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Urbino I, Lengliné E, Rabian F, Cerrano M, Kim R, Chevillon F, Ferrero D, Sébert M, Dhedin N, Itzykson RA, Adès L, Raffoux E, Dombret H, Audisio E, Clappier E, Boissel N. Blinatumomab Consolidation for Adult B-Cell Acute Lymphoblastic Leukemia in First and Second Complete Remission. Blood Adv 2024:bloodadvances.2023012139. [PMID: 38507689 DOI: 10.1182/bloodadvances.2023012139] [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] [Received: 11/08/2023] [Revised: 02/02/2024] [Accepted: 02/15/2024] [Indexed: 03/22/2024] Open
Affiliation(s)
| | | | | | - Marco Cerrano
- Department of Oncology, Division of Hematology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Torino, Torino, Italy
| | - Rathana Kim
- Université Paris Cité - Hopital Saint-Louis APHP - INSERM U944, PARIS, France
| | - Florian Chevillon
- Department of Hematology, University Hospital Saint-Louis, AP-HP, Paris, France
| | | | | | | | | | - Lionel Adès
- AP-HP, Hôpital Saint Louis and University of Paris, and INSERM U944, Paris, France
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Urbino I, Secreto C, Apolito V, Olivi M, Arrigo G, Boscaro E, Catania FM, D'Ardia S, Frairia C, Giai V, Freilone R, Bruno B, Lanzarone G, Giaccone L, Busca A, Dellacasa CM, Ferrero D, Audisio E, Cerrano M. Sorafenib in combination with intensive chemotherapy for relapsed or refractory FLT3-ITD positive acute myeloid leukemia: A two centers experience. Leuk Res 2024; 136:107421. [PMID: 38042648 DOI: 10.1016/j.leukres.2023.107421] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/31/2023] [Accepted: 11/14/2023] [Indexed: 12/04/2023]
Affiliation(s)
- Irene Urbino
- Department of Oncology, Division of Hematology, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Carolina Secreto
- Department of Oncology, Division of Hematology, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Vincenzo Apolito
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Turin, Italy; Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, Regina Margherita Children's Hospital, Turin, Italy
| | - Matteo Olivi
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Turin, Italy
| | - Giulia Arrigo
- Department of Oncology, Division of Hematology, A.O.U. Città della Salute e della Scienza, Turin, Italy; Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Turin, Italy
| | - Eleonora Boscaro
- Department of Oncology, Division of Hematology, A.O.U. Città della Salute e della Scienza, Turin, Italy; Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Turin, Italy
| | - Federica Maria Catania
- Department of Oncology, Division of Hematology, A.O.U. Città della Salute e della Scienza, Turin, Italy; Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Turin, Italy
| | - Stefano D'Ardia
- Department of Oncology, Division of Hematology, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Chiara Frairia
- Department of Oncology, Division of Hematology, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Valentina Giai
- Department of Oncology, Division of Hematology, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Roberto Freilone
- Department of Oncology, Division of Hematology, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Benedetto Bruno
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Turin, Italy; Division of Hematology, Allogeneic Transplant and Cell Therapy Unit, AOU "Città della Salute e della Scienza di Torino" University of Turin, Italy
| | - Giuseppe Lanzarone
- Division of Hematology, Allogeneic Transplant and Cell Therapy Unit, AOU "Città della Salute e della Scienza di Torino" University of Turin, Italy
| | - Luisa Giaccone
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Turin, Italy; Division of Hematology, Allogeneic Transplant and Cell Therapy Unit, AOU "Città della Salute e della Scienza di Torino" University of Turin, Italy
| | - Alessandro Busca
- Department of Oncology, Division of Hematology, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Chiara Maria Dellacasa
- Department of Oncology, Division of Hematology, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Dario Ferrero
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Turin, Italy; Division of Hematology, Allogeneic Transplant and Cell Therapy Unit, AOU "Città della Salute e della Scienza di Torino" University of Turin, Italy
| | - Ernesta Audisio
- Department of Oncology, Division of Hematology, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Marco Cerrano
- Department of Oncology, Division of Hematology, A.O.U. Città della Salute e della Scienza, Turin, Italy.
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Apolito V, Arrigo G, Vasseur L, Olivi M, Perrone S, Giai V, Secreto C, Di Biase F, De Simone MC, Copia C, Gravetti A, Freilone R, Bruno B, Lanzarone G, Beggiato E, Frairia C, Audisio E, D'Ardia S, Ferrero D, Cerrano M, Ferrara F. Validation of SIE/SIES/GITMO consensus criteria for unfitness to predict early mortality and survival in acute myeloid leukaemia patients treated with hypomethylating agents and venetoclax. Br J Haematol 2023; 203:e98-e101. [PMID: 37533098 DOI: 10.1111/bjh.19022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 07/17/2023] [Accepted: 07/25/2023] [Indexed: 08/04/2023]
Affiliation(s)
- Vincenzo Apolito
- Division of Haematology, University of Turin, Turin, Italy
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, Regina Margherita Children's Hospital, Turin, Italy
| | - Giulia Arrigo
- Division of Haematology, Department of Oncology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Loic Vasseur
- Hôpital Saint-Louis, Assistance, Publique-Hôpitaux de Paris, Paris, France
| | - Matteo Olivi
- Division of Haematology, University of Turin, Turin, Italy
| | - Silvia Perrone
- Division of Haematology, Department of Oncology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Valentina Giai
- Division of Haematology, Department of Oncology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Carolina Secreto
- Division of Haematology, Department of Oncology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | | | | | | | | | - Roberto Freilone
- Division of Haematology, Department of Oncology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | | | | | | | - Chiara Frairia
- Division of Haematology, Department of Oncology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Ernesta Audisio
- Division of Haematology, Department of Oncology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Stefano D'Ardia
- Division of Haematology, Department of Oncology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Dario Ferrero
- Division of Haematology, University of Turin, Turin, Italy
| | - Marco Cerrano
- Division of Haematology, Department of Oncology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Turin, Italy
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Oliva EN, Riva M, Niscola P, Santini V, Breccia M, Giai V, Poloni A, Patriarca A, Crisà E, Capodanno I, Salutari P, Reda G, Cascavilla N, Ferrero D, Guarini A, Tripepi G, Iannì G, Russo E, Castelli A, Fattizzo B, Beltrami G, Bocchia M, Molteni A, Fenaux P, Germing U, Ricco A, Palumbo GA, Impera S, Di Renzo N, Rivellini F, Buccisano F, Stamatoullas-Bastard A, Liberati AM, Candoni A, Delfino IM, Arcadi MT, Cufari P, Rizzo L, Bova I, D'Errigo MG, Zini G, Latagliata R. Eltrombopag for Low-Risk Myelodysplastic Syndromes With Thrombocytopenia: Interim Results of a Phase II, Randomized, Placebo-Controlled Clinical Trial (EQOL-MDS). J Clin Oncol 2023; 41:4486-4496. [PMID: 37294914 PMCID: PMC10552995 DOI: 10.1200/jco.22.02699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 03/16/2023] [Accepted: 05/01/2023] [Indexed: 06/11/2023] Open
Abstract
PURPOSE In myelodysplastic syndromes (MDS), severe thrombocytopenia is associated with poor prognosis. This multicenter trial presents the second-part long-term efficacy and safety results of eltrombopag in patients with low-risk MDS and severe thrombocytopenia. METHODS In this single-blind, randomized, placebo-controlled, phase-II trial of adult patients with International Prognostic Scoring System low- or intermediate-1-risk MDS, patients with a stable platelet (PLT) count (<30 × 103/mm3) received eltrombopag or placebo until disease progression. Primary end points were duration of PLT response (PLT-R; calculated from the time of PLT-R to date of loss of PLT-R, defined as bleeding/PLT count <30 × 103/mm3 or last date in observation) and long-term safety and tolerability. Secondary end points included incidence and severity of bleeding, PLT transfusions, quality of life, leukemia-free survival, progression-free survival, overall survival and pharmacokinetics. RESULTS From 2011 to 2021, of 325 patients screened, 169 patients were randomly assigned oral eltrombopag (N = 112) or placebo (N = 57) at a starting dose of 50 mg once daily to maximum of 300 mg. PLT-R, with 25-week follow-up (IQR, 14-68) occurred in 47/111 (42.3%) eltrombopag patients versus 6/54 (11.1%) in placebo (odds ratio, 5.9; 95% CI, 2.3 to 14.9; P < .001). In eltrombopag patients, 12/47 (25.5%) lost the PLT-R, with cumulative thrombocytopenia relapse-free survival at 60 months of 63.6% (95% CI, 46.0 to 81.2). Clinically significant bleeding (WHO bleeding score ≥ 2) occurred less frequently in the eltrombopag arm than in the placebo group (incidence rate ratio, 0.54; 95% CI, 0.38 to 0.75; P = .0002). Although no difference in the frequency of grade 1-2 adverse events (AEs) was observed, a higher proportion of eltrombopag patients experienced grade 3-4 AEs (χ2 = 9.5, P = .002). AML evolution and/or disease progression occurred in 17% (for both) of eltrombopag and placebo patients with no difference in survival times. CONCLUSION Eltrombopag was effective and relatively safe in low-risk MDS with severe thrombocytopenia. This trial is registered with ClinicalTrials.gov identifier: NCT02912208 and EU Clinical Trials Register: EudraCT No. 2010-022890-33.
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Affiliation(s)
- Esther Natalie Oliva
- U.O.C. Ematologia, Grande Ospedale Metropolitano Bianchi Melacrino Morelli, Reggio di Calabria, Italy
| | - Marta Riva
- Dipartimento di Ematologia, Ospedale Niguarda Ca' Granda, Milano, Italy
| | | | - Valeria Santini
- U.O. di Ematologia, Azienda Ospedaliera Universitaria Careggi, Firenze, Italy
| | - Massimo Breccia
- Dipartimento di Ematologia Policlinico Umberto I, Università La Sapienza, Roma, Italy
| | - Valentina Giai
- S.C. a Direzione Universitaria di Ematologia A.O., SS. Antonio e Biagio e Cesare Arrigo Alessandria, Alessandria, Italy
| | - Antonella Poloni
- Clinica di Ematologia Azienda Ospedaliera Universitaria—Ospedali Riuniti di Ancona, Ancona, Italy
| | | | - Elena Crisà
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy
| | - Isabella Capodanno
- U.O. di Ematologia, A.U.S.L.-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Prassede Salutari
- Dipartimento Oncologico-Ematologico, Ospedale Civile Spirito Santo, Pescara, Italy
| | - Gianluigi Reda
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Nicola Cascavilla
- U.O. Ematologia Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Dario Ferrero
- Dipartimento Biotecnologie Molecolari, Ematologia Universitaria A.O.U. Citta' della Salute e della Scienza di Torino, Turin, Italy
| | - Attilio Guarini
- U.O. Ematologia I.R.C.C.S. Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Giovanni Tripepi
- IFC-CNR Institute of Clinical Physiology, Reggio Calabria, Italy
| | | | - Emilio Russo
- Department of Pharmacology, University of Germaneto Catanzaro, Catanzaro, Italy
| | | | - Bruno Fattizzo
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Dipartimento di Oncologia ed Emato-Oncologia, Università degli Studi di Milano, Milan, Italy
| | - Germana Beltrami
- U.O. Ematologia e terapie cellulari, IRCCS Azienda Ospedaliera Universitaria San Martino, Genova, Italy
| | - Monica Bocchia
- UOC Ematologia, Università di Siena, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | | | - Pierre Fenaux
- Groupe Francais desmyélodysplasies (GFM), Paris, France
| | - Ulrich Germing
- Department of Hematology, Oncology, and Clinical Immunology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Alessandra Ricco
- U.O. Ematologia con Trapianto, Azienda Ospedale Policlinicodi Bari, Bari, Italy
| | - Giuseppe A. Palumbo
- Dipartimento di Scienze Mediche Chirurgiche e Tecnologie Avanzate “G.F. Ingrassia”, University of Catania, Catania, Italy
| | - Stefana Impera
- U.O. C. Ematologia, A. O.ad Alta Specializzazione Ospedale Garibaldi Nesima, Catania, Italy
| | | | - Flavia Rivellini
- Divisione Ematologia, P.O. A. Tortora di Pagani-ASL Salerno, Pagani, Italy
| | - Francesco Buccisano
- Divisione di Biopatologia e Diagnostica per Immagini, Policlinico Universitario Tor Vergata, Rome, Italy
| | | | - Anna Marina Liberati
- S.C. Oncoematologia, Università degli Studi di Perugia A.O. Santa Maria, Terni, Italy
| | - Anna Candoni
- Divisione Ematologia, P.O. Santa Maria della Misericordia, A.S.U.F.C di Udine, Udine, Italy
| | - Ilaria Maria Delfino
- U.O.C. Ematologia, Grande Ospedale Metropolitano Bianchi Melacrino Morelli, Reggio di Calabria, Italy
| | - Maria Teresa Arcadi
- U.O. Farmacia Grande Ospedale Metropolitano Bianchi Melacrino Morelli, Reggio di Calabria, Italy
| | - Patrizia Cufari
- U.O.C. Ematologia, Grande Ospedale Metropolitano Bianchi Melacrino Morelli, Reggio di Calabria, Italy
| | - Lorenzo Rizzo
- Dipartimento di Ematologia, Ospedale Niguarda Ca' Granda, Milan, Italy
| | - Irene Bova
- U.O.S. di Genetica Medica Grande Ospedale Metropolitano Bianchi Melacrino Morelli, Reggio di Calabria, Italy
| | - Maria Grazia D'Errigo
- U.O.S. di Genetica Medica Grande Ospedale Metropolitano Bianchi Melacrino Morelli, Reggio di Calabria, Italy
| | - Gina Zini
- Fondazione Policlinico, Universitario A. Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
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Boscaro E, Urbino I, Catania FM, Arrigo G, Secreto C, Olivi M, D'Ardia S, Frairia C, Giai V, Freilone R, Ferrero D, Audisio E, Cerrano M. Modern Risk Stratification of Acute Myeloid Leukemia in 2023: Integrating Established and Emerging Prognostic Factors. Cancers (Basel) 2023; 15:3512. [PMID: 37444622 DOI: 10.3390/cancers15133512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/02/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023] Open
Abstract
An accurate estimation of AML prognosis is complex since it depends on patient-related factors, AML manifestations at diagnosis, and disease genetics. Furthermore, the depth of response, evaluated using the level of MRD, has been established as a strong prognostic factor in several AML subgroups. In recent years, this rapidly evolving field has made the prognostic evaluation of AML more challenging. Traditional prognostic factors, established in cohorts of patients treated with standard intensive chemotherapy, are becoming less accurate as new effective therapies are emerging. The widespread availability of next-generation sequencing platforms has improved our knowledge of AML biology and, consequently, the recent ELN 2022 recommendations significantly expanded the role of new gene mutations. However, the impact of rare co-mutational patterns remains to be fully disclosed, and large international consortia such as the HARMONY project will hopefully be instrumental to this aim. Moreover, accumulating evidence suggests that clonal architecture plays a significant prognostic role. The integration of clinical, cytogenetic, and molecular factors is essential, but hierarchical methods are reaching their limit. Thus, innovative approaches are being extensively explored, including those based on "knowledge banks". Indeed, more robust prognostic estimations can be obtained by matching each patient's genomic and clinical data with the ones derived from very large cohorts, but further improvements are needed.
