1
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Barilà G, Quaglia FM, Furlan A, Pescosta N, Bonalumi A, Marcon C, Pascarella A, Tinelli M, De March E, Lico A, Sartori R, Clissa C, De Sabbata G, Nappi D, Porrazzo M, De Marchi R, Pavan L, Tosetto A, Gherlinzoni F, Krampera M, Bassan R, Patriarca F, Semenzato G, Zambello R. A real-life study of daratumumab-bortezomib-dexamethasone (D-VD) in lenalidomide exposed/refractory multiple myeloma patients: a report from the Triveneto Myeloma Working Group. Ann Hematol 2024; 103:125-132. [PMID: 37731147 PMCID: PMC10761376 DOI: 10.1007/s00277-023-05443-8] [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] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 09/05/2023] [Indexed: 09/22/2023]
Abstract
Treatment of lenalidomide refractory (Len-R) multiple myeloma (MM) patients still represents an unmet clinical need. In the last years, daratumumab-bortezomib-dexamethasone (D-VD) combination was extensively used in this setting, even though only a small fraction of Len-R patients was included in the pivotal trial. This real-life study aimed to evaluate the efficacy and safety of the D-VD regimen in a cohort that exclusively enrolled Len exposed or refractory MM patients. The study cohort included 57 patients affected by relapsed/refractory MM. All patients were previously exposed to Len, with 77.2% being refractory. The overall response rate (ORR) was 79.6% with 43% of cases obtaining at least a very good partial response (VGPR). The D-VD regimen showed a favorable safety profile, with low frequency of grade 3-4 adverse events, except for thrombocytopenia observed in 21.4% of patients. With a median follow-up of 13 months, median progression-free survival (PFS) was 17 months. No significant PFS differences were observed according to age, ISS, LDH levels, type of relapse, and high-risk FISH. Len exposed patients displayed a PFS advantage as compared to Len refractory patients (29 vs 16 months, p = 0.2876). Similarly, patients treated after Len maintenance showed a better outcome as compared to patients who had received a full-dose Len treatment (23 vs 13 months, p = 0.1728). In conclusion, our real-world data on D-VD combination showed remarkable efficacy in Len-R patients, placing this regimen as one of the standards of care to be properly taken into account in this MM setting.
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Affiliation(s)
| | | | - Anna Furlan
- Hematology Unit, Santa Maria di Ca' Foncello Hospital, Treviso, Italy
| | - Norbert Pescosta
- Ematologia e Centro TMO, Ospedale Centrale Bolzano, Bozen, Italy
| | - Angela Bonalumi
- Hematology Unit, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Chiara Marcon
- Hematology and Transplant Center Unit, Udine University Hospital, DAME, University of Udine, Udine, Italy
| | - Anna Pascarella
- Hematology Unit, Ospedale dell'Angelo, Mestre-Venezia, Italy
| | - Martina Tinelli
- Hematology Unit, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Elena De March
- Department of Medicine, Section of Hematology, Belluno Hospital, Belluno, Italy
| | - Albana Lico
- Hematology Unit, San Bortolo Hospital, Vicenza, Italy
| | - Roberto Sartori
- Department of Clinical and Experimental Oncology, Onco-hematology Unit, Veneto Institute of Oncology, IOV-IRCCS, Castelfranco Veneto (TV), Italy
| | - Cristina Clissa
- Hematology Unit, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Giovanni De Sabbata
- Struttura Complessa Ematologia, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Davide Nappi
- Ematologia e Centro TMO, Ospedale Centrale Bolzano, Bozen, Italy
| | - Marika Porrazzo
- Struttura Complessa Ematologia, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Roberta De Marchi
- Department of Clinical and Experimental Oncology, Onco-hematology Unit, Veneto Institute of Oncology, IOV-IRCCS, Castelfranco Veneto (TV), Italy
| | - Laura Pavan
- Department of Medicine (DIMED), Hematology and Clinical Immunology section, Padova University School of Medicine, Via Giustiniani 2, 35128, Padua, Italy
| | | | | | - Mauro Krampera
- Hematology Unit, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Renato Bassan
- Hematology Unit, Ospedale dell'Angelo, Mestre-Venezia, Italy
| | - Francesca Patriarca
- Hematology and Transplant Center Unit, Udine University Hospital, DAME, University of Udine, Udine, Italy
| | - Gianpietro Semenzato
- Department of Medicine (DIMED), Hematology and Clinical Immunology section, Padova University School of Medicine, Via Giustiniani 2, 35128, Padua, Italy
| | - Renato Zambello
- Department of Medicine (DIMED), Hematology and Clinical Immunology section, Padova University School of Medicine, Via Giustiniani 2, 35128, Padua, Italy.
