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Nature conservation has often been depicted as an effective policy measure to redress the ongoing environmental problems across the globe. The need to ensure sustainability for people’s secured subsistence has rendered nature conservation an indispensable scheme in the tourism development policy. It is evident that during the last couple of decades, the notion of “conservation” has become less established whilst tourism development has been prioritised as a profit making venture by both the national and international agencies. Numerous solutions have been prescribed by international organisations adopting tourism as an “immense potentiality” which mostly represented a sustainability effort for the local development and environment. South Asia in general and Bangladesh, in particular, are no different, since policy for nature conservation has been misplaced and misread to reach sustainability goals, as it has always been connected with the tourism development agenda. From a systematic literature review, it was found that the use of natural resources by local people was exemplified as a threat to sustainability where the relations between conservation and tourism became a policy issue. The paper intends to problematise the mechanism of tourism policies for nature conservation or conservation policies for tourism development that overlooks the local eco-cultural management practice for sustainability. Along with the environmental discourses, an eco-cultural critique on sustainability was employed.

After decades of emergency initiatives and a widespread institutional disengagement, in 2012, Italy adopted the National Strategy for the inclusion of Roma, Sinti and Caminanti communities, which o...

The appropriation of nature under current capitalist conditions implies the intensification of processes of exploitation of labour, dispossession of peasants’ lands, indiscriminate extracti...

Partendo da un discorso generale sull’ambiguo rapporto tra politiche neoliberali, questione abitativa e segregazione in Europa, prendiamo in considerazione il caso italiano, esaminando in primo luogo le caratteristiche del welfare abitativo per metterne in luce le variabili rilevanti nella spiegazione dei fenomeni di segregazione. Ci focalizziamo infine sul caso milanese, con un’analisi dei processi di segregazione e delle limitate e ambivalenti risposte pubbliche, interpretate sempre alla luce del discorso neoliberale sulla citta impostosi negli ultimi anni.

The evaluation of the quality of health services has become a topic of crucial importance in public policy and in the socio-health organizations called to play a proactive and participatory role in the process of innovation and improvement of their caring work. In this paper we present a research project evaluation, through the discussion of a case study carried out in a residence for elderly people, the objectives of which concerned two different levels of operation: the identification of indicators for the continuous development of the quality and the creation of effective tools for selfevaluation.

I Contratti di quartiere sono progetti integrati di recupero urbano indirizzati a quartieri caratterizzati da diffuso degrado delle costruzioni, da carenze di servizi e da scarsa coesione sociale. Gli interventi previsti hanno contenuto urbanistico e sociale e sono realizzati predisponendo forme di partecipazione dei residenti. L'articolo esamina i limiti di questo tipo di intervento considerando gli aspetti legati alla prassi di governo (difficoltŕ nel coinvolgimento dei residenti), e si interroga sull'effettiva capacitŕ di promuovere attraverso questo tipo di azione percorsi di inclusione sociale, il rischio č infatti quello di confinare a livello locale le cause dell'esclusione sociale, perdendo cosě di vista il contesto piů ampio sia a livello macroeconomico che macrosociale.

Primary lymphomas of the breast (PBNHL) are uncommon. Magnetic resonance imaging (MRI) features of these malignancies can be relevant in establishing the extent of disease and planning the appropriate therapeutic strategy, usually represented by chemo- and radiotherapy, rather than surgery. The purpose of this study was to assess MRI features of PBNHL.MRI examinations performed on seven patients with known PBNHL were retrospectively evaluated. Lesions were analysed for both morphology and kinetics and classified according to the Breast Imaging Reporting and Data System (BI-RADS) categories.The mean MRI maximum diameter was 44 mm (range 12-69). Six lesions showed a mass-like enhancement; one lesion showed a non-mass-like enhancement. For mass-like lesions, kinetic curve assessment of initial rise showed slow enhancement in one lesion, rapid enhancement in four lesions and medium enhancement in one lesion. Assessment of delayed enhancement showed plateau in five lesions and washout in one lesion. MRI BI-RADS categories were distributed as follows: one BI-RADS II, one BI-RADS III, three BI-RADS IV and two BI-RADS V.MRI features of primary breast lymphomas in this study cohort suggest that the occurrence of a PBNHL should be considered in the presence of large enhancing lesions of the breast, especially if associated with skin thickening. MRI may also have an important role in the assessment of response to therapy and diagnosis of recurrence.

