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Casavecchia G, Spinosa G, De Gennaro L, Zicchino S, Gravina M, Magnesa M, Di Biase M, Brunetti ND. Incidence of cardiovascular events in patients with chronic myeloid leukaemia treated with tyrosine kinase inhibitors. Acta Cardiol 2022; 77:130-135. [PMID: 33685352 DOI: 10.1080/00015385.2021.1888017] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND The introduction of imatinib and tyrosine kinase inhibitors as therapeutic strategy for Philadelphia chromosome-positive chronic myeloid leukaemia (CML) has represented an important step forward for treatment of this disease. The aim of this study was therefore to evaluate the incidence of cardiovascular adverse events (CVEs) in patients affected by CML treated with TKI in an observational prospective study. METHODS All consecutive patients affected by CML and treated with TKI in our Institution were enrolled in the study from February 2005 to September 2018 with a clinical, laboratory and instrumental follow-up. RESULTS Sixty-one consecutive patients were enrolled, 29 with imatinib, 15 with nilotinib, 11 with dasatinib, 3 with bosutinib and 3 with ponatinib. Neither patients in therapy with bosutinib nor with nilotinib had CVE during follow-up. Incidence rates per person/year were 0 for bosutinib and nilotinib, 0.15 for dasatinib, 0.19 for imatinib and 1.69 for ponatinib (Log Rank p < 0.05); differences in terms of incidence of adverse outcomes remained significant also after multivariate correction. CONCLUSIONS In patients with CML treated with TKIs, therapy with ponatinib was associated with a higher risk of CVE than other TKIs. The lowest incidence of CVE was associated with bosutinib and nilotinib.
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Affiliation(s)
- Grazia Casavecchia
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | | | | | - Stefano Zicchino
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Matteo Gravina
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Michele Magnesa
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Matteo Di Biase
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
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Betta G, Cipolli C, Carcione F, Franco S, Bonaiuto P, Ciarnella M, Petrilli S, De Marco G, Tuozzi G, Gioia E, Zagarella F, Treglia E, Cristini C, Cesa-Bianchini G, Cristini L, Belova S, Ushakov D, Mazhul LA, Knyazev VN, De Caroli ME, Licciardello O, Falanga R, Sagone E, Tomassoni R, Dorfman L, D'Angiò A, Trezza T, Lungu MA, Di Nuovo S, Bonaiuto P, Biasi V, Montemurro M, Salvatore S, Mastandrea S, Gorrese A, Starnino B, Bonaviri G, Cogliani M, Di Nenna M, Dei P, Petrov VM, Carcione M, Rigas AV, Kalamakis D, De Vito L, Madonna F, Pulli G, Åkerström U, Tiozzo E, Stamatina Panagiotakopoulou I, Diamanti L, Parsi MR, Spinosa G, Tudorel O, Vintilă M, Cosmin G, D'Angiò G, Viceconte L, Goian C, Baldassare I, Ferdinandi L, Greco C, Matarazzo O, Pallikaris I, Zanon A, Panaccione D, Gargano M, Broccoli A, Santangelo N, Mele LM, Blezza F, Paone F, Brandolini R, Petrini M, Amodio S, Barattucci M. Contributi scientifici in memoria di Antonio Fusco. Clin Ter 2020; 171:8-271. [PMID: 33211061 DOI: 10.7417/ct.2020.2227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Come si leggerà nell'Introduzione della sezione propriamente scientifica del Volume, il presente testo nasce dalla volontà e, soprattutto, dall'esigenza culturale di omaggiare il fu Prof. Antonio Fusco. Un debito scientifico ed umano che trova il suo locus naturale in questa prima parte del testo stesso, cui farà poi seguito la parte propriamente scientifica. In siffatta parentesi dovuta per le ragioni appena menzionate, il lettore, l'amico o l'allievo dell'opera del Prof. Fusco potranno trovare un suo sintetico Curriculum Vitae, correlato da una specifica ed accurata prosa, svolta dal già Magnifico Rettore Carlo Cipolli; il quale, oltre che evidenziare, ricordando, i meriti del collega oramai scomparso, aggiunge alsuo scritto un elemento che sarebbe imprescindibile a non trasformare lo stesso in una mera sequenza di parole: l'amicizia e l'affetto per un amico che, oramai, non c'è più. A fine lettura, evidente risuonerà il fatto che la vita di ognuno, se mossa dalla passione per ciò per cui si è predisposti cognitivamente e psicologicamente, può essere ricca di riconoscimenti, riconoscenze e soddisfazioni che, lungi dal divenire un cuscino di allori su cui adagiarsi, per una mente creativa come quella del Prof. Fusco hanno funto solo da motivazioni ad