1
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Fardella E, Zanirato G, Magni M, Caldarelli N, Chiappella A, Dodero A, Ljevar S, Orsucci L, Re A, Usai SV, Stefoni V, Castellino C, Rossi FG, Pinto A, Carniti C, Corradini P. Prognostic impact of pretreatment cell-free DNA concentration in newly diagnosed peripheral T-cell lymphomas. Br J Haematol 2024. [PMID: 38176400 DOI: 10.1111/bjh.19280] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/14/2023] [Accepted: 12/19/2023] [Indexed: 01/06/2024]
Abstract
Peripheral T-cell lymphomas (PTCLs) have a poor prognosis and, to date, there are no reliable predictive biomarkers of response. In this work we explored the prognostic impact of cell-free DNA (cfDNA) concentration in 75 newly diagnosed patients enrolled in a prospective multicenter study. Pre-treatment cfDNA was strongly associated with clinical risk factors and was identified as a superior predictor for shorter progression-free survival in multivariable analysis, outweighing canonical risk parameters. Furthermore, we identified a cfDNA value above which survival worsens. In conclusion, pre-treatment cfDNA concentration represents an easily usable predictive biomarker that is highly associated with survival of PTCL patients.
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Affiliation(s)
| | - G Zanirato
- Division of Hematology and Stem Cell Transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Magni
- Division of Hematology and Stem Cell Transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - A Chiappella
- Division of Hematology and Stem Cell Transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A Dodero
- Division of Hematology and Stem Cell Transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - S Ljevar
- Unit of Biostatistics for Clinical Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - L Orsucci
- Division of Hematology, Azienda Ospedaliera e Universitaria Città della Salute e della Scienza, Turin, Italy
| | - A Re
- Hematology Division, ASST Spedali Civili di Brescia, Brescia, Italy
| | - S V Usai
- Hematology Unit, Ospedale Oncologico Armando Businco, Cagliari, Italy
| | - V Stefoni
- Institute of Hematology Seràgnoli, University of Bologna, Bologna, Italy
| | - C Castellino
- Division of Hematology, Azienda Ospedaliera S. Croce e Carle, Cuneo, Italy
| | - F G Rossi
- Division of Hematology, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - A Pinto
- Hematology-Oncology & Stem Cell Transplantation Unit, IRCCS Istituto Nazionale Tumori, Fondazione G. Pascale, Napoli, Italy
| | - C Carniti
- Division of Hematology and Stem Cell Transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - P Corradini
- University of Milan, Milan, Italy
- Division of Hematology and Stem Cell Transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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2
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Chiappella A, Carniti C, Re A, Castellino C, Evangelista A, Ciancia R, Orsucci L, Pinto A, Usai SV, Arcari A, Ilariucci F, Rossi FG, Benedetti F, Flenghi L, Ghiggi C, Molinari AL, Stefoni V, Volpetti S, Zilioli VR, Ballerini F, Bruna R, Cavallo F, Musuraca G, Patti C, Re F, Tani M, Varettoni M, Zanni M, Dodero A, Pileri SA, Ciccone G, Corradini P. ROMIDEPSIN‐CHOEP PLUS UP‐FRONT STEM‐CELL TRANSPLANTATION IN PERIPHERAL T‐CELL LYMPHOMA (PTCL): FIRST ANALYSIS OF THE PHASE II FIL‐PTCL13 STUDY. Hematol Oncol 2021. [DOI: 10.1002/hon.130_2880] [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: 11/06/2022]
