5 results on '"Carpenedo, Monica"'
Search Results
2. Practical recommendations for the management of patients with ITP during the COVID-19 pandemic
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Rodeghiero, Francesco, Cantoni, Silvia, Carli, Giuseppe, Carpenedo, Monica, Carrai, Valentina, Chiurazzi, Federico, De Stefano, Valerio, Santoro, Cristina, Siragusa, Sergio, Zaja, Francesco, Vianelli, Nicola, Rodeghiero, F., Cantoni, S., Carli, G., Carpenedo, M., Carrai, V., Chiurazzi, F., De Stefano, V., Santoro, C., Siragusa, S., Zaja, F., and Vianelli, N. more...
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Practical recommendations ,hemic and lymphatic diseases ,COVID-19 ,ITP ,Review Article ,Immune thrombocytopenia - Abstract
The current COVID-19 pandemic requires revisiting our current approach to major blood disorders, including ITP (Immune Thrombocytopenia), stirring up the production of several disease-specific practical guidelines. This report describes an updated version of consensus-based practical guidelines on the management of ITP, adapted to the Italian health system and social context. It highlights the role of the hematologist in offering guidance for choosing differentiated approaches in relation to specific circumstances and is intended to provide them with a useful tool for sharing the decision-making process with their patients. Probably, the greatest risk to avoid for a patient with suspected, ongoing or relapsed ITP - that is not severe enough to place him or her at risk for major bleeding - is to be infected in non-hospital and hospital healthcare settings. This risk must be carefully considered when adapting the diagnostic and therapeutic approach. More in detail, the document first addresses the appropriate management for COVID-19 negative patients with newly diagnosed ITP or who experience a relapse of previous ITP, according to first and second lines of treatment and then the management of COVID-19 positive patients according to their severity, from paucisymptomatic to those requiring admission to Intensive Cure Units (ICU). The pros and cons of the different treatments required to correct platelet count are discussed, as are some specific situations, including chronic ITP, splenectomy, thromboembolic complication and anti COVID-19 vaccination. more...
- Published
- 2021
Catalog
3. Management of elderly patients with immune thrombocytopenia: Real-world evidence from 451 patients older than 60 years.
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Palandri, Francesca, Santoro, Cristina, Carpenedo, Monica, Cantoni, Silvia, Barcellini, Wilma, Carli, Giuseppe, Carrai, Valentina, Rossi, Elena, Rivolti, Elena, Lucchesi, Alessandro, Rotondo, Francesco, Baldacci, Erminia, Auteri, Giuseppe, Sutto, Emanuele, Di Pietro, Christian, Catani, Lucia, Bartoletti, Daniela, De Stefano, Valerio, Ruggeri, Marco, and Mazzucconi, Maria Gabriella more...
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IDIOPATHIC thrombocytopenic purpura , *OLDER patients , *CARDIOVASCULAR diseases risk factors , *BLOOD platelet disorders , *DISEASE complications , *OLD age - Abstract
Primary Immune thrombocytopenia (ITP) in the elderly is a major clinical challenge which is increasingly frequent due to global ageing population. To describe baseline ITP features, management, and outcome, a centralized electronic database was established, including data of 451 patients aged ≥60 years that were treated from 2000 onwards and were observed for ≥1 year (total observation of 2704 patient-years). At ITP diagnosis, median age was 71.1 years (age ≥ 75: 42.8%); 237 (53.9%) patients presented with haemorrhages (grade ≥ 3: 7.5%). First-line therapy included prednisone (82.9%), dexamethasone (14.6%), thrombopoietin-receptor agonists (TRAs, 1.3%), and oral immunosuppressive agents (1.1%). Prednisone starting dose ≥1 mg/kg/d (p =.01) and dexamethasone 40 mg/d (p <.001) were mainly reserved to patients aged 60–74, who were more treated with rituximab (RTX, p =.02) and splenectomy (p =.03) second-line. Overall response rates to first and second-line therapies were 83.8% and 84.5%, respectively, regardless of age and treatment type/dose. A total of 178 haemorrhages in 101 patients (grade ≥ 3: n. 52, 29.2%; intracranial in 6 patients), 49 thromboses in 43 patients (grade ≥ 3: n. 26, 53.1%) and 115 infections in 94 patients (grade ≥ 3: n. 23, 20%) were observed during follow-up. Incidence rates of complications per 100 patient-years were: 4.5 (haemorrhages, grade ≥ 3: 1.7), 1.7 (thromboses, grade ≥ 3: 0.9), and 3.9 (infections, grade ≥ 3: 0.7). TRAs use were associated with reduced risk of bleeding and infections, while cardiovascular risk factors (particularly, diabetes) significantly predicted thromboses and infections. Age-adapted treatment strategies are required in elderly and very elderly patients. • Very old age significantly influences treatment strategy in ITP. • Responses and disease complications are comparable in elderly and very elderly. • TRAs use may reduce risk of bleedings and infections in the elderly. • History of diabetes and thrombosis, but not TRAs use, increases thrombotic risk. [ABSTRACT FROM AUTHOR] more...
