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Autore F, Fresa A, Innocenti I, Principe MID, Maglione R, Stefanizzi C, Pelliccia S, Romeo A, Cimino G, Papa E, Padua LD, Andriani A, Mengarelli A, Tafuri A, Ditto C, Mauro FR, Del Poeta G, Laurenti L. Correspondence in reference to the previously published manuscript: Reduction of cycles of bendamustine plus rituximab therapy in the cases with good response for indolent B-cell lymphomas. Hematol Oncol 2023; 41:571-573. [PMID: 35319789 DOI: 10.1002/hon.2989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Takezaki et al. analyzed the outcome of 57 patients with indolent lymphomas treated with Bendamustine plus Rituximab (BR) according to the number of cycles received, showing that patients who discontinued BR after four cycles had similar outcomes compared to patients who received five or six cycles. Considering the similarities but also the differences between indolent lymphomas and chronic lymphocytic leukemia (CLL), we enriched the results obtained with a cohort of CLL patients treated with BR starting from the experience of the Lazio region group on CLL. Out of 115 patients, 97 (84%) received 4-6 cycles of BR, while 18 (16%) received 1-3 cycles. The outcome of the group of patients who received at least 4 cycles was superior in terms of response rate (ORR 96% vs. ORR 83%, p = 0.041; CR 58% vs. CR 28%, p = 0.052 respectively) and PFS [median PFS 52.6 (40.3-64.9) versus 26.2 (19.3-33.0) months, p < 0.001]. The number of patients undergoing 4 cycles of BR (4-cycles group) and 5-6 cycles (over-4-cycles group) was 9 and 88, respectively. Compared to analysis conducted by the Japanese group in indolent lymphomas, in CLL we did not observe any difference between the outcome of the 4-cycles group and the over-4-cycles group in terms of ORR (89% vs. 97%, p = 0.268) and in survival [median PFS 40.8 (13.7-67.8) versus 52.6 (38.7-66.5) months, p = 0.117]. Moreover, we observed that patients who achieved a clinical CR showed overlapping outcomes with patients who received more than 4 cycles [CR vs. non-CR median PFS not reached vs. 11.0 months; over-4-cycles group median PFS 52.6 months (40.3-64.9); p < 0.001]. Nowadays chemoimmunotherapy with BR is reserved to fit elderly CLL patients, and there are many chemo-free treatment options available; therefore, discontinuation after 4 cycles may be permissible in patients who obtained a CR in order to limit toxicity as much as possible.
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Affiliation(s)
- Francesco Autore
- Dipartimento di Diagnostica per Immagini, Hematology Unit, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Alberto Fresa
- Institute of Hematology, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Idanna Innocenti
- Dipartimento di Diagnostica per Immagini, Hematology Unit, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Maria Ilaria Del Principe
- Department of Biomedicine and Prevention, Hematology Unit, University tor Vergata of Rome, Rome, Italy
| | - Raffaele Maglione
- Department of Cellular Biotechnologies and Hematology, Hematology Unit, Sapienza University, Rome, Italy
| | | | - Sabrina Pelliccia
- Hematology Unit, Azienda Ospedaliera-Universitaria Sant'Andrea, Rome, Italy
| | - Azzurra Romeo
- Hematology Unit, Ospedale Santa Maria Goretti, Latina, Italy
| | - Giuseppe Cimino
- Hematology Unit, Ospedale Santa Maria Goretti, Latina, Italy
| | - Elena Papa
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Laura De Padua
- Hematology Unit, Fabrizio Spaziani Hospital, Frosinone, Italy
| | | | - Andrea Mengarelli
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Agostino Tafuri
- Hematology Unit, Azienda Ospedaliera-Universitaria Sant'Andrea, Rome, Italy
| | - Concetta Ditto
- Division of Hematology, Ospedale Belcolle, Viterbo, Italy
| | - Francesca Romana Mauro
- Department of Cellular Biotechnologies and Hematology, Hematology Unit, Sapienza University, Rome, Italy
| | - Giovanni Del Poeta
- Department of Biomedicine and Prevention, Hematology Unit, University tor Vergata of Rome, Rome, Italy
| | - Luca Laurenti