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2
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Bruzzese A, Derudas D, Galli M, Martino EA, Rocco S, Conticello C, Califano C, Giuliani N, Mangiacavalli S, Farina G, Lombardo A, Brunori M, Rossi E, Antonioli E, Ria R, Zambello R, Di Renzo N, Mele G, Marcacci G, Pietrantuono G, Palumbo G, Cascavilla N, Cerchione C, Belotti A, Criscuolo C, Uccello G, Curci P, Vigna E, Mendicino F, Iaccino E, Mimmi S, Botta C, Vincelli D, Sgherza N, Bonalumi A, Cupelli L, Stocchi R, Martino M, Ballanti S, Gangemi D, Gagliardi A, Gamberi B, Pompa A, Tripepi G, Frigeri F, Consoli U, Bringhen S, Zamagni E, Patriarca F, De Stefano V, Di Raimondo F, Palmieri S, Petrucci MT, Offidani M, Musto P, Boccadoro M, Cavo M, Neri A, Morabito F, Gentile M. Elotuzumab plus Lenalidomide and Dexamethasone in Relapsed/Refractory Multiple Myeloma: Extended 3-year follow-up of a multicenter, retrospective clinical experience with 319 cases outside of controlled clinical trials. Hematol Oncol 2022; 40:704-715. [PMID: 35608183 DOI: 10.1002/hon.3031] [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] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 05/21/2022] [Indexed: 11/09/2022]
Abstract
The combination of elotuzumab, lenalidomide, and dexamethasone (EloRd) enhanced the clinical benefit over Rd with a manageable toxicity profile in the ELOQUENT-2 trial, leading to its approval in relapsed/refractory multiple myeloma (RRMM). The present study is a 3-year follow-up update of a previously published Italian real-life RRMM cohort of patients treated with EloRd. This revised analysis entered 319 RRMM patients accrued in 41 Italian centers. After a median follow-up of 36 months (range 6-55), 236 patients experienced disease progression or died. Median progression-free survival (PFS) and overall survival (OS) were 18.4 and 34 months, respectively. The updated multivariate analyses showed a significant reduction of PFS and OS benefit magnitude only in cases with ISS stage III. Major adverse events included grade 3/4 neutropenia (18.5%), anemia (15.4%), lymphocytopenia (12.5%), and thrombocytopenia (10.7%), while infection rates and pneumonia were 33.9% and 18.9%, respectively. No new safety signals with longer follow-up have been observed. Of 319 patients, 245 (76.7%) reached at least a partial remission. A significantly lower response rate was found in patients previously exposed to lenalidomide. In conclusion, our study confirms that EloRd is a safe and effective regimen for RRMM patients, maintaining benefits across multiple unfavorable subgroups. This article is protected by copyright. All rights reserved.
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Affiliation(s)
| | | | - Monica Galli
- Hematology and Bone Marrow Transplant Unit, Azienda Socio-Sanitaria Territoriale-Papa Giovanni XXIII, Bergamo, Italy
| | | | | | - Concetta Conticello
- Department of medical and surgical specialties, Hematology Section, University of Catania, Catania, Italy
| | - Catello Califano
- Onco-hematology Unit, Ospedale Umberto I, Nocera Inferiore, Italy
| | | | - Silvia Mangiacavalli
- Hematology Division, Department of Hematology-Oncology, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - Giuliana Farina
- UOC Ematologia a Indirizzo Oncologico, AORN "Sant'Anna e San Sebastiano", Caserta, Italy
| | | | - Marino Brunori
- Internal Medicine, Ospedale S. Croce, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Presidio of Fano, Italy
| | - Elena Rossi
- Istituto di Ematologia, Università Cattolica, Fondazione Policlinico Gemelli IRCCS, Roma, Italy
| | | | - Roberto Ria
- Department of Biomedical Science, University of Bari "Aldo Moro" Medical School, Internal Medicine "G. Baccelli", Policlinico, Bari, Italy
| | - Renato Zambello
- Department of Medicine, Hematology and Clinical Immunology Section, Padua University School of Medicine, Padua, Italy
| | | | | | - Gianpaolo Marcacci
- Hematology and Bone Marrow Transplant Unit, Fondazione 'G. Pascale', Istituto Nazionale Tumori, IRCCS, Napoli, Italy
| | - Giuseppe Pietrantuono
- Unit of Hematology and Stem Cell Transplantation, IRCCS-CROB, Referral Cancer Center of Basilicata, Rionero in Vulture (Pz), Italy
| | - Gaetano Palumbo
- Department of Hematology, Hospital University Riuniti, Foggia, Italy
| | - Nicola Cascavilla
- Department of Hematology and Bone Marrow Transplant, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Claudio Cerchione
- Hematology Unit, IRCCS - Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy
| | | | | | | | - Paola Curci
- Unit of Hematology and Stem Cell Transplantation, AOUC Policlinico, Bari, Italy
| | - Ernesto Vigna
- Hematology Unit, Azienda Ospedaliera of Cosenza, Cosenza, Italy
| | | | - Enrico Iaccino
- Department of Experimental and Clinical Medicine, University "Magna Graecia" of Catanzaro, Pavia, Italy
| | - Selena Mimmi
- Department of Experimental and Clinical Medicine, University "Magna Graecia" of Catanzaro, Pavia, Italy
| | - Cirino Botta
- Hematology Unit, Azienda Ospedaliera of Cosenza, Cosenza, Italy.,Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Donatella Vincelli
- Hematology Unit, Department of Hemato-Oncology and Radiotherapy, Great Metropolitan Hospital "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | - Nicola Sgherza