Summary Background Thalidomide, as a single agent, has been recently found to induce a clinical response in one third of refractory or relapsed myeloma patients. Although it has been reported that thalidomide significantly inhibits angiogenesis, it is still unclear whether its clinical effect is mediated, at least in part, by its anti-angiogenic properties. Patients and methods We evaluated thalidomide as a single agent in myeloma, myelodysplastic syndromes (MDS) and histiocytosis, i.e. hematological diseases characterized by increased angiogenesis, and measured prospectively a number of surrogate angiogenesis markers. Results Clinical responses were observed in 7 of 17 myeloma and 2 of 5 MDS patients. The histiocytosis patient had a partial response. At the time of the best clinical response, plasma levels of angiogenic growth factors, vascular endothelial growth factor (VEGF) and basic-fibroblast growth factor (b-FGF), were significantly decreased, and flow cytometry indicated a decrease of activated endothelial cells in the bone marrow of responding MDS patients. Conclusions These observations confirm thalidomide efficacy in myeloma, suggest a possible use in MDS and histiocytosis and may contribute to the prediction of clinical response and to understanding the mechanism of thalidomide’s action.

The slow component of the output pulse of Semi-Insulating (SI) Gallium Arsenide (GaAs) particle detectors, which affects charge collection efficiency (cce), has been generally attributed to trapping/detrapping effects. However, most of the detectors analyzed in the literature can only be operated below the voltage V/sub d/ necessary to extend the electric field all the way to the ohmic contact, making difficult to distinguish between the effect of the non-active part of the detector and that of trapping/detrapping. To do that, we have carefully analyzed the output signals of SI GaAs detectors, operated below and above V/sub d/ and irradiated with /sup 241/Am /spl alpha/ particles. When the detector is biased below V/sub d/ the output signals are affected also by the non-active part of the detector itself, while, when the detector is operated above V/sub d/, the output signals are only affected by trapping/detrapping of charge carriers. We found that trapping/detrapping is only relevant for the hole contribution to the signal. Trapping/detrapping effects are in agreement with the characteristics of deep levels present in the detectors as analyzed by means of PICTS (Photo Induced Current Transient Spectroscopy) and P-DLTS (Photo Deep Level Transient Spectroscopy).

Observations have been made of the behaviour of high resistivity silicon and semi-insulating gallium arsenide ionizing radiation detectors after exposure of up to 30 Mrad 60 Co photons. Results are presented on leakage current and deep level defects of the substrate material of photon damage devices. These findings have been related to the charge collection efficiency of the detectors.

In recent papers, we have investigated, within the context of the RD-8 experiment, the behaviour as a function of bias of the active region of particle detectors made by Alenia SpA on semi-insulating liquid encapsulated Czochralski gallium arsenide: the active region width depends linearly on the bias voltage. The diodes were found to break down as soon as the field reached the back ohmic contact. This suggested that the ohmic contact was injecting holes into the diode, therefore we have decided to develop a new, non-injecting, non-alloyed ohmic contact. This new contact allows us to go far beyond, five times, the voltage bias necessary to have a fully active detector. The higher voltage reached by the detectors helps us improve the charge collection efficiency, up to more than 95% for alphas and more than 90% for beta (mips) particles and X-rays, giving a more stable operation of the detectors. For the first time we can explore the characteristics of a GaAs detector beyond the voltage needed for it to be completely active.

In a recent paper, it was described how semi-insulating (SI) liquid encapsulated Czochralski (LEC) gallium arsenide particle detectors made by Alenia SpA have been tested and found to be understandable in terms of one function: the local charge collection efficiency. We have now measured, always within the context of the RD8 experiment, the local charge collection efficiency for these diodes using a technique called OBIC (optical beam induced current) and derived the active region width ( W ) as a function of bias in a range of values lower than those obtainable with particles. Using data both from OBIC and from the previous paper, W is found to behave approximately linearly as a function of bias larger than about 50 V. Below this value, W follows a square root law as a function of bias.

VAD, (Vincristine, Doxorubicin and Dexamethasone) was initially proposed as a salvage therapy for myeloma patients in whom prior alkylating agent therapy failed, although in recent years VAD has been surpassed by novel combination therapies with new biological agents such as thalidomide (and its derivative, lenalidomide) and bortezomib. After the excellent results obtained by the novel agents, VAD can no longer be proposed in preparation to autologous transplantation, although there are still indications that VAD remains useful and clinically relevant in the initial treatment of symptomatic multiple myeloma.

This study was an evaluation of the psychomotor profiles of 22 schizophrenic patients, investigated by means of a test battery developed for the assessment of psychomotor profiles of 10- to 12-year-old children. Analysis indicates chat abnormal psychomotor development is an inherent feature of the disease and probably is antecedent to a full psychopathological picture.

