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2. IgM-secreting diffuse large B-cell lymphoma: results of a multicentre clinicopathological and molecular study

Author

Cox, M. Christina, Marcheselli, Luigi, Scafetta, Giorgia, Visco, Carlo, Hohaus, Stefan, Annibali, Ombretta, Musuraca, Gerardo, Fabbri, Alberto, Cantonetti, Maria, Pelliccia, Sabrina, Papotti, Robel, Petrucci, Luigi, Tani, Monica, Battistini, Roberta, Arcari, Annalisa, Luminari, Stefano, Lopez, Gianluca, Alma, Eleonora, Pupo, Livio, Carli, Giuseppe, Marchesi, Francesco, Re, Francesca, Scarpino, Stefania, D’amore, Emanuele S. G., Larocca, Luigi M., Bianchi, Antonella, Pepe, Giuseppina, Natalino, Fiammetta, Anticoli-Borza, Paola, Cenfra, Natalia, Andriani, Alessandro, Abruzzese, Elisabetta, Tesei, Cristiano, Leoncini, Lorenzo, Asioli, Silvia, Ruco, Luigi, and Di Napoli, Arianna

Published
2022
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3. The outcome of patients with Hodgkin lymphoma and early relapse after autologous stem cell transplant has improved in recent years

Author

Bazarbachi, Ali, Boumendil, Ariane, Finel, Hervé, Khvedelidze, Irma, Romejko-Jarosinska, Joanna, Tanase, Alina, Akhtar, Saad, Ben Othman, Tarek, Ma’koseh, Mohammad, Afanasyev, Boris, Cheikh, Jean, Briones, Javier, Gülbas, Zafer, Hamladji, Rose-Marie, Elverdi, Tugrul, Blaise, Didier, Martínez, Carmen, Alma, Eleonora, Halaburda, Kazimierz, Sousa, Aida Botelho, Glass, Bertram, Robinson, Steven, Montoto, Silvia, and Sureda, Anna

Published
2022
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4. Risk of SARS-CoV-2 infection in patients with hematologic diseases receiving tixagevimab/cilgavimab as pre-exposure prophylaxis in most recent Omicron sublineages era

Author

Vergori, Alessandra, primary, Lepri, Alessandro Cozzi, additional, Chiuchiarelli, Marta, additional, Mazzotta, Valentina, additional, Metafuni, Elisabetta, additional, Matusali, Giulia, additional, Siciliano, Valentina, additional, Paulicelli, Jessica, additional, Alma, Eleonora, additional, Siniscalchi, Agostina, additional, Sica, Simona, additional, Abruzzese, Elisabetta, additional, Fantoni, Massimo, additional, Antinori, Andrea, additional, and Cingolani, Antonella, additional

Published
2024
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5. Novel Targets and Advanced Therapies in Diffuse Large B Cell Lymphomas.

Author

D'Alò, Francesco, Bellesi, Silvia, Maiolo, Elena, Alma, Eleonora, Bellisario, Flaminia, Malafronte, Rosalia, Viscovo, Marcello, Campana, Fabrizia, and Hohaus, Stefan

Subjects
THERAPEUTIC use of antineoplastic agents, THERAPEUTIC use of monoclonal antibodies, INVESTIGATIONAL drugs, CANCER chemotherapy, IMMUNE checkpoint inhibitors, B cell lymphoma, CELL receptors
Abstract

Simple Summary: Diffuse large B cell lymphoma is the most common type of B cell neoplasm, and can be cured by traditional chemoimmunotherapy in 60–70% of cases. Relapsed/refractory patients usually have a dismal prognosis and most of them finally succumb to lymphoma. In the last decade, several new innovative therapies have been approved against DLBCL, targeting both surface antigens and the intracellular pathways of neoplastic B cells. Compared to standard chemotherapy, new monoclonal antibodies and engineered T cells have shown an increased response rate, progression-free survival and overall survival, but, on the other side of the coin, patients have been experiencing new kinds of toxicities, previously unknown, that clinicians have been learning to manage. Here, we review new drugs that are already approved or under investigation for DLBCL and the corresponding molecular target on lymphoma cells. Since the introduction of rituximab in the late 1990s, significant progress has been made in advancing targeted therapies for B cell lymphomas, improving patients' chance of being cured and clinicians' therapeutic armamentarium. A better understanding of disease biology and pathogenic pathways, coupled with refinements in immunophenotypic and molecular diagnostics, have been instrumental in these achievements. While traditional chemotherapy remains fundamental in most cases, concerns surrounding chemorefractoriness and cumulative toxicities, particularly the depletion of the hemopoietic reserve, underscore the imperative for personalized treatment approaches. Integrating targeted agents, notably monoclonal antibodies, alongside chemotherapy has yielded heightened response rates and prolonged survival. A notable paradigm shift is underway with innovative-targeted therapies replacing cytotoxic drugs, challenging conventional salvage strategies like stem cell transplantation. This review examines the landscape of emerging targets for lymphoma cells and explores innovative therapies for diffuse large B cell lymphoma (DLBCL). From Chimeric Antigen Receptor-T cells to more potent monoclonal antibodies, antibody–drug conjugates, bispecific antibodies, checkpoint inhibitors, and small molecules targeting intracellular pathways, each modality offers promising avenues for therapeutic advancement. This review aims to furnish insights into their potential implications for the future of DLBCL treatment strategies. [ABSTRACT FROM AUTHOR]

Published
2024
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6. Correction: The outcome of patients with Hodgkin lymphoma and early relapse after autologous stem cell transplant has improved in recent years

Author

Bazarbachi, Ali, Boumendil, Ariane, Finel, Hervé, Khvedelidze, Irma, Romejko-Jarosinska, Joanna, Tanase, Alina, Akhtar, Saad, Ben Othman, Tarek, Ma’koseh, Mohammad, Afanasyev, Boris, El-Cheikh, Jean, Briones, Javier, Gülbas, Zafer, Hamladji, Rose-Marie, Elverdi, Tugrul, Blaise, Didier, Martínez, Carmen, Alma, Eleonora, Halaburda, Kazimierz, Sousa, Aida Botelho, Glass, Bertram, Robinson, Steven, Montoto, Silvia, and Sureda, Anna

Published
2022
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7. Endoscopic Ultrasound-Guided Fine Needle Biopsy in the Diagnostic Work-Up of Deep-Seated Lymphadenopathies and Spleen Lesions: A Monocentric Experience

Author

Bellisario, Flaminia, primary, Attili, Fabia, additional, Campana, Fabrizia, additional, Borrelli de Andreis, Federica, additional, Bellesi, Silvia, additional, Maiolo, Elena, additional, Alma, Eleonora, additional, Malafronte, Rosalia, additional, Macis, Giuseppe, additional, Larocca, Luigi Maria, additional, Annunziata, Salvatore, additional, D’Alò, Francesco, additional, and Hohaus, Stefan, additional

Published
2023
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8. P1380: THE COMPOSITION OF INFUSED CD19-CAR-T PRODUCT IMPACTS ON EFFICACY