- Unit of Hematology and Stem Cell Transplantation, AOUC Policlinico, Bari, Italy
| | - Angela Bonalumi
- Section of Hematology, Department of Medicine, University of Verona, Verona, Italy
| | - Luca Cupelli
- Hematology Unit and Pathology Department, S. Eugenio Hospital Rome, Rome, Italy
| | | | - Massimo Martino
- Stem Cell Transplantation Unit, Department of Hemato-Oncology and Radiotherapy, Great Metropolitan Hospital "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | - Stelvio Ballanti
- Institute of Haematology and Stem Cell transplantation, University of Perugia, Ospedale Santa Maria della Misericordia, Perugia, Italy
| | - Dominella Gangemi
- Hematology Unit, Fabrizio Spaziani Hospital, Frosinone, Pavia, Italy
| | - Alfredo Gagliardi
- Complex Operative Unit of Hematology, S. Maria di Loreto Nuovo Hospital, Napoli, Italy
| | | | - Alessandra Pompa
- Hematology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - Giovanni Tripepi
- Nephrology Center of National Research Institute of Biomedicine and Molecular Immunology, Reggio Calabria, Italy
| | - Ferdinando Frigeri
- UOC Ematologia a Indirizzo Oncologico, AORN "Sant'Anna e San Sebastiano", Caserta, Italy
| | - Ugo Consoli
- Department of Experimental and Clinical Medicine, University "Magna Graecia" of Catanzaro, Pavia, Italy
| | - Sara Bringhen
- Division of Hematology, University of Torino, AOU Città della Salute e della,, Scienza di Torino, Italy
| | - Elena Zamagni
- Seràgnoli Institute of Hematology and Medical Oncology, University of Bologna, Bologna, Italy
| | | | - Valerio De Stefano
- Istituto di Ematologia, Università Cattolica, Fondazione Policlinico Gemelli IRCCS, Roma, Italy
| | - Francesco Di Raimondo
- Department of medical and surgical specialties, Hematology Section, University of Catania, Catania, Italy
| | | | - Maria Teresa Petrucci
- Department of Cellular Biotechnologies and Hematology, Sapienza University of Rome, Bari, Italy
| | | | - Pellegrino Musto
- Unit of Hematology and Stem Cell Transplantation, AOUC Policlinico, Bari, Italy.,Department of Emergency and Organ Transplantation, "Aldo Moro" University School of Medicine, Bari, Italy
| | - Mario Boccadoro
- Division of Hematology, University of Torino, AOU Città della Salute e della,, Scienza di Torino, Italy
| | - Michele Cavo
- Seràgnoli Institute of Hematology and Medical Oncology, University of Bologna, Bologna, Italy
| | - Antonino Neri
- Scientific Direction IRCCS of Reggio Emilia, I-42123 Reggio Emilia, Emilia-Romagna, Italy
| | - Fortunato Morabito
- Hemato-Oncology department, Augusta Victoria Hospital of Jerusalem, Israel.,Biotechnology Research Unit, AO di Cosenza, Italy
| | - Massimo Gentile
- Hematology Unit, Azienda Ospedaliera of Cosenza, Cosenza, Italy
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3
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Laini L, Bonalumi A, Bosio S, Villa N, Amoroso V, Lorini L, Zanini B, Schivardi G, Di Mauro P, Cosentini D, Vassalli L, Alberti A, Esposito A, Cremaschi V, Simoncini E, Berruti A, Pedersini R. 86P Change in dietary habits does not affect body composition in early breast cancer patients treated with aromatase inhibitor. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.03.101] [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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4
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Bertoglio P, Lomangino I, Querzoli G, Bonalumi A, Bogina GS, Terzi AC. Primary Hodgkin lymphoma of the lung arising with hemoptysis and pulmonary consolidation: a case report. Monaldi Arch Chest Dis 2021; 91. [PMID: 34121376 DOI: 10.4081/monaldi.2021.1781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 05/07/2021] [Indexed: 11/23/2022] Open
Abstract
Classic Hodgkin lymphomas are neoplasms originating from lymphoid tissue. Primary extranodal classic Hodgkin lymphoma (PE-cHL) of the lung is rare. A 37-year-old Caucasian male was referred to our hospital for recurrent episodes of hemoptysis, cough and bronchitis. A CT scan showed a massive left upper lung consolidation, which was positive at the PET scan. After several inconclusive tests and no benefit from medical therapies, the patient underwent a left upper lobectomy; pathology report showed a classical type Hodgkin lymphoma with no lymph-nodes involvement. Four cycles of adjuvant chemotherapy were administered with no toxicity. At the last follow up 14 months after surgery, the patient is alive and free from disease. Primary extranodal classical Hodgkin lymphoma of the lung is a rare entity, but it should be considered as a differential diagnosis in young patients with pulmonary consolidation even without systemic symptoms.
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Affiliation(s)
- Pietro Bertoglio
- Division of Thoracic Surgery, IRCCS Sacro Cuore-Don Calabria Hospital, Negrar (VR).
| | | | - Giulia Querzoli
- Division of Pathological Anatomy, IRCCS Sacro Cuore-Don Calabria Hospital, Negrar (VR).
| | | | - Giuseppe S Bogina
- Division of Pathological Anatomy, IRCCS Sacro Cuore-Don Calabria Hospital, Negrar (VR).
| | - Alberto C Terzi
- Division of Thoracic Surgery, IRCCS Sacro Cuore-Don Calabria Hospital, Negrar (VR).
