1
|
Marando A, Di Blasi E, Tucci F, Aquilano MC, Bonoldi E. DOG1 expression in neuroendocrine neoplasms: Potential applications and diagnostic pitfalls. Pathol Res Pract 2023; 248:154623. [PMID: 37331184 DOI: 10.1016/j.prp.2023.154623] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 06/20/2023]
Abstract
Neuroendocrine neoplasms represent a heterogeneous group of rare tumors, more frequently arising from gastroenteropancreatic tract and lungs. At the time of diagnosis, 20% of cases are metastatic, and 10% of cases are considered as cancer of unknown primary origin. Several immunohistochemical markers are routinely used to confirm the neuroendocrine differentiation, first among all Synaptophysin and Chromogranin-A; on the other hand, different immunohistochemical markers are used to establish primary anatomical site, as TTF1, CDX2, Islet-1 and Calcitonin, but no marker is available in order to distinguish among different sites of the digestive tract. DOG1 (discovered on GIST-1) is a gene normally expressed in interstitial cells of Cajal and, in routine practice, DOG1 immunostaining is used in diagnosis of GIST (gastrointestinal stromal tumor). DOG1 expression has been described in several neoplasms other than GIST, both in mesenchymal and epithelial neoplasms. In the present study, DOG1 immunostaining has been performed in a large cohort of neuroendocrine neoplasms, including neuroendocrine tumors and neuroendocrine carcinomas, in order to evaluate frequency, intensity and pattern of expression in different anatomical site and in different tumor grade. DOG1 expression was detected in a large percentage of neuroendocrine tumors, with statistically significant association between DOG1 expression and gastrointestinal tract neuroendocrine tumors. As a consequence, DOG1 could be included in marker panel for the identification of primary site in neuroendocrine metastases of unknown primary origin; moreover, these results recommend careful evaluation of DOG1 expression in gastrointestinal neoplasms, in particular in differential diagnosis between epithelioid GIST and neuroendocrine tumors.
Collapse
Affiliation(s)
- A Marando
- Department of Surgical Pathology, Niguarda Hospital, Milano, Italy.
| | - E Di Blasi
- School of Pathology, University of Milan, Milan, Italy
| | - F Tucci
- School of Pathology, University of Milan, Milan, Italy
| | - M C Aquilano
- Department of Surgical Pathology, Niguarda Hospital, Milano, Italy
| | - E Bonoldi
- Department of Surgical Pathology, Niguarda Hospital, Milano, Italy
| |
Collapse
|
2
|
Abi-Jaoudeh N, Sadeghi B, Javan H, Na J, Beaton G, Tucci F, Ravula S, Imagawa DK. Drug-Eluting Embolic Loaded with Tyrosine Kinase Inhibitor Targeted Therapies for Transarterial Chemoembolization in a VX2 Model. Cancers (Basel) 2023; 15:3236. [PMID: 37370846 DOI: 10.3390/cancers15123236] [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: 04/26/2023] [Revised: 06/05/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
Drug-eluting embolic transarterial chemoembolization (DEE-TACE) improves the overall survival of hepatocellular carcinoma (HCC), but the agents used are not tailored to HCC. Our patented liposomal formulation enables the loading and elution of targeted therapies onto DEEs. This study aimed to establish the safety, feasibility, and pharmacokinetics of sorafenib or regorafenib DEE-TACE in a VX2 model. DEE-TACE was performed in VX2 hepatic tumors in a selective manner until stasis using liposomal sorafenib- or regorafenib-loaded DEEs. The animals were euthanized at 1, 24, and 72 h timepoints post embolization. Blood samples were taken for pharmacokinetics at 5 and 20 min and at 1, 24, and 72 h. Measurements of sorafenib or regorafenib were performed in all tissue samples on explanted hepatic tissue using the same mass spectrometry method. Histopathological examinations were carried out on tumor tissues and non-embolized hepatic specimens. DEE-TACE was performed on 23 rabbits. The plasma concentrations of sorafenib and regorafenib were statistically significantly several folds lower than the embolized liver at all examined timepoints. This study demonstrates the feasibility of loading sorafenib or regorafenib onto commercially available DEEs for use in TACE. The drugs eluted locally without release into systemic circulation.
Collapse
Affiliation(s)
- Nadine Abi-Jaoudeh
- Department of Radiological Sciences, University of California Irvine, Orange, CA 92697, USA
| | - Ben Sadeghi
- Department of Radiological Sciences, University of California Irvine, Orange, CA 92697, USA
| | - Hanna Javan
- Department of Radiological Sciences, University of California Irvine, Orange, CA 92697, USA
| | - Jim Na
- Cullgen, Inc., San Diego, CA 92130, USA
| | | | - Fabio Tucci
- Epigen Biosciences, San Diego, CA 92121, USA
| | | | - David K Imagawa
- Department of Surgery, University of California Irvine, Orange, CA 92697, USA
| |
Collapse
|
3
|
Bernardo M, Gentner B, Tucci F, Fumagalli F, Silvani P, Filisetti C, Redaelli D, Acquati S, Zonari E, Rovelli A, Parini R, Marca GL, Naldini L, Aiuti A. PS1220 EX-VIVO HEMATOPOIETIC STEM CELL GENE THERAPY (GT) FOR MUCOPOLYSACCHARIDOSIS TYPE I HURLER (MPSIH): PRELIMINARY RESULTS FROM A PHASE I/II CLINICAL STUDY. Hemasphere 2019. [DOI: 10.1097/01.hs9.0000563164.44448.4c] [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: 11/25/2022] Open
|
4
|
Caselli D, Galli L, Tondo A, Cuzzubbo D, Casini T, Simone LD, Tamburini A, Bambi F, Tucci F, Aricò M. Use of Micafungin for the Management of a Cluster of Invasive Aspergillosis in Children with Cancer. ACTA ACUST UNITED AC 2019. [DOI: 10.9734/jamps/2019/v20i330112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Background: Progressive increase of the capacity to cure children with cancer makes their rescue from life-threatening infectious complications, such as invasive fungal infections, a compelling challenge. Local outbreak among patients at risk may occur, and the optimal strategy for their management, including prophylactic regimens, is not defined.
Purpose: We describe our experience in the use of micafungin to break a cluster of invasive aspergillosis in children and adolescent with cancer.
Methods: Since study start, all in-patients who had severe neutropenia (<500/mm3) received prophylaxis with micafungin (1 mg/kg; ≤50 mg) daily i.v. until discharge. Serial testing of galactomannan was used as screening test for invasive aspergillosis; lung computed tomography was performed in patients who tested positive at repeated assay.
Results: Among 27 patients enrolled, one was excluded due to breakthrough invasive aspergillosis diagnosed on day 2. The remaining 26 patients were observed for a minimum of 90 days. Four patients had one positive galactomannan test; this was confirmed at second (but not at third) serial assay in a single patient. None of the patients developed invasive aspergillosis. The drug was very well tolerated, with no side effects related to micafungin administration. The total cost of the drug used for this “prophylaxis” in the study patients was €30.451, with a mean cost per patient of €1.133.
Conclusions: “Prophylactic” use of micafungin was safe, feasible and turned out to be associated with breaking the cluster of invasive aspergillosis in neutropenic patients exposed to an environmental risk. The pharmaco-economic evaluation also turned to be highly favorable.
Collapse
|
5
|
Farruggia P, Fioredda F, Puccio G, Onofrillo D, Russo G, Barone A, Bonanomi S, Boscarol G, Finocchi A, Ghilardi R, Giordano P, Ladogana S, Lassandro G, Luti L, Lanza T, Mandaglio R, Marra N, Martire B, Mastrodicasa E, Motta M, Notarangelo LD, Pillon M, Porretti L, Serafinelli J, Trizzino A, Tucci F, Veltroni M, Verzegnassi F, Ramenghi U, Dufour C. Idiopathic neutropenia of infancy: Data from the Italian Neutropenia Registry. Am J Hematol 2019; 94:216-222. [PMID: 30456824 DOI: 10.1002/ajh.25353] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 10/27/2018] [Accepted: 11/12/2018] [Indexed: 01/13/2023]
Abstract
Autoimmune neutropenia of infancy (AIN) is characterized by low risk of severe infection, tendency to spontaneously resolve and typically onset at ≤4-5 years of age; it is due to auto-antibodies whose detection is often difficult. In case of negativity of 4 antineutrophils autoantibody tests, after having excluded ethnic, postinfection, drug induced, or congenital neutropenia, according to the Italian guidelines the patients will be defined as affected by "idiopathic neutropenia" (IN). We describe the characteristics of 85 IN patients enrolled in the Italian neutropenia registry: they were compared with 336 children affected by AIN. The 2 groups were clinically very similar and the main differences were detection age (later in IN), length of disease (longer in IN) and, among recovered patients, age of spontaneous recovery: the median age at resolution was 2.13 years in AINs and 3.03 years in INs (P = .00002). At bivariate analysis among AIN patients earlier detection age (P = .00013), male sex (P = .000748), absence of leucopenia (P = .0045), and absence of monocytosis (P = .0419) were significantly associated with earlier recovery; in the IN group only detection age (P = .013) and absence of monocytosis (P = .0333) were significant. At multivariate analysis detection age and absence of monocytosis were independently significant (P = 6.7e-05 and 4.4e-03, respectively) in the AIN group, whereas in the IN group only detection age stayed significant (P = .013).
