59 results on '"Masera G"'
Search Results
2. Air pollution and childhood leukaemia: a nationwide case-control study in Italy
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Badaloni, C., Ranucci, A., Cesaroni, G., Zanini, G., Vienneau, D., Al Aidrous, F., De Hoogh, K., Magnani, C., Forastiere, F., Mattioli, Stefano, Miligi, L., Rondelli, R., Salvan, A., Masera, G., Rizzari, C., Bisanti, L., Zambon, P., Greco, A., Cannizzaro, S., Gafa, L., Luzzatto, L. L., Benvenuti, A., Michelozzi, P., Kirchmayer, U., Cocco, P., Galassi, C., Celentano, E., Guarino, E., Assennato, G., de Nichilo, G., Merlo, D. F., Bocchini, V., Mosciatti, P., Minelli, L., Chiavarini, M., Cuttini, M., Casotto, V., Torregrossa, M. V., Valenti, R. M., Haupt, R., Lagorio, S., Risica, S., Polichetti, A., Bochicchio, F., Nuccetelli, C., Biddau, P., Arico, M., De Salvo, G. L., Locatelli, F., Pession, Andrea, Varotto, S., Poggi, V., Massaglia, P., Monetti, D., Targhetta, R., Bernini, G., Pannelli, F., Sampietro, G., Schiliro, G., Pulsoni, A., Badaloni, C., Ranucci, A., Cesaroni, G., Zanini, G., Vienneau, D., Al-Aidrous, F., De Hoogh, K., Magnani, C., Forastiere, F., C. Badaloni, A. Ranucci, G. Cesaroni, G. Zanini, D. Vienneau, F. Al-Aidrou, K. De Hoogh, C. Magnani, F. Forastiere, S. Mattioli, L. Miligi, R. Rondelli, A. Salvan, G. Masera, C. Rizzari, L. Bisanti, P. Zambon, A. Greco, S. Cannizzaro, L. Gafa, L. L. Luzzatto, A. Benvenuti, P. Michelozzi, U. Kirchmayer, P. Cocco, C. Galassi, E. Celentano, E. Guarino, G. Assennato, G. de Nichilo, D. F. Merlo, V. Bocchini, P. Mosciatti, L. Minelli, M. Chiavarini, M. Cuttini, V. Casotto, M. V. Torregrossa, R. M. Valenti, R. Haupt, S. Lagorio, S. Risica, A. Polichetti, F. Bochicchio, C. Nuccetelli, P. Biddau, M. Arico, G. L. De Salvo, F. Locatelli, A. Pession, S. Varotto, V. Poggi, P. Massaglia, D. Monetti, R. Targhetta, G. Bernini, F. Pannelli, G. Sampietro, G. Schiliro, and A. Pulsoni
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Male ,Pediatrics ,Air pollution ,NO2 ,Land use Regression Model ,Logistic regression ,medicine.disease_cause ,Economica ,Residence Characteristics ,USE REGRESSION-MODELS ,Medicine ,Child ,Children ,Vehicle Emissions ,General Environmental Science ,USE REGRESSION-MODELS, RESIDENTIAL TRAFFIC DENSITY, MAGNETIC-FIELDS, POOLED ANALYSIS, RISK-FACTOR, CANCER, EXPOSURE, CHILDREN, NO2, ASSOCIATION ,Leukemia ,Incidence ,Incidence (epidemiology) ,ASSOCIATION ,CANCER ,Childhood leukaemia ,Italy ,Child, Preschool ,Female ,Case-Control Studie ,Human ,medicine.medical_specialty ,Socio-culturale ,MAGNETIC-FIELDS ,POOLED ANALYSIS ,RISK-FACTOR ,Air Pollution ,Occupational Exposure ,Environmental health ,Traffic Indicator ,Humans ,EXPOSURE ,RESIDENTIAL TRAFFIC DENSITY ,Exposure assessment ,Vehicle Emission ,business.industry ,Public Health, Environmental and Occupational Health ,Case-control study ,Ambientale ,Infant ,Carcinogens, Environmental ,Automobile ,Case-Control Studies ,Residence Characteristic ,Dispersion Model ,Etiology ,General Earth and Planetary Sciences ,Particulate Matter ,Residence ,business ,Automobiles - Abstract
Objectives Leukaemia is the most common cancer in children, but its aetiology is still poorly understood. We tested the hypothesis that traffic-related air pollution is associated with paediatric leukaemia because of chronic exposure to several potential carcinogens. Methods The Italian SETIL study (Study on the aetiology of lymphohematopoietic malignancies in children) was conducted in 14 Italian regions. All incident cases of leukaemia in children aged ≤10 years from these regions (period 1998–2001) were eligible for enrolment. Two controls per case, matched on birth date, gender and region of residence were randomly selected from the local population registries. Exposure assessment at birth residence included traffic indicators (distance to main roads and length of main roads within 100 m) and estimates of pollutants concentrations (particulate matter -PM 2.5 and PM 10 - and gases -NO 2 and O 3 -) from national dispersion model and land use regression models. The association between the exposure variables and leukaemia was assessed by logistic regression analyses. Results Participation rates were 91.4% among cases and 69.2% in controls; 620 cases (544 acute lymphocytic and 76 acute non-lymphocytic leukaemia) and 957 controls were included. Overall, when considering the residence at birth, 35.6% of cases and 42.4% of controls lived along busy roads, and the mean annual PM 10 levels were 33.3 (SD=6.3) and 33.4 µg/m 3 (SD=6.5), respectively. No association was found, and all ORs, independent of the method of assessment and the exposure windows, were close to the null value. Conclusions Using various exposure assessment strategies, air pollution appears not to affect the incidence of childhood leukaemia.
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- 2013
3. Long-term results of the Italian Association of Pediatric Hematology and Oncology (AIEOP) Studies 82, 87, 88, 91 and 95 for childhood acute lymphoblastic leukemia
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Conter V., Aricò M., Basso G., Biondi A., Barisone E., Messina C., Parasole R., De Rossi G., Locatelli F., Santoro N., Micalizzi C., Citterio M., Rizzari C., Silvestri D., Rondelli R., Lo Nigro L., Ziino O., Testi A.M., Masera G., Valsecchi M.G., Associazione Italiana di Ematologia ed Oncologia Pediatrica, PESSION, ANDREA, Conter V., Aricò M., Basso G., Biondi A., Barisone E., Messina C., Parasole R., De Rossi G., Locatelli F., Pession A., Santoro N., Micalizzi C., Citterio M., Rizzari C., Silvestri D., Rondelli R., Lo Nigro L., Ziino O., Testi AM., Masera G., Valsecchi MG., Associazione Italiana di Ematologia ed Oncologia Pediatrica., Conter, V, Aricò, M, Basso, G, Biondi, A, Barisone, E, Messina, C, Parasole, R, De Rossi, G, Locatelli, F, Pession, A, Santoro, N, Micalizzi, C, Citterio, M, Rizzari, C, Silvestri, D, Rondelli, R, Lo Nigro, L, Ziino, O, Testi, A, Masera, G, and Valsecchi, M
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Male ,Oncology ,Cancer Research ,medicine.medical_specialty ,Pediatrics ,acute lymphoblastic leukemia ,childhood ,long-term results ,Time Factors ,Adolescent ,Time Factor ,Prognosi ,Medical Oncology ,Systemic therapy ,Follow-Up Studie ,Risk Factors ,Internal medicine ,Acute lymphocytic leukemia ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Child ,Survival rate ,Childhood Acute Lymphoblastic Leukemia ,Antineoplastic Combined Chemotherapy Protocol ,Hematology ,business.industry ,Risk Factor ,Remission Induction ,Infant ,Cancer ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,Prognosis ,medicine.disease ,Minimal residual disease ,Survival Rate ,Treatment Outcome ,Italy ,El Niño ,Child, Preschool ,Female ,Cranial Irradiation ,business ,Follow-Up Studies ,Human - Abstract
We analyzed the long-term outcome of 4865 patients treated in Studies 82, 87, 88, 91 and 95 for childhood acute lymphoblastic leukemia (ALL) of the Italian Association of Pediatric Hematology and Oncology (AIEOP). Treatment was characterized by progressive intensification of systemic therapy and reduction of cranial radiotherapy. A progressive improvement of results with reduction of isolated central nervous system relapse rate was obtained. Ten-year event-free survival increased from 53% in Study 82 to 72% in Study 95, whereas survival improved from 64 to 82%. Since 1991, all patients were treated according to Berlin-Frankfurt-Muenster (BFM) ALL treatment strategy. In Study 91, reduced treatment intensity (25%) yielded inferior results, but intensification of maintenance with high-dose (HD)-L-asparaginase (randomized) allowed to compensate for this disadvantage; in high-risk patients (HR, 15%), substitution of intensive polychemotherapy blocks for conventional BFM backbone failed to improve results. A marked improvement of results was obtained in HR patients when conventional BFM therapy was intensified with three polychemotherapy blocks and double delayed intensification (Study 95). The introduction of minimal residual disease monitoring and evaluation of common randomized questions by AIEOP and BFM groups in the protocol AIEOP-BFM-ALL 2000 are expected to further ameliorate treatment of children with ALL.
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- 2010
4. Risk of neuroblastoma, maternal characteristics and perinatal exposures: the SETIL study
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Parodi S, Merlo DF, Ranucci A, Miligi L, Benvenuti A, Rondelli R, Magnani C, Haupt R, Mattioli S, Salvan A, Masera G, Rizzari C, Bisanti L, Zambon P, Greco Veneto A, Cannizzaro S, Gafà L, Luzzatto LL, Michelozzi P, Kirchmayer U, Cocco P, Galassi C, Celentano E, Guarino E, Assennato G, de Nichilo G, Bocchini V, Mosciatti P, Pubblica S, Minelli L, Chiavarini M, Cuttini M, Casotto V, Torregrossa MV, Valenti RM, Forastiere F, Lagorio S, Risica S, Polichetti A, Bochicchio F, Nuccetelli C, Biddau P, Aricò M, DeSalvo GL, Locatelli F, Pession A, Varotto S, Poggi V, Massaglia P, Monetti D, Targhetta R, Bernini G, Lippi A, Nardi M, Acquaviva A, Pannelli F, Tumori R, Sampietro G, Schilirò G, Pulsoni A, Legittimo P, Barone Adesi F, Cavariani F, Belletti I, Troeschel L, Calisti R, Marche C, Silvestri S, Sommani L, Farioli A, Tozzi GA, Terracini B, Paolucci G, Andreuccetti D, Anglesio L, Bertolotti M, Bevitori P, Biancotto R, Biggeri A, Bucci S, Comba P, Crosignani P, d'Amore G, Duglio E, Erna M, Ferrante D, Gelli L, Gilardetti M, Guidotti P, Lombardi M, Loomis D, Magnoni M, Merletti F, Miceli G, Mozzo P, Poggi A, Pons O, Rasulo A, Roletti S, Rosa M, Mestre V, Ru O, Russo G, Sgorbati G, Simonato L, Sivo D, Stievano B, Tofani S, Troti F, Tumino R, Valle M, Vecchia P, Erminio G, Galleni B., PANICO, SALVATORE, Parodi, Stefano, Merlo, Domenico Franco, Ranucci, Alessandra, Miligi, Lucia, Benvenuti, Alessandra, Rondelli, Roberto, Magnani, Corrado, Haupt, Riccardo, [ .., Mattioli, Stefano, ], Parodi, S, Merlo, Df, Ranucci, A, Miligi, L, Benvenuti, A, Rondelli, R, Magnani, C, Haupt, R, Mattioli, S, Salvan, A, Masera, G, Rizzari, C, Bisanti, L, Zambon, P, Greco Veneto, A, Cannizzaro, S, Gafà, L, Luzzatto, Ll, Michelozzi, P, Kirchmayer, U, Cocco, P, Galassi, C, Celentano, E, Guarino, E, Assennato, G, de Nichilo, G, Bocchini, V, Mosciatti, P, Pubblica, S, Minelli, L, Chiavarini, M, Cuttini, M, Casotto, V, Torregrossa, Mv, Valenti, Rm, Forastiere, F, Lagorio, S, Risica, S, Polichetti, A, Bochicchio, F, Nuccetelli, C, Biddau, P, Aricò, M, Desalvo, Gl, Locatelli, F, Pession, A, Varotto, S, Poggi, V, Massaglia, P, Monetti, D, Targhetta, R, Bernini, G, Lippi, A, Nardi, M, Acquaviva, A, Pannelli, F, Tumori, R, Sampietro, G, Schilirò, G, Pulsoni, A, Legittimo, P, Barone Adesi, F, Cavariani, F, Belletti, I, Troeschel, L, Calisti, R, Marche, C, Silvestri, S, Sommani, L, Farioli, A, Tozzi, Ga, Terracini, B, Paolucci, G, Andreuccetti, D, Anglesio, L, Bertolotti, M, Bevitori, P, Biancotto, R, Biggeri, A, Bucci, S, Comba, P, Crosignani, P, D'Amore, G, Duglio, E, Erna, M, Ferrante, D, Gelli, L, Gilardetti, M, Guidotti, P, Lombardi, M, Loomis, D, Magnoni, M, Merletti, F, Miceli, G, Mozzo, P, Panico, Salvatore, Poggi, A, Pons, O, Rasulo, A, Roletti, S, Rosa, M, Mestre, V, Ru, O, Russo, G, Sgorbati, G, Simonato, L, Sivo, D, Stievano, B, Tofani, S, Troti, F, Tumino, R, Valle, M, Vecchia, P, Erminio, G, and Galleni, B.
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Cancer Research ,Pediatrics ,medicine.medical_specialty ,Epidemiology ,Socio-culturale ,ELF magnetic fields ,ELF magnetic field ,Nervous System Malformation ,Neuroblastoma ,Economica ,Work related exposure ,parental occupation ,male ,Pregnancy ,Risk Factors ,maternal exposure ,medicine ,Parental occupation ,Maternal characteristic ,Neurofibromatosis ,humans ,Neurofibromatosi ,neurofibromatosis ,business.industry ,Risk Factor ,Incidence (epidemiology) ,case-control studies ,Ambientale ,Congenital malformations ,nervous system malformations ,Odds ratio ,medicine.disease ,Pregnancy Complication ,Pregnancy Complications ,female ,Oncology ,congenital malformations ,maternal characteristics ,neuroblastoma ,incidence ,Etiology ,Congenital malformation ,Case-Control Studie ,business ,Human - Abstract
Purpose: Neuroblastoma (NB) is the most common extra-cranial paediatric solid tumour. Incidence peaks in infancy, suggesting a role of in-utero and neonatal exposures but its aetiology is largely unknown. The aim of the present study is to evaluate the association between maternal characteristics and perinatal factors with the risk of NB, using data from the SETIL database. Methods: SETIL is a large Italian population-based case-control study established to evaluate several potential cancer risk factors in 0-10 year olds. Information about maternal characteristics, reproductive history, environmental and occupational exposures during pregnancy, as well as newborns' characteristics were obtained using a structured questionnaire. Extremely low frequency magnetic field (ELF-MF) home exposure was measured. The study included 1044 healthy controls and 153 NB cases, diagnosed between 1998 and 2001. Results: A twofold risk was associated to exposure in pregnancy to chemical products for domestic work and to hair dye. The risk associated with the latter was higher among 0-17 month old children (OR. =. 5.5, 95%CI: 1.0-29.3). Risk was increased for children whose mothers had suffered work related exposure in the preconception period to solvents (OR. =. 2.0 95%CI: 1.0-4.1) and in particular to aromatic hydrocarbons (OR. =. 9.2, 95%CI: 2.4-34.3). No association was observed with ELF-MF exposure. A higher risk was found among children with congenital malformations (OR. =. 4.9, 95%CI: 1.8-13.6) or neurofibromatosis (2 cases and 0 controls, p=. 0.016). Conclusions: Our study suggests maternal exposure to hair dyes and aromatic hydrocarbons plays a role and deserves further investigation. The association with congenital malformations might also be explained by over-diagnosis.External exposure, in particular during and before pregnancy might contribute to NB occurrence.
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- 2014
5. Management of Chronic Childhood Immune Thrombocytopenic Purpura: AIEOP Consensus Guidelines
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De Mattia D, Del Vecchio GC, Russo G, De Santis A, Ramenghi U, Notarangelo L, Jankovic M, Molinari AC, Zecca M, Nobili B, Giordano P, AIEOP ITP Study Group, Acquaviva A, Amendola G, Baronci C, Binda S, Bisogno G, Bussetti C, Ciliberti A, Citterio M, Del Principe D, Farruggia P, Ladogana S, Magro S, Masera G, Menichelli A, Nardi M, Parodi E, Tucci F, Vimercati C., PESSION, ANDREA, DE MATTIA, D, DEL VECCHIO, Gc, Russo, G, DE SANTIS, A, Ramenghi, U, Notarangelo, L, Jankovic, M, Molinari, Ac, Zecca, M, Nobili, Bruno, Giordano, P, AIEOP ITP STUDY, Group, De Mattia D, Del Vecchio GC, Russo G, De Santis A, Ramenghi U, Notarangelo L, Jankovic M, Molinari AC, Zecca M, Nobili B, Giordano P, and AIEOP-ITP Study Group,Acquaviva A, Amendola G, Baronci C, Binda S, Bisogno G, Bussetti C, Ciliberti A, Citterio M, Del Principe D, Farruggia P, Ladogana S, Magro S, Masera G, Menichelli A, Nardi M, Parodi E, Pession A, Tucci F, Vimercati C.