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Affiliation(s)
- Eleonora Boscaro
- Division of Hematology, Department of Oncology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Irene Urbino
- Division of Hematology, Department of Oncology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Federica Maria Catania
- Division of Hematology, Department of Oncology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Giulia Arrigo
- Division of Hematology, Department of Oncology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Carolina Secreto
- Division of Hematology, Department of Oncology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Matteo Olivi
- Division of Hematology, Department of Oncology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Stefano D'Ardia
- Division of Hematology, Department of Oncology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Chiara Frairia
- Division of Hematology, Department of Oncology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Valentina Giai
- Division of Hematology, Department of Oncology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Roberto Freilone
- Division of Hematology, Department of Oncology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Dario Ferrero
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, 10126 Turin, Italy
| | - Ernesta Audisio
- Division of Hematology, Department of Oncology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Marco Cerrano
- Division of Hematology, Department of Oncology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, 10126 Turin, Italy
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6
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Lanino L, Restuccia F, Perego A, Ubezio M, Fattizzo B, Riva M, Consagra A, Musto P, Cilloni D, Oliva EN, Palmieri R, Poloni A, Califano C, Capodanno I, Itri F, Elena C, Fozza C, Pane F, Pelizzari AM, Breccia M, Di Bassiano F, Crisà E, Ferrero D, Giai V, Barraco D, Vaccarino A, Griguolo D, Minetto P, Quintini M, Paolini S, Sanpaolo G, Sessa M, Bocchia M, Di Renzo N, Diral E, Leuzzi L, Genua A, Guarini A, Molteni A, Nicolino B, Occhini U, Rivoli G, Bono R, Calvisi A, Castelli A, Di Bona E, Di Veroli A, Ferrara F, Fianchi L, Galimberti S, Grimaldi D, Marchetti M, Norata M, Frigeni M, Sancetta R, Selleri C, Tanasi I, Tosi P, Turrini M, Giordano L, Finelli C, Pasini P, Naldi I, Santini V, Della Porta MG. Real-world efficacy and safety of luspatercept and predictive factors of response in patients with lower risk myelodysplastic syndromes with ring sideroblasts. Am J Hematol 2023. [PMID: 37222267 DOI: 10.1002/ajh.26960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 04/28/2023] [Accepted: 04/30/2023] [Indexed: 05/25/2023]
Affiliation(s)
- Luca Lanino
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | | | | | - Marta Ubezio
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Bruno Fattizzo
- SC Ematologia, IRCCS Ca' Granda Ospedale Maggiore Policlinico & Dipartimento di Oncologia ed Emato-oncologia, University of Milan, Milan, Italy
| | - Marta Riva
- S.C. Ematologia, Dipartimento di Ematologia, Oncologia e Medicina Molecolare, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Angela Consagra
- MDS Unit, Dipartimento Medicina Sperimentale e Clinica, AOU Careggi, Università di Firenze, Firenze, Italy
| | - Pellegrino Musto
- Dipartimento di Medicina di Precisione e Rigenerativa e Area Ionica, Università degli Studi "Aldo Moro", AOU Consorziale Policlinico, Bari, Italy
| | - Daniela Cilloni
- AO Ordine Mauriziano, Università degli Studi di Torino, Turin, Italy
| | - Esther Natalie Oliva
- UOC Ematologia, Grande Ospedale Metropolitano Bianchi Melacrino Morelli, Reggio Calabria, Italy
| | | | - Antonella Poloni
- Università Politecnica Marche, UOC Ematologia, AOU Marche, Ancona, Italy
| | | | - Isabella Capodanno
- Azienda Unità Sanitaria Locale- IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Federico Itri
- AOU San Luigi Gonzaga, SCDU Medicina Interna ad Indirizzo Ematologico, Università degli Studi di Torino, Torino, Italy
| | - Chiara Elena
- UOC Ematologia1, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Claudio Fozza
- Dipartimento di Medicina, Chirurgia e Farmacia, Università di Sassari, Sassari, Italy
| | - Fabrizio Pane
- Dipartimento di Medicina Clinica e Chirurgia, Università di Napoli Federico II, Naples, Italy
| | | | | | | | - Elena Crisà
- AOU Maggiore della Carità, Università del Piemonte Orientale, Novara, Italy
| | - Dario Ferrero
- SC Ematologia, AOU Città della Salute e della Scienza, Torino, Italy
| | - Valentina Giai
- SC Ematologia, AOU Città della Salute e della Scienza, Torino, Italy
| | - Daniela Barraco
- SC Ematologia, Ospedale di Circolo, ASST Sette Laghi, Varese, Italy
| | | | - Davide Griguolo
- UCO Ematologia, Azienda Sanitaria Universitaria Giuliano Isontina, Ospedale Maggiore, Trieste, Italy
| | - Paola Minetto
- Clinica Ematologica, IRCCS-Policlinico San Martino, Genoa, Italy
| | - Martina Quintini
- Azienda Ospedaliera di Perugia, Ospedale Santa Maria della Misericordia, Perugia, Italy
| | - Stefania Paolini
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Grazia Sanpaolo
- UOC Ematologia e Trapianto di Cellule Staminali Emopoietiche - Ospedale Casa Sollievo della Sofferenza, IRCCS San Giovanni Rotondo, San Giovanni Rotondo, Italy
| | - Mariarosaria Sessa
- Hematology Section, Department of Medical Sciences, Azienda Ospedaliero-Universitaria, Arcispedale S.Anna, University of Ferrara, Ferrara, Italy
| | - Monica Bocchia
- UOC Ematologia, Azienda Ospedaliero Universitaria Senese, Università di Siena, Siena, Italy
| | - Nicola Di Renzo
- UOC Ematologia e Trapianto di Cellule Staminali P.O. "Vito Fazzi" -ASL Lecce, Lecce, Italy
| | - Elisa Diral
- Unità di Ematologia e Trapianto di Midollo Osseo, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Livia Leuzzi
- SC Oncologia, SS Oncoematologia, PO Fatebenefratelli, ASST Fatebenefratelli Sacco, Milan, Italy
| | | | | | | | - Barbara Nicolino
- SSD Ematologia, ASLTO4 Presidio Ospedaliero di Ivrea, Ivrea, Italy
| | | | - Giulia Rivoli
- IRCCS Ospedale Policlinico San Martino, U.O Ematologia e terapie Cellulari, Genoa, Italy
| | - Roberto Bono
- A.O.O.R Villa Sofia - Cervello, U.O.S.D. Unità Trapianti di Midollo Osseo, Palermo, Italy
| | - Anna Calvisi
- U.O.C. Ematologia - CTMO Ospedale San Francesco, Nuoro, Italy
| | | | - Eros Di Bona
- Oncoematologia, AULSS 7 Pedemontana, Bassano del Grappa, Italy
| | | | | | - Luana Fianchi
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - Sara Galimberti
- Dipartimento di Medicina Clinica e Sperimentale, Università di Pisa, Pisa, Italy
| | | | - Monia Marchetti
- Hematology Unit, AO Santi Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Marianna Norata
- Hematology Unit, IRCCS - Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori", Meldola, Italy
| | - Marco Frigeni
- Dipartimento di Oncologia ed Ematologia, Azienda Socio-Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | | | - Carmine Selleri
- UOC Ematologia, AOU San Giovanni Dio e Ruggi d'Aragona, Università di Salerno, Salerno, Italy
| | - Ilaria Tanasi
- U.O.C. di Ematologia Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Patrizia Tosi
- UO Ematologia Ospedale Infermi Rimini, Rimini, Italy
| | - Mauro Turrini
- Division of Hematology, Valduce Hospital, Como, Italy
| | - Laura Giordano
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Carlo Finelli
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Paolo Pasini
- AIPASIM (Associazione Italiana Pazienti con Sindrome Mielodisplastica), ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Ilaria Naldi
- MDS Unit, Dipartimento Medicina Sperimentale e Clinica, AOU Careggi, Università di Firenze, Firenze, Italy
| | - Valeria Santini
- MDS Unit, Dipartimento Medicina Sperimentale e Clinica, AOU Careggi, Università di Firenze, Firenze, Italy
| | - Matteo Giovanni Della Porta
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
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7
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Olivi M, Di Biase F, Lanzarone G, Arrigo G, Martella F, Apolito V, Secreto C, Freilone R, Bruno B, Audisio E, Ferrero D, Beggiato E, Cerrano M. Thrombosis in Acute Myeloid Leukemia: Pathogenesis, Risk Factors and Therapeutic Challenges. Curr Treat Options Oncol 2023; 24:693-710. [PMID: 37099265 DOI: 10.1007/s11864-023-01089-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2023] [Indexed: 04/27/2023]
Abstract
OPINION STATEMENT Prophylaxis and treatment of thrombosis in leukemic patients still represent a major challenge with several clinical questions yet to be solved. Indeed, the paucity of evidence makes the management of venous thromboembolic events difficult and not uniform. Due to thrombocytopenia, patients with acute myeloid leukemia (AML) are underrepresented in trials investigating prophylaxis and treatment of thrombosis in cancer, and prospective data are lacking. Likewise, the therapeutic approach with anti-coagulants in leukemic patients is inferred from guidelines originally developed in the solid cancer setting and clear recommendations in the thrombocytopenic population are limited. Importantly, the discrimination of patients at high risk of bleeding from those with a predominant risk of thrombosis remains extremely difficult with no predictive score validated so far. Thus, the management of thrombosis often relies on clinician experience, and it is tailored to the individual patient, constantly balancing thrombotic and hemorrhagic risks. Who would benefit from primary prophylaxis and how a thrombotic event should be appropriately treated are some of the unanswered questions that the future guidelines and trials should address. Moreover, a greater effort should be made to identify robust predictive factors able to guide clinicians in the management of this potential serious complication for AML patients.
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Affiliation(s)
- Matteo Olivi
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Turin, Italy
| | - Federica Di Biase
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Turin, Italy
| | - Giuseppe Lanzarone
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Turin, Italy
| | - Giulia Arrigo
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Turin, Italy
- Department of Oncology, Division of Hematology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Corso Bramante 88/90, 10126, Turin, Italy
| | - Federica Martella
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Turin, Italy
- Department of Hematology and Bone Marrow Transplant, Hospital Card. G. Panico, Tricase, LE, Italy
| | - Vincenzo Apolito
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Turin, Italy
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, Regina Margherita Children's Hospital, Turin, Italy
| | - Carolina Secreto
- Department of Oncology, Division of Hematology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Corso Bramante 88/90, 10126, Turin, Italy
| | - Roberto Freilone
- Department of Oncology, Division of Hematology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Corso Bramante 88/90, 10126, Turin, Italy
| | - Benedetto Bruno
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Turin, Italy
| | - Ernesta Audisio
- Department of Oncology, Division of Hematology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Corso Bramante 88/90, 10126, Turin, Italy
| | - Dario Ferrero
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Turin, Italy
| | - Eloise Beggiato
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Turin, Italy
| | - Marco Cerrano
- Department of Oncology, Division of Hematology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Corso Bramante 88/90, 10126, Turin, Italy.
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8
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Lanza F, Monaco F, Ciceri F, Cairoli R, Sacchi MV, Guidetti A, Marchetti M, Massaia M, Arcaini L, Krampera M, Mohamed S, Gherlinzoni F, Mecucci C, Gentile M, Romano I, Venditti A, Ruggeri M, Ferrero D, Coviello E, Fabbri E, Corradini P, Passamonti F. Lack of efficacy of convalescent plasma in COVID-19 patients with concomitant hematological malignancies: An Italian retrospective study. Hematol Oncol 2022; 40:857-863. [PMID: 35932208 PMCID: PMC9538413 DOI: 10.1002/hon.3060] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 05/23/2022] [Revised: 07/27/2022] [Accepted: 07/30/2022] [Indexed: 12/13/2022]
Abstract
A multicenter retrospective study was designed to assess clinical outcome of COVID-19 in patients with hematological malignancies (HM) following treatment with anti-SARS-CoV-2 convalescent plasma (CP) or standard of care therapy. To this aim, a propensity score matching was used to assess the role of non-randomized administration of CP in this high-risk cohort of patients from the Italian Hematology Alliance on COVID-19 (ITA-HEMA-COV) project, now including 2049 untreated control patients. We investigated 30- and 90-day mortality, rate of admission to intensive care unit, proportion of patients requiring mechanical ventilatory support, hospitalization time, and SARS-CoV-2 clearance in 79 CP recipients and compared results with 158 propensity score-matched controls. Results indicated a lack of efficacy of CP in the study group compared with the untreated group, thus confirming the negative results obtained from randomized studies in immunocompetent individuals with COVID-19. In conclusion, this retrospective analysis did not meet the primary and secondary end points in any category of immunocompromized patients affected by HM.
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Affiliation(s)
| | | | - Fabio Ciceri
- IRCCS Ospedale San RaffaeleUniversity Vita‐Salute San RaffaeleMilanoItaly
| | | | - Maria Vittoria Sacchi
- Hematology Unit, SCDU Ematologia ‐ Az Ospedaliera Santi Antonio e Biagio e Cesare ArrigoAlessandriaItaly
| | | | - Monia Marchetti
- Hematology Unit, SCDU Ematologia ‐ Az Ospedaliera Santi Antonio e Biagio e Cesare ArrigoAlessandriaItaly
| | | | - Luca Arcaini
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo and Department of Molecular MedicineUniversity of PaviaPaviaItaly
| | | | - Sara Mohamed
- Hematology UnitAzienda Sanitaria Universitaria Giuliano IsontinaTriesteItaly
| | | | | | | | | | - Adriano Venditti
- Hematology, Department of Biomedicine and PreventionUniversity Tor VergataRomaItaly
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9
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Martella F, Cerrano M, Di Cuonzo D, Secreto C, Olivi M, Apolito V, D'Ardia S, Frairia C, Giai V, Lanzarone G, Urbino I, Freilone R, Giaccone L, Busca A, Dellacasa CM, Audisio E, Ferrero D, Beggiato E. Frequency and risk factors for thrombosis in acute myeloid leukemia and high-risk myelodysplastic syndromes treated with intensive chemotherapy: a two centers observational study. Ann Hematol 2022; 101:855-867. [PMID: 35128571 DOI: 10.1007/s00277-022-04770-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 01/21/2022] [Indexed: 12/17/2022]
Abstract
The frequency of thrombosis in AML has been evaluated only in a few studies and no validated predictive model is currently available. Recently, DIC score was shown to identify patients at higher thrombotic risk. We aimed to evaluate the frequency of thromboembolism in AML patients treated with intensive chemotherapy and to assess the ability of genetic and clinical factors to predict the thrombotic risk. We performed a retrospective observational study including 222 newly diagnosed adult AML (210) and high-risk MDS (12), treated with intensive chemotherapy between January 2013 and February 2020. With a median follow-up of 44 months, we observed 50 thrombotic events (90% were venous, VTE). The prevalence of thrombosis was 22.1% and the 6-months cumulative incidence of thrombosis was 10%. The median time to thrombosis was 84 days and 52% of the events occurred within 100 days from AML diagnosis. Khorana and DIC score failed to stratify patients according to their thrombotic risk. Only history of a thrombotic event (p = 0.043), particularly VTE (p = 0.0053), platelet count above 100 × 109/L at diagnosis (p = 0.036) and active smoking (p = 0.025) significantly and independently increased the risk of thrombosis, the latter particularly of arterial events. AML genetic profile did not affect thrombosis occurrence. Results were confirmed considering only thromboses occurring within day 100 from diagnosis. DIC score at diagnosis, but not thrombosis, was independently associated with reduced survival (p = 0.004). Previous VTE, platelet count above 100 × 109/L and active smoking were the only factors associate with increased thrombotic risk in AML patients treated intensively, but further studies are needed to validate these results.
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Affiliation(s)
- Federica Martella
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Turin, Italy
| | - Marco Cerrano
- Department of Oncology, Division of Hematology, AOU Città della Salute e della Scienza di Torino, Presidio Molinette, 10126, Turin, Italy.
| | - Daniela Di Cuonzo
- Unit of Clinical Epidemiology, CPO, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Carolina Secreto
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Turin, Italy
| | - Matteo Olivi
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Turin, Italy
| | - Vincenzo Apolito
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Turin, Italy
| | - Stefano D'Ardia
- Department of Oncology, Division of Hematology, AOU Città della Salute e della Scienza di Torino, Presidio Molinette, 10126, Turin, Italy
| | - Chiara Frairia
- Department of Oncology, Division of Hematology, AOU Città della Salute e della Scienza di Torino, Presidio Molinette, 10126, Turin, Italy
| | - Valentina Giai
- Department of Oncology, Division of Hematology, AOU Città della Salute e della Scienza di Torino, Presidio Molinette, 10126, Turin, Italy
| | - Giuseppe Lanzarone
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Turin, Italy
| | - Irene Urbino
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Turin, Italy
| | - Roberto Freilone
- Department of Oncology, Division of Hematology, AOU Città della Salute e della Scienza di Torino, Presidio Molinette, 10126, Turin, Italy
| | - Luisa Giaccone
- Department of Oncology, SSD Trapianto Allogenico, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Alessandro Busca
- Department of Oncology, SSD Trapianto Allogenico, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Chiara Maria Dellacasa
- Department of Oncology, SSD Trapianto Allogenico, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Ernesta Audisio
- Department of Oncology, Division of Hematology, AOU Città della Salute e della Scienza di Torino, Presidio Molinette, 10126, Turin, Italy
| | - Dario Ferrero
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Turin, Italy
| | - Eloise Beggiato
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Turin, Italy
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10
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Giai V, Bensi T, Bertassello C, Savio M, Ferrero D, Ciriello MM, Ladetto M. Hematopoietic Stem Cells (HSC) and Granulocyte Macrophage Progenitors (GMP) are the Oxidative Stress Targets in Low/Intermediate-1 Risk Myelodysplastic Syndromes. J Biotechnol Biomed 2022; 5:226-235. [PMID: 36644527 PMCID: PMC9836226 DOI: 10.26502/jbb.2642-91280063] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Introduction Myelodysplastic Syndromes (MDS) are a heterogenous group of clonal hematopoietic stem cell malignancies. Previous studies showed that Reactive Oxygen Species (ROS) play a role in the pathogenesis and clinical evolution of MDS, contributing to Hematopoietic Stem and Progenitor Cells (HSPC) genetic instability. Less is known about ROS levels in the various sub-populations of MDS HSPC and how they correlate with clinical data in MDS patients. Our study aims to analyze ROS levels in MDS Hematopoietic Stem Cells (HSC), common myeloid progenitors (CMP), Granulocyte Macrophages Progenitors (GMP) and megakaryocyte-erythrocyte progenitors (MEP); afterwards, we looked at the relationship between ROS levels and clinical data. Methods thirty-eight MDS and 27 Normal Bone Marrow (NBM) samples were collected; ROS levels were analyzed via multicolor flow cytometry. Results In both NBM and MDS, HSC showed much higher ROS levels than progenitors (3 to 4 folds, p < 0.0001); HSC ROS were significantly more elevated in MDS-no excess blasts versus MDS with excess blasts and versus NBM. GMP from MDS-no excess blasts showed higher ROS compared to NBM GMP. The 3 MDS with Ringed Sideroblasts (RS) showed more elevated ROS in HSC and GMP compared to the not RS low/intermediate-1 MDS; the 2 monosomy 7 patients displayed higher ROS levels in each subpopulation compared to the normal karyotype MDS; the only del(5q) patient did not show relevant differences in ROS levels compared to the median of the normal karyotype MDS ROS. The 9 high transfusion burden patients exhibited higher ROS in HSC and GMP compared to NBM HSC and GMP. These data were not confirmed in low transfusion burden (n:2) and non-transfused patients (n:26). In low/intermediate-1 MDS, a direct correlation between ferritin values and ROS levels in progenitors, but not in HSC, was detected. Interestingly, low/intermediate-1 risk patients that are no longer responding to recombinant human erythropoietin (rh-EPO) showed higher ROS levels in GMP and HSC. Conclusions Our data showed that ROS can play a role in the pathogenesis and maintenance of low and intermediate-1 risk MDS clone; ROS status can be influenced by several clinical factors as ferritin levels and rh-EPO treatment. In this scenario, high ROS levels can contribute to genetic instability and influence progression to AML. Further biological studies are needed to elucidate ROS role in MDS pathogenesis and analyze the possible benefit of antioxidant drugs added to the standard MDS treatments.
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Affiliation(s)
- Valentina Giai
- Division of Hematology, SS Antonio e Biagio and Cesare Arrigo Hospital, Alessandria, Italy
- Division of Hematology, AUO Città della Salute e della Scienza, Torino, Italy
| | - Thea Bensi
- Flow-cytometry worked, SS Antonio e Biagio and Cesare Arrigo Hospital, Alessandria, Italy
| | - Claudia Bertassello
- Division of Hematology, SS Antonio e Biagio and Cesare Arrigo Hospital, Alessandria, Italy
| | - Michela Savio
- Pathology, SS Antonio e Biagio and Cesare Arrigo Hospital, Alessandria, Italy
| | - Dario Ferrero
- Division of Hematology, University of Turin, Torino, Italy
| | - Maria Matilde Ciriello
- Flow-cytometry worked, SS Antonio e Biagio and Cesare Arrigo Hospital, Alessandria, Italy
| | - Marco Ladetto
- Division of Hematology, SS Antonio e Biagio and Cesare Arrigo Hospital, Alessandria, Italy
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11
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Giaccone L, Brunello L, Londono JS, Scaldaferri M, Cerrano M, Redoglia V, Omedè P, Lia G, Massaia M, Ferrero D, Cavallo F, Bringhen S, Leone S, Cattel F, Francisci T, Tassi V, Evangelista A, Boccadoro M, Bruno B. Cost efficiency and effectiveness of biosimilar filgrastim in autologous transplant. Bone Marrow Transplant 2021; 57:312-314. [PMID: 34848834 DOI: 10.1038/s41409-021-01541-1] [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] [Received: 05/12/2021] [Revised: 11/11/2021] [Accepted: 11/19/2021] [Indexed: 11/09/2022]
Affiliation(s)
- Luisa Giaccone
- Division of Hematology, A.O.U. Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy. .,Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy.
| | - Lucia Brunello
- Division of Hematology, A.O.U. Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy.,Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Jaime Suarez Londono
- Division of Hematology and Medical Oncology, Perlmutter Cancer Center, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, USA
| | - Matilde Scaldaferri
- Pharmacy, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Marco Cerrano
- Division of Hematology, A.O.U. Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy.,Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Valter Redoglia
- Division of Hematology, A.O.U. Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy.,Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Paola Omedè
- Division of Hematology, A.O.U. Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy
| | - Giuseppe Lia
- Division of Hematology, A.O.U. Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy.,Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Massimo Massaia
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Dario Ferrero
- Division of Hematology, A.O.U. Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy.,Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Federica Cavallo
- Division of Hematology, A.O.U. Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy.,Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Sara Bringhen
- Division of Hematology, A.O.U. Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy
| | - Sarah Leone
- Department of Internal Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - Francesco Cattel
- Pharmacy, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Tiziana Francisci
- Blood bank and immunohematology, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Valter Tassi
- Blood bank and immunohematology, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Andrea Evangelista
- Unit of clinical epidemiology, A.O.U. Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy
| | - Mario Boccadoro
- Division of Hematology, A.O.U. Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy.,Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Benedetto Bruno
- Division of Hematology, A.O.U. Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy.,Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy.,Division of Hematology and Medical Oncology, Perlmutter Cancer Center, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, USA
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12
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Caprioli C, Lussana F, Salmoiraghi S, Cavagna R, Buklijas K, Elidi L, Zanghi' P, Michelato A, Delaini F, Oldani E, Intermesoli T, Grassi A, Gianfaldoni G, Mannelli F, Ferrero D, Audisio E, Terruzzi E, De Paoli L, Cattaneo C, Borlenghi E, Cavattoni I, Tajana M, Scattolin AM, Mattei D, Corradini P, Campiotti L, Ciceri F, Bernardi M, Todisco E, Cortelezzi A, Falini B, Pavoni C, Bassan R, Spinelli O, Rambaldi A. Clinical significance of chromatin-spliceosome acute myeloid leukemia: a report from the Northern Italy Leukemia Group (NILG) randomized trial 02/06. Haematologica 2021; 106:2578-2587. [PMID: 32855275 PMCID: PMC8485674 DOI: 10.3324/haematol.2020.252825] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Indexed: 12/05/2022] Open
Abstract
Secondary acute myeloid leukemia (sAML) after myelodysplastic or myeloproliferative disorders is a high-risk category currently identified by the clinical history or specific morphological and cytogenetic abnormalities. However, in the absence of these features, uncertainties to identify the secondary nature of some cases, otherwise defined as de novo AML, remain. In order to test whether a chromatinspliceosome (CS) mutational signature might better define the de novo AML group, we analyzed a prospective cohort of 413 newly diagnosed AML patients who were enrolled in a randomized clinical trial (NILG AML 02/06) and who provided samples for accurate cytogenetic and molecular characterization. Among clinically defined de novo AML, 17.6% carried CS mutations (CS-AML) and showed clinical characteristics closer to sAML (older age, lower white blood cell counts and higher rate of multilineage dysplasia). Outcomes in this group were adverse, more similar to those of sAML as compared to de novo AML (overall survival, 30% in CS-AML and 17% in sAML vs. 61% in de novo AML, P<0.0001; disease-free survival, 26% in CS-AML and 22% in sAML vs. 54% of de novo AML, P<0.001) and independently confirmed by multivariable analysis. Allogeneic transplant in first complete remission improved survival in both sAML and CS-AML patients. In conclusion, these findings highlight the clinical significance of identifying CS-AML for improved prognostic prediction and potential therapeutic implications. (NILG AML 02/06; clinicaltrials gov. Identifier: NCT00495287).
