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Viviani S, Vanazzi A, Frassoni S, Rusconi C, Rossi A, Romano A, Patti C, Schiavotto C, Sorasio R, Marasco V, Lissandrini L, Rapezzi D, Gottardi D, Cocito F, Mulè A, Leotta S, Gini G, Sorio M, Derenzini E, Rambaldi A, Bagnardi V, Tarella C. High-dose chemotherapy and autologous stem cell transplant as first salvage treatment for relapsed or refractory Hodgkin Lymphoma in the era of PET-adapted strategies. Leuk Lymphoma 2024; 65:460-471. [PMID: 38164812 DOI: 10.1080/10428194.2023.2298273] [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] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/18/2023] [Indexed: 01/03/2024]
Abstract
Data on the efficacy of high-dose chemotherapy and autologous stem cell transplantation (ASCT) for classical Hodgkin lymphoma (cHL) patients who failed a PET-driven first-line therapy are limited.We retrospectively evaluated 220 adult cHL patients who underwent ASCT from 2009 to 2021 at 11 centers in Italy. Overall, 49.5% had refractory disease, 23.2% relapsed < 12 and 27.3% ≥12 months from the end of first-line chemotherapy. The 3-year progression-free survival (PFS) and overall survival (OS) were 73.8% and 89.4%. In univariable analysis for PFS events PET-2+ (HR 2.69, p = .001), anemia (HR 2.22, p = .019), refractory disease (HR 1.76, p = .045), less than CR before ASCT (HR 3.24, p < .001) and >2 lines of salvage therapy (HR 2.52; p = .004) were associated with a higher risk of failure after ASCT. In multivariable analysis, >2 lines of salvage therapy (HR 3.28, p = .004) and RT before ASCT (HR 3.00, p = 0.041) retained significance.ASCT is an effective salvage approach for cHL patients treated in the era of PET-adapted therapies.
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Affiliation(s)
- Simonetta Viviani
- Division of Onco-Hematology, IEO, European Institute of Oncology IRCCS, Milano, Italy
| | - Anna Vanazzi
- Division of Onco-Hematology, IEO, European Institute of Oncology IRCCS, Milano, Italy
| | - Samuele Frassoni
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milano, Italy
| | - Chiara Rusconi
- Department of Hematology and Stem Cell Transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Andrea Rossi
- Department of Hematology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Alessandra Romano
- Division of Haematology, Azienda Ospedaliera Policlinico-Vittorio Emanuele, University of Catania, Italy
| | - Caterina Patti
- Division of Hematology 1, Azienda Ospedali Riuniti Villa Sofia-Cervello Palermo, Italy
| | | | - Roberto Sorasio
- Department of Hematology, S. Croce e Carle Hospital, Cuneo, Italy
| | - Vincenzo Marasco
- Department of Hematology and Stem Cell Transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Laura Lissandrini
- Division of Hematology, Presidio Ospedaliero S. Bortolo, Vicenza, Italy
| | - Davide Rapezzi
- Department of Hematology, S. Croce e Carle Hospital, Cuneo, Italy
| | - Daniela Gottardi
- University Division of Hematology and Cellular Therapy, A.O. Ordine Mauriziano, Torino, Italy
| | - Federica Cocito
- Division of Hematology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Antonio Mulè
- Division of Hematology 1, Azienda Ospedali Riuniti Villa Sofia-Cervello Palermo, Italy
| | - Salvatore Leotta
- Division of Haematology, Azienda Ospedaliera Policlinico-Vittorio Emanuele, University of Catania, Italy
| | - Guido Gini
- Hematology Unit, AUO Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy
| | - Marco Sorio
- Division of Medicine, Hematology Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Enrico Derenzini
- Division of Onco-Hematology, IEO, European Institute of Oncology IRCCS, Milano, Italy
- Department of Health Sciences, University of Milano, Italy
| | - Alessandro Rambaldi
- Department of Hematology, ASST Papa Giovanni XXIII, Bergamo, Italy
- Department of Oncology and Hematology, University of Milano, Italy
| | - Vincenzo Bagnardi
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milano, Italy
| | - Corrado Tarella
- Division of Onco-Hematology, IEO, European Institute of Oncology IRCCS, Milano, Italy
- Department of Health Sciences, University of Milano, Italy
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Minoia C, Viviani S, Silvestris E, Palini S, Parissone F, De Palma G, Fedina A, Cormio G, Guarini A, Gini G, Montano L, Merli F, Peccatori FA. Fertility preservation and monitoring in adult patients diagnosed with lymphoma: consensus-based practical recommendations by the Fondazione Italiana Linfomi & Società Italiana della Riproduzione Umana. Front Oncol 2023; 13:1252433. [PMID: 37766870 PMCID: PMC10520955 DOI: 10.3389/fonc.2023.1252433] [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: 07/03/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023] Open
Abstract
Introduction Fertility preservation (FP) and monitoring has considerable relevance in the multidisciplinary approach to cancer patients. In these consensus-based practical recommendations, the scientific societies Fondazione Italiana Linfomi (FIL) and Società Italiana della Riproduzione Umana (SIRU) reviewed the main aspects and identified the optimal paths which aim to preserve and monitor fertility in patients diagnosed with lymphoma at the different phases of the disease and during long-term survivorship. Methods For the Panel, eleven experts were selected for their expertise in research and clinical practice on onco-fertility and lymphoma. The Panel's activity was supervised by a chairman. A series of rank-ordering key questions were proposed according to their clinical relevance and discussed among the Panel, focusing on patients diagnosed with non-Hodgkin's lymphomas and Hodgkin lymphoma. Agreement among all the Panelists on the content and terminology of the statements was evaluated by a web-based questionnaire according to the Delphi methodology. Results From the literature review a total of 78 questions or sentences, divided into the 6 areas of interest, were identified. By applying the Gwet's AC, k was: Section 1: 0,934 (Very good); Section 2: 0,958 (Very good); Section 3: 0,863 (Very good); Section 4: 0,649 (Good); Section 5: 0,936 (Very good); Section 6 raw agreement 100%. Two rounds of Delphi allowed to provide the maximum agreement. All statements were newly discussed in a round robin way and confirmed for the drafting of the final recommendations. Discussion These recommendations would be useful for onco-hematologists, gynecologists, urologists, and general practice physicians who take care of young lymphoma patients to guarantee an evidence-based oncofertility assessment and treatment during the oncologic pathway.
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Affiliation(s)
- Carla Minoia
- Hematology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Simonetta Viviani
- Division of Onco-Hematology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Erica Silvestris
- Gynecologic Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Simone Palini
- Physiopathology of Reproduction Unit, Cervesi Hospital, Cattolica, Italy
| | - Francesca Parissone
- Department of Obstetrics and Gynecology, Azienda Ospedaliera Universitaria Integrata di Verona, Università di Verona, Verona, Italy
| | - Giuseppe De Palma
- Institutional BioBank, Experimental Oncology and Biobank Management Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Anna Fedina
- Data Office Fondazione Italiana Linfomi, Alessandria, Italy
| | - Gennaro Cormio
- IRCCS Istituto Tumori Departiment of Interdisciplinary Medicine (DIM), University of Bari, Bari, Italy
| | - Attilio Guarini
- Hematology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Guido Gini
- Clinic of Hematology Azienda Ospedaliera Universitaria (AOU) delle Marche, Ancona, Italy
| | - Luigi Montano
- Andrology Unit and Service of Lifestyle Medicine in UroAndrology, Local Health Authority (ASL), Salerno, Italy
| | - Francesco Merli
- Hematology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Biggi A, Chauvie S, Fallanca F, Guerra L, Bergesio F, Menga M, Bianchi A, Gregianin M, Chiaravalloti A, Schillaci O, Pavoni C, Patti C, Picardi M, Romano A, Schiavotto C, Sorasio R, Viviani S, La Nasa G, Trentin L, Rambaldi A, Gallamini A. Predictive value on advance hodgkin lymphoma treatment outcome of end-of treatment FDG PET/CT in the HD0607 clinical trial. Hematol Oncol 2023; 41:415-423. [PMID: 36534947 DOI: 10.1002/hon.3117] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/27/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022]
Abstract
The Lugano classification for response assessment in lymphoma recommends the use of the 5-point-scale Deauville Score (DS) to assess response evaluation of end-of-treatment FDG-PET/CT (eotPET) in Hodgkin Lymphoma (HL); nevertheless, there is a paucity of data on its accuracy and reproducibility. We focus here on the cohort of advanced stage IIb-IV HL patients enrolled in the HD0607 clinical trial (NCT identifier 00795613) that having had a negative interim PET performed 6 cycles of ABVD (Doxorubicin, Vinblastine, Vincristine and Dacarbazine) and then performed an eotPET. Negative patients were randomized to radiotherapy and no further treatment while positive patients were treated based on local policies. eotPET was re-evaluated independently by two readers evaluated and progression free survival was analysed (PFS). eotPET of 254 patients were analysed. The median follow-up was 43 months. The best receiver operator characteristics cut-off values to distinguish positive and negative patients was 4. The area-under-the-curve was 0.81 (95%CI, 0.70-0.91). Three-years PFS was 0.95 (95% CI 0.90-0.97) in eotPET negative and 0.22 (95% CI 0.11-0.43) in eotPET positive. DS demonstrated a good reproducibility of positivity/negativity between the readers consensus and local site evaluation where the agreement occurred on 95.0% of patients. The present study demonstrates that eotPET is an accurate tool to predict treatment outcome in HL and confirms the appropriateness of the Lugano classification for eotPET evaluation.
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Affiliation(s)
- Alberto Biggi
- Nuclear Medicine Division, Santa Croce e Carle Hospital, Cuneo, Italy
| | - Stephane Chauvie
- Medical Physics Division, Santa Croce e Carle Hospital, Cuneo, Italy
| | - Federico Fallanca
- Nuclear Medicine Division, IRCSS Ospedale San Raffaele, Milano, Italy
| | - Luca Guerra
- Nuclear Medicine Division, Ospedale San Gerardo, Monza, Italy
| | - Fabrizio Bergesio
- Medical Physics Division, Santa Croce e Carle Hospital, Cuneo, Italy
| | - Massimo Menga
- Nuclear Medicine Division, Ospedale Trieste, Trieste, Italy
| | - Andrea Bianchi
- Nuclear Medicine Division, Santa Croce e Carle Hospital, Cuneo, Italy
| | | | | | | | - Chiara Pavoni
- Haematology Division, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Caterina Patti
- Haematologiy. Division, V. Cervello Hospital, Palermo, Italy
| | - Marco Picardi
- Clinical Medicine and Surgery Department, Federico II University, Naples, Italy
| | - Alessandra Romano
- Hematology Division, Policlinico Vittorio Emanuele Hospital, Catania, Italy
| | | | - Roberto Sorasio
- Haematology Division, Santa Croce e Carle Hospital, Cuneo, Italy
| | | | | | - Livio Trentin
- Hematology Division, Università di Padova, Padova, Italy
| | | | - Andrea Gallamini
- Department Recherche Innovation et Statistique, Centre A. Lacassagne, Nice, France
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Sow SO, Tapia MD, Haidara FC, Diallo F, Traore Y, Traoré A, Kodio M, Borrow R, Townsend-Payne K, Yuan L, Yang S, Shi L, Chen J, Fang G, Lin J, Hu R, Viviani S, Huang Z. Safety and immunogenicity of quadrivalent meningococcal polysaccharide vaccine (MPV ACYW135) compared with quadrivalent meningococcal conjugate vaccine (Menactra®) in Malian children. Hum Vaccin Immunother 2023:2230829. [PMID: 37401618 DOI: 10.1080/21645515.2023.2230829] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2023] Open
Abstract
Affordable, polyvalent meningococcal vaccines are needed for use in emergency reactive immunization campaigns. A phase IV randomized, observer-blind, controlled study compared the safety and immunogenicity of a quadrivalent meningococcal polysaccharide vaccine (MPV-4, MPV ACYW135) and quadrivalent meningococcal ACWY conjugate vaccine (MCV-4, Menactra®). Healthy, 2- to 10-year-old children in Bamako, Mali, were randomized 1:1 to receive one dose of MPV-4 or MCV-4. Safety outcomes were evaluated for 6 months post-immunization. Immunogenicity for all serogroups was assessed for non-inferiority between MPV-4 and MCV-4 30 days post immunization by serum bactericidal antibody assay using baby rabbit complement (rSBA). From December 2020 to July 2021, 260 healthy subjects were consented and randomized. At Day 30 post-immunization, the proportions of subjects with rSBA titers ≥ 128 for all serogroups in the MPV-4 group were non-inferior to those in MCV-4 group. The proportions of subjects with rSBA ≥ 4-fold increase and rSBA titers ≥ 8 for all serogroups were similar among vaccine groups (P > .05). Geometric Mean Titers and Geometric Mean Fold Increases for all serogroups in both vaccine groups were similar (P > .05). Few local and systemic post-immunization reactions of similar severity and duration were observed within 7 days and were similar in both groups (P > .05). All resolved without sequelae. Unsolicited adverse events were similar in both groups regarding relationship to study vaccine, severity and duration. No serious adverse events were reported during the study period. MPV ACYW135 showed a non-inferior immunogenicity profile and a comparable reactogenicity profile to MCV-4 in Malian children aged 2-10 years.Clinical Trial Registration: NCT04450498.
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Affiliation(s)
- Samba O Sow
- Centre pour le Développement des Vaccins du Mali (CVD-Mali), Bamako, Mali
| | - Milagritos D Tapia
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Fatoumata Diallo
- Centre pour le Développement des Vaccins du Mali (CVD-Mali), Bamako, Mali
| | - Youssouf Traore
- Centre pour le Développement des Vaccins du Mali (CVD-Mali), Bamako, Mali
| | - Awa Traoré
- Centre pour le Développement des Vaccins du Mali (CVD-Mali), Bamako, Mali
| | - Mamoudou Kodio
- Centre pour le Développement des Vaccins du Mali (CVD-Mali), Bamako, Mali
| | - Ray Borrow
- Vaccine Evaluation Unit, UK Health Security Agency, Public Health Laboratory, Manchester, UK
| | - Kelly Townsend-Payne
- Vaccine Evaluation Unit, UK Health Security Agency, Public Health Laboratory, Manchester, UK
| | - Lin Yuan
- Walvax Biotechnology Co., Ltd., Kunming, Yunnan, China
| | - Shuyuan Yang
- Walvax Biotechnology Co., Ltd., Kunming, Yunnan, China
| | - Lei Shi
- Walvax Biotechnology Co., Ltd., Kunming, Yunnan, China
| | - Jingjing Chen
- Walvax Biotechnology Co., Ltd., Kunming, Yunnan, China
| | - Guoliang Fang
- Walvax Biotechnology Co., Ltd., Kunming, Yunnan, China
| | - Jianxiang Lin
- Walvax Biotechnology Co., Ltd., Kunming, Yunnan, China
| | - Ruoyu Hu
- Walvax Biotechnology Co., Ltd., Kunming, Yunnan, China
| | - Simonetta Viviani
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Zhen Huang
- Walvax Biotechnology Co., Ltd., Kunming, Yunnan, China
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Gotti M, Sciarra R, Pulsoni A, Merli F, Luminari S, Zerbi C, Trentin L, Re A, Rusconi C, Viviani S, Rossi A, Cocito F, Botto B, Meli E, Pinto A, Dogliotti I, Gini G, Puccini B, Ricci F, Nassi L, Fabbri A, Liberati AM, Merli M, Filippi AR, Bonfichi M, Zoboli V, Tartaglia G, Annechini G, D’Elia GM, Del Giudice I, Alvarez I, Visentin A, Pravato S, Dalceggio D, Pagani C, Ferrari S, Cristinelli C, Lazic T, Ferretti VV, Ricardi U, Arcaini L. Role of Rituximab Addition to First-line Chemotherapy Regimens in Nodular Lymphocyte-predominant Hodgkin Lymphoma: A Study by Fondazione Italiana Linfomi. Hemasphere 2023; 7:e837. [PMID: 37034003 PMCID: PMC10079338 DOI: 10.1097/hs9.0000000000000837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 12/29/2022] [Indexed: 04/08/2023] Open
Abstract
Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare entity whose neoplastic cells retain a B-cell phenotype with expression of CD20. Radiotherapy is recommended for favorable stage IA disease while for other stages guidelines suggest therapeutic strategies similar to those used for classic HL. The role of rituximab, although quite widespread, is not completely elucidated. We retrospectively analyzed baseline characteristics of 308 consecutive patients with NLPHL diagnosed in 19 Italian centers from 2000 to 2018. With a median follow-up of 8.4 years (interquartile range: 4.5–12.4) for treated patients, median overall survival (OS) was not reached and estimated 5-year OS was 97.8% and 5-year progression-free survival (PFS) was 84.5%. Five-year cumulative incidence of histological transformation was 1.4%, 95% confidence interval (CI), 0.5%-3.8%. After adjusting for lymphocyte count, splenic involvement, bulky disease and B symptoms (fever, drenching night sweats, unintentional loss >10% of body weight within the preceding 6 months), patients with stage II or more showed superior PFS with immunochemotherapy in comparison to chemotherapy alone (hazard ratio = 0.4, 95% CI, 0.2-0.8; P = 0.015). Our data suggest an advantage of the use of rituximab combined with chemotherapy ± radiotherapy in the treatment of stage II–III–IV NLPHL.