agire instancabilmente guardando sempre al futuro. Il lavoro di una vita che, materialmente, è sancito da un supporto poco più di cm 25x15: una targa. Una materialità evidente che, con grande commozione e riconoscenza, è stata affissa il 25 ottobre 2019 sull'aula fronte l'Aula Magna del Campus "La Folcara", a testimonianza che quello spirito creativo in continua evoluzione non si ferma; non si arresta neppure con la fine biologica di chi lo ha "posseduto". Rimangono le opere ed il pensiero del Prof. Fusco e restano gli affetti. A tal proposito, il lettore troverà una breve e sentita sezione su Testimonianze; coloro i quali hanno avuto modo, nell'arco della vita accademica ed umana, personale, di Fusco di conoscerlo. Ecco, allora, che i ricordi saranno i veri protagonisti di questa parentesi. Dopo di ciò, prima dei contributi prettamente scientifici dei lavori, tenutisi in occasione del Convegno Internazionale Psicologia, Arte, Letteratura. Antiche e Nuove Tendenze, seguiranno i saluti delle autorità che in quei due giorni si sono succedute a rappresentare non solo l'istituzione affiliata, ma anche la relazione di stima e di affetto che le legava al compianto Professore. Si passerà, infine, al volume tradizionalmente inteso.
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Lazzarotto D, Candoni A, Filì C, Forghieri F, Pagano L, Busca A, Spinosa G, Zannier ME, Simeone E, Isola M, Borlenghi E, Melillo L, Mosna F, Lessi F, Fanin R. Clinical outcome of myeloid sarcoma in adult patients and effect of allogeneic stem cell transplantation. Results from a multicenter survey. Leuk Res 2016; 53:74-81. [PMID: 28056398 DOI: 10.1016/j.leukres.2016.12.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [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: 09/08/2016] [Revised: 12/14/2016] [Accepted: 12/19/2016] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Myeloid Sarcoma (MS) is a rare hematologic myeloid neoplasm that can involve any site of the body. It can occur as an exclusively extramedullary form or it can be associated with an acute myeloid leukemia (AML), a chronic myeloproliferative neoplasm (MPN) or a myelodysplastic syndrome (MDS) at onset or at relapse. The rarity of MS does not enable prospective clinical trials and therefore a specific multicenter register can be useful for the clinical and biological studies of this rare disease. PATIENTS AND RESULTS we report the clinical characteristics and outcome of 48 histologically confirmed MS, diagnosed and treated in 9 Italian Hematological Centers in the last 10 years. The patient's median age was 46 years. There were 9/48 de novo extramedullary MS, 24/48 de novo AML-related MS and 15/48 were secondary AML-related MS. The most common extramedullary anatomic sites of disease were: skin, lymph nodes and soft tissues. Forty-three patients (90%) underwent a program of intensive chemotherapy including FLAI, HDAC-IDA, HyperCVAD and MEC schemes, with a DDI of 5% and a CR Rate of 45%. Twenty-two (46%) patients underwent Allogeneic SCT, 13 from a MUD, 8 from an HLA-identical sibling donor and 1 from an haploidentical donor. The median OS of the whole population (48 pts) was 16.7 months. The OS probability at 1, 2 and 5 years was 64%, 39% and 33%, respectively. The OS was better in patients that underwent an intensive therapeutic program (median OS: 18 months vs 5 months). Among the intensively treated patients, in univariate analysis, the OS was better in young patients (P=0,008), in patients that underwent Allo-SCT (P=0,009) and in patients that achieved a CR during treatment (P=0,001), and was worse in pts with secondary AML-related MS (P=0,007). Age, response to intensive chemotherapy and Allo-SCT were the only three variables that significantly influenced DFS (P=0,02, P=0,01 and P=0,04, respectively). In multivariable analysis, Allo-SCT and response to intensive chemotherapy remained significant in predicting a better OS (P=0,04 and P=0,001, respectively), and response to intensive chemotherapy was the only significant variable in predicting DFS (P=0,01). After Allo-SCT we observe a survival advantage in patients who achieved a pre-transplant CR (P=0,008) and in those who developed a chronic GvHD (P=0,05). CONCLUSIONS Patients with MS, both with de novo and secondary forms, still have a very unfavorable outcome and require an intensive therapeutic program, that includes Allo-SCT whenever possible. The outcome after Allo-SCT is positively influenced by the development of chronic GvHD suggesting a Graft versus MS effect.
