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Martini T, Biguzzi R, Francesconi I, Lelli S, Currà MF, Borsellino B. How We Prevented an anti-P1 Mediated Hemolytic Transfusion Reaction. Mediterr J Hematol Infect Dis 2024; 16:e2024009. [PMID: 38223483 PMCID: PMC10786142 DOI: 10.4084/mjhid.2024.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 12/14/2023] [Indexed: 01/16/2024] Open
Affiliation(s)
- Tiziano Martini
- Immunohematology and Transfusion Medicine Unit, AUSL Romagna, M. Bufalini Hospital, Cesena, Italy
| | - Rino Biguzzi
- Immunohematology and Transfusion Medicine Unit, AUSL Romagna, M. Bufalini Hospital, Cesena, Italy
| | - Irene Francesconi
- Immunohematology and Transfusion Medicine Unit, AUSL Romagna, M. Bufalini Hospital, Cesena, Italy
| | - Sabrina Lelli
- Immunohematology and Transfusion Medicine Unit, AUSL Romagna, M. Bufalini Hospital, Cesena, Italy
| | - Maria Federica Currà
- Immunohematology and Transfusion Medicine Unit, AUSL Romagna, M. Bufalini Hospital, Cesena, Italy
| | - Beatrice Borsellino
- Immunohematology and Transfusion Medicine Unit, AUSL Romagna, M. Bufalini Hospital, Cesena, Italy
- Department of Biomedicine and Prevention, PhD in Immunology, Molecular Medicine and Applied Biotechnology, University of Rome Tor Vergata, Rome, Italy
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Attardi E, Savi A, Borsellino B, Piciocchi A, Cipriani M, Ottone T, Fabiani E, Divona M, Travaglini S, Pascale MR, Awada H, Durmaz A, Visconte V, Della Porta MG, Venditti A, Maciejewski JP, Gurnari C, Voso MT. Applicability of 2022 classifications of acute myeloid leukemia in the real-world setting. Blood Adv 2023; 7:5122-5131. [PMID: 37327116 PMCID: PMC10477447 DOI: 10.1182/bloodadvances.2023010173] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/24/2023] [Accepted: 06/07/2023] [Indexed: 06/18/2023] Open
Abstract
The increasing knowledge of molecular genetics of acute myeloid leukemia (AML) necessitated the update of previous diagnostic and prognostic schemes, which resulted in the development of the World Health Organization (WHO), the International Consensus Classification (ICC), and the new European LeukemiaNet (ELN) recommendations in 2022. We aimed to provide a real-world application of the new models, unravel differences and similarities, and test their implementation in clinical AML diagnosis. A total of 1001 patients diagnosed with AML were reclassified based on the new schemes. The overall diagnostic changes between the WHO 2016 and the WHO 2022 and ICC classifications were 22.8% and 23.7%, respectively, with a 13.1% difference in patients' distribution between ICC and WHO 2022. The 2022 ICC "not otherwise specified" and WHO "defined by differentiation" AML category sizes shrank when compared with that in WHO 2016 (24.1% and 26.8% respectively, vs 38.7%), particularly because of an expansion of the myelodysplasia (MDS)-related group. Of 397 patients with a MDS-related AML according to the ICC, 55.9% were defined by the presence of a MDS-related karyotype. The overall restratification between ELN 2017 and ELN 2022 was 12.9%. The 2022 AML classifications led to a significant improvement of diagnostic schemes. In the real-world setting, conventional cytogenetics, usually rapidly available and less expensive than molecular characterization, stratified 56% of secondary AML, still maintaining a powerful diagnostic role. Considering the similarities between WHO and ICC diagnostic schemes, a tentative scheme to generate a unified model is desirable.
