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D’Arena G, Vitale C, Pietrantuono G, Villani O, Mansueto G, D’Auria F, Statuto T, D’Agostino S, Sabetta R, Tarasco A, Innocenti I, Autore F, Fresa A, Valvano L, Tomasso A, Cafaro L, Lamorte D, Laurenti L. What Does Atypical Chronic Lymphocytic Leukemia Really Mean? A Retrospective Morphological and Immunophenotypic Study. Cancers (Basel) 2024; 16:469. [PMID: 38275909 PMCID: PMC10814247 DOI: 10.3390/cancers16020469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
Atypical chronic lymphocytic leukemia (CLL) is still defined according to morphological criteria. However, deviance from the typical surface immunological profile suggests an atypical immunological-based CLL. A large cohort of patients with CLL was retrospectively evaluated aiming at assessing morphological (FAB criteria), immunophenotypical (two or more discordances from the typical profile), and clinical-biological features of atypical CLL. Compared to typical cases, morphologically atypical CLL showed a greater percentage of unmutated IgVH and CD38 positivity, and a higher expression of CD20. Immunophenotypically atypical CLL was characterized by more advanced clinical stages, higher expression of CD20, higher rate of FMC7, CD79b and CD49d positivity, and by an intermediate-high expression of membrane surface immunoglobulin, compared to typical cases. When patients were categorized based on immunophenotypic and morphologic concordance or discordance, no difference emerged. Finally, morphological features better discriminated patients' prognosis in terms of time-to-first treatment, while concordant atypical cases showed overall a worse prognosis. Discordant cases by immunophenotype and/or morphology did not identify specific prognostic groups. Whether-in the era of molecular markers used as prognostic indicators-it does make sense to focus on morphology and immunophenotype features in CLL is still matter of debate needing further research.
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Affiliation(s)
- Giovanni D’Arena
- Immuno-Hematology and Transfusion Medicine Unit, “San Luca” Hospital, 84078 Vallo della Lucania, Italy; (R.S.); (A.T.)
| | - Candida Vitale
- A.O.U. Città della Salute e della Scienza di Torino and Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, 10125 Torino, Italy;
| | - Giuseppe Pietrantuono
- Hematology and Stem Cell Transplantation Unit, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy; (G.P.); (O.V.); (G.M.); (S.D.)
| | - Oreste Villani
- Hematology and Stem Cell Transplantation Unit, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy; (G.P.); (O.V.); (G.M.); (S.D.)
| | - Giovanna Mansueto
- Hematology and Stem Cell Transplantation Unit, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy; (G.P.); (O.V.); (G.M.); (S.D.)
| | - Fiorella D’Auria
- Laboratory of Clinical Pathology, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy;
| | - Teodora Statuto
- Laboratory of Clinical Research and Advanced Diagnostics, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy; (T.S.); (L.V.)
| | - Simona D’Agostino
- Hematology and Stem Cell Transplantation Unit, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy; (G.P.); (O.V.); (G.M.); (S.D.)
| | - Rosalaura Sabetta
- Immuno-Hematology and Transfusion Medicine Unit, “San Luca” Hospital, 84078 Vallo della Lucania, Italy; (R.S.); (A.T.)
| | - Angela Tarasco
- Immuno-Hematology and Transfusion Medicine Unit, “San Luca” Hospital, 84078 Vallo della Lucania, Italy; (R.S.); (A.T.)
| | - Idanna Innocenti
- Hematology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (I.I.); (F.A.); (A.F.); (A.T.); (L.L.)
| | - Francesco Autore
- Hematology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (I.I.); (F.A.); (A.F.); (A.T.); (L.L.)
| | - Alberto Fresa
- Hematology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (I.I.); (F.A.); (A.F.); (A.T.); (L.L.)
| | - Luciana Valvano
- Laboratory of Clinical Research and Advanced Diagnostics, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy; (T.S.); (L.V.)
| | - Annamaria Tomasso
- Hematology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (I.I.); (F.A.); (A.F.); (A.T.); (L.L.)
| | - Lorenzo Cafaro
- Immuno-Hematology and Transfusion Medicine Unit, “Immacolata” Hospital, 84073 Sapri, Italy;
| | - Daniela Lamorte
- Laboratory of Preclinical and Translational Research, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Vulture, Italy;
| | - Luca Laurenti
- Hematology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (I.I.); (F.A.); (A.F.); (A.T.); (L.L.)
