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Zaccheddu E, Zappu A, Barella S, Clemente MG, Orecchia V, Pilia MP, Piras S, Pitturru C, Scarano M, Origa R. Unplanned pregnancy in women with beta-thalassaemia treated with luspatercept. Br J Haematol 2024. [PMID: 38652468 DOI: 10.1111/bjh.19480] [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] [Received: 01/26/2024] [Revised: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 04/25/2024]
Affiliation(s)
- Eleonora Zaccheddu
- SC Microcitemie e Anemie Rare, Ospedale Pediatrico Microcitemico, Cagliari, Italy
| | - Antonietta Zappu
- SC Microcitemie e Anemie Rare, Ospedale Pediatrico Microcitemico, Cagliari, Italy
| | - Susanna Barella
- SC Microcitemie e Anemie Rare, Ospedale Pediatrico Microcitemico, Cagliari, Italy
| | | | - Valeria Orecchia
- SC Microcitemie e Anemie Rare, Ospedale Pediatrico Microcitemico, Cagliari, Italy
| | - Maria Paola Pilia
- SC Microcitemie e Anemie Rare, Ospedale Pediatrico Microcitemico, Cagliari, Italy
| | - Simona Piras
- SC Microcitemie e Anemie Rare, Ospedale Pediatrico Microcitemico, Cagliari, Italy
| | - Carla Pitturru
- SC Microcitemie e Anemie Rare, Ospedale Pediatrico Microcitemico, Cagliari, Italy
| | | | - Raffaella Origa
- SC Microcitemie e Anemie Rare, Ospedale Pediatrico Microcitemico, Cagliari, Italy
- SSD Neonatologia, ARNAS G. Brotzu, Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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Ponti ML, Comitini F, Murgia D, Ganga R, Canu R, Dessì C, Foschini ML, Leoni G, Morittu M, Perra M, Pilia MP, Casini MR, Zappu A, Origa R. Impact of the direct-acting antiviral agents (DAAs) on chronic hepatitis C in Sardinian patients with transfusion-dependent Thalassemia major. Dig Liver Dis 2019; 51:561-567. [PMID: 30658940 DOI: 10.1016/j.dld.2018.12.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 12/19/2018] [Accepted: 12/20/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Direct antiviral agents (DAAs) have revolutionised the standard of care for the treatment of hepatitis even in patients with hemoglobinopathies. The aim of this study is to show how, thanks to DAAs, HCV infection has been substantially eradicated in one of the biggest Centres for the management of Thalassemia in Europe. METHODS Thalassemia major patients regularly transfused and iron chelated in Cagliari (Italy) who were HCV-RNA positive were evaluated for the potential prescription of antiviral therapy. RESULTS A total of 99 patients, 26 of whom had been diagnosed with cirrhosis, were treated with at least one dose of DAAs, which proved to be safe and well tolerated. Two of the patients died during the treatment after becoming HCV-RNA negative while another voluntarily interrupted the therapy. The final SVR in the patients who completed the treatment was 100%, while measuring 97% (96/99) in the Intention-to-Treat analysis. After DAAs, no new cases of hepatocellular carcinoma have been reported. CONCLUSIONS The use of DAAs in patients suffering from beta-Thalassemia major with chronic hepatitis C or cirrhosis can be considered safe and effective. Close monitoring for hepatocellular carcinoma development is, in any case, recommended indefinitely post-SVR.
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Affiliation(s)
| | | | | | | | - Roberto Canu
- Medicine I, 'G.Brotzu' Hospital, Cagliari, Italy
| | - Carlo Dessì
- Thalassemia Unit, 'A. Cao' Hospital, A.O. 'G. Brotzu', Cagliari, Italy
| | | | | | - Maddalena Morittu
- Thalassemia Unit, 'A. Cao' Hospital, A.O. 'G. Brotzu', Cagliari, Italy
| | - Maria Perra
- Thalassemia Unit, 'A. Cao' Hospital, A.O. 'G. Brotzu', Cagliari, Italy
| | - Maria Paola Pilia
- Thalassemia Unit, 'A. Cao' Hospital, A.O. 'G. Brotzu', Cagliari, Italy
| | | | - Antonietta Zappu
- Thalassemia Unit, 'A. Cao' Hospital, A.O. 'G. Brotzu', Cagliari, Italy
| | - Raffaella Origa
- Thalassemia Unit, 'A. Cao' Hospital, A.O. 'G. Brotzu', Cagliari, Italy.