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5
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Gentile M, Specchia G, Derudas D, Galli M, Botta C, Rocco S, Conticello C, Califano C, Giuliani N, Mangiacavalli S, Attingenti E, Lombardo A, Brunori M, Rossi E, Antonioli E, Ria R, Zambello R, Di Renzo N, Mele G, Marcacci G, Musto P, Capalbo S, Cascavilla N, Cerchione C, Belotti A, Criscuolo C, Uccello G, Curci P, Vigna E, Fraticelli V, Vincelli D, Bonalumi A, Siniscalchi A, Stocchi R, Martino M, Ballanti S, Gangemi D, Gagliardi A, Gamberi B, Pompa A, Recchia AG, Tripepi G, Pitino A, Frigeri F, Consoli U, Bringhen S, Zamagni E, Patriarca F, De Stefano V, Di Raimondo F, Palmieri S, Petrucci MT, Offidani M, Boccadoro M, Cavo M, Morabito F. Elotuzumab, lenalidomide, and dexamethasone as salvage therapy for patients with multiple myeloma: Italian, multicenter, retrospective clinical experience with 300 cases outside of controlled clinical trials. Haematologica 2021; 106:291-294. [PMID: 32107338 PMCID: PMC7776255 DOI: 10.3324/haematol.2019.241513] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Massimo Gentile
- Hematology Unit and Biotechnology Research Unit, Azienda Ospedaliera of Cosenza, Cosenza
| | | | | | - Monica Galli
- Hematology and Bone Marrow Transplant Unit, Ospedale Papa Giovanni XXIII, Bergamo
| | - Cirino Botta
- Hematology Unit and Biotechnology Research Unit, Azienda Ospedaliera of Cosenza, Cosenza
| | | | - Concetta Conticello
- Dept of medica and surgical specialties, Hematology Section, University of Catania, Catania
| | | | | | | | | | | | - Marino Brunori
- Internal Medicine, Ospedale S. Croce, Ospedali Riuniti Marche Nord, Fano
| | - Elena Rossi
- Ematologia, Università Cattolica, Fondazione Policlinico Gemelli IRCCS, Roma
| | | | - Roberto Ria
- Department of Biomedical Science, University of Bari
| | - Renato Zambello
- Medicine, Hematology and Clinical Immunology, Padua University School of Medicine, Padua
| | | | | | - Gianpaolo Marcacci
- Hematology and Bone Marrow Transplant Unit, Fondazione 'G. Pascale', IRCCS, Napoli
| | - Pellegrino Musto
- Hematology and Stem Cell Transplantation, IRCCS-CROB, Rionero in Vulture
| | - Silvana Capalbo
- Department of Hematology, Hospital University Riuniti, Foggia
| | - Nicola Cascavilla
- Hematology and Bone Marrow Transplant, Casa Sollievo della Sofferenza, San Giovanni Rotondo
| | - Claudio Cerchione
- Hematology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (MO)
| | | | | | | | | | - Ernesto Vigna
- Hematology Unit and Biotechnology Research Unit, Azienda Ospedaliera of Cosenza, Cosenza
| | - Vincenzo Fraticelli
- Hematology Unit and Biotechnology Research Unit, Azienda Ospedaliera of Cosenza, Cosenza
| | | | - Angela Bonalumi
- Section of Hematology, Department of Medicine, University of Verona, Verona
| | | | | | - Massimo Martino
- Hemato-Oncology and Radiotherapy, Great Metropolitan Hospital
| | - Stelvio Ballanti
- Hematology, Ospedale Santa Maria della Misericordia, University of Perugia, Perugia
| | | | - Alfredo Gagliardi
- Complex Operative Unit of Hematology, S. Maria di Loreto Nuovo Hospital, Napoli
| | | | - Alessandra Pompa
- Hematology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano
| | | | - Giovanni Tripepi
- Nephrology Center of National Research Institute, Reggio Calabria
| | | | | | - Ugo Consoli
- Hematology Department, G. Garibaldi Hospital, Catania
| | - Sara Bringhen
- Div of Hematology,University of Torino,AOU Città della Salute e della Scienza di Torino
| | - Elena Zamagni
- Seragnoli Institute of Hematology and Medical Oncology, University of Bologna, Bologna
| | | | - Valerio De Stefano
- Istituto di Ematologia, Università Cattolica, Fondazione Policlinico Gemelli IRCCS, Roma
| | - Francesco Di Raimondo
- Department of Medical and Surgical Specialties, Hematology Section, University of Catania
| | | | | | | | - Mario Boccadoro
- Div of Hematology,University of Torino,AOU Città della Salute e della Scienza di Torino
| | - Michele Cavo
- Seragnoli Institute of Hematology and Medical Oncology, University of Bologna, Bologna
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6
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Rocchi S, Tacchetti P, Pantani L, Mancuso K, Rizzello I, di Giovanni Bezzi C, Scalese M, Dozza L, Marzocchi G, Martello M, Barilà G, Antonioli E, Staderini M, Buda G, Petrini M, Cea M, Quaresima M, Furlan A, Bonalumi A, Cavo M, Zamagni E. A real-world efficacy and safety analysis of combined carfilzomib, lenalidomide, and dexamethasone (KRd) in relapsed/refractory multiple myeloma. Hematol Oncol 2020; 39:41-50. [PMID: 33085797 DOI: 10.1002/hon.2820] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 08/07/2020] [Revised: 10/14/2020] [Accepted: 10/19/2020] [Indexed: 01/01/2023]
Abstract
Carfilzomib-lenalidomide-dexamethasone (KRd) has been approved for the treatment of relapsed/refractory multiple myeloma (RRMM). We conducted a retrospective analysis of 197 RRMM patients (pts) between January 2016 and March 2018 in six Italian hematologic centers, with the aim to evaluate efficacy and safety of KRd in real-life. At KRd initiation 27% carried high risk cytogenetic abnormalities (HRCA) [del17p and/or t(4;14) and/or t(14;16)], median number of prior lines of therapy was 2 (1-8), nearly all pts (96%) received prior bortezomib (18% refractory) while 45% were exposed to lenalidomide (R; 22% refractory). At the median of 12.5 months, 52% of the pts had discontinued treatment, mainly (66%) for progression. Main grade 3-4 adverse events were neutropenia (21%), infections (11%), and hypertension (6%). Overall, the response rate was 88%. The median progression-free survival (PFS) was 19.8 months and 1-year overall survival (OS) rate was 80.6%. By subgroup analysis, extended PFS and OS were observed for pts who received ≤2 prior lines of therapy (HR = 0.42, p < 0.001 and HR = 0.35, p = 0.001, respectively), not refractory to prior R (HR = 0.37, p < 0.001, and HR = 0.47, p = 0.024), without HRCA (HR = 0.33, p = 0.005 and HR = 0.26, p = 0.016) and achieving ≥ very good partial response (VGPR; HR = 0.17, p < 0.001 and HR = 0.18, p < 0.001). In conclusion, KRd demonstrated to be effective in RRMM pts treated in real-world setting, without new safety concerns. Better survival outcomes emerged for pts with ≤2 prior lines of therapy, achieving at least a VGPR, and without HRCA.
