1
|
Abstract
A case of Reed-Sternberg (R-S) leukaemia is described, and the results of the morphological, cytochemical and cytokinetic studies on the circulating neoplastic cells are reported. Detailed data are given for each of the 3 types of abnormal circulating cells: abnormal mononuclear (AM) cells, Hodgkin's (H) cells and R-S cells. Our results cannot discriminate whether R-S cells derive from monocyte-macrophages or from B-cell lineage. However, some data suggest that H and R-S cells may likely originate from AM cells. The unfavourable clinical significance of the appearance of circulating R-S cells is discussed taking into account the other few cases reported in literature.
Collapse
|
2
|
Gay F, Oliva S, Petrucci MT, Montefusco V, Conticello C, Musto P, Catalano L, Evangelista A, Spada S, Campbell P, Ria R, Salvini M, Offidani M, Carella AM, Omedé P, Liberati AM, Troia R, Cafro AM, Malfitano A, Falcone AP, Caravita T, Patriarca F, Nagler A, Spencer A, Hajek R, Palumbo A, Boccadoro M. Autologous transplant vs oral chemotherapy and lenalidomide in newly diagnosed young myeloma patients: a pooled analysis. Leukemia 2016; 31:1727-1734. [PMID: 28008174 DOI: 10.1038/leu.2016.381] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 10/28/2016] [Accepted: 11/07/2016] [Indexed: 12/22/2022]
Abstract
In newly diagnosed myeloma patients, upfront autologous transplant (ASCT) prolongs progression-free survival 1 (PFS1) compared with chemotherapy plus lenalidomide (CC+R). Salvage ASCT at first relapse may still effectively rescue patients who did not receive upfront ASCT. To evaluate the long-term benefit of upfront ASCT vs CC+R and the impact of salvage ASCT in patients who received upfront CC+R, we conducted a pooled analysis of 2 phase III trials (RV-MM-209 and EMN-441). Primary endpoints were PFS1, progression-free survival 2 (PFS2), overall survival (OS). A total of 268 patients were randomized to 2 courses of melphalan 200 mg/m2 and ASCT (MEL200-ASCT) and 261 to CC+R. Median follow-up was 46 months. MEL200-ASCT significantly improved PFS1 (median: 42 vs 24 months, HR 0.53; P<0.001), PFS2 (4 years: 71 vs 54%, HR 0.53, P<0.001) and OS (4 years: 84 vs 70%, HR 0.51, P<0.001) compared with CC+R. The advantage was noticed in good and bad prognosis patients. Only 53% of patients relapsing from CC+R received ASCT at first relapse. Upfront ASCT significantly reduced the risk of death (HR 0.51; P=0.007) in comparison with salvage ASCT. In conclusion, these data confirm the role of upfront ASCT as the standard approach for all young myeloma patients.
Collapse
Affiliation(s)
- F Gay
- Myeloma Unit, Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - S Oliva
- Myeloma Unit, Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - M T Petrucci
- Division of Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University of Roma, Roma, Italy
| | - V Montefusco
- Department of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - C Conticello
- Division of Hematology, Azienda Policlinico 'Vittorio Emanuele', University of Catania, Catania, Italy
| | - P Musto
- Scientific Direction, IRCCS-CROB, Referral Cancer Center of Basilicata, Rionero in Vulture, Potenza, Italy
| | - L Catalano
- Hematology, Department of Clinical Medicine and Surgery, AOU Federico II, Napoli, Italy
| | - A Evangelista
- Unit of Clinical Epidemiology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino and CPO Piemonte, Torino, Italy
| | - S Spada
- Myeloma Unit, Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - P Campbell
- Haematology Department, Cancer Services, Barwon Health, Geelong, Australia
| | - R Ria
- Department of Biomedical Science, University of Bari 'Aldo Moro' Medical School, Internal Medicine 'G. Baccelli' Policlinico, Bari, Italy
| | - M Salvini
- Myeloma Unit, Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - M Offidani