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Floris F, Comitini F, Leoni G, Moi P, Morittu M, Orecchia V, Perra M, Pilia MP, Zappu A, Casini MR, Origa R. Quality of life in Sardinian patients with transfusion-dependent Thalassemia: a cross-sectional study. Qual Life Res 2018; 27:2533-2539. [PMID: 29922915 DOI: 10.1007/s11136-018-1911-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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] [Accepted: 06/05/2018] [Indexed: 12/31/2022]
Abstract
PURPOSE The aim of this study has been to evaluate the physical, psychological, and social well-being in a large group of Sardinian adult patients with transfusion-dependent beta-Thalassemia when compared with a group of healthy subjects of the same age and geographical extraction. METHODS Male or female patients ≥ 18 years of age with Thalassemia major on regular transfusion at Thalassemia Center in Cagliari (Italy) were requested to complete the World Health Organization Quality of life-BREF (WHOQOL-BREF) questionnaire. The WHOQOL-BREF was also made available online to age- and sex-matched non-thalassemic adult subjects living in Sardinia. RESULTS Two hundred and seven subjects with Thalassemia were invited to participate in the study. The questionnaire was also completed by 211 age- and sex-matched non-thalassemic subjects living in Sardinia. Scores suggestive of a good quality of life were obtained in all the areas investigated. Thalassemia patients had scores at least as good as those of non-thalassemic subjects in all items and the percentage of those with a score ≥ 60 was higher among patients. The analysis of demographic actually highlights that the disease has a little effect on their personal and social lives. There was a positive association between subjective well-being and effective clinical conditions. Moreover, the association between health perception and adherence to treatment suggests that compliance with treatment contributes to the well-being of the patient, both physically and psychologically. CONCLUSIONS Adult subjects with Thalassemia who live in Western countries have a good quality of life in accordance with the advances in the management of the disease.
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Affiliation(s)
| | | | - GiovanBattista Leoni
- Ospedale Pediatrico Microcitemico "A.Cao" - A.O. "G.Brotzu", Via Jenner s.n., 09121, Cagliari, Italy
| | - Paolo Moi
- University of Cagliari, Cagliari, Italy
| | - Maddalena Morittu
- Ospedale Pediatrico Microcitemico "A.Cao" - A.O. "G.Brotzu", Via Jenner s.n., 09121, Cagliari, Italy
| | - Valeria Orecchia
- Ospedale Pediatrico Microcitemico "A.Cao" - A.O. "G.Brotzu", Via Jenner s.n., 09121, Cagliari, Italy
| | - Maria Perra
- Ospedale Pediatrico Microcitemico "A.Cao" - A.O. "G.Brotzu", Via Jenner s.n., 09121, Cagliari, Italy
| | - Maria Paola Pilia
- Ospedale Pediatrico Microcitemico "A.Cao" - A.O. "G.Brotzu", Via Jenner s.n., 09121, Cagliari, Italy
| | - Antonietta Zappu
- Ospedale Pediatrico Microcitemico "A.Cao" - A.O. "G.Brotzu", Via Jenner s.n., 09121, Cagliari, Italy
| | - Maria Rosaria Casini
- Ospedale Pediatrico Microcitemico "A.Cao" - A.O. "G.Brotzu", Via Jenner s.n., 09121, Cagliari, Italy
| | - Raffaella Origa
- Ospedale Pediatrico Microcitemico "A.Cao" - A.O. "G.Brotzu", Via Jenner s.n., 09121, Cagliari, Italy.
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Caocci G, Orofino MG, Vacca A, Piroddi A, Piras E, Addari MC, Caria R, Pilia MP, Origa R, Moi P, La Nasa G. Long-term survival of beta thalassemia major patients treated with hematopoietic stem cell transplantation compared with survival with conventional treatment. Am J Hematol 2017; 92:1303-1310. [PMID: 28850704 DOI: 10.1002/ajh.24898] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Revised: 08/22/2017] [Accepted: 08/24/2017] [Indexed: 11/12/2022]
Abstract
Allogeneic hematopoietic stem cell transplantation (HSCT) in thalassemia remains a challenge. We reported a single-centre case-control study of a large cohort of 516 children and adult patients treated with HSCT or blood transfusion support and iron chelation therapy; 258 patients (median age 12, range 1-45) underwent sibling (67%) or unrelated (33%) HSCT; 97 patients were adults (age ≥ 16 years). The median follow-up after HSCT was 11 years (range 1-30). The conditioning regimen was busulfan (80.6%) or treosulfan-based (19.4%). A cohort of 258 age-sex matched conventionally treated (CT) patients was randomly selected. In transplanted patients the 30-year overall survival (OS) and thalassemia-free survival (TFS) were 82.6 ± 2.7% and 77.8 ± 2.9%, compared to the OS of 85.3 ± 2.7% in CT patients (P = NS); The incidence of grade II-IV acute and chronic graft versus host disease (GvHD) was 23.6% and 12.9% respectively. The probability of rejection was 6.9%. Transplant-related mortality (TRM) (13.8%) was similar to the probability of dying of cardiovascular events in CT patients (12.2%). High-risk Pesaro score (class 3) was associated with lower OS (OR = 1.99, 95% C.I.=1.31-3.03) and TFS (OR = 1.54, 95% C.I.=1.12-2.12). In adult patients, the 23-years OS and TFS after HSCT were 70 ± 5% and 67.3 ± 5%, compared to 71.2 ± 5% of OS in CT (P = NS). Finally, treosulfan was associated with lower risk of acute GvHD (P = .004; OR = 0.28, 95% C.I.=0.12-0.67). In conclusion, the 30-year survival rate of ex-thalassemia patients after HSCT was similar to that expected in CT thalassemia patients, with the vast majority of HSCT survivors cured from thalassemia.