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Affiliation(s)
- Serena Rocchi
- Azienda Ospedaliero-Universitaria di Bologna, Italia - Istituto di Ematologia "Seràgnoli", Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale - Università degli Studi, Bologna, Italy
| | - Paola Tacchetti
- Azienda Ospedaliero-Universitaria di Bologna, Italia - Istituto di Ematologia "Seràgnoli", Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale - Università degli Studi, Bologna, Italy
| | - Lucia Pantani
- Azienda Ospedaliero-Universitaria di Bologna, Italia - Istituto di Ematologia "Seràgnoli", Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale - Università degli Studi, Bologna, Italy
| | - Katia Mancuso
- Azienda Ospedaliero-Universitaria di Bologna, Italia - Istituto di Ematologia "Seràgnoli", Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale - Università degli Studi, Bologna, Italy
| | - Ilaria Rizzello
- Azienda Ospedaliero-Universitaria di Bologna, Italia - Istituto di Ematologia "Seràgnoli", Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale - Università degli Studi, Bologna, Italy
| | - Chiara di Giovanni Bezzi
- Azienda Ospedaliero-Universitaria di Bologna, Italia - Istituto di Ematologia "Seràgnoli", Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale - Università degli Studi, Bologna, Italy
| | | | - Luca Dozza
- Azienda Ospedaliero-Universitaria di Bologna, Italia - Istituto di Ematologia "Seràgnoli", Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale - Università degli Studi, Bologna, Italy
| | - Giulia Marzocchi
- Azienda Ospedaliero-Universitaria di Bologna, Italia - Istituto di Ematologia "Seràgnoli", Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale - Università degli Studi, Bologna, Italy
| | - Marina Martello
- Azienda Ospedaliero-Universitaria di Bologna, Italia - Istituto di Ematologia "Seràgnoli", Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale - Università degli Studi, Bologna, Italy
| | - Gregorio Barilà
- Hematology and Clinical Immunology, Padua University School of Medicine, Padua, Italy
| | | | | | - Gabriele Buda
- Department of Clinical and Experimental Medicine, U.O. Hematology, University of Pisa, Pisa, Italy
| | - Mario Petrini
- Department of Clinical and Experimental Medicine, U.O. Hematology, University of Pisa, Pisa, Italy
| | - Michele Cea
- Hematology Unit, Department of Internal Medicine (DiMI), University of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Anna Furlan
- U.O. Hematology, Ca Foncello Hospital, Treviso, Italy
| | - Angela Bonalumi
- Hematology Unit, Department of Medicine, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Michele Cavo
- Azienda Ospedaliero-Universitaria di Bologna, Italia - Istituto di Ematologia "Seràgnoli", Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale - Università degli Studi, Bologna, Italy
| | - Elena Zamagni
- Azienda Ospedaliero-Universitaria di Bologna, Italia - Istituto di Ematologia "Seràgnoli", Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale - Università degli Studi, Bologna, Italy
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Salvagno G, Pucci M, Veneri D, Bonalumi A, Alzetta D, Lippi G, Dima F. Evaluation of the platelet count with the Sysmex DI-60 system. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.823] [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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8
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Bonifacio M, Scaffidi L, Binotto G, Miggiano MC, Danini M, Minotto C, Griguolo D, Marin L, Frison L, D'Amore F, Basso M, Sartori R, Tinelli M, Stulle M, Fortuna S, Bonalumi A, Bertoldero G, De Biasi E, Ruggeri M, Semenzato G, Fanin R, Pizzolo G, Krampera M, Tiribelli M. Safety and efficacy of switching from branded to generic imatinib in chronic phase chronic myeloid leukemia patients treated in Italy. Leuk Res 2018; 74:75-79. [PMID: 30308414 DOI: 10.1016/j.leukres.2018.09.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 09/15/2018] [Accepted: 09/29/2018] [Indexed: 12/18/2022]
Abstract
The use of generic drugs after patent expiration of their originators is a relative novelty in the treatment of chronic cancer patients in Western countries. In this observational study we analyzed a cohort of 294 Italian chronic phase chronic myeloid leukemia patients treated frontline with branded imatinib (Glivec®) for at least 6 months and then uniformly switched to generic imatinib upon requirement of health authorities in early 2017. Median age at diagnosis was 57 years (range 19-87). Sokal risk was low/intermediate/high in 55%, 32% and 8% of cases, respectively. Median duration of branded imatinib treatment was 7.4 years (range 0.5-16.7). At a median follow-up of 7.5 months after switch to generic imatinib, 17% of patients reported new or worsening side effects, but grade 3-4 non-hematological adverse events were rare. Six patients switched back to branded imatinib, with improvement in the side effect profile, and 4 pts moved to bosutinib or nilotinib for resistance/intolerance. The majority of patients were in major (26%) or deep molecular response (66%) at the time of switch. Molecular responses remained stable, improved or worsened in 61%, 25% and 14% of patients, respectively. We conclude that switch to generic imatinib for patients who have been receiving branded imatinib appears to be effective and safe. Molecular responses may continue to improve over time. Some patients experienced new or worsened side effects but less than 5% of the whole cohort needed to switch back to branded imatinib or move to other treatments. Savings were around 3 million Euros.