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Pediatrics ,medicine.medical_specialty ,Platelet count ,Adolescent ,Consensus Development Conferences as Topic ,Prednisolone ,Rho(D) Immune Globulin ,medicine.medical_treatment ,conta piastrinica ,Splenectomy ,Platelet Transfusion ,management of pediatric thrombocytopenia ,idiopathic thrombocytopenic purpura ,platelet count ,trattamento della piastrinopenia pediatrica ,porpora trombocitopenica idiopatica ,Immune system ,immune system diseases ,hemic and lymphatic diseases ,medicine ,Pediatric thrombocytopenia ,Humans ,Platelet ,Idiopathic thrombocytopenic purpura ,Management of pediatric thrombocytopenia ,Thrombocytopenia ,Child ,Purpura, Thrombocytopenic, Idiopathic ,biology ,business.industry ,Immunoglobulins, Intravenous ,Infant ,Hematology ,General Medicine ,medicine.disease ,Thrombocytopenic purpura ,Purpura ,Chronic disease ,Platelet transfusion ,Child, Preschool ,Chronic Disease ,biology.protein ,Antibody ,medicine.symptom ,business ,Idiopathic thrombocytopenic purpura, Management of pediatric thrombocytopenia, Pediatric thrombocytopenia, Platelet count, Thrombocytopenia - Abstract
Background/Objective: The management of chronic childhood idiopathic thrombocytopenic purpura (ITP) is distinct from acute ITP. Similar to the publication on acute ITP guidelines, the AIEOP (Associazione Italiana di Ematologia e Oncologia Pediatrica) considered it appropriate to develop consensus guidelines for chronic childhood ITP to provide useful and shared information for physicians, healthcare professionals, parents and patients. Design/Methods: A preliminary, evidence-based document issued by a select group of AIEOP pediatric hematologists was discussed, modified and approved during a Consensus Conference according to procedures previously validated by the AIEOP Board. Results: The guidelines give prominence to the periodical reevaluation of all the etiological hypotheses of thrombocytopenia in relation to its clinical condition. The majority of chronic ITP children do not require treatment, especially if bleeding is absent or minimal. The treatment decision depends on several factors other than the platelet count, and treatment options are suggested in relation to the therapeutic scenarios. Recommendations are given regarding support for surgery, particular hemorrhagic conditions, daily activities/sports, as well as for vaccines and drugs. Experimental treatments are also discussed.
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- 2010
6. The Quality of Life of Children and Adolescents with X-Linked Agammaglobulinemia
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Soresina A., Nacinovich R., Bomba M., Cassani M., Molinaro A., Sciotto A., Martino S., Cardinale F., De Mattia D., Putti C., Dellepiane R.M., Felici L., Parrinello G., Neri F., Plebani A., Pierani P., DeMattia D., Martire B., Armenio L., Dammacco F., Ranieri G., Masi M., Miniaci A., Pession A., Rondelli R., Notarangelo L. D., Cao, Cossu F., Del Giacco S., Manconi P., Evangelista I., Magro S., Morgione S., STRISCIUGLIO, PIETRO, Anastasio E., Schillirò G., Paganelli R., Sticca M., Sperlì D., Carpino L., Bernini G., Azzari C., Maggi E., Romagnani S., Matucci A., Vultaggio A., Castagnola E., Gattorno M., Presta G., Civino A., Gambaretto G., Fasoli S., Salpietro C., Pietrogrande M.C., DellePiane R.M., Panisi C., Cambiaghi G., Pietrogrande M., Roncarolo M.G., Aiuti A., Masera G., Biondi A., Sala A., PIGNATA, CLAUDIO, Poggi V., Menna G., Di Nardo R., D'Apuzzo A., Pelliccia A., Correra A., Marone G., SPADARO, GIUSEPPE, Carli M., Zanesco L., Basso G., Putti M.C., Semenzato G., Agostini C., Amato G.M., Aricò M., Trizzino A., Izzi G., Bertolini P., Locatelli F., Zecca M., Rondini G., Marseglia G.L., Maccario R., Bossi G., Favre C., Consolini R., Vecchi V., Sacchini P., Rinaldi G., Ugazio A.G., Rossi P., Livadiotti S., Cancrini C., Finocchi A., Stabile A., Duse M., Iacobini M., Quinti I., Moschese V., Cecere F., Morgese G., Acquaviva A., De Zan G., Strafella S., Tamaro P., Rabusin M., Tovo P.A., Nespoli L., Marinoni M., Porcellini A., Cazzola G.A., Annarosa, Soresina, Renata, Nacinovich, Monica, Bomba, Morena, Cassani, Molinaro, Anna, Antonella, Sciotto, Silvana, Martino, Fabio, Cardinale, Domenico, Mattia, Caterina, Putti, Rosa Maria, Dellepiane, Leonardo, Felici, Giovanni, Parrinello, Francesca, Neri, Alessandro, Plebani, Soresina, A, Nacinovich, R, Bomba, M, Cassani, M, Molinaro, A, Sciotto, A, Martino, S, Cardinale, F, De Mattia, D, Putti, C, Dellepiane, R, Felici, L, Parrinello, G, Neri, F, Plebani, A, Soresina, A., Nacinovich, R., Bomba, M., Cassani, M., Molinaro, A., Sciotto, A., Martino, S., Cardinale, F., De Mattia, D., Putti, C., Dellepiane, R. M., Felici, L., Parrinello, G., Neri, F., Plebani, A., Pierani, P., Demattia, D., Martire, B., Armenio, L., Dammacco, F., Ranieri, G., Masi, M., Miniaci, A., Pession, A., Rondelli, R., Notarangelo, L. D., Cao, Cossu, F., Del Giacco, S., Manconi, P., Evangelista, I., Magro, S., Morgione, S., Strisciuglio, Pietro, Anastasio, E., Schillirò, G., Paganelli, R., Sticca, M., Sperlì, D., Carpino, L., Bernini, G., Azzari, C., Maggi, E., Romagnani, S., Matucci, A., Vultaggio, A., Castagnola, E., Gattorno, M., Presta, G., Civino, A., Gambaretto, G., Fasoli, S., Salpietro, C., Pietrogrande, M. C., Panisi, C., Cambiaghi, G., Pietrogrande, M., Roncarolo, M. G., Aiuti, A., Masera, G., Biondi, A., Sala, A., Pignata, Claudio, Poggi, V., Menna, G., Di Nardo, R., D'Apuzzo, A., Pelliccia, A., Correra, A., Marone, G., Spadaro, Giuseppe, Carli, M., Zanesco, L., Basso, G., Putti, M. C., Semenzato, G., Agostini, C., Amato, G. M., Aricò, M., Trizzino, A., Izzi, G., Bertolini, P., Locatelli, F., Zecca, M., Rondini, G., Marseglia, G. L., Maccario, R., Bossi, G., Favre, C., Consolini, R., Vecchi, V., Sacchini, P., Rinaldi, G., Ugazio, A. G., Rossi, P., Livadiotti, S., Cancrini, C., Finocchi, A., Stabile, A., Duse, M., Iacobini, M., Quinti, I., Moschese, V., Cecere, F., Morgese, G., Acquaviva, A., De Zan, G., Strafella, S., Tamaro, P., Rabusin, M., Tovo, P. A., Nespoli, L., Marinoni, M., Porcellini, A., and Cazzola, G. A.
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Male ,Pediatrics ,medicine.medical_specialty ,x-linked agammaglobulinemia ,Activities of daily living ,Adolescent ,X-linked agammaglobulinemia ,Health Status ,Immunology ,pedsql 4.0 generic core scale ,Quality of life ,children ,Agammaglobulinemia ,Surveys and Questionnaires ,Activities of Daily Living ,health-related quality of life ,parents ,medicine ,Humans ,Immunology and Allergy ,PedsQL 4.0 Generic Core Scale ,Child ,Settore MED/38 - Pediatria Generale e Specialistica ,Health related quality of life ,quality of live ,business.industry ,Immunoglobulins, Intravenous ,Genetic Diseases, X-Linked ,medicine.disease ,Socioeconomic Factors ,Child, Preschool ,Mutation ,Quality of Life ,Female ,X-linked agammaglobulinemia - children - parents - health-related quality of life - PedsQL 4.0 Generic Core Scale ,business - Abstract
Introduction: The health-related quality of life in X-linked agammaglobulinemia was investigated in 25 children and adolescents patients through the Italian version of Pediatric Quality of Life Inventory 4.0 Generic Core Scale for patients aged less then 18 years, comparing child perception to that of the parents and the physician's evaluation. The data were compared with the ones of 80 healthy controls and the literature data of a group of patients with rheumatic diseases. Discussion: The agammaglobulinemia subjects perceived a lower global quality of life than the healthy subjects, but significantly higher than the rheumatic diseases controls. The clinical relevance of health-related quality of life assessment in X-linked agammaglobulinemia pediatric patients is discussed. © 2008 Springer Science+Business Media, LLC.
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- 2009
7. Patterns of domestic migrations and access to childhood cancer care centres in Italy: A report from the hospital based registry of the Italian Association of Pediatric Hematology and Oncology (AIEOP)
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Dama, E, Rondelli, R, De Rosa, M, Aricò, M, Carli, M, Bellani, Ff, Magnani, C, Merletti, F, Pastore, G, Pession, A, Madon, E, Dini, G, Carnelli, V, Fedeli, F, Fossati Bellani, F, Masera, G, Locatelli, F, Cornelli, Pe, Notarangelo, L, Nespoli, L, Bagnulo, S, Marradi, P, Musi, L, Rodeghiero, F, Grotto, P, Rossetti, F, Battisti, L, Tamaro, Paolo, Mascarin, M, Nocerino, A, Izzi, G, Paolucci, P, Ambrosioni, G, Picci, P, Borgna Pignatti, C, Vecchi, V, Bernini, G, Morgese, G, Favre, C, Zucchetti, P, Pierani, P, Felici, L, Visani, G, Di Bartolomeo, P, Ballati, G, Castello, Ma, De Rossi, G, Donfrancesco, A, Foà, R, Menichelli, A, Riccardi, R, Di Tullio MT, Fiorillo, A, Poggi, V, Amendola, G, Ladogana, S, Ruggiero, L, Pozzi, S, De Mattia, D, Magro, S, Nobile, F, Sperlì, D, Schilirò, G, Gallisai, D, Biddau, P., Dama, E, Rondelli, R, De Rosa, M, Aricò, M, Carli, M, Bellani, Ff, Magnani, C, Merletti, F, Pastore, G, Pession, A, Madon, E, Dini, G, Carnelli, V, Fedeli, F, Fossati Bellani, F, Masera, G, Locatelli, F, Cornelli, Pe, Notarangelo, L, Nespoli, L, Bagnulo, S, Marradi, P, Musi, L, Rodeghiero, F, Grotto, P, Rossetti, F, Battisti, L, Tamaro, Paolo, Mascarin, M, Nocerino, A, Izzi, G, Paolucci, P, Ambrosioni, G, Picci, P, Borgna Pignatti, C, Vecchi, V, Bernini, G, Morgese, G, Favre, C, Zucchetti, P, Pierani, P, Felici, L, Visani, G, Di Bartolomeo, P, Ballati, G, Castello, Ma, De Rossi, G, Donfrancesco, A, Foà, R, Menichelli, A, Riccardi, R, Di Tullio, Mt, Fiorillo, A, Poggi, V, Amendola, G, Ladogana, S, Ruggiero, L, Pozzi, S, De Mattia, D, Magro, S, Nobile, F, Sperlì, D, Schilirò, G, Gallisai, D, Biddau, P., Dama E, Rondelli R, De Rosa M, Aricò M, Carli M, Bellani FF, Magnani C, Merletti F, Pastore G, Pession A, and Italian Association of Pediatric Hematology and Oncology (AIEOP).
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Oncology ,Male ,Cancer Research ,medicine.medical_specialty ,Adolescent ,Paediatric haematology ,care access ,childhood cancer ,italy ,specialised cancer centres ,Childhood cancer ,Child Health Services ,Regional Medical Programs ,Tertiary care ,Health Services Accessibility ,domestic migration ,Internal medicine ,Neoplasms ,Oncology Service, Hospital ,medicine ,Humans ,Child ,Specialised cancer centres ,Care access ,Italy ,business.industry ,Infant, Newborn ,Infant ,Hospital based ,El Niño ,Child, Preschool ,Residence ,Female ,Health Services Research ,Pediatric hematology ,business ,Delivery of Health Care - Abstract
Tertiary care centres, grouped in the Italian Association of Paediatric Haematology and Oncology (AIEOP) are unevenly distributed across the country. In an attempt to describe their perceived efficacy, we matched the residence and the location of the treatment centre in 18,441 patients aged ⩽15 years treated in the AIEOP network between 1989 and 2005. Overall, centres located in the central and southern regions were less appealing than those located in the North, although this trend decreased over the study period. Patients with solid tumours migrated more frequently than those with leukaemia or lymphoma. Information resulting from better knowledge of the non-random migrations for treatment of children with cancer will be useful to refine planning of the national paediatric haematology-oncology network with social and economic implications.
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- 2008
8. Survival of children with cancer in Italy, 1989-98. A report from the hospital based registry of the Italian Association of Pediatric Haematology and Oncology (AIEOP)
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Pession A, Dama E, Rondelli R, Magnani C, De Rosa M, Locatelli F, Fagioli F, Haupt R, Jankovic M, Terracini B, Merletti F, Pastore G, Italian Association of Paediatric Haematology, Oncology Madon E, Dini G, Carnelli V, Fedeli F, Fossati Bellani F, Masera G, Cornelli PE, Porta F, Dorizzi A, Nespoli A, Carli M, Marradi P, Rodeghiero F, Musi L, Mascarin M, Nocerino A, Izzi G, Paolucci P, Ambrosioni G, Picci P, Borgna Pignatti C, Bernini G, Morgese G, Favre C, Aversa F, Pierani P, Di Marzio A, Foà R, De Rossi G, Donfrancesco A, Castello MA, Casale F, Poggi V, Auricchio S, Antonelli P, Ladogana S, De Mattia D, Magro S, Nobile F, Aricò M, Schilirò G, Gallisai D, Argiolu F., TAMARO, PAOLO, Pession, A, Dama, E, Rondelli, R, Magnani, C, De Rosa, M, Locatelli, F, Fagioli, F, Haupt, R, Jankovic, M, Terracini, B, Merletti, F, Pastore, G, Italian Association of Paediatric, Haematology, Oncology Madon, E, Dini, G, Carnelli, V, Fedeli, F, Fossati Bellani, F, Masera, G, Cornelli, Pe, Porta, F, Dorizzi, A, Nespoli, A, Carli, M, Marradi, P, Rodeghiero, F, Musi, L, Tamaro, Paolo, Mascarin, M, Nocerino, A, Izzi, G, Paolucci, P, Ambrosioni, G, Picci, P, Borgna Pignatti, C, Bernini, G, Morgese, G, Favre, C, Aversa, F, Pierani, P, Di Marzio, A, Foà, R, De Rossi, G, Donfrancesco, A, Castello, Ma, Casale, F, Poggi, V, Auricchio, S, Antonelli, P, Ladogana, S, De Mattia, D, Magro, S, Nobile, F, Aricò, M, Schilirò, G, Gallisai, D, Argiolu, F., Pession A, Dama E, Rondelli R, Magnani C, De Rosa M, Locatelli F, Fagioli F, Haupt R, Jankovic M, Terracini B, Merletti F, Pastore G, and on behalf of the Italian Association of Paediatric Haematology and Oncology
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Oncology ,Male ,Cancer Research ,medicine.medical_specialty ,Pediatrics ,Adolescent ,Lymphoproliferative disorders ,Cancer registration ,survival ,children cancer ,Internal medicine ,Neuroblastoma ,Neoplasms ,medicine ,Humans ,Survivors ,Sex Distribution ,Child ,Survival rate ,Childhood cancer ,Gender ,Italy ,Survival ,Hematology ,business.industry ,Hazard ratio ,Cancer ,Infant ,medicine.disease ,Lymphoma ,El Niño ,Child, Preschool ,Female ,business ,Epidemiologic Methods - Abstract
We describe the survival patterns of 10,791 Italian children (age 0-14) diagnosed with cancer during 1989-1998 and who were included in the hospital-based registry of the Italian Association of Paediatric Haematology and Oncology. Five-year cumulative survival percentages were 76% for lymphoproliferative disorders and 68% for solid tumours. Survival rates in 1994-1998 significantly improved for acute lymphocytic leukaemia (ALL), acute non-lymphocytic leukaemia, Hodgkin's lymphoma and Wilms' tumour. Gender and age were determinants of survival for some specific types of cancer. Girls with ALL and neuroblastoma exhibited a significant advantage (hazard ratio HR 0.72, 0.62-0.83) and disadvantage (HR 0.73, 0.59-0.90) over boys, respectively. Children with a Wilms' tumour diagnosed above age 3 had a worse prognosis than younger children (HR 2.3, 1.4-4.1). The persisting gender-related difference in survival rate for ALL requires understanding as to whether it is attributable to delays in the adoption of more recent therapeutic protocols, while the corresponding findings for Wilms' tumour and neuroblastoma deserve further biological interpretation.
