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Di Paola A, Marrapodi MM, Pota E, Colucci Cante R, Rana D, Giliberti G, Di Feo G, Ahmed S, Roberti D, Nigro R, Rossi F, Argenziano M. Role of Nutraceuticals in Counteracting Inflammation in In Vitro Macrophages Obtained from Childhood Cancer Survivors. Cancers (Basel) 2024; 16:714. [PMID: 38398105 PMCID: PMC10886672 DOI: 10.3390/cancers16040714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/03/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
The advancement of anti-cancer therapies has markedly improved the survival rate of children with cancer, making them long-term childhood cancer survivors (CCS). Nevertheless, these treatments cause a low-grade inflammatory state, determining inflamm-aging and, thus, favoring the early onset of chronic diseases normally associated with old age. Identification of novel and safer therapeutic strategies is needed to counteract and prevent inflamm-aging. Macrophages are cells involved in immune and inflammatory responses, with a pivotal role in iron metabolism, which is related to inflammation. We obtained macrophages from CCS patients and evaluated their phenotype markers, inflammatory states, and iron metabolism by Western blotting, ELISA, and iron assays. We observed a strong increase in classically activated phenotype markers (M1) and iron metabolism alteration in CCS, with an increase in intracellular iron concentration and inflammatory markers. These results suggest that the prevalence of M1 macrophages and alteration of iron metabolism could be involved in the worsening of inflammation in CCS. Therefore, we propose macrophages and iron metabolism as novel therapeutic targets to counteract inflamm-aging. To avoid toxic regimens, we tested some nutraceuticals (resveratrol, curcumin, and oil-enriched lycopene), which are already known to exert anti-inflammatory properties. After their administration, we observed a macrophage switch towards the anti-inflammatory phenotype M2, as well as reductions in pro-inflammatory cytokines and the intracellular iron concentration. Therefore, we suggest-for the first time-that nutraceuticals reduce inflammation in CCS macrophages through a novel anti-inflammatory mechanism of action, modulating iron metabolism.
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Affiliation(s)
- Alessandra Di Paola
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.D.P.); (M.M.M.); (E.P.); (G.D.F.); (D.R.); (M.A.)
| | - Maria Maddalena Marrapodi
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.D.P.); (M.M.M.); (E.P.); (G.D.F.); (D.R.); (M.A.)
| | - Elvira Pota
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.D.P.); (M.M.M.); (E.P.); (G.D.F.); (D.R.); (M.A.)
| | - Rosa Colucci Cante
- Department of Industrial Engineering, University of Niccolò Cusano, 00166 Rome, Italy;
| | - Deeksha Rana
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (D.R.); (G.G.); (S.A.)
| | - Giulia Giliberti
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (D.R.); (G.G.); (S.A.)
| | - Giuseppe Di Feo
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.D.P.); (M.M.M.); (E.P.); (G.D.F.); (D.R.); (M.A.)
| | - Shakeel Ahmed
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (D.R.); (G.G.); (S.A.)
| | - Domenico Roberti
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.D.P.); (M.M.M.); (E.P.); (G.D.F.); (D.R.); (M.A.)
| | - Roberto Nigro
- Department of Chemical, Materials and Industrial Production Engineering, University of Naples Federico II, 80125 Naples, Italy;
| | - Francesca Rossi
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.D.P.); (M.M.M.); (E.P.); (G.D.F.); (D.R.); (M.A.)
| | - Maura Argenziano
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.D.P.); (M.M.M.); (E.P.); (G.D.F.); (D.R.); (M.A.)
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Pastorino F, Capasso M, Brignole C, Lasorsa VA, Bensa V, Perri P, Cantalupo S, Giglio S, Provenzi M, Rabusin M, Pota E, Cellini M, Tondo A, De Ioris MA, Sementa AR, Garaventa A, Ponzoni M, Amoroso L. Therapeutic Targeting of ALK in Neuroblastoma: Experience of Italian Precision Medicine in Pediatric Oncology. Cancers (Basel) 2023; 15:cancers15030560. [PMID: 36765519 PMCID: PMC9913103 DOI: 10.3390/cancers15030560] [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: 11/15/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 01/18/2023] Open
Abstract
Neuroblastoma (NB) is the most common extracranial solid tumor in childhood. Patients with relapsed/refractory disease have a poor prognosis, and additional therapeutic options are needed. Mutations and amplifications in the ALK (Anaplastic Lymphoma Kinase) gene constitute a key target for treatment. Our goal, within the Italian project of PeRsonalizEdMEdicine (PREME), was to evaluate the genomic status of patients with relapsed/refractory NB and to implement targeted therapies in those with targetable mutations. From November 2018 to November 2021, we performed Whole Exome Sequencing or Targeted Gene Panel Sequencing in relapsed/refractory NB patients in order to identify druggable variants. Activating mutations of ALK were identified in 8(28.57%) of 28 relapsed/refractory NB patients. The mutation p.F1174L was found in six patients, whereas p.R1275Q was found in one and the unknown mutation p.S104R in another. Three patients died before treatment could be started, while five patients received crizotinib: two in monotherapy (one with p.F1174L and the other with p.S104R) and three (with p.F1174L variant) in combination with chemotherapy. All treated patients showed a clinical improvement, and one had complete remission after two cycles of combined treatment. The most common treatment-related toxicities were hematological. ALK inhibitors may play an important role in the treatment of ALK-mutated NB patients.
