50 results on '"Scortechini I"'
Search Results
2. Italian consensus conference for the outpatient autologous stem cell transplantation management in multiple myeloma
- Author
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Martino, M, Lemoli, R M, Girmenia, C, Castagna, L, Bruno, B, Cavallo, F, Offidani, M, Scortechini, I, Montanari, M, Milone, G, Postacchini, L, and Olivieri, A
- Published
- 2016
- Full Text
- View/download PDF
3. VERY LOW RATE OF RE-ADMISSION AFTER AN EARLY DISCHARGE OUTPATIENT MODEL FOR AUTOGRAFTING IN MULTIPLE MYELOMA PATIENTS: AN ITALIAN MULTI-CENTER RETROSPECTIVE STUDY: PH-P518
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Martino, M., Montanari, M., Ferrara, F., Ciceri, F., Scortechini, I., Console, G., Messina, G., Irrera, G., Palmieri, S., Marktel, S., Cimminiello, M., Castagna, L., Milone, G., Offidani, M., Tripepi, G., Bruno, B., Lemoli, Massimo R., Rambaldi, A., and Olivieri, A.
- Published
- 2014
4. MOBILIZATION-DRIVEN POST-CONSOLIDATION THERAPY IN 72 ELDERLY AML PATIENTS: FEASIBILITY AND EFFICACY OF ASCT VS LOW DOSE GEMTUZUMAB-OZOGAMICIN: PH-O131
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Olivieri, A., Capelli, D., Chiarucci, M., Poloni, A., Saraceni, F., Mancini, G., Trappolini, S., Montanari, M., Scortechini, I., Rupoli, S., Offidani, M., Scortechini, A. R., Gini, G., Discepoli, G., and Leoni, P.
- Published
- 2014
5. Combined administration of alpha-erythropoietin and filgrastim can improve the outcome and cost balance of autologous stem cell transplantation in patients with lymphoproliferative disorders
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Olivieri, A, Scortechini, I, Capelli, D, Montanari, M, Lucesole, M, Gini, G, Troiani, M, Offidani, M, Poloni, A, Masia, M C, Raggetti, G M, and Leoni, P
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- 2004
- Full Text
- View/download PDF
6. Total lymphoid irradiation and antithymocyte globulin to reduce graft-versus-host disease after allografting in haematological malignancies: a GITMO experience: O385
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Giaccone, L., Festuccia, M., Scortechini, I., Gigli, F., Cavattoni, I., Filippi, A., Carnevale-Schianca, F., Partiarca, F., Pini, M., Risitano, A. M., Gallamini, A., Pastano, R., Casini, M., Montanari, M., Fanin, R., Boccadoro, M., Ricardi, U., Bruno, B., and Messina, G.
- Published
- 2011
7. Feasibility of outpatient autologous stem cell transplantation in 238 patients with haematologic malignancy: O305
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Montanari, M., Scortechini, I., Capelli, D., and Mancini, G.
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- 2011
8. Amifostine to Reduce the Toxicity of Outpatient ASCT in Multiple Myeloma: A115
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Scortechini, I, Montanari, M, Capelli, D, Inglese, E, Offidani, M, Poloni, A, Gini, G, Mancini, G, Trappolini, S, and Leoni, P
- Published
- 2009
9. Very Low Rate of Readmission after an Early Discharge Outpatient Model for Autografting in Multiple Myeloma Patients: An Italian Multicenter Retrospective Study
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Martino, M, Montanari, M, Ferrara, F, Ciceri, F, Scortechini, I, Palmieri, S, Marktel, S, Cimminiello, M, Messina, G, Irrera, G, Offidani, M, Console, G, Castagna, L, Milone, G, Bruno, Benedetto, Tripepi, G, Lemoli, Rm, Olivieri, A, Terapia Cellulare – Sezione Trapianto Autologo, Gruppo Italiano per il Trapianto di Midollo Osseo Cellule Staminali Emopoietiche e., Saglio, Giuseppe, Martino, M, Montanari, M, Ferrara, F, Ciceri, Fabio, Scortechini, I, Palmieri, S, Marktel, S, Cimminiello, M, Messina, G, Irrera, G, Offidani, M, Console, G, Castagna, L, Milone, G, Bruno, B, Tripepi, G, Lemoli, Rm, and Olivieri, A.
- Subjects
Adult ,Male ,medicine.medical_specialty ,Autologous stem cell transplantation ,Patient Readmission ,Transplantation, Autologous ,Autologous stem-cell transplantation ,Multiple myeloma ,Internal medicine ,Outpatients ,medicine ,Mucositis ,Early discharge model ,Humans ,Gruppo Italiano per il Trapianto di Midollo Osseo (GITMO) survey ,Aged ,Retrospective Studies ,Univariate analysis ,Transplantation ,business.industry ,Incidence (epidemiology) ,Outpatient ,Retrospective cohort study ,Hematology ,Middle Aged ,medicine.disease ,Surgery ,Italy ,Female ,business ,Complication ,Stem Cell Transplantation - Abstract
We analyzed the main modalities and clinical outcomes of the early discharge outpatient model in autologous stem cell transplantation (EDOM-ASCT) for multiple myeloma in Italy. EDOM-ASCT was employed in 382 patients, for a total of 522 procedures, between 1998 and 2012. Our study showed high homogeneity among centers in terms of inclusion criteria, supportive care, and in hospital readmission criteria. Overall, readmissions during the aplastic phase occurred in 98 of 522 transplantations (18.8%). The major extrahematological complication was neutropenic fever in 161 cases (30.8%), which required readmission in 76 cases. The incidence of severe World Health Organization grade 3 to 4 mucositis was 9.6%. By univariate analysis, fever, mucositis, altered renal function at diagnosis, second transplantation, and transplantation performed late in the course of the disease were significantly correlated with readmission, whereas fever, mucositis, altered renal function, and timing of transplantation remained the only independent predictors by multivariate analysis. Overall, transplantation-related mortality was 1.0%. No center effect was observed in this study (P = .36). The safety and low rate of readmission of the EDOM-ASCT in myeloma trial suggest that this strategy could be extended to other transplantation centers if a stringent patient selection and appropriate management are applied. (C) 2014 American Society for Blood and Marrow Transplantation.
- Published
- 2014
10. MAKING THE RIGHT CHOICE: THE ROLE OF FITNESS STATUS IN THE MANAGEMENT OF FIRST-LINE TREATMENT IN CHRONIC LYMPHOCYTIC LEUKEMIA PATIENTS (CLL FITNESS STUDY)
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Scarfo, L, Quaresmini, G, Mauro, Fr, Orlandi, E, Reda, G, Laurenti, L, Coscia, Marta, Ambrosetti, A, Murru, R, Trentin, L, Guelill, A, Visco, C, Morabito, F, Frustaci, A, Ciolli, S, Rossini, F, Cuneo, A, Gozzetti, A, Scortechini, I, Pane, F, Zinzani, Pl, Ferrara, F, Mannina, D, Marasca, R, Pierri, I, Specchia, G, Chiarenza, A, Zallio, F, Molica, S, De Paoli, L, Torreggiani, A, Brugiatelli, M, Semenzato, G, Innocenti, I, Picardi, P, Pizzolo, G, Foa, R, Rambaldi, A, and Ghia, P.
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- 2015
11. Multi-center experience using total lymphoid irradiation and anti-thymocyte globulin as conditioning for allografting in hematological malignancies
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Messina G, Giaccone L, Festuccia M, Irrera G, Scortechini I, Sorasio R, Gigli F, Passera R, Cavattoni I, Filippi AR, Schianca FC, Pini M, Selleri C, Levis A, Mordini N, Gallamini A, Pastano R, Casini M, Aglietta M, Montanari M, Console G, Boccadoro M, Ricardi U, Bruno B., RISITANO, ANTONIO MARIA, Messina, G, Giaccone, L, Festuccia, M, Irrera, G, Scortechini, I, Sorasio, R, Gigli, F, Passera, R, Cavattoni, I, Filippi, Ar, Schianca, Fc, Pini, M, Risitano, ANTONIO MARIA, Selleri, C, Levis, A, Mordini, N, Gallamini, A, Pastano, R, Casini, M, Aglietta, M, Montanari, M, Console, G, Boccadoro, M, Ricardi, U, and Bruno, B.
- Published
- 2012
12. Factors affecting successful mobilization with plerixafor: an Italian prospective survey in 215 patients with multiple myeloma and lymphoma
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Lanza, F., Lemoli, R. M., Olivieri, A., Laszlo, D., Martino, M., Specchia, G., Pavone, V., Imola, M., Pasini, A., Milone, G., Scortechini, I., Todisco, E., Guggiari, E., Cascavilla, N., Martinelli, G., Rambaldi, A., and Bosi, A.
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Adult ,Male ,Benzylamines ,Receptors, CXCR4 ,Adolescent ,Lymphoma ,Cyclams ,NO ,Aged ,Blood Component Removal ,Chemoradiotherapy ,Data Collection ,Female ,Hematopoietic Stem Cell Mobilization ,Heterocyclic Compounds ,Humans ,Italy ,Leukapheresis ,Middle Aged ,Multiple Myeloma ,Platelet Count ,Predictive Value of Tests ,Prospective Studies ,Young Adult ,Receptors ,CXCR4 - Abstract
Although the efficacy of plerixafor in peripheral blood stem cell (PBSC) mobilization has been explored in several studies, factors associated with successful plerixafor mobilization after administration of granulocyte-colony-stimulating factor (G-CSF), with or without chemotherapy, have not been investigated. We analyzed data on PBSC mobilization from a large Italian database of lymphoma and myeloma plerixafor-treated patients.Two endpoints were established to define successful mobilization: patients with at least 2 × 10(6) CD34+ cells/kg collected by three leukapheresis procedures and patients achieving a peak count of at least 20 × 10(6) CD34+ cells/L during mobilization.Plerixafor achieved successful mobilization in both predicted (n = 64) and proven poor mobilizers (PMs; n = 143), classified according to the Gruppo Italiano Trapianto di Midollo Osseo (GITMO) criteria. Successful mobilization was independent of type of mobilization (steady state or chemotherapy); age; sex; disease; number or type of chemotherapy regimens preceding plerixafor; radiation therapy; prior treatment with melphalan, carmustine, lenalidomide, and radioimmune conjugates; and laboratory variables. Multivariate analysis identified previous fludarabine treatment and premobilization platelet count as predictors of successful mobilization.This large, prospective, nationwide study confirmed plerixafor efficacy for mobilizing PBSCs when added to G-CSF with or without chemotherapy. Plerixafor can overcome negative effects of most predictors of poor mobilization to achieve satisfactory harvest both in predicted and proven PM.