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- 2008
9. Statement by members of the Ponte di Legno group on the right of children with leukemia to have full access to essential treatment for acute lymphoblastic leukemia
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Arico, M, Basso, Giuseppe, Biondi, A, Conter, V, Masera, G, Rognoni, G, Valsecchi, Mg, Cario, G, Gadner, H, Haas, O, Harbott, J, Panzer, R, Riehm, H, Shrappe, M, Stackelberg, A, Stanulla, M, Zimmermann, M, Camita, B, Caroll, W, Gaynon, P, Hunger, S, Nachman, J, Schultz, K, Winick, N, Horstmann, M, JANKA SCHAUB, G, Stary, J, Trka, J, Sallan, S, Silverman, L, Pieters, R, Veerman, A, Bertrand, Y, Suciu, S, Leverger, G, Horibe, K, Eden, Ob, Harrison, C, Gibson, B, Forestier, E, Schmiegelow, K, Vettenranta, K, Campana, D, COUSTON SMITH, E, Evans, We, Handgretinger, R, Pui, Ch, Relling, Mv, Lang, Dc, Manabe, A, Tsuchida, M, Pinkel, D., Tognoni, G, Masera, G, Pui, C, Eden, T, Nachman, J, Gadner, H, Gaynon, P, Evans, W, and Schrappe, M
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Pediatrics ,medicine.medical_specialty ,Clinical Trials as Topic ,Statement (logic) ,business.industry ,Lymphoblastic Leukemia ,Health Policy ,International Cooperation ,Child Welfare ,Hematology ,Patient Advocacy ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,medicine.disease ,Health Services Accessibility ,Precursor Cell Lymphoblastic Leukemia Lymphoma ,Leukemia ,Oncology ,Acute lymphocytic leukemia ,medicine ,Humans ,business ,Child - Published
- 2004
10. Effect of protracted high-dose L-asparaginase given as a second exposure in a Berlin-Frankfurt-Münster-based treatment: results of the randomized 9102 intermediate-risk childhood acute lymphoblastic leukemia study--a report from the Associazione Italiana Ematologia Oncologia Pediatrica
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Rizzari, C, Valsecchi, Mg, Aricò, M, Conter, V, Testi, A, Barisone, E, Casale, F, Lo Nigro, L, Rondelli, R, Basso, Giuseppe, Santoro, N, Masera, G, Associazione Italiano Ematologia Oncologia Pediatrica, Rizzari, C, Valsecchi, M, Aricò, M, Conter, V, Testi, A, Barisone, E, Casale, F, Lo Nigro, L, Rondelli, R, Basso, G, Santoro, N, Masera, G, Valsecchi, Mg, Arico, M, Casale, Fiorina, LO NIGRO, L, and ASSOCIAZIONE ITALIANO EMATOLOGIA ONCOLOGIA, Pediatrica
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Male ,Cancer Research ,medicine.medical_specialty ,Asparaginase ,Adolescent ,Context (language use) ,Antineoplastic Agents ,Injections, Intramuscular ,Disease-Free Survival ,law.invention ,Antineoplastic Agent ,chemistry.chemical_compound ,Randomized controlled trial ,law ,Internal medicine ,Acute lymphocytic leukemia ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Child ,Childhood Acute Lymphoblastic Leukemia ,Antineoplastic Combined Chemotherapy Protocol ,business.industry ,Standard treatment ,Therapeutic effect ,Infant, Newborn ,Infant ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,medicine.disease ,Chemotherapy regimen ,Surgery ,Treatment Outcome ,Oncology ,chemistry ,Child, Preschool ,Female ,business ,Human - Abstract
PURPOSE: To assess in a randomized study the therapeutic effect of the addition of high-dose l-asparaginase (HD ASP) in the context of a Berlin-Frankfurt-Münster (BFM)–based chemotherapy regimen for intermediate risk (IR) childhood acute lymphoblastic leukemia (ALL). PATIENTS AND METHODS: From March 1991 to April 1995, a total of 705 patients, with 59% of the cohort of patients fewer than 15 years old, with newly diagnosed non-B ALL, enrolled onto the Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP) ALL-91 study, were assigned to the IR group. Patients in remission at the beginning of the reinduction phase were randomized either to the standard treatment (SD ASP arm) or the experimental treatment (HD ASP arm; weekly intramuscular administration of HD ASP 25,000 IU/m2 repeated for a total of 20 weeks). Most of the patients (90%) were treated with Erwinia chrysanthemi l-asparaginase product. RESULTS: Among the 610 patients randomized to the SD ASP arm (n = 322) or to the HD ASP arm (n = 288), relapse occurred at a median time of 24 months after randomization in 76 (24%) and in 64 children (22%), respectively. Most of the relapses occurred in the marrow (100 isolated, 21 combined). There was no significant difference between the disease-free survival in the two treatment arms (P = .64), with estimated values at 7 years from randomization of 72.4% (SE 3.1) v 75.7% (SE 2.6) in the SD ASP and HD ASP arms, respectively. CONCLUSION: No advantage was observed for IR ALL children treated with BFM-based intensive chemotherapy who received protracted E chrysanthemi HD ASP during reinduction and the early continuation phase.
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- 2001
11. Long-Term Results of a Randomized Trial on Extended Use of High Dose <scp>l</scp>-Asparaginase for Standard Risk Childhood Acute Lymphoblastic Leukemia
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Elisabeth R. van Wering, Andrea Pession, Edina Magyarosy, Carmelo Rizzari, Franco Locatelli, Willem Kamps, Maria Grazia Valsecchi, Anna van der Does, Maurizio Aricò, Giuseppe Masera, Luca Lo Nigro, Giuseppe Basso, Pession A, Valsecchi MG, Masera G, A. Kamps W, Magyarosy E, Rizzari C, R. van Wering E, Lo Nigro L, van der Does A, Locatelli F, Basso G, Aricò M., Pession, A, Valsecchi, M, Masera, G, Kamps, W, Magyarosy, E, Rizzari, C, van Wering, E, Lo Nigro, L, van der Does, A, Locatelli, F, Basso, G, and Aricò, M
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Male ,Cancer Research ,Pediatrics ,medicine.medical_treatment ,CHILDHOOD ,CHILDREN ,law.invention ,Antineoplastic Agent ,chemistry.chemical_compound ,Randomized controlled trial ,law ,INTENSIVE ASPARAGINASE ,Antineoplastic Combined Chemotherapy Protocols ,Age Factor ,Child ,Acute leukemia ,Age Factors ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,CANCER ,Treatment Outcome ,Oncology ,TOTAL THERAPY ,Child, Preschool ,Female ,Human ,PROTOCOLS ,medicine.medical_specialty ,Asparaginase ,Adolescent ,Antineoplastic Agents ,Disease-Free Survival ,Drug Administration Schedule ,Follow-Up Studie ,ASPARAGINASE ,Acute lymphocytic leukemia ,medicine ,Humans ,Risk factor ,Childhood Acute Lymphoblastic Leukemia ,Chemotherapy ,Antineoplastic Combined Chemotherapy Protocol ,business.industry ,Infant ,medicine.disease ,Clinical trial ,chemistry ,FOLLOW-UP ,ALL ,business ,Follow-Up Studies - Abstract
Purpose Between September 1991 and May 1997, within the International Berlin-Frankfurt-Muenster Study Group (I-BFM-SG), a randomized study was performed aimed at assessing the efficacy of prolonged use of high-dose l-asparaginase (HD-l-ASP) during continuation therapy in children with standard risk (SR) acute lymphoblastic leukemia (ALL), treated with a reduced BFM-type chemotherapy. Patients and Methods The Italian, Dutch, and Hungarian groups participated in this study denominated IDH-ALL-91, and 494 children were enrolled. Treatment consisted of a BFM-type modified backbone with omission of the IB part in induction and elimination of two doses of anthracyclines during reinduction in both arms at the beginning of continuation therapy. Patients were randomly assigned to receive (YES-ASP) or not (NO-ASP) 20 weekly HD-l-ASP (25,000 IU/m2). Results The event-free-survival and overall survival probabilities at 10 years for the entire group were 82.5% (1.8) and 90.3% (1.3), respectively. Of the 490 patients eligible for random assignment, 355 (72.4%) were randomly assigned (178 YES-ASP and 177 NO-ASP). After a median follow-up of 9 years, the probability of disease-free survival at 10 years was 87.5% (SE, 2.5) for YES-ASP arm versus 78.7% (SE, 3.3) for NO-ASP arm (P = .03). In multivariate analysis, NO-ASP arm (P = .03), male sex (P = .004), and age older than 10 years (P = .0003) had a significantly adverse impact on outcome. Conclusion In this subset of patients, selected with criteria not including monitoring of minimal residual disease, application of extended HD-l-ASP may improve prognosis, compensating reduced leukemia control that results from adoption of a reduced-intensity BFM-backbone for treatment of children with SR ALL.
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- 2005
12. Long-term results of the AIEOP-ALL-95 Trial for Childhood Acute Lymphoblastic Leukemia: insight on the prognostic value of DNA index in the framework of Berlin-Frankfurt-Muenster based chemotherapy
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Maria Grazia Valsecchi, Andrea Pession, Carmelo Rizzari, Valentino Conter, Nicola Santoro, Maurizio Aricò, Giuseppe Basso, Daniela Silvestri, Elena Barisone, Franco Locatelli, Andrea Biondi, Rosanna Parasole, Fiorina Casale, Giuseppe Masera, Luca Lo Nigro, Chiara Messina, Matteo Luciani, Concetta Micalizzi, Anna Maria Testi, Aricò M., Valsecchi MG., Rizzari C., Barisone E., Biondi A., Casale F., Locatelli F., Lo Nigro L., Luciani M., Messina C., Micalizzi C., Parasole R., Pession A., Santoro N., Testi AM., Silvestri D., Basso G., Masera G., Conter V., Casale, Fiorina, Aricò, M., Valsecchi, M., Rizzari, C., Barisone, E., Biondi, A., Locatelli, F., LO NIGRO, L., Luciani, M., Messina, C., Micalizzi, C., Parasole, R., Pession, A., Testi, A., Silvestri, D., Basso, G., Masera, G., Conter, V., Santoro, N., Aricò, M, Valsecchi, M, Rizzari, C, Barisone, E, Biondi, A, Casale, F, Locatelli, F, Lo Nigro, L, Luciani, M, Messina, C, Micalizzi, C, Parasole, R, Pession, A, Santoro, N, Testi, A, Silvestri, D, Basso, G, Masera, G, and Conter, V
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Male ,Oncology ,Cancer Research ,Pediatrics ,medicine.medical_treatment ,Childhood ALL ,Prednisone ,Antineoplastic Combined Chemotherapy Protocols ,Medicine ,Mercaptopurine ,Remission Induction ,Cytarabine ,DNA, Neoplasm ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,Prognosis ,Acute Lymphoblastic Leukemia ,Combined Modality Therapy ,Survival Rate ,Treatment Outcome ,Italy ,AIEOP -ALL-95 Study ,Vincristine ,Child, Preschool ,Female ,medicine.drug ,medicine.medical_specialty ,Cyclophosphamide ,Acute lymphocytic leukemia ,Internal medicine ,Asparaginase ,Humans ,Childhood Acute Lymphoblastic Leukemia ,Survival rate ,Chemotherapy ,Chi-Square Distribution ,business.industry ,DNA Index ,Daunorubicin ,Infant ,medicine.disease ,Childhood ,Methotrexate ,Risk factor ,Cranial Irradiation ,business - Abstract
Purpose Between May 1995 and August 2000 the Associazione Italiana di Ematologia Oncologia Pediatrica conducted the ALL-95 study for risk-directed, Berlin-Frankfurt-Muenster (BFM) –oriented therapy of childhood acute lymphoblastic leukemia, aimed at exploring treatment reduction in standard-risk patients (SR) and intensification during continuation therapy in intermediate-risk patients (IR) as randomized questions and treatment intensification in high-risk patients (HR). The prognostic value of DNA index was explored in this setting. Patients and Methods A total of 1,744 patients were enrolled (115, SR; 1,385, IR; and 244, HR). SR patients (DNA index ≥ 1.16 and < 1.60; age, 1 to 5 years; and WBC < 20,000, non–T-immunophenotype, with no high-risk features) received a reduced induction therapy (no anthracyclines); IR patients were randomly assigned to receive or not receive vincristine and dexamethasone pulses during maintenance; HR therapy was based on a conventional BFM schedule intensified with three chemotherapy blocks followed by a double reinduction phase. Results The event-free survival and overall survival probabilities at 10 years for the entire group were 72.5% (SE, 1.3) and 83.6% (SE, 0.9); 85.0% (SE, 3.4) and 95.5% (SE, 2.0) in SR, 75.1% (SE, 1.5) and 87.5% (SE, 0.9) in IR, and 51.0% (SE, 3.2) and 57.2% (SE, 3.3) in HR patients, respectively. Patients with a favorable DNA index had superior EFS in both IR (83.8% [2.7%] v 73.9% [1.7%]) and in HR (67.8% [9.4%] and 49.6% [3.5%]). Of the six patients with DNA index less than 0.8, only one remained in remission. Conclusion Favorable DNA index was associated with a better prognosis in IR and HR patients defined by presenting clinical criteria and treatment with a BFM-oriented chemotherapy.
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- 2008
13. Childhood high-risk acute lymphoblastic leukemia in first remission: results after chemotherapy or transplant from the AIEOP ALL 2000 study
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Fiorina Casale, Elena Barisone, Gaetano La Barba, Anna Maria Testi, Daniela Silvestri, Maurizio Aricò, Concetta Micalizzi, Paolo Tamaro, Giuseppe Basso, Rosanna Parasole, Lucia Dora Notarangelo, Carmelo Rizzari, Maria Grazia Valsecchi, Ottavio Ziino, Valentino Conter, Antonella Colombini, Maria Caterina Putti, Marco Zecca, Luca Lo Nigro, Franco Locatelli, Giuseppe Masera, Andrea Biondi, Nicola Santoro, Gabriella Casazza, Andrea Pession, Conter, V, Valsecchi, M, Parasole, R, Putti, M, Locatelli, F, Barisone, E, Lo Nigro, L, Santoro, N, Aricò, M, Ziino, O, Pession, A, Testi, A, Micalizzi, C, Casale, F, Zecca, M, Casazza, G, Tamaro, P, La Barba, G, Notarangelo, L, Silvestri, D, Colombini, A, Rizzari, C, Biondi, A, Masera, G, Basso, G, Valsecchi, Mg, Putti, Mc, Testi, Am, Tamaro, Paolo, Notarangelo, Ld, Basso, G., Conter, V1, and Casale, Fiorina
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Male ,medicine.medical_specialty ,Neoplasm, Residual ,Adolescent ,medicine.medical_treatment ,Immunology ,Chromosomal translocation ,high risk ,acute lymphoblastic leukemia ,Hematopoietic stem cell transplantation ,Biochemistry ,Gastroenterology ,Antineoplastic Combined Chemotherapy Protocols ,Child ,Child, Preschool ,Combined Modality Therapy ,Female ,Hematopoietic Stem Cell Transplantation ,Humans ,Infant ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,Radiotherapy ,Remission Induction ,Treatment Outcome ,Hematology ,Cell Biology ,Prednisone ,hemic and lymphatic diseases ,Internal medicine ,Medicine ,Neoplasm ,Preschool ,Chemotherapy ,Antineoplastic Combined Chemotherapy Protocol ,business.industry ,medicine.disease ,Minimal residual disease ,Surgery ,Clinical trial ,Radiation therapy ,N/A ,Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA ,Residual ,business ,Human ,medicine.drug - Abstract
The outcome of high-risk (HR) Acute Lymphoblastic Leukemia (ALL) patients enrolled in AIEOP-BFM ALL 2000 study (NCT00613457) in Italy is described. Overall, 1999 Philadelphia negative ALL patients entered the study. HR criteria were: minimal residual disease (MRD) levels ≥10-3 at day 78 (HR-MRD), no complete remission (no-CR) at day 33, t(4;11) translocation, Prednisone Poor Response (PPR). Treatment (2 years) included protocol I, 3 polychemotherapy blocks, delayed intensification (protocol IIx2 or IIIx3), cranial radiotherapy, maintenance. 312 HR patients (15.6% of the total) had 5-year event-free survival (EFS) and overall survival (OS) of 58.9%(SE 2.8) and 68.9%(2.6). In hierarchical order, EFS was 45.9%(4.4) in 132 HR-MRD patients, 41.2%(11.9) in 17 patients no-CR at day 33, 36.4%(14.5) in 11 patients with t(4;11), 74.0%(3.6) in 152 HR patients only for PPR. No statistically significant difference was found for disease-free survival (DFS) in patients with very high risk features (HR-MRD, no-CR at day 33, t(4;11) translocation), given HSCT (n=66) or chemotherapy only (n=88), after adjusting for waiting time to hematopoietic stem cell transplantation (HSCT) (5.7 months). Patients at HR only for PPR have favorable outcome. High risk MRD is associated with poor outcome despite intensive treatment and/or HSCT and may qualify for innovative therapies. The study is registered at the US National Institutes of Health website http://clinicaltrials.gov as "Combination Chemotherapy Based on Risk of Relapse in Treating Young Patients With Acute Lymphoblastic Leukaemia" with the protocol identification number NCT00613457.
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- 2014
14. Role of early diagnosis for a noninvasive treatment of pulmonary thromboembolism in leukemic children
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C Arrigo, Ettore Biagi, Giuseppe Masera, A. Riva, P F Marchi, Attilio Rovelli, G. Marraro, Cornelio Uderzo, Marchi, P, Uderzo, C, Riva, A, Rovelli, A, Biagi, E, Arrigo, C, Marraro, G, and Masera, G
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medicine.medical_specialty ,Time Factors ,Time Factor ,Key words Children ,medicine.medical_treatment ,Short Communication ,Respiratory failure ,Scintigraphy ,Diagnosis, Differential ,Leukemia, Promyelocytic, Acute ,Intensive care ,Acute lymphocytic leukemia ,Thromboembolism ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Chemotherapy ,Humans ,Child ,Bone Marrow Transplantation ,Mechanical ventilation ,Antineoplastic Combined Chemotherapy Protocol ,Leukemia ,medicine.diagnostic_test ,business.industry ,Heparin ,Respiratory disease ,Anticoagulant ,Anticoagulants ,Infant ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,medicine.disease ,Surgery ,Pulmonary embolism ,Oncology ,Radiology ,business ,Complication ,Pulmonary Embolism ,Human - Abstract
Pulmonary thromboembolism (PTE) in leukemic children undergoing intensive chemotherapy should be promptly recognized so that specific therapy can be started. Our experience with the two cases reported here has led us to propose guidelines for the treatment of initial PTE in a pediatric hematology unit. Two children with leukemia developed PTE, the first during the relapse for acute lymphoblastic leukemia and the second at the onset of acute promyelocytic leukemia. In both cases, the diagnosis of PTE was based on clinical assessment of sudden acute respiratory failure with positive pulmonary perfusional scintigraphy in spite of a negative chest X-ray. The subintensive supervision consisted of instrumental monitoring with the assistance of an intensive care anesthetist. The clinical monitoring was based on the serial registration of respiratory rate, cardiac rate, SaO2 and body temperature. The thrombolytic therapy, together with heparin prophylaxis, was successfully administered in the hematology ward without the need for intensive care support (i.e. mechanical ventilation). The success of the treatment was documented by the criterion of a return to the normal cardiorespiratory parameters a few hours after the start of the thrombolytic treatment. Furthermore, a chest CT scan in case 1 and an arteriography in case 2 confirmed the PTE-related hypoperfusion. On the basis of this experience, the authors point out that in the course of acute respiratory failure in leukemic children, the combination of a negative chest X-ray and a positive pulmonary perfusional scintigraphy (compared whenever possible with ventilatory scintigraphy) in the presence of a negative CT scan could be a reliable diagnostic tool for PTE. This pathology should be treated promptly and with specific therapy to avoid progression to a severe, massive PTE.
