66 results on '"Amadori, S."'
Search Results
2. Clinical significance of bax/bcl-2 ratio in chronic lymphocytic leukemia
- Author
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Del Principe, M. I., primary, Bo, M. D., additional, Bittolo, T., additional, Buccisano, F., additional, Rossi, F. M., additional, Zucchetto, A., additional, Rossi, D., additional, Bomben, R., additional, Maurillo, L., additional, Cefalo, M., additional, De Santis, G., additional, Venditti, A., additional, Gaidano, G., additional, Amadori, S., additional, de Fabritiis, P., additional, Gattei, V., additional, and Del Poeta, G., additional
- Published
- 2015
- Full Text
- View/download PDF
3. Remembering Professor Roberto Stasi (August 24th 1961 - January 28th 2014)
- Author
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Rodeghiero, F., primary, Amadori, S., additional, and Pane, F., additional
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- 2014
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4. Autologous peripheral blood stem cell transplantation as first line treatment of multiple myeloma: an Italian Multicenter Study
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Tribalto, M., Amadori, S., Cudillo, L., Caravita, T., Del Poeta, G., Meloni, G., Avvisati, G., Petrucci, M. T., Pulsoni, A., Giuseppe Leone, Sica, S., Martelli, M., Tabilio, A., Fioritoni, G., Majolino, I., and Mandelli, F.
- Subjects
Adult ,Male ,Neutrophils ,Antigens, CD34 ,Infections ,Transplantation, Autologous ,Dexamethasone ,Disease-Free Survival ,multiple myeloma ,transplant ,peripheral blood stem cells ,melphalan ,busulfan ,Risk Factors ,Antineoplastic Combined Chemotherapy Protocols ,Granulocyte Colony-Stimulating Factor ,Humans ,Cyclophosphamide ,Retrospective Studies ,Platelet Count ,Stem Cells ,Age Factors ,Cytarabine ,Hematopoietic Stem Cell Transplantation ,Middle Aged ,Myeloablative Agonists ,Prognosis ,Survival Rate ,Treatment Outcome ,Italy ,Evaluation Studies as Topic ,Vincristine ,Blood Component Removal ,Erythrocyte Transfusion ,Multiple Myeloma ,Settore MED/15 - Malattie del Sangue ,Follow-Up Studies - Abstract
The outcome of patients with multiple myeloma (MM) has not changed markedly since the introduction of melphalan and prednisone. In recent years several studies have investigated the role of intensive therapy followed by infusion of autologous peripheral blood stem cells (PBSC) together with the administration of hematopoietic growth factors. In this study we evaluated the feasibility and efficacy of a PBSC transplantation program for patients with de novo MM in a multicenter setting.In a non-randomized controlled trial 52 patients with de novo MM from 6 Italian centers underwent a three phase treatment strategy including 3 cycles of VAD-like chemotherapy for initial debulking, followed by high-dose cyclophosphamide (HD-CY) and collection of PBSC, that were transplanted after a conditioning regimen with melphalan plus busulfan. Maintenance treatment was a conventional dose of interferon, given until relapse. Actuarial survival and response duration curves were plotted according to Kaplan and Meier's method; the groups were compared using the log rank test. Response rates were compared by the c(2) test; multivariate analysis was performed according to the stepwise regression model.Overall 39/52 (75%) of patients responded, with a complete remission (CR) rate of 31%. After a median follow-up of 55 months, median duration of event-free survival (EFS) and overall survival (OS) are 21 and 57 months, with 24% and 48% probabilities of being event-free and alive after 6 years, respectively. Among the group of 39 responders, CR was significantly associated with prolonged response and survival (2 deaths and 6 relapses/16 patients) as compared with PR (11 deaths and 15 relapses/23 patients), and remained the only significant variable also in a multivariate analysis. Myelosuppression did not protract beyond one week in transplanted patients; extra-hematologic toxicity was very low.This multicenter study confirms the feasibility of an aggressive approach to de novo MM patients. Additional confirmation is given of the increased rate of CR, and the significant prolonged survival observed in complete responders. In this experience the association melphalan plus busulfan was shown to be effective, at least as part of conditioning regimens, in the transplant strategy.
- Published
- 2000
5. Value of infliximab (Remicade(R)) in patients with low-risk myelodysplastic syndrome: final results of a randomized phase II trial (EORTC trial 06023) of the EORTC Leukemia Group
- Author
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Baron, F., primary, Suciu, S., additional, Amadori, S., additional, Muus, P., additional, Zwierzina, H., additional, Denzlinger, C., additional, Delforge, M., additional, Thyss, A., additional, Selleslag, D., additional, Indrak, K., additional, Ossenkoppele, G., additional, and de Witte, T., additional
- Published
- 2011
- Full Text
- View/download PDF
6. CD69 is independently prognostic in chronic lymphocytic leukemia: a comprehensive clinical and biological profiling study
- Author
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Del Poeta, G., primary, Del Principe, M. I., additional, Zucchetto, A., additional, Luciano, F., additional, Buccisano, F., additional, Maria Rossi, F., additional, Bruno, A., additional, Biagi, A., additional, Bulian, P., additional, Maurillo, L., additional, Neri, B., additional, Bomben, R., additional, Simotti, C., additional, Coletta, A. M., additional, Dal Bo, M., additional, de Fabritiis, P., additional, Venditti, A., additional, Gattei, V., additional, and Amadori, S., additional
- Published
- 2011
- Full Text
- View/download PDF
7. Value of allogeneic versus autologous stem cell transplantation and chemotherapy in patients with myelodysplastic syndromes and secondary acute myeloid leukemia. Final results of a prospective randomized European Intergroup Trial
- Author
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de Witte, T., primary, Hagemeijer, A., additional, Suciu, S., additional, Belhabri, A., additional, Delforge, M., additional, Kobbe, G., additional, Selleslag, D., additional, Schouten, H. C., additional, Ferrant, A., additional, Biersack, H., additional, Amadori, S., additional, Muus, P., additional, Jansen, J. H., additional, Hellstrom-Lindberg, E., additional, Kovacsovics, T., additional, Wijermans, P., additional, Ossenkoppele, G., additional, Gratwohl, A., additional, Marie, J.-P., additional, and Willemze, R., additional
- Published
- 2010
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- View/download PDF
8. A one-mutation mathematical model can explain the age incidence of acute myeloid leukemia with mutated nucleophosmin (NPM1)
- Author
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Liso, A., primary, Castiglione, F., additional, Cappuccio, A., additional, Stracci, F., additional, Schlenk, R. F., additional, Amadori, S., additional, Thiede, C., additional, Schnittger, S., additional, Valk, P. J.M., additional, Dohner, K., additional, Martelli, M. F., additional, Schaich, M., additional, Krauter, J., additional, Ganser, A., additional, Martelli, M. P., additional, Bolli, N., additional, Lowenberg, B., additional, Haferlach, T., additional, Ehninger, G., additional, Mandelli, F., additional, Dohner, H., additional, Michor, F., additional, and Falini, B., additional
- Published
- 2008
- Full Text
- View/download PDF
9. Activity and safety profile of low-dose rituximab for the treatment of autoimmune cytopenias in adults
- Author
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Provan, D., primary, Butler, T., additional, Evangelista, M. L., additional, Amadori, S., additional, Newland, A. C., additional, and Stasi, R., additional
- Published
- 2007
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10. Monitoring of minimal residual disease in adult acute myeloid leukemia using peripheral blood as an alternative source to bone marrow
- Author
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Maurillo, L., primary, Buccisano, F., additional, Spagnoli, A., additional, Del Poeta, G., additional, Panetta, P., additional, Neri, B., additional, Del Principe, M. I., additional, Mazzone, C., additional, Consalvo, M. I., additional, Tamburini, A., additional, Ottaviani, L., additional, Fraboni, D., additional, Sarlo, C., additional, De Fabritiis, P., additional, Amadori, S., additional, and Venditti, A., additional
- Published
- 2007
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- View/download PDF
11. Autologous stem cell transplantation after complete remission and first consolidation in acute myeloid leukemia patients aged 61 70 years: results of the prospective EORTC GIMEMA AML 13 study
- Author
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Thomas, X., primary, Suciu, S., additional, Rio, B., additional, Leone, G., additional, Broccia, G., additional, Fillet, G., additional, Jehn, U., additional, Feremans, W., additional, Meloni, G., additional, Vignetti, M., additional, de Witte, T., additional, and Amadori, S., additional
- Published
- 2007
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12. Mucositis in patients with hematologic malignancies: an overview
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Niscola, P., primary, Romani, C., additional, Cupelli, L., additional, Scaramucci, L., additional, Tendas, A., additional, Dentamaro, T., additional, Amadori, S., additional, and de Fabritiis, P., additional
- Published
- 2007
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- View/download PDF
13. A phase III comparative trial of m-BACOD vs m-BNCOD in the treatment of stage II-IV diffuse non-Hodgkin's lymphomas
- Author
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Guglielmi, C., Gherlinzoni, F., Amadori, S., Mazza, P., Mantovani, L., Lauria, F., Martelli, M., PIER LUIGI ZINZANI, Greco, V., Poletti, G., Gherardi, S., Mandelli, F., and Tura, S.