- Published
- 2014
13. Bendamustine in combination with rituximab as first line therapy for patients with chronic lymphocytic leukemia (cll): a retrospective real practice italian multicentre study
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Gentile, M, Ciolli, S, Molica, S, Di Renzo, N, Selleri, Carmine, Villa, Mr, De Paolis, Mr, Scortechini, I, Giannotta, A, Minoia, C, Boncompagni, R, Bonanno, V, Levato, L, Musso, M, Mastrullo, L, Melpignano, A, Murru, R, Angelucci, E, Caparrotti, G, Guarini, A, Pinto, A, Ferrara, F, Zinzani, P, and Morabito, F. .
- Published
- 2014
14. Bortezomib plus dexamethasone followed by escalating donor lymphocyte infusions is an effective and safe treatment for patients with multiple myeloma relasing or progressing after stem cell transplantation
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Montefusco, V, Spina, F, Patriarca, F, Offidani, M, Bruno, Benedetto, Montanari, M, Mussetti, A, Sperotto, A, Scortechini, I, Dodero, A, Fanin, R, Valagussa, P, and Corradini, P.
- Published
- 2013
15. Multicenter experience using total lymphoid irradiation and antithymocyte globulin as conditioning for allografting in hematological malignancies
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Messina, G, Giaccone, Luisa, Festuccia, M, Irrera, G, Scortechini, I, Sorasio, R, Gigli, F, Passera, R, Cavattoni, I, Filippi, Andrea Riccardo, Schianca, Fc, Pini, M, Risitano, Am, Selleri, C, Levis, A, Mordini, N, Gallamini, A, Pastano, R, Casini, M, Aglietta, Massimo, Montanari, M, Console, G, Boccadoro, Mario, Ricardi, Umberto, Bruno, Benedetto, and Gruppo Italiano Trapianti di Midollo
- Subjects
Male ,Myeloid ,Transplantation Conditioning ,Graft vs Host Disease ,total lymphoid irradiation ,antithymocyte globulin ,bone marrow transplantation ,Graft-versus-host disease ,Gastroenterology ,Severity of Illness Index ,HLA Antigens ,Recurrence ,Nonmyeloablative conditioning ,biology ,Incidence (epidemiology) ,Hematopoietic Stem Cell Transplantation ,Hematology ,Middle Aged ,surgical procedures, operative ,medicine.anatomical_structure ,Hematologic Neoplasms ,Histocompatibility ,Cyclosporine ,Female ,Whole-Body Irradiation ,Total lymphoid irradiation/antithymocyte globulin ,Adult ,medicine.medical_specialty ,Globulin ,anti-thymocyte globulin ,Refractory ,Antigen ,Internal medicine ,medicine ,Humans ,Transplantation, Homologous ,hematological malignancies ,Aged ,Antilymphocyte Serum ,Transplantation ,business.industry ,Mycophenolic Acid ,medicine.disease ,Survival Analysis ,Anti-thymocyte globulin ,Surgery ,biology.protein ,business - Abstract
A non myeloablative conditioning with total lymphoid irradiation (TLI) and antithymocyte globulin (ATG) was shown to protect against graft-versus-host disease (GVHD). To evaluate the effects of TLI-ATG in a multicenter study, 45 heavily pretreated patients, median age 51, with lymphoid (n = 38) and myeloid (n = 7) malignancies were enrolled at 9 centers. Twenty-eight patients (62%) received at least 3 lines of treatment before allografting, and 13 (29%) had refractory/relapsed disease at the time of transplantation. Peripheral blood hematopoietic cells were from HLA identical sibling (n = 30), HLA-matched (n = 9), or 1 antigen HLA-mismatched (n = 6) unrelated donors. A cumulative TLI dose of 8 Gy was administered from day −11 through −1 with ATG at the dose of 1.5 mg/kg/day (from day −11 through −7). GVHD prophylaxis consisted of cyclosporine and mycophenolate mofetil. Donor engraftment was reached in 95% of patients. Grade II to IV acute GVHD (aGVHD) developed in 6 patients (13.3%), and in 2 of these patients, it developed beyond day 100. Incidence of chronic GVHD (cGVHD) was 35.8%. One-year nonrelapse mortality was 9.1%. After a median follow-up of 28 months (range, 3-57 months) from transplantation, median overall survival was not reached, whereas median event-free survival was 20 months. This multicenter experience confirms that TLI-ATG protects against GVHD and maintains graft-vs-tumor effects.
- Published
- 2012
16. Total lymphoid irradiation and antithymocyte globulin to reduce graft-versus-host disease after allografting in haematological malignancies: a GITMO experience
- Author
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Giaccone, Luisa, Festuccia, MORENO BENEDETTO, Scortechini, I, Gigli, F, Cavattoni, I, Filippi, Andrea Riccardo, Carnevale Schianca, F, Partiarca, F, Pini, M, Risitano, Am, Gallamini, A, Pastano, R, Casini, M, Montanari, M, Fanin, R, Boccadoro, Mario, Ricardi, Umberto, Bruno, Benedetto, and Messina, G.
- Published
- 2011
17. A115 Amifostine to Reduce the Toxicity of Outpatient ASCT in Multiple Myeloma
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Scortechini, I, primary, Montanari, M, additional, Capelli, D, additional, Inglese, E, additional, Offidani, M, additional, Poloni, A, additional, Gini, G, additional, Mancini, G, additional, Trappolini, S, additional, and Leoni, P, additional
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- 2009
- Full Text
- View/download PDF
18. VERY LOW RATE OF RE-ADMISSION AFTER AN EARLY DISCHARGE OUTPATIENT MODEL FOR AUTOGRAFTING IN MULTIPLE MYELOMA PATIENTS: AN ITALIAN MULTI-CENTER RETROSPECTIVE STUDY
- Author
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Martino, M., Montanari, M., Ferrara, F., Ciceri, F., Scortechini, I., Console, G., Messina, G., Irrera, G., Palmieri, S., Marktel, S., Cimminiello, M., Castagna, L., Milone, G., Offidani, M., Tripepi, G., Bruno, B., ROBERTO MASSIMO LEMOLI, Rambaldi, A., and Olivieri, A.
19. ALLOGENEIC STEM CELL TRANSPLANTATION IN PATIENTS OLDER THAN 60 YEARS: A REGISTRY STUDY OF THE TRANSPLANT ACTIVITY FROM 2000 TO 2017 ON BEHALF OF THE GRUPPO ITALIANO TRAPIANTO DI MIDOLLO OSSEO (GITMO)
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Malagola, M., Polverelli, N., Martino, M., Rubini, V., Stanghellini, M. T. Lupo, Patriarca, F., Fanin, R., Bruno, B., Giaccone, L., Faraci, D. G., Grillo, G., Bramanti, S., Castagna, L., Bernasconi, P., Colombo, A. A., Gobbi, M., Nicoli, P., Natale, A., Santarone, S., Terruzzi, E., Olivieri, A., Scortechini, I., Chiusolo, P., Metafuni, E., Carella, A. M., Merla, E., Casini, M., Cavattoni, I., Arpinati, M., Nozzoli, C., Cutini, I., Mazza, P., Mazzone, A., Bassi, S., Onida, F., Saporiti, G., Canale, F. A., Vacca, A., Piras, E., Galieni, P., Falcioni, S., Luppi, M., Debbia, G., Iori, P. A., Ursula La Rocca, Pavone, V., Mele, A., Skert, C., Carobolante, F., Carluccio, P., Borghero, C., Elice, F., Proia, A., Fanelli, F., Selleri, C., Sacchi, N., Mammoliti, S., Oldani, E., Ciceri, F., Russo, D., and Bonifazi, F.
20. EFFECTIVENESS AND SAFETY OF IBRUTINIB IN RELAPSED/REFRACTORY MANTLE CELL LYMPHOMA TREATED IN ITALY ACCORDING TO THE IBRUTINIB NAMED PATIENT PROGRAM: THE REAL LIFE RESULTS
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Morigi, A., Federico Sottotetti, Gotti, M., Spina, M., Volpetti, S., Ferrero, S., Spina, F., Pisani, F., Merli, M., Visco, C., Paolini, R., Zilioli, V. R., Baldini, L., Di Renzo, N., Tosi, P., Cascavilla, N., Molica, S., Ilariucci, F., Rigolin, G. M., D Alo, F., Vanazzi, A., Santambrogio, E., Marasca, R., Mastrullo, L., Castellino, C., Desabbata, G., Scortechini, I., Trentin, L., Morello, L., Argnani, L., and Zinzani, P. L.
