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Mulas O, Efficace F, Orofino MG, Piroddi A, Piras E, Vacca A, Barella S, Costa A, Giesinger JM, La Nasa G, Caocci G. Health-Related Quality-of-Life Profile of Pediatric Patients with β Thalassemia after Hematopoietic Stem Cell Transplantation. J Clin Med 2023; 12:6047. [PMID: 37762987 PMCID: PMC10532003 DOI: 10.3390/jcm12186047] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 08/29/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
Matched hematopoietic stem cell transplantation (HSCT) is a feasible and curative treatment in pediatric patients with beta thalassemia major (β-TM). However, little data are available regarding patients and their parents' health-related quality of life (HRQoL) after the procedure. As such, we investigated the HRQoL of pediatric patients with β-TM after HSCT compared to that of patients treated with blood transfusions and iron chelation. The health-related quality of life of 43 β-TM pediatric patients and 43 parents were evaluated using the Pediatric Quality of Life Inventory (PedsQL). A total of 25 patients underwent HSCT: 15 from a sibling and 10 from an HLA-matched donor. The median follow-up time from HSCT was 5 years (range 1-13 years). The mean ages at the survey were 10.1 years (range 5-15) and 9.6 years (range 5-15) for transfused and transplanted patients, respectively. A significant reduction in HRQoL was reported in the group of transfused patients compared with that of patients transplanted in the following PedsQL domains: children's and parents' physical functions, Δ = -15.4, p = 0.009 and Δ = -11.3, p = 0.002, respectively; children's and parents' emotional functioning, Δ = -15.2, p = 0.026 and Δ = -15.2, p = 0.045, respectively; child's and parents' school functioning, Δ = -25, p = 0.005 and Δ = -22.5, p = 0.011, respectively; total child and parents scores, Δ = -14.5, p = 0.004 and Δ = -13.2, p = 0.005, respectively. The results of a multivariable analysis showed that the HSCT procedure was significantly associated with a higher total child PedsQL score (adjusted mean difference = 15.3, p = 0.001) and a higher total parent PedsQL score (adjusted mean difference = 14.1, p = 0.006). We found no significant difference in the HRQoL measured after sibling or unrelated human leukocyte antigen (HLA)-matched HSCT. Finally, a significant positive correlation across all the PedsQL domains was found between the scores reported by the children and those reported by their parents. In conclusion, our study shows that HSCT in pediatric patients with β-TM is associated with a good overall HRQoL profile. This information further supports physicians when counseling patients and their parents before the HSCT procedure.
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Affiliation(s)
- Olga Mulas
- Hematology Unit, Businco Hospital, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (O.M.); (G.L.N.)
| | - Fabio Efficace
- Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA) Data Center, 00161 Rome, Italy;
| | - Maria Grazia Orofino
- Bone Marrow Transplant Center, Pediatric Hospital “Microcitemico A. Cao”, 09121 Cagliari, Italy; (M.G.O.); (A.P.)
| | - Antonio Piroddi
- Bone Marrow Transplant Center, Pediatric Hospital “Microcitemico A. Cao”, 09121 Cagliari, Italy; (M.G.O.); (A.P.)
| | - Eugenia Piras
- Hematology Unit, Businco Hospital, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (O.M.); (G.L.N.)
| | - Adriana Vacca
- Hematology Unit, Businco Hospital, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (O.M.); (G.L.N.)
| | - Susanna Barella
- Pediatric Clinic, Thalassemia and Rare Diseases, Pediatric Hospital “Microcitemico A. Cao”, 09121 Cagliari, Italy;
| | - Alessandro Costa
- Hematology Unit, Businco Hospital, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (O.M.); (G.L.N.)
| | - Johannes M. Giesinger
- University Hospital of Psychiatry II, Medical University of Innsbruck, 6020 Innsbruck, Austria;
| | - Giorgio La Nasa
- Hematology Unit, Businco Hospital, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (O.M.); (G.L.N.)
| | - Giovanni Caocci
- Hematology Unit, Businco Hospital, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (O.M.); (G.L.N.)
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Barabino L, Galitzia A, Murru R, Caocci G, Greco M, Targhetta C, Angioni G, Vacca A, Piras E, Frau V, Mulas O, La Nasa G. Three is better than two: humoral response in allogeneic HSCT after the third BNT162b2 SARS-CoV-2 mRNA vaccine. Eur Rev Med Pharmacol Sci 2023; 27:6914-6916. [PMID: 37606101 DOI: 10.26355/eurrev_202308_33262] [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] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Affiliation(s)
- L Barabino
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
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Nosiglia O, Cambón V, Filippi P, Ríos A, Romero Y, Vacca A, Gaiero C, Angulo M. Development of pectoral muscle atrophy in critically ill patients. Med Intensiva 2023; 47:350-353. [PMID: 36464581 DOI: 10.1016/j.medine.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/15/2022] [Accepted: 10/23/2022] [Indexed: 05/29/2023]
Affiliation(s)
- O Nosiglia
- Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
| | - V Cambón
- Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
| | - P Filippi
- Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
| | - A Ríos
- Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
| | - Y Romero
- Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
| | - A Vacca
- Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
| | - C Gaiero
- Centro de Tratamiento Intensivo, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
| | - M Angulo
- Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay; Laboratorio de Exploración Funcional Respiratoria, Centro de Tratamiento Intensivo, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay.
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Barabino L, Galitzia A, Murru R, Caocci G, Targhetta C, Greco M, Angioni G, Mulas O, Vacca A, Piras E, Frau V, Costa A, La Nasa G. Chronic graft vs. host disease and hypogammaglobulinemia predict a lower immunological response to the BNT162b2 mRNA COVID-19 vaccine after allogeneic hematopoietic stem cell transplantation. Eur Rev Med Pharmacol Sci 2022; 26:8984-8989. [PMID: 36524517 DOI: 10.26355/eurrev_202212_30572] [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: 01/12/2023]
Abstract
OBJECTIVE Due to the high mortality rate of COVID-19, the assessment of BNT162b2 SARS-CoV-2 mRNA vaccine (Pfizer-BioNTech) efficacy in allogeneic hematopoietic stem cell transplant (HSCT) recipients is mandatory. PATIENTS AND METHODS We conducted a single-center pilot study with the main objective of evaluating the immunogenicity of the BNT162b2 mRNA vaccine in 31 hematological patients who underwent hematopoietic stem cell transplantation within the previous 12 months and/or were affected by chronic graft-vs.-host-disease (cGVHD), by the assessment of antibody levels at 30-45 days after the second dose of vaccine. RESULTS After the second dose of vaccine, 23 out of 31 patients (74%) showed a positive immune response. The presence of severe cGVHD or Ig deficiency identified 7 out of 8 (85%) of non-responders. The median absolute cluster of differentiation 19 (CD19) count was significantly lower in non-responders vs. responders (109/µl vs. 351/µl). Underlying pathology, comorbidities, type of donor, time intervals from transplant and cluster of differentiation 3/cluster of differentiation 4/cluster of differentiation 8 (CD3/CD4/CD8) subsets were not significantly associated with an effective immune response to vaccination. CONCLUSIONS Despite the limited sample of patients enrolled, our findings suggest that hypogammaglobulinemia and cGVHD could be associated with poor humoral response to the BNT162b2.
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Affiliation(s)
- L Barabino
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
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Mulas O, Caocci G, Efficace F, Piras E, Targhetta C, Frau V, Barella S, Piroddi A, Orofino MG, Vacca A, La Nasa G. Long-term health-related quality of life in patients with β-thalassemia after unrelated hematopoietic stem cell transplantation. Bone Marrow Transplant 2022; 57:1833-1836. [DOI: 10.1038/s41409-022-01823-2] [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] [Received: 06/15/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 11/09/2022]
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Franza F, Vacca A, Minò M, Solomita B, Papa F, De Paola A, Franza A. “Family Burnout” of psychiatric patients: its role during the COVID-19 pandemic. Eur Psychiatry 2022. [PMCID: PMC9562937 DOI: 10.1192/j.eurpsy.2022.499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Family members caregivers (FMCs) of patients with severe psychiatric disorders (SMPD) are subjected to a complex system of fatigue and stress. FMCs can be subjected to a care burden defined as “Family Burnout”. Caring of family members of patients affected by psychiatric disorder suffered an additional burden during the pandemic period. Objectives To investigate the stress, burnout and compassion fatigue in FMCs during the pandemic vs non-pandemic period. Methods In our observational study we recruited family members (FMCs) of SMPDs (DSM-5). The severity was assessed with BPRS > 31; from March 2021 to July 2021 (T1), in 66 FMCs (38 females, 28 men) that completed following questionnaires: CBI (Caregiver Burden Inventory), ProQOL (compassion satisfaction and compassion fatigue (burnout and secondary trauma) subscales]. These data (T1) were compared with the scores obtained in the same family members in 2019 (T0) in a pre-pandemic period. Results ProQOL data /T1) have a higher total score than those observed in a previous study (T0). They show a lower main score in Compassion Satisfaction (CS) subscale [T1 vs T0; 34.27 vs 38.89 (p < .00.5). CS subscale T0 vs T1= 34.84% vs 12.12%). High levels of burnout were found in 28.79% (T1) vs 13.64% (T0) of FMCs group. Similar results showed in the Secondary Trauma subscale and CBI with higher scores in T1 vs T0. Conclusions The comparative mean results (2019 vs 2021) showed that in the same group of FMCs, the mean values obtained with same scales were higher during the lockdown. During health crisis, FMCs of psychiatric patients are subjected to high levels of stress. Disclosure No significant relationships.
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Sgarra L, Caccavo VP, Katsouras G, Di Monaco A, Quadrini F, Vitulano N, Troisi F, Solimando A, Cicco S, Nacci C, Potenza MA, Desantis V, Vacca A, Montagnani M, Grimaldi M. Folates dysmetabolism promotes atrial cardiomyopathy/fibrillation through a cardiac-bone marrow networking involving endothelial progenitor cell dysfunction and erythropoiesis diversion. Europace 2022. [DOI: 10.1093/europace/euac053.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private hospital(s). Main funding source(s): dedicated cardiovascular research foud
Background
Recent advances support the concept that pre-persistent Atrial Fibrillation (AF) does not explain the wholeness of embolic strokes, suggesting the recently postulated hypothesis of a broad Atrial Cardiomyopathy (AC). In contrast to its worldwide distribution and its very inclusive definition, pathogenic mechanisms underlying AC are still largely unknown. Folate cycle disorders (FCD) are a yet underrated dysmetabolism only partly explained by methylene tetrahydrofolate reductase (MTHFR)-inherited defects. On a translational basis, FCD could hinder both endothelial and circulating endothelial progenitor cell (EPCs) functioning, therefore providing one-shot explanation to both atrial stasis (increasing atrial fibrosis and generating atrial hypocontractility) and endothelial dysfunction (ED). If such cardiac-bone marrow networking would be verified, a fundamental pathogenic mechanism of AC and subsequent AF would be unraveled.
Purpose
This study aims to enquire for the hypothesis that: 1) atrial fibrosis (AFib) would relate to FCD (intended as both: a)MTHFR C677T inherited mutations and b)bone-marrow function disorders, here referring to erythropoiesis diversions) and 2) AF patients would show dysfunctional EPCs.
Methods
We studied 59 consecutive patients admitted to the Cardiology Unit of the General Hospital "F.Miulli", with preserved EF, subjected to AF ablation. AFib was quantified by relative % of low-voltage (<0,5 mV) bipolar peak-to-peak points, with respect to the wholeness of the endocavitary mapping. Blood count cell was evaluated. MTHFR C677T genotypes were elucidated by RT-PCR. Folate were measured by a commercial laboratory test. EPCs isolation and characterization were performed by Ficoll-Hypaque gradient and flow cytometry analysis for cell surface antigens: CD45, CD34, CD133, VEGFR2 and KDR. EPCs functional wound healing assay was performed.
Results
Baseline characteristics did not differ between Sample and Control groups (Fig. 1 – Left Table). % of Afib significantly differs between C677T MTHFR homozigosis patients (n=15) with respect to non-C677T MTHFR homozygosis patients (n=44) (Fig.1 – Right graph. - p < 0,02). Once univariate analysis was performed, subsequent multivariate analysis highlights highest fit once merged RBC, RDW-SD and folates values were inputed: Goodness of fit was proper, modelling good (Fig.2 – superior graph. - R2=0,39; p=0,0001). Either RBC, RDW-SD and folates coefficient reached significance (p < 0,0001; p < 0,01; p < 0,05 respectively). Number of EPCs significantly differs between AF patients and matched controls (Fig 2 – inferior graph. – p < 0,001).
Conclusions
Our findings support the hypothesis that genetically determined folates dysmetabolism (MTHFR dysfunction) promotes AFib via a complex cardiac-bone marrow networking involving circulating EPCs and unraveled by erythropoiesis diversions. Such results suggest a pathogenic role of folate cycle disorders in the AC development.
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Affiliation(s)
- L Sgarra
- Regional General Hospital F. Miulli, Acquaviva Delle Fonti, Italy
| | - VP Caccavo
- Regional General Hospital F. Miulli, Acquaviva Delle Fonti, Italy
| | - G Katsouras
- Regional General Hospital F. Miulli, Acquaviva Delle Fonti, Italy
| | - A Di Monaco
- Regional General Hospital F. Miulli, Acquaviva Delle Fonti, Italy
| | - F Quadrini
- Regional General Hospital F. Miulli, Acquaviva Delle Fonti, Italy
| | - N Vitulano
- Regional General Hospital F. Miulli, Acquaviva Delle Fonti, Italy
| | - F Troisi
- Regional General Hospital F. Miulli, Acquaviva Delle Fonti, Italy
| | - A Solimando
- Polyclinic Hospital of Bari, Department of Biomedical sciences and Human Ongology - Internal Medicine Section, Bari, Italy
| | - S Cicco
- Polyclinic Hospital of Bari, Department of Biomedical sciences and Human Ongology - Internal Medicine Section, Bari, Italy
| | - C Nacci
- Polyclinic Hospital of Bari, Department of Medical Sciences and Human Oncology - Pharmacology section, Bari, Italy
| | - MA Potenza
- Polyclinic Hospital of Bari, Department of Medical Sciences and Human Oncology - Pharmacology section, Bari, Italy
| | - V Desantis
- Polyclinic Hospital of Bari, Department of Medical Sciences and Human Oncology - Pharmacology section, Bari, Italy
| | - A Vacca
- Polyclinic Hospital of Bari, Department of Biomedical sciences and Human Ongology - Internal Medicine Section, Bari, Italy
| | - M Montagnani
- Polyclinic Hospital of Bari, Department of Medical Sciences and Human Oncology - Pharmacology section, Bari, Italy
| | - M Grimaldi
- Regional General Hospital F. Miulli, Acquaviva Delle Fonti, Italy