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- 2020
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4. Management of elderly patients with immune thrombocytopenia: Real-world evidence from 451 patients older than 60 years
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Michele Cavo, Francesco Rotondo, Lucia Catani, Marco Ruggeri, Monica Carpenedo, Erminia Baldacci, Silvia Cantoni, Alessandro Lucchesi, Emanuele Sutto, Daniela Bartoletti, Francesca Palandri, Giuseppe Carli, Francesco Rodeghiero, Elena Rossi, Valentina Carrai, Christian Di Pietro, Cristina Santoro, Maria Gabriella Mazzucconi, Wilma Barcellini, Nicola Vianelli, Elena Rivolti, Valerio De Stefano, Giuseppe Auteri, Palandri, Francesca, Santoro, Cristina, Carpenedo, Monica, Cantoni, Silvia, Barcellini, Wilma, Carli, Giuseppe, Carrai, Valentina, Rossi, Elena, Rivolti, Elena, Lucchesi, Alessandro, Rotondo, Francesco, Baldacci, Erminia, Auteri, Giuseppe, Sutto, Emanuele, Di Pietro, Christian, Catani, Lucia, Bartoletti, Daniela, De Stefano, Valerio, Ruggeri, Marco, Mazzucconi, Maria Gabriella, Cavo, Michele, Rodeghiero, Francesco, and Vianelli, Nicola more...
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medicine.medical_specialty ,Eltrombopag ,Azathioprine ,030204 cardiovascular system & hematology ,03 medical and health sciences ,chemistry.chemical_compound ,Elderly ,0302 clinical medicine ,Prednisone ,Internal medicine ,medicine ,Humans ,Dexamethasone ,Aged ,Purpura, Thrombocytopenic, Idiopathic ,Romiplostim ,Toxicity ,business.industry ,Retrospective cohort study ,Hematology ,medicine.disease ,Comorbidity ,Thrombocytopenia ,Immune thrombocytopenia ,Settore MED/15 - MALATTIE DEL SANGUE ,ITP ,TPO-receptor agonists ,chemistry ,TPO-receptor agonist ,030220 oncology & carcinogenesis ,Splenectomy ,Rituximab ,business ,Immunosuppressive Agents ,medicine.drug - Abstract
INTRODUCTION: Primary Immune thrombocytopenia (ITP) in the elderly is a major clinical challenge which is increasingly frequent due to global ageing population. MATERIALS AND METHODS: To describe baseline ITP features, management, and outcome, a centralized electronic database was established, including data of 451 patients aged ≥60years that were treated from 2000 onwards and were observed for ≥1year (total observation of 2704 patient-years). RESULTS: At ITP diagnosis, median age was 71.1years (age≥75: 42.8%); 237 (53.9%) patients presented with haemorrhages (grade≥3: 7.5%). First-line therapy included prednisone (82.9%), dexamethasone (14.6%), thrombopoietin-receptor agonists (TRAs, 1.3%), and oral immunosuppressive agents (1.1%). Prednisone starting dose ≥1mg/kg/d (p=.01) and dexamethasone 40mg/d (p  more...