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Affiliation(s)
- Manuel Gotti
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Roberta Sciarra
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Molecular Medicine, University of Pavia, Italy
| | - Alessandro Pulsoni
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
| | - Francesco Merli
- Division of Hematology, Azienda USL-IRCCS of Reggio Emilia, Italy
| | - Stefano Luminari
- Division of Hematology, Azienda USL-IRCCS of Reggio Emilia, Italy
- Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Italy
| | - Caterina Zerbi
- Department of Molecular Medicine, University of Pavia, Italy
| | - Livio Trentin
- Hematology Unit, Department of Medicine - DIMED, University of Padova, Italy
| | - Alessandro Re
- Division of Hematology, Spedali Civili, Brescia, Italy
| | - Chiara Rusconi
- Division of Hematology and Blood Marrow Transplantation, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Simonetta Viviani
- Division of Hematology and Blood Marrow Transplantation, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Andrea Rossi
- Hematology and Bone Marrow Transplant Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Federica Cocito
- Division of Hematology, ASST Monza, Ospedale S. Gerardo, Monza, Italy
| | - Barbara Botto
- Division of Hematology, Azienda Ospedale Città della Salute e della Scienza, Torino, Italy
| | - Erika Meli
- Division of Hematology, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Antonello Pinto
- Hematology-Oncology and Stem-Cell Transplantation Unit, Department of Hematology and Developmental Therapeutics, Istituto Nazionale Tumori, Fondazione G. Pascale, IRCCS, Napoli, Italy
| | - Irene Dogliotti
- Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino, Italy
| | - Guido Gini
- Department of Hematology, Ospedali Riuniti, Ancona, Italy
| | | | - Francesca Ricci
- Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy
| | - Luca Nassi
- Hematology, Department of Translational Medicine, AOU Maggiore della Carità and University of Eastern Piedmont, Novara, Italy
| | - Alberto Fabbri
- Division of Hematology, Azienda Ospedaliero- Universitaria Senese, Siena, Italy
| | - Anna Marina Liberati
- Division of Hematology, Azienda Ospedalaliera S. Maria di terni – Università degli Studi di Perugia, Italy
| | - Michele Merli
- Division of Hematology, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Andrea Riccardo Filippi
- Radiation Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Italy
| | - Maurizio Bonfichi
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Valentina Zoboli
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Germana Tartaglia
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
| | - Giorgia Annechini
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
| | - Gianna Maria D’Elia
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
| | - Ilaria Del Giudice
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
| | - Isabel Alvarez
- Division of Hematology, Azienda USL-IRCCS of Reggio Emilia, Italy
| | - Andrea Visentin
- Hematology Unit, Department of Medicine - DIMED, University of Padova, Italy
| | - Stefano Pravato
- Hematology Unit, Department of Medicine - DIMED, University of Padova, Italy
| | | | - Chiara Pagani
- Division of Hematology, Spedali Civili, Brescia, Italy
| | - Silvia Ferrari
- Hematology and Bone Marrow Transplant Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | - Tanja Lazic
- Department of Molecular Medicine, University of Pavia, Italy
| | - Virginia Valeria Ferretti
- Service of Clinical Epidemiology and Biometry, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Umberto Ricardi
- Radiation Oncology, Department of Oncology, University of Turin, Italy
| | - Luca Arcaini
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Molecular Medicine, University of Pavia, Italy
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Marchi S, Coppola C, Piu P, Benincasa L, Dapporto F, Manenti A, Viviani S, Montomoli E, Trombetta CM. SARS-CoV-2 epidemiological trend before vaccination era: a seroprevalence study in Apulia, Southern Italy, in 2020. Z Gesundh Wiss 2023:1-6. [PMID: 36776202 PMCID: PMC9898852 DOI: 10.1007/s10389-023-01834-3] [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] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 01/23/2023] [Indexed: 02/09/2023]
Abstract
Aim The present study aimed at assessing the prevalence of antibodies against SARS-CoV-2 in the general population in the province of Bari (Apulia region, Southern Italy) during the year 2020. Subject and methods In this study, 1325 serum samples collected from January to December 2020 were tested for the presence of IgM and IgG antibodies against whole-virus SARS-CoV-2 antigen by commercial ELISA. Positive samples were further tested by in-house ELISA for the detection of anti-receptor binding domain (RBD) IgM and IgG antibodies and by micro-neutralization (MN) assay for the detection of neutralizing antibody. Results One hundred (7.55%) samples had the presence of at least one antibody class against SARS-CoV-2 by commercial ELISA, of which 88 (6.6%) showed IgG and 19 (1.4%) showed IgM antibodies. The proportion of samples with IgG antibodies increased from 1.9% in January-February to 9.6% in November-December, while no significant increase was observed for IgM. When tested by in-house ELISA and MN assay, 17.0% and 31.6% were found positive to RBD IgG and RBD IgM, respectively, while 12.0% showed neutralizing antibody. Conclusion The proportion of samples with SARS-CoV-2 IgG antibodies increased during 2020, especially in the second half of the year, consistent with data reported by the routine epidemiological surveillance of SARS-CoV-2 cases. Despite the high number of reported cases, the seroprevalence values are relatively low, and only a small proportion of samples had neutralizing antibodies. Supplementary Information The online version contains supplementary material available at 10.1007/s10389-023-01834-3.
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Affiliation(s)
- Serena Marchi
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
| | - Chiara Coppola
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
| | | | | | | | | | - Simonetta Viviani
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
| | - Emanuele Montomoli
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
- VisMederi srl, 53100 Siena, Italy
- VisMederi Research srl, 53100 Siena, Italy
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7
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Viviani S, Willems P, Pagliusi S. Strengthening clinical development activities and preparedness for vaccine manufacturers from emerging countries: Results of a survey. Vaccine X 2022; 13:100255. [PMID: 36654839 PMCID: PMC9841010 DOI: 10.1016/j.jvacx.2022.100255] [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: 02/09/2022] [Revised: 11/09/2022] [Accepted: 12/27/2022] [Indexed: 12/29/2022] Open
Abstract
Vaccine development, in most cases, is a long, complex process, often lasting years and involving a combination of public and private stakeholders. Particularly, the vaccine clinical development process is highly regulated by several guidelines, regulatory pathways and science-based recommendations from experts. Designing and executing a successful clinical development plan for any candidate vaccine requires a solid scientific, medical, operational and regulatory knowledge and expertise, to comply with regulations and assure adequate benefit-risk balance for the product to be used in mass vaccination of healthy populations. The purpose of this study was to assess the approaches and practices related to Clinical Development functions, and related activities among vaccine manufacturers based in emerging countries, and to identify industry needs in terms of organizational development and training needs. A structured questionnaire designed specifically for assessing indicators of clinical activities, in the last five years, comprised of four sections aimed to collect information on (1) the organizational structure and the activities conducted by the clinical functions; (2) the clinical trial design ability and the management of clinical trial documents; (3) the clinical trial management and monitoring activities; (4) the quality aspects of clinical activities. The results suggest that the great majority of respondents is engaged in intense clinical development activities, as indicated by the high number of licensed vaccines available and supplied in the national markets or in foreign markets, including vaccines with WHO prequalification status. Areas to further strengthen the clinical activities and medical research preparedness were identified. Greater engagements of stakeholders' and investments will be required to expand the clinical basis in vaccine R&D, and to support achieving a high level of preparedness in emerging countries, for development of new vaccines against future regional epidemics and global pandemics.
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Affiliation(s)
- Simonetta Viviani
- Vaccines, Epidemiology & Public Health, Via Gramsci 12, Loc.Strove, 53035 Monteriggioni, Siena, Italy
| | - Paul Willems
- Independent Expert in Clinical Development, Safety & Pharmacovigilance
| | - Sonia Pagliusi
- DCVMN International, Route de Crassier 7, 1262 Eysinns-Nyon, Switzerland,Corresponding author.
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8
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Trombetta CM, Marchi S, Viviani S, Manenti A, Casa E, Dapporto F, Remarque EJ, Bollati V, Manini I, Lazzeri G, Montomoli E. A serological investigation in Southern Italy: was SARS-CoV-2 circulating in late 2019? Hum Vaccin Immunother 2022; 18:2047582. [PMID: 35289714 PMCID: PMC8935457 DOI: 10.1080/21645515.2022.2047582] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
In March 2020, the first pandemic caused by a coronavirus was declared by the World Health Organization. Italy was one of the first and most severely affected countries, particularly the northern part of the country. The latest evidence suggests that the virus could have been circulating, at least in Italy, before the first autochthonous SARS-COV-2 case was detected in February 2020. The present study aimed to investigate the presence of antibodies against SARS-CoV-2 in human serum samples collected in the last months of 2019 (September–December) in the Apulia region, Southern Italy. Eight of 455 samples tested proved positive on in-house receptor-binding-domain-based ELISA. Given the month of collection of the positive samples, these findings may indicate early circulation of SARS-CoV-2 in Apulia region in the autumn of 2019. However, it cannot be completely ruled out that the observed sero-reactivity could be an unknown antigen specificity in another virus to which subjects were exposed containing an epitope adventitiously cross-reactive with an epitope of SARS-CoV-2.
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Affiliation(s)
| | - Serena Marchi
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Simonetta Viviani
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | | | | | | | - Edmond J Remarque
- Department of Virology, Biomedical Primate Research Centre, Rijswijk, The Netherlands
| | - Valentina Bollati
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Ilaria Manini
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Giacomo Lazzeri
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Emanuele Montomoli
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.,VisMederi srl, Siena, Italy.,VisMederi Research srl, Siena, Italy
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9
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Dapporto F, Leonardi M, Trombetta CM, Semplici C, Piu P, Piccini G, Benincasa L, Marchi S, Andreano E, Lovreglio P, Buonvino N, Decaro N, Stufano A, Lorusso E, Bombardieri E, Ruello A, Viviani S, Rappuoli R, Molesti E, Manenti A, Montomoli E. The neutralizing response to SARS-CoV-2 Omicron variants BA.1 and BA.2 in COVID-19 patients and homologous and heterologous vaccinees. Hum Vaccin Immunother 2022; 18:2129196. [PMID: 36269939 DOI: 10.1080/21645515.2022.2129196] [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] [Indexed: 12/15/2022] Open
Abstract
The rapid replacement of Omicron BA.1 by BA.2 sublineage is very alarming, raising the question of whether BA.2 can escape the immunity acquired after BA.1 infection. We compared the neutralizing activity toward the Omicron BA.1 and BA.2 sub-lineages in five groups: COVID-19 patients; subjects who had received two doses of mRNA vaccine; subjects naturally infected with SARS-CoV-2 who had received two doses of mRNA; and subjects who had received three doses of homologous or heterologous vaccine. The results obtained highlight the importance of vaccine boosters in eliciting neutralizing antibody responses against Omicron sub-lineages, and suggest that the adenovirus vectored vaccine elicits a lower response against BA.1 than against BA.2 sub-lineage.
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Affiliation(s)
| | | | - Claudia Maria Trombetta
- VisMederi Research srl, Siena, Italy.,Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | | | | | | | - Linda Benincasa
- VisMederi srl, Siena, Italy.,VisMederi Research srl, Siena, Italy
| | - Serena Marchi
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Emanuele Andreano
- Monoclonal Antibody Discovery (MAD) Lab, Fondazione Toscana Life Sciences, Siena, Italy
| | - Piero Lovreglio
- Interdisciplinary Department of Medicine, Section of Occupational Medicine, University of Bari, Bari, Italy
| | - Nicola Buonvino
- U.O.C. Penitentiary Medicine - Department of Territorial Care, Bari Local Health Authority, Bari, Italy
| | - Nicola Decaro
- Department of Veterinary Medicine, University of Bari, Valenzano, Italy
| | - Angela Stufano
- Interdisciplinary Department of Medicine, Section of Occupational Medicine, University of Bari, Bari, Italy
| | - Eleonora Lorusso
- Department of Veterinary Medicine, University of Bari, Valenzano, Italy
| | | | | | - Simonetta Viviani
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Rino Rappuoli
- Monoclonal Antibody Discovery (MAD) Lab, Fondazione Toscana Life Sciences, Siena, Italy.,Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Siena, Italy
| | | | | | - Emanuele Montomoli
- VisMederi srl, Siena, Italy.,VisMederi Research srl, Siena, Italy.,Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
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10
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Marchi S, Dragoni F, Boccuto A, Idoko OT, Zazzi M, Sow S, Diallo A, Viviani S, Montomoli E, Vicenti I, Trombetta CM. Neutralizing activity of African lineage Zika virus immune sera towards Asian lineage. Acta Trop 2022; 237:106736. [DOI: 10.1016/j.actatropica.2022.106736] [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: 09/21/2022] [Revised: 10/27/2022] [Accepted: 10/27/2022] [Indexed: 11/27/2022]
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11
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Trombetta CM, Piccini G, Pierleoni G, Leonardi M, Dapporto F, Marchi S, Andreano E, Paciello I, Benincasa L, Lovreglio P, Buonvino N, Decaro N, Stufano A, Lorusso E, Bombardieri E, Ruello A, Viviani S, Rappuoli R, Molesti E, Manenti A, Montomoli E. Immune response to SARS-CoV-2 Omicron variant in patients and vaccinees following homologous and heterologous vaccinations. Commun Biol 2022; 5:903. [PMID: 36056181 PMCID: PMC9439265 DOI: 10.1038/s42003-022-03849-0] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 08/16/2022] [Indexed: 11/09/2022] Open
Abstract
The SARS-CoV-2 Omicron variant has rapidly replaced the Delta variant of concern. This new variant harbors worrisome mutations on the spike protein, which are able to escape the immunity elicited by vaccination and/or natural infection. To evaluate the impact and susceptibility of different serum samples to the Omicron variant BA.1, samples from COVID-19 patients and vaccinated individuals were tested for their ability to bind and neutralize the original SARS-CoV-2 virus and the Omicron variant BA.1. COVID-19 patients show the most drastic reduction in Omicron-specific antibody response in comparison with the response to the wild-type virus. Antibodies elicited by a triple homologous/heterologous vaccination regimen or following natural SARS-CoV-2 infection combined with a two-dose vaccine course, result in highest neutralization capacity against the Omicron variant BA.1. Overall, these findings confirm that vaccination of COVID-19 survivors and booster dose to vaccinees with mRNA vaccines is the correct strategy to enhance the antibody cross-protection against Omicron variant BA.1.