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Benintende G, Pozzo F, Innocenti I, Autore F, Fresa A, D’Arena G, Gattei V, Lurenti L. Measurable residual disease in chronic lymphocytic leukemia. Front Oncol 2023; 13:1112616. [PMID: 36865804 PMCID: PMC9971803 DOI: 10.3389/fonc.2023.1112616] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 01/24/2023] [Indexed: 02/16/2023] Open
Abstract
Measurable residual disease (MRD) is defined as the presence of residual cancer cells after treatment in patients with clinically undetectable disease, who would otherwise be considered in complete remission. It is a highly sensitive parameter which indicates the disease burden and predicts survival in this setting of patients. In recent years, MRD has gained a role in many hematological malignancies as a surrogate endpoint for clinical trials: undetectable MRD has been correlated to longer progression free survival (PFS) and overall survival (OS). New drugs and combinations have been developed with the aim to achieve MRD negativity, which would indicate favorable prognosis. Different methods to measure MRD have also been devised, which include flow cytometry, polymerase chain reaction (PCR) and next generation sequencing (NGS), with different sensitivity and accuracy in evaluating deep remission after treatment. In this review, we will analyze the current recommendations for the detection of MRD, with particular focus on its role in Chronic Lymphocytic Leukemia (CLL), as well as the different detection methods. Moreover, we will discuss the results of clinical trials and the role of MRD in new therapeutic schemes with inhibitors and monoclonal antibodies. MRD is not currently used in the clinical practice to evaluate response to treatment, due to technical and economical limitations, but it's gaining more and more interest in trials settings, especially since the introduction of venetoclax. The use of MRD in trials will likely be followed by a broader practical application in the future. The aim of this work is to provide a reader-friendly summary of the state of art in the field, as MRD will soon become an accessible tool to evaluate our patients, predict their survival and guide physician's therapeutic choices and preferences.
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Affiliation(s)
- Giulia Benintende
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy,*Correspondence: Giulia Benintende,
| | - Federico Pozzo
- Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico di Aviano (CRO) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Idanna Innocenti
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Francesco Autore
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Alberto Fresa
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Giovanni D’Arena
- “San Luca” Hospital, Azienda Sanitaria Locale (ASL) Salerno, Salerno, Italy
| | - Valter Gattei
- Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico di Aviano (CRO) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Luca Lurenti
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
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Valvano L, D’Auria F, Grieco V, Statuto T, Nozza F, Pietrantuono G, Villani O, D’Arena G, Lamorte D. Case report: Hematologic malignancies concomitant diagnosis of hairy cell leukemia and chronic lymphocytic leukemia: A rare association. Front Oncol 2022; 12:1069977. [PMID: 36544707 PMCID: PMC9760757 DOI: 10.3389/fonc.2022.1069977] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 11/14/2022] [Indexed: 12/12/2022] Open
Abstract
A case of concomitant hairy cell leukemia (HCL) and chronic lymphocytic leukemia (CLL) in a 50- year-old man was reported. Flow cytometry and droplet digital PCR (ddPCR) were used to detect the B-Raf proto-oncogene (BRAF) V600E mutation. The HCL population was the predominant component. The patient was first treated with cladribine and then with rituximab and achieved HCL partial remission. Importantly, the high sensitivity of our flow cytometric approach allowed the detection of a small population "P3," in addition to the typical HCL and CLL clones. The P3 clone changed over time, from an HCL-like to a CLL-like immunophenotype. This case is added to the few other cases of synchronous HCL and CLL already reported in the literature and underlines the importance of analyzing chronic lymphoproliferative disorders by highly sensitive diagnostic techniques, like the multicolor flow cytometry and ddPCR, to evaluate the possible association between HCL and CLL at diagnosis.