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Affiliation(s)
- Fabio Pastorino
- UOSD Laboratory of Experimental Therapies in Oncology, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy
| | - Mario Capasso
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Via Pansini 5, 80131 Napoli, Italy
- CEINGE Biotecnologie Avanzate, Via G. Salvatore, 486, 80145 Napoli, Italy
| | - Chiara Brignole
- UOSD Laboratory of Experimental Therapies in Oncology, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy
| | - Vito A. Lasorsa
- CEINGE Biotecnologie Avanzate, Via G. Salvatore, 486, 80145 Napoli, Italy
| | - Veronica Bensa
- UOSD Laboratory of Experimental Therapies in Oncology, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy
| | - Patrizia Perri
- UOSD Laboratory of Experimental Therapies in Oncology, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy
| | - Sueva Cantalupo
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Via Pansini 5, 80131 Napoli, Italy
- CEINGE Biotecnologie Avanzate, Via G. Salvatore, 486, 80145 Napoli, Italy
| | - Serena Giglio
- UO Pediatria-Neonatologia/Nido PO A. Ajello ASP Trapani, 91100 Trapani, Italy
| | - Massimo Provenzi
- Pediatric Oncology, Ospedale Papa Giovanni XXIII, Piazza Organizzazione Mondiale Sanità 1, 24127 Bergamo, Italy
| | - Marco Rabusin
- Department of Pediatrics, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Via dell’Istria 65/1, 34137 Trieste, Italy
| | - Elvira Pota
- UOSD di Ematologia ed Oncologia Pediatrica, Università Degli Studi Della Campania “Luigi Vanvitelli,” Piazza Luigi Miraglia 2, 80138 Napoli, Italy
| | - Monica Cellini
- Division of Paediatric Hemato-Oncology, University Hospital Azienda Policlinico di Modena, Via del Pozzo 71, 41124 Modena, Italy
| | - Annalisa Tondo
- Department of Hematology-Oncology, Anna Meyer Children’s Hospital, VialePieraccini 24, 50139 Firenze, Italy
| | - Maria A. De Ioris
- Department of Paediatric Haematology/Oncology, and Cell and Gene Therapy, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Angela R. Sementa
- Dipartimento di Patologia, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy
| | - Alberto Garaventa
- UOC Oncologia, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini 5, 16147 Genova, Italy
| | - Mirco Ponzoni
- UOSD Laboratory of Experimental Therapies in Oncology, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy
- Correspondence: ; Tel.: +39-01056363539; Fax: +39-0103779820
| | - Loredana Amoroso
- UOC Oncologia, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini 5, 16147 Genova, Italy
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Rossi F, Tortora C, Paoletta M, Marrapodi MM, Argenziano M, Di Paola A, Pota E, Di Pinto D, Di Martino M, Iolascon G. Osteoporosis in Childhood Cancer Survivors: Physiopathology, Prevention, Therapy and Future Perspectives. Cancers (Basel) 2022; 14:cancers14184349. [PMID: 36139510 PMCID: PMC9496695 DOI: 10.3390/cancers14184349] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [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: 07/25/2022] [Revised: 09/01/2022] [Accepted: 09/06/2022] [Indexed: 11/29/2022] Open
Abstract
Simple Summary Anti-cancer treatments induced an increase in the childhood cancer survival rate. However, they are responsible for several long-term side effects in childhood cancer survivors, including osteoporosis. Cancer itself, a sedentary lifestyle, and an unhealthy diet might adversely affect bone health. Early identification and adequate management of bone fragility in childhood cancer survivors could be useful to prevent osteoporosis onset and consequently fragility fractures. Abstract The improvement of chemotherapy, radiotherapy, and surgical interventions, together with hematopoietic stem cell transplantation, increased childhood cancer survival rate in the last decades, reaching 80% in Europe. Nevertheless, anti-cancer treatments are mainly responsible for the onset of long-term side effects in childhood cancer survivors (CCS), including alterations of the endocrine system function and activity. In particular, the most frequent dysfunction in CCS is a metabolic bone disorder characterized by low bone mineral density (BMD) with increased skeletal fragility. BMD loss is also a consequence of a sedentary lifestyle, malnutrition, and cancer itself could affect BMD, thus inducing osteopenia and osteoporosis. In this paper, we provide an overview of possible causes of bone impairment in CCS in order to propose management strategies for early identification and treatment of skeletal fragility in this population.
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Affiliation(s)
- Francesca Rossi
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, Via L. De Crecchio 4, 80138 Napoli, Italy
- Correspondence: ; Tel.: +39-081-566-5423
| | - Chiara Tortora
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, Via L. De Crecchio 4, 80138 Napoli, Italy
| | - Marco Paoletta
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Maria Maddalena Marrapodi
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, Via L. De Crecchio 4, 80138 Napoli, Italy
| | - Maura Argenziano
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, Via L. De Crecchio 4, 80138 Napoli, Italy
| | - Alessandra Di Paola
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, Via L. De Crecchio 4, 80138 Napoli, Italy
| | - Elvira Pota
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, Via L. De Crecchio 4, 80138 Napoli, Italy
| | - Daniela Di Pinto
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, Via L. De Crecchio 4, 80138 Napoli, Italy
| | - Martina Di Martino
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, Via L. De Crecchio 4, 80138 Napoli, Italy
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
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Punzo F, Argenziano M, Tortora C, Di Paola A, Mutarelli M, Pota E, Di Martino M, Di Pinto D, Marrapodi MM, Roberti D, Rossi F. Effect of CB2 Stimulation on Gene Expression in Pediatric B-Acute Lymphoblastic Leukemia: New Possible Targets. Int J Mol Sci 2022; 23:8651. [PMID: 35955786 PMCID: PMC9369382 DOI: 10.3390/ijms23158651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 01/27/2023] Open
Abstract
Acute lymphoblastic leukemia type B (B-ALL) is the most common kind of pediatric leukemia, characterized by the clonal proliferation of type B lymphoid stem cells. Important progress in ALL treatments led to improvements in long-term survival; nevertheless, many adverse long-term consequences still concern the medical community. Molecular and cellular target therapies, together with immunotherapy, are promising strategies to overcome these concerns. Cannabinoids, enzymes involved in their metabolism, and cannabinoid receptors type 1 (CB1) and type 2 (CB2) constitute the endocannabinoid system, involved in inflammation, immune response, and cancer. CB2 receptor stimulation exerts anti-proliferative and anti-invasive effects in many tumors. In this study, we evaluated the effects of CB2 stimulation on B-ALL cell lines, SUP-B15, by RNA sequencing, Western blotting, and ELISA. We observe a lower expression of CB2 in SUP-B15 cells compared to lymphocytes from healthy subjects, hypothesizing its involvement in B-ALL pathogenesis. CB2 stimulation reduces the expression of CD9, SEC61G, TBX21, and TMSB4X genes involved in tumor growth and progression, and also negatively affects downstream intracellular pathways. Our findings suggest an antitumor role of CB2 stimulation in B-ALL, and highlight a functional correlation between CB2 receptors and specific anti-tumoral pathways, even though further investigations are needed.