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Affiliation(s)
| | | | | | | | | | - Serena Marchi
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Emanuele Andreano
- Monoclonal Antibody Discovery (MAD) Lab, Fondazione Toscana Life Sciences, Siena, Italy
| | - Ida Paciello
- Monoclonal Antibody Discovery (MAD) Lab, Fondazione Toscana Life Sciences, Siena, Italy
| | | | - Piero Lovreglio
- Interdisciplinary Department of Medicine, Section of Occupational Medicine, University of Bari, Bari, Italy
| | - Nicola Buonvino
- U.O.C. Penitentiary Medicine-Department of Territorial Care, Bari Local Health Authority, Bari, Italy
| | - Nicola Decaro
- Department of Veterinary Medicine, University of Bari, Bari, Italy
| | - Angela Stufano
- Interdisciplinary Department of Medicine, Section of Occupational Medicine, University of Bari, Bari, Italy
| | - Eleonora Lorusso
- Department of Veterinary Medicine, University of Bari, Bari, Italy
| | | | | | - Simonetta Viviani
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Rino Rappuoli
- Monoclonal Antibody Discovery (MAD) Lab, Fondazione Toscana Life Sciences, Siena, Italy.,Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Siena, Italy
| | | | | | - Emanuele Montomoli
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.,VisMederi srl, Siena, Italy.,VisMederi Research srl, Siena, Italy
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12
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Marchi S, Lanave G, Camero M, Dapporto F, Manenti A, Benincasa L, Acciavatti A, Brogi G, Viviani S, Montomoli E, Trombetta CM. SARS-CoV-2 Circulation during the First Year of the Pandemic: A Seroprevalence Study from January to December 2020 in Tuscany, Italy. Viruses 2022; 14:v14071441. [PMID: 35891420 PMCID: PMC9324460 DOI: 10.3390/v14071441] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Received: 04/21/2022] [Revised: 06/24/2022] [Accepted: 06/28/2022] [Indexed: 11/16/2022] Open
Abstract
Italy was the second country affected by the SARS-CoV-2 pandemic; the virus spread mainly in Northern Italy with a subsequent diffusion to the center and southern part of the country. In this study, we aimed to assess the prevalence of antibodies against SARS-CoV-2 in the general population of the Siena province in the Tuscany region (Central Italy) during 2020. A total of 2480 serum samples collected from January to December 2020 were tested for IgM and IgG antibodies against SARS-CoV-2 by a commercial ELISA. Positive and borderline samples were further tested for the presence of anti-receptor-binding domain (RBD) IgM and IgG antibodies by an in-house ELISA and by a micro-neutralization assay. Out of the 2480 samples tested by the commercial ELISA, 81 (3.3%) were found to be positive or borderline for IgG and 58 (2.3%) for IgM in a total of 133 samples (5.4%) found to be positive or borderline for at least one antibody class. When the commercial ELISA and in-house ELISA/micro-neutralization assay results were combined, 26 samples (1.0%) were positive for RBD IgG, 11 (0.4%) for RBD IgM, and 23 (0.9%) for a neutralizing antibody. An increase in seroprevalence was observed during the year 2020, especially from the end of summer, consistent with the routine epidemiological surveillance of COVID-19 cases.
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Affiliation(s)
- Serena Marchi
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (S.V.); (E.M.); (C.M.T.)
- Correspondence:
| | - Gianvito Lanave
- Department of Veterinary Medicine, University of Bari, 70010 Valenzano, Italy; (G.L.); (M.C.)
| | - Michele Camero
- Department of Veterinary Medicine, University of Bari, 70010 Valenzano, Italy; (G.L.); (M.C.)
| | | | | | | | | | - Giulio Brogi
- NeoMedica Srl, 53100 Siena, Italy; (A.A.); (G.B.)
| | - Simonetta Viviani
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (S.V.); (E.M.); (C.M.T.)
| | - Emanuele Montomoli
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (S.V.); (E.M.); (C.M.T.)
- VisMederi Srl, 53100 Siena, Italy; (F.D.); (A.M.)
- VisMederi Research Srl, 53100 Siena, Italy;
| | - Claudia Maria Trombetta
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (S.V.); (E.M.); (C.M.T.)
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13
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Viviani S. Efficacy and Effectiveness of the Meningococcal Conjugate Group A Vaccine MenAfriVac ® in Preventing Recurrent Meningitis Epidemics in Sub-Saharan Africa. Vaccines (Basel) 2022; 10:vaccines10040617. [PMID: 35455366 PMCID: PMC9027557 DOI: 10.3390/vaccines10040617] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/11/2022] [Accepted: 04/13/2022] [Indexed: 02/01/2023] Open
Abstract
For more than a century, epidemic meningococcal disease mainly caused by serogroup A Neisseria meningitidis has been an important public health problem in sub-Saharan Africa. To address this problem, an affordable meningococcal serogroup A conjugate vaccine, MenAfriVac®, was developed specifically for populations in the African meningitis belt countries. MenAfriVac® was licensed based on safety and immunogenicity data for a population aged 1–29 years. In particular, the surrogate markers of clinical efficacy were considered to be the higher immunogenicity and the ability to prime immunological memory in infants and young children compared to a polysaccharide vaccine. Because of the magnitude of serogroup A meningitis epidemics and the high morbidity and mortality burden, the World Health Organization (WHO) recommended the MenAfriVac® deployment strategy, starting with mass vaccination campaigns for 1–29-year-olds to rapidly interrupt serogroup A person-to-person transmission and establish herd protection, followed by routine immunization of infants and toddlers to sustain protection and prevent epidemics. After licensure and WHO prequalification of MenAfriVac®, campaigns began in December 2010 in Burkina Faso, Mali, and Niger. By the middle of 2011, it was clear that the vaccine was highly effective in preventing serogroup A carriage and disease. Post introduction meningitis surveillance revealed that serogroup A meningococcal disease had disappeared from all age groups, suggesting that robust herd immunity had been achieved.
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Affiliation(s)
- Simonetta Viviani
- Department of Molecular and Developmental Medicine, University of Siena, Via Aldo Moro 2, 53100 Siena, Italy
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14
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Withanage K, De Coster I, Cools N, Viviani S, Tourneur J, Chevandier M, Lambiel M, Willems P, Le Vert A, Nicolas F, Van Damme P. Phase 1 randomized, placebo-controlled, dose-escalating study to evaluate OVX836, a nucleoprotein-based influenza vaccine: intramuscular results. J Infect Dis 2021; 226:119-127. [PMID: 34653245 PMCID: PMC9373130 DOI: 10.1093/infdis/jiab532] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 10/13/2021] [Indexed: 11/12/2022] Open
Abstract
Background OVX836 is a recombinant protein vaccine targeting the highly conserved influenza nucleoprotein (NP), which could confer broad-spectrum protection against this disease. Methods A randomized, placebo-controlled, double-blind, dose-escalating, single- center, first-in-human study was conducted in 36 healthy adults aged 18–49 years. Twelve subjects per cohort (9 vaccine and 3 placebo) received 2 OVX836 intramuscular administrations on days 1 and 28 at the dose level of 30 µg, 90 µg, or 180 µg. Safety and immunogenicity were assessed after each vaccination and for 150 days in total. Results OVX836 was safe and well tolerated at all dose levels, with no difference in solicited local and systemic symptoms, and unsolicited adverse events between the first and second administration, or between dose levels. All subjects presented pre-existing NP-specific immunity at baseline. OVX836 induced a significant increase in NP-specific interferon-gamma T cells and anti-NP immunoglobulin G at all dose levels after the first vaccination. The second vaccination did not further increase the response. There was a trend for a dose effect in the immune response. Conclusions The safety and reactogenicity profile, as well as the humoral and cellular immune responses, encourage further evaluation of OVX836 in a larger Phase 2a study.
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Affiliation(s)
- Kanchanamala Withanage
- Vaccine and Infectious Disease Institute (VaxInfectio), Faculty of Medicine and Health Sciences, University of Antwerp, Campus Drie Eiken, Universiteitsplein, Antwerpen, Belgium
| | - Ilse De Coster
- Vaccine and Infectious Disease Institute (VaxInfectio), Faculty of Medicine and Health Sciences, University of Antwerp, Campus Drie Eiken, Universiteitsplein, Antwerpen, Belgium
| | - Nathalie Cools
- Laboratory of Experimental Hematology, Vaccine and Infectious Disease Institute (VaxInfectio), Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein, Antwerpen, Belgium
| | - Simonetta Viviani
- Independent Scientific Advisor on Vaccines, Epidemiology and Public Health, Via Gramsci, I-Monteriggioni, Siena, Italy. Acting as Chief Medical Officer for Osivax at the time of the clinical study
| | | | | | | | | | | | | | - Pierre Van Damme
- Vaccine and Infectious Disease Institute (VaxInfectio), Faculty of Medicine and Health Sciences, University of Antwerp, Campus Drie Eiken, Universiteitsplein, Antwerpen, Belgium
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15
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Marchi S, Remarque EJ, Viviani S, Rizzo C, Monteverde Spencer GT, Coluccio R, Montomoli E, Trombetta CM. Measles immunity over two decades in two large Italian Regions: How far is the elimination goal? Vaccine 2021; 39:5928-5933. [PMID: 34456073 DOI: 10.1016/j.vaccine.2021.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 02/22/2021] [Revised: 07/29/2021] [Accepted: 08/02/2021] [Indexed: 11/30/2022]
Abstract
In Italy, the inclusion of measles vaccine in children immunization schedule and the promotion of national mass vaccination campaigns increased measles vaccination coverage. However, measles outbreaks continue to occur increasingly involving adolescents and adults. The aim of this study was to evaluate the prevalence to measles antibody in a sample of Italian population between 1993 and 2018. Human serum samples from subjects aged 3-40 years were collected between 1993 and 2018 and tested for measles IgG antibodies by commercial ELISA. During the study period, the 3-10-year-old age group showed the most important change, with a significant increase in 2003-2007 in both seroprevalence and IgG levels, followed by a slow decrease. The 11-18-year-old age group showed relatively stable seroprevalence rates and IgG levels over the years. The 19-30-year-old group showed stable seroprevalence rates, albeit with a decrease in IgG levels. After a significant increase in 1999-2002, the 31-40-year-old age group had high seroprevalence rates and IgG levels. Despite efforts at national level for implementing measles vaccination, a large proportion of the population is still susceptible to measles. Even if vaccination coverage increases enough to achieve the level of immunization required for herd immunity in new birth cohorts, outbreaks will continue to occur if there are immunity gaps in older age groups. Establishing policies for measles vaccination targeting adult population is needed to close immunity gaps and reach the elimination goal.
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Affiliation(s)
- Serena Marchi
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
| | - Edmond J Remarque
- Department of Virology, Biomedical Primate Research Centre, Rijswijk, the Netherlands
| | - Simonetta Viviani
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Caterina Rizzo
- Functional Area Clinical Pathways and Epidemiology, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | | | - Rosa Coluccio
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Emanuele Montomoli
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy; VisMederi srl, Siena, Italy
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16
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Viviani S, Dellino M, Ramadan S, Peracchio C, Marcheselli L, Minoia C, Guarini A. Fertility preservation strategies for patients with lymphoma: a real-world practice survey among Fondazione Italiana Linfomi centers. Tumori 2021; 108:572-577. [PMID: 34431742 DOI: 10.1177/03008916211040556] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 11/16/2022]
Abstract
BACKGROUND Improvement in the prognosis of lymphomas in recent decades has allowed focus on reducing long-term toxicity of treatment, including infertility. The aim of this study was to assess the fertility preservation knowledge and practices among hematologic centers affiliated with Fondazione Italiana Linfomi (FIL) in Italy. METHODS A survey questionnaire was provided to 152 FIL centers between December 2019 and December 2020. RESULTS Responses from 58 centers (38%) were received. All respondents reported informing patients about treatment-related gonadotoxicity. A minority of patients (10% female, 20% male) refused fertility preservation due to personal reasons. The most common fertility preservation options offered to female patients were mature oocyte cryopreservation (43.1%), ovarian tissue cryopreservation (6.9%), and mature oocyte or ovarian tissue cryopreservation (39.7%). Six centers (10.3%) did not perform any procedures. All centers offered sperm cryopreservation for male patients. Challenges regarding the time intervals between lymphoma diagnosis and fertility consultation (up to 20 days) as well as between consultation and fertility preservation procedure (up to 40 days) were revealed. CONCLUSIONS This survey provides insight into fertility preservation practices among Italian hematologic centers and points out an urgent need to improve close cooperation between hematologists and fertility preservation specialists in order to avoid unacceptable delays in lymphoma treatment.
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Affiliation(s)
- Simonetta Viviani
- Division of Onco-Hematology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Miriam Dellino
- Gynecologic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II," Bari, Italy
| | - Safaa Ramadan
- Division of Onco-Hematology, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Medical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
| | | | | | - Carla Minoia
- Hematology Unit, IRCCS Istituto Tumori "Giovanni Paolo II," Bari, Italy
| | - Attilio Guarini
- Hematology Unit, IRCCS Istituto Tumori "Giovanni Paolo II," Bari, Italy
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17
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Trombetta CM, Marchi S, Viviani S, Manenti A, Benincasa L, Ruello A, Bombardieri E, Vicenti I, Zazzi M, Montomoli E. Serum Neutralizing Activity against B.1.1.7, B.1.351, and P.1 SARS-CoV-2 Variants of Concern in Hospitalized COVID-19 Patients. Viruses 2021; 13:1347. [PMID: 34372553 PMCID: PMC8310013 DOI: 10.3390/v13071347] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/01/2021] [Accepted: 07/08/2021] [Indexed: 11/17/2022] Open
Abstract
The recent spreading of new SARS-CoV-2 variants, carrying several mutations in the spike protein, could impact immune protection elicited by natural infection or conferred by vaccination. In this study, we evaluated the neutralizing activity against the viral variants that emerged in the United Kingdom (B.1.1.7), Brazil (P.1), and South Africa (B.1.351) in human serum samples from hospitalized patients infected by SARS-CoV-2 during the first pandemic wave in Italy in 2020. Of the patients studied, 59.5% showed a decrease (≥2 fold) in neutralizing antibody titer against B.1.1.7, 83.3% against P.1, and 90.5% against B.1.351 with respect to the original strain. The reduction in antibody titers against all analyzed variants, and in particular P.1 and B.1.351, suggests that previous symptomatic infection might be not fully protective against exposure to SARS-CoV-2 variants carrying a set of relevant spike mutations.
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Affiliation(s)
- Claudia Maria Trombetta
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (S.M.); (S.V.); (E.M.)
| | - Serena Marchi
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (S.M.); (S.V.); (E.M.)
| | - Simonetta Viviani
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (S.M.); (S.V.); (E.M.)
| | - Alessandro Manenti
- VisMederi srl, Strada del Petriccio e Belriguardo 35, 53100 Siena, Italy;
| | - Linda Benincasa
- VisMederi Research srl, Strada del Petriccio e Belriguardo 35, 53100 Siena, Italy;
| | - Antonella Ruello
- Humanitas Gavazzeni, Via Mauro Gavazzeni 21, 24125 Bergamo, Italy; (A.R.); (E.B.)
| | - Emilio Bombardieri
- Humanitas Gavazzeni, Via Mauro Gavazzeni 21, 24125 Bergamo, Italy; (A.R.); (E.B.)
| | - Ilaria Vicenti
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy; (I.V.); (M.Z.)
| | - Maurizio Zazzi
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy; (I.V.); (M.Z.)
| | - Emanuele Montomoli
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (S.M.); (S.V.); (E.M.)
- VisMederi srl, Strada del Petriccio e Belriguardo 35, 53100 Siena, Italy;
- VisMederi Research srl, Strada del Petriccio e Belriguardo 35, 53100 Siena, Italy;
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18
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Marchi S, Montomoli E, Viviani S, Giannecchini S, Stincarelli MA, Lanave G, Camero M, Alessio C, Coluccio R, Trombetta CM. West Nile Virus Seroprevalence in the Italian Tuscany Region from 2016 to 2019. Pathogens 2021; 10:pathogens10070844. [PMID: 34357994 PMCID: PMC8308575 DOI: 10.3390/pathogens10070844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/30/2021] [Accepted: 07/02/2021] [Indexed: 11/16/2022] Open
Abstract
Although in humans West Nile virus is mainly the cause of mild or sub-clinical infections, in some cases a neuroinvasive disease may occur predominantly in the elderly. In Italy, several cases of West Nile virus infection are reported every year. Tuscany was the first Italian region where the virus was identified; however, to date only two cases of infection have been reported in humans. This study aimed at evaluating the prevalence of antibodies against West Nile virus in the area of Siena Province to estimate the recent circulation of the virus. Human serum samples collected in Siena between 2016 and 2019 were tested for the presence of antibodies against West Nile virus by ELISA. ELISA positive samples were further evaluated using immunofluorescence, micro neutralization, and plaque reduction neutralization assays. In total, 1.9% (95% CI 1.2–3.1) and 1.4% (95% CI 0.8–2.4) of samples collected in 2016–2017 were positive by ELISA and immunofluorescence assay, respectively. Neutralizing antibodies were found in 0.7% (95% CI 0.3–1.5) of samples. Additionally, 0.9% (95% CI 0.4–1.7) and 0.65% (95% CI 0.3–1.45) of samples collected in 2018–2019 were positive by ELISA and immunofluorescence assay, respectively. The prevalence of neutralizing antibodies was 0.5% (95% CI 0.2–1.3). Although no human cases of West Nile infection were reported in the area between 2016 and 2019 and virus prevalence in the area of Siena Province was as low as less than 1%, the active asymptomatic circulation confirms the potential concern of this emergent virus for human health.
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Affiliation(s)
- Serena Marchi
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (E.M.); (S.V.); (C.A.); (R.C.); (C.M.T.)
- Correspondence:
| | - Emanuele Montomoli
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (E.M.); (S.V.); (C.A.); (R.C.); (C.M.T.)