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Affiliation(s)
- Davide Lazzarotto
- Division of Hematology and Bone Marrow Transplantation, Azienda Sanitaria-Universitaria Integrata, University of Udine, Italy.
| | - Anna Candoni
- Division of Hematology and Bone Marrow Transplantation, Azienda Sanitaria-Universitaria Integrata, University of Udine, Italy
| | - Carla Filì
- Division of Hematology and Bone Marrow Transplantation, Azienda Sanitaria-Universitaria Integrata, University of Udine, Italy
| | - Fabio Forghieri
- Section of Hematology, Department of Surgical and Medical Sciences, University of Modena and Reggio Emilia, Italy
| | - Livio Pagano
- Department of Hematology, Università Cattolica Sacro Cuore, Rome, Italy
| | - Alessandro Busca
- Division of Hematology, Ospedale S. Giovanni Battista, Torino, Italy
| | - Giuseppina Spinosa
- Division of Hematology, Azienda Ospedaliera Universitaria Ospedali Riuniti di Foggia, Italy
| | - Maria Elena Zannier
- Division of Hematology and Bone Marrow Transplantation, Azienda Sanitaria-Universitaria Integrata, University of Udine, Italy
| | - Erica Simeone
- Division of Hematology and Bone Marrow Transplantation, Azienda Sanitaria-Universitaria Integrata, University of Udine, Italy
| | - Miriam Isola
- Department of Medical and Biological Sciences, Section of Statistics, University of Udine, Italy
| | - Erika Borlenghi
- Division of Hematology, Azienda Ospedaliera Spedali Civili di Brescia, Italy
| | - Lorella Melillo
- Division of Hematology, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Federico Mosna
- Division of Hematology, Department of Specialty Medicine, Ospedale Ca' Foncello, Treviso, Italy
| | - Federica Lessi
- Padua University School of Medicine, Department of Medicine, Hematology and Clinical Immunology, Italy
| | - Renato Fanin
- Division of Hematology and Bone Marrow Transplantation, Azienda Sanitaria-Universitaria Integrata, University of Udine, Italy
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Mazza P, Specchia G, Di Renzo N, Cascavilla N, Tarantini G, Capalbo SF, Urbano T, Albano F, Giovannni R, Falcone AP, Santeramo MT, Spinosa G, Pisconti S. Ruxolitinib - better prognostic impact in low-intermediate 1 risk score: evaluation of the 'rete ematologica pugliese' (REP) in primary and secondary myelofibrosis. Leuk Lymphoma 2016; 58:138-144. [PMID: 27263544 DOI: 10.1080/10428194.2016.1189547] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
We evaluated ruxolitinib in 65 patients with myelofibrosis according to age, sex, time of diagnosis, grade of fibrosis, prognostic score risk, Janus kinase (JAK) status, primary or secondary myelofibrosis, previous treatment, and dosage. Outcome measures were response rate, time to response, duration of response, and event-free survival and survival. Kaplan and Meier curves show a significant difference in event-free survival according to the prognostic score, in favor of patients with low int1 (p = 0.0009). The Cox stepwise model confirmed the result, the int2 high-risk score being the most powerful negative independent parameter (0.001), followed by JAK (0.008); other parameters, such as diagnosis more than 5 years earlier, grade III-IV fibrosis, and ruxolitinib dose have a negligible impact. Time to response was shorter (p = 0.001) in primary myelofibrosis. In conclusion, ruxolitinib is effective, with a better outcome in patients with a low-int1 risk score. This may suggest considering an earlier administration in the disease course.