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Affiliation(s)
- Francesca Punzo
- Department of Woman, Child and General and Specialist Surgery, Via Luigi De Crecchio 4, 80138 Naples, Italy; (F.P.); (M.A.); (C.T.); (A.D.P.); (E.P.); (M.D.M.); (D.D.P.); (M.M.M.); (D.R.)
| | - Maura Argenziano
- Department of Woman, Child and General and Specialist Surgery, Via Luigi De Crecchio 4, 80138 Naples, Italy; (F.P.); (M.A.); (C.T.); (A.D.P.); (E.P.); (M.D.M.); (D.D.P.); (M.M.M.); (D.R.)
| | - Chiara Tortora
- Department of Woman, Child and General and Specialist Surgery, Via Luigi De Crecchio 4, 80138 Naples, Italy; (F.P.); (M.A.); (C.T.); (A.D.P.); (E.P.); (M.D.M.); (D.D.P.); (M.M.M.); (D.R.)
| | - Alessandra Di Paola
- Department of Woman, Child and General and Specialist Surgery, Via Luigi De Crecchio 4, 80138 Naples, Italy; (F.P.); (M.A.); (C.T.); (A.D.P.); (E.P.); (M.D.M.); (D.D.P.); (M.M.M.); (D.R.)
| | - Margherita Mutarelli
- Istituto di Scienze Applicate e Sistemi Intelligenti “Eduardo Caianiello” ISASI-CNR, Via Campi Flegrei 34, 80078 Pozzuoli, Italy;
| | - Elvira Pota
- Department of Woman, Child and General and Specialist Surgery, Via Luigi De Crecchio 4, 80138 Naples, Italy; (F.P.); (M.A.); (C.T.); (A.D.P.); (E.P.); (M.D.M.); (D.D.P.); (M.M.M.); (D.R.)
| | - Martina Di Martino
- Department of Woman, Child and General and Specialist Surgery, Via Luigi De Crecchio 4, 80138 Naples, Italy; (F.P.); (M.A.); (C.T.); (A.D.P.); (E.P.); (M.D.M.); (D.D.P.); (M.M.M.); (D.R.)
| | - Daniela Di Pinto
- Department of Woman, Child and General and Specialist Surgery, Via Luigi De Crecchio 4, 80138 Naples, Italy; (F.P.); (M.A.); (C.T.); (A.D.P.); (E.P.); (M.D.M.); (D.D.P.); (M.M.M.); (D.R.)
| | - Maria Maddalena Marrapodi
- Department of Woman, Child and General and Specialist Surgery, Via Luigi De Crecchio 4, 80138 Naples, Italy; (F.P.); (M.A.); (C.T.); (A.D.P.); (E.P.); (M.D.M.); (D.D.P.); (M.M.M.); (D.R.)
| | - Domenico Roberti
- Department of Woman, Child and General and Specialist Surgery, Via Luigi De Crecchio 4, 80138 Naples, Italy; (F.P.); (M.A.); (C.T.); (A.D.P.); (E.P.); (M.D.M.); (D.D.P.); (M.M.M.); (D.R.)
| | - Francesca Rossi
- Department of Woman, Child and General and Specialist Surgery, Via Luigi De Crecchio 4, 80138 Naples, Italy; (F.P.); (M.A.); (C.T.); (A.D.P.); (E.P.); (M.D.M.); (D.D.P.); (M.M.M.); (D.R.)
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Rossi F, Tortora C, Di Martino M, Di Paola A, Di Pinto D, Marrapodi MM, Argenziano M, Pota E. Alteration of osteoclast activity in childhood cancer survivors: Role of iron and of CB2/TRPV1 receptors. PLoS One 2022; 17:e0271730. [PMID: 35862357 PMCID: PMC9302719 DOI: 10.1371/journal.pone.0271730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/06/2022] [Indexed: 11/30/2022] Open
Abstract
Childhood cancer survivors (CCS) are predisposed to the onset of osteoporosis (OP). It is known that iron overload induces osteoclasts (OCs) overactivity and that the iron chelator Deferasirox (DFX) can counteract it. The Cannabinoid Receptor type 2 (CB2) and the transient receptor potential vanilloid type-1 (TRPV1) are potential therapeutic targets for OP. In this study we isolated OCs from peripheral blood of 20 CCS and investigated osteoclast biomarkers expression and iron metabolism evaluating iron release by OCs and the expression of several molecules involved in its regulation. Moreover, we analyzed the effects of CB2 and TRPV1 stimulation in combination with DFX on osteoclast activity and iron metabolism. We observed, for the first time, an osteoclast hyperactivation in CCS suggesting a role for iron in its development. Moreover, we confirmed the well-known role of CB2 and TRPV1 receptors in bone metabolism, suggesting the receptors as possible key biomarkers of bone damage. Moreover, we demonstrated a promising synergism between pharmacological compounds, stimulating CB2 or inhibiting/desensitizing TRPV1 and DFX, in counteracting osteoclast overactivity in CCS to improve their quality of life.
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Affiliation(s)
- Francesca Rossi
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, Napoli, Italy
- * E-mail:
| | - Chiara Tortora
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Martina Di Martino
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Alessandra Di Paola
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Daniela Di Pinto
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Maria Maddalena Marrapodi
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Maura Argenziano
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Elvira Pota
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, Napoli, Italy
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Marrapodi MM, Mascolo A, di Mauro G, Mondillo G, Pota E, Rossi F. The safety of blinatumomab in pediatric patients with acute lymphoblastic leukemia: A systematic review and meta-analysis. Front Pediatr 2022; 10:929122. [PMID: 35935358 PMCID: PMC9354602 DOI: 10.3389/fped.2022.929122] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Blinatumomab is a bispecific CD19-directed CD3 T-cell engager that has proven efficacy in children with relapsed or refractory B-cell acute lymphoblastic leukemia (ALL). Despite its efficacy, it has also been associated with the development of potentially serious adverse events such as the cytokine release syndrome (CRS) and neurologic events. The present meta-analysis aimed to assess the safety profile of blinatumomab in terms of serious adverse events, CRS, and neurologic events (such as seizure and encephalopathy) in pediatric patients with B-cell ALL. METHODS AND FINDINGS A systematic review was conducted in Pubmed up to December 10, 2021 to retain pediatric clinical trials on blinatumomab. A random effect meta-analysis approach was used. This study followed the PRISMA statement. Four out of the 255 initial references were selected, of which 2 were phase 1/2 clinical trials and 2 phase 3 clinical trials. Blinatumomab was associated with a lower risk of serious adverse events (Risk ratio RR, 0.56; 95% CI, 0.32-0.99), febrile neutropenia (RR, 0.13; 95% CI, 0.06-0.26), infection (RR, 0.40; 95% CI, 0.29-0.56), and grade ≥ 3 adverse events (RR, 0.79; 95% CI, 0.67-0.93) compared to chemotherapy. No difference in the risk of CRS (RR, 8.37; 95% CI, 0.27-260.97) and seizure (RR, 6.43; 95% CI, 0.79-53.08) was observed between groups, while for encephalopathy a higher risk was associated with blinatumomab compared to chemotherapy (RR, 8.90; 95% CI, 1.08-73.29). CONCLUSION Our data support the good safety profile of bliantumomab in treating pediatric patients with B-ALL.