- VisMederi S.r.l., 53100 Siena, Italy
| | - Simonetta Viviani
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (E.M.); (S.V.); (C.A.); (R.C.); (C.M.T.)
| | - Simone Giannecchini
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Firenze, Italy; (S.G.); (M.A.S.)
| | - Maria A. Stincarelli
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Firenze, Italy; (S.G.); (M.A.S.)
| | - Gianvito Lanave
- Department of Veterinary Medicine, University of Bari, 70010 Valenzano, Italy; (G.L.); (M.C.)
| | - Michele Camero
- Department of Veterinary Medicine, University of Bari, 70010 Valenzano, Italy; (G.L.); (M.C.)
| | - Caterina Alessio
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (E.M.); (S.V.); (C.A.); (R.C.); (C.M.T.)
| | - Rosa Coluccio
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (E.M.); (S.V.); (C.A.); (R.C.); (C.M.T.)
- VisMederi S.r.l., 53100 Siena, Italy
| | - Claudia Maria Trombetta
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (E.M.); (S.V.); (C.A.); (R.C.); (C.M.T.)
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19
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Marchi S, Viviani S, Remarque EJ, Ruello A, Bombardieri E, Bollati V, Milani GP, Manenti A, Lapini G, Rebuffat A, Montomoli E, Trombetta CM. Characterization of antibody response in asymptomatic and symptomatic SARS-CoV-2 infection. PLoS One 2021; 16:e0253977. [PMID: 34214116 PMCID: PMC8253392 DOI: 10.1371/journal.pone.0253977] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 06/16/2021] [Indexed: 12/30/2022] Open
Abstract
SARS-CoV-2 pandemic is causing high morbidity and mortality burden worldwide with unprecedented strain on health care systems. To investigate the time course of the antibody response in relation to the outcome we performed a study in hospitalized COVID-19 patients. As comparison we also investigated the time course of the antibody response in SARS-CoV-2 asymptomatic subjects. Study results show that patients produce a strong antibody response to SARS-CoV-2 with high correlation between different viral antigens (spike protein and nucleoprotein) and among antibody classes (IgA, IgG, and IgM and neutralizing antibodies). The antibody peak is reached by 3 weeks from hospital admission followed by a sharp decrease. No difference was observed in any parameter of the antibody classes, including neutralizing antibodies, between subjects who recovered or with fatal outcome. Only few asymptomatic subjects developed antibodies at detectable levels.
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Affiliation(s)
- Serena Marchi
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Simonetta Viviani
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Edmond J. Remarque
- Department of Virology, Biomedical Primate Research Centre, Rijswijk, The Netherlands
| | | | | | - Valentina Bollati
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Gregorio P. Milani
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | | | - Annunziata Rebuffat
- Presidio Ospedaliero di Campostaggia, Località Campostaggia, Poggibonsi, Italy
| | - Emanuele Montomoli
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
- VisMederi srl, Siena, Italy
- VisMederi Research srl, Siena, Italy
| | - Claudia M. Trombetta
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
- * E-mail:
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Pitisuttithum P, Dhitavat J, Sirivichayakul C, Pitisuthitham A, Sabmee Y, Chinwangso P, Kerdsomboon C, Fortuna L, Spiegel J, Chauhan M, Poredi IK, van den Biggelaar AH, Wijagkanalan W, Viviani S, Mansouri S, Pham HT. Antibody persistence 2 and 3 years after booster vaccination of adolescents with recombinant acellular pertussis monovalent aP gen or combined TdaP gen vaccines. EClinicalMedicine 2021; 37:100976. [PMID: 34386749 PMCID: PMC8343263 DOI: 10.1016/j.eclinm.2021.100976] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/20/2021] [Accepted: 06/04/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Recombinant pertussis vaccines inducing long-lasting immune responses could help to control the rise in pertussis. We here report on persisting antibody responses 2 and 3 years after booster vaccination with a new generation recombinant acellular pertussis vaccine. METHODS Participants of a phase 2/3 randomised-controlled clinical trial with a monovalent pertussis vaccine containing genetically inactivated pertussis toxin (aPgen) or its tetanus and diphtheria toxoids combination (TdaPgen), or a chemically detoxified comparator vaccine (Tdapchem), (originally conducted between July and August 2015) were invited to participate in observational studies of persisting antibody responses 2 and 3 years after vaccination. Serum IgG against pertussis toxin (PT-IgG) and filamentous hemagglutinin (FHA-IgG) were assessed by ELISA, and PT-neutralising antibodies (PT-Nab) by Chinese Hamster Ovary cell assay. FINDINGS Waning of antibodies stabilised in aPgen and TdaPgen vaccinees 2 and 3 years after vaccination. Three years post-vaccination PT-neutralising antibodies remained 4·6-fold (95% Confidence Interval (CI) 2·6-8·1) and 3·7-fold (95% CI 2·2-6·1) higher, PT-IgG antibodies 3·0-fold (95% CI 2·2-4·1) and 2·5-fold (95% CI 1·9-3·3) higher, and FHA-IgG antibodies 1·8-fold (95% CI 1·3-2·5) and 1·6-fold (95% CI 1·2-2·1) higher than baseline in aPgen and TdaPgen recipients, respectively. In the Tdapchem group, PT-neutralising and PT-IgG and FHA-IgG antibodies were back at baseline levels 2 years post-vaccination. Three years post-vaccination seroconversion rates for PT-neutralising antibodies were 65·0% (95% CI 44·1-85·9) and 55·0% (95% CI 33·2-76·8) in aPgen and TdaPgen recipients, respectively. INTERPRETATION Considering the persistence of elevated antibody responses 3 years post-booster vaccination, genetically detoxified monovalent aPgen and TdaPgen vaccines can be expected to induce longer-lasting protection than chemically inactivated Tdap vaccines. FUNDING BioNet-Asia.
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Affiliation(s)
- Punnee Pitisuttithum
- Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok 10400, Thailand
| | - Jittima Dhitavat
- Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok 10400, Thailand
| | - Chukiat Sirivichayakul
- Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok 10400, Thailand
| | - Arom Pitisuthitham
- Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok 10400, Thailand
| | - Yupa Sabmee
- Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok 10400, Thailand
| | - Pailinrut Chinwangso
- BioNet-Asia Co., Ltd., 19 Soi Udomsuk 37, Sukhumvit 103 Road, Bangjak, Prakanong, Bangkok 10260, Thailand
| | - Chawanee Kerdsomboon
- BioNet-Asia Co., Ltd., 19 Soi Udomsuk 37, Sukhumvit 103 Road, Bangjak, Prakanong, Bangkok 10260, Thailand
| | - Librada Fortuna
- BioNet-Asia Co., Ltd., 19 Soi Udomsuk 37, Sukhumvit 103 Road, Bangjak, Prakanong, Bangkok 10260, Thailand
| | - Jane Spiegel
- BioNet-Asia Co., Ltd., 19 Soi Udomsuk 37, Sukhumvit 103 Road, Bangjak, Prakanong, Bangkok 10260, Thailand
| | - Mukesh Chauhan
- BioNet-Asia Co., Ltd., 19 Soi Udomsuk 37, Sukhumvit 103 Road, Bangjak, Prakanong, Bangkok 10260, Thailand
| | - Indrajeet Kumar Poredi
- BioNet-Asia Co., Ltd., 19 Soi Udomsuk 37, Sukhumvit 103 Road, Bangjak, Prakanong, Bangkok 10260, Thailand
| | | | - Wassana Wijagkanalan
- BioNet-Asia Co., Ltd., 19 Soi Udomsuk 37, Sukhumvit 103 Road, Bangjak, Prakanong, Bangkok 10260, Thailand
| | - Simonetta Viviani
- BioNet-Asia Co., Ltd., 19 Soi Udomsuk 37, Sukhumvit 103 Road, Bangjak, Prakanong, Bangkok 10260, Thailand
| | - Souad Mansouri
- BioNet-Asia Co., Ltd., 19 Soi Udomsuk 37, Sukhumvit 103 Road, Bangjak, Prakanong, Bangkok 10260, Thailand
- Corresponding author.
| | - Hong Thai Pham
- BioNet-Asia Co., Ltd., 19 Soi Udomsuk 37, Sukhumvit 103 Road, Bangjak, Prakanong, Bangkok 10260, Thailand
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21
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Gallamini A, Rambaldi A, Patti C, Romano A, Viviani S, Bolis S, Oppi S, Trentin L, Cantonetti M, Sorasio R, Gavarotti P, Gottardi D, Schiavotto C, Battistini R, Gini G, Ferreri A, Pavoni C, Bergesio F, Ficola U, Guerra L, Chauvie S. BASELINE METABOLIC TUMOR VOLUME AND IPS PREDICT ABVD FAILURE IN ADVANCED‐STAGE HODGKIN LYMPHOMA WITH A NEGATIVE INTERIM PET SCAN AFTER 2 CHEMOTHERAPY CYCLES. A RETROSPECTIVE ANALYSIS FROM THE GITIL/FIL HD0607 TRIAL. Hematol Oncol 2021. [DOI: 10.1002/hon.19_2879] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- A Gallamini
- Antoine Lacassagne Cancer Center Research and Clinical Innovation Nice France
| | - A Rambaldi
- Ospedale Papa Giovanni XXIII Hematology Bergamo Italy
| | - C Patti
- Ospedali Riuniti di Palermo Hematology Palermo Italy
| | - A Romano
- Policlinico Universitario A. Ferrarotto Hematology Catania Italy
| | - S Viviani
- Istituto Europeo di Ematologia Hematology Milano Italy
| | - S Bolis
- Ospedale S. Gerardo Hematology Monza Italy
| | - S Oppi
- Ospedale Antonio Businco Hematology Cagliari Italy
| | - L Trentin
- Azienda Ospedaliera di Padova Hematology Padova Italy
| | | | - R Sorasio
- Ospedale S. Croce e Carle Hematology Cuneo Italy
| | - P Gavarotti
- Ospedale S. Giovanni Battista Hematology ‐ University Torino Italy
| | - D Gottardi
- Ospedale Mauriziano Hematology Torino Italy
| | | | - R Battistini
- Ospedale S. Camillo Forlanini Hematology Roma Italy
| | - G Gini
- Ospedali Riuniti di Ancona Hematology Ancona Italy
| | | | - C Pavoni
- Ospedale Papa Giovanni XXIII Hematology Bergamo Italy
| | - F Bergesio
- Ospedale S. Croce e Carle Medical Physics Cuneo Italy
| | - U Ficola
- Ospedale La Maddalena Nuclear Medicine Palermo Italy
| | - L Guerra
- Ospedale S. Gerardo Nuclear Medicine Monza Italy
| | - S Chauvie
- Ospedale S. Croce e Carle Medical Physics Cuneo Italy
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22
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Minoia C, Gerardi C, Allocati E, De Sanctis V, Franceschetti S, Viviani S, Annunziata MA, Bari A, Skrypets T, Oliva S, Puzzovivo A, Di Molfetta S, Caccavari V, Di Russo A, Loseto G, Daniele A, Nassi L, Gini G, Guarini A. LATE TOXICITIES AND LONG‐TERM MONITORING IN CLASSICAL HODGKIN LYMPHOMA AND DIFFUSE LARGE B‐CELL LYMPHOMA SURVIVORS: A SERIES OF SYSTEMATIC REVIEWS OF THE FONDAZIONE ITALIANA LINFOMI. Hematol Oncol 2021. [DOI: 10.1002/hon.105_2881] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- C. Minoia
- IRCCS Istituto Tumori "Giovanni Paolo II" Hematology Unit Bari Italy
| | - C. Gerardi
- Istituto di Ricerche Farmacologiche "Mario Negri" IRCCS Centro Politiche Regolatorie in Sanità Milan Italy
| | - E. Allocati
- Istituto di Ricerche Farmacologiche "Mario Negri" IRCCS Centro Politiche Regolatorie in Sanità Milan Italy
| | - V. De Sanctis
- Faculty of Medicina e Psicologia Sant'Andrea Hospital University of Rome "La Sapienza" Department of Radiation Oncology Rome Italy
| | | | - S. Viviani
- IEO European Institute of Oncology IRCCS Division of Hemato‐Oncology Milan Italy
| | - M. A. Annunziata
- Centro di Riferimento Oncologico di Aviano (CRO) IRCCS Unit of Oncological Psychology Aviano Italy
| | - A. Bari
- Università di Modena e Reggio Emilia UO Terapie Mirate in Oncoematologia ed Osteoncologia Dipartimento di Scienze Mediche e Chirurgiche Materno‐Infantili e dell'Adulto Modena Italy
| | - T. Skrypets
- IRCCS Istituto Tumori "Giovanni Paolo II" Hematology Unit Bari Italy
| | - S. Oliva
- IRCCS Istituto Tumori "Giovanni Paolo II" Cardiology Unit Bari Italy
| | - A. Puzzovivo
- IRCCS Istituto Tumori "Giovanni Paolo II Cardiology Unit Bari Italy
| | - S. Di Molfetta
- University of Bari "Aldo Moro" Department of Emergency and Organ Transplantation Section of Internal Medicine Endocrinology Andrology and Metabolic Diseases Bari Italy
| | - V. Caccavari
- Istituto Clinico Città Studi Assisted Reproduction Unit Milan Italy
| | - A. Di Russo
- Fondazione IRCCS Istituto Nazionale dei Tumori Radiotherapy Unit Milan Italy
| | - G. Loseto
- IRCCS Istituto Tumori "Giovanni Paolo II" Hematology Unit Bari Italy
| | - A. Daniele
- IRCCS Istituto Tumori "Giovanni Paolo II" Experimental Oncology and Biobank Management Unit Bari Italy
| | - L. Nassi
- Careggi Hospital and University of Florence Lymphoma Unit Hematology Department Florence Italy
| | - G. Gini
- AOU Ospedali Riuniti Ancona‐Università Politecnica delle Marche Clinic of Hematology Ancona Italy
| | - A. Guarini
- IRCCS Istituto Tumori "Giovanni Paolo II" Hematology Unit Bari Italy
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23
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Gallamini A, Walewski J, Rambaldi A, Viviani S, Sureda A, André M, Rossi C, Moccia A, Zucca E, Rossi D, Filippi A, Meignan M, Chauvie S, Zaucha JM. RADIATION FREE THERAPY OR THE INITIAL TREATMENT OF GOOD PROGNOSIS EARLY NON‐BULKY HODGKIN LYMPHOMA, DEFINED BY A LOW METABOLIC TUMOR VOLUME AND A NEGATIVE PET‐2 ‐ RAFTING TRIAL. Hematol Oncol 2021. [DOI: 10.1002/hon.158_2880] [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] [Indexed: 11/09/2022]
Affiliation(s)
- A. Gallamini
- Antoine Lacassagne Cancer Center Research and Clinical Innovation Nice France
| | - J. Walewski
- Marii Skłodowskiej‐Curie Institute Onco‐Hematology Warsaw Poland
| | - A. Rambaldi
- Ospedale Papa Giovanni XXIII Hematology Bergamo Italy
| | - S. Viviani
- Istituto Europeo di Ematologia Hematology Milano Italy
| | - A. Sureda
- Institut Català d'Oncologia Hematology Barcelona Spain
| | - M. André
- Cliniques universitaires Saint‐Luc ‐ UC Louvain Hematology Louvain Belgium
| | - C. Rossi
- CHU Bocage Hematology Dijon France
| | - A. Moccia
- Istituto Oncologico della Svizzera Italiana Hematology Bellinzona Switzerland
| | - E. Zucca
- Istituto Oncologico della Svizzera Italiana Hematology Bellinzona Switzerland
| | - D. Rossi
- Istituto Oncologico della Svizzera Italiana Hematology Bellinzona Switzerland
| | - A. Filippi
- Policlinico S. Matteo IRCCS Radiation Oncology Pavia Italy
| | - M. Meignan
- Henry Mondor Hospital LYSA Imaging Paris France
| | - S. Chauvie
- Ospedale S. Croce e Carle Medical Physics Cuneo Italy
| | - J. M. Zaucha
- Medical University of Gdansk Hematology Gdansk Poland
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24
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Romano A, Pavoni C, Di Raimondo F, Tarella C, Viviani S, Rossi A, Patti C, Picardi M, Cantonetti M, La Nasa G, Trentin L, Bolis S, Zoli V, Gavarotti P, Corradini P, Cimminiello M, Schiavotto C, Parvis G, Zanotti R, Gini G, Ferreri AJM, Viero P, Chauvie S, Biggi A, Massimo Gianni A, Gallamini A, Rambaldi A. The neutrophil to lymphocyte ratio (NLR) and the presence of large nodal mass are independent predictors of early response: A subanalysis of the prospective phase II PET-2-adapted HD0607 trial. Cancer Med 2020; 9:8735-8746. [PMID: 33155754 PMCID: PMC7724487 DOI: 10.1002/cam4.3396] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 07/06/2020] [Accepted: 07/30/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The neutrophil to lymphocyte ratio (NLR) and the lymphocyte to monocyte ratio (LMR) can reflect both the myeloid dysfunction and T-cell immune suppression and have prognostic significance. METHODS In 771 newly diagnosed advanced-stage Hodgkin Lymphoma (HL) patients we evaluated the baseline values of NLR and LMR as predictors of clinical outcome. According to the multicenter prospective phase II GITIL-HD0607 trial, all patients received two ABVD courses and if PET-2 negative received four additional ABVD cycles while if PET-2-positive patients were randomized to either BEACOPP escalated (Be) plus BEACOPP baseline (Bb) (4 + 4 courses) or Be + Bb (4 + 4) and Rituximab. PET scans were centrally reviewed by an expert panel by Blinded Independent Central Review. RESULTS Higher NLR and lower LMR were associated with a PET-2 positivity and failure to achieve long-term disease control, respectively. By univariate and multivariate analysis, large nodal mass (>7 cm), IPS ≥ 3, NLR > 6 were strong independent predictors of early PET-2 response after ABVD. Only NLR > 6 and IPS ≥ 3 were strong independent predictors of outcome at diagnosis; however, when PET-2 status was added, only PET-2-positive status and IPS ≥ 3 were independent predictors of PFS. Focusing on PET-2-negative patients, those with NLR > 6 had an inferior 3-year PFS compared to patients with NLR ≤ 6 (84% vs 89% months, P = .03). CONCLUSION In advanced-stage HL patients treated with a PET-2-driven strategy, IPS ≥ 3 and NLR > 6 are independent predictors of outcome at diagnosis while the presence of large nodal mass, IPS ≥ 3, and NLR > 6 at diagnosis are independent predictors of early ABVD response.