- Hematology Department, AOU Ospedali Riuniti di Ancona, Ancona, Italy
| | - A M Carella
- Hematology and Bone Marrow Transplantation Unit, IRCCS San Martino-Ist, Genova, Italy
| | - P Omedé
- Myeloma Unit, Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - A M Liberati
- Department of Oncohematology, AO S.Maria di Terni, Terni, Italy
| | - R Troia
- Myeloma Unit, Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - A M Cafro
- Division of Hematology, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - A Malfitano
- Myeloma Unit, Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - A P Falcone
- Division of Hematology, Casa Sollievo della Sofferenza Hospital, IRCCS, San Giovanni Rotondo, Italy
| | - T Caravita
- UOC Ematologia S. Eugenio ASL RM2 Roma, Roma, Italy
| | - F Patriarca
- Department of Hematology, Azienda Ospedaliera-Universitaria di Udine, DISM, Università di Udine, Udine, Italy
| | - A Nagler
- Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - A Spencer
- Department of Clinical Haematology, Alfred Health-Monash University, Melbourne, Australia
| | - R Hajek
- Blood Cancer Research Group, Department of Haematooncology, Faculty Hospital Ostrava, Ostrava, Czech Republic.,Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - A Palumbo
- Myeloma Unit, Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - M Boccadoro
- Myeloma Unit, Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| |
Collapse
|
3
|
Hughes DA, Malfitano A, Davenport A, Carr SB. S42 Eradication success of non-tuberculous mycobacterial infections in a paediatric cystic fibrosis population. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
4
|
Rinaldi G, Galanti D, Stagno A, Bronte E, Marchese A, Badalamenti G, Semprevivo M, Terruso L, Vanella V, Alessi I, Fulfaro F, Malfitano A, Cordova A, Albanese V, Volpe C, Incorvaia L, Russo A. Methotrexate chemotherapy in elderly patients with locally advanced head and neck cancer: preliminary results. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw340.13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
5
|
Cutti S, Zaramella M, Pavesi L, Uglietti A, Malfitano A, Martinelli V, Muzzi A, Marena C, Maserati R. Increasing awareness on HIV and STDs: a four-year program on high school in the Province of Pavia. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv175.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
6
|
Parisi A, Malfitano A, Bruno R, Calderon W, Sacchi P, Patruno S, Filice G. [New trends in the therapy of cryptococcosis in AIDS patients]. Infez Med 2003; 4:204-7. [PMID: 12858025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
The Authors report the clinical and microbiological findings about a 6-months follow up of 9 AIDS-patients with Cryptococcosis. Among these, 7 patients suffered from meningo-encephalitis and 2 from haematogenous infection. The fungicidal treatment during acute illness, included the administration of Amphotericin B (0.6 mg/Kg/die i.v.) plus Flucytosine (100 mg/kg/die i.v.) during the first 15 days followed from itraconazole at doses of 400 mg/die in a single administration, during the following 15 days. The chronic suppressive therapy included itraconazole at doses of 200 mg/die p.o. indefinitely. During the 6-months follow up, one patient died of polymicrobial pneumonia and another of hepatic failure related to a reactivation of a previous HCV hepatitis. In 2 patients the presence of multiple nodular lesions in the cerebral CT scan, related to cryptococcal granulomas, was associated to a persistence of positive liquoral cultures and to a poor prognosis. In 3 patients with meningo-encephalitis, the three drugs regimen was quite effective in eradicating the neurological infection and no relapses were observed during the 6-months follow up. The 2 patients with hematogenous infection alone, didn't relapse during the 6-months follow up.