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Affiliation(s)
- Maria Maddalena Marrapodi
- Department of Woman, Child and General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Annamaria Mascolo
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Naples, Italy.,Department of Experimental Medicine - Section of Pharmacology "L. Donatelli", University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Gabriella di Mauro
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Naples, Italy.,Department of Experimental Medicine - Section of Pharmacology "L. Donatelli", University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Gianluca Mondillo
- Department of Woman, Child and General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Elvira Pota
- Department of Woman, Child and General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Francesca Rossi
- Department of Woman, Child and General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
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Argenziano M, Tortora C, Paola AD, Pota E, Martino MD, Pinto DD, Leva CD, Rossi F. Eltrombopag and its iron chelating properties in pediatric acute myeloid leukemia. Oncotarget 2021; 12:1377-1387. [PMID: 34262648 PMCID: PMC8274721 DOI: 10.18632/oncotarget.28000] [Citation(s) in RCA: 5] [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: 05/10/2021] [Accepted: 06/11/2021] [Indexed: 01/08/2023] Open
Abstract
Pediatric acute myeloid leukemia (AML) represents 20% of total childhood leukemia diagnoses and is characterized by poor prognosis with a long-term survival rate around the 50%, when patients are properly treated. The standard treatment for pediatric AML currently consists in a combination of cytarabine (Ara-C) and antracycline. Iron plays an important role in cancer development and progression. Targeting iron and its metabolism mediators could be a novel therapeutic strategy in cancer.Deferasirox (DFX) inhibits cancer cell proliferation and its use as an antiblastic drug could be suggested. Eltrombopag (ELT), a thrombopoietin receptor agonist used in immunethrombocytopenia, shows anticancer properties related to its emerging iron chelating properties. We compare the anticancer effect of classically used cytarabine with DFX and ELT effects in a pediatric AML cell line, THP-1, in order to identify innovative and more effective therapeutic strategies. ELT and DFX reduce intracellular iron concentration by inhibiting its uptake and by promoting its release. In particular, even though further investigations are needed to better understand the extact underlying action mechanisms, we demonstrated that ELT improves cytarabine antineoplastic activity in pediatric AML cell line.
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Affiliation(s)
- Maura Argenziano
- Department of Woman, Child and General and Specialist Surgery, University of Campania Luigi Vanvitelli, Naples 80138, Italy
| | - Chiara Tortora
- Department of Woman, Child and General and Specialist Surgery, University of Campania Luigi Vanvitelli, Naples 80138, Italy
| | - Alessandra Di Paola
- Department of Experimental Medicine, University of Campania Luigi Vanvitelli, Naples 80138, Italy
| | - Elvira Pota
- Department of Woman, Child and General and Specialist Surgery, University of Campania Luigi Vanvitelli, Naples 80138, Italy
| | - Martina Di Martino
- Department of Woman, Child and General and Specialist Surgery, University of Campania Luigi Vanvitelli, Naples 80138, Italy
| | - Daniela Di Pinto
- Department of Woman, Child and General and Specialist Surgery, University of Campania Luigi Vanvitelli, Naples 80138, Italy
| | - Caterina Di Leva
- Department of Woman, Child and General and Specialist Surgery, University of Campania Luigi Vanvitelli, Naples 80138, Italy
| | - Francesca Rossi
- Department of Woman, Child and General and Specialist Surgery, University of Campania Luigi Vanvitelli, Naples 80138, Italy
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Piccolo V, Russo T, Di Pinto D, Pota E, Di Martino M, Piluso G, Ronchi A, Argenziano G, Di Brizzi EV, Santoro C. Poikiloderma With Neutropenia and Mastocytosis: A Case Report and a Review of Dermatological Signs. Front Med (Lausanne) 2021; 8:680363. [PMID: 34179048 PMCID: PMC8222900 DOI: 10.3389/fmed.2021.680363] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 04/27/2021] [Indexed: 12/02/2022] Open
Abstract
Poikiloderma with neutropenia (PN) is a very rare genetic disorder mainly characterized by poikiloderma and congenital neutropenia, which explains the recurrence of respiratory infections and risk of developing bronchiectasis. Patients are also prone to develop hematological and skin cancers. Here, we present the case of a patient, the only child of apparently unrelated Serbian parents, affected by PN resulting from the homozygous mutation NM_024598.3:c.243G>A (p.Trp81Ter) of USB1; early onset of poikiloderma (1 year of age) was associated with cutaneous mastocytosis. We also provide a review of the literature on this uncommon condition with a focus on dermatological findings.