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Affiliation(s)
- Alessandra Romano
- Dipartimento di Specialità medico-Chirurgiche, CHIRMED, Sezione di Ematologia, Università degli studi di Catania, Catania, Italy
| | - Chiara Pavoni
- Ematologia, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | - Francesco Di Raimondo
- Dipartimento di Specialità medico-Chirurgiche, CHIRMED, Sezione di Ematologia, Università degli studi di Catania, Catania, Italy
| | - Corrado Tarella
- Onco-Hematology Unit, Istituto Europeo di Oncologia, Milan, Italy.,Università degli Studi di Milano, Milano, Italy
| | - Simonetta Viviani
- Ematologia e onco-ematologia pediatrica, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan, Italy
| | - Andrea Rossi
- Ematologia, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | - Caterina Patti
- Ematologia, Azienda Villa Sofia-Cervello, Palermo, Italy
| | | | | | | | - Livio Trentin
- Ematologia Dipartimento di Medicina, Università di Padova, Padova, Italy
| | | | | | - Paolo Gavarotti
- Ematologia Universitaria, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Italy
| | - Paolo Corradini
- Dipartimento di oncologia-ematologia, Università degli Studi di Milano, Milano, Italy
| | | | | | - Guido Parvis
- Divisione Universitaria Medicina Interna, AO San Luigi, Orbassano, Italy
| | - Roberta Zanotti
- Divisione di Medicina, Unità di Ematologia, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Guido Gini
- Divisione Universitaria di Ematologia, Nuovo Ospedale Torrette, Ancona, Italy
| | - Andrés J M Ferreri
- Unità di Ricerca Clinica Linfomi, IRCSS Ospedale San Raffaele, Milano, Italy
| | - Piera Viero
- Ematologia, Ospedale dell'Angelo, Mestre, Italy
| | - Stephane Chauvie
- Medicina Nucleare Azienda Ospedaliera Santa Croce e Carle, Cuneo, Italy
| | - Alberto Biggi
- Medicina Nucleare Azienda Ospedaliera Santa Croce e Carle, Cuneo, Italy
| | - Alessandro Massimo Gianni
- Onco-Hematology Unit, Istituto Europeo di Oncologia, Milan, Italy.,Università degli Studi di Milano, Milano, Italy
| | - Andrea Gallamini
- Department recherch e innovation et statistique, Centre A. Lacassagne, Nice, France
| | - Alessandro Rambaldi
- Ematologia, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy.,Dipartimento di oncologia-ematologia, Università degli Studi di Milano, Milano, Italy
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Gallamini A, Rossi A, Patti C, Picardi M, Romano A, Cantonetti M, Oppi S, Viviani S, Bolis S, Trentin L, Gini G, Battistini R, Chauvie S, Sorasio R, Pavoni C, Zanotti R, Cimminiello M, Schiavotto C, Viero P, Mulé A, Fallanca F, Ficola U, Tarella C, Guerra L, Rambaldi A. Consolidation Radiotherapy Could Be Safely Omitted in Advanced Hodgkin Lymphoma With Large Nodal Mass in Complete Metabolic Response After ABVD: Final Analysis of the Randomized GITIL/FIL HD0607 Trial. J Clin Oncol 2020; 38:3905-3913. [PMID: 32946355 DOI: 10.1200/jco.20.00935] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To investigate the role of consolidation radiotherapy (cRT) in advanced-stage Hodgkin lymphoma (HL) presenting at baseline with a large nodal mass (LNM) in complete metabolic response after doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) chemotherapy. PATIENTS AND METHODS Advanced-stage (IIB-IVB) HL patients, enrolled in the HD 0607 trial (Clinicaltrial.gov identifier NCT00795613), with both a negative PET after two (PET-2) and six (PET-6) ABVD cycles, who presented at baseline with an LNM, defined as a nodal mass with the largest diameter ≥ 5 cm, were prospectively randomly assigned to receive cRT over the LNM or no further treatment (NFT). RESULTS Among 296 randomly assigned patients, the largest diameter of LNM at baseline was 5-7 cm in 101 (34%; subgroup A) and 8-10 cm in 96 (32%; subgroup B), whereas classic bulky (diameter > 10 cm) was detected in 99 (33%; subgroup C). Two hundred eighty patients (88%) showed a postchemotherapy RM. The median dose of cRT was 30.6 Gy (range, 24-36 Gy). After a median follow-up of 5.9 years (range, 0.5-10 years), the 6-year progression-free survival rate of patients who underwent cRT or NFT was, respectively, 91% (95% CI, 84% to 99%) and 95% (95% CI, 89% to 100%; P = .62) in subgroup A; 98% (95% CI, 93% to 100%) and 90% (95% CI, 80% to 100%; P = .24) in subgroup B; 89% (95% CI, 81% to 98%) and 86% (95% CI, 77% to 96%; P = .53) in subgroup C (classic bulky). CONCLUSION cRT could be safely omitted in patients with HL presenting with an LNM and a negative PET-2 and PET-6 scan, irrespective from the LNM size detected at baseline.
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Affiliation(s)
- Andrea Gallamini
- Research and Clinical Innovation Department, A. Lacassagne Cancer Center, Nice, France
| | - Andrea Rossi
- Hematology, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | | | - Marco Picardi
- Hematology, Policlinico Federico II Hospital, Naples, Italy
| | | | | | - Sara Oppi
- Department of Hematology, Businco Hospital, Cagliari, Italy
| | - Simonetta Viviani
- Department of Hematology, IRCCS National Institute of Tumors, Milan, Italy
| | | | - Livio Trentin
- Hematology, Medicine, Padua University, Padua, Italy
| | - Guido Gini
- Hematology, Ospedali Riuniti Le Torrette, Ancona, Italy
| | | | - Stephane Chauvie
- Medical Physics Unit, Santa Croce e Carle Hospital, Cuneo, Italy
| | | | - Chiara Pavoni
- Hematology, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | - Roberta Zanotti
- Hematology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | | | | | - Piera Viero
- Hematology Ospedale dell'Angelo, Mestre, Venice, Italy
| | | | - Federico Fallanca
- Nuclear Medicine Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Umberto Ficola
- Nuclear Medicine Department, La Maddalena Hospital, Palermo, Italy
| | - Corrado Tarella
- Onco-Hematology European Institute of Oncology, IRCCS, Milan, Italy.,Department of Health Sciences, University of Milan, Milan, Italy
| | - Luca Guerra
- Nuclear Medicine, San Gerardo University Hospital, Monza, Italy
| | - Alessandro Rambaldi
- Hematology, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy.,Department of Oncology-Hematology, University of Milan, Milan, Italy
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Marchi S, Viviani S, Montomoli E, Trombetta CM. Measles Susceptibility in Apulia: The Italian Mirror? J Infect Dis 2020; 222:1414-1415. [PMID: 32343809 DOI: 10.1093/infdis/jiaa212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 04/23/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Serena Marchi
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Simonetta Viviani
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Emanuele Montomoli
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.,VisMederi, Siena, Italy
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27
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Marchi S, Monti M, Viviani S, Remarque EJ, Esposito S, Principi N, Ruggiero L, Montomoli E, Trombetta CM. Immunity to measles in Italian children and adolescents: a persistent problem in view of measles elimination. J Public Health (Oxf) 2020; 43:e601-e609. [PMID: 32915205 DOI: 10.1093/pubmed/fdaa153] [Citation(s) in RCA: 2] [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] [Received: 02/12/2020] [Revised: 07/27/2020] [Accepted: 08/10/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Despite efforts to increase coverage by two doses of measles vaccine in Italy, measles continues to circulate, with over 13 000 cases of disease since 2013. This study aimed to evaluate immunity to measles in Italian children and adolescents. METHODS A total of 378 serum samples from subjects aged 9 months-18 years were collected in Northern, Central and Southern regions of Italy between 2012 and 2016. Specific IgG antibodies against measles were measured by a commercial ELISA kit. RESULTS The frequency of IgG-positive samples ranged from 10.5% in infants under 1 year to 98.3% in children aged 6-7 years. The frequency of IgG was 72.2% in subjects aged 1-2 years, 85.6% in those aged 3-5 years and 88.3 and 86.8% in those aged 8-10 and 11-18 years, respectively. In Northern Italy, IgG prevalence was consistent with data on vaccination coverage, whereas some differences were observed in samples from subjects aged more than 8 years in Central and Southern Italy. CONCLUSIONS Our findings confirm that a large proportion of children and adolescents in Italy are still susceptible to measles. While data on first- and second-dose measles vaccination are essential, they are not sufficient to identify susceptible population cohorts to be targeted by vaccination.
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Affiliation(s)
- Serena Marchi
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
| | - Martina Monti
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
| | - Simonetta Viviani
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
| | - Edmond J Remarque
- Department of Virology, Biomedical Primate Research Centre, 2288 Rijswijk, The Netherlands
| | - Susanna Esposito
- Pediatric Clinic Pietro Barilla Children's Hospital Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Nicola Principi
- Department of Mother and Infant Sciences, University of Milan, 20122 Milan, Italy
| | - Luca Ruggiero
- Paediatriec Highly Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Emanuele Montomoli
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy.,VisMederi Srl, 53100 Siena, Italy
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Viviani S, Mazzocchi A, Pavoni C, Taverna F, Rossi A, Patti C, Romano A, Trentin L, Sorasio R, Guidetti A, Gottardi D, Tarella C, Cimminiello M, Zanotti R, Farina L, Ferreri AJM, Galbiati M, Corradini P, Gianni AM, Gallamini A, Rambaldi A. Early serum TARC reduction predicts prognosis in advanced-stage Hodgkin lymphoma patients treated with a PET-adapted strategy. Hematol Oncol 2020; 38:501-508. [PMID: 32602970 DOI: 10.1002/hon.2775] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 03/31/2020] [Revised: 06/24/2020] [Accepted: 06/25/2020] [Indexed: 12/11/2022]
Abstract
Among patients with advanced-stage classical Hodgkin lymphoma (cHL) receiving ABVD chemotherapy, PET performed after the first two treatment cycles (PET-2) has prognostic value. However, 15% of patients with a negative PET-2 will experience treatment failure. Here we prospectively evaluated serum thymus and activation-regulated chemokine (TARC) levels, to improve risk assessment in patients treated according to HD0607 PET-driven trial (#NCT00795613). In 266 patients with available serum samples, who have agreed to participate in a sub-study for assessment of the role of TARC monitoring, serum TARC levels were measured at baseline and at time of PET-2 by commercially available ELISA test kits. The primary end-point was to evaluate the association between TARC after 2 ABVD cycles and PFS. Median TARC-2 values were significantly higher in PET-2-positive patients compared to PET-2-negative patients (P = .001), and in patients with treatment failure compared to those in continuous CR (P = .01). The 4-year PFS significantly differed between patients with TARC-2 >800 pg/mL vs ≤800 pg/mL (64% vs 86%, P = .0001). Moreover, among PET-2-negative patients, elevated TARC-2 identified those with a worse prognosis (74% vs 89%; P = .01). In multivariable analysis, TARC-2 >800 pg/mL was a significant independent predictor of PFS in the whole study population (HR 2.39, P = .004) and among the PET-2-negative patients (HR 2.49, P = .02). In conclusion, our results indicate that TARC-2 serum levels above 800 pg/mL suggest the need for a stringent follow-up in PET-2-negative patients, and the evaluation of new drugs in PET-2-positive, who will likely fail to respond to intensification with escalated BEACOPP.
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Affiliation(s)
- Simonetta Viviani
- Department of Hemato-Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Arabella Mazzocchi
- Immuno-hematology and Transfusion Medicine Service, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Chiara Pavoni
- Department of Oncology and Hematology, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | - Francesca Taverna
- Immuno-hematology and Transfusion Medicine Service, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Andrea Rossi
- Department of Oncology and Hematology, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | - Caterina Patti
- Division of Hematology 1, Azienda Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy
| | - Alessandra Romano
- Department of Medical and Surgery Science, Hematology Unit, University of Catania, Catania, Italy
| | - Livio Trentin
- Department of Hematology, University of Padova, Padova, Italy
| | - Roberto Sorasio
- Division of Hematology, Azienda Ospedaliera Santa Croce e Carle, Cuneo, Italy
| | - Anna Guidetti
- Department of Hemato-Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Daniela Gottardi
- Division of Hematology, Ospedale Mauriziano Umberto I di Torino, Turin, Italy
| | - Corrado Tarella
- Hemato-Oncology Division, European Institute of Oncology IRCCS, Milan, Italy.,University Department "Scienze della Salute" (DISS), University of Milan, Milan, Italy
| | | | - Roberta Zanotti
- Hematology Unit, Department of Medicine, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Lucia Farina
- Department of Hemato-Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Andrés José Maria Ferreri
- Lymphoma Unit, Department of Onco-Hematology, IRCCS Istituto di Ricovero e Cura a Carattere Scientifico Ospedale San Raffaele, Milan, Italy
| | - Marina Galbiati
- Immuno-hematology and Transfusion Medicine Service, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Paolo Corradini
- Department of Hemato-Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Andrea Gallamini
- Division of Hematology, Azienda Ospedaliera Santa Croce e Carle, Cuneo, Italy
| | - Alessandro Rambaldi
- Department of Oncology and Hematology, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy.,Department of Oncology and Hematology, University of Milan, Milan, Italy
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André MPE, Carde P, Viviani S, Bellei M, Fortpied C, Hutchings M, Gianni AM, Brice P, Casasnovas O, Gobbi PG, Zinzani PL, Dupuis J, Iannitto E, Rambaldi A, Brière J, Clément-Filliatre L, Heczko M, Valagussa P, Douxfils J, Depaus J, Federico M, Mounier N. Long-term overall survival and toxicities of ABVD vs BEACOPP in advanced Hodgkin lymphoma: A pooled analysis of four randomized trials. Cancer Med 2020; 9:6565-6575. [PMID: 32710498 PMCID: PMC7520354 DOI: 10.1002/cam4.3298] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/28/2020] [Accepted: 06/10/2020] [Indexed: 11/15/2022] Open
Abstract
Purpose We explored the potential overall survival (OS) benefit of bleomycin, etoposide, doxorubicin (Adriamycin), cyclophosphamide, vincristine (Oncovin), procarbazine, and prednisone (BEACOPP) over doxorubicin (Adriamycin), bleomycin, vinblastine, and dacarbazine (ABVD) in a pooled analysis of four randomized trials. Patients and methods Primary objective was to evaluate the OS impact of BEACOPP using individual patient data. Secondary objectives were progression‐free survival (PFS), secondary cancers, and use of autologous stem cell transplantation (ASCT). Results About 1227 patients were included. The 7‐year OS was 84.3% (95% CI 80.8‐87.2) for ABVD vs 87.7% (95% CI 84.5‐90.2) for BEACOPP. Two follow‐up periods were identified based on survival curves and hazard ratio (HR) over time. For the first 18 months, there was no difference. For the second period of ≥18 months, ABVD patients had a higher death risk (HRABVD vs BEACOPP = 1.59; 95% CI 1.09‐2.33). A Cox model stratified by trial and evaluating the effect of treatment and International Prognostic Index (IPI) score as fixed effects showed that both were statistically significant (treatment, P = .0185; IPI score, P = .0107). The 7‐year PFS was 71.1% (95% CI 67.1‐74.6) for ABVD vs 81.1% (95% CI 77.5‐84.2) for BEACOPP (P < .001). After ABVD, 25 secondary cancers (4.0%) were reported with no myelodysplasia (MDS)/acute myeloid leukemia (AML) compared to 36 (6.5%) after BEACOPP, which included 13 patients with MDS/AML. Following ABVD, 86 patients (13.8%) received ASCT vs 39 (6.4%) for BEACOPP. Conclusions This analysis showed a slight improvement in OS for BEACOPP and confirmed a PFS benefit. Frontline use of BEACOPP instead of ABVD increased secondary leukemia incidence but halved the requirement for ASCT.