- Published
- 2019
5. Alternate use of thrombopoietin receptor agonists in adult primary immune thrombocytopenia patients: A retrospective collaborative survey from Italian hematology centers
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Angela Maria Ciminello, Giorgina Specchia, Fabrizio Pane, Silvia Cantoni, Roberto Cairoli, Felicetto Ferrara, Erminia Baldacci, Francesco Zaja, Ugo Consoli, Alessandra Ricco, Andrea Artoni, Monica Carpenedo, Valerio De Stefano, Michele Nichelatti, Mariella D'Adda, Nicola Vianelli, Francesco Rodeghiero, Elena Rossi, Wilma Barcellini, Valentina Carrai, Andrea Visentin, Maria Gabriella Mazzucconi, Marco Ruggeri, Domenica Caramazza, Cantoni, Silvia, Carpenedo, Monica, Mazzucconi, Maria Gabriella, DE STEFANO, Valerio Flavio, Carrai, Valentina, Ruggeri, Marco, Specchia, Giorgina, Vianelli, Nicola, Pane, Fabrizio, Consoli, Ugo, Artoni, Andrea, Zaja, Francesco, D'Adda, Mariella, Visentin, Andrea, Ferrara, Felicetto, Barcellini, Wilma, Caramazza, Domenica, Baldacci, Erminia, Rossi, Elena, Ricco, Alessandra, Ciminello, Angela, Rodeghiero, Francesco, Nichelatti, Michele, Cairoli, Roberto, Cantoni, S, Carpenedo, M, Mazzucconi, M, De Stefano, V, Carrai, V, Ruggeri, M, Specchia, G, Vianelli, N, Pane, F, Consoli, U, Artoni, A, Zaja, F, D'Adda, M, Visentin, A, Ferrara, F, Barcellini, W, Caramazza, D, Baldacci, E, Rossi, E, Ricco, A, Ciminello, A, Rodeghiero, F, Nichelatti, M, Cairoli, R, and De Stefano, Valerio more...
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Adolescent ,Adult ,Aged ,80 and over ,Female ,Humans ,Italy ,Male ,Middle Aged ,Purpura ,Thrombocytopenic ,Idiopathic ,Receptors ,Thrombopoietin ,Retrospective Studies ,Surveys and Questionnaires ,Young Adult ,Hematology ,Aged, 80 and over ,Purpura, Thrombocytopenic, Idiopathic ,Receptors, Thrombopoietin ,Thrombopoietin receptor agonists ,chemistry.chemical_compound ,0302 clinical medicine ,Retrospective Studie ,Surveys and Questionnaire ,Young adult ,Thrombopoietin receptor agonists, Immune thrombocytopenia ,immune thrombocytopenia ,030220 oncology & carcinogenesis ,Receptor ,medicine.drug ,Human ,medicine.medical_specialty ,Thrombopoietin Receptor Agonists ,Eltrombopag ,03 medical and health sciences ,Internal medicine ,medicine ,Adverse effect ,Romiplostim ,business.industry ,Retrospective cohort study ,Immune thrombocytopenia ,Settore MED/15 - MALATTIE DEL SANGUE ,chemistry ,Immunology ,ITP ,business ,030215 immunology - Abstract
Sequential use of the TPO-RAs romiplostim and eltrombopag in ITP patients failing either agent was retrospectively evaluated to assess efficacy and impact of clinical characteristics on outcome. Patients were grouped into 5 categories: efficacy issues: 1st TPO-RA failure; loss of response; non-efficacy issues: platelet fluctuations; patient's preference; adverse event development. Either one TPO-RA sequence was analyzed at 3 month and at last follow-up. 106/546 patients on TPO-RA underwent switch and 65% achieved, regained or maintained a short- term response independent of switch sequence, gender or age; lower response rates were associated with lines of previous therapy; disease duration lowers probability to respond. Clinically, patients switched for efficacy issue did not differ from those switched for non-efficacy issues. Response was achieved/regained in 57.8% of patients switched for efficacy issues, the lowest response rates were observed in non-responders to 1st TPO-RA; 80% of patients switched for non-efficacy issues maintained a response. Platelet fluctuation resolved in 44.4%. Of the 49 patients evaluable for long-term outcome, 27 were in response on therapy; 16 discontinued the TPO-RA for reasons other than efficacy, while only 6 were non responders. We confirm the efficacy of TPO-RA switch; once achieved, response to the 2nd TPO-RA seems durable. more...
- Published
- 2018
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