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Degiuli M, Aguilar HAR, Solej M, Azzolina D, Marchiori G, Corcione F, Bracale U, Peltrini R, Di Nuzzo MM, Baldazzi G, Cassini D, Sica GS, Pirozzi B, Muratore A, Calabrò M, Jovine E, Lombardi R, Anania G, Chiozza M, Petz W, Pizzini P, Persiani R, Biondi A, Reddavid R. ASO Visual Abstract: A Randomized Phase III Trial of Complete Mesocolic Excision in Comparison with Conventional Surgery for Right Colon Cancer: Interim Analysis of a Nationwide Multicenter Study of the Italian Society of Surgical Oncology Colorectal Cancer Network (CoME-In Trial). Ann Surg Oncol 2024; 31:1700-1701. [PMID: 38198001 DOI: 10.1245/s10434-023-14794-5] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Affiliation(s)
- M Degiuli
- Division of Surgical Oncology and Digestive Surgery, Department of Oncology, San Luigi University Hospital, University of Turin, Orbassano, Italy
| | - H A Resendiz Aguilar
- Division of Surgical Oncology and Digestive Surgery, Department of Oncology, San Luigi University Hospital, University of Turin, Orbassano, Italy
| | - M Solej
- Division of Surgical Oncology and Digestive Surgery, Department of Oncology, San Luigi University Hospital, University of Turin, Orbassano, Italy
| | - D Azzolina
- Department of Environmental and Preventive Sciences, University of Ferrara, Ferrara, Italy
| | - G Marchiori
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - F Corcione
- Minimally Invasive, General and Oncologic Surgery Unit, University Federico II of Naples, Naples, Italy
| | - U Bracale
- Minimally Invasive, General and Oncologic Surgery Unit, University Federico II of Naples, Naples, Italy
| | - R Peltrini
- Minimally Invasive, General and Oncologic Surgery Unit, University Federico II of Naples, Naples, Italy
| | - M M Di Nuzzo
- Minimally Invasive, General and Oncologic Surgery Unit, University Federico II of Naples, Naples, Italy
| | - G Baldazzi
- ASST Ovest Milanese, P.O. Nuovo Ospedale di Legnano, Legnano, Italy
| | - D Cassini
- ASST Ovest Milanese, P.O. Nuovo Ospedale di Legnano, Legnano, Italy
| | - G S Sica
- Minimally Invasive and Gastrointestinal Surgery Unit, Università e Policlinico Tor Vergata, Rome, Italy
| | - B Pirozzi
- Minimally Invasive and Gastrointestinal Surgery Unit, Università e Policlinico Tor Vergata, Rome, Italy
| | - A Muratore
- Surgical Department, Edoardo Agnelli Hospital, Pinerolo, Italy
| | - M Calabrò
- Surgical Department, Edoardo Agnelli Hospital, Pinerolo, Italy
| | - E Jovine
- IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | - R Lombardi
- IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | - G Anania
- Dipartimento Scienze Mediche, Università di Ferrara, Ferrara, Italy
| | - M Chiozza
- Dipartimento Scienze Mediche, Università di Ferrara, Ferrara, Italy
| | - W Petz
- Digestive Surgery European Institute of Oncology IRCCS, Milan, Italy
| | - P Pizzini
- Digestive Surgery European Institute of Oncology IRCCS, Milan, Italy
| | - R Persiani
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Biondi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - R Reddavid
- Division of Surgical Oncology and Digestive Surgery, Department of Oncology, San Luigi University Hospital, University of Turin, Orbassano, Italy.
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Zecchin M, Ciminello E, Mari V, Proclemer A, D'Onofrio A, Zanotto G, De Ponti R, Capovilla TM, Laricchiuta P, Biondi A, Sampaolo L, Pascucci S, Sinagra G, Boriani G, Carrani E, Torre M. A global analysis of implants and replacements of pacemakers and cardioverter-defibrillators before, during, and after the COVID-19 pandemic in Italy. Intern Emerg Med 2024; 19:107-114. [PMID: 37934343 PMCID: PMC10827813 DOI: 10.1007/s11739-023-03450-1] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/03/2023] [Indexed: 11/08/2023]
Abstract
At the beginning of the COVID-19 emergency, non-urgent surgical procedures had to be deferred, but also emergencies were reduced. To assess the global trend of pacemaker (PM) and implantable cardiac-defibrillator (ICD) procedures performed in Italy before, during, and after the first COVID-19 emergency, all the Italian hospital discharge records related to PM/ICD procedures performed between 2012 and 2021, sent to the National Institute of Health, were reviewed. Compared to 2019, in 2020, there was a reduction of first PM implants (52,216 to 43,962, -16%; p < 0.01), but not replacements (16,591 to 17,331, + 4%; p = 0.16). In particular, in April 2020, there was a drop of first implants (- 53,4% vs the average value of April 2018 and April 2019; p < 0.01), while the reduction of replacements was less evident (-32.6%; p = NS). In 2021, PM procedures increased to values similar to the pre-pandemic period. A reduction of ICD procedures was observed in 2020 (22,355, -7% toward 2019), mainly in April 2020 (- 46% vs April 2018/April 2019; p = 0.03). In 2021, the rate of ICD procedures increased (+ 14% toward 2020). A non-significant reduction of "urgent" procedures (complete atrioventricular block for PM and ventricular fibrillation for ICD), even in April 2020, was observed. In 2020, there was a reduction of first PM implants and ICDs, offset by increased activity in 2021. No decrease in PM replacements was observed, and the drop in "urgent" PM and ICD procedures was not statistically significant.
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Affiliation(s)
- Massimo Zecchin
- Cardiothoracovascular Department, Cattinara Hospital, ASUGI and University of Trieste, Trieste, Italy
| | | | | | | | | | | | | | - Teresa Maria Capovilla
- Cardiothoracovascular Department, Cattinara Hospital, ASUGI and University of Trieste, Trieste, Italy
| | | | | | | | | | - Gianfranco Sinagra
- Cardiothoracovascular Department, Cattinara Hospital, ASUGI and University of Trieste, Trieste, Italy
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
| | | | - Marina Torre
- Italian National Institute of Health, Rome, Italy
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3
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Tirelli F, Lorenzon L, Biondi A, Neri I, Santoro G, Persiani R. Functional outcomes after transanal total mesorectal excision (TaTME): a random forest analysis to predict patients' outcomes. Tech Coloproctol 2023; 27:1037-1046. [PMID: 36871281 PMCID: PMC9985820 DOI: 10.1007/s10151-023-02775-5] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 02/13/2023] [Indexed: 03/06/2023]
Abstract
PURPOSE Anorectal, sexual, and urinary dysfunction are common issues after rectal cancer surgery, although seldom explored. The primary aim of this study was to investigate postoperative anorectal functional results. METHODS Patients with mid/low-rectal cancer treated with transanal TME (TaTME) with primary anastomosis with/without diverting stoma between 2015 and 2020 were reviewed and selected if they had a minimum follow-up of 6 months (from the primary procedure or stoma reversal). Patients were interviewed using validated questionnaires and the primary outcome was bowel function based on Low Anterior Resection Syndrome (LARS) scores. Statistical analyses were performed to identify clinical/operative variables correlated with worse outcomes. A random forest (RF) algorithm was computed to classify patients at a greater risk of minor/major LARS. RESULTS Ninety-seven patients were selected out of 154 TaTME performed. Overall, 88.7% of the patients had a protective stoma and 25.8% reported major LARS at mean follow-up of 19.0 months. Statistical analyses documented that age, operative time, and interval to stoma reversal correlated with LARS outcomes. The RF analysis disclosed worse LARS symptoms in patients with longer operative time (> 295 min) and stoma reversal interval (> 5.6 months). If the interval ranged between 3 and 5.6 months, older patients (> 65 years) reported worse outcomes. Finally, no statistical difference was documented when comparing the rate of minor/major LARS in the first 27 cases versus others. CONCLUSION One-quarter of the patients developed major LARS after TaTME. An algorithm based on clinical/operative variables, such as age, operative time, and time to stoma reversal, was developed to identify categories at risk for LARS symptoms.
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Affiliation(s)
- F Tirelli
- General Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University, Largo Francesco Vito 1, 00168, Rome, Italy
| | - L Lorenzon
- General Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University, Largo Francesco Vito 1, 00168, Rome, Italy
| | - A Biondi
- General Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University, Largo Francesco Vito 1, 00168, Rome, Italy.
| | - I Neri
- General Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University, Largo Francesco Vito 1, 00168, Rome, Italy
| | - G Santoro
- General Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University, Largo Francesco Vito 1, 00168, Rome, Italy
| | - R Persiani
- General Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University, Largo Francesco Vito 1, 00168, Rome, Italy
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Pascucci S, Langella F, Franzò M, Tesse MG, Ciminello E, Biondi A, Carrani E, Sampaolo L, Zanoli G, Berjano P, Torre M. National spine surgery registries' characteristics and aims: globally accepted standards have yet to be met. Results of a scoping review and a complementary survey. J Orthop Traumatol 2023; 24:49. [PMID: 37715871 PMCID: PMC10505129 DOI: 10.1186/s10195-023-00732-4] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 08/15/2023] [Indexed: 09/18/2023] Open
Abstract
BACKGROUND Surgery involving implantable devices is widely used to solve several health issues. National registries are essential tools for implantable device surveillance and vigilance. In 2017, the European Union encouraged Member States to establish "registries and databanks for specific types of devices" to evaluate device safety and performance and ensure their traceability. Spine-implantable devices significantly impact patient safety and public health; spine registries might help improve surgical outcomes. This study aimed to map existing national spine surgery registries and highlight their features and organisational standards to provide an essential reference for establishing other national registries. METHODS A scoping search was performed using the Embase, PubMed/Medline, Scopus, and Web of Science databases for the terms "registry", "register", "implantable", and all terms and synonyms related to spinal diseases and national registries in publications from January 2000 to December 2020. This search was later updated and finalised through a web search and an ad hoc survey to collect further detailed information. RESULTS Sixty-two peer-reviewed articles were included, which were related to seven national spine registries, six of which were currently active. Three additional active national registries were found through the web search. The nine selected national registries were set up between 1998 and 2021. They collect data on the procedure and use patient-reported outcome measures (PROMs) for the follow-up. CONCLUSION Our study identified nine currently active national spine surgery registries. However, globally accepted standards for developing a national registry of spine surgery are yet to be established. Therefore, an international effort to increase result comparability across registries is highly advisable. We hope the recent initiative from the Orthopaedic Data Evaluation Panel (ODEP) to establish an international collaboration will meet these needs.
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Affiliation(s)
- Simona Pascucci
- Scientific Secretariat of the President's Office, Italian National Institute of Health, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy
- Department of Mechanical and Aerospace Engineering, La Sapienza University of Rome, Rome, Italy
| | | | - Michela Franzò
- Department of Medico-Surgical Sciences and Biotechnologies, Rome, Italy
| | - Marco Giovanni Tesse
- Orthopaedics Section, Department of Neuroscience and Organs of Sense, Faculty of Medicine and Surgery, University of Bari, AOU Consorziale Policlinico, 70124, Bari, Italy
| | - Enrico Ciminello
- Scientific Secretariat of the President's Office, Italian National Institute of Health, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy
| | - Alessia Biondi
- Scientific Secretariat of the President's Office, Italian National Institute of Health, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy
| | - Eugenio Carrani
- Scientific Secretariat of the President's Office, Italian National Institute of Health, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy
| | - Letizia Sampaolo
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy
| | | | | | - Marina Torre
- Scientific Secretariat of the President's Office, Italian National Institute of Health, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy.
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5
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Lombardi PM, Bernasconi D, Baiocchi GL, Berselli M, Biondi A, Castoro C, Catarci M, Degiuli M, Fumagalli Romario U, Giacopuzzi S, Marchesi F, Marrelli D, Mazzola M, Molfino S, Olmi S, Rausei S, Rosa F, Rosati R, Roviello F, Santi S, Solaini L, Staderini F, Viganò J, Ferrari G. Open versus laparoscopic gastrectomy for advanced gastric cancer: a propensity score matching analysis of survival in a western population-on behalf of the Italian Research Group for Gastric Cancer. Gastric Cancer 2022; 25:1105-1116. [PMID: 35864239 DOI: 10.1007/s10120-022-01321-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/05/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Oncologic outcomes after laparoscopic gastrectomy for advanced gastric cancer in the West have been poorly investigated. The aim of the present study was to compare survival outcomes in patients undergoing curative-intent laparoscopic and open gastrectomy for advanced gastric cancer in several centres belonging to the Italian Research Group for Gastric Cancer. METHODS Data of patients operated between 2015 and 2018 were retrospectively analysed. Propensity Score Matching was performed to balance baseline characteristics of patients undergoing laparoscopic and open gastrectomy. The primary endpoint was 3-year overall survival. Secondary endpoints were 3-year disease-free survival and short-term outcomes. Multivariable regression analyses for survival were conducted. RESULTS Data were retrieved from 20 centres. Of the 717 patients included, 438 patients were correctly matched, 219 per group. The 3-year overall survival was 73.6% and 68.7% in the laparoscopic and open group, respectively (p = 0.40). When compared with open gastrectomy, laparoscopic gastrectomy showed comparable 3-year disease-free survival (62.8%, vs 58.9%, p = 0.40), higher rate of return to intended oncologic treatment (56.9% vs 40.2%, p = 0.001), similar 30-day morbidity/mortality. Prognostic factors for survival were ASA Score ≥ 3, age-adjusted Charlson Comorbidity Index ≥ 5, lymph node ratio ≥ 0.15, p/ypTNM Stage III and return to intended oncologic treatment. CONCLUSIONS Laparoscopic gastrectomy for advanced gastric cancer offers similar rates of survival when compared to open gastrectomy, with higher rates of return to intended oncologic treatment. ASA score, age-adjusted Charlson Comorbidity Index, lymph node ratio, return to intended oncologic treatment and p/ypTNM Stage, but not surgical approach, are prognostic factors for survival.
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Affiliation(s)
- Pietro Maria Lombardi
- Division of Minimally-Invasive Surgical Oncology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, 20162, Milan, Italy. .,IRCCS Humanitas Research Hospital, Unit of Foregut Surgery, Via Manzoni 56, Rozzano, 20089, Milan, Italy.
| | - D Bernasconi
- Bicocca Bioinformatics Biostatistics and Bioimaging Centre-B4, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.,Functional Department for Higher Education, Research, and Development, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - G L Baiocchi
- General Surgery, ASST Cremona, Cremona, Italy.,Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - M Berselli
- Unit of General Surgery, Ospedale di Circolo e Fondazione Macchi, ASST Settelaghi, Varese, Italy
| | - A Biondi
- Dipartimento Di Scienze Mediche E Chirurgiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli n. 8, 00168, Rome, Italy.,Università Cattolica del Sacro Cuore, Largo F. Vito n.1, 00168, Rome, Italy
| | - C Castoro
- IRCCS Humanitas Research Hospital, Unit of Foregut Surgery, Via Manzoni 56, Rozzano, 20089, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Milan, Italy
| | - M Catarci
- General Surgery Unit, Sandro Pertini Hospital, ASL Roma 2, Rome, Italy
| | - M Degiuli
- Department of Oncology, University of Torino, Turin, Italy.,Surgical Oncology and Digestive Surgery Unit, San Luigi University Hospital, Orbassano, TO, Italy
| | - U Fumagalli Romario
- Digestive Surgery, European Institute of Oncology, IRCCS, 20141, Milan, Italy
| | - S Giacopuzzi
- Department of General and Upper G.I. Surgery, University of Verona, Verona, Italy
| | - F Marchesi
- Unit of General Surgery, Parma University Hospital, Parma, Italy
| | - D Marrelli
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Siena, Italy
| | - M Mazzola
- Division of Minimally-Invasive Surgical Oncology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, 20162, Milan, Italy
| | - S Molfino
- Department of Clinical and Experimental Sciences, University of Brescia and Third Division of General Surgery, Brescia Civili Hospital, Brescia, Italy
| | - S Olmi
- Head of General and Oncologic Surgery. Center for Minimal Invasive and Laparoscopic Surgery, Policlinico San Marco, Senior Research Vita-Salute University San Raffaele Milan (UNISR), Zingonia, Italy
| | - S Rausei
- Department of Surgery, ASST Valle Olona, Gallarate, Italy
| | - F Rosa
- Digestive Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - R Rosati
- Department of Gastrointestinal Surgery, San Raffaele Research Hospital, 20132, Milan, Italy.,Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, 20132, Milan, Italy
| | - F Roviello
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Siena, Italy
| | - S Santi
- Division of Esophageal Surgery Regional Referral Center "Mauro Rossi" for Diagnosis and Treatment of Diseases of Esophagus, Azienda Ospedaliero-Universitaria Pisana (AOUP), Via Paradisa 2, 56010, Pisa, Italy
| | - L Solaini
- Department of Medical and Surgical Sciences, University of Bologna, Morgagni-Pierantoni Hospital, Forlì, Italy
| | - F Staderini
- Digestive Surgery Unit, Department of Clinical and Experimental Medicine, Careggi University Hospital of Florence, Florence, Italy
| | - J Viganò
- General Surgery. Department of Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - G Ferrari
- Division of Minimally-Invasive Surgical Oncology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, 20162, Milan, Italy
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6
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Boisseau W, Darsaut TE, Fahed R, Findlay JM, Bourcier R, Charbonnier G, Smajda S, Ognard J, Roy D, Gariel F, Carlson AP, Shotar E, Ciccio G, Marnat G, Sporns PB, Gaberel T, Jecko V, Weill A, Biondi A, Boulouis G, Bras AL, Aldea S, Passeri T, Boissonneau S, Bougaci N, Gentric JC, Diestro JDB, Omar AT, Al-Jehani HM, Hage GE, Volders D, Kaderali Z, Tsogkas I, Magro E, Holay Q, Zehr J, Iancu D, Raymond J. Surgical or Endovascular Treatment of MCA Aneurysms: An Agreement Study. AJNR Am J Neuroradiol 2022; 43:1437-1444. [PMID: 36137654 PMCID: PMC9575541 DOI: 10.3174/ajnr.a7648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/28/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND PURPOSE MCA aneurysms are still commonly clipped surgically despite the recent development of a number of endovascular tools and techniques. We measured clinical uncertainty by studying the reliability of decisions made for patients with middle cerebral artery (MCA) aneurysms. MATERIALS AND METHODS A portfolio of 60 MCA aneurysms was presented to surgical and endovascular specialists who were asked whether they considered surgery or endovascular treatment to be an option, whether they would consider recruitment of the patient in a randomized trial, and whether they would provide their final management recommendation. Agreement was studied using κ statistics. Intrarater reliability was assessed with the same, permuted portfolio of cases of MCA aneurysm sent to the same specialists 1 month later. RESULTS Surgical management was the preferred option for neurosurgeons (n = 844/1320; [64%] responses/22 raters), while endovascular treatment was more commonly chosen by interventional neuroradiologists (1149/1500 [76.6%] responses/25 raters). Interrater agreement was only "slight" for all cases and all judges (κ = 0.094; 95% CI, 0.068-0.130). Agreement was no better within specialties or with more experience. On delayed requestioning, 11 of 35 raters (31%) disagreed with themselves on at least 20% of cases. Surgical management and endovascular treatment were always judged to be a treatment option, for all patients. Trial participation was offered to patients 65% of the time. CONCLUSIONS Individual clinicians did not agree regarding the best management of patients with MCA aneurysms. A randomized trial comparing endovascular with surgical management of patients with MCA aneurysms is in order.