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Affiliation(s)
| | - Luigi Scaffidi
- Department of Medicine, Section of Hematology, University of Verona, Italy
| | - Gianni Binotto
- Padua School of Medicine, Department of Medicine, Hematology and Clinical Immunology, Padua, Italy
| | | | - Marco Danini
- Hematology Departmental Unit, P. Cosma Hospital, Camposampiero, Padua, Italy
| | - Claudia Minotto
- Department of Medical Specialities, Oncology and Onco-Haematology Unit, Mirano, Venice, Italy
| | - Davide Griguolo
- Division of Hematology and BMT, Department of Medical Area, University of Udine, Italy
| | - Luciana Marin
- Division of Hematology and BMT, Department of Medical Area, University of Udine, Italy
| | - Luca Frison
- Padua School of Medicine, Department of Medicine, Hematology and Clinical Immunology, Padua, Italy
| | - Fabio D'Amore
- Padua School of Medicine, Department of Medicine, Hematology and Clinical Immunology, Padua, Italy
| | - Marco Basso
- Hematology Department, Castelfranco Veneto Regional Hospital, Castelfranco Veneto, Treviso, Italy
| | - Roberto Sartori
- Hematology Department, Castelfranco Veneto Regional Hospital, Castelfranco Veneto, Treviso, Italy
| | - Martina Tinelli
- Department of Internal Medicine, G Fracastoro Hospital, San Bonifacio, Verona, Italy
| | - Manuela Stulle
- Hematology Division, Azienda Sanitaria Universitaria Integrata, Trieste, Italy
| | - Stefania Fortuna
- Department of Internal Medicine, Alto Vicentino Hospital, Santorso, Vicenza, Italy
| | - Angela Bonalumi
- Department of Medicine, Section of Hematology, University of Verona, Italy
| | - Giovanni Bertoldero
- Department of Medical Specialities, Oncology and Onco-Haematology Unit, Mirano, Venice, Italy
| | - Ercole De Biasi
- Hematology Departmental Unit, P. Cosma Hospital, Camposampiero, Padua, Italy
| | - Marco Ruggeri
- Hematology Department, San Bortolo Hospital, Vicenza, Italy
| | - Gianpietro Semenzato
- Padua School of Medicine, Department of Medicine, Hematology and Clinical Immunology, Padua, Italy
| | - Renato Fanin
- Division of Hematology and BMT, Department of Medical Area, University of Udine, Italy
| | - Giovanni Pizzolo
- Department of Medicine, Section of Hematology, University of Verona, Italy
| | - Mauro Krampera
- Department of Medicine, Section of Hematology, University of Verona, Italy
| | - Mario Tiribelli
- Division of Hematology and BMT, Department of Medical Area, University of Udine, Italy
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Rigo A, Ferrarini I, Bonalumi A, Tecchio C, Montresor A, Laudanna C, Vinante F. Efficient lysis of B-chronic lymphocytic leukemia cells by the plant-derived sesquiterpene alcohol α-bisabolol, a dual proapoptotic and antiautophagic agent. Oncotarget 2018; 9:25877-25890. [PMID: 29899828 PMCID: PMC5995246 DOI: 10.18632/oncotarget.25398] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 04/28/2018] [Indexed: 12/14/2022] Open
Abstract
The sesquiterpene α-bisabolol (α-BSB) is a cytotoxic agent against acute leukemia and chronic myeloid leukemia cells. Here the profile of α-BSB citotoxicity was evaluated ex vivo in primary mononuclear blood cells isolated from 45 untreated B-chronic lymphocytic leukemia (B-CLL) patients. We studied the effects of α-BSB by flow cytometric and western blotting techniques with the following findings: (1) α-BSB was an effective proapoptotic agent against B-CLL cells (IC50 42 ± 15 μM). It was also active, but to a lesser extent, on normal residual B cells and monocytes (IC50 68 ± 34 and 74 ± 28 μM, respectively; p < 0.01), while T-cells, though not achieving IC50, were nevertheless decreased. (2) Lipid raft content positively correlated with α-BSB cell sensitivity, while neither the phenotype of B-CLL cells nor the disease clinical stage did affect the sensitivity to α-BSB. (3) Flow cytometry analysis evidenced the induction of pores in mitochondrial and lysosomal membrane after 3- to 5-hour exposure of B-CLL cells to α-BSB, leading to apoptosis; in contrast, western blotting analysis showed inhibition of the autophagic flux. Therefore, according to cellular selectivity, α-BSB is a cytotoxic agent preferentially active against leukemic cells, while its lower activity on normal B cells, monocytes and T cells may account for an additive anti-inflammatory effect targeting the leukemia-associated pro-inflammatory microenvironment. Consistent with the observed effects on intracellular processes, α-BSB should be regarded as a dual agent, both activating mitochondrial-based apoptosis and inhibiting autophagy by disrupting lysosomes.