Affiliation(s)
- A. Chiappella
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano Hematology and Stem Cell Transplantation Milano Italy
| | - C. Carniti
- Fondazione IRCCS, Istituto Nazionale dei Tumori di Milano Laboratory of Hematology Division of Hematology and Stem Cell Transplantation Milano Italy
| | - A. Re
- ASST Spedali Civili di Brescia Hematology Division Brescia Italy
| | - C. Castellino
- Azienda Ospedaliera S. Croce e Carle Division of Hematology Cuneo Italy
| | - A. Evangelista
- Azienda Ospedaliera e Universitaria Città della Salute e della Scienza and CPO Piemonte Unit of Clinical Epidemiology Torino Italy
| | - R. Ciancia
- Centro di Riferimento Oncologico (CRO) IRCCS Onco‐hematology and Stem Cell Transplantation and Cellular Therapies Aviano Italy
| | - L. Orsucci
- Azienda Ospedaliera e Universitaria Città della Salute e della Scienza Division of Hematology Torino Italy
| | - A. Pinto
- Istituto Nazionale Tumori, Fondazione G. Pascale, IRCCS Hematology‐Oncology & Stem Cell Transplantation Unit Napoli Italy
| | - S. V. Usai
- Ospedale Oncologico Armando Businco Hematology Cagliari Italy
| | - A. Arcari
- Ospedale Guglielmo da Saliceto Hematology Unit Piacenza Italy
| | - F. Ilariucci
- Azienda USL‐IRCCS, Hematology Reggio Emilia Italy
| | - F. G. Rossi
- Fondazione IRCCS Cà Granda OM Policlinico Division of Hematology Milano Italy
| | - F. Benedetti
- Azienda Ospedaliera Universitaria di Verona Hematology and Stem Cell Transplantation Verona Italy
| | - L. Flenghi
- Azienda Ospedaliera di Perugia Hematology Perugia Italy
| | - C. Ghiggi
- IRCCS Ospedale Policlinico San Martino Hematology Genova Italy
| | | | - V. Stefoni
- University of Bologna Institute of Hematology "Seràgnoli" Bologna Italy
| | - S. Volpetti
- Presidio Ospedaliero Universitario "Santa Maria della Misericordia” di Udine ASUFC Clinic of Hematology Udine Italy
| | - V. R. Zilioli
- ASST Grande Ospedale Metropolitano Niguarda Division of Hematology Milano Italy
| | - F. Ballerini
- IRCCS Ospedale Policlinico San Martino Clinic of Hematology Genova Italy
| | - R. Bruna
- Ospedale Maggiore Della Carità Division of Hematology Novara Italy
| | - F. Cavallo
- University of Torino Azienda Ospedaliera e Universitaria Città della Salute e della Scienza Division of Hematology Department of Molecular Biotechnologies and Health Sciences Torino Italy
| | - G. Musuraca
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori" Division of Hematology Meldola Italy
| | - C. Patti
- Azienda Villa Sofia Cervello Division of Onco‐Hematology Palermo Italy
| | - F. Re
- Azienda Ospedaliera‐Universitaria di Parma Hematology and CTMO Parma Italy
| | - M. Tani
- Ospedale Santa Maria delle Croci Hematology Unit Ravenna Italy
| | - M. Varettoni
- Fondazione IRCCS Policlinico San Matteo Division of Hematology Pavia Italy
| | - M. Zanni
- Azienda Ospedaliera Santi Antonio e Biagio e Cesare Arrigo Division of Hematology Alessandria Italy
| | - A. Dodero
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano Hematology and Stem Cell Transplantation Milano Italy
| | - S. A. Pileri
- European Institute of Oncology IRCCS Division of Haematopathology Milano Italy