Collapse
Affiliation(s)
- A Parisi
- Divisione di Malattie Infettive e Tropicali, Universita degli Studi di Pavia-IRCCS, Policlinico San Matteo
| | | | | | | | | | | | | |
Collapse
|
7
|
|
8
|
Agostoni C, Migliorini D, Dorigoni N, Malfitano A, Scaglia M. Genital ulcer in an AIDS patient with disseminated leishmaniasis. Eur J Clin Microbiol Infect Dis 1998; 17:813-4. [PMID: 9923531 DOI: 10.1007/s100960050197] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- C Agostoni
- Institute of Infectious Diseases, University-IRCCS San Matteo, Pavia, Italy
| | | | | | | | | |
Collapse
|
9
|
Agostoni C, Dorigoni N, Malfitano A, Caggese L, Marchetti G, Corona S, Gatti S, Scaglia M. Mediterranean leishmaniasis in HIV-infected patients: epidemiological, clinical, and diagnostic features of 22 cases. Infection 1998; 26:93-9. [PMID: 9561378 DOI: 10.1007/bf02767767] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Twenty-two Italian HIV-infected patients developed leishmaniasis, clinically manifested as visceral (13 cases), cutaneous (2 cases) and disseminated disease (7 cases). Twenty were males and two females (mean age: 32.8 years) with a mean CD4+ cell count of 46.8/microliter at diagnosis; risk factors were intravenous drug use (17 patients) and sexual behaviour (two bisexual, two homosexual, one heterosexual). All but one patient lived or travelled in hypoendemic Italian regions and other Mediterranean countries. Apart from the two patients with cutaneous leishmaniasis, the clinico-pathological and biological spectrum of the infection was often atypical, especially in patients with disseminated disease. The diagnosis was routinely made by direct recovery of parasites in biological specimens, mainly in bone marrow aspirate, whereas serology was negative or borderline in most of the patients. Among 17 in vitro isolates, Leishmania infantum was the only species involved with previously undescribed isoenzyme patterns in two cases. Treatment with antimonials and other drugs showed only temporary clinical improvement in some patients. Relapses were the rule. Leishmaniasis confirms itself as an opportunistic infection in HIV-positive persons. Secondary chemoprophylaxis should be considered in cases of relapsing disease.
Collapse
Affiliation(s)
- C Agostoni
- Infectious Diseases Research Labs, University-IRCCS San Matteo, Pavia, Italy
| | | | | | | | | | | | | | | |
Collapse
|
10
|
Parisi A, Malfitano A, Bruno R, Calderon W, Sacchi P, Patruno SF, Filice G. Efficacy of a short-term amphotericin B + flucytosine combination therapy followed by itraconazole monotherapy in acute and chronic AIDS-associated cryptococcosis. Mycoses 1997; 40:203-7. [PMID: 9476489 DOI: 10.1111/j.1439-0507.1997.tb00215.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The authors report the clinical and microbiological findings of a 6-month follow-up of nine AIDS patients affected with cryptococcosis. Among these, seven patients suffered from meningoencephalitis and two from disseminated infection. The antifungal therapy during acute illness included the administration of amphotericin B at doses of 0.6 mg kg-1 day-1 i.v. plus flucytosine at doses of 100 mg kg-1 day-1 i.v. during the first 15 days followed by itraconazole at doses of 400 mg day-1 p.o. in the following 15 days. The maintenance treatment included itraconazole at doses of 200 mg day-1 p.o. indefinitely. During the 6-month follow-up, one patient died of hepatic failure related to C virus (HCV) hepatitis reactivation and another patient died of polymicrobial pneumonia. In two patients, the presence of multiple nodular lesions in the cerebral computerized tomography (CT) scan, related to cryptococcal granulomas, was associated with the persistance of fungi in the cerebrospinal fluid. In three patients with meningoencephalitis the three-drugs regimen was effective in eradicating the neurological infection, and relapses were not observed during the maintenance therapy with itraconazole during the 6-month follow-up. The two patients with haematogenous cryptococcosis did not relapse after the 6-month follow-up.