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Affiliation(s)
- Luciana Valvano
- Laboratory of Clinical and Advanced Diagnostics, Centro di Riferimento Oncologico della Basilicata (IRCCS CROB), Rionero in Vulture, Italy
| | - Fiorella D’Auria
- Laboratory of Clinical Pathology, Centro di Riferimento Oncologico della Basilicata (IRCCS CROB), Rionero in Vulture, Italy
| | - Vitina Grieco
- Laboratory of Clinical and Advanced Diagnostics, Centro di Riferimento Oncologico della Basilicata (IRCCS CROB), Rionero in Vulture, Italy
| | - Teodora Statuto
- Laboratory of Clinical and Advanced Diagnostics, Centro di Riferimento Oncologico della Basilicata (IRCCS CROB), Rionero in Vulture, Italy
| | - Filomena Nozza
- Laboratory of Clinical and Advanced Diagnostics, Centro di Riferimento Oncologico della Basilicata (IRCCS CROB), Rionero in Vulture, Italy
| | - Giuseppe Pietrantuono
- Hematology and Stem Cell Transplantation Unit, Centro di Riferimento Oncologico della Basilicata (IRCCS CROB), Rionero in Vulture, Italy
| | - Oreste Villani
- Hematology and Stem Cell Transplantation Unit, Centro di Riferimento Oncologico della Basilicata (IRCCS CROB), Rionero in Vulture, Italy
| | - Giovanni D’Arena
- Hematology, P. O. S. Luca, ASL, Salerno, Italy,*Correspondence: Giovanni D’Arena, ; Daniela Lamorte,
| | - Daniela Lamorte
- Laboratory of Preclinical and Translational Research, Centro di Riferimento Oncologico della Basilicata (IRCCS CROB), Rionero in Vulture, Italy,*Correspondence: Giovanni D’Arena, ; Daniela Lamorte,
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Giudice A, Aliberti SM, Barbieri A, Pentangelo P, Bisogno I, D’Arena G, Cianciola E, Caraglia M, Capunzo M. Potential Mechanisms by which Glucocorticoids Induce Breast Carcinogenesis through Nrf2 Inhibition. Front Biosci (Landmark Ed) 2022; 27:223. [DOI: 10.31083/j.fbl2707223] [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] [Received: 05/27/2022] [Revised: 06/20/2022] [Accepted: 06/30/2022] [Indexed: 11/06/2022]
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Innocenti I, Tomasso A, Benintende G, Autore F, Fresa A, Vuono F, Stirparo L, Galli E, D’Arena G, Sorà F, Efremov D, Laurenti L. SUBCUTANEOUS IMMUNOGLOBULINS IN CHRONIC LYMPHOCYTIC LEUKAEMIA WITH SECONDARY ANTIBODY DEFICIENCY. A MONOCENTRIC EXPERIENCE DURING COVID‐19 PANDEMICS. Hematol Oncol 2022; 40:469-474. [PMID: 35076123 PMCID: PMC9015622 DOI: 10.1002/hon.2966] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Secondary antibody deficiency (SAD) is a frequent manifestation of chronic lymphocytic leukemia (CLL) that increases the risk of infections. However, no formal guideline are available regarding the eligibility for prophylaxis or the delivery method, dosage, frequency of administration and duration of immunoglobulin replacement therapy (IgRT). The aim of this study was to assess the efficacy and safety of subcutaneous IgRT (SCIg) and its impact on quality of life (QoL) of CLL pts in the Covid‐19 era. Ten CLL pts with SAD were treated with subcutaneous IgRT (SCIg) at our institution between October 2019 and December 2020. Median age was 66 years and five patients had comorbidities. Seven patients were receiving therapy for CLL when treatment with SCIg was initiated. All pts received 10 g total dose hyaluronidase‐free SCIg independently from body weight. The IgG level and CD4/CD8, CD19 and CD16/56 lymphocytes subset were recorded at baseline and every 3 months. No patient experienced infectious events nor Covid‐19 mediated interstitial pneumonia while on SCIg therapy. All patients tolerated well the therapy and experienced an increase of IgG levels, which was then stable in time. We conclude that SCIg administration in CLL pts with SAD is efficacious and safe as infectious prophylaxis. This route of administration appears particularly advantageous in the Covid‐19 era, because of the self‐administration at home which results in improvement in the QoL and reduced treatment expenditures.