- Subjects
Adult ,Male ,Lymphoma, Non-Hodgkin ,Leucovorin ,Middle Aged ,Dexamethasone ,Bleomycin ,Methotrexate ,Doxorubicin ,Vincristine ,Antineoplastic Combined Chemotherapy Protocols ,Humans ,Female ,Prospective Studies ,Mitoxantrone ,Cyclophosphamide ,Aged ,Randomized Controlled Trials as Topic - Abstract
From September, 1984 to July, 1986 seventy previously untreated adult patients with advanced non-Hodgkin's lymphoma of intermediate or high grade histology were enrolled in an open phase III multicenter, comparative chemotherapeutic trial. The objectives were to compare, by means of response rate, duration of response and survival time, the efficacy and safety of substituting mitoxantrone for doxorubicin in the combination chemotherapy regimen m-BACOD (methotrexate, bleomycin, doxorubicin, cyclophosphamide, vincristine and dexamethasone). Thirty-five patients were randomly assigned to receive m-B-NOVANTRONE TM (mitoxantrone)-COD (m-BNCOD) and 35 m-B-ADRIAMYCIN TM (doxorubicin)-COD. The complete response rate was 57% for both treatment groups, and no significant disease-free survival and survival differences were found between the two groups of patients. Patients treated with m-BACOD experienced severe alopecia more frequently (p less than 0.001) and, after 10 cycles, six adverse cardiac event of WHO grade greater than 1, as opposed to none among those who received m-BNCOD. The mitoxantrone-containing regimen (m-BNCOD) has equivalent efficacy and reduced toxicity compared to the standard doxorubicin-containing regimen (m-BACOD) in patients with poor prognosis NHL.
- Published
- 1989
14. Evaluation of a polychemotherapeutic regimen including Idarubicin (4-demethoxydaunorubicin) in relapsed acute lymphocytic leukemia
- Author
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Mandelli, Franco, Testi, Anna Maria, ALOE SPIRITI, Maria Antonietta, Giona, Fiorina, Meloni, Giovanna, Moleti, Ml, Amadori, S, and Pacciarini, Ma
- Subjects
Adult ,Male ,Clinical Trials as Topic ,Antibiotics, Antineoplastic ,Adolescent ,Daunorubicin ,Cytarabine ,Leukemia, Lymphoid ,Methotrexate ,Vincristine ,Child, Preschool ,Antineoplastic Combined Chemotherapy Protocols ,Asparaginase ,Humans ,Female ,Child ,Idarubicin ,Follow-Up Studies - Published
- 1986
15. Blastic plasmacytoid dendritic cell neoplasm with leukemic presentation: an Italian multicenter study
- Author
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Livio, Pagano, Caterina Giovanna, Valentini, Alessandro, Pulsoni, Simona, Fisogni, Paola, Carluccio, Francesco, Mannelli, Monia, Lunghi, Gianmatteo, Pica, Francesco, Onida, Chiara, Cattaneo, Pier Paolo, Piccaluga, Eros, Di Bona, Elisabetta, Todisco, Pellegrino, Musto, Antonio, Spadea, Alfonso, D'Arco, Stefano, Pileri, Giuseppe, Leone, Sergio, Amadori, Fabio, Facchetti, Emilio, Berti, Pagano L, Valentini CG, Pulsoni A, Fisogni S, Carluccio P, Mannelli F, Lunghi M, Pica G, Onida F, Cattaneo C, Piccaluga P, Di Bona E, Todisco E, Musto P, Spadea A, D'Arco A, Pileri S, Leone G, Amadori S, Facchetti F, Pagano, L, Valentini, C, Pulsoni, A, Fisogni, S, Carluccio, P, Mannelli, F, Lunghi, M, Pica, G, Onida, F, Cattaneo, C, Piccaluga, P, Di Bona, E, Todisco, E, Musto, P, Spadea, A, D'Arco, A, Pileri, S, Leone, G, Amadori, S, Facchetti, F, and Berti, E
- Subjects
Adult ,Male ,medicine.medical_specialty ,Myeloid ,medicine.medical_treatment ,Hematopoietic stem cell transplantation ,Gastroenterology ,Immunophenotyping ,leukemia plasmacytoid dendritic cell skin involvement myeloid origin outcame ,Young Adult ,Bone Marrow ,MED/15 - MALATTIE DEL SANGUE ,hemic and lymphatic diseases ,Internal medicine ,MED/35 - MALATTIE CUTANEE E VENEREE ,Biomarkers, Tumor ,medicine ,Humans ,Letters to the Editor ,Aged ,Retrospective Studies ,Aged, 80 and over ,Acute leukemia ,Chemotherapy ,Leukemia ,Hematology ,business.industry ,Remission Induction ,Hematopoietic Stem Cell Transplantation ,Articles ,Dendritic Cells ,Middle Aged ,medicine.disease ,MED/08 - ANATOMIA PATOLOGICA ,Surgery ,Regimen ,Treatment Outcome ,medicine.anatomical_structure ,Italy ,Female ,Lymph Nodes ,business ,Settore MED/15 - Malattie del Sangue ,Blastic plasmacytoid - Abstract
The objective of this study was to evaluate the clinical features, prognostic factors, and efficacy of treatments in patients with blastic plasmacytoid dendritic cell neoplasm with a leukemic presentation at onset of the disease. In order to do this, a retrospective multicenter study was performed from 2005-2011 in 28 Italian hematology divisions in which 43 cases were collected. Forty-one patients received an induction therapy, consisting of an acute myeloid leukemia-type regimen in 26 patients (60%) and acute lymphoid leukemia/lymphoma-type regimen in 15 patients (35%). Six patients (14%) underwent allogeneic hematopoietic stem cell transplantation. Seventeen patients (41%) achieved a complete remission: seven after acute myeloid leukemia-type treatment and 10 after an acute lymphoid leukemia/lymphoma-type regimen, with a significant advantage for acute lymphoid leukemia/lymphoma-type chemotherapy (P=0.02). Relapse occurred in six of the 17 patients (35%) who achieved complete remission, more frequently after acute lymphoid leukemia/lymphoma-type chemotherapy. The median overall survival was 8.7 months (range, 0.2-32.9). The patients treated with an acute myeloid leukemia-type regimen had an overall survival of 7.1 months (range, 0.2-19.5), whereas that of the patients receiving acute lymphoid leukemia/lymphoma-type chemotherapy was 12.3 months (range, 1-32.9) (P=0.02). The median overall survival of the allogeneic hematopoietic stem cell transplant recipients was 22.7 months (range, 12-32.9), and these patients had a significant survival advantage compared to the non-transplanted patients (median 7.1 months, 0.2-21.3; P=0.03). In conclusion, blastic plasmacytoid dendritic cell neoplasm with bone-marrow involvement is an aggressive subtype of high-risk acute leukemia. The rarity of this disease does not enable prospective clinical trials to identify the better therapeutic strategy, which, at present, is based on clinicians' experience.
- Published
- 2012
16. Long-term follow-up of a trial comparing post-remission treatment with autologous or allogeneic bone marrow transplantation or intensive chemotherapy in younger acute myeloid leukemia patients.
- Author
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Baron F, Efficace F, Cannella L, Willemze R, Vignetti M, Muus P, Marie JP, Ferrero D, Fazi P, La Sala E, Bourhis JH, Fabbiano F, Bosi A, Sborgia M, Martinelli G, Wittnebel S, Trisolini S, Petti MC, Halkes CJM, van der Velden WJFM, de Witte T, Amadori S, Zittoun RA, and Suciu S
- Subjects
- Antineoplastic Combined Chemotherapy Protocols adverse effects, Bone Marrow Transplantation, Cytarabine therapeutic use, Follow-Up Studies, Humans, Remission Induction, Transplantation, Autologous, Hematopoietic Stem Cell Transplantation, Leukemia, Myeloid, Acute drug therapy
- Published
- 2020
- Full Text
- View/download PDF
17. Impact of induction regimen and allogeneic hematopoietic cell transplantation on outcome in younger adults with acute myeloid leukemia with a monosomal karyotype.