Collapse
Affiliation(s)
- A Parisi
- Department of Infectious and Tropical Diseases, University of Pavia, Italy
| | | | | | | | | | | | | |
Collapse
|
11
|
Scaglia M, Malfitano A, Douville H, Sacchi P, Gatti S, Gradoni L, Gramiccia M. Reply. Clin Infect Dis 1997. [DOI: 10.1093/clinids/24.6.1283-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
12
|
Scaglia M, Malfitano A, Douville H, Sacchi P, Gatti S, Gradoni L, Gramiccia M. Dermonodular and visceral leishmaniasis due to Leishmania infantum with a new isoenzyme pattern: report of a case involving a patient with AIDS. Clin Infect Dis 1996; 22:376-7. [PMID: 8838204 DOI: 10.1093/clinids/22.2.376] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Affiliation(s)
- M Scaglia
- Clinical Parasitology Laboratory, University-IRCCS San Matteo, Pavia, Italy
| | | | | | | | | | | | | |
Collapse
|
13
|
Mondelli MU, Cerino A, Bono F, Cividini A, Maccabruni A, Aricò M, Malfitano A, Barbarini G, Piazza V, Minoli L. Hepatitis C virus (HCV) core serotypes in chronic HCV infection. J Clin Microbiol 1994; 32:2523-7. [PMID: 7814491 PMCID: PMC264095 DOI: 10.1128/jcm.32.10.2523-2527.1994] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Recently, two distinct hepatitis C virus (HCV) serologic types have been identified on the basis of amino acid variations in the core region. The two serologic types can readily discriminate between genotypes I-II-V (serotype 1) and III-IV (serotype 2), according to the Okamoto classification. We compared HCV core serotyping with genotyping with sera from 363 anti-HCV-positive patients (309 HCV RNA positive by PCR) using a synthetic core peptide-based enzyme immunoassay and PCR amplification of core region sequences with type-specific primers, respectively. Serologic responses to HCV serotypes were successfully identified in 164 (45%) patients, of whom 153 were viremic. Eighty-nine patients had evidence of exposure to serotype 1: 8 of these were infected with genotype I, 50 were infected with genotype II, 2 were infected with genotype III, 7 were infected with genotype V, 13 had infections with mixed genotypes, 3 were infected with an indeterminate genotype, and 6 were nonviremic. Seventy-four patients had been exposed to serotype 2: 64 were infected with genotype III, 3 were infected with mixed genotypes, 2 were infected with an indeterminate genotype, and 5 were nonviremic. The serum of one patient, infected with genotype III, showed reactivity to both serotypes. Comparative evaluation of HCV core region serotyping and genotyping with sera from 294 viremic patients infected with a known HCV genotype showed a remarkable concordance between HCV core region genotyping and serotyping, with only 2 apparently discordant serum samples (both from patients with genotype III infection) of 148 (1.4%) successfully serotyped samples. Serotype 1 infection was more frequently observed in patients with overt chronic liver disease and accounted for all successfully serotyped samples from intravenous drug abusers. In contrast, serotype 2 was more prevalent in subjects with biochemically silent HCV infection (alanine aminotransferase, < 45 U/liter), in agreement with previous findings at the molecular level. HCV core serologic typing is a simple, inexpensive, and highly reproducible assay that can be applied to more than 50% of viremic HCV antibody carriers prior to the use of more sophisticated molecular typing techniques. Moreover, it may be helpful in tracking transmissions routes, particularly for incorrectly stored samples in which the RNA has degraded or for subjects who have cleared the virus and therefore have only antibodies remaining to testify to a remote infection. The lack of recognition of the core sequence from residues 67 to 81, which contains a minor B-cell epitope used to detect type-specific immunoreactivity, may explain the negative serologic findings for half of the patients.
Collapse
Affiliation(s)
- M U Mondelli
- Istituto di Clinica delle Malattie Infettive, University of Pavia, Italy
| | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Novati S, Malfitano A, Sacchi P, Patruno SF, Tornari PM, Rondanelli EG. HIV-related Hodgkin's disease. Report of nine cases. Haematologica 1993; 78:34-7. [PMID: 7684010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The association between lymphoproliferative disease and AIDS is now well known, but only non-Hodgkin's lymphomas (LNH) are surely related to HIV infection. Hodgkin's disease (HD) occurs rarely in HIV seropositives, so it is impossible to establish a connection between AIDS and this neoplasm. METHODS AND RESULT We describe nine cases of HIV seropositive patients who developed HD in different stages of the HIV infection. We carefully examine clinical course and response to therapy in these patients, above all paying attention to opportunistic infections (OI) and progression to full-blown AIDS. CONCLUSION Finally, we discuss the possibility of including HD among the definition criteria for AIDS.