Collapse
Affiliation(s)
- Piero Farruggia
- Pediatric Hematology and Oncology Unit; A.R.N.A.S. Ospedale Civico; Palermo Italy
| | - Francesca Fioredda
- Clinical and Experimental Unit G. Gaslini Children's Hospital; Genoa Italy
| | - Giuseppe Puccio
- Department of Sciences for Health Promotion; University of Palermo; Palermo Italy
| | - Daniela Onofrillo
- Pediatric Hematology and Oncology Unit, Department of Hematology; Spirito Santo Hospital; Pescara Italy
| | - Giovanna Russo
- Pediatric Hematology and Oncology Unit, Azienda Policlinico-Vittorio Emanuele; University of Catania; Catania Italy
| | - Angelica Barone
- Department of Pediatric Onco-Hematology; University Hospital; Parma Italy
| | - Sonia Bonanomi
- MBBM Foundation, Department of Pediatrics; University of Milano - Bicocca; Monza Italy
| | - Gianluca Boscarol
- Department of Pediatrics; Central Teaching Hospital Bolzano; Bolzano Italy
| | | | - Roberta Ghilardi
- Department of Pediatrics; Ospedale Maggiore Policlinico IRCCS; Milan Italy
| | - Paola Giordano
- Department of Biomedical Sciences and Human Oncology; Pediatric Section, University "A. Moro" of Bari; Bari Italy
| | - Saverio Ladogana
- Department of Hematology; IRCCS Casa Sollievo della Sofferenza; San Giovanni Rotondo Italy
| | - Giuseppe Lassandro
- Department of Biomedical Sciences and Human Oncology; Pediatric Section, University "A. Moro" of Bari; Bari Italy
| | - Laura Luti
- Pediatric Hematology Oncology; Bone Marrow Transplant, Azienda Ospedaliero Universitaria Pisana, S. Chiara Hospital; Pisa Italy
| | - Tiziana Lanza
- Clinical and Experimental Unit G. Gaslini Children's Hospital; Genoa Italy
| | | | | | - Baldassare Martire
- Pediatric Science and Surgery Department; Pediatric Onco-Hematology Unit, Hospital Policlinico- Giovanni XXIII; Bari Italy
| | - Elena Mastrodicasa
- Pediatric Oncology Hematology Unit; S. Maria Della Misericordia Hospital; Perugia Italy
| | - Milena Motta
- Pediatric Hematology and Oncology Unit, Azienda Policlinico-Vittorio Emanuele; University of Catania; Catania Italy
| | - Lucia Dora Notarangelo
- Onco-Haematology and Bone Marrow Transplantation Unit; Children's Hospital; Brescia Italy
| | - Marta Pillon
- Pediatric Onco-Hematology Department; University of Padova; Padova
| | - Laura Porretti
- Flow Cytometry Service; Laboratory of Clinical Chemistry and Microbiology, IRCCS “Ca‘ Granda” Foundation, Maggiore Hospital Policlinico; Milan Italy
| | | | - Angela Trizzino
- Pediatric Hematology and Oncology Unit; A.R.N.A.S. Ospedale Civico; Palermo Italy
| | - Fabio Tucci
- Department of Pediatric Onco-Hematology; Meyer Children's Hospital; Florence Italy
| | - Marinella Veltroni
- Department of Pediatric Onco-Hematology; Meyer Children's Hospital; Florence Italy
| | - Federico Verzegnassi
- Institute for Maternal and Child Health (I.R.C.C.S) Burlo Garofolo; Trieste Italy
| | - Ugo Ramenghi
- Department of Pediatric and Public Health Sciences; University of Torino; Italy
| | - Carlo Dufour
- Clinical and Experimental Unit G. Gaslini Children's Hospital; Genoa Italy
| |
Collapse
|
6
|
Pacelli C, Tataranni T, Agriesti F, Mazzoccoli C, Lecce L, Lopriore P, Tucci F, Capitanio N, Formisano P, Piccoli C. PO-268 Adipose-derived mesenchymal stem cells microenvironment promotes the tumorigenic phenotype in triple negative breast cancer cell line. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.299] [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: 11/03/2022] Open
|
7
|
Farruggia P, Puccio G, Fioredda F, Lanza T, Porretti L, Ramenghi U, Barone A, Bonanomi S, Finocchi A, Ghilardi R, Ladogana S, Marra N, Martire B, Notarangelo LD, Onofrillo D, Pillon M, Russo G, Lo Valvo L, Serafinelli J, Tucci F, Zunica F, Verzegnassi F, Dufour C. Autoimmune neutropenia of childhood secondary to other autoimmune disorders: Data from the Italian neutropenia registry. Am J Hematol 2017; 92:E546-E549. [PMID: 28567966 DOI: 10.1002/ajh.24803] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 05/26/2017] [Indexed: 11/07/2022]
Affiliation(s)
- Piero Farruggia
- Pediatric Hematology and Oncology Unit, A.R.N.A.S. Ospedale Civico, Palermo, Italy
| | - Giuseppe Puccio
- Department of Sciences for Health Promotion, University of Palermo, Italy
| | - Francesca Fioredda
- Clinical and Experimental Hematology Unit, G. Gaslini Children's Hospital, Genova, Italy
| | - Tiziana Lanza
- Clinical and Experimental Hematology Unit, G. Gaslini Children's Hospital, Genova, Italy
| | - Laura Porretti
- Flow Cytometry Service, Laboratory of Clinical Chemistry and Microbiology, IRCCS "Ca' Granda" Foundation, Maggiore Hospital Policlinico, Milan, Italy
| | - Ugo Ramenghi
- Ematologia, Dipartimento di Scienze Pediatriche, Ospedale Infantile Regina Margherita, Torino, Italy
| | - Angelica Barone
- Department of Pediatric Onco-hematology, University Hospital, Parma, Italy
| | - Sonia Bonanomi
- Fondazione MBBM, Clinica Pediatrica, Università di Milano - Bicocca, A.O. San Gerardo, Monza, Italy
| | | | - Roberta Ghilardi
- Department of Pediatrics, IRCCS "Ca' Granda" Foundation, Maggiore Hospital Policlinico, Milan, Italy
| | - Saverio Ladogana
- Department of Hematology, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | | | - Baldassare Martire
- Dipartimento di Scienze e Chirurgia Pediatriche, U. O. Oncoematologia Pediatrica, Ospedale Policlinico- Giovanni XXIII, Bari, Italy
| | - Lucia Dora Notarangelo
- Pediatric Oncology-Hematology and BMT Unit, Children's Hospital, Spedali Civili, Brescia, Italy
| | | | - Marta Pillon
- Dipartimento di Oncoematologia Pediatrica, Università di Padova, Italy
| | - Giovanna Russo
- Pediatric Hematology and Oncology Unit, Policlinico Hospital, University of Catania, Italy
| | - Laura Lo Valvo
- Pediatric Hematology and Oncology Unit, Policlinico Hospital, University of Catania, Italy
| | | | - Fabio Tucci
- Department of Pediatric Onco-Hematology, Meyer Children's Hospital, Florence, Italy
| | - Fiammetta Zunica
- Pediatric Oncology-Hematology and BMT Unit, Children's Hospital, Spedali Civili, Brescia, Italy
| | | | - Carlo Dufour
- Clinical and Experimental Hematology Unit, G. Gaslini Children's Hospital, Genova, Italy
| |
Collapse
|
8
|
Ciullini Mannurita S, Vignoli M, Colarusso G, Tucci F, Veltroni M, Frenos S, Tintori V, Aricò M, Bigley V, Collin M, Favre C, Gambineri E. Timely follow-up of a GATA2 deficiency patient allows successful treatment. J Allergy Clin Immunol 2016; 138:1480-1483.e4. [PMID: 27481672 DOI: 10.1016/j.jaci.2016.06.004] [Citation(s) in RCA: 6] [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] [Received: 12/11/2015] [Revised: 05/26/2016] [Accepted: 06/03/2016] [Indexed: 11/16/2022]
Affiliation(s)
- Sara Ciullini Mannurita
- Department of "NEUROFARBA," Section of Child's Health, University of Florence, Florence, Italy
| | - Marina Vignoli
- Department of "NEUROFARBA," Section of Child's Health, University of Florence, Florence, Italy
| | - Gloria Colarusso
- Department of "NEUROFARBA," Section of Child's Health, University of Florence, Florence, Italy
| | - Fabio Tucci
- Hematology-Oncology Department, "Anna Meyer Children's Hospital," Florence, Italy
| | - Marinella Veltroni
- Hematology-Oncology Department, "Anna Meyer Children's Hospital," Florence, Italy
| | - Stefano Frenos
- Hematology-Oncology Department, "Anna Meyer Children's Hospital," Florence, Italy
| | - Veronica Tintori
- Hematology-Oncology Department, "Anna Meyer Children's Hospital," Florence, Italy
| | - Maurizio Aricò
- Hematology-Oncology Department, "Anna Meyer Children's Hospital," Florence, Italy
| | - Venetia Bigley
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Matthew Collin
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Claudio Favre
- Hematology-Oncology Department, "Anna Meyer Children's Hospital," Florence, Italy
| | - Eleonora Gambineri
- Department of "NEUROFARBA," Section of Child's Health, University of Florence, Florence, Italy; Hematology-Oncology Department, "Anna Meyer Children's Hospital," Florence, Italy.
| |
Collapse
|
9
|
Miano M, Ramenghi U, Russo G, Rubert L, Barone A, Tucci F, Farruggia P, Petrone A, Mondino A, Lo Valvo L, Crescenzio N, Bellia F, Olivieri I, Palmisani E, Caviglia I, Dufour C, Fioredda F. Mycophenolate mofetil for the treatment of children with immune thrombocytopenia and Evans syndrome. A retrospective data review from the Italian association of paediatric haematology/oncology. Br J Haematol 2016; 175:490-495. [PMID: 27447678 DOI: 10.1111/bjh.14261] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [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: 04/02/2016] [Accepted: 06/07/2016] [Indexed: 12/15/2022]
Abstract
Mycophenolate mofetil (MMF) has been shown to be effective in children with immune thrombocytopenia (ITP) and Evans syndrome (ES), but data from larger series and details on the timing of the response are lacking. We evaluated 56 children treated with MMF for ITP (n = 40) or ES (n = 16), which was primary or secondary to autoimmune lymphoproliferative syndrome -related syndrome (ARS). Thirty-five of the 54 evaluable patients (65%) achieved a partial (18%) or complete (46%) response after a median (range) of 20 (7-137) and 37 (7-192) d, respectively. ITP and ES patients responded in 58% and 81% of cases (P = not significant, ns), with complete response in 32% and 81% (P = 0·01), respectively. 60% and 73% of children with primary disease and ARS responded (P = ns) with complete response in 34% and 68% of cases (P = 0·01), respectively. Six of 35 (17%) children relapsed after a median of 283 d (range 189-1036). Limited toxicity was observed in four patients. The median durations of treatment and follow-up were seven and 12·7 months, respectively. This is the largest reported cohort of patients treated with MMF for ITP/ES. The results show that MMF is effective and safe and provides a relatively quick response, suggesting that it has a potential role as an alternative to more aggressive and expensive second/further-line treatments.
