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Meloni G, Schott-Brua V, Vilain A, Loevenbruck H, Consortium E, MacLeod AAN. Application of childhood apraxia of speech clinical markers to French-speaking children: A preliminary study. Int J Speech Lang Pathol 2020; 22:683-695. [PMID: 33666129 DOI: 10.1080/17549507.2020.1844799] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE Childhood apraxia of speech (CAS) is difficult to diagnose because there is little agreement on objective clinical markers. Since studies of phonological development in French-speaking children are scarce, there are even fewer recognised markers in French as compared to English. This study aims to determine if a set of operationalised, quantitative measures derived from clinical markers of CAS in English corroborate with clinical CAS diagnosis in French-speaking children. This research contributes to improving differential diagnosis of CAS and phonological disorder cross-linguistically. METHOD We collected data from five children diagnosed with CAS, nine children diagnosed with phonological disorder, and 75 typically-developing children aged 5.10-9.2 years old. All children were assessed on three speech production tasks: picture-naming, non-word repetition, and diadochokinesis. We extracted 20 quantitative measures corresponding to commonly accepted clinical features of CAS. RESULT Similar to English-speaking children, French-speaking children with CAS exhibited a high number of vowel errors, consonant and cluster errors, consonant epentheses, devoicing errors, slow diadochokinesis rate, more inconsistency and increased errors with longer words. Contrary to studies on English, these children with CAS did not produce intrusive schwas or vowels. CONCLUSION This multiple-case study highlights the need for cross-linguistic diagnostic criteria for CAS.
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Affiliation(s)
- G Meloni
- Ecole d'Orthophonie et d'Audiologie, Faculté de Médecine, Université de Montréal, Montréal, Canada
- Laboratoire de Psychologie et de NeuroCognition, CNRS, Université Grenoble Alpes, Grenoble, France
- GIPSA-lab, Speech & Cognition Department, Grenoble INP, CRNS, Université Grenoble Alpes, Grenoble, France
| | - V Schott-Brua
- Centre de formation en orthophonie, Institut Universitaire de Technologie Lyon 1, Université Lyon 1, Villeurbanne, France, and
| | - A Vilain
- GIPSA-lab, Speech & Cognition Department, Grenoble INP, CRNS, Université Grenoble Alpes, Grenoble, France
| | - H Loevenbruck
- Laboratoire de Psychologie et de NeuroCognition, CNRS, Université Grenoble Alpes, Grenoble, France
| | | | - A A N MacLeod
- Communication Sciences & Disorders, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
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Pintus D, Puggioni G, Melzi E, Meloni G, Rocchigiani A, Manunta D, Palmarini M, Savini G, Oggiano A, Ligios C. Sheep and Bluetongue Virus: An Animal Model for Studying the Pathogenesis of Hypofertility Caused by Arboviruses. J Comp Pathol 2018. [DOI: 10.1016/j.jcpa.2017.10.008] [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: 11/30/2022]
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Saraceni F, Bruno B, Lemoli RM, Meloni G, Arcese W, Falda M, Ciceri F, Alessandrino EP, Specchia G, Scimè R, Raimondi R, Bacigalupo A, Bosi A, Onida F, Rambaldi A, Bonifazi F, Olivieri A. Autologous stem cell transplantation is still a valid option in good- and intermediate-risk AML: a GITMO survey on 809 patients autografted in first complete remission. Bone Marrow Transplant 2016; 52:163-166. [PMID: 27668760 DOI: 10.1038/bmt.2016.233] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- F Saraceni
- Hematology and Bone Marrow Transplantation, Polytechnic University of Marche-Ospedali Riuniti, Ancona, Italy
| | - B Bruno
- National Registry GITMO & Data Managing, Ospedale San Martino, Genova, Italy
| | - R M Lemoli
- Hematology Clinic, Department of Internal Medicine (DiMI), University of Genoa, IRCCS AOU S. Martino-IST, Genova, Italy
| | - G Meloni
- Hematology, Department of Cellular Biotechnologies and Hematology, 'Sapienza' University of Rome, Rome, Italy
| | - W Arcese
- Rome Transplant Network, Department of Hematology, Stem Cell Transplant Unit, Tor Vergata University, Rome, Italy
| | - M Falda
- Hematology 2 Unit, San Giovanni Battista Hospital and University, Turin, Italy
| | - F Ciceri
- Hematology and BMT Unit, Department of Oncology, San Raffaele Scientific Institute, Milano, Italy
| | - E P Alessandrino
- Department of Hematology, University of Pavia, Policlinico S Matteo-IRCCS, Pavia, Italy
| | - G Specchia
- Hematology Department, University of Bari, Bari, Italy
| | - R Scimè
- Department of Hematology and Bone Marrow Transplant Unit Ospedale Cervello, Palermo, Italy
| | - R Raimondi
- Department of Hematology, S Bortolo Hospital, Vicenza, Italy
| | - A Bacigalupo
- Institute of Haematology, Università Cattolica Sacro Cuore, Roma, Italy
| | - A Bosi
- Haematology Department, Azienda Ospedaliero Universitaria Careggi, Firenze, Italy
| | - F Onida
- Hematology - BMT Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - A Rambaldi
- Hematology and BMT Unit, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - F Bonifazi
- Hematology Clinic, Department of Internal Medicine (DiMI), University of Genoa, IRCCS AOU S. Martino-IST, Genova, Italy
| | - A Olivieri
- Hematology and Bone Marrow Transplantation, Polytechnic University of Marche-Ospedali Riuniti, Ancona, Italy
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Versluis J, In 't Hout FEM, Devillier R, van Putten WLJ, Manz MG, Vekemans MC, Legdeur MC, Passweg JR, Maertens J, Kuball J, Biemond BJ, Valk PJM, van der Reijden BA, Meloni G, Schouten HC, Vellenga E, Pabst T, Willemze R, Löwenberg B, Ossenkoppele G, Baron F, Huls G, Cornelissen JJ. Comparative value of post-remission treatment in cytogenetically normal AML subclassified by NPM1 and FLT3-ITD allelic ratio. Leukemia 2016; 31:26-33. [PMID: 27416910 DOI: 10.1038/leu.2016.183] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 05/25/2016] [Accepted: 06/15/2016] [Indexed: 01/07/2023]
Abstract
Post-remission treatment (PRT) in patients with cytogenetically normal (CN) acute myeloid leukemia (AML) in first complete remission (CR1) is debated. We studied 521 patients with CN-AML in CR1, for whom mutational status of NPM1 and FLT3-ITD was available, including the FLT3-ITD allelic ratio. PRT consisted of reduced intensity conditioning (RIC) allogeneic hematopoietic stem cell transplantation (alloHSCT) (n=68), myeloablative conditioning (MAC) alloHSCT (n=137), autologous hematopoietic stem cell transplantation (autoHSCT) (n=168) or chemotherapy (n=148). Favorable overall survival (OS) was found for patients with mutated NPM1 without FLT3-ITD (71±4%). Outcome in patients with a high FLT3-ITD allelic ratio appeared to be very poor with OS and relapse-free survival (RFS) of 23±8% and 12±6%, respectively. Patients with wild-type NPM1 without FLT3-ITD or with a low allelic burden of FLT3-ITD were considered as intermediate-risk group because of similar OS and RFS at 5 years, in which PRT by RIC alloHSCT resulted in better OS and RFS as compared with chemotherapy (hazard ratio (HR) 0.56, P=0.022 and HR 0.50, P=0.004, respectively) or autoHSCT (HR 0.60, P=0.046 and HR 0.60, P=0.043, respectively). The lowest cumulative incidence of relapse (23±4%) was observed following MAC alloHSCT. These results suggest that alloHSCT may be preferred in patients with molecularly intermediate-risk CN-AML, while the choice of conditioning type may be personalized according to risk for non-relapse mortality.