Author

Bellesi, Silvia, primary, Galli, Eugenio, additional, Cesare, Giacomo DI, additional, Iacovelli, Camilla, additional, Pansini, Ilaria, additional, Maiolo, Elena, additional, Alma, Eleonora, additional, Malafronte, Rosalia, additional, Bellisario, Flaminia, additional, Alò, Francesco D’, additional, Bianchi, Maria, additional, Piccirillo, Nicola, additional, Chiusolo, Patrizia, additional, Sica, Simona, additional, Sorà, Federica, additional, and Hohaus, Stefan, additional

Published
2023
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9. P1091: CLINICAL IMPLICATIONS OF T CELL SUBSET COMPOSITION DURING MAINTENANCE THERAPY AFTER FIRST-LINE IMMUNOCHEMOTHERAPY CONTAINING BENDAMUSTINE IN PATIENTS WITH FOLLICULAR LYMPHOMA

Author

Malafronte, Rosalia, primary, Bellesi, Silvia, additional, Maiolo, Elena, additional, Iacovelli, Camilla, additional, Campana, Fabrizia, additional, Fatone, Federica, additional, Bellisario, Flaminia, additional, Alma, Eleonora, additional, Alò, Francesco D’, additional, and Hohaus, Stefan, additional

Published
2023
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10. Safety and efficacy of SARS‐Cov2 neutralizing monoclonal antibodies after stem cell transplant or CAR‐T cell infusion

Author

Metafuni, Elisabetta, primary, Cingolani, Antonella, additional, Fantoni, Massimo, additional, Chiusolo, Patrizia, additional, Giammarco, Sabrina, additional, Sorà, Federica, additional, Galli, Eugenio, additional, Hohaus, Stefan, additional, D’Alò, Francesco, additional, Bellesi, Silvia, additional, Maiolo, Elena, additional, Alma, Eleonora, additional, Laurenti, Luca, additional, Innocenti, Idanna, additional, Autore, Francesco, additional, Limongiello, Maria Assunta, additional, Santangelo, Rosaria, additional, Marchetti, Simona, additional, Ricci, Rosalba, additional, and Sica, Simona, additional

Published
2023
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11. Multicolor flow cytometry on pericardial effusion for a prompt diagnosis and treatment of hematological malignancies with heart involvement

Author

Cappannoli, Luigi, primary, Imazio, Massimo, additional, Hohaus, Stefan, additional, Saponara, Gianluigi, additional, D’Amario, Domenico, additional, Bellesi, Silvia, additional, Maiolo, Elena, additional, Viscovo, Marcello, additional, Fatone, Federica, additional, Alma, Eleonora, additional, D’Alò, Francesco, additional, Crea, Filippo, additional, and Sanna, Tommaso, additional

Published
2022
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13. Safety and efficacy of SARS-Cov2 neutralizing monoclonal antibodies after stem cell transplant or CAR-T cell infusion

Author

Metafuni, Elisabetta, Cingolani, Antonella, Fantoni, Massimo, Chiusolo, Patrizia, Giammarco, Sabrina, Sorà, Federica, Galli, Eugenio, Hohaus, Stefan, D'Alò, Francesco, Bellesi, Silvia, Maiolo, Elena, Alma, Eleonora, Laurenti, Luca, Innocenti, Idanna, Autore, Francesco, Limongiello, Maria Assunta, Santangelo, Rosaria, Marchetti, Simona, Ricci, Rosalba, Sica, Simona, Cingolani, Antonella (ORCID:0000-0002-3793-2755), Fantoni, Massimo (ORCID:0000-0001-6913-8460), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Hohaus, Stefan (ORCID:0000-0002-5534-7197), Laurenti, Luca (ORCID:0000-0002-8327-1396), Santangelo, Rosaria (ORCID:0000-0002-8056-218X), Metafuni, Elisabetta, Cingolani, Antonella, Fantoni, Massimo, Chiusolo, Patrizia, Giammarco, Sabrina, Sorà, Federica, Galli, Eugenio, Hohaus, Stefan, D'Alò, Francesco, Bellesi, Silvia, Maiolo, Elena, Alma, Eleonora, Laurenti, Luca, Innocenti, Idanna, Autore, Francesco, Limongiello, Maria Assunta, Santangelo, Rosaria, Marchetti, Simona, Ricci, Rosalba, Sica, Simona, Cingolani, Antonella (ORCID:0000-0002-3793-2755), Fantoni, Massimo (ORCID:0000-0001-6913-8460), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Hohaus, Stefan (ORCID:0000-0002-5534-7197), Laurenti, Luca (ORCID:0000-0002-8327-1396), and Santangelo, Rosaria (ORCID:0000-0002-8056-218X)

Abstract

NA

Published
2022

14. PD-L1 expression in peripheral blood granulocytes at diagnosis as prognostic factor in classical Hodgkin lymphoma

Author

Cuccaro, Annarosa, Bellesi, Silvia, Galli, Eugenio, Zangrilli, I., Corrente, Francesco, Cupelli, Elisa, Fatone, Federica, Maiolo, E., Alma, Eleonora, Viscovo, Marcello, D'Alo, F., Annunziata, Salvatore, Martini, M., Rufini, Vittoria, Giordano, Alessandro, De Stefano, Valerio, Larocca, Luigi Maria, Hohaus, Stefan, Cuccaro A., Bellesi S., Galli E., Corrente F., Cupelli E., Fatone F., Alma E., Viscovo M., Annunziata S. (ORCID:0000-0003-3241-1501), Rufini V. (ORCID:0000-0002-2052-8078), Giordano A. (ORCID:0000-0002-6978-0880), De Stefano V. (ORCID:0000-0002-5178-5827), Larocca L. M. (ORCID:0000-0003-1739-4758), Hohaus S. (ORCID:0000-0002-5534-7197), Cuccaro, Annarosa, Bellesi, Silvia, Galli, Eugenio, Zangrilli, I., Corrente, Francesco, Cupelli, Elisa, Fatone, Federica, Maiolo, E., Alma, Eleonora, Viscovo, Marcello, D'Alo, F., Annunziata, Salvatore, Martini, M., Rufini, Vittoria, Giordano, Alessandro, De Stefano, Valerio, Larocca, Luigi Maria, Hohaus, Stefan, Cuccaro A., Bellesi S., Galli E., Corrente F., Cupelli E., Fatone F., Alma E., Viscovo M., Annunziata S. (ORCID:0000-0003-3241-1501), Rufini V. (ORCID:0000-0002-2052-8078), Giordano A. (ORCID:0000-0002-6978-0880), De Stefano V. (ORCID:0000-0002-5178-5827), Larocca L. M. (ORCID:0000-0003-1739-4758), and Hohaus S. (ORCID:0000-0002-5534-7197)

Abstract

Hodgkin lymphoma (HL) is a neoplastic disease in which the inflammatory microenvironment plays a pivotal role in the tumorigenesis. Neutrophilia is a typical finding in HL at diagnosis and, in particular, in association with lymphocytopenia, is a negative prognostic factor. As the immune checkpoint Programmed Death (PD)-L1/PD-1 has become an important therapeutic target, we were interested in the expression of PD-L1 in peripheral blood (PB) leukocytes using flow cytometry and RT-PCR in patients with HL and healthy controls. Granulocytes were the major PB cell fraction expressing PD-L1. PD-L1 expression on granulocytes was higher in patients with HL than in controls and correlated with lower T-cell numbers in PB. We analyzed for associations between PD-L1 expression in PB granulocytes at the time of diagnosis with patient characteristics and outcome in 126 patients with HL treated with standard chemotherapy adriamycin, bleomycin, vinblastine, and dacarbazine. Increased PD-L1 expression in PB associated with advanced disease, systemic symptoms, positive interim positron emission tomography, and inferior progression-free survival (PFS). PFS at 4 years was 81% (95% C.I., 71–87%) in patients with normal PD-L1 expression and 56% (95% C.I., 35–72%) in patients with higher-than-normal PD-L1 expression (p = 0.002). In conclusion, PD-L1 expression in PB could become a potentially actionable prognostic factor in HL.