21. Survival risk score for real-life relapsed/refractory chronic lymphocytic leukemia patients receiving ibrutinib. A campus CLL study
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Valter Gattei, Gian Matteo Rigolin, Yair Herishanu, Aaron Polliack, Annalisa Chiarenza, Francesca Rossi, Fortunato Morabito, Marzia Varettoni, Paolo Sportoletti, Roberta Murru, Riccardo Bomben, Gianluigi Reda, Giovanni Tripepi, Giacomo Loseto, Luca Laurenti, Graziella D’. Arrigo, Annalisa Biagi, Antonella Zucchetto, Adalgisa Condoluci, Ugo Consoli, Antonio Cuneo, Ilaria Del Giudice, Davide Rossi, Anna Grazia Recchia, Francesco Di Raimondo, Riccardo Moia, Giovanni Del Poeta, Robin Foà, Gianluca Gaidano, Ilaria Scortechini, Vincenzo Fraticelli, Ilaria Angeletti, Daniela Pietrasanta, Angela Rago, Cirino Botta, Marta Coscia, Ernesto Vigna, Francesca Romana Mauro, Massimo Gentile, Gentile M., Morabito F., Del Poeta G., Mauro F.R., Reda G., Sportoletti P., Laurenti L., Coscia M., Herishanu Y., Recchia A.G., Varettoni M., Murru R., Chiarenza A., Condoluci A., Moia R., Pietrasanta D., Loseto G., Consoli U., Scortechini I., Rossi F.M., Zucchetto A., Fraticelli V., Vigna E., Botta C., Tripepi G., Arrigo G.D., Rago A., Angeletti I., Biagi A., Del Giudice I., Bomben R., Rigolin G.M., Rossi D., Di Raimondo F., Gaidano G., Polliack A., Cuneo A., Foa R., and Gattei V.
- Subjects
Oncology ,Cancer Research ,medicine.medical_specialty ,Survival risk score ,Chronic lymphocytic leukemia ,Treatment outcome ,Antineoplastic Agents ,risk score ,NO ,chemistry.chemical_compound ,relapsed/refractory chronic lymphocytic leukemia ,Antineoplastic Agents, Immunological ,Piperidines ,ibrutinib ,Internal medicine ,medicine ,Humans ,real-life ,Molecular Targeted Therapy ,Chronic ,Protein Kinase Inhibitors ,Framingham Risk Score ,Leukemia ,chronic lymphocytic leukemia ,prognosis ,business.industry ,Adenine ,B-Cell ,Hematology ,medicine.disease ,Prognosis ,Leukemia, Lymphocytic, Chronic, B-Cell ,prognostic score ,Lymphocytic ,Survival risk score, real-life, relapsed/refractory chronic lymphocytic leukemia, ibrutinib ,Settore MED/15 - MALATTIE DEL SANGUE ,Immunological ,Treatment Outcome ,chemistry ,Ibrutinib ,Relapsed refractory ,business - Published
- 2021
22. Assessment of the 4-factor score: Retrospective analysis of 586 CLL patients receiving ibrutinib. A campus CLL study
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Ilaria Scortechini, Riccardo Moia, Marzia Varettoni, Francesca Romana Mauro, Sara Galimberti, Giovanni Del Poeta, Graziella D'Arrigo, Marta Coscia, Luca Laurenti, Ernesto Vigna, Davide Rossi, Annalisa Biagi, Gianluca Gaidano, Daniele Caracciolo, Riccardo Bomben, Ilaria Angeletti, Gianluigi Reda, Giovanna Cutrona, Daniela Pietrasanta, Gilberto Fronza, Ramona Cassin, Antonino Neri, Aaron Polliack, Annalisa Chiarenza, Yair Herishanu, Fortunato Morabito, Ilaria Del Giudice, Valter Gattei, Francesca Rossi, Roberta Murru, Giovanni Tripepi, Andrea Visentin, Livio Trentin, Antonio Cuneo, Angela Rago, Antonella Zucchetto, Adalgisa Condoluci, Giacomo Loseto, Ugo Consoli, Enrica Antonia Martino, Manlio Ferrarini, Massimo Gentile, Francesco Di Raimondo, Francesco Mendicino, Paolo Sportoletti, Robin Foà, Cirino Botta, Morabito F., Tripepi G., Del Poeta G., Mauro F.R., Reda G., Sportoletti P., Laurenti L., Coscia M., Herishanu Y., Varettoni M., Murru R., Chiarenza A., Visentin A., Condoluci A., Moia R., Pietrasanta D., Loseto G., Consoli U., Scortechini I., Rossi F.M., Zucchetto A., Vigna E., Martino E.A., Mendicino F., Botta C., Caracciolo D., Cassin R., D'Arrigo G., Galimberti S., Rago A., Angeletti I., Biagi A., Del Giudice I., Bomben R., Neri A., Fronza G., Cutrona G., Rossi D., Di Raimondo F., Cuneo A., Gaidano G., Polliack A., Trentin L., Foa R., Ferrarini M., Gattei V., and Gentile M.
- Subjects
Oncology ,Male ,chronic B cell leukemia ,chronic lymphocytic leukemia ,ibrutinib ,4-factor score ,prognosis ,Datasets as Topic ,Severity of Illness Index ,chemistry.chemical_compound ,Piperidines ,Retrospective analysis ,Multicenter Studies as Topic ,Chronic ,Leukemia ,Hematology ,Middle Aged ,Prognosis ,Lymphocytic ,Progression-Free Survival ,Ibrutinib ,Female ,medicine.medical_specialty ,real-word study ,Factor score ,Antineoplastic Agents ,Adenine ,Aged ,Follow-Up Studies ,Humans ,Leukemia, Lymphocytic, Chronic, B-Cell ,Proportional Hazards Models ,Protein Kinase Inhibitors ,Reproducibility of Results ,Retrospective Studies ,Risk Assessment ,Survival Analysis ,NO ,Internal medicine ,Severity of illness ,medicine ,Progression-free survival ,Survival analysis ,business.industry ,Proportional hazards model ,B-Cell ,Retrospective cohort study ,Settore MED/15 - MALATTIE DEL SANGUE ,chemistry ,business ,chronic lymphocytic leukaemia - Abstract
Not Available
- Published
- 2021
23. Venetoclax infectious risk score to identify patients with chronic lymphocytic leukemia at high infectious risk during venetoclax treatment: A multicenter SEIFEM study.
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Autore F, Visentin A, Deodato M, Vitale C, Galli E, Fresa A, Fazzi R, Sanna A, Olivieri J, Scortechini I, Del Principe MI, Sportoletti P, Schiattone L, Maschio N, Facchinelli D, Marchesi F, Coscia M, Tedeschi A, Trentin L, Innocenti I, Candoni A, Busca A, Pagano L, and Laurenti L
- Subjects
- Humans, Bridged Bicyclo Compounds, Heterocyclic adverse effects, Risk Factors, Antineoplastic Combined Chemotherapy Protocols adverse effects, Leukemia, Lymphocytic, Chronic, B-Cell drug therapy, Antineoplastic Agents therapeutic use, Sulfonamides
- Published
- 2024
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- View/download PDF
24. Real-World Outcome of Treatment with Single-Agent Ibrutinib in Italian Patients with Chronic Lymphocytic Leukemia: Final Results of the EVIdeNCE Study.
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Mauro FR, Scalzulli PR, Scarfò L, Minoia C, Murru R, Sportoletti P, Frigeri F, Albano F, Di Renzo N, Sanna A, Laurenti L, Massaia M, Cassin R, Coscia M, Patti C, Pennese E, Tafuri A, Chiarenza A, Galieni P, Perbellini O, Selleri C, Califano C, Ferrara F, Cuneo A, Murineddu M, Palumbo G, Scortechini I, Tedeschi A, Trentin L, Varettoni M, Pane F, Liberati AM, Merli F, Morello L, Musuraca G, Tani M, Ibatici A, Regazzoni G, Di Candia M, Palma M, Arienti D, and Molica S
- Abstract
Real-world data in clinical practice are needed to confirm the efficacy and safety that ibrutinib has demonstrated in clinical trials of patients with chronic lymphocytic leukemia (CLL). We described the real-world persistence rate, patterns of use, and clinical outcomes in 309 patients with CLL receiving single-agent ibrutinib in first line (1L, n = 118), 2L ( n = 127) and ≥3L ( n = 64) in the prospective, real-world, Italian EVIdeNCE study. After a median follow-up of 23.9 months, 29.8% of patients discontinued ibrutinib (1L: 24.6%, 2L: 29.9%, ≥3L: 39.1%), mainly owing to adverse events (AEs)/toxicity (14.2%). The most common AEs leading to discontinuation were infections (1L, ≥3L) and cardiac events (2L). The 2-year retention rate was 70.2% in the whole cohort (1L: 75.4%, 2L: 70.1%, ≥3L: 60.9%). The 2-year PFS and OS were, respectively, 85.4% and 91.7% in 1L, 80.0% and 86.2% in 2L, and 70.1% and 80.0% in ≥3L. Cardiovascular conditions did not impact patients' clinical outcomes. The most common AEs were infections (30.7%), bleeding (12.9%), fatigue (10.0%), and neutropenia (9.7%), while grade 3-4 atrial fibrillation occurred in 3.9% of patients. No new safety signals were detected. These results strongly support ibrutinib as a valuable treatment option for CLL.
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- 2024
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25. Lymphadenopathy as a predictor of progression during venetoclax treatment in chronic lymphocytic leukemia. A campus chronic lymphocytic leukemia study.