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Cicco S, Mozzini C, Marozzi M, Carella R, De Fazio G, Vacca A, Cariddi C, Setti A, Pappagallo F, Solimando A, Ria R. P365 CARDIOVASCULAR RISK SCORE MAY BE USEFUL IN STRATIFY DEATH RISK IN HOSPITALIZED COVID19 PATIENTS. Eur Heart J Suppl 2022. [PMCID: PMC9384117 DOI: 10.1093/eurheartj/suac012.351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background COVID–19 induce a robust systemic inflammation. Patients with cardiovascular disease (CVD) present an increased death risk. However, many efforts are spent to identify possible predictors of negative outcomes in order to have a more specific clinical setting. CVD score are useful tools in evaluation of risk of cardiovascular events Aim: We evaluated oxygenation and characteristics in COVID–19 according to cardiovascular risk stratification performed using Framingham (FRS) and Atherosclerotic cardiovascular disease (ASCVD) risk scores. Material and Methods We evaluated 155 COVID–19 patients (110 males and 45 females, aged 67.43±14.72 yrs). All patients underwent to a complete physical examination, chest imaging, laboratory tests, and blood gas analysis at the time of diagnosis. Seventeen patients died (10 males and 7 females, aged 74.71±7.23 yrs) while the remaining 138 patients (100 males and 38 females, aged 66.07±15.16 yrs) were alive at discharge. Results No differences there were in Hb, C–reactive protein nor in d–dimers between the two groups. Compared to alive, died group presents a significant increase in white blood cells (p < 0.05) and d–dimers (p < 0.05). No difference there were in pCO2, SO2, and in alveolar arteriolar oxygen difference (A–aDO2). On the contrary, in died patients there is an increased pO2 (p < 0.05) and a decreased ratio between oxygen inspired and pO2 (P/F; p < 0.05). Died patients have increased both in FRS (27.37±5.03 vs 21.33±9.49, p < 0.05) and ASCVD (40.18±20.36 vs 21.47±17.23, p < 0.05). FRS, but not ASCVD, presents a negative correlation to P/F (r–0.42, p < 0.05) in died while no correlation was found in alive. No other correlation has been found with blood gas parameters or in the phlogosis parameters evaluated in the two groups. ROC curve analysis showed a good performance in prediction of death for both scores (AUC FRS 0.71, ASCVD 0.77) with a good sensitivity (FRS 76.92%, ASVCD 75.00%) and specificity (FRS 65.00%, ASCVD 81.13%). Discussion CVD may be considered as a major risk factor for death in COVID–19 patients. The increase risk relates to a reduced lung capacity but it is not related to alteration in gas exchange. Similarly, CV risk results independent from inflammatory state we found. CVD risk score may be useful to stratify patients at admittance for a better treatment
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Affiliation(s)
- S Cicco
- UNIT OF INTERNAL MEDICINE “GUIDO BACCELLI”, DEPARTMENT OF BIOMEDICAL SCIENCES AND HUMAN ONCOLOGY, UNIVERSITY OF BARI, BARI; DEPARTMENT OF MEDICINE, SECTION OF INTERNAL MEDICINE, CARLO POMA HOSPITAL, MANTOVA; DIVISION OF INTERNAL MEDICINE, DEPARTMENT OF MEDICINE, UNIVERSITY OF UDINE, UDINE; DIPARTIMENTO DELL‘EMERGENZA E TRAPIANTI D‘ORGANO (DETO), SEZIONE DI ANESTESIOLOGIA E RIANIMAZIONE, OSPEDALE
| | - C Mozzini
- UNIT OF INTERNAL MEDICINE “GUIDO BACCELLI”, DEPARTMENT OF BIOMEDICAL SCIENCES AND HUMAN ONCOLOGY, UNIVERSITY OF BARI, BARI; DEPARTMENT OF MEDICINE, SECTION OF INTERNAL MEDICINE, CARLO POMA HOSPITAL, MANTOVA; DIVISION OF INTERNAL MEDICINE, DEPARTMENT OF MEDICINE, UNIVERSITY OF UDINE, UDINE; DIPARTIMENTO DELL‘EMERGENZA E TRAPIANTI D‘ORGANO (DETO), SEZIONE DI ANESTESIOLOGIA E RIANIMAZIONE, OSPEDALE
| | - M Marozzi
- UNIT OF INTERNAL MEDICINE “GUIDO BACCELLI”, DEPARTMENT OF BIOMEDICAL SCIENCES AND HUMAN ONCOLOGY, UNIVERSITY OF BARI, BARI; DEPARTMENT OF MEDICINE, SECTION OF INTERNAL MEDICINE, CARLO POMA HOSPITAL, MANTOVA; DIVISION OF INTERNAL MEDICINE, DEPARTMENT OF MEDICINE, UNIVERSITY OF UDINE, UDINE; DIPARTIMENTO DELL‘EMERGENZA E TRAPIANTI D‘ORGANO (DETO), SEZIONE DI ANESTESIOLOGIA E RIANIMAZIONE, OSPEDALE
| | - R Carella
- UNIT OF INTERNAL MEDICINE “GUIDO BACCELLI”, DEPARTMENT OF BIOMEDICAL SCIENCES AND HUMAN ONCOLOGY, UNIVERSITY OF BARI, BARI; DEPARTMENT OF MEDICINE, SECTION OF INTERNAL MEDICINE, CARLO POMA HOSPITAL, MANTOVA; DIVISION OF INTERNAL MEDICINE, DEPARTMENT OF MEDICINE, UNIVERSITY OF UDINE, UDINE; DIPARTIMENTO DELL‘EMERGENZA E TRAPIANTI D‘ORGANO (DETO), SEZIONE DI ANESTESIOLOGIA E RIANIMAZIONE, OSPEDALE
| | - G De Fazio
- UNIT OF INTERNAL MEDICINE “GUIDO BACCELLI”, DEPARTMENT OF BIOMEDICAL SCIENCES AND HUMAN ONCOLOGY, UNIVERSITY OF BARI, BARI; DEPARTMENT OF MEDICINE, SECTION OF INTERNAL MEDICINE, CARLO POMA HOSPITAL, MANTOVA; DIVISION OF INTERNAL MEDICINE, DEPARTMENT OF MEDICINE, UNIVERSITY OF UDINE, UDINE; DIPARTIMENTO DELL‘EMERGENZA E TRAPIANTI D‘ORGANO (DETO), SEZIONE DI ANESTESIOLOGIA E RIANIMAZIONE, OSPEDALE
| | - A Vacca
- UNIT OF INTERNAL MEDICINE “GUIDO BACCELLI”, DEPARTMENT OF BIOMEDICAL SCIENCES AND HUMAN ONCOLOGY, UNIVERSITY OF BARI, BARI; DEPARTMENT OF MEDICINE, SECTION OF INTERNAL MEDICINE, CARLO POMA HOSPITAL, MANTOVA; DIVISION OF INTERNAL MEDICINE, DEPARTMENT OF MEDICINE, UNIVERSITY OF UDINE, UDINE; DIPARTIMENTO DELL‘EMERGENZA E TRAPIANTI D‘ORGANO (DETO), SEZIONE DI ANESTESIOLOGIA E RIANIMAZIONE, OSPEDALE
| | - C Cariddi
- UNIT OF INTERNAL MEDICINE “GUIDO BACCELLI”, DEPARTMENT OF BIOMEDICAL SCIENCES AND HUMAN ONCOLOGY, UNIVERSITY OF BARI, BARI; DEPARTMENT OF MEDICINE, SECTION OF INTERNAL MEDICINE, CARLO POMA HOSPITAL, MANTOVA; DIVISION OF INTERNAL MEDICINE, DEPARTMENT OF MEDICINE, UNIVERSITY OF UDINE, UDINE; DIPARTIMENTO DELL‘EMERGENZA E TRAPIANTI D‘ORGANO (DETO), SEZIONE DI ANESTESIOLOGIA E RIANIMAZIONE, OSPEDALE
| | - A Setti
- UNIT OF INTERNAL MEDICINE “GUIDO BACCELLI”, DEPARTMENT OF BIOMEDICAL SCIENCES AND HUMAN ONCOLOGY, UNIVERSITY OF BARI, BARI; DEPARTMENT OF MEDICINE, SECTION OF INTERNAL MEDICINE, CARLO POMA HOSPITAL, MANTOVA; DIVISION OF INTERNAL MEDICINE, DEPARTMENT OF MEDICINE, UNIVERSITY OF UDINE, UDINE; DIPARTIMENTO DELL‘EMERGENZA E TRAPIANTI D‘ORGANO (DETO), SEZIONE DI ANESTESIOLOGIA E RIANIMAZIONE, OSPEDALE
| | - F Pappagallo
- UNIT OF INTERNAL MEDICINE “GUIDO BACCELLI”, DEPARTMENT OF BIOMEDICAL SCIENCES AND HUMAN ONCOLOGY, UNIVERSITY OF BARI, BARI; DEPARTMENT OF MEDICINE, SECTION OF INTERNAL MEDICINE, CARLO POMA HOSPITAL, MANTOVA; DIVISION OF INTERNAL MEDICINE, DEPARTMENT OF MEDICINE, UNIVERSITY OF UDINE, UDINE; DIPARTIMENTO DELL‘EMERGENZA E TRAPIANTI D‘ORGANO (DETO), SEZIONE DI ANESTESIOLOGIA E RIANIMAZIONE, OSPEDALE
| | - A Solimando
- UNIT OF INTERNAL MEDICINE “GUIDO BACCELLI”, DEPARTMENT OF BIOMEDICAL SCIENCES AND HUMAN ONCOLOGY, UNIVERSITY OF BARI, BARI; DEPARTMENT OF MEDICINE, SECTION OF INTERNAL MEDICINE, CARLO POMA HOSPITAL, MANTOVA; DIVISION OF INTERNAL MEDICINE, DEPARTMENT OF MEDICINE, UNIVERSITY OF UDINE, UDINE; DIPARTIMENTO DELL‘EMERGENZA E TRAPIANTI D‘ORGANO (DETO), SEZIONE DI ANESTESIOLOGIA E RIANIMAZIONE, OSPEDALE
| | - R Ria
- UNIT OF INTERNAL MEDICINE “GUIDO BACCELLI”, DEPARTMENT OF BIOMEDICAL SCIENCES AND HUMAN ONCOLOGY, UNIVERSITY OF BARI, BARI; DEPARTMENT OF MEDICINE, SECTION OF INTERNAL MEDICINE, CARLO POMA HOSPITAL, MANTOVA; DIVISION OF INTERNAL MEDICINE, DEPARTMENT OF MEDICINE, UNIVERSITY OF UDINE, UDINE; DIPARTIMENTO DELL‘EMERGENZA E TRAPIANTI D‘ORGANO (DETO), SEZIONE DI ANESTESIOLOGIA E RIANIMAZIONE, OSPEDALE
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Branca E, Cicco S, Susca N, Longo L, Albanese F, Pappagallo F, Giliberti T, Morelli C, Dell‘Atti C, Ingravallo G, Prete M, Solimando A, Lauletta G, Vacca A, Ria R. P87 MEDIASTINAL SYNDROME REVEALED HEART LOCALIZATION OF A PRIMARY MEDIASTINAL B–CELL LYMPHOMA. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Background
Primary mediastinal B–cell lymphoma (PMBCL) is an aggressive B–cell lymphoma that represents 2–3% of non –Hodgkin lymphoma cases and typically affects young adult Caucasian women. Diagnosis can be difficult and often need a multidisciplinary approach.
Case
a 75 year old female, with history of hypertension, came to ER for severe dyspnea. She complains also neck and left arm oedema. Blue swelling of face and trunk were described. Heart PoCUS was inconclusive, describing only a hypoechoic dilation of right atrium while the other three heart chambers were reduced in dimensions. Chest TC revealed a huge mediastinal mass next to a thrombosis of superior cava vein and right atrium (7 cm diameter) and a diffuse subsegmental pulmonary embolism. Arm and neck Lymphnodes were also enlarged . Low molecular weight heparin was given twice a day. Due the respiratory failure a high–flow nasal cannula oxygen treatment was performed. PET revealed FDG uptake in antero–superior mediastinum, but there was the same uptake in heart right atrium without a connection with the previous described. Therefore, this was no more considered as thrombus but as mass. The micro–bubble test revealed right to left shunt. She refused heart MRI. The patient was not suitable for an open–surgery biopsy, thus she was scheduled for a TC guided one, in order to obtain a pathological diagnosis for a suspected right atrium sarcoma. Due to the high risk we choose to perform the less invasive as possible way to have a histological sample. Thus, and intravascular biopsy of atrial mass by femoral vein was performed. The patient did not present any sequelae after procedure and she continued anticoagulation. The subsequent histological analysis revealed a PMBCL with a primary localization in Right atrium. Unfortunately, a sepsis by multiple resistant pseudomonas Aeruginosa and Aspergillus spp. arose and the patient died three weeks after biopsy.
Conclusion
A PMBCL is a rare and aggressive disease. Like in our patient, mediastinal syndrome is often associated to the disease. However, intracardiac localization are even rarer events. In large case series, less than 1% of intracardiac masses were lymphomas. In our patient, open–surgery was not suitable for multiple comorbidities. However, intravascular approach was less aggressive but effective to obtain enough tissue for diagnosis. Unfortunately, the immune suppression related to PMBCL and opportunistic infections drive a mortal sepsis.
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Affiliation(s)
- E Branca
- UNIT OF INTERNAL MEDICINE “GUIDO BACCELLI”, DEPARTMENT OF BIOMEDICAL SCIENCES AND HUMAN ONCOLOGY, UNIVERSITY OF BARI “ALDO MORO”, BARI; UOC OF INTERVENTIONAL RADIOLOGY, AUOC POLICLINICO DI BARI, BARI; SECTION OF PATHOLOGY, DEPARTMENT OF EMERGENCY AND ORGAN TRANSPLANTATION (DETO), UNIVERSITY OF BARI “ALDO MORO”, BARI
| | - S Cicco
- UNIT OF INTERNAL MEDICINE “GUIDO BACCELLI”, DEPARTMENT OF BIOMEDICAL SCIENCES AND HUMAN ONCOLOGY, UNIVERSITY OF BARI “ALDO MORO”, BARI; UOC OF INTERVENTIONAL RADIOLOGY, AUOC POLICLINICO DI BARI, BARI; SECTION OF PATHOLOGY, DEPARTMENT OF EMERGENCY AND ORGAN TRANSPLANTATION (DETO), UNIVERSITY OF BARI “ALDO MORO”, BARI
| | - N Susca
- UNIT OF INTERNAL MEDICINE “GUIDO BACCELLI”, DEPARTMENT OF BIOMEDICAL SCIENCES AND HUMAN ONCOLOGY, UNIVERSITY OF BARI “ALDO MORO”, BARI; UOC OF INTERVENTIONAL RADIOLOGY, AUOC POLICLINICO DI BARI, BARI; SECTION OF PATHOLOGY, DEPARTMENT OF EMERGENCY AND ORGAN TRANSPLANTATION (DETO), UNIVERSITY OF BARI “ALDO MORO”, BARI
| | - L Longo
- UNIT OF INTERNAL MEDICINE “GUIDO BACCELLI”, DEPARTMENT OF BIOMEDICAL SCIENCES AND HUMAN ONCOLOGY, UNIVERSITY OF BARI “ALDO MORO”, BARI; UOC OF INTERVENTIONAL RADIOLOGY, AUOC POLICLINICO DI BARI, BARI; SECTION OF PATHOLOGY, DEPARTMENT OF EMERGENCY AND ORGAN TRANSPLANTATION (DETO), UNIVERSITY OF BARI “ALDO MORO”, BARI
| | - F Albanese
- UNIT OF INTERNAL MEDICINE “GUIDO BACCELLI”, DEPARTMENT OF BIOMEDICAL SCIENCES AND HUMAN ONCOLOGY, UNIVERSITY OF BARI “ALDO MORO”, BARI; UOC OF INTERVENTIONAL RADIOLOGY, AUOC POLICLINICO DI BARI, BARI; SECTION OF PATHOLOGY, DEPARTMENT OF EMERGENCY AND ORGAN TRANSPLANTATION (DETO), UNIVERSITY OF BARI “ALDO MORO”, BARI
| | - F Pappagallo
- UNIT OF INTERNAL MEDICINE “GUIDO BACCELLI”, DEPARTMENT OF BIOMEDICAL SCIENCES AND HUMAN ONCOLOGY, UNIVERSITY OF BARI “ALDO MORO”, BARI; UOC OF INTERVENTIONAL RADIOLOGY, AUOC POLICLINICO DI BARI, BARI; SECTION OF PATHOLOGY, DEPARTMENT OF EMERGENCY AND ORGAN TRANSPLANTATION (DETO), UNIVERSITY OF BARI “ALDO MORO”, BARI
| | - T Giliberti
- UNIT OF INTERNAL MEDICINE “GUIDO BACCELLI”, DEPARTMENT OF BIOMEDICAL SCIENCES AND HUMAN ONCOLOGY, UNIVERSITY OF BARI “ALDO MORO”, BARI; UOC OF INTERVENTIONAL RADIOLOGY, AUOC POLICLINICO DI BARI, BARI; SECTION OF PATHOLOGY, DEPARTMENT OF EMERGENCY AND ORGAN TRANSPLANTATION (DETO), UNIVERSITY OF BARI “ALDO MORO”, BARI
| | - C Morelli
- UNIT OF INTERNAL MEDICINE “GUIDO BACCELLI”, DEPARTMENT OF BIOMEDICAL SCIENCES AND HUMAN ONCOLOGY, UNIVERSITY OF BARI “ALDO MORO”, BARI; UOC OF INTERVENTIONAL RADIOLOGY, AUOC POLICLINICO DI BARI, BARI; SECTION OF PATHOLOGY, DEPARTMENT OF EMERGENCY AND ORGAN TRANSPLANTATION (DETO), UNIVERSITY OF BARI “ALDO MORO”, BARI
| | - C Dell‘Atti
- UNIT OF INTERNAL MEDICINE “GUIDO BACCELLI”, DEPARTMENT OF BIOMEDICAL SCIENCES AND HUMAN ONCOLOGY, UNIVERSITY OF BARI “ALDO MORO”, BARI; UOC OF INTERVENTIONAL RADIOLOGY, AUOC POLICLINICO DI BARI, BARI; SECTION OF PATHOLOGY, DEPARTMENT OF EMERGENCY AND ORGAN TRANSPLANTATION (DETO), UNIVERSITY OF BARI “ALDO MORO”, BARI
| | - G Ingravallo
- UNIT OF INTERNAL MEDICINE “GUIDO BACCELLI”, DEPARTMENT OF BIOMEDICAL SCIENCES AND HUMAN ONCOLOGY, UNIVERSITY OF BARI “ALDO MORO”, BARI; UOC OF INTERVENTIONAL RADIOLOGY, AUOC POLICLINICO DI BARI, BARI; SECTION OF PATHOLOGY, DEPARTMENT OF EMERGENCY AND ORGAN TRANSPLANTATION (DETO), UNIVERSITY OF BARI “ALDO MORO”, BARI
| | - M Prete
- UNIT OF INTERNAL MEDICINE “GUIDO BACCELLI”, DEPARTMENT OF BIOMEDICAL SCIENCES AND HUMAN ONCOLOGY, UNIVERSITY OF BARI “ALDO MORO”, BARI; UOC OF INTERVENTIONAL RADIOLOGY, AUOC POLICLINICO DI BARI, BARI; SECTION OF PATHOLOGY, DEPARTMENT OF EMERGENCY AND ORGAN TRANSPLANTATION (DETO), UNIVERSITY OF BARI “ALDO MORO”, BARI
| | - A Solimando
- UNIT OF INTERNAL MEDICINE “GUIDO BACCELLI”, DEPARTMENT OF BIOMEDICAL SCIENCES AND HUMAN ONCOLOGY, UNIVERSITY OF BARI “ALDO MORO”, BARI; UOC OF INTERVENTIONAL RADIOLOGY, AUOC POLICLINICO DI BARI, BARI; SECTION OF PATHOLOGY, DEPARTMENT OF EMERGENCY AND ORGAN TRANSPLANTATION (DETO), UNIVERSITY OF BARI “ALDO MORO”, BARI
| | - G Lauletta
- UNIT OF INTERNAL MEDICINE “GUIDO BACCELLI”, DEPARTMENT OF BIOMEDICAL SCIENCES AND HUMAN ONCOLOGY, UNIVERSITY OF BARI “ALDO MORO”, BARI; UOC OF INTERVENTIONAL RADIOLOGY, AUOC POLICLINICO DI BARI, BARI; SECTION OF PATHOLOGY, DEPARTMENT OF EMERGENCY AND ORGAN TRANSPLANTATION (DETO), UNIVERSITY OF BARI “ALDO MORO”, BARI
| | - A Vacca
- UNIT OF INTERNAL MEDICINE “GUIDO BACCELLI”, DEPARTMENT OF BIOMEDICAL SCIENCES AND HUMAN ONCOLOGY, UNIVERSITY OF BARI “ALDO MORO”, BARI; UOC OF INTERVENTIONAL RADIOLOGY, AUOC POLICLINICO DI BARI, BARI; SECTION OF PATHOLOGY, DEPARTMENT OF EMERGENCY AND ORGAN TRANSPLANTATION (DETO), UNIVERSITY OF BARI “ALDO MORO”, BARI
| | - R Ria
- UNIT OF INTERNAL MEDICINE “GUIDO BACCELLI”, DEPARTMENT OF BIOMEDICAL SCIENCES AND HUMAN ONCOLOGY, UNIVERSITY OF BARI “ALDO MORO”, BARI; UOC OF INTERVENTIONAL RADIOLOGY, AUOC POLICLINICO DI BARI, BARI; SECTION OF PATHOLOGY, DEPARTMENT OF EMERGENCY AND ORGAN TRANSPLANTATION (DETO), UNIVERSITY OF BARI “ALDO MORO”, BARI
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10
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Cicco S, Solimando A, Susca N, Inglese G, Melaccio A, De Fazio G, Vacca A, Ria R. P318 RIGHT HEART CHANGE IMPACTS ON SURVIVAL IN PATIENTS AFFECTED BY CARDIAC AMYLOIDOSIS: A SINGLE CENTRE STUDY. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Amyloidosis is due to deposition of an excessive amount of protein in tissues. Cardiac Amyloidosis (CA) is an inauspicious prognostic factor and leading sudden death. We retrospectively analyzed 135 systemic amyloidosis, admitted between 1981 and 2019. 54 patients (46.30% F, aged 63.95±12.82) presented CA at baseline. In 53 patients, it was associated with a multiorgan involvement, while in one there was a primary myocardial deposition. We compared this group with the 81 patients (49.30% F, aged 58.33±15.65) who did not meet criteria for CA. CA presented a decreased SBP (p = 0.036), while nCA had an increased proteinuria (p = 0.02). TnI and NT–proBNP were significantly increased compared to nCA (p = 0.031 and p = 0.047, respectively). In CA patients we found an increased LDH compared to nCA (p = 0.0011). CA patients were also found to have an increased interventricular septum thickness compared to nCA (p = 0.002), a decreased Ejection Fraction (p = 0.0018) and Doppler velocity E/e’ ratio (p = 0.0095). Moreover, CA patients had an enhanced right atrium area (p = 0.0179), right ventricle basal diameter (p = 0.0112) and wall thickness (p = 0.0471) compared to nCA, and an increased inferior cava vein diameter (p = 0.0495) as well. TAPSE was the method chosen to evaluate systolic function of the right heart. In CA subjects very poor TAPSE levels were found compared to nCA patients (p = 0.0495). Additionally, we found a significant positive correlation between TAPSE and lymphocyte count (r = 0.47; p = 0.031) as well as Gamma globulins (r = 0.43, p = 0.033), Monoclonal components (r = 0.72; p = 0.047) and IgG values (r = 0.62, p = 0.018). CA patients had very poor survival rates compared to controls (30 vs. 66 months, p = 0.15). Mean survival of CA individuals was worse also when stratified according to NT–proBNP levels, using 2500 pg/mL as class boundary (174 vs. 5.5 months, respectively p = 0.013). In much the same way, a decreased right heart systolic function was correlated with a worse prognosis (18.0 months median survival, not reached in subjects with higher values than 18 mm, p = 0.0186). Finally, our data highlight the potential prognostic and predictive value of right heart alterations characterizing amyloidosis, as a novel clinical parameter correlated to increased LDH and immunoglobulins levels. Overall, we confirm the clinical relevance of cardiac involvement suggests that right heart evaluation may be considered as a new marker for clinical risk stratification in patients with amyloidosis.
