava
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | | | - Francesco Frassoni
- Department of Pediatric Hemato-Oncology and Stem Cell and Cellular Therapy Laboratory, Institute G. Gaslini, Largo G Gaslini, Genoa, 16147 Italy
| | - Giuseppe Saglio
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Daniela Cilloni
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
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Morotti A, Gned D, Di Martino L, Cristaldi G, Alì A, Nicoli P, Veltri A, Guerrasio A. The challenging diagnosis of pancreatic masses: not all tumors are cancers. Case Rep Med 2015; 2015:832463. [PMID: 25945095 PMCID: PMC4402166 DOI: 10.1155/2015/832463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 03/20/2015] [Accepted: 03/23/2015] [Indexed: 11/23/2022] Open
Abstract
In the elderly patients, where biopsy-induced complications could outweigh the benefit, the identification of pancreatic masses is generally referred to as a synonymous of pancreatic cancer and patients are dismissed with no further options than palliative and supportive care. Notwithstanding, not all pancreatic tumors are cancers and therefore alternative diagnoses need to be investigated, especially when patients are unfit for invasive diagnostic procedures. Here, we report a case of an aged patient that was admitted to an internal medicine division for a previously diagnosed pancreatic cancer. The reassessment of the diagnosis has allowed identifying the pancreatic mass as a manifestation of focal pancreatitis in the context of an IgG4-related disease. Accordingly, patient was treated with steroids with rapid clinical improvement. This clinical case suggests that autoimmune diseases should always be considered in the differential diagnosis of pancreatic masses of the elderly.
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Affiliation(s)
- Alessandro Morotti
- Department of Clinical and Biological Sciences, University of Turin and San Luigi Hospital, Orbassano 10043, Italy
- Division of Internal Medicine, San Luigi Hospital, Orbassano 10043, Italy
| | - Dario Gned
- Department of Diagnostic Imaging, San Luigi Gonzaga Hospital, University of Turin, Orbassano 10043, Italy
| | | | - Gaetano Cristaldi
- Division of Internal Medicine, San Luigi Hospital, Orbassano 10043, Italy
| | - Anna Alì
- Division of Internal Medicine, San Luigi Hospital, Orbassano 10043, Italy
| | - Paolo Nicoli
- Department of Clinical and Biological Sciences, University of Turin and San Luigi Hospital, Orbassano 10043, Italy
| | - Andrea Veltri
- Department of Diagnostic Imaging, San Luigi Gonzaga Hospital, University of Turin, Orbassano 10043, Italy
| | - Angelo Guerrasio
- Department of Clinical and Biological Sciences, University of Turin and San Luigi Hospital, Orbassano 10043, Italy
- Division of Internal Medicine, San Luigi Hospital, Orbassano 10043, Italy
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14
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Bracco E, Rosso V, Serra A, Carnuccio F, Gaidano V, Nicoli P, Musto P, Saglio G, Frassoni F, Cilloni D. Design and application of a novel PNA probe for the detection at single cell level of JAK2V617F mutation in Myeloproliferative Neoplasms. BMC Cancer 2013; 13:348. [PMID: 23865766 PMCID: PMC3728119 DOI: 10.1186/1471-2407-13-348] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Accepted: 07/10/2013] [Indexed: 12/03/2022] Open
Abstract
Background Mutation(s) of the JAK2 gene (V617F) has been described in a significant proportion of Philadelphia negative Myeloproliferative Neoplasms (MPN) patients and its detection is now a cornerstone in the diagnostic algorithm. Methods We developed a novel assay based on peptide nucleic acid (PNA) technology coupled to immuno-fluorescence microscopy (PNA-FISH) for the specific detection at a single cell level of JAK2-mutation thus improving both the diagnostic resolution and the study of clonal prevalence. Results Using this assay we found a percentage of mutated CD34+ cells ranging from 40% to 100% in Polycythemia Vera patients, from 15% to 80% in Essential Thrombocythemia and from 25% to 100% in Primary Myelofibrosis. This method allows to distinguish, with a high degree of specificity, at single cell level, between CD34+ progenitor stem cells harbouring the mutated or the wild type form of JAK2 in NPM patients. Conclusions This method allows to identify multiple gene abnormalities which will be of paramount relevance to understand the pathophysiology and the evolution of any type of cancer.
