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Al-Juhaishi T, Borogovac A, Ibrahimi S, Wieduwilt M, Ahmed S. Reappraising the Role of Allogeneic Hematopoietic Stem Cell Transplantation in Relapsed and Refractory Hodgkin’s Lymphoma: Recent Advances and Outcomes. J Pers Med 2022; 12:jpm12020125. [PMID: 35207613 PMCID: PMC8880200 DOI: 10.3390/jpm12020125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/04/2022] [Accepted: 01/10/2022] [Indexed: 12/07/2022] Open
Abstract
Hodgkin’s lymphoma is a rare yet highly curable disease in the majority of patients treated with modern chemotherapy regimens. For patients who fail to respond to or relapse after initial systemic therapies, treatment with high-dose chemotherapy and autologous hematopoietic stem cell transplantation can provide a cure for many with chemotherapy-responsive lymphoma. Patients who relapse after autologous transplant or those with chemorefractory disease have poor prognosis and represent a high unmet need. Allogeneic hematopoietic stem cell transplantation provides a proven curative therapy for these patients and should be considered, especially in young and medically fit patients. The use of newer agents in this disease such as brentuximab vedotin and immune checkpoint inhibitors can help bring more patients to transplantation and should be considered as well.
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Affiliation(s)
- Taha Al-Juhaishi
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK 73104, USA; (A.B.); (S.I.); (M.W.)
- Correspondence: ; Tel.: +1-40527-18001
| | - Azra Borogovac
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK 73104, USA; (A.B.); (S.I.); (M.W.)
| | - Sami Ibrahimi
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK 73104, USA; (A.B.); (S.I.); (M.W.)
| | - Matthew Wieduwilt
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK 73104, USA; (A.B.); (S.I.); (M.W.)
| | - Sairah Ahmed
- MD Anderson Cancer Center, University of Texas, Houston, TX 77030, USA;
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2
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Marani C, Raiola AM, Morbelli S, Dominietto A, Ferrarazzo G, Avenoso D, Giannoni L, Varaldo R, Gualandi F, Grazia D, Lamparelli T, Bregante S, Van Lint MT, Ibatici A, Bovis F, Lemoli RM, Gobbi M, Bacigalupo A, Angelucci E. Haploidentical Transplants with Post-Transplant Cyclophosphamide for Relapsed or Refractory Hodgkin Lymphoma: The Role of Comorbidity Index and Pretransplant Positron Emission Tomography. Biol Blood Marrow Transplant 2018; 24:2501-2508. [PMID: 30041010 DOI: 10.1016/j.bbmt.2018.07.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 07/15/2018] [Indexed: 02/07/2023]
Abstract
Disease relapse remains an unmet medical need for patients with Hodgkin lymphoma (HL) receiving an allogeneic hematopoietic cell transplantation (HCT). With the aim of identifying patients at high risk for post-transplant relapse, we retrospectively reviewed 41 HL patients who had received haploidentical (haplo) nonmyeloablative (NMA) HCT with high dose post-transplant cyclophosphamide (PT-Cy) for graft-versus-host (GVHD) prophylaxis. Primary refractory disease, relapse within 6 months from autologous stem cell transplantation, age, pretransplant chemotherapy, HCT comorbidity index (HCT-CI), sex mismatch, tumor burden and pretransplant fluorodeoxyglucose positron emission tomography (FDG-PET) status, assessed by Deauville score, were analyzed as variables influencing outcomes. All but 1 patient engrafted: median time to neutrophil and platelet recovery was 15 (interquartile range, 13 to 23) days and 19 (interquartile range, 12 to 28) days, respectively. Cumulative incidence of severe (grade III to IV) acute graft-versus-host disease (GVHD) and 3-year moderate-severe chronic GVHD was 2.4% and 11.8%, respectively. The 3-year overall (OS), progression free (PFS), and graft relapse-free survival (GRFS) were 75.6%, 43.9%, and 39%, respectively. On multivariate analysis, 3-year OS was significantly worse in patients with HCT-CI ≥3 (hazard ratio [HR], 5.0; 95% confidence interval [CI], 1.1 to 21.8; P = .03). Three-year relapse rate, 3-year PFS, and 3-year GRFS were significantly worse in patients with HCT-CI ≥3 (HR, 3.5; 95% CI, 1.3 to 9.3; P = .01; HR, 3.3; 95% CI, 1.2 to 9.0; P = .02; and HR, 4.2; 95% CI, 1.7 to 9.9; P = .001, respectively) and in patients with a Deauville score ≥4 on pretransplant FDG-PET (HR, 4.4; 95% CI, 1.6-12.4; P = .005, HR, 3.8; 95% CI, 1.5 to 9.7; P = .005; and 3.2; 95% CI, 1.3 to 7.9; P = .01, respectively). On univariate analysis, 3-year NRM was significantly worse only in patients with a HCT-CI ≥3 (HR, 17.6; 95% CI, 1.4 to 221.0). Among relapsed or refractory HL patients undergoing haplo NMA HCT with PT-Cy, pretransplant FDG-PET with a Deauville score ≥4 and HCT-CI ≥3 identified patients at high risk of relapse. Moreover, an HCT-CI ≥3 was associated with higher NRM and lower OS.