Collapse
Affiliation(s)
- Maurizio Miano
- Haematology Unit, I.R.C.C.S. Istituto Giannina Gaslini, Genoa, Italy.
| | - Ugo Ramenghi
- Haematology Unit, Paediatric Department, University of Turin, Turin, Italy
| | - Giovanna Russo
- Department of Paediatrics, Unit of Paediatric Haematology and Oncology, University of Catania, Catania, Italy
| | - Laura Rubert
- Haematology-Oncology Unit, I.R.C.C.S. Policlinico Fondazione San Matteo Pavia, Pavia, Italy
| | - Angelica Barone
- Paediatric and Onco-Haematology Unit, University Hospital of Parma, Parma, Italy
| | - Fabio Tucci
- Paediatric Haematology-Oncology Unit, Ospedale Pediatrico Meyer, Florence, Italy
| | - Piero Farruggia
- Paediatric Haematology and Oncology Unit, "G. Di Cristina" Children's Hospital, Palermo, Italy
| | | | - Anna Mondino
- Haematology Unit, Paediatric Department, University of Turin, Turin, Italy
| | - Laura Lo Valvo
- Department of Paediatrics, Unit of Paediatric Haematology and Oncology, University of Catania, Catania, Italy
| | | | - Francesco Bellia
- Department of Paediatrics, Unit of Paediatric Haematology and Oncology, University of Catania, Catania, Italy
| | - Irene Olivieri
- Haematology Unit, I.R.C.C.S. Istituto Giannina Gaslini, Genoa, Italy
| | - Elena Palmisani
- Haematology Unit, I.R.C.C.S. Istituto Giannina Gaslini, Genoa, Italy
| | - Ilaria Caviglia
- Infectious Diseases Unit, I.R.C.C.S. Istituto Giannina Gaslini, Genoa, Italy
| | - Carlo Dufour
- Haematology Unit, I.R.C.C.S. Istituto Giannina Gaslini, Genoa, Italy
| | | |
Collapse
|
10
|
Farruggia P, Fioredda F, Puccio G, Porretti L, Lanza T, Ramenghi U, Ferro F, Macaluso A, Barone A, Bonanomi S, Caruso S, Casazza G, Davitto M, Ghilardi R, Ladogana S, Mandaglio R, Marra N, Martire B, Mastrodicasa E, Dora Notarangelo L, Onofrillo D, Robustelli G, Russo G, Trizzino A, Tucci F, Pillon M, Dufour C. Autoimmune neutropenia of infancy: Data from the Italian neutropenia registry. Am J Hematol 2015; 90:E221-2. [PMID: 26361081 DOI: 10.1002/ajh.24187] [Citation(s) in RCA: 24] [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: 09/06/2015] [Accepted: 09/09/2015] [Indexed: 11/11/2022]
Affiliation(s)
- Piero Farruggia
- Pediatric Hematology and Oncology Unit; A.R.N.A.S. Ospedale Civico; Palermo Italy
| | - Francesca Fioredda
- Clinical and Experimental Hematology Unit; G. Gaslini Children's Hospital; Genova Italy
| | - Giuseppe Puccio
- Department of Sciences for Health Promotion; University of Palermo; Palermo Italy
| | - Laura Porretti
- Flow Cytometry Service, Laboratory of Clinical Chemistry and Microbiology; IRCCS “Ca' Granda” Foundation, Maggiore Hospital Policlinico; Milan Italy
| | - Tiziana Lanza
- Clinical and Experimental Hematology Unit; G. Gaslini Children's Hospital; Genova Italy
| | - Ugo Ramenghi
- Ematologia del Dipartimento Di Scienze Pediatriche; Ospedale Infantile Regina Margherita; Torino Italy
| | - Francesca Ferro
- Ematologia del Dipartimento Di Scienze Pediatriche; Ospedale Infantile Regina Margherita; Torino Italy
| | - Alessandra Macaluso
- Pediatric Hematology and Oncology Unit; A.R.N.A.S. Ospedale Civico; Palermo Italy
| | - Angelica Barone
- Department of Pediatric Onco-Hematology; University Hospital; Parma Italy
| | - Sonia Bonanomi
- Fondazione MBBM, Clinica Pediatrica; Università Di Milano - Bicocca; Monza Italy
| | - Silvia Caruso
- Servizio Di Epidemiologia E Biostatistica-Istituto; G. Gaslini Children's Hospital; Genova Italy
| | - Gabriella Casazza
- Paediatric Hematology Oncology, Bone Marrow Transplant; Azienda Ospedaliero Universitaria Pisana, Ospedale S. Chiara; Pisa Italy
| | - Mirella Davitto
- Ematologia del Dipartimento Di Scienze Pediatriche; Ospedale Infantile Regina Margherita; Torino Italy
| | - Roberta Ghilardi
- Department of Pediatrics; IRCCS “Ca' Granda” Foundation, Maggiore Hospital Policlinico; Milan Italy
| | - Saverio Ladogana
- Department of Hematology; IRCCS Casa Sollievo Della Sofferenza; San Giovanni Rotondo Italy
| | | | | | - Baldassare Martire
- Dipartimento Di Scienze E Chirurgia Pediatriche; U. O. Oncoematologia Pediatrica, Ospedale Policlinico- Giovanni XXIII; Bari Italy
| | - Elena Mastrodicasa
- Pediatric Oncology Hematology Unit; S. Maria Della Misericordia Hospital; Perugia Italy
| | - Lucia Dora Notarangelo
- Pediatric Oncology-Hematology and BMT Unit; Children’ Hospital, Spedali Civili; Brescia Italy
| | | | - Giuseppe Robustelli
- Fondazione MBBM, Clinica Pediatrica; Università Di Milano - Bicocca; Monza Italy
| | - Giovanna Russo
- Pediatric Hematology and Oncology Unit; Policlinico Hospital, University of Catania; Catania Italy
| | - Angela Trizzino
- Pediatric Hematology and Oncology Unit; A.R.N.A.S. Ospedale Civico; Palermo Italy
| | - Fabio Tucci
- Department of Pediatric Oncology-Hematology; Meyer Children's Hospital; Florence Italy
| | - Marta Pillon
- Dipartimento Di Oncoematologia Pediatrica; Università Di Padova; Padova Italy
| | - Carlo Dufour
- Clinical and Experimental Hematology Unit; G. Gaslini Children's Hospital; Genova Italy
| |
Collapse
|
11
|
Barone A, Lucarelli A, Onofrillo D, Verzegnassi F, Bonanomi S, Cesaro S, Fioredda F, Iori AP, Ladogana S, Locasciulli A, Longoni D, Lanciotti M, Macaluso A, Mandaglio R, Marra N, Martire B, Maruzzi M, Menna G, Notarangelo LD, Palazzi G, Pillon M, Ramenghi U, Russo G, Svahn J, Timeus F, Tucci F, Cugno C, Zecca M, Farruggia P, Dufour C, Saracco P. Diagnosis and management of acquired aplastic anemia in childhood. Guidelines from the Marrow Failure Study Group of the Pediatric Haemato-Oncology Italian Association (AIEOP). Blood Cells Mol Dis 2015; 55:40-7. [DOI: 10.1016/j.bcmd.2015.03.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Accepted: 03/28/2015] [Indexed: 02/03/2023]
|
12
|
Fioredda F, Calvillo M, Lanciotti M, Cefalo MG, Tucci F, Farruggia P, Casazza G, Martire B, Bonanomi S, Notarangelo L, Barone A, Palazzi G, Davitto M, Barella S, Cardinale F, Mastrodicasa E, Cugno C, Russo G, Caviglia I, Caruso S, Castagnola E, Dufour C. Lethal sepsis and malignant transformation in severe congenital neutropenia: report from the Italian Neutropenia Registry. Pediatr Blood Cancer 2015; 62:1110-2. [PMID: 25619745 DOI: 10.1002/pbc.25401] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 08/05/2014] [Accepted: 11/21/2014] [Indexed: 11/10/2022]
|
13
|
Randi ML, Geranio G, Bertozzi I, Micalizzi C, Ramenghi U, Tucci F, Notarangelo LD, Ladogana S, Menna G, Giordano P, Consarino C, Farruggia P, Zanazzo GA, Fiori GM, Burnelli R, Russo G, Jankovich M, Peroni E, Duner E, Basso G, Fabris F, Putti MC. Are all cases of paediatric essential thrombocythaemia really myeloproliferative neoplasms? Analysis of a large cohort. Br J Haematol 2015; 169:584-9. [PMID: 25716342 DOI: 10.1111/bjh.13329] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [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: 11/21/2014] [Accepted: 01/05/2015] [Indexed: 12/25/2022]
Abstract
Sporadic essential thrombocythaemia (ET) is rare in paediatrics, and the diagnostic and clinical approach to paediatric cases cannot be simply copied from experience with adults. Here, we assessed 89 children with a clinical diagnosis of ET and found that 23 patients (25·8%) had a clonal disease. The JAK2 V617F mutation was identified in 14 children, 1 child had the MPL W515L mutation, and 6 had CALR mutations. The monoclonal X-chromosome inactivation pattern was seen in six patients (two with JAK2 V617F and two with CALR mutations). The other 66 patients (74·2%) had persistent thrombocytosis with no clonality. There were no clinical or haematological differences between the clonal and non-clonal patients. The relative proportion of ET-specific mutations in the clonal children was much the same as in adults. The higher prevalence of non-clonal cases suggests that some patients may not have myeloproliferative neoplasms, with significant implications for their treatment.
Collapse
Affiliation(s)
- Maria L Randi
- Department of Medicine - DIMED, Internal Medicine-CLOPD, University of Padova, Padova, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
De Rocco D, Bottega R, Cappelli E, Cavani S, Criscuolo M, Nicchia E, Corsolini F, Greco C, Borriello A, Svahn J, Pillon M, Mecucci C, Casazza G, Verzegnassi F, Cugno C, Locasciulli A, Farruggia P, Longoni D, Ramenghi U, Barberi W, Tucci F, Perrotta S, Grammatico P, Hanenberg H, Ragione FD, Dufour C, Savoia A. Molecular analysis of Fanconi anemia: the experience of the Bone Marrow Failure Study Group of the Italian Association of Pediatric Onco-Hematology. Haematologica 2014. [DOI: 10.3324/haematol.2014.116004] [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: 11/09/2022] Open
|
15
|
Zeidler C, Grote UAH, Nickel A, Brand B, Carlsson G, Cortesão E, Dufour C, Duhem C, Notheis G, Papadaki HA, Tamary H, Tjønnfjord GE, Tucci F, Van Droogenbroeck J, Vermylen C, Voglova J, Xicoy B, Welte K. Outcome and management of pregnancies in severe chronic neutropenia patients by the European Branch of the Severe Chronic Neutropenia International Registry. Haematologica 2014; 99:1395-402. [PMID: 24997149 DOI: 10.3324/haematol.2013.099101] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Long-term granulocyte-colony stimulating factor treatment has been shown to be safe and effective in severe chronic neutropenia patients. However, data on its use during pregnancy are limited. To address this issue, we analyzed all pregnancies reported to the European branch of the Severe Chronic Neutropenia International Registry since 1994. A total of 38 pregnancies in 21 women with chronic neutropenia (16 pregnancies in 10 women with congenital, 10 in 6 women with cyclic, 12 in 5 women with idiopathic neutropenia) were reported. Granulocyte-colony stimulating factor was administered throughout pregnancy in 16 women and for at least one trimester in a further 5 women. No major differences were seen between treated and untreated women with respect to pregnancy outcome, newborn complications and infections. In addition, we evaluated the genetic transmission of known or suspected genetic defects in 16 mothers having 22 newborns as well as in 8 men fathering 15 children. As a proof of inheritance, neutropenia was passed on to the newborn in 58% from female and in 62% from male patients with ELANE mutations, but also to some newborns from parents with unknown gene mutation. Based on our results, granulocyte-colony stimulating factor therapy has been shown to be safe for mothers throughout pregnancies and for newborns without any signs of teratogenicity. With an increasing number of adult patients, genetic counseling prior to conception and supportive care of mothers during pregnancy are crucial. The acceptance of having affected children may reflect the high quality of life obtained due to this treatment.