Published
2022

15. Anti CD20-based immunochemotherapy abolishes antibody response to Covid-19 mRNA vaccine in lymphoma patients vaccinated during active first line treatment

Author

Bellesi, Silvia, Sali, Michela, Maiolo, Maria Elisa, Pereyra Boza, Maria Del Carmen, Alma, Eleonora, Palucci, Ivana, Fatone, Federica, De Maio, Flavio, Viscovo, Marcello, D'Alo, F., De Stefano, Valerio, Hohaus, Stefan, Sanguinetti, Maurizio, Bellesi S., Sali M. (ORCID:0000-0003-3609-2990), Maiolo E., Pereyra Boza M. D. C., Alma E., Palucci I., Fatone F., De Maio F., Viscovo M., De Stefano V. (ORCID:0000-0002-5178-5827), Hohaus S. (ORCID:0000-0002-5534-7197), Sanguinetti M. (ORCID:0000-0002-9780-7059), Bellesi, Silvia, Sali, Michela, Maiolo, Maria Elisa, Pereyra Boza, Maria Del Carmen, Alma, Eleonora, Palucci, Ivana, Fatone, Federica, De Maio, Flavio, Viscovo, Marcello, D'Alo, F., De Stefano, Valerio, Hohaus, Stefan, Sanguinetti, Maurizio, Bellesi S., Sali M. (ORCID:0000-0003-3609-2990), Maiolo E., Pereyra Boza M. D. C., Alma E., Palucci I., Fatone F., De Maio F., Viscovo M., De Stefano V. (ORCID:0000-0002-5178-5827), Hohaus S. (ORCID:0000-0002-5534-7197), and Sanguinetti M. (ORCID:0000-0002-9780-7059)

Abstract

N/A

Published
2022

16. DLBCL with an associated IgM serum paraprotein (IgMs- DLBCL) has poor prognosis and frequent mutations in MYD88, CD79B and TP53 genes

Author

Cox, Maria Christina, primary, Marcheselli, Luigi, additional, Scafetta, Giorgia, additional, Visco, Carlo, additional, Hohaus, Stefan, additional, Annibali, Ombretta, additional, Musuraca, Gerardo, additional, Fabbri, Alberto, additional, Cantonetti, Maria, additional, Pelliccia, Sabrina, additional, Papotti, Robel, additional, Petrucci, Luigi, additional, Tani, Monica, additional, Battistini, Roberta, additional, Arcari, Annalisa, additional, Luminari, Stefano, additional, Lopez, Gianluca, additional, Alma, Eleonora, additional, Pupo, Livio, additional, Carli, Giuseppe, additional, Marchesi, Francesco, additional, Re, Francesca, additional, Scarpino, Stefania, additional, D’amore, Emanuele, additional, Larocca, Luigi M, additional, Bianchi, Antonella, additional, Pepe, Giuseppina, additional, Natalino, Fiammetta, additional, Anticoli-Borza, Paola, additional, Cenfra, Natalia, additional, Andriani, Alessandro, additional, Abruzzese, Elisabetta, additional, Tesei, Cristiano, additional, Leoncini, Lorenzo, additional, Asioli, Silvia, additional, Ruco, Luigi, additional, and Napoli, Arianna Di, additional

Published
2022
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17. Anti CD20-based immunochemotherapy abolishes antibody response to Covid-19 mRNA vaccine in lymphoma patients vaccinated during active first line treatment

Author

Bellesi, Silvia, primary, Sali, Michela, additional, Maiolo, Elena, additional, Pereyra Boza, Maria del Carmen, additional, Alma, Eleonora, additional, Palucci, Ivana, additional, Fatone, Federica, additional, De Maio, Flavio, additional, Viscovo, Marcello, additional, D’Alò, Francesco, additional, De Stefano, Valerio, additional, Hohaus, Stefan, additional, and Sanguinetti, Maurizio, additional

Published
2022
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18. PD-L1 expression in peripheral blood granulocytes at diagnosis as prognostic factor in classical Hodgkin lymphoma

Author

Cuccaro, Annarosa, primary, Bellesi, Silvia, additional, Galli, Eugenio, additional, Zangrilli, Ilaria, additional, Corrente, Francesco, additional, Cupelli, Elisa, additional, Fatone, Federica, additional, Maiolo, Elena, additional, Alma, Eleonora, additional, Viscovo, Marcello, additional, D'Alò, Francesco, additional, Annunziata, Salvatore, additional, Martini, Maurizio, additional, Rufini, Vittoria, additional, Giordano, Alessandro, additional, De Stefano, Valerio, additional, Larocca, Luigi Maria, additional, and Hohaus, Stefan, additional

Published
2022
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21. Days alive outside hospital and readmissions in patients undergoing allogeneic transplants from identical siblings or alternative donors

Author

Sora', Federica, Chiusolo, Patrizia, Laurenti, Luca, Innocenti, Idanna, Autore, Francesco, Giammarco, S., Metafuni, Elisabetta, Alma, Eleonora, Di Giovanni, Alessia, Sica, Simona, Bacigalupo, Andrea, Sora F. (ORCID:0000-0002-9607-5298), Chiusolo P. (ORCID:0000-0002-1355-1587), Laurenti L. (ORCID:0000-0002-8327-1396), Innocenti I., Autore F., Metafuni E., Alma E., Di Giovanni A., Sica S. (ORCID:0000-0003-2426-3465), Bacigalupo A. (ORCID:0000-0002-9119-567X), Sora', Federica, Chiusolo, Patrizia, Laurenti, Luca, Innocenti, Idanna, Autore, Francesco, Giammarco, S., Metafuni, Elisabetta, Alma, Eleonora, Di Giovanni, Alessia, Sica, Simona, Bacigalupo, Andrea, Sora F. (ORCID:0000-0002-9607-5298), Chiusolo P. (ORCID:0000-0002-1355-1587), Laurenti L. (ORCID:0000-0002-8327-1396), Innocenti I., Autore F., Metafuni E., Alma E., Di Giovanni A., Sica S. (ORCID:0000-0003-2426-3465), and Bacigalupo A. (ORCID:0000-0002-9119-567X)