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Affiliation(s)
- Carlo Marani
- Division of Haematology and Bone Marrow Transplantation, Policlinico San Martino, IRCCS Ospedale Policlinico San Martino, Genoa, Italy per l'Oncologia, Genoa, Italy; Haematology Clinic, Department of Internal Medicine, University of Genoa, Policlinico San Martino, IRCCS Ospedale Policlinico San Martino, Genoa, Italy per l'Oncologia, Genoa, Italy.
| | - Anna Maria Raiola
- Division of Haematology and Bone Marrow Transplantation, Policlinico San Martino, IRCCS Ospedale Policlinico San Martino, Genoa, Italy per l'Oncologia, Genoa, Italy
| | - Silvia Morbelli
- Nuclear Medicine Unit, Department of Health Sciences, Policlinico San Martino, IRCCS Ospedale Policlinico San Martino, Genoa, Italy per l'Oncologia, Genoa, Italy
| | - Alida Dominietto
- Division of Haematology and Bone Marrow Transplantation, Policlinico San Martino, IRCCS Ospedale Policlinico San Martino, Genoa, Italy per l'Oncologia, Genoa, Italy
| | - Giulia Ferrarazzo
- Nuclear Medicine Unit, Department of Health Sciences, Policlinico San Martino, IRCCS Ospedale Policlinico San Martino, Genoa, Italy per l'Oncologia, Genoa, Italy
| | - Daniele Avenoso
- Division of Haematology and Bone Marrow Transplantation, Policlinico San Martino, IRCCS Ospedale Policlinico San Martino, Genoa, Italy per l'Oncologia, Genoa, Italy; Haematology Clinic, Department of Internal Medicine, University of Genoa, Policlinico San Martino, IRCCS Ospedale Policlinico San Martino, Genoa, Italy per l'Oncologia, Genoa, Italy
| | - Livia Giannoni
- Division of Haematology and Bone Marrow Transplantation, Policlinico San Martino, IRCCS Ospedale Policlinico San Martino, Genoa, Italy per l'Oncologia, Genoa, Italy
| | - Riccardo Varaldo
- Division of Haematology and Bone Marrow Transplantation, Policlinico San Martino, IRCCS Ospedale Policlinico San Martino, Genoa, Italy per l'Oncologia, Genoa, Italy
| | - Francesca Gualandi
- Division of Haematology and Bone Marrow Transplantation, Policlinico San Martino, IRCCS Ospedale Policlinico San Martino, Genoa, Italy per l'Oncologia, Genoa, Italy
| | - Di Grazia
- Division of Haematology and Bone Marrow Transplantation, Policlinico San Martino, IRCCS Ospedale Policlinico San Martino, Genoa, Italy per l'Oncologia, Genoa, Italy
| | - Teresa Lamparelli
- Division of Haematology and Bone Marrow Transplantation, Policlinico San Martino, IRCCS Ospedale Policlinico San Martino, Genoa, Italy per l'Oncologia, Genoa, Italy
| | - Stefania Bregante
- Division of Haematology and Bone Marrow Transplantation, Policlinico San Martino, IRCCS Ospedale Policlinico San Martino, Genoa, Italy per l'Oncologia, Genoa, Italy
| | - Maria Teresa Van Lint
- Division of Haematology and Bone Marrow Transplantation, Policlinico San Martino, IRCCS Ospedale Policlinico San Martino, Genoa, Italy per l'Oncologia, Genoa, Italy
| | - Adalberto Ibatici
- Division of Haematology and Bone Marrow Transplantation, Policlinico San Martino, IRCCS Ospedale Policlinico San Martino, Genoa, Italy per l'Oncologia, Genoa, Italy
| | - Francesca Bovis
- Biostatistics Unit, Department of Health Sciences, University of Genoa, Italy
| | - Roberto Massimo Lemoli
- Haematology Clinic, Department of Internal Medicine, University of Genoa, Policlinico San Martino, IRCCS Ospedale Policlinico San Martino, Genoa, Italy per l'Oncologia, Genoa, Italy
| | - Marco Gobbi
- Haematology Clinic, Department of Internal Medicine, University of Genoa, Policlinico San Martino, IRCCS Ospedale Policlinico San Martino, Genoa, Italy per l'Oncologia, Genoa, Italy
| | - Andrea Bacigalupo
- Haematology Institute, Policlinico Universitario A Gemelli, Cattolica University, Rome, Italy
| | - Emanuele Angelucci
- Division of Haematology and Bone Marrow Transplantation, Policlinico San Martino, IRCCS Ospedale Policlinico San Martino, Genoa, Italy per l'Oncologia, Genoa, Italy