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Affiliation(s)
| | | | - Simonetta Viviani
- Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Division of Hemato-Oncology, IEO European Institute of Oncology, Milan, Italy
| | - Monica Bellei
- Fondazione Italiana Limfomi, Dipartimento di Scienze Medische e Chirurgiche Materno-Infantili e dell'Adulto, University of Modena, e Reggio Emilia, Modena, Italy
| | - Catherine Fortpied
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Martin Hutchings
- Department of Hematology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Alessandro M Gianni
- Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Division of Hemato-Oncology, IEO European Institute of Oncology, Milan, Italy
| | - Pauline Brice
- APHP Hopital Saint-louis, Hemato-oncologie, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Olivier Casasnovas
- Hematology department and INSERM1231, Hôpital F. Mitterand, Dijon, France
| | - Paolo G Gobbi
- Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo and Università degli Studi di Pavia, Pavia, Italy
| | - Pier Luigi Zinzani
- Institute of Hematology "Seràgnoli", University of Bologna, Bologna, Italy
| | - Jehan Dupuis
- Unité Hémopathies Lymphoïdes, AP-HP Hôpital Henri Mondor, Créteil, France
| | - Emilio Iannitto
- Department of Oncology, Haematology Unit, AOU Policlinico P. Giaccone, Palermo, Italy
| | - Alessandro Rambaldi
- Department of Oncology-Hematology, Università degli Studi di Milano e Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | - Josette Brière
- APHP Hopital Saint-louis, Hemato-oncologie, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | | | - Marian Heczko
- Department of Hematology, Besancon Hospital, Besancon, France
| | - Pinuccia Valagussa
- Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Division of Hemato-Oncology, IEO European Institute of Oncology, Milan, Italy
| | - Jonathan Douxfils
- Department of Pharmacy, Namur Thrombosis and Hemostasis Centre (NTHC), Namur Research Institute for Life Sciences (NARILIS), University of Namur, Namur, Belgium
| | - Julien Depaus
- Hematology Department, CHU UCL Namur, Yvoir, Belgium
| | - Massimo Federico
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Centro Oncologico Modenese, Modena, Italy
| | - Nicolas Mounier
- Department of Onco-Haematology, Archet Hospital, Nice, France
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Merli F, Ballerini F, Botto B, Gotti M, Pavone V, Pulsoni A, Stefani PM, Massaro F, Viviani S. Hodgkin's lymphoma: post- autologous transplantation consolidation therapy. Acta Biomed 2020; 91:23-29. [PMID: 32525131 PMCID: PMC7944651 DOI: 10.23750/abm.v91is-5.9914] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 05/25/2020] [Indexed: 11/23/2022]
Abstract
A first-line chemotherapy program based on the ABVD regimen is currently considered the golden standard by most hematologists, being able to achieve a cure without any need of subsequent therapies in >70% of patients with advanced-stage Hodgkin's lymphoma (HL). To increase this percentage, efforts in recent decades focused on the development of new therapeutic strategies. A first major effort was the introduction of the BEACOPP chemotherapy regimen, which is able to increase the response rate and to reduce the need of salvage therapies. However, this result did not demonstrate an advantage in terms of overall survival compared to ABVD, mainly due to an excess of non lymphoma-related events in the follow-up phase. Here we describe three clinical cases of young HL patients who had relapsed/refractory disease after the induction chemotherapy. These three clinical cases provide practical and real world evidence in favor of the use of BV in monotherapy as consolidation treatment after autologous stem cells transplantation in patients with relapsed/refractory HL.
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Affiliation(s)
- Francesco Merli
- Hematology Unit, Azienda Unità Sanitaria Locale - IRCCS, Reggio Emilia, Italy.
| | - Filippo Ballerini
- Clinic of Hematology, Department of Internal Medicine (DiMI), University of Genoa, Italy; S. Martino Hospital IRCCS, Genoa, Italy .
| | - Barbara Botto
- Dipartimento di Oncologia ed Ematologia, A.O Città della Salute e della Scienza di Torino, San Giovanni Battista. Torino, Italy .
| | - Manuel Gotti
- Department of Hematology Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
| | - Vincenzo Pavone
- Dept. of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
| | - Alessandro Pulsoni
- Department of Cellular Biotechnologies and Hematology, La Sapienza University, Rome, Italy.
| | | | - Fulvio Massaro
- Hematology Unit, Azienda Unità Sanitaria Locale - IRCCS, Reggio Emilia, Italy.
| | - Simonetta Viviani
- Onco-Hematology Division, IEO, European Institute of Oncology, IRCCS, Milan, Italy.
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Schiano de Colella JM, Viviani S, Rapezzi D, PATTI CATERINA, Clement Filliatre L, Rossi A, Bijou F, Cantonetti M, Borel C, Thamphya B, Schiappa R, Chamorey E, Debaigt C, Gastaud L, Thyss A, Gallamini A. Brentuximab vedotin and bendamustine as first-line treatment of Hodgkin lymphoma in the elderly (HALO Trial). J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.8029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8029 Background: Hodgkin Lymphoma (HL) treatment in the elderly is a challenge, as standard ABVD is able to cure no more than 60% of the patients (p.). Bendamustine (Be), and Brentuximab Vedotin (BV), are well-tolerated and effective drugs in relapsing HL, but only preliminary data exist in 1st line treatment of the elderly (Evens AM 2018). Methods: HALO is a prospective international multicenter open-label phase I/II study (NCT02467946) to assess the safety and efficacy of Be-BV in advanced-stage elderly HL p. Briefly, BV 1.2 mg/kg on D1, and Be 90 mg/m2 on D1-2 were administered Q3W for 6 cycles. The primary endpoint was the feasibility and the efficacy of Be-BV. Results: Between July 2015 and February 2019, 59/60 p. consecutive enrolled received at least 1 Be-BV cycle, and are valuable for primary endpoint. One p. was excluded because a histological review showing angioimmunoblastic T-Cell Lymphoma. The mean age was 70.32 (62-79), and M/F ratio 41/18. The Ann-Arbor stage was IIB in 12, III in 14 and IV in 33 patients, B-symptoms (y/n) 40/19. IPS was 0-2 in 19 and ≥ 3 in 40 p., P.S. (ECOG) was 0-1 in 53, 2 in 6 p., nonetheless most of them were frail, as ADL was ≥ 6 in 47 (79%) and IADL was ≥ 8 in 42 (71%) p. Most frequent co-morbidities were cardio-vascular disease (45) metabolism disorders (31) prostatic adenoma (11). 163 treatment-related adverse events (WHO 3-4) were recorded: neutropenia and lymphopenia, (134), infections (7), cutaneous reactions (5), liver toxicity (2). No case of grade > 2 peripheral neuropathy was recorded. Out of 59 p., 41 concluded and 18 interrupted the treatment for toxicity (8), progression (5), treatment failure (2), CMV reactivation (3). The latter was recorded in 17 p., 12/17 received valgancyclovir. 4 p. died with CMV viremia. After a mean follow-up of 20.6 (0.3-46.5) months, 37/59 (63%) were in CR, while 22 (37%) have progressed (5) or relapsed (17). The 2-y OS and PFS in ITT analysis were 83% (95% CI 71-96) and 54% (95% CI 41-72) and in PP 89% (95%CI 75-100) and 78% (95%CI 64-96), respectively. 22 p. had a PFS event: 5 progression (2 deaths), 17 relapse (8 deaths). 10 p. died for recurrent HL (5), sepsis (1), secondary malignancy (2), respiratory insufficiency (1) and unknown (1). Conclusions: The Be-BV combination, a novel anthracycline-free regiment for first line treatment of HL in elderly, proved effective in unselected, frail, poor-risk, HL p. aged more than 60 in daily hospital real life. The CMV reactivation is frequent and should be treated with preemptive antiviral therapy upon detection of CMV DNA in plasma. Clinical trial information: NCT02467946 .
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Affiliation(s)
| | | | | | | | | | - Andrea Rossi
- Asst Papa Giovanni XXIII Bergamo, Bergamo, Italy
| | | | | | - Cécile Borel
- Institut Universitaire du Cancer de Toulouse, Toulouse Cedex, France
| | | | - Renaud Schiappa
- Biostatistics’ Unite, Antoine Lacassagne Cancer Center, University of Cote d’Azur, Nice, France
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Blanchard Rohner G, Chatzis O, Chinwangso P, Rohr M, Grillet S, Salomon C, Lemaître B, Boonrak P, Lawpoolsri S, Clutterbuck E, Poredi IK, Wijagkanalan W, Spiegel J, Pham HT, Viviani S, Siegrist CA. Boosting Teenagers With Acellular Pertussis Vaccines Containing Recombinant or Chemically Inactivated Pertussis Toxin: A Randomized Clinical Trial. Clin Infect Dis 2020; 68:1213-1222. [PMID: 30759183 DOI: 10.1093/cid/ciy594] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 04/24/2018] [Accepted: 07/24/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Protection induced by acellular pertussis (aP) vaccines is partial and short-lived, especially in teenagers, calling for novel immunization strategies. METHODS We conducted an investigator-driven proof-of-concept randomized controlled trial in aP-primed adolescents in Geneva to assess the immunogenicity and reactogenicity of a novel recombinant aP (r-aP) vaccine including recombinant pertussis toxin (PT) and filamentous hemagglutinin (FHA) coadministered with tetanus-diphtheria toxoids (Td), compared to a licensed tetanus-diphtheria-aP vaccine containing chemically detoxified PT (cd/Tdap). The primary immunological endpoints were day 28/365 geometric mean concentrations (GMCs) of total and neutralizing anti-PT antibodies. Memory B cells were assessed. RESULTS Sixty-two aP-primed adolescents were randomized and vaccinated with r-aP + Td or cd/Tdap. Reactogenicity, adverse events, and baseline GMCs were similar between the groups. Day 28 PT-neutralizing GMCs were low after cd/Tdap (73.91 [95% confidence interval {CI}, 49.88-109.52] IU/mL) and approximately 2-fold higher after r-aP + Td (127.68 [95% CI, 96.73-168.53] IU/mL; P = .0162). Anti-PT GMCs were also low after cd/Tdap (52.43 [95% CI, 36.41-75.50] IU/mL) and 2-fold higher after r-aP + Td (113.74 [95% CI, 88.31-146.50] IU/mL; P = .0006). Day 28 anti-FHA GMCs were similar in both groups. Day 365 anti-PT (but not PT-neutralizing) GMCs remained higher in r-aP + Td vaccinees. PT-specific memory B cells increased significantly after r-aP + Td but not cd/Tdap boosting. CONCLUSIONS Boosting aP-primed adolescents with r-aP induced higher anti-PT and PT-neutralizing responses than cd/Tdap and increased PT-specific memory B cells. Despite this superior immunogenicity, r-aP may have to be given repeatedly, earlier, and/or with novel adjuvants to exert an optimal influence in aP-primed subjects. CLINICAL TRIALS REGISTRATION NCT02946190.
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Affiliation(s)
- Geraldine Blanchard Rohner
- Department of Paediatrics, Children's Hospital of Geneva, University Hospitals of Geneva.,Center for Vaccinology and Neonatal Immunology, Department of Pediatrics and Pathology-Immunology, Medical Faculty and University Hospitals of Geneva, Switzerland
| | - Olga Chatzis
- Department of Paediatrics, Children's Hospital of Geneva, University Hospitals of Geneva.,Center for Vaccinology and Neonatal Immunology, Department of Pediatrics and Pathology-Immunology, Medical Faculty and University Hospitals of Geneva, Switzerland
| | | | - Marie Rohr
- Department of Paediatrics, Children's Hospital of Geneva, University Hospitals of Geneva.,Center for Vaccinology and Neonatal Immunology, Department of Pediatrics and Pathology-Immunology, Medical Faculty and University Hospitals of Geneva, Switzerland
| | - Stéphane Grillet
- Center for Vaccinology and Neonatal Immunology, Department of Pediatrics and Pathology-Immunology, Medical Faculty and University Hospitals of Geneva, Switzerland
| | - Carole Salomon
- Department of Paediatrics, Children's Hospital of Geneva, University Hospitals of Geneva
| | - Barbara Lemaître
- Laboratory of Vaccinology, University Hospitals of Geneva, Switzerland
| | - Pitchaya Boonrak
- Center of Excellence for Biomedical and Public Health Informatics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Saranath Lawpoolsri
- Center of Excellence for Biomedical and Public Health Informatics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Elizabeth Clutterbuck
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford.,National Institute for Health Research Oxford Biomedical Research Centre, United Kingdom
| | | | | | | | | | | | - Claire-Anne Siegrist
- Department of Paediatrics, Children's Hospital of Geneva, University Hospitals of Geneva.,Center for Vaccinology and Neonatal Immunology, Department of Pediatrics and Pathology-Immunology, Medical Faculty and University Hospitals of Geneva, Switzerland
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Marchi S, Viviani S, Montomoli E, Trombetta CM. Elimination of congenital rubella: a seroprevalence study of pregnant women and women of childbearing age in Italy. Hum Vaccin Immunother 2019; 16:895-898. [PMID: 31674859 PMCID: PMC7227624 DOI: 10.1080/21645515.2019.1688041] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Prevention of congenital rubella is achieved by vaccination of susceptible women of childbearing age. In Italy, the National Plan for Measles and Congenital Rubella Elimination 2010–2015 implemented catch-up vaccination activities targeting susceptible adolescents and young adults, including women of childbearing age. The aim of this study was to assess the immunity against rubella in women of childbearing age in Tuscany (Central Italy) and Apulia (Southern Italy) and pregnant women in Apulia after the implementation of the National Plan for Measles and Congenital Rubella Elimination. Overall, anti-rubella IgG prevalence in women of childbearing age samples was 88.6% in Tuscany and 84.3% in Apulia. The lowest prevalence was observed in samples of 26–35 years old women of childbearing age in Apulia with 77.8%. Only 62.7% of samples from 26–35 years old pregnant women had IgG against rubella, and one sample out of 95 was positive to IgM. The findings of this study highlight the need for increasing awareness on the risk of contracting rubella infection during pregnancy and implement vaccination strategies to create opportunities for administration of rubella containing vaccines in young girls and women of childbearing age.