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Affiliation(s)
- Antonella Rigo
- Section of Hematology, Department of Medicine, University of Verona, Verona, Italy
- Cancer Research and Cell Biology Laboratory, Department of Medicine, University of Verona, Verona, Italy
| | - Isacco Ferrarini
- Section of Hematology, Department of Medicine, University of Verona, Verona, Italy
- Cancer Research and Cell Biology Laboratory, Department of Medicine, University of Verona, Verona, Italy
| | - Angela Bonalumi
- Section of Hematology, Department of Medicine, University of Verona, Verona, Italy
| | - Cristina Tecchio
- Section of Hematology, Department of Medicine, University of Verona, Verona, Italy
| | - Alessio Montresor
- Section of General Pathology, Department of Medicine, University of Verona, Verona, Italy
| | - Carlo Laudanna
- Section of General Pathology, Department of Medicine, University of Verona, Verona, Italy
| | - Fabrizio Vinante
- Section of Hematology, Department of Medicine, University of Verona, Verona, Italy
- Cancer Research and Cell Biology Laboratory, Department of Medicine, University of Verona, Verona, Italy
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Russignan A, Spina C, Tamassia N, Cassaro A, Rigo A, Bagnato A, Rosanò L, Bonalumi A, Gottardi M, Zanatta L, Giacomazzi A, Scupoli MT, Tinelli M, Salvadori U, Mosna F, Zamò A, Cassatella MA, Vinante F, Tecchio C. In reply to Schäfer et al: new evidence on the role of endothelin-1 axis as a potential therapeutic target in multiple myeloma. Br J Haematol 2018; 184:1052-1055. [PMID: 29726006 DOI: 10.1111/bjh.15240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Anna Russignan
- Haematology and Bone-Marrow Transplant Unit, Department of Medicine, Verona University, Verona, Italy
| | - Cecilia Spina
- Haematology and Bone-Marrow Transplant Unit, Department of Medicine, Verona University, Verona, Italy
| | - Nicola Tamassia
- Section of General Pathology, Department of Medicine, Verona University, Verona, Italy
| | - Adriana Cassaro
- Haematology and Bone-Marrow Transplant Unit, Department of Medicine, Verona University, Verona, Italy
| | - Antonella Rigo
- Haematology and Bone-Marrow Transplant Unit, Department of Medicine, Verona University, Verona, Italy
| | - Anna Bagnato
- Preclinical Models and New Therapeutic Agents Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - Laura Rosanò
- Preclinical Models and New Therapeutic Agents Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - Angela Bonalumi
- Haematology and Bone-Marrow Transplant Unit, Department of Medicine, Verona University, Verona, Italy
| | | | - Lucia Zanatta
- Pathology Unit, Ospedale Regionale Cà Foncello, Treviso, Italy
| | - Alice Giacomazzi
- Haematology and Bone-Marrow Transplant Unit, Department of Medicine, Verona University, Verona, Italy
| | - Maria T Scupoli
- Inderdepartmental Laboratory for Medical Research (LURM), Department of Pathology and Diagnostics, Verona University, Verona, Italy
| | - Martina Tinelli
- Haematology and Bone-Marrow Transplant Unit, Department of Medicine, Verona University, Verona, Italy
| | - Ugo Salvadori
- Haematology and Bone-Marrow Transplant Unit, Department of Medicine, Verona University, Verona, Italy
| | - Federico Mosna
- Haematology, Ospedale Regionale Cà Foncello, Treviso, Italy
| | - Alberto Zamò
- Section of Pathology, Department of Pathology and Diagnostics, Verona University, Verona, Italy
| | - Marco A Cassatella
- Section of General Pathology, Department of Medicine, Verona University, Verona, Italy
| | - Fabrizio Vinante
- Haematology and Bone-Marrow Transplant Unit, Department of Medicine, Verona University, Verona, Italy
| | - Cristina Tecchio
- Haematology and Bone-Marrow Transplant Unit, Department of Medicine, Verona University, Verona, Italy
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Russignan A, Spina C, Tamassia N, Cassaro A, Rigo A, Bagnato A, Rosanò L, Bonalumi A, Gottardi M, Zanatta L, Giacomazzi A, Scupoli MT, Tinelli M, Salvadori U, Mosna F, Zamò A, Cassatella MA, Vinante F, Tecchio C. Endothelin-1 receptor blockade as new possible therapeutic approach in multiple myeloma. Br J Haematol 2017; 178:781-793. [DOI: 10.1111/bjh.14771] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 04/14/2017] [Indexed: 01/31/2023]
Affiliation(s)
- Anna Russignan
- Haematology and Bone-Marrow Transplant Unit; Department of Medicine; Verona University; Verona Italy
| | - Cecilia Spina
- Haematology and Bone-Marrow Transplant Unit; Department of Medicine; Verona University; Verona Italy
| | - Nicola Tamassia
- Section of General Pathology; Department of Medicine; Verona University; Verona Italy
| | - Adriana Cassaro
- Haematology and Bone-Marrow Transplant Unit; Department of Medicine; Verona University; Verona Italy
| | - Antonella Rigo
- Haematology and Bone-Marrow Transplant Unit; Department of Medicine; Verona University; Verona Italy
| | - Anna Bagnato
- Preclinical Models and New Therapeutic Agents Unit; Regina Elena National Cancer Institute; Rome Italy
| | - Laura Rosanò