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Affiliation(s)
- S Cicco
- U.O.C. MEDICINA INTERNA UNIVERSITARIA “G. BACCELLI” – DIPARTIMENTO DI MEDICINA INTERNA E ONCOLOGIA MEDICA, A.O. POLICLINICO DI BARI, BARI
| | - A Solimando
- U.O.C. MEDICINA INTERNA UNIVERSITARIA “G. BACCELLI” – DIPARTIMENTO DI MEDICINA INTERNA E ONCOLOGIA MEDICA, A.O. POLICLINICO DI BARI, BARI
| | - N Susca
- U.O.C. MEDICINA INTERNA UNIVERSITARIA “G. BACCELLI” – DIPARTIMENTO DI MEDICINA INTERNA E ONCOLOGIA MEDICA, A.O. POLICLINICO DI BARI, BARI
| | - G Inglese
- U.O.C. MEDICINA INTERNA UNIVERSITARIA “G. BACCELLI” – DIPARTIMENTO DI MEDICINA INTERNA E ONCOLOGIA MEDICA, A.O. POLICLINICO DI BARI, BARI
| | - A Melaccio
- U.O.C. MEDICINA INTERNA UNIVERSITARIA “G. BACCELLI” – DIPARTIMENTO DI MEDICINA INTERNA E ONCOLOGIA MEDICA, A.O. POLICLINICO DI BARI, BARI
| | - G De Fazio
- U.O.C. MEDICINA INTERNA UNIVERSITARIA “G. BACCELLI” – DIPARTIMENTO DI MEDICINA INTERNA E ONCOLOGIA MEDICA, A.O. POLICLINICO DI BARI, BARI
| | - A Vacca
- U.O.C. MEDICINA INTERNA UNIVERSITARIA “G. BACCELLI” – DIPARTIMENTO DI MEDICINA INTERNA E ONCOLOGIA MEDICA, A.O. POLICLINICO DI BARI, BARI
| | - R Ria
- U.O.C. MEDICINA INTERNA UNIVERSITARIA “G. BACCELLI” – DIPARTIMENTO DI MEDICINA INTERNA E ONCOLOGIA MEDICA, A.O. POLICLINICO DI BARI, BARI
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11
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Magistro A, Cicco S, Marozzi M, Narcisi V, Carrieri A, Longo S, Giliberti T, Melaccio A, Solimando A, Lauletta G, Vacca A, Ria R. P317 FATAL EVOLUTION IN A YOUNG WOMAN DUE TO AMYLOIDOSIS HEART FAILURE IN A RARE MULTIPLE MYELOMA DISEASE. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
Immunoglobulin (Ig) D (IgD) monoclonal gammopathy is a rare subtype of multiple myeloma (MM) associated with a worse prognosis. Ig light chains amyloidosis is a disorder characterized by extracellular deposition of Ig light chains in various tissues, leading to organ dysfunction.
Case
A 29–year–old woman was admitted for dyspnea and tachycardia for moderate efforts. Lab revealed hypogammaglobulinemia with a monoclonal IgD K paraprotein. There was an increase in K free chains, with a dramatic increase in K/λ free chains Ratio. Proteinuria was 1360 mg/24h with a free K chains Bence Jones Protein. An increase in values of Troponin–I (137,5 pg/mL) and NT–proBNP (12527 pg/mL) pointed towards heart involvement. Furthermore, the ECG showed low voltages in the peripheral leads. Echocardiogram showed a moderate concentric left ventricular hypertrophy with diffused myocardial speckled pattern, an ejection fraction (EF) of 53% and PAPs of 71 mmHg and pericardial effusion. Chest CT scan showed bilateral pleural effusion. Spine MRI and whole body PET/CT indicated areas of osteolytic lesions. Plasma cells infiltration (85% CD138, MUM1 and K chains positivity) was present at bone marrow biopsy. Amyloid deposition was detected in abdominal fat tissue sample. Total bone scintigraphy excluded a transthyretin heart deposition. Thus, amyloidosis associate to IgD MM was diagnosed. In few days heart failure worsened (hs–cTnI 156,6 pg/mL; NT–proBNP 26583 pg/mL, EF 48%,) and the patient began complaining non–productive cough, dyspnea, and columnar edema of the lower limbs. She was not eligible for bone marrow transplantation, so daratumumab, bortezomib, melphalan and prednisone were administered. Despite serological improvement after a short five days course of therapy, she worsened with a further reduction of EF (35%). Blood gas analysis showed hypoxemia and lactate increase quickly turned into a cardiogenic shock. She died by cardiac arrest, just three weeks after admission.
Discussion
The present case is remarkable for age and gender of the patient as well as the rapid onset and fast worsening of symptoms, which were related to secondary heart amyloid deposition. Symptoms associated to cardiac amyloidosis are expressions of right heart involvement. The early good results of the therapy did not turn the evolution of disease. The fatal and overwhelming progression of the myocardial involvement led to the patient’s death in less than one month.
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Affiliation(s)
- A Magistro
- U.O.C. MEDICINA INTERNA UNIVERSITARIA “G. BACCELLI” – DIPARTIMENTO DI MEDICINA INTERNA E ONCOLOGIA MEDICA, A.O. POLICLINICO DI BARI, BARI
| | - S Cicco
- U.O.C. MEDICINA INTERNA UNIVERSITARIA “G. BACCELLI” – DIPARTIMENTO DI MEDICINA INTERNA E ONCOLOGIA MEDICA, A.O. POLICLINICO DI BARI, BARI
| | - M Marozzi
- U.O.C. MEDICINA INTERNA UNIVERSITARIA “G. BACCELLI” – DIPARTIMENTO DI MEDICINA INTERNA E ONCOLOGIA MEDICA, A.O. POLICLINICO DI BARI, BARI
| | - V Narcisi
- U.O.C. MEDICINA INTERNA UNIVERSITARIA “G. BACCELLI” – DIPARTIMENTO DI MEDICINA INTERNA E ONCOLOGIA MEDICA, A.O. POLICLINICO DI BARI, BARI
| | - A Carrieri
- U.O.C. MEDICINA INTERNA UNIVERSITARIA “G. BACCELLI” – DIPARTIMENTO DI MEDICINA INTERNA E ONCOLOGIA MEDICA, A.O. POLICLINICO DI BARI, BARI
| | - S Longo
- U.O.C. MEDICINA INTERNA UNIVERSITARIA “G. BACCELLI” – DIPARTIMENTO DI MEDICINA INTERNA E ONCOLOGIA MEDICA, A.O. POLICLINICO DI BARI, BARI
| | - T Giliberti
- U.O.C. MEDICINA INTERNA UNIVERSITARIA “G. BACCELLI” – DIPARTIMENTO DI MEDICINA INTERNA E ONCOLOGIA MEDICA, A.O. POLICLINICO DI BARI, BARI
| | - A Melaccio
- U.O.C. MEDICINA INTERNA UNIVERSITARIA “G. BACCELLI” – DIPARTIMENTO DI MEDICINA INTERNA E ONCOLOGIA MEDICA, A.O. POLICLINICO DI BARI, BARI
| | - A Solimando
- U.O.C. MEDICINA INTERNA UNIVERSITARIA “G. BACCELLI” – DIPARTIMENTO DI MEDICINA INTERNA E ONCOLOGIA MEDICA, A.O. POLICLINICO DI BARI, BARI
| | - G Lauletta
- U.O.C. MEDICINA INTERNA UNIVERSITARIA “G. BACCELLI” – DIPARTIMENTO DI MEDICINA INTERNA E ONCOLOGIA MEDICA, A.O. POLICLINICO DI BARI, BARI
| | - A Vacca
- U.O.C. MEDICINA INTERNA UNIVERSITARIA “G. BACCELLI” – DIPARTIMENTO DI MEDICINA INTERNA E ONCOLOGIA MEDICA, A.O. POLICLINICO DI BARI, BARI
| | - R Ria
- U.O.C. MEDICINA INTERNA UNIVERSITARIA “G. BACCELLI” – DIPARTIMENTO DI MEDICINA INTERNA E ONCOLOGIA MEDICA, A.O. POLICLINICO DI BARI, BARI
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Delia M, Carluccio P, Gagliardi VP, Mestice A, Chiusolo P, Arpinati M, Milone GA, Martino M, Mazza P, Ingrosso C, Vacca A, Saporiti G, Zallio F, Attolico I, Pastore D, Specchia G, Albano F, Musto P. Deciphering the effects of graft Tregs on chronic graft-versus-host disease: results from a prospective, multicenter study in patients with acute leukemia undergoing allogeneic peripheral blood stem cell transplantation. Bone Marrow Transplant 2022; 57:1042-1044. [PMID: 35440806 DOI: 10.1038/s41409-022-01676-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 04/01/2022] [Accepted: 04/01/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Mario Delia
- Hematology and Stem Cell Transplantation Unit, AOUC Policlinico, Bari, Italy.
| | - Paola Carluccio
- Hematology and Stem Cell Transplantation Unit, AOUC Policlinico, Bari, Italy
| | - Vito Pier Gagliardi
- Hematology and Stem Cell Transplantation Unit, AOUC Policlinico, Bari, Italy
| | - Anna Mestice
- Hematology and Stem Cell Transplantation Unit, AOUC Policlinico, Bari, Italy.,Department of Emergency and Organ Transplantation, "Aldo Moro" University - School of Medicine, Bari, Italy
| | - Patrizia Chiusolo
- Hematology, Fondazione Policlinico Universitario "Gemelli" IRCCS, Rome, Italy
| | - Mario Arpinati
- Hematology and BMT, AOU Policlinico "S Orsola Malpighi" IRCCS, Bologna, Italy
| | - Giulio Antonio Milone
- Programma di Trapianto Emopoietico Metropolitano, Azienda Policlinico-Vittorio Emanuele, Catania, Italy
| | - Massimo Martino
- Bone Marrow Transplantation, Grande Ospedale Metropolitano "Bianchi Melacrino Morelli", Reggio, Calabria, Italy
| | - Patrizio Mazza
- Hematology and BMT Unit, Ospedale "S.G.Moscati", Taranto, Italy
| | | | - Adriana Vacca
- Hematology and BMT, Presidio Ospedaliero "A. Businco", Cagliari, Italy
| | - Giorgia Saporiti
- Centro Trapianti di midollo - UOC Ematologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano - Università degli Studi di Milano, Milan, Italy
| | - Francesco Zallio
- Bone Marrow Transplantation Unit, Ospedale "SS Biagio e Arrigo", Alessandria, Italy
| | - Immacolata Attolico
- Hematology and Stem Cell Transplantation Unit, AOUC Policlinico, Bari, Italy
| | | | - Giorgina Specchia
- Former Full Professor of Hematology, "Aldo Moro" University - School of Medicine, Bari, Italy
| | - Francesco Albano
- Hematology and Stem Cell Transplantation Unit, AOUC Policlinico, Bari, Italy.,Department of Emergency and Organ Transplantation, "Aldo Moro" University - School of Medicine, Bari, Italy
| | - Pellegrino Musto
- Hematology and Stem Cell Transplantation Unit, AOUC Policlinico, Bari, Italy.,Department of Emergency and Organ Transplantation, "Aldo Moro" University - School of Medicine, Bari, Italy
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13
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Bonifazi F, Pavoni C, Peccatori J, Giglio F, Arpinati M, Busca A, Bernasconi P, Grassi A, Iori AP, Patriarca F, Brunello L, Di Grazia C, Carella AM, Cilloni D, Picardi A, Proia A, Santarone S, Sorasio R, Carluccio P, Chiusolo P, Cupri A, Luppi M, Nozzoli C, Baronciani D, Casini M, Grillo G, Musso M, Onida F, Palazzo G, Parma M, Tringali S, Vacca A, Vallisa D, Sacchi N, Oldani E, Masciulli A, Gheorghiu A, Girmenia C, Martino M, Bruno B, Rambaldi A, Ciceri F. Myeloablative conditioning with thiotepa-busulfan-fludarabine does not improve the outcome of patients transplanted with active leukemia: final results of the GITMO prospective trial GANDALF-01. Bone Marrow Transplant 2022; 57:949-958. [PMID: 35413985 PMCID: PMC9200637 DOI: 10.1038/s41409-022-01626-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 11/09/2022]
Abstract
The outcome of refractory/relapsed (R/R) acute leukemias is still dismal and their treatment represents an unmet clinical need. However, allogeneic transplantation (allo-HSCT) remains the only potentially curative approach in this setting. A prospective study (GANDALF-01, NCT01814488; EUDRACT:2012-004008-37) on transplantation with alternative donors had been run by GITMO using a homogeneous myeloablative conditioning regimen with busulfan, thiotepa and fludarabine while GVHD prophylaxis was stratified by donor type. The study enrolled 101 patients; 90 found an alternative donor and 87 ultimately underwent allo-HSCT. Two-year overall survival of the entire and of the transplant population (primary endpoint) were 19% and 22%, without significant differences according to disease, donor type and disease history (relapsed vs refractory patients). Two-year progression-free survival was 19% and 17% respectively. The cumulative incidences of relapse and non-relapse mortality were 49% and 33% at two years. Acute grade II-IV and chronic GVHD occurred in 23 and 10 patients. Dose intensification with a myeloablative two-alkylating regimen as sole strategy for transplanting R/R acute leukemia does seem neither to improve the outcome nor to control disease relapse. A pre-planned relapse prevention should be included in the transplant strategy in this patient population.
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Affiliation(s)
| | - Chiara Pavoni
- Department of Oncology and Hematology Azienda Socio-Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | - Jacopo Peccatori
- Department of Onco-Hematology - Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Fabio Giglio
- Department of Onco-Hematology - Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Mario Arpinati
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Alessandro Busca
- SSD Trapianto Cellule Staminali, AOU Città della salute e della Scienza, Torino, Italy
| | - Paolo Bernasconi
- Centro trapianti di cellule staminali ematopoietiche, UOC Ematologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Anna Grassi
- Department of Oncology and Hematology Azienda Socio-Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | - Anna Paola Iori
- Ematologia, AOU Policlinico Umberto 1, Sapienza Università di Roma, Roma, Italy
| | - Francesca Patriarca
- Clinica Ematologica e Centro Trapianti, ASUFC, Udine; DAME, Università di Udine, Udine, Italy
| | - Lucia Brunello
- di Ematologia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Carmen Di Grazia
- Ematologia e Centro Trapianti. IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Angelo Michele Carella
- SSD UTIE e Terapie Cellulari, Dipartimento Scienze Mediche, Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
| | - Daniela Cilloni
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Alessandra Picardi
- Rome Transplant Network, Department of Biotecnology and Prevention, Tor Vergata University, Rome, Italy.,Stem Cell Transplant Program of AORN Cardarelli, Naples, Italy
| | - Anna Proia
- Ematologia e Trapianto CSE, AO San Camillo-Forlanini, Roma, Italy
| | | | | | - Paola Carluccio
- Department of Emergency and Organ Transplantation (D.E.T.O.), Hematology Section, University of Bari, Bari, Italy
| | - Patrizia Chiusolo
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Alessandra Cupri
- Unità di Trapianto di Midollo, Divisione di Ematologia, Azienda Ospedaliera Policlinico di Catania, Catania, Italy
| | - Mario Luppi
- Department of Medical and Surgical Sciences Unimore Azienda Ospedaliera Universitaria di Modena, Modena, Italy
| | - Chiara Nozzoli
- Department of Cellular Therapies and Transfusion Medicine, Careggi Hospital, Florence, Italy
| | | | | | | | - Maurizio Musso
- UOC di Oncoematologia e TMO Dipartimento Oncologico "La Maddalena" Palermo, Palermo, Italy
| | - Francesco Onida
- IRCCS Ca' Granda Ospedale Maggiore Policlinico Centro Trapianti Midollo Osseo - UOC Ematologia - Università degli Studi di Milano Dipartimento di Oncologia e Emato-Oncologia, Milano, Italy
| | | | - Matteo Parma
- Divisione di Ematologia e Centro Trapianti di Midollo, Ospedale San Gerardo, Monza, Italy
| | - Stefania Tringali
- AOR Villa Sofia Cervello, Dipartimento Oncologia, UOSD Unità Trapianti di Midollo Osseo, Palermo, Italy
| | - Adriana Vacca
- UO Centro Trapianti di Midollo Osseo Presidio Ospedaliero R. Binaghi, Cagliari, Italy
| | | | | | - Elena Oldani
- Department of Oncology and Hematology Azienda Socio-Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | | | - Angela Gheorghiu
- Trials Office GITMO Gruppo Italiano per il Trapianto di Midollo Osseo, cellule staminali emopoietiche e terapia Cellulare, Genova, Italy
| | - Corrado Girmenia
- Ematologia, AOU Policlinico Umberto 1, Sapienza Università di Roma, Roma, Italy
| | - Massimo Martino
- Stem Cell Transplant and Cellular Therapies Unit, Grande Ospedale Metropolitano "BMM", Reggio Calabria, Italy
| | - Benedetto Bruno
- Dipartimento di Biotecnologie Molecolari e Scienze per la Salute - Università di Torino, Torino, Italy
| | - Alessandro Rambaldi
- Department of Oncology and Hematology Azienda Socio-Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy.,University of Milan, Milan, Italy
| | - Fabio Ciceri
- Department of Onco-Hematology - Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
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14
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Bavaro DF, Diella L, Solimando AG, Cicco S, Buonamico E, Stasi C, Ciannarella M, Marrone M, Carpagnano F, Resta O, Carpagnano GE, Palmieri VO, Vacca A, Dell'Aera M, Dell'Erba A, Migliore G, Aricò M, Saracino A. Bamlanivimab and Etesevimab administered in an outpatient setting for SARS-CoV-2 infection. Pathog Glob Health 2022; 116:297-304. [PMID: 35138229 PMCID: PMC8862158 DOI: 10.1080/20477724.2021.2024030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
The early administration of anti-SARS-CoV-2 monoclonal antibodies (mAb) could decrease the risk of severe disease and the need of inpatients care. Herein, our clinical experience with Bamlanivimab/Etesevimab for the treatment of early SARS-CoV-2 infection through an outpatient service was described. Patients with confirmed COVID-19 were selected by General Practitioners (GPs) if eligible to mAb administration, according to manufacturer and AIFA (Agenzia-Italiana-del-Farmaco) criteria. If suitability was confirmed by the Multidisciplinary Team, the patient was evaluated within the next 48-72 hours. Then, all patients underwent a medical evaluation, followed by mAb infusion or hospitalization if the medical condition had worsened. Overall, from March 29th to June 4th, 2021, 106 patients with confirmed COVID-19 were identified by GPs; 26 were considered not eligible and then excluded, while 9 refused treatment. Among the 71 remaining, 6 were not treated because of worsening of symptoms soon after selection. Finally, 65 received mAb therapy. All treated patients survived. However, 2/65 developed adverse events (allergic reaction and atrial fibrillation, respectively) and 6/65 needed hospitalization. By performing univariate logistic regression analysis, diabetes was the only risk factor for hospitalization after mAb administration [aOR = 9.34, 95%CI = 1.31-66.49, p= .026]. Importantly, subjects who worsened awaiting mAb were more frequently obese (OR = 16.66, 95%CI = 1.80-153.9, p= .013) and received home corticosteroid therapy for COVID-19 (OR = 14.11, 95%CI = 1.53-129.6, p= .019). Establishing a network among GPs and COVID units could be an effective strategy to provide mAb treatment to patients with early SARS-CoV-2 infection to reduce hospitalizations and pressure on healthcare systems.