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Affiliation(s)
- Serena Marchi
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Simonetta Viviani
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Emanuele Montomoli
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.,VisMederi srl, Siena, Italy
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Viviani S. Joint models for a GLM-type longitudinal response and a time-to-event with smooth random effects. J Appl Stat 2019. [DOI: 10.1080/02664763.2019.1617253] [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] [Indexed: 10/26/2022]
Affiliation(s)
- S. Viviani
- Statistics Division, Food and Agriculture Organization (FAO) of the United Nations, Viale delle Terme di Caracalla, 00153, Roma, Italy
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Marchi S, Montomoli E, Remarque EJ, Monteverde Spencer GT, Azzarello A, Viviani S, Trombetta CM. Pertussis over two decades: seroepidemiological study in a large population of the Siena Province, Tuscany Region, Central Italy. BMJ Open 2019; 9:e032987. [PMID: 31666278 PMCID: PMC6830678 DOI: 10.1136/bmjopen-2019-032987] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To evaluate seroprevalence against Bordetella pertussis in Tuscany, a large Italian region, from 1992 to 2005 and from 2013 to 2016. DESIGN Seroepidemiological study. PARTICIPANTS 1812 serum samples collected in Tuscany from subjects older than 12 years from 1992 to 2005 and from 2013 to 2016. OUTCOME MEASURES Specific antibody levels were determined by means of standard commercial ELISA using a dual cut-off of 50 and 125 IU/mL as markers of past and recent infection/vaccination, respectively. RESULTS The highest values of IgG titres were observed in 1992-1994 in all subjects (69.5 IU/mL), with prevalence values of subjects with IgG titres of >50 and >125 IU/mL of 68.3% and 23.8%, respectively. IgG titres decreased in the years thereafter (37.8 IU/mL in 2002-2005), together with prevalence values (41.7% and 8.1% in 2002-2005). In 2013-2016, both IgG titres and prevalence values showed a slight increase (50.6 IU/mL, 53.9% and 14.7%, respectively). IgG titres and prevalence followed the same age-related trend in all time periods considered, with the highest values in subjects aged 12-22 years. The lowest values were found in the age group of subjects aged 23-35 years (OR 0.54). CONCLUSIONS Since 2002, approximately half of the population over 22 years of age have low IgG titres and are presumably susceptible to acquiring and transmitting pertussis infection. In addition, in 2013-2016, almost one-third of subjects aged 12-22 years, that is, the age group most likely to have been vaccinated against pertussis in infancy, had low antibody levels. Improving vaccination coverage and implementing careful surveillance are therefore recommended in order to prevent morbidity and mortality due to pertussis.
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Affiliation(s)
- Serena Marchi
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Emanuele Montomoli
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
- VisMederi srl, Siena, Italy
| | - Edmond J Remarque
- Department of Virology, Biomedical Primate Research Centre, Rijswijk, The Netherlands
| | | | - Angela Azzarello
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Simonetta Viviani
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
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Abstract
Measles in pregnancy may lead to serious sequelae for newborns and mothers. In Italy assessment of immunity against measles is not recommended as pregnancy screening. This study aimed to assess the immunity against measles in pregnant women from Apulia Region in Southern Italy between 2016 and 2017. Overall, 96.9% of pregnant women were positive for anti-measles IgG, younger women aged 19–29 years had a seroprevalence below 90%. No samples were positive for anti-measles IgM. In conclusion, younger pregnant women showed to be at higher risk of contracting measles during pregnancy. These findings have implication for measles vaccination policy and highlight the need for measles antibody testing in pregnancy screening in Italy.
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Affiliation(s)
- Serena Marchi
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Martina Monti
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Simonetta Viviani
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Emanuele Montomoli
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.,VisMederi srl, Siena, Italy
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Gallamini A, Rossi A, Patti C, Picardi M, Romano A, Cantonetti M, Oppi S, Viviani S, Bolis S, Trentin L, Gini G, Battistini R, Chauvie S, Bertolotti L, Pavoni C, Parvis G, Zanotti R, Gavarotti P, Cimminiello M, Schiavotto C, Viero P, Avigdor A, Tarella C, Rambaldi A. CONSOLIDATION RADIOTHERAPY COULD BE OMITTED IN ADVANCED HODGKIN LYMPHOMA WITH LARGE NODAL MASS IN COMPLETE METABOLIC RESPONSE AFTER ABVD. FINAL ANALYSIS OF THE RANDOMIZED HD0607 TRIAL. Hematol Oncol 2019. [DOI: 10.1002/hon.105_2629] [Citation(s) in RCA: 2] [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] [Indexed: 11/10/2022]
Affiliation(s)
- A. Gallamini
- Research & Clinical Innovation; Antoine Lacassagne Cancer Centre; Nice France
| | - A. Rossi
- Department of Oncology-Hematology; University of Milan and Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII; Bergamo Italy
| | - C. Patti
- Hematology; V. Cervello Hospital; Palermo Italy
| | - M. Picardi
- Hematology; Policlinico Federico II; Naples Italy
| | - A. Romano
- Hematology; Policlinico Vittorio Emanuele Hospital; Catania Italy
| | - M. Cantonetti
- Hematology; Policlinico Hospital Tor Vergata; Rome Italy
| | - S. Oppi
- Hematology; Businco Oncology Hospital; Cagliari Italy
| | - S. Viviani
- Hematology; National Institute of tumors; Milan Italy
| | - S. Bolis
- Hematology; S. Gerardo University Hospital; Monza Italy
| | | | - G. Gini
- Hematology; Ospedali Riuniti Le Torrette; Ancona Italy
| | - R. Battistini
- Hematology; S. Camillo Forlanini Hospital; Rome Italy
| | - S. Chauvie
- Medical Physics; S. Croce Hospital; Cuneo Italy
| | | | - C. Pavoni
- Department of Oncology-Hematology; University of Milan and Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII; Bergamo Italy
| | - G. Parvis
- Hematology; Mauriziano Hospital; Turin Italy
| | - R. Zanotti
- Hematology; Azienda Ospedaliera Universitaria Integrata; Verona Italy
| | - P. Gavarotti
- Hematology; University Hospital Città della salute; Turin Italy
| | | | | | - P. Viero
- Hematology; Dell'Angelo Hospital; Venice Italy
| | - A. Avigdor
- Hematolog and Bone Marrow Transplantation; Sheba Medical Center; Tel-Aviv Israel
| | - C. Tarella
- Hematology; European Institute of Oncology; Milan Italy
| | - A. Rambaldi
- Department of Oncology-Hematology; University of Milan and Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII; Bergamo Italy
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Gallamini A, Schiano de Colella J, Viotti J, Bijou F, Rambaldi A, Perrot A, Patti C, Gastaud L, Sorasio R, Debaigt C, Schiappa R, Chamorey E, Viviani S, Thyss A. BRENTUXIMAB-VEDOTIN AND BENDAMUSTINE IS A FEASIBLE AND EFFECTIVE DRUG COMBINATION AS FIRST-LINE TREATMENT OF HODGKIN LYMPHOMA IN THE ELDERLY (HALO TRIAL). Hematol Oncol 2019. [DOI: 10.1002/hon.101_2630] [Citation(s) in RCA: 2] [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] [Indexed: 11/09/2022]
Affiliation(s)
- A. Gallamini
- Clinical Research and Innovation; A. Lacassagne Cancer Center; Nice France
| | | | - J. Viotti
- Département d'Epidemiologie; de Biostatistiques et des Données de Santé, Centre Antoine Lacassagne; Nice France
| | - F. Bijou
- Oncologie Médicale; Institut Bergonié; Bordeaux France
| | - A. Rambaldi
- Ematologia; Ospedale Papa Giovanni XXII; Bergamo Italy
| | - A. Perrot
- Service Hématologie et Médecine Interne; CHU Nancy-Brabois; Vandoeuvre Les Nancy France
| | - C. Patti
- Ematologia; Ospedali Riuniti Villa Sofia e Cervello; Palermo Italy
| | - L. Gastaud
- Département d'Oncologie Médicale; Centre Antoine Lacassagne; Nice France
| | - R. Sorasio
- Ematologia; Ospedale Sante Croce e Carle; Cuneo Italy
| | - C. Debaigt
- Clinical Research and Innovation; A. Lacassagne Cancer Center; Nice France
| | - R. Schiappa
- Département d'Epidemiologie; de Biostatistiques et des Données de Santé, Centre Antoine Lacassagne; Nice France
| | - E. Chamorey
- Département d'Epidemiologie; de Biostatistiques et des Données de Santé, Centre Antoine Lacassagne; Nice France
| | - S. Viviani
- Dipartimento di Oncologia Medica; Istituto Nazionale Dei Tumori; Milano Italy
| | - A. Thyss
- Département d'Oncologie Médicale; Centre Antoine Lacassagne; Nice France
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Abstract
In order to investigate the production of interleukin-2 (IL-2) in human neoplasms, we determined IL-2 and soluble IL-2 receptors (sIL-2R) in serum from 18 patients with lymphoma and 28 patients with solid tumors, with (15 cases) or without (13 cases) metastases. As controls, 58 healthy subjects were evaluated. Low levels of IL-2 were not observed in patients with lymphoma or limited solid tumor but abnormally low concentrations of IL-2 were seen in 4/15 metastatic solid tumors, associated with abnormally high values of sIL-2R. This preliminary study confirms in vivo the reduced IL-2 production in metastatic solid neoplasms, previously documented in vitro
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Affiliation(s)
- P Lissoni
- Division of Radiation Oncology, Ospedale San Gerardo, Monza, Italy
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Pitisuttithum P, Chokephaibulkit K, Sirivichayakul C, Sricharoenchai S, Dhitavat J, Pitisuthitham A, Phongsamart W, Boonnak K, Lapphra K, Sabmee Y, Wittawatmongkol O, Chauhan M, Wijagkanalan W, Hommalai G, Fortuna L, Chinwangso P, Poredi IK, van den Biggelaar AHJ, Pham HT, Viviani S. Antibody persistence after vaccination of adolescents with monovalent and combined acellular pertussis vaccines containing genetically inactivated pertussis toxin: a phase 2/3 randomised, controlled, non-inferiority trial. Lancet Infect Dis 2018; 18:1260-1268. [PMID: 30266329 DOI: 10.1016/s1473-3099(18)30375-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 06/04/2018] [Accepted: 06/05/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND The immunogenicity of acellular pertussis vaccines and persistence of immunity after vaccination might be improved by using genetically inactivated pertussis toxin (PTgen) instead of chemically inactivated pertussis toxin (PTchem) because of the preservation of conformational epitopes. We assessed the safety and immunogenicity of two vaccines containing PTgen 1 year after vaccination. METHODS We did a phase 2/3 non-inferiority, randomised, controlled trial involving 450 adolescents (age 12-17 years) enrolled between July 6, 2015, and Aug 20, 2015. Participants were randomised 1:1:1 to receive one dose of vaccine containing PTgen and filamentous haemagglutinin (FHA) either in a monovalent formulation (aP[PTgen/FHA]) or in a combined formulation with tetanus and reduced-dose diphtheria toxoids (TdaP[PTgen/FHA]) or to receive a commercial vaccine containing reduced-dose PTchem (Tdap) as a comparator. We report a secondary trial outcome, namely antibody persistence 1 year after vaccination, assessed per protocol in 150 randomly preselected participants (50 per group). Seroconversion was defined as antibody titres at least four times greater than at baseline. Safety was assessed in all trial participants. This study is registered in the Thai Clinical Trial Registry, number TCTR20150703002. FINDINGS Between June 5, 2016, and Aug 9, 2016, 442 (98%) of 450 enrolled participants attended a 1-year follow-up visit. After 1 year, persistent seroconversion for pertussis toxin neutralising antibodies was seen in 38 (76%, 95% CI 64-88) participants in the aP(PTgen/FHA) group and 41 (81%, 70-92) in the TdaP(PTgen/FHA) group, but in only four (8%, 1-16) in the Tdap comparator group. Seroconversion rates for IgG antibodies against pertussis toxin and FHA were also greater in the aP(PTgen/FHA) group (82%, 95% CI 71-93 and 64%, 51-77, respectively) and TdaP(PTgen/FHA) group (75%, 63-87 and 56%, 42-70, respectively) than in the Tdap group (4%, 0-9, p<0·0001, and 28%, 16-41, p=0·0007, respectively). 13 serious adverse events were reported in 12 participants and all were judged to be unrelated to the study vaccines. Five pregnancies were reported during follow-up, none of which had any maternal or neonatal complications. INTERPRETATION A monovalent and a combined recombinant acellular pertussis vaccine containing PTgen induced antibody responses that were greater and sustained for longer than those achieved with the Tdap comparator vaccine. New recombinant pertussis vaccines containing PTgen might offer new opportunities to limit pertussis resurgence and can be widely used, including in pregnant women. FUNDING BioNet-Asia.
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Affiliation(s)
- Punnee Pitisuttithum
- Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, Ratchathewi, Bangkok, Thailand
| | - Kulkanya Chokephaibulkit
- Paediatric Infectious Diseases Unit, Department of Paediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkoknoi, Bangkok, Thailand
| | - Chukiat Sirivichayakul
- Department of Tropical Paediatrics, Faculty of Tropical Medicine, Mahidol University, Ratchathewi, Bangkok, Thailand
| | - Sirintip Sricharoenchai
- Paediatric Infectious Diseases Unit, Department of Paediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkoknoi, Bangkok, Thailand
| | - Jittima Dhitavat
- Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, Ratchathewi, Bangkok, Thailand
| | - Arom Pitisuthitham
- Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, Ratchathewi, Bangkok, Thailand
| | - Wanatpreeya Phongsamart
- Paediatric Infectious Diseases Unit, Department of Paediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkoknoi, Bangkok, Thailand
| | - Kobporn Boonnak
- Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, Ratchathewi, Bangkok, Thailand
| | - Keswadee Lapphra
- Paediatric Infectious Diseases Unit, Department of Paediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkoknoi, Bangkok, Thailand
| | - Yupa Sabmee
- Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, Ratchathewi, Bangkok, Thailand
| | - Orasri Wittawatmongkol
- Paediatric Infectious Diseases Unit, Department of Paediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkoknoi, Bangkok, Thailand
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Abstract
INTRODUCTION Hodgkin's lymphoma (HL) patients refractory to first-line therapy or relapsed after autologous stem cell transplantation have a dismal prognosis, and their treatment represents an unmet medical need. Brentuximab vedotin (BV) is a second-generation antibody-drug conjugate (ADC) constituted by an anti-CD30 antibody linked to the cytotoxic drug monomethyl auristatin E. The first administration of BV in relapsed and refractory HL patients in a phase I study showed an impressive antilymphoma activity and prompted development of the drug. Areas covered: This article reviews pharmaceutical characteristics of ADC and specific chemical features of BV related to mechanism of action and mechanism of resistance. Administration recommendation and main toxicities will also be described. Antilymphoma efficacy of BV alone and in combination with conventional chemotherapy and new compounds in different settings of HL patients will be examined. Expert opinion: BV seems to be an effective and safe option for treatment of HL patients. BV alone or in association with chemotherapy as salvage regimen or as bridge to autologous or allogeneic transplant showed encouraging results. Exploration of new drug combinations and new settings of treatment is warranted in order to reduce long-term therapy-related toxicities and ameliorate survival of poor prognosis patients.
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Affiliation(s)
- Simonetta Viviani
- a Division of Hematology and BMT Unit, Department of Medical Oncology and Hematology , Fondazione IRCCS Istituto Nazionale Tumori , Milano , Italy
| | - Anna Guidetti
- a Division of Hematology and BMT Unit, Department of Medical Oncology and Hematology , Fondazione IRCCS Istituto Nazionale Tumori , Milano , Italy.,b Department of Oncology and Hemato-Oncology , University of Milano , Milano , Italy
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Carella AM, Corradini P, Mussetti A, Ricardi U, Vitolo U, Viviani S. Treatment of classical Hodgkin lymphoma in the era of brentuximab vedotin and immune checkpoint inhibitors. Ann Hematol 2018; 97:1301-1315. [PMID: 29802458 DOI: 10.1007/s00277-018-3366-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 02/11/2018] [Accepted: 05/06/2018] [Indexed: 12/19/2022]
Abstract
The majority of Hodgkin lymphoma patients are now cured with conventional first-line therapy; however, 10-15% of early-stage disease and less than 30% of advanced-stage patients are refractory(rare) or relapsed. Salvage second-line therapy combined with high-dose therapy and autologous stem-cell transplantation can cure 40-50% of patients. Recently novel agents (Brentuximab Vedotin and Immune Checkpoint inhibitors) have demonstrated evidence of therapeutic activity and are potential bridge to an allogeneic stem-cell transplantation. The review is aimed to present not only salvage strategies; indeed, the paper contains paragraphs about therapy and new treatment options at diagnosis.
