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Your search keyword '"Grasso, Antonio Giacomo"' showing total 2 results
Start Over Author "Grasso, Antonio Giacomo" Topic pediatric
2 results on '"Grasso, Antonio Giacomo"'

1. Pre-Transplant Total Lymphocyte Count Determines Anti-Thymocyte Globulin Exposure, Modifying Graft-versus-Host Disease Incidence and Post-Transplant Thymic Restoration: A Single-Center Retrospective Study.

Author

Grasso, Antonio Giacomo, Simeone, Roberto, Maestro, Alessandra, Zanon, Davide, and Maximova, Natalia

Subjects
*GRAFT versus host disease, *LYMPHOCYTE count, *DISEASE incidence, *GLOBULINS, *THYMUS tumors, *MAGNETIC resonance imaging
Abstract

The use of anti-thymocyte globulin (ATG) as part of conditioning to prevent graft-versus-host disease (GVHD) may severely impair immune reconstitution (IR). We analyzed relationships between ATG exposure, the recipient lymphocyte count, IR, and transplant outcome. We retrospectively reviewed patients aged ≤ 18 years who underwent allogeneic HSCT between April 2005 and April 2020. The outcomes of interest included the incidence of GVHD, overall survival (OS), and IR. IR was analyzed through thymic magnetic resonance imaging (MRI) and by quantifying T CD4+ and recent thymic emigrants (RTEs). The ATG-exposed group was split into a low ATG/lymphocyte ratio subgroup (ratio < 0.01) and a high ATG/lymphocyte ratio subgroup (ratio > 0.01). The low ratio subgroup had a higher incidence of GVHD (29 [59%] vs. 7 [16.6%]) but a better IR in both laboratory and MRI imaging assessments (p < 0.0001). The median thymic volume in the low ratio subgroup was significantly higher (14.7 cm3 vs. 4.5 cm3, p < 0.001). This was associated with a better OS and lower transplant-related mortality (TRM) (80.4% vs. 58.0%, p = 0.031) and (13.1% vs. 33.0%, p = 0.035). An individualized approach to ATG dosing allows for the obtainment of rapid thymic reconstitution and the best transplant-related outcomes. [ABSTRACT FROM AUTHOR]

Published
2023
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2. New Applications of JAK/STAT Inhibitors in Pediatrics: Current Use of Ruxolitinib

Author

Annalisa Marcuzzi, Erika Rimondi, Elisabetta Melloni, Arianna Gonelli, Antonio Giacomo Grasso, Egidio Barbi, Natalia Maximova, Marcuzzi, Annalisa, Rimondi, Erika, Melloni, Elisabetta, Gonelli, Arianna, Grasso, Antonio Giacomo, Barbi, Egidio, and Maximova, Natalia

Subjects
pediatrics, ruxolitinib, GVHD, Pharmaceutical Science, Janus kinase, cytokines, inflammation, NO, pediatric, Drug Discovery, cytokine, Molecular Medicine
Abstract

Janus kinases (JAK) are a family of tyrosine kinases (JAK1, JAK2, JAK3, and TYK2) that transduce cytokine-mediated signals through the JAK–STAT metabolic pathway. These kinases act by regulating the transcription of specific genes capable of inducing biological responses in several immune cell subsets. Inhibition of Janus kinases interferes with the JAK–STAT signaling pathway. Besides being used in the treatment of cancer and inflammatory diseases, in recent years, they have also been used to treat inflammatory conditions, such as graft-versus-host disease (GVHD) and cytokine release syndrome as complications of allogeneic hematopoietic stem cell transplantation and cell therapy. Recently, the FDA approved the use of ruxolitinib, a JAK1/2 inhibitor, in the treatment of acute steroid-refractory GVHD (SR-aGVHD), highlighting the role of JAK inhibition in this immune deregulation. Ruxolitinib was initially used to treat myelofibrosis and true polycythemia in a high-dose treatment and caused hematological toxicity. Since a lower dosage often could not be effective, the use of ruxolitinib was suspended. Subsequently, ruxolitinib was evaluated in adult patients with SR-aGVHD and was found to achieve a rapid and effective response. In addition, its early low-dose use in pediatric patients affected by GVHD has proved effective, safe, and reasonably preventive. The review aims to describe the potential properties of ruxolitinib to identify new therapeutic strategies.

Published
2022

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