Collapse
Affiliation(s)
| | | | - Anna Nickel
- Molecular Hematopoiesis, Hannover Medical School, Germany
| | - Beate Brand
- Molecular Hematopoiesis, Hannover Medical School, Germany
| | - Göran Carlsson
- Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Emília Cortesão
- Department of Hematology, Hospitais da Universidade de Coimbra, Portugal
| | - Carlo Dufour
- Hematology Unit, G. Gaslini Children's Institute, Genova, Italy
| | - Caroline Duhem
- Department of Hematology-Oncology, Centre Hospitalier de Luxembourg, Luxembourg
| | - Gundula Notheis
- Department for Pediatric Hematology/Oncology and Infection/Immunity, Dr. von Haunersches Kinderspital, Ludwig-Maximilians-University, Munich, Germany
| | - Helen A Papadaki
- Department of Hematology, University Hospital of Heraklion, Greece
| | - Hannah Tamary
- Pediatric Hematology Unit, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Geir E Tjønnfjord
- Department of Haematology, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway
| | - Fabio Tucci
- Department of Pediatric Onco-Hematology, AOU Meyer, Florence, Italy
| | | | - Christiane Vermylen
- Department of Pediatric Hematology, Université Catholique de Louvain, Cliniques Universitaires Saint Luc, Brussels, Belgium
| | - Jaroslava Voglova
- 4 Department of Internal Medicine - Haematology, University Hospital, Hradec Králové, Czech Republic
| | - Blanca Xicoy
- Department of Hematology, Germans Trias i Pujol Hospital, Badalona, Spain
| | - Karl Welte
- Molecular Hematopoiesis, Hannover Medical School, Germany
| |
Collapse
|
16
|
De Rocco D, Bottega R, Cappelli E, Cavani S, Criscuolo M, Nicchia E, Corsolini F, Greco C, Borriello A, Svahn J, Pillon M, Mecucci C, Casazza G, Verzegnassi F, Cugno C, Locasciulli A, Farruggia P, Longoni D, Ramenghi U, Barberi W, Tucci F, Perrotta S, Grammatico P, Hanenberg H, Della Ragione F, Dufour C, Savoia A. Molecular analysis of Fanconi anemia: the experience of the Bone Marrow Failure Study Group of the Italian Association of Pediatric Onco-Hematology. Haematologica 2014; 99:1022-31. [PMID: 24584348 DOI: 10.3324/haematol.2014.104224] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Fanconi anemia is an inherited disease characterized by congenital malformations, pancytopenia, cancer predisposition, and sensitivity to cross-linking agents. The molecular diagnosis of Fanconi anemia is relatively complex for several aspects including genetic heterogeneity with mutations in at least 16 different genes. In this paper, we report the mutations identified in 100 unrelated probands enrolled into the National Network of the Italian Association of Pediatric Hematoly and Oncology. In approximately half of these cases, mutational screening was carried out after retroviral complementation analyses or protein analysis. In the other half, the analysis was performed on the most frequently mutated genes or using a next generation sequencing approach. We identified 108 distinct variants of the FANCA, FANCG, FANCC, FANCD2, and FANCB genes in 85, 9, 3, 2, and 1 families, respectively. Despite the relatively high number of private mutations, 45 of which are novel Fanconi anemia alleles, 26% of the FANCA alleles are due to 5 distinct mutations. Most of the mutations are large genomic deletions and nonsense or frameshift mutations, although we identified a series of missense mutations, whose pathogenetic role was not always certain. The molecular diagnosis of Fanconi anemia is still a tiered procedure that requires identifying candidate genes to avoid useless sequencing. Introduction of next generation sequencing strategies will greatly improve the diagnostic process, allowing a rapid analysis of all the genes.
Collapse
Affiliation(s)
| | - Roberta Bottega
- Department of Medical Sciences, University of Trieste, Italy
| | - Enrico Cappelli
- Clinical and Experimental Hematology Unit, G. Gaslini Children's Hospital, Genoa, Italy
| | - Simona Cavani
- Human Genetics laboratory, "E.O. Ospedali Galliera", Genoa, Italy
| | - Maria Criscuolo
- Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, Italy
| | - Elena Nicchia
- Department of Medical Sciences, University of Trieste, Italy
| | - Fabio Corsolini
- Clinical and Experimental Hematology Unit, G. Gaslini Children's Hospital, Genoa, Italy
| | - Chiara Greco
- Pediatric Onco-Hematology, "Azienda Ospedaliero Universitaria Pisana", Pisa, Italy
| | - Adriana Borriello
- Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, Italy
| | - Johanna Svahn
- Clinical and Experimental Hematology Unit, G. Gaslini Children's Hospital, Genoa, Italy
| | - Marta Pillon
- Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy
| | | | | | - Federico Verzegnassi
- Pediatric Onco-Hematology, "Azienda Ospedaliero Universitaria Pisana", Pisa, Italy
| | - Chiara Cugno
- Pediatric Onco-Hematology, "Fondazione IRCCS Policlinico San Matteo", Pavia, Italy
| | - Anna Locasciulli
- Department of Pediatric and Pediatric Hematology, S.Camillo Hospital, Rome, Italy
| | - Piero Farruggia
- Pediatric Onco-Hematology, ARNAS Civico Hospital, Palermo, Italy
| | - Daniela Longoni
- Pediatrics Unit, University of Milano-Bicocca, Fondazione MBBM, Ospedale San Gerardo, Monza, Italy
| | - Ugo Ramenghi
- Department of Pediatric and Public Health Sciences, Sapienza Università di Roma, Firenze, Italy
| | - Walter Barberi
- Dipartimento di Biotecnologia Cellulari ed Ematologia, Sapienza Università di Roma, Firenze, Italy
| | - Fabio Tucci
- Pediatric Onco-Hematology, "Azienda Ospedaliero-Universitaria" Meyer, Firenze, Italy
| | | | - Paola Grammatico
- Department of Molecular Medicine, "La Sapienza" University, Rome, Italy
| | - Helmut Hanenberg
- Department of Otorhinolaryngology & Head/Neck Surgery, Heinrich Heine University School of Medicine, Duesseldorf, Germany Pediatric Hematology/Oncology, Wells Center for Pediatric Research, Department of Pediatrics, The Riley Hospital, Indiana University School of Medicine, Indianapolis, IN, USA Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Fulvio Della Ragione
- Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, Italy
| | - Carlo Dufour
- Clinical and Experimental Hematology Unit, G. Gaslini Children's Hospital, Genoa, Italy
| | - Anna Savoia
- Department of Medical Sciences, University of Trieste, Italy Pediatric Onco-Hematology, "Azienda Ospedaliero Universitaria Pisana", Pisa, Italy
| | | |
Collapse
|
17
|
Caselli D, Tondo A, Tucci F, Casini T, Paolicchi O, Savelli S, Aricò M. Adenovirus pneumonia during induction therapy for childhood acute lymphoblastic leukemia. Pediatr Blood Cancer 2013; 60:1390-1. [PMID: 23630183 DOI: 10.1002/pbc.24550] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 03/04/2013] [Accepted: 03/07/2013] [Indexed: 11/09/2022]
Affiliation(s)
- Désirée Caselli
- Department of Pediatric Hematology-Oncology; Azienda Ospedaliero-Universitaria Meyer Children Hospital; Firenze Italy
| | - Annalisa Tondo
- Department of Pediatric Hematology-Oncology; Azienda Ospedaliero-Universitaria Meyer Children Hospital; Firenze Italy
| | - Fabio Tucci
- Department of Pediatric Hematology-Oncology; Azienda Ospedaliero-Universitaria Meyer Children Hospital; Firenze Italy
| | - Tommaso Casini
- Department of Pediatric Hematology-Oncology; Azienda Ospedaliero-Universitaria Meyer Children Hospital; Firenze Italy
| | - Olivia Paolicchi
- Department of Pediatric Hematology-Oncology; Azienda Ospedaliero-Universitaria Meyer Children Hospital; Firenze Italy
| | - Sara Savelli
- Department of Radiology; Azienda Ospedaliero-Universitaria Meyer Children Hospital; Firenze Italy
| | - Maurizio Aricò
- Department of Pediatric Hematology-Oncology; Azienda Ospedaliero-Universitaria Meyer Children Hospital; Firenze Italy
| |
Collapse
|
18
|
Ben Hariz M, Abkari A, Boudraa G, Boukthir S, Tucci F, Greco L. Diagnostic de la maladie cœliaque dans les pays du bassin méditerranéen : les nouveaux critères de l’ESPGHAN sont-ils immédiatement applicables ? Arch Pediatr 2013. [DOI: 10.1016/j.arcped.2013.02.037] [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: 11/24/2022]
|
19
|
Fioredda F, Calvillo M, Bonanomi S, Coliva T, Tucci F, Farruggia P, Pillon M, Martire B, Ghilardi R, Ramenghi U, Renga D, Menna G, Pusiol A, Barone A, Gambineri E, Palazzi G, Casazza G, Lanciotti M, Dufour C. Congenital and acquired neutropenias consensus guidelines on therapy and follow-up in childhood from the Neutropenia Committee of the Marrow Failure Syndrome Group of the AIEOP (Associazione Italiana Emato-Oncologia Pediatrica). Am J Hematol 2012; 87:238-43. [PMID: 22213173 DOI: 10.1002/ajh.22242] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [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: 10/17/2011] [Accepted: 10/26/2011] [Indexed: 12/12/2022]
Abstract
The management of congenital and acquired neutropenias presents some differences according to the type of the disease. Treatment with recombinant human granulocyte-colony stimulating factor (G-CSF) is not standardized and scanty data are available on the best schedule to apply. The frequency and the type of longitudinal controls in patients affected with neutropenias are not usually discussed in the literature. The Neutropenia Committee of the Marrow Failure Syndrome Group (MFSG) of the Associazione Italiana di Emato-Oncologia Pediatrica (AIEOP) elaborated this document following design and methodology formerly approved by the AIEOP board. The panel of experts reviewed the literature on the topic and participated in a conference producing a document that includes recommendations on neutropenia treatment and timing of follow-up.
Collapse
|
20
|
Fioredda F, Calvillo M, Bonanomi S, Coliva T, Tucci F, Farruggia P, Pillon M, Martire B, Ghilardi R, Ramenghi U, Renga D, Menna G, Barone A, Lanciotti M, Dufour C. Congenital and acquired neutropenia consensus guidelines on diagnosis from the Neutropenia Committee of the Marrow Failure Syndrome Group of the AIEOP (Associazione Italiana Emato-Oncologia Pediatrica). Pediatr Blood Cancer 2011; 57:10-7. [PMID: 21448998 DOI: 10.1002/pbc.23108] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2010] [Accepted: 02/07/2011] [Indexed: 12/30/2022]
Abstract
Congenital and acquired neutropenia are rare disorders whose frequency in pediatric age may be underestimated due to remarkable differences in definition or misdiagnosed because of the lack of common practice guidelines. Neutropenia Committee of the Marrow Failure Syndrome Group (MFSG) of the AIEOP (Associazione Italiana Emato-Oncologia Pediatrica) elaborated this document following design and methodology formerly approved by the AIEOP board. The panel of experts reviewed the literature on the topic and participated in a conference producing a document which includes a classification of neutropenia and a comprehensive guideline on diagnosis of neutropenia.