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Li Z, Ju X, Lee K, Clarke C, Hsu JL, Abadir E, Bryant CE, Pears S, Sunderland N, Heffernan S, Hennessy A, Lo TH, Pietersz GA, Kupresanin F, Fromm PD, Silveira PA, Tsonis C, Cooper WA, Cunningham I, Brown C, Clark GJ, Hart DNJ. CD83 is a new potential biomarker and therapeutic target for Hodgkin lymphoma. Haematologica 2018; 103:655-665. [PMID: 29351987 PMCID: PMC5865416 DOI: 10.3324/haematol.2017.178384] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 01/10/2018] [Indexed: 11/30/2022] Open
Abstract
Chemotherapy and hematopoietic stem cell transplantation are effective treatments for most Hodgkin lymphoma patients, however there remains a need for better tumor-specific target therapy in Hodgkin lymphoma patients with refractory or relapsed disease. Herein, we demonstrate that membrane CD83 is a diagnostic and therapeutic target, highly expressed in Hodgkin lymphoma cell lines and Hodgkin and Reed-Sternberg cells in 29/35 (82.9%) Hodgkin lymphoma patient lymph node biopsies. CD83 from Hodgkin lymphoma tumor cells was able to trogocytose to surrounding T cells and, interestingly, the trogocytosing CD83+T cells expressed significantly more programmed death-1 compared to CD83-T cells. Hodgkin lymphoma tumor cells secreted soluble CD83 that inhibited T-cell proliferation, and anti-CD83 antibody partially reversed the inhibitory effect. High levels of soluble CD83 were detected in Hodgkin lymphoma patient sera, which returned to normal in patients who had good clinical responses to chemotherapy confirmed by positron emission tomography scans. We generated a human anti-human CD83 antibody, 3C12C, and its toxin monomethyl auristatin E conjugate, that killed CD83 positive Hodgkin lymphoma cells but not CD83 negative cells. The 3C12C antibody was tested in dose escalation studies in non-human primates. No toxicity was observed, but there was evidence of CD83 positive target cell depletion. These data establish CD83 as a potential biomarker and therapeutic target in Hodgkin lymphoma.
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Affiliation(s)
- Ziduo Li
- Dendritic Cell Research, ANZAC Research Institute, Sydney, Australia
- Sydney Medical School, University of Sydney, Australia
| | - Xinsheng Ju
- Dendritic Cell Research, ANZAC Research Institute, Sydney, Australia
- Sydney Medical School, University of Sydney, Australia
| | - Kenneth Lee
- Sydney Medical School, University of Sydney, Australia
- Department of Anatomical Pathology, Concord Repatriation General Hospital, Sydney, Australia
| | - Candice Clarke
- Department of Anatomical Pathology, Concord Repatriation General Hospital, Sydney, Australia
| | - Jennifer L Hsu
- Dendritic Cell Research, ANZAC Research Institute, Sydney, Australia
- Sydney Medical School, University of Sydney, Australia
| | - Edward Abadir
- Dendritic Cell Research, ANZAC Research Institute, Sydney, Australia
- Sydney Medical School, University of Sydney, Australia
| | - Christian E Bryant
- Dendritic Cell Research, ANZAC Research Institute, Sydney, Australia
- Institute of Haematology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Suzanne Pears
- Animal Facility, Royal Prince Alfred Hospital, Sydney, Australia
| | | | - Scott Heffernan
- Animal Facility, Royal Prince Alfred Hospital, Sydney, Australia
| | | | - Tsun-Ho Lo
- Dendritic Cell Research, ANZAC Research Institute, Sydney, Australia
- Sydney Medical School, University of Sydney, Australia
| | - Geoffrey A Pietersz
- Burnet Institute, Melbourne, Australia
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Fiona Kupresanin
- Dendritic Cell Research, ANZAC Research Institute, Sydney, Australia
| | - Phillip D Fromm
- Dendritic Cell Research, ANZAC Research Institute, Sydney, Australia
- Sydney Medical School, University of Sydney, Australia
| | - Pablo A Silveira
- Dendritic Cell Research, ANZAC Research Institute, Sydney, Australia
- Sydney Medical School, University of Sydney, Australia
| | - Con Tsonis
- Dendritic Cell Research, ANZAC Research Institute, Sydney, Australia
| | - Wendy A Cooper
- Sydney Medical School, University of Sydney, Australia
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia
- School of Medicine, University of Western Sydney, Australia
| | - Ilona Cunningham
- Department of Haematology, Concord Repatriation General Hospital, Sydney, Australia
| | - Christina Brown
