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Assanto GM, Di Rocco A, Malfona F, Capriata M, Del Giudice I, Petrucci L, Girardi P, D’Elia GM, Martelli M, Gentile G, Micozzi A, Pulsoni A. Impact of anti-SARS-CoV-2 monoclonal antibodies in the management of patients with lymphoma and COVID19: A retrospective study. Hematol Oncol 2023; 41:343-353. [PMID: 36521843 PMCID: PMC9877821 DOI: 10.1002/hon.3113] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 11/16/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
COVID19 in patients affected by lymphoma represents an important challenge because of the higher mortality rate. Anti-SARS-CoV-2 monoclonal antibodies (anti-S MoAbs) appear promising in this setting. We report a monocentric retrospective study including 176 patients affected by lymphoma which developed SARS-CoV-2 infection since the start of COVID19 pandemic. Overall, mortality was 13.1%, with a decreasing trend between first waves to the last wave of pandemic (18.5% vs. 9.4%, p 0.076). Patients receiving anti-S MoAbs (41.3%) showed inferior mortality rate (overall survival, OS 93.2% vs. 82.7%, p 0.025) with no serious toxicity, reduced documented pneumonia (26% vs. 33%, p 0.005), and reduced need of oxygen support (14.5% vs. 35.7%, p 0.003). Among patients who received 3 doses of vaccine, the employment of anti-COVID MoAbs showed a trend of superior survival versus those who did not receive Anti-S MoAbs (OS rates 97.3% vs. 84.2%, p 0.064). On multivariate analysis, active haematological disease (OS 72% (HR 2.49 CI 1.00-6.41), bendamustine exposure (OS 60% HR 4.2 CI 1.69-10.45) and at least one comorbidity (HR 6.53 CI 1.88-22.60) were independent prognostic factors for death. Our study confirms the adverse prognostic role of COVID-19 in lymphoma patients in presence of active disease, comorbidities and previous exposure to bendamustine. In our experience, anti-S MoAbs represented a therapeutic option in vaccinated patients.
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Affiliation(s)
| | - Alice Di Rocco
- HematologyDepartment of Translational and Precision MedicineSapienza University of RomeRomeItaly
| | - Francesco Malfona
- HematologyDepartment of Translational and Precision MedicineSapienza University of RomeRomeItaly
| | - Marcello Capriata
- HematologyDepartment of Translational and Precision MedicineSapienza University of RomeRomeItaly
| | - Ilaria Del Giudice
- HematologyDepartment of Translational and Precision MedicineSapienza University of RomeRomeItaly
| | - Luigi Petrucci
- HematologyDepartment of Translational and Precision MedicineSapienza University of RomeRomeItaly
| | - Paola Girardi
- HematologyDepartment of Translational and Precision MedicineSapienza University of RomeRomeItaly
| | - Gianna Maria D’Elia
- HematologyDepartment of Translational and Precision MedicineSapienza University of RomeRomeItaly
| | - Maurizio Martelli
- HematologyDepartment of Translational and Precision MedicineSapienza University of RomeRomeItaly
| | - Giuseppe Gentile
- HematologyDepartment of Translational and Precision MedicineSapienza University of RomeRomeItaly
| | - Alessandra Micozzi
- HematologyDepartment of Translational and Precision MedicineSapienza University of RomeRomeItaly
| | - Alessandro Pulsoni
- HematologyDepartment of Translational and Precision MedicineSapienza University of RomeRomeItaly
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Gotti M, Sciarra R, Pulsoni A, Merli F, Luminari S, Zerbi C, Trentin L, Re A, Rusconi C, Viviani S, Rossi A, Cocito F, Botto B, Meli E, Pinto A, Dogliotti I, Gini G, Puccini B, Ricci F, Nassi L, Fabbri A, Liberati AM, Merli M, Filippi AR, Bonfichi M, Zoboli V, Tartaglia G, Annechini G, D’Elia GM, Del Giudice I, Alvarez I, Visentin A, Pravato S, Dalceggio D, Pagani C, Ferrari S, Cristinelli C, Lazic T, Ferretti VV, Ricardi U, Arcaini L. Role of Rituximab Addition to First-line Chemotherapy Regimens in Nodular Lymphocyte-predominant Hodgkin Lymphoma: A Study by Fondazione Italiana Linfomi. Hemasphere 2023; 7:e837. [PMID: 37034003 PMCID: PMC10079338 DOI: 10.1097/hs9.0000000000000837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 12/29/2022] [Indexed: 04/08/2023] Open