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Affiliation(s)
| | | | - Silvia Salmoiraghi
- ASST Ospedale Papa Giovanni XXIII and FROM Research Foundation, Bergamo, Italy
| | | | | | - Lara Elidi
- ASST Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | | | | | | | - Elena Oldani
- ASST Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | | | - Anna Grassi
- ASST Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | | | | | - Dario Ferrero
- AOU Città della Salute e della Scienza, Torino, Italy
| | | | | | - Lorella De Paoli
- Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Renato Bassan
- Ospedale dell'Angelo e SS. Giovanni e Paolo, Venezia Mestre, Italy
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13
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Crisà E, Zallio F, Zacchi G, Cerrano M, Rivolta G, Ferrero D, Deambrogi C, Essa W, Awikeh B, Nicolosi M, Santini V, Gaidano G, Bruno B, Patriarca A. Topic: AS08-Treatment/AS08h-Allogeneic hematopoietic cell transplantation - Bridging to transplantation. Leuk Res 2021. [DOI: 10.1016/j.leukres.2021.106680.10] [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: 11/28/2022]
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14
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Ferrante M, Furlan D, Zibellini S, Borriero M, Candido C, Sahnane N, Uccella S, Genuardi E, Alessandria B, Bianchi B, Mora B, Grimaldi D, Defrancesco I, Jiménez C, Cavallo F, Ferrero D, Dogliotti I, Merli M, Varettoni M, Ferrero S, Drandi D. MYD88 L265P Detection in IgM Monoclonal Gammopathies: Methodological Considerations for Routine Implementation. Diagnostics (Basel) 2021; 11:diagnostics11050779. [PMID: 33926007 PMCID: PMC8146978 DOI: 10.3390/diagnostics11050779] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 03/19/2021] [Revised: 04/17/2021] [Accepted: 04/23/2021] [Indexed: 12/19/2022] Open
Abstract
In IgM monoclonal gammopathies MYD88L265P is a prognostic and predictive biomarker of therapy response. MYD88L265P detection is mainly performed by allele-specific quantitative PCR (ASqPCR), however recently, droplet digital PCR (ddPCR) has been proved to be suitable for MYD88L265P screening and minimal residual disease monitoring (MRD). This study compared ASqPCR and ddPCR to define the most sensitive method for MYD88L265P detection in bone marrow (BM), peripheral blood (PB) sorted or unsorted CD19+ cells, and in plasma cell-free DNA (cfDNA). Overall, the analysis showed a good concordance rate (74%) between the two methods, especially in BM samples, while discordances (26%) were mostly in favor of ddPCR (ddPCR+ vs. ASqPCR-) and were particularly evident in samples with low mutational burden, such as PB and cfDNA. This study highlights ddPCR as a feasible approach for MYD88L265P detection across different specimen types (including cfDNA). Interestingly, its high sensitivity makes CD19+ selection dispensable. On the other hand, our results showed that MYD88L265P detection on PB samples, especially with ASqPCR, is suboptimal for screening and MRD analysis. Finally, significantly different MYD88L265P mutational levels observed between Waldenström Macroglobulinemia and IgM monoclonal gammopathy of undetermined significance patients suggest the need for further studies in order to identify possible correlations between mutational levels and risk of progression to Waldenström.
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Affiliation(s)
- Martina Ferrante
- Department of Molecular Biotechnology and Health Sciences, Hematology Division, University of Torino, 10100 Torino, Italy; (M.F.); (M.B.); (E.G.); (B.A.); (D.G.); (F.C.); (D.F.); (D.D.)
| | - Daniela Furlan
- Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy; (D.F.); (S.U.)
| | - Silvia Zibellini
- Division of Hematology, IRCCS Foundation, Policlinico San Matteo, 27100 Pavia, Italy; (S.Z.); (C.C.); (I.D.); (M.V.)
| | - Michela Borriero
- Department of Molecular Biotechnology and Health Sciences, Hematology Division, University of Torino, 10100 Torino, Italy; (M.F.); (M.B.); (E.G.); (B.A.); (D.G.); (F.C.); (D.F.); (D.D.)
| | - Chiara Candido
- Division of Hematology, IRCCS Foundation, Policlinico San Matteo, 27100 Pavia, Italy; (S.Z.); (C.C.); (I.D.); (M.V.)
| | - Nora Sahnane
- University Hospital “Ospedale di Circolo e Fondazione Macchi”-ASST Sette Laghi, University of Insubria, 21100 Varese, Italy; (N.S.); (B.B.); (B.M.); (M.M.)
| | - Silvia Uccella
- Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy; (D.F.); (S.U.)
| | - Elisa Genuardi
- Department of Molecular Biotechnology and Health Sciences, Hematology Division, University of Torino, 10100 Torino, Italy; (M.F.); (M.B.); (E.G.); (B.A.); (D.G.); (F.C.); (D.F.); (D.D.)
| | - Beatrice Alessandria
- Department of Molecular Biotechnology and Health Sciences, Hematology Division, University of Torino, 10100 Torino, Italy; (M.F.); (M.B.); (E.G.); (B.A.); (D.G.); (F.C.); (D.F.); (D.D.)
| | - Benedetta Bianchi
- University Hospital “Ospedale di Circolo e Fondazione Macchi”-ASST Sette Laghi, University of Insubria, 21100 Varese, Italy; (N.S.); (B.B.); (B.M.); (M.M.)
| | - Barbara Mora
- University Hospital “Ospedale di Circolo e Fondazione Macchi”-ASST Sette Laghi, University of Insubria, 21100 Varese, Italy; (N.S.); (B.B.); (B.M.); (M.M.)
| | - Daniele Grimaldi
- Department of Molecular Biotechnology and Health Sciences, Hematology Division, University of Torino, 10100 Torino, Italy; (M.F.); (M.B.); (E.G.); (B.A.); (D.G.); (F.C.); (D.F.); (D.D.)
| | - Irene Defrancesco
- Division of Hematology, IRCCS Foundation, Policlinico San Matteo, 27100 Pavia, Italy; (S.Z.); (C.C.); (I.D.); (M.V.)
| | - Cristina Jiménez
- Hematology Department, University Hospital of Salamanca, Research Biomedical Institute of Salamanca (IBSAL), CIBERONC and Center for Cancer Research-IBMCC (USAL-CSIC), 37001 Salamanca, Spain;
| | - Federica Cavallo
- Department of Molecular Biotechnology and Health Sciences, Hematology Division, University of Torino, 10100 Torino, Italy; (M.F.); (M.B.); (E.G.); (B.A.); (D.G.); (F.C.); (D.F.); (D.D.)
- Hematology, A.O.U. Città della Salute e della Scienza, University of Torino, 10100 Torino, Italy
| | - Dario Ferrero
- Department of Molecular Biotechnology and Health Sciences, Hematology Division, University of Torino, 10100 Torino, Italy; (M.F.); (M.B.); (E.G.); (B.A.); (D.G.); (F.C.); (D.F.); (D.D.)
- Hematology, A.O.U. Città della Salute e della Scienza, University of Torino, 10100 Torino, Italy
| | - Irene Dogliotti
- Stem Cell Transplant Unit, University Hospital AOU Città della Salute e della Scienza, 10100 Torino, Italy;
| | - Michele Merli
- University Hospital “Ospedale di Circolo e Fondazione Macchi”-ASST Sette Laghi, University of Insubria, 21100 Varese, Italy; (N.S.); (B.B.); (B.M.); (M.M.)
| | - Marzia Varettoni
- Division of Hematology, IRCCS Foundation, Policlinico San Matteo, 27100 Pavia, Italy; (S.Z.); (C.C.); (I.D.); (M.V.)
| | - Simone Ferrero
- Department of Molecular Biotechnology and Health Sciences, Hematology Division, University of Torino, 10100 Torino, Italy; (M.F.); (M.B.); (E.G.); (B.A.); (D.G.); (F.C.); (D.F.); (D.D.)
- Hematology, A.O.U. Città della Salute e della Scienza, University of Torino, 10100 Torino, Italy
- Correspondence: ; Tel.: +39-388-064-3900
| | - Daniela Drandi
- Department of Molecular Biotechnology and Health Sciences, Hematology Division, University of Torino, 10100 Torino, Italy; (M.F.); (M.B.); (E.G.); (B.A.); (D.G.); (F.C.); (D.F.); (D.D.)
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15
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Ferrero D, Bonello F, Oliva S, Gay F, Boccadoro M. Can the dismal prognosis of patients with central nervous system plasma cell neoplasms be improved? Leuk Res 2021; 107:106592. [PMID: 33933932 DOI: 10.1016/j.leukres.2021.106592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/19/2021] [Accepted: 04/06/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Dario Ferrero
- Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy.
| | - Francesca Bonello
- Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Stefania Oliva
- Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Francesca Gay
- Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Mario Boccadoro
- Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
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16
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Dogliotti I, Ragaini S, Vassallo F, Boccellato E, De Luca G, Perutelli F, Boccomini C, Clerico M, Botto B, Grimaldi D, Orsucci L, Ferrero S, Vitale C, Ferrero D, Coscia M, Cavallo F. Real Life Use of Bendamustine in Elderly Patients with Lymphoid Neoplasia. J Pers Med 2021; 11:jpm11040249. [PMID: 33808164 PMCID: PMC8066290 DOI: 10.3390/jpm11040249] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 02/19/2021] [Revised: 03/19/2021] [Accepted: 03/25/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Bendamustine is a cytotoxic alkylating drug with a broad range of indications as a single agent or in combination therapy in lymphoid neoplasia patients. However, its tolerability in elderly patients is still debated. METHODS An observational, retrospective study was carried out; patients with chronic lymphocytic leukemia (CLL) or lymphoma, aged ≥ 65 years old, treated with bendamustine-based regimens in first or subsequent lines between 2010 and 2020 were considered eligible. RESULTS Overall, 179 patients aged ≥ 65 years were enrolled, 53% between 71 and 79 years old. Cumulative Illness Rating Scale (CIRS) comorbidity score was ≥6 in 54% patients. Overall survival (OS) at 12 months was 95% (95% confidence interval [CI]: 90-97%); after a median follow up of 50 months, median OS was 84 months. The overall response rate was 87%, with 56% complete responses; the median time to progression (TTP) was 61 months. The baseline factors affecting OS by multivariable analysis were sex, histological diagnosis, renal function, and planned bendamustine dose, while only type of lymphoma and bendamustine dose impacted on TTP. Main adverse events were neutropenia (grade ≥ 3: 43%) and infections (any grade: 36%), with 17% of patients requiring hospital admission. CONCLUSIONS The responses to bendamustine, as well as survival, are relevant even in advanced age patients, with a manageable incidence of acute toxicity.
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Affiliation(s)
- Irene Dogliotti
- Stem Cell Transplant Unit, A.O.U., Città della Salute e della Scienza di Torino, 10126 Turin, Italy;
| | - Simone Ragaini
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, A.O.U., Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (S.R.); (E.B.); (G.D.L.); (F.P.); (M.C.); (D.G.); (S.F.); (C.V.); (D.F.); (M.C.)
| | - Francesco Vassallo
- Division of Hematology, A.O.U., Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (F.V.); (C.B.); (B.B.); (L.O.)
| | - Elia Boccellato
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, A.O.U., Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (S.R.); (E.B.); (G.D.L.); (F.P.); (M.C.); (D.G.); (S.F.); (C.V.); (D.F.); (M.C.)
| | - Gabriele De Luca
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, A.O.U., Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (S.R.); (E.B.); (G.D.L.); (F.P.); (M.C.); (D.G.); (S.F.); (C.V.); (D.F.); (M.C.)
| | - Francesca Perutelli
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, A.O.U., Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (S.R.); (E.B.); (G.D.L.); (F.P.); (M.C.); (D.G.); (S.F.); (C.V.); (D.F.); (M.C.)
| | - Carola Boccomini
- Division of Hematology, A.O.U., Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (F.V.); (C.B.); (B.B.); (L.O.)
| | - Michele Clerico
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, A.O.U., Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (S.R.); (E.B.); (G.D.L.); (F.P.); (M.C.); (D.G.); (S.F.); (C.V.); (D.F.); (M.C.)
| | - Barbara Botto
- Division of Hematology, A.O.U., Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (F.V.); (C.B.); (B.B.); (L.O.)
| | - Daniele Grimaldi
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, A.O.U., Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (S.R.); (E.B.); (G.D.L.); (F.P.); (M.C.); (D.G.); (S.F.); (C.V.); (D.F.); (M.C.)
| | - Lorella Orsucci
- Division of Hematology, A.O.U., Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (F.V.); (C.B.); (B.B.); (L.O.)
| | - Simone Ferrero
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, A.O.U., Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (S.R.); (E.B.); (G.D.L.); (F.P.); (M.C.); (D.G.); (S.F.); (C.V.); (D.F.); (M.C.)
| | - Candida Vitale
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, A.O.U., Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (S.R.); (E.B.); (G.D.L.); (F.P.); (M.C.); (D.G.); (S.F.); (C.V.); (D.F.); (M.C.)
| | - Dario Ferrero
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, A.O.U., Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (S.R.); (E.B.); (G.D.L.); (F.P.); (M.C.); (D.G.); (S.F.); (C.V.); (D.F.); (M.C.)
| | - Marta Coscia
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, A.O.U., Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (S.R.); (E.B.); (G.D.L.); (F.P.); (M.C.); (D.G.); (S.F.); (C.V.); (D.F.); (M.C.)
| | - Federica Cavallo
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, A.O.U., Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (S.R.); (E.B.); (G.D.L.); (F.P.); (M.C.); (D.G.); (S.F.); (C.V.); (D.F.); (M.C.)
- Correspondence: ; Tel.: +39-01-1633-4556; Fax: +39-01-1633-6507
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Clavio M, Crisà E, Miglino M, Guolo F, Ceccarelli M, Salvi F, Allione B, Ferrero D, Balleari E, Finelli C, Poloni A, Selleri C, Danise P, Cilloni D, Di Tucci AA, Cametti G, Freilone R, Fanin R, Bigazzi C, Zambello R, Crugnola M, Oliva EN, Centurioni R, Alesiani F, Catarini M, Castelli A, Abbadessa A, Capalbo SF, Musto P, Angelucci E, Santini V. Overall survival of myelodysplastic syndrome patients after azacitidine discontinuation and applicability of the North American MDS Consortium scoring system in clinical practice. Cancer 2021; 127:2015-2024. [PMID: 33739457 DOI: 10.1002/cncr.33472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/07/2020] [Accepted: 12/16/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Azacitidine (AZA) is the standard treatment for myelodysplastic syndromes (MDS); however, many patients prematurely stop therapy and have a dismal outcome. METHODS The authors analyzed outcomes after AZA treatment for 402 MDS patients consecutively enrolled in the Italian MDS Registry of the Fondazione Italiana Sindromi Mielodisplastiche, and they evaluated the North American MDS Consortium scoring system in a clinical practice setting. RESULTS At treatment discontinuation, 20.3% of the patients were still responding to AZA, 35.4% of the cases had primary resistance, and 44.3% developed adaptive resistance. Overall survival (OS) was better for patients who discontinued treatment while in response because of planned allogeneic hematopoietic stem cell transplantation (HSCT; median OS, not reached) in comparison with patients with primary resistance (median OS, 4 months) or adaptive resistance (median OS, 5 months) or patients responsive but noncompliant/intolerant to AZA (median OS, 4 months; P = .004). After AZA discontinuation, 309 patients (77%) received best supportive care (BSC), 60 (15%) received active treatments, and 33 (8%) received HSCT. HSCT was associated with a significant survival advantage, regardless of the response to AZA. The North American MDS Consortium scoring system was evaluable in 278 of the 402 cases: patients at high risk had worse OS than patients at low risk (3 and 7 months, respectively; P < .001). The score was predictive of survival both in patients receiving BSC (median OS, 2 months for high-risk patients vs 5 months for low-risk patients) and in patients being actively treated (median OS, 8 months for high-risk patients vs 16 months for low-risk patients; P < .001), including transplant patients. CONCLUSIONS Real-life data confirm that this prognostic scoring system for MDS patients failing a hypomethylating agent seems to be a useful tool for optimal prognostic stratification and for choosing a second-line treatment after AZA discontinuation.