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Affiliation(s)
- D F Bavaro
- Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - L Diella
- Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - A G Solimando
- Department of Biomedical Sciences and Human Oncology, Section of Internal Medicine 'G. Baccelli' University Hospital Policlinico, Bari, Italy
| | - S Cicco
- Department of Biomedical Sciences and Human Oncology, Section of Internal Medicine 'G. Baccelli' University Hospital Policlinico, Bari, Italy
| | - E Buonamico
- Department of Basic Medical Science, Institute of Respiratory Disease, Neuroscience, and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - C Stasi
- Clinica Medica 'A. Murri', Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| | - M Ciannarella
- Clinica Medica 'A. Murri', Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| | - M Marrone
- Interdisciplinary Department of Medicine, University of Bari - Section of Legal Medicine, Bari General Hospital, Bari, Italy
| | - F Carpagnano
- Section of Health Management, Policlinico Hospital, Bari, Italy
| | - O Resta
- Department of Basic Medical Science, Institute of Respiratory Disease, Neuroscience, and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - G E Carpagnano
- Department of Basic Medical Science, Institute of Respiratory Disease, Neuroscience, and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - V O Palmieri
- Clinica Medica 'A. Murri', Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| | - A Vacca
- Department of Biomedical Sciences and Human Oncology, Section of Internal Medicine 'G. Baccelli' University Hospital Policlinico, Bari, Italy
| | - M Dell'Aera
- Hospital Pharmacy, Direttore Farmacia Ospedaliera Aou Policlinico Di Bari, Bari, Italy
| | - A Dell'Erba
- Interdisciplinary Department of Medicine, University of Bari - Section of Legal Medicine, Bari General Hospital, Bari, Italy
| | - G Migliore
- General Direction, Policlinico Hospital, Bari, Italy
| | - M Aricò
- Strategic Direction, Policlinico Hospital, Bari, Italy
| | - A Saracino
- Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
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15
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Cicco S, Mozzini C, Carella R, De Fazio G, Vacca A, Cariddi C, Setti A, Pappagallo F, Solimando AG, Ria R. Cardiovascular Risk Score and Pulmonary Gas Exchange in COVID-19 Patients Show No Correlation. Advances in Experimental Medicine and Biology 2022; 1395:105-109. [PMID: 36527622 DOI: 10.1007/978-3-031-14190-4_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND COVID-19 induces robust systemic inflammation. Patients with cardiovascular disease (CVD) are at an increased risk of death. However, much effort is being spent to identify possible predictors of negative outcomes in order to have a more specific clinical setting. CVD scores are a useful tool in evaluating risk of cardiovascular events. AIM We evaluated oxygenation and characteristics in COVID-19 patients according to cardiovascular risk stratification performed using the Framingham risk score (FRS) for cardiovascular disease. MATERIALS AND METHODS We evaluated 155 COVID-19 patients (110 males and 45 females, aged 67.43 ± 14.72 years). All patients underwent a complete physical examination, chest imaging, laboratory tests and blood gas analysis at the time of diagnosis. Seventeen patients died (10 males and 7 females, aged 74.71 ± 7.23 years) while the remaining 138 patients (100 males and 38 females, aged 66.07 ± 15.16 years) were alive at discharge. RESULTS Deceased patients have an increased FRS compared to those that survived (27.37 ± 5.03 vs. 21.33 ± 9.49, p < 0.05). Compared to survivors, the deceased group presents with a significant increase in white blood cells (p < 0.05) and D-dimers (p < 0.05). There was no difference in pCO2, SO2, and in alveolar arteriolar oxygen difference (A-aDO2). On the contrary, in deceased patients there was an increased pO2 (p < 0.05) and a decreased ratio between oxygen inspired and pO2 (P/F; p < 0.05). FRS shows a negative correlation to P/F (r = 0.42, p < 0.05) in the deceased while no correlation was found in the survivors. No other correlation has been found with blood gas parameters or in the inflammation parameters evaluated in the two groups. DISCUSSION CVD may be considered as a major risk factor for death in COVID-19 patients. The increased risk relates to a reduced lung capacity but it is not related to blood gas values. Similarly, CV risk score results are independent from the inflammatory status of the patients.
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16
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Malagola M, Polverelli N, Rubini V, Martino M, Patriarca F, Bruno B, Giaccone L, Grillo G, Bramanti S, Bernasconi P, De Gobbi M, Natale A, Terruzzi E, Olivieri A, Chiusolo P, Carella AM, Casini M, Nozzoli C, Mazza P, Bassi S, Onida F, Vacca A, Falcioni S, Luppi M, Iori AP, Pavone V, Skert C, Carluccio P, Borghero C, Proia A, Selleri C, Sacchi N, Mammoliti S, Oldani E, Ciceri F, Russo D, Bonifazi F. GITMO Registry Study on Allogeneic Transplantation in Patients Aged ≥60 Years from 2000 to 2017: Improvements and Criticisms. Transplant Cell Ther 2021; 28:96.e1-96.e11. [PMID: 34818581 DOI: 10.1016/j.jtct.2021.11.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 10/13/2021] [Accepted: 11/15/2021] [Indexed: 12/18/2022]
Abstract
Today, allogeneic stem cell transplantation (allo-SCT) can be offered to patients up to age 70 to 72 years and represents one of the most effective curative treatments for many hematologic malignancies. The primary objective of the study was to collect data from the allo-SCTs performed in Italy between 2000 and 2017 in patients aged ≥60 years to evaluate the changes in safety and efficacy outcomes, as well as their distribution and characteristics over time. The Italian Group for Bone Marrow Transplantation, Hematopoietic Stem Cells and Cell Therapy (GITMO) AlloEld study (ClinicalTrials.gov identifier NCT04469985) is a retrospective analysis of allo-SCTs performed at 30 Italian transplantation centers in older patients (age ≥60 years) between 2000 and 2017 (n = 1996). For the purpose of this analysis, patients were grouped into 3 time periods: time A, 2000 to 2005 (n = 256; 12%); time B, 2006 to 2011 (n = 584; 29%); and time C, 2012 to 2017 (n = 1156; 59%). After a median follow-up of 5.6 years, the 5-year nonrelapse mortality (NRM) remained stable (time A, 32.8%; time B, 36.2%; and time C, 35.0%; P = .5), overall survival improved (time A, 28.4%; time B, 31.8%; and time C, 37.3%; P = .012), and the cumulative incidence of relapse was reduced (time A, 45.3%; time B, 38.2%; time C, 30.0%; P < .0001). The 2-year incidence of extensive chronic graft-versus-host disease was reduced significantly (time A, 17.2%; time B, 15.8%; time C, 12.2%; P = .004). Considering times A and B together (2000 to 2011), the 2-year NRM was positively correlated with the Hematopoietic Cell Transplantation Comorbidity Index (HCT-CI) score; NRM was 25.2% in patients with an HCT-CI score of 0, 33.9% in those with a score of 1 or 2, and 36.1% in those with a score of 3 (P < .001). However, after 2012, the HCT-CI score was not significantly predictive of NRM. This study shows that the transplantation procedure in elderly patients became more effective over time. Relapse incidence remains the major problem, and strategies to prevent it are currently under investigation (eg, post-transplantation maintenance). The selection of patients aged ≥60 could be improved by combining HCT-CI and frailty assessment to better predict NRM.
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Affiliation(s)
- Michele Malagola
- Blood Diseases and Cell Therapies Unit, Bone Marrow Transplant Unit, "ASST-Spedali Civili" Hospital of Brescia; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
| | - Nicola Polverelli
- Blood Diseases and Cell Therapies Unit, Bone Marrow Transplant Unit, "ASST-Spedali Civili" Hospital of Brescia; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Vicky Rubini
- Blood Diseases and Cell Therapies Unit, Bone Marrow Transplant Unit, "ASST-Spedali Civili" Hospital of Brescia; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Massimo Martino
- Stem Cell Transplant and Cellular Therapies Unit, "BMM" Hospital, Reggio Calabria, Italy
| | - Francesca Patriarca
- Hematologic Clinic and Transplant Center, University Hospital of Central Friuli, DAME, University of Udine, Udine, Italy
| | - Benedetto Bruno
- Department of Oncology, SSD Allogeneic Stem Cell Transplantation, "Città della Salute e della Scienza", Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Turin, Turin, Italy
| | - Luisa Giaccone
- Department of Oncology, SSD Allogeneic Stem Cell Transplantation, "Città della Salute e della Scienza", Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Turin, Turin, Italy
| | - Giovanni Grillo
- Division of Hematology and Marrow Transplant, Niguarda Hospital, Milan, Italy
| | | | - Paolo Bernasconi
- Transplant Center, Unit of Hematology, Foundation IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marco De Gobbi
- Department of Clinical and Biological Sciences, University of Turin, Internal Medicine and Hematology Division, San Luigi University Hospital - Orbassano (Turin), Italy
| | - Annalisa Natale
- Hematologic Intensive Care, Pescara Hospital, Pescara, Italy
| | | | - Attilio Olivieri
- Haematology Clinic, "Ospedali Riuniti," University Hospital of Ancona, Ancona, Italy
| | - Patrizia Chiusolo
- Department of Medical Imaging, Radiotherapy, Oncology, and Hematology, "A. Gemelli IRCCS" University Teaching Hospital Foundation, Hematology Division, Department of Radiological and Hematological Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Angelo Michele Carella
- SSD Hematologic Intensive Care and Cell Therapy Unit; Department of Medical Sciences, "Casa Sollievo della Sofferenza" Foundation, San Giovanni Rotondo, Italy
| | - Marco Casini
- Hematology and Bone Marrow Transplantation, Bolzano Hospital, Bolzano, Italy
| | - Chiara Nozzoli
- Cell Therapy and Ttransfusion Medicine, "Careggi" University Hospital, Florence, Italy
| | - Patrizio Mazza
- PO San Giuseppe Moscati, Department of Hematology with Transplant Division, ASL Taranto, Italy
| | - Simona Bassi
- Hematology Unit, "G. da Saliceto" Hospital, Piacenza, Italy
| | - Francesco Onida
- IRCCS Foundation "Ospedale Maggiore Ca' Granda Policlinico," University of Milan, Milan, Italy
| | - Adriana Vacca
- Hematology Unit, CTMO PO, "A. Businco", ARNAS Brotzu, Cagliari, Italy
| | - Sadia Falcioni
- Unit of Hematology and Cellular Therapy, "C. e G. Mazzoni" Hospital, Ascoli Piceno, Italy
| | - Mario Luppi
- Department of Medical and Surgical Sciences, UNIMORE, Division of Hematology, Azienda Ospedaliera Universitaria di Modena, Modena, Italy
| | - Anna Paola Iori
- Department of Hematology, Oncology, and Dermatology, "Umberto I" University Hospital, Roma Sapienza University, Rome, Italy
| | - Vincenzo Pavone
- Department of Hematology and Bone Marrow Transplantation, "Card. G. Panico" Hospital, Tricase, Italy
| | - Cristina Skert
- Unit of Hematology/Bone Marrow Transplantation, Unit "Ospedale dell'Angelo" Venice, Mestre, Italy
| | - Paola Carluccio
- Hematology and Stem Cell Transplantation Unit, Department of Emergency and Organ Transplantation, "Aldo Moro" University of Bari, Bari, Italy
| | - Carlo Borghero
- Hematology Department, "San Bortolo" Hospital, Vicenza, Italy
| | - Anna Proia
- Unit of Hematology and Stem Cell Transplant Center, "San Camillo" Hospital, Rome, Italy
| | - Carmine Selleri
- "San Giovanni di Dio e Ruggi d'Aragona" University Hospital, Salerno, Italy
| | - Nicoletta Sacchi
- Italian Bone Marrow Donor Registry, E. O. Galliera Hospitals, Genoa, Italy
| | | | - Elena Oldani
- Hematology Unit, "ASST Papa Giovanni XXIII," Bergamo, Italy
| | - Fabio Ciceri
- Department of Onco-Hematology, Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Milan, Italy
| | - Domenico Russo
- Blood Diseases and Cell Therapies Unit, Bone Marrow Transplant Unit, "ASST-Spedali Civili" Hospital of Brescia; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
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17
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Martino M, Pitino A, Gori M, Bruno B, Crescimanno A, Federico V, Picardi A, Tringali S, Ingrosso C, Carluccio P, Pastore D, Musuraca G, Paviglianiti A, Vacca A, Serio B, Storti G, Mordini N, Leotta S, Cimminiello M, Prezioso L, Loteta B, Ferreri A, Colasante F, Merla E, Giaccone L, Busca A, Musso M, Scalone R, Di Renzo N, Marotta S, Mazza P, Musto P, Attolico I, Selleri C, Canale FA, Pugliese M, Tripepi G, Porto G, Martinelli G, Carella AM, Cerchione C. Letermovir Prophylaxis for Cytomegalovirus Infection in Allogeneic Stem Cell Transplantation: A Real-World Experience. Front Oncol 2021; 11:740079. [PMID: 34616684 PMCID: PMC8489185 DOI: 10.3389/fonc.2021.740079] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 08/13/2021] [Indexed: 12/15/2022] Open
Abstract
Despite effective treatments, cytomegalovirus (CMV) continues to have a significant impact on morbidity and mortality in allogeneic stem cell transplant (allo-SCT) recipients. This multicenter, retrospective, cohort study aimed to evaluate the reproducibility of the safety and efficacy of commercially available letermovir for CMV prophylaxis in a real-world setting. Endpoints were rates of clinically significant CMV infection (CSCI), defined as CMV disease or CMV viremia reactivation within day +100-+168. 204 adult CMV-seropositive allo-SCT recipients from 17 Italian centres (median age 52 years) were treated with LET 240 mg/day between day 0 and day +28. Overall, 28.9% of patients underwent a haploidentical, 32.4% a matched related, and 27.5% a matched unrelated donor (MUD) transplant. 65.7% were considered at high risk of CSCI and 65.2% had a CMV seropositive donor. Low to mild severe adverse events were observed in 40.7% of patients during treatment [gastrointestinal toxicity (36.3%) and skin rash (10.3%)]. Cumulative incidence of CSCI at day +100 and day +168 was 5.4% and 18.1%, respectively, whereas the Kaplan-Meier event rate was 5.8% (95% CI: 2.4-9.1) and 23.3% (95% CI: 16.3-29.7), respectively. Overall mortality was 6.4% at day +100 and 7.3% at day +168. This real-world experience confirms the efficacy and safety of CMV.