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Autore F, Innocenti I, Reda G, Visentin A, Vitale C, Piciocchi A, Fresa A, Leone MMA, Farina L, Quaresmini G, Baratè C, Giordano A, Ferrari A, Angeletti I, De Paolis MR, Malerba L, Chiurazzi F, Loseto G, Catania G, Sportoletti P, Scortechini I, Moia R, Gentile M, Rigolin GM, Mattiello V, Gattei V, Coscia M, Trentin L, Foà R, Cuneo A, and Laurenti L
- Subjects
- Humans, Retrospective Studies, Bridged Bicyclo Compounds, Heterocyclic adverse effects, Recurrence, Antineoplastic Combined Chemotherapy Protocols adverse effects, Leukemia, Lymphocytic, Chronic, B-Cell pathology, Lymphadenopathy chemically induced, Lymphadenopathy drug therapy
- Abstract
Clinical or biological parameters useful to predict progression during treatment in real-life setting with ibrutinib, idelalisib and venetoclax in relapsed/refractory chronic lymphocytic leukemia (CLL) are still debated. We conducted a multi-center retrospective study on CLL patients treated with ibrutinib and/or idelalisib who were switched to venetoclax for progression or due to adverse events to identify any clinical and/or biological parameters useful to predict progression during treatment with venetoclax. Of all the 128 evaluable patients, 81 had received ibrutinib prior to switching to venetoclax, 35 had received idelalisib and 12 both. When comparing the three subgroups, we did not notice any statistical difference in terms of clinical or biological features. No variable at baseline and at different time points during the follow-up (at 6, 12, 18 and 24 months) was found to predict progression nor to have significance for Progression Free Survival (PFS) in the ibrutinib group and in the idelalisib group and in subgroups according to the line of treatment. Analyzing the data of the venetoclax treatment, after a median follow up of 14.3 months, median PFS was not reached and estimated 3-year PFS was 54%. Of the 128 patients treated with venetoclax, 28 (22%) experienced progressive disease. At multivariate analysis for predictive factors for progression, lymph node diameter >56.5 mm before starting treatment emerged as an independent risk factor for progression. The lymph node predictive role for progression during venetoclax treatment could be a new parameter that deserves to be investigate in future studies., (© 2023 The Authors. Hematological Oncology published by John Wiley & Sons Ltd.)
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- 2023
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26. Autologous Stem Cell Transplantation in Multiple Myeloma: Where Are We and Where Do We Want to Go?
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Morè S, Corvatta L, Manieri VM, Saraceni F, Scortechini I, Mancini G, Fiorentini A, Olivieri A, and Offidani M
- Subjects
- Antineoplastic Combined Chemotherapy Protocols therapeutic use, Dexamethasone, Humans, Transplantation, Autologous, Hematopoietic Stem Cell Transplantation adverse effects, Multiple Myeloma drug therapy
- Abstract
The introduction of high-dose therapy in the 1990s as well as the development of drugs such as thalidomide, lenalidomide, and bortezomib in the 2000s led to an impressive improvement in outcome of patients with multiple myeloma (MM) eligible for autologous stem cell transplantation (ASCT). Clinical trials conducted in the first ten years of the twenty-first century established as standard therapy for these patients a therapeutic approach including induction, single or double ASCT, consolidation, and maintenance therapy. More recently, incorporating second-generation proteasome inhibitors carfilzomib and monoclonal antibody daratumumab into each phase of treatment significantly improved the efficacy of ASCT in terms of measurable residual disease (MRD) negativity, Progression Free Survival (PFS), and Overall Survival (OS). The availability of techniques such as multiparameter flow cytometry (MFC) and next-generation sequencing (NGS) for MRD assessment allowed the design of MRD-based response-adjusted trials that will define, in particular, the role of consolidation and maintenance therapies. In this review, we will provide an overview of the most recent evidence and the future prospects of ASCT in MM patients.
- Published
- 2022
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27. Central pontine myelinolysis after hematopoietic stem cell transplantation: survey in 169 consecutive transplanted patients and review of literature.
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Scortechini I, Inglese E, Saraceni F, Poiani M, Mancini G, Urbano G, Lotito AF, Colaneri F, Federici I, Polonara G, and Olivieri A
- Subjects
- Humans, Magnetic Resonance Imaging, Hematopoietic Stem Cell Transplantation adverse effects, Myelinolysis, Central Pontine etiology, Transplants
- Published
- 2021
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28. Gastrointestinal Complications after Allogeneic Hematopoietic Stem Cell Transplant: A Multidisciplinary Approach with Early Endoscopic Evaluation.
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Tarantino G, Saraceni F, Mancini G, Poiani M, Maroni L, Goteri G, Scortechini I, Fiorentini A, Dubbini MV, Marini F, Daretti L, Marzioni M, Bendia E, Benedetti A, and Olivieri A
- Abstract
Gastrointestinal complications (GICs) represent the major cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Differential diagnosis of GICs is of paramount importance since early and reliable identification of graft-versus-host disease (GVHD) is essential for a correct management of the patients. The aim of the present retrospective study was to evaluate the occurrence of GICs after allo-HSCT and to assess the diagnostic performance of a quick endoscopic and histological assessment in the differential diagnosis between GVHD and other GI conditions. Between January 2015 and August 2019, 122 consecutive patients receiving an allo-HSCT were managed by an interdisciplinary team, supported by a dedicated endoscopic service. Clinical, therapeutic, endoscopic and histological data were analyzed for each patient. Collectively, 94 of the patients developed GICs (77%). A moderate-severe mucositis was the most frequent complication, occurring in 79 patients (84%). Acute GI-GVHD was diagnosed in 35 patients (37% of whom with GICs) and 19 of them with a moderate-severe grade. Infective acute colitis developed in eight patients, mainly due to Clostridium difficile (CD) and Cytomegalovirus infections (8.5%). Rectal biopsy showed the highest sensitivity and specificity (80% and 100%, respectively). However, when biopsy procedures were guided by symptoms and performed on apparently intact mucosa, upper histology also provided a high negative predictive value (80%). Our multidisciplinary approach with a quick endoscopic/histologic investigation in the patients receiving an allo-HSCT and who suffered GICs could improve diagnostic and therapeutic management in this challenging setting., Competing Interests: The authors declare they have no conflicts of interest., (© 2021 International Academy for Clinical Hematology. Publishing services by Atlantis Press International B.V.)
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- 2021
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29. Conditioning Regimens for Frail Patients with Acute Leukemia Undergoing Allogeneic Stem Cell Transplant: How to Strike Gently.
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Saraceni F, Scortechini I, Fiorentini A, Dubbini MV, Mancini G, Federici I, Colaneri FR, Lotito AF, Guerzoni S, Puglisi B, and Olivieri A
- Abstract
Despite the recent dramatic progress in acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) therapy, allogeneic transplant remains a mainstay of treatment for patients with acute leukemia. The availability of novel compounds and low intensity chemotherapy regimens made it possible for a significant proportion of elderly and comorbid patients with AML or ALL to undergo curative treatment protocols. In addition, the expansion of donor availability and the recent dramatic progress in haploidentical stem cell transplant, allow the identification of an available donor for nearly every patient. Therefore, an increasing number of transplants are currently performed in elderly and frail patients with AML or ALL. However, allo-Hematopoietic stem cell transplant (HSCT) in this delicate setting represents an important challenge, especially regarding the selection of the conditioning protocol. Ideally, conditioning intensity should be reduced as much as possible; however, in patients with acute leukemia relapse remains the major cause of transplant failure. In this article we present modern tools to assess the patient health status before transplant, review the available data on the outcome of frail AML an ALL patients undergoing allo-HSCT, and discuss how preparatory regimens can be optimized in this setting., Competing Interests: The authors declare they have no conflicts of interest., (© 2021 International Academy for Clinical Hematology. Publishing services by Atlantis Press International B.V.)
- Published
- 2021
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30. Effectiveness of ibrutinib as first-line therapy for chronic lymphocytic leukemia patients and indirect comparison with rituximab-bendamustine: Results of study on 486 cases outside clinical trials.
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Morabito F, Tripepi G, Del Poeta G, Mauro FR, Reda G, Sportoletti P, Laurenti L, Coscia M, Herishanu Y, Bossio S, Varettoni M, Murru R, Chiarenza A, Visentin A, Condoluci A, Moia R, Pietrasanta D, Loseto G, Consoli U, Scortechini I, Rossi FM, Zucchetto A, Al-Janazreh H, Vigna E, Martino EA, Cassin R, D Arrigo G, Galimberti S, Rago A, Angeletti I, Biagi A, Del Giudice I, Bomben R, Neri A, Fronza G, Monti P, Menichini P, Olivieri J, Cutrona G, Rossi D, Cuneo A, Di Raimondo F, Gaidano G, Polliack A, Trentin L, Foà R, Ferrarini M, Gattei V, and Gentile M
- Subjects
- Adenine pharmacology, Adenine therapeutic use, Aged, Bendamustine Hydrochloride pharmacology, Humans, Piperidines pharmacology, Progression-Free Survival, Rituximab pharmacology, Adenine analogs & derivatives, Bendamustine Hydrochloride therapeutic use, Leukemia, Lymphocytic, Chronic, B-Cell drug therapy, Piperidines therapeutic use, Rituximab therapeutic use
- Published
- 2021
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31. TP53 disruption as a risk factor in the era of targeted therapies: A multicenter retrospective study of 525 chronic lymphocytic leukemia cases.
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Morabito F, Del Poeta G, Mauro FR, Reda G, Sportoletti P, Laurenti L, Coscia M, Herishanu Y, Bossio S, Varettoni M, Murru R, Chiarenza A, Visentin A, Condoluci A, Moia R, Pietrasanta D, Loseto G, Consoli U, Scortechini I, Recchia AG, Rossi FM, Zucchetto A, Al-Janazreh H, Martino EA, Vigna E, Tripepi G, D'Arrigo G, Galimberti S, Rago A, Angeletti I, Biagi A, Del Giudice I, Bomben R, Neri A, Fronza G, Cutrona G, Jaksic O, Olivieri J, Rossi D, Di Raimondo F, Cuneo A, Gaidano G, Polliack A, Trentin L, Foà R, Ferrarini M, Gattei V, and Gentile M
- Subjects
- Chromosome Deletion, Chromosomes, Human, Pair 17, Humans, Molecular Targeted Therapy, Mutation, Prognosis, Retrospective Studies, Risk Factors, Leukemia, Lymphocytic, Chronic, B-Cell genetics, Leukemia, Lymphocytic, Chronic, B-Cell therapy, Tumor Suppressor Protein p53 genetics
- Published
- 2021
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32. Assessment of the 4-factor score: Retrospective analysis of 586 CLL patients receiving ibrutinib. A campus CLL study.