| | - G. Ciccone
- Azienda Ospedaliera e Universitaria Città della Salute e della Scienza and CPO Piemonte Unit of Clinical Epidemiology Torino Italy
| | - P. Corradini
- Chair of Hematology University of Milano Fondazione IRCCS Istituto Nazionale dei Tumori di Milano Division of Hematology and Stem Cell Transplantation Milano Italy
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3
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Ferrero S, Moia R, Cascione L, Zaccaria GM, Rinaldi A, Alessandria B, Grimaldi D, Favini C, Evangelista A, Schipani M, Narni F, Stelitano C, Stefani PM, Benedetti F, Mian M, Casaroli I, Zanni M, Castellino C, Pavone V, Galimberti S, Re F, Rossi D, Cortelazzo S, Gaidano G, Ladetto M, Bertoni F. A COMPLETELY GENETIC PROGNOSTIC MODEL OVERCOMES CLINICAL PROGNOSTICATORS IN MANTLE CELL LYMPHOMA: RESULTS FROM THE MCL0208 TRIAL FROM THE FONDAZIONE ITALIANA LINFOMI (FIL). Hematol Oncol 2021. [DOI: 10.1002/hon.59_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: 11/08/2022]
Affiliation(s)
- S. Ferrero
- Hematology Department of Molecular Biotechnologies and Health Sciences University of Torino Hematology 1, AOU "Città della salute e della scienza di Torino" Torino Italy
| | - R. Moia
- Division of Hematology Department of Translational Medicine Università del Piemonte Orientale Novara Italy
| | - L. Cascione
- Institute of Oncology Research Faculty of Biomedical Sciences USI, Bellinzona SIB Swiss Institute of Bioinformatics Lausanne Switzerland
| | - G. M. Zaccaria
- Hematology and Cell Therapy Unit IRCCS Istituto Tumori 'Giovanni Paolo II' Bari Italy
| | - A. Rinaldi
- Institute of Oncology Research Faculty of Biomedical Sciences USI Bellinzona Switzerland
| | - B. Alessandria
- Hematology Department of Molecular Biotechnologies and Health Sciences University of Torino Torino Italy
| | - D. Grimaldi
- Hematology Department of Molecular Biotechnologies and Health Sciences University of Torino Torino Italy
| | - C. Favini
- Division of Hematology Department of Translational Medicine Università del Piemonte Orientale Novara Italy
| | - A. Evangelista
- Unit of Cancer Epidemiology CPO Piemonte A.O.U. Città della Salute e della Scienza di Torino Torino Italy
| | - M. Schipani
- Division of Hematology Department of Translational Medicine Università del Piemonte Orientale Novara Italy
| | - F. Narni
- Department of Medical and Surgical Sciences Section of Hematology University of Modena and Reggio Emilia Azienda Ospedaliero Universitaria Policlinico Modena Italy
| | - C. Stelitano
- Hematology Department AO "Bianchi‐Melacrino‐Morelli" Reggio Calabria Italy
| | - P. M. Stefani
- Hematology Unit General Hospital Ca' Foncello Treviso Italy
| | - F. Benedetti
- Hematology University Division Verona Hospital Verona Italy
| | - M. Mian
- Department of Haematology and CBMT Bolzano Hospital Bolzano Italy
| | - I. Casaroli
- Haematology Unit ASST Monza San Gerardo Monza Italy
| | - M. Zanni
- Hematology Unit Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo Alessandria Italy
| | - C. Castellino
- Department of Hematology S. Croce e Carle Hospital Cuneo Italy
| | - V. Pavone
- UOC Ematologia e Trapianto Az. Osp. C. Panico Tricase Italy
| | - S. Galimberti
- Section of Hematology Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - F. Re