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Affiliation(s)
- Enrico Attardi
- Department of Biomedicine and Prevention, Molecular Medicine and Applied Biotechnology, University of Rome Tor Vergata, Rome, Italy
| | - Arianna Savi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Beatrice Borsellino
- Department of Biomedicine and Prevention, Molecular Medicine and Applied Biotechnology, University of Rome Tor Vergata, Rome, Italy
| | - Alfonso Piciocchi
- Italian Group for Adult Hematologic Diseases (GIMEMA) Foundation, Rome, Italy
| | - Marta Cipriani
- Italian Group for Adult Hematologic Diseases (GIMEMA) Foundation, Rome, Italy
- Department of Statistical Sciences, University of Rome La Sapienza, Rome, Italy
| | - Tiziana Ottone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Neuro-Oncohematology Unit, Istituto di Ricovero e Cura a Carattere Scientifico Fondazione Santa Lucia, Rome, Italy
| | - Emiliano Fabiani
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- UniCamillus-Saint Camillus International University of Health Sciences, Rome, Italy
| | - Mariadomenica Divona
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- UniCamillus-Saint Camillus International University of Health Sciences, Rome, Italy
| | - Serena Travaglini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Maria Rosaria Pascale
- Department of Biomedicine and Prevention, Molecular Medicine and Applied Biotechnology, University of Rome Tor Vergata, Rome, Italy
| | - Hussein Awada
- Translational Hematology and Oncology Research Department, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH
| | - Arda Durmaz
- Translational Hematology and Oncology Research Department, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH
| | - Valeria Visconte
- Translational Hematology and Oncology Research Department, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH
| | - Matteo Giovanni Della Porta
- IRCCS Humanitas Clinical & Research Center and Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Adriano Venditti
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Jaroslaw P. Maciejewski
- Translational Hematology and Oncology Research Department, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH
| | - Carmelo Gurnari
- Department of Biomedicine and Prevention, Molecular Medicine and Applied Biotechnology, University of Rome Tor Vergata, Rome, Italy
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Translational Hematology and Oncology Research Department, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH
| | - Maria Teresa Voso
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Neuro-Oncohematology Unit, Istituto di Ricovero e Cura a Carattere Scientifico Fondazione Santa Lucia, Rome, Italy
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Pasqualone G, Buzzatti E, Palmieri R, Savi A, Pascale MR, Borsellino B, Guarnera L, Buccisano F, Voso MT, Maurillo L, Sconocchia G, Venditti A, Del Principe MI. Case report: A Saprochaete clavata (Magnusiomyces clavatus) severe infection effectively treated with granulocyte transfusion in a young patient with myeloid sarcoma. Front Oncol 2022; 12:970188. [PMID: 36185191 PMCID: PMC9521543 DOI: 10.3389/fonc.2022.970188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/19/2022] [Indexed: 11/13/2022] Open
Abstract
Myeloid sarcoma is a hematologic malignancy consisting of extramedullary tissue involvement by myeloid blasts, usually considered as acute myeloid leukemia and treated accordingly. The disease itself, together with chemotherapy and disease-associated factors, may have an impact in increasing the risk of developing severe and frequently life-threatening infections. Herein, we describe the case of a patient with a right breast skin lesion, histologically diagnosed myeloid sarcoma, who developed a severe disseminated fungal infection by Saprochaete clavata (Magnusiomyces clavatus), during the first consolidation course of chemotherapy. Despite maximum antifungal therapy, the infection progressed and the fungus continued to be isolated until granulocyte transfusion therapy was initiated. Our experience suggests that patients with profound and long-lasting neutropenia could benefit from granulocyte transfusions as additional therapy in severe fungal infections resistant to broad-spectrum antimicrobial therapy.