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Affiliation(s)
- Giovanni Caocci
- Bone Marrow Transplant Center, Hospital Binaghi and Microcitemico; Cagliari Italy
- Department of Medical Sciences and Public Health; University of Cagliari; Cagliari Italy
| | - Maria Grazia Orofino
- Bone Marrow Transplant Center, Hospital Binaghi and Microcitemico; Cagliari Italy
| | - Adriana Vacca
- Bone Marrow Transplant Center, Hospital Binaghi and Microcitemico; Cagliari Italy
| | - Antonio Piroddi
- Bone Marrow Transplant Center, Hospital Binaghi and Microcitemico; Cagliari Italy
| | - Eugenia Piras
- Bone Marrow Transplant Center, Hospital Binaghi and Microcitemico; Cagliari Italy
| | - Maria Carmen Addari
- Bone Marrow Transplant Center, Hospital Binaghi and Microcitemico; Cagliari Italy
| | - Rossella Caria
- Bone Marrow Transplant Center, Hospital Binaghi and Microcitemico; Cagliari Italy
| | - Maria Paola Pilia
- Pediatric Clinic, Thalassemias and Rare Diseases; Pediatric Hospital “Microcitemico A. Cao”; Cagliari Italy
| | - Raffaella Origa
- Pediatric Clinic, Thalassemias and Rare Diseases; Pediatric Hospital “Microcitemico A. Cao”; Cagliari Italy
| | - Paolo Moi
- Department of Medical Sciences and Public Health; University of Cagliari; Cagliari Italy
- Pediatric Clinic, Thalassemias and Rare Diseases; Pediatric Hospital “Microcitemico A. Cao”; Cagliari Italy
| | - Giorgio La Nasa
- Bone Marrow Transplant Center, Hospital Binaghi and Microcitemico; Cagliari Italy
- Department of Medical Sciences and Public Health; University of Cagliari; Cagliari Italy
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Origa R, Tatti F, Zappu A, Leoni GB, Dessì C, Moi P, Morittu M, Orecchia V, Denotti AR, Pilia MP, Anni F, Perra M, Casini MR, Barella S. Earlier initiation of transfusional and iron chelation therapies in recently born children with transfusion-dependent thalassemia. Am J Hematol 2017; 92:E627-E628. [PMID: 28741691 DOI: 10.1002/ajh.24869] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 07/19/2017] [Accepted: 07/21/2017] [Indexed: 12/21/2022]
Affiliation(s)
- Raffaella Origa
- Department of Medical Sciences and Public Health; University of Cagliari; Cagliari Italy
| | - Federica Tatti
- Department of Medical Sciences and Public Health; University of Cagliari; Cagliari Italy
| | - Antonietta Zappu
- Ospedale Pediatrico Microcitemico “A.Cao”-A.O. G.Brotzu; Cagliari Italy
| | | | - Carlo Dessì
- Ospedale Pediatrico Microcitemico “A.Cao”-A.O. G.Brotzu; Cagliari Italy
| | - Paolo Moi
- Department of Medical Sciences and Public Health; University of Cagliari; Cagliari Italy
- Ospedale Pediatrico Microcitemico “A.Cao”-A.O. G.Brotzu; Cagliari Italy
| | - Maddalena Morittu
- Ospedale Pediatrico Microcitemico “A.Cao”-A.O. G.Brotzu; Cagliari Italy
| | - Valeria Orecchia
- Ospedale Pediatrico Microcitemico “A.Cao”-A.O. G.Brotzu; Cagliari Italy
| | - Anna Rita Denotti
- Department of Medical Sciences and Public Health; University of Cagliari; Cagliari Italy
| | - Maria Paola Pilia
- Ospedale Pediatrico Microcitemico “A.Cao”-A.O. G.Brotzu; Cagliari Italy
| | - Franco Anni
- Department of Medical Sciences and Public Health; University of Cagliari; Cagliari Italy
| | - Maria Perra
- Ospedale Pediatrico Microcitemico “A.Cao”-A.O. G.Brotzu; Cagliari Italy
| | | | - Susanna Barella
- Ospedale Pediatrico Microcitemico “A.Cao”-A.O. G.Brotzu; Cagliari Italy
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