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Costa LJ, LeBlanc TW, Tesch H, Sonneveld P, Kyle RP, Sinyavskaya L, Hlavacek P, Meche A, Ren J, Schepart A, Aydin D, Nador G, DiBonaventura MD. Elranatamab efficacy in MagnetisMM-3 compared with real-world control arms in triple-class refractory multiple myeloma. Future Oncol 2024. [PMID: 38415370 DOI: 10.2217/fon-2023-0995] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024] Open
Abstract
Elranatamab efficacy in the single-arm, registrational MagnetisMM-3 trial (NCT04649359) was compared with that of physician's choice of treatment (PCT) for triple-class refractory multiple myeloma. MagnestisMM-3 eligibility criteria were applied to two USA-based oncology electronic health record databases, COTA and Flatiron Health (FH), to identify cohorts for this study (NCT05932290). Applied statistical techniques accounted for cohort imbalances. MagnetisMM-3 (BCMA-naive; n = 123) outcomes were compared with those from COTA (n = 239) and FH (n = 152). Elranatamab was associated with a significantly higher objective response rate (risk ratios, 1.88-2.25), significantly longer progression-free survival (hazard ratios [HRs], 0.37-0.57), and, across most analyses, significantly longer overall survival (HRs, 0.46-0.66) versus PCT. BCMA-naive patients who were treated with elranatamab exhibited significantly better outcomes than patients treated in real-world clinical practice.
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Affiliation(s)
- Luciano J Costa
- The University of Alabama at Birmingham, School of Medicine - Medicine - Hematology & Oncology, Birmingham, AL 35294, USA
| | - Thomas W LeBlanc
- Division of Hematologic Malignancies & Cellular Therapy, Duke University School of Medicine, Durham, NC 27705-3976, USA
| | - Hans Tesch
- Bethanien Hospital, Center for Hematology and Oncology, Frankfurt, 60389, Germany
| | - Pieter Sonneveld
- Department of Hematology, Erasmus University, 3062, PA Rotterdam, The Netherlands
| | | | | | | | | | - Jinma Ren
- Pfizer Inc, Collegeville, PA 19426, USA
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Mol I, Hu Y, LeBlanc TW, Cappelleri JC, Chu H, Nador G, Aydin D, Schepart A, Hlavacek P. A matching-adjusted indirect comparison of the efficacy of elranatamab versus physician's choice of treatment in patients with triple-class exposed/refractory multiple myeloma. Curr Med Res Opin 2024; 40:199-207. [PMID: 38078866 DOI: 10.1080/03007995.2023.2277850] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 10/27/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION For patients with triple-class exposed/refractory multiple myeloma (TCE/R MM), prognosis is poor and effective treatment options are limited. Elranatamab is a novel B-cell maturation antigen (BCMA)- and CD3-directed bispecific antibody which was approved by the US Food and Drug Administration in August 2023 and demonstrated safety and efficacy in patients with TCE/R MM in the phase 2, single-arm MagnetisMM-3 trial (NCT04649359). To compare the effectiveness of elranatamab vs physician's choice of treatment (PCT) in the absence of head-to-head comparative data, a matching-adjusted indirect comparison (MAIC) was conducted. METHODS Individual patient data from MagnetisMM-3 (Cohort A [BCMA-naïve] N = 123, 14.7 months of follow-up) were reweighted to match published summary data from two real-world studies of PCT in patients with TCE/R MM (LocoMMotion and MAMMOTH) using a propensity score-type logistic regression. Unanchored MAIC analyses were conducted according to National Institute for Health and Care Excellence (NICE) Decision Support Unit (DSU) 18 guidance. RESULTS Compared with PCT in LocoMMotion, elranatamab was associated with a significantly higher objective response rate (ORR rate difference: 37.52; 95% CI 26.20-48.83; odds ratio: 4.85; 95% CI 2.85-8.23) and complete or stringent complete response rate (≥CR rate difference: 42.29; 95% CI 31.84-52.74; odds ratio: 184.01; 95% CI 24.66-1372.86), longer progression-free survival (PFS HR 0.32; 95% CI 0.20-0.49), and overall survival (OS HR 0.62; 95% CI 0.40-0.94). Compared with PCT in MAMMOTH, elranatamab was associated with significantly higher ORR (rate difference: 28.14; 95% CI 16.77-39.52; odds ratio: 3.24; 95% CI 1.98-5.32) and ≥ CR (rate difference: 26.22; 95% CI 16.40-36.05; odds ratio: 5.48; 95% CI 2.88-10.44), as well as longer PFS (HR 0.25; 95% CI 0.17-0.37) and OS (HR 0.49; 95% CI 0.33-0.71). Sensitivity analysis results were consistent with the base case. CONCLUSION In the MAIC, elranatamab was consistently associated with improved rates and depth of response and significantly longer PFS and OS versus PCT in LocoMMotion and MAMMOTH.