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Affiliation(s)
- J Versluis
- Department of Hematology, Erasmus University Medical Center Cancer Institute, Rotterdam, The Netherlands
| | - F E M In 't Hout
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Laboratory medicine, Laboratory of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - R Devillier
- Department of Hematology, Erasmus University Medical Center Cancer Institute, Rotterdam, The Netherlands
| | - W L J van Putten
- HOVON Data Center, Erasmus University Medical Center Cancer Institute-Clinical Trial Center, Rotterdam, The Netherlands
| | - M G Manz
- Division of Hematology, University Hospital Zürich, Zürich, Switzerland
| | - M-C Vekemans
- Department of Hematology, Hôpital St Luc, Brussels, Belgium
| | - M-C Legdeur
- Department of Hematology, Medisch Spectrum Twente, Enschede, The Netherlands
| | - J R Passweg
- Stem Cell Transplant Team, University Hospital Basel, Basel, Switzerland
| | - J Maertens
- Department of Hematology, University Hospital Gasthuisberg, Leuven, Belgium
| | - J Kuball
- Department of Immunology and Hematology, University Medical Center, Utrecht, The Netherlands
| | - B J Biemond
- Department of Hematology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - P J M Valk
- Department of Hematology, Erasmus University Medical Center Cancer Institute, Rotterdam, The Netherlands
| | - B A van der Reijden
- Department of Laboratory medicine, Laboratory of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - G Meloni
- Department of Cellular Biotechnologies and Hematology, 'Sapienza' University, Rome, Italy
| | - H C Schouten
- Department of Hematology, University Hospital Maastricht, Maastricht, The Netherlands
| | - E Vellenga
- Department of Hematology, University Medical Center Groningen, Groningen, The Netherlands
| | - T Pabst
- Department of Medical Oncology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - R Willemze
- Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands
| | - B Löwenberg
- Department of Hematology, Erasmus University Medical Center Cancer Institute, Rotterdam, The Netherlands
| | - G Ossenkoppele
- Department of Hematology, VU University Medical Center, Amsterdam, The Netherlands
| | - F Baron
- Department of Hematology, University of Liège, Liège, Belgium
| | - G Huls
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J J Cornelissen
- Department of Hematology, Erasmus University Medical Center Cancer Institute, Rotterdam, The Netherlands
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Sarà G, Oliveri A, Martino G, Serra S, Meloni G, Pais A. Response of captive seabass and seabream as behavioural indicator in aquaculture. Italian Journal of Animal Science 2016. [DOI: 10.4081/ijas.2007.1s.823] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- G. Sarà
- Dipartimento di Biologia Animale. Università di Palermo, Italy
| | - A. Oliveri
- Dipartimento di Biologia Animale. Università di Palermo, Italy
| | - G. Martino
- Dipartimento di Biologia Animale. Università di Palermo, Italy
| | - S. Serra
- Sezione di Acquacoltura ed Ecologia Marina. Dipartimento di Scienze Zootecniche. Università di Sassari, Italy
| | - G. Meloni
- Sezione di Acquacoltura ed Ecologia Marina. Dipartimento di Scienze Zootecniche. Università di Sassari, Italy
| | - A. Pais
- Sezione di Acquacoltura ed Ecologia Marina. Dipartimento di Scienze Zootecniche. Università di Sassari, Italy
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Pais A, Chessa LA, Serra S, Ruiu A, Meloni G. Suspended culture of Ostrea edulis in the Calich lagoon (North western Sardinia, Italy): preliminary results. Italian Journal of Animal Science 2016. [DOI: 10.4081/ijas.2007.1s.810] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- A. Pais
- Sezione di Acquacoltura ed Ecologia Marina, Dipartimento di Scienze Zootecniche. Università di Sassari, Italy
| | - L. A. Chessa
- Sezione di Acquacoltura ed Ecologia Marina, Dipartimento di Scienze Zootecniche. Università di Sassari, Italy
| | - S. Serra
- Sezione di Acquacoltura ed Ecologia Marina, Dipartimento di Scienze Zootecniche. Università di Sassari, Italy
| | - A. Ruiu
- Sezione di Acquacoltura ed Ecologia Marina, Dipartimento di Scienze Zootecniche. Università di Sassari, Italy
| | - G. Meloni
- Sezione di Acquacoltura ed Ecologia Marina, Dipartimento di Scienze Zootecniche. Università di Sassari, Italy
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Guidet B, Meloni G, Reignier J. Contrat unique : une solution et un risque pour la recherche à promotion industrielle. Propositions de « sortie de crise ». Réanimation 2016. [DOI: 10.1007/s13546-015-1160-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Potì L, Meloni G, Berrettini G, Fresi F, Foggi T, Secondini M, Giorgi L, Cavaliere F, Hackett S, Petronio A, Nibbs P, Forgan R, Leong A, Masciulli R, Pfander C. Sub-Nyquist field trial using time frequency packed DP-QPSK super-channel within fixed ITU-T grid. Opt Express 2015; 23:16196-16208. [PMID: 26193592 DOI: 10.1364/oe.23.016196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Sub-Nyquist time frequency packing technique was demonstrated for the first time in a super-channel field trial transmission over long-haul distances. The technique allows a limited spectral occupancy even with low order modulation formats. The transmission was successfully performed on a deployed Australian link between Sydney and Melbourne which included 995 km of uncompensated SMF with coexistent traffic. 40 and 100 Gb/s co-propagating channels were transmitted together with the super-channel in a 50 GHz ITU-T grid without additional penalty. The super-channel consisted of eight sub-channels with low-level modulation format, i.e. DP-QPSK, guaranteeing better OSNR robustness and reduced complexity with respect to higher order formats. At the receiver side, coherent detection was used together with iterative maximum-a-posteriori (MAP) detection and decoding. A 975 Gb/s DP-QPSK super-channel was successfully transmitted between Sydney and Melbourne within four 50GHz WSS channels (200 GHz). A maximum potential SE of 5.58 bit/s/Hz was achieved with an OSNR = 15.8 dB, comparable to the OSNR of the installed 100 Gb/s channels. The system reliability was proven through long term measurements. In addition, by closing the link in a loop back configuration, a potential SE∙d product of 9254 bit/s/Hz·km was achieved.
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Andriolli N, Fresi F, Bontempi F, Malacarne A, Meloni G, Klamkin J, Poti L, Contestabile G. InP monolithically integrated coherent transmitter. Opt Express 2015; 23:10741-6. [PMID: 25969111 DOI: 10.1364/oe.23.010741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
A novel InP monolithically integrated coherent transmitter has been designed, fabricated and tested. The photonic integrated circuit consists of a distributed Bragg reflector laser and a modified nested Mach-Zehnder modulator having tunable input power splitters. Back-to-back coherent transmission for PDM-QPSK signals is reported up to 10 Gbaud (40 Gb/s) using the integrated laser and up to 32Gbaud (128 Gb/s) using an external low phase noise laser.
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Lotta LA, Valsecchi C, Pontiggia S, Mancini I, Cannavò A, Artoni A, Mikovic D, Meloni G, Peyvandi F. Measurement and prevalence of circulating ADAMTS13-specific immune complexes in autoimmune thrombotic thrombocytopenic purpura. J Thromb Haemost 2014; 12:329-36. [PMID: 24354764 DOI: 10.1111/jth.12494] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND The formation of ADAMTS13-specific circulating immune complexes (CICs) may be a pathophysiologic mechanism in autoimmune thrombotic thrombocytopenic purpura (TTP), but has not been systematically investigated. OBJECTIVES (a) To develop an assay for ADAMTS13-specific CICs; (b) to evaluate their prevalence in autoimmune TTP; and (c) to assess their association with ADAMTS13-related measurements and clinical features in autoimmune TTP patients. PATIENTS/METHODS We developed and validated an ELISA method for ADAMTS13-specific CICs. ADAMTS13-specific CICs were searched for in 55 patients with autoimmune TTP from the Milan TTP Registry (URL:http://www.ttpdatabase.org/) and 28 controls. The associations between ADAMTS13-specific CIC levels and ADAMTS13 activity, antigen, anti-ADAMTS13 IgGs and acute TTP clinical features were assessed by multivariate linear regression. RESULTS Intra- and inter-assay coefficients of variation of the new test were 5.3 and 9.6%. In 36 patients with severe ADAMTS13 deficiency and anti-ADAMTS13 autoantibodies, the prevalence of ADAMTS13-specific CICs was 47% (n = 17; 95% confidence interval [CI], 32-63%). ADAMTS13-specific CICs were detected also in seven of 19 (37%; 95% CI, 19-59%) patients with reduced ADAMTS13 activity, but apparently negative anti-ADAMTS13 autoantibodies. ADAMTS13-specific CICs were not associated with ADAMTS13 activity, antigen or anti-ADAMTS13 IgGs. In patients with acute TTP, increasing levels of ADAMTS13-specific CICs were associated with a higher number of plasma-exchange procedures required to attain remission (per 0.1 increase in normalized OD values, beta, 2.9; 95% CI, -0.7 to 6.5). CONCLUSIONS Approximately one to two-thirds of patients with autoimmune TTP display ADAMTS13-specific CICs. A thorough investigation of the prognostic relevance of ADAMTS13-specific CIC levels in autoimmune TTP is warranted.