Aims. Diffuse large B-cell lymphomas (DLBCL) can be divided into different subgroups (germinal center B-cell-like [GCB] and non-GCB) according to their gene expression profiles. Immunohistochemistry has been proposed as a surrogate for identifying these subgroups, but data about its efficacy in providing prognostic information are conflicting. Methods and results. This study retrospectively analyzed a series of 105 DLBCL, defined as GCB and non-GCB according to CD10, bcl-6, and MUM1 expression. All patients received a first-line anthracycline-based (CHOP-like) chemotherapy. A total of 50 patients (48%) were identified as GCB and 55 (52%) as non-GCB. The overall response rate was 89% (94/105), with 62 (59%) complete response. Disease progressions were equally distributed between the 2 subgroups and were not significantly different ( P = .756) considering the primary site of involvement (nodal or extranodal). The median follow-up was 62 months (range 5-126 months). Overall survival at 5 years was not significantly different between the groups ( P = .3468) and was 72.3% and 66.6% for GCB and non-GCB, respectively. Conclusion. The results do not support the prognostic value of GCB and non-GCB immunohistochemical categories in DLBCL of both nodal and extranodal origin. Furthermore, a limited number of antigens may be not sufficient to identify the same patterns defined by cDNA microarray. Prospective studies are warranted to address this issue.

Summary Background The aim of this study was to assess clinicopathological characteristics and outcome in a series of primary ocular adnexal lymphomas (POALs). Patients and methods Nineteen patients with localised (stage IE) POAL were followed for a median of 96 months (24–156). The diagnosis was based on surgical biopsies followed by immunohistochemistry in 16 cases or fine-needle aspiration followed by immunocytophenotypic analysis in three cases. Twelve patients were treated with local radiotherapy (RT), five with chemotherapy (CT), and two refused further therapy after apparently radical tumour removal achieved by the diagnostic excisional biopsy. Results The histological and immunological pattern was consistent with a diagnosis of MALT-type lymphoma (11 cases), follicular center non-Hodgkin’s lymphoma (three cases), a large-cell variant of Burkitt’s lymphoma (one case), and large-cell transformed MALT lymphoma (one case). Low-grade lymphoma was diagnosed in the three cases which underwent fine-needle aspiration biopsy. All of the patients achieved and maintained complete remission except for those treated with surgical excision alone (two MALT conjunctival lymphoma cases): one of these relapsed locally, the other experienced the systemic spread of a transformed diffuse large-cell lymphoma and died 72 months after diagnosis. The side effects consisted of two cases of RT-related cataract after 52 and 72 months. Conclusions Regardless of histology, prognosis was excellent when surgery plus RT was adopted, and CT seems to be a valid alternative to RT. Surgery alone may be sub-optimal.

We report on the performance and limitations of a 7 mm2, 100 μm thick SI LEC GaAs detector, operated in overdepleted conditions with applied bias of 400 V at 20°C and −30°C, in detecting X- and γ-rays. At 20°C performance is limited to a charge collection efficiency of 92% and to an energy resolution of about 16.8 keV FWHM on the 59.5 keV line of 241Am. At −30°C the charge collection efficiency is 85% and a resolution in between 1.8 and 2.2 keV FWHM in the photon energy range 8–60 keV has been achieved. The latest data represent to our knowledge the best ones yet reported for GaAs LEC detectors.

A procedure for the evaluation of the depletion region width of a Schottky barrier diode made on semi-insulating materials has been assessed and applied to gallium arsenide nuclear detectors. This procedure, which makes use of the optical beam induced current method of charge collection scanning microscopy, allows the direct measurement of the depletion layer width. By taking into account the high resistivity of the material under examination and measuring the diode reverse current, it is possible to evaluate the actual voltage applied at the depletion layer boundaries. It was found that, at low actual bias values, the voltage dependence of the depletion layer follows the usual square root power law, while at increasing voltages, it changes into a linear behavior. An explanation in terms of deep trap effect and trap field-enhanced capture cross-section is proposed even though further work must be done to explain the space charge width dependence on bias applied in terms of the deep trap influence.

Semi-insulating gallium arsenide has been irradiated by protons and by gamma-rays with different doses. The irradiation-induced deep level defects have been investigated by current transient spectroscopy to find their energy, capture cross sections and generation rate.Two electron traps at Ec+0.14eV(E13) and Ec-0.70eV(E4) and a hole trap at Ec-0.14eV(H2) in addition to the levels existing before the irradiation have been detected in the irradiated samples. These findings have been related to the performance of gallium arsenide charge particle detectors.