Abstract
Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare entity whose neoplastic cells retain a B-cell phenotype with expression of CD20. Radiotherapy is recommended for favorable stage IA disease while for other stages guidelines suggest therapeutic strategies similar to those used for classic HL. The role of rituximab, although quite widespread, is not completely elucidated. We retrospectively analyzed baseline characteristics of 308 consecutive patients with NLPHL diagnosed in 19 Italian centers from 2000 to 2018. With a median follow-up of 8.4 years (interquartile range: 4.5–12.4) for treated patients, median overall survival (OS) was not reached and estimated 5-year OS was 97.8% and 5-year progression-free survival (PFS) was 84.5%. Five-year cumulative incidence of histological transformation was 1.4%, 95% confidence interval (CI), 0.5%-3.8%. After adjusting for lymphocyte count, splenic involvement, bulky disease and B symptoms (fever, drenching night sweats, unintentional loss >10% of body weight within the preceding 6 months), patients with stage II or more showed superior PFS with immunochemotherapy in comparison to chemotherapy alone (hazard ratio = 0.4, 95% CI, 0.2-0.8; P = 0.015). Our data suggest an advantage of the use of rituximab combined with chemotherapy ± radiotherapy in the treatment of stage II–III–IV NLPHL.
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Affiliation(s)
- Manuel Gotti
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Roberta Sciarra
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Molecular Medicine, University of Pavia, Italy
| | - Alessandro Pulsoni
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
| | - Francesco Merli
- Division of Hematology, Azienda USL-IRCCS of Reggio Emilia, Italy
| | - Stefano Luminari
- Division of Hematology, Azienda USL-IRCCS of Reggio Emilia, Italy
- Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Italy
| | - Caterina Zerbi
- Department of Molecular Medicine, University of Pavia, Italy
| | - Livio Trentin
- Hematology Unit, Department of Medicine - DIMED, University of Padova, Italy
| | - Alessandro Re
- Division of Hematology, Spedali Civili, Brescia, Italy
| | - Chiara Rusconi
- Division of Hematology and Blood Marrow Transplantation, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Simonetta Viviani
- Division of Hematology and Blood Marrow Transplantation, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Andrea Rossi
- Hematology and Bone Marrow Transplant Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Federica Cocito
- Division of Hematology, ASST Monza, Ospedale S. Gerardo, Monza, Italy
| | - Barbara Botto
- Division of Hematology, Azienda Ospedale Città della Salute e della Scienza, Torino, Italy
| | - Erika Meli
- Division of Hematology, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Antonello Pinto
- Hematology-Oncology and Stem-Cell Transplantation Unit, Department of Hematology and Developmental Therapeutics, Istituto Nazionale Tumori, Fondazione G. Pascale, IRCCS, Napoli, Italy
| | - Irene Dogliotti
- Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino, Italy
| | - Guido Gini
- Department of Hematology, Ospedali Riuniti, Ancona, Italy
| | | | - Francesca Ricci
- Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy
| | - Luca Nassi
- Hematology, Department of Translational Medicine, AOU Maggiore della Carità and University of Eastern Piedmont, Novara, Italy
| | - Alberto Fabbri
- Division of Hematology, Azienda Ospedaliero- Universitaria Senese, Siena, Italy
| | - Anna Marina Liberati
- Division of Hematology, Azienda Ospedalaliera S. Maria di terni – Università degli Studi di Perugia, Italy
| | - Michele Merli
- Division of Hematology, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Andrea Riccardo Filippi