Abstract

We have studied the number of days alive outside the Hospital (DAOH) and the number of readmissions within the first 100 days after transplant in 185 patients who received an allogeneic hemopoietic stem cell transplant (HSCT). The donors were matched siblings (SIB; n=61), or alternative donors (ALT; n=124). The median number of DAOH for SIB transplants (78 days, range 21-84) was significantly greater than DAOH for ALT donor grafts (73 days, range 2-87) (p=0.0003). Other positive predictors of DAOH were the use of reduced-intensity regimens (p=0.01), grade 0-I acute graft versus host disease (GvHD) (p=0.0006), and a comorbidity index equal or less than two (p=0.04). Fifty-one patients required readmission (22%), which was predicted by grade II-IV acute GvHD (p=0.009), higher comorbidity index (p=0.06), and ALT donors as compared to SIBS (p=0.08). The CI of readmission was 18% (95%CI 10-31) for SIB and 30% (95%CI 23-39) for ALT donor grafts. The non relapse mortality (NRM) for patients readmitted was 25% (95%CI 15-43%), compared to 5% (95%CI 2-12%) for patients not readmitted (p=0.0001). In a multivariate analysis, readmission was the strongest predictor of non-relapse mortality (NRM) (HR 2.0) (p=0.0006) and survival (HR 3.4) (p<0.0001). In conclusion: ALT donor transplants have lower numbers of DAOH, as compared to SIB grafts, which implies longer stay in hospital and higher costs. Readmission to hospital within 100 days, is predicted by acute GvHD, comorbidity index, donor type, and has a significant strong impact on non-relapse mortality and survival.

Published
2020

22. SARS CoV 2 infection in chronic myelogenous leukemia: Severe hematological presentation

Author

Sora', Federica, Chiusolo, Patrizia, Laurenti, Luca, Innocenti, Idanna, Autore, Francesco, Alma, Eleonora, Viscovo, Marcello, Fusco, Domernico, Maresca, Maddalena, Tumbarello, Mario, Sica, Simona, Sorà, Federica (ORCID:0000-0002-9607-5298), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Laurenti, Luca (ORCID:0000-0002-8327-1396), Tumbarello, Mario (ORCID:0000-0002-9519-8552), Sica, Simona (ORCID:0000-0003-2426-3465), Sora', Federica, Chiusolo, Patrizia, Laurenti, Luca, Innocenti, Idanna, Autore, Francesco, Alma, Eleonora, Viscovo, Marcello, Fusco, Domernico, Maresca, Maddalena, Tumbarello, Mario, Sica, Simona, Sorà, Federica (ORCID:0000-0002-9607-5298), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Laurenti, Luca (ORCID:0000-0002-8327-1396), Tumbarello, Mario (ORCID:0000-0002-9519-8552), and Sica, Simona (ORCID:0000-0003-2426-3465)

Abstract

N/A

Published
2020

23. Venous Thromboembolism in Lymphoma: Risk Stratification and Antithrombotic Prophylaxis

Author

Hohaus, Stefan, Bartolomei, Francesca, Cuccaro, Annarosa, Maiolo, Elena, Alma, Eleonora, D'Alo', Francesco, Bellesi, Silvia, Rossi, Elena, De Stefano, Valerio, Stefan Hohaus (ORCID:0000-0002-5534-7197), Francesca Bartolomei, Annarosa Cuccaro, Elena Maiolo, Eleonora Alma, Francesco D'Alò (ORCID:0000-0003-3576-8522), Silvia Bellesi, Elena Rossi (ORCID:0000-0002-7572-9379), Valerio De Stefano (ORCID:0000-0002-5178-5827), Hohaus, Stefan, Bartolomei, Francesca, Cuccaro, Annarosa, Maiolo, Elena, Alma, Eleonora, D'Alo', Francesco, Bellesi, Silvia, Rossi, Elena, De Stefano, Valerio, Stefan Hohaus (ORCID:0000-0002-5534-7197), Francesca Bartolomei, Annarosa Cuccaro, Elena Maiolo, Eleonora Alma, Francesco D'Alò (ORCID:0000-0003-3576-8522), Silvia Bellesi, Elena Rossi (ORCID:0000-0002-7572-9379), and Valerio De Stefano (ORCID:0000-0002-5178-5827)

Abstract

Lymphoma is listed among the neoplasias with a high risk of venous thromboembolism (VTE). Risk factors for VTE appear to differ from risk factors in solid tumors. We review the literature of the last 20 years for reports identifying these risk factors in cohorts consisting exclusively of lymphoma patients. We selected 25 publications. The most frequent studies were analyses of retrospective single-center cohorts. We also included two reports of pooled analyses of clinical trials, two meta-analyses, two analyses of patient registries, and three analyses of population-based databases. The VTE risk is the highest upfront during the first two months after lymphoma diagnosis and decreases over time. This upfront risk may be related to tumor burden and the start of chemotherapy as contributing factors. Factors consistently reported as VTE risk factors are aggressive histology, a performance status ECOG ≥ 2 leading to increased immobility, more extensive disease, and localization to particular sites, such as central nervous system (CNS) and mediastinal mass. Association between laboratory values that are part of risk assessment models in solid tumors and VTE risk in lymphomas are very inconsistent. Recently, VTE risk scores for lymphoma were developed that need further validation, before they can be used for risk stratification and primary prophylaxis. Knowledge of VTE risk factors in lymphomas may help in the evaluation of the individual risk-benefit ratio of prophylaxis and help to design prospective studies on primary prophylaxis in lymphoma.

Published
2020

25. Evolution of Outcome over Time for Relapsed Hodgkin Lymphoma after Autologous Stem Cell Transplant: Improved Survival for Early Relapse in Recent Years

Author

Bazarbachi, Ali, primary, Boumendil, Ariane, additional, Finel, Hervé, additional, Khvedelidze, Irma, additional, Romejko-Jarosinska, Joanna, additional, Tanase, Alina Daniela, additional, Akhtar, Saad, additional, Ben Othman, Tarek, additional, Tbakhi, Abdelghani, additional, Afanasyev, Boris, additional, Briones, Javier, additional, Gülbas, Zafer, additional, Elcheikh, Jean, additional, Hamladji, Rose-Marie, additional, Elverdi, Tugrul, additional, Blaise, Didier, additional, Martinez, Carmen, additional, Alma, Eleonora, additional, Halaburda, Kazimierz, additional, Botelho de Sousa, Aida, additional, Glass, Bertram, additional, Robinson, Stephen, additional, Montoto, Silvia, additional, and Sureda Balari, Anna, additional

Published
2020
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26. IgM-Secreting Diffuse Large B-Cell Lymphoma (DLBCL) Is a Poor Prognostic Subset within the Non-Germinal-Centre-Type (GC-type): An Italian Multicentre Study

Author

Cox, M. Christina, primary, Marcheselli, Luigi, additional, Musuraca, Gerardo, additional, Cantonetti, Maria, additional, Visco, Carlo, additional, Hohaus, Stefan, additional, Annibali, Ombretta, additional, Fabbri, Alberto, additional, Tani, Monica, additional, Luminari, Stefano, additional, Battistini, Roberta, additional, Petrucci, Luigi, additional, Re, Francesca, additional, Marchesi, Francesco, additional, Anticoli Borza, Paola, additional, Natalino, Fiammetta, additional, Abruzzese, Elisabetta, additional, Pelliccia, Sabrina, additional, Mammoli, Fabiana, additional, Pupo, Livio, additional, Carli, Giuseppe, additional, Alma, Eleonora, additional, Tomarchio, Valeria, additional, Cencini, Emanuele, additional, Fabbri, Francesca, additional, Meconi, Federico, additional, D'Amore, Emanuele, additional, Larocca, Luigi Maria, additional, Asioli, Silvia, additional, Scafetta, Giorgia, additional, Tesei, Cristiano, additional, Ruco, Luigi, additional, and Di Napoli, Arianna, additional

Published
2020
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28. DAYS ALIVE OUTSIDE HOSPITAL AND RE-ADMISSIONS IN PATIENTS UNDERGOING ALLOGENEIC TRANSPLANTS FROM IDENTICAL SIBLINGS, UNRELATED DONORS OR HAPLOIDENTICAL DONORS “.