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Affiliation(s)
- Idanna Innocenti
- Sezione di Ematologia, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed EmatologiaFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
| | - Annamaria Tomasso
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed EmatologicheUniversità Cattolica del Sacro CuoreRomeItaly
| | - Giulia Benintende
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed EmatologicheUniversità Cattolica del Sacro CuoreRomeItaly
| | - Francesco Autore
- Sezione di Ematologia, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed EmatologiaFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
| | - Alberto Fresa
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed EmatologicheUniversità Cattolica del Sacro CuoreRomeItaly
| | - Florenzia Vuono
- Sezione di Ematologia, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed EmatologiaFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
| | - Luca Stirparo
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed EmatologicheUniversità Cattolica del Sacro CuoreRomeItaly
| | - Eugenio Galli
- Sezione di Ematologia, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed EmatologiaFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
| | - Giovanni D’Arena
- UO di Ematologia e Trapianto di cellule staminaliIRCCS Centro di riferimento Oncologico della BasilicataRionero in VultureItaly
| | - Federica Sorà
- Sezione di Ematologia, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCSUniversità Cattolica del Sacro CuoreRomeItaly
| | - Dimitar Efremov
- Molecular HematologyInternational Center for Genetic Engineering and BiotechnologyTriesteItaly
| | - Luca Laurenti
- Sezione di Ematologia, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCSUniversità Cattolica del Sacro CuoreRomeItaly
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D’Arena G, La Penna A, Crocamo A, Ametrano M, Di Palma A, Avino D, Pietrantuono G, Gambardella M. SARS-COV2 Infection in Vaccinated Patients: Look for Clinical History and Test Humoral Immunity. Indian J Hematol Blood Transfus 2021; 38:207-209. [PMID: 34658544 PMCID: PMC8504430 DOI: 10.1007/s12288-021-01499-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 10/05/2021] [Indexed: 12/04/2022] Open
Affiliation(s)
| | | | - Antonino Crocamo
- Infectious Disease Unit, “S. Luca” Hospital, Vallo della Lucania, Italy
| | | | - Anna Di Palma
- Laboratory of Diagnostics Hematology, Ospedale Tortora, Pagani, Italy
| | - Daniela Avino
- Laboratory of Diagnostics Hematology, Ospedale Tortora, Pagani, Italy
| | - Giuseppe Pietrantuono
- Hematology and Stem Cell Transplantation Unit, Cancer Referral Center of Basilicata, Rionero in Vulture, Italy
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D’Auria F, Valvano L, Rago L, Statuto T, Calice G, D’Arena G, Fusco V, Musto P. Monoclonal B-cell lymphocytosis and prostate cancer: incidence and effects of radiotherapy. J Investig Med 2019; 67:779-782. [DOI: 10.1136/jim-2018-000902] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2018] [Indexed: 11/03/2022]
Abstract
Monoclonal B-cells lymphocytosis (MBL) is a benign condition that may precede chronic lymphocytic leukemia (CLL), not rarely present in peripheral blood of healthy elderly people, among which there is also a male prevalence. Though CLL has been associated with various types of solid tumors, including prostate cancer (PC), no data exist about the relationship between PC and MBL. We studied the frequency of CLL-like MBL clones in a group of 48 patients affected by PC and followed them during and after whole-pelvis radiotherapy (WPRT) treatment. We found four MBL clones (8.3%), two of which (4.2%) had a B-cell clonal count >1000 cells/µL (‘clinical MBL’). A single case (1.8%) of ‘low-count’ MBL occurred in a control group of 54 healthy males. Notably, normal B-lymphocytes were consistently affected by WPRT, while MBL clones were less radiosensitive. Our results suggest a possible association between ‘clinical’ MBL and PC and show a different impact of the radiation on monoclonal respect to normal B-cells, which could also imply a greater risk of clonal transformation.