Collapse
|
21
|
Ziino O, Tucci F, Rossi MR. Outpatient management of febrile neutropenia in children with cancer. Pediatr Rep 2011; 3:e8. [PMID: 21647281 PMCID: PMC3103131 DOI: 10.4081/pr.2011.e8] [Citation(s) in RCA: 4] [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: 12/06/2010] [Revised: 03/18/2011] [Accepted: 03/18/2011] [Indexed: 11/29/2022] Open
Abstract
Optimizing the therapeutic strategies based on the results of randomized studies comparing different regimens led to a better prognosis of nearly all pediatric malignancies during the past four decades. Fever and neutropenia (FN) is a common complication in patients undergoing chemotherapy to treat cancer. There is no consensus on when standard therapy can be safely reduced; this lack of consensus leads to important variations in management of FN between different institutions, usually conducted according to local attitudes. To address this issue, the Infection working group of the Italian association for pediatric hematology oncology (AIEOP) organized a consensus meeting. This paper reports the agreement derived from this meeting.
Collapse
Affiliation(s)
- Ottavio Ziino
- Pediatric Oncohematology Operative Unit, ARNAS Ospedale Civico Di Cristina Benfratelli, Palermo
| | | | | |
Collapse
|
22
|
Russo G, Miraglia V, Branciforte F, Matarese SMR, Zecca M, Bisogno G, Parodi E, Amendola G, Giordano P, Jankovic M, Corti A, Nardi M, Farruggia P, Battisti L, Baronci C, Palazzi G, Tucci F, Ceppi S, Nobili B, Ramenghi U, De Mattia D, Notarangelo L. Effect of eradication of Helicobacter pylori in children with chronic immune thrombocytopenia: a prospective, controlled, multicenter study. Pediatr Blood Cancer 2011; 56:273-8. [PMID: 20830773 DOI: 10.1002/pbc.22770] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The eradication of Helicobacter pylori has been associated with remission of immune thrombocytopenia (ITP) in approximately half of eradicated patients. Data on children are limited to small case series. PROCEDURE Children from 16 centers in Italy, who were less than 18 years of age and diagnosed with chronic ITP (cITP), were screened for H. pylori infection. Positive patients underwent standard triple therapy with amoxicillin, clarithromycin, and omeprazole. The eradication response was defined as follows: complete response, platelet (PLT) count ≥ 150 × 10(9) /L; partial response, PLT count of at least 50 × 10(9) /L; no response, PLT count <50 × 10(9) /L. RESULTS Of 244 screened patients, 50 (20%) had H. pylori infection, 37 of which received eradication therapy and completed follow-up. Eradication was successful in 33/37 patients (89%). PLT recovery was demonstrated in 13/33 patients after eradication (39%), whereas spontaneous remission was observed in 17/166 (10%) H. pylori-negative patients (P < 0.005). Responders more often required second line eradication (9/13), whereas a second cycle was required in 3/20 non-responders (P < 0.005). CONCLUSIONS Among the large cohort of patients, those who underwent successful H. pylori eradication showed a significantly higher PLT response. Therefore, it may be appropriate to look for H. pylori and eventually eradicate it in children with cITP.
Collapse
Affiliation(s)
- Giovanna Russo
- Centro di Riferimento di Ematologia ed Oncologia Pediatrica, Università di Catania, Catania, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Colarusso G, Gambineri E, Lapi E, Casini T, Tucci F, Lippi F, Azzari C. Evans syndrome and antibody deficiency: an atypical presentation of chromosome 22q11.2 deletion syndrome. Pediatr Rep 2010; 2:e13. [PMID: 21589826 PMCID: PMC3094001 DOI: 10.4081/pr.2010.e13] [Citation(s) in RCA: 4] [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: 03/12/2010] [Revised: 05/20/2010] [Accepted: 05/25/2010] [Indexed: 12/21/2022] Open
Abstract
We report a case of an 8-year-old male patient with Evans syndrome and severe hypogammaglobulinemia, subsequently in whom the 22q11.2 deletion syndrome (22q11.2 DS) was diagnosed. No other clinical sign of 22q11.2 DS was present with the exception of slight facial dysmorphism. The case is of particular interest because it suggests the need to research chromosome 22q11.2 deletion in patients who present with autoimmune cytopenia and peculiar facial abnormalities, which could be an atypical presentation of an incomplete form of 22q11.2 DS.
Collapse
|
24
|
Moree WJ, Li BF, Jovic F, Coon T, Yu J, Gross RS, Tucci F, Marinkovic D, Zamani-Kord S, Malany S, Bradbury MJ, Hernandez LM, O’Brien Z, Wen J, Wang H, Hoare SRJ, Petroski RE, Sacaan A, Madan A, Crowe PD, Beaton G. Characterization of Novel Selective H1-Antihistamines for Clinical Evaluation in the Treatment of Insomnia. J Med Chem 2009; 52:5307-10. [DOI: 10.1021/jm900933k] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Wilna J. Moree
- Neurocrine Biosciences, 12780 El Camino Real, San Diego, California 92130
| | - Bin-Feng Li
- Neurocrine Biosciences, 12780 El Camino Real, San Diego, California 92130
| | - Florence Jovic
- Neurocrine Biosciences, 12780 El Camino Real, San Diego, California 92130
| | - Timothy Coon
- Neurocrine Biosciences, 12780 El Camino Real, San Diego, California 92130
| | - Jinghua Yu
- Neurocrine Biosciences, 12780 El Camino Real, San Diego, California 92130
| | - Raymond S. Gross
- Neurocrine Biosciences, 12780 El Camino Real, San Diego, California 92130
| | - Fabio Tucci
- Neurocrine Biosciences, 12780 El Camino Real, San Diego, California 92130
| | - Dragan Marinkovic
- Neurocrine Biosciences, 12780 El Camino Real, San Diego, California 92130
| | - Said Zamani-Kord
- Neurocrine Biosciences, 12780 El Camino Real, San Diego, California 92130
| | - Siobhan Malany
- Neurocrine Biosciences, 12780 El Camino Real, San Diego, California 92130
| | | | - Lisa M. Hernandez
- Neurocrine Biosciences, 12780 El Camino Real, San Diego, California 92130
| | - Zhihong O’Brien
- Neurocrine Biosciences, 12780 El Camino Real, San Diego, California 92130
| | - Jianyun Wen
- Neurocrine Biosciences, 12780 El Camino Real, San Diego, California 92130
| | - Hua Wang
- Neurocrine Biosciences, 12780 El Camino Real, San Diego, California 92130
| | - Samuel R. J. Hoare
- Neurocrine Biosciences, 12780 El Camino Real, San Diego, California 92130
| | - Robert E. Petroski
- Neurocrine Biosciences, 12780 El Camino Real, San Diego, California 92130
| | - Aida Sacaan
- Neurocrine Biosciences, 12780 El Camino Real, San Diego, California 92130
| | - Ajay Madan
- Neurocrine Biosciences, 12780 El Camino Real, San Diego, California 92130
| | - Paul D. Crowe
- Neurocrine Biosciences, 12780 El Camino Real, San Diego, California 92130
| | - Graham Beaton
- Neurocrine Biosciences, 12780 El Camino Real, San Diego, California 92130
| |
Collapse
|
25
|
Farruggia P, D'Angelo P, Acquaviva A, Trizzino A, Tucci F, Cilloni D, Messa F, D'Ambrosio A, Aricò M. Hypereosinophilic syndrome in childhood: clinical and molecular features of two cases. Pediatr Hematol Oncol 2009; 26:129-35. [PMID: 19382034 DOI: 10.1080/08880010902773024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Hypereosinophilic syndrome (HES) represents a heterogeneous group of diseases, some of which are being clarified by recent advances in molecular genetics. It is very rare in children. Uncertainties in classification and lack of prospective studies make therapeutic decisions difficult. The authors report two cases of HES in which steroid therapy was effective.
Collapse
Affiliation(s)
- Piero Farruggia
- Pediatric Hematology & Oncology, G. Di Cristina Children's Hospital, Palermo, Italy.
| | | | | | | | | | | | | | | | | |
Collapse
|
26
|
|
27
|
Chen C, Tran J, Arellano M, Fleck B, Pontillo J, Marinkovic D, Tucci F, Wen J, Saunders J. Studies on the Structure-Activity Relationship of the Basic Amine of Phenylpiperazines as Melanocortin-4 Receptor Antagonists. Med Chem 2008; 4:67-74. [DOI: 10.2174/157340608783331498] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
28
|
Chen C, Jiang W, Tucci F, Tran JA, Fleck BA, Hoare SR, Joppa M, Markison S, Wen J, Sai Y, Johns M, Madan A, Chen T, Chen CW, Marinkovic D, Arellano M, Saunders J, Foster AC. Discovery of 1-[2-[(1S)-(3-dimethylaminopropionyl)amino-2-methylpropyl]-4-methylphenyl]-4-[(2R)-methyl-3-(4-chlorophenyl)-propionyl]piperazine as an orally active antagonist of the melanocortin-4 receptor for the potential treatment of cachexia. J Med Chem 2007; 50:5249-52. [PMID: 17918824 DOI: 10.1021/jm070806a] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A potent and selective antagonist of the melanocortin-4 receptor, 1-[2-[(1S)-(3-dimethylaminopropionyl)amino-2-methylpropyl]-6-methylphenyl]-4-[(2R)-methyl-3-(4-chlorophenyl)propionyl]piperazine (10d), was identified from a series piperazinebenzylamine attached with a N,N-dimethyl-beta-alanine side chain. This compound possessed high water solubility and exhibited good metabolic profiles. In animals, 10d showed moderate to good oral bioavailability and promoted food intake in tumor-bearing mice after oral administration.
Collapse
Affiliation(s)
- Chen Chen
- Department of Medicinal Chemistry, Neurocrine Biosciences, Inc., 12790 El Camino Real, San Diego, California 92130, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Cesaro S, Giacchino M, Locatelli F, Spiller M, Buldini B, Castellini C, Caselli D, Giraldi E, Tucci F, Tridello G, Rossi MR, Castagnola E. Safety and efficacy of a caspofungin-based combination therapy for treatment of proven or probable aspergillosis in pediatric hematological patients. BMC Infect Dis 2007; 7:28. [PMID: 17442100 PMCID: PMC1871594 DOI: 10.1186/1471-2334-7-28] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2006] [Accepted: 04/18/2007] [Indexed: 05/13/2023] Open
Abstract
Background Fungal infections are diagnosed increasingly often in patients affected by hematological diseases and their mortality has remained high. The recent development of new antifungal drugs gives the clinician the possibility to assess the combination of antifungal drugs with in-vitro or in animal-model synergistic effect. Methods We analyzed retrospectively the safety and efficacy of caspofungin-based combination therapy in 40 children and adolescents, most of them were being treated for a malignant disease, who developed invasive aspergillosis (IA) between November 2002 and November 2005. Results Thirteen (32.5%) patients developed IA after hematopoietic stem cell transplantation (HSCT), 13 after primary diagnosis, usually during remission-induction chemotherapy, and 14 after relapse of disease. Severe neutropenia was present in 31 (78%) out of the 40 patients. IA was classified as probable in 20 (50%) and documented in 20 (50%) patients, respectively. A favorable response to antifungal therapy was obtained in 21 patients (53%) and the probability of 100-day survival was 70%. Different, though not significant, 100-day survival was observed according to the timing of diagnosis of IA: 51.9% after HSCT; 71.4% after relapse; and 84.6% after diagnosis of underlying disease, p 0.2. After a median follow-up of 0.7 years, 20 patients are alive (50%). Overall, the combination therapy was well tolerated. In multivariate analysis, the factors that were significantly associated to a better overall survival were favorable response to antifungal therapy, p 0.003, and the timing of IA in the patient course of underlying disease, p 0.04. Conclusion This study showed that caspofungin-based combination antifungal therapy is an effective therapeutic option also for pediatric patients with IA. These data need to be confirmed by prospective, controlled studies.