- Haematology and Bone Marrow Transplant Unit Parma General Hospital Parma Italy
| | - D. Rossi
- Institute of Oncology Research Faculty of Biomedical Sciences USI, Bellinzona, Switzerland Oncology Institute of Southern Switzerland (IOSI) Bellinzona,Bellinzona Switzerland
| | - S. Cortelazzo
- Oncology Unit Italy Medical & Center Hospital Humanitas Gavazzeni and Castelli Bergamo Italy
| | - G. Gaidano
- Division of Hematology Department of Translational Medicine Università del Piemonte Orientale Novara Italy
| | - M. Ladetto
- Division of Hematology Department of Translational Medicine Università del Piemonte Orientale Novara, Division of Hematology Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo Alessandria Italy
| | - F. Bertoni
- Institute of Oncology Research Faculty of Biomedical Sciences USI, Bellinzona, Switzerland Oncology Institute of Southern Switzerland (IOSI) Bellinzona,Bellinzona Switzerland
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4
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Chiappella A, Carniti C, Evangelista A, Re A, Cabras M, Stefoni V, Castellino C, Congiu A, Pinto A, Zanni M, Rusconi C, Molinari A, Ciancia R, Baldini L, Nassi L, Re F, Tani M, Ilariucci F, Cavallo F, Santoro A, Volpetti S, Dodero A, Pileri S, Ciccone G, Corradini P. PHASE II FIL-PTCL13 STUDY OF ROMIDEPSIN-CHOEP FOLLOWED BY HIGH-DOSE CHEMOTHERAPY AND TRANSPLANTATION IN UNTREATED PERIPHERAL T-CELL LYMPHOMAS. Hematol Oncol 2019. [DOI: 10.1002/hon.3_2632] [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: 11/08/2022]
Affiliation(s)
- A. Chiappella
- Ematologia; AOU Città della Salute e della Scienza di Torino; Torino Italy
| | - C. Carniti
- Ematologia; Università degli Studi di Milano; Milano Italy
| | - A. Evangelista
- SSD Epidemiologia Clinica e Valutativa; Clinical Trial Center, AOU Città della Salute e della Scienza di Torino e CPO Piemonte; Torino Italy
| | - A. Re
- Ematologia; ASTT Spedali Civili di Brescia; Brescia Italy
| | - M.G. Cabras
- Ematologia; Ospedale Oncologico Armando Businco; Cagliari Italy
| | - V. Stefoni
- Ematologia; Policlinico S.Orsola-Malpighi, Istituto di Ematologia "Seragnoli"; Bologna Italy
| | - C. Castellino
- Ematologia e Trapianto di Midollo Osseo; AO Santa Croce e Carle; Cuneo Italy
| | - A.G. Congiu
- Ematologia; Ospedale Policlinico San Martino S.S.R.L. - IRCCS per l'Oncologia; Genova Italy
| | - A. Pinto
- Ematologia Oncologica; Istituto Nazionale Tumori - IRCCS Fondazione G. Pascale; Napoli Italy
| | - M. Zanni
- Ematologia; AO SS Antonio e Biagio e Cesare Arrigo; Alessandria Italy
| | - C. Rusconi
- Ematologia; ASST Grande Ospedale Metropolitano Niguarda; Milano Italy
| | | | - R. Ciancia
- Oncoematologia; trapianti emopoietici e terapie cellulari, Centro di Riferimento Oncologico CRO, IRCCS; Aviano Italy
| | - L. Baldini
- Ematologia; Ospedale Maggiore Policlinico - Fondazione IRCCS Ca' Granda; Milano Italy
| | - L. Nassi
- Ematologia; AOU Maggiore della Carità di Novara; Novara Italy
| | - F. Re
- Ematologia e CTMO; AOU Ospedale Maggiore di Parma; Parma Italy
| | - M. Tani
- Ematologia; Ospedale Santa Maria delle Croci; Ravenna Italy
| | - F. Ilariucci
- Ematologia; Azienda Ospedaliera Arcispedale Santa Maria Nuova - IRCCS; Reggio Emilia Italy
| | - F. Cavallo
- Ematologia; Università degli Studi - AOU Città della Salute e della Scienza di Torino; Torino Italy