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D’Arena G, Pietrantuono G, Musto P. Pseudomembranous colitis in acute lymphoblastic leukaemia. Postgrad Med J 2018; 94:361. [DOI: 10.1136/postgradmedj-2018-135605] [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] [Received: 01/29/2018] [Accepted: 02/11/2018] [Indexed: 11/03/2022]
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D’Arena G, Simeon V, Laurenti L, Cimminiello M, Innocenti I, Gilio M, Padula A, Vigliotti ML, De Lorenzo S, Loseto G, Passarelli A, Di Minno MND, Tucci M, De Feo V, D’Auria F, Silvestris F, Di Minno G, Musto P. Adverse drug reactions after intravenous rituximab infusion are more common in hematologic malignancies than in autoimmune disorders and can be predicted by the combination of few clinical and laboratory parameters: results from a retrospective, multicenter study of 374 patients. Leuk Lymphoma 2017; 58:2633-2641. [DOI: 10.1080/10428194.2017.1306648] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Giovanni D’Arena
- Hematology and Stem Cell Transplantation Unit, IRCCS-CROB, Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Vittorio Simeon
- Laboratory of Preclinical and Translational Research, IRCCS-CROB, Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Luca Laurenti
- Hematology and Stem Cell Transplantation Unit, Catholic University of ‘Sacred Hearth’, Rome, Italy
| | - Michele Cimminiello
- Hematology and Stem Cell Transplantation Unit, ‘S. Carlo’ Hospital, Potenza, Italy
| | - Idanna Innocenti
- Hematology and Stem Cell Transplantation Unit, Catholic University of ‘Sacred Hearth’, Rome, Italy
| | - Michele Gilio
- Rheumatology Department, ‘S. Carlo’ Hospital, Potenza, Italy
- Department of Health Sciences, University of Catanzaro ‘Magna Graecia’, Catanzaro, Italy
| | - Angela Padula
- Rheumatology Department, ‘S. Carlo’ Hospital, Potenza, Italy
| | | | - Sonya De Lorenzo
- Hematology and Stem Cell Transplantation Unit, ‘A. Tortora’ Hospital, Pagani, Italy
| | - Giacomo Loseto
- Hematology Unit, IRCCS National Cancer Research Institute ‘Giovanni Paolo II’, Bari, Italy
| | - Anna Passarelli
- Department of Biomedical Sciences and Human Oncology, ‘Aldo Moro’ University, Bari, Italy
| | - Matteo Nicola Dario Di Minno
- Department of Clinical Medicine and Surgery, Regional Service Centre of Coagulation Disorders, ‘Federico II’ University, Naples, Italy
- Unit of Cell and Molecular Biology in Cardiovascular Diseases, IRCCS Monzino Cardiology Center, Milan, Italy
| | - Marco Tucci
- Department of Biomedical Sciences and Human Oncology, ‘Aldo Moro’ University, Bari, Italy
| | - Vincenzo De Feo
- Department of Pharmacology, University of Salerno, Salerno, Italy
| | - Fiorella D’Auria
- Laboratory of Clinical and Advanced Diagnostics, IRCCS-CROB, Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Francesco Silvestris
- Department of Biomedical Sciences and Human Oncology, ‘Aldo Moro’ University, Bari, Italy
| | - Giovanni Di Minno
- Department of Clinical Medicine and Surgery, Regional Service Centre of Coagulation Disorders, ‘Federico II’ University, Naples, Italy
| | - Pellegrino Musto
- Scientific Direction, IRCCS-CROB, Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
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Laurenti L, Autore F, Innocenti I, D’Arena G, Coscia M, Mondello P, Chiusolo P, Bellesi S, Efremov DG, Sica S, Mauro FR. Autoimmune hemolytic anemia during bendamustine plus rituximab treatment in CLL patients: multicenter experience. Leuk Lymphoma 2016; 57:2429-31. [DOI: 10.3109/10428194.2015.1137293] [Citation(s) in RCA: 7] [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: 11/13/2022]
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Laurenti L, Innocenti I, Autore F, Vannata B, Efremov DG, Ciolli S, Del Poeta G, Mauro FR, Cortelezzi A, Borza PA, Ghio F, Mondello P, Murru R, Gozzetti A, Cariccio MRL, Piccirillo N, Boncompagni R, Cantonetti M, Principe MID, Reda G, Bongarzoni V, Cervetti G, Pitini V, Foà R, Sica S, D’Arena G. Bendamustine in combination with rituximab for elderly patients with previously untreated B-cell chronic lymphocytic leukemia: A retrospective analysis of real-life practice in Italian hematology departments. Leuk Res 2015; 39:1066-70. [DOI: 10.1016/j.leukres.2015.07.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 07/20/2015] [Accepted: 07/22/2015] [Indexed: 01/20/2023]
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Giudice A, Crispo A, Massimiliano G, D’Arena G, Tecce MF, Grimaldi M, Amore A, Esposito E, Montella M. Metabolic Syndrome, Insulin Resistance, Circadian Disruption, Antioxidants and Pancreatic Carcinoma: an Overview. JGLD 2014. [DOI: 10.15403/jgld-1282] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The incidence and number of deaths caused by pancreatic tumours have been gradually rising, while the incidence and mortality of other common cancers have been declining. Risk factors for this malignant disease include cigarette smoking, family history of chronic pancreatitis, advancing age, male sex, diabetes mellitus, obesity, non-0 blood group, a high-fat diet, alcohol consumption and possibly Helicobacter pylori and hepatitis B virus infections. Metabolic diseases have become the leading cause of death in many countries. Our paper serves as a focused and updated discussion about the development of novel preventive strategies for this deadly disease.