Abstract 3956 Background: Recently in large randomized studies, the addition of Rituximab to standard chemotherapy in the first-line treatment of follicular lymphoma (FL) demonstrated improvements in long-term outcome in FL. Methods: We compared the outcome of 111 naive FL patients (pts) treated at our institution from 1995 to 2009 with a single alkylating agent in combination or not with Rituximab: 58 pts received Chlorambucil plus Rituximab (R-Chl) and 53 pts Chlorambucil and prednisone (Chl+PDN). The 2 schedules included an induction phase, where Chlorambucil was given at 6mg/mq for 6 consecutive weeks in both groups and the Rituximab in 4 weekly administrations. The maintenance phase was longer in the Chl+PDN group: Chlorambucil was administered 6mg/mq daily 14 days each month for a total of 12-months of treatment versus 14 days with monthly-Rituximab for 4 consecutive months in the R-Chl group. Results: The demographic and prognostic factors are reported in Table 1. At the end of treatment the ORR was 98% in the R-Chl pts and 77% in the Chl+PDN group, with a percentage of complete response of 79% and 55% respectively. No significant incidence of adverse events were reported and only one HBsAg positive patient in R-Chl group discontinued the therapy. One case of myelodysplastic syndrome was described in a Chl+PDN relapsed patient. With a median follow up of 34 months, the OS and the EFS in R-Chl pts is 95% and 76% respectively. Otherwise, with a median observation time of 82 months in the Chl+PDN group 73% are alive and only 28% of pts maintained the response. The median time to subsequent therapy (TTST) is 21 and 15 months respectively in the 2 groups. Conclusions: The addition of Rituximab to alkylating in first-line treatment in previously untreated FL pts improves significantly the EFS and prolongs the time to next antilymphoma therapy compared with alkylating alone. Because of its low toxicity profile, our combination with Rituximab and Chlorambucil could be considered a first-line therapy, especially in FL patients not eligible for aggressive chemotherapy regimens. Disclosures: No relevant conflicts of interest to declare.

Abstract 3210 Poster Board III-147 BACKGROUND High-dose chemotherapy followed by autologous Peripheral Blood Stem Cell (PBSC) transplantation represents an effective option in relapsing/refractory malignant lymphoma as well as in selected solid tumors. Collection of a sufficient amount of stem cells (CD34+ ≥ 2.0×106/kg) by apheresis is mandatory for the procedure. However many factors could influence the mobilization of PBSC and about 30% of patients eligible for this therapeutic option fail stem cell mobilization. Peripheral CD34+ counts of 20/μL is conventionally considered the cut-off for a successful collection. METHODS With the aim to identify those factors affecting PBSC mobilization, we retrospectively reviewed data about our experience at European Institute of Oncology from 01/2005 to 05/2009. By evaluating the number of CD34+cells after mobilization, patients were considered as good mobilizers (peripheral CD34+ ≥ 20/μL, group A), relative poor mobilizers (peripheral CD34+ counts 5/μL. Patients characteristics were: 140 male, 108 female; median age was 51 yrs; diagnosis included: 124 Non Hodgkin Lymphoma (NHL), 50 Hodgkin Lymphoma (HL), 35 Multiple Myeloma (MM), 5 Acute Leukemia (AL) and 33 solid tumors, 1 Chronic Lymphocitic Leukemia (CLL); mean number of previous chemotherapy lines was 1 (0-9). The main mobilization regimens in hematological patients were cyclophosphamide 4g/mq (n=118) and ESHAP either followed by G-CSF (n=27) or pegylated G-CSF (n=48); the majority of patients affected by solid tumors received ICE regimen plus G-CSF (n=26). RESULTS By evaluating the number of CD34+cells after mobilization, 163 (65.7%) patients resulted good mobilizers, 43 (17.3%) patients relative poor mobilizers and 42 (17%) patients absolute poor mobilizers. All patients in group A, 31 patients in group B (72%) and 8 patients in group C (19%) collected >2.0×106 CD34+cells/kg. According the Two-sided Fisher's exact test, more than 3 previous chemotherapy lines before mobilization (p CONCLUSIONS These results could help to identify those factors affecting PBSC mobilization. To reduce poor mobilizers we suggest to anticipate mobilization program and to evaluate the opportunity to reserve purine analogs or radioimmunotherapy after collection. About 20% of patients defined as absolute poor mobilizers might successfully mobilize PBSC by lowering the CD34+ cut-off before apheresis. Disclosures No relevant conflicts of interest to declare.