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Affiliation(s)
- Isha Mol
- Cytel Inc., Rotterdam, The Netherlands
| | - Yannan Hu
- Cytel Inc., Rotterdam, The Netherlands
| | - Thomas W LeBlanc
- Division of Hematologic Malignancies and Cellular Therapy, Duke University School of Medicine, Durham, NC, USA
| | | | | | - Guido Nador
- Pfizer Inc., Tadworth, Surrey, United Kingdom
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Agarwal G, Nador G, Varghese S, Getu H, Palmer C, Watson E, Pereira C, Sallemi G, Partington K, Patel N, Soundarajan R, Mills R, Brouwer R, Maritati M, Shah A, Peppercorn D, Oppermann U, Edwards CM, Rodgers CT, Javaid MK, Gooding S, Ramasamy K. Prospective Assessment of Tumour Burden and Bone Disease in Plasma Cell Dyscrasias Using DW-MRI and Exploratory Bone Biomarkers. Cancers (Basel) 2022; 15:cancers15010095. [PMID: 36612090 PMCID: PMC9817825 DOI: 10.3390/cancers15010095] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 11/28/2022] [Accepted: 12/09/2022] [Indexed: 12/28/2022] Open
Abstract
Novel biomarkers for tumour burden and bone disease are required to guide clinical management of plasma cell dyscrasias. Recently, bone turnover markers (BTMs) and Diffusion-Weighted Magnetic Resonance Imaging (DW-MRI) have been explored, although their role in the prospective assessment of multiple myeloma (MM) and monoclonal gammopathy of undetermined significance (MGUS) is unclear. Here, we conducted a pilot observational cohort feasibility study combining serum BTMs and DW-MRI in addition to standard clinical assessment. Fifty-five patients were recruited (14 MGUS, 15 smouldering MM, 14 new MM and 12 relapsed MM) and had DW-MRI and serum biomarkers (P1NP, CTX-1, ALP, DKK1, sclerostin, RANKL:OPG and BCMA) measured at baseline and 6-month follow-up. Serum sclerostin positively correlated with bone mineral density (r = 0.40-0.54). At baseline, serum BCMA correlated with serum paraprotein (r = 0.42) and serum DKK1 correlated with serum free light chains (r = 0.67); the longitudinal change in both biomarkers differed between International Myeloma Working Group (IMWG)-defined responders and non-responders. Myeloma Response Assessment and Diagnosis System (MY-RADS) scoring of serial DW-MRI correlated with conventional IMWG response criteria for measuring longitudinal changes in tumour burden. Overall, our pilot study suggests candidate radiological and serum biomarkers of tumour burden and bone loss in MM/MGUS, which warrant further exploration in larger cohorts to validate the findings and to better understand their clinical utility.
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Affiliation(s)
- Gaurav Agarwal
- Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, UK
- Correspondence: (G.A.); (K.R.)