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Morabito F, Tripepi G, Del Poeta G, Mauro FR, Reda G, Sportoletti P, Laurenti L, Coscia M, Herishanu Y, Varettoni M, Murru R, Chiarenza A, Visentin A, Condoluci A, Moia R, Pietrasanta D, Loseto G, Consoli U, Scortechini I, Rossi FM, Zucchetto A, Vigna E, Martino EA, Mendicino F, Botta C, Caracciolo D, Cassin R, D'Arrigo G, Galimberti S, Rago A, Angeletti I, Biagi A, Del Giudice I, Bomben R, Neri A, Fronza G, Cutrona G, Rossi D, Di Raimondo F, Cuneo A, Gaidano G, Polliack A, Trentin L, Foà R, Ferrarini M, Gattei V, and Gentile M
- Subjects
- Adenine therapeutic use, Aged, Datasets as Topic statistics & numerical data, Female, Follow-Up Studies, Humans, Leukemia, Lymphocytic, Chronic, B-Cell mortality, Male, Middle Aged, Multicenter Studies as Topic, Prognosis, Progression-Free Survival, Proportional Hazards Models, Reproducibility of Results, Retrospective Studies, Risk Assessment, Survival Analysis, Adenine analogs & derivatives, Antineoplastic Agents therapeutic use, Leukemia, Lymphocytic, Chronic, B-Cell drug therapy, Piperidines therapeutic use, Protein Kinase Inhibitors therapeutic use, Severity of Illness Index
- Published
- 2021
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33. Comparison of ibrutinib and idelalisib plus rituximab in real-life relapsed/resistant chronic lymphocytic leukemia cases.
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Morabito F, Tripepi G, Del Poeta G, Mauro FR, Reda G, Sportoletti P, Laurenti L, Coscia M, Herishanu Y, Bossio S, Varettoni M, Murru R, Chiarenza A, Visentin A, Condoluci A, Moia R, Pietrasanta D, Loseto G, Consoli U, Scortechini I, Rossi FM, Zucchetto A, Al-Janazreh H, Vigna E, Martino EA, Mendicino F, Cassin R, D'Arrigo G, Galimberti S, Rago A, Angeletti I, Biagi A, Del Giudice I, Bomben R, Neri A, Fronza G, Monti P, Menichini P, Cutrona G, Jaksic O, Rossi D, Di Raimondo F, Cuneo A, Gaidano G, Polliack A, Trentin L, Foà R, Ferrarini M, Gattei V, and Gentile M
- Subjects
- Adenine administration & dosage, Adenine analogs & derivatives, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols adverse effects, Biomarkers, Tumor, Drug Resistance, Neoplasm, Female, Humans, Immunoglobulins genetics, In Situ Hybridization, Fluorescence, Leukemia, Lymphocytic, Chronic, B-Cell diagnosis, Leukemia, Lymphocytic, Chronic, B-Cell etiology, Leukemia, Lymphocytic, Chronic, B-Cell mortality, Male, Middle Aged, Mutation, Piperidines administration & dosage, Proportional Hazards Models, Purines administration & dosage, Quinazolinones administration & dosage, Recurrence, Retreatment, Rituximab administration & dosage, Treatment Outcome, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Leukemia, Lymphocytic, Chronic, B-Cell drug therapy
- Abstract
Objectives: To compare the capacity of ibrutinib (IB) and idelalisib-rituximab (IDELA-R) of prolonging overall survival (OS) as in CLL patients, previously treated with chemotherapy only., Methods: A real-life cohort of 675 cases has been identified and investigated in the database of the groups participating in the study., Results: At an unadjusted univariate analysis, a significant death risk reduction was observed favoring IB (IDELA-R vs IB HR = 0.5, 95% CI = 0.36-0.71) although with some limitations due to the non-randomized and retrospective nature of the study and to the lower number of patients in the IDELA-R group (112 cases) related to the current prescribing practice. To overcome the potential problem of confounding by indication, we adjusted the association between the type of therapy and mortality for all variables significantly associated with OS at Cox univariate analysis. Furthermore, those variables, differently distributed between the two study groups, were introduced into the multivariate Cox model to improve the effectiveness of the analysis. By introducing all these variables into the multiple Cox regression model, we confirmed the protective effect of IB vs IDELA-R (HR = 0.67, 95% CI = 0.45-0.98, P = .04) independent of potential confounders., Conclusions: Although our analysis presents some constraints, that is, the unavailability of additional potential confounders, and the retrospective nature of the study, this observation may be of help for the daily clinical practice, particularly in the absence of randomized trials comparing the two schedules., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Published
- 2021
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34. Severe COVID-19 in a patient with chronic graft-versus-host disease after hematopoietic stem cell transplant successfully treated with ruxolitinib.
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Saraceni F, Scortechini I, Mancini G, Mariani M, Federici I, Gaetani M, Barbatelli P, Minnucci ML, Bagnarelli P, and Olivieri A
- Subjects
- Humans, Male, Middle Aged, Nitriles, Pyrimidines, SARS-CoV-2, COVID-19 complications, COVID-19 pathology, Graft vs Host Disease complications, Hematopoietic Stem Cell Transplantation adverse effects, Pyrazoles therapeutic use
- Abstract
Graft-versus-host disease (GVHD) is a common complication of hematopoietic stem cell transplant, which is known to be mediated by cytotoxic T-cell effectors and dysregulated inflammatory cytokines. Similarly, the lung injury observed in severe COVID-19 cases appears to be related to a massive production of pro-inflammatory cytokines. The selective JAK1/2 inhibitor ruxolitinib has shown promising results in the context of GVHD, and different trials are currently underway in patients with severe COVID-19; nevertheless, no clinical observation of safety or efficacy of treatment with ruxolitinib in this context has been published yet. We describe a first case of severe COVID-19 developed after hematopoietic stem cell transplantation in a patient with a concomitant chronic GVHD (cGVHD), in which a treatment with ruxolitinib was administered with good tolerance and positive outcome., (© 2020 Wiley Periodicals LLC.)
- Published
- 2021
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35. Survival risk score for real-life relapsed/refractory chronic lymphocytic leukemia patients receiving ibrutinib. A campus CLL study.
- Author
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Gentile M, Morabito F, Del Poeta G, Mauro FR, Reda G, Sportoletti P, Laurenti L, Coscia M, Herishanu Y, Recchia AG, Varettoni M, Murru R, Chiarenza A, Condoluci A, Moia R, Pietrasanta D, Loseto G, Consoli U, Scortechini I, Rossi FM, Zucchetto A, Fraticelli V, Vigna E, Botta C, Tripepi G, Arrigo G, Rago A, Angeletti I, Biagi A, Del Giudice I, Bomben R, Rigolin GM, Rossi D, Di Raimondo F, Gaidano G, Polliack A, Cuneo A, Foà R, and Gattei V
- Subjects
- Adenine administration & dosage, Adenine adverse effects, Adenine therapeutic use, Antineoplastic Agents, Immunological administration & dosage, Antineoplastic Agents, Immunological adverse effects, Humans, Leukemia, Lymphocytic, Chronic, B-Cell diagnosis, Molecular Targeted Therapy, Piperidines administration & dosage, Piperidines adverse effects, Prognosis, Protein Kinase Inhibitors administration & dosage, Protein Kinase Inhibitors adverse effects, Treatment Outcome, Adenine analogs & derivatives, Antineoplastic Agents, Immunological therapeutic use, Leukemia, Lymphocytic, Chronic, B-Cell drug therapy, Leukemia, Lymphocytic, Chronic, B-Cell mortality, Piperidines therapeutic use, Protein Kinase Inhibitors therapeutic use
- Published
- 2021
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36. Validation of a survival-risk score (SRS) in relapsed/refractory CLL patients treated with idelalisib-rituximab.
- Author
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Gentile M, Martino EA, Visentin A, Coscia M, Reda G, Sportoletti P, Mauro FR, Laurenti L, Varettoni M, Murru R, Chiarenza A, Vigna E, Mendicino F, Lucia E, Bossio S, Recchia AG, Moia R, Pietrasanta D, Loseto G, Consoli U, Scortechini I, Rossi FM, Zucchetto A, Al-Janazreh H, Vitale C, Tripepi G, D'Arrigo G, Angeletti I, Bomben R, Neri A, Cutrona G, Fronza G, Di Raimondo F, Gaidano G, Cuneo A, Foà R, Ferrarini M, Trentin L, Gattei V, and Morabito F
- Subjects
- Adult, Aged, Aged, 80 and over, Disease-Free Survival, Female, Humans, Male, Middle Aged, Purines administration & dosage, Quinazolinones administration & dosage, Rituximab administration & dosage, Survival Rate, Antineoplastic Combined Chemotherapy Protocols administration & dosage, Leukemia, Lymphocytic, Chronic, B-Cell drug therapy, Leukemia, Lymphocytic, Chronic, B-Cell mortality
- Published
- 2020
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37. Ibrutinib for bridging to allogeneic hematopoietic cell transplantation in patients with chronic lymphocytic leukemia or mantle cell lymphoma: a study by the EBMT Chronic Malignancies and Lymphoma Working Parties.