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Affiliation(s)
- Enrico Bracco
- Division of Hematology and Internal Medicine, Department of Oncology, University of Turin, Turin, Italy
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15
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Ruzzenente A, Pachera S, Iacono C, Valdegamberi A, Nicoli P, Campagnaro T, Piccirillo G, Guglielmi A. Optimal treatment strategy in extremely elderly patients with hepatocellular carcinoma. BMC Geriatr 2009. [PMCID: PMC4290829 DOI: 10.1186/1471-2318-9-s1-a18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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16
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Nicoli P, Bosa M, Rotolo A, Cilloni D, Saglio G. Herpetic leg paralysis and abdominal ileus in a patient with idiopathic myelofibrosis. Intern Emerg Med 2009; 4:65-6. [PMID: 18629653 DOI: 10.1007/s11739-008-0173-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2008] [Accepted: 06/09/2008] [Indexed: 11/28/2022]
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17
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Nicoli P, Defilippi I, Carturan S, Roetto A, Messa F, Arruga F, Messa E, Rotolo A, Iacobucci I, Bracco E, Saglio G, Cilloni D. Detection of humoral immune responses against WT1 antigen in patients affected by different hematological malignancies. Acta Haematol 2008; 120:47-50. [PMID: 18824841 DOI: 10.1159/000158576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2008] [Accepted: 06/25/2008] [Indexed: 11/19/2022]
Affiliation(s)
- Paolo Nicoli
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
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18
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Cilloni D, Rotolo A, Nicoli P, Bosa M, Saglio G. New drugs in the treatment of chronic myeloid leukaemia. Rev Bras Hematol Hemoter 2008. [DOI: 10.1590/s1516-84842008000800007] [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: 11/22/2022] Open
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Cilloni D, Messa F, Arruga F, Defilippi I, Gottardi E, Fava M, Carturan S, Catalano R, Bracco E, Messa E, Nicoli P, Diverio D, Sanz MA, Martinelli G, Lo-Coco F, Saglio G. Early prediction of treatment outcome in acute myeloid leukemia by measurement of WT1 transcript levels in peripheral blood samples collected after chemotherapy. Haematologica 2008; 93:921-4. [PMID: 18443273 DOI: 10.3324/haematol.12165] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The Wilms' tumor gene WT1 is a reliable marker for minimal residual disease assessment in acute leukemia patients. The study was designed to demonstrate the potential use of WT1 to establish quality of remission in acute leukemia patients for early identification of patients at high risk of relapse. A prospective study based on a quantitative Real-Time PCR (TaqMan) assay in 562 peripheral blood samples collected from 82 acute leukemia patients at diagnosis and during follow-up was established. The evaluation of WT1 in peripheral blood samples after induction chemotherapy can distinguish the continuous complete remission patients from those who obtain only an "apparent" complete remission and who could relapse within a few months. WT1 helps identify patients at high risk of relapse soon after induction chemotherapy allowing post-induction therapy in high risk patients to be intensified.
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Affiliation(s)
- Daniela Cilloni
- Dept. of Clinical and Biological Sciences of the University of Turin, San Luigi Hospital, Gonzole 10, 10043 Orbassano, Turin, Italy.