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Affiliation(s)
- Patrizio Mazza
- a Department of Hematology-Oncology , Complex Operative Unit of Hematology ASL , Taranto , Italy
| | - Giorgina Specchia
- b Department of Emergency and Organ Transplantation , Complex Operative Unit of Hematology , Bari , Italy
| | - Nicola Di Renzo
- c Complex Operative Unit of Hematology - ASL , Lecce , Italy
| | - Nicola Cascavilla
- d Unit of Hematology and Bone Marrow Transplantation 'Casa Sollievo Della Sofferenza' S. Giovanni Rotondo , Foggia , Italy
| | | | | | - Tiziana Urbano
- a Department of Hematology-Oncology , Complex Operative Unit of Hematology ASL , Taranto , Italy
| | - Francesco Albano
- b Department of Emergency and Organ Transplantation , Complex Operative Unit of Hematology , Bari , Italy
| | | | - Antonietta Pia Falcone
- d Unit of Hematology and Bone Marrow Transplantation 'Casa Sollievo Della Sofferenza' S. Giovanni Rotondo , Foggia , Italy
| | | | | | - Salvatore Pisconti
- a Department of Hematology-Oncology , Complex Operative Unit of Hematology ASL , Taranto , Italy
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Improta S, Villa M, Volpe A, Sanpaolo G, Spinosa G, Farina G, Cantore N, Cascavilla N, Capalbo S, Storti S, Mastrullo L. 352 Iron overload in low-risk myelodysplastic syndromes (MDS): A multicentric study. Leuk Res 2011. [DOI: 10.1016/s0145-2126(11)70354-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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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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Capalbo S, Spinosa G, Franzese MG, Palumbo G. Early deferasirox treatment in a patient with myelodysplastic syndrome results in a long-term reduction in transfusion requirements. Acta Haematol 2009; 121:19-20. [PMID: 19287132 DOI: 10.1159/000209206] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2009] [Accepted: 01/06/2009] [Indexed: 11/19/2022]
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8
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Santangelo M, Zuccaro M, De Rosa P, Tammaro V, Grassia S, Federico S, Ciotola AL, Spinosa G, Renda A. Older kidneys donor transplantation: five years' experience without biopsy and using clinical laboratory and macroscopic anatomy evaluation. Transplant Proc 2007; 39:1835-7. [PMID: 17692626 DOI: 10.1016/j.transproceed.2007.05.039] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The exponential increase in organ demand is not associated with a similar increase of available kidneys. This emergency led to expanded criteria to consider a kidney transplantable. The aim of this retrospective study was to explain our use of older donor kidneys without biopsy. MATERIALS AND METHODS Between 2000 and 2005, 58 older kidneys were harvested: 27 were transplanted in our center; 13 were discarded; and 18 were transplanted in other centers. We considered 3 factors to define kidney quality: macroscopic anatomy, multiple factors linked to the donor, and clinical-laboratory data. After transplantation, we observed the patients for at least 1 year and up to 6 years. DISCUSSION At 1 year, 24/27 (89%) patients had a functional kidney, 2 patients showed an initial renal failure and 1 patient lost the kidney. At maximum follow-up, 19 patients (70%) had functional kidneys, 4 with initial renal failure. These results compared with the kidneys harvested using Standard Donor Kidney Criteria are acceptable. Obviously we need long-term follow-up to increase, the amount of data and obtain a definitive outcome. CONCLUSION Biopsy is the gold standard for the definition of an older kidney's quality. When a biopsy is not feasible, the study of the macroscopic anatomy the kidney's donor and of some donor's parameters represent an acceptable biopsy alternative, being able to rescue some organs that would be otherwise lost.
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Affiliation(s)
- M Santangelo
- General, Thoracic and Vascular Surgery Department, O U of General Surgery and Organ Transplantation, University of Naples Federico II, Naples, Italy.