e19520 Background: The role of FDG-PET for staging and response assessment in Hodgkin lymphoma (HL) is still evolving. We report our experience with the intent of evaluate prognostic role of 18FDG-PET in terms of long term complete remission (CR). Methods: We retrospectively analysed 65 consecutive pts affected by newly diagnosed HL. Median age was 36 yrs. Histology included 50 classical and 10 lymphocyte predominance HL. According to Hasenclever index, 58 out of 65 pts were considered at low risk, 5 at intermediate and 2 at high risk. 30/65 pts showed good prognosis (defined as IA-IIA, < 3 nodal sites, ERS < 50) and received 4 cycles of VBM followed by involved field (IF) radiotherapy (RT); the remaining 35 pts received hybrid ChlVPP/ABVVP for 6 cycles followed by IF RT in case of bulky disease. All patients underwent 18FDG-PET scans at diagnosis, after the fourth cycle in the VBM group, after the third cycle in the ChlVPP/ABVVP (interim 18FDG-PET), at the end of treatment in all patients. Fisher exact test was used to compare percentages between groups. Results: CR was recorded in 60 (92%) pts. Interim 18FDG-PET was negative in 52 out of 65 pts (80%), all in CR at the end of treatment. Eight out of 13 pts with positive interim 18FDG-PET obtained a CR at the end of treatment (100% versus 62%, Fisher exact text p18FDG-PET was negative in 5 of them, positive in 1 case. Two deaths occurred, one among pts with negative and one with positive interim 18FDG-PET. After a median follow-up of 30 months, 3-year freedom from treatment failure was 83% and 62% in pts with negative and positive interim 18FDG-PET, respectively (Log-rank test p18FDG-PET demonstrate a predictive role regarding the achievement of CR and treatment failure, at least as relevant as Hasenclever index, but failed to predict clinical result in 12 (18%) pts. Its role in defining the best therapeutical approach in HL pts must be further investigated in randomized clinical trials. No significant financial relationships to disclose.

BACKGROUND: Red marrow (RM) is the critical organ in Radioimmunotherapy (RIT) with 90Y-ibritumomab tiuxetan, especially at myeloablative activities. Different methods for the evaluation of the adsorbed dose in RM have been investigated. The blood method relates the blood time-activity curve to RM by a factor that accounts for the activity concentration ratio between RM and blood. Alternative dosimetric approaches including image analysis and marrow aspirations (MA) were introduced for RM dose comparison in order to collect information about the dose delivered and to verify the correct time of Autologous Stem Cells Transplantation (ASCT). PATIENTS AND METHODS: Twenty-six patients affected by resistant/refractory B-cell Non Hodgkin Lymphoma (NHL) were enrolled in a phase I/II study to determine the feasibility and safety of High Activity (HA) of 90Y-ibritumomab tiuxetan followed by ASC support. Three 90Y-ibritumomab tiuxetan activity levels were planned: 30 MBq/kg (4 patients), 45 MBq/kg (4 patients), 56 MBq/kg (18 patients). One week before treatment all patients underwent dosimetry with 111Inibritumomab tiuxetan. The activity concentration was measured in 9 serial blood samples up to 7 days post injection (pi) and planar images in all patients, in MA in 8 out of 18 patients planned at 56 MBq/kg (4 patients at 160 h pi; 4 patients on day planned for ASCT, i.e. day 0). ASC were reinfused 13 days after 90Y-ibritumomab tiuxetan. ASCT was considered at low risk when the adsorbed dose to reinfused stem cells (rSC) (i.e. dose to RM at time of ASCT) was < 50 mGy. Engraftment was considered delayed if on day 28 from reinfusion ANC did not reach 1.0x109/L or PLT were not ≥ 20.0x109/L. RESULTS: A median of 4,25x106/kg (1,45–20x106/kg) CD34+ cells were reinfused for each patient. A delay of engraftment occurred in only 1 patient who received 56 MBq/kg with a baseline ANC count of 0.20x109/L. Bone marrow biopsies were negative for disease localization in all patients at baseline, but 10 out of 26 had shown prior lymphoma infiltration. Considering the blood method the adsorbed dose to rSC resulted < 50 mGy in all patients with a median adsorbed dose of 11 mGy (4 – 28 mGy). ASC would be reinfused earlier in all patients except one. In particular, the 1st day with a dose to rSC < 50 mGy ranged from day -9 to day -5 at 30 MBq/kg; from day -8 to day -4 at 45 MBq/kg; from day -9 to day 0 at 56 MBq/kg, with a median value on day -3. We observed a possible correlation between total activity administered, dose delivered to RM and dose detectable on day of reinfusion, with higher doses to RM and rSC for those patients planned to received the highest activity. We also evaluated the dose to rSC if reinfusion would be performed 7 days after RIT: only 6 out of 26 patients showed a dose to SC < 50 mGy (2 at the 1st activity level, 3 at the 2nd and 1 at the 3rd activity level). Considering the MA method, the median adsorbed dose to the rSC resulted 25 mGy (9 - 69 mGy): in 2 out of 8 patients evaluated the adsorbed dose to the rSC was > 50 mGy on day 0 (69 and 51 mGy respectively). Even if ASC would be reinfused earlier in 5 out of 8 patients, the first day with a dose to rSC < 50 mGy ranged from day -3 to day +1. Despite bone marrow biopsy being negative in all patients at baseline, scintigraphic images (L2–L4 uptake) showed spine marrow uptake in almost all patients. CONCLUSIONS: Although alternative methods investigated - MA and imaging - are affected by uncertain factors (blood contamination of MA, difficult L2-L4 uptake image quantification), both indicate comparable results, about 2.5-folds higher, suggesting that the blood method provides an underestimate of RM dose. ASCT performed 13 days after HA 90Y-ibritumomab tiuxetan is generally safe. We suggest caution in anticipating the timing of ASCT with respect to 90Y-ibritumomab tiuxetan in those patients planned to receive an activity > 45 MBq/kg: alternative dosimetric approaches including image analysis and MA should be considered.

