5 results on '"Crippa, C."'
Search Results
2. What is the best treatment strategy before autologous peripheral blood stem cell transplantation in POEMS syndrome?
- Author
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Autore F, Bramanti S, Lessi F, Innocenti I, Galli E, Rocchi S, Ribolla R, Derudas D, Oliva S, Stefanoni P, Marcatti M, Schenone A, La Nasa G, Crippa C, Zamagni E, Riva M, Mazza R, Mannina D, Sica S, Bacigalupo A, and Laurenti L
- Subjects
- Humans, Transplantation, Autologous, Autografts, Cyclophosphamide therapeutic use, Peripheral Blood Stem Cell Transplantation, POEMS Syndrome diagnosis, POEMS Syndrome therapy
- Abstract
Autologous peripheral blood stem cell transplantation (aPBSCT) provides optimal outcomes in POEMS syndrome but the definition of the best treatment before aPBSCT remains to be defined because of the rarity of the disease and the heterogeneity of published case series. We collected clinical and laboratory data of patients with POEMS syndrome undergoing aPBSCT from 1998 to 2020 in ten Italian centers. The primary endpoint of the study was to evaluate the impact of prior therapies and mobilization regimen on outcome. We divided the patients into three groups: patients who did not receive any treatment before transplant (15 patients, group A: front-line), patients pre-treated with other agents (14 patients, group B) and patients treated with cyclophosphamide as their mobilizing regimen (16 patients, group C). The three groups did not show differences in terms of demographic and clinical characteristics. All 45 patients underwent aPBSCT after a high-dose melphalan conditioning regimen, with a median follow-up of 77 months (range, 37-169 months). The responses were not statistically different between the three groups (P=0.38). Progression-free and overall survival rates at 6 years were: 70% (95% confidence interval: 55-85%) and 91% (95% confidence interval: 82-99) 65%, respectively, and did not differ between the three groups. The cumulative incidence of transplant-related mortality and relapse was 4% and 36%, respectively. In conclusion, in a relatively large number of patients with POEMS syndrome, undergoing an autologous transplant, pre-treatment and disease status at transplant did not appear to have an impact on major transplant outcomes.
- Published
- 2024
- Full Text
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3. Feasibility and outcome of tandem stem cell autotransplants in multiple myeloma.
- Author
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Galli M, Nicolucci A, Valentini M, Belfiglio M, Delaini F, Crippa C, Barbui AM, Giussani U, Rambaldi A, and Barbui T
- Subjects
- Adult, Aged, Antineoplastic Combined Chemotherapy Protocols administration & dosage, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Case Management, Cohort Studies, Combined Modality Therapy, Cyclophosphamide administration & dosage, Dexamethasone administration & dosage, Disease Progression, Doxorubicin administration & dosage, Feasibility Studies, Female, Follow-Up Studies, Granulocyte Colony-Stimulating Factor pharmacology, Hematopoietic Stem Cell Mobilization, Humans, Life Tables, Male, Melphalan administration & dosage, Melphalan pharmacology, Middle Aged, Multiple Myeloma drug therapy, Multiple Myeloma mortality, Multiple Myeloma radiotherapy, Prednisone administration & dosage, Survival Analysis, Thalidomide administration & dosage, Transplantation, Autologous, Treatment Outcome, Vincristine administration & dosage, Whole-Body Irradiation, Multiple Myeloma surgery, Peripheral Blood Stem Cell Transplantation methods
- Abstract
Background and Objectives: Clinical trials have shown that high dose chemotherapy (HDT) with peripheral stem cell autotransplantation is presently the best treatment for patients with symptomatic multiple myeloma (MM). In the context of an outcomes research project, we analyzed the feasibility of this strategy in clinical practice in a large cohort of consecutive, unselected patients with newly diagnosed MM and looked at the major determinants of response of patients enrolled in a HDT with tandem autotransplantation (Total Therapy I, TTI) program., Design and Methods: Two hundred and fourteen patients were treated outside of a clinical trial and regularly followed-up at our Center for symptomatic MM. Ninety-seven patients (45%) received conventional chemo-radiotherapy regimens, 110 (51%) entered the TTI program and the remaining 7 patients (3.3%) were enrolled in other programs involving HDT with autotransplantation., Results: Patients enrolled in HDT with tandem autotransplantation programs were 14 years younger and less likely to have co-morbidities than patients treated with conventional therapy. Median overall survivals of the two groups were 60 and 33 months, respectively. Thirteen percent of the patients enrolled in the TTI program did not receive the first HDT with autotransplantation, mostly because of disease progression, and another 16% did not proceed to the second HDT with autotransplantation mainly because of infections or drug-related complications. Most patients achieved complete remission after the second autotransplantation, with acceptable toxicity. However, only patients with a major reduction of the myeloma burden at the end of induction therapy enjoyed significantly prolonged event-free and overall survivals., Interpretation and Conclusions: Approximately one third of patients with newly diagnosed symptomatic MM completed the TTI program. These data suggest the need to improve the induction therapy in order to increase both the number of patients able to proceed to autotransplantation programs and to enhance the rate of early response.
