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Ligia S, Passucci M, Assanto GM, D'Elia GM, Annechini G, De Propris MS, Martelli M, Del Giudice I, Tiacci E, Pulsoni A. Early clearance of hairy cell leukaemia in the bone marrow after first-line treatment with cladribine predicts a favourable outcome. Br J Haematol 2024; 204:1288-1292. [PMID: 38050458 DOI: 10.1111/bjh.19237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/15/2023] [Accepted: 11/21/2023] [Indexed: 12/06/2023]
Abstract
First-line purine nucleoside analogues (PNAs) in hairy cell leukaemia (HCL) allow deep and long-lasting responses. We retrospectively analysed 53 HCL patients treated frontline with cladribine and assessed for response at 2 and 6 months after treatment to evaluate the kinetics of response. The estimated median progression-free survival was significantly different according to the degree of residual HCL infiltrate detected by immunohistochemistry at the bone marrow biopsy at 2 months (≤5% vs. >5%, 247 vs. 132 months, respectively, p = 0.033), but not at 6 months (p = 0.79). Our data suggest a favourable prognostic impact of early marrow HCL clearance in patients treated with cladribine.
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Affiliation(s)
- S Ligia
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - M Passucci
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - G M Assanto
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - G M D'Elia
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - G Annechini
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - M S De Propris
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - M Martelli
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - I Del Giudice
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - E Tiacci
- Department of Medicine and Surgery, Institute of Hematology and Center for Hemato-Oncology Research, University and Hospital of Perugia, Perugia, Italy
| | - A Pulsoni
- Hematology, Department of Translational and Precision Medicine, Sapienza University, S.M. Goretti Hospital, Latina, Italy
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Assanto GM, Ciotti G, Brescini M, Agrippino R, Lapietra G, De Luca ML, Annechini G, D'Elia GM, Chiaravalloti A, Del Giudice I, Pulsoni A. FAVOURABLE PROGNOSTIC ROLE OF HIGH BASAL MAXIMAL STANDARDIZED UPTAKE VALUE IN FOLLICULAR LYMPHOMA. Hematol Oncol 2021. [DOI: 10.1002/hon.95_2881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- G. M. Assanto
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - G. Ciotti
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - M. Brescini
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - R. Agrippino
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - G. Lapietra
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - M. L. De Luca
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - G. Annechini
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - G. M. D'Elia
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - A. Chiaravalloti
- Nuclear medicine Department of Biomedicine and Prevention Nuclear Medicine University Tor Vergata Rome Italy
| | - I. Del Giudice
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - A. Pulsoni
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
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Assanto GM, Agrippino R, Lapietra G, De Luca ML, Chiaravalloti A, Annechini G, D'Elia GM, Ciotti G, Martelli M, Pulsoni A. THE ROLE OF END OF TREATMENT PET CT EVALUATED BY DEAUVILLE FIVE‐POINT SCALE AS PROGNOSTIC ROLE IN HODGKIN LYMPHOMA. Hematol Oncol 2021. [DOI: 10.1002/hon.69_2881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- G. M. Assanto
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - R. Agrippino
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - G. Lapietra
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - M. L. De Luca
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - A. Chiaravalloti
- Nuclear medicine Department of Biomedicine and Prevention Nuclear Medicine University Tor Vergata Rome, Italy Rome Italy
| | - G. Annechini
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - G. M. D'Elia
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - G. Ciotti
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - M. Martelli
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - A. Pulsoni
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
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Fama A, Rago A, Gioiosa F, Marzano C, Latagliata R, Mammì C, Laganà C, D'Elia GM, Bizzoni L, Trasarti S, Ferretti A, Breccia M, Riggio O, Tafuri A. [Budd-Chiari syndrome and splanchnic vein thrombosis: masked myeloproliferative neoplasms and JAK2V617F]. Clin Ter 2010; 161:169-171. [PMID: 20499034] [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: 05/29/2023]
Abstract
The Budd-Chiari Syndrome (BCS) and the splanchnic vein thrombosis are characterized by hepatic venous outflow obstruction, generally due to venous thrombosis. These rare diseases are usually caused by multiple concurrent factors, including acquired and inherited thrombophilias. Since the diagnosis of myeloproliferative neoplasms (MPNs) is often difficult in patients with BCS and splanchnic vein thrombosis because of spleen enlargement, secondary pancytopenia and bleeding disorders, recent observations have included in the diagnostic work-up the analysis of the JAK2 mutation. The revision of several recent reports clarify the importance of the JAK2V617F detection in the diagnostic work-up of the BCS and splanchnic vein thrombosis, allowing the demonstration of masked MPNs among these cases that may benefit, in the near future, of target molecular therapies directed toward the JAK2 mutation.