- Author
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Baron F, Stevens-Kroef M, Kicinski M, Meloni G, Muus P, Marie JP, Halkes CJM, Thomas X, Vrhovac R, Albano F, Lefrère F Sr, Sica S, Mancini M, Venditti A, Hagemeijer A, Jansen JH, Amadori S, de Witte T, Willemze R, and Suciu S
- Subjects
- Adolescent, Adult, Age Factors, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Combined Modality Therapy, Female, Humans, Induction Chemotherapy, Leukemia, Myeloid, Acute diagnosis, Leukemia, Myeloid, Acute mortality, Male, Middle Aged, Odds Ratio, Prognosis, Survival Analysis, Transplantation, Homologous, Treatment Outcome, Young Adult, Abnormal Karyotype, Hematopoietic Stem Cell Transplantation adverse effects, Hematopoietic Stem Cell Transplantation methods, Leukemia, Myeloid, Acute genetics, Leukemia, Myeloid, Acute therapy, Monosomy genetics
- Abstract
Monosomal karyotype confers a poor prognosis in patients with acute myeloid leukemia. Here, we determined the impact of the type of remission-induction chemotherapy and the impact of having a donor in younger acute myeloid leukemia patients with a monosomal karyotype included in two phase III trials. In the first trial patients were randomized to receive either daunorubicin, mitoxantrone, or idarubicin in addition to standard-dose cytarabine and etoposide for induction chemotherapy. In the second trial patients were randomized to standard-dose cytarabine or high-dose cytarabine induction, both with daunorubicin and etoposide. In both trials, patients who achieved a complete remission with or without complete hematologic recovery underwent allogeneic hematopoietic stem cell transplantation if they had a donor; otherwise, they underwent autologous transplantation. In comparison to patients with intermediate-risk cytogenetics without a monosomal karyotype (n=1,584) and with adverse cytogenetics without a monosomal karyotype (n=218), patients with a monosomal karyotype (n=188) were more likely not to achieve a complete remission with or without count recovery [odds ratio=2.85, 95% confidence interval (95%, CI): 2.10-3.88] and had shorter overall survival [hazard ratio, (HR)=2.44, 95% CI: 2.08-2.88]. There was no impact of the type of anthracycline or of the dose of cytarabine on outcomes in patients with a monosomal karyotype. Among monosomal karyo type patients who achieved a complete remission with or without count recovery, HLA-identical related donor availability was associated with longer survival from complete remission with or without count recovery (HR=0.59, 95% CI: 0.37-0.95). ClinicalTrials.gov identifiers: AML-10: NCT00002549; AML-12: NCT00004128., (Copyright© 2019 Ferrata Storti Foundation.)
- Published
- 2019
- Full Text
- View/download PDF
18. Low-dose clofarabine in combination with a standard remission induction in patients aged 18-60 years with previously untreated intermediate and bad-risk acute myeloid leukemia or high-risk myelodysplastic syndrome: combined phase I/II results of the EORTC/GIMEMA AML-14A trial.
- Author
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Selleslag D, Suciu S, Meloni G, Muus P, Halkes CJ, Venditti A, Ramadan SM, Pruijt H, Meert L, Vignetti M, Marie JP, Wittnebel S, de Witte T, Amadori S, Willemze R, and Baron F
- Subjects
- Adolescent, Adult, Clofarabine, Drug Administration Schedule, Female, Gene Expression, Humans, Leukemia, Myeloid, Acute genetics, Leukemia, Myeloid, Acute mortality, Leukemia, Myeloid, Acute pathology, Male, Middle Aged, Myelodysplastic Syndromes genetics, Myelodysplastic Syndromes mortality, Myelodysplastic Syndromes pathology, Oncogene Proteins, Fusion genetics, Oncogene Proteins, Fusion metabolism, Random Allocation, Remission Induction, Risk Factors, Survival Analysis, Transplantation, Homologous, Treatment Outcome, Adenine Nucleotides therapeutic use, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Arabinonucleosides therapeutic use, Cytarabine therapeutic use, Hematopoietic Stem Cell Transplantation, Leukemia, Myeloid, Acute therapy, Myelodysplastic Syndromes therapy
- Published
- 2017
- Full Text
- View/download PDF
19. Clinical significance of bax/bcl-2 ratio in chronic lymphocytic leukemia.
- Author
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Del Principe MI, Dal Bo M, Bittolo T, Buccisano F, Rossi FM, Zucchetto A, Rossi D, Bomben R, Maurillo L, Cefalo M, De Santis G, Venditti A, Gaidano G, Amadori S, de Fabritiis P, Gattei V, and Del Poeta G
- Subjects
- Adult, Aged, Aged, 80 and over, Chlorambucil administration & dosage, Disease-Free Survival, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Prednisolone administration & dosage, Retrospective Studies, Rituximab administration & dosage, Survival Rate, Vidarabine administration & dosage, Vidarabine analogs & derivatives, Antineoplastic Combined Chemotherapy Protocols administration & dosage, Leukemia, Lymphocytic, Chronic, B-Cell blood, Leukemia, Lymphocytic, Chronic, B-Cell drug therapy, Leukemia, Lymphocytic, Chronic, B-Cell mortality, Proto-Oncogene Proteins c-bcl-2 blood, bcl-2-Associated X Protein blood
- Abstract
In chronic lymphocytic leukemia the balance between the pro-apoptotic and anti-apoptotic members of the bcl-2 family is involved in the pathogenesis, chemorefractoriness and clinical outcome. Moreover, the recently proposed anti-bcl-2 molecules, such as ABT-199, have emphasized the potential role of of bcl-2 family proteins in the context of target therapies. We investigated bax/bcl-2 ratio by flow cytometry in 502 patients and identified a cut off of 1.50 to correlate bax/bcl-2 ratio with well-established clinical and biological prognosticators. Bax/bcl-2 was 1.50 or over in 263 patients (52%) with chronic lymphocytic leukemia. Higher bax/bcl-2 was associated with low Rai stage, lymphocyte doubling time over 12 months, beta-2 microglobulin less than 2.2 mg/dL, soluble CD23 less than 70 U/mL and a low risk cytogenetic profile (P<0.0001). On the other hand, lower bax/bcl-2 was correlated with unmutated IGHV (P<0.0001), mutated NOTCH1 (P<0.0001) and mutated TP53 (P=0.00007). Significant shorter progression-free survival and overall survival were observed in patients with lower bax/bcl-2 (P<0.0001). Moreover, within IGHV unmutated (168 patients) and TP53 mutated (37 patients) subgroups, higher bax/bcl-2 identified cases with significant longer PFS (P=0.00002 and P=0.039). In multivariate analysis of progression-free survival and overall survival, bax/bcl-2 was an independent prognostic factor (P=0.0002 and P=0.002). In conclusion, we defined the prognostic power of bax/bcl-2 ratio, as determined by a flow cytometric approach, and highlighted a correlation with chemoresistance and outcome in chronic lymphocytic leukemia. Finally, the recently proposed new therapies employing bcl-2 inhibitors prompted the potential use of bax/bcl-2 ratio to identify patients putatively resistant to these molecules., (Copyright© Ferrata Storti Foundation.)