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Affiliation(s)
- Vincenzo Piccolo
- Dermatology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Teresa Russo
- Dermatology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Daniela Di Pinto
- Department of Women and Child Health and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Elvira Pota
- Department of Women and Child Health and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Martina Di Martino
- Department of Women and Child Health and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giulio Piluso
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Andrea Ronchi
- Anatomic Pathology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | | | | | - Claudia Santoro
- Department of Women and Child Health and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.,Department of Physical and Mental Health, and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
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Argenziano M, Di Paola A, Tortora C, Di Pinto D, Pota E, Di Martino M, Perrotta S, Rossi F, Punzo F. Effects of Iron Chelation in Osteosarcoma. Curr Cancer Drug Targets 2020; 21:443-455. [PMID: 33380300 DOI: 10.2174/1568009620666201230090531] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 08/04/2020] [Revised: 10/19/2020] [Accepted: 10/25/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Osteosarcoma is an aggressive bone tumor. It represents the principal cause of cancer-associated death in children. Considering the recent findings on the role of iron in cancer, iron chelation has been investigated for its antineoplastic properties in many tumors. Deferasirox is the most used iron chelator compound and in previous studies showed an anticancer effect in hematologic and solid malignancies. Eltrombopag is a Thrombopoietin receptor used in thrombocytopenia that also binds and mobilize iron. It demonstrated an effect on iron overload conditions and also in contrasting cancer cell proliferation. OBJECTIVE We analyzed the effects of deferasirox and eltrombopag in human osteosarcoma cells in an attempt to identify other therapeutic approaches for this tumor. METHODS We cultured and treated with deferasirox and Eltrombopag, alone and in combination, two human osteosarcoma cell lines, MG63 and 143B. After 72h exposure, we performed RTqPCR, Western Blotting, Iron Assay and cytofluorimetric assays to evaluate the effect on viability, apoptosis, cell cycle progression and ROS production. RESULTS The iron-chelating properties of the two compounds are also confirmed in osteosarcoma, but we did not observe any direct effect on tumor progression. DISCUSSION We tested deferasirox and eltrombopag, alone and in combination, in human osteosarcoma cells for the first time and demonstrated that their iron-chelating activity does not influence biochemical pathways related to cancer progression and maintenance. CONCLUSION Although further investigations on possible effects mediated by cells of the tumor microenvironment could be of great interest, in vitro iron chelation in osteosarcoma does not impair tumor progression.
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Affiliation(s)
- Maura Argenziano
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alessandra Di Paola
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Chiara Tortora
- Department of Woman, Child and General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Daniela Di Pinto
- Department of Woman, Child and General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Elvira Pota
- Department of Woman, Child and General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Martina Di Martino
- Department of Woman, Child and General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Silverio Perrotta
- Department of Woman, Child and General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Francesca Rossi
- Department of Woman, Child and General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Francesca Punzo
- Department of Woman, Child and General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
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Crisci S, Pota E, Iaccarino G, Postiglione I, Meo C, Mele S, De Filippi R, Pinto A. Childhood Therapy-Related Acute Myeloid Leukemia with t(16;21)(q24;q22)/RUNX1-CBFA2T3 After a Primitive Neuroectodermal Tumor of the Chest Wall. Clin Lymphoma Myeloma Leuk 2020; 20:e660-e666. [PMID: 32651109 DOI: 10.1016/j.clml.2020.05.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 05/19/2020] [Accepted: 05/21/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Stefania Crisci
- Hematology-Oncology and Stem-Cell Transplantation Unit, Department of Hematology and Developmental Therapeutics, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy.
| | - Elvira Pota
- Pediatric Hematology-Oncology Unit, Department of Pediatrics, AOU, Università della Campania "Luigi Vanvitelli", Naples, Italy
| | - Giancarla Iaccarino
- Hematology-Oncology and Stem-Cell Transplantation Unit, Department of Hematology and Developmental Therapeutics, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - Irene Postiglione
- Hematology-Oncology and Stem-Cell Transplantation Unit, Department of Hematology and Developmental Therapeutics, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - Concetta Meo
- Hematology-Oncology and Stem-Cell Transplantation Unit, Department of Hematology and Developmental Therapeutics, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - Sara Mele
- Hematology-Oncology and Stem-Cell Transplantation Unit, Department of Hematology and Developmental Therapeutics, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - Rosaria De Filippi
- Hematology-Oncology and Stem-Cell Transplantation Unit, Department of Hematology and Developmental Therapeutics, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy; Department of Clinical Medicine and Surgery, Università degli Studi Federico II, Naples, Italy
| | - Antonio Pinto
- Hematology-Oncology and Stem-Cell Transplantation Unit, Department of Hematology and Developmental Therapeutics, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
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Mascolo A, Scavone C, Bertini M, Brusco S, Punzo F, Pota E, Di Martino M, Di Pinto D, Rossi F. Safety of Anticancer Agents Used in Children: A Focus on Their Off-Label Use Through Data From the Spontaneous Reporting System. Front Pharmacol 2020; 11:621. [PMID: 32457620 PMCID: PMC7221123 DOI: 10.3389/fphar.2020.00621] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 04/20/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Among factors influencing the higher risk of developing unknown or rare adverse drug reactions (ADRs) among children and adolescents, there is the frequent off-label use of drugs that seems to be very common in pediatric oncological patients. Our study aim to collect and evaluate data on the safety profile of antineoplastic drugs and their off-label use in the pediatrics population using real life data. METHODS We retrieved Individual Case Safety Reports (ICSRs) with an anticancer agent as suspected drug among those reported through the Campania spontaneous reporting system from 1 January 2013 to 30 September 2019. We classified ICSRs into four off-label categories: "age," "route of administration," "weight," and "therapeutic indication." We defined an ICSR as an off-label case if it met at least one of the aforementioned categories for at least one of the reported suspected antineoplastic drugs. RESULTS A total of 18 ICSRs (7.6%) out of 236 were classified as off-label cases. The median age of patients was 13 years (interquartile range, IQR: 6-16), with 94.4% of cases occurring in male patients. In the classification of the off-label category, 16 ICSRs were categorized according to the "therapeutic indication" and two for the "age." No case was categorized for the off-label categories "route of administration" and "weight." The two off-label cases categorized as "age" were both related to the use of brentuximab vedotin for Hodgkin's lymphoma in patients aged 16 years. Twenty-nine ADRs (1.6 suspected adverse drug reactions per ICSR) were identified among off-label cases. Among ADRs, those reported more than one were diarrhea (N = 3), neutropenia (N = 3), nausea (N = 2), pyrexia (N = 2), and vomit (N = 2). CONCLUSIONS Our findings showed a low number of ICSRs classified as off-label. The majority of off-label ICSRs were categorized for the "therapeutic indication." This low number of off-label ICSRs might be largely due to the underreporting phenomenon, which is a major limit in pharmacovigilance. Therefore, we believe that spreading pharmacovigilance knowledge and awareness might improve this aspect.