- Author
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Dreger P, Michallet M, Bosman P, Dietrich S, Sobh M, Boumendil A, Nagler A, Scheid C, Cornelissen J, Niederwieser D, Müller L, Vandenberghe E, Scortechini I, Schoemans H, Andersen NS, Finke J, Russo D, Ljungman P, Passweg J, van Gelder M, Durakovic N, Labussiere-Wallet H, Berg T, Wulf G, Bethge W, Bunjes D, Stilgenbauer S, Canepari ME, Schaap M, Fox CP, Kröger N, Montoto S, and Schetelig J
- Subjects
- Adenine analogs & derivatives, Adult, Aged, Allografts, Disease-Free Survival, Female, Humans, Male, Middle Aged, Piperidines, Survival Rate, Graft vs Host Disease mortality, Graft vs Host Disease prevention & control, Hematopoietic Stem Cell Transplantation, Leukemia, Lymphocytic, Chronic, B-Cell mortality, Leukemia, Lymphocytic, Chronic, B-Cell therapy, Lymphoma, Mantle-Cell mortality, Lymphoma, Mantle-Cell therapy, Pyrazoles administration & dosage, Pyrimidines administration & dosage
- Abstract
The aim of this retrospective study was to investigate the safety and efficacy of allogeneic hematopoietic cell transplantation (alloHCT) in patients pre-treated with ibrutinib. Eligible were patients aged >18 years allotransplanted for chronic lymphocytic leukemia (CLL) or mantle cell lymphoma (MCL) after prior exposure to ibrutinib who were registered with the EBMT registry. Seventy patients (CLL 48, MCL 22) were included. At the time of alloHCT, 73% of the patients were ibrutinib responsive. All patients except one engrafted, and acute GVHD grade 2-4 (3-4) was observed in 49% (12%) of 68 evaluable patients. The cumulative incidence of chronic GVHD was 54% 1 year after transplant. In the CLL group, 12-month non-relapse mortality, relapse incidence (RI), progression-free survival (PFS), and overall survival (OS) were 10, 30, 60, and 72%, respectively, and in the MCL group 5, 19, 76, and 86%, respectively. Pre-transplant ibrutinib failure and poor performance status predicted inferior RI, PFS and OS in the CLL group. In conclusion, ibrutinib does not affect the safety of a subsequent alloHCT. While the relatively high post-transplant relapse risk in ibrutinib-exposed patients with CLL deserves further study, in patients with MCL consolidating disease responses to ibrutinib with alloHCT seems to be a promising option.
- Published
- 2019
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38. Italian real life experience with ibrutinib: results of a large observational study on 77 relapsed/refractory mantle cell lymphoma.
- Author
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Broccoli A, Casadei B, Morigi A, Sottotetti F, Gotti M, Spina M, Volpetti S, Ferrero S, Spina F, Pisani F, Merli M, Visco C, Paolini R, Zilioli VR, Baldini L, Di Renzo N, Tosi P, Cascavilla N, Molica S, Ilariucci F, Rigolin GM, D'Alò F, Vanazzi A, Santambrogio E, Marasca R, Mastrullo L, Castellino C, Desabbata G, Scortechini I, Trentin L, Morello L, Argnani L, and Zinzani PL
- Abstract
Although sometimes presenting as an indolent lymphoma, mantle cell lymphoma (MCL) is an aggressive disease, hardly curable with standard chemo-immunotherapy. Current approaches have greatly improved patients' outcomes, nevertheless the disease is still characterized by high relapse rates. Before approval by EMA, Italian patients with relapsed/refractory MCL were granted ibrutinib early access through a Named Patient Program (NPP). An observational, retrospective, multicenter study was conducted. Seventy-seven heavily pretreated patients were enrolled. At the end of therapy there were 14 complete responses and 14 partial responses, leading to an overall response rate of 36.4%. At 40 months overall survival was 37.8% and progression free survival was 30%; disease free survival was 78.6% at 4 years: 11/14 patients are in continuous complete response with a median of 36 months of follow up. Hematological toxicities were manageable, and main extra-hematological toxicities were diarrhea (9.4%) and lung infections (9.0%). Overall, 4 (5.2%) atrial fibrillations and 3 (3.9%) hemorrhagic syndromes occurred. In conclusions, thrombocytopenia, diarrhea and lung infections are the relevant adverse events to be clinically focused on; regarding effectiveness, ibrutinib is confirmed to be a valid option for refractory/relapsed MCL also in a clinical setting mimicking the real world., Competing Interests: CONFLICTS OF INTEREST No potential conflicts of interest were disclosed.
- Published
- 2018
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39. Immunomodulatory Effects of Tyrosine Kinase Inhibitor In Vitro and In Vivo Study.
- Author
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Marinelli Busilacchi E, Costantini A, Viola N, Costantini B, Olivieri J, Butini L, Mancini G, Scortechini I, Chiarucci M, Poiani M, Poloni A, Leoni P, and Olivieri A
- Subjects
- Blood Specimen Collection, Cells, Cultured, Cytokines drug effects, Humans, Immunologic Factors pharmacology, Killer Cells, Natural drug effects, Protein Kinase Inhibitors immunology, Pyrimidines pharmacology, Pyrimidines therapeutic use, T-Lymphocyte Subsets drug effects, T-Lymphocytes, Regulatory drug effects, Protein Kinase Inhibitors pharmacology, Protein-Tyrosine Kinases antagonists & inhibitors
- Abstract
Pathogenesis of chronic graft-versus-host disease (cGVHD) is incompletely defined, involving donor-derived CD4 and CD8-positive T lymphocytes as well as B cells. Standard treatment is lacking for steroid-dependent/refractory cases; therefore, the potential usefulness of tyrosine kinase inhibitors (TKIs) has been suggested, based on their potent antifibrotic effect. However, TKIs seem to have pleiotropic activity. We sought to evaluate the in vitro and in vivo impact of different TKIs on lymphocyte phenotype and function. Peripheral blood mononuclear cells (PBMCs) from healthy donors were cultured in the presence of increasing concentrations of nilotinib, imatinib, dasatinib, and ponatinib; in parallel, 44 PBMC samples from 15 patients with steroid-dependent/refractory cGVHD treated with nilotinib in the setting of a phase I/II trial were analyzed at baseline, after 90, and after 180 days of therapy. Flow cytometry was performed after labeling lymphocytes with a panel of monoclonal antibodies (CD3, CD4, CD16, CD56, CD25, CD19, CD45RA, FoxP3, CD127, and 7-amino actinomycin D). Cytokine production was assessed in supernatants of purified CD3
+ T cells and in plasma samples from nilotinib-treated patients. Main T lymphocyte subpopulations were not significantly affected by therapeutic concentrations of TKIs in vitro, whereas proinflammatory cytokine (in particular, IL-2, IFN-γ, tumor necrosis factor-α, and IL-10) and IL-17 production showed a sharp decline. Frequency of T regulatory, B, and natural killer (NK) cells decreased progressively in presence of therapeutic concentrations of all TKIs tested in vitro, except for nilotinib, which showed little effect on these subsets. Of note, naive T regulatory cell (Treg) subset accumulated after exposure to TKIs. Results obtained in vivo on nilotinib-treated patients were largely comparable, both on lymphocyte subset kinetics and on cytokine production by CD3-positive cells. This study underlines the anti-inflammatory and immunomodulatory effects of TKIs and supports their potential usefulness as treatment for patients with steroid-dependent/refractory cGVHD. In addition, both in vitro and in vivo data point out that compared with other TKIs, nilotinib could better preserve the integrity of some important regulatory subsets, such as Treg and NK cells., (Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.)- Published
- 2018
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40. Combination of bendamustine and rituximab as front-line therapy for patients with chronic lymphocytic leukaemia: multicenter, retrospective clinical practice experience with 279 cases outside of controlled clinical trials.
- Author
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Gentile M, Zirlik K, Ciolli S, Mauro FR, Di Renzo N, Mastrullo L, Angrilli F, Molica S, Tripepi G, Giordano A, Di Raimondo F, Selleri C, Coscia M, Musso M, Orsucci L, Mannina D, Rago A, Giannotta A, Ferrara F, Herishanu Y, Shvidel L, Tadmor T, Scortechini I, Ilariucci F, Murru R, Guarini A, Musuraca G, Mineo G, Vincelli I, Arcari A, Tarantini G, Caparrotti G, Chiarenza A, Levato L, Villa MR, De Paolis MR, Zinzani PL, Polliack A, and Morabito F
- Subjects
- Adult, Aged, Bendamustine Hydrochloride administration & dosage, Bendamustine Hydrochloride adverse effects, Female, Humans, Male, Middle Aged, Retrospective Studies, Rituximab administration & dosage, Rituximab adverse effects, Treatment Outcome, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Leukemia, Lymphocytic, Chronic, B-Cell drug therapy
- Abstract
Recently, encouraging results in terms of safety and efficacy have been obtained using bendamustine-rituximab (BR) in untreated chronic lymphocytic leukaemia (CLL) patients enrolled in a phase II study. Here, we report a retrospective international multicenter study of CLL patients treated with BR as front-line therapy. The cohort included 279 patients with progressive CLL from 33 centers (29 Italian, 3 Israeli and 1 German) who received at least 1 cycle of BR as first-line treatment during the 2008-2014 period. The primary objective of this study was to evaluate the efficacy and safety of BR administered as front-line therapy, outside of controlled clinical trials. Median age was 70 years (range, 43-86 years); 62.4% were males and 35.8% had Binet stage C. Forty-two patients (15.2%) were unfit (cumulative illness rating scale [CIRS] score ≥7), and 140 (50.2%) had creatinine clearance ≤70 ml/min. Fluorescent in situ hybridisation analysis, available for 192 cases, showed that 21 (10.9%) had del11q and 18 (9.4%) del17p. The overall response rate (ORR) was 86.4%, with a complete remission rate of 28%. Patients with del17p had an ORR of 66.7%. After median follow-up of 24 months, the 2-year progression-free survival (PFS) was 69.9%; CIRS ≥7, immunoglobulin heavy-chain variable-region (IGHV) unmutated status, del17p and BR dose intensity <80% were independently associated with shorter PFS. Grade III or IV neutropenia, thrombocytopenia, and anaemia were observed in 25.9%, 15.4%, and 15.1% of patients, respectively. Twenty-four patients (8.6%) had severe infections. BR is also an effective and safe regimen for untreated CLL patients, outside of controlled clinical trials., (Copyright © 2016 Elsevier Ltd. All rights reserved.)