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Affiliation(s)
- A Fama
- Dipartimento di Biotecnologie Cellulari ed Ematologia, Università Sapienza, Roma, Italia
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Breccia M, Cannella L, Frustaci A, Stefanizzi C, D'Elia GM, Alimena G. Chronic myelomonocytic leukemia with antecedent refractory anemia with excess blasts: Further evidence for the arbitrary nature of current classification systems. Leuk Lymphoma 2009; 49:1292-6. [DOI: 10.1080/10428190802123499] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [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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Latagliata R, Bongarzoni V, Carmosino I, Mengarelli A, Breccia M, Borza PA, D'Andrea M, D'Elia GM, Mecarocci S, Morano SG, Petti MC, Mandelli F, Alimena G. Acute myelogenous leukemia in elderly patients not eligible for intensive chemotherapy: the dark side of the moon. Ann Oncol 2006; 17:281-5. [PMID: 16373393 DOI: 10.1093/annonc/mdj112] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [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: 11/13/2022] Open
Abstract
BACKGROUND Acute Myelogenous Leukemia (AML) is a common disease in people aged>60 years. About 50% of the patients are not eligible for aggressive chemotherapy (CT) and are only managed with conservative approaches. Results in this subset of patients have not been reported so far. PATIENTS AND METHODS We retrospectively evaluated 244 consecutive elderly AML patients (M/F 143/101, median age 72 years, range 60-90) diagnosed at our institution from January 1989 to December 1998 and not eligible for intensive CT. Eighty-nine patients (36.5%) had evolved from previous myelodysplasia (sAML). Fifty-three out of 192 (26.4%) patients with available bone marrow (BM) analysis had oligoblastic leukaemia (blasts<40% and WBC<15x10(9)/l). RESULTS Sixty-seven patients (27.5%) were managed with supportive treatment only. One hundred seventy-seven patients (72.5%), in order to control disease, received conservative CT, consisting of Hydroxyurea (HU) (127 patients, 71.7%), Cytarabine and 6-Thioguanine (39 patients, 22%) or low-dose cytarabine (11 patients, 6.3%). Median overall survival was 179 days (1-3278) with 50 patients (20.5%) surviving>12 months. Older age (>75 years), poor WHO PS (>2), lower PLT levels (<50x10(9)/l) and higher absolute peripheral blast count (>5x10(9)/l) showed a negative prognostic impact on survival in multivariate analysis. CONCLUSIONS Our data outline the great heterogeneity of elderly AML patients not eligible for intensive CT. A simple scoring system including easily evaluable parameters, which could distinguish subjects with different prognosis, is proposed. Moreover, randomized studies in order to establish best conservative approaches are warranted.
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Affiliation(s)
- R Latagliata
- Dipartimento di Biotecnologie Cellulari ed Ematologia, Universita La Sapienza di Roma, Ematologia, Ospedale S. Giovanni, Roma, Ematologia, Istituto Regina Elena, Roma, Italy.
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Breccia M, Petti MC, Fraternali-Orcioni G, Monarca B, Latagliata R, D'Elia GM, Mandelli F, Pileri SA. Granulocytic sarcoma with breast and skin presentation: a report of a case successfully treated by local radiation and systemic chemotherapy. Acta Haematol 2001; 104:34-7. [PMID: 11111120 DOI: 10.1159/000041067] [Citation(s) in RCA: 12] [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: 11/19/2022]
Abstract
Granulocytic sarcoma (GS) is a rare extramedullary tumor composed of immature myeloid cells. It is usually associated with leukemia or other myeloproliferative disorders, but can also occur without overt hematologic disease, i.e. in patients with a normal bone marrow and no history of acute myelogenous leukemia. This primary extramedullary lesion may indeed represent a diagnostic and therapeutic dilemma for both the hematopathologist and oncologist. We describe a case of GS diagnosed in a nonleukemic patient and review the literature regarding the pathologic features and treatment of this condition.