Abbreviations. ARE: antioxidant response element; COX-2: cyclooxygenase-2; IGFs: insulin-like growthfactors; IGF1R: IGF-1 receptor; MetS: metabolic syndrome; NAFLD: non-alcoholic fatty liver disease;NAFPD: non-alcoholic fatty pancreas disease; NASH: non-alcoholic steatohepatitis; NASP: non-alcoholic steatopancreatitis; PPARγ : peroxisome proliferator-activated receptor γ; PPARs: peroxisome proliferatoractivated receptors.
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D’Arena G, Musto P. Monoclonal B-cell lymphocytosis. Transl Med UniSa 2014; 8:75-9. [PMID: 24779000 PMCID: PMC4000465] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 01/04/2014] [Indexed: 10/26/2022] Open
Abstract
Monoclonal B-cell lymphocytosis (MBL) is an asymptomatic hematologic condition defined by the presence of a small (<5 x 10(9)/L) clonal B-cell population in the peripheral blood in the absence of lymph-node enlargement, cytopenias or autoimmune diseases. It is found in approximately 3-12% of normal persons depending on the accuracy of analytical techniques applied. According to the immunophenotypic profile of clonal B-cells, the majority of MBL cases (75%) are classified as chronic lymphocytic leukemia (CLL)-like. This form may progress into CLL at a rate of 1-2% per year. It is thought that CLL is always preceded by MBL. The remaining MBL cases are defined as atypical CLL-like (CD5+/CD20(bright)) and CD5(-) MBL. The MBL clone size is quite heterogenous. Accordingly, two forms of MBL are identified: i) high-count, or 'clinical' MBL, in which an evidence of lymphocytosis (<5 x 10(9)/L clonal B-cells) is seen, and ii) a low-count MBL, in which a normal leukocyte count is found and that is identified only in population-screening studies. Both forms of MBL may carry the cytogenetic abnormalities that are the hallmark of CLL, including 13q-, 17p- and trisomy 12. Consistent with the indolent phenotype of this condition, genetic lesions, such as TP53, ATM, NOTCH1 and SF3B1 mutations, usually associated with high-risk CLL, are rarely seen. Overall, no prognostic indicator of evolution of MBL to overt CLL has been found at present time. However, taking into account this possibility, a clinical and lab monitoring (at least annually), is recommended.
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Affiliation(s)
- G. D’Arena
- Hematology and Stem Cell Transplantation Unit, Rionero in Vulture (Pz), Italy,
| | - P. Musto
- Scientific Direction, IRCCS, Centro di Riferimento Oncologico della Basilicata, Rionero in Vulture (Pz), Italy
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D’Arena G, Pietrantuono G, Buccino E, Pacifico G, Musto P. Fournier's Gangrene Complicating Hematologic Malignancies: a Case Report and Review of Licterature. Mediterr J Hematol Infect Dis 2013; 5:e2013067. [PMID: 24363882 PMCID: PMC3867231 DOI: 10.4084/mjhid.2013.067] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [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: 08/18/2013] [Accepted: 10/08/2013] [Indexed: 12/11/2022] Open
Abstract
Fournier's gangrene (FG) is a rare but severe necrotizing fasciitis of the external genitalia that may complicate the clinical course of hematologic malignancies and sometimes may be the first sign of the disease. The clinical course of FG is very aggressive and the mortality is still high despite the improvement in its management. Early recognition of FG and prompt appropriate treatment with surgical debridement and administration of antibiotics are the cornerstone of the management of this very severe disease. A review of the scientific literature focusing on the topic of FG complicating hematologic disorders is reported.