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Affiliation(s)
- L A Lotta
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Fondazione Luigi Villa and Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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Roberti ML, Ricottini L, Capponi A, Sclauzero E, Vicenti P, Fiorentini E, Savoia C, Scornavacca G, Brazioli D, Gaio L, Giannetti R, Ignazzi C, Meloni G, Chinni LM. Immunomodulating treatment with low dose interleukin-4, interleukin-10 and interleukin-11 in psoriasis vulgaris. J BIOL REG HOMEOS AG 2014; 28:133-139. [PMID: 24750799] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Psoriasis is a chronic inflammatory skin disease affecting approximately 2-3 percent of the world population; it is characterised by hyperproliferation and hyperplasia of the superficial layers of the epidermis. Inappropriate signals released by the immune system determine an altered keratinocyte differentiation, resulting in the formation of desquamating, thickened, inflamed and erythematous plaques. The aim of this investigation was to study the pharmacological activity and safety of three low dose cytokines, Guna-Interleukin 4, Guna-Interleukin 10 and Guna-Interleukin 11 at the concentration of 10 fg/ml in patients affected by moderate to slight psoriasis vulgaris. The multicenter, double-blind, randomized, placebo-controlled clinical trial involved 48 patients who were enrolled and followed up according to a 8-month experimental project. All patients received, according to a cross-over model, either the experimental treatment or placebo, alternatively. Globally, in the 41 evaluated patients it was observed a PASI significant reduction (Friedman test: p=0.00960). The DLQI too decreased significantly in all subjects compared to baseline (Friedman test: p=0.00007). The safety of the treatment with three low dose cytokines administered simultaneously was proved; no adverse event was reported during the whole trial.
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Affiliation(s)
| | | | | | - E Sclauzero
- OSTEMDA, Therapeutic Strategies Empowerment and Advanced Diagnostic Methods Organization, Udine, Italy
| | - P Vicenti
- Private Practice, Altamura, Bari, Italy
| | - E Fiorentini
- Dermatological Health Clinic, Aversa, Caserta, Italy
| | - C Savoia
- Private Practice, Fino Mornasco, Como, Italy
| | | | | | - L Gaio
- Private Practice, Caserta, Italy
| | | | - C Ignazzi
- Local Health Unit (ASL), Putignano, Bari, Italy
| | - G Meloni
- GEA Medica Medical Center, Montebelluna, Treviso, Italy
| | - L M Chinni
- Istituto Dermopatico dellImmacolata (IDI), Rome, Italy
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Capria S, De Angelis F, Gentile G, Trisolini S, Brocchieri S, Canichella M, Chiusolo P, Micozzi A, Foà R, Meloni G. Complete remission obtained with azacitidine in a patient with concomitant therapy related myeloid neoplasm and pulmonary mucormycosis. Mediterr J Hematol Infect Dis 2013; 5:e2013048. [PMID: 23936619 PMCID: PMC3736875 DOI: 10.4084/mjhid.2013.048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Accepted: 06/11/2013] [Indexed: 12/03/2022] Open
Abstract
Mucormycosis is the third cause of invasive mycosis after candidiasis and aspergillosis in AML patients, representing a poor prognostic factor associated with a high rate of fatal outcome. We report a case of a patient with AML and a concomitant pulmonary mucormycosis at diagnosis, who obtained a complete remission both of her AML and of the fungal infection. The incidence of the infection at the onset of leukemia is extremely unusual, and, to our knowledge, the sporadic cases reported in the literature are included in heterogeneous series retrospectively examined. In our case, Liposomal Amphotericin B as single agent appeared incapable of controlling the infection, so anti-infective therapy was intensified with posaconazole and simultaneously antileukemic treatment with 5-azacitidine was started, with the understanding that the only antifungal treatment would not have been able to keep the infection under control for a long time if not associated with a reversal of neutropenia related to the disease. We observed a progressive improvement of the general conditions, a healing of pneumonia and a complete remission of the leukemic disease, suggesting that a careful utilization of the new compounds available today, in terms of both antifungal and antileukemic treatment, may offer a curative chance a patient who would have otherwise been considered unfit for a potentially curative therapeutic strategy.
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Affiliation(s)
- S. Capria
- Department of Cellular Biotechnologies and Hematology, “Sapienza” University of Rome, Rome, Italy
| | - F. De Angelis
- Department of Cellular Biotechnologies and Hematology, “Sapienza” University of Rome, Rome, Italy
| | - G. Gentile
- Department of Cellular Biotechnologies and Hematology, “Sapienza” University of Rome, Rome, Italy
| | - S.M. Trisolini
- Department of Cellular Biotechnologies and Hematology, “Sapienza” University of Rome, Rome, Italy
| | - S. Brocchieri
- Department of Radiologic Sciences, Azienda Policlinico Umberto I, “Sapienza” University of Rome, Rome, Italy
| | - M. Canichella
- Department of Cellular Biotechnologies and Hematology, “Sapienza” University of Rome, Rome, Italy
| | - P. Chiusolo
- Department of Hematology, Catholic University of the Sacred Heart, Rome, Italy
| | - A. Micozzi
- Department of Cellular Biotechnologies and Hematology, “Sapienza” University of Rome, Rome, Italy
| | - R. Foà
- Department of Cellular Biotechnologies and Hematology, “Sapienza” University of Rome, Rome, Italy
| | - G. Meloni
- Department of Cellular Biotechnologies and Hematology, “Sapienza” University of Rome, Rome, Italy
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Abstract
Interleukin (IL)-2 is a glycoprotein lymphokine which induces proliferation of all subclasses of T-lymphocytes, natural killer cells and lymphokine activated killer cells, differentiation of cytotoxic cells and secretion of other cytokines, especially interferon-gamma. A fundamental property of IL-2 activated effector cells is to selectively lyse freshly isolated tumour cells. Work carried out on animal tumour models and application in human therapeutics has suggested the potential value of an immunotherapeutic approach in haematological malignancies, especially in the setting of minimal residual disease. Extensive phase I/II trials have been conducted in all haematological diseases, but the most interesting results have been obtained in acute myeloid leukaemia and non-Hodgkin's lymphoma, where the possibility of achieving partial and complete responses in patients with advanced disease has been reported. The feasibility and immunomodulatory effects of IL-2 treatment in patients with minimal residual disease after high-dose chemotherapy have also been explored. However, the heterogeneity of cases treated and administration schedules used does not allow definitive conclusions to be drawn about the true impact of IL-2 treatment on the prognosis of these patients. The clearly encouraging results reported in the literature deserve further investigation from a biological and clinical point of view; until the role of IL-2 in haematological malignancies has been identified, it should be used only in the investigative setting of clinical trials.