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9
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Specchia G, Pastore D, Carluccio P, Spinosa G, Giannoccaro M, Rizzi R, Mestice A, Liso V. Gemtuzumab ozogamicin with cytarabine and mitoxantrone as a third-line treatment in a poor prognosis group of adult acute myeloid leukemia patients: a single-center experience. Ann Hematol 2007; 86:425-8. [PMID: 17364181 DOI: 10.1007/s00277-007-0272-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2006] [Accepted: 02/07/2007] [Indexed: 11/26/2022]
Abstract
We analyzed the safety and efficacy of gemtuzumab ozogamicin (GO) combined with cytarabine and mitoxantrone in the treatment of 21 patients with acute myeloid leukemia (11 refractory and 10 in second relapse). Patients' median age was 52 years (range 36-68); all patients had previously been treated with anthracycline-containing regimens (daunorubicin and idarubicin). GO at a dosage of 3 mg/m2 was administered as a 2-h intravenous infusion on days 1 and 14, cytarabine at 100 mg/m2 on days 1-7, and mitoxantrone at 12 mg/m2 on days 1-3. Infusion-related events were observed in 15 of 21 (71.4%) patients. The incidence of grade 1 or 2 elevations of bilirubin and hepatic transaminases was 4 of 21 (19%) and 3 of 21 (14.2%). In response to chemotherapy, 2 of 21 (9.5%) achieved complete remission and 2 of 21 (9.5%) achieved complete remission with incomplete platelet recovery, with an overall remission rate of 4 of 21(19%); median survival of these 4 patients was 7 months. Four of 21 patients (19%) died during aplasia after chemotherapy; no veno-occlusive disease occurred. No treatment-related cardiotoxicity or cerebellar toxicity was observed. In our experience, the addition of GO to mitoxantrone and cytarabine is feasible in refractory or second relapse acute myeloid leukemia patients but yields a low response rate when used as a third-line treatment.
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Affiliation(s)
- G Specchia
- Hematology Section, DAP, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy.
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Santangelo M, De Rosa P, Spiezia S, Spinosa G, Grassia S, Zuccaro M, Renda A. Healing of surgical incision in kidney transplantation: a single transplant center's experience. Transplant Proc 2006; 38:1044-6. [PMID: 16757258 DOI: 10.1016/j.transproceed.2006.03.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [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: 02/03/2023]
Abstract
INTRODUCTION Impaired healing of the surgical incision represents a common complication after kidney transplantation. We led a retrospective study seeking to understand the factors linked to these complications and reasons for their reduction during the last year. PATIENTS AND METHODS From January 2000 to April 2004, 170 consecutive kidney transplantations were performed in a homogenous patient population. We evaluated the influence of following factors to determine impaired healing of the incision: antirejection drugs, overweight/obesity, age, delayed graft function (DGF), diabetes, and abdominal wall reconstruction technique. RESULTS Among 165 patients we observed 26 (15.76%) cases of impaired healing of the surgical incision: 17 (65,38%) with first-level and nine with second-level wound complications. CONCLUSIONS Impaired healing of the surgical incision influences the outcome of kidney transplant patients. In our study we observed that cyclosporine and tacrolimus similary affected the incision's healing. It was not possible to evaluate the role of basiliximab. A univariate analysis of the factors related to complications revealed overweight and DGF. However, all patients developing second-level complications showed more risk factors. Patients who had not had reconstruction of the muscle layers showed a greater incidence of surgical complications, whereas patients who had skin sutured with an intradermic technique did not show an increased risk.
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Affiliation(s)
- M Santangelo
- General, Thoracic and Vascular Surgery Department, OU of General Surgery and Organ Transplantation, University of Naples Federico II, Torre del Greco, Italy.
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Abstract
The new dialytic and medical therapies have improved the survival of uremic patients and their preservation of a efficacious clinical condition so as to warrant suitability for transplantation, even after a long period of dialysis. In addition, today the use of a "marginal donor" and "marginal kidney" are often used to increase the pool of available organs, so that the surgeon must face more technical difficulties than in the past; anomalies of the donor kidney, harvesting and bench surgery damages, as well as vascular pathologies in the recipient. A review of our 151 renal transplantations from January 1999 to May 2003 showed that it was often possible to overcome these technical difficulties yielding good results. This work sought to demonstrate that neither "marginal donor"/"marginal kidney" used to expand donor pool nor recipient vascular pathologies should be considered transplant contraindications. Knowledge of various technical options and the ability to put them rapidly into practice are necessary to use any organ.