- Published
- 2016
- Full Text
- View/download PDF
20. Blastic plasmacytoid dendritic cell neoplasm with leukemic presentation: an Italian multicenter study.
- Author
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Pagano L, Valentini CG, Pulsoni A, Fisogni S, Carluccio P, Mannelli F, Lunghi M, Pica G, Onida F, Cattaneo C, Piccaluga PP, Di Bona E, Todisco E, Musto P, Spadea A, D'Arco A, Pileri S, Leone G, Amadori S, and Facchetti F
- Subjects
- Adult, Aged, Aged, 80 and over, Biomarkers, Tumor metabolism, Bone Marrow pathology, Dendritic Cells metabolism, Female, Hematopoietic Stem Cell Transplantation, Humans, Immunophenotyping, Italy, Leukemia mortality, Leukemia therapy, Lymph Nodes pathology, Male, Middle Aged, Remission Induction, Retrospective Studies, Treatment Outcome, Young Adult, Dendritic Cells pathology, Leukemia diagnosis
- Abstract
The objective of this study was to evaluate the clinical features, prognostic factors, and efficacy of treatments in patients with blastic plasmacytoid dendritic cell neoplasm with a leukemic presentation at onset of the disease. In order to do this, a retrospective multicenter study was performed from 2005-2011 in 28 Italian hematology divisions in which 43 cases were collected. Forty-one patients received an induction therapy, consisting of an acute myeloid leukemia-type regimen in 26 patients (60%) and acute lymphoid leukemia/lymphoma-type regimen in 15 patients (35%). Six patients (14%) underwent allogeneic hematopoietic stem cell transplantation. Seventeen patients (41%) achieved a complete remission: seven after acute myeloid leukemia-type treatment and 10 after an acute lymphoid leukemia/lymphoma-type regimen, with a significant advantage for acute lymphoid leukemia/lymphoma-type chemotherapy (P=0.02). Relapse occurred in six of the 17 patients (35%) who achieved complete remission, more frequently after acute lymphoid leukemia/lymphoma-type chemotherapy. The median overall survival was 8.7 months (range, 0.2-32.9). The patients treated with an acute myeloid leukemia-type regimen had an overall survival of 7.1 months (range, 0.2-19.5), whereas that of the patients receiving acute lymphoid leukemia/lymphoma-type chemotherapy was 12.3 months (range, 1-32.9) (P=0.02). The median overall survival of the allogeneic hematopoietic stem cell transplant recipients was 22.7 months (range, 12-32.9), and these patients had a significant survival advantage compared to the non-transplanted patients (median 7.1 months, 0.2-21.3; P=0.03). In conclusion, blastic plasmacytoid dendritic cell neoplasm with bone-marrow involvement is an aggressive subtype of high-risk acute leukemia. The rarity of this disease does not enable prospective clinical trials to identify the better therapeutic strategy, which, at present, is based on clinicians' experience.
- Published
- 2013
- Full Text
- View/download PDF
21. Value of infliximab (Remicade®) in patients with low-risk myelodysplastic syndrome: final results of a randomized phase II trial (EORTC trial 06023) of the EORTC Leukemia Group.
- Author
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Baron F, Suciu S, Amadori S, Muus P, Zwierzina H, Denzlinger C, Delforge M, Thyss A, Selleslag D, Indrak K, Ossenkoppele G, and de Witte T
- Subjects
- Adult, Aged, Aged, 80 and over, Antibodies, Monoclonal administration & dosage, Antibodies, Monoclonal adverse effects, Antineoplastic Agents administration & dosage, Antineoplastic Agents adverse effects, Female, Humans, Infliximab, Male, Medication Adherence, Middle Aged, Myelodysplastic Syndromes mortality, Survival Analysis, Treatment Outcome, Tumor Necrosis Factor-alpha antagonists & inhibitors, Antibodies, Monoclonal therapeutic use, Antineoplastic Agents therapeutic use, Myelodysplastic Syndromes drug therapy
- Abstract
Tumor-necrosis factor alpha activity has been correlated to ineffective erythropoiesis in lower risk myelodysplastic syndromes. Infliximab (Remicade(®)) is an anti-tumor necrosis factor alpha chimeric antibody that is used in the treatment of patients with rheumatoid arthritis or Crohn's disease. Forty-six patients with myelodysplastic syndromes and a relatively low risk of developing acute leukemia were included in a randomized phase II study assessing the therapeutic activity of two dosages of infliximab administration (3 mg/kg vs. 5 mg/kg). The primary end point was the response rate. Responses were observed in 3 of 22 patients (13.1%) randomized to the 3 mg/kg arm, versus 0 of 21 patients randomized in the 5 mg/kg arm. According to the statistical design of the current study, neither of the two infliximab dose schedules tested showed sufficient activity as a single agent in this cohort of unselected patients with early myelodysplastic syndrome.
- Published
- 2012
- Full Text
- View/download PDF
22. CD69 is independently prognostic in chronic lymphocytic leukemia: a comprehensive clinical and biological profiling study.
- Author
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Del Poeta G, Del Principe MI, Zucchetto A, Luciano F, Buccisano F, Rossi FM, Bruno A, Biagi A, Bulian P, Maurillo L, Neri B, Bomben R, Simotti C, Coletta AM, Dal Bo M, de Fabritiis P, Venditti A, Gattei V, and Amadori S
- Subjects
- Adult, Aged, Aged, 80 and over, Antibodies, Monoclonal, Murine-Derived administration & dosage, Antigens, CD genetics, Antigens, Differentiation, T-Lymphocyte genetics, Biomarkers, Tumor genetics, Cohort Studies, Female, Humans, Lectins, C-Type genetics, Leukemia, Lymphocytic, Chronic, B-Cell drug therapy, Leukemia, Lymphocytic, Chronic, B-Cell genetics, Male, Middle Aged, Prognosis, Rituximab, Vidarabine administration & dosage, Vidarabine analogs & derivatives, Antigens, CD metabolism, Antigens, Differentiation, T-Lymphocyte metabolism, Biomarkers, Tumor metabolism, Lectins, C-Type metabolism, Leukemia, Lymphocytic, Chronic, B-Cell diagnosis, Leukemia, Lymphocytic, Chronic, B-Cell metabolism
- Abstract
Background: CD69 is expressed in several hemopoietic cells and is an early activation marker in chronic lymphocytic leukemia. Chronic lymphocytic leukemia is a clinically heterogeneous disease which needs novel prognostic parameters which can be easily and efficiently managed., Design and Methods: We investigated CD69 by flow cytometry in a series of 417 patients affected by chronic lymphocytic leukemia and compared this to other biological and clinical prognosticators., Results: CD69 was associated with Rai stages (P=0.00002), β(2)-microglobulin (P=0.0005) and soluble CD23 (P<0.0001). CD69 and ZAP-70 (P=0.018) or CD38 (P=0.00015) or immunoglobulin variable heavy chain gene mutations (P=0.0005) were also significantly correlated. Clinically, CD69 positive chronic lymphocytic leukemias received chemotherapy more frequently (74%; P<0.0001), and presented a shorter duration of response after fludarabine plus rituximab (P=0.010) as well as shorter progression free survival and overall survival (P<0.0001). CD69 demonstrated true additive prognostic properties, since the CD69(+) plus ZAP-70(+) or CD38(+) or immunoglobulin variable heavy chain gene unmutated patients had the worst progression free survival and overall survival (P<0.0001). Interestingly, low CD69 expression was necessary to correctly prognosticate the longer progression free survival of patients with a low tumor burden of β(2)-microglobulin (P=0.002), of soluble CD23 (P=0.020), or of Rai stages 0-I (P=0.005). CD69 was confirmed to be an independent prognostic factor in multivariate analysis of progression free survival (P=0.017) and overall survival (P=0.039)., Conclusions: Our data indicate that CD69 is significantly correlated with poor clinical and biological prognostic factors and is confirmed to be an independent disease prognosticator. This supports its introduction in a routine laboratory assessment and, possibly, in a prognostic scoring system for chronic lymphocytic leukemia, after an adequate standardization process.
- Published
- 2012
- Full Text
- View/download PDF
23. Dexamethasone compared to prednisolone for adults with acute lymphoblastic leukemia or lymphoblastic lymphoma: final results of the ALL-4 randomized, phase III trial of the EORTC Leukemia Group.
- Author
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Labar B, Suciu S, Willemze R, Muus P, Marie JP, Fillet G, Berneman Z, Jaksic B, Feremans W, Bron D, Sinnige H, Mistrik M, Vreugdenhil G, De Bock R, Nemet D, Gilotay C, Amadori S, and de Witte T
- Subjects
- Adolescent, Adult, Aged, Antineoplastic Agents, Hormonal, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Combined Modality Therapy, Disease-Free Survival, Female, Hematopoietic Stem Cell Transplantation methods, Humans, Male, Middle Aged, Precursor Cell Lymphoblastic Leukemia-Lymphoma drug therapy, Remission Induction, Young Adult, Dexamethasone administration & dosage, Prednisolone administration & dosage
- Abstract
Background: Corticosteroids are a standard component of the treatment of acute lymphoblastic leukemia and lymphoblastic lymphoma. Our aim was to determine whether dexamethasone results in a better outcome than prednisolone., Design and Methods: Adult patients with acute lymphoblastic leukemia or lymphoblastic lymphoma were randomized to receive, as part of their induction therapy on days 1-8 and 15-22, either dexamethasone 8 mg/m(2) or prednisolone 60 mg/m(2). Those who reached complete remission were given two courses of consolidation therapy with high-dose cytarabine and mitoxantrone and methotrexate and asparaginase. Subsequently patients younger than 50 years, with a suitable donor, were to undergo allogeneic stem cell transplantation, whereas the others were planned to receive either an autologous stem cell transplant or high-dose maintenance chemotherapy with prophylactic central nervous system irradiation. Randomization was done with a minimization technique. The primary endpoint was event-free survival and the analyses was conducted on an intention-to-treat basis., Results: Between August 1995 and October 2003, 325 patients between 15 to 72 years of age were randomized to receive either dexamethasone (163 patients) or prednisolone (162 patients). After induction and the course of first consolidation therapy, 131 (80.4%) patients in the dexamethasone group and 124 (76.5%) in the prednisolone group achieved complete remission. No significant difference was observed between the two treatment groups with regards to 6-year event-free survival rates (+/-SE) which were 25.9% (3.6%) and 28.7% (3.5%) in the dexamethasone and prednisolone groups, respectively (P=0.82, hazard ratio 0.97; 95% confidence interval, 0.75-1.25). Disease-free survival after complete remission was also similar in the dexamethasone and prednisolone groups, the 6-year rates being 32.3% and 37.5%, respectively (hazard ratio 1.03; 95% confidence interval 0.76-1.40). The 6-year cumulative incidences of relapse were 49.8% and 53.5% (Gray's test: P=0.30) while the 6-year cumulative incidences of death were 18% and 9% (Gray's test: P=0.07)., Conclusions: In the ALL-4 trial in adult patients with acute lymphoblastic leukemia or lymphoblastic lymphoma, treatment with dexamethasone did not show any advantage over treatment with prednisolone.