- Sydney Medical School, University of Sydney, Australia
- Institute of Haematology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Georgina J Clark
- Dendritic Cell Research, ANZAC Research Institute, Sydney, Australia
- Sydney Medical School, University of Sydney, Australia
| | - Derek N J Hart
- Dendritic Cell Research, ANZAC Research Institute, Sydney, Australia
- Sydney Medical School, University of Sydney, Australia
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Perales MA, Sauter CS, Armand P. Reprint of: Fast Cars and No Brakes: Autologous Stem Cell Transplantation as a Platform for Novel Immunotherapies. Biol Blood Marrow Transplant 2016; 22:S9-S14. [PMID: 26899275 DOI: 10.1016/j.bbmt.2016.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Accepted: 10/14/2015] [Indexed: 11/24/2022]
Abstract
Autologous stem cell transplantation (ASCT) is indicated in a number of hematologic malignancies, including multiple myeloma, non-Hodgkin lymphoma, and Hodgkin lymphoma. Relapse, however, remains 1 of the main causes of post-ASCT failure, and several strategies are being investigated to decrease the risk of relapse of progression. Recent advances in the treatment of hematological malignancies have included adoptive transfer of genetically modified T cells that express chimeric antigen receptors or T cell receptors, as well the use of checkpoint inhibitors. Early clinical results in non-transplantation patients have been very promising. This review will focus on the use of gene-modified T cells and checkpoint inhibitors in stem cell transplantation.
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Affiliation(s)
- Miguel-Angel Perales
- Department of Medicine, Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York.
| | - Craig S Sauter
- Department of Medicine, Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Philippe Armand
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
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5
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Musso M, Messina G, Di Renzo N, Di Carlo P, Vitolo U, Scalone R, Marcacci G, Scalzulli PR, Moscato T, Matera R, Crescimanno A, Santarone S, Orciuolo E, Merenda A, Pavone V, Pastore D, Donnarumma D, Carella AM, Ciochetto C, Cascavilla N, Mele A, Lanza F, Di Nicola M, Bonizzoni E, Pinto A. Improved outcome of patients with relapsed/refractory Hodgkin lymphoma with a new fotemustine-based high-dose chemotherapy regimen. Br J Haematol 2016; 172:111-21. [PMID: 26458240 PMCID: PMC5053328 DOI: 10.1111/bjh.13803] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2015] [Accepted: 08/03/2015] [Indexed: 01/04/2023]
Abstract
High-dose chemotherapy (HDT) with autologous stem cell transplantation is the standard of care for relapsed/refractory (RR) Hodgkin lymphoma (HL). Given that HDT may cure a sizeable proportion of patients refractory to first salvage, development of newer conditioning regimens remains a priority. We present the results of a novel HDT regimen in which carmustine was substituted by a third-generation chloroethylnitrosourea, fotemustine, with improved pharmacokinetics and safety (FEAM; fotemustine, etoposide, cytarabine, melphalan) in 122 patients with RR-HL accrued into a prospective registry-based study. Application of FEAM resulted in a 2-year progression-free survival (PFS) of 73·8% [95% confidence interval (CI), 0·64-0·81] with median PFS, overall survival and time to progression yet to be reached. The 2-year risk of progression adjusted for the competitive risk of death was 19·4% (95% CI, 0·12-0·27) for the entire patient population. Most previously established independent risk factors, except for fluorodeoxyglucose ((18) (F) FDG)-uptake, were unable to predict for disease progression and survival after FEAM. Although 32% of patients had (18) (F) FDG-positrin emission tomography-positive lesions before HDT, the 2-year risk of progression adjusted for competitive risk of death was 19·4% (95% CI; 0·12-0·27). No unusual acute toxicities or early/late pulmonary adverse events were registered. FEAM emerges as an ideal HDT regimen for RR-HL patients typically pre-exposed to lung-damaging treatments.