| | - A. Santoro
- Ematologia; Istituto Clinico Humanitas; Rozzano Italy
| | - S. Volpetti
- Ematologia; ASUI Santa Maria della Misericordia; Udine Italy
| | - A. Dodero
- Ematologia; Fondazione IRCCS Istituto Nazionale dei Tumori; Milano Italy
| | - S.A. Pileri
- Emopatologia; Istituto Europeo Oncologico IRCCS; Milano Italy
| | - G. Ciccone
- SSD Epidemiologia Clinica e Valutativa; Clinical Trial Center, AOU Città della Salute e della Scienza di Torino e CPO Piemonte; Torino Italy
| | - P. Corradini
- Ematologia; Fondazione IRCCS Istituto Nazionale dei Tumori - Università degli Studi di Milano; Milano Italy
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5
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Ferreri AJ, Calimeri T, Conte G, Ponzoni M, Fallanca F, Cattaneo D, Scarano E, Flavio C, Sassone M, Foppoli M, Perrone S, Cecchetti C, Lopedote P, Gritti G, Castellino C, Verga L, Olcese F, Mazza R, Ciceri F, Bordignon C, Anzalone N, Corti A. R-CHOP PRECEDED BY ENGINEERED TUMOR NECROSIS FACTOR (TNF) IN RELAPSED OR REFRACTORY PRIMARY DIFFUSE LARGE B-CELL LYMPHOMA OF THE CNS (rPCNSL): FINAL RESULTS OF THE INGRID TRIAL. Hematol Oncol 2019. [DOI: 10.1002/hon.115_2629] [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: 11/09/2022]
Affiliation(s)
- A. J. Ferreri
- Lymphoma Unit; IRCCS Ospedale San Raffaele; Milano Italy
| | - T. Calimeri
- Lymphoma Unit; IRCCS Ospedale San Raffaele; Milano Italy
| | - G. Conte
- Neuroradiology Unit; IRCCS Ospedale San Raffaele; Milano Italy
| | - M. Ponzoni
- Pathology Unit; IRCCS Ospedale San Raffaele; Milano Italy
| | - F. Fallanca
- Nuclear Medicine; IRCCS Ospedale San Raffaele; Milano Italy
| | - D. Cattaneo
- Unit of Clinical Pharmacology; ASTT Fatebenefratelli Sacco University Hospital; Milano Italy
| | - E. Scarano
- Lymphoma Unit; IRCCS Ospedale San Raffaele; Milano Italy
| | - C. Flavio
- Tumor Biology and Vascular Targeting Unit; DIBIT-1, 3A1, Lab. 6, IRCCS Ospedale San Raffaele; Milano Italy
| | - M. Sassone
- Lymphoma Unit; IRCCS Ospedale San Raffaele; Milano Italy
| | - M. Foppoli
- Lymphoma Unit; IRCCS Ospedale San Raffaele; Milano Italy
| | - S. Perrone
- Lymphoma Unit; IRCCS Ospedale San Raffaele; Milano Italy
| | - C. Cecchetti
- Lymphoma Unit; IRCCS Ospedale San Raffaele; Milano Italy
| | - P. Lopedote
- Lymphoma Unit; IRCCS Ospedale San Raffaele; Milano Italy
| | - G. Gritti
- Hematology Unit; Ospedale Papa Giovanni XXIII; Bergamo Italy
| | - C. Castellino
- Unit of Hematology; Ospedale Santa Croce E Carle; Cuneo Italy
| | - L. Verga
- Division of Hematology; "S Gerardo" Hospital University of Milano-Bicocca; Monza Italy
| | - F. Olcese
- S.c.Oncologia-Ematologia, ASL5 Liguria; La Spezia Italy
| | - R. Mazza
- Operative Unit of Medical Oncology and Hematology; Humanitas Cancer Center; Milano Italy
| | - F. Ciceri
- Hematology and BMT Unit, Department of Onco-Hematology; IRCCS Ospedale San Raffaele; Milano Italy
| | | | - N. Anzalone
- Neuroradiology Unit; IRCCS Ospedale San Raffaele; Milano Italy
| | - A. Corti
- Tumor Biology and Vascular Targeting Unit; DIBIT-1, 3A1, Lab. 6, IRCCS Ospedale San Raffaele; Milano Italy
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6