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Affiliation(s)
- Massimo Martino
- Centro Unico Regionale Trapianti Cellule Staminali e Terapie Cellulari (CTMO), Grande Ospedale Metropolitano "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | - Annalisa Pitino
- Istituto di Fisiologia Clinica del Consiglio Nazionale delle Ricerche (CNR), Roma, Italy
| | - Mercedes Gori
- Istituto di Fisiologia Clinica del Consiglio Nazionale delle Ricerche (CNR), Roma, Italy
| | - Benedetto Bruno
- Dipartimento di Oncologia, SSD Trapianto Allogenico di Cellule Staminali, AOU Città della Salute e della Scienza di Torino, Torino, Italy.,Dipartimento di Biotecnologie Molecolari e Scienze per la Salute, Divisione di Ematologia, Università di Torino, Torino, Italy
| | | | - Vincenzo Federico
- Ematologia e Trapianto di Cellule Staminali, Polo Ospedaliero "Vito Fazzi", Lecce, Italy
| | - Alessandra Picardi
- UOC Ematologia con Trapianto CSE, AORN "Antonio Cardarelli", Napoli, Italy.,Dipartimento di Biomedicina e Prevenzione, Università di Roma Tor Vergata, Roma, Italy
| | | | - Claudia Ingrosso
- Ematologia e Trapianto di Midollo Osseo, Ospedale "San Giuseppe Moscati", Taranto, Italy
| | - Paola Carluccio
- UOC di Ematologia con Trapianto, Dipartimento di Emergenza e Trapianti d'Organo, Università degli Studi "Aldo Moro" e AOUC Policlinico di Bari, Bari, Italy
| | - Domenico Pastore
- Divisione di Ematologia, Ospedale "Antonio Perrino", Brindisi, Italy
| | - Gerardo Musuraca
- Unità di Ematologia, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Annalisa Paviglianiti
- Centro Unico Regionale Trapianti Cellule Staminali e Terapie Cellulari (CTMO), Grande Ospedale Metropolitano "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | - Adriana Vacca
- UO Ematologia - CTMO, Polo Ospedaliero "Armando Businco", Cagliari, Italy
| | - Bianca Serio
- Dipartimento di Medicina, Chirurgia e Odontoiatria, Università di Salerno, Salerno, Italy
| | - Gabriella Storti
- Unità di Ematologia, Azienda Ospedaliera "San Giuseppe Moscati", Avellino, Italy
| | - Nicola Mordini
- SC Ematologia, Azienda Ospedaliera "S. Croce e Carle", Cuneo, Italy
| | - Salvatore Leotta
- Programma di Trapianto Emopoietico, Azienda Policlinico "Vittorio Emanuele", Catania, Italy
| | | | - Lucia Prezioso
- Ematologia e Centro Trapianti Midollo Osseo (CTMO), Dipartimento ad Attività Integrata Medicina Generale e Specialistica, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Barbara Loteta
- Centro Unico Regionale Trapianti Cellule Staminali e Terapie Cellulari (CTMO), Grande Ospedale Metropolitano "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | - Anna Ferreri
- Centro Unico Regionale Trapianti Cellule Staminali e Terapie Cellulari (CTMO), Grande Ospedale Metropolitano "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | - Fabrizia Colasante
- Ospedale I.R.C.C.S. Casa Sollievo della Sofferenza - Centro Trapianti di Cellule Staminali, San Giovanni Rotondo, Italy
| | - Emanuela Merla
- Ospedale I.R.C.C.S. Casa Sollievo della Sofferenza - Centro Trapianti di Cellule Staminali, San Giovanni Rotondo, Italy
| | - Luisa Giaccone
- Dipartimento di Oncologia, SSD Trapianto Allogenico di Cellule Staminali, AOU Città della Salute e della Scienza di Torino, Torino, Italy.,Dipartimento di Biotecnologie Molecolari e Scienze per la Salute, Divisione di Ematologia, Università di Torino, Torino, Italy
| | - Alessandro Busca
- Dipartimento di Oncologia, SSD Trapianto Allogenico di Cellule Staminali, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Maurizio Musso
- Unità Operativa di Oncoematologia e TMO, Istituto "La Maddalena", Palermo, Italy
| | - Renato Scalone
- Unità Operativa di Oncoematologia e TMO, Istituto "La Maddalena", Palermo, Italy
| | - Nicola Di Renzo
- Ematologia e Trapianto di Cellule Staminali, Polo Ospedaliero "Vito Fazzi", Lecce, Italy
| | - Serena Marotta
- UOC Ematologia con Trapianto CSE, AORN "Antonio Cardarelli", Napoli, Italy
| | - Patrizio Mazza
- Ematologia e Trapianto di Midollo Osseo, Ospedale "San Giuseppe Moscati", Taranto, Italy
| | - Pellegrino Musto
- UOC di Ematologia con Trapianto, Dipartimento di Emergenza e Trapianti d'Organo, Università degli Studi "Aldo Moro" e AOUC Policlinico di Bari, Bari, Italy
| | - Immacolata Attolico
- UOC di Ematologia con Trapianto, Dipartimento di Emergenza e Trapianti d'Organo, Università degli Studi "Aldo Moro" e AOUC Policlinico di Bari, Bari, Italy
| | - Carmine Selleri
- Dipartimento di Medicina, Chirurgia e Odontoiatria, Università di Salerno, Salerno, Italy
| | - Filippo Antonio Canale
- Centro Unico Regionale Trapianti Cellule Staminali e Terapie Cellulari (CTMO), Grande Ospedale Metropolitano "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | - Marta Pugliese
- Centro Unico Regionale Trapianti Cellule Staminali e Terapie Cellulari (CTMO), Grande Ospedale Metropolitano "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | - Giovanni Tripepi
- Istituto di Fisiologia Clinica del Consiglio Nazionale delle Ricerche (CNR), Reggio Calabria, Italy
| | - Gaetana Porto
- Centro Unico Regionale Trapianti Cellule Staminali e Terapie Cellulari (CTMO), Grande Ospedale Metropolitano "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | - Giovanni Martinelli
- Unità di Ematologia, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Angelo Michele Carella
- Ospedale I.R.C.C.S. Casa Sollievo della Sofferenza - Centro Trapianti di Cellule Staminali, San Giovanni Rotondo, Italy
| | - Claudio Cerchione
- Unità di Ematologia, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
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Delia M, Carluccio P, Mestice A, Chiusolo P, Metafuni E, Bellesi S, Arpinati M, Milone GA, Martino M, Mazza P, Ingrosso C, Vacca A, Saporiti G, Zallio F, Attolico I, Pastore D, Specchia G, Albano F, Musto P. The Impact of Graft CD3 Cell/Regulatory T Cell Ratio on Acute Graft-versus-Host Disease and Post-Transplantation Outcome: A Prospective Multicenter Study of Patients with Acute Leukemia Undergoing Allogeneic Peripheral Blood Stem Cell Transplantation. Transplant Cell Ther 2021; 27:918.e1-918.e9. [PMID: 34403789 DOI: 10.1016/j.jtct.2021.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/24/2021] [Accepted: 08/05/2021] [Indexed: 12/13/2022]
Abstract
Although it is well known that tumor site- or bone marrow-infiltrating regulatory T cells (Tregs) might be correlated with worse outcomes in solid tumors and acute leukemias by promoting immune surveillance escape, their contribution to the immediate post-allogeneic transplantation phase by peripheral blood (PB) allografts remains unclear. Moreover, the Treg content in stem cells harvested from PB has been suggested to be correlated with acute graft versus-host-disease (aGVHD) and immunologic recovery after allogeneic PB stem cell transplantation (allo-PBSCT). This study aimed to investigate the impact of the graft content of Tregs, as graft CD3+/Tregs ratio (gCD3/TregsR), on acute GVHD and post-allo-PBSCT outcomes. We prospectively enrolled 94 consecutive patients at 9 Italian centers of the Gruppo Italiano Trapianto di Midollo Osseo (GITMO) with acute myelogenous (n = 71; 75%) or lymphoblastic (n = 23; 25%) leukemia in complete remission who underwent matched related donor (n = 35; 37%) or unrelated donor (n = 59; 63%) allo-PBSCT. The median graft CD3+ cell, Treg, and gCD3/TregsR values were 196 × 106/kg body weight (range, 17 to 666 × 106/kg), 3 × 106/kg (range, 0.1 to 35 × 106/kg), and 71 (range, 1 to 1883), respectively. The discriminatory power of the gCD3/TregsR value to predict grade ≥II aGVHD was assessed by estimating the area under the receiver operating characteristic (ROC) curve (AUC). Any grade and grade ≥II aGVHD occurred in 24 (26%) and 17 (18%) allo-PBSCT recipients, respectively. By ROC analysis, AUC (0.74; 95% confidence interval [CI], 0.608 to 0.866; P = .002) identified 70 as the optimal gCD3/TregsR cutoff value predicting the appearance of grade ≥II aGVHD with 76% sensitivity and 71% specificity. Patients were subdivided into a high (ROC curve value ≥70) gCD3/TregsR group (HR; n = 48) and a low (ROC curve value <70) gCD3/TregsR group (LR; n = 46). The incidence of grade II-IV aGVHD was lower in the LR group compared with the HR group (9% [4 of 46] versus 27% [13 of 48]) in both univariate analysis (odds ratio [OR], 4.8; 95% CI, 1.44 to 16.17; P = .015) and multivariate analysis (OR, 5.0; 95% CI, 1.34 to 18.93; P = .017), whereas no differences were documented taking into account aGVHD of any grade. The overall survival, disease-free survival, nonrelapse mortality, and relapse rates at 2 and 3 years were 61% and 54%, 62% and 55%, 15% and 23%, and 27% and 30%, respectively. Of note, gCD3/TregsR did not significantly correlate with relapse (P = .135). Taken together, our data from this prospective multicenter study confirm the value of Tregs in preventing aGVHD while maintaining the graft-versus-leukemia effect. © 2021 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc.
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Affiliation(s)
- Mario Delia
- Hematology and Stem Cell Transplantation Unit, AOUC Policlinico, Bari, Italy.
| | - Paola Carluccio
- Hematology and Stem Cell Transplantation Unit, AOUC Policlinico, Bari, Italy
| | - Anna Mestice
- Hematology and Stem Cell Transplantation Unit, AOUC Policlinico, Bari, Italy; Department of Emergency and Organ Transplantation, Aldo Moro University School of Medicine, Bari, Italy
| | - Patrizia Chiusolo
- Hematology, Fondazione Policlinico Universitario Gemelli IRCCS, Rome, Italy
| | | | - Silvia Bellesi
- Hematology, Fondazione Policlinico Universitario Gemelli IRCCS, Rome, Italy
| | - Mario Arpinati
- Hematology and BMT, AOU Policlinico S Orsola Malpighi IRCCS, Bologna, Italy
| | - Giulio Antonio Milone
- Metropolitan Hematopoietic Transplantation Program, Azienda Policlinico-Vittorio Emanuele, Catania, Italy
| | - Massimo Martino
- Bone Marrow Transplantation, Grande Ospedale Metropolitano Bianchi Melacrino Morelli, Reggio Calabria, Italy
| | - Patrizio Mazza
- Hematology and BMT Unit, Ospedale S. G. Moscati, Taranto, Italy
| | | | - Adriana Vacca
- Hematology and BMT, Presidio Ospedaliero A. Businco, Cagliari, Italy
| | - Giorgia Saporiti
- Hematology and Bone Marrow Transplantation Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano-Università degli Studi di Milano, Milan, Italy
| | - Francesco Zallio
- Bone Marrow Transplantation Unit, Ospedale SS Biagio e Arrigo, Alessandria, Italy
| | - Immacolata Attolico
- Hematology and Stem Cell Transplantation Unit, AOUC Policlinico, Bari, Italy
| | | | | | - Francesco Albano
- Hematology and Stem Cell Transplantation Unit, AOUC Policlinico, Bari, Italy; Department of Emergency and Organ Transplantation, Aldo Moro University School of Medicine, Bari, Italy
| | - Pellegrino Musto
- Hematology and Stem Cell Transplantation Unit, AOUC Policlinico, Bari, Italy; Department of Emergency and Organ Transplantation, Aldo Moro University School of Medicine, Bari, Italy
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Catanzaro G, Filardi T, Sabato C, Vacca A, Migliaccio S, Morano S, Ferretti E. Tissue and circulating microRNAs as biomarkers of response to obesity treatment strategies. J Endocrinol Invest 2021; 44:1159-1174. [PMID: 33111214 PMCID: PMC8124039 DOI: 10.1007/s40618-020-01453-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/15/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Obesity, characterized by an increased amount of adipose tissue, is a metabolic chronic alteration which has reached pandemic proportion. Lifestyle changes are the first line therapy for obesity and a large variety of dietary approaches have demonstrated efficacy in promoting weight loss and improving obesity-related metabolic alterations. Besides diet and physical activity, bariatric surgery might be an effective therapeutic strategy for morbid obese patients. Response to weight-loss interventions is characterised by high inter-individual variability, which might involve epigenetic factors. microRNAs have critical roles in metabolic processes and their dysregulated expression has been reported in obesity. AIM The aim of this review is to provide a comprehensive overview of current studies evaluating changes in microRNA expression in obese patients undergoing lifestyle interventions or bariatric surgery. RESULTS A considerable number of studies have reported a differential expression of circulating microRNAs before and after various dietary and bariatric surgery approaches, identifying several candidate biomarkers of response to weight loss. Significant changes in microRNA expression have been observed at a tissue level as well, with entirely different patterns between visceral and subcutaneous adipose tissue. Interestingly, relevant differences in microRNA expression have emerged between responders and non-responders to dietary or surgical interventions. A wide variety of dysregulated microRNA target pathways have also been identified, helping to understand the pathophysiological mechanisms underlying obesity and obesity-related metabolic diseases. CONCLUSIONS Although further research is needed to draw firm conclusions, there is increasing evidence about microRNAs as potential biomarkers for weight loss and response to intervention strategies in obesity.
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Affiliation(s)
- G Catanzaro
- Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - T Filardi
- Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - C Sabato
- Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - A Vacca
- Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - S Migliaccio
- Department of Movement, Human and Health Sciences, "Foro Italico" University of Rome, Rome, Italy
| | - S Morano
- Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - E Ferretti
- Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
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Bellando Randone S, Wilhalme H, Bruni C, Siegert E, Airò P, Irace R, Distler O, Doria A, Ananieva LP, Czirják L, Denton C, Allanore Y, Riccieri V, Vacca A, Foeldvari I, Hoffmann-Vold AM, Gabrielli A, Matucci-Cerinic M, Furst D. POS0321 USE OF HYDROXYCHLOROQUINE AND SYSTEMIC SCLEROSIS: RESULTS FROM A PROSPECTIVE OBSERVATIONAL STUDY ON THE EUSTAR COHORT. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Hydroxychloroquine (HCQ) is a well-tolerated drug that contributes to downregulating the immune response against autoantigens and it has been used in several autoimmune diseases. In systemic sclerosis (SSc) it is used to treat inflammatory arthritis without proof of efficacy.Objectives:Our aim was to evaluate the use of HCQ and its impact on Health Assessment Questionnaire disability index (HAQ-DI) and the Cochin Hand Function Status (CHFS). in a large SSc cohort compared to a propensity matched group of SSc patients not using HCQ.Methods:SSc patients from the European Scleroderma Trials and Research (EUSTAR) data base treated with HCQ for at least 6 months were evaluated. Demographic and clinical data, concomitant drugs, duration of HCQ treatment and reasons for its discontinuation, HAQ-DI and CHFS (at least 2 evaluation) were recorded and were the outcome variables of interest. Statistical analysis was performed using propensity score matching for age, gender, disease duration, corticosteroids, immunosuppressives, vasoactive drugs, DMARDs in a 3:1 control:HCQ ratio. Standard descriptive statistics and Student’s t-test and Chi-square test were used to assess the propensity-matched groups.Results:1,636 of 17,805 SSc patients (9.2%) were treated with HCQ for at least 6 months; out of these 3% (50/1636). had at least a baseline and follow-up HAQ-DI evaluation, (and 44/1636 (2.7%) had at least a baseline and follow-up CHFS evaluation. Propensity matching assured that pts were matched for demographic variables such as gender (mean on HCQ vs no HCQ:femals:92.0 vs 85.3), age(49.8 vs 49.97yrs) disease duration(8.3 vs 9.1 yrs), limited disease(55.3 vs 62.6%) as well as background medications (P>0.1-0.9). We did not find any significant changes in HAQ or CHFS (difference in slope) over 365 days of treatment, comparing the HCQ-treated group to the non-HCQ treated patients (p=0.240 for both (Figure 1).Conclusion:Results from the EUSTAR registry showed that HCQ was used by 9.2% of SSc patients. HCQ use did not improve the HAQ or CHFS, comparing HCQ users to non-HCQ users.Disclosure of Interests:Silvia Bellando Randone: None declared, Holly Wilhalme: None declared, Cosimo Bruni: None declared, Elise Siegert: None declared, Paolo Airò: None declared, Rosaria Irace: None declared, Oliver Distler: None declared, Andrea Doria: None declared, Lidia P. Ananieva: None declared, László Czirják: None declared, Christopher Denton: None declared, Yannick Allanore: None declared, Valeria Riccieri: None declared, ALESSANDRA VACCA: None declared, Ivan Foeldvari Consultant of: Gilead, Novartis, Pfizer, Hexal, BMS, Sanofi, MEDAC, Anna-Maria Hoffmann-Vold Speakers bureau: Actelion, Boehringer Ingelheim, Roche, Merck Sharp & Dohme, Lilly and Medscape, Consultant of: Actelion, Boehringer Ingelheim, Roche, Bayer, ARXX, and Medscape, Grant/research support from: Boehringer Ingelheim, Armando Gabrielli: None declared, Marco Matucci-Cerinic: None declared, Daniel Furst: None declared
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Tsaouli G, Barbarulo A, Vacca A, Screpanti I, Felli MP. Molecular Mechanisms of Notch Signaling in Lymphoid Cell Lineages Development: NF-κB and Beyond. Adv Exp Med Biol 2020; 1227:145-164. [PMID: 32072504 DOI: 10.1007/978-3-030-36422-9_10] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Notch is a ligand-receptor interaction-triggered signaling cascade highly conserved, that influences multiple lineage decisions within the hematopoietic and the immune system. It is a recognized model of intercellular communication that plays an essential role in embryonic as well as in adult immune cell development and homeostasis. Four members belong to the family of Notch receptors (Notch1-4), and each of them plays nonredundant functions at several developmental stages. Canonical and noncanonical pathways of Notch signaling are multifaceted drivers of immune cells biology. In fact, increasing evidence highlighted Notch as an important modulator of immune responses, also in cancer microenvironment. In these contexts, multiple transduction signals, including canonical and alternative NF-κB pathways, play a relevant role. In this chapter, we will first describe the critical role of Notch and NF-κB signals in lymphoid lineages developing in thymus: natural killer T cells, thymocytes, and thymic T regulatory cells. We will address also the role played by ligand expressing cells. Given the importance of Notch/NF-κB cross talk, its role in T-cell leukemia development and progression will be discussed.
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Affiliation(s)
- G Tsaouli
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - A Barbarulo
- Department of Immunology, Institute of Immunity and Transplantation, Royal Free Hospital, London, UK
| | - A Vacca
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - I Screpanti
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy.
| | - M P Felli
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
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Frassanito MA, Saltarella I, Vinella A, Muzio LL, Pannone G, Fumarulo R, Vacca A, Mariggiò MA. Survivin overexpression in head and neck squamous cell carcinomas as a new therapeutic target (Review). Oncol Rep 2019; 41:2615-2624. [PMID: 30896830 DOI: 10.3892/or.2019.7082] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 03/13/2019] [Indexed: 11/06/2022] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) is the sixth most commonly diagnosed cancer worldwide. It has poor clinical outcome due to intrinsic or acquired drug resistance. Deregulation of both apoptosis and autophagy contributes to chemotherapy resistance and disease progression. A new member of the inhibitors of apoptosis protein (IAP) family, namely survivin, is selectively overexpressed in tumors, including HNSCC, but not in normal tissues. Thus, it is considered a tumor biomarker. Here, we reviewed survivin expression and function in tumor progression focusing on its nodal role in the regulation of cell apoptosis and autophagy. Based on literature data, survivin targeting may be envisaged as a novel therapeutic strategy.
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Affiliation(s)
- M A Frassanito
- Department of Biomedical Sciences and Human Oncology, Unit of General Pathology, University of Bari Aldo Moro, I‑70124 Bari, Italy
| | - I Saltarella
- Department of Biomedical Sciences and Human Oncology, Unit of Internal Medicine and Clinical Oncology, University of Bari Aldo Moro, I‑70124 Bari, Italy
| | - A Vinella
- Department of Biomedical Sciences and Human Oncology, Unit of General Pathology, University of Bari Aldo Moro, I‑70124 Bari, Italy
| | - L Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, I‑70121 Foggia, Italy
| | - G Pannone
- Department of Clinical and Experimental Medicine, University of Foggia, I‑70121 Foggia, Italy
| | - R Fumarulo
- Department of Biomedical Sciences and Human Oncology, Unit of General Pathology, University of Bari Aldo Moro, I‑70124 Bari, Italy
| | - A Vacca
- Department of Biomedical Sciences and Human Oncology, Unit of Internal Medicine and Clinical Oncology, University of Bari Aldo Moro, I‑70124 Bari, Italy
| | - M A Mariggiò
- Department of Biomedical Sciences and Human Oncology, Unit of General Pathology, University of Bari Aldo Moro, I‑70124 Bari, Italy
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Cicco S, Castellana G, Marra L, Dragonieri S, Carratù P, Ranieri G, Resta O, Vacca A. Analysis of Aortic Remodeling and Stiffness in Patients with Obstructive Sleep Apnea Syndrome: Preliminary Results. Adv Exp Med Biol 2019; 1072:251-255. [PMID: 30178354 DOI: 10.1007/978-3-319-91287-5_40] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
Obstructive sleep apnea (OSA) is a well-known risk factor for cardiovascular diseases. Several studies have shown that OSA is associated with vessel remodeling, but few studies have examined aorta. AIM to analyse aortic remodelling in OSA. METHODS Thirty consecutive OSA patients (22 males and 8 females, aged 58.5 ± 13.2 years) were studied. All patients underwent a morning blood gas analysis, a full cardiorespiratory evaluation, including nocturnal polygraphy and echocardiography, that assessed aortic root diameter (ARD) and aortic stiffness index (ASI). Patients were grouped as follows: Group 1, non-severe OSA (Apnea-Hypopnea Index; AHI <30, 14 patients); Group 2, severe OSA (AHI ≥30, 16 patients). RESULTS No difference was found between the groups in ARD as absolute value (Group 1, 33.64 ± 0.91 mm; Group 2, 33.64 ± 1.02, p = ns) and as normalized value for the body surface area - ARDi (Group 1, 16.72 ± 0.63 mm/m2; Group 2, 16.09 ± 0.44, p = ns). Moreover, no difference was found in the ASI (Group 1, 14.04 ± 2.26; Group 2, 13.41 ± 2.22, p = ns). Considering all OSA patients, AHI showed an inverse correlation with ARDi (p = 0.018) and ASI (p = 0.0449). Moreover, the ASI showed a direct correlation with ARDi (p = 0.01) and morning PaO2 (p = 0.0349) as well as an inverse correlation with the oxygen desaturation index (ODI, p = 0.031) and total time with apnea and hypopnea (p = 0.039). CONCLUSION No difference was found between severe and non-severe OSA in ARD. Surprisingly, the data show that the severity of OSA correlates inversely with the ASI and ARDi. The relation between PaO2 and stiffness might be explained by a feedback mechanism that tries to overcome the reduction of aortic elasticity due to night desaturation. These findings need to be investigated in further studies with a larger study population.