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Affiliation(s)
- Marino Clavio
- Fondazione Italiana Sindromi Mielodisplastiche-ETS, Bologna, Italy
- UO Clinic of Hematology, Department of Internal Medicine, University of Genoa, Ospedale Policlinico San Martino-IRCCS, Genoa, Italy
| | - Elena Crisà
- Fondazione Italiana Sindromi Mielodisplastiche-ETS, Bologna, Italy
- Division of Hematology, Department of Translational Medicine, Università del Piemonte Orientale and Ospedale Maggiore della Carità, Novara, Italy
| | - Maurizio Miglino
- Fondazione Italiana Sindromi Mielodisplastiche-ETS, Bologna, Italy
- UO Clinic of Hematology, Department of Internal Medicine, University of Genoa, Ospedale Policlinico San Martino-IRCCS, Genoa, Italy
| | - Fabio Guolo
- Fondazione Italiana Sindromi Mielodisplastiche-ETS, Bologna, Italy
- UO Clinic of Hematology, Department of Internal Medicine, University of Genoa, Ospedale Policlinico San Martino-IRCCS, Genoa, Italy
| | - Manuela Ceccarelli
- Fondazione Italiana Sindromi Mielodisplastiche-ETS, Bologna, Italy
- SCDU Epidemiologia dei Tumori, CPO Piemonte, Turin, Italy
| | - Flavia Salvi
- Fondazione Italiana Sindromi Mielodisplastiche-ETS, Bologna, Italy
- UO Hematology, SS Antonio e Biagio Hospital, Alessandria, Italy
| | - Bernardino Allione
- Fondazione Italiana Sindromi Mielodisplastiche-ETS, Bologna, Italy
- Division of Hematology, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Dario Ferrero
- Fondazione Italiana Sindromi Mielodisplastiche-ETS, Bologna, Italy
- Division of Hematology, University of Turin, AOU Città della Salute e della Scienza, Turin, Italy
| | - Enrico Balleari
- Fondazione Italiana Sindromi Mielodisplastiche-ETS, Bologna, Italy
- UO Internal Medicine, Ospedale Policlinico San Martino-IRCCS, Genoa, Italy
| | - Carlo Finelli
- Fondazione Italiana Sindromi Mielodisplastiche-ETS, Bologna, Italy
- UO Hematology, AOU Policlinico Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy
| | - Antonella Poloni
- Fondazione Italiana Sindromi Mielodisplastiche-ETS, Bologna, Italy
- Hematology, Università Politecnica Marche, AOU Ospedali Riuniti, Ancona, Italy
| | - Carmine Selleri
- Fondazione Italiana Sindromi Mielodisplastiche-ETS, Bologna, Italy
- Hematology and Transplant Unit, San Giovanni di Dio e Ruggi d'Aragona University Hospital, Salerno, Italy
| | - Paolo Danise
- Fondazione Italiana Sindromi Mielodisplastiche-ETS, Bologna, Italy
- Hematology Laboratory, Umberto I Hospital, Nocera Inferiore, Italy
| | - Daniela Cilloni
- Fondazione Italiana Sindromi Mielodisplastiche-ETS, Bologna, Italy
- Department of Clinical and Biological Sciences, University of Turin, San Luigi Hospital, Turin, Italy
| | - Anna Angela Di Tucci
- Fondazione Italiana Sindromi Mielodisplastiche-ETS, Bologna, Italy
- Divisione di Ematologia, Ospedale Businco, Cagliari, Italy
| | - Gianni Cametti
- Fondazione Italiana Sindromi Mielodisplastiche-ETS, Bologna, Italy
- Division of Internal Medicine, ASLTO5, Turin, Italy
| | - Roberto Freilone
- Fondazione Italiana Sindromi Mielodisplastiche-ETS, Bologna, Italy
- Servizio di Oncologia ed Ematologia, Ciriè, Italy
| | - Renato Fanin
- Fondazione Italiana Sindromi Mielodisplastiche-ETS, Bologna, Italy
- Clinica Ematologia e Trapianto Midollo Osseo, AOU Santa Maria della Misericordia, Udine, Italy
| | - Catia Bigazzi
- Fondazione Italiana Sindromi Mielodisplastiche-ETS, Bologna, Italy
- UOC di Ematologia, Ospedale Gen. le Prov. le C. G. Mazzoni, Ascoli Piceno, Italy
| | - Renato Zambello
- Fondazione Italiana Sindromi Mielodisplastiche-ETS, Bologna, Italy
- Hematology and Clinical Immunology Branch, Department of Medicine, University of Padua, Padua, Italy
| | - Monica Crugnola
- Fondazione Italiana Sindromi Mielodisplastiche-ETS, Bologna, Italy
- Hematology Unit and BMT Center, Azienda Ospedaliero Universitaria di Parma, Parma, Italy
| | - Esther N Oliva
- Fondazione Italiana Sindromi Mielodisplastiche-ETS, Bologna, Italy
- Hematology Unit, Grande Ospedale Metropolitano Bianchi Melacrino Morelli, Reggio Calabria, Italy
| | - Riccardo Centurioni
- Fondazione Italiana Sindromi Mielodisplastiche-ETS, Bologna, Italy
- UOS di Ematologia, Ospedale di Civitanova Marche, Costamartina, Italy
| | - Francesco Alesiani
- Fondazione Italiana Sindromi Mielodisplastiche-ETS, Bologna, Italy
- Unità Operativa Semplice di Ematologia, Ospedale di San Severino, San Severino Marche, Italy
| | - Massimo Catarini
- Fondazione Italiana Sindromi Mielodisplastiche-ETS, Bologna, Italy
- Divisione di Medicina Interna, Ospedale Civile di Macerata, Macerata, Italy
| | - Andrea Castelli
- Fondazione Italiana Sindromi Mielodisplastiche-ETS, Bologna, Italy
- Division of Hematology, Ospedale degli Infermi, Biella, Italy
| | - Antonio Abbadessa
- Fondazione Italiana Sindromi Mielodisplastiche-ETS, Bologna, Italy
- Onco-Hematology, AORN S. Anna e S. Sebastiano National Hospital, Caserta, Italy
| | - Silvana F Capalbo
- Fondazione Italiana Sindromi Mielodisplastiche-ETS, Bologna, Italy
- Hematology Unit, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Foggia, Italy
| | - Pellegrino Musto
- Fondazione Italiana Sindromi Mielodisplastiche-ETS, Bologna, Italy
- Regional Department of Hematology, IRCCS-CROB, Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Emanuele Angelucci
- Fondazione Italiana Sindromi Mielodisplastiche-ETS, Bologna, Italy
- Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Valeria Santini
- Fondazione Italiana Sindromi Mielodisplastiche-ETS, Bologna, Italy
- MDS Unit, AOU Careggi, Dipartimento di Medicina Sperimentale e Clinica, University of Florence, Florence, Italy
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18
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Dragani M, Rege Cambrin G, Berchialla P, Dogliotti I, Rosti G, Castagnetti F, Capodanno I, Martino B, Cerrano M, Ferrero D, Gambacorti-Passerini C, Crugnola M, Elena C, Breccia M, Iurlo A, Cattaneo D, Galimberti S, Gozzini A, Bocchia M, Lunghi F, Cedrone M, Sgherza N, Luciano L, Russo S, Santoro M, Giai V, Caocci G, Levato L, Abruzzese E, Sora F, Saglio G, Fava C. A Retrospective Analysis about Frequency of Monitoring in Italian Chronic Myeloid Leukemia Patients after Discontinuation. J Clin Med 2020; 9:jcm9113692. [PMID: 33213044 PMCID: PMC7698481 DOI: 10.3390/jcm9113692] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/11/2020] [Accepted: 11/13/2020] [Indexed: 01/26/2023] Open
Abstract
Successful discontinuation of tyrosine kinase inhibitors has been achieved in patients with chronic-phase chronic myeloid leukemia (CML). Careful molecular monitoring after discontinuation warrants safe and prompt resumption of therapy. We retrospectively evaluated how molecular monitoring has been conducted in Italy in a cohort of patients who discontinued tyrosine kinase inhibitor (TKI) treatment per clinical practice. The outcome of these patients has recently been reported-281 chronic-phase CML patients were included in this subanalysis. Median follow-up since discontinuation was 2 years. Overall, 2203 analyses were performed, 17.9% in the first three months and 38.4% in the first six months. Eighty-six patients lost major molecular response (MMR) in a mean time of 5.7 months-65 pts (75.6%) during the first six months. We evaluated the number of patients who would experience a delay in diagnosis of MMR loss if a three-month monitoring schedule was adopted. In the first 6 months, 19 pts (29.2%) would have a one-month delay, 26 (40%) a 2-month delay. Very few patients would experience a delay in the following months. A less intense frequency of monitoring, particularly after the first 6 months off treatment, would not have affected the success of treatment-free remission (TFR) nor put patients at risk of progression.
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Affiliation(s)
- Matteo Dragani
- Department of Clinical and Biological Sciences, University of Turin, 10043 Orbassano, Italy; (G.R.C.); (P.B.); (G.S.); (C.F.)
- Correspondence: ; Tel.: +39-011-902-6709
| | - Giovanna Rege Cambrin
- Department of Clinical and Biological Sciences, University of Turin, 10043 Orbassano, Italy; (G.R.C.); (P.B.); (G.S.); (C.F.)
| | - Paola Berchialla
- Department of Clinical and Biological Sciences, University of Turin, 10043 Orbassano, Italy; (G.R.C.); (P.B.); (G.S.); (C.F.)
| | - Irene Dogliotti
- Hematology Unit, Department of Biotechnology and Health Sciences, University of Turin, 10126 Turin, Italy; (I.D.); (M.C.); (D.F.)
| | - Gianantonio Rosti
- Institute of Hematology “L. e A. Seràgnoli”, University of Bologna, 40138 Bologna, Italy; (G.R.); (F.C.)
| | - Fausto Castagnetti
- Institute of Hematology “L. e A. Seràgnoli”, University of Bologna, 40138 Bologna, Italy; (G.R.); (F.C.)
| | - Isabella Capodanno
- Hematology Unit, Azienda Unità Sanitaria Locale-IRCCS, 42123 Reggio Emilia, Italy;
| | - Bruno Martino
- Hematology Unit, Grande Ospedale Metropolitano “Bianchi-Melacrino-Morelli”, 89124 Reggio Calabria, Italy;
| | - Marco Cerrano
- Hematology Unit, Department of Biotechnology and Health Sciences, University of Turin, 10126 Turin, Italy; (I.D.); (M.C.); (D.F.)
| | - Dario Ferrero
- Hematology Unit, Department of Biotechnology and Health Sciences, University of Turin, 10126 Turin, Italy; (I.D.); (M.C.); (D.F.)
| | | | - Monica Crugnola
- Division of Hematology, Azienda Ospedaliero-Universitaria di Parma, 43126 Parma, Italy;
| | - Chiara Elena
- Department of Hematology Oncology, Foundation IRCCS Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy;
| | - Massimo Breccia
- Department of Translational and Precision Medicine, Sapienza University, 00161 Rome, Italy;
| | - Alessandra Iurlo
- Hematology Division, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.I.); (D.C.)
| | - Daniele Cattaneo
- Hematology Division, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.I.); (D.C.)
| | - Sara Galimberti
- Hematology Department, University of Pisa, 56126 Pisa, Italy;
| | - Antonella Gozzini
- Hematology Division, Policlinico Careggi di Firenze, 50139 Firenze, Italy;
| | - Monica Bocchia
- Hematology Unit, University of Siena, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy;
| | - Francesca Lunghi
- Hematology and Bone Marrow Transplant Unit, San Raffaele Scientific Institute IRCCS, 20132 Milano, Italy;
| | - Michele Cedrone
- Hematology Division, Az. Ospedaliera San Giovanni Addolorata, 00184 Rome, Italy;
| | - Nicola Sgherza
- Division of Hematology, IRCCS Ospedale Casa Sollievo Sofferenza, 71043 San Giovanni Rotondo, Italy;
| | - Luigia Luciano
- Hematology Unit, “Federico II” Hospital, University of Naples, 80131 Napoli, Italy;
| | - Sabina Russo
- Department of Internal Medicine, AOU Policlinico di Messina, 98124 Messina, Italy;
| | - Marco Santoro
- Hematology Unit, University of Palermo, 90127 Palermo, Italy;
| | - Valentina Giai
- Hematology Unit, Antonio e Biagio e Cesare Arrigo Hospital, 15121 Alessandria, Italy;
| | - Giovanni Caocci
- Hematology Unit, Department of Medical Sciences, University of Cagliari, 09121 Cagliari, Italy;
| | - Luciano Levato
- Department Hematology-Oncology, Azienda Ospedaliera Pugliese-Ciaccio, 88100 Catanzaro, Italy;
| | - Elisabetta Abruzzese
- Hematology Unit, S. Eugenio Hospital, Tor Vergata University, 00144 Rome, Italy;
| | - Federica Sora
- Hematology Unit, Fondazione Policlinico Universitario Gemelli IRCCS, 00168 Rome, Italy;
| | - Giuseppe Saglio
- Department of Clinical and Biological Sciences, University of Turin, 10043 Orbassano, Italy; (G.R.C.); (P.B.); (G.S.); (C.F.)
| | - Carmen Fava
- Department of Clinical and Biological Sciences, University of Turin, 10043 Orbassano, Italy; (G.R.C.); (P.B.); (G.S.); (C.F.)
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19
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Cerrano M, Castella B, Lia G, Olivi M, Faraci DG, Butera S, Martella F, Scaldaferri M, Cattel F, Boccadoro M, Massaia M, Ferrero D, Bruno B, Giaccone L. Immunomodulatory and clinical effects of daratumumab in T-cell acute lymphoblastic leukaemia. Br J Haematol 2020; 191:e28-e32. [PMID: 32686081 DOI: 10.1111/bjh.16960] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Marco Cerrano
- Division of Haematology, Department of Oncology, A.O.U. Città della Salute e della Scienza di Torino, Presidio Molinette, Torino, Italy.,Division of Haematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | | | - Giuseppe Lia
- Division of Haematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Matteo Olivi
- Division of Haematology, Department of Oncology, A.O.U. Città della Salute e della Scienza di Torino, Presidio Molinette, Torino, Italy.,Division of Haematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Danilo G Faraci
- Division of Haematology, Department of Oncology, A.O.U. Città della Salute e della Scienza di Torino, Presidio Molinette, Torino, Italy.,Division of Haematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Sara Butera
- Division of Haematology, Department of Oncology, A.O.U. Città della Salute e della Scienza di Torino, Presidio Molinette, Torino, Italy.,Division of Haematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Federica Martella
- Division of Haematology, Department of Oncology, A.O.U. Città della Salute e della Scienza di Torino, Presidio Molinette, Torino, Italy.,Division of Haematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Matilde Scaldaferri
- SC Farmacia, A.O.U. Città della Salute e della Scienza di Torino, Presidio Molinette, Torino, Italy
| | - Francesco Cattel
- SC Farmacia, A.O.U. Città della Salute e della Scienza di Torino, Presidio Molinette, Torino, Italy
| | - Mario Boccadoro
- Division of Haematology, Department of Oncology, A.O.U. Città della Salute e della Scienza di Torino, Presidio Molinette, Torino, Italy.,Division of Haematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | | | - Dario Ferrero
- Division of Haematology, Department of Oncology, A.O.U. Città della Salute e della Scienza di Torino, Presidio Molinette, Torino, Italy.,Division of Haematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Benedetto Bruno
- Division of Haematology, Department of Oncology, A.O.U. Città della Salute e della Scienza di Torino, Presidio Molinette, Torino, Italy.,Division of Haematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Luisa Giaccone
- Division of Haematology, Department of Oncology, A.O.U. Città della Salute e della Scienza di Torino, Presidio Molinette, Torino, Italy.,Division of Haematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
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20
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Crisà E, Kulasekararaj AG, Adema V, Such E, Schanz J, Haase D, Shirneshan K, Best S, Mian SA, Kizilors A, Cervera J, Lea N, Ferrero D, Germing U, Hildebrandt B, Martínez ABV, Santini V, Sanz GF, Solé F, Mufti GJ. Impact of somatic mutations in myelodysplastic patients with isolated partial or total loss of chromosome 7. Leukemia 2020; 34:2441-2450. [PMID: 32066866 DOI: 10.1038/s41375-020-0728-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 12/19/2019] [Accepted: 01/28/2020] [Indexed: 11/09/2022]
Abstract
Monosomy 7 [-7] and/or partial loss of chromosome 7 [del(7q)] are associated with poor and intermediate prognosis, respectively, in myelodysplastic syndromes (MDS), but somatic mutations may also play a key complementary role. We analyzed the impact on the outcomes of deep targeted mutational screening in 280 MDS patients with -7/del(7q) as isolated cytogenetic abnormality (86 with del(7q) and 194 with -7). Patients with del(7q) or -7 had similar demographic and disease-related characteristics. Somatic mutations were detected in 79% (93/117) of patients (82% in -7 and 73% in del(7q) group). Median number of mutations per patient was 2 (range 0-8). There was no difference in mutation frequency between the two groups. Patients harbouring ≥2 mutations had a worse outcome than patients with <2 or no mutations (leukaemic transformation at 24 months, 38% and 20%, respectively, p = 0.044). Untreated patients with del(7q) had better overall survival (OS) compared with -7 (median OS, 34 vs 17 months, p = 0.034). In multivariable analysis, blast count, TP53 mutations and number of mutations were independent predictors of OS, whereas the cytogenetic subgroups did not retain prognostic relevance. This study highlights the importance of mutational analysis in terms of prognosis in MDS patients with isolated -7 or del(7q).
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Affiliation(s)
- Elena Crisà
- Department of Haematological Medicine, King's College Hospital, NHS Foundation Trust, London, UK. .,Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy. .,Fondazione Italiana Sindromi Mielodisplastiche (FISiM), Bologna, Italy.
| | - Austin G Kulasekararaj
- Department of Haematological Medicine, King's College Hospital, NHS Foundation Trust, London, UK
| | - Vera Adema
- Institut de Recerca Contra la Leucèmia Josep Carreras, ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Esperanza Such
- Department of Hematology, Hospital Universitario La Fe, Valencia, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
| | - Julie Schanz
- Department of Hematology and Medical Oncology, University Medical Center of Göttingen, Göttingen, Germany
| | - Detlef Haase
- Department of Hematology and Medical Oncology, University Medical Center of Göttingen, Göttingen, Germany
| | - Katayoon Shirneshan
- Department of Hematology and Medical Oncology, University Medical Center of Göttingen, Göttingen, Germany
| | - Steven Best
- Laboratory for Molecular Haemato-Oncology, King's College Hospital, NHS Foundation Trust, London, UK
| | - Syed A Mian
- Department of Haematological Medicine, King's College Hospital, NHS Foundation Trust, London, UK.,Haematopoietic Stem Cell Laboratory, The Francis Crick Institute, London, UK
| | - Aytug Kizilors
- Laboratory for Molecular Haemato-Oncology, King's College Hospital, NHS Foundation Trust, London, UK
| | - José Cervera
- Genetics Unit, Hospital Universitario La Fe, Valencia, Spain
| | - Nicholas Lea
- Laboratory for Molecular Haemato-Oncology, King's College Hospital, NHS Foundation Trust, London, UK
| | - Dario Ferrero
- Fondazione Italiana Sindromi Mielodisplastiche (FISiM), Bologna, Italy.,Division of Hematology, University of Torino, AOU Città della Salute e della Scienza, Torino, Italy
| | - Ulrich Germing
- Department of Hematology, Oncology, and Clinical Immunology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Barbara Hildebrandt
- Institute of Human Genetics, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | | | - Valeria Santini
- Fondazione Italiana Sindromi Mielodisplastiche (FISiM), Bologna, Italy.,MDS UNIT, AOU Careggi, University of Florence, Firenze, Italy
| | - Guillermo F Sanz
- Department of Hematology, Hospital Universitario La Fe, Valencia, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain.,Department of Medicine, University of Valencia, Valencia, Spain
| | - Francesc Solé
- Institut de Recerca Contra la Leucèmia Josep Carreras, ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ghulam J Mufti
- Department of Haematological Medicine, King's College Hospital, NHS Foundation Trust, London, UK
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21
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Gianfaldoni G, Mannelli F, Intermesoli T, Bencini S, Giupponi D, Farina G, Cutini I, Bonetti MI, Masciulli A, Audisio E, Ferrero D, Pavoni C, Scattolin AM, Bosi A, Rambaldi A, Bassan R. Early peripheral clearance of leukemia-associated immunophenotypes in AML: centralized analysis of a randomized trial. Blood Adv 2020; 4:301-311. [PMID: 31978214 PMCID: PMC6988394 DOI: 10.1182/bloodadvances.2019000406] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 12/20/2019] [Indexed: 12/15/2022] Open
Abstract
Although genetics is a relevant risk factor in acute myeloid leukemia (AML), it can be minimally informative and/or not readily available for the early identification of patients at risk for treatment failure. In a randomized trial comparing standard vs high-dose induction (ClinicalTrials.gov #NCT00495287), we studied early peripheral blast cell clearance (PBC) as a rapid predictive assay of chemotherapy response to determine whether it correlates with the achievement of complete remission (CR), as well as postremission outcome, according to induction intensity. Individual leukemia-associated immunophenotypes (LAIPs) identified pretherapy by flow cytometry were validated and quantified centrally after 3 days of treatment, expressing PBC on a logarithmic scale as the ratio of absolute LAIP+ cells on day 1 and day 4. Of 178 patients, 151 (84.8%) were evaluable. Patients in CR exhibited significantly higher median PBC (2.3 log) compared with chemoresistant patients (1.0 log; P < .0001). PBC < 1.0 predicted the worst outcome (CR, 28%). With 1.5 log established as the most accurate cutoff predicting CR, 87.5% of patients with PBC >1.5 (PBChigh, n = 96) and 43.6% of patients with PBC ≤1.5 (PBClow, n = 55) achieved CR after single-course induction (P < .0001). CR and PBChigh rates were increased in patients randomized to the high-dose induction arm (P = .04) and correlated strongly with genetic/cytogenetic risk. In multivariate analysis, PBC retained significant predictive power for CR, relapse risk, and survival. Thus, PBC analysis can provide a very early prediction of outcome, correlates with treatment intensity and disease subset, and may support studies of customized AML therapy.