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Affiliation(s)
- F Mandelli
- Dipartimento di Biotecnologie Cellulari e Ematologia - Università degli Studi 'La Sapienza', Roma, Italy
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Meloni G, Mancini M, Gianfelici V, Martelli MP, Foa R, Falini B. Late relapse of acute myeloid leukemia with mutated NPM1 after eight years: evidence of NPM1 mutation stability. Haematologica 2008. [DOI: 10.3324/haematol.000059] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Tangaro S, Bellotti R, De Carlo F, Gargano G, Lattanzio E, Monno P, Massafra R, Delogu P, Fantacci ME, Retico A, Bazzocchi M, Bagnasco S, Cerello P, Cheran SC, Lopez Torres E, Zanon E, Lauria A, Sodano A, Cascio D, Fauci F, Magro R, Raso G, Ienzi R, Bottigli U, Masala GL, Oliva P, Meloni G, Caricato AP, Cataldo R. MAGIC-5: an Italian mammographic database of digitised images for research. Radiol Med 2008; 113:477-85. [DOI: 10.1007/s11547-008-0282-5] [Citation(s) in RCA: 16] [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] [Received: 08/01/2007] [Accepted: 09/21/2007] [Indexed: 10/22/2022]
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16
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Falini B, Martelli MP, Mecucci C, Liso A, Bolli N, Bigerna B, Pucciarini A, Pileri S, Meloni G, Martelli MF, Haferlach T, Schnittger S. Cytoplasmic mutated nucleophosmin is stable in primary leukemic cells and in a xenotransplant model of NPMc+ acute myeloid leukemia in SCID mice. Haematologica 2008; 93:775-9. [DOI: 10.3324/haematol.12225] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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17
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Willemze R, Suciu S, Mandelli F, de Witte T, Labar B, Marie J, Meloni G, Mistrik M, Liso V, Selleslag D, Beksac M, Fabbiano F, Peta A, Thomas X, Bron D, Fillet G, Muus P, Theys A, Fazi P, Baila L, Vignetti M, Amadori S. OP08 High dose (HD-AraC) vs standard dose cytosine arabinoside (SD-AraC) during induction in acute myelogenous leukemia (AML): Impact on stem cell mobilization after consolidation and on autologous transplantation (AML-12 trial). Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70288-6] [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: 11/30/2022]
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18
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Gorello P, La Starza R, Brandimarte L, Trisolini SM, Pierini V, Crescenzi B, Limongi MZ, Nanni M, Belloni E, Tapinassi C, Gerbino E, Martelli MF, Foà R, Meloni G, Pelicci PG, Mecucci C. A PDGFRB-positive acute myeloid malignancy with a new t(5;12)(q33;p13.3) involving the ERC1 gene. Leukemia 2007; 22:216-8. [PMID: 17690697 DOI: 10.1038/sj.leu.2404894] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
MESH Headings
- Adaptor Proteins, Signal Transducing/genetics
- Adult
- Chromosomes, Human, Pair 12/genetics
- Chromosomes, Human, Pair 5/genetics
- Humans
- In Situ Hybridization, Fluorescence
- Leukemia, Monocytic, Acute/diagnosis
- Leukemia, Monocytic, Acute/genetics
- Leukemia, Monocytic, Acute/therapy
- Male
- Nerve Tissue Proteins/genetics
- Receptor, Platelet-Derived Growth Factor beta/genetics
- Translocation, Genetic
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19
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Fanciulli G, Meloni G, Locatelli M, Bottazzo GF, Delitala G. Diabetes-related autoantibodies in schoolchildren with celiac disease. Annales d'Endocrinologie 2007; 68:212-3. [PMID: 17610837 DOI: 10.1016/j.ando.2007.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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20
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Sanz MA, Labopin M, Gorin NC, de la Rubia J, Arcese W, Meloni G, Bacigalupo A, Alessandrino P, Carreras E, Iriondo A, Novitzky N, Jacobs P, Bandini G, Lo-Coco F, Frassoni F, Rocha V. Hematopoietic stem cell transplantation for adults with acute promyelocytic leukemia in the ATRA era: a survey of the European Cooperative Group for Blood and Marrow Transplantation. Bone Marrow Transplant 2007; 39:461-9. [PMID: 17322930 DOI: 10.1038/sj.bmt.1705620] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
We performed a survey of the European Cooperative Group for Blood and Marrow Transplantation to analyze the outcome of 625 acute promyelocytic leukemia (APL) patients transplanted with auto- or allogeneic-hematopoietic stem cell transplantation (autoHSCT, alloHSCT) after 1993, in first (CR1) or in second complete remission (CR2). Leukemia-free survival (LFS) at 5 years in CR1 was 69% for 149 patients autografted and 68% for 144 patients allografted, whereas in CR2, LFS was 51% in 195 autoHSCT and 59% in 137 alloHSCT recipients, respectively. In the group of autoHSCT for CR1 (n=149), higher relapse incidence (RI) was associated with shorter time from diagnosis to transplant (<7.6 months); transplant-related mortality (TRM) was increased in older patients (>47 years), whereas for CR2, longer time from diagnosis to transplant (>18 months) was associated with increased LFS and decreased RI. In the alloHSCT group for CR1 (n=144), age (<33 years) was associated with increased LFS and decreased TRM and for CR2 (n=137), the use of mobilized peripheral blood stem cells was associated with decreased TRM. Female recipient, a female donor to male recipient and transplants performed before 1997 were associated with decreased RI. In conclusion, HSCT still appears to have a role in APL, especially for patients in CR2.
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Affiliation(s)
- M A Sanz
- Hematology Service, Hospital Universitario La Fe, Valencia, Spain.
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21
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Capria S, Latagliata R, Avvisati G, Breccia M, Cimino G, Diverio D, Petti MC, Meloni G. BAVC regimen and autologous bone marrow transplantation for APL patients in second molecular remission: updated results. Bone Marrow Transplant 2005; 36:83-4. [PMID: 15880128 DOI: 10.1038/sj.bmt.1704995] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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22
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Caronna R, Cardi M, Meloni G, Mangioni S, Spera G, Benedetti M, Frantellizzi V, Layek D, Catinelli S, Schiratti M, Chirletti P. Results of emergency surgery in patients with Moschowitz's disease refractory to hematological treatment: is splenectomy always advisable? Suppl Tumori 2005; 4:S146-7. [PMID: 16437957] [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: 05/06/2023]
Abstract
BACKGROUND Patients with thrombotic thrombocytopenic purpura (TTP), Moschowitz's disease, run a high risk of perioperative bleeding and need intensive hematologic support. In some patients, TTP is associated with cancer but the surgical role in these patients is still unclear. To illustrate the surgical problems and outcome we present the case histories of three patients with TTP observed in our emergency department. MATERIALS AND METHODS Two patients had TTP secondary to cancer and one patient with primary TTP (no evidence of neoplasia) had emergency operation for gastric hemorrhage, occlusion and TTP unresponsive to plasmapheresis. RESULTS The first two patients who had not radical resection of cancer and no splenectomy, died for TTP complications. The third patient who underwent emergency splenectomy, had an uneventful postoperative course and TTP completely regressed. CONCLUSIONS These case reports suggest that patients with TTP should be screened to rule out cancer. In patients with acute cancer-related complications emergency surgery should aim to resect the cancer. An associated splenectomy may increase the effectiveness of postoperative hematologic therapy.
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Affiliation(s)
- R Caronna
- Istituto Dipartimentalizzato di Chirurgia d'Urgenza e di Pronto Soccorso, Cattedra di Chirurgia d'Urgenza II
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23
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Ferretti G, Petti MC, Carlini P, Zeuli M, Picardi A, Meloni G, Bria E, Papaldo P, Fabi A, Cognetti F. Zoledronic acid-associated thrombotic thrombocytopenic purpura. Ann Oncol 2004; 15:1847-8. [PMID: 15550592 DOI: 10.1093/annonc/mdh478] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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24
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Elia L, Gottardi E, Floriddia G, Grillo R, Ciambelli F, Luciani M, Chiusolo P, Invernizzi R, Meloni G, Foà R, Saglio G, Cimino G. Retrospective comparison of qualitative and quantitative reverse transcriptase polymerase chain reaction in diagnosing and monitoring the ALL1-AF4 fusion transcript in patients with acute lymphoblastic leukaemia. Leukemia 2004; 18:1824-30. [PMID: 15318246 DOI: 10.1038/sj.leu.2403448] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We compared quantitative reverse transcriptase polymerase chain reaction (Q-RT-PCR) to qualitative RT-PCR in determining response to therapy and predicting clinical outcome in 18 retrospectively selected patients with ALL positive for the ALL1-AF4 fusion and with frozen RNA samples collected at diagnosis and during follow-up (96 samples analysed). The ALL1-AF4 junction was detected by qualitative RT-PCR in 18 patients and by Q-RT-PCR in 17 patients (one patient harboured the rare e10-e6 ALL1-AF4 junction, which falls outside of the primer and probe location designed for the Q-RT-PCR). In three of the 12 patients negative to qualitative RT-PCR after induction therapy, a small number of ALL1-AF4 copies was detected by Q-RT-PCR. Thus nine patients were negative and eight positive. Seven of the eight positive patients suffered a relapse, including two of the three patients positive to Q-RT-PCR yet negative to qualitative RT-PCR. Moreover, we found two (5%) discordant results among the 39 follow-up tests of the nine patients who converted to a negative qualitative-quantitative PCR status. The results suggest that qualitative RT-PCR is more appropriate for the routine diagnosis of this genetic alteration. However, Q-RT-PCR is more accurate in assessing the molecular response after induction treatment and could be more useful in clinical decision-making in ALL1-AF4-positive ALL patients.
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Affiliation(s)
- L Elia
- Department of Cellular Biotechnology and Haematology, La Sapienza University, Rome, Italy
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25
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Sirohi B, Powles R, Kulkarni S, Rudin C, Frassoni F, Bacigalupo A, Singhal S, Vaidya S, Labopin M, Michallet M, Blaise D, Reiffers J, Meloni G, Rio B, Treleaven J, Horton C, Mehta J. Reassessing autotransplantation for acute myeloid leukaemia in first remission – a matched pair analysis of autologous marrow vs peripheral blood stem cells. Bone Marrow Transplant 2004; 33:1209-14. [PMID: 15094749 DOI: 10.1038/sj.bmt.1704511] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The role of autologous stem cell transplantation in adult patients with acute myeloid leukaemia (AML) in first remission is unclear, yet it has become standard treatment for myeloma and this paper explores whether the source of transplanted stem cells may explain this paradox. In total, 57 patients from the Royal Marsden Hospital who received an unpurged bone marrow transplant (ABMT) were matched with 114 patients from the EBMT registry who had undergone peripheral blood stem cell transplantation (PBSCT). Patients were matched for karyotype, FAB type, remission-autograft interval and age. In the PBSCT group, haematopoietic recovery was significantly faster and nonrelapse mortality at 4 years was significantly lower (13 vs 1%, P=0.04). The relapse rate and overall survival at 4 years (20 vs 31% and 77 vs 63%) were also better with PBSCT, although the differences were not statistically significant. Autografting should be reassessed in a randomised trial for first remission AML patients using peripheral blood as a source of stem cells rather than bone marrow.