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Affiliation(s)
- Giovanni D’Arena
- Onco-Hematology and Stem Cell Transplantation Unit, IRCCS “Centro di Riferimento Oncologico della Basilicata”, Rionero in Vulture (Pz), Italy
| | - Giuseppe Pietrantuono
- Onco-Hematology and Stem Cell Transplantation Unit, IRCCS “Centro di Riferimento Oncologico della Basilicata”, Rionero in Vulture (Pz), Italy
| | - Emilio Buccino
- Surgical Department, “S. Giovanni di Dio” Hospital, Melfi (Pz), Italy
| | | | - Pellegrino Musto
- Scientific Direction, IRCCS “Centro di Riferimento Oncologico della Basilicata”, Rionero in Vulture (Pz), Italy
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15
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D’Arena G, Laurenti L, Coscia M, Cortelezzi A, Chiarenza A, Pozzato G, Vigliotti ML, Nunziata G, Fragasso A, Villa MR, Grossi A, Selleri C, Deaglio S, La Sala A, Del Poeta G, Simeon V, Aliberti L, De Martino L, Giudice A, Musto P, De Feo V. Complementary and alternative medicine use in patients with chronic lymphocytic leukemia: an Italian multicentric survey. Leuk Lymphoma 2013; 55:841-7. [DOI: 10.3109/10428194.2013.803223] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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D’Arena G, Simeon V, D’Auria F, Statuto T, Sanzo PD, Martino LD, Marandino A, Sangiorgio M, Musto P, Feo VD. Regulatory T-cells in chronic lymphocytic leukemia: actor or innocent bystander? Am J Blood Res 2013; 3:52-57. [PMID: 23358515 PMCID: PMC3555189] [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] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Accepted: 12/29/2012] [Indexed: 06/01/2023]
Abstract
Regulatory T (Treg) cells are now under extensive investigation in chronic lymphocytic leukemia (CLL). This small subset of T-cells has been, in fact, considered to be involved in the pathogenesis and progression of CLL. However, whether Treg dysregulation in CLL plays a key role or it rather represents a simple epiphenomenon is still matter of debate. In the former case, Treg cells could be appealing for targeting therapies. Finally, Treg cells have also been proposed as a prognostic indicator of the disease clinical course.
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Affiliation(s)
- Giovanni D’Arena
- Onco-Hematology Department, IRCCS Centro di Riferimento Oncologico della BasilicataRionero in Vulture, Italy
| | - Vittorio Simeon
- Laboratory of Preclinical and Translational Research, IRCCS Centro di Riferimento Oncologico della BasilicataRionero in Vulture, Italy
| | - Fiorella D’Auria
- Laboratory of Clinical Research and Advanced Diagnostics, IRCCS Centro di Riferimento Oncologico della BasilicataRionero in Vulture, Italy
| | - Teodora Statuto
- Laboratory of Clinical Research and Advanced Diagnostics, IRCCS Centro di Riferimento Oncologico della BasilicataRionero in Vulture, Italy
| | - Paola Di Sanzo
- Department of Pharmacy, University of SalernoSalerno, Italy
| | | | | | | | - Pellegrino Musto
- Onco-Hematology Department, IRCCS Centro di Riferimento Oncologico della BasilicataRionero in Vulture, Italy
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17
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Crowther-Swanepoel D, Di Bernardo MC, Jamroziak K, Karabon L, Frydecka I, Deaglio S, D’Arena G, Rossi D, Gaidano G, Olver B, Lloyd A, Broderick P, Laurenti L, Szemraj-Rogucka Z, Robak T, Catovsky D, Houlston RS. Common genetic variation at 15q25.2 impacts on chronic lymphocytic leukaemia risk. Br J Haematol 2011; 154:229-33. [DOI: 10.1111/j.1365-2141.2011.08706.x] [Citation(s) in RCA: 17] [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: 11/29/2022]
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18
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D’Arena G, Capalbo S, Laurenti L, Del Poeta G, Nunziata G, Deaglio S, Spinosa G, Tarnani M, De Padua L, Califano C, Ferrara F, Cascavilla N. Chronic lymphocytic leukemia-associated immune thrombocytopenia treated with rituximab: a retrospective study of 21 patients. Eur J Haematol 2010; 85:502-7. [DOI: 10.1111/j.1600-0609.2010.01527.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Laurenti L, De Padua L, Tarnani M, Piccirillo N, Falcucci P, D’Arena G, Innocenti I, Marietti S, Efremov DG, Chiusolo P, Zini G, Sora’ F, Sica S, Leone G. Comparison between oral and intravenous fludarabine plus cyclophosphamide regime as front-line therapy in patients affected by chronic lymphocytic leukaemia: influence of biological parameters on the clinical outcome. Ann Hematol 2010; 90:59-65. [DOI: 10.1007/s00277-010-1025-y] [Citation(s) in RCA: 12] [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] [Received: 02/22/2010] [Accepted: 06/25/2010] [Indexed: 11/28/2022]