Collapse
Affiliation(s)
- Simone Cesaro
- Pediatric Hematology Oncology, Department of Pediatrics, University of Padua, Italy
| | - Mareva Giacchino
- Pediatric Oncology Hematology, Regina Elena Hospital, University of Turin, Italy
| | - Franco Locatelli
- Pediatric Hematology Oncology, IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - Monica Spiller
- Pediatric Hematology Oncology, Department of Pediatrics, University of Padua, Italy
| | - Barbara Buldini
- Pediatric Hematology Oncology, IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - Claudia Castellini
- Pediatric Hematology Oncology, Sant'Orsola Hospital, University of Bologna, Italy
| | - Desireè Caselli
- Pediatric Hematology Oncology, G. Di Cristina ARNAS Hospital, Palermo, Italy
| | | | - Fabio Tucci
- Pediatric Hematology Oncology, Meyer Hospital, University of Florence, Italy
| | - Gloria Tridello
- Pediatric Hematology Oncology, Department of Pediatrics, University of Padua, Italy
| | | | - Elio Castagnola
- Division of Pediatric Infectious Disease, "Giannina Gaslini" Institute, Genua, Italy
| |
Collapse
|
30
|
Randi ML, Putti MC, Scapin M, Pacquola E, Tucci F, Micalizzi C, Zanesco L, Fabris F. Pediatric patients with essential thrombocythemia are mostly polyclonal and V617FJAK2 negative. Blood 2006; 108:3600-2. [PMID: 16849644 DOI: 10.1182/blood-2006-04-014746] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [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: 01/30/2023] Open
Abstract
Abstract
Essential thrombocythemia (ET) is rare in children, and little or no information is available about clonality or JAK2 mutations. However, the analyses in this work prove useful for the diagnosis of adult myeloproliferative disorders (MPDs). We evaluated the clonality status and V617FJAK2 mutation in 20 children affected by ET and compared them with 47 consecutive adult ET cases. Clonality was evaluated on the DNA of granulocytes and on the RNA of platelets. V617FJAK2 was analyzed by sequencing tests, allele-specific polymerase chain reaction (PCR), and digestion by BsaXI. A monoclonal pattern was found in 4 (28.5%) of 14 children and in 45% of informative adults. Heterozygous V617FJAK2 was found less frequently in children than in adults (P < .009). Only 2 girls showed both the V617FJAK2 mutation and a monoclonal pattern; one of them was the only child presenting a major thrombotic complication. In contrast to adults, most children with ET do not show either a clonal disorder or the V617FJAK2 mutation.
Collapse
Affiliation(s)
- Maria Luigia Randi
- Department of Medical and Surgical Sciences, University of Padua, via Giustiniani 2, 35128 Padua, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
31
|
Castagnola E, Cesaro S, Giacchino M, Livadiotti S, Tucci F, Zanazzo G, Caselli D, Caviglia I, Parodi S, Rondelli R, Cornelli PE, Mura R, Santoro N, Russo G, De Santis R, Buffardi S, Viscoli C, Haupt R, Rossi MR. Fungal infections in children with cancer: a prospective, multicenter surveillance study. Pediatr Infect Dis J 2006; 25:634-9. [PMID: 16804435 DOI: 10.1097/01.inf.0000220256.69385.2e] [Citation(s) in RCA: 118] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Data on epidemiology and survival after fungal infections in patients with cancer are primarily based on studies in adults, whereas few data are available on children. METHODS A prospective, multicenter, 2-year surveillance of fungal infections in children receiving antineoplastic treatment was performed in 15 Italian centers. For each case, defined by means of EORTC-IFIG/NIAID-MSG, information was collected on age, phase of treatment, presence of neutropenia or lymphocytopenia, administration of antifungal drugs and survival. RESULTS Ninety-six episodes (42 proven [19 fungemias, 23 deep tissue infections], 17 probable and 37 possible invasive mycoses) were reported. Most of them (73%) followed aggressive chemotherapy, 21% allogeneic hematopoietic stem cell transplantation and only 6% moderately aggressive treatment. Neutropenia was present in 77% of the episodes, and it had a longer duration before deep tissue mycosis as compared with fungemia (P = 0.020). Lymphocytopenia was present in 75% of the episodes observed in nonneutropenic patients. As compared with children with fungemia, patients with probable invasive mycoses had a 25.7-fold increased risk of death, whereas it was 7.7-fold greater in children with possible invasive mycoses and 5-fold higher in those with proven deep tissue infection (P = 0.004). The risk of death was also 3.8-fold higher in patients already receiving antifungals at the time of diagnosis of infection as compared with those not receiving antimycotic drugs. CONCLUSIONS In children with cancer, aggressive antineoplastic treatment, severe and longlasting neutropenia and lymphocytopenia are associated with fungal infections. These features as the clinical pictures are similar to those reported in adults, but in children, the overall and the infection-specific (fungemia or mycosis with deep tissue infection) mortalities are lower.
Collapse
|
32
|
Tucci F, Tran J, Jiang W, Pontillo J, Marinkovic D, White N, Arellano M, Fleck B, Wen J, Saunders J, Foster A, Chen C. Synthesis of Piperazinephen-1-ylethylamines as Potent and Selective Antagonists of the Human Melanocortin-4 Receptor. LETT DRUG DES DISCOV 2006. [DOI: 10.2174/157018006777574249] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
33
|
Abstract
We examined the possibility of using microsatellite and mitochondrial DNA polymorphisms as markers to detect the clonal origin of tumor cells found in the same patient. We considered two children with complex tumor diseases: one with supratentorial primitive neuroectodermal tumors (PNET) and a hepatic rhabdoid tumor and another with brain and abdominal rhabdoid tumors. In the first patient we found an mtDNA cytosine insertion both in the normal tissue and in the primary tumor, whereas in the hepatic tumor we detected an insertion of 2 cytosine. In the second child, who had a constitutional mutation of hSNF5/INI-1, we identified the same mtDNA pattern both in normal tissue and in the abdominal tumor but not in the brain tumor, which presented three different mtDNA polymorphisms. Thus, we demonstrated the same clonal origin for tumors in the first patient and different clonal origins of the tumors in the second patient. At times it is very difficult to discriminate two neoplastic lesions or metastatic diseases by using only histopathologic techniques. Molecular examination of clonality is a useful tool to obtain information about the origin of synchronous and/or metachronous tumors found in the same patient.
Collapse
Affiliation(s)
- Laura Giunti
- Department of Pediatrics, Medical Genetics Units, Florence University Medical School at the A. Meyer Children's Hospital, via Luca Giordano 13, 50132 Florence, Italy
| | | | | | | | | | | |
Collapse
|
34
|
Cesaro S, Spiller M, Giacchino M, Buldini B, Castellini C, Caselli D, Giraldi E, Tucci F, Tridello G, Locatelli F, Rossi M, Castagnola E. 107 Safety and efficacy of a caspofungin-based combination therapy for the treatment of invasive mycoses in pediatric hematological patients. Int J Infect Dis 2006. [DOI: 10.1016/s1201-9712(06)80104-9] [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: 11/16/2022] Open
|
35
|
Iannalfi A, Bernini G, Caprilli S, Lippi A, Tucci F, Messeri A. Painful procedures in children with cancer: comparison of moderate sedation and general anesthesia for lumbar puncture and bone marrow aspiration. Pediatr Blood Cancer 2005; 45:933-8. [PMID: 16106428 DOI: 10.1002/pbc.20567] [Citation(s) in RCA: 28] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND The study was conducted to compare moderate sedation (MS) with general anesthesia (GA) in the management of frequently performed lumbar puncture or bone marrow aspiration (BMA) during the treatment of childhood cancer. PROCEDURE The MS (14 patients for 30 procedures) was managed by non-anesthesiologists (combined nitrous oxide-midazolam +/- non-pharmacological techniques). The GA was managed by anesthesiologists (17 patients for 30 procedures). A neutral observer recorded side effects, use of sedative antagonists, recovery time, oncologist's evaluation, procedure behaviors check list (PBCL); subjective perceptions during the procedure with a questionnaire administered to children (>6 years) and their parents; drugs costs and professional resources. P-values <0.05 were considered significant. RESULTS We had two inadequate sedations in MS (6.6%) versus 0 in GA. We had no significant differences in side effects (7.10% MS vs. 8.6% in GA), use of antagonists (2.90% GA vs. 0 MS), PBCL, oncologist evaluation and questionnaire data or drugs costs. We observed significant differences in recovery times (MS, mean 43 +/- SD min vs. GA, mean 117 +/- SD min) and professional resources costs. The effects of non-pharmacological techniques on anxiety were perceived very positively by both children and parents (on 0-4 scale, mean scores 3.57 for the children; 3.53 for the parents). CONCLUSIONS Our study suggests that MS compared favorably to GA with respect to both safety and efficacy. When performed by non-anesthesiologists, MS may be associated with better compliance and cost-effectiveness as it relies on the contribution of non-pharmacological techniques.
Collapse
Affiliation(s)
- Alberto Iannalfi
- Department of Pediatrics, Pediatric Onco-Hematology, University of Florence, Italy.
| | | | | | | | | | | |
Collapse
|
36
|
Sardi I, Giunti L, Donati P, Lacitignola L, Tucci F, Sardo L, Giovannucci Uzielli ML, Bernini G. Loss of heterozygosity and p53 polymorphism Pro72Arg in a young patient with medulloblastoma. Oncol Rep 2003; 10:773-5. [PMID: 12684657] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
Differently from conventional primary neuroectodermal tumors (PNETs), molecular features of undifferentiated lesions have been poorly studied. Medulloblastoma and PNET neoplasms showed a high incidence of loss of heterozygosity (LOH) on chromosome 17p13, in the region of tumor suppressor gene p53. Recent studies have shown a significant correlation between the presence of p53 Arg72Pro polymorphism and several undifferentiated carcinomas. We performed molecular analysis in an anaplastic tumor of posterior fossa in a patient with a constitutional maternal translocation [46,XX,t(5;19)] and a history of headache, nausea and vomiting. We identified the presence of LOH at 17p13 and Pro72Arg polymorphism in tumor DNA. These molecular findings helped us better characterize this undifferentiated tumor and led to a more aggressive therapy.