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- 2014
15. Road Traffic Pollution and Childhood Leukemia: A Nationwide Case-control Study in Italy
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Corrado Magnani, Alessandra Ranucci, Chiara Badaloni, Giulia Cesaroni, Daniela Ferrante, Lucia Miligi, Stefano Mattioli, Roberto Rondelli, Luigi Bisanti, Paola Zambon, Santina Cannizzaro, Paola Michelozzi, Pierluigi Cocco, Egidio Celentano, Giorgio Assennato, Domenico Franco Merlo, Paola Mosciatti, Liliana Minelli, Marina Cuttini, Maria Valeria Torregrossa, Susanna Lagorio, Riccardo Haupt, Francesco Forastiere, Andrea Farioli, Alberto Salvan, Giuseppe Masera, Carmelo Rizzari, Alessandra Greco Veneto, Lorenzo Gafà, Lia Lidia Luzzatto, Alessandra Benvenuti, Ursula Kirchmayer, Claudia Galassi, Erni Guarino, Gigliola de Nichilo, Vittorio Bocchini, Manuela Chiavarini, Veronica Casotto, Rosaria Maria Valenti, Serena Risica, Alessandro Polichetti, Francesco Bochicchio, Cristina Nuccetelli, Pierfranco Biddau, Maurizio Aricò, Gian Luca DeSalvo, Franco Locatelli, Andrea Pession, Stefania Varotto, Vincenzo Poggi, Pia Massaglia, Daniele Monetti, Roberto Targhetta, Gabriella Bernini, Franco Pannelli, Giuseppe Sampietro, Gino Schilirò, Alessandro Pulsoni, Stefano Parodi, Magnani, Corrado, Ranucci, Alessandra, Badaloni, Chiara, Cesaroni, Giulia, Ferrante, Daniela, Miligi, Lucia, Mattioli, Stefano, Rondelli, Roberto, Bisanti, Luigi, Zambon, Paola, Cannizzaro, Santina, Michelozzi, Paola, Cocco, Pierluigi, Celentano, Egidio, Assennato, Giorgio, Merlo, Domenico Franco, Mosciatti, Paola, Minelli, Liliana, Cuttini, Marina, Torregrossa, Maria Valeria, Lagorio, Susanna, Haupt, Riccardo, Forastiere, Francesco, Magnani C, Ranucci A, Badaloni C, Cesaroni G, Ferrante D, Miligi L, Mattioli S, Rondelli R, Bisanti L, Zambon P, Cannizzaro S, Michelozzi P, Cocco P, Celentano E, Assennato G, Merlo DF, Mosciatti P, Minelli L, Cuttini M, Torregrossa MV, Lagorio S, Haupt R, Forastiere F, SETIL Working Group., Magnani, C, Ranucci, A, Badaloni, C, Cesaroni, G, Ferrante, D, Miligi, L, Mattioli, S, Rondelli, R, Bisanti, L, Zambon, P, Cannizzaro, S, Michelozzi, P, Cocco, P, Celentano, E, Assennato, G, Merlo, D, Mosciatti, P, Minelli, L, Cuttini, M, Torregrossa, M, Lagorio, S, Haupt, R, Forastiere, F, Farioli, A, Salvan, A, Masera, G, Rizzari, C, Greco Veneto, A, Gafa, L, Luzzatto, L, Benvenuti, A, Kirchmayer, U, Galassi, C, Guarino, E, de Nichilo, G, Bocchini, V, Chiavarini, M, Casotto, V, Valenti, R, Risica, S, Polichetti, A, Bochicchio, F, Nuccetelli, C, Biddau, P, Arico, M, Desalvo, G, Locatelli, F, Pession, A, Varotto, S, Poggi, V, Massaglia, P, Monetti, D, Targhetta, R, Bernini, G, Pannelli, F, Sampietro, G, Schiliro, G, Pulsoni, A, and Parodi, S
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Myeloid ,Male ,Future studies ,010501 environmental sciences ,Settore MED/42 - Igiene Generale E Applicata ,01 natural sciences ,0302 clinical medicine ,Economica ,hemic and lymphatic diseases ,Medicine ,030212 general & internal medicine ,Child ,Road traffic ,acute non lymphoblastic leukemia ,childhood ,environment ,leukemia ,road traffic ,air pollution ,case-control studies ,child ,child, preschool ,female ,humans ,infant ,Italy ,leukemia, myeloid, acute ,male ,precursor cell lymphoblastic leukemia-lymphoma ,risk ,motor vehicles ,medicine (all) ,Leukemia ,Traffic pollution ,Medicine (all) ,General Medicine ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,Motor Vehicles ,Leukemia, Myeloid, Acute ,Acute non Lymphoblastic Leukemia ,Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA ,Road Traffic ,Child, Preschool ,Female ,Medical emergency ,Case-Control Studie ,Human ,Risk ,Childhood leukemia ,Socio-culturale ,Acute ,Environment ,Precursor Cell Lymphoblastic Leukemia Lymphoma ,03 medical and health sciences ,Environmental health ,Air Pollution ,Humans ,Preschool ,0105 earth and related environmental sciences ,business.industry ,Case-control study ,Type specific ,Ambientale ,Infant ,medicine.disease ,Childhood ,Case-Control Studies ,Motor Vehicle ,business - Abstract
Background The association of childhood leukemia with traffic pollution was considered in a number of studies from 1989 onwards, with results not entirely consistent and little information regarding subtypes. Aim of the study We used the data of the Italian SETIL case-control on childhood leukemia to explore the risk by leukemia subtypes associated to exposure to vehicular traffic. Methods We included in the analyses 648 cases of childhood leukemia (565 Acute lymphoblastic–ALL and 80 Acute non lymphoblastic-AnLL) and 980 controls. Information on traffic exposure was collected from questionnaire interviews and from the geocoding of house addresses, for all periods of life of the children. Results We observed an increase in risk for AnLL, and at a lower extent for ALL, with indicators of exposure to traffic pollutants. In particular, the risk was associated to the report of closeness of the house to traffic lights and to the passage of trucks (OR: 1.76; 95% CI 1.03–3.01 for ALL and 6.35; 95% CI 2.59–15.6 for AnLL). The association was shown also in the analyses limited to AML and in the stratified analyses and in respect to the house in different period of life. Conclusions Results from the SETIL study provide some support to the association of traffic related exposure and risk for AnLL, but at a lesser extent for ALL. Our conclusion highlights the need for leukemia type specific analyses in future studies. Results support the need of controlling exposure from traffic pollution, even if knowledge is not complete.
- Published
- 2016
16. The Eleventh International Childhood Acute Lymphoblastic Leukemia Workshop Report: Ponte di Legno, Italy, May 6-7, 2009
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Ching-Hon Pui, Martin Schrappe, Kjeld Schmiegelow, Andrea Biondi, Stephen P. Hunger, Giuseppe Masera, André Baruchel, Biondi, A, Baruchel, A, Hunger, S, Masera, G, Schmiegelow, K, Schrappe, M, and Pui, C
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Cancer Research ,Pediatrics ,medicine.medical_specialty ,Down syndrome ,education ,acute lymphoblastic leukemia ,Eleventh ,Article ,Precursor Cell Lymphoblastic Leukemia Lymphoma ,03 medical and health sciences ,0302 clinical medicine ,hemic and lymphatic diseases ,Medicine ,leukmia induction failure ,Childhood Acute Lymphoblastic Leukemia ,health care economics and organizations ,030304 developmental biology ,dic(9 ,20) ALL ,Children, ALL ,0303 health sciences ,business.industry ,Down syndrome ALL ,hemic and immune systems ,Hematology ,medicine.disease ,t(1 ,19) ALL ,Oncology ,030220 oncology & carcinogenesis ,business ,Philadelphia chromosome-positive ALL - Abstract
The Eleventh International Childhood Acute Lymphoblastic Leukemia Workshop Report: Ponte di Legno, Italy, 6–7 May 2009
- Published
- 2009
17. Beneficial and harmful effects of anthracyclines in the treatment of childhood acute lymphoblastic leukaemia: a systematic review and meta-analysis
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Rob Pieters, Susan M. Richards, T. Eden, Pediatrics, Masera, G, Valsecchi, M, and Childhood Acute Lymphoblastic Leukaemia Collaborative, G
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Oncology ,Adult ,Male ,medicine.medical_specialty ,Cardiotonic Agents ,Anthracycline ,Adolescent ,Heart Diseases ,Article ,Disease-Free Survival ,Young Adult ,Internal medicine ,hemic and lymphatic diseases ,Odds Ratio ,Medicine ,childhood acute lymphoblastic leukaemia ,Humans ,Anthracyclines ,Child ,Childhood all ,Randomized Controlled Trials as Topic ,Cardiotoxicity ,Antibiotics, Antineoplastic ,business.industry ,Remission Induction ,Infant ,hemic and immune systems ,Hematology ,Odds ratio ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,Confidence interval ,medicine.anatomical_structure ,Meta-analysis ,Child, Preschool ,Lymphoblastic leukaemia ,Female ,Bone marrow ,business - Abstract
Summary Anthracyclines are used to treat childhood acute lymphoblastic leukaemia (ALL) but non-randomized studies suggest that cardiotoxicity may be a problem. Individual patient data from trials in childhood ALL that randomized anthracyclines or methods of reducing cardiotoxicity were analysed by standard meta-analysis methods. Results were grouped and combined according to: addition of an anthracycline to standard therapy, type of anthracycline, mode of administration, and the use of a cardioprotectant. Data from 958 patients in 4 trials, recruiting between 1972 and 1984, showed that addition of an anthracycline reduced bone marrow relapse and, non-significantly, non-bone marrow relapse, resulting in an increased relapse-free interval. However there was a non-significant increase in induction failures, and in deaths in first remission. Event-free survival at 5 years was 56·7% with anthracycline versus 52·8% without (Odds Ratio = 0·91; 95% Confidence Interval = 0·76-1·10; P = 0·3). There were no significant differences found in other treatment comparisons. The limited data from trials did not demonstrate differences in clinically evident cardiotoxicity. Anthracyclines are effective against bone marrow relapse but have not been shown to significantly increase event free survival in childhood ALL. The evidence on type of anthracycline, method of administration or use of cardioprotectant was insufficient to be able to rule out important differences. © 2009 Blackwell Publishing Ltd.
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- 2009
18. Treatment of Pediatric non-Hodgkin lymphomas in a country with limited resources: Results of the first national protocol in Nicaragua
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Gloria Tridello, Angelo Rosolen, R. Palacios, Fulgencio Baez, G. Mendez, Cavalli Franco, Valentino Conter, Roberta Ortiz, Giuseppe Masera, Mg. Valsecchi, Elena C. Ocampo, L. Manfredini, T. Gutierrez, F. Fossati Bellani, Marta Pillon, Baez, F, Pillon, M, Manfredini, L, Ocampo, E, Mendez, G, Ortiz, R, Palacios, R, Gutierrez, T, Tridello, G, Conter, V, Valsecchi, M, Fossati Bellani, F, Cavalli, F, Masera, G, and Rosolen, A
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Male ,Pediatrics ,medicine.medical_specialty ,limted resources ,Adolescent ,Drug availability ,Developing country ,Nicaragua ,Context (language use) ,Developing Countrie ,linfoma non-Hodgkin ,child ,immune system diseases ,hemic and lymphatic diseases ,Antineoplastic Combined Chemotherapy Protocols ,Overall survival ,Humans ,Medicine ,Developing Countries ,Protocol (science) ,Antineoplastic Combined Chemotherapy Protocol ,business.industry ,Lymphoma, Non-Hodgkin ,Infant ,Hematology ,Oncology ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Female ,business ,Limited resources - Abstract
We report the results of a protocol for the diagnosis and treatment of pediatric non-Hodgkin lymphomas (NHL) conducted in Nicaragua in the context of an international collaborative program. Fifty-three children with NHL treated between 1996 and 2003 were retrospectively evaluated. Therapy was designed based on local drug availability and affordability with dose and schedule adaptations for Burkitt and lymphoblastic lymphomas. With a median follow-up of 3 years, the projected 9-year overall survival was 63% and event-free survival 53%. The treatment was efficacious, feasible, and well tolerated in spite of the local socio-economical conditions.
- Published
- 2008
19. Optimization of PCR-based minimal residual disease diagnostics for childhood acute lymphoblastic leukemia in a multi-center setting
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E R Panzer-Grümayer, André Schrauder, M Konrad, V H J van der Velden, C. R. Bartram, Andrea Biondi, Giovanni Cazzaniga, Thomas Flohr, Martin Schrappe, Giuseppe Basso, Rosemary Sutton, Giuseppe Masera, J. J. M. Van Dongen, J M Wijkhuijs, Vandervelden, V, Panzergrumayer, E, Cazzaniga, G, Flohr, T, Sutton, R, Schrauder, A, Basso, G, Schrappe, M, Wijkhuijs, J, Konrad, M, Bartram, C, Masera, G, Biondi, A, van Dongen, J, and Immunology
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Oncology ,Cancer Research ,medicine.medical_specialty ,Neoplasm, Residual ,Time Factors ,Polymerase Chain Reaction ,Risk Assessment ,hemic and lymphatic diseases ,Internal medicine ,Acute lymphocytic leukemia ,medicine ,Humans ,Lymphoid neoplasms ,Child ,Childhood Acute Lymphoblastic Leukemia ,Acute leukemia ,Hematology ,business.industry ,Reproducibility of Results ,hemic and immune systems ,DNA, Neoplasm ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,medicine.disease ,Minimal residual disease ,Immunology ,business ,PCR, minimal residual disease, ALL - Abstract
Minimal residual disease (MRD) diagnostics is used for treatment stratification in childhood acute lymphoblastic leukemia. We aimed to identify and solve potential problems in multicenter MRD studies to achieve and maintain consistent results between the AIEOP/BFM ALL-2000 MRD laboratories. As the dot-blot hybridization method was replaced by the real-time quantitative polymerase chain reaction (RQ-PCR) method during the treatment protocol, special attention was given to the comparison of MRD data obtained by both methods and to the reproducibility of RQ-PCR data. Evaluation of all key steps in molecular MRD diagnostics identified several pitfalls that resulted in discordant MRD results. In particular, guidelines for RQ-PCR data interpretation appeared to be crucial for obtaining concordant MRD results. The experimental variation of the RQ-PCR was generally less than three-fold, but logically became larger at low MRD levels below the reproducible sensitivity of the assay (-4). Finally, MRD data obtained by dot-blot hybridization were comparable to those obtained by RQ-PCR analysis (r2=0.74). In conclusion, MRD diagnostics using RQ-PCR analysis of immunoglobulin/T-cell receptor gene rearrangements is feasible in multicenter studies but requires standardization; particularly strict guidelines for interpretation of RQ-PCR data are required. We further recommend regular quality control for laboratories performing MRD diagnostics in international treatment protocols.
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- 2007
20. AMOR: A proposed cooperative effort to improve outcomes of childhood cancer in Central America
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Jose C. Barrantes Zamorra, Maria G. Valsecch, Federico Antillon, Miguel Bonilla, Gianni Tognoni, Scott C. Howard, Ronald D. Barr, Ligia Fu Carrasco, Belgica Moreno, Giuseppe Masera, Fulgencio Baez, Raul C. Ribeiro, Antillon, F, Baez, F, Barr, R, Barrantes Zamorra, J, Carrasco, L, Moreno, B, Bonilla, M, Tognoni, G, Valsecchi, M, Howard, S, Ribeiro, R, and Masera, G
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Gerontology ,medicine.medical_specialty ,International Cooperation ,Child Health Services ,MEDLINE ,Developing country ,Medical Oncology ,Pediatrics ,Unit (housing) ,Neoplasms ,Health care ,Humans ,Medicine ,Child ,Pediatric ,business.industry ,Cancer ,Central America ,Hematology ,medicine.disease ,Pediatric cancer ,Italy ,Oncology ,Family medicine ,General partnership ,North America ,Pediatrics, Perinatology and Child Health ,Child Health Service ,Neoplasm ,business ,Developed country ,Human - Abstract
The dramatic reduction of pediatric cancer mortality rates has been one of the greatest accomplishments of contemporary medicine. About 80% of children with cancer are now expected to be cured by current therapies. However, most of the world's children have no access to cancer treatment. The translation of effective pediatric cancer therapies to impoverished regions of the world presents an enormous challenge to the health care profession. Over the past 20 years, efforts have been under way to extend adequate cancer treatment to an increasing number of children in developing countries. These initiatives, collectively designated "twinning programs," consist essentially of a partnership between a pediatric cancer unit in a developing country and a group of health care providers in the developed world. Here we review the twinning programs that have been implemented in Central America, discuss their impact on the development of local resources and the outcome of childhood cancer, and propose a collaborative research initiative aimed at improving the international dissemination of progress in pediatric hematology-oncology.