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Affiliation(s)
- S Cicco
- Department of Biomedical Sciences and Human Oncology, Section of Internal Medicine, University of Bari "Aldo Moro" Medical School, Policlinico, piazza Giulio Cesare, Italy
| | - G Castellana
- Department of Cardiac, Thoracic, and Vascular Science, Institute of Respiratory Disease, University of Bari "Aldo Moro" Medical School, Policlinico, piazza Giulio Cesare, Italy
| | - L Marra
- Department of Cardiac, Thoracic, and Vascular Science, Institute of Respiratory Disease, University of Bari "Aldo Moro" Medical School, Policlinico, piazza Giulio Cesare, Italy
| | - S Dragonieri
- Department of Cardiac, Thoracic, and Vascular Science, Institute of Respiratory Disease, University of Bari "Aldo Moro" Medical School, Policlinico, piazza Giulio Cesare, Italy
| | - P Carratù
- Department of Cardiac, Thoracic, and Vascular Science, Institute of Respiratory Disease, University of Bari "Aldo Moro" Medical School, Policlinico, piazza Giulio Cesare, Italy
| | - G Ranieri
- Department of Biomedical Sciences and Human Oncology, Section of Internal Medicine, University of Bari "Aldo Moro" Medical School, Policlinico, piazza Giulio Cesare, Italy
| | - O Resta
- Department of Cardiac, Thoracic, and Vascular Science, Institute of Respiratory Disease, University of Bari "Aldo Moro" Medical School, Policlinico, piazza Giulio Cesare, Italy
| | - A Vacca
- Department of Biomedical Sciences and Human Oncology, Section of Internal Medicine, University of Bari "Aldo Moro" Medical School, Policlinico, piazza Giulio Cesare, Italy
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Del Principe MI, Dragonetti G, Verga L, Candoni A, Marchesi F, Cattaneo C, Delia M, Potenza L, Farina F, Ballanti S, Decembrino N, Castagnola C, Nadali G, Fanci R, Orciulo E, Veggia B, Offidani M, Melillo L, Manetta S, Tumbarello M, Venditti A, Busca A, Aversa F, Pagano L, Pepa RD, Ferrari A, Piedimonte M, Andrea OS, Fracchiolla NS, Sciumè M, Lessi F, Prezioso L, Spolzino A, Rambaldi B, Russo D, di Ematologia C, Maracci L, Sarlo C, Annibali O, Cefalo M, Zizzari A, Blasi RD, Zama D, Mancini V, Salutari P, Cesaro S, Garzia MG, Vacca A, Dargenio M, Invernizzi R, Perruccio K, Quinto AM, Chierichini A, Spadea A. ‘Real-life’ analysis of the role of antifungal prophylaxis in preventing invasive aspergillosis in AML patients undergoing consolidation therapy: Sorveglianza Epidemiologica Infezioni nelle Emopatie (SEIFEM) 2016 study. J Antimicrob Chemother 2019; 74:1062-1068. [DOI: 10.1093/jac/dky550] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 11/23/2018] [Accepted: 11/30/2018] [Indexed: 12/17/2022] Open
Affiliation(s)
- Maria Ilaria Del Principe
- Cattedra di Ematologia, Dipartimento di Biomedicina e Prevenzione, Università degli Studi di Roma ‘Tor Vergata’, Roma, Italy
| | - Giulia Dragonetti
- Istituto di Ematologia, Fondazione Policlinico Universitario A. Gemelli-IRCCS-Università Cattolica del Sacro Cuore, Roma, Italy
| | - Luisa Verga
- Clinica Ematologica, Ospedale San Gerardo, ASST Monza, Università Milano Bicocca, Milano, Italy
| | - Anna Candoni
- Clinica di Ematologia e Unità di terapie Cellulari ‘Carlo Melzi’-Azienda Sanitaria-Universitaria, Integrata, Udine, Italy
| | - Francesco Marchesi
- Haematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Roma, Italy
| | - Chiara Cattaneo
- Divisione di Ematologia, ASST-Spedali Civili di Brescia, Brescia, Italy
| | - Mario Delia
- Sezione di Ematologia, Dipartimento dell'Emergenza e dei Trapianti d'Organo-Università di Bari, Bari, Italy
| | - Leonardo Potenza
- UOC Ematologia, Dipartimento di Scienze Mediche e Chirurgiche Materno infantili e dell’Adulto, Università di Modena e Reggio Emilia, Modena, Italy
| | | | | | - Nunzia Decembrino
- UOC Oncoematologia Pediatrica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Carlo Castagnola
- Dipartimento Onco-Ematologico Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Gianpaolo Nadali
- Unità Operativa Complessa di Ematologia, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Rosa Fanci
- Unità Funzionale di Ematologia, Azienda Ospedaliero-Universitaria Careggi e Università di Firenze, Firenze, Italy
| | - Enrico Orciulo
- Dipartimento di Oncologia, Trapianti e Tecnologie Avanzate, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | | | - Massimo Offidani
- Clinica di Ematologia, Azienda Ospedaliero-Universitaria, Ospedali Riunti di Ancona, Ancona, Italy
| | - Lorella Melillo
- Divisione di Ematologia, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Sara Manetta
- Stem Cell Transplant Centre, AOU Citta’ della Salute e della Scienza, Torino, Italy
| | - Mario Tumbarello
- Istituto di Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli-IRCCS-Università Cattolica del Sacro Cuore, Roma, Italy
| | - Adriano Venditti
- Cattedra di Ematologia, Dipartimento di Biomedicina e Prevenzione, Università degli Studi di Roma ‘Tor Vergata’, Roma, Italy
| | - Alessandro Busca
- Stem Cell Transplant Centre, AOU Citta’ della Salute e della Scienza, Torino, Italy
| | - Franco Aversa
- Dipartimento di Medicina Interna, Università di Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Livio Pagano
- Istituto di Ematologia, Fondazione Policlinico Universitario A. Gemelli-IRCCS-Università Cattolica del Sacro Cuore, Roma, Italy
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Prete M, Leone P, Frassanito MA, Desantis V, Marasco C, Cicco S, Dammacco F, Vacca A, Racanelli V. Belimumab restores Treg/Th17 balance in patients with refractory systemic lupus erythematosus. Lupus 2018; 27:1926-1935. [PMID: 30180771 DOI: 10.1177/0961203318797425] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 01/12/2023]
Abstract
Belimumab, a specific inhibitor of the soluble B lymphocyte stimulator (BlyS), is the first biological drug approved by the United States Food and Drug Administration for the treatment of patients with active systemic lupus erythematosus (SLE) refractory to standard therapy. Given that an imbalance between regulatory T cells (Treg) and interleukin (IL)-17A-secreting T cells (Th17) has been reported in various autoimmune disorders, we assessed the frequency of both Treg and Th17 peripheral blood populations before and after belimumab administration in 20 patients with active SLE refractory to standard therapy. After six months of treatment, the mean SELENA-SLEDAI score as well as the mean anti-double-stranded DNA antibody titers were significantly decreased. In addition, we observed a significant increase in Treg percentages and a parallel, significant decrease in Th17 percentages, accompanied by significantly reduced serum levels of IL-21. In vitro studies showed that Treg purified from belimumab-treated patients were fully functional and displayed a suppressor function similar to that of Treg purified from healthy donors. Belimumab can restore Treg/Th17 balance in SLE patients with uncontrolled disease activity, and this results in decreased flare rate and reduced glucocorticoid dosage.
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Affiliation(s)
- M Prete
- Department of Biomedical Sciences and Human Oncology, Unit of Internal Medicine "Guido Baccelli", University of Bari Medical School, Bari, Italy
| | - P Leone
- Department of Biomedical Sciences and Human Oncology, Unit of Internal Medicine "Guido Baccelli", University of Bari Medical School, Bari, Italy
| | - M A Frassanito
- Department of Biomedical Sciences and Human Oncology, Unit of Internal Medicine "Guido Baccelli", University of Bari Medical School, Bari, Italy
| | - V Desantis
- Department of Biomedical Sciences and Human Oncology, Unit of Internal Medicine "Guido Baccelli", University of Bari Medical School, Bari, Italy
| | - C Marasco
- Department of Biomedical Sciences and Human Oncology, Unit of Internal Medicine "Guido Baccelli", University of Bari Medical School, Bari, Italy
| | - S Cicco
- Department of Biomedical Sciences and Human Oncology, Unit of Internal Medicine "Guido Baccelli", University of Bari Medical School, Bari, Italy
| | - F Dammacco
- Department of Biomedical Sciences and Human Oncology, Unit of Internal Medicine "Guido Baccelli", University of Bari Medical School, Bari, Italy
| | - A Vacca
- Department of Biomedical Sciences and Human Oncology, Unit of Internal Medicine "Guido Baccelli", University of Bari Medical School, Bari, Italy
| | - V Racanelli
- Department of Biomedical Sciences and Human Oncology, Unit of Internal Medicine "Guido Baccelli", University of Bari Medical School, Bari, Italy
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Abstract
In vivo and in vitro techniques are available for reseach on the functions of endothelial cells during angiogenesis. In this review we describe and evaluate the methodology and specific features of some of the most frequently used in vivo assays.
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Affiliation(s)
- D Ribatti
- Institute of Human Anatomy, Histology and Embryology, University of Bari Medical School, Italy.
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Frau J, Carai M, Coghe G, Fenu G, Lorefice L, La Nasa G, Mamusa E, Vacca A, Marrosu MG, Cocco E. Long-term follow-up more than 10 years after HSCT: a monocentric experience. J Neurol 2017; 265:410-416. [PMID: 29270686 DOI: 10.1007/s00415-017-8718-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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] [Received: 11/20/2017] [Revised: 12/13/2017] [Accepted: 12/17/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND Autologous hematopoietic stem cell transplantation (aHSCT) is used in aggressive relapsing and progressive multiple sclerosis (MS). The multicentre studies and case series reported have relatively short follow-up. AIM To evaluate long-term effect and safety of HSCT in MS. MATERIALS AND METHODS Patients referred to the MS centre of Cagliari and undergoing HSCT were included. Variations in relapses and EDSS before and after HSCT were evaluated by Wilcoxon test. A descriptive analysis was made for other clinical data. RESULTS Nine patients (female 6, males 3; 5 relapsing-remitting, 2 secondary progressive, 1 primary progressive, and 1 progressive relapsing) performed HSCT (1999-2006). The median follow-up was 11 years (11-18). Eight patients underwent aHSCT, seven using a low intensity conditioning regimen, and one an intermediate intensity. The primary progressive underwent allogeneic HSCT, due to onco hematological disease. The relapses number decreased in the 2 years following the procedure compared to the two preceding years (p = 0.041). New relapses or disease progressions were observed after a range of 7 (low intensity regimen)-118 (intermediate intensity) months. At last follow-up, the EDSS was stable in two patients, improved in two, and worse in five (maximum 2 EDSS in one patient). Six patients showed new lesions, and seven gadolinium-enhancing on brain MRI after a mean of 23.3 and 19.8 months, respectively. Two serious adverse events were reported: melanoma, and progressive multifocal leukoencephalopathy. CONCLUSIONS AND DISCUSSION Our results confirm in a long follow-up the efficacy of HSCT in reducing relapses and disability progression. The risk/benefit profile is better for intermediate intensity regimens.
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Affiliation(s)
- Jessica Frau
- Department of Medical Sciences and Public Health, Multiple Sclerosis Center, ATS Sardegna, Ospedale Binaghi, University of Cagliari, Via Is Guadazzonis 2, 09126, Cagliari, Italy.
| | - Margherita Carai
- Department of Medical Sciences and Public Health, Multiple Sclerosis Center, ATS Sardegna, Ospedale Binaghi, University of Cagliari, Via Is Guadazzonis 2, 09126, Cagliari, Italy
| | - Giancarlo Coghe
- Department of Medical Sciences and Public Health, Multiple Sclerosis Center, ATS Sardegna, Ospedale Binaghi, University of Cagliari, Via Is Guadazzonis 2, 09126, Cagliari, Italy
| | - Giuseppe Fenu
- Department of Medical Sciences and Public Health, Multiple Sclerosis Center, ATS Sardegna, Ospedale Binaghi, University of Cagliari, Via Is Guadazzonis 2, 09126, Cagliari, Italy
| | - Lorena Lorefice
- Department of Medical Sciences and Public Health, Multiple Sclerosis Center, ATS Sardegna, Ospedale Binaghi, University of Cagliari, Via Is Guadazzonis 2, 09126, Cagliari, Italy
| | - Giorgio La Nasa
- Department of Medical Sciences and Public Health, Bone Marrow Transplant Center, University of Cagliari, Via Is Guadazzonis 2, 09126, Cagliari, Italy
| | - Elena Mamusa
- Department of Medical Sciences and Public Health, Multiple Sclerosis Center, ATS Sardegna, Ospedale Binaghi, University of Cagliari, Via Is Guadazzonis 2, 09126, Cagliari, Italy
| | - Adriana Vacca
- Department of Medical Sciences and Public Health, Bone Marrow Transplant Center, University of Cagliari, Via Is Guadazzonis 2, 09126, Cagliari, Italy
| | - Maria Giovanna Marrosu
- Department of Medical Sciences and Public Health, Multiple Sclerosis Center, ATS Sardegna, Ospedale Binaghi, University of Cagliari, Via Is Guadazzonis 2, 09126, Cagliari, Italy
| | - Eleonora Cocco
- Department of Medical Sciences and Public Health, Multiple Sclerosis Center, ATS Sardegna, Ospedale Binaghi, University of Cagliari, Via Is Guadazzonis 2, 09126, Cagliari, Italy
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Sanna M, Caocci G, Orrù F, Ledda A, Vacca A, Piras E, Fozza C, Deias P, Tidore G, Dore F, La Nasa G. Safe fluoroquinolones prophylaxis in blood cancer patients with chemotherapy-induced neutropenia and Glucose-6-Phosphate-Dehydrogenase deficiency. J Clin Pharm Ther 2017; 42:733-737. [DOI: 10.1111/jcpt.12571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 05/09/2017] [Indexed: 11/29/2022]
Affiliation(s)
- M. Sanna
- Hematology Unit; Department of Medical Sciences and Public Health; Bone Marrow Transplant Center; R. Binaghi Hospital; University of Cagliari; Cagliari Italy
| | - G. Caocci
- Hematology Unit; Department of Medical Sciences and Public Health; Bone Marrow Transplant Center; R. Binaghi Hospital; University of Cagliari; Cagliari Italy
| | - F. Orrù
- Hematology Unit; Department of Medical Sciences and Public Health; Bone Marrow Transplant Center; R. Binaghi Hospital; University of Cagliari; Cagliari Italy
| | - A. Ledda
- Hematology Unit; Department of Medical Sciences and Public Health; Bone Marrow Transplant Center; R. Binaghi Hospital; University of Cagliari; Cagliari Italy
| | - A. Vacca
- Hematology Unit; Department of Medical Sciences and Public Health; Bone Marrow Transplant Center; R. Binaghi Hospital; University of Cagliari; Cagliari Italy
| | - E. Piras
- Hematology Unit; Department of Medical Sciences and Public Health; Bone Marrow Transplant Center; R. Binaghi Hospital; University of Cagliari; Cagliari Italy
| | - C. Fozza
- Department of Clinical and Experimental Medicine; University of Sassari; Sassari Italy
| | - P. Deias
- Hematology Unit; Department of Medical Sciences and Public Health; Bone Marrow Transplant Center; R. Binaghi Hospital; University of Cagliari; Cagliari Italy
| | - G. Tidore
- Department of Clinical and Experimental Medicine; University of Sassari; Sassari Italy
| | - F. Dore
- Department of Clinical and Experimental Medicine; University of Sassari; Sassari Italy
| | - G. La Nasa
- Hematology Unit; Department of Medical Sciences and Public Health; Bone Marrow Transplant Center; R. Binaghi Hospital; University of Cagliari; Cagliari Italy
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Caocci G, Orofino MG, Vacca A, Piroddi A, Piras E, Addari MC, Caria R, Pilia MP, Origa R, Moi P, La Nasa G. Long-term survival of beta thalassemia major patients treated with hematopoietic stem cell transplantation compared with survival with conventional treatment. Am J Hematol 2017; 92:1303-1310. [PMID: 28850704 DOI: 10.1002/ajh.24898] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Revised: 08/22/2017] [Accepted: 08/24/2017] [Indexed: 11/12/2022]
Abstract
Allogeneic hematopoietic stem cell transplantation (HSCT) in thalassemia remains a challenge. We reported a single-centre case-control study of a large cohort of 516 children and adult patients treated with HSCT or blood transfusion support and iron chelation therapy; 258 patients (median age 12, range 1-45) underwent sibling (67%) or unrelated (33%) HSCT; 97 patients were adults (age ≥ 16 years). The median follow-up after HSCT was 11 years (range 1-30). The conditioning regimen was busulfan (80.6%) or treosulfan-based (19.4%). A cohort of 258 age-sex matched conventionally treated (CT) patients was randomly selected. In transplanted patients the 30-year overall survival (OS) and thalassemia-free survival (TFS) were 82.6 ± 2.7% and 77.8 ± 2.9%, compared to the OS of 85.3 ± 2.7% in CT patients (P = NS); The incidence of grade II-IV acute and chronic graft versus host disease (GvHD) was 23.6% and 12.9% respectively. The probability of rejection was 6.9%. Transplant-related mortality (TRM) (13.8%) was similar to the probability of dying of cardiovascular events in CT patients (12.2%). High-risk Pesaro score (class 3) was associated with lower OS (OR = 1.99, 95% C.I.=1.31-3.03) and TFS (OR = 1.54, 95% C.I.=1.12-2.12). In adult patients, the 23-years OS and TFS after HSCT were 70 ± 5% and 67.3 ± 5%, compared to 71.2 ± 5% of OS in CT (P = NS). Finally, treosulfan was associated with lower risk of acute GvHD (P = .004; OR = 0.28, 95% C.I.=0.12-0.67). In conclusion, the 30-year survival rate of ex-thalassemia patients after HSCT was similar to that expected in CT thalassemia patients, with the vast majority of HSCT survivors cured from thalassemia.