Collapse
Affiliation(s)
- S Novati
- Istituto di Clinica delle Malattie Infettive, Policlinico San Matteo
| | | | | | | | | | | |
Collapse
|
15
|
Chichino G, Bernuzzi AM, Bruno A, Cevini C, Atzori C, Malfitano A, Scaglia M. Intestinal capillariasis (Capillaria philippinensis) acquired in Indonesia: a case report. Am J Trop Med Hyg 1992; 47:10-2. [PMID: 1636874 DOI: 10.4269/ajtmh.1992.47.10] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
We report a case of intestinal capillariasis in a 32-year-old Italian man. After he made a trip to Indonesia that lasted approximately one month, he developed heartburn, abdominal pain, irregular bowel movements, headache, fatigue, weight loss, low-grade fever, and severe itching. The diagnosis was provided by the recovery of Capillaria philippinensis eggs in the stool. Treatment with oral albendazole, 200 mg twice a day for 21 days, resulted in clinical and parasitologic cure. This is the first report of C. philippinensis infection acquired in Indonesia.
Collapse
Affiliation(s)
- G Chichino
- Department of Infectious Diseases, University-IRCCS S., Pavia, Italy
| | | | | | | | | | | | | |
Collapse
|
16
|
Rondanelli EG, Malfitano A. [Hematologic manifestations of HIV disease]. Haematologica 1991; 76 Suppl 3:46-50. [PMID: 1752542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- E G Rondanelli
- Istituto di Clinica delle Malattie Infettive, Università degli Studi di Pavia
| | | |
Collapse
|
17
|
Monfardini S, Tirelli U, Vaccher E, Errante D, Rezza G, Talamint R, Albericci F, Barbui T, Bernasconi C, Cajozzo A, Cargnel A, Clerici M, Lalla D, Dessalvi P, Fiaccadori F, Garavelli PL, Giudici M, Gherlinzoni F, Deliliers GL, Lazzarin A, Luzi G, Luzzati R, Malfitano A, Mandelli F, Marigo S, Montesarchio V, Moroni N, Puppo F, Raise E, Rizzardini G, Rizzi M, Rossi E, Saliva G, Scanni A, Sinicco A, Vaglia A, Foà R, Gavosto F. Hodgkin's Disease in 50 Intravenous Drug Users with HIV-Infection. Leuk Lymphoma 1991; 3:375-84. [PMID: 27467428 DOI: 10.3109/10428199109070281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Fifty cases of Hodgkin's disease in intravenous drug users (IVDU) have been collected by the Italian Cooperative Group on AIDS-Related Tumors (G.I.C.A.T.). Ninety-two per cent of the patients were males; the median age was 26 years. Persistent generalized lymphadenopathy (PGL) at onset was present in 54% of patients, AIDS in 9%, ARC in 9% while 28% were simply HIV-positive. The initial median absolute number of CD4 lymphocytes was 264/mmc. Opportunistic infections were diagnosed in 20% of patients. In most patients the histological pattern was that of mixed cellularity and lymphocytic depletion (76%). In almost half the initial symptom was a persistent lymph node enlargement due to PGL. In the majority of patients (58%) only a clinical staging and bone marrow biopsy could be performed due to the presence of opportunistic infections, rapid disease progression or refusal of pathologic staging procedures. One patient presented with a Waldeyer's ring involvement, but no other unusual presentations were observed. After MOPP alternated or followed by ABVD or MOPP alone, 15/29 CR (52%) and 14/29 PR (48%) were observed. The median duration of CR was 14 months, while the median survival of CR has not been reached; the median survival of patients treated with chemotherapy with CD4 values at presentation {geq}400/mmc was significantly superior to that in those with CD4 < 400/mmc. The overall median survival was 16 months. Twenty-eight per cent of patients receiving chemotherapy + radiotherapy developed opportunistic as well as non-opportunistic infections (21%). Lethal hepatic toxicity was observed in 2 patients. In conclusion, Hodgkin's disease in IVDU was not found to be associated with unusual presentations, as previously reported for homosexuals. Complete remissions could be achieved in over 50% of patients, but in IVDU non-opportunistic infections in addition to opportunistic infections may also limit treatment administration. The presence of parenchymal functional impairment due to drug abuse, or drug abuse-related infections, such as pneumonia, endocarditis and hepatitis, should lead to the choice of antitumour agents with no or only minor potential liver, lung and cardiac toxicity.