Author

Sorà, Federica, primary, Chiusolo, Patrizia, additional, Laurenti, Luca, additional, Innocenti, Idanna, additional, Autore, Francesco, additional, Giammarco, Sabrina, additional, Metafuni, Elisabetta, additional, Alma, Eleonora, additional, Di giovanni, Alessia, additional, Sica, Simona, additional, and Bacigalupo, Andrea, additional

Published
2020
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31. The prognostic impact of monoclonal immune globulin and free light chain secretion in diffuse large B cell lymphoma (DLBCL)

Author

Maiolo, Elena, primary, Alma, Eleonora, additional, Napodano, Cecilia, additional, Gulli, Francesca, additional, Bellesi, Silvia, additional, Cuccaro, Annarosa, additional, Pocino, Krizia, additional, D’Alo’, Francesco, additional, Iachini, Marco, additional, Martini, Maurizio, additional, Larocca, Luigi Maria, additional, De Stefano, Valerio, additional, Basile, Umberto, additional, and Hohaus, Stefan, additional

Published
2019
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32. Outcome of Patients with Hodgkin Lymphoma Treated with Brentuximab Vedotin for Relapse after Autologous Stem Cell Transplant: A Retrospective Analysis of the LWP-EBMT

Author

Chavda, Nikesh Dhiraj, primary, Robinson, Stephen, additional, Boumendil, Ariane, additional, Khvedelidze, Irma, additional, Finel, Hervé, additional, Akhtar, Saad, additional, Rauf, M S, additional, Durakovic, Nadira, additional, Vrhovac, Radovan, additional, Musso, Maurizio, additional, Brice, Pauline, additional, Arat, Mutlu, additional, Blaise, Didier, additional, Collin, Matthew P., additional, Romejko-Jarosinska, Joanna, additional, Stamatoullas, Aspasia, additional, Ozkurt, Zubeyde Nur, additional, Robak, Tadeusz, additional, Wahlin, Björn E, additional, Wilson, Keith, additional, Alma, Eleonora, additional, Pastano, Rocco, additional, Castagna, Luca, additional, Bazarbachi, Ali, additional, Ghesquieres, Hervé, additional, Colita, Andrei, additional, and Montoto, Silvia, additional

Published
2019
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33. The neutrophil/lymphocyte ratio ≥3.5 is a prognostic marker in diffuse large B-cell lymphoma: a retrospective analysis from the database of the Italian regional network ‘Rete Ematologica del Lazio per i Linfomi’ (RELLI)

Author

Annibali, Ombretta, primary, Hohaus, Stefan, additional, Marchesi, Francesco, additional, Cantonetti, Maria, additional, Di Rocco, Alice, additional, Tomarchio, Valeria, additional, Di Napoli, Arianna, additional, Pelliccia, Sabrina, additional, Battistini, Roberta, additional, Anticoli Borza, Paola, additional, Abruzzese, Elisabetta, additional, Cenfra, Natalia, additional, Andriani, Alessandro, additional, Tesei, Cristiano, additional, Alma, Eleonora, additional, Palombi, Francesca, additional, Pupo, Livio, additional, Petrucci, Luigi, additional, Becilli, Marco, additional, Maiolo, Elena, additional, Bellesi, Silvia, additional, Cuccaro, Annarosa, additional, D’Alò, Francesco, additional, and Cox, Maria Christina, additional

Published
2019
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34. Vitamin D deficiency and supplementation in patients with aggressive B-cell lymphomas treated with immunochemotherapy

Author

Hohaus, Stefan, Tisi, Maria Chiara, Bellesi, Silvia, Maiolo, Elena, Alma, Eleonora, Tartaglia, Germana, Corrente, Francesco, Cuccaro, Annarosa, D'Alo', Francesco, Basile, Umberto, Larocca, Luigi Maria, De Stefano, Valerio, Hohaus, Stefan (ORCID:0000-0002-5534-7197), D'Alo', Francesco (ORCID:0000-0003-3576-8522), Larocca, Luigi Maria (ORCID:0000-0003-1739-4758), De Stefano, Valerio (ORCID:0000-0002-5178-5827), Hohaus, Stefan, Tisi, Maria Chiara, Bellesi, Silvia, Maiolo, Elena, Alma, Eleonora, Tartaglia, Germana, Corrente, Francesco, Cuccaro, Annarosa, D'Alo', Francesco, Basile, Umberto, Larocca, Luigi Maria, De Stefano, Valerio, Hohaus, Stefan (ORCID:0000-0002-5534-7197), D'Alo', Francesco (ORCID:0000-0003-3576-8522), Larocca, Luigi Maria (ORCID:0000-0003-1739-4758), and De Stefano, Valerio (ORCID:0000-0002-5178-5827)

Abstract

Vitamin D deficiency has been reported to be a negative prognostic factor in elderly patients with aggressive B-cell lymphomas. In vitro data suggest that vitamin D supplementation may enhance rituximab-mediated cytotoxicity. We prospectively assessed 25-hydroxyvitamin D [25(OH)D] levels at diagnosis in a cohort of 155 patients with aggressive B-cell lymphomas of whom 128 had diffuse large B-cell lymphoma (DLBCL) not otherwise specified. 25(OH)D levels were deficient (<20 ng/mL) in 105 (67%), insufficient (20–29 ng/mL) in 32 (21%), and normal (≥30 ng/mL) in 18 (12%) patients with a seasonal variation. Patient characteristics associated with lower 25(OH)D levels were poor performance status, overweight, B-symptoms, elevated LDH, lower albumin and hemoglobin levels. As a result of a change in practice pattern, 116 patients received vitamin D3 (cholecalciferol) supplementation that included a loading phase with daily replacement and subsequent maintenance phase with a weekly dose of 25,000 IU until end of treatment. This resulted in a significant increase in 25(OH)D levels, with normalization in 56% of patients. We analyzed the impact of 25(OH)D levels on event-free survival in patients treated with Rituximab-CHOP. 25(OH)D levels below 20 ng/mL at diagnosis and IPI were independently associated with inferior EFS. Moreover, patients with normalized 25(OH)D levels following supplementation showed better EFS than patients with persistently deficient/insufficient 25(OH)D levels. Our study provides the first evidence that achievement of normal 25(OH)D levels after vitamin D3 supplementation is associated with improved outcome in patients with DLBCL and deficient/insufficient 25(OH)D levels when receiving rituximab-based treatment.