Here we present the clinical results and the outcomes of 143 consecutive newly-diagnosed follicular lymphoma (FL) patients (pts) treated with 3 different modalities of treatment in our institution from 1994 until 2007. During this period, from 1994 to 2002, 55 pts received Chlorambucil and Prednisone (Chl+PDN), subsequently 31 pts Rituximab with Chlorambucil (R-Chl) and 57 pts a 4-weekly standard-dose of Rituximab alone (R). Chlorambucil was given in an induction phase at 10mg/day for 6 consecutive weeks followed by a longer maintenance phase in the first group: 2-week pulses of 10 mg daily with 2-week intervals for a total of 12-months of treatment versus four 2-week pulses with monthly-Rituximab. In the single agent R group 36 pts received maintenance with at least 4-bimonthly administrations. The 3 groups were comparable for demographic and prognostic factors: median age at diagnosis was 55 yrs, over 60% of pts were in advanced stages and mainly asyptomatic (about 90%) and over 50% of pts in each group were low-risk FLIPI. A third of pts in both Rituximab-based treatment groups had bone marrow involvement and bulky disease. In terms of ORR 78% of pts treated with Chl+PDN, 97% with R-Chl and 72% with R single agent, obtained a clinical response, with a percentage of complete response of 58%, 90% and 47% respectively. No significant incidence of adverse events were reported and none discontinued the therapy because of toxicity. One case of myelodysplatic syndrome was described in a relapsed patient of the Chl-PDN group. With a median follow up of 72, 56 and 27 months in the 3 groups evaluated, the CR rate was maintained in 29%, 74% and 37% of pts respectively with a median duration of response of 36, 40 and 24 months. Rituximab as first-line in FL pts seems safe, feasible and able to induce a high rate of clinical response similar to those achieved with standard chemotherapy alone. On the other hand, the immunochemotherapy seems to confirm its superiority in terms of response rate and duration of response.

Early stage HL patients (pts) benefit from a short course of chemotherapy combined with IF radiotherapy. In our previous experience six courses of VBM chemotherapy (Stanford regimen) were administered with IF radiotherapy. However, despite good clinical results, the schedule was modified in terms of total chemotherapy cycles delivered, in order to reduce the risk of long term toxicities. PET and CT scan were performed at staging to identify a low risk patients (pts) group. From May 2001 to November 2006, 32 treatment naïve Hodgkin’s lymphoma pts (18 male, 14 female) were treated with four courses of VBM chemotherapy (D1, 8: Vinblastine 6 mg/sm, Bleomycin 10 mg/sm, Methotrexate 30 mg/sm, repeated every 28 days) followed by IF radiotherapy. Median age was 37 years (range 16–73). Main histology was classical HL in 26 pts, while lymphocyte predominant was observed in 6 pts. Pts were all stage I-IIA (no bulky disease), no more than three sites involved, performance status 0–1 and ESR < 50. CT scans were performed before and after chemotherapy and radiotherapy. PET scans were performed before and after chemotherapy in 26 pts, and after radiotherapy if not performed before or in case of positivity after chemotherapy. Chemotherapy was usually well tolerated: three pts experienced G3-4 neutropenia while the main non- haematological toxicities recorded were G3 transaminitis in 3 pts and G1-2 neuroconstipation/abdominal pain in 18 pts. IF radiotherapy was performed one month after the last chemotherapy cycle; median dose administered was 30Gy (range 26–30.4). At the end of chemotherapy 7 pts were PET positive. While one patient developed progressive disease, the other six pts became negative after radiotherapy and are still in complete remission (CR). 29 pts (90%) completed the whole program obtaining a CR. Two pts progressed before radiotherapy, while one patient shifted to an anthracycline containing schedule after two cycles due to stable disease. With a median follow-up of 42 months (range: 7–73), all pts are alive. 1 out of 29 CR pts progressed and is now receiving intensive chemotherapy program with autologous stem cell transplant. In our experience four cycles of VBM chemotherapy combined with IF radiotherapy is an effective program. Furthermore this regimen that doesn’t contain alkylating agents or anthracyclines avoids alopecia and decreases the risk of long term toxicity. PET scan effectively helps to identify low risk early stage HL pts that can take advantage of this therapeutic approach.