| | - Guido Nador
- Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, UK
| | - Sherin Varghese
- Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, UK
- Oxford Translational Myeloma Centre, Oxford OX3 7LD, UK
| | - Hiwot Getu
- Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, UK
| | - Charlotte Palmer
- Botnar Research Centre, The Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford OX3 7LD, UK
| | - Edmund Watson
- Botnar Research Centre, The Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford OX3 7LD, UK
| | - Claudio Pereira
- Botnar Research Centre, The Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford OX3 7LD, UK
| | - Germana Sallemi
- Botnar Research Centre, The Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford OX3 7LD, UK
| | - Karen Partington
- Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
| | - Neel Patel
- Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
| | - Rajkumar Soundarajan
- Oxford Centre for Magnetic Resonance, Radcliffe Department of Medicine, University of Oxford, Oxford OX3 9DU, UK
| | - Rebecca Mills
- Oxford Centre for Magnetic Resonance, Radcliffe Department of Medicine, University of Oxford, Oxford OX3 9DU, UK
| | - Richard Brouwer
- Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, UK
- Oxford Translational Myeloma Centre, Oxford OX3 7LD, UK
| | - Marina Maritati
- Botnar Research Centre, The Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford OX3 7LD, UK
| | - Aarti Shah
- Department of Radiology, Hampshire Hospitals NHS Foundation Trust, Hampshire SO22 5DG, UK
| | - Delia Peppercorn
- Department of Radiology, Hampshire Hospitals NHS Foundation Trust, Hampshire SO22 5DG, UK
| | - Udo Oppermann
- Oxford Translational Myeloma Centre, Oxford OX3 7LD, UK
- Botnar Research Centre, The Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford OX3 7LD, UK
| | - Claire M. Edwards
- Botnar Research Centre, The Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford OX3 7LD, UK
- Nuffield Department of Surgical Sciences (NDS), Oxford OX3 9DU, UK
| | | | - Muhammad Kassim Javaid
- Botnar Research Centre, The Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford OX3 7LD, UK
| | - Sarah Gooding
- Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, UK
- Oxford Translational Myeloma Centre, Oxford OX3 7LD, UK
- MRC Molecular Haematology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford OX3 9DS, UK
| | - Karthik Ramasamy
- Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, UK
- Oxford Translational Myeloma Centre, Oxford OX3 7LD, UK
- Correspondence: (G.A.); (K.R.)
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Olechnowicz SWZ, Weivoda MM, Lwin ST, Leung SK, Gooding S, Nador G, Javaid MK, Ramasamy K, Rao SR, Edwards JR, Edwards CM. Multiple myeloma increases nerve growth factor and other pain-related markers through interactions with the bone microenvironment. Sci Rep 2019; 9:14189. [PMID: 31578352 PMCID: PMC6775275 DOI: 10.1038/s41598-019-50591-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 09/15/2019] [Indexed: 12/30/2022] Open
Abstract
Interactions between multiple myeloma (MM) and bone marrow (BM) are well documented to support tumour growth, yet the cellular mechanisms underlying pain in MM are poorly understood. We have used in vivo murine models of MM to show significant induction of nerve growth factor (NGF) by the tumour-bearing bone microenvironment, alongside other known pain-related characteristics such as spinal glial cell activation and reduced locomotion. NGF was not expressed by MM cells, yet bone stromal cells such as osteoblasts expressed and upregulated NGF when cultured with MM cells, or MM-related factors such as TNF-α. Adiponectin is a known MM-suppressive BM-derived factor, and we show that TNF-α-mediated NGF induction is suppressed by adiponectin-directed therapeutics such as AdipoRON and L-4F, as well as NF-κB signalling inhibitor BMS-345541. Our study reveals a further mechanism by which cellular interactions within the tumour-bone microenvironment contribute to disease, by promoting pain-related properties, and suggests a novel direction for analgesic development.
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Affiliation(s)
- Sam W Z Olechnowicz
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, UK
- Oxford Centre for Translational Myeloma Research, University of Oxford, Oxford, UK
| | - Megan M Weivoda
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, UK
| | - Seint T Lwin
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, UK
| | - Szi K Leung
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, UK
| | - Sarah Gooding
- Oxford Centre for Translational Myeloma Research, University of Oxford, Oxford, UK
- MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
- Oxford University Hospitals NHS Trust, Oxford, UK
- NIHR Oxford Biomedical Research Centre Blood Theme, Oxford, UK
| | - Guido Nador
- Oxford University Hospitals NHS Trust, Oxford, UK
| | - Muhammed Kassim Javaid
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, UK
| | - Karthik Ramasamy
- Oxford Centre for Translational Myeloma Research, University of Oxford, Oxford, UK
- Oxford University Hospitals NHS Trust, Oxford, UK
- NIHR Oxford Biomedical Research Centre Blood Theme, Oxford, UK
| | - Srinivasa R Rao
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - James R Edwards
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, UK
- Oxford Centre for Translational Myeloma Research, University of Oxford, Oxford, UK
| | - Claire M Edwards
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, UK.
- Oxford Centre for Translational Myeloma Research, University of Oxford, Oxford, UK.
- NIHR Oxford Biomedical Research Centre Blood Theme, Oxford, UK.