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Affiliation(s)
- B Sirohi
- Royal Marsden Hospital and Institute of Cancer Research Surrey, UK
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26
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Capria S, Vitolo D, Cartoni C, Dessanti L, Micozzi A, Mandelli F, Meloni G. Neutropenic enterocolitis in acute leukemia: diagnostic and therapeutic dilemma. Ann Hematol 2003; 83:195-7. [PMID: 15064870 DOI: 10.1007/s00277-003-0755-5] [Citation(s) in RCA: 18] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2003] [Accepted: 08/01/2003] [Indexed: 12/15/2022]
Abstract
The main purpose of this report is to focus on the importance of an accurate etiologic diagnosis of gastrointestinal complications during chemotherapy for acute myeloid leukemia, taking into account that a syndrome characterized by bowel wall thickening associated with diarrhea and abdominal pain may have etiologies different from neutropenic enterocolitis (NE) and in such a case necessitate a different treatment approach. We describe a case of a 46-year-old woman affected by acute myeloid leukemia presenting the onset of a syndrome with clinical features of NE. Supportive therapy for NE was instituted, but during treatment the patient presented a life-threatening gastrointestinal bleeding and was submitted in emergency to hemicolectomy. Following surgery, the patient recovered completely and she is currently alive in complete remission after receiving allogeneic bone marrow transplantation. Histological examination of the surgical specimens showed that the acute abdominal syndrome was related to massive infiltration of the bowel by leukemia cells. A correct baseline evaluation and a prompt diagnosis of the complication may help in making the therapeutic decision, which in our case led necessarily to a surgical procedure, because the bleeding was due to post-chemotherapy necrosis of the leukemic infiltrating tissue. A close collaboration between the hematologist and the surgeon may provide guidelines for behavior in such cases, giving these patients the possibility of survival and the opportunity to carry on the treatment planned for the primary disease.
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Affiliation(s)
- S Capria
- Department of biotecnologie cellulari ed ematologia, University "La Sapienza", via Benevento 6, 00161, Rome, Italy
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27
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Petti MC, Tafuri A, Latagliata R, Aloe Spiriti MA, Montefusco E, Mancini M, Meloni G, Petrucci MT, Spadea A, Redi R, Alimena G, Mandelli F. High-dose hydroxyurea in the treatment of poor-risk myeloid leukemias. Ann Hematol 2003; 82:476-480. [PMID: 12835916 DOI: 10.1007/s00277-003-0693-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2003] [Accepted: 05/15/2003] [Indexed: 11/28/2022]
Abstract
The aim of the study was to evaluate the antileukemic effectiveness and toxicity of high-dose hydroxyurea (HHY) and to assess its acute toxicity. Between August 1997 and October 1998, 12 consecutive adult patients (>18 years) with high-risk acute myeloid leukemia (AML) (four patients in first early relapse, seven patients with secondary AML, and one patient with de novo AML concomitant to a lymphoproliferative disorder) were enrolled to receive a single course of HY (100 mg/kg per day) until bone marrow aplasia or for a maximum of 30 days. Of the 12 patients, 5 (41.6%) achieved complete remission (CR), 1 achieved partial remission (PR), 4 were resistant to treatment, and 2 died during induction from infection. No patient with relapsed AML achieved CR, while it was achieved by five of eight patients with secondary AML at diagnosis; five of six MDR1+ patients achieved CR. As concerns follow-up of the CR patients, one did not receive any further treatment and died in CR from pulmonary aspergillosis, and one with a concomitant chronic lymphocytic leukemia (CLL) received two courses of FLAG (fludarabine, cytarabine, granulocyte colony-stimulating factor) regimen with disappearance of the clonal Ig rearrangement, but relapsed after 11 months and died from pneumonia. The remaining three patients were consolidated with two courses of high-dose cytosine arabinoside (AraC), followed by peripheral blood stem cell transplantation (PBSCT) in one patient. One of them relapsed after 3 months, while the other two are still in continuous complete remission (CCR) after 16 and 28 months, respectively. This study has demonstrated the safety and efficacy of HHY in inducing CR in AML patients with unfavorable prognosis. Despite the small number of patients, these encouraging results warrant further studies.
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MESH Headings
- Adult
- Antineoplastic Agents/adverse effects
- Antineoplastic Agents/therapeutic use
- Bone Marrow Transplantation
- Cytogenetic Analysis
- Dose-Response Relationship, Drug
- Female
- Gene Expression
- Genes, MDR
- Humans
- Hydroxyurea/administration & dosage
- Hydroxyurea/adverse effects
- In Situ Hybridization, Fluorescence
- Leukemia, Myeloid/drug therapy
- Leukemia, Myeloid/genetics
- Leukemia, Myeloid/mortality
- Leukemia, Myeloid/surgery
- Leukemia, Myeloid, Acute/complications
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/etiology
- Lymphoproliferative Disorders/complications
- Male
- Middle Aged
- Myelodysplastic Syndromes/complications
- Neoplasm Recurrence, Local
- Prognosis
- Remission Induction
- Treatment Outcome
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Affiliation(s)
- M C Petti
- Sezione di Ematologia, Istituto Regina Elena, IFO, Italy.
| | - A Tafuri
- Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza", Rome, Italy
| | - R Latagliata
- Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza", Rome, Italy
| | - M A Aloe Spiriti
- Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza", Rome, Italy
| | - E Montefusco
- Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza", Rome, Italy
| | - M Mancini
- Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza", Rome, Italy
| | - G Meloni
- Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza", Rome, Italy
| | - M T Petrucci
- Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza", Rome, Italy
| | - A Spadea
- Sezione di Ematologia, Istituto Regina Elena, IFO, Italy
| | - R Redi
- Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza", Rome, Italy
| | - G Alimena
- Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza", Rome, Italy
| | - F Mandelli
- Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza", Rome, Italy
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28
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Locasciulli A, Bruno B, Alessandrino EP, Meloni G, Arcese W, Bandini G, Cassibba V, Rotoli B, Morra E, Majolino I, Alberti A, Bacigalupo A. Hepatitis reactivation and liver failure in haemopoietic stem cell transplants for hepatitis B virus (HBV)/hepatitis C virus (HCV) positive recipients: a retrospective study by the Italian group for blood and marrow transplantation. Bone Marrow Transplant 2003; 31:295-300. [PMID: 12621466 DOI: 10.1038/sj.bmt.1703826] [Citation(s) in RCA: 63] [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] [Indexed: 02/08/2023]
Abstract
Hepatitis B virus/hepatitis C virus (HBV/HCV) positive patients undergoing haemopoietic stem cell transplantation (HSCT) are at risk of hepatitis reactivation and fatal liver failure: we have conducted a retrospective study to assess the risk in 20 Italian transplant centres. A total of 90 patients infected with HBV (n=33) or HCV (n=57) receiving allogeneic (n=36) or autologous (n=54) haemotopoietic stem cell transplant (HSCT) between 1996 and 2000 were reviewed. The biochemical profiles and outcomes of infection-related liver disease were also analysed. The risk of death at 2 years was comparable when considering type of infection (3% for HBV vs 8% for HCV, P=0.6) or type of HSCT (7% for allogeneic vs 5% for autologous HHSCT, P=0.34). Hepatitis reactivation followed by resolution was more frequent in HCV+ than in HBV+ patients receiving an allograft (100% vs 16%, P=0.004). In HBV+ cases, risk of reactivation was comparable after autologous or allogeneic transplantation (66 vs 81%, P=0.3), but liver disease was more severe and occurred earlier in the autologous group. Our results indicate that HBV and HCV infection should not be taken as an absolute contraindication for HSCT and the risk of life-threatening liver complications are similar after allogeneic or autologous transplants.