Published
2018

35. The prognostic impact of monoclonal immune globulin and free light chain secretion in diffuse large B cell lymphoma (DLBCL).

Author

Maiolo, Elena, Alma, Eleonora, Napodano, Cecilia, Gulli, Francesca, Bellesi, Silvia, Cuccaro, Annarosa, Pocino, Krizia, D'Alo', Francesco, Iachini, Marco, Martini, Maurizio, Larocca, Luigi Maria, De Stefano, Valerio, Basile, Umberto, and Hohaus, Stefan

Subjects
*B cells, *GLOBULINS, *BLOOD proteins, *LYMPHOMAS, *SECRETION
Abstract

We analyzed the prognostic impact of levels of free light chains (FLC) in 106 patients with DLBCL, selecting 61 patients with a monoclonal (M) protein in serum, and 45 patients without a M protein as an IPI-matched control group. Patients with a M protein had higher levels of FLC, but these were not of prognostic significance in this group. The presence of a M protein nullified associations of κ-FLC with several laboratory parameters indicating immune system activation observed in patients without a M protein. Patients without M protein and κ-FLC >50 mg/L had a significant inferior event-free survival (p =.004). The presence of M protein of an IgM type at diagnosis was a negative outcome predictor (p =.008), while a non-IgM M protein did not significantly impact on prognosis. In conclusion, the prognostic performance of the FLC assay is altered by the presence of a M protein. [ABSTRACT FROM AUTHOR]

Published
2020
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36. Vitamin D deficiency and supplementation in patients with aggressive B‐cell lymphomas treated with immunochemotherapy

Author

Hohaus, Stefan, primary, Tisi, Maria Chiara, additional, Bellesi, Silvia, additional, Maiolo, Elena, additional, Alma, Eleonora, additional, Tartaglia, Germana, additional, Corrente, Francesco, additional, Cuccaro, Annarosa, additional, D'Alo', Francesco, additional, Basile, Umberto, additional, Larocca, Luigi Maria, additional, and De Stefano, Valerio, additional

Published
2017
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38. The Neutrophil/Lymphocyte Ratio (N/L) Is a Prognostic Marker in Patients with Diffuse Large B Cell Lymphoma: A Prospective Study from the Lazio Lymphoma Registry

Author

Annibali, Ombretta, primary, Hohaus, Stefan, additional, Tomarchio, Valeria, additional, Anticoli Borza, Paola, additional, Cantonetti, Maria, additional, Battistini, Roberta, additional, Montanaro, Marco, additional, De Angelis, Federico, additional, Cimino, Giuseppe, additional, Palombi, Francesca, additional, Liberati, Anna Marina, additional, Abruzzese, Elisabetta, additional, Tesei, Cristiano, additional, Tisi, Maria Chiara, additional, Alma, Eleonora, additional, Rizzuto, Giuliana, additional, Pupo, Livio, additional, Zoli, Valerio, additional, Maiolo, Elena, additional, Ansuinelli, Michela, additional, Naso, Virginia, additional, Bianchi, Maria Paola, additional, and Cox, Maria Christina, additional

Published
2016
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39. Whole blood EBV-DNA predicts outcome in diffuse large B-cell lymphoma

Author

Tisi, Maria Chiara, Cupelli, Elisa, Santangelo, Rosaria, Maiolo, Elena, Alma, Eleonora, Giachelia, Manuela, Martini, Maurizio, Bellesi, Silvia, D'Alo', Francesco, Voso, Maria Teresa, Pompili, Maurizio, Leone, Giuseppe, Larocca, Luigi Maria, Hohaus, Stefan, Santangelo, Rosaria (ORCID:0000-0002-8056-218X), Martini, Maurizio (ORCID:0000-0002-6260-6310), D'Alo', Francesco (ORCID:0000-0003-3576-8522), Pompili, Maurizio (ORCID:0000-0001-6699-7980), Larocca, Luigi Maria (ORCID:0000-0003-1739-4758), Hohaus, Stefan (ORCID:0000-0002-5534-7197), Tisi, Maria Chiara, Cupelli, Elisa, Santangelo, Rosaria, Maiolo, Elena, Alma, Eleonora, Giachelia, Manuela, Martini, Maurizio, Bellesi, Silvia, D'Alo', Francesco, Voso, Maria Teresa, Pompili, Maurizio, Leone, Giuseppe, Larocca, Luigi Maria, Hohaus, Stefan, Santangelo, Rosaria (ORCID:0000-0002-8056-218X), Martini, Maurizio (ORCID:0000-0002-6260-6310), D'Alo', Francesco (ORCID:0000-0003-3576-8522), Pompili, Maurizio (ORCID:0000-0001-6699-7980), Larocca, Luigi Maria (ORCID:0000-0003-1739-4758), and Hohaus, Stefan (ORCID:0000-0002-5534-7197)

Abstract

An association between Epstein-Barr Virus (EBV) infection and lymphoproliferative diseases has been reported with EBV + diffuse large B cell-lymphoma (DLBCL) of the elderly described as a distinct entity. In a cohort of 218 human immunodeficiency virus (HIV)-negative patients with diffuse large B-cell lymphomas, we detected EBV-DNA in 25% of whole blood (WB) samples at diagnosis. Presence and viral load in WB, mononuclear cells or plasma did not predict the presence of EBV in the tumor biopsy. Positive Hepatitis C virus (HCV) serology was associated with a higher frequency of EBV in WB. Patients with EBV-DNA in WB had a significantly shorter progression-free (p = 0.02) and overall survival (p = 0.05) after immunochemotherapy with R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, Prednisolone). We conclude that detection of EBV in WB is not a surrogate marker for EBV-association in diffuse large B-cell lymphoma, however it associates with worse outcome.

Published
2016

40. Whole blood EBV-DNA predicts outcome in diffuse large B-cell lymphoma

Author

Tisi, Maria Chiara, primary, Cupelli, Elisa, additional, Santangelo, Rosaria, additional, Maiolo, Elena, additional, Alma, Eleonora, additional, Giachelia, Manuela, additional, Martini, Maurizio, additional, Bellesi, Silvia, additional, D’Alò, Francesco, additional, Voso, Maria Teresa, additional, Pompili, Maurizio, additional, Leone, Giuseppe, additional, Larocca, Luigi Maria, additional, and Hohaus, Stefan, additional

Published
2015
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42. Tumor-associated and immunochemotherapy-dependent long-term alterations of the peripheral blood NK cell compartment in DLBCL patients

Author

Cox, M Christina, primary, Battella, Simone, additional, La Scaleia, Raffaella, additional, Pelliccia, Sabrina, additional, Di Napoli, Arianna, additional, Porzia, Alessandra, additional, Cecere, Francesca, additional, Alma, Eleonora, additional, Zingoni, Alessandra, additional, Mainiero, Fabrizio, additional, Ruco, Luigi, additional, Monarca, Bruno, additional, Santoni, Angela, additional, and Palmieri, Gabriella, additional