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20
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D’Arena G, Vigliotti ML, Dell’Olio M, Villa MR, Mantuano S, Scalzulli PR, La Sala A, Abbadessa A, Mastrullo L, Cascavilla N. Rituximab to treat chronic lymphoproliferative disorder-associated pure red cell aplasia. Eur J Haematol 2009; 82:235-9. [DOI: 10.1111/j.1600-0609.2008.01187.x] [Citation(s) in RCA: 19] [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: 11/30/2022]
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22
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Cascavilla N, D’Arena G, Greco MM, Melillo L, Merla E, Carella AM. Gemtuzumab ozogamicin as maintenance therapy after autologous stem cell transplantation in elderly patients with acute myeloid leukaemia. Br J Haematol 2008; 142:852-3. [DOI: 10.1111/j.1365-2141.2008.07247.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Deaglio S, Aydin S, Vaisitti T, Bergui L, Omede’ P, Bonello L, D’Arena G, Chiorino G, Efremov D, Malavasi F. Response to SDF-1 defines a subset of CD38+/ZAP-70+ CLL patients with a common genetic signature and aggressive behavior (96.23). The Journal of Immunology 2007. [DOI: 10.4049/jimmunol.178.supp.96.23] [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] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract
Chronic lymphocytic leukemia (CLL), traditionally considered a disease of failed apoptosis, is now seen as characterized by a different propensity to grow according to microenvironmental signals. CD38 (surface receptor) and ZAP-70 (cytoplasmic molecule) independently predict unfavorable outcome in CLL patients. We reported that CD38 is a receptor mediating interactions with nurse-like cells (NLC) and transducing proliferation signals. The production by NLC of the attractant SDF-1α and the presence of ZAP-70 in CXCR4 pathway suggested that CD38 and ZAP-70 control CLL cell migration. We show that CD38+/ZAP-70+ patients feature enhanced ability to respond to SDF-1α. The functional link between the two molecules was confirmed by showing that i) CD38 engagement leads to ZAP-70 phosphorylation in CLL cells and in ad hoc modified B line expressing a ZAP-70-myc construct. Further, ii) CD38 signals are effective only in presence of ZAP-70, as seen in 22 molecularly characterized patients.
Lastly, a separation of the patient cohort based on migration, brought to the identification of 23 differentially expressed genes: 12 are involved in cell motility, migration and neoplastic transformation.
This work provides biological evidence explaining why the combination of CD38 and ZAP-70 in routine clinics results in a more efficient identification of CLL patients with aggressive disease.
Sponsors: CLL-GRF, AIRC, FIRMS.
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Affiliation(s)
- Silvia Deaglio
- 1University of Torino, via Santena 19, TORINO, 10126, Italy,
| | - S Aydin
- 1University of Torino, via Santena 19, TORINO, 10126, Italy,
| | - T Vaisitti
- 1University of Torino, via Santena 19, TORINO, 10126, Italy,
| | - L Bergui
- 1University of Torino, via Santena 19, TORINO, 10126, Italy,
| | - P Omede’
- 1University of Torino, via Santena 19, TORINO, 10126, Italy,
| | - L Bonello
- 1University of Torino, via Santena 19, TORINO, 10126, Italy,
| | - G D’Arena
- 2Fondazione Pascale, via Canigiani, 1, Napoli, 80131, Italy,
| | - G Chiorino
- 3Fondo Tempia, via Malta 3, Biella, 13900, Italy,
| | - D Efremov
- 4ICGEB, via Ramarini 32, Monterotondo, I-00016, Italy
| | - F Malavasi
- 1University of Torino, via Santena 19, TORINO, 10126, Italy,
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Marcacci G, Petti M, Ferrara F, Scarpato N, Storti S, D’Arena G, Palombi F, Palmieri S, Andretta C, Pinto A. Comparison of fixed dose (6 mg) pegfilgrastim and daily filgrastim to accelerate hemopoietic recovery after autologous stem cell transplantation (ASCT). Biol Blood Marrow Transplant 2006. [DOI: 10.1016/j.bbmt.2005.11.288] [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: 10/25/2022]
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