- Published
- 2005
4. The development of more than one histologic type of lymphoma in the same patient is frequent and confers a worse prognosis.
- Author
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Tucci A, Motta M, Ungari M, Ruggeri G, Crippa C, Borlenghi E, Ubiali A, Facchetti F, and Rossi G
- Subjects
- Humans, Incidence, Lymph Nodes pathology, Lymphoma classification, Neoplasms, Second Primary classification, Prognosis, Retrospective Studies, Lymphoma diagnosis, Neoplasms, Second Primary diagnosis
- Abstract
Background and Objectives: Distinct types of lymphoma may develop in the same patient either simultaneously or sequentially. The frequency and clinical significance of this phenomenon are still only partially known., Design and Methods: We conducted a retrospective analysis of all cases of lymphomas of different histology occurring in the same patient, denoting these cases as multiple histology lymphoma (MHL). The clinicopathologic characteristics of these cases were compared with those of cases with a single histology (SHL). The histologic classifications were made according to the REAL classification by the same pathologists throughout the study period., Results: MHL were identified in 46 of 347 (13%) consecutive cases of lymphoma diagnosed at a single institution. They presented more frequently in stage III-IV (p=0.008), but the age, sex, and IPI score of patients with MHL did not differ from those of patients with SHL. Small lymphocytic/lymphoplasmacytic subtype was more frequent (16.1% vs 3%, p<0.0001) and Hodgkin's lymphoma (4% vs 16%; p=0.004) less frequent in MHL. Response rates to treatment were similar (85% vs 77.5%), whereas 5-year overall survival was significantly lower for MHL than for SHL (31% vs 67%; p=0.015). Among MHL, 14 cases were diagnosed simultaneously and 32 sequentially, after a median of 18 months. The two subgroups with simultaneous and sequential presentation did not differ in their demographic, clinicopathologic or prognostic characteristics., Interpretation and Conclusions: Lymphomas of different histology develop frequently in the same patient, either simultaneously or sequentially. Patients with MHL form a subgroup with few peculiar presenting clinicopathologic features but a markedly worse prognosis, thus warranting prospective biological and clinical studies.
- Published
- 2005
5. Recombinant human erythropoietin and the risk of thrombosis in patients receiving thalidomide for multiple myeloma.
- Author
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Galli M, Elice F, Crippa C, Comotti B, Rodeghiero F, and Barbui T
- Subjects
- Adult, Aged, Aged, 80 and over, Anticoagulants therapeutic use, Antineoplastic Agents pharmacology, Antineoplastic Agents therapeutic use, Drug Synergism, Erythropoietin pharmacology, Erythropoietin therapeutic use, Female, Humans, Male, Middle Aged, Multiple Myeloma complications, Recombinant Proteins, Risk, Thalidomide pharmacology, Thalidomide therapeutic use, Thrombosis epidemiology, Thrombosis etiology, Thrombosis prevention & control, Venous Thrombosis chemically induced, Venous Thrombosis epidemiology, Venous Thrombosis etiology, Venous Thrombosis prevention & control, Warfarin therapeutic use, Antineoplastic Agents adverse effects, Erythropoietin adverse effects, Multiple Myeloma drug therapy, Thalidomide adverse effects, Thrombosis chemically induced
- Abstract
Among 199 patients treated with thalidomide for multiple myeloma, four thromboses occurred in 49 cases during erythropoietin therapy (prevalence 8.1%; annual rate 7.25%), and another 14 events occurred in patients not on erythropoietin (9.3%; 7.56%). Thus, erythropoietin would seem not to increase the risk of thrombosis of myeloma patients receiving thalidomide.
- Published
- 2004
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