Published
2015
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43. HIGH-DOSE CHEMOTHERAPY WITH AUTOLOGOUS STEM CELL TRANSPLANTATION IN FIRST LINE TREATMENT FOR HIGH-RISK DIFFUSE LARGE B CELL LYMPHOMA (DLBCL) IN THE RITUXIMAB ERA: AN INTENTION TO TREAT-ANALYSIS

Author

Tisi, Maria Chiara, Maiolo, Elena, D'Alo', Francesco, Bellesi, Silvia, Sora', Federica, Chiusolo, Patrizia, Laurenti, Luca, Picardi, Marika, Alma, Eleonora, Larocca, Luigi Maria, Sica, Simona, Hohaus, Stefan, D'Alo', Francesco (ORCID:0000-0003-3576-8522), Sora', Federica (ORCID:0000-0002-9607-5298), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Laurenti, Luca (ORCID:0000-0002-8327-1396), Larocca, Luigi Maria (ORCID:0000-0003-1739-4758), Sica, Simona (ORCID:0000-0003-2426-3465), Hohaus, Stefan (ORCID:0000-0002-5534-7197), Tisi, Maria Chiara, Maiolo, Elena, D'Alo', Francesco, Bellesi, Silvia, Sora', Federica, Chiusolo, Patrizia, Laurenti, Luca, Picardi, Marika, Alma, Eleonora, Larocca, Luigi Maria, Sica, Simona, Hohaus, Stefan, D'Alo', Francesco (ORCID:0000-0003-3576-8522), Sora', Federica (ORCID:0000-0002-9607-5298), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Laurenti, Luca (ORCID:0000-0002-8327-1396), Larocca, Luigi Maria (ORCID:0000-0003-1739-4758), Sica, Simona (ORCID:0000-0003-2426-3465), and Hohaus, Stefan (ORCID:0000-0002-5534-7197)

Abstract

Background: The combination of Rituximab and CHOP (R-CHOP) is considered to be the standard treatment for patients (pts) with newly diagnosed diffuse large B-cell lymphoma (DLBCL). Treatment results are still unsatisfactory in a significant proportion of patients, particularly in those with a high-risk disease defined by the IPI score. The use of high-dose chemotherapy with autologous stem-cell transplantation (ASCT) is standard clinical practice for patients with relapsed/refractory DLBCL, while its significance as consolidation in first-line treatment remains unclear. Aims: We analyzed safety and effectiveness of R-CHOP followed by salvage chemotherapy and ASCT for patients with young (<65 years) high-risk DLBCL, defined by an age-adjusted IPI score of 2/3, for whom from 2004 on our institutional guidelines recommended ASCT as consolidation. We analyzed prognostic factors in this group. Methods: The treatment program consisted of 4 cycles R-CHOP-14 followed by 3 cycles of a DHAP-like salvage regimen, R-MICMA (Sorà et al, Cancer 2006; 106: 859), and consolidation with Busulfan-Melphalan supported with ASCT. We observed 76 consecutive patients (median age 50 years, range 15- 64 years; 32 females and 44 males) diagnosed between May 2004 and January 2013 with DLBCL who had an age-adjusted IPI score of 2 or 3. Response was assessed according to Cheson criteria (Cheson et al, JCO 1999; 17:1244). Results: Nine of 76 patients (12%) were not eligible for the treatment program that included ASCT. Reasons were important comorbidities in 6 pts (1 cardiac, 2 neurologic, 1 hepatic, 1 hematologic, 1 renal) and start of another treatment regimen (CODOX-M/IVAC in the suspicion of a Burkitt lymphoma) in 3 pts. Response after 4 cycles R-CHOP was CR/CRu in 40/67 pts (60%), PR in 21/67 pts (31%) and NR in 6/67 (9%). Sixty-one patients went on to salvage chemotherapy with R-MICMA, while 6 pts in CR/CRu continued R-CHOP, and 53 pts were transplanted. Reasons not to proceed to transplan

Published
2014

45. Contribution of Genome-Wide Association Studies to Scientific Research: A Pragmatic Approach to Evaluate Their Impact

Author

Ricigliano, Vito A. G., primary, Umeton, Renato, additional, Germinario, Lorenzo, additional, Alma, Eleonora, additional, Briani, Martina, additional, Di Segni, Noemi, additional, Montesanti, Dalma, additional, Pierelli, Giorgia, additional, Cancrini, Fabiana, additional, Lomonaco, Cristiano, additional, Grassi, Francesca, additional, Palmieri, Gabriella, additional, and Salvetti, Marco, additional

Published
2013
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46. Distinct Phenotypic and Functional Immunological Alterations Characterize the Peripheral Blood Compartment of Patients with Diffuse Large B Cell Lymphoma (DLBCL).

Author

Cox, M. Christina, primary, La Scaleia, Raffaella, additional, Pelliccia, Sabrina, additional, Napoli, Arianna Di, additional, Alma, Eleonora, additional, Battella, Simone, additional, Naso, Virginia, additional, Porzia, Alessandra, additional, Ruco, Luigi, additional, Spiriti, Maria Antonietta Aloe, additional, Ambrogi, Vincenzo, additional, Mainiero, Fabrizio, additional, Amadori, Sergio, additional, Monarca, Bruno, additional, Santoni, Angela, additional, and Palmieri, Gabriella, additional

Published
2012
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47. Enhancing lymphoma diagnosis on core needle biopsies: Integrating immunohistochemistry with flow cytometry.

Author

Bellesi S, Schiaffini G, Contegiacomo A, Maiolo E, Iacovelli C, Malafronte R, D'Innocenzo S, Alma E, Bellisario F, Viscovo M, Campana F, De Filippis A, D'Alò F, Larocca LM, De Stefano V, Iezzi R, and Hohaus S

Abstract

Image-guided core needle biopsies (IG-CNB) represent a minimally invasive approach for obtaining tissue in patients with lymphadenopathy and suspected lymphoma. Despite their utility, diagnostic challenges persist, with lower efficacy compared with excisional biopsies. Our study aimed to evaluate the potential utility of incorporation of flow cytometry (FC) alongside immunohistochemistry (IHC) when performing IG-CNB for suspected lymphoproliferative diseases. Analyzing 170 consecutive cases, guided by ultrasound (n = 94) or computer tomography (n = 76), we employed a diagnostic algorithm, already established in our laboratory practice, utilizing three antibody cocktail-equipped tubes tailored for defining lymphomas, particularly those of B-cell origin. FC expedited the diagnostic process, yielding presumptive results in 87.6% of cases within 48 h, with a positive predictive value of 98%. Addition of FC to routine IHC enhanced the diagnostic rate from 91.2% to 95.3%, reducing IG-CNB failure rate by 45%, from 8.8% to 4.7%. This enhancement was particularly notable for deep-seated sites and in the setting of suspected disease recurrences. Consequently, FC emerges as a valuable adjunctive tool, allowing for the improvement of diagnostic performance, with a particular focus on the ability to quantify the expression of surface markers for targeted therapies, and holding the potential to diminish the necessity for repeat excisional biopsies subsequent to IG-CNB procedures., (© 2024 International Clinical Cytometry Society.)