- Radiation Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Italy
| | - Maurizio Bonfichi
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Valentina Zoboli
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Germana Tartaglia
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
| | - Giorgia Annechini
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
| | - Gianna Maria D’Elia
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
| | - Ilaria Del Giudice
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
| | - Isabel Alvarez
- Division of Hematology, Azienda USL-IRCCS of Reggio Emilia, Italy
| | - Andrea Visentin
- Hematology Unit, Department of Medicine - DIMED, University of Padova, Italy
| | - Stefano Pravato
- Hematology Unit, Department of Medicine - DIMED, University of Padova, Italy
| | | | - Chiara Pagani
- Division of Hematology, Spedali Civili, Brescia, Italy
| | - Silvia Ferrari
- Hematology and Bone Marrow Transplant Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | - Tanja Lazic
- Department of Molecular Medicine, University of Pavia, Italy
| | - Virginia Valeria Ferretti
- Service of Clinical Epidemiology and Biometry, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Umberto Ricardi
- Radiation Oncology, Department of Oncology, University of Turin, Italy
| | - Luca Arcaini
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Molecular Medicine, University of Pavia, Italy
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Assanto GM, Ciotti G, Brescini M, De Luca ML, Annechini G, D’Elia GM, Agrippino R, Del Giudice I, Martelli M, Chiaravalloti A, Pulsoni A. High Basal Maximal Standardized Uptake Value (SUV max) in Follicular Lymphoma Identifies Patients with a Low Risk of Long-Term Relapse. Cancers (Basel) 2021; 13:cancers13122876. [PMID: 34207518 PMCID: PMC8227030 DOI: 10.3390/cancers13122876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/03/2021] [Accepted: 06/07/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Despite that the unfavorable prognostic role of a high Total Metabolic Tumor Volume (TMTV) in Follicular Lymphoma has been demonstrated, the role of SUVmax alone at baseline PET/CT could have a different prognostic role. PATIENTS AND METHODS We performed a retrospective observational monocentric cohort study. All patients affected by FL who underwent a basal PET/CT were included. Two subgroups were identified and compared in terms of PFS and OS: (A) Basal SUVmax ≤ 6; and (B) Basal SUVmax > 6. RESULTS Ninety-four patients were included, 34 in group A (36.2%) and 60 in group B (63.8%). The PFS at two years was comparable in the two groups (97%). The five-year PFS was 73.5% for group A and 95% for group B (p 0.005). The five-year PFS in the whole cohort was 87.5%. A clear advantage was confirmed in group A in the absence of other risk factors. Patients with SUVmax ≤ 6 and no risk factors showed a 5-year PFS of 73% against 83% for patients with SUVmax > 6 and at least two risk factors. CONCLUSION A high FDG uptake favorably correlated with PFS. A low basal SUVmax reflected a higher rate of late relapse requiring a prolonged follow-up. The basal SUVmax is an approachable parameter with prognostic implications.
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Affiliation(s)
- Giovanni Manfredi Assanto
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Via Benevento 6, 00161 Rome, Italy; (G.M.A.); (G.C.); (M.B.); (M.L.D.L.); (G.A.); (G.M.D.); (R.A.); (I.D.G.); (M.M.)
| | - Giulia Ciotti
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Via Benevento 6, 00161 Rome, Italy; (G.M.A.); (G.C.); (M.B.); (M.L.D.L.); (G.A.); (G.M.D.); (R.A.); (I.D.G.); (M.M.)
| | - Mattia Brescini
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Via Benevento 6, 00161 Rome, Italy; (G.M.A.); (G.C.); (M.B.); (M.L.D.L.); (G.A.); (G.M.D.); (R.A.); (I.D.G.); (M.M.)
| | - Maria Lucia De Luca
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Via Benevento 6, 00161 Rome, Italy; (G.M.A.); (G.C.); (M.B.); (M.L.D.L.); (G.A.); (G.M.D.); (R.A.); (I.D.G.); (M.M.)