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Affiliation(s)
- Giacomo Gianfaldoni
- Struttura Organizzativa Dipartimentale (SOD) Ematologia, Università di Firenze, and
| | - Francesco Mannelli
- Struttura Organizzativa Dipartimentale (SOD) Ematologia, Università di Firenze, and
- Centro Ricerca e Innovazione Malattie Mieloproliferative, Azienda Ospedaliero-Universitaria (AOU) Careggi, Florence, Italy
| | - Tamara Intermesoli
- Unità Strutturale Complessa di Ematologia, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - Sara Bencini
- Struttura Organizzativa Dipartimentale (SOD) Ematologia, Università di Firenze, and
- Centro Diagnostico di Citofluorimetria e Immunoterapia, AOU Careggi, Florence, Italy
| | - Damiano Giupponi
- Unità Strutturale Complessa di Ematologia, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - Giorgio Farina
- Unità Operativa Laboratorio Analisi-Citofluorimetria, Ospedale dell'Angelo, Mestre-Venezia, Italy
| | - Ilaria Cutini
- Struttura Organizzativa Dipartimentale (SOD) Ematologia, Università di Firenze, and
- SOD Terapie Cellulari e Medicina Trasfusionale, AOU Careggi, Florence, Italy
| | - Maria Ida Bonetti
- Struttura Organizzativa Dipartimentale (SOD) Ematologia, Università di Firenze, and
| | - Arianna Masciulli
- Unità Strutturale Complessa di Ematologia, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - Ernesta Audisio
- Struttura Complessa di Ematologia, Ospedale Molinette, Turin, Italy
| | - Dario Ferrero
- Divisione di Ematologia, Università di Torino, Azienda Ospedaliera S. Giovanni Battista, Turin, Italy; and
| | - Chiara Pavoni
- Unità Strutturale Complessa di Ematologia, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | | | - Alberto Bosi
- Struttura Organizzativa Dipartimentale (SOD) Ematologia, Università di Firenze, and
| | - Alessandro Rambaldi
- Unità Strutturale Complessa di Ematologia, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - Renato Bassan
- Unità Operativa di Ematologia, Ospedale dell'Angelo, Mestre-Venezia, Italy
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22
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Balleari E, Filiberti RA, Salvetti C, Allione B, Angelucci E, Bruzzone M, Calzamiglia T, Cavaliere M, Cavalleri M, Cilloni D, Clavio M, Crisà E, Da Col A, Danise P, Pilo F, Ferrero D, Finelli C, Gioia D, Lemoli RM, Masiera E, Messa E, Miglino M, Musto P, Natalie Oliva E, Poloni A, Salvi F, Sanna A, Scudeletti M, Tassara R, Santini V. Effects of different doses of erythropoietin in patients with myelodysplastic syndromes: A propensity score-matched analysis. Cancer Med 2019; 8:7567-7576. [PMID: 31657156 PMCID: PMC6912022 DOI: 10.1002/cam4.2638] [Citation(s) in RCA: 4] [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: 05/07/2019] [Revised: 09/15/2019] [Accepted: 10/05/2019] [Indexed: 11/29/2022] Open
Abstract
Background Erythropoiesis‐stimulating agents effectively improve the hemoglobin levels in a fraction of anemic patients with myelodysplastic syndromes (MDS). Higher doses (HD) of recombinant human erythropoietin (rhEPO) have been proposed to overcome suboptimal response rates observed in MDS patients treated with lower “standard doses” (SD) of rhEPO. However, a direct comparison between the different doses of rhEPO is lacking. Methods A cohort of 104 MDS patients treated with HD was retrospectively compared to 208 patients treated with SD in a propensity score‐matched analysis to evaluate hematological improvement‐erythroid (HI‐E) rate induced by the different doses of rhEPO. The impact of rhEPO doses on survival and progression to leukemia was also investigated. Results Overall HI‐E rate was 52.6%. No difference was observed between different rhEPO doses (P = .28) in matched cohorts; in a subgroup analysis, transfusion‐dependent patients and patients with higher IPSS‐R score obtained a higher HI‐E rate with HD, although without significant impact on overall survival (OS). Achievement of HI‐E resulted in superior OS. At univariate analysis, a higher HI‐E rate was observed in transfusion‐independent patients (P < .001), with a lower IPSS‐R score (P < .001) and lower serum EPO levels (P = .027). Multivariate analysis confirmed that rhEPO doses were not significantly related to HI‐E (P = .26). There was no significant difference in OS or progression to leukemia in patients treated with HD vs SD. Conclusion SD are substantially equally effective to HD to improve anemia and influencing survival in MDS patients stratified according to similar propensity to be exposed to rhEPO treatment.
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Affiliation(s)
- Enrico Balleari
- Fondazione Italiana Sindromi Mielodisplastiche (FISM), Bologna, Italy.,UO Internal Medicine, Ospedale Policlinico San Martino-IRCCS, Genova, Italy
| | | | - Chiara Salvetti
- Fondazione Italiana Sindromi Mielodisplastiche (FISM), Bologna, Italy.,UO Hematology, University of Turin, Torino, Italy
| | - Bernardino Allione
- Fondazione Italiana Sindromi Mielodisplastiche (FISM), Bologna, Italy.,UO Hematology, Molinette Hospital, Torino, Italy
| | - Emanuele Angelucci
- Fondazione Italiana Sindromi Mielodisplastiche (FISM), Bologna, Italy.,UO Hematology, Ospedale Policlinico San Martino-IRCCS, Genova, Italy
| | - Marco Bruzzone
- UO Clinical Epidemiology, Ospedale Policlinico San Martino-IRCCS, Genova, Italy
| | - Tullio Calzamiglia
- Fondazione Italiana Sindromi Mielodisplastiche (FISM), Bologna, Italy.,UO Internal Medicine-ASL 1, Sanremo (IM), Italy
| | - Marina Cavaliere
- Fondazione Italiana Sindromi Mielodisplastiche (FISM), Bologna, Italy.,UO Internal Medicine-ASL 2, Savona, Italy
| | - Maurizio Cavalleri
- Fondazione Italiana Sindromi Mielodisplastiche (FISM), Bologna, Italy.,UO Internal Medicine-ASL 4, Sestri Levante (GE), Italy
| | - Daniela Cilloni
- Fondazione Italiana Sindromi Mielodisplastiche (FISM), Bologna, Italy.,UO Department of Clinical and Biological Sciences, University of Turin, Torino, Italy
| | - Marino Clavio
- Fondazione Italiana Sindromi Mielodisplastiche (FISM), Bologna, Italy.,UO Clinic of Hematology, Department of Internal Medicine, University of Genoa, Ospedale Policlinico San Martino-IRCCS, Genova, Italy
| | - Elena Crisà
- Fondazione Italiana Sindromi Mielodisplastiche (FISM), Bologna, Italy.,UO Hematology, University of Turin, Torino, Italy
| | - Anna Da Col
- Fondazione Italiana Sindromi Mielodisplastiche (FISM), Bologna, Italy.,UO Internal Medicine, Ospedale Policlinico San Martino-IRCCS, Genova, Italy
| | - Paolo Danise
- Fondazione Italiana Sindromi Mielodisplastiche (FISM), Bologna, Italy.,UO Hematology, Nocera Hospital, Nocera Inferiore, Italy
| | - Federica Pilo
- Fondazione Italiana Sindromi Mielodisplastiche (FISM), Bologna, Italy.,UO Hematology-P.O. Oncologico Businco AOG. Brotzu, Cagliari, Italy
| | - Dario Ferrero
- Fondazione Italiana Sindromi Mielodisplastiche (FISM), Bologna, Italy.,UO Hematology, University of Turin, Torino, Italy
| | - Carlo Finelli
- Fondazione Italiana Sindromi Mielodisplastiche (FISM), Bologna, Italy.,UO Hematology, AOU Policlinico Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy
| | - Daniela Gioia
- Fondazione Italiana Sindromi Mielodisplastiche (FISM), Bologna, Italy
| | - Roberto Massimo Lemoli
- Fondazione Italiana Sindromi Mielodisplastiche (FISM), Bologna, Italy.,UO Clinic of Hematology, Department of Internal Medicine, University of Genoa, Ospedale Policlinico San Martino-IRCCS, Genova, Italy
| | - Elisa Masiera
- Fondazione Italiana Sindromi Mielodisplastiche (FISM), Bologna, Italy
| | - Emanuela Messa
- Fondazione Italiana Sindromi Mielodisplastiche (FISM), Bologna, Italy.,UO Internal Medicine, ASLTo4, Carmagnola, Italy
| | - Maurizio Miglino
- Fondazione Italiana Sindromi Mielodisplastiche (FISM), Bologna, Italy.,UO Clinic of Hematology, Department of Internal Medicine, University of Genoa, Ospedale Policlinico San Martino-IRCCS, Genova, Italy
| | - Pellegrino Musto
- Fondazione Italiana Sindromi Mielodisplastiche (FISM), Bologna, Italy.,Regional Department of Hematology, IRCCS-CROB, Referral Cancer Center of Basilicata, Rionero in Vulture (Pz), Italy
| | - Esther Natalie Oliva
- Fondazione Italiana Sindromi Mielodisplastiche (FISM), Bologna, Italy.,UO Hematology, Grande Ospedale Metropolitano "Bianchi Melacrino Morelli", Reggio Calabria, Italy
| | - Antonella Poloni
- Fondazione Italiana Sindromi Mielodisplastiche (FISM), Bologna, Italy.,UO Hematology, Università Politecnica delle Marche, Ancona, Italy
| | - Flavia Salvi
- Fondazione Italiana Sindromi Mielodisplastiche (FISM), Bologna, Italy.,UO Hematology, SS. Antonio e Biagio Hospital, Alessandria, Italy
| | - Alessandro Sanna
- Fondazione Italiana Sindromi Mielodisplastiche (FISM), Bologna, Italy.,Ematologia, Ospedale di Livorno, Livorno, Italy
| | - Marco Scudeletti
- Fondazione Italiana Sindromi Mielodisplastiche (FISM), Bologna, Italy.,UO Internal Medicine-ASL 4, Sestri Levante (GE), Italy
| | - Rodolfo Tassara
- Fondazione Italiana Sindromi Mielodisplastiche (FISM), Bologna, Italy.,UO Internal Medicine-ASL 2, Savona, Italy
| | - Valeria Santini
- Fondazione Italiana Sindromi Mielodisplastiche (FISM), Bologna, Italy.,MDS Unit, AOU Careggi, University of Florence, Firenze, Italy
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23
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Cerrano M, Candoni A, Crisà E, Dubbini MV, D'Ardia S, Zannier ME, Boccadoro M, Audisio E, Bruno B, Ferrero D. FLAI induction regimen in elderly patients with acute myeloid leukemia. Leuk Lymphoma 2019; 60:3339-3340. [PMID: 31159609 DOI: 10.1080/10428194.2019.1620943] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Marco Cerrano
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Turin, Italy.,Department of Oncology, Division of Hematology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Anna Candoni
- Division of Hematology and SCT, University of Udine, Udine, Italy
| | - Elena Crisà
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Turin, Italy.,Department of Oncology, Division of Hematology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | | | - Stefano D'Ardia
- Department of Oncology, Division of Hematology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | | | - Mario Boccadoro
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Turin, Italy.,Department of Oncology, Division of Hematology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Ernesta Audisio
- Department of Oncology, Division of Hematology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Benedetto Bruno
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Turin, Italy.,Department of Oncology, SSD Trapianto Allogenico, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Dario Ferrero
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Turin, Italy.,Department of Oncology, Division of Hematology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Turin, Italy
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24
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Dragani M, Rege-Cambrin G, Ferrero D, Abruzzese E, Pregno P, Elena C, Cedrone M, Santoro M, Andreani G, Saglio G, Fava C. Beyond the comfort zone of deep molecular response: discontinuation in major molecular response chronic myeloid leukemia. Leuk Lymphoma 2019; 60:3330-3332. [PMID: 31161827 DOI: 10.1080/10428194.2019.1622103] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Matteo Dragani
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
| | - Giovanna Rege-Cambrin
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
| | - Dario Ferrero
- Department of Molecular Biotechnologies and Health Sciences, Hematology Division, University of Turin, Turin, Italy
| | | | - Patrizia Pregno
- Department of Hematology, A.O.U Città della Salute e della Scienza di Torino, Turin, Italy
| | - Chiara Elena
- Hematology Unit, University of Pavia, Pavia, Italy
| | - Michele Cedrone
- UOC of Hematology, San Giovanni - Addolorata Hospital, Rome, Italy
| | - Marco Santoro
- Hematology Unit, University of Palermo, Palermo, Italy
| | - Giacomo Andreani
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
| | - Giuseppe Saglio
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
| | - Carmen Fava
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
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25
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Baron F, Efficace F, Cannella L, Willemze R, Vignetti M, Muus P, Marie JP, Ferrero D, Fazi P, La Sala E, Bourhis JH, Fabbiano F, Bosi A, Sborgia M, Martinelli G, Wittnebel S, Trisolini S, Petti MC, Halkes CJM, van der Velden WJFM, de Witte T, Amadori S, Zittoun RA, Suciu S. Long-term follow-up of a trial comparing post-remission treatment with autologous or allogeneic bone marrow transplantation or intensive chemotherapy in younger acute myeloid leukemia patients. Haematologica 2019; 105:e13-e16. [PMID: 31097634 DOI: 10.3324/haematol.2019.221333] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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] Open
Affiliation(s)
| | - Fabio Efficace
- Gruppo Italiano Malattie Ematologiche Dell'Adulto GIMEMA, Rome, Rome, Italy
| | - Laura Cannella
- Gruppo Italiano Malattie Ematologiche Dell'Adulto GIMEMA, Rome, Rome, Italy
| | - Roel Willemze
- Leiden University Medical Center, Leiden, the Netherlands
| | - Marco Vignetti
- Gruppo Italiano Malattie Ematologiche Dell'Adulto GIMEMA, Rome, Rome, Italy
| | - Petra Muus
- Radboud University Medical Center, Nijmegen, the Netherlands.,Currently: King's College Hospital, London, UK
| | | | - Dario Ferrero
- Department of Medicine and Experimental Oncology, Torino, Italy
| | - Paola Fazi
- Gruppo Italiano Malattie Ematologiche Dell'Adulto GIMEMA, Rome, Rome, Italy
| | - Edoardo La Sala
- Gruppo Italiano Malattie Ematologiche Dell'Adulto GIMEMA, Rome, Rome, Italy
| | | | | | | | | | - Giovanni Martinelli
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | | | | | | | | | | | - Theo de Witte
- Radboud University Medical Center, Nijmegen, the Netherlands
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26
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Fava C, Rege-Cambrin G, Dogliotti I, Cerrano M, Berchialla P, Dragani M, Rosti G, Castagnetti F, Gugliotta G, Martino B, Gambacorti-Passerini C, Abruzzese E, Elena C, Pregno P, Gozzini A, Capodanno I, Bergamaschi M, Crugnola M, Bocchia M, Galimberti S, Rapezzi D, Iurlo A, Cattaneo D, Latagliata R, Breccia M, Cedrone M, Santoro M, Annunziata M, Levato L, Stagno F, Cavazzini F, Sgherza N, Giai V, Luciano L, Russo S, Musto P, Caocci G, Sorà F, Iuliano F, Lunghi F, Specchia G, Pane F, Ferrero D, Baccarani M, Saglio G. Observational study of chronic myeloid leukemia Italian patients who discontinued tyrosine kinase inhibitors in clinical practice. Haematologica 2019; 104:1589-1596. [PMID: 30819917 PMCID: PMC6669161 DOI: 10.3324/haematol.2018.205054] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 02/27/2019] [Indexed: 12/22/2022] Open
Abstract
It is judged safe to discontinue treatment with tyrosine kinase inhibitors (TKI) for chronic myeloid leukemia (CML) in experimental trials on treatment-free remission (TFR). We collected a total of 293 Italian patients with chronic phase CML who discontinued TKI in deep molecular response. Seventy-two percent of patients were on treatment with imatinib, and 28% with second generation TKI at the time of discontinuation. Median duration of treatment with the last TKI was 77 months [Interquartile Range (IQR) 54;111], median duration of deep molecular response was 46 months (IQR 31;74). Duration of treatment with TKI and duration of deep molecular response were shorter with second generation TKI than with imatinib (P<0.001). Eighty-eight percent of patients discontinued as per clinical practice, and reasons for stopping treatment were: toxicity (20%), pregnancy (6%), and shared decision between treating physician and patient (62%). After a median follow up of 34 months (range, 12-161) overall estimated TFR was 62% (95%CI: 56;68). At 12 months, TFR was 68% (95%CI: 62;74) for imatinib, 73% (95%CI: 64;83) for second generation TKI. Overall median time to restart treatment was six months (IQR 4;11). No progressions occurred. Although our study has the limitation of a retrospective study, our experience within the Italian population confirms that discontinuation of imatinib and second generation TKI is feasible and safe in clinical practice.