- Published
- 2016
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41. Reversal of poor graft function with iron-chelating therapy after allogeneic transplantation for severe aplastic anemia.
- Author
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Olivieri J, Mancini G, Goteri G, Scortechini I, Giantomassi F, Chiarucci M, Leoni P, and Olivieri A
- Subjects
- Adult, Anemia, Aplastic diagnosis, Female, Humans, Iron Chelating Agents pharmacology, Severity of Illness Index, Transplantation Conditioning, Transplantation, Homologous, Treatment Outcome, Anemia, Aplastic therapy, Graft Survival drug effects, Hematopoietic Stem Cell Transplantation adverse effects, Iron Chelating Agents therapeutic use
- Published
- 2016
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42. Mobilization-driven postconsolidation therapy in elderly patients with acute myeloid leukemia: feasibility and efficacy of autologous stem cell transplantation versus low-dose gemtuzumab ozogamicin.
- Author
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Capelli D, Chiarucci M, Poloni A, Saraceni F, Mancini G, Trappolini S, Troiani E, Montanari M, Scortechini I, Offidani M, Rupoli S, Scortechini AR, Gini G, Discepoli G, Leoni P, and Olivieri A
- Subjects
- Aminoglycosides administration & dosage, Antibodies, Monoclonal, Humanized administration & dosage, Antineoplastic Agents administration & dosage, Disease-Free Survival, Feasibility Studies, Female, Gemtuzumab, Humans, Leukemia, Myeloid, Acute mortality, Male, Prospective Studies, Aminoglycosides therapeutic use, Antibodies, Monoclonal, Humanized therapeutic use, Antineoplastic Agents therapeutic use, Hematopoietic Stem Cell Transplantation methods, Leukemia, Myeloid, Acute drug therapy, Transplantation Conditioning methods
- Abstract
We prospectively evaluated 2 postconsolidation strategies, administered according to the mobilization outcome, in 72 acute myeloid leukemia (AML) fit elderly patients, achieving complete remission after the first high-dose cytarabine-based induction. Autologous stem cell transplantation (ASCT) was performed in patients collecting ≥3 × 10(6) CD34(+)/kg and low-dose gemtuzumab ozogamicin (GO) was performed in poor mobilizers (collecting <3 × 10(6) CD34(+)/kg). Fifty-five patients (76.3%) underwent peripheral blood stem cell (PBSC) mobilization, after first consolidation, and 24 of 55 (44%) collected >3 × 10(6) CD34(+) cells/kg. Among the 55 patients eligible for PBSC mobilization, 7 did not receive the planned treatment, 23 were allocated for ASCT, and 25 were allocated for GO on an intention-to-treat basis. With a median follow-up of 70 months (range, 24 to 124), 20 of 55 patients are alive, 18 of them in continuous complete remission. The 8-year overall survival (OS) and disease-free survival (DFS) are, respectively, 35.9% (95% confidence interval [CI] 24% to 49.8%) and 31.2% (95% CI, 21% to 43.8%), median OS and DFS were 22 and 16 months, respectively. In multivariate analysis, postconsolidation treatment and hyperleukocytosis (WBC > 50,000/μL) significantly predicted OS and DFS, whereas secondary AML was significantly associated with a higher relapse rate (83.4% versus 54% of de novo AML). Patients with hyperleukocytosis had 0% 3-year OS versus the 46% (at 8 years) in patients without hyperleukocytosis (P = .01); 57% of patients in the GO arm are alive at 8 years, compared with 25.4% of patients in the ASCT arm, who had an overall relative risk (RR) of death of 2.6 (95% CI, 1.2 to 5.8; P = .02). DFS at 8 years was 45.3% in patients receiving GO, compared with 26% in ASCT arm (RR, 2.1; 95% CI, 1 to 4.3; P = .05). Our study outlines low feasibility and efficacy of ASCT in elderly AML patients, whereas postconsolidation with GO appears safe and effective in this unfavorable setting. The study was registered at Umin Clinical Trial Registry (www.umin.ac.jp/ctr), number R000014052., (Copyright © 2014 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2014
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43. Conditioning regimen with BCNU, etoposide, cytarabine and melphalan plus amifostine for outpatient autologous stem cell transplant: feasibility and outcome in 97 patients with lymphoma.
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Scortechini I, Montanari M, Mancini G, Inglese E, Calandrelli M, Chiarucci M, Offidani M, Capelli D, Gini G, Poloni A, Mancini S, Raggetti G, Leoni P, and Olivieri A
- Subjects
- Amifostine administration & dosage, Carmustine administration & dosage, Cytarabine administration & dosage, Etoposide administration & dosage, Humans, Melphalan administration & dosage, Outpatients, Transplantation, Autologous, Treatment Outcome, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Hematopoietic Stem Cell Transplantation, Lymphoma therapy, Transplantation Conditioning
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- 2014
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44. Very low rate of readmission after an early discharge outpatient model for autografting in multiple myeloma patients: an Italian multicenter retrospective study.
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Martino M, Montanari M, Ferrara F, Ciceri F, Scortechini I, Palmieri S, Marktel S, Cimminiello M, Messina G, Irrera G, Offidani M, Console G, Castagna L, Milone G, Bruno B, Tripepi G, Lemoli RM, and Olivieri A
- Subjects
- Adult, Aged, Female, Humans, Italy epidemiology, Male, Middle Aged, Multiple Myeloma epidemiology, Outpatients, Patient Readmission, Retrospective Studies, Stem Cell Transplantation statistics & numerical data, Transplantation, Autologous, Multiple Myeloma therapy, Stem Cell Transplantation methods
- Abstract
We analyzed the main modalities and clinical outcomes of the early discharge outpatient model in autologous stem cell transplantation (EDOM-ASCT) for multiple myeloma in Italy. EDOM-ASCT was employed in 382 patients, for a total of 522 procedures, between 1998 and 2012. Our study showed high homogeneity among centers in terms of inclusion criteria, supportive care, and in hospital readmission criteria. Overall, readmissions during the aplastic phase occurred in 98 of 522 transplantations (18.8%). The major extrahematological complication was neutropenic fever in 161 cases (30.8%), which required readmission in 76 cases. The incidence of severe World Health Organization grade 3 to 4 mucositis was 9.6%. By univariate analysis, fever, mucositis, altered renal function at diagnosis, second transplantation, and transplantation performed late in the course of the disease were significantly correlated with readmission, whereas fever, mucositis, altered renal function, and timing of transplantation remained the only independent predictors by multivariate analysis. Overall, transplantation-related mortality was 1.0%. No center effect was observed in this study (P = .36). The safety and low rate of readmission of the EDOM-ASCT in myeloma trial suggest that this strategy could be extended to other transplantation centers if a stringent patient selection and appropriate management are applied., (Copyright © 2014 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2014
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45. Factors affecting successful mobilization with plerixafor: an Italian prospective survey in 215 patients with multiple myeloma and lymphoma.
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Lanza F, Lemoli RM, Olivieri A, Laszlo D, Martino M, Specchia G, Pavone V, Imola M, Pasini A, Milone G, Scortechini I, Todisco E, Guggiari E, Cascavilla N, Martinelli G, Rambaldi A, and Bosi A
- Subjects
- Adolescent, Adult, Aged, Benzylamines, Blood Component Removal methods, Chemoradiotherapy, Cyclams, Data Collection, Female, Humans, Italy, Leukapheresis methods, Male, Middle Aged, Platelet Count, Predictive Value of Tests, Prospective Studies, Young Adult, Hematopoietic Stem Cell Mobilization methods, Heterocyclic Compounds therapeutic use, Lymphoma therapy, Multiple Myeloma therapy, Receptors, CXCR4 antagonists & inhibitors
- Abstract
Background: Although the efficacy of plerixafor in peripheral blood stem cell (PBSC) mobilization has been explored in several studies, factors associated with successful plerixafor mobilization after administration of granulocyte-colony-stimulating factor (G-CSF), with or without chemotherapy, have not been investigated. We analyzed data on PBSC mobilization from a large Italian database of lymphoma and myeloma plerixafor-treated patients., Study Design and Methods: Two endpoints were established to define successful mobilization: patients with at least 2 × 10(6) CD34+ cells/kg collected by three leukapheresis procedures and patients achieving a peak count of at least 20 × 10(6) CD34+ cells/L during mobilization., Results: Plerixafor achieved successful mobilization in both predicted (n = 64) and proven poor mobilizers (PMs; n = 143), classified according to the Gruppo Italiano Trapianto di Midollo Osseo (GITMO) criteria. Successful mobilization was independent of type of mobilization (steady state or chemotherapy); age; sex; disease; number or type of chemotherapy regimens preceding plerixafor; radiation therapy; prior treatment with melphalan, carmustine, lenalidomide, and radioimmune conjugates; and laboratory variables. Multivariate analysis identified previous fludarabine treatment and premobilization platelet count as predictors of successful mobilization., Conclusion: This large, prospective, nationwide study confirmed plerixafor efficacy for mobilizing PBSCs when added to G-CSF with or without chemotherapy. Plerixafor can overcome negative effects of most predictors of poor mobilization to achieve satisfactory harvest both in predicted and proven PM., (© 2013 American Association of Blood Banks.)
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- 2014
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46. 6q deletion detected by fluorescence in situ hybridization using bacterial artificial chromosome in chronic lymphocytic leukemia.