| | - Giorgia Annechini
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Via Benevento 6, 00161 Rome, Italy; (G.M.A.); (G.C.); (M.B.); (M.L.D.L.); (G.A.); (G.M.D.); (R.A.); (I.D.G.); (M.M.)
| | - Gianna Maria D’Elia
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Via Benevento 6, 00161 Rome, Italy; (G.M.A.); (G.C.); (M.B.); (M.L.D.L.); (G.A.); (G.M.D.); (R.A.); (I.D.G.); (M.M.)
| | - Roberta Agrippino
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Via Benevento 6, 00161 Rome, Italy; (G.M.A.); (G.C.); (M.B.); (M.L.D.L.); (G.A.); (G.M.D.); (R.A.); (I.D.G.); (M.M.)
| | - Ilaria Del Giudice
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Via Benevento 6, 00161 Rome, Italy; (G.M.A.); (G.C.); (M.B.); (M.L.D.L.); (G.A.); (G.M.D.); (R.A.); (I.D.G.); (M.M.)
| | - Maurizio Martelli
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Via Benevento 6, 00161 Rome, Italy; (G.M.A.); (G.C.); (M.B.); (M.L.D.L.); (G.A.); (G.M.D.); (R.A.); (I.D.G.); (M.M.)
| | - Agostino Chiaravalloti
- Nuclear Medicine, Department of Biomedicine and Prevention, University Tor Vergata, 00133 Rome, Italy;
- Nuclear Medicine, Istituto Neurologico Mediterraneo IRCCS Neuromed, 86077 Pozzilli, Italy
| | - Alessandro Pulsoni
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Via Benevento 6, 00161 Rome, Italy; (G.M.A.); (G.C.); (M.B.); (M.L.D.L.); (G.A.); (G.M.D.); (R.A.); (I.D.G.); (M.M.)
- Correspondence:
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Molica M, Massaro F, Annechini G, Baldacci E, D’Elia GM, Rosati R, Trisolini SM, Volpicelli P, Foà R, Capria S. Life-Threatening Autoimmune Hemolytic Anemia and Idhiopatic Thrombocytopenic Purpura. Successful Selective Splenic Artery Embolization. Mediterr J Hematol Infect Dis 2016; 8:e2016020. [PMID: 27158433 PMCID: PMC4848020 DOI: 10.4084/mjhid.2016.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 03/14/2016] [Indexed: 11/08/2022] Open
Abstract
Selective splenic artery embolization (SSAE) is a nonsurgical intervention characterized by the transcatheter occlusion of the splenic artery and/or its branch vessels using metallic coils or other embolic devices. It has been applied for the management of splenic trauma, hypersplenism with portal hypertension, hereditary spherocytosis, thalassemia and splenic hemangioma. We hereby describe a case of a patient affected by idiopathic thrombocytopenic purpura (ITP) and warm auto-immune hemolytic anemia (AIHA) both resistant to immunosuppressive and biological therapies, not eligible for a surgical intervention because of her critical conditions. She underwent SSAE and achieved a hematologic complete response within a few days without complications. SSAE is a minimally invasive procedure to date not considered a standard option in the management of AIHA and ITP. However, following the progressive improvement of the techniques, its indications have been extended, with a reduction in morbidity and mortality compared to splenectomy in patients with critical clinical conditions. SSAE was a lifesaving therapeutic approach for our patient and it may represent a real alternative for the treatment of resistant AIHA and ITP patients not eligible for splenectomy.
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Affiliation(s)
- Matteo Molica
- Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
| | - Fulvio Massaro
- Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
| | - Giorgia Annechini
- Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
| | - Erminia Baldacci
- Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
| | - Gianna Maria D’Elia
- Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
| | - Riccardo Rosati
- Department of Radiological Sciences, Vascular and Interventional Unit, “Sapienza” University of Rome, Rome, Italy
| | | | - Paola Volpicelli
- Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
| | - Robin Foà
- Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
| | - Saveria Capria
- Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
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