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Affiliation(s)
- W Boisseau
- From the Department of Radiology (W.B., D.R., A.W., D.I., J.R.), Division of Neuroradiology
| | - T E Darsaut
- Department of Surgery (T.E.D., J.M.F.), Division of Neurosurgery, University of Alberta Hospital, Mackenzie Health Sciences Centre, Edmonton, Alberta, Canada
| | - R Fahed
- Department of Medicine (R.F.), Division of Neurology, The Ottawa Hospital, Ottawa Hospital Research Institute and University of Ottawa, Ottawa, Ontario, Canada
| | - J M Findlay
- Department of Surgery (T.E.D., J.M.F.), Division of Neurosurgery, University of Alberta Hospital, Mackenzie Health Sciences Centre, Edmonton, Alberta, Canada
| | - R Bourcier
- Department of Neuroradiology (R.B.), University Hospital of Nantes, Nantes, France
| | - G Charbonnier
- Departments of Interventional Neuroradiology (G. Charbonnier, A.B.)
| | - S Smajda
- Departments of Interventional Neuroradiology (S.S.)
| | - J Ognard
- Department of Interventional Neuroradiology (J.O., J.C.G.), Hôpital de la Cavale Blanche, Brest, Bretagne, France
| | - D Roy
- From the Department of Radiology (W.B., D.R., A.W., D.I., J.R.), Division of Neuroradiology
| | - F Gariel
- Departments of Neuroradiology (F.G., G.M.)
| | - A P Carlson
- Department of Neurosurgery (A.P.C.), University of New Mexico Hospital, Albuquerque, New Mexico
| | - E Shotar
- Department of Neuroradiology (E.S.), Groupe Hospitalier de Pitié Salpêtrière, Paris, France
| | - G Ciccio
- Department of Interventional Neuroradiology (G. Ciccio), Centre Hospitalier de Bastia, Bastia, Corse, France
| | - G Marnat
- Departments of Neuroradiology (F.G., G.M.)
| | - P B Sporns
- Department of Neuroradiology (P.B.S., I.T.), Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
- Department of Diagnostic and Interventional Neuroradiology (P.B.S.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - T Gaberel
- Department of Neurosurgery (T.G.), University Hospital of Caen, Caen, France
| | - V Jecko
- Neurosurgery (V.J.), University Hospital of Bordeaux, Bordeaux, France
| | - A Weill
- From the Department of Radiology (W.B., D.R., A.W., D.I., J.R.), Division of Neuroradiology
| | - A Biondi
- Departments of Interventional Neuroradiology (G. Charbonnier, A.B.)
| | - G Boulouis
- Department of Neuroradiology (G.B.), University Hospital of Tours, Tours, Indre et Loire, France
| | - A L Bras
- Department of Radiology (A.L.B.), Groupement Hospitaliser Bretagne Atlantique-Hôpital Chubert, Vannes, Bretagne, France
| | - S Aldea
- Neurosurgery (S.A.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - T Passeri
- Department of Neurosurgery (T.P.), Lariboisière Hospital, Assistance Publique Hôpitaux de Paris, University of Paris, Paris, France
| | - S Boissonneau
- Department of Neurosurgery (S.B.), La Timone Hospital
- L'Institut National de la Santé et de la Recherche Médicale (S.B.), Institut de Neurosciences des Systèmes, Aix Marseille University, Marseille, France
| | - N Bougaci
- Neurosurgery (N.B.), Besançon University Hospital, Besançon, France
| | - J C Gentric
- Department of Interventional Neuroradiology (J.O., J.C.G.), Hôpital de la Cavale Blanche, Brest, Bretagne, France
| | - J D B Diestro
- Division of Diagnostic and Therapeutic Neuroradiology (J.D.B.D.), Department of Medical Imaging, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - A T Omar
- Division of Neurosurgery (A.T.O.), Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - H M Al-Jehani
- Department of Neurosurgery, Radiology and Critical Care Medicine (H.M.A.-J.), King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University, Alkhobar, Saudi Arabia
| | - G El Hage
- Department of Neurosurgery (G.E.H.), Centre Hospitalier de l'Université de Montréal,Montreal, Québec, Canada
| | - D Volders
- Department of Radiology (D.V.), Dalhousie University, Halifax, Nova Scotia, Canada
| | - Z Kaderali
- Division of Neurosurgery (Z.K.), GB1-Health Sciences Centre, Winnipeg, Manitoba, Canada
| | - I Tsogkas
- Department of Neuroradiology (P.B.S., I.T.), Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - E Magro
- Department of Neurosurgery (E.M.), Centre Hospitalier Universitaire Cavale Blanche, UBO L'Institut National de la Santé et de la Recherche Médicale, LaTIM UMR 1101, Brest, France
| | - Q Holay
- Department of Radiology (Q.H.), Hôpital d'Instruction des Armées Saint-Anne, Toulon, France
| | - J Zehr
- Department of Mathematics and Statistics (J.Z.), Pavillon André-Aisenstadt,Montreal, Québec, Canada
| | - D Iancu
- From the Department of Radiology (W.B., D.R., A.W., D.I., J.R.), Division of Neuroradiology
| | - J Raymond
- From the Department of Radiology (W.B., D.R., A.W., D.I., J.R.), Division of Neuroradiology
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7
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Cattoni A, Molinari S, Gaiero A, De Lorenzo P, Fichera G, Riva B, Di Marco S, Tommesani C, Mariani E, Medici F, Pagni F, Nicolosi ML, Fraschini D, Napolitano S, Rovelli A, Biondi A, Valsecchi MG, Balduzzi A. Thyroid disorders following hematopoietic stem cell transplantation in childhood: the impact of the conditioning regimen on thyroid dysfunction, volume changes and occurrence of nodules. Transplant Cell Ther 2022; 28:506.e1-506.e12. [PMID: 35660063 DOI: 10.1016/j.jtct.2022.05.040] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 05/14/2022] [Accepted: 05/24/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Thyroid late effects are among the most frequent sequelae reported after pediatric hematopoietic stem cell transplantation (HSCT). Though the detrimental effects of radiotherapy on the developing thyroid gland have been extensively assessed, the role of chemotherapy-only conditioning regimens is still controversial. OBJECTIVE We aimed at describing the occurrence, monitoring and management of thyroid function disorders (i.e. Graves' disease, Hashimoto thyroiditis and non-autoimmune hypothyroidism), nodules and volumetric changes over a 20-year observation period in a single pediatric transplant unit. In addition, we assessed the impact of different conditioning regimens on thyroid health. STUDY design Retrospective observational analysis. The study population included 244 patients transplanted for pediatric malignant or non-malignant diseases between 1999 and 2018 and for whom at least four thyroid function tests and one or more thyroid ultrasound(s) assessed sequentially after HSCT were available. RESULTS The 15-year cumulative incidence (CI) of either autoimmune or non-autoimmune thyroid dysfunctions (34%, SE 5.3%) did not statistically differ between total body irradiation- (TBI-) and chemo-based regimens (p 0.23). Indeed, the CI after busulfan (BU) was overall superimposable to that recorded after TBI (10-year CI: 22.2% versus 25.9%, respectively). Nevertheless, the CI of non-autoimmune hypothyroidism was statistically higher after BU- (12.4%, SE 3.7%) than after other chemotherapy only-based-conditionings (3.1%, SE 3.1%; p 0.02, 5-year CI), treosulfan included. The overall CI of nodules was low for the first 5 years after HSCT (1.9%, SE 0.9%), but it showed a subsequent steep increase over time, with a 15-year CI as high as 52.1% (SE 7.5%). TBI-conditioned patients experienced a higher 15-year CI of nodules (66.8%, SE 9.1%) compared to those receiving chemo-only regimens (33.6%, SE 9.5%; p 0.02), whereas age > 10 years upon transplantation showed a protective effect (HR 0.42, 95% confidence interval 0.2-0.88). Finally, a systematic sonographic follow-up highlighted a progressive statistically significant reduction in thyroid antero-posterior diameter among patients conditioned with TBI (p 0.005), but not after chemo-only regimens. CONCLUSIONS TBI and younger age upon HSCT play a remarkable and statistically demonstrated detrimental role on the occurrence of thyroid nodules, both benign and malignant. TBI and BU expose patients to a higher cumulative incidence of thyroid dysfunctions than other chemo-only regimens, treosulfan included. Accordingly, BU can be regarded as the most thyrotoxic agent among those administered as a part of a chemo-only conditioning regimen. Finally, patients conditioned with TBI, but not with other regimens, show a progressive decrease in thyroid volume over time, as assessed by sequential ultrasounds.
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Affiliation(s)
- A Cattoni
- Department of Pediatrics, Università degli Studi di Milano-Bicocca, Fondazione MBBM, Ospedale San Gerardo, Via Pergolesi 33, 20900 - Monza, Italy.
| | - S Molinari
- Department of Pediatrics, Università degli Studi di Milano-Bicocca, Fondazione MBBM, Ospedale San Gerardo, Via Pergolesi 33, 20900 - Monza, Italy
| | - A Gaiero
- Department of Pediatrics, Ospedale San Paolo, Via Genova 30, 17100 - Savona, Italy
| | - P De Lorenzo
- Tettamanti Research Center, Department of Pediatrics, Università degli Studi di Milano-Bicocca, Via Pergolesi 33, 20900 - Monza, Italy; Bicocca Center of Bioinformatics, Biostatistics and Bioimaging (B4), School of Medicine and Surgery, Università degli Studi di Milano-Bicocca, Via Pergolesi 33, 20900 - Monza, Italy
| | - G Fichera
- Department of Pediatrics, Ospedale San Paolo, Via Genova 30, 17100 - Savona, Italy
| | - B Riva
- Department of Pediatrics, Università degli Studi di Milano-Bicocca, Fondazione MBBM, Ospedale San Gerardo, Via Pergolesi 33, 20900 - Monza, Italy
| | - S Di Marco
- Department of Pediatrics, Università degli Studi di Milano-Bicocca, Fondazione MBBM, Ospedale San Gerardo, Via Pergolesi 33, 20900 - Monza, Italy
| | - C Tommesani
- Department of Pediatrics, Università degli Studi di Milano-Bicocca, Fondazione MBBM, Ospedale San Gerardo, Via Pergolesi 33, 20900 - Monza, Italy
| | - E Mariani
- Department of Pediatrics, Università degli Studi di Milano-Bicocca, Fondazione MBBM, Ospedale San Gerardo, Via Pergolesi 33, 20900 - Monza, Italy
| | - F Medici
- Department of Pediatrics, Università degli Studi di Milano-Bicocca, Fondazione MBBM, Ospedale San Gerardo, Via Pergolesi 33, 20900 - Monza, Italy
| | - F Pagni
- Department of Pathology, Università degli Studi di Milano-Bicocca, Ospedale San Gerardo, Via Pergolesi 33, 20900 - Monza, Italy
| | - M L Nicolosi
- Department of Pediatrics, Università degli Studi di Milano-Bicocca, Fondazione MBBM, Ospedale San Gerardo, Via Pergolesi 33, 20900 - Monza, Italy
| | - D Fraschini
- Department of Pediatrics, Università degli Studi di Milano-Bicocca, Fondazione MBBM, Ospedale San Gerardo, Via Pergolesi 33, 20900 - Monza, Italy
| | - S Napolitano
- Department of Pediatrics, Università degli Studi di Milano-Bicocca, Fondazione MBBM, Ospedale San Gerardo, Via Pergolesi 33, 20900 - Monza, Italy
| | - A Rovelli
- Department of Pediatrics, Università degli Studi di Milano-Bicocca, Fondazione MBBM, Ospedale San Gerardo, Via Pergolesi 33, 20900 - Monza, Italy
| | - A Biondi
- Department of Pediatrics, Università degli Studi di Milano-Bicocca, Fondazione MBBM, Ospedale San Gerardo, Via Pergolesi 33, 20900 - Monza, Italy
| | - M G Valsecchi
- Bicocca Center of Bioinformatics, Biostatistics and Bioimaging (B4), School of Medicine and Surgery, Università degli Studi di Milano-Bicocca, Via Pergolesi 33, 20900 - Monza, Italy
| | - A Balduzzi
- Department of Pediatrics, Università degli Studi di Milano-Bicocca, Fondazione MBBM, Ospedale San Gerardo, Via Pergolesi 33, 20900 - Monza, Italy
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8
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Saettini F, Radaelli S, Ocello L, Ferrari GM, Corti P, Dell'Acqua F, Ippolito D, Foresti S, Gervasini C, Badolato R, Biondi A. Secondary hemophagocytic lymphohystiocytosis in a Rubinstein Taybi syndrome patient. Pediatr Hematol Oncol 2022; 39:74-79. [PMID: 34018455 DOI: 10.1080/08880018.2021.1928802] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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] [Indexed: 02/08/2023]
Abstract
Rubinstein-Taybi syndrome (RSTS) is an autosomal dominant disorder, caused by variants in CREBBP or EP300. Affected individuals present with distinctive craniofacial features, broad thumbs and/or halluces, intellectual disability and immunodeficiency. Here we report on one RSTS patient who experienced hemophagocytic lymphohystiocytosis (HLH) and disseminated herpes virus 1 ( HSV-1) disease. The clinical picture of RSTS is expanding to include autoinflammatory, autoimmune, and infectious complications. Prompt treatment of HLH and disseminated HSV-1 can lower the mortality rate of these life-threatening conditions.
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Affiliation(s)
- F Saettini
- Pediatric Hematology Department, Fondazione MBBM, Universita degli Studi di Milano-Bicocca Dipartimento di Medicina e Chirurgia, Monza, Italy
| | - S Radaelli
- Pediatric Hematology Department, Fondazione MBBM, Universita degli Studi di Milano-Bicocca Dipartimento di Medicina e Chirurgia, Monza, Italy
| | - L Ocello
- Pediatric Hematology Department, Fondazione MBBM, Universita degli Studi di Milano-Bicocca Dipartimento di Medicina e Chirurgia, Monza, Italy
| | - G M Ferrari
- Pediatric Hematology Department, Fondazione MBBM, Universita degli Studi di Milano-Bicocca Dipartimento di Medicina e Chirurgia, Monza, Italy
| | - P Corti
- Pediatric Hematology Department, Fondazione MBBM, Universita degli Studi di Milano-Bicocca Dipartimento di Medicina e Chirurgia, Monza, Italy
| | - F Dell'Acqua
- Pediatric Hematology Department, Fondazione MBBM, Universita degli Studi di Milano-Bicocca Dipartimento di Medicina e Chirurgia, Monza, Italy
| | - D Ippolito
- Department of Diagnostic Radiology, Ospedale San Gerardo, Monza, Italy
| | - S Foresti
- Infectious Diseases Unit, Ospedale San Gerardo, Monza, Italy
| | - C Gervasini
- Department of Medical Genetics, Universita degli Studi di Milano, Milano, Italy
| | - R Badolato
- Department of Clinical and Experimental Sciences, Brescia University, Brescia, Italy
| | - A Biondi
- Pediatric Hematology Department, Fondazione MBBM, Universita degli Studi di Milano-Bicocca Dipartimento di Medicina e Chirurgia, Monza, Italy
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9
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Stutterheim J, de Lorenzo P, van der Sluin IM, Alten J, Ancliffe P, Attarbaschi A, Aversa L, Boer JM, Biondi A, Brethon B, Diaz P, Cazzaniga G, Escherich G, Ferster A, Kotecha RS, Lausen B, Leung AW, Locatelli F, Silverman L, Stary J, Szczepanski T, van der Velden VHJ, Vora A, Zuna J, Schrappe M, Valsecchi MG, Pieters R. Minimal residual disease and outcome characteristics in infant KMT2A-germline acute lymphoblastic leukaemia treated on the Interfant-06 protocol. Eur J Cancer 2021; 160:72-79. [PMID: 34785111 DOI: 10.1016/j.ejca.2021.10.004] [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: 08/16/2021] [Revised: 10/05/2021] [Accepted: 10/08/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND The outcome of infants with KMT2A-germline acute lymphoblastic leukaemia (ALL) is superior to that of infants with KMT2A-rearranged ALL but has been inferior to non-infant ALL patients. Here, we describe the outcome and prognostic factors for 167 infants with KMT2A-germline ALL enrolled in the Interfant-06 study. METHODS Univariate analysis on prognostic factors (age, white blood cell count at diagnosis, prednisolone response and CD10 expression) was performed on KMT2A-germline infants in complete remission at the end of induction (EOI; n = 163). Bone marrow minimal residual disease (MRD) was measured in 73 patients by real-time quantitative polymerase chain reaction at various time points (EOI, n = 68; end of consolidation, n = 56; and before OCTADAD, n = 57). MRD results were classified as negative, intermediate (<5∗10-4), and high (≥5∗10-4). RESULTS The 6-year event-free and overall survival was 73.9% (standard error [SE] = 3.6) and 87.2% (SE = 2.7). Relapses occurred early, within 36 months from diagnosis in 28 of 31 (90%) infants. Treatment-related mortality was 3.6%. Age <6 months was a favourable prognostic factor with a 6-year disease-free survival (DFS) of 91% (SE = 9.0) compared with 71.7% (SE = 4.2) in infants >6 months of age (P = 0.04). Patients with high EOI MRD ≥5 × 10-4 had a worse outcome (6-year DFS 61.4% [SE = 12.4], n = 16), compared with patients with undetectable EOI MRD (6-year DFS 87.9% [SE = 6.6], n = 28) or intermediate EOI MRD <5 × 10-4 (6-year DFS 76.4% [SE = 11.3], n = 24; P = 0.02). CONCLUSION We conclude that young age at diagnosis and low EOI MRD seem favourable prognostic factors in infants with KMT2A-germline ALL and should be considered for risk stratification in future clinical trials.