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Nador G, Ramasamy K, Panitsas F, Pratt G, Sadler R, Javaid MK. Testing and management for monoclonal gammopathy of uncertain significance and myeloma patients presenting with osteoporosis and fragility fractures. Rheumatology (Oxford) 2019; 58:1142-1153. [PMID: 31225884 DOI: 10.1093/rheumatology/kez127] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 03/03/2019] [Indexed: 12/19/2022] Open
Abstract
Multiple myeloma, the second most frequent blood cancer, and its precursor, monoclonal gammopathy of uncertain significance, are associated with an increased risk of fragility fractures. However, current guidelines fail to offer explicit indications for healthcare professionals in terms of testing and thresholds for onward referral. The purpose of this review is to present the association of these conditions and metabolic bone disease and to highlight the importance of considering a diagnosis of monoclonal gammopathy of uncertain significance and myeloma in the context of a secondary fracture prevention assessment and of a multidisciplinary approach in managing these patients.
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Affiliation(s)
- Guido Nador
- Department of Clinical Haematology, Oxford University Hospitals, Oxford, UK
| | - Karthik Ramasamy
- Department of Clinical Haematology, Oxford University Hospitals, Oxford, UK.,NIHR, BRC Blood Theme, Oxford, UK
| | - Fotios Panitsas
- Haematology Department, Larissa University Hospital, Larissa, Greece
| | - Guy Pratt
- Haematology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham
| | - Ross Sadler
- Department of Immunology, Oxford University Hospitals, Oxford
| | - Muhammad Kassim Javaid
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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Phillips E, Wilson W, Benjamin R, Popat R, Braganza N, Clifton-Hadley L, Bygrave C, Cavenagh J, Chapman M, Owen R, Ramasamy K, Sive J, Streetly M, Nador G, Arnott S, Hassan S, Kishore B, Moore S, Virchis A, Willis F, Yong K. PF599 EFFICACY OF BORTEZOMIB, THALIDOMIDE AND DEXAMETHASONE FOR TREATMENT OF PATIENTS WITH CARFILZOMIB-REFRACTORY MYELOMA IN THE UK NCRI CARDAMON TRIAL. Hemasphere 2019. [DOI: 10.1097/01.hs9.0000560684.31002.b1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Nosari A, Nichelatti M, De Gasperi A, Nador G, Anghilieri M, Mazza E, Cozzi P, Mancini V, Miqueleiz S, Bettinelli L, Lucchesini C, Baraté C, Ricci F, Ciapanna D, Ravelli E, Morra E. Incidence of Sepsis in Central Venous Catheter-Bearing Patients with Hematologic Malignancies: Preliminary Results. J Vasc Access 2018; 5:168-73. [PMID: 16596561 DOI: 10.1177/112972980400500406] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Indwelling central venous catheters (CVCs) are essential devices in the management of patients with hematological disorders treated with chemotherapy. However, their nature predisposes patients to unwanted complications. Methods CVC-related complications were retrospectively analyzed in 227 hematologic patients who were consecutively admitted to our hematology department between May 2002 and April 2004. Patients’ diagnoses comprised acute myeloid leukemia (36.8%), acute lymphoid leukemia (7.3%), lymphoproliferative disorders (28.3%), multiple myeloma (19.5%), myeloproliferative syndromes (5%) and others (3.1%). The CVCs used were polyurethane three lumen 7-Fr (111 patients) for chemotherapy and 12-Fr (114 patients) for chemotherapy and peripheral blood stem cell apheresis, plus two tunneled catheters. Results The pathological events were: bacteriaemias (n=46); occlusions (n=10); exit tunnel infections (n=8); thrombosis (n=6); lung emboli (n=2). Among febrile patients the bacteriemia frequency was 20%, of which 13.6% were CVC-related (with a higher incidence in leukemia patients (p=0.027). Among the isolates, gram-positive bacteria were found in 29 cases (23 CVC-related cases), and gram-negative bacteria in 16 cases (8 CVC-related cases). Only one patient had Candida albicans sepsis. At univariate and multivariate analysis significant risk factors for infection (p<0.0001) were only the number of days/catheters and neutropenia duration. Conclusions In our hematologic patients, the CVC complications were mainly septic, with only 10.1% of CVC-related bacteriemias, despite prolonged catheterization duration. Acute leukemia patients were at major risk for sepsis, probably due to a more severe neutropenia and prolonged catheterization duration.