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Affiliation(s)
- Gianmario Pasqualone
- Hematology, Department of Biomedicine and Prevention, Università degli studi di Roma Tor Vergata, Rome, Italy
| | - Elisa Buzzatti
- Hematology, Department of Biomedicine and Prevention, Università degli studi di Roma Tor Vergata, Rome, Italy
| | - Raffaele Palmieri
- Hematology, Department of Biomedicine and Prevention, Università degli studi di Roma Tor Vergata, Rome, Italy
| | - Arianna Savi
- Hematology, Department of Biomedicine and Prevention, Università degli studi di Roma Tor Vergata, Rome, Italy
| | - Maria Rosaria Pascale
- Hematology, Department of Biomedicine and Prevention, Università degli studi di Roma Tor Vergata, Rome, Italy
| | - Beatrice Borsellino
- Hematology, Department of Biomedicine and Prevention, Università degli studi di Roma Tor Vergata, Rome, Italy
| | - Luca Guarnera
- Hematology, Department of Biomedicine and Prevention, Università degli studi di Roma Tor Vergata, Rome, Italy
| | - Francesco Buccisano
- Hematology, Department of Biomedicine and Prevention, Università degli studi di Roma Tor Vergata, Rome, Italy
| | - Maria Teresa Voso
- Hematology, Department of Biomedicine and Prevention, Università degli studi di Roma Tor Vergata, Rome, Italy
| | - Luca Maurillo
- Hematology, Department of Biomedicine and Prevention, Università degli studi di Roma Tor Vergata, Rome, Italy
| | - Giuseppe Sconocchia
- Institute of Translational Pharmacology, Department of Biomedical Sciences, National Research Council (CNR), Rome, Italy
- *Correspondence: Giuseppe Sconocchia,
| | - Adriano Venditti
- Hematology, Department of Biomedicine and Prevention, Università degli studi di Roma Tor Vergata, Rome, Italy
| | - Maria Ilaria Del Principe
- Hematology, Department of Biomedicine and Prevention, Università degli studi di Roma Tor Vergata, Rome, Italy
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Buzzatti E, Paterno G, Palmieri R, Esposito F, Pascale MR, Mallegni F, Guarnera L, Pasqualone G, Irno Consalvo MA, Fraboni D, Moretti F, Savi A, Borsellino B, Maurillo L, Buccisano F, Sconocchia G, Venditti A, Del Principe MI. Occult central nervous system involvement guides therapeutic choices in blastic plasmacytoid dendritic cell neoplasms. Leuk Lymphoma 2022; 63:1754-1757. [DOI: 10.1080/10428194.2022.2042687] [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: 10/18/2022]
Affiliation(s)
- Elisa Buzzatti
- Hematology, Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
- Fondazione Policlinico Tor Vergata, Rome, Italy
| | - Giovangiacinto Paterno
- Hematology, Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
| | - Raffaele Palmieri
- Hematology, Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
- Fondazione Policlinico Tor Vergata, Rome, Italy
| | - Fabiana Esposito
- Hematology, Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
- Fondazione Policlinico Tor Vergata, Rome, Italy
| | - Maria Rosaria Pascale
- Hematology, Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
- Fondazione Policlinico Tor Vergata, Rome, Italy
| | - Flavia Mallegni
- Hematology, Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
- Fondazione Policlinico Tor Vergata, Rome, Italy
| | - Luca Guarnera
- Hematology, Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
- Fondazione Policlinico Tor Vergata, Rome, Italy
| | - Gianmario Pasqualone
- Hematology, Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
- Fondazione Policlinico Tor Vergata, Rome, Italy
| | - Maria Antonietta Irno Consalvo
- Hematology, Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
- Fondazione Policlinico Tor Vergata, Rome, Italy
| | - Daniela Fraboni
- Hematology, Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
- Fondazione Policlinico Tor Vergata, Rome, Italy
| | - Federico Moretti
- Hematology, Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
- Fondazione Policlinico Tor Vergata, Rome, Italy
| | - Arianna Savi
- Hematology, Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
- Fondazione Policlinico Tor Vergata, Rome, Italy
| | | | | | - Francesco Buccisano
- Hematology, Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
- Fondazione Policlinico Tor Vergata, Rome, Italy
| | - Giuseppe Sconocchia
- Laboratory of Tumor Immunology and Immunotherapy, Institute of Translation Pharmacology, Department of Medicine, National Research Council of Italy (CNR), Rome, Italy
| | - Adriano Venditti
- Hematology, Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
- Fondazione Policlinico Tor Vergata, Rome, Italy
| | - Maria Ilaria Del Principe