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- 2005
21. SETIL: Italian multicentric epidemiological case–control study on risk factors for childhood leukaemia, non hodgkin lymphoma and neuroblastoma: study population and prevalence of risk factors in Italy
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Lucia Miligi, Corrado Magnani, Susanna Lagorio, Pierluigi Cocco, Claudia Galassi, Roberto Rondelli, Veronica Casotto, L. Gafa, Ursula Kirchmayer, Rosalia Maria Valenti, Serena Risica, Maria Valeria Torregrossa, Marina Cuttini, Paola Mosciatti, Luigi Bisanti, Erni Guarino, Egidio Celentano, Francesco Forastiere, Giuseppe Masera, Alessandro Polichetti, Alberto Salvan, Paola Zambon, Alessandra Benvenuti, Domenico Franco Merlo, Manuela Chiavarini, Lia Lidia Luzzatto, Vittorio Bocchini, Pierfranco Biddau, Stefano Mattioli, Alessandra Ranucci, Liliana Minelli, F. Pannelli, Santina Cannizzaro, Gigliola de Nichilo, Carmelo Rizzari, Giorgio Assennato, Paola Michelozzi, Riccardo Haupt, Magnani, C., Mattioli, S., Miligi, L., Ranucci, A., Rondelli, R., Salvan, A., Bisanti, L., Masera, G., Rizzari, C., Zambon, P., Cannizzaro, S., Gafà, L., Luzzatto, L., Benvenuti, A., Michelozzi, P., Kirchmayer, U., Cocco, P., Biddau, P., Galassi, C., Celentano, E., Guarino, E., Assennato, G., Nichilo, G., Merlo, D., Bocchini, V., Pannelli, F., Mosciatti, P., Minelli, L., Chiavarini, M., Cuttini, M., Casotto, V., Torregrossa, M., Valenti, R., Forastiere, F., Haupt, R., Lagorio, S., Risica, S., Polichetti, A., Magnani, Corrado, Mattioli, Stefano, Miligi, Lucia, Ranucci, Alessandra, Rondelli, Roberto, Salvan, Alberto, Bisanti, Luigi, Masera, Giuseppe, Rizzari, Carmelo, Zambon, Paola, Cannizzaro, Santina, Gafà, Lorenzo, Luzzatto, Lia Lidia, Benvenuti, Alessandra, Michelozzi, Paola, Kirchmayer, Ursula, Cocco, Pierluigi, Biddau, Pierfranco, Galassi, Claudia, Celentano, Egidio, Guarino, Erni, Assennato, Giorgio, de Nichilo, Gigliola, Merlo, Domenico Franco, Bocchini, Vittorio, Pannelli, Franco, Mosciatti, Paola, Minelli, Liliana, Chiavarini, Manuela, Cuttini, Marina, Casotto, Veronica, Torregrossa, Maria Valeria, Valenti, Rosalia Maria, Forastiere, Francesco, Haupt, Riccardo, Lagorio, Susanna, Risica, Serena, and Polichetti, Alessandro
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Male ,Pediatrics ,Passive smoking ,Lymphoma ,Epidemiology ,Non hogdkin lymphoma ,medicine.disease_cause ,Settore MED/42 - Igiene Generale E Applicata ,Neuroblastoma ,Economica ,hemic and lymphatic diseases ,Prevalence ,risk factors ,Leukaemia ,Child ,education.field_of_study ,Incidence (epidemiology) ,Incidence ,Lymphoma, Non-Hodgkin ,non hodgkin lymphoma and neuroblastoma ,Environmental exposure ,Italy ,Child, Preschool ,Population study ,Female ,Human ,medicine.medical_specialty ,Population ,Non-Hodgkin ,Socio-culturale ,study population ,Risk Assessment ,childhood leukaemia ,medicine ,Humans ,education ,Preschool ,Pregnancy ,business.industry ,Research ,Case-control study ,Infant, Newborn ,Ambientale ,Infant ,Environmental Exposure ,medicine.disease ,Newborn ,business - Abstract
Background Aetiology of childhood leukaemia and childhood neoplasm is poorly understood. Information on the prevalence of risk factors in the childhood population is limited. SETIL is a population based case–control study on childhood leukaemia, conducted with two companion studies on non-Hodgkin Lymphoma (NHL) and neuroblastoma. The study relies on questionnaire interviews and 50 Hz magnetic field (ELF-MF) indoor measurements. This paper discusses the SETIL study design and includes descriptive information. Methods The study was carried out in 14 Italian regions (78.3% of Italian population aged 0–10). It included leukaemia, NHL and neuroblastoma cases incident in 0–10 year olds in 1998–2001, registered by the Italian Association of Paediatric Haematology and Oncology (AIEOP) (accrual over 95% of estimated incidence). Two controls for each leukaemia case were randomly sampled from the Local Health Authorities rolls, matched by gender, birthdate and residence. The same controls were used in NHL and neuroblastoma studies. Parents were interviewed at home on: physical agents (ELF-MF and ionizing radiation), chemicals (smoking, solvents, traffic, insecticides), occupation, medical and personal history of children and parents, infectious diseases, immunizations and associated factors. Occupational exposure was collected using job specific modules. ELF-MF was measured in the main rooms (spot measurement) and close to child’s bed (48 hours measurement). Results The study included: 683 leukaemia cases (87% ALL, 13% AnLL), 97 NHL, 155 neuroblastomas, and 1044 controls. ELF-MF long term measurements were obtained for 61.1% of controls and 81.6% of leukaemia cases; 8.8% of controls were exposed at over 0.1 microTesla (μT), 3.5% and 2.1% at respectively over 0.2 and 0.3 μT. 25% of controls’ fathers had smoked over 10 cigarettes/day during the year of conception, varying according to education and region. Maternal smoking was less common (71.4% did not smoke in pregnancy). Maternal passive smoking during pregnancy was reported by 31.2% of controls; the child’s passive smoking for 28.6%. Occupational exposure to solvents was estimated in 18.3% of controls’ fathers and 7.7% of mothers. Contact with public was more frequent among mothers (36.1%) than fathers (23.4%). Conclusions SETIL represents a data source on exposure of Italian children to a broad array of potential carcinogenic factors. Electronic supplementary material The online version of this article (doi:10.1186/s13052-014-0103-5) contains supplementary material, which is available to authorized users.
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- 2014
22. Morbidity and Mortality Due to Liver Disease in Children Undergoing Allogeneic Bone Marrow Transplantation: A 10-Year Prospective Study
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Marina Testa, Attilio Rovelli, Anna Locasciulli, Giuseppe Masera, Paola Sparano, Laura Vecchi, Maria Grazia Valsecchi, Cornelio Uderzo, Alfredo Alberti, Daniela Longoni, Locasciulli, A, Testa, M, Valsecchi, M, Vecchi, L, Longoni, D, Sparano, P, Rovelli, A, Uderzo, C, Masera, G, and Alberti, A
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Male ,HBsAg ,medicine.medical_specialty ,Cirrhosis ,Adolescent ,Immunology ,Chronic liver disease ,Biochemistry ,Gastroenterology ,Follow-Up Studie ,Liver disease ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Child ,Bone Marrow Transplantation ,Hepatitis ,business.industry ,Liver Diseases ,Liver Disease ,Infant ,Cell Biology ,Hematology ,Hepatitis C ,Hepatitis B ,medicine.disease ,digestive system diseases ,Surgery ,Prospective Studie ,Child, Preschool ,Elevated transaminases ,Female ,Morbidity ,business ,Follow-Up Studies - Abstract
We have conducted a long-term prospective study of children undergoing bone marrow transplantation (BMT) to assess morbidity and mortality for liver disease. One hundred eleven consecutive children were enrolled between June 1985 and June 1995 and were followed-up for a median of 5.5 years after BMT. Before transplant 48/111 children (43%) had abnormal alanine aminotransferase (ALT), none were HBsAg+ and 4/111 were anti-HCV+. After BMT 4/111 patients (3.6%) died of liver failure. No relationship was found between pretransplant hepatitis B (HBV) or C (HCV) infection or elevated transaminases and development of severe liver damage. Eighty-two out of one hundred and eleven patients (74%) had abnormalities of ALT after BMT, transient (n = 54) or persistent (n = 28). None developed clinical signs or symptoms of end stage liver disease or of cirrhosis during follow-up. No significant difference in prevalence of liver disease, was found between children with normal or abnormal ALT at BMT (relative risk [RR] = 1.04). HCV infection could be implicated in the etiology of chronic liver disease in 14/28 patients; 2 other patients were found infected by HBV alone (1 case) or combined with HCV (1 case). In the remaining 12 the etiology of chronic liver disease could not be defined. Posttransplant hepatitis B occurred in 4/111 children (3.6%), including a recipient from a donor who had been previously vaccinated against HBV, while no patient who had been vaccinated developed hepatitis B. The rate of posttransplant seroconversion to anti-HCV was 15%.
- Published
- 1997
23. Detection of PICALM-MLLT10 (CALM-AF10) and outcome in children with T-lineage acute lymphoblastic leukemia
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Barbara Buldini, Rosanna Parasole, Carmelo Rizzari, Andrea Pession, Andrea Biondi, Francesco Locatelli, Maria Grazia Valsecchi, Matteo Luciani, Valentino Conter, Nanette Santoro, Elena Barisone, Maurizio Aricò, Fiorina Casale, Giuseppe Masera, Concetta Micalizzi, Elena Mirabile, Giuseppe Basso, L Lo Nigro, Giovanni Cazzaniga, Chiara Messina, Daniela Silvestri, Cinzia Caserta, Manuela Tumino, L Lo Nigro, E Mirabile, M Tumino, C Caserta, G Cazzaniga, C Rizzari, D Silvestri, B Buldini, E Barisone, F Casale, M Luciani, F Locatelli, C Messina, C Micalizzi, A Pession, R Parasole, N Santoro, G Masera, G Basso, M Aricò, M Valsecchi, A Biondi, V Conter, Lo Nigro, L, Mirabile, E, Tumino, M, Caserta, C, Cazzaniga, G, Rizzari, C, Silvestri, D, Buldini, B, Barisone, E, Casale, Fiorina, Luciani, M, Locatelli, F, Messina, C, Micalizzi, C, Pession, A, Parasole, R, Santoro, N, Masera, G, Basso, G, Aricò, M, Valsecchi, M, Biondi, A, Conter, V., Casale, F, and Conter, V
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Male ,Cancer Research ,Lineage (genetic) ,Adolescent ,Lymphoblastic Leukemia ,UP-REGULATION, CELL, MUTATIONS, FUSION ,Precursor T-Cell Lymphoblastic Leukemia-Lymphoma ,PICALM ,children ,hemic and lymphatic diseases ,Humans ,Medicine ,Child ,business.industry ,PICALM-MLLT10 ,Infant ,hemic and immune systems ,Hematology ,N/A ,Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA ,Oncology ,Child, Preschool ,Monomeric Clathrin Assembly Proteins ,Immunology ,Female ,T-ALL ,business ,Transcription Factors - Abstract
Approximately 10–15% of pediatric patients with acute lymphoblastic leukemia (ALL) have a T-cell phenotype. The prognosis of these patients has improved over the last years, owing to the use of more intensive treatment strategies. Characterization of molecular alterations with prognostic impact in T-ALL may be of great help for an early identification of patients at high risk (HR) of failure in whom more intensive treatments, including allogeneic hematopoietic stem cell transplantation, may be considered.
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- 2013
24. Screening for Coagulopathy and Identification of Children With Acute Lymphoblastic Leukemia at a Higher Risk of Symptomatic Venous Thrombosis: An AIEOP Experience
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Maria Grazia Valsecchi, Valentino Conter, Daniela Silvestri, Massimo Grassi, Antonella Colombini, Paola Giordano, Rosanna Parasole, Giuseppe Masera, Carmelo Rizzari, Nicola Santoro, Elena Barisone, Roberta Caruso, Santoro, N, Colombini, A, Silvestri, D, Grassi, M, Giordano, P, Parasole, R, Barisone, E, Caruso, R, Conter, V, Valsecchi, M, Masera, G, and Rizzari, C
- Subjects
Male ,medicine.medical_specialty ,Pediatrics ,Adolescent ,Lymphoblastic Leukemia ,acute lymphoblastic leukemia ,children ,Risk Factors ,hemic and lymphatic diseases ,Antineoplastic Combined Chemotherapy Protocols ,Prevalence ,medicine ,Coagulopathy ,Humans ,Child ,Intensive care medicine ,Childhood Acute Lymphoblastic Leukemia ,Randomized Controlled Trials as Topic ,Retrospective Studies ,Venous Thrombosis ,business.industry ,Infant ,Venous Thromboembolism ,Hematology ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,medicine.disease ,Predictive value ,Venous thrombosis ,Oncology ,Case-Control Studies ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Female ,business ,symptomatic venous thrombosis - Abstract
Venous thromboembolic events (VTEs) are frequent complications of childhood acute lymphoblastic leukemia (ALL) treatment. The aim of the study was to evaluate the rate of symptomatic VTEs in children with ALL and the predictive value of clinical and biological factors and routine monitoring of coagulation parameters in identifying children at a higher risk of this complication.Between September 2000 and July 2006, 2042 children (≥1 and younger than 18 y) with newly diagnosed ALL were enrolled in Italy in the AIEOP (Italian Association of Pediatric Hematology and Oncology)-BFM (Berlin-Frankfurt-Muenster) ALL 2000 trial. Patients with symptomatic VTEs (deep venous thromboses or cerebral venous thromboses) were identified after a careful review of clinical records. The impact of coagulation derangement at the onset of VTEs was evaluated by a nested case-control study.Forty-eight (2.4%) children presented with a VTE. The rate of VTEs was higher in male patients (P=0.001); patients randomized to receive dexamethasone tended to have a higher rate of VTE compared with those who received prednisone (P=0.10). The coagulation derangement at the onset of VTE was not associated with VTE occurrence. The prevalence of a factor V Leiden G1691A mutation and the prothrombin G20210A variant was higher in children with VTE than that expected in the general population.
- Published
- 2013
25. A new challenge in clinical research in childhood ALL: The prospective meta-analysis strategy for intergroup collaboration
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G. Masera, Maria Grazia Valsecchi, Valsecchi, M, and Masera, G
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medicine.medical_specialty ,law.invention ,Outcome Assessment (Health Care) ,Meta-Analysis as Topic ,Randomized controlled trial ,law ,Outcome Assessment, Health Care ,medicine ,Humans ,Prospective Studies ,Child ,Intensive care medicine ,Prospective cohort study ,Childhood Acute Lymphoblastic Leukemia ,Randomized Controlled Trials as Topic ,Protocol (science) ,business.industry ,Data Collection ,Hematology ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,Surgery ,Clinical trial ,Prospective Studie ,Clinical research ,Oncology ,Meta-analysis ,business ,Human - Abstract
We consider the problems arising in clinical research on childhood acute lymphoblastic leukemia (ALL). Given the therapeutic progress achieved over the last few decades, any improvement in the outcome for the majority of children with ALL is difficult to assess with the usual size trials. Furthermore, the progress in genetics and molecular biology has now led to the identification of subgroups of children, typically with rare characteristics, for whom new treatments still await evaluation. For both these aspects of clinical research, there is an increasing need for international intergroup cooperation. After a discussion on the role of retrospective meta-analysis and randomized controlled trials in ALL research, we suggest that intergroup studies could be made more feasible, but still scientifically rigorous, by adopting a strategy of prospective meta-analysis. This strategy can be described as follows: i) different groups prospectively plan to ask the same randomized question within their protocols which may differ in other aspects, and to pool their data in order to evaluate treatment effect; ii) the management of the study can be de-centralized, by allowing each group to be responsible for conducting its own protocol. We would like to stimulate the debate on the methodological and practical aspects of research perspectives in ALL (and in pediatric oncology).
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- 1996
26. Duration and intensity of maintenance chemotherapy in acute lymphoblastic leukaemia: overview of 42 trials involving 12 000 randomised children
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E Greaves, R Allison, V Datton, Archie Bleyer, A Reiter, Harland N. Sather, S Murphy, C P Steuber, M F Auclerc, E C GordonSmith, Indraneel Mittra, Colin Baigent, A Solidoro, M Donnelly, Michael L. Hancock, M Cairo, D Sinclair, E Lepage, P A Shetty, C Harwood, Andrea Pession, R. D. Gelber, T Vietti, A Bancillon, D Mahoney, Richard Peto, V J Land, Santarelli, F SackmanMuriel, Maria Grazia Valsecchi, Giuseppe Masera, Mike Clarke, H Riehm, Richard Gray, C Perez, W Crist, H Duong, Michael E. Trigg, O R McIntyre, J Simone, Ching-Hon Pui, Jon Godwin, Paul S. Gaynon, Julian Peto, L Clavell, Keith Wheatley, J Chessells, Stephen E. Sallan, Martin Schrappe, O B Eden, S Richards, Roberto Rondelli, J Durrant, C Bailey, J Lilleyman, A Burnett, G Schaison, Gregory H. Reaman, Richards, S, Gray, R, Peto, R, Gaynon, P, Masera, G, Pession, A, Rondelli, R, Valsecchi, M, Reiter, A, Riehm, H, Schrappe, M, Mcintyre, O, Bleyer, A, Cairo, M, Reaman, G, Sather, H, Trigg, M, Auclerc, M, Bancillon, A, Lepage, E, Schaison, G, Clavell, L, Datton, V, Donnelly, M, Gelber, R, Sallan, S, Sackman-Smith, E, Lilleyman, J, Land, V, Mahoney, D, Murphy, S, Steuber, C, Vietti, T, Crist, W, Hancock, M, Pui, C, Simone, J, Mittra, I, Shetty, P, Allison, R, Baigent, C, Clarke, M, Duong, H, Durrant, J, Godwin, J, Greaves, E, Harwood, C, Peto, J, Sinclair, D, and Wheatley, K
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Adult ,Oncology ,medicine.medical_specialty ,Adolescent ,Antineoplastic Agents ,Drug Administration Schedule ,Antineoplastic Agent ,Precursor Cell Lymphoblastic Leukemia Lymphoma ,Internal medicine ,medicine ,Humans ,Duration (project management) ,Child ,Survival analysis ,Randomized Controlled Trials as Topic ,Maintenance chemotherapy ,Dose-Response Relationship, Drug ,business.industry ,General Medicine ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,Survival Analysis ,Intensity (physics) ,Surgery ,Lymphoblastic leukaemia ,business ,Human - Abstract
The effects on long-term outcome in childhood acute lymphoblastic leukaemia (ALL) of the duration and the intensity of maintenance chemotherapy need to be assessed reliably. With this objective the Childhood ALL Collaborative Group coordinated a worldwide overview of all randomised trials that began before 1987.Individual patient data were sought for about 3900 children in trials of longer vs shorter maintenance (eg, 3 vs 2 years), 3700 in trials of intensive "reinduction" chemotherapy during maintenance, and 4400 in trials of various other questions, including 1300 in trials of pulses of vincristine and prednisone (VP) during maintenance. Analyses were of survival in first remission, overall survival, and cause-specific mortality.Deaths during remission were increased by longer maintenance (2.7 percent vs 1.2 percent), VP pulses (4.0 vs 3.2 percent), and intensive reinduction (4.8 percent vs 3.3 percent), but these increases were counterbalanced by reductions in relapses. Total events (relapse or death) were significantly reduced by longer maintenance (23.3 percent vs 27.6 percent), VP pulses (31.2 percent vs 40.4 percent) and intensive reinduction (27.8 percent vs 35.8 percent) (each 2p0.001). Many of those who relapsed were successfully re-treated, however, and only for intensive reinduction was overall survival significantly improved (18.5 percent vs 22.3 percent; 2p=0.01).Intensive reinduction chemotherapy in these trials produced an absolute improvement of about 4 percent in long-term survival; if the extra deaths in remission had been avoided, this would have been a 5 percent benefit. Further improvements in survival seem more likely to be obtained with intensive treatment than with longer low-level maintenance.