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Affiliation(s)
- Giovanni Caocci
- Bone Marrow Transplant Center, Hospital Binaghi and Microcitemico; Cagliari Italy
- Department of Medical Sciences and Public Health; University of Cagliari; Cagliari Italy
| | - Maria Grazia Orofino
- Bone Marrow Transplant Center, Hospital Binaghi and Microcitemico; Cagliari Italy
| | - Adriana Vacca
- Bone Marrow Transplant Center, Hospital Binaghi and Microcitemico; Cagliari Italy
| | - Antonio Piroddi
- Bone Marrow Transplant Center, Hospital Binaghi and Microcitemico; Cagliari Italy
| | - Eugenia Piras
- Bone Marrow Transplant Center, Hospital Binaghi and Microcitemico; Cagliari Italy
| | - Maria Carmen Addari
- Bone Marrow Transplant Center, Hospital Binaghi and Microcitemico; Cagliari Italy
| | - Rossella Caria
- Bone Marrow Transplant Center, Hospital Binaghi and Microcitemico; Cagliari Italy
| | - Maria Paola Pilia
- Pediatric Clinic, Thalassemias and Rare Diseases; Pediatric Hospital “Microcitemico A. Cao”; Cagliari Italy
| | - Raffaella Origa
- Pediatric Clinic, Thalassemias and Rare Diseases; Pediatric Hospital “Microcitemico A. Cao”; Cagliari Italy
| | - Paolo Moi
- Department of Medical Sciences and Public Health; University of Cagliari; Cagliari Italy
- Pediatric Clinic, Thalassemias and Rare Diseases; Pediatric Hospital “Microcitemico A. Cao”; Cagliari Italy
| | - Giorgio La Nasa
- Bone Marrow Transplant Center, Hospital Binaghi and Microcitemico; Cagliari Italy
- Department of Medical Sciences and Public Health; University of Cagliari; Cagliari Italy
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Raab M, Ria R, Schlenzka J, Krahnke T, Haunschild J, Herrmann F, Fiedler U, Dawson K, Stumpp M, Tadjalli Mehr K, Harstrick A, Vacca A, Goldschmidt H. MP0250 – a dual inhibitor of VEGF and HGF - plus bortezomib + dexamethasone in a phase 2 open-label, single-arm, multicenter trial in patients with refractory and relapsed multiple myeloma (RRMM). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx373.047] [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: 11/14/2022] Open
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Caocci G, Greco M, Delogu G, Secchi C, Perra A, Ghiani S, Orru F, Vacca A, Galimi F, La Nasa G. Ruxolitinib therapy and telomere length in myelofibrosis. Blood Cancer J 2016; 6:e479. [PMID: 27716743 PMCID: PMC5098263 DOI: 10.1038/bcj.2016.91] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- G Caocci
- Hematology Unit, Department of Medical Sciences, Bone Marrow Transplant Center, R. Binaghi Hospital, University of Cagliari, Cagliari, Italy
| | - M Greco
- Hematology Unit, Department of Medical Sciences, Bone Marrow Transplant Center, R. Binaghi Hospital, University of Cagliari, Cagliari, Italy
| | - G Delogu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - C Secchi
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy.,National Institute of Biostructures and Biosystems, University of Sassari, Sassari, Italy
| | - A Perra
- Hematology Unit, Department of Medical Sciences, Bone Marrow Transplant Center, R. Binaghi Hospital, University of Cagliari, Cagliari, Italy
| | - S Ghiani
- Hematology Unit, Department of Medical Sciences, Bone Marrow Transplant Center, R. Binaghi Hospital, University of Cagliari, Cagliari, Italy
| | - F Orru
- Hematology Unit, Department of Medical Sciences, Bone Marrow Transplant Center, R. Binaghi Hospital, University of Cagliari, Cagliari, Italy
| | - A Vacca
- Hematology Unit, Department of Medical Sciences, Bone Marrow Transplant Center, R. Binaghi Hospital, University of Cagliari, Cagliari, Italy
| | - F Galimi
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy.,National Institute of Biostructures and Biosystems, University of Sassari, Sassari, Italy
| | - G La Nasa
- Hematology Unit, Department of Medical Sciences, Bone Marrow Transplant Center, R. Binaghi Hospital, University of Cagliari, Cagliari, Italy
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Nettis E, Di Leo E, Pastore A, Distaso M, Zaza I, Vacca M, Macchia L, Vacca A. Probiotics and refractory chronic spontaneous urticaria. Eur Ann Allergy Clin Immunol 2016; 48:182-187. [PMID: 27608474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Background. In chronic spontaneous urticaria (CSU) first-line therapy with an antihistamine-based regimen may not achieve satisfactory control in patients. Thus, a continuing need exists for effective and safe treatments for refractory CSU. Aim. To evaluate the clinical efficacy and safety of an intake of a combination of 2 probiotics (Lactobacillus salivarius LS01 and Bifidobacterium breve BR03) in patients with CSU who remain symptomatic despite concomitant H1-antihistamine therapy. Methods. This report analyzes the effects of therapy with two probiotic strains on the clinical progress of 52 unselected patients with difficulty to treat CSU underwent to medical examination in two Italian specialist urticaria Clinics between September 2013 and September 2014. A mixture of Lactobacillus LS01 and Bifidobacterium BR03 were administered in each patient twice daily for 8 weeks. To evaluate patients' improvement with probiotics, urticaria activity score over 7 days (UAS7) was used at baseline and at week 8 in addition to a 5-question urticaria quality of life questionnaire. Results. Fifty-two patients with CSU were included in this study (10 male and 42 female, age range 19-72 years). Mean disease duration was 1.5 years. Fourteen patients discontinued treatment, so evaluable population consisted of 38 patients. Nine of the 38 patients experienced mild clinical improvement during probiotic treatment (23.7%); one patient reported significant clinical improvement (2.6%) and one patient had complete remission of urticaria (2.6%). Twenty-seven patients did not have improvement in symptoms (71.1%). No side effects during the course of therapy were reported. Conclusions. A combination of Lactobacillus salivarius LS01 and Bifidobacterium breve BR03 administered twice daily for 8 weeks might reduce the symptoms scores and improve quality of life scores in a part of patients with CSU who remained symptomatic despite treatment with H1 antihistamine mostly in subjects with allergic rhinitis.
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Affiliation(s)
- E Nettis
- Department of Allergy and Clinical Immunology, University of Bari Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy. Phone: +39 080 5592 821 Fax: +39 080 5593 576 E-mail:
| | - E Di Leo
- Section of Allergology and Clinical Immunology, Unit of Internal Medicine, "F. Miulli" Hospital, Acquaviva delle Fonti, Bari, Italy
| | - A Pastore
- Department of Allergy and Clinical Immunology, University of Bari Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - M Distaso
- Department of Allergy and Clinical Immunology, University of Bari Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - I Zaza
- Department of Allergy and Clinical Immunology, University of Bari Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - M Vacca
- Department of Allergy and Clinical Immunology, University of Bari Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - L Macchia
- Department of Allergy and Clinical Immunology, University of Bari Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - A Vacca
- Department of Allergy and Clinical Immunology, University of Bari Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy
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Calogiuri GF, Al-Sowaidi S, Nettis E, Cortellini G, Macchia L, Vacca A, Kounis NG. A joint allergist/cardiologist classification for thienopyridines hypersensitivity reactions based on their symptomatic patterns and its impact on the management strategies. Int J Cardiol 2016; 222:509-514. [PMID: 27505343 DOI: 10.1016/j.ijcard.2016.07.115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 07/08/2016] [Indexed: 11/15/2022]
Abstract
The role and importance of thienopyridines such as ticlopidine, clopidogrel, and prasugrel is well-established for several indications, ranging from prevention of acute coronary syndromes to percutaneous coronary interventions, where the dual antiplatelet therapy represents the gold standard to avoid denovo coronary stenosis. However, there is a significant cohort of patients with coronary artery disease who may manifest hypersensitivity reactions to thienopyridines. The examination of the various case reports from medical literature leads to identify mainly four clinical patterns of hypersensitivity to thienopyridines which involves more frequently cutaneous, hematologic, and articular tissues, therefore the kind and predominance of clinical symptoms may determine a different clinical approach to overcome or neutralize thienopyridines hypersensitivity.
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Affiliation(s)
- G F Calogiuri
- Pneumology Department Civil Hospital "NinettoMelli"S. Pietro Vernotico, Brindisi, Italy; Section of Allergology and Clinical Immunology, Department of Internal Medicine, Immunology and Infectious Diseases, University of Bari Medical School, Bari, Italy.
| | - S Al-Sowaidi
- Department of Internal Medicine, UAE University, Al-Ain, United Arab Emirates
| | - E Nettis
- Section of Allergology and Clinical Immunology, Department of Internal Medicine, Immunology and Infectious Diseases, University of Bari Medical School, Bari, Italy
| | - G Cortellini
- Internal Medicine Allergy and Rheumatology Unit, Rimini Hospital, Rimini, Italy
| | - L Macchia
- Section of Allergology and Clinical Immunology, Department of Internal Medicine, Immunology and Infectious Diseases, University of Bari Medical School, Bari, Italy
| | - A Vacca
- Department of Biomedical Science and Human Oncology, Section of Internal Medicine and Clinical Oncology University of Bari Medical School, Bari, Italy
| | - N G Kounis
- Department of Cardiology, University of Patras Medical School, Patras, Achaia, Greece
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Di Lorenzo L, Vacca A, Corfiati M, Lovreglio P, Soleo L. Evaluation of Tumor Necrosis Factor-Alpha and Granulocyte Colony-Stimulating Factor Serum Levels in Lead-Exposed Smoker Workers. Int J Immunopathol Pharmacol 2016; 20:239-47. [PMID: 17624258 DOI: 10.1177/039463200702000204] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [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: 11/15/2022] Open
Abstract
Inorganic lead (Pb) is able to modulate the immune response even at low to moderate exposure levels. It inhibits in vitro and in vivo activities of neutrophil leucocytes and influences their blood count in humans. Neutrophil functions are governed by a number of cytokines. Pb has been shown to affect leukocyte production of some of these cytokines in vitro. The objective of this study is to assess serum tumor necrosis factor-alpha (TNF-α) and granulocyte colony-stimulating factor (G-CSF) levels of thirty-three male lead-exposed (E) workers at a lead recycling plant as compared with twenty-eight male non-exposed (NE) workers at a food processing plant, whose current smoking habit was known. Serum TNF-α and G-CSF levels were measured by a quantitative sandwich enzyme immunoassay. Blood lead levels (Pb-B) were significantly higher in E (geometric mean (GM) 30.7 μg/dl, GSD 1.7; min-max: 9.1–81.6 μg/dl) workers than controls (GM 3.6 μg/dl, GSD 1.7; min-max: 1.0–11.0 μg/dl). E workers had significantly higher serum TNF-α (median: 107.1; min-max: 11.1–623.0 pg/ml) and G-CSF levels (median: 53.0, min-max: 31.1–197.0 pg/ml) than NE workers (TNF-α: median: 12.0; min-max: 9.4–18.8 pg/ml; G-CSF: median: 34.3, min-max: 25.1–52.2 pg/ml). In particular, the TNF-α level was shown to be significantly influenced by lead exposure and smoking habit, as well as by interaction between these two factors. Both serum TNF-α and G-CSF levels were correlated with Pb-B and absolute neutrophil count. This study is the first to detect higher serum levels of G-CSF in E over NE workers. Our data confirm that exposure to low to medium doses of lead may interfere in the complex cytokine network involved in inflammation, especially in workers who are current smokers.
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Affiliation(s)
- L Di Lorenzo
- Department of Internal and Public Medicine, Section of Occupational Medicine, University of Bari, Italy.
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Jridi I, Catacchio I, Majdoub H, Villard C, Shahbazzadeh D, El Ayeb M, Vacca A, Borchani L. Purification and characterization of two novel Hemiscorpius lepturus scorpion venom-derived phospholipases A2 which inhibit angiogenesis in vitro. Toxicon 2016. [DOI: 10.1016/j.toxicon.2016.01.018] [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: 11/28/2022]
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Micheli F, Palermo R, Talora C, Ferretti E, Vacca A, Napolitano M. Regulation of proapoptotic proteins Bak1 and p53 by miR-125b in an experimental model of Alzheimer's disease: Protective role of 17β-estradiol. Neurosci Lett 2016; 629:234-240. [PMID: 27235580 DOI: 10.1016/j.neulet.2016.05.049] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 05/10/2016] [Accepted: 05/24/2016] [Indexed: 11/29/2022]
Abstract
Alzheimer's disease has become one of the most impacting disorders since world population is rapidly aging. MicroRNA-125b plays a crucial role in many cellular processes and pathologies, but, to date, its role in Alzheimer's disease is controversial. In this study, we demonstrated, for the first time, that the down regulation of miR-125b is a key event for the neurotoxic effect of Aβ treatment in cortical neurons. Moreover, we found that 17β-estradiol treatment protects neurons from the Aβ-peptide induced neurotoxicity by increasing miR-125b expression that, in turn, decreased the expression, both at gene and protein levels, of the pro-apoptopic proteins Bak1 and p53. Overall, our data reveal miR-125b as a novel neuro-protector miRNA in Alzheimer's disease.
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Affiliation(s)
- F Micheli
- Department of Molecular Medicine, University "La Sapienza", 00161 Rome, Italy
| | - R Palermo
- Center for Life Nano Science@Sapienza, Istituto Italiano di Tecnologia, Rome, Italy
| | - C Talora
- Department of Molecular Medicine, University "La Sapienza", 00161 Rome, Italy
| | - E Ferretti
- Department of Experimental Medicine, University "La Sapienza", Rome, Italy
| | - A Vacca
- Department of Experimental Medicine, University "La Sapienza", Rome, Italy
| | - M Napolitano
- Department of Molecular Medicine, University "La Sapienza", 00161 Rome, Italy.
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Caira M, Candoni A, Verga L, Busca A, Delia M, Nosari A, Caramatti C, Castagnola C, Cattaneo C, Fanci R, Chierichini A, Melillo L, Mitra ME, Picardi M, Potenza L, Salutari P, Vianelli N, Facchini L, Cesarini M, De Paolis MR, Di Blasi R, Farina F, Venditti A, Ferrari A, Garzia M, Gasbarrino C, Invernizzi R, Lessi F, Manna A, Martino B, Nadali G, Offidani M, Paris L, Pavone V, Rossi G, Spadea A, Specchia G, Trecarichi EM, Vacca A, Cesaro S, Perriello V, Aversa F, Tumbarello M, Pagano L. Pre-chemotherapy risk factors for invasive fungal diseases: prospective analysis of 1,192 patients with newly diagnosed acute myeloid leukemia (SEIFEM 2010-a multicenter study). Haematologica 2015; 100:284-92. [PMID: 25638805 DOI: 10.3324/haematol.2014.113399] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Correct definition of the level of risk of invasive fungal infections is the first step in improving the targeting of preventive strategies. We investigated the potential relationship between pre-hospitalization exposure to sources of fungi and the development of invasive fungal infections in adult patients with newly diagnosed acute myeloid leukemia after their first course of chemotherapy. From January 2010 to April 2012, all consecutive acute myeloid leukemia patients in 33 Italian centers were prospectively registered. Upon first admission, information about possible pre-chemotherapy risk factors and environmental exposure was collected. We recorded data regarding comorbid conditions, employment, hygienic habits, working and living environment, personal habits, hobbies, and pets. All invasive fungal infections occurring within 30 days after the first course of chemotherapy were recorded. Of the 1,192 patients enrolled in this study, 881 received intensive chemotherapy and were included in the present analysis. Of these, 214 developed an invasive fungal infection, including 77 proven/probable cases (8.7%). Of these 77 cases, 54 were proven/probable invasive mold infections (6.1%) and 23 were proven yeast infections (2.6%). Upon univariate analysis, a significant association was found between invasive mold infections and age, performance status, diabetes, chronic obstructive pulmonary disease, smoking, cocaine use, job, hobbies, and a recent house renovation. Higher body weight resulted in a reduced risk of invasive mold infections. Multivariate analysis confirmed the role of performance status, job, body weight, chronic obstructive pulmonary disease, and house renovation. In conclusion, several hospital-independent variables could potentially influence the onset of invasive mold infections in patients with acute myeloid leukemia. Investigation of these factors upon first admission may help to define a patient's risk category and improve targeted prophylactic strategies. (Clinicaltrial.gov: NCT01315925)
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Affiliation(s)
- Morena Caira
- Istituto di Ematologia, Università Cattolica del Sacro Cuore, Roma
| | - Anna Candoni
- Clinica Ematologica, Azienda Ospedaliero Universitaria di Udine
| | - Luisa Verga
- Unità di Ematologia, Università Milano Bicocca, Ospedale S.Gerardo, Monza
| | | | - Mario Delia
- Hematology and BMT Unit, Department of Emergency and Organ Transplantation, University of Bari, Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari
| | - Annamaria Nosari
- Divisione di Ematologia e Centro Trapianti Midollo, Ospedale Niguarda Ca' Granda, Milan
| | | | - Carlo Castagnola
- Dipartimento Onco-Ematologico Fondazione ICRRS Policlinico San Matteo, Pavia
| | | | - Rosa Fanci
- Unità Funzionale di Ematologia, Azienda Ospedaliero-Universitaria Careggi e Università di Firenze
| | | | - Lorella Melillo
- Unità di Ematologia, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo
| | | | - Marco Picardi
- Azienda Ospedaliera Universitaria Federico II Napoli, Dipartimento di Medicina Clinica e Chirurgia
| | - Leonardo Potenza
- Sezione di Ematologia, Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell'Adulto, Università di Modena e Reggio Emilia
| | | | - Nicola Vianelli
- Istituto di Ematologia ed Oncologia Clinica "Lorenzo e Ariosto Serágnoli", Ospedale S.Orsola-Malpighi, Università di Bologna
| | - Luca Facchini
- Divisione di Ematologia, Arciospedale S.Maria Nuova, Reggio Emilia
| | - Monica Cesarini
- Istituto di Ematologia, Università Cattolica del Sacro Cuore, Roma
| | | | - Roberta Di Blasi
- Istituto di Ematologia, Università Cattolica del Sacro Cuore, Roma
| | - Francesca Farina
- Unità di Ematologia, Università Milano Bicocca, Ospedale S.Gerardo, Monza
| | - Adriano Venditti
- Ematologia, Dipartimento di Biomedicina e Prevenzione, Università Tor Vergata, Roma
| | | | | | | | - Rosangela Invernizzi
- Dipartimento di Medicina Interna, Università di Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia
| | - Federica Lessi
- Ematologia ed Immunologia Clinica, Dipartimento di Medicina, Universita' di Padova
| | | | - Bruno Martino
- Divisione di Ematologia, Azienda Ospedaliera "Bianchi Melacrino Morelli", Reggio Calabria
| | - Gianpaolo Nadali
- UOC Ematologia, Azienda Ospedaliera Universitaria Integrata di Verona
| | | | - Laura Paris
- Divisione di Ematologia e Centro Trapianti Midollo, Ospedale Niguarda Ca' Granda, Milan
| | | | | | - Antonio Spadea
- Unità di Ematologia, Istituti Fisioterapici Ospitalieri, Roma
| | - Giorgina Specchia
- Hematology and BMT Unit, Department of Emergency and Organ Transplantation, University of Bari, Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari
| | | | | | - Simone Cesaro
- Emato-Oncologia Pediatrica, Azienda Ospedaliera Universitaria Integrata, Verona
| | - Vincenzo Perriello
- Istituto di Ematologia, Ospedale S. Maria della Misericordia, Università di Perugia, Italy
| | | | - Mario Tumbarello
- Istituto di Malattie Infettive, Università Cattolica del Sacro Cuore, Roma
| | - Livio Pagano
- Istituto di Ematologia, Università Cattolica del Sacro Cuore, Roma
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Floris A, Piga M, Massa L, Vacca S, Corraine M, Vacca A, Garau P, Ibba V, Cauli A, Mathieu A. AB0542 Disease Flares in a Monocentric Cohort of Patients with Systemic Lupus Erythematosus: Incidence, Clinical and Laboratory Characteristics, Associated Factors and Treatment. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.6160] [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: 11/03/2022]
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Calogiuri GF, Muratore L, Nettis E, Casto AM, Di Leo E, Vacca A. Immediate-type hypersensitivity reaction to Mannitol as drug excipient (E421): a case report. Eur Ann Allergy Clin Immunol 2015; 47:99-102. [PMID: 25951149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Allergic reactions to mannitol have been reported rarely, despite its widespread use as a drug and as a food excipient. This is the first case report in which oral mannitol induces an immediate type hypersensitivity as a drug excipient, in a 42 year old man affected by rhinitis to olive tree pollen. Unusual and undervalued risk factors for mannitol hypersensitivity are examined.