- Published
- 2010
- Full Text
- View/download PDF
24. Prognostic impact of genetic characterization in the GIMEMA LAM99P multicenter study for newly diagnosed acute myeloid leukemia.
- Author
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Lo-Coco F, Cuneo A, Pane F, Cilloni D, Diverio D, Mancini M, Testoni N, Bardi A, Izzo B, Bolli N, La Starza R, Fazi P, Iacobelli S, Piciocchi A, Vignetti M, Amadori S, Mandelli F, Pelicci PG, Mecucci C, Falini B, and Saglio G
- Subjects
- Adolescent, Adult, Cytogenetics, DNA Mutational Analysis, Genetic Markers, Humans, Italy, Karyotyping, Leukemia, Myeloid, Acute therapy, Middle Aged, Multivariate Analysis, Mutation, Nucleophosmin, Prognosis, Prospective Studies, Remission Induction, Leukemia, Myeloid, Acute diagnosis, Leukemia, Myeloid, Acute genetics
- Abstract
Background: Recent advances in genetic characterization of acute myeloid leukemia indicate that combined cytogenetic and molecular analyses provide better definition of prognostic groups. The aim of this study was to verify this prospectively in a large group of patients., Design and Methods: Genetic characterization was prospectively carried out in 397 patients with acute myeloid leukemia (median age, 46 years) receiving uniform treatment according to the LAM99P protocol of the Italian GIMEMA group. The impact of genetic markers on response to therapy and outcome was assessed by univariate and multivariate analyses., Results: For induction response, conventional karyotyping identified three groups with complete remission rates of 92%, 67% and 39% (p<0.0001). Complete remission rates in NPM1 mutated (NPM1+) and wild-type (NPM1-) groups were 76% and 60%, respectively, for the whole population and 81% and 61% in the group with normal karyotype (p<0.001 and p=0.026, respectively). Multivariate analysis indicated that low risk karyotype and NPM1+ were independent factors favorably affecting complete remission. Multivariate analysis of overall and disease-free survival among 269 patients who achieved complete remission showed a significant impact of karyotype on both estimates and of FLT3 status on disease free-survival (FLT3-ITD vs. FLT3 wild-type, p=0.0001). NPM1 status did not significantly influence disease free-survival in either the whole population or in the patients with a normal karyotype in this series, probably due to the low number of cases analyzed., Conclusions: These results reiterate the prognostic relevance of combining cytogenetic and mutational analysis in the diagnostic work up of patients with acute myeloid leukemia.
- Published
- 2008
- Full Text
- View/download PDF
25. Optimal post-remission therapy for flow-cytometry minimal residual disease positive adult patients with acute myeloid leukemia.
- Author
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Buccisano F, Maurillo L, Del Poeta G, Gattei V, Amadori S, and Venditti A
- Subjects
- Acute Disease, Adult, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Blood Cell Count, Combined Modality Therapy, Disease-Free Survival, Flow Cytometry, Humans, Leukemia, Myeloid blood, Leukemia, Myeloid drug therapy, Leukemia, Myeloid mortality, Leukemia, Myeloid pathology, Neoplasm, Residual, Remission Induction, Survival Analysis, Transplantation, Autologous, Transplantation, Homologous, Treatment Outcome, Hematopoietic Stem Cell Transplantation, Leukemia, Myeloid surgery
- Published
- 2006
26. Phase II multicenter study of arsenic trioxide, ascorbic acid and dexamethasone in patients with relapsed or refractory multiple myeloma.
- Author
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Wu KL, Beksac M, van Droogenbroeck J, Amadori S, Zweegman S, and Sonneveld P
- Subjects
- Adult, Aged, Arsenic Trioxide, Drug Therapy, Combination, Follow-Up Studies, Humans, Middle Aged, Multiple Myeloma mortality, Recurrence, Arsenicals administration & dosage, Ascorbic Acid administration & dosage, Dexamethasone administration & dosage, Multiple Myeloma drug therapy, Oxides administration & dosage
- Abstract
Arsenic trioxide induces growth inhibition and apoptosis in multiple myeloma cell lines. Reducing glutathione by ascorbic acid may enhance the efficacy of arsenic trioxide. Here we report the results of an international multi-center study of arsenic trioxide in combination with ascorbic acid and dexamethasone as treatment for patients with advanced multiple myeloma.
- Published
- 2006
27. Home care management of patients affected by hematologic malignancies: a review.
- Author
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Niscola P, de Fabritiis P, Cartoni C, Romani C, Sorrentino F, Dentamaro T, Piccioni D, Scaramucci L, Giovannini M, Amadori S, and Mandelli F
- Subjects
- Disease Management, Hematologic Neoplasms epidemiology, Humans, Palliative Care methods, Hematologic Neoplasms therapy, Home Care Services
- Abstract
Home care (HC) has an increasingly expanding role in the global management of patients affected by hematologic malignancies. Integrated strategies, including causal-targeted and supportive treatments according to hematologic expertise and a holistic approach inspired by the philosophy and practice of palliative medicine, may allow suitable management and the possibility for most patients to stay at home. Physical, social and psychological needs of patients are likely to vary according to the course of their disease and the treatments they are receiving. Therefore, consideration should be given to different models of care and how to tackle patients' diverse needs, as outlined by reported experiences which claimed that HC can provide appropriate solutions not only for terminally and chronically ill patients but also for those in other phases of disease. According to these studies and to our own experience, when appropriate measures and structured operating models are adopted, HC results in a safe, effective and economically realistic alternative to traditional in-hospital treatment. Therefore, all efforts should be made to overcome budget and administrative barriers and to ensure a more widespread use of this model of care.
- Published
- 2006
28. Clinical significance of soluble p53 protein in B-cell chronic lymphocytic leukemia.
- Author
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Del Principe MI, Del Poeta G, Venditti A, Buccisano F, Maurillo L, Marini R, Cox MC, Panetta P, Suppo G, Degan M, Bruno A, Gattei V, and Amadori S
- Subjects
- ADP-ribosyl Cyclase 1 blood, Adult, Aged, Aged, 80 and over, Antimetabolites, Antineoplastic therapeutic use, Burkitt Lymphoma drug therapy, Burkitt Lymphoma genetics, Burkitt Lymphoma mortality, Disease Progression, Female, Flow Cytometry, Gene Rearrangement, B-Lymphocyte, Heavy Chain, Humans, Immunoglobulin Heavy Chains genetics, Immunoglobulin Variable Region genetics, Immunophenotyping, In Situ Hybridization, Fluorescence, Interphase, Life Tables, Male, Middle Aged, Predictive Value of Tests, Prognosis, Proportional Hazards Models, Solubility, Vidarabine analogs & derivatives, Vidarabine therapeutic use, ZAP-70 Protein-Tyrosine Kinase blood, Biomarkers, Tumor blood, Burkitt Lymphoma blood, Enzyme-Linked Immunosorbent Assay, Neoplasm Proteins blood, Tumor Suppressor Protein p53 blood
- Abstract
Background and Objectives: p53 status and CD38 antigen are biological factors influencing response to therapy and clinical course in B-cell chronic lymphocytic leukemia (B-CLL). This study tests the hypothesis that soluble p53 alone and in association with CD38 can enucleate B-CLL subsets at worse prognosis., Design and Methods: Wild and mutant forms of p53 protein were evaluated in 197 B-CLL patients at diagnosis or before progression by an immunoenzymatic method in plasma using an anti-p53 monoclonal antibody. CD38 expression was analyzed by a multicolor flow cytometric assay., Results: Higher levels of both soluble p53 (sp53) and CD38 were significantly correlated with intermediate and high Rai stages, with higher beta2-microglobulin and soluble CD23 values, determined at diagnosis. Shorter overall survival (OS) and progression-free survival (PFS) were both observed in sp53+ and CD38+ patients (p<0.0001). Simultaneous positivity or negativity for sp53 and CD38 identified two subsets of patients, the former with a worse prognosis and the latter with a better prognosis with regard to PFS (p<0.0001) and OS (p<0.0001). The predictive value of sp53 and CD38 was retained among the patients within the intermediate Rai risk group., Interpretation and Conclusions: sp53 and CD38 together with ZAP-70 were confirmed to be independent prognostic factors in multivariate analysis. With regard to PFS, ZAP-70, sp53 and CD38 were confirmed to be independent prognostic factors. Concerning OS, ZAP-70, CD38 and age (< or > 60 years) were independent prognostic factors whereas sp53 showed only a tendency towards statistical significance.