Mantle cell lymphoma (MCL) is an aggressive disease, currently incurable with standard-dose chemotherapy. Autologous cell transplantation (ASCT) is frequently considered a therapeutical approach in MCL, despite not generally being curative. In controlled studies upfront ASCT showed a significant event-free survival advantage, that might be improved by the addition of the anti-CD20 monoclonal-antibody (MoAb) (Rituximab®) in the myeloablative regimen. Based on these evidences, we prospectively analysed our patients (pts) affected by MCL, who received a continuous Rituximab administration in course on treatment. From May 2000 to the present we treated 22 pts with histological diagnosis of MCL, including 16 pts (73%) newly diagnosed. The majority were male (15/22) and the median age at diagnosis was 56 years old (range 35–66). Disease was stage III–IV: 21 pts with bone marrow involvement in 60%. Eleven pts presented extranodal involvement. The induction schedule included 2–4 CHOP-like regimen with MoAb (R-ACOD), followed by mobilization chemotherapy with cyclophosphamide, MoAb and G-CSF. Harvest was performed successfully in all pts with a median number of CD34-positive cells of 8.0 x 106/Kg (1.9–22.8 106/Kg). Subsequently the pts received 2 cycles of high-dose, cytarabine-based regimen with MoAb (R-ESHAP). Rituximab injections were given at standard dose (375 mg/mq). Before ASCT, 11 pts (50%) were in complete response (CR); in particularly 5 of them who were pretreated. Eight achieved partial response, while one was in progression. Two pts were not restaged. One patient did not undergo ASCT, because of serious pulmonary infection after high-dose cytarabine. In terms of conditioning regimen all pts received Rituximab (375 mg/mq), Melphalan (180mg/mq) in association with either Idarubicin (15mg/mq for 3 days) in 13 pts and or Novantrone (60 mg/mq for 1 day) in 8 pts. After stem cell reinfusion and G-CSF from Day +5, the median time to recovery (neutrophil counts >0.5x103) was 14 days (range 13–28 days) in the first regimen versus 10 days (range 8–11 days) in the more recent regimen. During aplasia the infection rate was low, as a matter of fact we observed just two episodes of pneumonia, that resolved at neutrophil recovery. No toxic death was reported. Response at 3 months after ASCT was evaluable in 19 patients (90%); one was lost at follow-up, while one has been transplanted one month ago. Seventy patients (80%) achieved complete response, maintained in 11 of them after a median time of 23 month (range 10–79) after ASCT; seven of them were in complete response before the transplant procedure. With a median time of 27 months (range 9–46 months) 7 patients progressed and 4 of these died because of lymphoma. Our study supports that ASCT can be considered a valid approach to induce high response rate. To enhance the ASCT outcomes, the addition of Rituximab can be considered a feasible approach associated with its “purging in vivo” effect. Long-term disease control might be reflected upon a plateau in the survival curve, but a randomised study and longer follow up is warranted.

7093 Background: Byrd et al (Blood 2003) confirmed the synergistic effect of Rituximab and Fludarabine in the treatment of CLL patients (pts). The choice of purine analogue still remains controversial. We evaluated feasibility, efficacy, and toxicity of 2-CdA-Rituximab combination in the treatment of CLL and SLL pts requiring treatment. Methods: The combination therapy consisted of intravenous Rituximab at a dose of 375 mg/m2 on Day 1 and 2-CdA at a dose of 0.1 mg/kg (sc injection) per day on Days 2 through 6. The course was repeated at 4-week intervals for 4 times. 31 pts (21 CLL and 10 SLL) was enrolled in the study and the median age was 59 years (31–73); 42% of pts were pre-treated. A CT scan was abnormal in 95% of CLL pts. Immunophenotypic evaluation by ZAP-70 was positive in 70% of pts while no evaluable pts showed an adverse prognostic cytogenetic features by FISH. Minimal residual disease (MRD) assessment was performed by flow-cytometry and PCR methods. Results: 2 pts had to discontinue therapy after 2 cycle: one due to herpes zoster reactivation and the other one to the progression disease (PD). We observed grade 3 and 4 neutropenia in 4 pts (12%), major infections in 4 pts (12%) and no episodes of grade 3–4 thrombocytopenia. 24 pts were evaluable for response with an ORR of 96%. At the end of therapy 10 pts (42%), 7 CLL and 3 SLL, achieved a CR, with negative MRD (by PCR) in 4 pts (3 untreated); 13 pts (54%) obtained a PR and 1 patient had no response. With a median follow-up of 12 months (range 3–34) 7 pts (2 pts with MRD+CR and 5 pts with PR after treatment) experimented a PD; 5 of these pts were pre-treated and 2 died because of PD. Conclusions: The combination of 2- CDA and Rituximab seems to be tolerable and active principally for untreated pts and able to induce a molecular clearance also in pre-treated pts. The achieving of a CR with negative MRD seems to be the most important issue to improve the outcome. No significant financial relationships to disclose.