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Affiliation(s)
- Carmen Fava
- Department of Clinical and Biological Sciences, University of Turin, Orbassano
| | | | - Irene Dogliotti
- Department of Clinical and Biological Sciences, University of Turin, Orbassano
| | - Marco Cerrano
- Hematology Division, Department of Molecular Biotechnologies and Health Sciences, University of Turin, Turin
| | - Paola Berchialla
- Department of Clinical and Biological Sciences, University of Turin, Orbassano
| | - Matteo Dragani
- Department of Clinical and Biological Sciences, University of Turin, Orbassano
| | - Gianantonio Rosti
- Institute of Hematology "L. & A. Seràgnoli", St. Orsola University Hospital, Bologna
| | - Fausto Castagnetti
- Institute of Hematology "L. & A. Seràgnoli", St. Orsola University Hospital, Bologna
| | - Gabriele Gugliotta
- Institute of Hematology "L. & A. Seràgnoli", St. Orsola University Hospital, Bologna
| | - Bruno Martino
- Azienda Ospedaliera "Bianchi Melacrino Morelli", Reggio Calabria
| | | | | | - Chiara Elena
- Hematology Hunit, Fondazione IRCCS Policlinico San Matteo, Pavia
| | | | - Antonella Gozzini
- SC Terapie Cellulari e Medicina Trasfusionale, AOU Careggi, Florence
| | | | | | | | - Monica Bocchia
- Azienda Ospedaliera Universitaria, University of Siena, Siena
| | | | | | - Alessandra Iurlo
- Haematology Division, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan
| | - Daniele Cattaneo
- Haematology Division, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan
| | - Roberto Latagliata
- Department of Cellular Biotechnologies and Hematology, University La Sapienza, Rome
| | - Massimo Breccia
- Department of Cellular Biotechnologies and Hematology, University La Sapienza, Rome
| | | | | | | | - Luciano Levato
- Department Hematology-Oncology, Azienda Ospedaliera Pugliese-Ciaccio, Catanzaro
| | - Fabio Stagno
- Chair and Hematology Section, Ferrarotto Hospital, Catania
| | - Francesco Cavazzini
- Department of Medical Sciences -Haematology and Physiopathology of Haemostasis Section, Ferrara
| | - Nicola Sgherza
- Division of Hematology, IRCCS Ospedale Casa Sollievo Sofferenza, San Giovanni Rotondo
| | - Valentina Giai
- Division of Haematology, SS Antonio e Biagio e Cesare Arrigo Hospital, Alessandria
| | - Luigia Luciano
- Division of Hematology - Departments of Clinical Medicine and Surgery, University of Naples Federico II, Naples
| | - Sabina Russo
- Department of Internal Medicine, AOU Policlinico di Messina, Messina
| | - Pellegrino Musto
- IRCCS, Centro Di Riferimento Oncologico Della Basilicata, Rionero in Vulture
| | - Giovanni Caocci
- Department of Medical Sciences, University of Cagliari, Cagliari
| | - Federica Sorà
- Hematology Department, University Cattolica del Sacro Cuore - Policlinico A. Gemelli, Rome
| | | | - Francesca Lunghi
- Division of Haematology and Bone Marrow Transplant, Ospedale San Raffaele IRCCS, Milan
| | - Giorgina Specchia
- Division of Haematology with Transplant - Outpatients, Azienda Ospedaliero-Universitaria Policlinico Consorziale di Bari, Bari, Italy
| | - Fabrizio Pane
- Division of Hematology - Departments of Clinical Medicine and Surgery, University of Naples Federico II, Naples
| | - Dario Ferrero
- Hematology Division, Department of Molecular Biotechnologies and Health Sciences, University of Turin, Turin
| | - Michele Baccarani
- Institute of Hematology "L. & A. Seràgnoli", St. Orsola University Hospital, Bologna
| | - Giuseppe Saglio
- Department of Clinical and Biological Sciences, University of Turin, Orbassano
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27
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Messa E, Gioia D, Masiera E, Castiglione A, Ceccarelli M, Salvi F, Danise P, Sanna A, Allione B, Balleari E, Poloni A, Cametti G, Ferrero D, Tassara R, Finelli C, Bonferroni M, Musto P, Saglio G, Levis A, Santini V. Effects of erythropoiesis-stimulating agents on overall survival of International Prognostic Scoring System Low/Intermediate-1 risk, transfusion-independent myelodysplastic syndrome patients: a cohort study. Haematologica 2018; 104:e4-e8. [PMID: 30076178 DOI: 10.3324/haematol.2017.183590] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Affiliation(s)
- Emanuela Messa
- Division of Hematology, ASLTO 4, Ivrea (Turin).,Fondazione Italiana Sindromi Mielodisplastiche Onlus, Alessandria
| | - Daniela Gioia
- Fondazione Italiana Sindromi Mielodisplastiche Onlus, Alessandria
| | - Elisa Masiera
- Fondazione Italiana Sindromi Mielodisplastiche Onlus, Alessandria
| | - Anna Castiglione
- Unit of Clinical Epidemiology, "Città della Salute e della Scienza di Torino" Hospital, Turin
| | - Manuela Ceccarelli
- Unit of Clinical Epidemiology, "Città della Salute e della Scienza di Torino" Hospital, Turin
| | - Flavia Salvi
- Division of Hematology, "SS. Antonio e Biagio" Hospital, Alessandria.,Fondazione Italiana Sindromi Mielodisplastiche Onlus, Alessandria
| | - Paolo Danise
- Division of Onco-Hematology Nocera-Pagani, ASL Salerno.,Fondazione Italiana Sindromi Mielodisplastiche Onlus, Alessandria
| | - Alessandro Sanna
- Division of Hematology, Azienda Ospedaliera Universitaria Careggi, University of Florence.,Fondazione Italiana Sindromi Mielodisplastiche Onlus, Alessandria
| | - Bernardino Allione
- Division of Hematology, Azienda Ospedaliero-Universitaria "Città della Salute e della Scienza di Torino", Turin.,Fondazione Italiana Sindromi Mielodisplastiche Onlus, Alessandria
| | - Enrico Balleari
- Internal Medicine Department, IRCCS San Martino, Genoa, Italy.,Fondazione Italiana Sindromi Mielodisplastiche Onlus, Alessandria
| | - Antonella Poloni
- Division of Hematology, "Ospedali Riuniti", Ancona.,Fondazione Italiana Sindromi Mielodisplastiche Onlus, Alessandria
| | - Giovanni Cametti
- Division of Internal Medicine ASLTO5 Chieri (Turin).,Fondazione Italiana Sindromi Mielodisplastiche Onlus, Alessandria
| | - Dario Ferrero
- Division of Hematology, Azienda Ospedaliero-Universitaria "Città della Salute e della Scienza di Torino", University of Turin.,Fondazione Italiana Sindromi Mielodisplastiche Onlus, Alessandria
| | - Rodolfo Tassara
- Division of Medicine and Hematology, ASL2 Savonese, Savona.,Fondazione Italiana Sindromi Mielodisplastiche Onlus, Alessandria
| | - Carlo Finelli
- Institute of Hematology "L. e A. Seràgnoli", "Sant'Orsola-Malpighi" University Hospital, Bologna.,Fondazione Italiana Sindromi Mielodisplastiche Onlus, Alessandria
| | - Margherita Bonferroni
- Division of Hematology, "Santa Croce e Carle" Hospital, Cuneo, Italy.,Fondazione Italiana Sindromi Mielodisplastiche Onlus, Alessandria
| | - Pellegrino Musto
- IRCCS-CROB Regional Cancer Center of Basilicata, Rionero in Vulture, Potenza.,Fondazione Italiana Sindromi Mielodisplastiche Onlus, Alessandria
| | - Giuseppe Saglio
- Division of Hematology, "Mauriziano" Hospital, Turin, Italy.,Fondazione Italiana Sindromi Mielodisplastiche Onlus, Alessandria
| | - Alessandro Levis
- Fondazione Italiana Sindromi Mielodisplastiche Onlus, Alessandria
| | - Valeria Santini
- Division of Hematology, Azienda Ospedaliera Universitaria Careggi, University of Florence .,Fondazione Italiana Sindromi Mielodisplastiche Onlus, Alessandria
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28
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Crisà E, Cilloni D, Elli EM, Martinelli V, Palumbo GA, Pugliese N, Beggiato E, Frairia C, Cerrano M, Lanzarone G, Marchetti M, Mezzabotta M, Boccadoro M, Ferrero D. The use of erythropoiesis-stimulating agents is safe and effective in the management of anaemia in myelofibrosis patients treated with ruxolitinib. Br J Haematol 2018; 182:701-704. [DOI: 10.1111/bjh.15450] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 05/14/2018] [Indexed: 12/20/2022]
Affiliation(s)
- Elena Crisà
- Haematology Division; A.O.U. Città della Salute e della Scienza di Torino; University of Turin; Torino Italy
| | - Daniela Cilloni
- Haematology Division; Department of Clinical and Biological Sciences; Ospedale San Luigi di Orbassano; University of Turin; Orbassano Italy
| | - Elena M. Elli
- Haematology Division; Ospedale San Gerardo; ASST Monza; Monza Italy
| | | | - Giuseppe A. Palumbo
- Haematology Division; A.O.U. Policlinico-V.Emanuele; University of Catania; Catania Italy
| | | | - Eloise Beggiato
- Haematology Division; A.O.U. Città della Salute e della Scienza di Torino; University of Turin; Torino Italy
| | - Chiara Frairia
- Haematology Division; Department of Translational Medicine; Azienda Ospedaliero-Universitaria Maggiore della Carita; Novara Italy
| | - Marco Cerrano
- Haematology Division; A.O.U. Città della Salute e della Scienza di Torino; University of Turin; Torino Italy
| | - Giuseppe Lanzarone
- Haematology Division; A.O.U. Città della Salute e della Scienza di Torino; University of Turin; Torino Italy
| | | | - Mauro Mezzabotta
- Haematology Division; Ordine Mauriziano - Ospedale Umberto I; Torino Italy
| | - Mario Boccadoro
- Haematology Division; A.O.U. Città della Salute e della Scienza di Torino; University of Turin; Torino Italy
| | - Dario Ferrero
- Haematology Division; A.O.U. Città della Salute e della Scienza di Torino; University of Turin; Torino Italy
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29
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Brunello L, Passera R, Dellacasa CM, Giaccone L, Audisio E, Ferrero D, D'Ardia S, Allione B, Aydin S, Festuccia M, Lia G, Crisà E, Maffini E, Butera S, Busca A, Bruno B. Haplo-identical allografting with post-transplant cyclophosphamide in high-risk patients. Ann Hematol 2018; 97:2205-2215. [PMID: 29987350 DOI: 10.1007/s00277-018-3433-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 07/03/2018] [Indexed: 12/19/2022]
Abstract
Haplo-identical transplants (Haplo-Tx) are an important alternative for patients with hematological malignancies who lack a HLA-identical donor. Seventy-one T-replete Haplo-Tx were performed in 70 high-risk patients at our center; 22/70 (31%) patients with refractory/relapsed leukemia received sequential salvage therapy (SeqTh) with high-dose chemotherapy followed by Haplo-Tx during the chemotherapy-induced neutropenia. Graft-versus-host disease (GVHD) prophylaxis consisted of post-transplant cyclophosphamide (days + 3 and + 4) with tacrolimus and mycophenolic acid. After a median follow-up of 29.2 months, 3-year overall survival (OS) and event-free survival (EFS) were 43.8 and 40.2%, while 3-year cumulative incidences (CIs) of non-relapse mortality (NRM) and relapse (RI) were 27 and 33%. Day 100 and day 400 CI of grade III-IV acute and moderate-severe chronic GVHD were 11 and 15%. Three-year RI was significantly lower in patients in complete remission (CR) versus those not in CR at the time of transplant (21.5 vs. 48%, p = 0.009) and in patients who received PBSC as compared to BM (22 vs. 45%, p = 0.009). In patients treated with SeqTh, 3-year OS was 19%, while 3-year RI and NRM were 52 and 28% at a median follow-up of 50 months. Overall, Haplo-Tx was feasible in heavily pretreated high-risk patients without a suitable HLA-identical donor.
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Affiliation(s)
- Lucia Brunello
- Department of Oncology, SSD Trapianto Allogenico, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Torino, Italy
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Roberto Passera
- Division of Nuclear Medicine, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Chiara Maria Dellacasa
- Department of Oncology, SSD Trapianto Allogenico, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Torino, Italy
| | - Luisa Giaccone
- Department of Oncology, SSD Trapianto Allogenico, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Torino, Italy
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Ernesta Audisio
- Department of Oncology, Division of Hematology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Dario Ferrero
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
- Department of Oncology, Division of Hematology Univ., Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Stefano D'Ardia
- Department of Oncology, Division of Hematology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Bernardino Allione
- Department of Oncology, Division of Hematology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Semra Aydin
- Department of Oncology, Division of Hematology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Moreno Festuccia
- Department of Oncology, SSD Trapianto Allogenico, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Torino, Italy
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Giuseppe Lia
- Department of Oncology, SSD Trapianto Allogenico, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Torino, Italy
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Elena Crisà
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
- Department of Oncology, Division of Hematology Univ., Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Enrico Maffini
- Department of Oncology, SSD Trapianto Allogenico, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Torino, Italy
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Sara Butera
- Department of Oncology, SSD Trapianto Allogenico, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Torino, Italy
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Alessandro Busca
- Department of Oncology, SSD Trapianto Allogenico, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Torino, Italy
| | - Benedetto Bruno
- Department of Oncology, SSD Trapianto Allogenico, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Torino, Italy.
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy.
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30
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Ciaiolo C, Ferrero D, Pugliese A, Biglino A, Marletto G, Tonello M, Colzani G, Marietti G. Enhancement of Methotrexate Cytotoxicity by Modulation of Proliferative Activity in Normal and Neoplastic t Lymphocytes and in a Myeloid Leukemia Cell Line. Tumori 2018; 74:537-42. [PMID: 3064371 DOI: 10.1177/030089168807400507] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Recent advances in the modulation of cell kinetics with growth factors suggest that the effect of cyclespecific cytostatic drugs can be enhanced by combination with such factors. The truth of this hypothesis was investigated by studying the effect of phytohemoagglutinin and/or interlenkin 2 on the sensitivity to methotrexate (MTX) of normal T lymphocytes and of lymphoblastis of a patient with acute T-cell lymphoid leukemia. In both cases, inhibition of proliferation by MTX was increased from less than 30% in resting cells or those sub-optimally stimulated, in the case of leukemic blasts, to 68-83% in maximally stimulated cells. Similar results were observed when the AML 193 human myeloid leukemia line was stimulated with human recombinant granulocyte macrophage colony stimulation factor (GM-CSF). Under basal proliferation conditions, the addition of 1 μg/ml and 10 (μ/ml MTX was followed by 48% and 72% inhibition respectively. When 1 ng/ml GM-CSF (40 I.U./ml) was present, these figures rose to 89% and 91%. It is thus clear that growth factor-induced cell proliferation increases sensitivity to cyclespecific cytostatic agents. There is thus a biological premise for new perspectives in antineoplastic therapy.
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Affiliation(s)
- C Ciaiolo
- Amedeo di Savoia Hospital, Turin, Italia
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Iurlo A, Nobili A, Latagliata R, Bucelli C, Castagnetti F, Breccia M, Abruzzese E, Cattaneo D, Fava C, Ferrero D, Gozzini A, Bonifacio M, Tiribelli M, Pregno P, Stagno F, Vigneri P, Annunziata M, Cavazzini F, Binotto G, Mansueto G, Russo S, Falzetti F, Montefusco E, Gugliotta G, Storti S, D'Addosio AM, Scaffidi L, Cortesi L, Cedrone M, Rossi AR, Avanzini P, Mauro E, Spadea A, Celesti F, Giglio G, Isidori A, Crugnola M, Calistri E, Sorà F, Rege-Cambrin G, Sica S, Luciano L, Galimberti S, Orlandi EM, Bocchia M, Tettamanti M, Alimena G, Saglio G, Rosti G, Mannucci PM, Cortelezzi A. Imatinib and polypharmacy in very old patients with chronic myeloid leukemia: effects on response rate, toxicity and outcome. Oncotarget 2018; 7:80083-80090. [PMID: 27579540 PMCID: PMC5346773 DOI: 10.18632/oncotarget.11657] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 07/13/2016] [Indexed: 11/25/2022] Open
Abstract
Background About 40% of all patients with chronic myeloid leukemia are currently old or very old. They are effectively treated with imatinib, even though underrepresented in clinical studies. Furthermore, as it happens in the general population, they often receive multiple drugs for associated chronic illnesses. Aim of this study was to assess whether or not in imatinib-treated patients aged >75 years the exposure to polypharmacy (5 drugs or more) had an impact on cytogenetic and molecular response rates, event-free and overall survival, as well as on hematological or extra-hematological toxicity. Methods 296 patients at 35 Italian hematological institutions were evaluated. Results Polypharmacy was reported in 107 patients (36.1%), and drugs more frequently used were antiplatelets, diuretics, proton pump inhibitors, ACE-inhibitors, beta-blockers, calcium channel blockers, angiotensin II receptors blockers, statins, oral hypoglycemic drugs and alpha blockers. Complete cytogenetic response was obtained in 174 patients (58.8%), 78 (26.4%) within 6 month, 63 (21.3%) between 7 and 12 months. Major molecular response was obtained in 153 patients (51.7%), 64 (21.6%) within the 12 month. One hundred and twenty-eight cases (43.2%) of hematological toxicity were recorded, together with 167 cases (56.4%) of extra-hematological toxicity. Comparing patients exposed to polypharmacy to those without, no difference was observed pertaining to the dosage of imatinib, cytogenetic and molecular responses and hematological and extra-hematological toxicity. Conclusion Notwithstanding the several interactions reported in the literature between imatinib and some of the medications considered herewith, this fact does not seem to have a clinical impact on response rate and outcome.
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Affiliation(s)
- Alessandra Iurlo
- Oncohematology Division, IRCCS Ca' Granda - Maggiore Policlinico Hospital Foundation, University of Milan, Milan, Italy
| | - Alessandro Nobili
- Department of Neuroscience, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy
| | - Roberto Latagliata
- Department of Cellular Biotechnologies and Hematology, University "La Sapienza" of Rome, Rome, Italy
| | - Cristina Bucelli
- Oncohematology Division, IRCCS Ca' Granda - Maggiore Policlinico Hospital Foundation, University of Milan, Milan, Italy
| | - Fausto Castagnetti
- Institute of Hematology "L. and A. Seràgnoli", Department of Experimental, Diagnostic and Specialty Medicine, "S. Orsola-Malpighi" University Hospital, University of Bologna, Bologna, Italy
| | - Massimo Breccia
- Department of Cellular Biotechnologies and Hematology, University "La Sapienza" of Rome, Rome, Italy
| | | | - Daniele Cattaneo
- Oncohematology Division, IRCCS Ca' Granda - Maggiore Policlinico Hospital Foundation, University of Milan, Milan, Italy
| | - Carmen Fava
- Division of Hematology and Internal Medicine, University of Turin, "San Luigi Gonzaga" University Hospital, Orbassano, Turin, Italy
| | | | | | | | - Mario Tiribelli
- Division of Hematology and BMT, Azienda Ospedaliero - Universitaria di Udine, Udine, Italy
| | - Patrizia Pregno
- Hematology Unit, Azienda Ospedaliero Universitaria Città della Salute e della Scienza, Turin, Italy
| | - Fabio Stagno
- Hematology Unit, Ferrarotto Hospital, Catania, Italy
| | - Paolo Vigneri
- Hematology Unit, Ferrarotto Hospital, Catania, Italy
| | | | | | | | - Giovanna Mansueto
- Department of Onco-Hematology, IRCCS-CROB, Rionero in Vulture, Italy
| | | | - Franca Falzetti
- Division of Hematology and Clinical Immunology, Department of Medicine, University of Perugia, Perugia, Italy
| | | | - Gabriele Gugliotta
- Institute of Hematology "L. and A. Seràgnoli", Department of Experimental, Diagnostic and Specialty Medicine, "S. Orsola-Malpighi" University Hospital, University of Bologna, Bologna, Italy
| | - Sergio Storti
- Onco-Hematology Unit, Università Cattolica Giovanni Paolo II, Campobasso, Italy
| | - Ada M D'Addosio
- Immunohematology and Trasfusional Medicine Division, S. Pietro Fatebenefratelli Hospital, Rome, Italy
| | - Luigi Scaffidi
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Laura Cortesi
- Department of Neuroscience, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy
| | | | | | - Paolo Avanzini
- Hematology, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
| | - Endri Mauro
- Department of Internal Medicine, Pordenone General Hospital, Pordenone, Italy
| | - Antonio Spadea
- Hematology and Stem Cell Transplantation Unit, Regina Elena Institute, Rome, Italy
| | | | | | | | - Monica Crugnola
- Hematology and BMT Unit, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | | | - Federica Sorà
- Institute of Hematology, Università Cattolica Sacro Cuore, Rome, Italy
| | - Giovanna Rege-Cambrin
- Division of Hematology and Internal Medicine, University of Turin, "San Luigi Gonzaga" University Hospital, Orbassano, Turin, Italy
| | - Simona Sica
- Institute of Hematology, Università Cattolica Sacro Cuore, Rome, Italy
| | - Luigiana Luciano
- Hematology Unit, ''Federico II'' Hospital, University of Naples, Naples, Italy
| | - Sara Galimberti
- Department of Clinical and Experimental Medicine, Section of Hematology - University of Pisa, Pisa, Italy
| | - Ester M Orlandi
- Oncology-Hematology Department, Hematology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Monica Bocchia
- Hematology Unit, Azienda Ospedaliera Universitaria Senese and University of Siena, Siena, Italy
| | - Mauro Tettamanti
- Department of Neuroscience, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy
| | - Giuliana Alimena
- Department of Cellular Biotechnologies and Hematology, University "La Sapienza" of Rome, Rome, Italy
| | - Giuseppe Saglio
- Division of Hematology and Internal Medicine, University of Turin, "San Luigi Gonzaga" University Hospital, Orbassano, Turin, Italy
| | - Gianantonio Rosti
- Institute of Hematology "L. and A. Seràgnoli", Department of Experimental, Diagnostic and Specialty Medicine, "S. Orsola-Malpighi" University Hospital, University of Bologna, Bologna, Italy
| | - Pier Mannuccio Mannucci
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, IRCCS Ca' Granda - Maggiore Policlinico Hospital Foundation and University of Milan, Milan, Italy
| | - Agostino Cortelezzi
- Oncohematology Division, IRCCS Ca' Granda - Maggiore Policlinico Hospital Foundation, University of Milan, Milan, Italy
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Santini V, Allione B, Zini G, Gioia D, Lunghi M, Poloni A, Cilloni D, Sanna A, Masiera E, Ceccarelli M, Abdel-Wahab O, Terenzi A, Angelucci E, Finelli C, Onida F, Pelizzari A, Ferrero D, Saglio G, Figueroa M, Levis A. A phase II, multicentre trial of decitabine in higher-risk chronic myelomonocytic leukemia. Leukemia 2017; 32:413-418. [PMID: 28607470 PMCID: PMC5808077 DOI: 10.1038/leu.2017.186] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 04/21/2017] [Accepted: 05/24/2017] [Indexed: 12/30/2022]
Abstract
Chronic myelomonocytic leukemia (CMML) is a complex clonal hematological disorder classified among myelodysplastic (MDS)/myeloproliferative neoplasms. Prognosis is poor and there is a lack of effective treatments. The hypomethylating agent decitabine has shown activity against MDS and elderly acute myeloid leukemia, but there is little data focusing specifically on its efficacy in CMML. In this prospective, phase 2 Italian study, CMML patients received intravenous decitabine 20 mg/m2 per day on Days 1–5 of a 28-day treatment cycle. Response was evaluated after four and six cycles; patients responding at the end of six cycles could continue treatment with decitabine. Forty-three patients were enrolled; >50% were high-risk according to four CMML-specific scoring systems. In the intent-to-treat population (n=42), the overall response rate after six cycles was 47.6%, with seven complete responses (16.6%), eight marrow responses (19%), one partial response (2.4%) and four hematological improvements (9.5%). After a median follow-up of 51.5 months (range: 44.4–57.2), median overall survival was 17 months, with responders having a significantly longer survival than non-responders (P=0.02). Grade 3/4 anemia, neutropenia and thrombocytopenia occurred in 28.6%, 50% and 38% of patients, respectively. Decitabine appears to be an effective and well-tolerated treatment for patients with high-risk CMML.