- Published
- 2004
29. Combined analysis of bcl-2 and MDR1 proteins in 256 cases of acute myeloid leukemia.
- Author
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Venditti A, Del Poeta G, Maurillo L, Buccisano F, Del Principe MI, Mazzone C, Tamburini A, Cox C, Panetta P, Neri B, Ottaviani L, and Amadori S
- Subjects
- Acute Disease, Adolescent, Adult, Aged, Aged, 80 and over, Antigens, CD blood, Female, Flow Cytometry, Humans, Immunophenotyping, Leukemia, Myeloid blood, Male, Middle Aged, ATP Binding Cassette Transporter, Subfamily B, Member 1 blood, Antigens, CD34 blood, Leukemia, Myeloid genetics, Proto-Oncogene Proteins c-bcl-2 blood
- Abstract
Background and Objectives: The objective of this study was to investigate the expression of MDR1 and bcl-2 proteins in de novo acute myeloid leukemia (AML)., Design and Methods: The expression of MDR1 and bcl-2 was analyzed by flow cytometry in a large series of 256 consecutive cases of AML. The results were recorded as percentage of positivity and relative mean fluorescence intensity (rMFI). To determine individual protein levels, an index which equals the product of the percentage of positive cells and rMFI was generated., Results: Using cut-offs of >or=800 and 300 of the index value for bcl-2 and MDR1 expression, respectively, we identified 4 different classes of AML: 1) double negative; 2) single positive bcl-2+/MDR1-; 3) single positive bcl-2-/MDR1+; 4) double positive. The highest incidence of double negative cases was observed in the M2 class whereas double positive cases occurred more frequently in the M4, M5 and M6 subgroups. Seventy-eight percent and 71% of M0 and M1, respectively, showed single positive bcl-2+/MDR1- expression (p = 0.00001). Twenty-eight percent of patients belonging to the double positive category achieved complete remission, whereas for double negative, single positive bcl-2+MDR1- and single positive bcl-2-/MDR1+ category, the complete remission rate was 69%, 52% and 56%, respectively (p = 0.00038). In multivariate analysis, the double positive status independently affected frequency of complete remission (p = 0.008)., Interpretation and Conclusions: Bcl-2 is over-expressed in CD34+ AML; conversely, MDR1 is over-expressed in CD34- AML. However, the combined expression of the two proteins defines a subset of AML with a very poor prognosis.
- Published
- 2004
30. Sequential administration of gemtuzumab ozogamicin and conventional chemotherapy as first line therapy in elderly patients with acute myeloid leukemia: a phase II study (AML-15) of the EORTC and GIMEMA leukemia groups.
- Author
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Amadori S, Suciu S, Willemze R, Mandelli F, Selleslag D, Stauder R, Ho A, Denzlinger C, Leone G, Fabris P, Muus P, Vignetti M, Hagemeijer A, Beeldens F, Anak O, and De Witte T
- Subjects
- Acute Disease, Aged, Aminoglycosides administration & dosage, Antibodies, Monoclonal administration & dosage, Antibodies, Monoclonal, Humanized, Antineoplastic Combined Chemotherapy Protocols administration & dosage, Cisplatin administration & dosage, Drug Administration Schedule, Female, Gemtuzumab, Humans, Ifosfamide administration & dosage, Infusions, Intravenous, Leukemia, Myeloid mortality, Male, Middle Aged, Mitomycin administration & dosage, Reproducibility of Results, Survival Analysis, Vindesine administration & dosage, Aminoglycosides therapeutic use, Aminoglycosides toxicity, Antibodies, Monoclonal therapeutic use, Antibodies, Monoclonal toxicity, Antineoplastic Agents therapeutic use, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Leukemia, Myeloid drug therapy
- Abstract
Background and Objectives: Acute myeloid leukemia (AML) in the elderly is associated with low rates of response to conventional chemotherapy and long-term survival, highlighting the need for innovative treatment strategies. Gemtuzumab ozogamicin (GO) is an immunoconjugate that has shown activity in relapsed AML with a favorable safety profile. The aim of this collaborative trial was to assess the feasibility, safety, and antileukemic activity of administering GO followed by conventional chemotherapy as first line therapy in patients aged 61-75 years with AML., Design and Methods: Eligible patients received frontline treatment with GO 9 mg/m2 infused intravenously on days 1 and 15. Following response assessment to GO, patients were started on conventional chemotherapy consisting of the MICE regimen (mitoxantrone, cytarabine, etoposide). No further treatment was planned for complete responders., Results: Among the 57 evaluable patients, 38 (67%) completed the entire sequential treatment as planned. The overall response rate to the entire induction sequence was 54.4% (31/57), with complete remission (CR) in 35.1% and complete remission with incomplete platelet recovery (CRp) in 19.3%. Rates of failure due to treatment-related mortality or resistant disease were 14.1% (3 toxic deaths during the GO segment, 5 during MICE) and 29.9%, respectively. An initial response to GO was documented in 20 patients (35.1%), with CR in 22.8% and CRp in 12.3%; 6 additional patients entered a partial remission. Reversible myelosuppression and liver toxicity were the main adverse events during both segments of induction. Frontline GO was associated with modest mucosal and gastrointestinal toxicity, but grade 3-4 pancytopenia was universal and prolonged. Hepatic veno-occlusive disease developed in 3 patients after GO and 2 after MICE, resulting in 4 deaths from liver failure. One-year survival at follow-up was 34%. Twelve patients continue in CR/CRp after a median of 226 days., Interpretation and Conclusions: The sequential combination of GO and conventional chemotherapy is a feasible and active treatment strategy for older patients with untreated AML. This novel regimen is now being compared in a phase III trial (AML-17).
- Published
- 2004
31. Unrelated cord blood transplantation for children with high risk myelodysplastic syndromes.
- Author
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Picardi A, Del Principe D, Cudillo L, Dentamaro T, Amadori S, and de Fabritiis P
- Subjects
- Adolescent, Child, Child, Preschool, HLA Antigens immunology, Histocompatibility, Humans, Risk Factors, Transplantation, Homologous, Cord Blood Stem Cell Transplantation adverse effects, Cord Blood Stem Cell Transplantation methods, Myelodysplastic Syndromes therapy
- Published
- 2004
32. Recombinant factor VIIa for the management of severe hemorrhages in patients with hematologic malignancies.
- Author
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De Fabritiis P, Dentamaro T, Picardi A, Cudillo L, Masi M, and Amadori S
- Subjects
- Adult, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Child, Drug Evaluation, Female, Graft vs Host Disease complications, Hematologic Neoplasms drug therapy, Hematologic Neoplasms therapy, Hematopoietic Stem Cell Transplantation, Hemorrhage etiology, Hemorrhage therapy, Humans, Male, Middle Aged, Platelet Transfusion, Recombinant Proteins therapeutic use, Treatment Outcome, Factor VIIa therapeutic use, Hematologic Neoplasms complications, Hemorrhage drug therapy
- Published
- 2004
33. Evidence- and consensus-based practice guidelines for the therapy of primary myelodysplastic syndromes. A statement from the Italian Society of Hematology.