- Hematology, Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
- Fondazione Policlinico Tor Vergata, Rome, Italy
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Celletti C, Borsellino B, Castori M, Censi F, Calcagnini G, Camerota F, Strano S. A new insight on postural tachycardia syndrome in 102 adults with hypermobile Ehlers-Danlos Syndrome/hypermobility spectrum disorder. Monaldi Arch Chest Dis 2020; 90. [DOI: 10.4081/monaldi.2020.1286] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 04/09/2020] [Indexed: 11/23/2022] Open
Abstract
There is an association between joint hypermobility, hypermobile Ehlers-Danlos syndrome (hEDS) and different forms of orthostatic intolerance. Objective: to explore autonomic profile in a large cohort of adults with hEDS and hypermobility spectrum disorder (hEDS/HSD) with a multimodal approach. In this observational retrospective study, heart rate, blood pressure and baroreflex sensitivity were estimated in 102 hEDS/HSD subjects during deep breathing, Valsalva maneuver, standing up: 30-15 ratio, Head-Up Tilt and sustained handgrip. Abnormal results and head-up tilt test were common and included postural orthostatic tachycardia syndrome (POTS; 48%), orthostatic intolerance (25.5%) and hypotension (3.9%). Baroreflex sensitivity was significantly different in individuals with POTS compared to the others. This study confirms the high rate and heterogeneity of abnormal autonomic regulation in hEDS/HSD, and suggests the baroreflex sensitivity might distinguish comorbid POTS from other profiles in this subgroup of patients. Abnormal autonomic regulation is common in adults with hEDS/HSD and should be regularly assessed for tailoring the management approach.
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Abstract
BACKGROUND The asleep-awake-asleep (AAA) craniotomy is a technique that offers the opportunity of having a patient fully cooperative during the awake phase, and minimizes the possible discomfort, due to the asleep phase. The aim of this prospective observational study was to test the use of xenon in the first asleep phase of an AAA craniotomy, in patients undergoing craniotomy for brain tumor resection. METHODS The data have been collected from 40 awake craniotomy procedures, performed in patients with cerebral tumor, treated with the AAA technique. Patients were treated with xenon during the asleep phase, and quality of mapping, complications and qualitative judgment of the experience given by the patients were recorded. RESULTS The mapping was carried out as planned in 37 out of 40 cases. The doses of xenon administered during the first asleep phase of the anesthesia was 13±2 L. Time for awakening after xenon was switched off was 5±1 minute. A combination of xenon and regional anesthesia (with no need for additional systemic anesthetics) was adequate to accomplish craniotomy in 27/40 patients (67.5%). On the day after the operation, 37 patients recalled the testing procedure for mapping during the awake period, none had recollection of local anesthetic injections for regional anesthesia or sound associated with the neurosurgical drill. Five patients (12.5%) reported mild pain during tumor removal (VAS Score less than three). CONCLUSIONS In this case series, xenon anesthesia was successfully used for the sedative phase of an awake craniotomy accomplished with an AAA approach.
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Affiliation(s)
- Alexander Kulikov
- Department of Anesthesiology, Burdenko National Medical Research Center of Neurosurgery, Moscow, Russia -
| | - Federico Bilotta
- Department of Anesthesiology, Critical Care and Pain Medicine, Sapienza University, Rome, Italy
| | - Beatrice Borsellino
- Department of Anesthesiology, Critical Care and Pain Medicine, Sapienza University, Rome, Italy
| | - Denis Sel'kov
- Department of Anesthesiology, Burdenko National Medical Research Center of Neurosurgery, Moscow, Russia
| | - Grigory Kobyakov
- Department of Anesthesiology, Burdenko National Medical Research Center of Neurosurgery, Moscow, Russia
| | - Andrey Lubnin
- Department of Anesthesiology, Burdenko National Medical Research Center of Neurosurgery, Moscow, Russia
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Borsellino B, Schultz MJ, Gama de Abreu M, Robba C, Bilotta F. Mechanical ventilation in neurocritical care patients: a systematic literature review. Expert Rev Respir Med 2016; 10:1123-32. [DOI: 10.1080/17476348.2017.1235976] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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