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Affiliation(s)
- Maurizio Musso
- Dipartimento Oncologico “La Maddalena”UOC di Oncoematologia e TMOPalermoItaly
| | - Giuseppe Messina
- Azienda Ospedaliera ‘Bianchi Melacrino Morelli’C.T.M.O. Centro Unico Regionale Trapianti di Cellule Staminali e Terapie CellulariReggio CalabriaItaly
| | - Nicola Di Renzo
- UOC di Ematologia e Trapianto di Cellule StaminaliP.O. “Vito Fazzi”LecceItaly
| | - Paolo Di Carlo
- Unità Terapia Intensiva Ematologica per il Trapianto EmopoieticoOspedale CivilePescaraItaly
| | - Umberto Vitolo
- Dipartimento di Oncologia ed EmatologiaA.O. U.Città della Salute e della Scienza di Torino San Giovanni BattistaS.C. EmatologiaTorinoItaly
| | - Renato Scalone
- Dipartimento Oncologico “La Maddalena”UOC di Oncoematologia e TMOPalermoItaly
| | - Gianpaolo Marcacci
- Dipartimento di EmatologiaIstituto Nazionale TumoriFondazione ‘G. Pascale’IRCCSUOC di Ematologia Oncologica e Trapianto di Cellule StaminaliNapoliItaly
| | - Potito R. Scalzulli
- Divisione di EmatologiaIRCSS Casa Sollievo della SofferenzaSan Giovanni RotondoItaly
| | - Tiziana Moscato
- Azienda Ospedaliera ‘Bianchi Melacrino Morelli’C.T.M.O. Centro Unico Regionale Trapianti di Cellule Staminali e Terapie CellulariReggio CalabriaItaly
| | - Rossella Matera
- UOC di Ematologia e Trapianto di Cellule StaminaliP.O. “Vito Fazzi”LecceItaly
| | | | - Stella Santarone
- Unità Terapia Intensiva Ematologica per il Trapianto EmopoieticoOspedale CivilePescaraItaly
| | - Enrico Orciuolo
- Dipartimento di Oncologia, Trapianti e Tecnologie AvanzateAzienda Ospedaliero‐Universitaria PisanaPisaItaly
| | - Anxur Merenda
- ARNAS Ospedale Civico BenfratelliU.O. di EmatologiaPalermoItaly
| | - Vincenzo Pavone
- Ospedale Generale Provinciale “Cardinale G. Panico”S.C. di Ematologia e Trapianto di Cellule StaminaliTricase, LecceItaly
| | | | - Daniela Donnarumma
- Dipartimento di EmatologiaIstituto Nazionale TumoriFondazione ‘G. Pascale’IRCCSUOC di Ematologia Oncologica e Trapianto di Cellule StaminaliNapoliItaly
| | - Angelo M. Carella
- U.O. Complessa di EmatologiaIRCCS Azienda Ospedaliera Universitaria San Martino‐ISTGenovaItaly
| | - Chiara Ciochetto
- Dipartimento di Oncologia ed EmatologiaA.O. U.Città della Salute e della Scienza di Torino San Giovanni BattistaS.C. EmatologiaTorinoItaly
| | - Nicola Cascavilla
- Divisione di EmatologiaIRCSS Casa Sollievo della SofferenzaSan Giovanni RotondoItaly
| | - Anna Mele
- Ospedale Generale Provinciale “Cardinale G. Panico”S.C. di Ematologia e Trapianto di Cellule StaminaliTricase, LecceItaly
| | - Francesco Lanza
- Unità Operativa di EmatologiaIstituti Ospitalieri di CremonaCremonaItaly
| | - Massimo Di Nicola
- Dipartimento di Oncologia MedicaFondazione IRCCS Istituto Nazionale TumoriMilanoItaly
| | - Erminio Bonizzoni
- Sezione di Statistica Medica e Biometria ‘GA Maccaro’Dipartimento di Scienze Cliniche e di ComunitàUniversità di MilanoMilanoItaly
| | - Antonello Pinto
- Dipartimento di EmatologiaIstituto Nazionale TumoriFondazione ‘G. Pascale’IRCCSUOC di Ematologia Oncologica e Trapianto di Cellule StaminaliNapoliItaly
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