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Affiliation(s)
- A Nosari
- Division of Hematology, Niguarda Ca' Granda Hospital, Milan, Italy
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Tedeschi A, Rossi D, Motta M, Quaresmini G, Rossi M, Coscia M, Anastasia A, Rossini F, Cortelezzi A, Nador G, Scarfò L, Cairoli R, Frustaci AM, Dalceggio D, Picardi P, De Paoli L, Orlandi E, Rambaldi A, Massaia M, Gaidano G, Montillo M. A phase II multi-center trial of pentostatin plus cyclophosphamide with ofatumumab in older previously untreated chronic lymphocytic leukemia patients. Haematologica 2015; 100:e501-4. [PMID: 26294723 DOI: 10.3324/haematol.2015.132035] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
| | - Davide Rossi
- Division of Haematology, Department of Translational Medicine, Amedeo Avogadro University of EasternPiedmont, Novara, Italy
| | - Marina Motta
- Dept. of Haematology, Spedali Civili, Brescia, Italy
| | - Giulia Quaresmini
- Haematology and Bone MarrowTransplant Unit, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - Marianna Rossi
- Dept. of HaematologyOncology, Fondazione IRCCS Policlinico San Matteo &University of Pavia, Italy
| | - Marta Coscia
- Division of Haematology, University of Torino, A.O. Città della Salute e della Scienza di Torino, Italy
| | | | | | - Agostino Cortelezzi
- Dept. of Haematology and BMT Unit, University of Milan, Ospedale Maggiore, Italy
| | - Guido Nador
- Internal Medicine Dept., Hospital of Legnano, Italy
| | - Lydia Scarfò
- Dept. of Onco-Haematology, University Vita-Salute San Raffaele, Milan, Italy
| | | | | | | | - Paola Picardi
- Dept. of Haematology, Niguarda Cancer Center, Milan, Italy
| | - Lorenzo De Paoli
- Division of Haematology, Department of Translational Medicine, Amedeo Avogadro University of EasternPiedmont, Novara, Italy
| | - Ester Orlandi
- Dept. of HaematologyOncology, Fondazione IRCCS Policlinico San Matteo &University of Pavia, Italy
| | - Alessandro Rambaldi
- Haematology and Bone MarrowTransplant Unit, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - Massimo Massaia
- Division of Haematology, University of Torino, A.O. Città della Salute e della Scienza di Torino, Italy
| | - Gianluca Gaidano
- Division of Haematology, Department of Translational Medicine, Amedeo Avogadro University of EasternPiedmont, Novara, Italy
| | - Marco Montillo
- Dept. of Haematology, Niguarda Cancer Center, Milan, Italy
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Molteni A, Riva M, Pellizzari A, Borin L, Freyrie A, Greco R, Ubezio M, Bernardi M, Fariciotti A, Nador G, Nichelatti M, Ravano E, Morra E. Corrigendum to ‘Hematological improvement during iron-chelation therapy in myelodysplastic syndromes: The experience of the “Rete Ematologica Lombarda”’ [Leuk Res 37 (2013) 1233–1240]. Leuk Res 2014. [DOI: 10.1016/j.leukres.2013.11.018] [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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Molteni A, Riva M, Pellizzari A, Borin L, Freyre A, Greco R, Ubezio M, Bernardi M, Fariciotti A, Nador G, Nichelatti M, Ravano E, Morra E. Hematological improvement during iron-chelation therapy in myelodysplastic syndromes: The experience of the “Rete Ematologica Lombarda”. Leuk Res 2013; 37:1233-40. [DOI: 10.1016/j.leukres.2013.07.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Accepted: 07/01/2013] [Indexed: 12/16/2022]
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Nosari AM, Nador G, Gasperi AD, Ortisi G, Volonterio A, Cantoni S, Nichelatti M, Marbello L, Mazza E, Mancini V, Ravelli E, Ricci F, Ciapanna D, Garrone F, Gesu G, Morra E. Prospective monocentric study of non-tunnelled central venous catheter-related complications in hematological patients. Leuk Lymphoma 2009; 49:2148-55. [DOI: 10.1080/10428190802409930] [Citation(s) in RCA: 8] [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: 10/21/2022]
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Cesana C, Klersy C, Brando B, Nosari A, Scarpati B, Scampini L, Molteni A, Nador G, Santoleri L, Formenti M, Valentini M, Mazzone A, Morra E, Cairoli R. Prognostic value of circulating CD34+ cells in myelodysplastic syndromes. Leuk Res 2008; 32:1715-23. [DOI: 10.1016/j.leukres.2008.03.028] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2007] [Revised: 03/27/2008] [Accepted: 03/27/2008] [Indexed: 10/22/2022]
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Marbello L, Ricci F, Nosari AM, Turrini M, Nador G, Nichelatti M, Tedeschi A, Vismara E, Morra E. Outcome of hyperleukocytic adult acute myeloid leukaemia: A single-center retrospective study and review of literature. Leuk Res 2008; 32:1221-7. [DOI: 10.1016/j.leukres.2008.01.004] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2007] [Revised: 12/28/2007] [Accepted: 01/03/2008] [Indexed: 11/27/2022]