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Affiliation(s)
- J Stutterheim
- Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
| | - P de Lorenzo
- Center of Bioinformatics, Biostatistics and Bioimaging, University of Milano-Bicocca, Monza, Italy; Pediatrics, School of Medicine and Surgery, University of Milano- Bicocca, Fondazione MBBM/San Gerardo Hospital, Monza, Italy
| | - I M van der Sluin
- Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - J Alten
- Pediatrics, University Medical Center Schleswig-Holstein, Christian-Albrechts-University of Kiel, Germany
| | - P Ancliffe
- United Kingdom Children Cancer Study Group, London, United Kingdom
| | - A Attarbaschi
- St Anna Children's Hospital, Pediatric Hematology and Oncology, Austria
| | | | - J M Boer
- Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Oncode Institute, Utrecht, the Netherlands
| | - A Biondi
- Pediatrics, School of Medicine and Surgery, University of Milano- Bicocca, Fondazione MBBM/San Gerardo Hospital, Monza, Italy
| | - B Brethon
- Department of Pediatric Hematology, University Robert Debre Hospital, APHP, Paris, France
| | - P Diaz
- Chilean National Pediatric Oncology Group, Santiago, Chile
| | - G Cazzaniga
- Tettamanti Research Center, Pediatrics, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - G Escherich
- German Cooperative Study Group for Childhood Acute Lymphoblastic Leukemia, Hamburg, Germany
| | - A Ferster
- European Organisation for Research and Treatment of Cancer Children Leukemia Group, Brussels, Belgium
| | - R S Kotecha
- Australian and New Zealand Children's Haematology/Oncology Group, Perth Children's Hospital, Perth, Australia; Telethon Kids Cancer Centre, Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - B Lausen
- Rigshospitalet, University Hospital, Department of Pediatrics, Copenhagen, Denmark
| | - Alex Wk Leung
- The Chinese University of Hong Kong, Shatin, Hong Kong, Special Administrative Region, People's Republic of China
| | - F Locatelli
- Department of Pediatric Haematology and Oncology, IRCCS Ospedale Pediatrico Bambino Gesù, Sapienza University of Rome, Rome, Italy
| | - L Silverman
- Dana-Farber Cancer Institute, Pediatric Oncology, Boston, MA, USA
| | - J Stary
- Czech Working Group for Pediatric Hematology, Prague, Czech Republic
| | - T Szczepanski
- Polish Pediatric Leukemia/Lymphoma Study Group, Department of Pediatric Hematology and Oncology, Medical University of Silesia, Zabrze, Katowice, Poland
| | | | - A Vora
- United Kingdom Children Cancer Study Group, London, United Kingdom
| | - J Zuna
- CLIP, Department of Paediatric Haematology and Oncology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - M Schrappe
- Berlin-Frankfurt-Miu (¨)nster Group Germany, Kiel, Germany
| | - M G Valsecchi
- Center of Bioinformatics, Biostatistics and Bioimaging, University of Milano-Bicocca, Monza, Italy
| | - R Pieters
- Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Dutch Childhood Oncology Group, Utrecht, the Netherlands
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10
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Apolone G, Ardizzoni A, Biondi A, Bortolami A, Cardone C, Ciniselli CM, Conte P, Crippa C, de Braud F, Duca M, Gori S, Gritti G, Inno A, Luksch R, Lussana F, Maio M, Pasello G, Perrone F, Rambaldi A, Rossi G, Signorelli D, Soverini G, Valente M, Verderio P, Buzzetti G. Skip pattern approach toward the early access of innovative anticancer drugs. ESMO Open 2021; 6:100227. [PMID: 34352703 PMCID: PMC8350180 DOI: 10.1016/j.esmoop.2021.100227] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/29/2021] [Accepted: 07/06/2021] [Indexed: 10/29/2022] Open
Abstract
BACKGROUND With the rapid development of innovative anticancer treatments, the optimization of tools able to accelerate the access of new drugs to the market by the regulatory authority is a major issue. The aim of the project was to propose a reliable methodological pathway for the assessment of clinical value of new therapeutic innovative options, to objectively identify drugs which deserve early access (EA) priority for solid and possibly in other cancer scenarios, such as the hematological ones. MATERIALS AND METHODS After a comprehensive review of the European Public Assessment Report of 21 drugs, to which innovation had previously been attributed by the Italian Medicines Agency (Agenzia Italiana del Farmaco, AIFA), an expert panel formulated an algorithm for the balanced use of three parameters: Unmet Medical Need (UMN) according to AIFA criteria, Added Benefit (AB) according to the European Society for Medical Oncology's Magnitude of Clinical Benefit Scale (ESMO-MCBS) criteria and Quality of Evidence (QE) assessed by the Grades of Recommendation Assessment, Development and Evaluation (GRADE) method. By sequentially combining the above indicators, a final priority status (i.e. EA or not) was obtained using the skip pattern approach (SPA). RESULTS By applying the SPA to the non-curative setting in solid cancers, the EA status was obtained by 5 out of 14 investigated drugs (36%); by enhancing the role of some categories of the UMN, additional 4 drugs, for a total of 9 (64%), reached the EA status: 2 and 3 drugs were excluded for not achieving an adequate score according to AB and QE criteria, respectively. For hematology cancer, only the UMN criteria were found to be adequate. CONCLUSIONS The use of this model may represent a reliable tool for assessment available to the various stakeholders involved in the EA process and may help regulatory agencies in a more comprehensive and objective definition of new treatments' value in these contexts. Its generalizability in other national contexts needs further evaluation.
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Affiliation(s)
- G Apolone
- Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - A Ardizzoni
- Department of Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - A Biondi
- Department of Pediatrics, University of Milano Bicocca-Fondazione MBBM/Ospedale San Gerardo, Monza, Italy
| | - A Bortolami
- Rete Oncologica Veneta, Istituto Oncologico Veneto, Padova, Italy
| | - C Cardone
- Experimental Clinical Abdominal Oncology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Napoli, Italy
| | - C M Ciniselli
- Unit of Bioinformatics and Biostatistics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - P Conte
- Istituto Oncologico Veneto, Padova, Italy
| | - C Crippa
- Department of Hemathology, Spedali Civili di Brescia, Brescia, Italy
| | - F de Braud
- Department of Medical Oncology & Haematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - M Duca
- Department of Medical Oncology & Haematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - S Gori
- Department of Oncology, IRCCS Sacro Cuore Don Calabria Hospital of Negrar, Verona, Italy
| | - G Gritti
- Hematology and Bone Marrow Transplantation Unit, Azienda Socio-Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | - A Inno
- Department of Oncology, IRCCS Sacro Cuore Don Calabria Hospital of Negrar, Verona, Italy
| | - R Luksch
- Department of Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - F Lussana
- Hematology and Bone Marrow Transplantation Unit, Azienda Socio-Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | - M Maio
- Center for Immuno-Oncology, Medical Oncology and Immunotherapy, University Hospital of Siena, Siena, Italy
| | - G Pasello
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | - F Perrone
- Clinical Trials Unit, National Cancer Institute of Naples, Napoli, Italy
| | - A Rambaldi
- Department of Oncology-Hematology, University of Milan, Milano, Italy; Department of Oncology and Hematology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - G Rossi
- Deparment of Hematology ASST Spedali Civili di Brescia, Brescia, Italy
| | - D Signorelli
- Department of Medical Oncology & Haematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy; Niguarda Cancer Center-Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - G Soverini
- Deparment of Hematology ASST Spedali Civili di Brescia, Brescia, Italy
| | - M Valente
- Center for Immuno-Oncology, Medical Oncology and Immunotherapy, University Hospital of Siena, Siena, Italy
| | - P Verderio
- Unit of Bioinformatics and Biostatistics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
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11
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Donato AD, Biondi A, Cintoni M, D'Ugo D, Mele M, Persiani R, Persichetti E, Pulcini G, Rinninella E, Scialanga F. THE IMPACT OF THE NUTRICATT PROTOCOL ON BODY COMPOSITION OF SURGICAL PATIENTS OVER 75 YEARS OLD WITH COLORECTAL CANCER. Nutrition 2021. [DOI: 10.1016/j.nut.2021.111323] [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: 10/21/2022]
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12
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Saettini F, Coliva T, Vendemini F, Moratto D, Savoldi G, Borlenghi E, Masetti R, Niemeyer CM, Biondi A, Balduzzi A, Bonanomi S. When to suspect GATA2 deficiency in pediatric patients: from complete blood count to diagnosis. Pediatr Hematol Oncol 2021; 38:510-514. [PMID: 33726626 DOI: 10.1080/08880018.2020.1863536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- F Saettini
- Pediatric Hematology-Oncology Unit, Department of Pediatrics, University of Milano-Bicocca, MBBM Foundation, Monza, Italy
| | - T Coliva
- Pediatric Hematology-Oncology Unit, Department of Pediatrics, University of Milano-Bicocca, MBBM Foundation, Monza, Italy
| | - F Vendemini
- Pediatric Hematology-Oncology Unit, Department of Pediatrics, University of Milano-Bicocca, MBBM Foundation, Monza, Italy
| | - D Moratto
- Flow cytometry Laboratory, Diagnostic Department, ASST Spedali Civili di Brescia, Brescia, Italy
| | - G Savoldi
- Genetics Laboratory, Diagnostic Department, ASST Spedali Civili di Brescia, Brescia, Italy
| | - E Borlenghi
- Department of Hematology, Spedali Civili, Brescia, Italy
| | - R Masetti
- Pediatric Hematology-Oncology Unit, Department of Pediatrics, University of Bologna, Bologna, Italy
| | - C M Niemeyer
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology and Oncology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - A Biondi
- Pediatric Hematology-Oncology Unit, Department of Pediatrics, University of Milano-Bicocca, MBBM Foundation, Monza, Italy
| | - A Balduzzi
- Pediatric Hematology-Oncology Unit, Department of Pediatrics, University of Milano-Bicocca, MBBM Foundation, Monza, Italy
| | - S Bonanomi
- Pediatric Hematology-Oncology Unit, Department of Pediatrics, University of Milano-Bicocca, MBBM Foundation, Monza, Italy
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13
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Agnes A, Biondi A, Belia F, Di Giambenedetto S, Addolorato G, Antonelli M, D'Ugo D, Persiani R. Association between colorectal cancer and Streptococcus gallolyticus subsp. pasteuranus (former S. bovis) endocarditis: clinical relevance and cues for microbiota science. Case report and review of the literature. Eur Rev Med Pharmacol Sci 2021; 25:480-486. [PMID: 33506939 DOI: 10.26355/eurrev_202101_24417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The purpose of this paper is to contextualize the case of a patient with a synchronous diagnosis of colorectal cancer (CRC) and endocarditis from S. gallolyticus subsp. pasteuranus (former S. Bovis) within the current evidence, in order to determine if this condition is indicative of an underlying CRC and if it has any pathophysiologic significance. PATIENTS AND METHODS First, we describe the clinical case. Then, we review the literature focused on the association between infections from the former S. Bovis group and CRC and on the possible role of certain microbiota species on the occurrence of CRC. At last, we discuss the implications of this case considering the current evidence. RESULTS There is a strong association between all the species of the former S. Bovis group and CRC. There is initial evidence that these bacteria may contribute to CRC by a genomic passenger mechanism. CONCLUSIONS There are two main conclusions for this paper. The first one is that CRC neoplasms and endocarditis from all species of the former S. bovis group have a strong association. Any case of infection by these subspecies should prompt to a diagnostic completion by colonoscopy. The second one is that there is an increased need for detailed reports/series and original articles based on the evaluation of gut microbiota in patients with CRC, with the aim to clarify if the association between bacteria and CRC is causative or sporadic and to better understand the possible causative mechanism of specific bacteria in initiating and promoting CRC.
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Affiliation(s)
- A Agnes
- Department of Medical and Surgical Studies, Fondazione Policlinico Universitario A. Gemelli IRCSS, Università Cattolica del Sacro Cuore, Rome, Italy.
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14
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Findler M, Turjman AS, Raymond J, White PM, Sadeh-Gonik U, Taschner CA, Mazighi M, Biondi A, Gory B, Turjman F. Interobserver Agreement in Scoring Angiographic Results of Basilar Artery Occlusion Stroke Therapy. AJNR Am J Neuroradiol 2021; 42:1458-1463. [PMID: 34117020 DOI: 10.3174/ajnr.a7182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 03/09/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The modified TICI Infarction grading system is a metric currently used to evaluate angiographic results of thrombectomy for large-vessel occlusion in ischemic stroke. Originally designed for evaluating MCA territories, it is currently used for other vessel occlusions, including the posterior circulation. We postulate that the modified TICI use for the posterior circulation is not accurate due to the different vascular territories supplied by vertebrobasilar vasculature, making grading more complex. MATERIALS AND METHODS We collected angiographic results from 30 patients who presented with acute posterior circulation occlusions between 2015 and 2018 and underwent thrombectomy in our institution. Eight observers were asked to evaluate the TICI scores before and after thrombectomy. The multirater statistics were computed using Fleiss κ analysis. Further data were collected regarding the potential brain territories at risk and the existence of atherosclerotic disease in the basilar artery. RESULTS The overall agreement κ reached 0.277 (SD, 0.013), which suggests a "fair" agreement among the raters. On average, 45% of observers achieved a high accuracy in predicting brain areas at risk of ischemia. As for the existence of basilar atherosclerotic disease, a high agreement (defined as at least 5 of 6 observers) was seen in 20 of the 30 patients. CONCLUSIONS Despite TICI being ubiquitous in stroke diagnostics, the high variability of posterior circulation TICI scores calls into question its use in these strokes. Other methods should be developed to assess recanalization in the posterior circulation.
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Affiliation(s)
- M Findler
- Department of Neurology and Interventional Neuroradiology (M.F.), Rabin Medical Center, Petah Tikva, Israel
| | - A S Turjman
- Cognition Medical Corporation (Alexis S. Turjman), Boston, Massachusetts
| | - J Raymond
- Département de Radiologie, Radio-Oncologie et Médecine Nucléaire (J.R.), Université de Montréal, Montreal, Quebec, Canada
| | - P M White
- Department of Neuroradiology (P.M.W.), Royal Victoria Infirmary, Newcastle, UK
| | - U Sadeh-Gonik
- Department of Radiology and Interventional Neuroradiology (U.S.-G.), Tel Aviv Medical Center, Tel-Aviv, Israel
| | - C A Taschner
- Department of Neuroradiology (C.A.T.), University Medical Centre Freiburg, Freiburg, Germany
| | - M Mazighi
- Department of Interventional Neuroradiology (M.M.), Fondation Rothschild Hospital, Paris, France
| | - A Biondi
- Department of Neuroradiology and Endovascular Therapy (A.B.), Besancon University Hospital, Besancon, France
| | - B Gory
- Department of Diagnostic and Therapeutic Neuroradiology (B.G.), Centre Hospitalier Régional Universitaire Nancy, Nancy, France
| | - F Turjman
- Department of Interventional Neuroradiology (Francis Turjman), Hospices Civils de Lyon, Lyon,France
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Biondi A. LYMPHOMA TREATMENT IN DEVELOPING COUNTRIES. Hematol Oncol 2021. [DOI: 10.1002/hon.88_2879] [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] [Indexed: 11/12/2022]
Affiliation(s)
- A. Biondi
- Found. MBBM / San Gerardo Hospital, Pediatric Clinic Univers. Milano‐Bicocca Monza Italy
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16
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Vettoretto N, Foglia E, Ferrario L, Gerardi C, Molteni B, Nocco U, Lettieri E, Molfino S, Baiocchi GL, Elmore U, Rosati R, Currò G, Cassinotti E, Boni L, Cirocchi R, Marano A, Petz WL, Arezzo A, Bonino MA, Davini F, Biondi A, Anania G, Agresta F, Silecchia G. Could fluorescence-guided surgery be an efficient and sustainable option? A SICE (Italian Society of Endoscopic Surgery) health technology assessment summary. Surg Endosc 2021; 34:3270-3284. [PMID: 32274626 DOI: 10.1007/s00464-020-07542-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Indocyanine green fluorescence vision is an upcoming technology in surgery. It can be used in three ways: angiographic and biliary tree visualization and lymphatic spreading studies. The present paper shows the most outstanding results from an health technology assessment study design, conducted on fluorescence-guided compared with standard vision surgery. METHODS A health technology assessment approach was implemented to investigate the economic, social, ethical, and organizational implications related to the adoption of the innovative fluorescence-guided view, with a focus on minimally invasive approach. With the support of a multidisciplinary team, qualitative and quantitative data were collected, by means of literature evidence, validated questionnaires and self-reported interviews, considering the dimensions resulting from the EUnetHTA Core Model. RESULTS From a systematic search of literature, we retrieved the following studies: 6 on hepatic, 1 on pancreatic, 4 on biliary, 2 on bariatric, 4 on endocrine, 2 on thoracic, 11 on colorectal, 7 on urology, 11 on gynecology, 2 on gastric surgery. Fluorescence guide has shown advantages on the length of hospitalization particularly in colorectal surgery, with a reduction of the rate of leakages and re-do anastomoses, in spite of a slight increase in operating time, and is confirmed to be a safe, efficacious, and sustainable vision technology. Clinical applications are still presenting a low evidence in the literature. CONCLUSION The present paper, under the patronage of Italian Society of Endoscopic Surgery, based on an HTA approach, sustains the use of fluorescence-guided vision in minimally invasive surgery, in the fields of general, gynecologic, urologic, and thoracic surgery, as an efficient and economically sustainable technology.