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Affiliation(s)
- A Locasciulli
- Ematologia e Trapianto di Midollo, Ospedale S Camillo-Forlanoini, Rome, Italy
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29
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Keating S, Suciu S, de Witte T, Zittoun R, Mandelli F, Belhabri A, Amadori S, Fibbe W, Gallo E, Fillet G, Varet B, Meloni G, Hagemeijer A, Fazi P, Solbu G, Willemze R. The stem cell mobilizing capacity of patients with acute myeloid leukemia in complete remission correlates with relapse risk: results of the EORTC-GIMEMA AML-10 trial. Leukemia 2003; 17:60-7. [PMID: 12529661 DOI: 10.1038/sj.leu.2402782] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.6] [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] [Received: 06/27/2002] [Accepted: 08/19/2002] [Indexed: 11/08/2022]
Abstract
Variable numbers of CD34+ cells can be harvested from the blood of AML patients in CR after G-CSF supported mobilization following consolidation chemotherapy. We hypothesized that a decreased ability to mobilize stem cells reflects a chemotherapy-induced reduction in the number of normal and leukemic stem cells. We therefore analyzed whether the mobilizing capacity of these patients was of prognostic significance. 342 AML-patients in first CR received daily G-CSF from day 20 of the consolidation course and underwent 1-6 aphereses to obtain a minimum dose of 2 x 10(6) CD34+ cells/kg. Afterwards they were randomized for autologous bone marrow (BM) or blood SCT. As a surrogate marker for the mobilizing capacity, the highest yield of CD34+ cells of a single apheresis was adopted. Patients could be categorized into four groups: no harvest (n = 76), low yield (<1 x 10(6) CD34+/kg; n = 50), intermediate yield (1-6.9 x 10(6) CD34+ cells/kg; n = 128) and high yield (> or = 7 x 10(6) CD34+ cells/kg; n = 88). The median follow-up was 3.4 years; 163 relapses and 16 deaths in CR were reported. Autologous blood or BM SCT was performed in 36%, 64%, 81% and 88%, respectively, of the patients assigned to the no harvest, low, intermediate and high CD34+ yield group. The 3-year disease-free survival rate was 46.7%, 65.0%, 50.4% and 26.9% (P = 0.0002) and the relapse incidence was 47.5%, 30.1%, 43.1% and 71.9% (P < 0.0001). Multivariate Cox's proportional hazards model showed that the CD34+ yield was the most important independent prognostic variable (P = 0.005) after cytogenetics. Patients with the highest mobilizing capacity have a poor prognosis due to an increased relapse incidence.
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Affiliation(s)
- S Keating
- Department of Hematology, St Radboud University Hospital, Nijmegen, The Netherlands
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30
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Balducci G, Campodonico M, Gigli G, Meloni G, Cesaro SN. Experimental and computational study of the new gaseous molecules OMnF and OMnF2. J Chem Phys 2002. [DOI: 10.1063/1.1520141] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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31
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Meloni G, Trisolini SM, Capria S, Torelli GF, Baldacci E, Torromeo C, Valesini G, Mandelli F. How long can we give interleukin-2? Clinical and immunological evaluation of AML patients after 10 or more years of IL2 administration. Leukemia 2002; 16:2016-8. [PMID: 12357352 DOI: 10.1038/sj.leu.2402566] [Citation(s) in RCA: 16] [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] [Received: 12/04/2001] [Accepted: 03/03/2002] [Indexed: 11/09/2022]
Abstract
We have treated 20 patients, affected by acute myelogenous leukemia in advanced phase of the disease, with intravenous high-dose recombinant interleukin-2 (IL2) as induction treatment, achieving a complete remission (CR) in 11/20 of patients (55%). All CR patients were planned to receive a maintenance program with lower subcutaneous doses of IL2 until relapse. Currently, 5/11 patients are alive in continuous complete remission with a minimum follow-up of 9 years from IL2 induction. In the aim to investigate the treatment's side-effects during or after prolonged IL2 therapy, we decided to submit these patients to a clinical and immunological evaluation. Four patients have been evaluated as one, who independently stopped IL2 after 6 years, refused the check-up. No organ-specific treatment sequelae that may decrease the quality of life or may be life-threatening were found, concerning renal, liver and cardiovascular function. Endocrine abnormalities were detected in three patients, the most serious being a severe hypothyroidism, which prompted cessation of IL2 maintenance after 6 years and required thyroid supplementation treatment. Immunological studies were carried out prior to the last IL2 cycle and showed high levels of CD3-positive T cells expressing the IL2 receptor alpha chain (CD25), both in the peripheral blood and in the bone marrow. Our study shows that low-dose IL2 can be given for a prolonged period of time without serious organ-specific late sequelae and with a good quality of life.
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Affiliation(s)
- G Meloni
- Department of Biotecnologie Cellulari ed Ematologia, University La Sapienza, Rome, Italy
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32
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Meloni G, Gingerich KA. Atomization energies and enthalpies of formation of the SnBin (n=1–3) gaseous molecules by Knudsen cell mass spectrometry. J Chem Phys 2002. [DOI: 10.1063/1.1461813] [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: 11/15/2022] Open
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Proia A, Paesano R, Torcia F, Annino L, Capria S, Ferrari A, Ferrazza G, Pacifici E, Pantalissi A, Meloni G. Thrombotic thrombocytopenic purpura and pregnancy: a case report and a review of the literature. Ann Hematol 2002; 81:210-4. [PMID: 11976823 DOI: 10.1007/s00277-001-0426-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2001] [Accepted: 12/13/2001] [Indexed: 11/27/2022]
Abstract
Thrombotic thrombocytopenic purpura (TTP) is a severe disorder affecting the microcirculation of multiple organ systems. Plasma therapy has significantly reduced the mortality rate. Infections, pregnancy, cancers, drugs, and surgery were frequently associated with the initial episodes and relapses. Women who are either pregnant or in the postpartum period make up 10-25% of TTP patients, suggesting the interrelationship between TTP and pregnancy. The introduction of aggressive treatment with plasma transfusion or plasmapheresis improved maternal and fetal survival rates. We describe a case of a first successful pregnancy concomitant to a late relapse of TTP, in which the identification of important risk factors for both TTP and pregnancy allowed us easier hematological and obstetrical management. Proposed guidelines for pregnancy-related TTP management and a brief review of current treatment options for this rare condition are also included.
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Affiliation(s)
- A Proia
- Ematologia, Dipartimento di Biotecnologie Cellulari ed Ematologia, University La Sapienza, Rome, Italy
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Meloni G, Proia A, Antonini G, De Lena C, Guerrisi V, Capria S, Trisolini SM, Ferrazza G, Sideri G, Mandelli F. Thrombotic thrombocytopenic purpura: prospective neurologic, neuroimaging and neurophysiologic evaluation. Haematologica 2001; 86:1194-9. [PMID: 11694406] [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: 02/22/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Neurologic symptoms are present in 60% of patients with thrombotic thrombocytopenic purpura (TTP) on initial examination and ultimately develop in about 90% of cases during the course of the disease. Despite central nervous system involvement being frequent, abnormalities in the brain of patients with TTP are infrequent on neuroimaging (CT/MRI) and neurophysiologic (EEG) evaluation, often reversible and mainly limited to symptomatic stages of the disease. The aim of our study was to establish the value of a complete neurologic screening as part of the work up of TTP. DESIGN AND METHODS We prospectively evaluated 16 TTP patients, performing serial neurologic, neuroimaging and EEG examinations, independently of the presence of an objective central nervous system involvement. RESULTS Our study shows that a complete neurologic evaluation is of modest help in improving the diagnosis of TTP, but may be useful for the neurologic management. INTERPRETATION AND CONCLUSIONS Accurate neuroimaging and, especially, EEG evaluation and monitoring allowed us to identify patients who could benefit from anticonvulsive therapy, avoiding the unnecessary administration of the latter. The prognostic utility of complete neurologic screening in TTP remains to be conclusively demonstrated in larger prospective neurologic studies.
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Affiliation(s)
- G Meloni
- Dipartimento di Biotecnologie Cellulari ed Ematologia, University La Sapienza, Roma, Italy.
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Manfredi P, Cisternino M, Sampaolo P, Meloni G, Domini R. [Recurrent abdominal pain and primary amenorrhea in an adolescent with plurimalformative syndrome]. Minerva Pediatr 2001; 53:501-2. [PMID: 11668291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Affiliation(s)
- P Manfredi
- U. O. Pediatria, Azienda USL, Piacenza, Italy
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Petti MC, Pinazzi MB, Diverio D, Romano A, Petrucci MT, De Santis S, Meloni G, Tafuri A, Mandelli F, Lo Coco F. Prolonged molecular remission in advanced acute promyelocytic leukaemia after treatment with gemtuzumab ozogamicin (Mylotarg CMA-676). Br J Haematol 2001; 115:63-5. [PMID: 11722411 DOI: 10.1046/j.1365-2141.2001.03091.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.0] [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: 11/20/2022]
Abstract
We report a patient with acute promyelocytic leukaemia (APL) who received two doses of gemtuzumab ozogamicin for advanced disease. Previous treatments included front-line all-trans retinoic acid and anthracyclines, polychemotherapy consolidation, salvage chemotherapy for the first relapse followed by autologous stem cell transplantation (ASCT), arsenic trioxide for the second relapse followed by a second ASCT and then high-dose methotrexate for more advanced systemic disease with central nervous system involvement. The patient achieved prolonged haematological and molecular remission after monotherapy with gemtuzumab ozogamicin given at the time of the third relapse.