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MESH Headings
- Aged
- Antineoplastic Agents/therapeutic use
- Breast Neoplasms/diagnosis
- Breast Neoplasms/pathology
- Breast Neoplasms/therapy
- Combined Modality Therapy
- Female
- Humans
- Immunophenotyping
- Leukemia/diagnosis
- Leukemia/pathology
- Leukemia/therapy
- Leukemia, Myeloid/diagnosis
- Leukemia, Myeloid/pathology
- Leukemia, Myeloid/therapy
- Leukemia, Myeloid, Acute/diagnosis
- Leukemia, Myeloid, Acute/immunology
- Leukemia, Myeloid, Acute/therapy
- Radiotherapy, Adjuvant
- Skin Neoplasms/diagnosis
- Skin Neoplasms/pathology
- Skin Neoplasms/therapy
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Affiliation(s)
- M Breccia
- Dipartimento di Biotecnologie Cellulari ed Ematologia, Università La Sapienza, Roma, Italia
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Latagliata R, Breccia M, Pulsoni A, Aloe Spiriti MA, D'Elia GM, Spadea A, Montefusco E, Luzi G, Betrò P, Petti MC. Acute myeloblastic leukemia secondary to myelodysplasia (MDS-AML): a comparison of remission induction with three drugs versus standard two-drugs induction. Leuk Lymphoma 2000; 36:539-41. [PMID: 10784399 DOI: 10.3109/10428190009148402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 11/13/2022]
Abstract
To evaluate the addition of a third drug to standard induction chemotherapy in patients with MDS-AML, 23 patients (males/females 13/10, median age 54.3 years, range 24-74 years, median MDS duration 9.8 months, range 2-39 months) who received a standard 2-drugs induction were compared with 23 patients (males/females 11/12, median age 45.6 months, range 21-60 years, median MDS duration 8.3 months, range 2-29 months) who received an intensified 3-drugs induction with etoposide. CR rate, median CR duration and median OS were similar in both groups (48% vs 56%, 4.8 vs 5.9 months, 6.5 vs 7.0 months respectively). Among responding patients, all but one, who underwent allogeneic bone marrow transplantation, relapsed. In conclusion, addition of a third drug (etoposide) does not seem to significantly improve the poor prognosis of MDS-AML patients.
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Affiliation(s)
- R Latagliata
- Dipartimento di Biotecnologie Cellulari ed Ematologia, Università La Sapienza of Rome, Italy
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Girmenia C, Alimena G, Latagliata R, Morano SG, Celesti F, Coppola L, Spadea A, Tosti S, Mecarocci S, D'Elia GM, Tafuri A, Cimino G, Mandelli F. Out-patient management of acute myeloid leukemia after consolidation chemotherapy. Role of a hematologic emergency unit. Haematologica 1999; 84:814-9. [PMID: 10477455] [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: 02/13/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Increasing attention to quality of life and to health care costs has recently induced several cancer centers to change in-patient management into an out-patient setting even during high risk phases of disease. The aim of this prospective study was to evaluate feasibility and safety, as well as clinical characteristics, of out-hospital management of AML patients during their post-consolidation phase. DESIGN AND METHODS All patients who were treated over a three year period by the three following protocols were included in the study: AML10 EORTC/GIMEMA for patients with AML, except for APL, aged </= 60 years; AML 13 EORTC/GIMEMA, for patients with AML, except for APL, aged >60 years; AIDA GIMEMA for APL patients. All patients submitted to the AML10 and AML13 protocols and those patients submitted to the AIDA protocol with difficult peripheral vein access had a central venous catheter (CVC) sited. Patients treated as in-patients were discharged at the end of consolidation chemotherapy provided they were in a good clinical condition. They were routinely evaluated on an out-patient basis twice weekly. In the event of any complication they were referred to the Emergency Unit of our Department dedicated to out-patients with hematologic diseases. RESULTS One hundred and eleven patients with AML were eligible for intensive chemotherapy. After achievement of complete remission they received a total of 133 consolidation courses and in 127 instances they were followed on an out-patient basis during the aplastic phase. There were 69 cases (54%) of rehospitalization, 68 because of fever and only one because of severe anemia. Rehospitalization occurred in 90%,70% and 38% of courses in AML10, AML13 and AIDA protocols, respectively. Only one patient died: the cause of death was a brain hemorrhage. Coagulase negative staphylococci and viridans streptococci were the organisms most frequently isolated from blood. Most coagulase negative staphylococci were isolated in patients submitted to AML10 and AML13 protocols, who had an indwelling CVC. Empiric once-a-day antibacterial therapy with ceftriaxone and amikacin was effective in 75% of the cases and made early discharge possible in 28% of the cases with antibiotic therapy continued in an out-patient setting. Overall, patients were managed out of the hospital for 66% of the period of post-consolidation neutropenia (77%, 48% and 50% of the post-consolidation neutropenia period in patients treated with AIDA, AML10 and AML13 protocols, respectively). INTERPRETATION AND CONCLUSIONS Thanks to the availability of an emergency unit specifically dedicated to out-patients with hematologic diseases, selected out-hospital management of AML patients during post-consolidation cytopenia is a feasible, well accepted and cost-saving option, and can contribute to lower the risk of developing severe nosocomial infections. The empiric therapy with once-a-day ceftriaxone plus amikacin was effective, with the exception of staphylococcal infections, and made it possible to discharge patients early to continue treatment in an out-patient setting.
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Affiliation(s)
- C Girmenia
- Dipartimento di Biotecnologie Cellulari ed Ematologia, University "La Sapienza", Via Benevento 6, 00161, Rome, Italy.
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Sheehan MP, Loschen EL, D'Elia GM. Psychiatrists' perceptions of mental health manpower needs in various population areas. Hosp Community Psychiatry 1985; 36:1111-3. [PMID: 4054869 DOI: 10.1176/ps.36.10.1111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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