- Preclinical Models and New Therapeutic Agents Unit; Regina Elena National Cancer Institute; Rome Italy
| | - Angela Bonalumi
- Haematology and Bone-Marrow Transplant Unit; Department of Medicine; Verona University; Verona Italy
| | | | - Lucia Zanatta
- Pathology Unit; Ospedale Regionale Cà Foncello; Treviso Italy
| | - Alice Giacomazzi
- Haematology and Bone-Marrow Transplant Unit; Department of Medicine; Verona University; Verona Italy
| | - Maria Teresa Scupoli
- Interdepartmental Laboratory for Medical Research (LURM); Verona University; Verona Italy
| | - Martina Tinelli
- Haematology and Bone-Marrow Transplant Unit; Department of Medicine; Verona University; Verona Italy
| | - Ugo Salvadori
- Haematology and Bone-Marrow Transplant Unit; Department of Medicine; Verona University; Verona Italy
| | - Federico Mosna
- Haematology Unit; Ospedale Regionale Cà Foncello; Treviso Italy
| | - Alberto Zamò
- Section of Pathology; Department of Pathology and Diagnostic; Verona University; Verona Italy
| | - Marco A. Cassatella
- Section of General Pathology; Department of Medicine; Verona University; Verona Italy
| | - Fabrizio Vinante
- Haematology and Bone-Marrow Transplant Unit; Department of Medicine; Verona University; Verona Italy
| | - Cristina Tecchio
- Haematology and Bone-Marrow Transplant Unit; Department of Medicine; Verona University; Verona Italy
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Mosna F, Papayannidis C, Martinelli G, Di Bona E, Bonalumi A, Tecchio C, Candoni A, Capelli D, Piccin A, Forghieri F, Bigazzi C, Visani G, Zambello R, Zanatta L, Volpato F, Paolini S, Testoni N, Gherlinzoni F, Gottardi M. Complex karyotype, older age, and reduced first-line dose intensity determine poor survival in core binding factor acute myeloid leukemia patients with long-term follow-up. Am J Hematol 2015; 90:515-23. [PMID: 25753065 DOI: 10.1002/ajh.24000] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 02/27/2015] [Accepted: 03/02/2015] [Indexed: 12/23/2022]
Abstract
Approximately 40% of patients affected by core binding factor (CBF) acute myeloid leukemia (AML) ultimately die from the disease. Few prognostic markers have been identified. We reviewed 192 patients with CBF AML, treated with curative intent (age, 15-79 years) in 11 Italian institutions. Overall, 10-year overall survival (OS), disease-free survival (DFS), and event-free survival were 63.9%, 54.8%, and 49.9%, respectively; patients with the t(8;21) and inv(16) chromosomal rearrangements exhibited significant differences at diagnosis. Despite similar high complete remission (CR) rate, patients with inv(16) experienced superior DFS and a high chance of achieving a second CR, often leading to prolonged OS also after relapse. We found that a complex karyotype (i.e., ≥4 cytogenetic anomalies) affected survival, even if only in univariate analysis; the KIT D816 mutation predicted worse prognosis, but only in patients with the t(8;21) rearrangement, whereas FLT3 mutations had no prognostic impact. We then observed increasingly better survival with more intense first-line therapy, in some high-risk patients including autologous or allogeneic hematopoietic stem cell transplantation. In multivariate analysis, age, severe thrombocytopenia, elevated lactate dehydrogenase levels, and failure to achieve CR after induction independently predicted longer OS, whereas complex karyotype predicted shorter OS only in univariate analysis. The achievement of minimal residual disease negativity predicted better OS and DFS. Long-term survival was observed also in a minority of elderly patients who received intensive consolidation. All considered, we identified among CBF AML patients a subgroup with poorer prognosis who might benefit from more intense first-line treatment.
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Affiliation(s)
- Federico Mosna
- Department of Hematology; General Hospital; Treviso Italy
| | | | - Giovanni Martinelli
- Department of Hematology; Ist “LA Seragnoli,” University of Bologna; Bologna Italy
| | - Eros Di Bona
- Department of Hematology; General Hospital; Vicenza Italy
| | - Angela Bonalumi
- Department of Hematology; University of Verona; Verona Italy
| | | | - Anna Candoni
- Department of Hematology; University of Udine; Udine Italy
| | - Debora Capelli
- Department of Hematology; General Hospital; Ancona Italy
| | - Andrea Piccin
- Department of Hematology; General Hospital; Bolzano Italy
| | - Fabio Forghieri
- Department of Hematology; University of Modena; Modena Italy
| | - Catia Bigazzi
- Department of Hematology; General Hospital; Ascoli-Piceno Italy
| | | | - Renato Zambello
- Department of Hematology; University of Padova; Padova Italy
| | - Lucia Zanatta
- Department of Pathology; General Hospital; Treviso Italy
| | | | - Stefania Paolini
- Department of Hematology; Ist “LA Seragnoli,” University of Bologna; Bologna Italy
| | - Nicoletta Testoni
- Department of Hematology; Ist “LA Seragnoli,” University of Bologna; Bologna Italy
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