Published
2024
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48. Days Alive Outside Hospital and Readmissions in Patients Undergoing Allogeneic Transplants from Identical Siblings or Alternative Donors.

Author

Sora F, Chiusolo P, Laurenti L, Innocenti I, Autore F, Giammarco S, Metafuni E, Alma E, Di Giovanni A, Sica S, and Bacigalupo A

Abstract

We have studied the number of days alive outside the Hospital (DAOH) and the number of readmissions within the first 100 days after transplant in 185 patients who received an allogeneic hemopoietic stem cell transplant (HSCT). The donors were matched siblings (SIB; n=61), or alternative donors (ALT; n=124). The median number of DAOH for SIB transplants (78 days, range 21-84) was significantly greater than DAOH for ALT donor grafts (73 days, range 2-87) (p=0.0003). Other positive predictors of DAOH were the use of reduced-intensity regimens (p=0.01), grade 0-I acute graft versus host disease (GvHD) (p=0.0006), and a comorbidity index equal or less than two (p=0.04). Fifty-one patients required readmission (22%), which was predicted by grade II-IV acute GvHD (p=0.009), higher comorbidity index (p=0.06), and ALT donors as compared to SIBS (p=0.08). The CI of readmission was 18% (95%CI 10-31) for SIB and 30% (95%CI 23-39) for ALT donor grafts. The non relapse mortality (NRM) for patients re-admitted was 25% (95%CI 15-43%), compared to 5% (95%CI 2-12%) for patients not readmitted (p=0.0001). In a multivariate analysis, readmission was the strongest predictor of non-relapse mortality (NRM) (HR 2.0) (p=0.0006) and survival (HR 3.4) (p<0.0001)., In Conclusion: ALT donor transplants have lower numbers of DAOH, as compared to SIB grafts, which implies longer stay in hospital and higher costs. Readmission to hospital within 100 days, is predicted by acute GvHD, comorbidity index, donor type, and has a significant strong impact on non-relapse mortality and survival., Competing Interests: Competing interests: The authors declare no conflict of Interest.

Published
2020
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49. Vitamin D deficiency and supplementation in patients with aggressive B-cell lymphomas treated with immunochemotherapy.

Author

Hohaus S, Tisi MC, Bellesi S, Maiolo E, Alma E, Tartaglia G, Corrente F, Cuccaro A, D'Alo' F, Basile U, Larocca LM, and De Stefano V

Subjects
Aged, Cyclophosphamide therapeutic use, Dietary Supplements, Disease-Free Survival, Doxorubicin therapeutic use, Female, Humans, Immunotherapy methods, Lymphoma, Large B-Cell, Diffuse immunology, Lymphoma, Large B-Cell, Diffuse mortality, Male, Middle Aged, Prednisone therapeutic use, Treatment Outcome, Vincristine therapeutic use, Vitamin D analogs & derivatives, Vitamin D blood, Vitamin D Deficiency blood, Vitamin D Deficiency immunology, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Cholecalciferol administration & dosage, Lymphoma, Large B-Cell, Diffuse drug therapy, Rituximab therapeutic use, Vitamin D Deficiency drug therapy
Abstract

Vitamin D deficiency has been reported to be a negative prognostic factor in elderly patients with aggressive B-cell lymphomas. In vitro data suggest that vitamin D supplementation may enhance rituximab-mediated cytotoxicity. We prospectively assessed 25-hydroxyvitamin D [25(OH)D] levels at diagnosis in a cohort of 155 patients with aggressive B-cell lymphomas of whom 128 had diffuse large B-cell lymphoma (DLBCL) not otherwise specified. 25(OH)D levels were deficient (<20 ng/mL) in 105 (67%), insufficient (20-29 ng/mL) in 32 (21%), and normal (≥30 ng/mL) in 18 (12%) patients with a seasonal variation. Patient characteristics associated with lower 25(OH)D levels were poor performance status, overweight, B-symptoms, elevated LDH, lower albumin and hemoglobin levels. As a result of a change in practice pattern, 116 patients received vitamin D3 (cholecalciferol) supplementation that included a loading phase with daily replacement and subsequent maintenance phase with a weekly dose of 25,000 IU until end of treatment. This resulted in a significant increase in 25(OH)D levels, with normalization in 56% of patients. We analyzed the impact of 25(OH)D levels on event-free survival in patients treated with Rituximab-CHOP. 25(OH)D levels below 20 ng/mL at diagnosis and IPI were independently associated with inferior EFS. Moreover, patients with normalized 25(OH)D levels following supplementation showed better EFS than patients with persistently deficient/insufficient 25(OH)D levels. Our study provides the first evidence that achievement of normal 25(OH)D levels after vitamin D3 supplementation is associated with improved outcome in patients with DLBCL and deficient/insufficient 25(OH)D levels when receiving rituximab-based treatment., (© 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)

Published
2018
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50. Whole blood EBV-DNA predicts outcome in diffuse large B-cell lymphoma.

Author

Tisi MC, Cupelli E, Santangelo R, Maiolo E, Alma E, Giachelia M, Martini M, Bellesi S, D'Alò F, Voso MT, Pompili M, Leone G, Larocca LM, and Hohaus S

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Antibodies, Monoclonal, Murine-Derived therapeutic use, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Cyclophosphamide therapeutic use, Doxorubicin therapeutic use, Epstein-Barr Virus Infections immunology, Epstein-Barr Virus Infections virology, Female, Herpesvirus 4, Human immunology, Humans, Lymphoma, Large B-Cell, Diffuse diagnosis, Lymphoma, Large B-Cell, Diffuse drug therapy, Male, Middle Aged, Neoplasm Staging, Prednisone therapeutic use, Prognosis, Rituximab, Treatment Outcome, Vincristine therapeutic use, Young Adult, DNA, Viral, Epstein-Barr Virus Infections complications, Herpesvirus 4, Human genetics, Lymphoma, Large B-Cell, Diffuse etiology, Lymphoma, Large B-Cell, Diffuse mortality, Viral Load
Abstract

An association between Epstein-Barr Virus (EBV) infection and lymphoproliferative diseases has been reported with EBV + diffuse large B cell-lymphoma (DLBCL) of the elderly described as a distinct entity. In a cohort of 218 human immunodeficiency virus (HIV)-negative patients with diffuse large B-cell lymphomas, we detected EBV-DNA in 25% of whole blood (WB) samples at diagnosis. Presence and viral load in WB, mononuclear cells or plasma did not predict the presence of EBV in the tumor biopsy. Positive Hepatitis C virus (HCV) serology was associated with a higher frequency of EBV in WB. Patients with EBV-DNA in WB had a significantly shorter progression-free (p = 0.02) and overall survival (p = 0.05) after immunochemotherapy with R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, Prednisolone). We conclude that detection of EBV in WB is not a surrogate marker for EBV-association in diffuse large B-cell lymphoma, however it associates with worse outcome.

Published
2016
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