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Affiliation(s)
- G F Calogiuri
- Pneumology Department, Hospital Ninetto Melli, San Pietro Vernotico, Brindisi, Italy. Section of Allergology and Clinical Immunology, Department of Internal Medicine and Infectious Diseases, University of Bari Medical School, Bari, Italy. E-mail:
| | - L Muratore
- Allergy and Clinical Immunology Center, Civil Hospital Vito Fazzi, Lecce, Italy
| | - E Nettis
- Section of Allergology and Clinical Immunology, Department of Internal Medicine and Infectious Diseases, University of Bari Medical School, Bari, Italy
| | - A M Casto
- Allergy and Clinical Immunology Center, Civil Hospital Vito Fazzi, Lecce, Italy
| | - E Di Leo
- Section of Allergology and Clinical Immunology, Department of Internal Medicine and Infectious Diseases, University of Bari Medical School, Bari, Italy
| | - A Vacca
- Section of Allergology and Clinical Immunology, Department of Internal Medicine and Infectious Diseases, University of Bari Medical School, Bari, Italy. Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Bari, Italy
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Moschetta M, Reale A, Marasco C, Vacca A, Carratù MR. Therapeutic targeting of the mTOR-signalling pathway in cancer: benefits and limitations. Br J Pharmacol 2015; 171:3801-13. [PMID: 24780124 DOI: 10.1111/bph.12749] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 03/29/2014] [Accepted: 04/15/2014] [Indexed: 12/21/2022] Open
Abstract
The mammalian target of rapamycin (mTOR) plays an important role in the regulation of protein translation, cell growth and metabolism. The mTOR protein forms two distinct multi-subunit complexes: mTORC1 and mTORC2. The mTORC1 complex is activated by diverse stimuli, such as growth factors, nutrients, energy and stress signals; and essential signalling pathways, such as PI3K and MAPK, in order to control cell growth, proliferation and survival. mTORC1 also activates S6K1 and 4EBP1, which are involved in mRNA translation. The mTORC2 complex is resistant to rapamycin inhibitory activity and is generally insensitive to nutrient- and energy-dependent signals. It activates PKC-α and Akt and regulates the actin cytoskeleton. Deregulation of the mTOR-signalling pathway (PI3K amplification/mutation, PTEN loss of function, Akt overexpression, and S6K1, 4EBP1 and eIF4E overexpression) is common in cancer, and alterations in components of the mTOR pathway have a major role in tumour progression. Therefore, mTOR is an appealing therapeutic target in many tumours. Here we summarize the upstream regulators and downstream effectors of the mTORC1 and mTORC2 pathways, the role of mTOR in cancer, and the potential therapeutic values and issues related to the novel agents targeting the mTOR-signalling pathway.
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Affiliation(s)
- M Moschetta
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA; Section of Internal Medicine, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School 'Aldo Moro', Bari, Italy
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Mele G, Melpignano A, Quarta G, Palumbo G, Capalbo S, Falcone A, Cascavilla N, Palazzo G, Mazza P, Iannitto E, Curci P, Rizzi R, Specchia G, Rossini B, Pavone V, Ria R, Vacca A, Buquicchio C, Tarantini G, Minoia C, Guarini A, Ditonno P, Polimeno G, Reddiconto G, Di Renzo N. “Real world” outcome of lenalidomide plus dexamethasone in the setting of recurrent and refractory multiple myeloma: Extended follow-up of a retrospective multicenter study by the “rete ematologica pugliese”. Leuk Res 2015; 39:279-83. [DOI: 10.1016/j.leukres.2014.12.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 12/01/2014] [Accepted: 12/14/2014] [Indexed: 11/29/2022]
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Pagano L, Stamouli M, Tumbarello M, Verga L, Candoni A, Cattaneo C, Nadali G, Mitra ME, Mancini V, Nosari A, Garzia MG, Delia M, Storti S, Spadea A, Caramatti C, Perriello V, Sanna M, Vacca A, De Paolis MR, Potenza L, Salutari P, Castagnola C, Fanci R, Chierichini A, Melillo L, Picardi M, Facchini L, Martino B, Di Blasi R, Cesarini M, Offidani M, Vianelli N, Caira M, Lessi F, Ferrari A, Venditti A, Pavone V, Lo-Coco F, Aversa F, Busca A. Risk of invasive fungal infection in patients affected by acute promyelocytic leukaemia. A report by the SEIFEM-D registry. Br J Haematol 2015; 170:434-9. [PMID: 25626374 DOI: 10.1111/bjh.13308] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Livio Pagano
- Istituto di Ematologia, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Maria Stamouli
- Istituto di Ematologia, Università Cattolica del Sacro Cuore, Rome, Italy.,2nd Department of Internal Medicine Propaedeutic, Attikon University Hospital, Athens, Greece
| | - Mario Tumbarello
- Istituto di Malattie Infettive, Università Cattolica Del Sacro Duore, Rome, Italy
| | - Luisa Verga
- Unità di Ematologia, Ospedale San Gerardo, Università di Milano, Monza, Italy
| | - Anna Candoni
- Clinica di Ematologia, Università di Udine, Udine, Italy
| | - Chiara Cattaneo
- Divisione di Ematologia, Spedali Civili di Brescia, Brescia, Italy
| | - Gianpaolo Nadali
- UOC Ematologia, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Maria Enza Mitra
- Divisione di Ematologia e TMO, Policlinico di Palermo, Palermo, Italy
| | - Valentina Mancini
- Divisione di Ematologia e Centro Trapianti Midollo, Ospedale Niguarda Ca' Granda, Milan, Italy
| | - Annamaria Nosari
- Divisione di Ematologia e Centro Trapianti Midollo, Ospedale Niguarda Ca' Granda, Milan, Italy
| | | | - Mario Delia
- Sezione di Ematologia, Università di Bari, Bari, Italy
| | - Sergio Storti
- Divisione di Ematologia, Università Cattolica del S. Cuore, Campobasso, Italy
| | - Antonio Spadea
- Ematologia, Istituti Fisioterapici Ospitalieri, Rome, Italy
| | | | | | - Marco Sanna
- Istituto di Ematologia, Università di Cagliari, Cagliari, Italy
| | - Adriana Vacca
- Istituto di Ematologia, Università di Cagliari, Cagliari, Italy
| | | | - Leonardo Potenza
- Sezione di Ematologia, Dipartimento di Scienze Mediche Materno Infantili e dell'Adulto, Università degli Studi di Modena e Reggio Emilia, Modena, Italy
| | - Prassede Salutari
- Dipartimento di Ematologia Clinica, Ospedale Spirito Santo, Pescara, Italy
| | - Carlo Castagnola
- Dipartimento Onco-Ematologico, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Rosa Fanci
- Unità Operativa di Ematologia, Università di Firenze, Firenze, Italy
| | - Anna Chierichini
- Divisione di Ematologia, Ospedale S. Giovanni Addolorata, Rome, Italy
| | - Lorella Melillo
- Divisione di Ematologia, IRCCS Casa Sollievo della Sofferenza, S. Giovanni Rotondo, Napoli, Italy
| | - Marco Picardi
- Divisione di Ematologia, Università Federico II di Napoli, Napoli, Italy
| | - Luca Facchini
- Divisione di Ematologia, Arciospedale S. Maria Nuova, Reggio Emilia, Italy
| | - Bruno Martino
- Divisione di Ematologia, Azienda Ospedaliera BMM, Reggio Calabria, Italy
| | - Roberta Di Blasi
- Istituto di Ematologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Monica Cesarini
- Istituto di Ematologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Nicola Vianelli
- Istituto di Ematologia ed Oncologia Clinica, Ospedale S. Orsola-Malpighi, Università di Bologna, Bologna, Italy
| | - Morena Caira
- Istituto di Ematologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Federica Lessi
- Ematologia ed Immunologia Clinica, Dipartimento di Medicina, Università di Padova, Padova, Italy
| | | | | | | | | | - Franco Aversa
- Sezione di Ematologia, Università di Parma, Parma, Italy
| | - Alessandro Busca
- Dipartimento di Ematologia, Ospedale S.Giovanni Battista, Torino, Italy
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Pisu S, Caocci G, d’Aloja E, Efficace F, Vacca A, Piras E, Orofino MG, Addari C, Pintor M, Demontis R, Demuru F, Pittau MR, Collins GS, La Nasa G. Reassessing the approach to informed consent: the case of unrelated hematopoietic stem cell transplantation in adult thalassemia patients. Philos Ethics Humanit Med 2014; 9:13. [PMID: 25115172 PMCID: PMC4136633 DOI: 10.1186/1747-5341-9-13] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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] [Received: 07/28/2013] [Accepted: 06/29/2014] [Indexed: 05/02/2023] Open
Abstract
INTRODUCTION The informed consent process is the legal embodiment of the fundamental right of the individual to make decisions affecting his or her health., and the patient's permission is a crucial form of respect of freedom and dignity, it becomes extremely important to enhance the patient's understanding and recall of the information given by the physician. This statement acquires additional weight when the medical treatment proposed can potentially be detrimental or even fatal. This is the case of thalassemia patients pertaining to class 3 of the Pesaro classification where Allogenic hematopoietic stem cell transplantation (HSCT) remains the only potentially curative treatment. Unfortunately, this kind of intervention is burdened by an elevated transplantation-related mortality risk (TRM: all deaths considered related to transplantation), equal to 30% according to published reports. In thalassemia, the role of the patient in the informed consent process leading up to HSCT has not been fully investigated. This study investigated the hypothesis that information provided by physicians in the medical scenario of HSCT is not fully understood by patients and that misunderstanding and communication biases may affect the clinical decision-making process. METHODS A questionnaire was either mailed or given personally to 25 patients. A second questionnaire was administered to the 12 physicians attending the patients enrolled in this study. Descriptive statistics were used to evaluate the communication factors. RESULTS The results pointed out the difference between the risks communicated by physicians and the risks perceived by patients. Besides the study highlighted the mortality risk considered to be acceptable by patients and that considered to be acceptable by physicians. CONCLUSIONS Several solutions have been suggested to reduce the gap between communicated and perceived data. A multi-disciplinary approach may possibly help to attenuate some aspects of communication bias. Several tools have also been proposed to fill or to attenuate the gap between communicated and perceived data. But the most important tool is the ability of the physician to comprehend the right place of conscious consent in the relationship with the patient.
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Affiliation(s)
- Salvatore Pisu
- Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- Mediterranean Center of Clinical Bioethics, University of Cagliari-Sardegna Ricerche, Cagliari, Italy
| | - Giovanni Caocci
- Hematology, Department of Medical Sciences, University of Cagliari, Cagliari, Italy
- Bone Marrow Transplantation Center, Hospital “R. Binaghi”, Cagliari, Italy
| | - Ernesto d’Aloja
- Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- Mediterranean Center of Clinical Bioethics, University of Cagliari-Sardegna Ricerche, Cagliari, Italy
| | - Fabio Efficace
- Health Outcome Research Unit, Gruppo Italiano Malattie Ematologiche dell’Adulto (GIMEMA), Data Centre, Rome, Italy
| | - Adriana Vacca
- Bone Marrow Transplantation Center, Hospital “R. Binaghi”, Cagliari, Italy
| | - Eugenia Piras
- Bone Marrow Transplantation Center, Hospital “R. Binaghi”, Cagliari, Italy
| | - Maria Grazia Orofino
- Department of Biomedical Science and Biotechnology, Pediatric Clinic of the Bone Marrow Transplant Centre, University of Cagliari, Cagliari, Italy
| | - Carmen Addari
- Department of Biomedical Science and Biotechnology, Pediatric Clinic of the Bone Marrow Transplant Centre, University of Cagliari, Cagliari, Italy
| | - Michela Pintor
- Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- Mediterranean Center of Clinical Bioethics, University of Cagliari-Sardegna Ricerche, Cagliari, Italy
| | - Roberto Demontis
- Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Federica Demuru
- Mediterranean Center of Clinical Bioethics, University of Cagliari-Sardegna Ricerche, Cagliari, Italy
| | - Maria Rita Pittau
- Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Gary S Collins
- Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - Giorgio La Nasa
- Hematology, Department of Medical Sciences, University of Cagliari, Cagliari, Italy
- Bone Marrow Transplantation Center, Hospital “R. Binaghi”, Cagliari, Italy
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Vacca A, Porru G, Dessole G, Mathieu A, Cormier C, Fulla Y, Kahan A, Allanore Y. THU0061 Vitamin D Insufficiency and Deficiency in Two European Cohorts of Patients with Inflammatory Rheumatic Disorders. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5038] [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]
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Girmenia C, Raiola AM, Piciocchi A, Algarotti A, Stanzani M, Cudillo L, Pecoraro C, Guidi S, Iori AP, Montante B, Chiusolo P, Lanino E, Carella AM, Zucchetti E, Bruno B, Irrera G, Patriarca F, Baronciani D, Musso M, Prete A, Risitano AM, Russo D, Mordini N, Pastore D, Vacca A, Onida F, Falcioni S, Pisapia G, Milone G, Vallisa D, Olivieri A, Bonini A, Castagnola E, Sica S, Majolino I, Bosi A, Busca A, Arcese W, Bandini G, Bacigalupo A, Rambaldi A, Locasciulli A. Incidence and Outcome of Invasive Fungal Diseases after Allogeneic Stem Cell Transplantation: A Prospective Study of the Gruppo Italiano Trapianto Midollo Osseo (GITMO). Biol Blood Marrow Transplant 2014; 20:872-80. [DOI: 10.1016/j.bbmt.2014.03.004] [Citation(s) in RCA: 127] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2013] [Accepted: 03/04/2014] [Indexed: 11/24/2022]
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Vacca A, Loddo S, Melis MT, Funedda A, Puddu R, Verona M, Fanni S, Fantola F, Madrau S, Marrone VA, Serra G, Tore C, Manca D, Pasci S, Puddu MR, Schirru P. A GIS based method for soil mapping in Sardinia, Italy: a geomatic approach. J Environ Manage 2014; 138:87-96. [PMID: 24315681 DOI: 10.1016/j.jenvman.2013.11.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 10/29/2013] [Accepted: 11/14/2013] [Indexed: 06/02/2023]
Abstract
A new project was recently initiated for the realization of the "Land Unit and Soil Capability Map of Sardinia" at a scale of 1:50,000 to support land use planning. In this study, we outline the general structure of the project and the methods used in the activities that have been thus far conducted. A GIS approach was used. We used the soil-landscape paradigm for the prediction of soil classes and their spatial distribution or the prediction of soil properties based on landscape features. The work is divided into two main phases. In the first phase, the available digital data on land cover, geology and topography were processed and classified according to their influence on weathering processes and soil properties. The methods used in the interpretation are based on consolidated and generalized knowledge about the influence of geology, topography and land cover on soil properties. The existing soil data (areal and point data) were collected, reviewed, validated and standardized according to international and national guidelines. Point data considered to be usable were input into a specific database created for the project. Using expert interpretation, all digital data were merged to produce a first draft of the Land Unit Map. During the second phase, this map will be implemented with the existing soil data and verified in the field if also needed with new soil data collection, and the final Land Unit Map will be produced. The Land Unit and Soil Capability Map will be produced by classifying the land units using a reference matching table of land capability classes created for this project.
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Affiliation(s)
- A Vacca
- Dipartimento di Scienze Chimiche e Geologiche, Università degli Studi di Cagliari, Via Trentino 51, 09127 Cagliari, Italy.
| | - S Loddo
- Agenzia AGRIS Sardegna, Viale Trieste 111, 09123 Cagliari, Italy
| | - M T Melis
- Dipartimento di Scienze Chimiche e Geologiche, Università degli Studi di Cagliari, Via Trentino 51, 09127 Cagliari, Italy
| | - A Funedda
- Dipartimento di Scienze Chimiche e Geologiche, Università degli Studi di Cagliari, Via Trentino 51, 09127 Cagliari, Italy
| | - R Puddu
- Agenzia AGRIS Sardegna, Viale Trieste 111, 09123 Cagliari, Italy
| | - M Verona
- Agenzia AGRIS Sardegna, Viale Trieste 111, 09123 Cagliari, Italy
| | - S Fanni
- Agenzia AGRIS Sardegna, Viale Trieste 111, 09123 Cagliari, Italy
| | - F Fantola
- Agenzia LAORE Sardegna, Via Caprera 8, 09123 Cagliari, Italy
| | - S Madrau
- Dipartimento di Ingegneria del Territorio, Università degli Studi di Sassari, Viale Italia 39, 07100 Sassari, Italy
| | - V A Marrone
- Dipartimento di Scienze Chimiche e Geologiche, Università degli Studi di Cagliari, Via Trentino 51, 09127 Cagliari, Italy
| | - G Serra
- Agenzia AGRIS Sardegna, Viale Trieste 111, 09123 Cagliari, Italy
| | - C Tore
- Agenzia LAORE Sardegna, Via Caprera 8, 09123 Cagliari, Italy
| | - D Manca
- Agenzia AGRIS Sardegna, Viale Trieste 111, 09123 Cagliari, Italy
| | - S Pasci
- Dipartimento di Scienze Chimiche e Geologiche, Università degli Studi di Cagliari, Via Trentino 51, 09127 Cagliari, Italy
| | - M R Puddu
- Agenzia LAORE Sardegna, Via Caprera 8, 09123 Cagliari, Italy
| | - P Schirru
- Agenzia LAORE Sardegna, Via Caprera 8, 09123 Cagliari, Italy
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Vacca A, Ibba V, Cristo M, Dessole G, Garau P, Piga M, Porru G, Figus F, Dessì M, Cauli A, Mathieu A. AB0608 Elevated Circulating Tumor-Associated Antigens in Systemic Sclerosis: Association with Lung Fibrosis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5074] [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]
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48
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Cauli A, Dessole G, Porru G, Cassotta A, Piga M, Vacca A, Ibba V, Fiorillo M, Sorrentino R, Mathieu A. FRI0160 Comparable Amount of Free Heavy Chain and β2M in the Cytoplasm of Ex Vivo Peripheral Blood Mononuclear Cells of B*2705 Ankylosing Spondylitis Patients VS B*2705 and B*2709 Healthy Subjects Does not Support the UPR Theory. Influence of ERAP1 Polymorphisms. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4442] [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]
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49
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Piga M, Chessa E, Ibba V, Mura V, Vacca A, Garau P, Gabba A, Porru G, Cauli A, Mathieu A. THU0185 Biologics-Induced Autoimmune Renal Abnormalities: Systematic Literature Review and Analysis of A Monocentric Cohort of 707 Adult Patients Affected by Rheumatic Disease. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4524] [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: 11/03/2022]
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50
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Piga M, Peltz T, Perra D, Montaldo C, Vacca A, Garau P, Ibba V, Porru G, Figus F, Gabba A, Cauli A, Mathieu A. THU0014 Twenty-Year Follow-Up of Brain MRI in A Series of Patients with Systemic Lupus Erythematosus. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4488] [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]
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