- Author
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Alessandrino EP, Amadori S, Barosi G, Cazzola M, Grossi A, Liberato LN, Locatelli F, Marchetti M, Morra E, Rebulla P, Visani G, and Tura S
- Subjects
- Consensus, Disease Management, Eligibility Determination, Evidence-Based Medicine, Humans, Italy, Societies, Medical, Myelodysplastic Syndromes therapy, Practice Guidelines as Topic standards
- Abstract
Background and Objectives: Novel therapeutic agents and strategies have been introduced into the management of myelodysplastic syndromes (MDS) in the last years. This has led to more treatment options and a better chance of long-term survival for MDS patients, but also to uncertainty regarding the optimal use and possible side effects of these treatments. The Italian Society of Hematology commissioned a project to develop guidelines for the therapy of MDS using evidence-based knowledge and consensus-formation techniques., Design and Methods: An Advisory Council (AC) shaped the project around a series of key clinical questions, performed a systematic search for evidence and graded the available evidence according to the Scottish Intercollegiate Guidelines Network (SIGN). A list of clinical questions was mailed to each of 10 senior hematologists composing the Expert Panel (EP): the panelists were asked to rank the most relevant questions, and to formulate answers to the questions according to the tables of evidence. A scenario phase followed, so as to reach a consensus on the three top ranked questions. The EP was asked to score patient profiles as appropriate or not appropriate for the therapeutic strategy under scrutiny, according to the RAND technique. Finally, from September 2001 to January 2002, four Consensus Conferences conducted according to the Nominal Group Technique were held in Milan, Italy. The overall goal of the conferences was to take a final decision upon the appropriateness of the uncertain scenarios and of the uncertain responses to the clinical questions., Results: Evidence was judged sufficient for providing recommendations on the use of allogeneic stem cell transplantation, leukemia-like chemotherapy, autologous stem cell transplantation, low-dose chemotherapy, danazol, immunosuppressive therapy, hypomethylating agents and hematopoietic growth factors. Specific recommendations for supportive therapy, including iron chelation, were issued. Allogeneic stem cell transplantation was unanimously considered as the only curative treatment for MDS patients, and recommendations on its use were agreed based on patient's age, risk, clinical features and donor availability. AML-like chemotherapy was also considered a valuable therapeutic option for subsets of MDS patients. Autologous stem cell transplantation was recommended for patients who lack an HLA identical donor and have achieved complete remission with AML-like chemotherapy. Decitabine, recombinant human erythropoietin and immunosuppressive therapy were judged valuable therapeutic options for subsets of MDS patients whereas low-dose cytarabine was not. Specific therapeutic strategies for those subjects younger than 18 years or older than 75 years and the strategy of watchful waiting were decided by patient-oriented questions., Interpretation and Conclusions: Using evidence and consensus, recommendations for the treatment of MDS were issued. Statements were graded according to the strength of the supporting evidence and uncertainty was explicitly declared.
- Published
- 2002
34. Myelodysplastic syndromes: recent advances.
- Author
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Alessandrino EP, Amadori S, Cazzola M, Locatelli F, Mecucci C, Morra E, Saglio G, Visani G, and Tura S
- Subjects
- Age Factors, Antineoplastic Agents therapeutic use, Combined Modality Therapy trends, Cytogenetic Analysis, Hematopoietic Stem Cell Transplantation, Humans, Myelodysplastic Syndromes classification, Myelodysplastic Syndromes epidemiology, Myelodysplastic Syndromes etiology, Myelodysplastic Syndromes therapy
- Published
- 2001
35. Quantitative analysis of Fas and bcl-2 expression in hematopoietic precursors.
- Author
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Maurillo L, Del Poeta G, Venditti A, Buccisano F, Battaglia A, Santinelli S, Caravita T, Epiceno AM, Del Moro B, Tamburini A, Picardi A, Suppo G, Catalano G, Bruno A, and Amadori S
- Subjects
- Adult, Antigens, CD34 analysis, Blood Cells immunology, Blood Cells metabolism, Bone Marrow Cells immunology, Bone Marrow Cells metabolism, Fetal Blood cytology, Fetal Blood immunology, Fetal Blood metabolism, Hematopoietic Stem Cells immunology, Humans, Leukemia, Lymphoid pathology, Proto-Oncogene Proteins c-bcl-2 metabolism, fas Receptor metabolism, Hematopoietic Stem Cells metabolism, Proto-Oncogene Proteins c-bcl-2 biosynthesis, fas Receptor biosynthesis
- Abstract
Background and Objectives: We investigated the expression of bcl-2 and CD95 (Apo1-/Fas) on CD34+ cells obtained from bone marrow (BM), mobilized peripheral blood (MPB), and umbilical cord blood (UCB) samples. The expression of bcl-2 and Fas was then compared with that of other markers usually associated with immaturity; functional tests using the agonistic antibody anti- Fas CH11 were also carried out., Design and Methods: The analysis was performed by flow cytometry on purified CD34+ cells in a three (CD95 PE, CD34 APC and CD71 FITC) and in a four (CD38 PE, HLA-DR PerCP, CD34 APC and bcl-2 FITC) fluorescence assay., Results: The results were expressed as mean fluorescence index (MFI); bcl-2 expression was significantly higher (p < 0.001) in BM (3.73 +/- 0.63) than in MPB (2.47 +/- 0.39) and UCB (2.38 +/- 0.58); Fas was significantly less expressed (p < 0.001) in UCB (1.27 +/- 0.78) than in MBP (3.63 +/- 2.19) and BM (4.56 +/- 1.69). CD34 expression was significantly (p < 0.001) brighter in UCB compared to in MBP and BM, while CD38 and CD71 were significantly (p = 0.005 and p < 0.001, respectively) more expressed in BM than in MPB and UCB. Fas values were directly correlated to CD38; both Fas and bcl-2 were directly related to CD71 and inversely to CD34. Culture assays showed that hematopoietic precursor cells from BM, MPB and UCB had a low susceptibility to undergo Fas-mediated apoptosis., Interpretation and Conclusions: In conclusion, bcl-2 and Fas are less expressed in UCB than in MPB and BM; early hematopoietic precursor cells are relatively resistant to CD95-triggered apoptosis; the observed correlation between Fas/bcl-2 and markers of immaturity suggests that they may be determinants of commitment in early hematopoietic precursors.
- Published
- 2001
36. DHAP treatment: results of 18 patients with refractory or recurrent non Hodgkin's lymphoma.
- Author
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Martelli M, Cimino G, Gastaldi R, Mantovani L, Sgadari C, Amadori S, and Guglielmi C
- Subjects
- Adolescent, Adult, Cisplatin administration & dosage, Cytarabine administration & dosage, Dexamethasone administration & dosage, Humans, Middle Aged, Recurrence, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Lymphoma, Non-Hodgkin drug therapy
- Published
- 1990
37. Acute promyelocytic leukemia: clinical aspects and results of treatment in 62 patients.
- Author
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Petti MC, Avvisati G, Amadori S, Baccarani M, Guarini AR, Papa G, Rosti GA, Tura S, and Mandelli F
- Subjects
- Acute Disease, Adolescent, Adult, Aged, Child, Child, Preschool, Daunorubicin administration & dosage, Female, Humans, Leukemia, Myeloid, Acute pathology, Male, Middle Aged, Remission Induction, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Daunorubicin therapeutic use, Leukemia, Myeloid, Acute drug therapy
- Published
- 1987
38. Treatment of acute nonlymphoid leukaemia with five different schedules including cytosine arabinoside and 6-thioguanine.
- Author
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Mandelli F, Amadori S, De Luca AM, Deriu L, De Rossi G, Isacchi G, Mariani G, Monarca B, Papa G, and Di Giovanni F
- Subjects
- Adolescent, Adult, Aged, Antineoplastic Agents administration & dosage, Asparaginase therapeutic use, Child, Child, Preschool, Daunorubicin therapeutic use, Drug Therapy, Combination, Female, Humans, Male, Middle Aged, Vincristine therapeutic use, Antineoplastic Agents therapeutic use, Cytarabine therapeutic use, Leukemia drug therapy, Thioguanine therapeutic use
- Published
- 1977
39. Flow cytometric measurement (H-1 Technicon) of microcytic and hyperchromic red cell populations in pediatric patients affected by hereditary spherocytosis (HS).
- Author
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Ialongo P, Vignetti M, Cigliano G, Amadori S, and Mandelli F
- Subjects
- Child, Erythrocyte Indices, Humans, Spherocytosis, Hereditary surgery, Splenectomy, Erythrocytes pathology, Flow Cytometry, Spherocytosis, Hereditary blood
- Abstract
In 7 splenectomized and 21 non splenectomized pediatric patients with hereditary spherocytosis (HS), red cell size and hemoglobin concentration distribution (erythrograms) demonstrated the size and chromia degree of red cell populations. The H-1 Technicon graphic reports obtained in the analysis of HS blood showed a remarkable shift of the Hb concentration histograms to the right end of the x-axis, revealing the presence of a high percentage of hyperchromic red cells. The opposite shift was noted for volume histograms. Graphic findings were quantitated by a computerized program of the H-1 Technicon system. These data have enabled us to determine the percentage of microcytic and normocytic hyperchromic RBC. In particular, non splenectomized HS patients showed an increase in microcytic and hyperchromic RBC twice as high as that of splenectomized patients (data computed by erythrograms). Moreover, there is a significant difference (5.6%, p less than 0.01) between splenectomized and non splenectomized patients in the microcytic hyperchromic RBC percentage (data computed by special volume/hemoglobin concentration mapping).