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Affiliation(s)
- V Santini
- Department of Hematology, AOU Careggi, University of Florence, Florence, Italy
| | - B Allione
- AOU Citta della Salute e della Scienza, Torino, Italy
| | - G Zini
- Department of Oncology and Hematology, Hematology Institute, Fondazion e Policlinico Gemelli, UCSC, Rome, Italy
| | | | - M Lunghi
- Division of Haematology, Department of Translational Medicine, UPO, Novara, Italy
| | - A Poloni
- Department of Hematology, AOU Ospedali Riuniti, Università Politecnica Marche, Ancona, Italy
| | - D Cilloni
- Department of Clinical and Biological Sciences, San Luigi Hospital, University of Turin, Turin, Italy
| | - A Sanna
- Università degli studi di Firenze, Dipartimento di medicina sperimentale e Clinica, Firenze, Italy
| | | | - M Ceccarelli
- AOU Città della salute e della scienza di Torino, Torino, Italy
| | - O Abdel-Wahab
- Human Oncology and Pathogenesis Program, and Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - A Terenzi
- BMT Centre of Perugia, Department of Hematology, Perugia, Italy
| | - E Angelucci
- Hematology and Transplant Unit, Ospedale Oncologico di Riferimento Regionale Armando Businco, Cagliari, Italy
| | - C Finelli
- Institute of Hematology, S.Orsola-Malpighi University Hospital, Bologna, Italy
| | - F Onida
- Oncohematology Unit, Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico-Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - A Pelizzari
- Spedali Civili Brescia Hematology Unit, Brescia, Italy
| | - D Ferrero
- Hematology Division, Università degli Studi di Torino, Torino, Italy
| | - G Saglio
- Department of Clinical and Biological Sciences, University of Turin, Torino, Italy
| | - M Figueroa
- Department of Human Genetics and, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
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Messa E, Biale L, Castiglione A, Lunghi M, Bonferroni M, Salvi F, Allione B, Ferrero D, Calabrese C, De Gobbi M, Nicoli P, Gioia D, Levis A, Saglio G, Cilloni D. Erythroid response during iron chelation therapy in a cohort of patients affected by hematologic malignancies and aplastic anemia with transfusion requirement and iron overload: a FISM Italian multicenter retrospective study. Leuk Lymphoma 2017; 58:2752-2754. [DOI: 10.1080/10428194.2017.1312385] [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] [Indexed: 10/19/2022]
Affiliation(s)
| | - Lucia Biale
- AOU Città della Salute e della Scienza di Torino – Presidio Ospedaliero Molinette – SC Banca del Sangue e del plasma, Turin, Italy
| | - Anna Castiglione
- Unit of Cancer Epidemiology and CPO Piedmont, S. Giovanni Battista Hospital, Torino, Italy
| | - Monia Lunghi
- Division of Haematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Italy, Novara, Italy
| | | | - Flavia Salvi
- Department of Hematology, AO SS Antonio e Biagio e C. Arrigo, Alessandria, Italy
| | - Bernardino Allione
- Division of Hematology, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Dario Ferrero
- Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
| | - Chiara Calabrese
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
| | - Marco De Gobbi
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
| | - Paolo Nicoli
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
| | - Daniela Gioia
- FISM Registry, SS Antonio e Biagio e C. Arrigo Hospital, Alessandria, Tuscany, Italy
| | - Alessandro Levis
- Department of Hematology, AO SS Antonio e Biagio e C. Arrigo, Alessandria, Italy
| | - Giuseppe Saglio
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
| | - Daniela Cilloni
- Department of Clinical and Biological Sciences, Division of Hematology, University of Turin, Turin, Italy
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Messa E, Gioia D, Masiera E, Castiglione A, Ceccarelli M, Salvi F, Danise P, Sanna A, Allione B, Balleari E, Poloni A, Cametti G, Ferrero D, Tassara R, Finelli C, Bonferroni M, Ciccone G, Saglio G, Levis A, Santini V. Effects of Erythropoiesis-Stimulating Agents on Overall Survival of IPSS Low/INT-1 Risk Transfusion Independent Myelodysplastic Syndrome Patients, a FISM Study. Leuk Res 2017. [DOI: 10.1016/s0145-2126(17)30206-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Park S, Hamel JF, Toma A, Kelaidi C, Thépot S, Campelo MD, Santini V, Sekeres MA, Balleari E, Kaivers J, Sapena R, Götze K, Müller-Thomas C, Beyne-Rauzy O, Stamatoullas A, Kotsianidis I, Komrokji R, Steensma DP, Fensterl J, Roboz GJ, Bernal T, Ramos F, Calabuig M, Guerci-Bresler A, Bordessoule D, Cony-Makhoul P, Cheze S, Wattel E, Rose C, Vey N, Gioia D, Ferrero D, Gaidano G, Cametti G, Pane F, Sanna A, Germing U, Sanz GF, Dreyfus F, Fenaux P. Outcome of Lower-Risk Patients With Myelodysplastic Syndromes Without 5q Deletion After Failure of Erythropoiesis-Stimulating Agents. J Clin Oncol 2017; 35:1591-1597. [PMID: 28350519 DOI: 10.1200/jco.2016.71.3271] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Most anemic patients with non-deleted 5q lower-risk myelodysplastic syndromes (MDS) are treated with erythropoiesis-stimulating agents (ESAs), with a response rate of approximately 50%. Second-line treatments, including hypomethylating agents (HMAs), lenalidomide (LEN), and investigational drugs, may be used after ESA failure in some countries, but their effect on disease progression and overall survival (OS) is unknown. Here, we analyzed outcome after ESA failure and the effect of second-line treatments. Patients and Methods We examined an international retrospective cohort of 1,698 patients with non-del(5q) lower-risk MDS treated with ESAs. Results Erythroid response to ESAs was 61.5%, and median response duration was 17 months. Of 1,147 patients experiencing ESA failure, 653 experienced primary failure and 494 experienced relapse after a response. Primary failure of ESAs was associated with a higher risk of acute myeloid leukemia (AML) progression, which did not translate into an OS difference. Of 450 patients (39%) who received second-line treatment, 194 received HMAs, 148 received LEN, and 108 received other treatments (MISC), whereas 697 received RBC transfusions only. Five-year AML cumulative incidence was 20.3%, 20.3%, and 11.3% for those receiving HMAs, LEN, and MISC, respectively ( P = .05). Five-year OS for patients receiving HMA, LEN, and MISC was 36.5%, 41.7%, and 51%, respectively ( P = .21). In a multivariable analysis adjusted for age, sex, revised International Prognostic Scoring System score, and progression at ESA failure, there was no significant OS difference among the three groups. Conclusion In this large, multicenter, retrospective cohort of patients with non-del(5q) lower-risk MDS treated with ESAs, none of the most commonly used second-line treatments (HMA and LEN) significantly improved OS. Early failure of ESAs was associated with a higher risk of AML progression.
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Affiliation(s)
- Sophie Park
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Jean-François Hamel
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Andrea Toma
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Charikleia Kelaidi
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Sylvain Thépot
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Maria Diez Campelo
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Valeria Santini
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Mikkael A Sekeres
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Enrico Balleari
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Jennifer Kaivers
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Rosa Sapena
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Katharina Götze
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Catharina Müller-Thomas
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Odile Beyne-Rauzy
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Aspasia Stamatoullas
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Ioannis Kotsianidis
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Rami Komrokji
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - David P Steensma
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Jaime Fensterl
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Gail J Roboz
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Teresa Bernal
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Fernando Ramos
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Marisa Calabuig
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Agnès Guerci-Bresler
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Dominique Bordessoule
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Pascale Cony-Makhoul
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Stéphane Cheze
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Eric Wattel
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Christian Rose
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Norbert Vey
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Daniela Gioia
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Dario Ferrero
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Gianluca Gaidano
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Giovanni Cametti
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Fabrizio Pane
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Alessandro Sanna
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Ulrich Germing
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Guillermo F Sanz
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - François Dreyfus
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Pierre Fenaux
- Sophie Park, Centre Hospitalier Universitaire (CHU) Grenoble Alpes, Université Grenoble Alpes, Grenoble; Jean-François Hamel and Sylvain Thépot, CHU d'Angers; Sylvain Thépot, Université d'Angers, Institut National de la Santé et de la Recherche Médicale, Unité 1232, and LabEx IGO, Angers; Andrea Toma, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil; Rosa Sapena and Pierre Fenaux, CHU Saint Louis, AP-HP, Université Paris X; François Dreyfus, CHU Cochin, AP-HP, Université Paris V, Paris; Charikleia Kelaidi, CHU Avicenne, Avicenne; Odile Beyne-Rauzy, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Agnès Guerci-Bresler, CHU Nancy, Nancy; Dominique Bordessoule, CHU Dupuytren, Limoges; Pascale Cony-Makhoul, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy; Stéphane Cheze, CHU de Caen, Caen; Eric Wattel, Centre Hospitalier Lyon-Sud, Pierre Bénite, Lyon; Christian Rose, Université Catholique de Lille, Lille; Norbert Vey, Institut Paoli-Calmettes Marseille, Marseille, France; Maria Diez Campelo, Hospital Universitario de Salamanca, Salamanca; Teresa Bernal, Hospital Central de Asturias, Oviedo; Fernando Ramos, Hospital de León, León; Marisa Calabuig, Hospital Clínico de Valencia; Guillermo F. Sanz, Hospital Universitario y Politecnico La Fe, Valencia, Spain; Valeria Santini and Alessandro Sanna, Azienda Ospedaliero Universitaria (AOU) Careggi and University of Florence, Florence; Enrico Balleari, Istituto di Ricovero e Cura a Carattere Scientifico AOU San Martino di Genova, Genova; Daniela Gioia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Dario Ferrero, Università degli Studi di Torino; Gianluca Gaidano, Amedeo Avogadro University of Eastern Piedmont, Torino; Giovanni Cametti, Ospedale Maggiore di Chieri, Chieri; Fabrizio Pane, Università Federico II, Napoli, Italy; Mikkael A. Sekeres and Jaime Fensterl, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Rami Komrokji, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; David P. Steensma, Dana-Farber Cancer Institute, Boston, MA; Gail J. Roboz, Weill Medical College of Cornell University, New York, NY; Jennifer Kaivers and Ulrich Germing, University of Düsseldorf, Düsseldorf; Katharina Götze and Catharina Müller-Thomas, Universität München, München, Germany; and Ioannis Kotsianidis, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
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Crisà E, Cerrano M, Beggiato E, Benevolo G, Lanzarone G, Manzini PM, Borchiellini A, Riera L, Boccadoro M, Ferrero D. Can pegylated interferon improve the outcome of polycythemia vera patients? J Hematol Oncol 2017; 10:15. [PMID: 28086927 PMCID: PMC5237341 DOI: 10.1186/s13045-017-0395-1] [Citation(s) in RCA: 12] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Accepted: 01/06/2017] [Indexed: 11/10/2022] Open
Abstract
Pegylated interferon (peg-IFN) was proven by phase II trials to be effective in polycythemia vera (PV); however, it is not clear whether it could improve patient outcome compared to hydroxyurea (HU). Here, we present an observational study on 65 PV patients aged 65 years or younger, who received either peg-IFN (30) or HU (35) according to the physician choice. Median follow-up was 75 months. The two cohorts were comparable for patient and disease characteristics. Eighty-seven percent of the patients treated with peg-INF responded, with a CR rate of 70% as compared to 100 and 49% with HU, respectively. Discontinuation rate was similar in the two groups (20% in peg-IFN vs 17% in HU). JAK2 allele burden was monitored in peg-INF arm only, and a reduction was observed in 88% of the patients. No thrombotic events were observed during peg-IFN treatment compared to three on HU. Disease progression to myelofibrosis or acute myeloid leukemia occurred to a patient only in peg-INF, compared to three in HU. Overall, three second malignancies were observed during the study, two in patients who received HU only, and one in a patient largely treated HU who received also peg-IFN for 3 months. Overall survival was significantly better for peg-IFN patients compared to HU, p = 0.027. Our study, albeit limited by small patient and event number and lack of randomization, confirms the efficacy of peg-INF in PV and shows a significant survival advantage for peg-INF-treated patients. Waiting for confirming data from the ongoing phase III trials, our study can support peg-INF as a first-line treatment option for PV, at least for younger patients.
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Affiliation(s)
- Elena Crisà
- Hematology Division, Università degli Studi di Torino, Via Genova 3, 10126, Turin, Italy
| | - Marco Cerrano
- Hematology Division, Università degli Studi di Torino, Via Genova 3, 10126, Turin, Italy.
| | - Eloise Beggiato
- Hematology Division, Università degli Studi di Torino, Via Genova 3, 10126, Turin, Italy
| | - Giulia Benevolo
- S.C. Hematology, A.O. Città della Salute e della Scienza, Turin, Italy
| | - Giuseppe Lanzarone
- Hematology Division, Università degli Studi di Torino, Via Genova 3, 10126, Turin, Italy
| | - Paola Maria Manzini
- Transfusion Medicine Unit, A.O. Città della Salute e della Scienza, Turin, Italy
| | | | - Ludovica Riera
- Section of Pathology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Turin, Italy
| | - Mario Boccadoro
- Hematology Division, Università degli Studi di Torino, Via Genova 3, 10126, Turin, Italy
| | - Dario Ferrero
- Hematology Division, Università degli Studi di Torino, Via Genova 3, 10126, Turin, Italy
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Cerrano M, Crisà E, Gottardi E, Aguzzi C, Boccadoro M, Ferrero D. Long-term therapy-free remission in a patient with platelet-derived growth factor receptor beta-rearranged myeloproliferative neoplasm. Am J Hematol 2016; 91:E353. [PMID: 27194679 DOI: 10.1002/ajh.24422] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 05/13/2016] [Accepted: 05/16/2016] [Indexed: 12/22/2022]
Affiliation(s)
- Marco Cerrano
- Hematology Division, Università Degli Studi Di Torino, Turin, Italy
| | - Elena Crisà
- Hematology Division, Università Degli Studi Di Torino, Turin, Italy
| | - Enrico Gottardi
- AOU San Luigi Gonzaga, SCDU Internal Medicine II, Orbassano, Italy
| | - Chiara Aguzzi
- Hematology Division, Università Degli Studi Di Torino, Turin, Italy
| | - Mario Boccadoro
- Hematology Division, Università Degli Studi Di Torino, Turin, Italy
| | - Dario Ferrero
- Hematology Division, Università Degli Studi Di Torino, Turin, Italy
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Maffini E, Giaccone L, Festuccia M, Brunello L, Buondonno I, Ferrero D, Boccadoro M, Dellacasa C, Busca A, Novero D, Bruno B. Ruxolitinib in steroid refractory graft-vs.-host disease: a case report. J Hematol Oncol 2016; 9:67. [PMID: 27502249 PMCID: PMC4977623 DOI: 10.1186/s13045-016-0298-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 08/03/2016] [Indexed: 01/09/2023] Open
Abstract
Background Allogeneic hematopoietic stem cell transplantation (HSCT) is potentially curative in a variety of hematological malignancies. Graft-vs.-host disease (GvHD) remains a life-threatening complication. Standard treatment is high-dose (HD) corticosteroids. Steroid-refractory (SR) GvHD is associated with poor prognosis. At present, second-line treatment is ill-defined and includes a number of agents. Novel insights into the pathophysiology of acute GvHD (aGvHD) highlight the relevant role of the host inflammatory response governed by several kinase families, including Janus kinases (JAK)1/2. Ruxolitinib, a JAK1/2 inhibitor approved for intermediate-2/high-risk myelofibrosis, was recently employed in SR-GvHD with encouraging overall response rates. Clinical experience however remains limited. Case presentation A 51-year-old male with refractory anemia with excess blast type-2 underwent a myeloablative allogeneic HSCT from a 9/10 HLA-matched unrelated donor after conditioning with busulfan and cyclophosphamide. GvHD prophylaxis consisted of cyclosporine, methotrexate, and thymoglobulin. CD34+ cells/kg infused were 8.69 × 106 kg. On day 29, the patient developed overall grade IV aGvHD with biopsy proven stage IV gastrointestinal (GI) GvHD refractory to HD corticosteroids. Patient conditions rapidly deteriorated and became critical despite the addition of mycophenolate mofetil and budesonide. On day 33, Ruxolitinib was started, and on day 39 the patient clinical conditions gradually improved. Complete resolution of aGvHD was also confirmed by histology on day 54. Conclusions At 5 months from HSCT, the patient is well and in continuous hematological complete remission without flare of GvHD. Ruxolitinib was discontinued on day 156. Ruxolitinib is feasible and effective in SR-aGvHD though large prospective clinical trials are warranted.