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Affiliation(s)
- N Vettoretto
- Chirurgia Montichiari, Azienda Socio Sanitaria Territoriale Degli Spedali Civili, V.le Ciotti 154, Montichiari, 25018, Brescia, Italy.
| | - E Foglia
- LIUC - Università Cattaneo, Castellanza, VA, Italy
| | - L Ferrario
- LIUC - Università Cattaneo, Castellanza, VA, Italy
| | - C Gerardi
- Centro di Politiche Regolatorie, Istituto di Ricerche Farmacologiche "Mario Negri" IRCCS, Milan, Italy
| | - B Molteni
- Department of Clinical and Experimental Surgery, University of Brescia, Brescia, Italy
| | - U Nocco
- Ingegneria Clinica, Azienda Socio Sanitaria Territoriale dei Sette Laghi, Varese, Italy
| | - E Lettieri
- School of Management, Department of Management, Economics and Industrial Engineering, Politecnico, Milano, Italy
| | - S Molfino
- Department of Clinical and Experimental Surgery, University of Brescia, Brescia, Italy
| | - G L Baiocchi
- Department of Clinical and Experimental Surgery, University of Brescia, Brescia, Italy
| | - U Elmore
- Department of Gastrointestinal Surgery, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - R Rosati
- Department of Gastrointestinal Surgery, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - G Currò
- Department of Human Pathology of Adult and Evolutive Age, University Hospital of Messina, Messina, Italy
| | - E Cassinotti
- Chirurgia Generale, Fondazione IRCCS - Ca' Granda - Ospedale Maggiore Policlinico - University of Milan, Milan, Italy
| | - L Boni
- Chirurgia Generale, Fondazione IRCCS - Ca' Granda - Ospedale Maggiore Policlinico - University of Milan, Milan, Italy
| | - R Cirocchi
- Department of Surgical Sciences, University of Perugia, Perugia, Italy
| | - A Marano
- Chirurgia Generale ed Oncologica, Azienda Ospedaliera S. Croce e Carle, Cuneo, Italy
| | - W L Petz
- Chirurgia, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - A Arezzo
- Department of Surgical Sciences, University of Torino, Turin, Italy
| | - M A Bonino
- Department of Surgical Sciences, University of Torino, Turin, Italy
| | - F Davini
- Centro multidisciplinare Chirurgia Robotica, Chirurgia Toracica mini-invasiva e Robotica, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - A Biondi
- Chirurgia Generale, Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy
| | - G Anania
- Chirurgia Generale, University of Ferrara, Ferrara, Italy
| | - F Agresta
- Chirurgia Generale, Azienda ULSS 5 "Polesana", Hospital of Adria, Adria, RO, Italy
| | - G Silecchia
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome-Polo Pontino, Rome, Italy
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Saettini F, Castelli I, Provenzi M, Fazio G, Quadri M, Cazzaniga G, Sala S, Dell'Acqua F, Sieni E, Coniglio ML, Pezzoli L, Iascone M, Vendemini F, Balduzzi AC, Biondi A, Rizzari C, Bonanomi S. A novel homozygous disruptive PRF1 variant (K285Sfs*4) causes very early-onset of familial hemophagocytic lymphohystiocytosis type 2. Pediatr Hematol Oncol 2021; 38:174-178. [PMID: 32696691 DOI: 10.1080/08880018.2020.1793849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- F Saettini
- Pediatric Hematology-Oncology Unit, Department of Pediatrics, University of Milano-Bicocca, MBBM Foundation, Monza, Italy
| | - I Castelli
- Pediatric Hematology-Oncology Unit, Department of Pediatrics, University of Milano-Bicocca, MBBM Foundation, Monza, Italy
| | - M Provenzi
- Pediatric Unit, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - G Fazio
- Centro Ricerca Tettamanti, University of Milan Bicocca, Monza, Italy
| | - M Quadri
- Centro Ricerca Tettamanti, University of Milan Bicocca, Monza, Italy
| | - G Cazzaniga
- Centro Ricerca Tettamanti, University of Milan Bicocca, Monza, Italy.,Department of Medicine and Surgery, University of Milan Bicocca, Monza, Italy
| | - S Sala
- Centro Ricerca Tettamanti, University of Milan Bicocca, Monza, Italy
| | - F Dell'Acqua
- Pediatric Hematology-Oncology Unit, Department of Pediatrics, University of Milano-Bicocca, MBBM Foundation, Monza, Italy
| | - E Sieni
- Department of Paediatric Oncohematology, Meyer Children's University Hospital, Florence, Italy
| | - M L Coniglio
- Department of Paediatric Oncohematology, Meyer Children's University Hospital, Florence, Italy
| | - L Pezzoli
- Molecular Genetics Laboratory, USSD LGM, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - M Iascone
- Molecular Genetics Laboratory, USSD LGM, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - F Vendemini
- Pediatric Hematology-Oncology Unit, Department of Pediatrics, University of Milano-Bicocca, MBBM Foundation, Monza, Italy
| | - A C Balduzzi
- Pediatric Hematology-Oncology Unit, Department of Pediatrics, University of Milano-Bicocca, MBBM Foundation, Monza, Italy
| | - A Biondi
- Pediatric Hematology-Oncology Unit, Department of Pediatrics, University of Milano-Bicocca, MBBM Foundation, Monza, Italy.,Centro Ricerca Tettamanti, University of Milan Bicocca, Monza, Italy
| | - C Rizzari
- Pediatric Hematology-Oncology Unit, Department of Pediatrics, University of Milano-Bicocca, MBBM Foundation, Monza, Italy
| | - S Bonanomi
- Pediatric Hematology-Oncology Unit, Department of Pediatrics, University of Milano-Bicocca, MBBM Foundation, Monza, Italy
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18
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Di Caterino F, Primikiris P, Vitale G, Charbonnier G, Biondi A. Safeguard pressure assisted device for local femoral hemostasis in neuroendovascular procedures: A single center study of 879 patients. J Neuroradiol 2020; 48:385-390. [PMID: 33212123 DOI: 10.1016/j.neurad.2020.10.003] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/06/2020] [Accepted: 10/31/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Various vascular closure devices (VCDs) are available for local hemostasis after percutaneous transfemoral approach for neuroendovascular procedures but they have been associated with an increased complication rate and limitations to a re-puncture of the artery. We evaluated the safety and efficacy of Safeguard® 24 cm pressure assisted device (Merit Medical, West Jordan, UT, USA) and the associated complications. METHODS From September 2016 to December 2019, 879 patients underwent neuroendovascular procedures via transfemoral approach using an introducer sheath ranging from 4 to 6-French and they were included in a prospective database. We registered the demographic characteristics and procedural factors. We evaluated the device failure and associated complications. RESULTS The Safeguard® was successful in 862 cases (98.1 %) with post-procedural local bleeding in 17 patients (1.9%). On univariate analysis, an association with local bleeding was observed with age >60 years (Odds ratio [OR] = 3.2, P = 0.04) and the use of an introducer sheath >4 F ([OR] = 3.1, P = 0.007). Female gender, antithrombotic medication and type of procedure (diagnostic or interventional) were not associated with local bleeding. On binary logistic regression analysis, there was association only for age >60 years ([OR] = 3, P = 0.04). CONCLUSION The Safeguard® 24 cm is safe and efficient. It is simple to use and it can be applied independently from vessel anatomic characteristics. It should though be used with caution in case of a femoral introducer sheath larger than 4 Fr and patients older than 60 years.
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Affiliation(s)
- F Di Caterino
- Department of Interventional Neuroradiology, Jean-Minjoz University Hospital, Besançon, France.
| | - P Primikiris
- Department of Interventional Neuroradiology, Jean-Minjoz University Hospital, Besançon, France
| | - G Vitale
- Department of Interventional Neuroradiology, Jean-Minjoz University Hospital, Besançon, France
| | - G Charbonnier
- Department of Interventional Neuroradiology, Jean-Minjoz University Hospital, Besançon, France
| | - A Biondi
- Department of Interventional Neuroradiology, Jean-Minjoz University Hospital, Besançon, France
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19
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Afzal Z, Stupalkowska W, Davies RJ, Wheeler J, Biondi A, Di Saverio S. Laparoscopic right hemicolectomy with complete mesocolic excision for a T4 caecal tumour adherent to the right iliac fossa and invading the lateral abdominal wall with associated phlegmon - a video vignette. Colorectal Dis 2020; 22:1783-1784. [PMID: 32534463 DOI: 10.1111/codi.15192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 05/25/2020] [Accepted: 05/27/2020] [Indexed: 02/08/2023]
Affiliation(s)
- Z Afzal
- Cambridge Colorectal Unit, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - W Stupalkowska
- Cambridge Colorectal Unit, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - R J Davies
- Cambridge Colorectal Unit, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - J Wheeler
- Cambridge Colorectal Unit, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - A Biondi
- University of Catania, Catania, Italy
| | - S Di Saverio
- Cambridge Colorectal Unit, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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20
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Saettini F, Fazio G, Corti P, Quadri M, Bugarin C, Gaipa G, Penco F, Moratto D, Chiarini M, Baronio M, Gazzurelli L, Imberti L, Paghera S, Giliani S, Cazzaniga G, Plebani A, Badolato R, Lougaris V, Gattorno M, Biondi A. Two siblings presenting with novel ADA2 variants, lymphoproliferation, persistence of large granular lymphocytes, and T-cell perturbations. Clin Immunol 2020; 218:108525. [PMID: 32659374 DOI: 10.1016/j.clim.2020.108525] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/26/2020] [Accepted: 07/07/2020] [Indexed: 12/25/2022]
Abstract
The presence of large granular lymphocytes has been reported in patients with ADA2 deficiency and T-LGL leukemia. Here we describe two siblings with novel ADA2 variants, expanding the mutational spectrum of ADA2 deficiency. We show that lymphoproliferation, persistence of large granular lymphocytes, T-cell perturbations, and activation of PI3K pathway, measured by means of phosphorylation levels of S6, are detectable in DADA2 patients without T-LGL leukemia.
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Affiliation(s)
- F Saettini
- Pediatric Hematology-Oncology Unit, Department of Pediatrics, University of Milano-Bicocca, MBBM Foundation, Monza, Italy.
| | - G Fazio
- Centro Ricerca Tettamanti, University of Milan Bicocca, Monza, Italy
| | - P Corti
- Pediatric Hematology-Oncology Unit, Department of Pediatrics, University of Milano-Bicocca, MBBM Foundation, Monza, Italy
| | - M Quadri
- Centro Ricerca Tettamanti, University of Milan Bicocca, Monza, Italy
| | - C Bugarin
- Centro Ricerca Tettamanti, University of Milan Bicocca, Monza, Italy
| | - G Gaipa
- Centro Ricerca Tettamanti, University of Milan Bicocca, Monza, Italy
| | - F Penco
- Center for Autoinflammatory disease and Immunodeficiencies, IRCCS G. Gaslini, Genova, Italy
| | - D Moratto
- Flow cytometry Laboratory, Diagnostic Department, ASST Spedali Civili di Brescia, Brescia, Italy
| | - M Chiarini
- Flow cytometry Laboratory, Diagnostic Department, ASST Spedali Civili di Brescia, Brescia, Italy
| | - M Baronio
- Pediatrics Clinic and Institute of Molecular Medicine A. Novicelli, Department of Clinical and Experimental Sciences, University of Brescia, ASST-Spedali Civili of Brescia, Brescia, Italy
| | - L Gazzurelli
- Pediatrics Clinic and Institute of Molecular Medicine A. Novicelli, Department of Clinical and Experimental Sciences, University of Brescia, ASST-Spedali Civili of Brescia, Brescia, Italy
| | - L Imberti
- Centro di Ricerca Emato-oncologica AIL (CREA), ASST Spedali Civili, Brescia, Italy
| | - S Paghera
- Centro di Ricerca Emato-oncologica AIL (CREA), ASST Spedali Civili, Brescia, Italy
| | - S Giliani
- Pediatrics Clinic and Institute of Molecular Medicine A. Novicelli, Department of Clinical and Experimental Sciences, University of Brescia, ASST-Spedali Civili of Brescia, Brescia, Italy
| | - G Cazzaniga
- Centro Ricerca Tettamanti, University of Milan Bicocca, Monza, Italy; Department of Medicine and Surgery, University of Milan Bicocca, Monza, Italy
| | - A Plebani
- Pediatrics Clinic and Institute of Molecular Medicine A. Novicelli, Department of Clinical and Experimental Sciences, University of Brescia, ASST-Spedali Civili of Brescia, Brescia, Italy
| | - R Badolato
- Pediatrics Clinic and Institute of Molecular Medicine A. Novicelli, Department of Clinical and Experimental Sciences, University of Brescia, ASST-Spedali Civili of Brescia, Brescia, Italy
| | - V Lougaris
- Pediatrics Clinic and Institute of Molecular Medicine A. Novicelli, Department of Clinical and Experimental Sciences, University of Brescia, ASST-Spedali Civili of Brescia, Brescia, Italy
| | - M Gattorno
- Center for Autoinflammatory disease and Immunodeficiencies, IRCCS G. Gaslini, Genova, Italy
| | - A Biondi
- Pediatric Hematology-Oncology Unit, Department of Pediatrics, University of Milano-Bicocca, MBBM Foundation, Monza, Italy; Centro Ricerca Tettamanti, University of Milan Bicocca, Monza, Italy
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21
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Cintoni M, Rinninella E, Grassi F, Leone S, Scialanga F, Biondi A, Persiani R, D'Ugo D, Gasbarrini A, Mele M. THE IMPACT OF THE NUTRICATT PROTOCOL ON BODY COMPOSITION OF COLORECTAL CANCER PATIENTS: PRELIMINARY DATA. Nutrition 2020. [DOI: 10.1016/j.nut.2020.110921] [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: 11/30/2022]
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Marmotti A, Biondi A, Bellato E, Mangiavini L, Ferrero G, Dettoni F, Bonasia D, Peretti GM, Colombero D, Agati G, Castoldi F. When math meets surgery: how to improve femoral interference screw alignment in ACL reconstruction. A cadaveric study. J BIOL REG HOMEOS AG 2020; 34:377-391. Congress of the Italian Orthopaedic Research Society. [PMID: 33261302] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Transtibial femoral tunnel drilling is still an alternative technique in ACL reconstruction. Femoral interference screw divergence is a potential pitfall associated with transtibial tunnel technique, as angles greater than 15° jeopardize graft fixation. Our mathematical model theorizes the proper degrees of knee flexion during femoral screw insertion and the correct screwdriver position to obtain a minimal divergence of the screw in the femoral tunnel. The cadaveric study confirms our method. Mathematical model: using rototranslation matrices, a correlation is demonstrated between the ACLtibial- guide angle, the knee flexion, and the screwdriver position. A theoretical minimal divergence between femoral interference screw and the femoral tunnel is obtainable following these assumptions: 1) knee hyperflexion during femoral screw insertion is obtained adding a flexion corresponding to the ACL-tibial-guide angle to the flexion while drilling the femoral tunnel; 2) screwdriver position (through the AM portal) is kept parallel to tibial plateau at a rotation of 15° medial to tibial sagittal plane. Cadaveric study: 24 cadaver knees were used. The transtibial tunnel was drilled with an 8 mm drill bit with the help of an ACL tibial guide set at 55°. To simulate femoral tunnel direction, a 2.4 mm K. wire was drilled through the femur with a transtibial 7 mm offset femoral drill guide. To simulate the femoral screw direction, a second 2.4 mm K. wire was drilled from the femoral entry point of the first wire through the femur, with a cannulated screwdriver. Screwdriver direction and knee flexion during the simulation were obtained following two different methods: GROUP A (mathematical model group, 12 knees), screwdriver direction and knee flexion were calculated following the mathematical model; in GROUP B (control group, 12 knees), knee hyperflexion and screwdriver medialization were manually obtained by a senior surgeon. The divergence between the femoral interference screw and the femoral tunnel was identified as the angle formed by the two wires, measured on the plane formed by the direction of the wires. Mean divergence angles between the K. wires were significantly different (p< 0.05) between the groups: GROUP 1 (mathematical rule): 7.25° (SD 2.2); GROUP 2 (free-hand technique): 17.3° (SD 2.9). Our study shows that a minimal divergence between the femoral tunnel and the screwdriver can be achieved simply by following a mathematical rule for correct intraoperative knee flexion and screwdriver position without the need for any specialized instrumentation. Namely, during femoral interference screw insertion through the anteromedial portal: 1) the correct knee flexion is the sum between the knee flexion angle while drilling the transtibial femoral tunnel AND the ACL tibial guide angle used during tibial tunnel drilling; 2) Correct screwdriver position is parallel to the tibial plateau, engaging the femoral tunnel with a position of 15° medial to tibial sagittal plane. This simple concept has clinical relevance in helping the surgeons in obtaining an optimal alignment between the femoral tunnel and the femoral interference screw during transtibial ACL reconstruction. Furthermore, following the assumptions of this study, a starting knee flexion angle around 70° during femoral tunnel drilling seems preferable for ACL reconstruction when the transtibial tunnel technique is used. Indeed, because ACL-tibial-guide angles range commonly from 50° to 60° and in vivo, the maximal intraoperative knee flexion attainable is 130°, a starting knee flexion around 70° is optimal to allows for adding flexion angles up to 60° before reaching the physiological limit value of 130°.