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Affiliation(s)
- Annamaria Mascolo
- Department of Experimental Medicine–Section of Pharmacology “L. Donatelli”, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Cristina Scavone
- Department of Experimental Medicine–Section of Pharmacology “L. Donatelli”, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Michele Bertini
- Department of Experimental Medicine–Section of Pharmacology “L. Donatelli”, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Simona Brusco
- Department of Experimental Medicine–Section of Pharmacology “L. Donatelli”, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Francesca Punzo
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Elvira Pota
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Martina Di Martino
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Daniela Di Pinto
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Francesca Rossi
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
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Indolfi C, Cappabianca S, Rossi F, Perrotta S, Procaccini E, Pota E, Martino MD, Pinto DD, Casale F, Indolfi P. Abbreviated breast magnetic resonance imaging (FAST-MRI): A novel approach to breast cancer screening in patients with previous Hodgkin lymphoma. Pediatr Blood Cancer 2019; 66:e27666. [PMID: 30786169 DOI: 10.1002/pbc.27666] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 01/30/2019] [Indexed: 11/06/2022]
Affiliation(s)
- Cristiana Indolfi
- Pediatric Hematology-Oncology Unit, University of Campania "Luigi Vanvitelli,", Naples, Italy
| | | | - Francesca Rossi
- Pediatric Hematology-Oncology Unit, University of Campania "Luigi Vanvitelli,", Naples, Italy
| | - Silverio Perrotta
- Pediatric Hematology-Oncology Unit, University of Campania "Luigi Vanvitelli,", Naples, Italy
| | | | - Elvira Pota
- Pediatric Hematology-Oncology Unit, University of Campania "Luigi Vanvitelli,", Naples, Italy
| | - Martina Di Martino
- Pediatric Hematology-Oncology Unit, University of Campania "Luigi Vanvitelli,", Naples, Italy
| | - Daniela Di Pinto
- Pediatric Hematology-Oncology Unit, University of Campania "Luigi Vanvitelli,", Naples, Italy
| | - Fiorina Casale
- Pediatric Hematology-Oncology Unit, University of Campania "Luigi Vanvitelli,", Naples, Italy
| | - Paolo Indolfi
- Pediatric Hematology-Oncology Unit, University of Campania "Luigi Vanvitelli,", Naples, Italy
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Punzo F, Tortora C, Di Pinto D, Pota E, Argenziano M, Di Paola A, Casale F, Rossi F. Bortezomib and endocannabinoid/endovanilloid system: a synergism in osteosarcoma. Pharmacol Res 2018; 137:25-33. [PMID: 30267762 DOI: 10.1016/j.phrs.2018.09.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 09/18/2018] [Accepted: 09/18/2018] [Indexed: 12/13/2022]
Abstract
Osteosarcoma is the most common primary malignant tumor of bone in children and adolescents. Bortezomib (BTZ) is an approved anticancer drug, classified as a selective reversible inhibitor of the ubiquitin-dependent proteasome system, that leads to cancer cell cycle arrest and apoptosis reducing the invasion ability of Osteosarcoma cells in vitro. It also regulates the RANK/RANKL/OPG system, involved in the pathogenesis of bone tumors and in cell migration. A side effect of BTZ is to induce painful sensory peripheral neuropathy which lead to cessation of therapy or dose reduction. Recently BTZ has been evaluated in combination with Cannabinoids targeting CB1 receptor, demonstrating a promising synergic effect. The Endocannabinoid/Endovanilloid (EC/EV) system includes two G protein-coupled receptors (CB1 and CB2), the Transient Potential Vanilloid 1 (TRPV1) channel and their endogenous ligands and enzymes. CB1 and CB2 are expressed mainly in Central Nervous System and Immune Peripheral cells respectively. TRPV1 is also expressed in primary sensory neurons and is involved in pain modulation. EC/EV system induces apoptosis, reduces invasion and cell proliferation in Osteosarcoma cell lines and is involved in bone metabolism. We analyzed the effects of BTZ, alone and in combination with selective agonists at CB2 (JWH-133) and TRPV1 (RTX) receptors, in the Osteosarcoma cell line (HOS) on Apoptosis, Cell Cycle progression, migration and bone balance. We observed that the stimulation of CB2 and TRPV1 receptors increase the efficacy of BTZ in inducing apoptosis and reducing invasion, cell cycle progression and by modulating bone balance. These data suggest the possibility to use BTZ, in combination with EC/EV agonists, in Osteosarcoma therapy reducing its dose and its side effects.
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Affiliation(s)
- Francesca Punzo
- Department of Women, Child and General and Specialist Surgery, Università degli Studi della Campania "Luigi Vanvitelli", Via De Crecchio 4, 80138, Naples, Italy; Department of Experimental Medicine, Division of Pharmacology "Leonardo Donatelli", Università degli Studi della Campania "Luigi Vanvitelli", Via S. Maria di Costantinopoli 14, 80138, Naples, Italy
| | - Chiara Tortora
- Department of Women, Child and General and Specialist Surgery, Università degli Studi della Campania "Luigi Vanvitelli", Via De Crecchio 4, 80138, Naples, Italy
| | - Daniela Di Pinto
- Department of Women, Child and General and Specialist Surgery, Università degli Studi della Campania "Luigi Vanvitelli", Via De Crecchio 4, 80138, Naples, Italy
| | - Elvira Pota
- Department of Women, Child and General and Specialist Surgery, Università degli Studi della Campania "Luigi Vanvitelli", Via De Crecchio 4, 80138, Naples, Italy
| | - Maura Argenziano
- Department of Experimental Medicine, Division of Pharmacology "Leonardo Donatelli", Università degli Studi della Campania "Luigi Vanvitelli", Via S. Maria di Costantinopoli 14, 80138, Naples, Italy
| | - Alessandra Di Paola
- Department of Women, Child and General and Specialist Surgery, Università degli Studi della Campania "Luigi Vanvitelli", Via De Crecchio 4, 80138, Naples, Italy
| | - Fiorina Casale
- Department of Women, Child and General and Specialist Surgery, Università degli Studi della Campania "Luigi Vanvitelli", Via De Crecchio 4, 80138, Naples, Italy
| | - Francesca Rossi
- Department of Women, Child and General and Specialist Surgery, Università degli Studi della Campania "Luigi Vanvitelli", Via De Crecchio 4, 80138, Naples, Italy.