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Affiliation(s)
- Enrico Maffini
- Department of Oncology, SSCVD Trapianto di Cellule Staminali, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy. .,Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy.
| | - Luisa Giaccone
- Department of Oncology, SSCVD Trapianto di Cellule Staminali, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy.,Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Moreno Festuccia
- Department of Oncology, SSCVD Trapianto di Cellule Staminali, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy.,Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Lucia Brunello
- Department of Oncology, SSCVD Trapianto di Cellule Staminali, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy.,Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | | | - Dario Ferrero
- Department of Oncology, SSCVD Trapianto di Cellule Staminali, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy.,Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Mario Boccadoro
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Chiara Dellacasa
- Department of Oncology, SSCVD Trapianto di Cellule Staminali, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Alessandro Busca
- Department of Oncology, SSCVD Trapianto di Cellule Staminali, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Domenico Novero
- Department of Pathology, AOU Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy
| | - Benedetto Bruno
- Department of Oncology, SSCVD Trapianto di Cellule Staminali, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy.,Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
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Ferrero D, Cerrano M, Crisà E, Aguzzi C, Giai V, Boccadoro M. How many patients can proceed from chronic myeloid leukaemia diagnosis to deep molecular response and long-lasting imatinib discontinuation? A real life experience. Br J Haematol 2016; 176:669-671. [PMID: 26914729 DOI: 10.1111/bjh.13983] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Dario Ferrero
- Haematology Division, Università degli Studi di Torino, Turin, Italy
| | - Marco Cerrano
- Haematology Division, Università degli Studi di Torino, Turin, Italy
| | - Elena Crisà
- Haematology Division, Università degli Studi di Torino, Turin, Italy
| | - Chiara Aguzzi
- Haematology Division, Università degli Studi di Torino, Turin, Italy
| | - Valentina Giai
- Haematology Division, Università degli Studi di Torino, Turin, Italy
| | - Mario Boccadoro
- Haematology Division, Università degli Studi di Torino, Turin, Italy
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Pelizzari A, Ferrero D, Molteni A, Allione B, Mezzabotta M, Clavio M, Borlenghi E, Rossi G, Masiera E, Santini V. 110 BIOSIMILAR EPOETIN ZETA FOR THE TREATMENT OF ANEMIA IN MYELODYSPLASTIC SYNDROMES (MDS). Leuk Res 2015. [DOI: 10.1016/s0145-2126(15)30111-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Breccia M, Luciano L, Latagliata R, Castagnetti F, Ferrero D, Cavazzini F, Trawinska MM, Annunziata M, Stagno F, Tiribelli M, Binotto G, Crisà E, Musto P, Gozzini A, Cavalli L, Montefusco E, Iurlo A, Russo S, Cedrone M, Rossi AR, Pregno P, Endri M, Spadea A, Molica M, Giglio G, Celesti F, Sorà F, Storti S, D'Addosio A, Cambrin GR, Isidori A, Sica S, Abruzzese E, Speccha G, Rosti G, Alimena G. Age influences initial dose and compliance to imatinib in chronic myeloid leukemia elderly patients but concomitant comorbidities appear to influence overall and event-free survival. Leuk Res 2014; 38:1173-6. [PMID: 25047978 DOI: 10.1016/j.leukres.2014.06.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [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: 04/12/2014] [Revised: 06/15/2014] [Accepted: 06/28/2014] [Indexed: 11/28/2022]
Abstract
We applied Charlson comorbidity index (CCI) stratification on a large cohort of chronic myeloid leukemia (CML) very elderly patients (>75 years) treated with imatinib, in order to observe the impact of concomitant diseases on both compliance and outcome. One hundred and eighty-one patients were recruited by 21 Italian centers. There were 95 males and 86 females, median age 78.6 years (range 75-93.6). According to Sokal score, 106 patients were classified as intermediate risk and 55 as high risk (not available in 20 patients). According to CCI stratification, 71 patients had score 0 and 110 a score ≥ 1. Imatinib standard dose was reduced at start of therapy (200-300 mg/day) in 68 patients independently from the evaluation of baseline comorbidities, but based only on physician judgement: 43.6% of these patients had score 0 compared to 34% of patients who had score ≥ 1. Significant differences were found in terms of subsequent dose reduction (39% of patients with score 0 compared to 53% of patients with score ≥ 1) and in terms of drug discontinuation due to toxicity (35% of patients with score 0 vs 65% of patients with score ≥ 1). We did not find significant differences as regards occurrence of hematologic side effects, probably as a consequence of the initial dose reduction: 39% of patients with score 0 experienced grade 3/4 hematologic toxicity (most commonly anemia) compared to 42% of patients with score ≥ 1. Independently from the initial dose, comorbidities again did not have an impact on development of grade 3/4 non-hematologic side effects (most commonly skin rash, muscle cramps and fluid retention): 62% of patients with score 0 compared to 52.5% of patients with score ≥ 1. Notwithstanding the reduced dose and the weight of comorbidities we did not find significant differences but only a trend in terms of efficacy: 66% of patients with score 0 achieved a CCyR compared to 54% of patients with score ≥ 1. Comorbidities appeared to have an impact on median OS (40.8 months for patients with score 0 vs 20.16 months for patients with score ≥ 1) on EFS and on non-CML death rate. Our results suggest that treatment of very elderly CML patients might be influenced by personal physician perception: evaluation at baseline of comorbidities according to CCI should improve initial decision-making in this subset of patients.
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Affiliation(s)
- Massimo Breccia
- Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza", Via Benevento 6, Roma 00161, Italy.
| | | | - Roberto Latagliata
- Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza", Via Benevento 6, Roma 00161, Italy
| | | | | | | | | | | | | | | | | | - Elena Crisà
- Ematologia, Università di Torino, Torino, Italy
| | - Pellegrino Musto
- Dipartimento Onco-Ematologico, IRCCS-CROB, Rionero in Vulture, Italy
| | | | | | | | - Alessandra Iurlo
- UOC Oncoematologia, Fondazione IRCSS Cà Granda Policlinico Milano, Milan, Italy
| | - Sabina Russo
- Ematologia, Università di Messina, Messina, Italy
| | | | | | | | - Mauro Endri
- Ematologia, Centro Trapianti Cremona, Cremona, Italy
| | | | - Matteo Molica
- Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza", Via Benevento 6, Roma 00161, Italy
| | | | | | - Federica Sorà
- Ematologia, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Sergio Storti
- Onco-Ematologia, Università Cattolica Giovanni Paolo II, Campobasso, Italy
| | | | | | | | - Simona Sica
- Ematologia, Università Cattolica del Sacro Cuore, Roma, Italy
| | | | | | | | - Giuliana Alimena
- Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza", Via Benevento 6, Roma 00161, Italy
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Ferrero D, Crisà E, Marmont F, Audisio E, Frairia C, Giai V, Gatti T, Festuccia M, Bruno B, Riera L, Passera R, Boccadoro M. Survival improvement of poor-prognosis AML/MDS patients by maintenance treatment with low-dose chemotherapy and differentiating agents. Ann Hematol 2014; 93:1391-400. [PMID: 24705888 DOI: 10.1007/s00277-014-2047-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 02/27/2014] [Indexed: 12/22/2022]
Abstract
We evaluated a maintenance, post-remission treatment with low-dose chemotherapy plus differentiating agents on poor-prognosis acute myeloid leukemia (AML)/myelodysplastic syndrome (MDS) patients ineligible to allografting. Patients had either age over 60 and/or secondary AML, therapy-related AML, previous relapse, high-risk MDS. Forty-five patients received the maintenance therapy based on two alternated schedules: (a) 6-thioguanine + 13-cis retinoic acid + dihydroxylated vitamin D3 and (b) low-dose cytarabine + 6-mercaptopurine + all-trans retinoic acid + dihydroxylated vitamin D3. We compared their outcome, at a median follow-up of 52 months, to that of a matched population of 49 patients who stopped treatments after consolidation. Maintenance group had a lower relapse incidence (70.3 vs. 86.4 % at 5 years p = 0.007) and a longer disease-free survival (median 21.2 vs. 8.7 months, p = 0.017). The relapse reduction improved overall survival: median 40.4 months (35.9 % at 5 years) for maintenance group vs. 15.8 (14.2 % at 5 years) for controls (p = 0.005). At multivariate Cox analysis, both cytogenetic and maintenance therapies resulted independent outcome predictors for overall survival. Maintenance treatment also reduced minimal residual disease (detected by WT1 and CBFβ-MYH11) in five of eight evaluable patients. The present results suggest that our strategy of maintenance therapy might improve the outcome of poor-risk AML/MDS patients.
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Affiliation(s)
- Dario Ferrero
- Section of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Turin, via Genova, 3, 10126, Turin, Italy,
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Cerrano M, Crisà E, Pregno P, Aguzzi C, Riccomagno P, Boccadoro M, Ferrero D. Excellent therapeutic results achieved in chronic myeloid leukemia patients with front-line imatinib and early treatment modifications in suboptimal responders: a retrospective study on 91 unselected patients. Am J Hematol 2013; 88:838-42. [PMID: 23757199 DOI: 10.1002/ajh.23501] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 05/27/2013] [Accepted: 05/28/2013] [Indexed: 12/15/2022]
Abstract
Second generation tyrosine kinase-inhibitors (TKI) have been claimed to represent now the first-choice therapy for chronic myeloid leukemia (CML). Indeed, they generally induce faster and deeper molecular responses compared to imatinib that, however, is equally effective in at least 50% of patients. Moreover, some recent reports have questioned the long term safety of dasatinib and nilotinib. Therefore, upfront imatinib with early shift to second generation TKI for patients with slow/incomplete response might be as effective as front-line second generation TKI, with a possibly better safety profile. We retrospectively evaluated 91 chronic phase CML patients (median follow-up 57 months, median age 61 years), treated front-line with standard-dose imatinib and early therapy modifications (at 3-12 months) in case of unsatisfactory response or intolerance. Thirty-three patients (24 with unsatisfactory response, 9 intolerant) changed therapy, either by increasing imatinib dose (11/91) or by switching to second generation TKI (22 directly, 4 after high-dose imatinib). Globally, our strategy led to complete cytogenetic response (CCyR) in 98% of the patients, major molecular response (MMR) in 88% and molecular response 4 logs (MR(4.0) ) in 62%. Three patients in CCyR (3%), 2 of them in MMR too, suddenly progressed to blastic phase. At the last follow-up nine patients had died, seven of CML-unrelated causes and two only of CML progression. These results suggest that our strategy could be as effective as front line second generation TKI, with most of patients still receiving imatinib, a drug of better known long-term side effects and lower cost.
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Affiliation(s)
- Marco Cerrano
- Hematology Division; Università degli Studi di Torino; Turin Italy
| | - Elena Crisà
- Hematology Division; Università degli Studi di Torino; Turin Italy
| | - Patrizia Pregno
- Hematology Division; Azienda Ospedaliera Città della Salute e della Scienza; Turin Italy
| | - Chiara Aguzzi
- Hematology Division; Università degli Studi di Torino; Turin Italy
| | - Paola Riccomagno
- Hematology Division; Azienda Ospedaliera Città della Salute e della Scienza; Turin Italy
| | - Mario Boccadoro
- Hematology Division; Università degli Studi di Torino; Turin Italy
| | - Dario Ferrero
- Hematology Division; Università degli Studi di Torino; Turin Italy
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Messa E, Gioia D, Masiera E, Allione B, Balleari E, Bonferroni M, Cametti G, Crisà E, Cilloni D, Danise P, Del Corso L, Ferrero D, Freilone R, Gaidano G, Lunghi M, Musto P, Pappano S, Pellizzari A, Poloni A, Santini V, Salvi F, Tassara R, Saglio G, Levis A. O-020 Erythropoietin alpha therapy in 1110 lower-risk MDS patients: A real life survey from the network of regional Italian MDS Registries. Leuk Res 2013. [DOI: 10.1016/s0145-2126(13)70042-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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45
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Santini V, Allione B, Lunghi M, Levis A, Poloni A, Angelucci E, Onida F, Terenzi A, Finelli C, Ferrero D. O-018 Efficacy of decitabine in advanced chronic myelomonocytic leukemia (CMML) patients. Leuk Res 2013. [DOI: 10.1016/s0145-2126(13)70040-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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46
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Latagliata R, Breccia M, Fava C, Stagno F, Tiribelli M, Luciano L, Gozzini A, Gugliotta G, Annunziata M, Cavazzini F, Ferrero D, Musto P, Capodanno I, Iurlo A, Visani G, Crugnola M, Calistri E, Castagnetti F, Vigneri P, Alimena G. Incidence, risk factors and management of pleural effusions during dasatinib treatment in unselected elderly patients with chronic myelogenous leukaemia. Hematol Oncol 2012; 31:103-9. [PMID: 22815278 DOI: 10.1002/hon.2020] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Revised: 06/03/2012] [Accepted: 06/05/2012] [Indexed: 11/10/2022]
Abstract
To assess the most important features and clinical impact of pleural effusions, which are a common toxicity during dasatinib treatment and often impair its high efficacy, 172 unselected consecutive patients with chronic myelogenous leukaemia in chronic phase treated in 27 Italian centres, with dasatinib when aged >60 years for resistance/intolerance to imatinib, were examined. During treatment, 52/172 patients (30.2%) presented pleural effusion, which was grades 1-2 in 38 patients and grades 3-4 in 14 patients (8.1% of the entire cohort of patients), according to the WHO scale; in 14/52 patients (26.9%), there was a concomitant pericardial effusion. Pleural effusion was recurrent in 25/52 patients (48.0%). Median time from dasatinib to first pleural effusion was 11.0 months (interquartile range 3.6-18.6). Eleven patients (6.4%) required permanent dasatinib discontinuation. Only presence of concomitant pulmonary disease ( p = 0.035) and initial daily dose of dasatinib (140 mg vs 100 mg, p = 0.014) were significantly associated with pleural effusions. There were no differences among patients with or without pleural effusions as concerns response rates and overall survival. Pleural effusions were common in our unselected 'real-life' population of elderly patients but were clinically manageable and did not seem to affect treatment results.
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Affiliation(s)
- Roberto Latagliata
- Department of Cellular Biotechnologies and Hematology, University La Sapienza, Rome, Italy.
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47
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Martini M, Ferrero D. Tecnology innovation related to comfort on commercial vehicles. G Ital Med Lav Ergon 2012; 34:321-327. [PMID: 23213810] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The scope of this article is to show the Iveco activity in terms of comfort improvement in all its product Portfolio, focusing on innovation research and realization of tools to get better the life of the driver on commercial vehicles. Comfort related to the ergonomics, thermal, vibrational comfort and after-treatment system in order to improve the life of driver and passengers. It is to remember that Commercial vehicles have different use from a car. For example an heavy truck cabin is not only a place where to drive 8 hours a day, but it is at the same time, an office, a place where to eat, where to sleep and to have a rest. The effort in the last 10 years of Iveco is to improve the comfort of the life of the drivers, utilizing continuous research in standards and innovative systems in order to increase the security and life improvement, focusing also on worldwide legislation as a partner in European committees for health and safety.
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48
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Lobetti-Bodoni C, Ferrero D, Genuardi E, Passera R, Bernocco E, Sia D, Grignani G, Crisà E, Monitillo L, Rocci A, Drandi D, Giai V, Zanni M, Boi M, Isaia G, Barbero D, Lunghi M, Abruzzese E, Radaelli F, Pini M, Pregno P, Carlo-Stella C, Gaidano G, Boccadoro M, Ladetto M. Telomere loss in Philadelphia-negative hematopoiesis after successful treatment of chronic myeloid leukemia: evidence for premature aging of the myeloid compartment. Mech Ageing Dev 2012; 133:479-88. [PMID: 22687638 DOI: 10.1016/j.mad.2012.05.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Revised: 04/11/2012] [Accepted: 05/29/2012] [Indexed: 01/08/2023]
Abstract
Telomere shortening, a well-known marker of aging and cellular stress, occurs under several conditions in the hematopoietic compartment, including aplastic anemia and following iatrogenic noxae. We decided to verify whether pathological telomere erosion also arises in restored Philadelphia-negative (Ph-negative) hematopoiesis following successful treatment of chronic myeloid leukemia (CML). Eighty-one CML patients in complete cytogenetic remission were compared to 76 age-matched healthy subjects. Myeloid cells of CML patients had shorter telomeres than controls (6521 bp vs 7233 bp, p<0.001). This difference was specific for the myeloid compartment, since it was not observed in lymphoid cells (6774 bp vs 6909 bp, p=0.620). Acquired Ph-negative cytogenetic abnormalities (p=0.010), lack of complete molecular remission (p=0.016) and age (p=0.013) were independent predictors of telomere shortening. Telomere dynamics were assessed over a median follow-up period of 22 months. We documented accelerated non-physiological ongoing telomere shortening in 17/59 CML patients (28%). Patients experiencing grade 2-4 hematological toxicity, during CML remission possessed significantly shorter telomeres compared to those lacking toxicity (p=0.005 for any toxicity, p=0.007 for anemia). CML patients suffer from significant and often ongoing telomere stress resulting in premature and selective aging of the myeloid compartment which might have long-term consequences on function and integrity of Ph-negative hematopoiesis.
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Affiliation(s)
- Chiara Lobetti-Bodoni
- Division of Hematology, University of Turin, A.O.U. San Giovanni Battista, Turin, Italy
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49
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Crisà E, Foli C, Passera R, Darbesio A, Garvey KB, Boccadoro M, Ferrero D. Long-term follow-up of myelodysplastic syndrome patients with moderate/severe anaemia receiving human recombinant erythropoietin + 13-cis-retinoic acid and dihydroxylated vitamin D3: independent positive impact of erythroid response on survival. Br J Haematol 2012; 158:99-107. [DOI: 10.1111/j.1365-2141.2012.09125.x] [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] [Received: 12/10/2011] [Accepted: 03/06/2012] [Indexed: 12/14/2022]
Affiliation(s)
- Elena Crisà
- Haematology Division; S. Giovanni Battista Hospital; University of Turin; Turin
| | | | - Roberto Passera
- Nuclear Medicine Service; S. Giovanni Battista Hospital; Turin
| | | | - Kimberly B. Garvey
- Haematology Division; S. Giovanni Battista Hospital; University of Turin; Turin
| | - Mario Boccadoro
- Haematology Division; S. Giovanni Battista Hospital; University of Turin; Turin
| | - Dario Ferrero
- Haematology Division; S. Giovanni Battista Hospital; University of Turin; Turin
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50
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Falco P, Levis A, Stacchini A, Ciriello MM, Geuna M, Notari P, Omedè P, Pautasso M, Prato G, Strola G, Gioia D, Bonferroni M, Cametti G, Ferrero D, Freilone R, Gaidano G, Marinone C, Marmont F, Pollio B, Salvi F, Saglio G, Girotto M. Prognostic relevance of cytometric quantitative assessment in patients with myelodysplastic syndromes. Eur J Haematol 2011; 87:409-18. [PMID: 21711395 DOI: 10.1111/j.1600-0609.2011.01676.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Morphology and cytogenetics are currently used to define prognosis in myelodysplastic syndromes (MDS). However, these parameters have some limits. Flow cytometry has been recently included in the diagnostic panel for MDS, and its prognostic significance is under evaluation. METHODS Marrow aspirates from 424 MDS patients were analyzed by flow cytometry to evaluate the impact of bone marrow cell immunophenotype on overall survival (OS) and leukemia-free survival (LFS). The immature compartment of myeloblasts was analyzed by the quantitative expression of CD34 (<3% vs. ≥3%), CD117, and CD11b(-) /CD66b(-) (<5% vs. ≥5%); myeloid maturation was analyzed by the expression of CD11b(+) /CD66b(++) (<15% vs. ≥15%) and CD11b(+) /CD66b(+) (<25% vs. ≥25%). RESULTS In univariate analysis, the expression of immaturity markers (CD34(+) , CD117(+) , and CD11b(-) /CD66b(-) ) was associated with shorter LFS and OS (P < 0.0001); higher expression of differentiation markers (CD11b(+) /CD66b(++) and CD11b(+) /CD66b(+) ) was associated with longer LFS (P < 0.0001 and P = 0.0002, respectively) and OS (P < 0.0001). In multivariate analysis, expression of CD34(+) (P = 0.007), CD117(+) (P = 0.013), and CD11b(+) /CD66b(++) (P = 0.023) retained independent prognostic value for OS, while only the expression of CD34(+) was a prognostic factor for LFS (P = 0.0003). Two different risk groups were defined according to the presence of 0-1 or ≥2 of these factors with significant different LFS and OS (P < 0.0001). This score showed prognostic value in predicting survival even in subanalysis according to IPSS and WHO subgroups. CONCLUSIONS Flow cytometric analysis in MDS may provide meaningful prognostic information. Blast percentage expressed as CD117(+) or CD34(+) cells and the quantitative assessment of myeloid maturation showed prognostic value for survival.
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Affiliation(s)
- Patrizia Falco
- Division of Hematology and Transfusional Medicine ASLTO4, Via Marchesi della Rocca 30, Ciriè, Turin.
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