Collapse
Affiliation(s)
- S Monfardini
- a Centro di Riferimento Oncologico, Via Pedemontana Occ., 33081, Aviano, PN, Italy
| | - U Tirelli
- a Centro di Riferimento Oncologico, Via Pedemontana Occ., 33081, Aviano, PN, Italy
| | - E Vaccher
- a Centro di Riferimento Oncologico, Via Pedemontana Occ., 33081, Aviano, PN, Italy
| | - D Errante
- a Centro di Riferimento Oncologico, Via Pedemontana Occ., 33081, Aviano, PN, Italy
| | - G Rezza
- a Centro di Riferimento Oncologico, Via Pedemontana Occ., 33081, Aviano, PN, Italy
| | - R Talamint
- a Centro di Riferimento Oncologico, Via Pedemontana Occ., 33081, Aviano, PN, Italy
| | - F Albericci
- b Ospedale Civile di Piacenza, Divisione Malattie Infettive, 29100, Piacenza, Italy
| | - T Barbui
- c Ospedale Civile di Bergamo, Divisione di Ematologia, 24100, Bergamo, Italy
| | - C Bernasconi
- d Policlinico S. Matteo, Divisione di Ematologia, Via Mentana 4, 27100, Pavia, Italy
| | - A Cajozzo
- e Istituto di Clinica Meica 111, Divisione di Malattie Cardiovascolari, Via del Vespro 127, Palermo, Italy
| | - A Cargnel
- f Ospedale L. Sacco, Divisione Malattie Infettive, Via G. B. Grassi 74, 20157, Milano, Italy
| | - M Clerici
- g Ospedale S. Carlo Borromeo, Divisione Oncologia Medica, Via Pio 111 n.3, Milano, Italy
| | - D Lalla
- h Ospedale Generale Provinciale S. Anna, Divisione Malattie Infettive, Via Napoleone 60, Como, Italy
| | - P Dessalvi
- i Ospedale A. Businico, Divisione di Ematologia, Via Jenner, Cagliari, Italy
| | - F Fiaccadori
- j Universita degli Studi di Parma, Cattedra di Malattie Infettive, Via Gramsci 14, Parma, Italy
| | - P L Garavelli
- k Ospedale Civile di Alessandria USL 70, Divisione di Malattie Infettive, Via Comunale 33, Valmadonna, AL, Italy
| | - M Giudici
- l Arcispedale, S. Maria Nuova, Divisione Malattie Infettive, Via Risorgimento, Reggio Emilia, Italy
| | - F Gherlinzoni
- m Policlinico S. Orsola, lnstituto di Ematologia, Via G. Massarenti 9, Bologna, Italy
| | - G L Deliliers
- n Ospedale Maggiore Milano, lnstituo di Scienze Mediche, Via F. Sforza 35, Milano, Italy
| | - A Lazzarin
- f Ospedale L. Sacco, Divisione Malattie Infettive, Via G. B. Grassi 74, 20157, Milano, Italy
| | - G Luzi
- o Cattedra di Allergologia ed Immunologia, Universita La Sapienza, Pol. Umberto, Viale Universita 37, Roma, Italy
| | - R Luzzati
- p Ospedale B. Trento, Divisione Malattie Infettive, Verona, Italy
| | - A Malfitano
- q lnstituto IRCCS, Divisione Malattie Infettive, Piazzale Golgi, 27100, Pavia, Italy
| | - F Mandelli
- r Cattedra di Ematologia, Dipartimento di Biopatologia Umana, Via Benevento 6,00161, Roma, Italy
| | - S Marigo
- s Ospedale S. Andrea, Via Veneto 197, Divisione Malattie Infettive, Via Veneto 197, 19100, La Spezia, Italy
| | - V Montesarchio
- t Cattedra di Oncologia Medica, Universita degli Studi di Napoli, Via Sergio Pansini 5, 80131, Napoli, Italy
| | - N Moroni
- f Ospedale L. Sacco, Divisione Malattie Infettive, Via G. B. Grassi 74, 20157, Milano, Italy
| | - F Puppo
- u Instituto Scientific0 di Medicina Interna, Universita degli Studi di Genova, Viale Benedetto XV 6, 16132, Genova, Italy
| | - E Raise
- v Ospedale Maggiore di Bologna, Divisione Malattie Infettive ed Immunopatologia., Via L. B. Nigrisoli 2, 40133, Bologna, Italy
| | - G Rizzardini