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Riccio I, Pota E, Marcarelli M, Affinita MC, Di Pinto D, Indolfi C, Del Regno N, Esposito M. Osteonecrosis as a complication in pediatric patients with acute lymphoblastic leukemia. Pediatr Med Chir 2016; 38:118. [DOI: 10.4081/pmc.2016.118] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 11/23/2015] [Accepted: 07/19/2016] [Indexed: 11/22/2022] Open
Abstract
Osteonecrosis is a significant adverse effect of treatment administered to children suffering from acute lymphoblastic leukemia (ALL) that may have a negative effect on the quality of life. The purpose of this study is to evaluate the rate of secondary vascular osteonecrosis (ON) in a population of pediatric patients with ALL treated with corticosteroids and cytostatic agents. A retrospective analysis of prospectively collected data of the medical records of 328 patients with ALL identified 4 cases with ON, corresponding to 1.2% of all cases observed. Of the 4 patients identified in our study 3 were girls and 1 was a boy, aged from 10 to 16 years old (average age at diagnosis, 12 years). Median time between the diagnosis of ALL and ON was 12.5 months (range, 12 to 36 months). Regarding the lesion size of ON, in all cases the femoral head (monolateral in 1 case and bilateral in 3 cases) was involved and was associated with the scapula-humeral joint in one case. ON of the weight-bearing joints has been identified as a severe complication in children with leukemia that may be associated with the development of articular surface collapse, subsequent debilitating arthritis, sometimes needing arthroplasty. For this reason it is very important to implement prevention strategies, especially in adolescent girls treated with steroids and chemotherapy. An early diagnosis of ON and careful orthopedic follow-up are necessary in order to avoid bone deformations related to the late start or the wrong therapy.
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Indolfi P, Picazio S, Perrotta S, Rossi F, Pession A, Di Martino M, Pota E, Di Pinto D, Indolfi C, Rondelli R, Vetrano F, Casale F. Time trends of cancer incidence in childhood in Campania region: 25 years of observation. Ital J Pediatr 2016; 42:82. [PMID: 27599999 PMCID: PMC5013613 DOI: 10.1186/s13052-016-0287-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 08/10/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Childhood cancer is relatively uncommon and the European age-standardized rate was 164 new case per million per year among children 0 to 14 years of age (95 % CI 158-170). Aims of our study are to evaluate the cases of these malignant diseases observed between 0 and 15 years of age in the Campania region between 1990 and 2014, the ration between observed and expected cases by disease and province of residence. Also we studied the percentage of extra-regional migration over the time by disease and province of residence. METHODS In this study we reported the patients with malignant disease observed in 25 years (1990-2014) based on the specialized registry, the Mod. 1.01 of the AIEOP (Association Italian Pediatric Hematology-Oncology). The size of the monitored population also allowed us to systematically examine five time trends: 1990-94: 1995-99; 2000-04; 2005-09; and 2010-14. RESULTS Between 1990 and 2014 a total of 3655 malignant neoplasms were reported: Napoli province (2059 cases), Salerno province (625), Caserta province (589), Avellino province (229), and Benevento province (153). Epidemiological data suggested that about 4100 cases could be expected in Campania region during the same period. The overall ratio between observed (O) and expected (E) numbers of cases in the five periods considered rose gradually from 0.69 in the first period to 0.76, then 0.82, 0.91, and 0.94, in the other periods considered. The extra-regional migration involved 1029 cases (28.1 %), showing a reduction from 33.7 % of the first period to 20.3 % of the last period considered. Considering single province of residence we observed the lowest rate of migration in Napoli and Caserta province, whereas higher levels were observed in the other provinces. For all provinces, except Salerno, the extra-regional migration declined significantly over time. CONCLUSIONS The present findings showed an increase over time of O/E ratio, probably due to improvement in the organization of centers and greater trust of families in local centers. It is possible to further improve the efficiency of healthcare system of Campania region and migration can be reduced with a more rational use of hospitals throughout region.
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Affiliation(s)
- Paolo Indolfi
- Servizio di Oncologia Pediatrica, Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica- Seconda Università degli Studi di Napoli, Naples, Italy. .,AIL Sezione "Valentina Picazio", Caserta, Italy.
| | | | - Silverio Perrotta
- Servizio di Oncologia Pediatrica, Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica- Seconda Università degli Studi di Napoli, Naples, Italy
| | - Francesca Rossi
- Servizio di Oncologia Pediatrica, Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica- Seconda Università degli Studi di Napoli, Naples, Italy
| | - Andrea Pession
- Unità di Oncologia ed Ematologia Pediatrica "Lalla Seràgnoli", Università di Bologna, Bologna, Italy
| | - Martina Di Martino
- Servizio di Oncologia Pediatrica, Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica- Seconda Università degli Studi di Napoli, Naples, Italy
| | - Elvira Pota
- Servizio di Oncologia Pediatrica, Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica- Seconda Università degli Studi di Napoli, Naples, Italy
| | - Daniela Di Pinto
- Servizio di Oncologia Pediatrica, Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica- Seconda Università degli Studi di Napoli, Naples, Italy
| | - Cristiana Indolfi
- Servizio di Oncologia Pediatrica, Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica- Seconda Università degli Studi di Napoli, Naples, Italy
| | - Roberto Rondelli
- Unità di Oncologia ed Ematologia Pediatrica "Lalla Seràgnoli", Università di Bologna, Bologna, Italy
| | - Francesco Vetrano
- Responsabile Registro Tumori Infantili Regione Campania, Naples, Italy
| | - Fiorina Casale
- Servizio di Oncologia Pediatrica, Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica- Seconda Università degli Studi di Napoli, Naples, Italy
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Ramaglia M, D'Angelo V, Iannotta A, Di Pinto D, Pota E, Affinita MC, Donofrio V, Errico ME, Lombardi A, Indolfi C, Casale F, Caraglia M. High EZH2 expression is correlated to metastatic disease in pediatric soft tissue sarcomas. Cancer Cell Int 2016; 16:59. [PMID: 27471434 PMCID: PMC4964052 DOI: 10.1186/s12935-016-0338-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 07/12/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Enhancer of Zeste Drosophila Homologue 2 (EZH2) is a key regulator of transcription as a member of polycomb repressive complex 2 (PRC2) which exerts repression of downstream genes and is correlated to invasiveness and progression of different tumours. Therefore, we evaluated the expression of PRC2 proteins in pediatric soft tissue sarcoma (rhabdomyosarcoma, RMS and extraosseous Ewing sarcoma, EES) correlating them to the clinical outcome of the patients. METHODS We analyzed PRC2 protein expression by quantitative real time PCR, western blotting and immunohistochemistry in 17 soft tissue sarcomas (11 RMS and 6 EES) enrolled at Paediatric Oncology Units of the Second University of Naples. Expression analysis was performed for EZH2, SUZ12 and EED. RESULTS Enhancer of Zeste Drosophila Homologue 2 was expressed with a different degree in 60 % of samples. Interestingly, the magnitude of EZH2 up regulation was significantly higher in patients presenting lymph node and/or distant metastases at the diagnosis. Moreover, patients overexpressing EZH2 had a lower probability of survival compared to patients negative or with low EZH2 expression. CONCLUSIONS Our study suggests that high EZH2 expression is associated to increased aggressiveness of the disease. Therefore, drugs that control its activity could be potentially used in the epigenetic target treatment of tumors with these alterations.