Collapse
Affiliation(s)
- Iacopo Sardi
- Unita di Oncoematologia, Ospedale Pediatrico A. Meyer, I-50132 Florence, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Bambi F, Fontanazza S, Messeri A, Lippi A, Tucci F, Tamburini A, Tintori V, Casini T, Lacitignola L, Tondo A, Veltroni M, Bernini G, Faulkner LB. Use of percutaneous radial artery catheter for peripheral blood progenitor cell collection in pediatric patients. Transfusion 2003; 43:254-8. [PMID: 12559022 DOI: 10.1046/j.1537-2995.2003.00292.x] [Citation(s) in RCA: 15] [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: 11/20/2022]
Abstract
BACKGROUND Leukapheresis procedures require adequate flow rates, which in children may frequently involve invasive vascular access placement. STUDY DESIGN AND METHODS A minimally invasive peripheral radial artery catheter was used for drawing blood in 85 leukapheresis procedures performed in 33 pediatric patients. Blood return to the patients was provided by either a central Broviac-type catheter or a peripheral venous access. The patients' age range was 1 to 18 years (median, 9.5) and the weight range was 9 to 73 kg (median, 29 kg). Vasocan Braunüle Luer Lock IV cannulas (22 gauge in 78 and 20 gauge in 7) were placed percutaneously under local anesthesia, and in 8 patients, catheter placement was carried out during general anesthesia for other procedures. A continuous flow cell separator was used in all cases (Fresenius AS104 in 23 and AS204 in 62). RESULTS Flow rates ranged from 18 to 45 mL per minute, the mean number of total blood volumes processed was 2.07 (range, 0.51-2.51), and the mean duration of the procedures was 150 minutes (range, 90-260). The 22-gauge cannulas provided adequate flow rates independently of patient age and weight. No significant thrombotic, embolic, hemorrhagic, ischemic, or infectious complications were observed. CONCLUSION Peripheral radial artery catheters are safe, are minimally invasive, and provide steady, high-flow rates, and they should be considered for patients requiring leukapheresis and lacking a suitable vascular access for drawing blood.
Collapse
Affiliation(s)
- Franco Bambi
- Blood Bank and Hematology-Oncology Service, Department of Pediatrics, University of Florence, Children's Hospital A. Meyer, Florence, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Sardi I, Tintori V, Marchi C, Veltroni M, Lippi A, Tucci F, Tamburini A, Bernini G, Faulkner L. Molecular profiling of high-risk neuroblastoma by cDNA array. Int J Mol Med 2002; 9:541-5. [PMID: 11956663] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
The aim of this study was to investigate gene expression changes in disseminated neuroblastoma by cDNA array technique. Three stage IV neuroblastomas and one neuroblastoma cell line (SK-N-FI) were analyzed. Expression profiles were confirmed by semiquantitative RT-PCR and in some instances by Northern blotting. Comparison of expression profiles identified several genes which were highly expressed as well as some which were down-regulated in tumor samples relatively to SK-N-FI cells. The tumors studied lacked N-myc overexpression, while showing up-regulation of basic transcription factors, growth factors and receptors such as NSEP, c-myc binding protein MM1, thymosin beta10 (TMSB10), TNF-R superfamily member 10A (TNFRSF10A) and FZ9. These results suggest that cDNA array technology is a powerful tool to identify a set of genes involved in neuroblastoma genesis and progression. Thus, the sensitive cDNA array may provide new insight into many aspects of pediatric tumors and play crucial role in the administration of adjuvant therapy of patients with neuroblastoma.
Collapse
Affiliation(s)
- Iacopo Sardi
- Unita di Oncoematologia, Ospedale Pediatrico A. Meyer, via L. Giordano 13, 50132 Florence, Italy.
| | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Sardi I, Tintori V, Marchi C, Veltroni M, Lippi A, Tucci F, Tamburini A, Bernini G, Faulkner L. Molecular profiling of high-risk neuroblastoma by cDNA array. Int J Mol Med 2002. [DOI: 10.3892/ijmm.9.5.541] [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: 11/05/2022] Open
|
40
|
Evans WE, Hon YY, Bomgaars L, Coutre S, Holdsworth M, Janco R, Kalwinsky D, Keller F, Khatib Z, Margolin J, Murray J, Quinn J, Ravindranath Y, Ritchey K, Roberts W, Rogers ZR, Schiff D, Steuber C, Tucci F, Kornegay N, Krynetski EY, Relling MV. Preponderance of thiopurine S-methyltransferase deficiency and heterozygosity among patients intolerant to mercaptopurine or azathioprine. J Clin Oncol 2001; 19:2293-301. [PMID: 11304783 DOI: 10.1200/jco.2001.19.8.2293] [Citation(s) in RCA: 285] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To assess thiopurine S-methyltransferase (TPMT) phenotype and genotype in patients who were intolerant to treatment with mercaptopurine (MP) or azathioprine (AZA), and to evaluate their clinical management. PATIENTS AND METHODS TPMT phenotype and thiopurine metabolism were assessed in all patients referred between 1994 and 1999 for evaluation of excessive toxicity while receiving MP or AZA. TPMT activity was measured by radiochemical analysis, TPMT genotype was determined by mutation-specific polymerase chain reaction restriction fragment length polymorphism analyses for the TPMT*2, *3A, *3B, and *3C alleles, and thiopurine metabolites were measured by high-performance liquid chromatography. RESULTS Of 23 patients evaluated, six had TPMT deficiency (activity < 5 U/mL of packed RBCs [pRBCs]; homozygous mutant), nine had intermediate TPMT activity (5 to 13 U/mL of pRBCs; heterozygotes), and eight had high TPMT activity (> 13.5 U/mL of pRBCs; homozygous wildtype). The 65.2% frequency of TPMT-deficient and heterozygous individuals among these toxic patients is significantly greater than the expected 10% frequency in the general population (P <.001, chi(2)). TPMT phenotype and genotype were concordant in all TPMT-deficient and all homozygous-wildtype patients, whereas five patients with heterozygous phenotypes did not have a TPMT mutation detected. Before thiopurine dosage adjustments, TPMT-deficient patients experienced more frequent hospitalization, more platelet transfusions, and more missed doses of chemotherapy. Hematologic toxicity occurred in more than 90% of patients, whereas hepatotoxicity occurred in six patients (26%). Both patients who presented with only hepatic toxicity had a homozygous-wildtype TPMT phenotype. After adjustment of thiopurine dosages, the TPMT-deficient and heterozygous patients tolerated therapy without acute toxicity. CONCLUSION There is a significant (> six-fold) overrepresentation of TPMT deficiency or heterozygosity among patients developing dose-limiting hematopoietic toxicity from therapy containing thiopurines. However, with appropriate dosage adjustments, TPMT-deficient and heterozygous patients can be treated with thiopurines, without acute dose-limiting toxicity.
Collapse
Affiliation(s)
- W E Evans
- St Jude Children's Research Hospital and University of Tennessee, Memphis 38101-0318, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Viscoli C, Castagnola E, Giacchino M, Cesáro S, Properzi E, Tucci F, Mura RM, Alvisi P, Zanazzo G, Surico G, Bonetti F, De Sio L, Izzi G, Di Cataldo A, Ziino O, Massolo F, Nardi M, Santoro N, Binda S. Bloodstream infections in children with cancer: a multicentre surveillance study of the Italian Association of Paediatric Haematology and Oncology. Supportive Therapy Group-Infectious Diseases Section. Eur J Cancer 1999; 35:770-4. [PMID: 10505037 DOI: 10.1016/s0959-8049(99)00052-0] [Citation(s) in RCA: 73] [Impact Index Per Article: 2.9] [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: 11/24/2022]
Abstract
A one-year prospective, multicentre surveillance study on aetiology, main clinical features and outcome of bloodstream infections in children with cancer was conducted in 18 paediatric haematology centres belonging to the Italian Association for Paediatric Haematology and Oncology. A total of 191 bloodstream infections were reported during the study period. Of them, 123 (64%) occurred in neutropenic and 68 (36%) in non-neutropenic patients. Gram-positive cocci caused 45% (85/191) of the episodes, gram-negative rods 41% (78/191), and fungi 9% (18/191). The remaining 5% (10/191) of the episodes were poly-microbial infections. A total of 204 pathogens were isolated (46% gram-positive cocci; 44% gram-negative rods; and 10% fungi). The aetiologic distribution was similar among neutropenic and non-neutropenic patients. A correlation between the infection and the presence of an indwelling central venous catheter was found in 20% (23/114) of the episodes among neutropenic patients and in 55% (23/62) among non-neutropenic patients. Gram-negative micro-organisms were isolated in an unusually high proportion of catheter-related infections (48%). The overall mortality rate from any cause within 30 days from the first positive blood culture was 11%, and was higher among patients who were neutropenic at the onset of the infection than among those who were not neutropenic (15 versus 4%, P = 0.03). In addition, the mortality was significantly higher in recipients of bone marrow transplantation than in patients with acute leukaemia or solid tumour (21, 11 and 6%, respectively) and was also higher in fungaemias and poly-microbial infections (22 and 30%) than in single gram-positive and gram-negative bacteraemias (11 and 6%).
Collapse
|
42
|
Faulkner LB, Tintori V, Tamburini A, Paoli A, Garaventa A, Viscardi E, Tucci F, Lippi AA, De Bernardi B, Bernini G. High-sensitivity immunocytologic analysis of neuroblastoma cells in paired blood and marrow samples. J Hematother 1998; 7:361-6. [PMID: 9735867 DOI: 10.1089/scd.1.1998.7.361] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
High-sensitivity immunocytochemistry was used to evaluate the relative frequency of neuroblastoma cells in bone marrow and peripheral blood in patients with neuroblastoma (NB). A total of 51 concomitant paired blood and marrow samples (102 total) from 35 patients with NB (age 4 months-31 years; stage 29 stage IV, 4 stage III, 2 stage IVS; 14 at diagnosis, 18 in relapse, 12 during treatment, and 7 off-therapy) were analyzed. Cytospins containing up to 10(6) cells each were prepared using the mononuclear cell (MNC) fraction. For immunocytologic staining, a primary mouse monoclonal anti-GD2 antibody (3F8), a secondary antimouse biotinylated antibody, and a streptavidin-alkaline phosphatase complex were used. A minimum of two cytospins containing a mean of 1.4 x 10(6) total MNCs was analyzed in addition to a negative and a positive control. No circulating tumor cells were detected when the concomitant marrow samples were negative or had <10 positive cells per 106 MNC (23 of 51 samples). Of the 18 marrow samples positive at 10-10,000 cells per 106 MNC, 6 had detectable NB cells in the corresponding blood sample, whereas for marrow samples with >10,000 NB cells per 10(6) MNC (1%), the concomitant blood sample was positive for 9 of the 10. When both marrow and blood samples were positive (15 BM-PB pairs), NB cell frequency was significantly lower in blood, with a mean difference of 2.14 logs (median 2.22, range -0.16-4.8, standard error 0.38). In patients with NB, circulating tumor cell frequencies seem to be substantially lower than in concomitant marrow samples, with a mean difference of >2 logs.