DLBCL can be divided into two prognostically different subgroups, germinal center B-cell-like (GCB) and activated B-cell-like (ABC), according to twodifferent gene patterns identified with cDNA microarray technology. Though valuable, this technology is expensive and not generally available. However, the identification of individual antigens related to different stages of B-cell differentiation using immunohistochemistry, can be used to assess the two profiles yielding comparable results with respect to cDNA microarray technique. We have retrospectively investigated 105 patients (pts) diagnosed with de novo DLBCL and treated at our centre between November 2001 and June 2004; the only inclusion criteria was the availability of a tissue biopsy at diagnosis. Median age was 62 (19–85); stage at diagnosis was I–II in 49 pts (47%), III in 14 pts (13%) and IV in 42 pts (40%); according to IPI, 74 (70%) pts were defined as low (0–2) and 31 (30%) as high risk (3–5). Interestingly, the majority (53%) of our pts, had a primary extranodal lymphoma at diagnosis. TMA analysis was performed with antibodies to CD10, bcl-6 and MUM1 allowing the following classification: 50 pts (48%) were considered having CGB lymphoma and 55 pts (52%) having ABC disease. According to IPI risk score, 38 pts with CGB and 36 with ABC lymphoma were at low risk (0–2) whereas 10 with CGB and 16 with ABC lymphoma were at high risk (3–5). All pts received a median of 6 cycles of a CHOP-like, antracycline-based polychemotherapy. Observed ORR was 89% (94/105); 62 (59%) pts achieved a CR, 32 (30.5%) a PR while 11 (10.5%) failed to respond to treatment. Median follow-up of the surviving pts was 45 months ( 5–110). The 3-year OS for the entire group was 71% and the 3-year EFS was 54%. In terms of CR, PD and resistance to therapy, no difference was observed between the two TMA types of DLBCL. Pts obtaining a CR after 1st line treatment were equally distributed in both groups (28.6% in CGB vs 30.5% in ABC) as were those not responding to therapy (3.8% in CGB versus 6.7% in ABC). A separate analysis in pts with stage IV disease at diagnosis was also performed and showed similar results (40.5% of CR, 23.8% of NR; no difference was observed between the two TMA defined subgroups). Pts who experienced a PD at any time, were equally distributed between the 2 subgroups, either if they relapsed after first line therapy (6 pts in CGB group , 10 in the ABC one) or after any other subsequent treatment (12 in the CGB group, 18 in the ABC one). Furthermore, 39 of 56 (69%) patients with extranodal presentation at diagnosis showed a CR independently of their subgroup distribution (37.5% in the CGL group vs 32.1% in the ABC one), and pts experiencing a PR were equally distributed between the two groups. Our data do not support the use of TMA to predict outcome in DLBCL. However, previously published data supporting the prognostic impact of TMA, have not enrolled pts with lymphomas of primary extranodal origin which, instead, were the majority in our study. Indeed, the study by Colomo et al, which enrolled 39% of pts affected by extranodal lymphomas, also failed to demonstrate a role of TMA in predicting outcome in DLBCL pts. Furthermore, the use of a limited number of antigens to define different subtypes of DLBCL may not be sufficient to identify the same patterns as defined by cDNA microarray technology.

Three zeolites with the heulandite framework were cation-exchanged with Ca, Na, K, and Rb. The heat behaviour of these phases was tested; it is characterized by contraction due to the flattening of the zeolitic channels and by destruction of the lattice. The flattening is explained as being due mainly to the attractive force of the extra-framework cations, which may or may not be able to compel the channels to flatten when the water is expelled. A high Si: Al ratio makes the channels harder to flatten, as probably does the presence of crystal defects. The easier it is to flatten channels, the lower the temperature of destruction of the lattice.

An Illite/Montmorillonite mineral found in a porphyritic rock of Alpe di Siusi has an I/M ratio of 80:20. Introducing proper chemical parameters in a Q-Mode program of sixty-six Illites and Illite/Montmorillonite from the literature suggests the possibility of distinguishing Illites from Illite/Montmorillonite.