- f Ospedale L. Sacco, Divisione Malattie Infettive, Via G. B. Grassi 74, 20157, Milano, Italy
| | - M Rizzi
- w Ospedali Riuniti, Divisione Malattie Infettive, Largo Barozzi 11, 24100, Bergamo, Italy
| | - E Rossi
- x Ospedali Civili di Brescia, Ill Medicina Sezione Ematologia, 25125, Brescia, Italy
| | - G Saliva
- y Ospedale S. Andrea, Divisione Malattie Infettive, C. so M. Abbiate 31, 13100, Vercelli, Italy
| | - A Scanni
- z Ospedale Fatebenefratelli e Oftalmico, Corso di Porta Nuova 23, 20121, Milano, Italy
| | - A Sinicco
- aa Universita di Torino-Ospedale Amedeo di Savoia, Divisione Malattie Infettive, Corso Svizzera 164, 10149, Torino, Italy
| | - A Vaglia
- ab Ospedale Civile di Vicenza, Viale F. Rodolfi, 36100, Vicenza, Italy
| | - R Foà
- ac Universita di Torino, Dipartimento di Scienzo Biomediche, Clinica Medica A, Via Genova 3, 10126, Torino, Italy
| | - F Gavosto
- ac Universita di Torino, Dipartimento di Scienzo Biomediche, Clinica Medica A, Via Genova 3, 10126, Torino, Italy
| |
Collapse
|
18
|
Vaccher E, Tirelli U, Lazzarin A, Rezza G, Malfitano A, Raise E, Carbone A, Contu L, Alessi E, Monfardini S. Epidemic Kaposi's sarcoma in Italy, a country with intravenous drug abusers as the major group at risk for AIDS: report of 60 cases. AIDS 1989; 3:321. [PMID: 2504238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
|
19
|
Brusamolino E, Malfitano A, Pagnucco G, Sacchi P, Orlandi E, Dornini G, Minoli L, Bernasconi C. HIV-related thrombocytopenic purpura: a study of 24 cases. Haematologica 1989; 74:51-6. [PMID: 2498184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
In this paper we review our experience with HIV-related thrombocytopenic purpura (TP) in 24 patients seen from October, 1985 through April, 1988: the median follow-up was 16 months (range 3-32). All patients belonged to risk groups for AIDS and intravenous drug abusers represented 83% of the entire cohort. The male/female ratio was 4, and most of the patients were Walter Reed stage 3. The mean value of platelets at diagnosis was 33 x 10(9)/liter (range 6-120), and half of the patients had severe thrombocytopenia with hemorrhagic symptoms. Anemia and/or neutropenia were concomitant with TP in 21% and 17% of cases; four cases had pancytopenia. Marrow pictures showed megakaryocytic hyperplasia in 68% of cases; myelodysplasia or hypoplasia were observed in 14% and 18% of patients, respectively; lymphoid aggregates were present in two cases. Antiplatelet antibodies and circulating immune complexes were detected in 40% and 50% of cases, and the mean T4/T8 ratio was 0.9 (range 0.4-1.8). Half of the patients did not require specific therapy due to lack of bleeding; however no spontaneous reversions to normal platelet values occurred. The response to steroids and to immunoglobulins (either high-dose or anti-D) was good but temporary, and required maintenance therapy. The 2-year actuarial risk of evolution into overt AIDS was 30%, with a crude rate of 4 cases over 365 person-months at risk. The events which determined AIDS were opportunistic infections in two cases, Kaposi's sarcoma and malignant lymphoma in the other two. A comparison with the features of idiopathic TP is made and hypotheses regarding the pathogenetic mechanisms are discussed.