- Dipartimento di Diagnostica per Immagini, Hematology Unit, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Institute of Hematology, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
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Buccisano F, Maurillo L, Piciocchi A, Del Principe MI, Sarlo C, Cefalo M, Ditto C, Di Veroli A, De Santis G, Irno Consalvo M, Fraboni D, Panetta P, Palomba P, Attrotto C, Del Poeta G, Sconocchia G, Lo-Coco F, Amadori S, Venditti A. Minimal residual disease negativity in elderly patients with acute myeloid leukemia may indicate different postremission strategies than in younger patients. Ann Hematol 2015; 94:1319-26. [PMID: 25869029 DOI: 10.1007/s00277-015-2364-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 03/22/2015] [Indexed: 11/29/2022]
Abstract
In the present analysis, we evaluated whether in elderly acute myeloid leukemia (AML) patients (>60 years), minimal residual disease (MRD) assessed by flow cytometry may have a role in guiding choice of postremission strategies. We analyzed 149 young and 61 elderly adults who achieved morphological CR after induction course of EORTC/GIMEMA protocols. Elderly patients reached a postconsolidation MRD negative status less frequently than younger ones (11 vs 28 %, p = 0.009). MRD negativity resulted in a longer 5-year disease-free survival (DFS) both in elderly (57 vs 13 %, p = 0.0197) and in younger patients (56 vs 31 %, p = 0.0017). Accordingly, 5-year cumulative incidence of relapse (CIR) of both elderly (83 vs 42 %, p = 0.045) and younger patients (59 vs 24 % p = NS) who were MRD positive doubled that of MRD negative ones. Nevertheless, CIR of MRD negative elderly patients was twofold higher than that of younger MRD negative ones (42 vs 24 %, p = NS). In conclusion, elderly patients in whom chemotherapy yields a MRD negative CR have duration of DFS and rate of CIR significantly better than those who remain MRD positive. Nonetheless, the high CIR rate observed in the elderly suggests that MRD negativity might have different therapeutic implications in this population than in the younger counterpart.
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Affiliation(s)
- F Buccisano
- Ematologia, Dipartimento di Biomedicina e Prevenzione, Università di Roma "Tor Vergata", Roma, Italia,
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Maurillo L, Buccisano F, Piciocchi A, Del Principe MI, Sarlo C, Di Veroli A, Panetta P, Irno-Consalvo M, Nasso D, Ditto C, Refrigeri M, De Angelis G, Cerretti R, Arcese W, Sconocchia G, Lo-Coco F, Amadori S, Venditti A. Minimal residual disease as biomarker for optimal biologic dosing of ARA-C in patients with acute myeloid leukemia. Am J Hematol 2015; 90:125-31. [PMID: 25377359 DOI: 10.1002/ajh.23893] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 10/30/2014] [Accepted: 10/31/2014] [Indexed: 11/05/2022]
Abstract
We assessed by flow cytometry minimal residual disease (MRD) in patients with acute myeloid leukemia (AML) given standard-dose (SDAC) and high-dose ARA-C (HDAC) regimens. Of 163 patients enrolled, 130 (median age, 45 years; range, 18-59 years) qualified for analysis, all achieving complete remission after treatment with SDAC (n = 78) or HDAC (n = 52) plus etoposide and daunorubicin. Consolidation consisted of intermediate-dose ARA-C and daunorubicin. MRD negativity was significantly more frequent in the SDAC vs. HDAC arm after both induction (37% vs. 15%, P = 0.007) and consolidation (44% vs. 18%, P = 0.002). Respective median residual leukemic cell counts with SDAC and HDAC use were 1.5 × 10(-3) and 4 × 10(-3) (P = 0.033) after induction and 5.7 × 10(-4) and 2.9 × 10(-3) (P = 0.008) after consolidation. Based on ARA-C schedule and post-consolidation MRD status, the four patient groups (SDAC-MRD(-) , HDAC-MRD(-) , SDAC-MRD(+) , and HDAC-MRD(+) ) displayed 5-year overall survival rates of 60%, 33%, 24%, and 42% (P = 0.007), respectively, with 24%, 35%, 74%, and 48% (P < 0.0001) respective cumulative incidence of relapse estimates. MRD may serve as a biomarker for optimal biologic dosing of ARA-C, and SDAC regimen appears to yield more frequent MRD negativity.