- Published
- 1989
40. Treatment of acute nonlymphocytic leukemia (ANLL) in elderly patients. Results of a multicentric study.
- Author
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Mandelli F, Amadori S, Fabiani F, Grignani F, Liso V, Martelli M, Neri A, Petti MC, and Tonato M
- Subjects
- Acute Disease, Cytarabine therapeutic use, Drug Therapy, Combination, Female, Humans, Male, Middle Aged, Remission, Spontaneous, Thioguanine therapeutic use, Aged, Leukemia drug therapy
- Published
- 1979
41. Methotrexate followed by L-asparaginase for the treatment of acute non lymphoid leukemia.
- Author
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Tribalto M, Amadori S, Avvisati G, Del Bianco P, Franchi A, Gallerano T, Papa G, and Mandelli F
- Subjects
- Acute Disease, Adolescent, Adult, Aged, Drug Administration Schedule, Drug Evaluation, Female, Humans, Male, Middle Aged, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Asparaginase administration & dosage, Leukemia drug therapy, Methotrexate administration & dosage
- Published
- 1985
42. Splenectomy in early chronic myeloid leukaemia: preliminary report on 37 cases.
- Author
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Tura S, Baccarani M, Mandelli F, Amadori S, Cajozzo A, di Marco P, Panzacchi G, Cacciola E, Musso R, Alberti A, Magro S, Rossi Ferrini P, Leoni F, Salti F, Basetta E, Monfardini S, Buonanno G, Rizzoli V, Carnevali C, Lucarelli G, Porcellini A, Torlontano G, and Fioritoni G
- Subjects
- Adolescent, Adult, Blood Cell Count, Blood Platelets, Cytarabine therapeutic use, Death, Drug Therapy, Combination, Hematopoiesis, Hemoperitoneum etiology, Humans, Hydroxyurea therapeutic use, Leukocyte Count, Middle Aged, Organ Size, Pleural Effusion etiology, Pneumonia etiology, Prednisone therapeutic use, Pyelonephritis etiology, Spleen pathology, Subphrenic Abscess etiology, Thrombocytosis etiology, Thrombophlebitis etiology, Vincristine therapeutic use, Leukemia, Myeloid surgery, Splenectomy adverse effects
- Published
- 1974
43. Late intensification therapy for childhood acute lymphocytic leukemia.
- Author
-
Meloni G, Mandelli F, Aloe Spiriti MA, Giona F, and Amadori S
- Subjects
- Child, Child, Preschool, Cytarabine administration & dosage, Humans, Long-Term Care, Recurrence, Thioguanine administration & dosage, Leukemia, Lymphoid drug therapy
- Published
- 1982
44. Clinical and biological aspects of acute monocytic leukemia (a retrospective study of 29 patients).
- Author
-
Petti MC, Amadori S, Annino L, Arcese W, Avvisati G, Di Lorenzo A, Gastaldi R, and Mandelli F
- Subjects
- Adolescent, Adult, Aged, Bone Marrow pathology, Cell Transformation, Neoplastic, Child, Daunorubicin administration & dosage, Female, Humans, Leukemia, Monocytic, Acute drug therapy, Leukemia, Monocytic, Acute genetics, Male, Middle Aged, Retrospective Studies, Leukemia, Monocytic, Acute diagnosis
- Published
- 1982
45. Human acute myelogenous and lymphoid leukemias: pattern of expression of cellular oncogenes.
- Author
-
Sposi NM, Mavilio F, Petrini M, Bottero L, Zappavigna V, Mastroberardino G, De Rossi G, Amadori S, Mandelli F, and Peschle C
- Subjects
- Humans, Proto-Oncogene Proteins isolation & purification, Leukemia, Lymphoid genetics, Leukemia, Myeloid, Acute genetics, Proto-Oncogene Proteins genetics, Proto-Oncogenes
- Published
- 1987
46. [Red cell metabolism in premature infants (author's transl)].
- Author
-
Papa G, De Laurenzi A, Amadori S, Anselmo AP, Cesaria R, and De Laurenzi A
- Subjects
- Acetylcholinesterase metabolism, Clinical Enzyme Tests, Erythrocytes enzymology, Fructose-Bisphosphate Aldolase metabolism, Glutathione Reductase metabolism, Humans, Infant, Newborn, L-Lactate Dehydrogenase metabolism, Malate Dehydrogenase metabolism, Phosphofructokinase-1 metabolism, Phosphopyruvate Hydratase metabolism, Pyruvate Kinase metabolism, Erythrocytes metabolism, Infant, Premature
- Published
- 1975
47. Combination chemotherapy of unfavourable prognosis non-Hodgkin's lymphomas (NHL). A retrospective study of 53 cases.
- Author
-
Mandelli F, Biagini C, Baroni CD, Bosman C, Alimena G, Anselmo AP, De Luca AM, Maurizi Enrici R, Petti N, Amadori S, and Papa G
- Subjects
- Adolescent, Adult, Aged, Child, Child, Preschool, Drug Therapy, Combination, Female, Humans, Lymphoma pathology, Lymphoma, Large B-Cell, Diffuse drug therapy, Lymphoma, Non-Hodgkin drug therapy, Male, Middle Aged, Neoplasm Staging, Prognosis, Antineoplastic Agents administration & dosage, Lymphoma drug therapy
- Published
- 1981
48. Growth kinetics of minimal tumour masses: implications for rational chemotherapy.
- Author
-
Pileri A, Boccadoro M, Mandelli F, and Amadori S
- Subjects
- Cell Division drug effects, Drug Synergism, Humans, Leukemia drug therapy, Leukemia, Lymphoid drug therapy, Multiple Myeloma drug therapy, Antineoplastic Agents administration & dosage, Neoplasms drug therapy
- Published
- 1981
49. Long-term survival in adult acute leukemia. A multicenter study of 56 patients.
- Author
-
Tura S, Gobbi M, Cavo M, Bachetti G, Mandelli F, Amadori S, Petti MC, Quattrin N, De Rosa L, Storti E, Rizzo SC, Bernasconi C, Salvaneschi L, Paolino W, Infelise V, Dini E, Barbui T, Bruzzese L, Abbadessa A, Martelli MF, and Rambotti P
- Subjects
- Adolescent, Adult, Age Factors, Aged, Child, Drug Therapy, Combination, Female, Humans, Leukemia drug therapy, Leukemia, Lymphoid drug therapy, Leukemia, Lymphoid mortality, Leukemia, Myeloid, Acute drug therapy, Leukemia, Myeloid, Acute mortality, Male, Middle Aged, Prognosis, Leukemia mortality
- Published
- 1982
50. Third-line chemotherapy with CAVP (CCNU, melphalan, etoposide and prednisone) in refractory Hodgkin's disease.
- Author
-
Cartoni C, Cimino G, Anselmo AP, Amadori S, and Mandelli F
- Subjects
- Adolescent, Adult, Aged, Etoposide administration & dosage, Humans, Lomustine administration & dosage, Melphalan administration & dosage, Middle Aged, Prednisone administration & dosage, Recurrence, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Hodgkin Disease drug therapy
- Abstract
Thirty-one patients affected by recurrent Hodgkin's disease have been treated with an oral combination chemotherapy including lomustine (CCNU 90 mg/sqm, on day 1), melphalan (Alkeran, 7.5 mg/sqm on days 1-5), etoposide (VP-16, 100 mg/sqm on days 6-10) and prednisone (40 mg/sqm on days 1-10). MOPP and ABVD regimens administered sequentially or in alternating fashion had been employed as first choice treatment. The majority of patients had extranodal (80%) and a progressive disease resistant to previous chemotherapy (80%). Complete and partial remission were induced in 8 (26%) and 5 patients (16%), respectively, with an overall response rate of 42%. Median duration of complete remission was 10 months. Patients who did not respond to previous chemotherapies had a significantly lower complete response rate (16%). Myelosuppression was the most frequent complication, with one patient dying of a thrombocytopenic hemorrhage. The oral administration of drugs allowed good patients', compliance with treatment. CAVP is an effective regimen in the management of patients with refractory Hodgkin's disease and the results obtained are comparable with other third-line chemotherapies.
- Published
- 1989
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