Collapse
|
20
|
Parisi A, Di Perri G, Strosselli M, Cairoli S, Malfitano A, Minoli L. [Computerized electroencephalography in the early diagnosis and monitoring of AIDS-related neurologic disorders]. Recenti Prog Med 1988; 79:503-5. [PMID: 3071838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
|
21
|
Marone P, Concia E, Grossi P, Malfitano A, Perversi L. Clinical safety and efficacy of ofloxacin. Chemioterapia 1988; 7:320-2. [PMID: 3224401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
In this study we report about the efficacy and tolerability of ofloxacin in the treatment of 15 patients with severe and moderately severe infections including osteomyelitis (5), soft tissue infections (5), salmonellosis in AIDS patients (2), acute or chronic pulmonary infections (2) and mediastinitis (1). The following organisms were isolated in culture specimens: Staphylococcus aureus (4), Pseudomonas aeruginosa (4), Staphylococcus epidermidis (3), Serratia marcescens (1), Escherichia coli (1), Aeromonas hydrophila (1), Klebsiella oxytoca (1), Klebsiella pneumoniae (1), Salmonella cholerae-suis (1), Salmonella sp. (1), Enterobacter cloacae (1). All isolates were sensitive to the drug. Of 5 cases with osteomyelitis, 2 were cured and 3 improved clinically (with bacteriological eradication of the pathogens). The best results were obtained in patients with soft tissue infections: 4 patients were cured and 1 improved. Two patients with salmonella bacteremia and AIDS experienced a recurrence 1 month and 2 months respectively after stopping therapy. The patient with mediastinitis was successfully treated. Improvement was recorded for 2 patients with bronchiectasis and exacerbation of chronic bronchitis. The drug was well tolerated, only one episode of mild nausea and vomiting was reported and did not require discontinuation of the therapy. The study indicates that ofloxacin is a safe and effective agent in the treatment of various infections.
Collapse
Affiliation(s)
- P Marone
- Istituto di Clinica delle Malattie Infettive, Università di Pavia, IRCCS Policlinico S. Matteo, Italy
| | | | | | | | | |
Collapse
|
22
|
Scaglia M, Brustia R, Gatti S, Bernuzzi AM, Strosselli M, Malfitano A, Capelli D. Autochthonous strongyloidiasis in Italy: an epidemiological and clinical review of 150 cases. Bull Soc Pathol Exot Filiales 1984; 77:328-332. [PMID: 6488423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
The Pavia District, Northern Italy, is an endemic area of strongyloidiasis. This study reviews the epidemiology and clinics of 150 cases. For this purpose, subjects were categorized for sex, age, origin, profession, acute and chronic disease, symptoms due to larval migration, immunodepression (if present). The incidence, with male predominance (74.7%), peaked among adults (94.6%), and in rural areas (69.3%). Patients experienced digestive (58.6%), cutaneous (34.6%) and respiratory complaints (16.7%). Thiabendazole was successful in most cases, except for 6 gastroresected subjects. Mebendazole at high doses (1 g t. i. d. X 10 days), was no valid alternative drug for 12 patients.
Collapse
|
23
|
Scaglia M, Gatti S, Malfitano A, Strosselli M, Brustia R. [Incidence of intestinal parasitosis among the Batwa and Hutu pygmy tribes of Rwanda]. Bull Soc Pathol Exot Filiales 1983; 76:818-24. [PMID: 6671271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The AA have carried out an epidemiological investigation on the incidence of intestinal parasitosis in groups of populations belonging to the pygmoid tribes Batwa and Hutu living in the Northern and Southern regions of Rwanda (East Africa). Positivity for intestinal parasites (protozoa and/or helminths) reached 100% in the 309 subjects examined, no significant difference in prevalence being observed between the Northern and Southern groups. Among the protozoa, E. coli and E. histolytica were most commonly found, while trichocephalosis and ascaridiasis were the most frequently encountered helminthiasis. The occasional finding of Strongyloides fülleborni infestation should also be pointed out.
Collapse
|
24
|
Malfitano A, Pallavicini EB, Cazzola M, Gorini M, Riccardi A, Perugini S. [Morphological and cytochemical studies of megakaryocytes in 25 patients with haemopoietic dysplasias (author's transl)]. Haematologica 1980; 65:585-94. [PMID: 6780417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
|
25
|
Cazzola M, Pallavicini EB, Daccò M, Inverardi F, Luliri P, Luraschi A, Malfitano A. Preliminary data on androgen treatment of haemopoietic dysplasias. Haematologica 1980; 65:136-7. [PMID: 6768651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
|