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MESH Headings
- Adult
- Aminoglycosides
- Anti-Bacterial Agents/therapeutic use
- Antibiotics, Antineoplastic/therapeutic use
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Humanized
- Antigens, CD/immunology
- Antigens, Differentiation, Myelomonocytic/immunology
- Arsenic Trioxide
- Arsenicals/therapeutic use
- Central Nervous System/immunology
- Combined Modality Therapy
- Female
- Gemtuzumab
- Gene Rearrangement
- Genes, MDR
- Hematopoietic Stem Cell Transplantation
- Humans
- Leukemia, Promyelocytic, Acute/drug therapy
- Leukemia, Promyelocytic, Acute/genetics
- Leukemia, Promyelocytic, Acute/immunology
- Leukemic Infiltration
- Oxides/therapeutic use
- Sialic Acid Binding Ig-like Lectin 3
- Translocation, Genetic
- Tretinoin/therapeutic use
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Affiliation(s)
- M C Petti
- Department of Cellular Biotechnology and Haematology, University La Sapienza, Roma, Italy
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Meloni G, Thomson LM, Gingerich KA. Structure and thermodynamic stability of the OsC and OsC2 molecules by theoretical calculations and by Knudsen cell mass spectrometry. J Chem Phys 2001. [DOI: 10.1063/1.1390504] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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39
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Meloni G, Proia A, Capria S, Romano A, Trapé G, Trisolini SM, Vignetti M, Mandelli F. Obesity and autologous stem cell transplantation in acute myeloid leukemia. Bone Marrow Transplant 2001; 28:365-7. [PMID: 11571508 DOI: 10.1038/sj.bmt.1703145] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2001] [Accepted: 05/11/2001] [Indexed: 11/09/2022]
Abstract
In the bone marrow transplant setting, several authors hypothesized that severely overweight patients are at increased risk of transplant-related toxicity, but different definitions of obesity, different body weight groupings and heterogeneous samples of patients were analyzed. To overcome these limitations, we retrospectively considered a homogeneous group of 54 patients (median age 36.5 years), with a diagnosis of de novo acute myeloid leukemia (AML), autografted in first complete remission (CR) with the Bu-Cy2 conditioning regimen, dosed on actual body weight. Patients were classified into three groups (obese, non-obese, underweight) using body mass index (BMI = kg/m(2)); for each group we analyzed transplant-related toxicity and mortality, overall survival and disease-free survival (OS/DFS). In spite of the relatively small number of patients, in our results high BMI appears a predictive factor for an increase of treatment-related toxicity and mortality. Moreover, 30 (55%) patients are currently alive in continuous CR, and after a median follow-up of 76.5 months (range 14-137) statistically significant differences in OS and DFS were detected between obese and non-obese groups (P = 0.012 and 0.021, respectively). Our study suggests that obesity may represent an independent risk factor for autograft in AML and further investigations are warranted.
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Affiliation(s)
- G Meloni
- Department of Biotecnologie Cellulari ed Ematologia, University La Sapienza, Roma, Italy
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Cesaro S, Meloni G, Messina C, Pillon M, Proglia A, Lanino E, Caniggia M, Bagnulo S, Pession A, Locatelli F. High-dose melphalan with autologous hematopoietic stem cell transplantation for acute myeloid leukemia: results of a retrospective analysis of the Italian Pediatric Group for Bone Marrow Transplantation. Bone Marrow Transplant 2001; 28:131-6. [PMID: 11509930 DOI: 10.1038/sj.bmt.1703122] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2000] [Accepted: 05/16/2001] [Indexed: 11/09/2022]
Abstract
This retrospective study from the Italian Association of Pediatric Hematology Oncology-Bone Marrow Transplant Group (AIEOP-TMO) reports the results of consolidation with high-dose melphalan and autologous hematopoietic stem cell transplantation (auto-HSCT) in patients with acute myeloid leukemia (AML) in first complete remission (CR1). From October 1994 to July 1999, 20 patients (median age 9.9 years, range 0.11-16.2) were treated in six centers. Eighteen had de novo AML and two had secondary AML. According to BFM criteria, 10 were classified as standard- and 10 as high-risk patients, respectively. The median time from diagnosis to CR1 and from diagnosis to Auto-HSCT were 1.1 months (range 0.8-1.6) and 4.3 months (range 3.1-6.2), respectively. Purging with either mafosfamide (three) or in vivo interleukin-2 (four) was performed in seven of 20 patients. Melphalan was administered at a dosage of 150-220 mg/m(2) (median 180). Median total number of nucleated cells infused was 2.5 x 10(8)/kg (range 1.1-8.9). The myeloablative regimen was well tolerated with no toxic death, veno-occlusive disease or life-threatening complications. All patients had hematopoietic recovery in a median time of 27 days for neutrophils and 44 days for platelets. Eight of 20 patients relapsed after a median time of 7.2 months from transplant (range 5.7-15.9). Six of them died (five of progression of disease and one of sepsis) while the remaining two patients are alive in CR2. The 3-year cumulative probability of survival and event-free-survival (EFS) is 62% and 56%, respectively. This study showed that in pediatric patients with AML consolidation of CR1 with high-dose melphalan allows survival and EFS to be obtained comparable to other auto-HSCT or chemotherapy published series with a potential sparing effect both on duration of treatment (with respect to chemotherapy) and on long-term side-effects (with respect to auto-HSCT with TBI or busulfan containing regimens).
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MESH Headings
- Adolescent
- Antineoplastic Agents, Alkylating/therapeutic use
- Bone Marrow Purging/methods
- Child
- Child, Preschool
- Combined Modality Therapy
- Cyclophosphamide/analogs & derivatives
- Cyclophosphamide/therapeutic use
- Female
- Hematopoietic Stem Cell Transplantation/adverse effects
- Humans
- Infant
- Interleukin-2/therapeutic use
- Italy
- Leukemia, Myeloid, Acute/classification
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/mortality
- Leukemia, Myeloid, Acute/therapy
- Male
- Melphalan/adverse effects
- Melphalan/therapeutic use
- Patient Selection
- Retrospective Studies
- Survival Rate
- Transplantation, Autologous
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Affiliation(s)
- S Cesaro
- Clinica di Oncoematologia Pediatrica, Dipartimento di Pediatria, Università di Padova, Italy
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Meloni G, Capria S, Vignetti M, Alimena G, de Fabritiis P, Montefusco E, Mandelli F. Ten-year follow-up of a single center prospective trial of unmanipulated peripheral blood stem cell autograft and interferon-alpha in early phase chronic myeloyd leukemia. Haematologica 2001; 86:596-601. [PMID: 11418368] [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: 02/20/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The potential role of autologous stem cell transplantation (ASCT) as an alternative therapeutic strategy in chronic myelogenous leukemia (CML) has been widely explored in pilot studies, but the clinical results in terms of survival have so far been evaluated only retrospectively and in heterogeneous groups of patients. The goal of our prospective study was to evaluate the feasibility and long-term efficacy of unmanipulated ASCT followed by low-dose interferon-alpha in a homogeneous group of patients affected by CML in a very early phase of disease. DESIGN AND METHODS Twenty-six unselected consecutive patients with CML in chronic phase underwent stem cell collection at diagnosis, then received cytoreductive treatment with hydroxyurea and, subsequently, a busulphan-melphalan myeloablative regimen followed by unmanipulated stem cell graft within one year of diagnosis. Interferon was given a median of 6.5 months after transplant at escalating doses, starting from 0.5 x 10(6) IU 3 times/week, on the basis of the clinical and hematologic tolerance. RESULTS Median chronic phase duration from diagnosis is 9 years. The ten-year projected probability of overall survival from diagnosis is 55% with a median follow-up of surviving patients of 9.5 years (8-10.5); median survival has not been reached after ten years. INTERPRETATION AND CONCLUSIONS Our experience suggests that high-dose therapy followed by unmanipulated peripheral blood stem cell transplantation and low-dose interferon-alpha is a feasible approach, which results in long-term survival in newly diagnosed CML patients. These data need to be confirmed in controlled trials comparing ASCT with other therapeutic approaches, such as the use of interferon-alpha alone or in combination with other agents.
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Affiliation(s)
- G Meloni
- Dipartimento di Biotecnologie Cellulari ed Ematología, Università La Sapienza, Rome, Italy.