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Affiliation(s)
- A Marmotti
- Department of Orthopaedic and Traumatology, University of Torino, Torino, Italy
| | - A Biondi
- EniProgetti S.p.A., University of Padova, Italy
| | - E Bellato
- Department of Orthopaedic and Traumatology, University of Torino, Torino, Italy
| | - L Mangiavini
- IRCCS Istituto Ortopedico Galeazzi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - G Ferrero
- Department of Orthopaedic and Traumatology, University of Torino, Torino, Italy
| | - F Dettoni
- Department of Orthopaedic and Traumatology, University of Torino, Torino, Italy
| | - D Bonasia
- Department of Orthopaedic and Traumatology, University of Torino, Torino, Italy
| | - G M Peretti
- IRCCS Istituto Ortopedico Galeazzi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - D Colombero
- Department of Orthopaedic and Traumatology, University of Torino, Torino, Italy
| | - G Agati
- Department of Orthopaedic and Traumatology, University of Torino, Torino, Italy
| | - F Castoldi
- Department of Orthopaedic and Traumatology, University of Torino, Torino, Italy
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23
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Tirelli F, Grieco M, Biondi A, Belia F, Persiani R. Delayed presentation of rectourethral fistula following TaTME (transanal total mesorectal excision). Tech Coloproctol 2019; 23:787-788. [PMID: 31435843 DOI: 10.1007/s10151-019-02046-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 07/17/2019] [Indexed: 11/25/2022]
Affiliation(s)
- F Tirelli
- General Surgery Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, L.go A. Gemelli 8, 00168, Rome, Italy.
| | - M Grieco
- General Surgery Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, L.go A. Gemelli 8, 00168, Rome, Italy
| | - A Biondi
- General Surgery Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, L.go A. Gemelli 8, 00168, Rome, Italy
| | - F Belia
- General Surgery Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, L.go A. Gemelli 8, 00168, Rome, Italy
| | - R Persiani
- General Surgery Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma-Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, 00168, Rome, Italy
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Sponga S, Di Mauro M, Pacini D, Murara G, Di Bartolomeo R, Cappabianca G, Beghi C, Weltert L, De Paulis R, De Vincentiis C, Biondi A, Santini F, Salsano A, Salvador L, Picichè M, Mariscalco G, Maselli D, Rinaldi M, Mancuso S, Scrofani R, Cagnoni G, Antona C, Dato G, Centofani P, De Bonis M, Pozzoli A, Cugola D, Galletti L, Villa E, Dossena Y, Troise G, Barili F, Paparella D, Margari V, Lorusso R, Parolari A, Livi U. OC69 SURGERY FOR BENTALL ENDOCARDITIS. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000549877.33309.a0] [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: 11/05/2022]
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Di Mauro M, Dato GA, Barili F, Corte AD, Ratta ED, Cugola D, Galletti L, Centofanti P, Santini F, Salsano A, Rinaldi M, Mancuso S, Cappabianca G, Beghi C, De Vincentiis C, Biondi A, Livi U, Sponga S, Pacini D, Murara G, Di Bortalomeo R, Scrofani R, Cagnoni G, Antona C, Nicolini F, Benassi F, De Bonis M, Pozzoli A, Casali G, Scrascia G, Bortolotti U, Falcetta G, Musumeci F, Gherli R, Vizzardi E, Salvador L, Piccichè M, Paparella D, Margari V, Troise G, Villa E, Dossena Y, Lucarelli C, Onorati F, Faggian G, Mariscalco G, Maselli D, Foschi M, Parolari A, Lorusso R. OC71 SURGICAL TREATMENT FOR ISOLATED TRICUSPID VALVE INFECTIVE ENDOCARDITIS. 25-YEAR RESULTS. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000549876.95190.c5] [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: 11/05/2022]
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Saitto G, Grimaldi F, Varrica A, Biondi A, Garatti A, Parolari A, De Vincentiis C, Menicanti L. RF42 LONG TERM RESULTS OF SEPTAL MYECTOMY IN OBSTRUCTIVE HYPERTROPHIC CARDIOMYOPATHY. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000550082.04944.3d] [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: 11/05/2022]
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Gaipa G, Buracchi C, Biondi A. Flow cytometry for minimal residual disease testing in acute leukemia: opportunities and challenges. Expert Rev Mol Diagn 2018; 18:775-787. [DOI: 10.1080/14737159.2018.1504680] [Citation(s) in RCA: 6] [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] [Indexed: 02/06/2023]
Affiliation(s)
- Giuseppe Gaipa
- Department of Pediatrics, University of Milano-Bicocca, Fondazione Tettamanti - Centro Ricerca M.Tettamanti, Monza, Italy
| | - Chiara Buracchi
- Department of Pediatrics, University of Milano-Bicocca, Fondazione Tettamanti - Centro Ricerca M.Tettamanti, Monza, Italy
| | - A Biondi
- Department of Pediatrics, University of Milano-Bicocca, Fondazione Tettamanti - Centro Ricerca M.Tettamanti, Monza, Italy
- Fondazione MBBM/Ospedale San Gerardo - Department of Pediatrics, University of Milano-Bicocca, Monza, Italy
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Di Saverio S, Segalini E, Birindelli A, Todero S, Podda M, Rizzuto A, Tugnoli G, Biondi A. Pancreas-sparing, ampulla-preserving duodenectomy for major duodenal (D1-D2) perforations. Br J Surg 2018; 105:1487-1492. [PMID: 30024637 DOI: 10.1002/bjs.10910] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 02/20/2018] [Accepted: 05/14/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Ideal surgical treatment for acute duodenal injuries should offer a definitive treatment, with low morbidity and mortality. It should be simple and easily reproducible by acute care surgeons in an emergency. Duodenal injury, due to major perforated or bleeding peptic ulcers or iatrogenic/traumatic perforation, represents a surgical challenge, with high morbidity and mortality. The aim was to review definitive surgery with pancreas-sparing, ampulla-preserving duodenectomy for these patients. METHODS Pancreas-sparing, ampulla-preserving D1-D2 duodenectomy was used for patients presenting with major duodenal injuries over a 5-year interval. The ampulla was identified and preserved using a transcystic/transpapillary tube. The outcomes were recorded. RESULTS Ten patients were treated with this technique; seven had perforated or bleeding peptic ulcers, two had iatrogenic perforations and one blunt abdominal trauma. Their mean age was 78 (range 65-84) years. Four patients were haemodynamically unstable. The location of the duodenal injury was always D1 and/or D2, above or in close proximity to the ampulla of Vater. The surgical approach was open in nine patients and laparoscopic in one. The mean duration of surgery was 264 (range 170-377) min. All patients were transferred to the ICU after surgery (mean ICU stay 4·4 (range 1-11) days), and the overall mean hospital stay was 17·8 (range 10-32) days. Six patients developed major postoperative complications: cardiorespiratory failure in five and gastrointestinal complications in four. Surgical reoperation was needed in one patient for postoperative necrotizing and bleeding pancreatitis. Two patients died from their complications. CONCLUSION Pancreas-sparing, ampulla-preserving D1-D2 duodenectomy for emergency treatment of major duodenal perforations is feasible and associated with satisfactory outcomes.
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Affiliation(s)
- S Di Saverio
- Department of Surgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - E Segalini
- Maggiore Hospital Regional Emergency Surgery and Trauma Centre, Bologna Local Health District, Bologna, Italy
| | - A Birindelli
- Maggiore Hospital Regional Emergency Surgery and Trauma Centre, Bologna Local Health District, Bologna, Italy
| | - S Todero
- Maggiore Hospital Regional Emergency Surgery and Trauma Centre, Bologna Local Health District, Bologna, Italy
| | - M Podda
- General, Emergency and Robotic Surgery Unit, San Francesco Hospital, Nuoro, Italy
| | - A Rizzuto
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - G Tugnoli
- Maggiore Hospital Regional Emergency Surgery and Trauma Centre, Bologna Local Health District, Bologna, Italy
| | - A Biondi
- Department of Surgery, University of Catania, Catania, Italy
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Pievani A, Michelozzi IM, Rambaldi B, Granata V, Corsi A, Dazzi F, Biondi A, Serafini M. Fludarabine as a cost-effective adjuvant to enhance engraftment of human normal and malignant hematopoiesis in immunodeficient mice. Sci Rep 2018; 8:9125. [PMID: 29904072 PMCID: PMC6002385 DOI: 10.1038/s41598-018-27425-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 02/11/2018] [Accepted: 05/31/2018] [Indexed: 11/18/2022] Open
Abstract
There is still an unmet need for xenotransplantation models that efficiently recapitulate normal and malignant human hematopoiesis. Indeed, there are a number of strategies to generate humanized mice and specific protocols, including techniques to optimize the cytokine environment of recipient mice and drug alternatives or complementary to the standard conditioning regimens, that can be significantly modulated. Unfortunately, the high costs related to the use of sophisticated mouse models may limit the application of these models to studies that require an extensive experimental design. Here, using an affordable and convenient method, we demonstrate that the administration of fludarabine (FludaraTM) promotes the extensive and rapid engraftment of human normal hematopoiesis in immunodeficient mice. Quantification of human CD45+ cells in bone marrow revealed approximately a 102-fold increase in mice conditioned with irradiation plus fludarabine. Engrafted cells in the bone marrow included hematopoietic stem cells, as well as myeloid and lymphoid cells. Moreover, this model proved to be sufficient for robust reconstitution of malignant myeloid hematopoiesis, permitting primary acute myeloid leukemia cells to engraft as early as 8 weeks after the transplant. Overall, these results present a novel and affordable model for engraftment of human normal and malignant hematopoiesis in immunodeficient mice.
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Affiliation(s)
- A Pievani
- M. Tettamanti Research Center, Department of Pediatrics, University of Milano-Bicocca, Monza, 20900, Italy.,Department of Haemato-Oncology, Rayne Institute, King's College London, London, SE59NU, UK
| | - I M Michelozzi
- M. Tettamanti Research Center, Department of Pediatrics, University of Milano-Bicocca, Monza, 20900, Italy
| | - B Rambaldi
- M. Tettamanti Research Center, Department of Pediatrics, University of Milano-Bicocca, Monza, 20900, Italy
| | - V Granata
- M. Tettamanti Research Center, Department of Pediatrics, University of Milano-Bicocca, Monza, 20900, Italy
| | - A Corsi
- Department of Molecular Medicine, Sapienza University of Rome, Rome, 00161, Italy
| | - F Dazzi
- Department of Haemato-Oncology, Rayne Institute, King's College London, London, SE59NU, UK
| | - A Biondi
- M. Tettamanti Research Center, Department of Pediatrics, University of Milano-Bicocca, Monza, 20900, Italy
| | - M Serafini
- M. Tettamanti Research Center, Department of Pediatrics, University of Milano-Bicocca, Monza, 20900, Italy.
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Lorenzon L, Bini F, Quatrale M, Biondi A, Persiani R, Di Pietropaolo M, Landolfi F, Iannicelli E, Marinozzi F, Balducci G, D'Ugo D. 3D MRI segmentation and 3D circumferential resection margin evaluation for a standard rectal cancer assessment. G Chir 2018; 39:152-157. [PMID: 29923484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
AIM Recent studies focused on rectal cancer suggested that a 3D imaging segmentation obtained from MRI data could contribute in the definition of the circumferential resection margin (CRM) and in the assessment of the tumor regression following neo-adjuvant treatments. Here, we propose a method for defining and visualizing the circumferential margins using 3D MRI segmentation; this methodology was tested in a clinical study comparing 3D CRM assessment vs standard MRI imaging. PATIENTS AND METHODS MRI scans performed before neo-adjuvant treatments were selected and reviewed. 3D mesorectal/tumor segmentations were obtained using Digital Imaging and COmmunications in Medicine (DICOM) data; CRMs were calculated using 3D volumes plus a color scale for the closest distances. RESULTS 3D reconstructions were possible in all selected cases and 3D images implemented by the color scale were positive for immediate CRM visualization. Statistical analyses comparing standard radiology disclosed that the degree of consistency, the reliability of ratings, the correlation and precision were optimal considering the overall cases, but lower in the CRM>0 mm sub-group. CONCLUSIONS This new method is not inferior comparing standard radiology; moreover, the imaging segmentation we obtained was highly promising and could be helpful in defining a standard CRM measurement, thus it could improve clinical practice.
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Lissoni P, Barni S, Rovelli F, Rescaldani R, Rizzo V, Biondi A, Tancini G. Correlation of Serum Interleukin-2 Levels, Soluble Interleukin-2 Receptors and T Lymphocyte Subsets in Cancer Patients. Tumori 2018; 76:14-7. [PMID: 2108515 DOI: 10.1177/030089169007600103] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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: 11/17/2022]
Abstract
An interleukin-2 (IL-2) in vitro reduced production has been observed in most metastatic cancer patients. At present, however, there are no data on blood IL-2 levels in vivo, because of the too low sensitivity of previous biological and enzyme immunoassay methods. The recent development of a sensitive RIA method allowed us to start a preliminary investigation of IL-2 production in basal conditions in human solid tumors. The study included 42 cancer patients. Breast and lung cancer were the two commonest neoplasms. Serum levels of IL-2 and soluble IL-2 receptors (SIL-2R), and CD4/CD8 ratio were measured in each patient. The control group consisted of 58 healthy subjects. Mean serum levels of IL-2 were significantly lower in metastatic patients (n = 23) than in those without metastases (n = 19). Patients with low CD4/CD8 ratio (n = 16) had significantly lower mean values of IL-2 than those with normal ratio (n=26). Finally, mean IL-2 concentrations were significanty lower in patients with elevated levels of SIL-2R than in those with normal values. These results would suggest that metastatic dissemination is associated with a decreased IL-2 production in vivo, and that reduced IL-2 production is more frequent in patients with low CD4/CD8 ratio.