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- 1996
27. The experience in nicaragua: childhood leukemia in low income countries-the main cause of late diagnosis may be 'medical delay'
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Giuseppe Masera, C. Pacheco, G. Lucchini, C. De Angelis, F. Baez, Valentino Conter, M. Arguello, A. Flores, Andrea Biondi, De Angelis, C, Pacheco, C, Lucchini, G, Arguello, M, Conter, V, Flores, A, Biondi, A, Masera, G, and Baez, F
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Pediatrics ,medicine.medical_specialty ,Childhood leukemia ,Referral ,Article Subject ,business.industry ,lcsh:RJ1-570 ,MEDLINE ,Developing country ,Myeloid leukemia ,lcsh:Pediatrics ,Retrospective cohort study ,Nicaragua, childhood leukemia, low income countries, late diagnosis ,medicine.disease ,Leukemia ,Pediatrics, Perinatology and Child Health ,medicine ,Clinical Study ,Observational study ,business - Abstract
Background. The event-free survival for pediatric leukemia in low-income Countries is much lower than in high-income countries. Late diagnosis, which is regarded as a contributing factor, may be due to “parental” or “medical” delay.Procedures. The present study analyses determinants of lag time from first symptoms to diagnosis of leukemia, comparing pediatric (0–16 years old) patients in two referral centers, one in Nicaragua and one in Italy. An observational retrospective study was conducted to assess factors influencing the time to diagnosis.Results. 81 charts of children diagnosed with acute myeloid leukemia or lymphoblastic leukemia were analyzed from each centre. Median lag time to diagnosis was higher in Nicaragua than in Italy (29 versus 14 days,P<0.001) and it was mainly due to “physician delay” (16.5 versus 7 days,P<0.001), whereas “patient delay” from symptoms to first medical assessment was similar in the two centers (7 versus 5 days,P=0.27). Moreover, median lag time from symptoms to diagnosis was decreased in Nicaraguan districts were a specific training program upon childhood oncological diseases was carried out (20.5 versus 40 days,P=0.0019).Conclusions. Our study shows that delay in diagnosis of childhood leukemia is mainly associated with “physician delay” and it may be overcome by programs of continuous medical education.
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- 2011
28. Low anthracyclines doses-induced cardiotoxicity in acute lymphoblastic leukemia long-term female survivors
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Cristina Giannattasio, Francesca Cesana, Donatella Fraschini, Fabiana Madotto, Anna Capra, Momcilo Jankovic, Giuseppe Masera, Maria Amigoni, Giuseppe Mancia, Marianna Galbiati, Amigoni, M, Giannattasio, C, Fraschini, D, Galbiati, M, Capra, A, Madotto, F, Cesana, F, Jankovic, M, Masera, G, and Mancia, G
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Adult ,Male ,medicine.medical_specialty ,Anthracycline ,Adolescent ,Lymphoblastic Leukemia ,Heart failure ,Acute lymphoblastic leukemia ,Young Adult ,Risk Factors ,Internal medicine ,medicine ,Humans ,Mass index ,Anthracyclines ,Survivors ,Child ,Body surface area ,Cardiotoxicity ,Antibiotics, Antineoplastic ,Cumulative dose ,business.industry ,Heart ,Hematology ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,medicine.disease ,Surgery ,Leukemia ,Oncology ,Echocardiography ,Pediatrics, Perinatology and Child Health ,Cardiology ,Female ,business ,Cardiomyopathies - Abstract
Background High dosage anthracyclines in pediatric patients with acute lymphoblastic leukemia (ALL) is associated with cardiotoxicity. However, data on the cardiac effects of lower cumulative doses of these drugs are not conclusive. The aim of this study was to assess the cardiac effects of low cumulative anthracycline doses in long-term survivors of ALL. Procedure Echocardiograms were performed on 62 long-term ALL survivors, without any overt or sub-clinical signs or symptoms of heart failure. The interval after stopping therapy was 12.6 ± 4.3 years; the mean cumulative dose of anthracyclines was 228.2 ± 42.3 mg/m2. Left ventricular (LV) structure and function were studied by echocolor-Doppler. An age, gender and body surface area (BSA) matched group of healthy subjects was used as controls. Cardiac data were analyzed before and after BSA normalization. Results Long term survivors of ALL, showed a lower LV mass index, interventricular septal and posterior wall thickness, which were independently related to gender and to age at which the ALL diagnosis was made. Data analyzed according to gender showed that abnormalities were confined to the female group. No alterations were observed in the ALL male group versus the corresponding control group. No relationship was observed between the echocardiografic abnormalities and the duration of follow-up or the anthracycline mean dose employed. Conclusions In the absence of any signs or symptoms of heart failure, female ALL survivors treated with low cumulative anthracycline doses, showed a reduced LV mass and wall thickness. This suggests that in female ALL survivors an echocardyographic follow-up should be recommended. Pediatr Blood Cancer. 2010;55:1343–1347. © 2010 Wiley-Liss, Inc.
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- 2010
29. Risk of Relapse of Childhood Acute Lymphoblastic Leukemia Is Predicted By Flow Cytometric Measurement of Residual Disease on Day 15 Bone Marrow
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Richard Ratei, Michael Dworzak, Barbara Buldini, Giuseppe Gaipa, Marinella Veltroni, Oscar Maglia, Andrea Biondi, Maria Grazia Valsecchi, Maurizio Aricò, Valentino Conter, Giuseppe Basso, Daniela Silvestri, Alessandra Benetello, Giuseppe Masera, Basso, G, Veltroni, M, Valsecchi, M, Dworzak, M, Ratei, R, Silvestri, D, Benetello, A, Buldini, B, Maglia, O, Masera, G, Conter, V, Arico, M, Biondi, A, and Gaipa, G
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Cancer Research ,medicine.medical_specialty ,Vincristine ,Pathology ,Asparaginase ,business.industry ,leukemia ,medicine.disease ,Gastroenterology ,Minimal residual disease ,Leukemia ,chemistry.chemical_compound ,medicine.anatomical_structure ,Oncology ,chemistry ,Internal medicine ,Acute lymphocytic leukemia ,medicine ,Bone marrow ,Risk factor ,business ,Childhood Acute Lymphoblastic Leukemia ,medicine.drug - Abstract
Purpose Speed of blast clearance is an indicator of outcome in childhood acute lymphoblastic leukemia (ALL). Availability of measurement of minimal residual disease (MRD) at an early time point with a reduced-cost method is of clinical relevance. In the AIEOP-BFM-ALL (Associazione Italiana Ematologia Oncologia Pediatrica and Berlin-Frankfurt-Münster Study Group) 2000 trial, patients were stratified by levels of polymerase chain reaction (PCR) MRD at day +33 and +78. AIEOP studied the prognostic impact of MRD measured by flow cytometry (FCM) at day 15 of induction therapy. Patients and Methods Bone marrow samples from 830 Italian patients were collected on day 15, after 14 days of steroids, and one dose of intrathecal methotrexate, vincristine, daunorubicine, and asparaginase. Cells were analyzed by four-color FCM for detection of leukemia-associated immunophenotypes. Results Three patient risk groups were identified by FCM: standard (< 0.1% blast cells; 42% of the total), intermediate (0.1 to < 10%; 47%), and high (≥ 10%; 11%). Their 5-year cumulative incidences of relapse were 7.5% (SE, 1.5), 17.5% (SE, 2.1), and 47.2% (SE, 5.9), respectively. In multivariate analysis, FCM was the most important prognostic factor among those available by day 15, with two-fold and five-fold increase in the risk of relapse compared with patients with less than 0.1%. PCR MRD, when added to the model, had significant prognostic impact; yet high levels of FCM MRD retained an independent ability to detect a significantly higher risk of relapse. Conclusion Measurement of FCM MRD in day 15 bone marrow was the most powerful early predictor of relapse, applicable to virtually all patients; it may complement PCR MRD–based stratification including later time points, thus allowing additional treatment tailoring.
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- 2009
30. Encephalopathy syndrome in children with hemato-oncological disorders is not always posterior and reversible
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Momcilo Jankovic, Giuseppe Masera, Daniele Grioni, Attilio Rovelli, Antonella Colombini, Margherita Contri, Carlo De Grandi, Valentino Conter, Giovanna Lucchini, Lucchini, G, Grioni, D, Colombini, A, Contri, M, De Grandi, C, Rovelli, A, Conter, V, Masera, G, and Jankovic, M
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Male ,medicine.medical_specialty ,Pediatrics ,Adolescent ,medicine.medical_treatment ,Encephalopathy ,Antineoplastic Agents ,Hematopoietic stem cell transplantation ,Intensive chemotherapy ,Electroencephalography ,Leukoencephalopathy ,Antineoplastic Agent ,Epilepsy ,medicine ,Humans ,Child ,Hematologic Neoplasm ,Brain Diseases ,medicine.diagnostic_test ,business.industry ,Brain Disease ,Hematopoietic Stem Cell Transplantation ,Hematology ,Syndrome ,medicine.disease ,Chemotherapy regimen ,Surgery ,Leukemia ,Diffusion Magnetic Resonance Imaging ,Oncology ,Child, Preschool ,Hematologic Neoplasms ,Pediatrics, Perinatology and Child Health ,Female ,business ,Human - Abstract
Background Posterior reversible leukoencephalopathy (PRES) is a clinical-radiological event that can affect children undergoing chemotherapy regimen. Studies have shown that it is not always reversible, in spite of its original definition. We analyzed PRES cases which occurred during the last 10 years at our institute to focus on their clinical, radiological and EEG follow-up. Procedures We analyzed 12 cases of PRES in children who underwent intensive chemotherapy regimens, detailing the acute neurological presentation of the syndrome, their neuro-imaging characteristics (MRI) and EEG findings, in both an acute phase and during follow-up. Results All patients survived the acute event, showing a clinical recovery of the acute neurological signs in 1–3 days and normalization of the EEG pattern in a period ranging from 1 to 8 months. During long term follow-up, four patients developed either clinical impairment or EEG-MRI anomalies. Conclusions We suggest that a long term follow-up is necessary to determine the reversibility of the neurological events. Clinical observation, as well as EEG and MRI should be included in follow-up evaluations. Pediatr Blood Cancer 2008;51:629–633. © 2008 Wiley-Liss, Inc.
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- 2008
31. Minimal residual disease-directed risk stratification using real-time quantitative PCR analysis of immunoglobulin and T-cell receptor gene rearrangements in the international multicenter trial AIEOP-BFM ALL 2000 for childhood acute lymphoblastic leukemia
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Martin Stanulla, Felix Niggli, Rosemary Sutton, J. J. M. Van Dongen, Rolf Koehler, Giuseppe Masera, Susanna Fischer, Andrea Biondi, V H J van der Velden, Martin Zimmermann, Thomas Flohr, André Schrauder, Martin Schrappe, Beat W. Schäfer, Giovanni Cazzaniga, Giuseppe Basso, Claus R. Bartram, Helmut Gadner, Maria Grazia Valsecchi, Renate Panzer-Grümayer, University of Zurich, Schrappe, M, Immunology, Flohr, T, Schrauder, A, Cazzaniga, G, Panzer Grümayer, R, van der Velden, V, Fischer, S, Stanulla, M, Basso, G, Niggli, F, Schäfer, B, Sutton, R, Koehler, R, Zimmermann, M, Valsecchi, M, Gadner, H, Masera, G, van Dongen, J, Biondi, A, Bartram, C, and International BFM Study, G
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Oncology ,Cancer Research ,medicine.medical_specialty ,Neoplasm, Residual ,Adolescent ,2720 Hematology ,610 Medicine & health ,Gene Rearrangement, T-Lymphocyte ,Polymerase Chain Reaction ,Risk Assessment ,Acute lymphocytic leukemia ,Multicenter trial ,Internal medicine ,hemic and lymphatic diseases ,medicine ,Humans ,1306 Cancer Research ,Risk factor ,Child ,Childhood Acute Lymphoblastic Leukemia ,Gene Rearrangement ,Genes, Immunoglobulin ,business.industry ,Infant ,Hematology ,Gene rearrangement ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,medicine.disease ,Minimal residual disease ,Surgery ,Clinical trial ,body regions ,10036 Medical Clinic ,Minimal residual disease, PCR, T-cell receptor, gene rearrangements, childhood acute lymphoblastic leukemia ,Child, Preschool ,2730 Oncology ,Risk assessment ,business - Abstract
Detection of minimal residual disease (MRD) is the most sensitive method to evaluate treatment response and one of the strongest predictors of outcome in childhood acute lymphoblastic leukemia (ALL). The 10-year update on the I-BFM-SG MRD study 91 demonstrates stable results (event-free survival), that is, standard risk group (MRD-SR) 93%, intermediate risk group (MRD-IR) 74%, and high risk group (MRD-HR) 16%. In multicenter trial AIEOP-BFM ALL 2000, patients were stratified by MRD detection using quantitative PCR after induction (TP1) and consolidation treatment (TP2). From 1 July 2000 to 31 October 2004, PCR target identification was performed in 3341 patients: 2365 (71%) patients had two or more sensitive targets (≥10-4), 671 (20%) patients revealed only one sensitive target, 217 (6%) patients had targets with lower sensitivity, and 88 (3%) patients had no targets. MRD-based risk group assignment was feasible in 2594 (78%) patients: 40% were classified as MRD-SR (two sensitive targets, MRD negativity at both time points), 8% as MRD-HR (MRD ≤10-3 at TP2), and 52% as MRD-IR. The remaining 823 patients were stratified according to clinical risk features: HR (n=108) and IR (n=715). In conclusion, MRD-PCR-based stratification using stringent criteria is feasible in almost 80% of patients in an international multicenter trial.
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- 2008
32. Periodic erythroexchange is an effective strategy for high risk paediatric patients with sickle-cell disease
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Manuela Calabria, Giuseppe Masera, C. Vimercati, Paolo Perseghin, Luisa Tavecchia, Simona Ronzoni, Francesca Riva, Nicoletta Masera, Lorena Pozzi, Masera, N, Tavecchia, L, Pozzi, L, Riva, F, Vimercati, C, Calabria, M, Ronzoni, S, Masera, G, and Perseghin, P
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Erythrocytapheresis ,Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Exchange transfusion ,Disease ,Anemia, Sickle Cell ,Quality of life ,Retrospective Studie ,Antisickling Agents ,Risk Factors ,Antisickling Agent ,medicine ,Humans ,Hydroxyurea ,In patient ,Child ,Paediatric patients ,Retrospective Studies ,business.industry ,Risk Factor ,Infant ,Retrospective cohort study ,Hematology ,Drug Tolerance ,Regimen ,Child, Preschool ,Costs and Cost Analysis ,Quality of Life ,Female ,business ,Erythrocyte Transfusion ,Human - Abstract
We performed an 11 year retrospective study on 34 sickle-cell paediatric patients, focusing on efficacy, safety and costs of an exchange transfusion program in 13 high risk patients. A good clinical control with improvement in patients' quality of life, no disease related complications, no significant iron overload and no procedure related side effects were observed during periodic erythroexchange. Costs of periodic erythroexchange versus chronic transfusion regimen were comparable. Periodic erythroexchange appeared a good alternative to chronic transfusion regimen for controlling the most severe forms of disease, particularly in patients who do not tolerate or do not respond to hydroxyurea.
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- 2007
33. Pulses of vincristine and dexamethasone in addition to intensive chemotherapy for children with intermediate-risk acute lymphoblastic leukaemia: a multicentre randomised trial
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Helmut Gadner, Yves Benoit, Jan Stary, Eduardo Dibar, A. Reiter, Martin Zimmermann, Edina Magyarosy, Daniela Silvestri, Martin Schrappe, Giuseppe Masera, Myriam Campbell, Maria Grazia Valsecchi, Valentino Conter, Hansjörg Riehm, Conter, V, Valsecchi, M, Silvestri, D, Campbell, M, Dibar, E, Magyarosy, E, Gadner, H, Stary, J, Benoit, Y, Zimmermann, M, Reiter, A, Riehm, H, Masera, G, and Schrappe, M
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Male ,medicine.medical_specialty ,Vincristine ,Adolescent ,Antineoplastic Agents, Hormonal ,medicine.medical_treatment ,Dexamethasone ,Disease-Free Survival ,law.invention ,Randomized controlled trial ,law ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Child ,Children, ALL ,Chemotherapy ,Intention-to-treat analysis ,business.industry ,Mercaptopurine ,Hazard ratio ,Infant ,General Medicine ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,Surgery ,Methotrexate ,Child, Preschool ,Female ,business ,medicine.drug - Abstract
Background: Studies in the 1970s and 1980s suggested that the outcome of childhood acute lymphoblastic leukaemia (ALL) could be improved by intensification of conventional continuation chemotherapy with pulses of vincristine sulfate and steroids. We aimed to investigate the efficacy and toxic effects of vincristine-dexamethasone pulses as an addition to the continuation-therapy phase in a large cohort of children with intermediate-risk disease who were treated with the Berlin-Frankfurt-Münster (BFM) treatment strategy. Methods: 3109 children, diagnosed with ALL and intermediate-risk features, were enrolled by eight participating organisations in eleven countries. All were treated with very similar protocols based on the BFM treatment strategy, which included induction, consolidation, reinduction, and continuation-therapy phases. At the beginning of the continuation-therapy phase, those patients in complete remission were randomly assigned to either a treatment or a control group. Control patients were given conventional mercaptopurine and methotrexate chemotherapy only. Patients in the treatment arm were also given pulses of vincristine (1·5 mg/m2 weekly for 2 weeks) and dexamethasone (6 mg/m2 daily for 7 days) every 10 weeks for six cycles. The primary outcome measure was disease-free survival. Analysis was by intention to treat. The study is registered at http://www.clinicaltrials.gov with the identifier NCT00411541. Findings: 174 patients (5·6%) relapsed or died in complete remission before randomisation. Of the remaining 2935 patients, 2618 (89·2%) were randomly assigned: 1325 to the treatment group and 1293 to the control group. With median follow-up of 4·8 years, 240 children in the treatment group and 241 in the control group had relapses; 15 in the treatment group and 14 controls died in complete remission or developed second malignant neoplasms. The 5-year and 7-year disease-free survival estimates were 79·8% (SE 1·2) and 77·5% (1·5) in the treatment group and 79·2% (1·2) and 78·4% (1·3) in the control group, respectively. Treatment with pulses of vincristine and dexamethasone was associated with a non-significant 3% relative-risk reduction (hazard ratio 0·97; 95% CI 0·81-1·15; p=0·70). Interpretation: Children with intermediate-risk ALL who received intensive chemotherapy based on BFM protocols did not benefit from intensification of the continuation-therapy phase with a schedule of pulses of vincristine and dexamethasone. © 2007 Elsevier Ltd. All rights reserved.