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Affiliation(s)
- P De Rosa
- General, Thoracic and Vascular Surgery Department, OU of General Surgery and Organ Transplantation, University of Naples Federico II, Italy
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12
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Fiume L, Busi C, Mattioli A, Spinelli C, Spinosa G, Bongini A. A conjugate of acyclovir monophosphate with lactosaminated albumin releases the phosphorylated drug in liver cells. Naturwissenschaften 1989; 76:74-6. [PMID: 2725686 DOI: 10.1007/bf00396711] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- L Fiume
- Dipartimento di Patologia sperimentale, Bologna
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13
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Spinosa G, Perlanski E, Leenen FH, Stewart RB, Grupp LA. Angiotensin converting enzyme inhibitors: animal experiments suggest a new pharmacological treatment for alcohol abuse in humans. Alcohol Clin Exp Res 1988; 12:65-70. [PMID: 2831750 DOI: 10.1111/j.1530-0277.1988.tb00134.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The prevalence of heavy alcohol consumption is a major problem of increasing proportions throughout the world. Although alcohol sensitizing drugs and more recently serotonin uptake inhibitors are drug interventions with some following, their long term beneficial consequences have yet to be demonstrated. In recent years, we have demonstrated that manipulating activity in the renin-angiotensin system will dramatically alter voluntary alcohol consumption in rats. Based on these findings, the present study evaluated the ability of a class of drugs known as the angiotensin converting enzyme inhibitors to reduce voluntary alcohol drinking in laboratory animals. These drugs prevent the conversion of angiotensin I to angiotensin II. They have been licensed for use in Europe and North America and are indicated in the treatment of hypertension. Our experiments showed that both captopril (Capoten, Squibb) and enalapril (Vasotec, Merck Sharpe & Dohme) can reduce alcohol drinking in both normotensive and hypertensive animals regardless of whether the pattern of intake is in a bout or of a less exaggerated nature. Furthermore, this change in alcohol intake can occur without concomitant changes in blood pressure, plasma renin activity, overall fluid balance, or the distribution and metabolism of alcohol. Taken together these findings suggest that the angiotensin converting enzyme inhibitors should be evaluated in a clinical setting for they may prove to be a useful new treatment or treatment adjunct for alcohol abuse in humans.
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Affiliation(s)
- G Spinosa
- Department of Pharmacology, University of Toronto, Canada
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14
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Fiume L, Busi C, Mattioli A, Spinosa G. Increased immunogenicity of some native antigenic determinants in a chemically changed human albumin. Naturwissenschaften 1987; 74:595-6. [PMID: 2450284 DOI: 10.1007/bf00368519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- L Fiume
- Dipartimento di Patologia sperimentale, Bologna
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15
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Fiume L, Busi C, Preti P, Spinosa G. Conjugates of ara-AMP with lactosaminated albumin: a study on their immunogenicity in mouse and rat. Cancer Drug Deliv 1987; 4:145-50. [PMID: 2453263 DOI: 10.1089/cdd.1987.4.145] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Complexes of albumin with oligosaccharides have been successfully employed in experimental chemotherapy as hepatotropic carriers of antiviral drugs or as vectors of anticancer-agents, but their clinical use is hampered by an immune response they might evoke. In the present experiments we have studied the humoral immunogenicity of conjugates of 9-beta-D-arabinofuranosyl adenine 5'-monophosphate (ara-AMP) with lactosaminated albumin (L-SA), in mice and rats. These complexes were prepared with the aim of increasing the chemotherapeutic index of ara-AMP in the treatment of chronic hepatitis B virus (HBV) infection. L-SA-ara-AMP conjugates prepared with heterologous albumin produced antibodies in mice and rats when repeatedly injected intraperitoneally. The same conjugates prepared with homologous albumin induced only low amounts of antibodies, when given by repeated intraperitoneal injection, whereas they did not evoke antibodies in mice and were tolerogenic in rats when administered repeatedly by the intravenous route. These results suggest that in a clinical use of drug conjugates prepared with oligosaccharide-albumin complexes the risk of an immune response can be reduced by employing human albumin and by injecting the conjugates by the intravenous route.