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Mattei D, Bassan R, Mordini N, Rapezzi D, Rambaldi A, Strola G, Peretti C, Del Grosso F, Ferraris AM, Castellino C, Gallamini A. Expansion of B cell precursors after unrelated cord blood transplantation for an adult patient. Bone Marrow Transplant 2007; 40:283-5. [PMID: 17529999 DOI: 10.1038/sj.bmt.1705714] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
MESH Headings
- Adult
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal/adverse effects
- Antigens, CD/genetics
- Antigens, CD/immunology
- Cell Proliferation
- Chromosomes, Human, X/genetics
- Chromosomes, Human, X/immunology
- Cord Blood Stem Cell Transplantation
- Cyclosporine/administration & dosage
- Cyclosporine/adverse effects
- Diarrhea/drug therapy
- Diarrhea/etiology
- Diarrhea/genetics
- Diarrhea/immunology
- Fatal Outcome
- Female
- Gastrointestinal Agents/administration & dosage
- Gastrointestinal Agents/adverse effects
- Graft Survival/immunology
- Graft vs Host Disease/genetics
- Graft vs Host Disease/immunology
- Graft vs Host Disease/pathology
- Graft vs Host Disease/prevention & control
- Humans
- Ileus/drug therapy
- Ileus/etiology
- Ileus/genetics
- Ileus/immunology
- Immunosuppressive Agents/administration & dosage
- Immunosuppressive Agents/adverse effects
- Infliximab
- Leukemia-Lymphoma, Adult T-Cell/complications
- Leukemia-Lymphoma, Adult T-Cell/genetics
- Leukemia-Lymphoma, Adult T-Cell/immunology
- Leukemia-Lymphoma, Adult T-Cell/pathology
- Neoplasm, Residual
- Precursor Cells, B-Lymphoid/immunology
- Precursor Cells, B-Lymphoid/pathology
- Transplantation Chimera/genetics
- Transplantation Chimera/immunology
- Transplantation Conditioning
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7
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Tarella C, Castellino C, Locatelli F, Caracciolo D, Corradini P, Falda M, Novarino A, Tassi V, Pileri A. G-CSF administration following peripheral blood progenitor cell (PBPC) autograft in lymphoid malignancies: evidence for clinical benefits and reduction of treatment costs. Bone Marrow Transplant 1998; 21:401-7. [PMID: 9509976 DOI: 10.1038/sj.bmt.1701104] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Clinical value and costs of G-CSF administration following autograft with mobilized peripheral blood progenitor cells (PBPC) were evaluated in two sequential groups of 20 patients each, treated for lymphoid neoplasms in the period February 1993 to January 1996. One group was given G-CSF (Filgrastim) (5 microg/kg/day), starting on day +1 until ANC was > 500/microl, the other received no G-CSF. All patients were conditioned with mitoxantrone 60 mg/m2 + L-PAM 180 mg/m2 and received large numbers of PBPC (median of 12 and 13 x 10(6) CD34+/kg, respectively). The median time to ANC > 500/microl was 10 days in the G-CSF group vs 14 days in controls (P < 0.0001). G-CSF was associated with a slightly faster platelet recovery (11 vs 13 days to plts > 20000/microl, P = 0.09). Median duration of fever (2.5 vs 5 days, P = 0.028), nonprophylactic antibiotics (8 vs 11 days, P = 0.019), and post-transplant hospitalization (13 vs 16 days, P = 0.0028) were also significantly reduced. The average cost per treatment in the G-CSF group amounted to about US$18241 as compared to US$21868 in the control group, implying a cost reduction of approximately 16%. Thus, G-CSF reduced morbidity with cost containment, supporting its use even if autograft is performed with large quantities of PBPC.