Collapse
Affiliation(s)
- L B Faulkner
- Department of Pediatrics, University of Florence, Ospedale Pediatrico A. Meyer, Italy
| | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Faulkner LB, Tucci F, Tamburini A, Tintori V, Lippi AA, Bambi F, Malentacca F, Azzari C, Gelli AM, Genovese F, Bernini G. G-CSF serum pharmacokinetics during peripheral blood progenitor cell mobilization: neutrophil count-adjusted dosage might potentially improve mobilization and be more cost-effective. Bone Marrow Transplant 1998; 21:1091-5. [PMID: 9645570 DOI: 10.1038/sj.bmt.1701241] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The optimal dosing schedule of G-CSF for peripheral blood progenitor cell (PBPC) mobilization is still under investigation although many centers use 10 microg/kg/day in a single subcutaneous dose. However, G-CSF clearance increases with increasing absolute neutrophil count (ANC). Hence a G-CSF dosage adjusted to ANC might be a reasonable approach. We measured G-CSF trough serum levels by sandwich ELISA assay at different ANCs in eight patients undergoing treatment with filgrastim at 10 microg/kg/day in a single subcutaneous dose. A total of 26 samples were analyzed, and a strong correlation between increasing ANC and decreasing G-CSF levels was found by linear regression analysis (P < 0.0003, r2 = 0.4199). For ANC values above 5000/microl the trough serum levels, ie 24 h after administration, were consistently below the level that provides maximal clonogenic precursor stimulation in vitro (10 ng/ml). Serial serum G-CSF measurements performed in three patients at 0, 3, 6, 9 and 24 h after G-CSF administration, showed a reduction of the area under the curve (AUC) with increasing ANC. For an ANC of 20000/microl or greater, the G-CSF serum level fell under the maximal in vitro stimulation threshold of 10 ng/ml within 12 h. This preliminary pharmacokinetic data seems to suggest that an ANC-adjusted G-CSF dosing schedule might improve the design of PBPC mobilization regimens.
Collapse
Affiliation(s)
- L B Faulkner
- Department of Pediatrics, University of Florence, Ospedale Pediatrico A Meyer, Italy
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Bambi F, Faulkner LB, Azzari C, Gelli AM, Tamburini A, Tintori V, Lippi AA, Tucci F, Bernini G, Genovese F. Pediatric peripheral blood progenitor cell collection: haemonetics MCS 3P versus COBE Spectra versus Fresenius AS104. Transfusion 1998; 38:70-4. [PMID: 9482397 DOI: 10.1046/j.1537-2995.1998.38198141501.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND An increasing number of apheresis machines are becoming available for peripheral blood progenitor cell (PBPC) collection in children. STUDY DESIGN AND METHODS At the Children's Hospital of Florence (Italy), three apheresis machines were evaluated: MCS 3P (Haemonetics) (10 procedures in 4 patients, aged 10-12 years, weight 23.5-64 kg), Spectra, (COBE) (8 procedures in 3 patients, aged 4-17 years, weight 19-59 kg), and AS104 (Fresenius) (24 procedures in 9 patients, aged 2-16 years, weight 13.6-60 kg). For PBPC quantitative analysis, CD34 cytofluorimetry was employed. Relevant variables analyzed included efficiency of CD34+ cell extraction and enrichment, mononuclear cell purity and red cell contamination of the apheresis components, and platelet count decreases after leukapheresis. RESULTS No significant differences in CD34+ cell-extraction abilities were found. However, the AS104 provided consistently purer leukapheresis components in terms of mononuclear cell and CD34+ cell enrichment (441 +/- 59%, vs. 240 +/- 35% and 290 +/- 42% for MCS 3P and Spectra, respectively). Postapheresis platelet counts dropped the least with the AS104. The smallest patient who underwent apheresis with MCS 3P (the only machine working on discontinuous flow and hence with greater volume shifts) weighed 23.5 kg and tolerated the procedure well, with no signs of hemodynamic instability. No significant complications were observed. CONCLUSION All machines seem to have comparable PBPC extraction efficiency, but the AS104 seems to give the component with the greatest PBPC enrichment. This feature might be relevant for further ex vivo cell processing (CD34+ cell selection, expansion, and so on).
Collapse
Affiliation(s)
- F Bambi
- Department of Pediatrics, University of Florence Azienda Ospedale A. Meyer, Italy
| | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Calamandrei M, Messeri A, Busoni P, Bernini G, Lippi A, Tucci F. Comparison of two application techniques of EMLA and pain assessment in pediatric oncology patients. Reg Anesth 1996; 21:557-560. [PMID: 8956392] [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: 05/22/2023]
Abstract
BACKGROUND AND OBJECTIVES The study was designed to compare the analgesic efficacy of the local anesthetic EMLA when applied as a patch and as a cream in combination with a Tegaderm dressing to pediatric oncology patients undergoing repeated lumbar punctures. METHODS The analgesic effect of the two products was assessed by a continuous or discrete visual analog scale in 24 children 3-16 years old, during two lumbar punctures. Distress was rated by use of the Observational Scale of Behavioral Distress. RESULTS No significant differences were found between the pain and distress scores for the different preparations of EMLA. CONCLUSION The EMLA patch and the EMLA cream are equally effective in alleviating pain associated with lumbar puncture. The EMLA patch simplifies and speeds up the application of EMLA. It also allows for control of the dose administered per application, thus preventing both over- and underdosing.
Collapse
Affiliation(s)
- M Calamandrei
- Anesthesia and Resuscitation Unit, A. Meyer Pediatric Hospital, Italy
| | | | | | | | | | | |
Collapse
|
46
|
Abstract
We report the case of a 6-year-old boy with X-linked adrenoleukodystrophy (ALD). In view of the acute onset of vomiting, fever, and coma, encephalitis was initially suspected. However, brain magnetic resonance imaging demonstrated a pattern of demyelination that was consistent with ALD; this diagnosis was confirmed by the finding of elevated plasma very long-chain fatty acids levels. At presentation, the patient was hyponatremic. That this metabolic disturbance and the coma resolved within hours of the initiation of corticosteroid therapy suggests that the presenting symptoms were secondary to adrenal cortical insufficiency. Primary adrenal failure was confirmed by endocrinologic evaluation. Thrombocytopenia, hepatic transaminase abnormalities, anemia and leukopenia developed during the subsequent course of therapy with oleic acid and erucic acid.
Collapse
Affiliation(s)
- E Zammarchi
- Department of Pediatrics, University of Florence, Italy
| | | | | | | | | | | |
Collapse
|
47
|
Manetti A, De Simone L, Pollini I, Cecchi F, Tucci F, Dolara A. [Generalized lymphangiomatosis with chylopericardium]. Pediatr Med Chir 1994; 16:81-3. [PMID: 8029097] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
A case of a child with lymphangiomatosis and chylopericardium is reported. Diagnosis of chylopericardium was performed at 11 months with ascendant lymphography which evidenced thoracic duct agenesia. At the age of 3 years he underwent operation of pleuro pericardial window. He was also treated with low fat medium chain triglyceride diet, and temporary clinical improvement occurred. The patient died at 13 years of age because of extensive lymphangiomatosis to abdomen, lungs and bones.
Collapse
Affiliation(s)
- A Manetti
- Unità Operativa di Cardiologia, Ospedale A. Meyer, Firenze, Italia
| | | | | | | | | | | |
Collapse
|
48
|
Abstract
We evaluated the prevalence of gastroesophageal reflux in 36 children, 22 (61.2%) male and 14 (38.8%) female (median age, 75.5 months; range, 18-178), with noncontrolled asthma by means of prolonged (22-24 h) esophageal pH monitoring. None of the children had gastrointestinal symptoms suggesting gastroesophageal reflux. Atopy was seen in 21 of 36 (58.3%) patients. Pathological gastroesophageal reflux was present in 27 (75%) children. All patients were given cisapride (0.2 mg/kg q.i.d.) for 3 months. A clinical and pharmacological score was determined, and a second pH-metric study was made at the end of the follow-up period. The following pH-metric parameters were evaluated: the total percentage of time pH was < 4, the number of reflux episodes, the number of reflux episodes lasting > 5 min, the length of the longest single reflux episode, and the percentage of time the esophageal pH was < 4 during sleep. The study was completed in 11 of 27 children. The percentage of time that esophageal pH was < 4 improved in nine of 11 (81.8%) patients (p = 0.013). The percentage of time that esophageal pH was < 4 during sleep showed the most significant decrease (p = 0.002) after treatment. Improvement in both clinical and pharmacological scores was highly significant (p < 0.0001) in 19 of 27 patients, eight of whom did not want to repeat the pH study. We conclude therefore that gastroesophageal reflux is frequently associated with noncontrolled asthma and that medical therapy for reflux may improve the further course of respiratory disease.
Collapse
Affiliation(s)
- F Tucci
- Department of Pediatrics, University of Florence, Italy
| | | | | | | | | | | |
Collapse
|
49
|
Tucci F, Resti M, Fontana R, Noccioli B, Mattei R, Monterisi N, Pellegrini T, Jenuso R, Adami Lami C. [Gastroesophageal reflux and respiratory pathology]. Pediatr Med Chir 1993; 15:11-5. [PMID: 8488118] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The prevalence of gastroesophageal reflux (GER) in 86 children with respiratory disease (recurrent pneumonia, chronic cough, bronchial asthma) has been evaluated by mean of prolonged (22-24 hours) esophageal pH-monitoring. The following parameters were evaluated: the total percentage of time pH < 4 and the percent time the esophageal pH was < 4 while sleeping. None of the children had gastrointestinal symptoms suggesting GER and no neurological disorder was noted in any of the studied patients. The mean age was 68.98 +/- 46.46 months (range 14-189); 53 (61.6%) males and 33 (38.4%) females were considered in the study. Atopy was evidenced in 42/86 (48.8%) children (total IgE > 2SD in 42/86 and prick tests positiveness in 32/86. A pH-metry indicating pathological GER was present in 52/86 (60.5%) children: 39/62 (62.9%) patients with bronchial asthma, 5/10 (50%) subjects with chronic cough and 8/14 (57.2%) children with recurrent pneumonia. No significant difference in the diagnosis of GER was recorded between atopic or non-atopic patients. The children with abnormal pH-metric recording were also evaluated by upper gastrointestinal series and/or endoscopy. A conventional barium radiology was performed in 44/52 patients and confirmed GER in 19/44 (43.2%). Esophagitis was evidenced in 21/46 (45.7%) studied patients. The presence of esophagitis was significantly (p = 0.032) related to the total percentage of time pH < 4, but the most significant (p = 0.002) association was with the percent time the esophageal pH was < 4 during sleep.(ABSTRACT TRUNCATED AT 250 WORDS)
Collapse
Affiliation(s)
- F Tucci
- Dipartimento di Pediatria, Clinica Pediatrica III, Firenze, Italia
| | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Marino JP, Tucci F, Comasseto JV. An Efficient Preparation of Functionalized Z-Vinylcuprates from Terminal Acetylenes and Their Reactions with Epoxides. Synlett 1993. [DOI: 10.1055/s-1993-22600] [Citation(s) in RCA: 32] [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: 10/27/2022]
|