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Affiliation(s)
- P Lissoni
- Divisione di Radioterapia Oncologica, Ospedale San Gerardo, Monza, Milano, Italy
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Gory B, Haussen DC, Piotin M, Steglich-Arnholm H, Holtmannspötter M, Labreuche J, Kyheng M, Taschner C, Eiden S, Nogueira RG, Papanagiotou P, Boutchakova M, Siddiqui AH, Lapergue B, Dorn F, Cognard C, Killer M, Mangiafico S, Ribo M, Psychogios MN, Spiotta AM, Labeyrie MA, Biondi A, Mazighi M, Turjman F. Impact of intravenous thrombolysis and emergent carotid stenting on reperfusion and clinical outcomes in patients with acute stroke with tandem lesion treated with thrombectomy: a collaborative pooled analysis. Eur J Neurol 2018; 25:1115-1120. [DOI: 10.1111/ene.13633] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 02/26/2018] [Indexed: 11/29/2022]
Affiliation(s)
- B. Gory
- Department of Diagnostic and Interventional Neuroradiology; INSERM U947; University Hospital of Nancy; Nancy France
| | - D. C. Haussen
- Department of Neurology; Emory University/Grady Memorial Hospital; Atlanta GA USA
| | - M. Piotin
- Department of Interventional Neuroradiology; Rothschild Foundation; Paris France
| | | | | | - J. Labreuche
- Department of Biostatistics; EA2694-Santé Publique: Epidémiologie et Qualité Des Soins; Lille University; Lille France
| | - M. Kyheng
- Department of Biostatistics; EA2694-Santé Publique: Epidémiologie et Qualité Des Soins; Lille University; Lille France
| | - C. Taschner
- Department of Neuroradiology; Medical Center-University of Freiburg; Freiburg
| | - S. Eiden
- Department of Neuroradiology; Medical Center-University of Freiburg; Freiburg
| | - R. G. Nogueira
- Department of Neurology; Emory University/Grady Memorial Hospital; Atlanta GA USA
| | - P. Papanagiotou
- Department of Diagnostic and Interventional Neuroradiology; Klinikum Bremen-Mitte/Bremen-Ost; Bremen Germany
| | - M. Boutchakova
- Department of Diagnostic and Interventional Neuroradiology; Klinikum Bremen-Mitte/Bremen-Ost; Bremen Germany
| | - A. H. Siddiqui
- Department of Neurosurgery; University at Buffalo; State University of New York; Buffalo NY USA
| | - B. Lapergue
- Department of Neurology; Stroke Center; Foch Hospital; Suresnes France
| | - F. Dorn
- Department of Neuroradiology; University Hospital of Munich; Munich Germany
| | - C. Cognard
- Department of Neuroradiology; University Hospital of Toulouse; Toulouse France
| | - M. Killer
- Department of Neuroradiology; Christian Doppler Clinic; Research Institute for Neurointervention; Paracelsus Medical University; Salzburg Austria
| | - S. Mangiafico
- Department of Interventional Neuroradiology; Careggi University Hospital; Florence Italy
| | - M. Ribo
- Department of Neurology; Hospital Vall D'Hebron; Barcelona Spain
| | - M. N. Psychogios
- Department of Neuroradiology; University Medical Center Göttingen; Göttingen Germany
| | - A. M. Spiotta
- Department of Neurosurgery; Medical University of South Carolina; Charleston SC USA
| | - M. A. Labeyrie
- Department of Interventional Neuroradiology; Lariboisière Hospital; Paris
| | - A. Biondi
- Department of Neuroradiology and Endovascular Therapeutic; University Hospital of Besançon; Besançon
| | - M. Mazighi
- Department of Interventional Neuroradiology; Rothschild Foundation; Paris France
| | - F. Turjman
- Department of Interventional Neuroradiology; Hospices Civils de Lyon; Lyon France
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Persiani R, Biondi A, Santullo F, Pennestrì F, Tirelli F, Sicoli F, Lirosi M, Fico V, D''Ugo D. Transanal total mesorectal excision (TaTME): Surgical technique description. Eur J Surg Oncol 2018. [DOI: 10.1016/j.ejso.2018.01.043] [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: 11/25/2022] Open
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di Saverio S, Birindelli A, Segalini E, Todero S, Botusan RA, Novello M, Kwan S, Biondi A. A novel technique for enterotomy closure in stapled laparoscopic intracorporeal anastomosis. Colorectal Dis 2017; 19:O372-O376. [PMID: 28833963 DOI: 10.1111/codi.13856] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 08/01/2017] [Indexed: 02/08/2023]
Abstract
AIM The proximal edge of the enterotomy in a side-to-side anastomosis has been shown to be the site at highest risk of leakage. Several methods have been described to overcome this vulnerability. The technical challenge of intra-corporeal anastomosis (ICA) is to re-create angles between tissues and instruments, similar to those in an open anastomosis. The axis between the suture line and the needle driver is paramount and this angle should be < 45°. METHOD The crotch stitch of the enterotomy is difficult because of the narrow space between the loops and the depth of the anastomosis. The usual technique is suturing right-handed, 'out-in and in-out', colonic edge first to small bowel. The risk of suture misplacement (e.g. 'out-in/out-in' or 'out-out') is similar to open procedures but laparoscopically the second bite is challenging, due to the straight needle-driver. This may lead to asymmetrical closure of the corner resulting in a slightly larger angle on the bowel side and a potential postoperative leak/fistula. Rotating the small bowel loop to counterbalance this issue, risks tearing of the staple line. The rationale is that starting with a back-handed stitch and taking the small bowel edge first would allow the necessary acute angled bite to be achieved. Subsequently, mounting the needle right-handed for taking the colonic edge also allows achievement of an acute angled bite. RESULTS Our novel technique, named the 'back-handed, left-to-right stitch' technique, is intended to achieve symmetrical approximation of the ileal and colonic edges during laparoscopy, with an optimal closure of the deepest extremity of the enterotomy. Such a stitch, used in a series of 10 patients, may be useful to avoid leaving an opening within this angle and/or to avoid potential technical pitfalls when closing the deepest apex of the enterotomy. CONCLUSION This 'back-handed, left-to-right' stitch described here allows a properly angled closure of the proximal edge of the enterotomy and a safe approximation of the corner of the enterotomy in a side-to-side ICA.
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Affiliation(s)
- S di Saverio
- Maggiore Hospital Regional Emergency Surgery and Trauma Center, Bologna Local Health District, Bologna, Italy
| | - A Birindelli
- Maggiore Hospital Regional Emergency Surgery and Trauma Center, Bologna Local Health District, Bologna, Italy
| | - E Segalini
- Maggiore Hospital Regional Emergency Surgery and Trauma Center, Bologna Local Health District, Bologna, Italy
| | - S Todero
- Maggiore Hospital Regional Emergency Surgery and Trauma Center, Bologna Local Health District, Bologna, Italy
| | - R A Botusan
- Maggiore Hospital Regional Emergency Surgery and Trauma Center, Bologna Local Health District, Bologna, Italy
| | - M Novello
- Colorectal Surgery Department, Cleveland Clinic, Cleveland, Ohio, USA
| | - S Kwan
- Royal Perth Hospital, University of Western Australia, Australia
| | - A Biondi
- Department of Surgery, University of Catania, Catania, Italy
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Abstract
INTRODUCTION Acute lymphoblastic leukemia (ALL) is the first neoplasm where the assessment of early response to therapy by minimal residual disease (MRD) monitoring has proven to be a fundamental tool for guiding therapeutic choices. In recent years, thanks to real-time quantitative PCR (qPCR), MRD monitoring has further achieved higher levels of sensitivity and standardization. However, some outstanding issues still remain to be addressed and emerging technologies hold the promise of improving MRD detection in ALL patients. Areas covered: Through a comprehensive review of the literature, we analyze the state-of-the-art of molecular MRD assessment in ALL to better understand how, in the upcoming years, some of its limitations could be tackled by emerging molecular technologies. Furthermore, we highlight the future role of molecular MRD monitoring in the context of personalized protocols, taking into account the growing genetic complexity in ALL. Expert commentary: Although new molecular technologies are promising tools for MRD assessment, qPCR still remains the gold standard for evaluating MRD in ALL. High-throughput sequencing and droplet digital PCR allow to identify new prognostic factors and/or MRD targets at diagnosis and to perform earlier MRD evaluations, thereby optimizing patient stratification and earlier MRD-based clinical intervention to improve ALL patient outcomes.
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Affiliation(s)
- Vittorio Nunes
- a Tettamanti Research Center, Department of Pediatrics , University of Milano Bicocca , Monza , Italy
| | - Gianni Cazzaniga
- a Tettamanti Research Center, Department of Pediatrics , University of Milano Bicocca , Monza , Italy
| | - A Biondi
- a Tettamanti Research Center, Department of Pediatrics , University of Milano Bicocca , Monza , Italy
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Rinninella E, Cintoni M, Persiani R, D’ugo D, Biondi A, Pennestrí F, Scialanga F, Basso L, Leone S, Miggiano G, Gasbarrini A, Mele M. SUN-P267: Nutricatt Protocol: A New Item in Eras Program for Colorectal Cancer Surgery? Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)30363-1] [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: 11/26/2022]
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Saettini F, Pelagatti MA, Sala D, Moratto D, Giliani S, Badolato R, Biondi A. Early diagnosis of PI3Kδ syndrome in a 2 years old girl with recurrent otitis and enlarged spleen. Immunol Lett 2017; 190:279-281. [PMID: 28842185 DOI: 10.1016/j.imlet.2017.08.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 06/14/2017] [Revised: 08/11/2017] [Accepted: 08/17/2017] [Indexed: 12/13/2022]
Abstract
Heterozygous gain of function mutations in the gene encoding p110δ subunit of PI3K have been recently associated with activated PI3K-δ syndrome (APDS), a novel combined immune deficiency characterized by recurrent sinopulmonary infections, lymphopenia, reduced class-switched memory B cells, lymphadenopathy, CMV and/or EBV viremia and EBV-related lymphoma. Here we report a dominant gain of function PIK3CD mutation (E1021K) in a patient presenting with recurrent otitis media, massive splenomegaly, and persistent EBV-viraemia. The immunological studies showed low IgA level, but normal IgM, IgG, and normal antibody response to diphtheria and tetanus toxoid vaccination. Analysis of B lymphocyte subsets revealed abnormal expansion of transitional B cells, and low percentage of switched CD27+IgD- and CD27+IgD+ memory B cells. Analysis of T cell compartment unveiled prevalence of terminally differentiated cells. This study suggests that PIK3CD gain of function mutations should be suspected despite incomplete phenotype in patients with early onset splenomegaly, persistent EBV viremia and abnormal B and T cell subsets despite normal IgG levels. Currently the optimal treatment is still debated, but prompt management can hopefully diminish incidence of severe long-lasting sequelae (i.e. bronchiectasis, ear and sinus damage).
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Affiliation(s)
- F Saettini
- Fondazione Monza e Brianza per il Bambino e la sua Mamma, Ospedale San Gerardo, Monza, Italy; Università degli Studi di Milano-Bicocca, Monza, Italy.
| | - M A Pelagatti
- Fondazione Monza e Brianza per il Bambino e la sua Mamma, Ospedale San Gerardo, Monza, Italy
| | - D Sala
- Fondazione Monza e Brianza per il Bambino e la sua Mamma, Ospedale San Gerardo, Monza, Italy
| | - D Moratto
- Nocivelli Institute for Molecular Medicine, Department of Molecular and Translational Medicine, University of Brescia, and Cytogenetics and Clinical Genetics Unit, Laboratory Department, Spedali Civili, Brescia, Italy
| | - S Giliani
- Nocivelli Institute for Molecular Medicine, Department of Molecular and Translational Medicine, University of Brescia, and Cytogenetics and Clinical Genetics Unit, Laboratory Department, Spedali Civili, Brescia, Italy
| | - R Badolato
- Università degli Studi di Brescia, Brescia, Italy
| | - A Biondi
- Fondazione Monza e Brianza per il Bambino e la sua Mamma, Ospedale San Gerardo, Monza, Italy; Università degli Studi di Milano-Bicocca, Monza, Italy
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Clarençon F, Di Maria F, Gabrieli J, Shotar E, Degos V, Nouet A, Biondi A, Sourour NA. Clinical Impact of Flat Panel Volume CT Angiography in Evaluating the Accurate Intraoperative Deployment of Flow-Diverter Stents. AJNR Am J Neuroradiol 2017; 38:1966-1972. [PMID: 28818824 DOI: 10.3174/ajnr.a5343] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Accepted: 06/09/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The deployment of flow-diverter stents may be difficult to analyse on regular DSA. The purpose of our study was to investigate the clinical impact of stent-dedicated flat panel volume CT angiography to evaluate intraoperatively the satisfactory deployment of flow-diverter stents. MATERIALS AND METHODS From January 2009 to April 2015, 83 consecutive patients (mean age, 51 years; 62 women) were treated in our institution with flow-diverter stents. Eighty-seven aneurysms (82 unruptured, 5 ruptured; 77 anterior, 10 posterior circulation) were treated in these 83 patients (4 patients had 2 aneurysms, both treated by means of flow-diverter stents). One patient was treated for a traumatic carotid cavernous fistula. In 80% of the cases (68/85) a flat panel volume CT angiography was performed in the angiographic suite just after the flow-diverter stent deployment. Stent visualization was assessed by 2 independent reviewers. The clinical impact of stent malapposition was evaluated. RESULTS Flow-diverter stent visualization was satisfactory in 73.5% of the cases. In 2 cases (2.9%) the flat panel volume CT angiography prompted the operator to perform an additional intrastent angioplasty for a condition that was previously underestimated. Four patients (4.7%) experienced acute thromboembolic complications; 3 others had delayed thromboembolic complications. Only 1 of these patients had thromboembolic complications (acute or delayed) related to stent misdeployment, which was easily managed intraoperatively with no clinical consequence. CONCLUSIONS Flat panel volume CT angiography is an interesting tool to depict flow-diverter stent misdeployment and may encourage the operator to perform intrastent angioplasty (2.9% of the cases in our experience) to reduce the risks of thromboembolic complications.
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Affiliation(s)
- F Clarençon
- From the Departments of Interventional Neuroradiology (F.C., J.G., E.S., N.-A.S.) .,Paris VI University (F.C., J.G., E.S., V.D.), Pierre et Marie Curie, Paris. France
| | - F Di Maria
- Department of Interventional Neuroradiology (F.D.M.), Foch Hospital, Suresnes, France
| | - J Gabrieli
- From the Departments of Interventional Neuroradiology (F.C., J.G., E.S., N.-A.S.).,Paris VI University (F.C., J.G., E.S., V.D.), Pierre et Marie Curie, Paris. France
| | - E Shotar
- From the Departments of Interventional Neuroradiology (F.C., J.G., E.S., N.-A.S.).,Paris VI University (F.C., J.G., E.S., V.D.), Pierre et Marie Curie, Paris. France
| | - V Degos
- Anesthesiology (V.D.).,Paris VI University (F.C., J.G., E.S., V.D.), Pierre et Marie Curie, Paris. France
| | - A Nouet
- Neurosurgery (A.N.), Pitié-Salpêtrière Hospital. Paris France
| | - A Biondi
- Department of Neuroradiology and Endovascular Therapy (A.B.), Besançon University Hospital, Besançon, France
| | - N-A Sourour
- From the Departments of Interventional Neuroradiology (F.C., J.G., E.S., N.-A.S.)
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Lorenzon L, Parini D, Rega D, Mellano A, Vigorita V, Biondi A, Jaminez-Rosellon R, Scheiterle M, Giannini I, Gallo G, Marino G, Turati L, Marsanic P, De Franco L, Marano L, De Luca R. Long-term outcomes in ypT0 rectal cancers: An international multi-centric investigation on behalf of Italian Society of Surgical Oncology Young Board (YSICO). Eur J Surg Oncol 2017; 43:1472-1480. [PMID: 28571778 DOI: 10.1016/j.ejso.2017.04.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 02/22/2017] [Revised: 04/12/2017] [Accepted: 04/30/2017] [Indexed: 12/26/2022] Open
Abstract
AIM To investigate the outcome and pattern of survivals of rectal cancer patients presenting a complete or nearly complete tumor response after neo-adjuvant treatment. METHODS Young surgeons <40 years old affiliated to the Italian Society of Surgical Oncology (YSICO) from 13 referral centers for colorectal cancer treatment, were invited to participate a retrospective study. Records from patients treated from 2005 to 2015 with a pathological diagnosis of ypT0/ypTis were retrieved and pooled in a common data-base for statistical purposes. All clinical and pathological variables were reviewed. Univariate and multivariate analyses were conducted with the end-point of survivals. RESULTS Two hundreds and sixty-one patients were analyzed including 237 ypT0 and 24 ypTis. Nodal positive patients were 8.7%. More than sixty-six percent of the patients did not perform adjuvant chemotherapy, with a statistical difference comparing N0 versus N+ patients (66.8% vs 40.9%, p 0.02). Mean follow-up was of 47.6 months. Twenty-two relapses were observed, 91.6% at a distant site. The mean time to recurrence was of 35.3 months. On univariate analysis, the use of adjuvant chemotherapy correlated with better OS exclusively in ypT0N + patients and not in ypT0N0. Univariate and multivariate analyses documented nodal positivity as the only prognostic factor correlated with a worse OS. CONCLUSION Recurrences were mostly diagnosed at a distant site and within the third year of follow-up. Nodal positivity was the only variable independently correlated with a worse OS. Univariate analysis documented a benefit for the use of adjuvant chemotherapy treatment exclusively in ypT0N + rectal cancers.
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Affiliation(s)
- L Lorenzon
- Surgical and Medical Department of Translational Medicine, Sant'Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy.
| | - D Parini
- General Surgery Unit, Santa Maria della Misericordia Hospital, Rovigo, Italy
| | - D Rega
- Colorectal Surgical Oncology, Istituto Nazionale per lo Studio e la Cura dei Tumori Fondazione Giovanni Pascale IRCCS, Naples, Italy
| | - A Mellano
- Surgical Oncology Unit, Candiolo Cancer Institute - IRCCS - Candiolo Cancer Institute - IRCCS, Turin, Italy
| | - V Vigorita
- Unit of Coloproctology, Department of General and Digestive Surgery, University Hospital Complex of Vigo Alvaro Conquieiro Hospital, Vigo, Spain
| | - A Biondi
- General Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli, Catholic University, Rome, Italy
| | | | - M Scheiterle
- Department of Medicine, Surgery and Neurosciences - Unit of General Surgery and Surgical Oncology, University of Siena, Italy
| | - I Giannini
- General Surgery Unit, Policlinico Bari, Italy
| | - G Gallo
- Coloproctology Unit, Santa Rita Clinic, Vercelli, Italy; Department of Medical and Surgical Sciences, University of Catanzaro, Italy
| | - G Marino
- Surgery Unit, IRCCS CROB Regional Oncologic Center, Rionero in Vulture, Potenza, Italy
| | - L Turati
- Surgical Oncology Unit, Treviglio Hospital, ASST Bergamo Ovest, Italy
| | - P Marsanic
- Surgical Oncology Unit, Candiolo Cancer Institute - IRCCS - Candiolo Cancer Institute - IRCCS, Turin, Italy
| | - L De Franco
- Department of Medicine, Surgery and Neurosciences - Unit of General Surgery and Surgical Oncology, University of Siena, Italy
| | - L Marano
- Multidisciplinary Robotic Surgery Unit, "San Matteo degli Infermi Hospital" - ASL Umbria 2, Spoleto, Perugia, Italy
| | - R De Luca
- Department of Surgical Oncology, National Cancer Research Centre, Istituto Tumori Giovanni Paolo II, Bari, Italy
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40
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Magnani C, Mezzanotte C, Cappuzzello C, Benedicenti F, Belotti D, Cabiati B, Bardini M, Fazio G, Cazzaniga G, Cooper L, Montini E, Gaipa G, Biondi A, Biagi E. Preclinical evaluation of donor-derived sleeping beauty modified CD19CAR+ lymphocytes for the treatment of acute lymphoblastic leukemia. Cytotherapy 2017. [DOI: 10.1016/j.jcyt.2017.02.032] [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: 11/26/2022]
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41
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Arcangeli S, Rotiroti M, Bardelli M, Simonelli L, Magnani C, Varani L, Biondi A, Tettamanti S, Biagi E. Balance of anti-CD123 Chimeric Antigen Receptor (CAR) binding affinity and density for the targeting of Acute Myeloid Leukemia. Cytotherapy 2017. [DOI: 10.1016/j.jcyt.2017.02.007] [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: 10/19/2022]
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42
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Savino AM, Sarno J, Trentin L, Vieri M, Fazio G, Bardini M, Bugarin C, Fossati G, Davis KL, Gaipa G, Izraeli S, Meyer LH, Nolan GP, Biondi A, Te Kronnie G, Palmi C, Cazzaniga G. The histone deacetylase inhibitor givinostat (ITF2357) exhibits potent anti-tumor activity against CRLF2-rearranged BCP-ALL. Leukemia 2017; 31:2365-2375. [PMID: 28331226 DOI: 10.1038/leu.2017.93] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Revised: 01/05/2017] [Accepted: 02/06/2017] [Indexed: 12/18/2022]
Abstract
Leukemias bearing CRLF2 and JAK2 gene alterations are characterized by aberrant JAK/STAT signaling and poor prognosis. The HDAC inhibitor givinostat/ITF2357 has been shown to exert anti-neoplastic activity against both systemic juvenile idiopathic arthritis and myeloproliferative neoplasms through inhibition of the JAK/STAT pathway. These findings led us to hypothesize that givinostat might also act against CRLF2-rearranged BCP-ALL, which lack effective therapies. Here, we found that givinostat inhibited proliferation and induced apoptosis of BCP-ALL CRLF2-rearranged cell lines, positive for exon 16 JAK2 mutations. Likewise, givinostat killed primary cells, but not their normal hematopoietic counterparts, from patients carrying CRLF2 rearrangements. At low doses, givinostat downregulated the expression of genes belonging to the JAK/STAT pathway and inhibited STAT5 phosphorylation. In vivo, givinostat significantly reduced engraftment of human blasts in patient-derived xenograft models of CRLF2-positive BCP-ALL. Importantly, givinostat killed ruxolitinib-resistant cells and potentiated the effect of current chemotherapy. Thus, givinostat in combination with conventional chemotherapy may represent an effective therapeutic option for these difficult-to-treat subsets of ALL. Lastly, the selective killing of cancer cells by givinostat may allow the design of reduced intensity regimens in CRLF2-rearranged Down syndrome-associated BCP-ALL patients with an overall benefit in terms of both toxicity and related complications.