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Dalsass A, Mestichelli F, Ruggieri M, Gaspari P, Pezzoni V, Vagnoni D, Angelini M, Angelini S, Bigazzi C, Falcioni S, Troiani E, Alesiani F, Catarini M, Attolico I, Scortechini I, Discepoli G, and Galieni P
- Subjects
- Adult, Aged, Aged, 80 and over, Biopsy, Chromosome Deletion, Chromosome Mapping, Chromosomes, Artificial, Bacterial, Chromosomes, Human, Pair 6 genetics, Female, Humans, Immunophenotyping, Male, Middle Aged, Oligonucleotides genetics, Prognosis, Time Factors, In Situ Hybridization, Fluorescence, Leukemia, Lymphocytic, Chronic, B-Cell genetics
- Abstract
Deletions of the long arm of chromosome 6 are known to occur at relatively low frequency (3-6%) in chronic lymphocytic leukemia (CLL), and they are more frequently observed in 6q21. Few data have been reported regarding other bands on 6q involved by cytogenetic alterations in CLL. The cytogenetic study was performed in nuclei and metaphases obtained after stimulation with a combination of CpG-oligonucleotide DSP30 and interleukin-2. Four bacterial artificial chromosome (BAC) clones mapping regions in bands 6q16, 6q23, 6q25, 6q27 were used as probes for fluorescence in situ hybridization in 107 CLL cases in order to analyze the occurrence and localization of 6q aberrations. We identified 11 cases (10.2%) with 6q deletion of 107 patients studied with CLL. The trends of survival curves and the treatment-free intervals (TFI) of patients with deletion suggest a better outcome than the other cytogenetic risk groups. We observed two subgroups with 6q deletion as the sole anomaly: two cases with 6q16 deletion, and three cases with 6q25.2-27 deletion. There were differences of age, stage, and TFI between both subgroups. By using BAC probes, we observed that 6q deletion has a higher frequency in CLL and is linked with a good prognosis. In addition, it was observed that the deletion in 6q16 appears to be the most frequent and, if present as the only abnormality, it could be associated with a most widespread disease., (© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Published
- 2013
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47. Bortezomib plus dexamethasone followed by escalating donor lymphocyte infusions for patients with multiple myeloma relapsing or progressing after allogeneic stem cell transplantation.
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Montefusco V, Spina F, Patriarca F, Offidani M, Bruno B, Montanari M, Mussetti A, Sperotto A, Scortechini I, Dodero A, Fanin R, Valagussa P, and Corradini P
- Subjects
- Adult, Aged, Antineoplastic Agents pharmacology, Boronic Acids pharmacology, Bortezomib, Dexamethasone pharmacology, Disease Progression, Female, Graft vs Host Disease immunology, Graft vs Host Disease pathology, Humans, Male, Middle Aged, Multiple Myeloma immunology, Multiple Myeloma mortality, Multiple Myeloma pathology, Prospective Studies, Pyrazines pharmacology, Recurrence, Remission Induction, Siblings, Survival Analysis, Transplantation, Homologous, Treatment Outcome, Unrelated Donors, Antineoplastic Agents therapeutic use, Boronic Acids therapeutic use, Dexamethasone therapeutic use, Hematopoietic Stem Cell Transplantation, Lymphocyte Transfusion, Multiple Myeloma therapy, Pyrazines therapeutic use
- Abstract
Multiple myeloma relapsing after allogeneic stem cell transplantation (alloSCT) has a poor outcome. To assess the safety and efficacy of bortezomib and dexamethasone (VD) combination followed by donor lymphocyte infusions (DLIs) in myeloma patients relapsing or progressing after alloSCT, a prospective phase II study was designed. The treatment plan consisted of three VD courses followed by escalated doses of DLIs in case of response or at least stable disease. Nineteen patients were enrolled with a median age of 57 years (range, 33 to 67); 14 patients were allografted from human leukocyte antigen-identical siblings and 5 from alternative donors. Sixteen of 19 patients received the planned treatment, but 3 patients did not: 2 patients because of disease progression and 1 refused. After the VD phase the response rate was 62%, with 1 complete remission, 6 very good partial remissions, 5 partial remissions, 2 patients with stable disease, and 5 with progressive disease. After the DLI phase, the response rate was 68%, but a significant upgrade of response was observed: 3 stringent complete remissions, 2 complete remissions, 5 very good partial remissions, 1 partial remission, 4 with stable disease, and 1 with progressive disease. With a median follow-up of 40 months (range, 29 to 68), the 3-year progression-free survival and overall survival rates were 31% and 73%, respectively. Neither unexpected organ toxicities, in particular severe neuropathy, nor severe acute graft-versus-host disease flares were observed. VD-DLIs is a safe treatment for multiple myeloma patients relapsing or progressing after alloSCT and may be effective., (Copyright © 2013 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.)
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- 2013
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48. Autologous hematopoietic progenitor cell transplantation for multiple myeloma through an outpatient program.
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Martino M, Montanari M, Bruno B, Console G, Irrera G, Messina G, Offidani M, Scortechini I, Moscato T, Fedele R, Milone G, Castagna L, and Olivieri A
- Subjects
- Ambulatory Care psychology, Clinical Trials as Topic methods, Hematopoietic Stem Cell Transplantation psychology, Humans, Multiple Myeloma diagnosis, Multiple Myeloma psychology, Outpatients psychology, Quality of Life psychology, Transplantation, Autologous methods, Ambulatory Care methods, Hematopoietic Stem Cell Transplantation methods, Multiple Myeloma therapy
- Abstract
Introduction: There are considerable concerns regarding the appropriate use of health care resources to reduce costs and waiting lists associated with autologous hematopoietic progenitor cell transplantation (AHPCT). One of the strategies to reach this goal is outpatient-based (OpB) AHPCT., Areas Covered: We reviewed all the reported experiences in this field and illustrated the various models of OpB AHPCT., Expert Opinion: The role of high-dose melphalan (HDM) followed by AHPCT in the treatment of Multiple Myeloma (MM) continues to evolve in the novel agent era and the International Myeloma Working Group recommends that AHPCT should be offered at some point in the course of the treatment program for a medically fit patient. The relatively short neutropenia and the limited extra-marrow toxicity after HDM support the hypothesis that MM patients are the most suitable for outpatient transplant programs. Various models have shown that the procedure is feasible and safe and may highly contribute to shorten waiting lists and to considerably cut health costs, with an improvement of quality of life. Ideal candidates may be those who are asymptomatic and fully active, who have a full-time caregiver and who can reside within easy reach from the transplant center.
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- 2012
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49. Low-dose Gemtuzumab-Ozogamicin as post-consolidation therapy in elderly patients with acute myeloid leukaemia: a pilot study.
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Poloni A, Capelli D, Trappolini S, Costantini B, Montanari M, Gini G, Scortechini I, Mancini G, Discepoli G, Leoni P, and Olivieri A
- Subjects
- Aged, Antibodies, Monoclonal, Humanized, Female, Gemtuzumab, Humans, Male, Middle Aged, Pilot Projects, Survival Analysis, Treatment Outcome, Aminoglycosides therapeutic use, Antibodies, Monoclonal therapeutic use, Antineoplastic Agents therapeutic use, Leukemia, Myeloid, Acute drug therapy
- Published
- 2010
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50. A new schedule of CHOP/rituximab plus granulocyte-macrophage colony-stimulating factor is an effective rescue for patients with aggressive lymphoma failing autologous stem cell transplantation.
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Olivieri A, Lucesole M, Capelli D, Gini G, Montanari M, Candela M, Troiani E, Scortechini I, Poloni A, and Leoni P
- Subjects
- Adult, Aged, Antibodies, Monoclonal, Murine-Derived, Cyclophosphamide administration & dosage, Disease-Free Survival, Doxorubicin administration & dosage, Female, Humans, Lymphoma complications, Lymphoma mortality, Male, Middle Aged, Prednisone administration & dosage, Recombinant Proteins, Remission Induction, Retrospective Studies, Rituximab, Salvage Therapy, Transplantation, Autologous, Treatment Failure, Vincristine administration & dosage, Antibodies, Monoclonal administration & dosage, Antineoplastic Agents administration & dosage, Antineoplastic Combined Chemotherapy Protocols administration & dosage, Granulocyte-Macrophage Colony-Stimulating Factor administration & dosage, Lymphoma therapy, Stem Cell Transplantation mortality
- Abstract
From 1999 to 2002, 20 patients with aggressive non-Hodgkin lymphoma, among 28 who failed autologous peripheral blood progenitor cell transplantation, were rescued with cyclophosphamide, hydroxydaunomycin, Oncovin (vincristine), and prednisone (CHOP)/rituximab (RTX) and granulocyte-macrophage colony-stimulating factor (GM-CSF). RTX was administered twice during each course of chemotherapy, before CHOP and after GM-CSF. This cytokine was given to increase the antibody-dependent cell-mediated cytotoxicity and to reduce the leukopenia on the basis of our preliminary data, which suggested that this cytokine can upregulate CD20 expression. The relevant (World Health Organization grade 3-4) toxicity mainly consisted of myelosuppression (neutropenia in 60% of patients). Fifteen patients achieved complete remission (CR) or had a partial response, with an overall response rate of 75% (60% CR and 15% partial response). Six of the 12 patients who achieved CR relapsed: 2 died of progressive disease, 1 died of infectious complications after allogeneic transplantation, and 3 are alive in second CR. Eight patients showed progressive disease: 5 died of progressive disease, 1 of secondary acute leukemia, and 1 of infectious complications after allogeneic transplantation, whereas 1 is alive in second CR. At last follow-up, 10 patients are alive, 6 of whom are in complete continuous remission, with a median follow-up of 31 months (range, 3-51 months). The projected 4-year progression-free survival is 31.4%, and the 4-year overall survival is 50%. This new association (RTX, CHOP, and GM-CSF) was feasible in approximately 70% of patients; the overall toxicity was manageable. The good response rate and the promising outcome observed in this subset of patients could be explained by the possible increased synergy between chemotherapy, RTX, and GM-CSF, which should be explored in further studies.
- Published
- 2005
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