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Affiliation(s)
- L Fiume
- Dipartimento di Patologia Sperimentale, Bologna, Italy
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Fiume L, Mattioli A, Spinosa G. Distribution of a conjugate of 9-beta-D-arabinofuranosyladenine 5'-monophosphate (ara-AMP) with lactosaminated albumin in parenchymal and sinusoidal cells of rat liver. Cancer Drug Deliv 1987; 4:11-6. [PMID: 2440549 DOI: 10.1089/cdd.1987.4.11] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
9-beta-D-Arabinofuranosyladenine 5'-monophosphate (ara-AMP) coupled to lactosaminated human albumin (L-HSA), injected i.v. into rats, selectively enters the liver. The conjugate concentration in parenchymal and sinusoidal hepatic cells, isolated by collagenase perfusion, was found to be practically equal in both cell types. This indicates that the high uptake of L-HSA-ara-AMP complex by the whole liver also corresponds to a high conjugate concentration in hepatocytes where ara-AMP should be targeted in order to increase its chemotherapeutic index in chronic hepatitis B treatment.
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Fiume L, Bassi B, Busi C, Mattioli A, Spinosa G, Faulstich H. Galactosylated poly(L-lysine) as a hepatotropic carrier of 9-beta-D-arabinofuranosyladenine 5'-monophosphate. FEBS Lett 1986; 203:203-6. [PMID: 2426140 DOI: 10.1016/0014-5793(86)80742-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
D-Galactopyranosyl residues were coupled to poly(L-lysine) and the antiviral agents arabinofuranosyladenine 5'-monophosphate (ara-AMP) and acyclovir were conjugated with this glycosylated polymer. In mice the ara-AMP conjugate accomplished a selective drug delivery to liver cells.
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Fiume L, Bassi B, Busi C, Mattioli A, Spinosa G. Drug targeting in antiviral chemotherapy. A chemically stable conjugate of 9-beta-D-arabinofuranosyl-adenine 5'-monophosphate with lactosaminated albumin accomplishes a selective delivery of the drug to liver cells. Biochem Pharmacol 1986; 35:967-72. [PMID: 2420334 DOI: 10.1016/0006-2952(86)90084-5] [Citation(s) in RCA: 61] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
With the aim of improving the chemotherapeutic index of 9-beta-D-arabinofuranosyl-adenine 5' monophosphate (ara-AMP) in the treatment of chronic hepatitis B, this drug was conjugated with lactosaminated serum albumin (L-SA), a neoglycoprotein which only enters into hepatocytes. We used a L-SA-ara-AMP conjugate which, in contrast to those previously employed, has the advantage of remaining soluble after lyophilization. We found in mice that: (I) this new conjugate was quite stable in the bloodstream where only a small part of ara-AMP was released; (II) after administration of the conjugate labelled in the drug moiety both acid insoluble and soluble radioactivities were several times higher in liver than in other organs; (III) in mice with Ectromelia virus hepatitis, the conjugate inhibited virus DNA synthesis in liver without affecting cellular DNA synthesis in intestine and bone marrow; (IV) the conjugate did not display any recognizable sign of acute toxicity even at doses several fold higher than those pharmacologically active; and (V) when prepared with homologous albumin it was not immunogenic.
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Fiume L, Mattioli A, Busi C, Spinosa G, Wieland T. Conjugates of adenine 9-alpha-D-arabinofuranoside monophosphate (ara-AMP) with lactosaminated homologous albumin are not immunogenic in the mouse. Experientia 1982; 38:1087-9. [PMID: 6182024 DOI: 10.1007/bf01955383] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Marcer V, Dander B, Spinosa G, Buonanno C. [Ajmaline treatment of supraventricular paroxysmal tachycardia in Wolff-Parkinson-White syndrome. Report of a neonatal case]. Minerva Pediatr 1976; 28:695-700. [PMID: 995079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Spinosa G, Barbato G. [Mepartricin: a new polyene antibiotic for the treatment of mycotic infections of the oral cavity in infants]. Minerva Pediatr 1975; 27:1491-5. [PMID: 1223638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Spinosa G, Mastella G. [Cystic teratoma of the ovary in a 17-month-old infant]. Fracastoro 1969; 62:679-82. [PMID: 5384280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Spinosa G, Marcer V, Mastella G. [Hurler's disease]. Fracastoro 1969; 62:298-304. [PMID: 4982309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Mastella G, Spinosa G. [Anhidrotic ectodermal dysplasia (Christ-Siemens-Weech syndrome)]. Fracastoro 1969; 62:219-24. [PMID: 5404892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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