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Colombo C, Argiolas L, La Vecchia C, Negri E, Meloni G, Meloni T. Influenza vaccine in healthy preschool children. Rev Epidemiol Sante Publique 2001; 49:157-62. [PMID: 11319482] [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: 02/19/2023] Open
Abstract
BACKGROUND Studies of influenza vaccination in healthy children have not definitely answered the question of their efficacy. METHODS We have carried out a randomized trial in a well selected population of healthy preschool children in Sardinia, Italy. During October 1995, 344 children aged 1 to 6 years, were randomly assigned to receive influenza vaccine (n=177) or no treatment (n=167). Two doses of a trivalent subvirion vaccine, containing 15mg of highly purified surface antigens from the component strains A/Johannesburg/33/94-like, A/Singapore/6/86-like and B/ Beijing/184/ 93-like were administered. Follow-up data were collected from December 1, 1995 through April 30, 1996. RESULTS Seroconversion was documented in 17 out of 17 children. No specific systemic symptoms or severe local reactions were observed after vaccination. Influenza-like episodes, defined by the presence of fever and cough or sore throat that lasted at least 72 hours, occurred in 63 (37.7%) of unvaccinated children and in 22 (12.4%) of vaccinated ones. The corresponding reduction in disease incidence was 67% (95% CI: 0.59-0.74). Three episodes of otitis were observed among children in the control group versus zero among vaccinated children (p=0.07). Mean duration of day care center absenteism was significantly reduced by vaccination (2.3 days in unvaccinated and 0.5 day in vaccinated children, p<0.001) CONCLUSIONS Influenza vaccine is safe and effective in healthy preschool children. However the favourable implications of vaccination on disease rate in subsequent years have to be evaluated.
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Affiliation(s)
- C Colombo
- Department of Pediatrics and Neonatology, University of Sassari, Viale San Petro 12, 07100 Sassari, Italy.
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Cartoni C, Dragoni F, Micozzi A, Pescarmona E, Mecarocci S, Chirletti P, Petti MC, Meloni G, Mandelli F. Neutropenic enterocolitis in patients with acute leukemia: prognostic significance of bowel wall thickening detected by ultrasonography. J Clin Oncol 2001; 19:756-61. [PMID: 11157028 DOI: 10.1200/jco.2001.19.3.756] [Citation(s) in RCA: 147] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Neutropenic enterocolitis (NE) is a severe complication of intensive chemotherapy and is barely identifiable by clinical signs alone. Ultrasonography (US) supports the diagnosis of NE by showing pathologic thickening of the bowel wall. The aim of this study was to evaluate the prognostic value of the degree of mural thickening evaluated by US in patients with clinically suspected NE. PATIENTS AND METHODS Neutropenic patients with fever, diarrhea, and abdominal pain after intensive chemotherapy for hematologic malignancies were studied with abdominal US. We evaluated the degree of bowel wall thickening detected by US and its correlation with the duration of the clinical syndrome as well as NE-related mortality. RESULTS Eighty-eight (6%) of 1,450 consecutive patients treated for leukemia had clinical signs of NE. In 44 (50%) of 88 patients, US revealed pathologic wall thickening (mean +/- SD, 10.2 +/- 2.9 mm; range, 6 to 18). The mean duration of symptoms was significantly longer in this group (7.9 days) than among patients without mural thickening (3.8 days, P <.0001), and the NE-related mortality rate was higher (29.5% v 0%, P <.001). Patients with bowel wall thickness of more than 10 mm had a significantly higher mortality rate (60%) than did those with bowel wall thickness < or = 10 mm (4.2%, P <.001). CONCLUSION Symptomatic patients with sonographically detected bowel wall thickening have a poor prognosis compared with patients without this finding. In addition, mural thickness of more than 10 mm is associated with poorer outcome among patients with NE.
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MESH Headings
- Acute Disease
- Adolescent
- Adult
- Blast Crisis/complications
- Blast Crisis/drug therapy
- Child
- Enterocolitis/chemically induced
- Enterocolitis/diagnostic imaging
- Enterocolitis/mortality
- Enterocolitis/pathology
- Humans
- Intestines/diagnostic imaging
- Intestines/pathology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/complications
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Leukemia, Myeloid/complications
- Leukemia, Myeloid/drug therapy
- Lymphoma, Non-Hodgkin/complications
- Lymphoma, Non-Hodgkin/drug therapy
- Middle Aged
- Neutropenia/chemically induced
- Neutropenia/diagnostic imaging
- Neutropenia/mortality
- Neutropenia/pathology
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy
- Prognosis
- Ultrasonography
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Affiliation(s)
- C Cartoni
- Department of Biotecnologie Cellulari ed Ematologia, Policlinico Umberto I, University La Sapienza, Rome, Italy.
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Beluffi G, Bassi L, Vitali MC, Meloni G, Caselli D. [Parry-Romberg syndrome and odontogenic cyst. A case report]. Radiol Med 2001; 101:88-90. [PMID: 11360760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Affiliation(s)
- G Beluffi
- Sezione di Radiologia Pediatrica, Servizio di Radiodiagnostica, IRCCS Policlinico S. Matteo, Pavia.
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Lupo R, Rapisarda S, Bottinelli O, Callegari L, Meloni G, Sammarchi L. Ultrasound and MRI for the long-term evaluation of surgical repair of the rotator cuffs. Chir Organi Mov 2001; 86:21-7. [PMID: 12025099] [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: 02/25/2023]
Abstract
About 1 year after surgery to repair the rotator cuff, a total of 20 patients (80% monotendinous injuries, 20% bitendinous injuries) were submitted to ultrasound and MRI to evaluate repair, quality of residual tissue, and to reveal any discrepancies between the two instrumental tests. The results showed that there was normal tendinous integrity in 16 cases (group A), while there were partial injuries, without evidence of complete lesion, in 4 cases (group B); tendinous thinning was evident in 10 patients (50%), while there were areas of intratendinous degeneration in 40% of the cases. The authors observed agreement between the data obtained by the two methods in 75% of cases, and emphasize the effectiveness of the two methods in postoperative evaluation of the cuff; they also confirm the tendinous dishomogeneousness observed in the patients in group B, not associated with poor clinical results, considering the absence of significant differences in the functional results between the two groups.
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Affiliation(s)
- R Lupo
- Istituto di Clinica Ortopedica e Traumatologica dell'Università di Pavia
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Meloni G, Gingerich KA. Thermodynamic study of the gaseous molecules Al2N, AlN, and Al2N2 by Knudsen cell mass spectrometry. J Chem Phys 2000. [DOI: 10.1063/1.1326848] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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Pinciroli F, Nahaissi D, Boschini M, Ferrari R, Meloni G, Camnasio M, Spaggiari P, Carnerone G. Security concept in 'MyAngelWeb' a website for the individual patient at risk of emergency. Int J Med Inform 2000; 60:203-10. [PMID: 11156740] [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: 02/18/2023]
Abstract
We describe the Security Plan for the 'MyAngelWeb' service. The different actors involved in the service are subject to different security procedures. The core of the security system is implemented at the host site by means of a DBMS and standard Information Technology tools. Hardware requirements for sustainable security are needed at the web-site construction sites. They are not needed at the emergency physician's site. At the emergency physician's site, a two-way authentication system (password and test phrase method) is implemented.
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Affiliation(s)
- F Pinciroli
- Department of Bioengineering, Politechnico di Milano, Cattedra di Informatica Medica, Milan, Italy.
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Meloni G, Capria S, Trasarti S, Ferrazza G, Micozzi A, Petrucci MT, Simone F, Trisolini SM, Mandelli F. High-dose idarubicine, busulphan and melphalan as conditioning for autologous blood stem cell transplantation in multiple myeloma. A feasibility study. Bone Marrow Transplant 2000; 26:1045-9. [PMID: 11108301 DOI: 10.1038/sj.bmt.1702668] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Extensive studies have tested the clinical impact of double and triple sequential transplants as front-line therapy in MM, following the suggestion that dose escalation can overcome the marked drug resistance characteristic of this disease, but the superiority of such approaches vs one single transplant has still to be demonstrated. The aim of our study was to evaluate the feasibility and efficacy of high-dose idarubicine intensification of a standard busulphan-melphalan conditioning regimen in MM. Twenty-eight patients (median age 55 years) with sensitive disease received PBSCT after high-dose idarubicine combined with busulphan and melphalan and followed by s.c. rhG-CSF until PMN recovery. The most severe toxicity was represented by oral mucositis which resolved with hemopoietic reconstitution. Overall response and CR rate were 52% and 40%, respectively. Currently, 36 patients are alive and 19 are progression-free a median of 20 months (12-36) from transplant. The 3-year projected probability of progression-free survival for patients transplanted after first-line treatment is 60%. The combination of Ida/Bu/Melph appears a promising alternative regimen for PBSCT in myeloma, with low transplant-related toxicity and fast hematological recovery. Long-term follow-up and a prospective randomized study, now ongoing, will probably clarify whether an idarubicine-intensified regimen will result in superior outcomes to conventional conditioning and even be comparable to a double consecutive transplant program.
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Affiliation(s)
- G Meloni
- Department of Biotecnologie Cellulari ed Ematologia, University La Sapienza, Roma, Italy
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