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- 2007
34. Improving outcomes for children with cancer in low-income countries in Latin America: a report on the recent meetings of the Monza International School of Pediatric Hematology/Oncology (MISPHO)-Part I
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Federico Antillon, Marco Marinoni, Ching-Hon Pui, Ronald D. Barr, Scott C. Howard, Alessandra Sala, Giuseppe Masera, Maria Grazia Valsecchi, Sandra Luna-Fineman, Raul C. Ribeiro, Luis Castillo, Gianni Tognoni, Miguel Bonilla, Howard, S, Marinoni, M, Castillo, L, Bonilla, M, Tognoni, G, Luna Fineman, S, Antillon, F, Valsecchi, M, Pui, C, Ribeiro, R, Sala, A, Barr, R, and Masera, G
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Acute promyelocytic leukemia ,Registrie ,Pediatrics ,medicine.medical_specialty ,Adolescent ,Prognosi ,International Cooperation ,Pediatric Hematology/Oncology ,Cancer Care Facilities ,Medical Oncology ,Information Service ,Internal medicine ,Neoplasms ,medicine ,Humans ,Registries ,Cooperative Behavior ,Rhabdomyosarcoma ,Intensive care medicine ,Child ,Pediatric ,Information Services ,Terminal Care ,Hematology ,business.industry ,Cancer Care Facilitie ,Cancer ,Disease Management ,Infant ,medicine.disease ,Prognosis ,Pediatric cancer ,Survival Analysis ,Regimen ,Latin America ,Nutrition Assessment ,Oncology ,Italy ,Withholding Treatment ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Quality of Life ,Neoplasm ,Survival Analysi ,Outcomes research ,business ,Human - Abstract
Pediatric cancer programs in low-income countries (LIC) can improve outcomes. However, treatment must be tailored to the patient's living conditions and the availability of supportive care. In some cases, a more intense regimen will decrease survival since the increase in death from toxicity may exceed any decrease in relapse. Attempts to practice evidence-based pediatric oncology are thwarted by the lack of evidence derived from local experience in LIC to determine optimal therapy. This report summarizes treatment regimens used by pediatric oncologists from 15 countries of the Caribbean, Central and South America who participate in the Monza International School of Pediatric Hematology/Oncology (MISPHO). Patients with hepatoblastoma, Wilms tumor, and histiocytosis treated on unmodified published protocols had outcomes comparable to those in high-income countries (HIC). Those with rhabdomyosarcoma, osteosarcoma, Hodgkin lymphoma, and acute myeloid leukemia treated with unmodified regimens had event-free survival estimates 10%-20% lower than those reported in HIC due to higher rates of toxic death, abandonment of therapy, and relapse. Treatment of retinoblastoma is complicated by advanced stages and extraocular disease at diagnosis; improved outcomes depend on education of pediatricians and the public to recognize early signs of this disease. Use of unmodified protocols for Burkitt lymphoma and acute lymphoblastic leukemia have been associated with unacceptable toxicity in LIC, so MISPHO centers have modified published regimens by giving lower doses of methotrexate and reducing use of anthracyclines. Despite the use of all-trans-retinoic acid during induction for acute promyelocytic leukemia, the incidence of fatal hemorrhage remains unacceptably high.
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- 2006
35. The eighth international childhood acute lymphoblastic leukemia workshop ('Ponte di Legno meeting') report: Vienna, Austria, April 27-28, 2005
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Martin Schrappe, Christine J. Harrison, Ch Pui, Giuseppe Masera, James B. Nachman, Helmut Gadner, Yves Benoit, T Eden, Gadner, H, Masera, G, Schrappe, M, Eden, T, Benoit, Y, Harrison, C, Nachman, J, and Pui, C
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Cancer Research ,Pediatrics ,medicine.medical_specialty ,Genetic Subgroups In T-ALL ,Lymphoblastic Leukemia ,education ,Down Syndrome ALL ,law.invention ,Childhood ALL ,Randomized controlled trial ,law ,Medicine ,Asparaginase ,AML1 Amplification ,Childhood all ,Childhood Acute Lymphoblastic Leukemia ,Minimal Residual Disease ,business.industry ,Secondary Cancer ,Hematology ,medicine.disease ,Leukemia ,Oncology ,Induction Failure ,Translocation 1(1 ,business ,19) - Abstract
The International Acute Lymphoblastic Leukemia Working Group, the so-called 'Ponte di Legno Workshop' has led to substantial progress in international collaboration in leukemia research. On April 27 -28, 2005, the 8th Meeting was held in Vienna, Austria, to continue the discussions about special common treatment elements in randomized clinical trials, ethical and clinical aspects of therapy. Furthermore, collaborative projects of clinical relevance with special emphasis on rare genetic subtypes of Childhood ALL were established. The following report summarizes the achievements and aspects of possible future cooperation. © 2006 Nature Publishing Group All rights reserved.
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- 2006
36. Ischemic stroke in children treated for acute lymphoblastic leukemia: a retrospective study
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Nicola Santoro, Paola Giordano, Silvana Varotto, Domenico De Mattia, Giovanni Carlo Del Vecchio, Carmelo Rizzari, Gianfranco Guido, Giuseppe Masera, Santoro, N, Giordano, P, Del Vecchio, G, Guido, G, Rizzari, C, Varotto, S, Masera, G, and De Mattia, D
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Pediatrics ,medicine.medical_specialty ,Prognosi ,Lymphoblastic Leukemia ,Venography ,Risk Factors ,Retrospective Studie ,Surveys and Questionnaires ,Antithrombotic ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Prevalence ,Humans ,Child ,Stroke ,Retrospective Studies ,Antineoplastic Combined Chemotherapy Protocol ,medicine.diagnostic_test ,business.industry ,Questionnaire ,Risk Factor ,Magnetic resonance imaging ,Retrospective cohort study ,Hematology ,Heparin ,Recovery of Function ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,medicine.disease ,Prognosis ,Magnetic Resonance Imaging ,Surgery ,Oncology ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Ischemic stroke ,business ,Tomography, X-Ray Computed ,medicine.drug ,Human - Abstract
The clinical and diagnostic findings and the factors influencing the neurologic and radiologic outcome of symptomatic ischemic stroke were evaluated in a group of 2,318 children with acute lymphoblastic leukemia (ALL) treated according to the AIEOP (Italian Association of Pediatric Hematology and Oncology) study protocols. In this multicentric retrospective study, a questionnaire was sent to each of the 43 AIEOP centers participating in the study. The questionnaire was designed to obtain information on the number, type, and time of occurrence of ischemic strokes, biologic and immunologic features of each case, as well as clinical data of the recruited patients. A prevalence of 0.47% was found. All ischemic strokes were sinovenous thrombosis (SVT). The most common neurologic presentations were diffuse neurologic signs and seizures. MRI with or without venography revealed SVT in 100% of cases; superficial SVT was diagnosed in the majority of cases. Antithrombotic drugs, in particular unfractioned heparin and low-molecular-weight heparin, were administered without bleeding complications. This series shows an excellent long-term neurologic outcome in children with SVT. However, a complete radiologic resolution was found in only 54% of cases; the involvement of deep cerebral venous sinuses was associated with an unfavorable imaging outcome.
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- 2005
37. The seventh international childhood acute lymphoblastic leukemia workshop report: Palermo, Italy, January 29--30, 2005
- Author
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Yves Bertrand, Martin Schrappe, G. Masera, M. G. Valsecchi, T. Eden, Paul S. Gaynon, Conter, Stephen P. Hunger, Rob Pieters, Andrea Biondi, Helmut Gadner, James B. Nachman, Kjeld Schmiegelow, G. E. Janka-Schaub, C H Pui, Maurizio Aricò, Keizo Horibe, André Baruchel, Aricó, M, Baruchel, A, Bertrand, Y, Biondi, A, Conter, V, Eden, T, Gadner, H, Gaynon, P, Horibe, K, Hunger, S, Janka Schaub, G, Masera, G, Nachman, J, Pieters, R, Schrappe, M, Schmiegelow, K, Valsecchi, M, Pui, C, and Pediatrics
- Subjects
Cancer Research ,Pediatrics ,medicine.medical_specialty ,Neoplasm, Residual ,business.industry ,Risk Factor ,Data Collection ,education ,Treatment options ,macromolecular substances ,Hematology ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,Precursor Cell Lymphoblastic Leukemia Lymphoma ,Antineoplastic Agent ,Oncology ,Italy ,hemic and lymphatic diseases ,Medicine ,business ,Child ,Childhood Acute Lymphoblastic Leukemia ,Human - Abstract
Between 1995 and 2004, six International Childhood Acute Lymphoblastic Leukemia (ALL) Workshop have been held, and the completion of several collaborative projects has established the clinical relevance and treatment options for several specific genetic subtypes of ALL. This meeting report summarizes the data presented in the seventh meeting and the discussion.
- Published
- 2005
38. All children have a right to full access to treatment for cancer
- Author
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Martin Schrappe, Giuseppe Masera, Tim Eden, Gianni Tognoni, Ching-Hon Pui, Eden, T, Pui, C, Schrappe, M, Tognoni, G, and Masera, G
- Subjects
Oncology ,medicine.medical_specialty ,Pediatrics ,Human Rights ,business.industry ,Cancer ,Antineoplastic Agents ,General Medicine ,Human Right ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,medicine.disease ,Health Services Accessibility ,Precursor Cell Lymphoblastic Leukemia Lymphoma ,Antineoplastic Agent ,Developing Countrie ,Text mining ,Internal medicine ,medicine ,Humans ,business ,Child ,Developing Countries - Published
- 2004
39. A survey of resources and activities in the MISPHO family of institutions in Latin America: a comparison of two eras
- Author
-
Alessandra Sala, Giuseppe Masera, Ronald D. Barr, Sala, A, Barr, R, and Masera, G
- Subjects
Gerontology ,Latin Americans ,Resource (biology) ,media_common.quotation_subject ,International Cooperation ,Child Health Services ,Staffing ,Developing country ,Pediatrics ,International school ,Developing Countrie ,Neoplasms ,Oncology Service, Hospital ,Institution ,Medicine ,Humans ,Child ,Developing Countries ,media_common ,Pediatric ,Medical education ,Health Resource ,Health Services Needs and Demand ,business.industry ,Hematology ,Pediatric cancer ,Latin America ,Oncology ,Health Care Survey ,Health Care Surveys ,Pediatrics, Perinatology and Child Health ,Neoplasm ,Health Resources ,business ,Limited resources ,Human - Abstract
Background In developing countries, implementation of effective pediatric cancer programs can reduce the overall rate of childhood mortality. To promote this objective, Monzas International School of Pediatric Hematology-Oncology (MISPHO)—for 14 countries with limited resources in Latin America—was launched in 1996. Methods A survey was conducted to evaluate the possible impact of MISPHO on the following areas: research, educational, and clinical activities, diagnostic services, transfusion medicine, supportive care, ancillary staffing complement, and parents' associations—before and after 1996. Results No institution lost resources or activities after 1996 and there were overall gains, in particular in educational activities, diagnostic capabilities, creation of single and multiple institutional treatment protocols. Conclusions Although notable improvements have occurred, there are still important needs that have to be satisfied. © 2004 Wiley-Liss, Inc.
- Published
- 2004
40. Clinical epidemiology of childhood cancer in Central America and Caribbean countries
- Author
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F. Antillon-Klussmann, A. P. Hernandez, Miguel Bonilla, P De Lorenzo, S. Machin, Gianni Tognoni, C. Pacheco, Giuseppe Masera, R. Nieves, F. Baez, Maria Grazia Valsecchi, R. Cabanas, M. Navarrete, N. Moreno, Valsecchi, M, Tognoni, G, Bonilla, M, Moreno, N, Baez, F, Pacheco, C, Hernandez, A, Antillon Klussmann, F, Machin, S, Cabanas, R, Navarrete, M, Nieves, R, De Lorenzo, P, and Masera, G
- Subjects
Pediatrics ,medicine.medical_specialty ,Psychological intervention ,Context (language use) ,Caribbean region ,Retrospective Studie ,Neoplasms ,Health care ,Epidemiology ,Medicine ,Humans ,Child ,Survival analysis ,Retrospective Studies ,business.industry ,Retrospective cohort study ,Central America ,Hematology ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,Survival Analysis ,Leukemia, Myeloid, Acute ,Oncology ,El Niño ,Caribbean Region ,Neoplasm ,Survival Analysi ,business - Abstract
BACKGROUND: Countries with scarce resources have the right to appropriate essential health care but very few reports discuss how this can be achieved. We assessed the survival of a large cohort of pediatric oncological patients to provide hard data on which to base realistic evaluation and planning schemes. PATIENTS AND METHODS: This multicenter retrospective survey covered consecutively diagnosed and treated patients admitted to eight national level hospitals in seven countries in Central America and the Caribbean. The research protocol was discussed extensively, so the data to be collected and the criteria for their evaluation were clearly pre-defined. We analysed 2214 patients diagnosed between 1996 and 1999 with various cancers, classified as hemato-oncological disorders (70%) and solid tumors (30%). RESULTS: Three-year overall survival was 48.4% [standard error (SE) 1.3]. Detailed analysis of acute lymphoblastic leukemia highlighted the wide intercountry variability: 3-year survival was 62.2% (SE 5.3) in Cuba, 74.2% (SE 3.3) in Costa Rica, 61.7% (SE 4.9) in Nicaragua, and lower in the other four countries. CONCLUSIONS: The yield of diagnostic-therapeutic protocols depends largely on the context of care in which they are applied. This paper documents the importance of including epidemiological research in interventions for cooperation in complex health areas such as pediatric oncology.
- Published
- 2004
41. Ponte di Legno Working Group: statement on the right of children with leukemia to have full access to essential treatment and report on the Sixth International Childhood Acute Lymphoblastic Leukemia Workshop
- Author
-
James B. Nachman, Paul S. Gaynon, Giuseppe Masera, Helmut Gadner, Martin Schrappe, OB Eden, C H Pui, William E. Evans, Pui, C, Schrappe, M, Masera, G, Nachman, J, Gadner, H, Eden, O, Evans, W, and Gaynon, P
- Subjects
Cancer Research ,medicine.medical_specialty ,Pediatrics ,Human Rights ,Statement (logic) ,International Cooperation ,education ,Human Right ,Philadelphia chromosome ,Health Services Accessibility ,hemic and lymphatic diseases ,Acute lymphocytic leukemia ,medicine ,Humans ,Child ,Childhood Acute Lymphoblastic Leukemia ,Acute leukemia ,business.industry ,Hematology ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,medicine.disease ,Minimal residual disease ,Surgery ,Transplantation ,Leukemia ,Oncology ,business - Abstract
The Sixth International Childhood ALL Workshop was made possible by unrestricted educational grants from Sanofi-Synethelabo Inc., Glaxosmithkline, Enzon Inc., and Ilex. Preparation of the Meeting Report was supported in part by the Österreichische Kinderkrebshilfe and private donations to the Children's Cancer Research Institute; the Associazione Italiana Ricerca sul Cancro, Fondazione Tettamanti, and Consiglio Nazionale Ricerche-Ministero Instruzione Universitá Ricerca); the Deutsche Krebshilfe, Bonn, and Madeleine Schickedanz Foundation, Fürth, Germany; Cancer Research UKJ; grants from the US National Institutes of Health (CA-21765, CA-51001, CA-31566, CA-78824, CA-29139, CA-37379, GM-61393, and GM61374), a Center of Excellence grant from the State of Tennessee, and the American Lebanese Syrian Associated Charities (ALSAC). C-H Pui is the American Cancer Society - FM Kirby Clinical Research Professor. © 2004 Nature Publishing Group. All rights reserved.