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Nosari A, Cairoli R, Ciapanna D, Gargantini L, Intropido L, Baraté C, Scarpati B, Santoleri L, Nador G, Pezzetti L, Morra E. Efficacy of single dose pegfilgrastim in enhancing the mobilization of CD34+ peripheral blood stem cells in aggressive lymphoma patients treated with cisplatin-aracytin-containing regimens. Bone Marrow Transplant 2006; 38:413-6. [PMID: 16878144 DOI: 10.1038/sj.bmt.1705459] [Citation(s) in RCA: 23] [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] [Indexed: 11/08/2022]
Abstract
Systematic data on the ability of pegfilgrastim to mobilize stem cells after chemotherapy are scarce. We evaluated the efficacy of a single 6 mg dose of pegfilgrastim for mobilizing peripheral blood stem cells (PBSC) in aggressive lymphoma patients. Between July 2004 and October 2005, 17 aggressive non-Hodgkin's lymphoma and 11 poor-risk Hodgkin's lymphoma were treated with cycles containing cisplatin-aracytin. At the end of chemotherapy, the patients received 6 mg of pegfilgrastim. Duration of grade 4 neutropenia, adverse events, time to neutrophil recovery, peak and harvest of CD34+ cells were recorded. Twenty-seven out of 28 patients harvested a median of 17.3 x 10(6)/CD34+ cells (range 2.5-28.9) after a median of 9 days (range 8-12 days), with a single apheresis procedure in 25 cases. All patients had grade 3-4 neutropenia, median duration 3 days. The only adverse event was mild bone pain. To date, 13 patients have been autografted with a median of 15.4 x 10(6) CD34+ pegfilgrastim-mobilized cells per kg (range 2.5-28.9) with rapid and sustained engraftment. Mobilization, harvesting and autografting of pegfilgrastim-mobilized PBC can be successfully achieved in pretreated patients with aggressive lymphoma.
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Affiliation(s)
- A Nosari
- Divisione di Ematologia, Niguarda Ca' Granda Hospital, Milan, Italy
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Nardoni A, Marchetti E, Sabattini E, Geatti O, Nador G. [Insulin, peptide C and glucide tolerance in chronic alcoholic hepatopathies]. Minerva Med 1984; 75:1933-8. [PMID: 6384824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Changes in blood glucose and insulin metabolism, both under basal conditions and after glucose and glucagon stimulus, were studied in 95 patients with chronic alcoholic hepatopathy. Peptide C was also determined in 19 patients. A high incidence of islet-cell insufficiency was noted. Stress is laid on the multiplicity of the pathogenetic mechanisms responsible for blood glucose and insulin changes during chronic alcoholic hepatopathy, particularly liver cell damage, hyperglucagonaemia, organic and/or functional islet-cell insufficiency, and peripheral insulin resistance. It is felt that the last two of these are of major importance, whereas liver cell damage is of secondary significance, at any rate as far as glucose and insulin turnover is concerned.
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16
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Nardoni A, Copetti R, Baldissera S, Busettini G, Cella R, Nador G. [Hypopotassemia during delirium tremens. Pathogenesis and clinical significance]. Minerva Med 1982; 73:3059-62. [PMID: 7145182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The authors have investigated the changes of kalemia and kaluria levels in 40 patients suffering from delirium tremens, and have observed during the acute stage of the illness, a swift fall of kalemia level without an increase of the kaluric excretion. The kalemic values quickly rise up again at the end of the delirium.. The authors think that an adrenergic mechanism is responsible for this quick and transient hypokalemia. The significance of this adrenergic mechanism in the alcohol withdrawal syndrome is at present widely proved.
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Abstract
The prolactin response to oral metoclopramide (10 mg) was investigated in 53 chronic alcoholics (26 with alcoholic cirrhosis and 27 without evidence of liver disease) from two to seven days after alcohol suspension. The response appeared significantly higher in patients than in healthy controls and was not related to the presence of liver disease. This finding may depend on the deactivation of the dopaminergic activities secondary to alcohol suspension; alternatively, ethanol could have a direct action on prolactin secretion.
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