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Affiliation(s)
- Luca Maurillo
- Ematologia; Dipartimento di Biomedicina e Prevenzione; Università Tor Vergata; Roma Italia
| | - Francesco Buccisano
- Ematologia; Dipartimento di Biomedicina e Prevenzione; Università Tor Vergata; Roma Italia
| | | | | | - Chiara Sarlo
- Ematologia; Dipartimento di Biomedicina e Prevenzione; Università Tor Vergata; Roma Italia
| | - Ambra Di Veroli
- Ematologia; Dipartimento di Biomedicina e Prevenzione; Università Tor Vergata; Roma Italia
| | - Paola Panetta
- Ematologia; Dipartimento di Biomedicina e Prevenzione; Università Tor Vergata; Roma Italia
| | - Maria Irno-Consalvo
- Ematologia; Dipartimento di Biomedicina e Prevenzione; Università Tor Vergata; Roma Italia
| | - Daniela Nasso
- Ematologia; Dipartimento di Biomedicina e Prevenzione; Università Tor Vergata; Roma Italia
| | - Concetta Ditto
- Ematologia; Dipartimento di Biomedicina e Prevenzione; Università Tor Vergata; Roma Italia
| | - Marco Refrigeri
- Ematologia; Dipartimento di Biomedicina e Prevenzione; Università Tor Vergata; Roma Italia
| | - Gottardo De Angelis
- Ematologia; Dipartimento di Biomedicina e Prevenzione; Università Tor Vergata; Roma Italia
| | - Raffaella Cerretti
- Ematologia; Dipartimento di Biomedicina e Prevenzione; Università Tor Vergata; Roma Italia
| | - William Arcese
- Ematologia; Dipartimento di Biomedicina e Prevenzione; Università Tor Vergata; Roma Italia
| | - Giuseppe Sconocchia
- Istituto di Farmacologia Traslazionale; Dipartimento di Medicina; CNR Roma Italia
| | - Francesco Lo-Coco
- Ematologia; Dipartimento di Biomedicina e Prevenzione; Università Tor Vergata; Roma Italia
- Fondazione S.Lucia - I.R.C.C.S; Roma Italia
| | - Sergio Amadori
- Ematologia; Dipartimento di Biomedicina e Prevenzione; Università Tor Vergata; Roma Italia
| | - Adriano Venditti
- Ematologia; Dipartimento di Biomedicina e Prevenzione; Università Tor Vergata; Roma Italia
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Buccisano F, Maurillo L, Neri B, Masala S, Mauriello A, Del Principe MI, Ditto C, Sarlo C, Cefalo M, Di Caprio L, Loreni G, Cicconi L, Amadori S, Venditti A. Thoracic Cord Compression Caused by Epidural Extramedullary Hematopoiesis During Erythroid-Stimulating Agent Therapy in Two Patients With Myelodysplastic Syndromes. J Clin Oncol 2013; 31:e189-91. [DOI: 10.1200/jco.2012.45.3209] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Venditti A, Buccisano F, Maurillo L, Del Principe MI, Sarlo C, Di Veroli A, Nasso D, Ditto C, Giannotti F, Grasso MA, Franchi A, Lo-Coco F, Amadori S. Risk allocation of adult patients with non-M3 acute myeloid leukemia. Drugs Cell Ther Hematol 2013. [DOI: 10.4081/dcth.2013.83] [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: 11/23/2022]
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Venditti A, Buccisano F, Maurillo L, Del Principe MI, Sarlo C, Di Veroli A, Nasso D, Ditto C, Giannotti F, Grasso MA, Franchi A, Lo-Coco F, Amadori S. Risk allocation of adult patients with non-M3 acute myeloid leukemia. Drugs Cell Ther Hematol 2013. [DOI: 10.4081/dcth.2013.3] [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: 11/23/2022]
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Postorino M, Cantonetti M, Franceschini L, De Angelis G, Cudillo L, Cerretti R, Giannì L, Rizzo M, Lombardo G, Didona B, Ditto C, Di Caprio L, Faccia S, Pupo L, Renzi W, Arcese D. P086 Allogeneic stem cell transplantation for advanced cutaneous T-cell lymphopma: unicentric experience. Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70434-4] [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: 11/29/2022]
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Abstract
Coryneform bacteria are frequently isolated from bovine mastitis with the lipophilic species, and Corynebacterium bovis is the most frequently isolated organism of this group. However, previous studies on the phylogeny of corynebacteria have incorporated only a single reference strain. We examined the phylogeny of C. bovis using 47 strains isolated from bovine mammary glands. Phylogenetic studies were performed by direct sequencing of the 16S ribosomal RNA and comparison to sequences of reference strains. All strains identified as C. bovis demonstrated similarity of 98% or higher to the ribosomal RNA gene sequences of the type strain of C. bovis. Phylogenetic analyses indicated that all strains tested clustered with members of the Corynebacterium urealyticum group confirming that C. bovis is a legitmate member of the genus Corynebacterium. Further investigation into the diversity within the species using repetitive element palindrome PCR indicated only minor differences between the strains tested. Corynebacterium bovis ATCC 13722 demonstrated the highest similarity (95%) with Brevibacterium helvolum, indicating that this organism does not belong in the genus Corynebacterium.
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Affiliation(s)
- J L Watts
- Pharmacia Corporation, Kalamazoo, MI, USA.
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