- Published
- 2004
42. Importance of minimal residual disease testing during the second year of disease: still no answer?
- Author
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Maurizio Aricò, Maria Grazia Valsecchi, Giuseppe Masera, Valentino Conter, Aricò, M, Conter, V, Valsecchi, M, and Masera, G
- Subjects
Cancer Research ,Disease free survival ,Pathology ,medicine.medical_specialty ,Neoplasm, Residual ,Time Factor ,Prognosi ,Disease ,Polymerase Chain Reaction ,Disease-Free Survival ,law.invention ,Precursor Cell Lymphoblastic Leukemia Lymphoma ,Antineoplastic Agent ,law ,Bone Marrow ,medicine ,Polymerase chain reaction ,Randomized Controlled Trials as Topic ,business.industry ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,Minimal residual disease ,medicine.anatomical_structure ,Oncology ,Bone marrow ,business ,Human - Published
- 2003
43. Improved outcome in high-risk childhood acute lymphoblastic leukemia defined by prednisone-poor response treated with double Berlin-Frankfurt-Muenster protocol II
- Author
-
Maria Concetta Micalizzi, Andrea Pession, Vincenzo Poggi, Giuseppe Masera, Maria Grazia Valsecchi, Carmelo Rizzari, Chiara Messina, Maurizio Aricò, Valentino Conter, Giulio De Rossi, Elena Barisone, Giuseppe Basso, Franco Locatelli, Aricò, M, Valsecchi, M, Conter, V, Rizzari, C, Pession, A, Messina, C, Barisone, E, Poggi, V, De Rossi, G, Locatelli, F, Micalizzi, M, Basso, G, and Masera, G
- Subjects
Male ,Drug Resistance ,Adrenal Cortex Hormone ,Biochemistry ,Gastroenterology ,Dexamethasone ,Translocation, Genetic ,Prednisone ,Adrenal Cortex Hormones ,Antineoplastic Combined Chemotherapy Protocols ,Child ,Remission Induction ,Cytarabine ,Hematology ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,Treatment Outcome ,Vincristine ,Child, Preschool ,Female ,Survival Analysi ,Human ,medicine.drug ,medicine.medical_specialty ,Cyclophosphamide ,Adolescent ,Immunology ,Context (language use) ,Risk Assessment ,Internal medicine ,Acute lymphocytic leukemia ,medicine ,Asparaginase ,Humans ,Thioguanine ,Childhood Acute Lymphoblastic Leukemia ,Antineoplastic Combined Chemotherapy Protocol ,business.industry ,Infant ,Cell Biology ,medicine.disease ,Survival Analysis ,Surgery ,Regimen ,Doxorubicin ,business - Abstract
One hundred ninety-eight children and adolescents were entered in the Associazione Italiana di Ematologia ed Oncologia Pediatrica (AIEOP)-ALL95 study for high-risk acute lymphoblastic leukemia (ALL). Inclusion criteria were poor response to initial prednisone/intrathecal methotrexate (prednisone-poor response [PPR]), resistance to induction therapy, translocation t(9;22), infants with the t(4;11), or CD10− ALL. The event-free survival (EFS) rate at 4 years was 56.5% (SE, 3.9%) for the entire group. The overall EFS rate in the current study was significantly better (P = .002) than that obtained in a comparable group of patients treated in the early 1990s in the AIEOP-ALL91 study. In particular, patients with PPR had a 4-year EFS of 61.1% (SE, 4.4%) versus 42.8% (SE, 5.4%) in the ALL 91 study (P = .008). Among PPR patients, those who were PPR-only (60.1%)—that is, they achieved CR and were negative for t(9;22) and t(4;11) translocations—had the best outcomes with this intensive treatment, even when additional adverse features (hyperleukocytosis, T phenotype) were present (4-year EFS, 70.1%; SE, 4.7%). We attribute this improvement to the replacement of 6 alternating blocks of non–cross-resistant drugs with an 8-drug reinduction regimen (Berlin-Frankfurt-Muenster [BFM] protocol II), repeated twice, in the context of a standard BFM-type intensive chemotherapy for high-risk ALL. This modified therapy may lead to high cure rates for patients defined as at high risk for intrinsic resistance to corticosteroids only.
- Published
- 2002
44. Near Infrared Spectroscopy (NIRS) as a New Non-Invasive Tool to Detect Oxidative Skeletal Muscle Impairment in Children Survived to Acute Lymphoblastic Leukaemia
- Author
-
Luca Pollastri, Alessandra Ferri, Giuseppe Masera, Giuseppe Miserocchi, Francesca Lanfranconi, Donatella Fraschini, Lanfranconi, F, Pollastri, L, Ferri, A, Fraschini, D, Masera, G, and Miserocchi, G
- Subjects
Male ,Muscle Physiology ,Muscle Functions ,Physiology ,Respiratory System ,lcsh:Medicine ,Body Mass Index ,Incremental exercise ,Hematologic Cancers and Related Disorders ,Heart Rate ,Medicine and Health Sciences ,Child ,lcsh:Science ,Musculoskeletal System ,Spectroscopy, Near-Infrared ,Multidisciplinary ,Muscles ,Muscle Biochemistry ,Hematology ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,Acute Lymphoblastic Leukemia ,Muscle atrophy ,medicine.anatomical_structure ,Lymphoblastic Leukemia ,Cardiology ,Female ,Anatomy ,medicine.symptom ,Oxidation-Reduction ,Research Article ,Muscle tissue ,medicine.medical_specialty ,Vastus lateralis muscle ,Atrophy ,Internal medicine ,Leukemias ,Heart rate ,medicine ,Humans ,Sports and Exercise Medicine ,Muscle, Skeletal ,Myopathy ,business.industry ,lcsh:R ,Biology and Life Sciences ,Skeletal muscle ,medicine.disease ,Surgery ,Oxygen ,Cardiovascular Anatomy ,lcsh:Q ,NIRS, acute lymphoblastic leukaemia, chidren, exercise ,business - Abstract
BACKGROUND: Separating out the effects of cancer and treatment between central and peripheral components of the O2 delivery chain should be of interest to clinicians for longitudinal evaluation of potential functional impairment in order to set appropriate individually tailored training/rehabilitation programmes. We propose a non-invasive method (NIRS, near infrared spectroscopy) to be used in routine clinical practice to evaluate a potential impairment of skeletal muscle oxidative capacity during exercise in children previously diagnosed with acute lymphoblastic leukaemia (ALL). The purpose of this study was to evaluate the capacity of skeletal muscle to extract O2 in 10 children diagnosed with ALL, 1 year after the end of malignancy treatment, compared to a control group matched for gender and age (mean±SD = 7.8±1.5 and 7.3±1.4 years, respectively). METHODS AND FINDINGS: Participants underwent an incremental exercise test on a treadmill until exhaustion. Oxygen uptake ([Formula: see text]), heart rate (HR), and tissue oxygenation status (Δ[HHb]) of the vastus lateralis muscle evaluated by NIRS, were measured. The results showed that, in children with ALL, a significant linear regression was found by plotting [Formula: see text] vs Δ[HHb] both measured at peak of exercise. In children with ALL, the slope of the HR vs [Formula: see text] linear response (during sub-maximal and peak work rates) was negatively correlated with the peak value of Δ[HHb]. CONCLUSIONS: The present study proves that the NIRS technique allows us to identify large inter-individual differences in levels of impairment in muscle O2 extraction in children with ALL. The outcome of these findings is variable and may reflect either muscle atrophy due to lack of use or, in the most severe cases, an undiagnosed myopathy.
- Published
- 2014
45. Long-term results of the Italian Association of Pediatric Hematology and Oncology (AIEOP) acute lymphoblastic leukemia studies, 1982-1995
- Author
-
Franco Mandelli, Giuseppe Masera, Andrea Biondi, Guido Paolucci, Conter, Maurizio Aricò, Andrea Pession, MG Valsecchi, Luigi Zanesco, Enrico Madon, Giuseppe Basso, Carmelo Rizzari, Roberto Rondelli, Conter, V, Aricò, M, Valsecchi, M, Basso, G, Biondi, A, Madon, E, Mandelli, F, Paolucci, G, Pession, A, Rizzari, C, Rondelli, R, Zanesco, L, and Masera, G
- Subjects
Cancer Research ,medicine.medical_specialty ,Pediatrics ,medicine.medical_treatment ,Population ,Context (language use) ,Systemic therapy ,Acute lymphocytic leukemia ,Antineoplastic Combined Chemotherapy Protocols ,Medicine ,Humans ,Intensive care medicine ,education ,Childhood Acute Lymphoblastic Leukemia ,education.field_of_study ,Chemotherapy ,Clinical Trials as Topic ,Antineoplastic Combined Chemotherapy Protocol ,business.industry ,Hematology ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,medicine.disease ,Minimal residual disease ,Oncology ,Meta-analysis ,business - Abstract
The first multicentric approach to childhood acute lymphoblastic leukemia (ALL) treatment in Italy started in the early 1970s when the Associazione Italiana di Ematologia ed Oncologia Pediatrica (AIEOP) was founded. Since then the AIEOP has conducted nationwide chemotherapy protocols. Results obtained in three different periods (1982-1986, 1987-1990, 1991-1995) are reported here. Treatment schedules have been characterized by a progressive intensification of systemic therapy and by a progressive substitution of protracted intrathecal therapy for cranial irradiation as central nervous system (CNS) preventive therapy. In the third period cranial radiotherapy (CRT) has been administered only to patients at high risk of relapse or with CNS involvement at diagnosis (about 15% of the overall population). A progressive improvement of therapeutic results, with a steady reduction of isolated CNS relapse rates have been obtained in the three periods considered here. The AIEOP experience shows that CRT can be safely omitted in non-high risk patients, unless they are T-ALL patients with WBC count at the diagnosis > or =100,000/mm3, and that intensification of treatment allows the improvement of overall results with a reduction of the impact of NCI prognostic criteria. Over the years, AIEOP has also continued to foster active cooperation at an international level. In the ongoing AIEOP ALL 2000 study, conducted in cooperation with the BFM group, patients are stratified according to the presence of translocations t(9;22) and t(4;11) and to treatment response (either initial steroid therapy or induction) or minimal residual disease). This cooperation will allow an adequate recruitment of patients to answer relevant randomized questions in the context of a study in which patients are stratified according to minimal residual disease findings.
- Published
- 2001
46. Educational symposium on long-term results of large prospective clinical trials for childhood acute lymphoblastic leukemia (1985-2000)
- Author
-
Stephen P. Hunger, Conter, Ching-Hon Pui, Giuseppe Masera, Rob Pieters, Martin Schrappe, Kjeld Schmiegelow, James B. Nachman, Schrappe, M, Nachman, J, Hunger, S, Schmiegelow, K, Conter, V, Masera, G, Pieters, R, Pui, C, and Pediatrics
- Subjects
Cancer Research ,Vincristine ,Asparaginase ,medicine.medical_specialty ,Pediatrics ,Time Factors ,Time Factor ,education ,Tioguanine ,chemistry.chemical_compound ,Prednisone ,hemic and lymphatic diseases ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Child ,Childhood Acute Lymphoblastic Leukemia ,health care economics and organizations ,Clinical Trials as Topic ,Antineoplastic Combined Chemotherapy Protocol ,business.industry ,hemic and immune systems ,Hematology ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,Mercaptopurine ,humanities ,Surgery ,Clinical trial ,Prospective Studie ,Oncology ,chemistry ,Cranial Irradiation ,business ,medicine.drug - Abstract
‘Educational symposium on long-term results of large prospective clinical trials for childhood acute lymphoblastic leukemia (1985–2000)’
- Published
- 2010
47. Early and late deaths after elective end of therapies for childhood cancer in Italy
- Author
-
M. Grazia Valsecchi, Silvio Napoli, Paola De Lorenzo, Momcilo Jankovic, Giuseppe Masera, Benedetto Terracini, Riccardo Haupt, Daniela Silvestri, Haupt, R, Valsecchi, M, Silvestri, D, De Lorenzo, P, Napoli, S, Masera, G, Terracini, B, and Jankovic, M
- Subjects
Adult ,Cancer Research ,Pediatrics ,medicine.medical_specialty ,Time Factors ,Time Factor ,Adolescent ,Population ,Follow-Up Studie ,Cohort Studies ,Neoplasms ,Medicine ,Humans ,Cumulative incidence ,education ,Child ,Survival analysis ,Cause of death ,education.field_of_study ,business.industry ,Cancer ,Infant ,medicine.disease ,Primary tumor ,Survival Analysis ,Oncology ,Italy ,Child, Preschool ,Cohort ,Neoplasm ,Survival Analysi ,Cohort Studie ,business ,Cohort study ,Follow-Up Studies - Abstract
The first cohort of subjects treated for cancer during childhood is now entering adulthood, and it is necessary to determine whether treatment has been sufficient to completely eradicate the neoplastic clone, and whether the cancer itself or treatment-related toxicity may have increased the risk of premature death. For these reasons, long-term survival and causes of death were evaluated in a cohort of subjects treated for childhood cancer who reached the elective end of therapy in continuous remission and were registered until 1992 in the Italian Registry of off-therapy subjects (OTR). The vital status of OTR subjects was ascertained in 1996 by a postal survey through census bureaux; for deceased subjects, the cause of death was defined and compared with the expected rates in the general population. At follow-up, out of 6402 eligible and evaluable subjects, 890 were found to have died; the estimated overall survival at 20 years was 80.7% (95% CI 79.3-82.1). Most of the patients (84.6%) died due to recurrence of the primary cancer, usually within the first 5 years after the OT. The cumulative incidence of death due to recurrence of the primary tumor was greater among subjects treated for solid tumor than among those treated for leukemia/lymphoma (p = 0.0001); in contrast, OT subjects after leukemia and lymphoma were more likely to die due to of medical complications of therapy (p < 0.02). Second cancers were the second most frequent cause of death, with a 12-fold risk compared with the general population; the figures were similar in the 2 cancer groups. Compared with the general population, OT subjects were 32 times more likely than same-age subjects to die. The SMR decreased to 6.1 when only non-cancer deaths were considered. Deaths due to external or avoidable causes occurred among survivors at a rate similar to that of the general population
- Published
- 2000
48. Outcome of treatment in children with Philadelphia chromosome-positive acute lymphoblastic leukemia
- Author
-
Maurizio Aricò, Maria Grazia Valsecchi, Bruce Camitta, Martin Schrappe, Judith Chessells, André Baruchel, Paul Gaynon, Lewis Silverman, Gritta Janka-Schaub, Willem Kamps, Ching-Hon Pui, V. Conter, H. Riehm, N. Heerema, S. Sallan, J. Pullen, J. Shuster, A. Carroll, S. Raimondi, S. Richards, Giuseppe Masera, Aricò, M, Valsecchi, M, Camitta, B, Schrappe, M, Chessells, J, Baruchel, A, Gaynon, P, Silverman, L, Janka-Schaub, G, Kamps, W, Pui, C, and Masera, G
- Subjects
Male ,CHILDHOOD ,THERAPY ,Antineoplastic Agent ,PEDIATRIC-ONCOLOGY-GROUP ,Retrospective Studie ,Child ,INTERIM ANALYSIS ,Bone Marrow Transplantation ,Philadelphia Chromosome Positive ,Remission Induction ,BONE-MARROW TRANSPLANTATION ,General Medicine ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,Prognosis ,Combined Modality Therapy ,Treatment Outcome ,Child, Preschool ,Female ,Survival Analysi ,Human ,Adult ,medicine.medical_specialty ,Adolescent ,Prognosi ,Antineoplastic Agents ,Philadelphia chromosome ,CANCER GROUP ,Disease-Free Survival ,POOR-PROGNOSIS ,Internal medicine ,Acute lymphocytic leukemia ,medicine ,Humans ,CLINICAL-SIGNIFICANCE ,PROSPECTIVE METAANALYSIS ,Survival analysis ,Proportional Hazards Models ,Retrospective Studies ,Proportional hazards model ,business.industry ,Induction chemotherapy ,Infant ,Retrospective cohort study ,Interim analysis ,medicine.disease ,Survival Analysis ,INTENSIVE CHEMOTHERAPY ,Surgery ,Proportional Hazards Model ,business - Abstract
Children with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph-positive ALL) have a poor prognosis, and there is no consensus on the optimal treatment for this variant of ALL.We reviewed the medical records of patients with Ph-positive ALL who were treated with intensive chemotherapy, with or without bone marrow transplantation, by 10 study groups or large single institutions from 1986 to 1996. Data on 326 children and young adults, who ranged in age from 0.4 to 19.9 years (median, 8.1), were analyzed to determine the rate of complete remission and the probability of event-free, disease-free and overall survival according to standard prognostic factors and type of treatment.The 267 patients who achieved a complete remission after induction chemotherapy (82 percent) were stratified into three subgroups according to the age and leukocyte count at the time of diagnosis: those with the best prognosis (a leukocyte count of less than 50,000 per cubic millimeter and an age of less than 10 years; 95 patients); those with an intermediate prognosis (intermediate-risk features; 92 patients); and those with the worst prognosis (a leukocyte count of more than 100,000 per cubic millimeter; 80 patients). The estimates of disease-free survival at five years (+/-SE) were 49+/-5 percent) for patients with the best prognosis), 30+/-5 percent (for those with an intermediate prognosis), and 20+/-5 percent (for those with the worst prognosis) (P0.001 for the overall comparison). We also found that transplantation of bone marrow from an HLA-matched related donor offered significantly greater benefit than intensive chemotherapy alone in terms of protecting patients from relapse or other adverse events (relative risk, 0.3; 95 percent confidence interval, 0.2 to 0.5; P0.001). This finding was consistent in all three groups.Unlike the usual type of all, Ph-positive ALL is associated with a poor prognosis. Nevertheless, in some patients with favorable prognosis features, the disease can be be controlled by intensive chemotherapy. Transplantation of bone marrow from an HLA-matched related donor is superior to other types of transplantation and to intensive chemotherapy alone in prolonging initial complete remissions.
- Published
- 2000
49. Income matters: reducing the mortality gap
- Author
-
Giuseppe Masera and Masera, G
- Subjects
Male ,Program evaluation ,Pediatrics ,medicine.medical_specialty ,International Cooperation ,Child Welfare ,Medical Oncology ,Socioeconomic Factor ,Child health services ,medicine ,Financial Support ,Program Development ,Child ,business.industry ,Italy ,Oncology ,Health Care Survey ,Child, Preschool ,Family medicine ,Income ,Child Health Service ,Neoplasm ,Female ,Program development ,Survival Analysi ,business ,Program Evaluation ,Human - Published
- 2008
50. Development of lens opacities with peculiar characteristics in patients affected by thalassemia major on chelating treatment with deferasirox (ICL670) at the Pediatric Clinic in Monza, Italy
- Author
-
Nicoletta Masera, M. Azzolini, Luisa Tavecchia, Giuseppe Masera, C. Rescaldani, C. Vimercati, P. Arpa, V. De Molfetta, Masera, N, Rescaldani, C, Azzolini, M, Vimercati, C, Tavecchia, L, Masera, G, De Molfetta, V, and Arpa, P
- Subjects
Adult ,Pediatrics ,medicine.medical_specialty ,Time Factors ,Time Factor ,Adolescent ,Thalassemia ,Iron Chelating Agents ,Benzoates ,Cataract ,Age related ,Humans ,Medicine ,In patient ,Child ,business.industry ,beta-Thalassemia ,Deferasirox ,Beta thalassemia ,Hematology ,Benzoic Acid ,Triazoles ,medicine.disease ,Pediatric clinic ,Iron Chelating Agent ,Italy ,Child, Preschool ,Triazole ,business ,Retinopathy ,medicine.drug - Abstract
About the 11–14% of patients with thalassemia major (TM) treated with deferasirox (DFO) develops retinopathy and/or lens opacities with an unclear pathogenesis but with a clear age related pattern.[1][1],[2][2] Possible causes can be either iron overload itself or DFO toxicity, with various
- Published
- 2008
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