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Affiliation(s)
- A M Savino
- Tettamanti Research Center, Department of Pediatrics, University of Milano Bicocca, Fondazione MBBM, Monza, Italy.,Department of Pediatric Hematology and Oncology, Leukemia Research Section, Edmond and Lily Children's Hospital, Sheba Medical Center, Ramat Gan, Israel.,Department of Molecular Human Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - J Sarno
- Tettamanti Research Center, Department of Pediatrics, University of Milano Bicocca, Fondazione MBBM, Monza, Italy
| | - L Trentin
- Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - M Vieri
- Tettamanti Research Center, Department of Pediatrics, University of Milano Bicocca, Fondazione MBBM, Monza, Italy
| | - G Fazio
- Tettamanti Research Center, Department of Pediatrics, University of Milano Bicocca, Fondazione MBBM, Monza, Italy
| | - M Bardini
- Tettamanti Research Center, Department of Pediatrics, University of Milano Bicocca, Fondazione MBBM, Monza, Italy
| | - C Bugarin
- Tettamanti Research Center, Department of Pediatrics, University of Milano Bicocca, Fondazione MBBM, Monza, Italy
| | - G Fossati
- Preclinical R&D Department, Italfarmaco S.p.A., Cinisello Balsamo, Milan, Italy
| | - K L Davis
- Baxter Laboratory in Stem Cell Biology, Department of Microbiology and Immunology, Stanford University, Stanford, CA, USA.,Hematology and Oncology, Department of Pediatrics, Stanford University, Stanford, CA, USA
| | - G Gaipa
- Tettamanti Research Center, Department of Pediatrics, University of Milano Bicocca, Fondazione MBBM, Monza, Italy
| | - S Izraeli
- Department of Pediatric Hematology and Oncology, Leukemia Research Section, Edmond and Lily Children's Hospital, Sheba Medical Center, Ramat Gan, Israel.,Department of Molecular Human Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - L H Meyer
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm, Germany
| | - G P Nolan
- Baxter Laboratory in Stem Cell Biology, Department of Microbiology and Immunology, Stanford University, Stanford, CA, USA.,Hematology and Oncology, Department of Pediatrics, Stanford University, Stanford, CA, USA
| | - A Biondi
- Tettamanti Research Center, Department of Pediatrics, University of Milano Bicocca, Fondazione MBBM, Monza, Italy
| | - G Te Kronnie
- Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - C Palmi
- Tettamanti Research Center, Department of Pediatrics, University of Milano Bicocca, Fondazione MBBM, Monza, Italy
| | - G Cazzaniga
- Tettamanti Research Center, Department of Pediatrics, University of Milano Bicocca, Fondazione MBBM, Monza, Italy
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43
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Taschner CA, Vedantham S, de Vries J, Biondi A, Boogaarts J, Sakai N, Lylyk P, Szikora I, Meckel S, Urbach H, Kan P, Siekmann R, Bernardy J, Gounis MJ, Wakhloo AK. Surpass Flow Diverter for Treatment of Posterior Circulation Aneurysms. AJNR Am J Neuroradiol 2016; 38:582-589. [PMID: 28007769 DOI: 10.3174/ajnr.a5029] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 10/11/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND PURPOSE Flow diverters for the treatment of posterior circulation aneurysms remain controversial. We aimed to identify factors contributing to outcome measures in patients treated with the Surpass flow diverter for aneurysms in this location. MATERIALS AND METHODS We conducted an observational study of 53 patients who underwent flow-diverter treatment for posterior circulation aneurysms at 15 centers. Key outcome measures were mortality, complete aneurysm occlusion, and modified Rankin Scale score at follow-up. RESULTS At follow-up (median, 11.3 months; interquartile range, 5.9-12.7 months), 9 patients had died, resulting in an all-cause mortality rate of 17.3% (95% CI, 7%-27.6%); 7 deaths (14%) were directly related to the procedure and none occurred in patients with a baseline mRS score of zero. After adjusting for covariates, a baseline mRS of 3-5 was more significantly (P = .003) associated with a higher hazard ratio for death than a baseline mRS of 0-2 (hazard ratio, 17.11; 95% CI, 2.69-109.02). After adjusting for follow-up duration, a 1-point increase in the baseline mRS was significantly (P < .001) associated with higher values of mRS at follow-up (odds ratio, 2.93; 95% CI, 1.79-4.79). Follow-up angiography in 44 patients (median, 11.3 months; interquartile range, 5.9-12.7 months) showed complete aneurysm occlusion in 29 (66%; 95% CI, 50.1%-79.5%). CONCLUSIONS Clinical results of flow-diverter treatment of posterior circulation aneurysms depend very much on patient selection. In this study, poorer outcomes were related to the treatment of aneurysms in patients with higher baseline mRS scores. Angiographic results showed a high occlusion rate for this subset of complex aneurysms.
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Affiliation(s)
- C A Taschner
- From the Department of Neuroradiology (C.A.T., S.M., H.U., J.B.), Medical Centre-University of Freiburg, Freiburg, Germany
| | | | - J de Vries
- Department of Neurosurgery (J.d.V., J.B.), Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
| | - A Biondi
- Department of Neuroradiology and Endovascular Therapy (A.B.), University of Besançon, Besançon, France
| | - J Boogaarts
- From the Department of Neuroradiology (C.A.T., S.M., H.U., J.B.), Medical Centre-University of Freiburg, Freiburg, Germany.,Department of Neurosurgery (J.d.V., J.B.), Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
| | - N Sakai
- Department of Neurosurgery (N.S.), Kobe City Medical Center General Hospital, Kobe, Japan
| | - P Lylyk
- Department of Neurosurgery (P.L.), Equipo de Neurocirugía Endovascular Radiología Intervencionista, Buenos Aires, Argentina
| | - I Szikora
- National Institute of Neurosciences (I.S.), Budapest, Hungary
| | - S Meckel
- From the Department of Neuroradiology (C.A.T., S.M., H.U., J.B.), Medical Centre-University of Freiburg, Freiburg, Germany
| | - H Urbach
- From the Department of Neuroradiology (C.A.T., S.M., H.U., J.B.), Medical Centre-University of Freiburg, Freiburg, Germany
| | - P Kan
- Department of Neurosurgery (P.K.), Baylor College of Medicine, Houston, Texas
| | - R Siekmann
- Department of Neuroradiology (R.S.), Klinikum Kassel, Kassel, Germany
| | - J Bernardy
- From the Department of Neuroradiology (C.A.T., S.M., H.U., J.B.), Medical Centre-University of Freiburg, Freiburg, Germany
| | - M J Gounis
- New England Center for Stroke Research (M.J.G.)
| | - A K Wakhloo
- Division of Neuroimaging and Intervention (A.K.W.), Departments of Radiology, Neurology, and Neurosurgery, University of Massachusetts Medical School, Worcester, Massachusetts
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44
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Rossetti D, Vitale SG, Gulino FA, Biondi A, Cignini P, Rapisarda AMC, Privitera S, Frigerio L. Pelvic arterial embolization for postpartum hemorrhage: long term results of a single center experience in 29,091 deliveries. CLIN EXP OBSTET GYN 2016. [DOI: 10.12891/ceog3132.2016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Madan V, Shyamsunder P, Han L, Mayakonda A, Nagata Y, Sundaresan J, Kanojia D, Yoshida K, Ganesan S, Hattori N, Fulton N, Tan KT, Alpermann T, Kuo MC, Rostami S, Matthews J, Sanada M, Liu LZ, Shiraishi Y, Miyano S, Chendamarai E, Hou HA, Malnassy G, Ma T, Garg M, Ding LW, Sun QY, Chien W, Ikezoe T, Lill M, Biondi A, Larson RA, Powell BL, Lübbert M, Chng WJ, Tien HF, Heuser M, Ganser A, Koren-Michowitz M, Kornblau SM, Kantarjian HM, Nowak D, Hofmann WK, Yang H, Stock W, Ghavamzadeh A, Alimoghaddam K, Haferlach T, Ogawa S, Shih LY, Mathews V, Koeffler HP. Comprehensive mutational analysis of primary and relapse acute promyelocytic leukemia. Leukemia 2016; 30:2430. [PMID: 27713533 PMCID: PMC7609306 DOI: 10.1038/leu.2016.237] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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46
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Manara E, Basso G, Zampini M, Buldini B, Tregnago C, Rondelli R, Masetti R, Bisio V, Frison M, Polato K, Cazzaniga G, Menna G, Fagioli F, Merli P, Biondi A, Pession A, Locatelli F, Pigazzi M. Characterization of children with FLT3-ITD acute myeloid leukemia: a report from the AIEOP AML-2002 study group. Leukemia 2016; 31:18-25. [PMID: 27416911 DOI: 10.1038/leu.2016.177] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 05/30/2016] [Accepted: 06/03/2016] [Indexed: 01/02/2023]
Abstract
Recurrent molecular markers have been routinely used in acute myeloid leukemia (AML) for risk assessment at diagnosis, whereas their post-induction monitoring still represents a debated issue. We evaluated the prognostic value and biological impact of minimal residual disease (MRD) and of the allelic ratio (AR) of FLT3-internal-tandem duplication (ITD) in childhood AML. We retrospectively screened 494 children with de novo AML for FLT3-ITD mutation, identifying 54 harboring the mutation; 51% of them presented high ITD-AR at diagnosis and had worse event-free survival (EFS, 19.2 versus 63.5% for low ITD-AR, <0.05). Forty-one percent of children with high levels of MRD after the 1st induction course, measured by a patient-specific real-time-PCR, had worse EFS (22.2 versus 59.4% in low-MRD patients, P<0.05). Next, we correlated these parameters with gene expression, showing that patients with high ITD-AR or persistent MRD had characteristic expression profiles with deregulated genes involved in methylation and acetylation. Moreover, patients with high CyclinA1 expression presented an unfavorable EFS (20.3 versus 51.2% in low CyclinA1 group, P<0.01). Our results suggest that ITD-AR levels and molecular MRD should be considered in planning clinical management of FLT3-ITD patients. Different transcriptional activation of epigenetic and oncogenic profiles may explain variability in outcome among these patients, for whom novel therapeutic approaches are desirable.
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Affiliation(s)
- E Manara
- Istituto di Ricerca Pediatrica - Città della Speranza, Padova, Italy
| | - G Basso
- Dipartimento di Salute della Donna e del Bambino, Clinica di Oncoematologia Pediatrica, Università di Padova, Padova, Italy
| | - M Zampini
- Istituto di Ricerca Pediatrica - Città della Speranza, Padova, Italy
| | - B Buldini
- Dipartimento di Salute della Donna e del Bambino, Clinica di Oncoematologia Pediatrica, Università di Padova, Padova, Italy
| | - C Tregnago
- Dipartimento di Salute della Donna e del Bambino, Clinica di Oncoematologia Pediatrica, Università di Padova, Padova, Italy
| | - R Rondelli
- Clinica Pediatrica, Università di Bologna, Ospedale 'S. Orsola', Bologna, Italy
| | - R Masetti
- Clinica Pediatrica, Università di Bologna, Ospedale 'S. Orsola', Bologna, Italy
| | - V Bisio
- Dipartimento di Salute della Donna e del Bambino, Clinica di Oncoematologia Pediatrica, Università di Padova, Padova, Italy
| | - M Frison
- Dipartimento di Salute della Donna e del Bambino, Clinica di Oncoematologia Pediatrica, Università di Padova, Padova, Italy
| | - K Polato
- Dipartimento di Salute della Donna e del Bambino, Clinica di Oncoematologia Pediatrica, Università di Padova, Padova, Italy
| | - G Cazzaniga
- Clinica Pediatrica, Centro Ricerca Tettamanti, Università di Milano-Bicocca, Monza, Italia
| | - G Menna
- Department of Paediatric Haemato-Oncology, Santobono-Pausilipon Hospital, Napoli, Italy
| | - F Fagioli
- Paediatric Onco-Haematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children's Hospital, Torino, Italy
| | - P Merli
- IRCCS Bambino Gesù Children's Hospital Rome, Università di Pavia, Rome, Italy
| | - A Biondi
- Clinica Pediatrica, Centro Ricerca Tettamanti, Università di Milano-Bicocca, Monza, Italia
| | - A Pession
- Clinica Pediatrica, Università di Bologna, Ospedale 'S. Orsola', Bologna, Italy
| | - F Locatelli
- IRCCS Bambino Gesù Children's Hospital Rome, Università di Pavia, Rome, Italy
| | - M Pigazzi
- Dipartimento di Salute della Donna e del Bambino, Clinica di Oncoematologia Pediatrica, Università di Padova, Padova, Italy
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47
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Rausei S, Ruspi L, Rosa F, Morgagni P, Marrelli D, Cossu A, Cananzi FCM, Lomonaco R, Coniglio A, Biondi A, Cipollari C, Graziosi L, Fumagalli U, Casella F, Bertoli P, di Leo A, Alfieri S, Vittimberga G, Roviello F, Orsenigo E, Quagliuolo V, Montemurro S, Baiocchi G, Persiani R, Bencivenga M, Donini A, Rosati R, Sansonetti A, Ansaloni L, Zanoni A, Galli F, Dionigi G. Extended lymphadenectomy in elderly and/or highly co-morbid gastric cancer patients: A retrospective multicenter study. Eur J Surg Oncol 2016; 42:1881-1889. [PMID: 27266816 DOI: 10.1016/j.ejso.2016.05.003] [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: 11/09/2015] [Revised: 03/15/2016] [Accepted: 05/05/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Gastrectomy with extended lymphadenectomy is considered the gold standard treatment for advanced gastric cancer, with no age- or comorbidity-related limitations. We evaluated the safety and efficacy of curative gastrectomy with extended nodal dissection, verifying survival in elderly and highly co-morbid patients. METHODS In a retrospective multicenter study, we examined 1322 non-metastatic gastric-cancer patients that underwent curative gastrectomy with D2 versus D1 lymphadenectomy from January 2000 to December 2009. Postoperative complications, overall survival (OS), and disease-specific survival (DSS) according to age and the Charlson Comorbidity Score were analyzed in relation to the extent of lymphadenectomy. RESULTS Postoperative morbidity was 30.4%. Complications were more frequent in highly co-morbid elderly patients, and, although general morbidity rates after D2 and D1 lymphadenectomy were similar (29.9% and 33.2%, respectively), they increased following D2 in highly co-morbid elderly patients (39.6%). D2-lymphadenectomy significantly improved 5-year OS and DSS (48.0% vs. 37.6% in D1, p < 0.001 and 72.6% vs. 58.1% in D1, p < 0.001, respectively) in all patients. In elderly patients, this benefit was present only in 5-year DSS. D2 nodal dissection induced better 5-year OS and DSS rates in elderly patients with positive nodes (29.7% vs. 21.2% in D1, p = 0.008 and 47.5% vs. 30.6% in D1, p = 0.001, respectively), although it was present only in DSS when highly co-morbid elderly patients were considered. CONCLUSION Extended lymphadenectomy confirmed better survival rates in gastric cancer patients. Due to high postoperative complication rate and no significant improvement of the OS, D1 lymphadenectomy should be considered in elderly and/or highly co-morbid gastric cancer patients.