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Affiliation(s)
- C Tarella
- Dipartimento di Medicina e Oncologia Sperimentale, Fondazione G Strumia, Azienda Ospedaliera S Giovanni di Torino, Italy
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8
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Ferrero D, Tarella C, Cherasco C, Bondesan P, Omedè P, Ravaglia R, Caracciolo D, Castellino C, Pileri A. A single step density gradient separation for large scale enrichment of mobilized peripheral blood progenitor cells collected for autotransplantation. Bone Marrow Transplant 1998; 21:409-13. [PMID: 9509977 DOI: 10.1038/sj.bmt.1701094] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Peripheral blood leukocytes are becoming the preferred source of hematopoietic progenitor/stem cells for autologous transplantation. However, in vitro purging procedures are complex and expensive when applied to peripheral blood progenitor cells harvests. This is mainly due to the large quantities of nucleated cells present in leukapheresis collections. Aiming to reduce total cellularity without significant loss of CD34+ cells, we developed an in vitro cell separation procedure based on ficoll/metrizoate gradient used at a final density of 1.067 g/ml. To obtain this density, standard Lympho-prep (1.077 g/ml) was diluted with normal saline solution (NaCl 9 g/l). Twenty-six leukapheresis collections (median cellularity 21.1 x 10(9), range 2.8-60) from 14 patients with non-Hodgkin's lymphoma, multiple myeloma or plasma cell leukemia were processed (median two leukaphereses per patient). Mean (+/- s.d.) recovery of total nucleated cells, CD34+ cells and CFU-GM was 20.9 +/- 10%, 74.7 +/- 22% and 70.5 +/- 19%, respectively. Cumulative per patient progenitor cell recovery was always above 50%, and as high as 80% in 10/14 patients, while total cellularity was reduced to a median 21.5% (10-33%) of pre-separation values. Contaminating neoplastic cells, identified by immunofluorescence in five collections, were reduced by 1-2 logs. The results indicate that our density gradient separation is an effective method to reduce total cellularity prior to immunological purging, without significant loss of progenitor cells.
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Affiliation(s)
- D Ferrero
- Dipartimento di Medicina e Oncologia Sperimentale, Divisione di Ematologia dell' Università di Torino, Azienda Ospedaliera San Giovanni Battista, Italy
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9
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Tarella C, Castellino C, Cherasco C, Bondesan P, Giaretta F, Corradini P, Caracciolo D, Gavarotti P, Pileri A. Peripheral blood progenitor cell mobilization in patients with primary refractory lymphoma or at first relapse: comparison with patients at diagnosis and impact on clinical outcome. Br J Haematol 1997; 99:41-6. [PMID: 9359500 DOI: 10.1046/j.1365-2141.1997.3433157.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Peripheral blood progenitor cell (PBPC) mobilization was evaluated in 53 patients receiving the high-dose sequential (HDS) regimen: 27 had non-Hodgkin's lymphoma or Hodgkin's disease, primary refractory or at first relapse, 26 had non-Hodgkin's lymphoma at diagnosis. Mobilization was assessed following either 7 g/m2 cyclophosphamide (48 patients) or 2 g/m2 etoposide, both followed by G-CSF (filgrastim) at 5 microg/kg/d. PBPC mobilization was significantly higher in patients at diagnosis compared to refractory/relapsed patients (median peak values of circulating CFU-GM: 25,209/ml v 4270/ml, P < 0.0001 and CD34+ cells: 286/microl v 47/microl, P < 0.0001). All patients receiving HDS as up-front treatment mobilized enough PBPC for an autograft, often requiring a single leukapheresis; whereas only 15 patients under salvage treatment with HDS were able to complete PBPC autograft. Bone marrow (BM) cells, alone or with PBPC, were needed in six patients, and autograft could not be performed in six patients. Among refractory/relapsed patients, those having a high PBPC mobilization experienced a significantly longer EFS compared to those who had not; autograft completion also significantly enhanced EFS. Thus, the use of an effective mobilizing protocol does not ensure adequate PBPC mobilization in moderately pretreated patients; low mobilization must be considered as an early sign of poor outcome in patients receiving a high-dose salvage programme.