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Affiliation(s)
- Maria Ramaglia
- Department of Woman, Child and General and Specialized Surgery, Pediatric Oncology Unit, Second University of Naples, Via L. De Crecchio, 2, 80138 Naples, Italy
| | - Velia D'Angelo
- Department of Woman, Child and General and Specialized Surgery, Pediatric Oncology Unit, Second University of Naples, Via L. De Crecchio, 2, 80138 Naples, Italy
| | - Adriana Iannotta
- Department of Woman, Child and General and Specialized Surgery, Pediatric Oncology Unit, Second University of Naples, Via L. De Crecchio, 2, 80138 Naples, Italy
| | - Daniela Di Pinto
- Department of Woman, Child and General and Specialized Surgery, Pediatric Oncology Unit, Second University of Naples, Via L. De Crecchio, 2, 80138 Naples, Italy
| | - Elvira Pota
- Department of Woman, Child and General and Specialized Surgery, Pediatric Oncology Unit, Second University of Naples, Via L. De Crecchio, 2, 80138 Naples, Italy
| | - Maria Carmen Affinita
- Department of Woman, Child and General and Specialized Surgery, Pediatric Oncology Unit, Second University of Naples, Via L. De Crecchio, 2, 80138 Naples, Italy
| | | | | | - Angela Lombardi
- Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, Naples, Italy
| | - Cristiana Indolfi
- Department of Woman, Child and General and Specialized Surgery, Pediatric Oncology Unit, Second University of Naples, Via L. De Crecchio, 2, 80138 Naples, Italy
| | - Fiorina Casale
- Department of Woman, Child and General and Specialized Surgery, Pediatric Oncology Unit, Second University of Naples, Via L. De Crecchio, 2, 80138 Naples, Italy
| | - Michele Caraglia
- Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, Naples, Italy
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D’Angelo V, Ramaglia M, Iannotta A, Francese M, Pota E, Affinita MC, Pecoraro G, Indolfi C, Di Martino M, Di Pinto D, Buffardi S, Poggi V, Indolfi P, Casale F. Influence of methylenetetrahydrofolate reductase gene polymorphisms on the outcome of pediatric patients with non-Hodgkin lymphoma treated with high-dose methotrexate. Leuk Lymphoma 2013; 54:2639-44. [DOI: 10.3109/10428194.2013.784758] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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D'Angelo V, Crisci S, Casale F, Addeo R, Giuliano M, Pota E, Finsinger P, Baldi A, Rondelli R, Abbruzzese A, Caraglia M, Indolfi P. High Erk-1 activation and Gadd45a expression as prognostic markers in high risk pediatric haemolymphoproliferative diseases. J Exp Clin Cancer Res 2009; 28:39. [PMID: 19298651 PMCID: PMC2664791 DOI: 10.1186/1756-9966-28-39] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2008] [Accepted: 03/19/2009] [Indexed: 01/13/2023]
Abstract
Studies on activated cell-signaling pathways responsible for neoplastic transformation are numerous in solid tumors and in adult leukemias. Despite of positive results in the evolution of pediatric hematopoietic neoplasias, there are some high-risk subtypes at worse prognosis. The aim of this study was to asses the expression and activation status of crucial proteins involved in cell-signaling pathways in order to identify molecular alterations responsible for the proliferation and/or escape from apoptosis of leukemic blasts. The quantitative and qualitative expression and activation of Erk-1, c-Jun, Caspase8, and Gadd45a was analyzed, by immunocytochemical (ICC) and western blotting methods, in bone marrow blasts of 72 patients affected by acute myeloid leukemia (AML), T-cell acute lymphoblastic leukemia (ALL) and stage IV non-Hodgkin Lymphoma (NHL). We found an upregulation of Erk-1, Caspase8, c-Jun, and Gadd45a proteins with a constitutive activation in 95.8%, 91.7%, 86.2%, 83.4% of analyzed specimens, respectively. It is worth noting that all AML patients showed an upregulation of all proteins studied and the high expression of GADD45a was associated to the lowest DFS median (p = 0.04). On univariate analysis, only Erk-1 phosphorylation status was found to be correlated with a significantly shorter 5-years DFS in all disease subgroups (p = 0.033) and the lowest DFS median in ALL/NHL subgroup (p = 0.04). Moreover, the simultaneous activation of multiple kinases, as we found for c-Jun and Erk-1 (r = 0.26; p = 0.025), might synergistically enhance survival and proliferation potential of leukemic cells. These results demonstrate an involvement of these proteins in survival of blast cells and, consequently, on relapse percentages of the different subgroups of patients.
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Affiliation(s)
- Velia D'Angelo
- Pediatric Oncology Service, Pediatric Department, F Fede, II University of Naples, Naples, Italy.
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Indolfi P, Casale F, D'Angelo V, Addeo R, Crisci S, Pota E, Di Tullio MT. P-glycoprotein (p-gp) expression and function as an independent prognostic factor in childhood acute lymphoblastic leukemia. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.8503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- P. Indolfi
- Oncology Pediatric Service, Naples, Italy
| | - F. Casale
- Oncology Pediatric Service, Naples, Italy
| | | | - R. Addeo
- Oncology Pediatric Service, Naples, Italy
| | - S. Crisci
- Oncology Pediatric Service, Naples, Italy
| | - E. Pota
- Oncology Pediatric Service, Naples, Italy
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Giuliano M, De Falco G, Tramparulo V, Condè V, Siesto A, Di Martino M, Pota E, Casale F, Indolfi P, Di Tullio MT. [The set up of a phone on-call service at the oncohematology paediatric service]. Assist Inferm Ric 2004; 23:167-9. [PMID: 15553334] [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] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Affiliation(s)
- Maria Giuliano
- S. A. di Oncologia Pediatrica, Dipartimento di Pediatria, II Università di Napoli
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