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Affiliation(s)
- S Rausei
- Department of Surgery, University of Insubria, Viale Luigi Borri, 57, 21100 Varese, VA, Italy.
| | - L Ruspi
- Department of Surgery, University of Insubria, Viale Luigi Borri, 57, 21100 Varese, VA, Italy
| | - F Rosa
- Division of Digestive Surgery, Department of Surgical Sciences, Catholic University, Largo F. Vito, 1, 00168 Rome, RM, Italy
| | - P Morgagni
- General Surgery, Morgagni-Pierantoni Hospital, Via Carlo Forlanini, 34, 47121 Forlì, FC, Italy
| | - D Marrelli
- Department of General Surgery and Oncology, University of Siena, Policlinico Santa Maria alle Scotte, Viale Bracci, 53100 Siena, SI, Italy
| | - A Cossu
- Department of Surgery, Vita-Salute San Raffaele University, Via Olgettina, 58, 20132 Milan, MI, Italy
| | - F C M Cananzi
- Division of Surgical Oncology, Humanitas Clinical and Research Center, Via Alessandro Manzoni, 56, 20089 Rozzano, MI, Italy
| | - R Lomonaco
- Surgery Unit, National Cancer Research Centre, Giovanni Paolo II, Viale Orazio Flacco 65, 70124 Bari, BA, Italy
| | - A Coniglio
- Department of Clinical and Experimental Sciences, Brescia University, Piazzale Spedali Civili, 1, 25123 Brescia, BS, Italy
| | - A Biondi
- Division of General Surgery, Department of Surgical Sciences, Catholic University, Largo F. Vito, 1, 00168 Rome, RM, Italy
| | - C Cipollari
- Department of Surgery, University of Verona, Ospedale Borgo Trento, P.le A. Stefani 1, 37126 Verona, VR, Italy
| | - L Graziosi
- General and Emergency Surgery, University of Perugia, S. Andrea delle Fratte, 06156 Perugia, PG, Italy
| | - U Fumagalli
- Division of General and Minimally Invasive Surgery, Humanitas Clinical and Research Center, Via Alessandro Manzoni, 56, 20089 Rozzano, MI, Italy
| | - F Casella
- Division of General Surgery, Vannini Hospital, Via di Acqua Bullicante, 4, 00177 Rome, RM, Italy
| | - P Bertoli
- Division of General Surgery I, Papa Giovanni XXIII Hospital, Piazza OMS, 1, 24127 Bergamo, BG, Italy
| | - A di Leo
- Division of General Surgery, Rovereto Hospital, Corso Verona, 4, 38068 Rovereto, TN, Italy
| | - S Alfieri
- Division of Digestive Surgery, Department of Surgical Sciences, Catholic University, Largo F. Vito, 1, 00168 Rome, RM, Italy
| | - G Vittimberga
- General Surgery, Morgagni-Pierantoni Hospital, Via Carlo Forlanini, 34, 47121 Forlì, FC, Italy
| | - F Roviello
- Department of General Surgery and Oncology, University of Siena, Policlinico Santa Maria alle Scotte, Viale Bracci, 53100 Siena, SI, Italy
| | - E Orsenigo
- Department of Surgery, Vita-Salute San Raffaele University, Via Olgettina, 58, 20132 Milan, MI, Italy
| | - V Quagliuolo
- Division of Surgical Oncology, Humanitas Clinical and Research Center, Via Alessandro Manzoni, 56, 20089 Rozzano, MI, Italy
| | - S Montemurro
- Surgery Unit, National Cancer Research Centre, Giovanni Paolo II, Viale Orazio Flacco 65, 70124 Bari, BA, Italy
| | - G Baiocchi
- Department of Clinical and Experimental Sciences, Brescia University, Piazzale Spedali Civili, 1, 25123 Brescia, BS, Italy
| | - R Persiani
- Division of General Surgery, Department of Surgical Sciences, Catholic University, Largo F. Vito, 1, 00168 Rome, RM, Italy
| | - M Bencivenga
- Department of Surgery, University of Verona, Ospedale Borgo Trento, P.le A. Stefani 1, 37126 Verona, VR, Italy
| | - A Donini
- General and Emergency Surgery, University of Perugia, S. Andrea delle Fratte, 06156 Perugia, PG, Italy
| | - R Rosati
- Department of Surgery, Vita-Salute San Raffaele University, Via Olgettina, 58, 20132 Milan, MI, Italy; Division of General and Minimally Invasive Surgery, Humanitas Clinical and Research Center, Via Alessandro Manzoni, 56, 20089 Rozzano, MI, Italy
| | - A Sansonetti
- Division of General Surgery, Vannini Hospital, Via di Acqua Bullicante, 4, 00177 Rome, RM, Italy
| | - L Ansaloni
- Division of General Surgery I, Papa Giovanni XXIII Hospital, Piazza OMS, 1, 24127 Bergamo, BG, Italy
| | - A Zanoni
- Division of General Surgery, Rovereto Hospital, Corso Verona, 4, 38068 Rovereto, TN, Italy
| | - F Galli
- Department of Surgery, University of Insubria, Viale Luigi Borri, 57, 21100 Varese, VA, Italy
| | - G Dionigi
- Department of Surgery, University of Insubria, Viale Luigi Borri, 57, 21100 Varese, VA, Italy
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Driessen EMC, de Lorenzo P, Campbell M, Felice M, Ferster A, Hann I, Vora A, Hovi L, Escherich G, Li CK, Mann G, Leblanc T, Locatelli F, Biondi A, Rubnitz J, Schrappe M, Silverman L, Stary J, Suppiah R, Szczepanski T, Valsecchi M, Pieters R. Outcome of relapsed infant acute lymphoblastic leukemia treated on the interfant-99 protocol. Leukemia 2016; 30:1184-7. [PMID: 26369984 DOI: 10.1038/leu.2015.246] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- E M C Driessen
- Pediatric Oncology/Hematology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - P de Lorenzo
- Interfant-99 Trial Data Center, Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Monza, Italy
| | - M Campbell
- Chilean National Pediatric Oncology Group, PINDA, Roberto del Rio Hospital, Universidad de Chile, Santiago, Chile
| | - M Felice
- Department of Pediatric Hematology/Oncology, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina
| | - A Ferster
- Department of Hemato-Oncology, Hôpital Unviversitaire des Enfants Reine Fabiola (ULB), Brussels, Belgium
| | - I Hann
- UK Children's Cancer Study Group, Great Ormond Street Hospital for Children, London, UK
| | - A Vora
- Department of Paediatric Haematology, Sheffield Children's Hospital, Sheffield, UK
| | - L Hovi
- Nordic Society of Paediatric Haematology and Oncology, University of Helsinki, Helsinki, Finland
| | - G Escherich
- University Medical Center Hamburg-Eppendorf, Clinic of Pediatric Hematology and Oncology, Hamburg, Germany
| | - C K Li
- Hong Kong Paediatric Haematology and Oncology Study Group, Prince of Wales Hospital, Hong Kong, China
| | - G Mann
- St. Anna Children's Cancer Research Institute and St. Anna Children's Hospital, Department of Pediatrics, Medical University School, Vienna, Austria
| | - T Leblanc
- Departement of Pediatric Hematology, Hôpital Robert-Debré, Paris, fort he FRALLE group, Paris, France
| | - F Locatelli
- Associazione Italiana Ematologia Oncologia Pediatrica, Italy Bambino Gesù Children's Hospital, Rome, Italy
| | - A Biondi
- Associazione Italiana Ematologia Oncologia Pediatrica, Italy Bambino Gesù Children's Hospital, Rome, Italy
| | - J Rubnitz
- St Jude Children's Research Hospital, Memphis, TN, USA
| | - M Schrappe
- Berlin-Frankfurt-Münster Study Group, Hannover, Germany
| | - L Silverman
- Dana-Farber Cancer Institute ALL Consortium, Boston, MA, USA
| | - J Stary
- Czech Pediatric Haematology, Prague, Czech Republic
| | - R Suppiah
- Australian and New Zealand Children's Haematology and Oncology Study Group, North Adelaide, Australia
| | - T Szczepanski
- Polish Pediatric Leukemia and Lymphoma Study Group, and Department of Pediatric Hematology and Oncology, Zabrze, Medical University of Silesia, Katowice, Poland
| | - M Valsecchi
- Interfant-99 Trial Data Center, Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Monza, Italy
| | - R Pieters
- Pediatric Oncology/Hematology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Dutch Childhood Oncology Group, The Hague, the Netherlands
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49
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Madan V, Shyamsunder P, Han L, Mayakonda A, Nagata Y, Sundaresan J, Kanojia D, Yoshida K, Ganesan S, Hattori N, Fulton N, Tan KT, Alpermann T, Kuo MC, Rostami S, Matthews J, Sanada M, Liu LZ, Shiraishi Y, Miyano S, Chendamarai E, Hou HA, Malnassy G, Ma T, Garg M, Ding LW, Sun QY, Chien W, Ikezoe T, Lill M, Biondi A, Larson RA, Powell BL, Lübbert M, Chng WJ, Tien HF, Heuser M, Ganser A, Koren-Michowitz M, Kornblau SM, Kantarjian HM, Nowak D, Hofmann WK, Yang H, Stock W, Ghavamzadeh A, Alimoghaddam K, Haferlach T, Ogawa S, Shih LY, Mathews V, Koeffler HP. Comprehensive mutational analysis of primary and relapse acute promyelocytic leukemia. Leukemia 2016; 30:1672-81. [PMID: 27063598 PMCID: PMC4972641 DOI: 10.1038/leu.2016.69] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [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: 12/01/2015] [Revised: 02/12/2016] [Accepted: 03/15/2016] [Indexed: 12/16/2022]
Abstract
Acute promyelocytic leukemia (APL) is a subtype of myeloid leukemia characterized by differentiation block at the promyelocyte stage. Besides the presence of chromosomal rearrangement t(15;17), leading to the formation of PML-RARA (promyelocytic leukemia-retinoic acid receptor alpha) fusion, other genetic alterations have also been implicated in APL. Here, we performed comprehensive mutational analysis of primary and relapse APL to identify somatic alterations, which cooperate with PML-RARA in the pathogenesis of APL. We explored the mutational landscape using whole-exome (n=12) and subsequent targeted sequencing of 398 genes in 153 primary and 69 relapse APL. Both primary and relapse APL harbored an average of eight non-silent somatic mutations per exome. We observed recurrent alterations of FLT3, WT1, NRAS and KRAS in the newly diagnosed APL, whereas mutations in other genes commonly mutated in myeloid leukemia were rarely detected. The molecular signature of APL relapse was characterized by emergence of frequent mutations in PML and RARA genes. Our sequencing data also demonstrates incidence of loss-of-function mutations in previously unidentified genes, ARID1B and ARID1A, both of which encode for key components of the SWI/SNF complex. We show that knockdown of ARID1B in APL cell line, NB4, results in large-scale activation of gene expression and reduced in vitro differentiation potential.
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Affiliation(s)
- V Madan
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
| | - P Shyamsunder
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
| | - L Han
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - A Mayakonda
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
| | - Y Nagata
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - J Sundaresan
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
| | - D Kanojia
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
| | - K Yoshida
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - S Ganesan
- Department of Haematology, Christian Medical College, Vellore, India
| | - N Hattori
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
| | - N Fulton
- Section of Hematology/Oncology, University of Chicago, Chicago, IL, USA
| | - K-T Tan
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
| | - T Alpermann
- Munich Leukemia Laboratory (MLL), Munich, Germany
| | - M-C Kuo
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - S Rostami
- Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - J Matthews
- Section of Molecular Hematology and Therapy, Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - M Sanada
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - L-Z Liu
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
| | - Y Shiraishi
- Laboratory of DNA Information Analysis, Human Genome Center, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - S Miyano
- Laboratory of DNA Information Analysis, Human Genome Center, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - E Chendamarai
- Department of Haematology, Christian Medical College, Vellore, India
| | - H-A Hou
- Department of Internal Medicine, National Taiwan University, Medical College and Hospital, Taipei, Taiwan
| | - G Malnassy
- Section of Hematology/Oncology, University of Chicago, Chicago, IL, USA
| | - T Ma
- Division of Hematology, Oncology and Stem Cell Transplantation, Department of Internal Medicine, University of Freiburg Medical Center, Freiburg, Germany
| | - M Garg
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
| | - L-W Ding
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
| | - Q-Y Sun
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
| | - W Chien
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
| | - T Ikezoe
- Department of Hematology and Respiratory Medicine, Kochi Medical School, Kochi University, Nankoku, Kochi, Japan
| | - M Lill
- Cedars-Sinai Medical Center, Division of Hematology/Oncology, UCLA School of Medicine, Los Angeles, CA, USA
| | - A Biondi
- Paediatric Haematology-Oncology Department and 'Tettamanti' Research Centre, Milano-Bicocca University, 'Fondazione MBBM', San Gerardo Hospital, Monza, Italy
| | - R A Larson
- Department of Medicine, University of Chicago Comprehensive Cancer Center, Chicago, IL, USA
| | - B L Powell
- Department of Internal Medicine, Section on Hematology and Oncology, Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC, USA
| | - M Lübbert
- Division of Hematology, Oncology and Stem Cell Transplantation, Department of Internal Medicine, University of Freiburg Medical Center, Freiburg, Germany
| | - W J Chng
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Hematology-Oncology, National University Cancer Institute of Singapore (NCIS), The National University Health System (NUHS), Singapore, Singapore
| | - H-F Tien
- Department of Internal Medicine, National Taiwan University, Medical College and Hospital, Taipei, Taiwan
| | - M Heuser
- Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - A Ganser
- Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - M Koren-Michowitz
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Hematology and Bone Marrow Transplantation, Sheba Medical Center, Tel Hashomer, Israel
| | - S M Kornblau
- Section of Molecular Hematology and Therapy, Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - H M Kantarjian
- Section of Molecular Hematology and Therapy, Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - D Nowak
- Department of Hematology and Oncology, University Hospital Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
| | - W-K Hofmann
- Department of Hematology and Oncology, University Hospital Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
| | - H Yang
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
| | - W Stock
- Section of Hematology/Oncology, University of Chicago, Chicago, IL, USA
| | - A Ghavamzadeh
- Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - K Alimoghaddam
- Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - T Haferlach
- Munich Leukemia Laboratory (MLL), Munich, Germany
| | - S Ogawa
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - L-Y Shih
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - V Mathews
- Department of Haematology, Christian Medical College, Vellore, India
| | - H P Koeffler
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore.,Cedars-Sinai Medical Center, Division of Hematology/Oncology, UCLA School of Medicine, Los Angeles, CA, USA.,Department of Hematology-Oncology, National University Cancer Institute of Singapore (NCIS), The National University Health System (NUHS), Singapore, Singapore
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50
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Ippolito D, Masetto A, Franzesi CT, Bonaffini PA, Sala A, Biondi A, Sironi S. Lower-limb MRI in the staging and re-staging of osteonecrosis in paediatric patients affected by acute lymphoblastic leukaemia after therapy. Skeletal Radiol 2016; 45:495-503. [PMID: 26782927 DOI: 10.1007/s00256-016-2329-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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: 11/06/2015] [Revised: 01/03/2016] [Accepted: 01/04/2016] [Indexed: 02/08/2023]
Abstract
PURPOSE To assess the diagnostic value of MRI examination in detecting and monitoring osteonecrotic lesions (ON) in childhood acute lymphoblastic leukaemia (ALL) after chemotherapy (CHT) and/or bone marrow transplantation (BMT). METHODS AND MATERIALS Seventy-three patients (37 males, mean age 12.4 years old) with ALL after treatment underwent a lower-limb MR examination between November 2006 and March 2012. In 47 there was clinical suspicion of ON, 26 were asymptomatic. Studies were performed with a 1 T and a 1.5 T scanner, acquiring short tau inversion recovery (STIR) and T1-weighted sequences in coronal plane from the hips to the ankles. The average acquisition time was 18 min. Considering baseline and follow-up examinations, the overall number of MRI studies was 195. RESULTS Fifty-four of 73 patients showed ON at MRI study, with an overall number of 323 ON (89 involving articular surface, 24 with joint deformity, JD). Twenty-five of 47 symptomatic patients showed subchondral ON lesions, 11 developed JD. Three of 26 asymptomatic patients showed subchondral bone ON at baseline examination but no JD at follow-up. Twenty-two of 28 BMT, 32/45 CHT patients developed ON. CONCLUSION Our MRI protocol proved to be feasible in evaluating ON in paediatric patients. Studies should be addressed only to symptomatic patients.
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Affiliation(s)
- D Ippolito
- School of Medicine, University of Milano-Bicocca Milan, Via Pergolesi 33, 20900, Monza (MB), Italy.
- Department of Diagnostic Radiology, H. San Gerardo, Via Pergolesi 33, 20900, Monza (MB), Italy.
| | - A Masetto
- School of Medicine, University of Milano-Bicocca Milan, Via Pergolesi 33, 20900, Monza (MB), Italy
- Department of Diagnostic Radiology, H. San Gerardo, Via Pergolesi 33, 20900, Monza (MB), Italy
| | - C Talei Franzesi
- School of Medicine, University of Milano-Bicocca Milan, Via Pergolesi 33, 20900, Monza (MB), Italy
- Department of Diagnostic Radiology, H. San Gerardo, Via Pergolesi 33, 20900, Monza (MB), Italy
| | - P A Bonaffini
- School of Medicine, University of Milano-Bicocca Milan, Via Pergolesi 33, 20900, Monza (MB), Italy
- Department of Diagnostic Radiology, H. San Gerardo, Via Pergolesi 33, 20900, Monza (MB), Italy
| | - A Sala
- School of Medicine, University of Milano-Bicocca Milan, Via Pergolesi 33, 20900, Monza (MB), Italy
- Department of Paediatric Haematology, H S. Gerardo, Via Pergolesi 33, 20900, Monza (MB), Italy
| | - A Biondi
- School of Medicine, University of Milano-Bicocca Milan, Via Pergolesi 33, 20900, Monza (MB), Italy
- Department of Paediatric Haematology, H S. Gerardo, Via Pergolesi 33, 20900, Monza (MB), Italy
| | - S Sironi
- School of Medicine, University of Milano-Bicocca Milan, Via Pergolesi 33, 20900, Monza (MB), Italy
- Department of Diagnostic Radiology, H. San Gerardo, Via Pergolesi 33, 20900, Monza (MB), Italy
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