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Affiliation(s)
- C Tarella
- Dipartimento di Medicina e Oncologia Sperimentale, Azienda Ospedaliera S. Giovanni Battista di Torino, Italy
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Tarella C, Benedetti G, Caracciolo D, Castellino C, Cherasco C, Bondesan P, Omedé P, Ruggieri D, Gianni AM, Pileri A. Both early and committed haemopoietic progenitors are more frequent in peripheral blood than in bone marrow during mobilization induced by high-dose chemotherapy + G-CSF. Br J Haematol 1995; 91:535-43. [PMID: 8555051 DOI: 10.1111/j.1365-2141.1995.tb05344.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Haemopoietic growth factor administration following high-dose chemotherapy markedly amplifies progenitor cell pool in the peripheral blood (PB). Collection and reinfusion of these cells enable rapid haemopoietic reconstitution following autograft. Less is known on engraftment potentiality of bone marrow (BM) cells taken under analogous conditions. To investigate this tissue, PB and BM were evaluated simultaneously during maximal mobilization in a series of 14 patients undergoing the HDS chemotherapy programme. A significantly higher growth of committed progenitors was found from PB rather than from BM (663 +/- 123 v 267 +/- 40 CFU-GM/10(5) MNC, respectively). Also, significantly more CFU-GM could be collected by a median of three leukaphereses, compared to those harvested from BM (158 +/- 31 v 16 +/- 4 x 10(4) CFU-GM/kg, respectively). Most mobilized CFU-GM were phenotypically immature (CD15-); in addition, circulating cells included primitive progenitors, as assessed by LTC-IC assay, or by evaluation of non-proliferating pre-CFU-GM, selected by an anti-CD71 immunotoxin. The amount of pre-CFU-GM determined by both techniques was consistently higher in PB than in BM. Moreover, a direct correlation could be established between circulating CFU-GM and primitive precursors. Thus, during optimally induced mobilization, PB contains many more haemopoietic progenitors, of both committed and primitive stages, than does BM. Under such conditions, PB is probably the best source of material for graft purposes.
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Affiliation(s)
- C Tarella
- Dipartimento di Medicina e Oncologia Sperimentale, Az. Ospedaliera S. Giovanni, Torino, Italy
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Tarella C, Gavarotti P, Caracciolo D, Corradini P, Cherasco C, Castellino C, Gallo E, Pileri A. Haematological support of high-dose sequential chemotherapy: clinical evidence for reduction of toxicity and high response rates in poor risk lymphomas. Ann Oncol 1995; 6 Suppl 4:3-8. [PMID: 8750137 DOI: 10.1093/annonc/6.suppl_4.s3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
The toxicity and feasibility of a high-dose sequential (HDS) chemotherapy programme delivered with growth factor support were evaluated in patients with intermediate and high-grade non-Hodgkin's lymphoma (NHL) or with progressive Hodgkin's disease. The scheme includes the sequential administration of single cytotoxic drugs at very high doses followed by intensified treatment with circulating progenitor autograft. In some instances, the original HDS scheme, initially designed at the Milan Cancer Center, was partially modified and intensified with a preliminary debulking phase. The use of G-CSF (filgrastim) made toxicity in the high-dose phase acceptable and allowed good harvests of peripheral blood progenitor cells (PBPC); the use of PBPC in the final autografting phase resulted in low haematological toxicity. Of 71 patients with NHL treated at our institution with either the original or the intensified HDS version, the overall toxicity-related mortality was 5.6%, thus comparable to lethal toxicity commonly associated with conventional chemotherapy. Adequate PBPC harvests are crucial for good tolerability of the programme. Optimal harvests are generally obtained in patients without neoplastic marrow infiltration while patients with marrow disease often have a poorer mobilisation. However, an optimally time-spaced chemotherapy debulking might also restore sufficient mobilisation in these latter patients. In terms of therapeutic efficacy, HDS had produced promising results since the initial experience in relapsed patients. More recently, HDS was evaluated as first-line treatment in a series of 22 consecutive patients, presenting with advanced-stage, intermediate-grade NHL other than diffuse large cell subtype. A CR rate of 82% was obtained following HDS, with a projected survival of 86% at five years. Thus, delivery of an intensive high-dose chemotherapy programme with haematopoietic growth factor support was found to be feasible and reasonably safe. The high anti-tumour efficacy of such a scheme makes it suitable for wider applicability in all those chemosensitive tumours where a dose increase might enhance the chance of cure.
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Affiliation(s)
- C Tarella
- Dipartimento di Medicina ed Oncologia Sperimentale, Divisione Universitaria di Ematologia, Azienda Ospedaliera San Giovanni Battista, Torino, Cuneo, Italy
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