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Cilloni D, Messa F, Rosso V, Arruga F, Defilippi I, Carturan S, Catalano R, Pautasso M, Panuzzo C, Nicoli P, Messa E, Morotti A, Iacobucci I, Martinelli G, Bracco E, Saglio G. Increase sensitivity to chemotherapeutical agents and cytoplasmatic interaction between NPM leukemic mutant and NF-κB in AML carrying NPM1 mutations. Leukemia 2008; 22:1234-40. [DOI: 10.1038/leu.2008.68] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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21
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Cilloni D, Messa F, Martinelli G, Gottardi E, Arruga F, Defilippi I, Carturan S, Messa E, Fava M, Giugliano E, Rosso V, Catalano R, Merante S, Nicoli P, Rondoni M, Ottaviani E, Soverini S, Tiribelli M, Pane F, Baccarani M, Saglio G. WT1 transcript amount discriminates secondary or reactive eosinophilia from idiopathic hypereosinophilic syndrome or chronic eosinophilic leukemia. Leukemia 2007; 21:1442-50. [PMID: 17508006 DOI: 10.1038/sj.leu.2404670] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Idiopathic hypereosinophilic syndromes (HES) comprise a spectrum of indolent to aggressive diseases characterized by persistent hypereosinophilia. Hypereosinophilia can result from the presence of a defect in the hematopoietic stem cell giving rise to eosinophilia, it can be present in many myeloproliferative disorders or alternatively it may be a reactive form, secondary to many clinical conditions. The hybrid gene FIP1L1-PDGRFalpha was identified in a subset of patients presenting with HES or chronic eosinophilic leukemia (CEL). In spite of this, the majority of HES patients do not present detectable molecular lesions and for many of them the diagnosis is based on exclusion criteria and sometimes it remains doubt. In this study we explored the possibility to distinguish between HES/CEL and reactive hypereosinophilia based on WT1 transcript amount. For this purpose, 312 patients with hypereosinophilia were characterized at the molecular and cytogenetic level and analyzed for WT1 expression at diagnosis and during follow-up. This study clearly demonstrates that WT1 quantitative assessment allows to discriminate between HES/CEL and reactive eosinophilia and represents a useful tool for disease monitoring especially in the patients lacking a marker of clonality.
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Affiliation(s)
- D Cilloni
- Division of Hematology and Internal Medicine, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.
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22
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Cilloni D, Rosso V, Messa E, Messa F, Arruga F, Defilippi I, Catalano R, Carturan S, Bittoto C, Boveri C, Nicoli P, Bracco E, Saglio G. P036 The oral iron chelator ICL670 is a potent inhibitor of NF-kB and this activity is independent from iron overload in MDS cells. Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70106-6] [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: 10/23/2022]
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Cilloni D, Nicoli P, Defilippi I, Girola E, Bondi A, Messa E, Roetto A, Messa F, Arruga F, Carturan S, Rosso V, Catalano R, Bracco E, Saglio G. P052 Detection of humoral immune responses against Wilms tumor gene (WT1) product in patients affected by myelodysplastic syndromes. Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70122-4] [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: 10/23/2022]
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Cilloni D, Messa E, Messa F, Carturan S, Defilippi I, Arruga F, Rosso V, Catalano R, Bracco E, Nicoli P, Saglio G. Genetic abnormalities as targets for molecular therapies in myelodysplastic syndromes. Ann N Y Acad Sci 2007; 1089:411-23. [PMID: 17261784 DOI: 10.1196/annals.1386.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Recent advances in molecular genetics have increased knowledge regarding the mechanisms leading to myelodysplastic syndrome (MDS), secondary acute myeloid leukemia (AML), and therapy-induced MDS. Many genetic defects underlying MDS and AML have been identified thereby allowing the development of new molecular-targeted therapies. Several new classes of drugs have shown promise in early clinical trials and may probably alter the standard of care of these patients in the near future. Among these new drugs are farnesyltransferase inhibitors and receptor tyrosine kinase inhibitors including FLT3 and VEGF inhibitors. These agents have been tested in patients with solid tumors and hematologic malignancies such as AML and MDS. Most of the studies in MDS are still in early stages of development. The DNA hypomethylating compounds azacytidine and decitabine may reduce hypermethylation and induce re-expression of key tumor suppressor genes in MDS. Biochemical compounds with histone deacetylase inhibitory activity, such as valproic acid (VPA), have been tested as antineoplastic agents. Finally, new vaccination strategies are developing in MDS patients based on the identification of MDS-associated antigens. Future therapies will attempt to resolve cytopenias in MDS, eliminate malignant clones, and allow differentiation by attacking specific mechanisms of the disease.
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Affiliation(s)
- Daniela Cilloni
- Department of Clinical and Biological Sciences of the University of Turin, San Luigi Hospital, Gonzole 10, 10043 Orbassano-Torino, Italy.
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