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Affiliation(s)
- A M Carella
- Division of Hematology and BMT Unit, Ospedale Policlinico San Martino, Genoa, Italy.
| | - P Corradini
- Division of Hematology and BMT Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A Mussetti
- Division of Hematology and BMT Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - U Ricardi
- Department of Oncology, Università di Torino, Turin, Italy
| | - U Vitolo
- AOU Citta' della Salute e della Scienza, Turin, Italy
| | - S Viviani
- Division of Hematology and BMT Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Affiliation(s)
- Andrea Gallamini
- Andrea Gallamini, Centre A. Lacassagne, Nice, France; Simonetta Viviani, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan, Italy; Chiara Pavoni, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo; and Alessandro Rambaldi, Università degli Studi di Milano, Milan, and Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | - Simonetta Viviani
- Andrea Gallamini, Centre A. Lacassagne, Nice, France; Simonetta Viviani, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan, Italy; Chiara Pavoni, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo; and Alessandro Rambaldi, Università degli Studi di Milano, Milan, and Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | - Chiara Pavoni
- Andrea Gallamini, Centre A. Lacassagne, Nice, France; Simonetta Viviani, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan, Italy; Chiara Pavoni, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo; and Alessandro Rambaldi, Università degli Studi di Milano, Milan, and Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | - Alessandro Rambaldi
- Andrea Gallamini, Centre A. Lacassagne, Nice, France; Simonetta Viviani, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan, Italy; Chiara Pavoni, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo; and Alessandro Rambaldi, Università degli Studi di Milano, Milan, and Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
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LaForce FM, Djingarey M, Viviani S, Preziosi MP. Successful African introduction of a new Group A meningococcal conjugate vaccine: Future challenges and next steps. Hum Vaccin Immunother 2018; 14:1098-1102. [PMID: 28968148 PMCID: PMC5989906 DOI: 10.1080/21645515.2017.1378841] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 09/08/2017] [Indexed: 10/18/2022] Open
Abstract
The introduction of a new Group A meningococcal conjugate vaccine, MenAfriVacR, has been a important public health success. Group A meningococcal meningitis has disappeared in all countries where the new Men A conjugate vaccine has been used at public health scale. However, continued control of Group A disease in sub-Saharan Africa will require that community immunity against Group A meningococci be maintained. Modeling studies have shown that unless herd immunity is maintained Group A meningococcal disease will return. To ensure that African populations remain protected birth cohorts must be protected with an EPI formulation of MenAfriVacR (5 mcg) given at 9 months with Measles 1. In addition, populations born after the initial 1-29 year old campaigns and consequently not yet immunized with the new Men A conjugate vaccine, will have to be immunized in country-specific catch-up campaigns. Countries with poor EPI coverage (Measles 1 coverage < 60%) will likely need quinquennial vaccination campaigns aimed at covering 1-4 year olds. Implementing these strategies is the only sure way of ensuring that Group A meningococcal meningitis epidemics will not recur. A second problem that requires urgent attention is the challenge of dealing with Non-A meningococcal meningitis epidemics in sub-Saharan Africa. Groups C, W and X meningococci are well-established circulating strains in sub-Saharan Africa and are responsible for yearly focal meningitis epidemics that vary in severity and remain unpredictable as to size and geographic distribution. For this reason, polyvalent meningococcal conjugate vaccines that are affordable and appropriate for the African context must be developed and introduced. These new meningococcal vaccines when combined with more affordable pneumococcal conjugate vaccines offer the promise of a meningitis-free Sub-Saharan Africa.
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Spina F, Radice T, De Philippis C, Soldarini M, Di Chio MC, Dodero A, Guidetti A, Viviani S, Corradini P. Allogeneic transplantation for relapsed and refractory Hodgkin lymphoma: long-term outcomes and graft-versus-host disease-free/relapse-free survival. Leuk Lymphoma 2018; 60:101-109. [PMID: 29716416 DOI: 10.1080/10428194.2018.1459607] [Citation(s) in RCA: 5] [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] [Indexed: 10/17/2022]
Abstract
This monocentric retrospective study included 70 consecutive relapsed/refractory Hodgkin lymphoma (RR-HL) patients receiving reduced-intensity allogeneic stem cell transplantation (alloSCT). We evaluated overall and progression-free survival (OS, PFS), graft-versus host disease/relapse-free survival (GFRS), and chronic GVHD-free OS (cGVHD-free OS) defined as OS without moderate-to-severe cGVHD. Patients had a median age of 33 years (range, 18-60 years), 23% had refractory disease (SD/PD). Donors were HLA identical (39%), unrelated (30%), or haploidentical (31%). Median follow-up was 6.2 years. Five-year OS was 59% and PFS was 49%. NRM was 16% at 1 year. 44% of patients had cGVHD, and 14% moderate-to-severe cGVHD at last follow-up. GFRS and cGVHD-free OS were 26 and 48% at 5 years. In multivariate analysis, resistant disease at alloSCT impacted survival and GFRS. In conclusion, disease response before alloSCT impacts survival and GFRS. GVHD outcomes may help comparing the long-term effects of the new salvage treatments that bridge patients to alloSCT.
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Affiliation(s)
- Francesco Spina
- a Division of Hematology , Fondazione IRCCS Istituto Nazionale Tumori , Milan , Italy
| | - Tommaso Radice
- a Division of Hematology , Fondazione IRCCS Istituto Nazionale Tumori , Milan , Italy.,b Department of Oncology and Onco-Hematology , Università degli Studi di Milano , Milan , Italy
| | - Chiara De Philippis
- a Division of Hematology , Fondazione IRCCS Istituto Nazionale Tumori , Milan , Italy.,b Department of Oncology and Onco-Hematology , Università degli Studi di Milano , Milan , Italy
| | - Martina Soldarini
- a Division of Hematology , Fondazione IRCCS Istituto Nazionale Tumori , Milan , Italy.,b Department of Oncology and Onco-Hematology , Università degli Studi di Milano , Milan , Italy
| | - Maria Chiara Di Chio
- a Division of Hematology , Fondazione IRCCS Istituto Nazionale Tumori , Milan , Italy.,b Department of Oncology and Onco-Hematology , Università degli Studi di Milano , Milan , Italy
| | - Anna Dodero
- a Division of Hematology , Fondazione IRCCS Istituto Nazionale Tumori , Milan , Italy
| | - Anna Guidetti
- a Division of Hematology , Fondazione IRCCS Istituto Nazionale Tumori , Milan , Italy
| | - Simonetta Viviani
- a Division of Hematology , Fondazione IRCCS Istituto Nazionale Tumori , Milan , Italy
| | - Paolo Corradini
- a Division of Hematology , Fondazione IRCCS Istituto Nazionale Tumori , Milan , Italy.,b Department of Oncology and Onco-Hematology , Università degli Studi di Milano , Milan , Italy
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Spinazzé S, Viviani S, Bidoli P, Rovelli F, Palmer P, Franks CR, Arienti F, Rivoltini L, Parmiani G. Effect of Prolonged Subcutaneous Administration of Interleukin-2 on the Orcadian Rhythms of Cortisol and Beta-Endorphin in Advanced Small Cell Lung Cancer Patients. Tumori 2018; 77:496-9. [PMID: 1666467 DOI: 10.1177/030089169107700609] [Citation(s) in RCA: 5] [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: 11/16/2022]
Abstract
Interleukin-2 has been shown to stimulate Cortisol secretion in man. Owing to its Immunosuppressive properties, an increase in Cortisol levels during interleukin-2 cancer immunotherapy could potentially counteract induced activation of the antitumor immune response. Few data are available about Cortisol secretion secondary to prolonged interleukin-2 administration. To Investigate the problem, we evaluated Cortisol circadian rhythms in 7 consecutive metastatic small cell lung cancer patients who received interleukin-2 subcutaneously for 4 weeks (daily dose: 6 × 106 × IU/m2). Venous blood samples were drawn at 8.00 a.m., 4.00 p.m. and 12.00 p.m., before Interleukin-2, and after each week until the end of the cycle. Beta-endorphin levels were also measured on the same samples. Four patients were evaluated during a second interleukin-2 cycle. Mean Cortisol levels increased during Interleukin-2 therapy, but were significantly higher than those seen in basal conditions after the first week of treatment. Moreover, Cortisol peaks observed during the second cycle of therapy were not significantly different from those seen during the first cycle. Mean beta-endorphin levels increased in response to interleukin-2 administration, but the increase did not reach statistical significance. The early Cortisol rise progressively decreased as treatment continued. This suggests that the interleukin-2-induced Cortisol rise has no relevant clinical importance in antagonizing the activation of an effective antitumor immune response during cancer immunotherapy with interleukin-2.
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Affiliation(s)
- S Spinazzé
- Division of Medical Oncology A, Istituto Nazionale Tumori, Milan, Italy
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Orazi A, Cattoretti G, Sozzi G, Miozzo M, Polli N, Delia D, Viviani S, Negretti E, Della Porta G, Rilke F. Morphologic, Immunologic, and Cytogenetic Characteristics of Secondary Acute Unclassifiable Leukemia in Hodgkin's Disease. Tumori 2018; 74:439-50. [PMID: 3188241 DOI: 10.1177/030089168807400411] [Citation(s) in RCA: 5] [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: 11/16/2022]
Abstract
Blast cells from five cases of secondary unclassifiable leukemia following therapy for Hodgkin's disease were studied by cytochemical, immunological and cytogenetic analyses. Cytochemical and immunological reactivity were in accordance with poorly differentiated, myeloid blasts. The four cases in which karyotype analysis was performed showed specific chromosomal abnormalities. No evidence of multiple lineage involvement was found. Problems in classifying these cases of secondary ANLL were due to the high grade of undifferentiation of the blast cells. Their low cytochemical reactivity with markers of myeloid differentiation was similar to what may be observed in patients with acute undifferentiated leukemia or with chronic myeloid leukemia in blast crisis.
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Affiliation(s)
- A Orazi
- Divisione di Anatomia Patologica e Citologia, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milano, Italia
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Abstract
From 1970 to 1980, 171 consecutive cases with non-Hodgkin's lymphomas (NHL) of Waldeyer's ring were admitted to this Institute. The cases were reviewed to evaluate whether involvement of Waldeyer's ring might represent a distinct clinicopathologic entity. Adequate pathologic staging was performed in 86% of cases. All slides were reviewed, and the histologic diagnosis given according to the Rappaport classification, the Kiel classification, and the recent Working Formulation of NHL for Clinical Usage. Waldeyer's ring alone was involved in 12.3% of the cases at presentation; regional nodes were positive in one-third (35.7%), and distant involvement was detected in half of the patients (52%). The tonsils represented the most frequent site of involvement by NHL within Waldeyer's ring. Treatments employed were heterogeneous, but most of the patients with stage I-II received radiotherapy alone. The present series shows that the association of involvement of Waldeyer's ring and the stomach by NHL occurs in less than 10% of the cases. Treatment results and patterns of recurrence fail to differentiate NHL involving Waldeyer's ring from those of other sites. Prognosis remains related to the classical variables and is independent of the site of onset.
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Lissoni P, Bolis S, MandalÀ M, Viviani S, Pogliani E, Barni S. Blood Concentrations of Tumor Necrosis Factor-Alpha in Malignant Lymphomas and Their Decrease as a Predictor of Disease Control in Response to Low-Dose Subcutaneous Immunotherapy with Interleukin-2. Int J Biol Markers 2018. [DOI: 10.1177/172460089901400308] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Tumor necrosis factor-alpha (TNF-α), a cytokine provided by both immunomodulating and inflammatory activities, has been described to be abnormally increased in the blood of patients affected by malignant lymphomas, particularly NHL. However, the biological and clinical significance of TNF-α secretion in malignant lymphomas is still controversial. The present study was carried out to further define TNF-α secretion in untreated malignant lymphomas and during low-dose IL-2 immunotherapy. The study included 80 malignant lymphoma patients, 54 of whom were affected by HD and the other 26 by NHL. The mean TNF-α serum concentrations observed in untreated lymphoma patients were significantly higher than those seen in the healthy controls, without significant differences between HD and NHL. Moreover, both HD and NHL lymphoma patients at clinical stage III-IV showed significantly higher mean TNF-α levels than those at clinical stage I-II. Finally, patients with systemic symptoms had higher mean TNF-α concentrations than those without any systemic symptoms, even though statistical significance was observed only for NHL patients. In a second study we have evaluated changes in TNF-α levels in seven evaluable lymphoma patients (NHL: 6; HD: 1) - who did not respond to conventional therapies - during subcutaneous low-dose IL-2 (3 MIU/day 6 days/week for 4 weeks). Long-term stable disease was achieved in four patients with NHL, whereas the other three progressed. In patients with stable disease the mean TNF-α concentrations significantly decreased during treatment, whereas they increased in progressing patients. This study, by showing an abnormally enhanced TNF-α secretion in both NHL and HD patients with advanced disease and systemic symptoms and a decrease in its levels in patients who achieved disease control on IL-2 immunotherapy, appears to confirm the unfavorable prognostic significance of enhanced TNF-α levels in malignant lymphomas.
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Affiliation(s)
- P. Lissoni
- Division of Radiation Oncology, San Gerardo Hospital, Monza
| | - S. Bolis
- Division of Hematology, San Gerardo Hospital, Monza
| | - M. MandalÀ
- Division of Radiation Oncology, San Gerardo Hospital, Monza
| | - S. Viviani
- Division of Medical Oncology, National Cancer Institute, Milano - Italy
| | - E. Pogliani
- Division of Hematology, San Gerardo Hospital, Monza
| | - S. Barni
- Division of Radiation Oncology, San Gerardo Hospital, Monza
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Gallamini A, Tarella C, Viviani S, Rossi A, Patti C, Mulé A, Picardi M, Romano A, Cantonetti M, La Nasa G, Trentin L, Bolis S, Rapezzi D, Battistini R, Gottardi D, Gavarotti P, Corradini P, Cimminiello M, Schiavotto C, Parvis G, Zanotti R, Gini G, Ferreri AJ, Viero P, Miglino M, Billio A, Avigdor A, Biggi A, Fallanca F, Ficola U, Gregianin M, Chiaravalloti A, Prosperini G, Bergesio F, Chauvie S, Pavoni C, Gianni AM, Rambaldi A. Early Chemotherapy Intensification With Escalated BEACOPP in Patients With Advanced-Stage Hodgkin Lymphoma With a Positive Interim Positron Emission Tomography/Computed Tomography Scan After Two ABVD Cycles: Long-Term Results of the GITIL/FIL HD 0607 Trial. J Clin Oncol 2018; 36:454-462. [DOI: 10.1200/jco.2017.75.2543] [Citation(s) in RCA: 135] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose To investigate the progression-free survival (PFS) of patients with advanced Hodgkin lymphoma (HL) after a risk-adapted treatment strategy that was based on a positive positron emission tomography scan performed after two doxorubicin, vinblastine, vincristine, and dacarbazine (ABVD) cycles (PET2). Patients and Methods Patients with advanced-stage (IIB to IVB) HL were consecutively enrolled. After two ABVD cycles, PET2 was performed and centrally reviewed according to the Deauville five-point scale. Patients with a positive PET2 were randomly assigned to four cycles of escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP) followed by four cycles of standard BEACOPP with or without rituximab. Patients with a negative PET2 continued ABVD, and those with a large nodal mass at diagnosis (≥ 5 cm) in complete remission with a negative PET at the end of chemotherapy were randomly assigned to radiotherapy or no further treatment. The primary end point was 3-year PFS. Results Of 782 enrolled patients, 150 (19%) had a positive and 630 (81%) a negative PET2. The 3-year PFS of all patients was 82%. The 3-year PFS of those with a positive and negative PET2 was 60% and 87%, respectively ( P < .001). The 3-year PFS of patients with a positive PET2 assigned to BEACOPP with or without rituximab was 63% versus 57% ( P = .53). In 296 patients with both interim and post-ABVD–negative PET who had a large nodal mass at diagnosis, radiotherapy was randomly added after chemotherapy without a significant PFS improvement (97% v 93%, respectively; P = .29). The 3-year overall survival of all 782 patients was 97% (99% and 89% for PET2 negative and positive, respectively). Conclusion The PET-driven switch from ABVD to escalated BEACOPP is feasible and effective in high-risk patients with advanced-stage HL.
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Affiliation(s)
- Andrea Gallamini
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Corrado Tarella
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Simonetta Viviani
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Andrea Rossi
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Caterina Patti
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Antonino Mulé
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Marco Picardi
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Alessandra Romano
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Maria Cantonetti
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Giorgio La Nasa
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Livio Trentin
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Silvia Bolis
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Davide Rapezzi
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Roberta Battistini
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Daniela Gottardi
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Paolo Gavarotti
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Paolo Corradini
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Michele Cimminiello
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Corrado Schiavotto
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Guido Parvis
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Roberta Zanotti
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Guido Gini
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Andrés J.M. Ferreri
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Piera Viero
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Maurizio Miglino
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Atto Billio
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Abraham Avigdor
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Alberto Biggi
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Federico Fallanca
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Umberto Ficola
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Michele Gregianin
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Agostino Chiaravalloti
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Giuseppe Prosperini
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Fabrizio Bergesio
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Stephane Chauvie
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Chiara Pavoni
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Alessandro Massimo Gianni
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
| | - Alessandro Rambaldi
- Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano
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