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16 results on '"Marbello, L"'

1. Anthracycline-induced cardiotoxicity: A multicenter randomised trial comparing two strategies for guiding prevention with enalapril: The International CardioOncology Society-one trial

Author

Cardinale, D, Ciceri, F, Latini, R, Franzosi, M, Sandri, M, Civelli, M, Cucchi, G, Menatti, E, Mangiavacchi, M, Cavina, R, Barbieri, E, Gori, S, Colombo, A, Curigliano, G, Salvatici, M, Rizzo, A, Ghisoni, F, Bianchi, A, Falci, C, Aquilina, M, Rocca, A, Monopoli, A, Milandri, C, Rossetti, G, Bregni, M, Malossi, A, Nassiacos, D, Verusio, C, Giordano, M, Staszewsky, L, Barlera, S, Nicolis, E, Magnoli, M, Masson, S, Cipolla, C, Curigliano, Sicuro, M, Rossetti, Maggioni, A, Labianca, R, Tettamanti, M, Senni, M, Finzi, A, Grosso, F, Vago, T, Gramenzi, S, Balconi, G, Bernasconi, R, Buratti, M, Ojeda-Fernandez, M, Vasami, A, Thiebat, B, Bare, C, Corzani, A, Coccolo, F, Colecchia, S, Pellegrini, C, Appio, L, Caico, I, Mesenzani, O, Campana, C, Gilardoni, M, Scognamiglio, G, Corrado, G, Battagin, D, De Rosa, F, Carpino, C, Palazzo, S, Giannessi, P, Zipoli, G, Pastori, P, Callegari, S, Sesenna, C, Fodor, C, Guiducci, D, Mazza, R, Turazza, F, Vallerio, P, Marbello, L, Sala, E, Fragasso, G, Trinca, S, Farolfi, A, Andreis, D, Lanzoni, L, Marchetti, F, Mioranza, E, Banzato, A, Re, F, Gaibazzi, N, Gullo, M, Turina, M, Gervasi, E, Giaroli, F, Barco, B, Bertolini, A, Sinagra, G, Aleksova, A, Guglielmi, A, Pinotti, G, Gueli, R, Mongiardi, C, Vallini, I, Cardinale D., Ciceri F., Latini R., Franzosi M. G., Sandri M. T., Civelli M., Cucchi G., Menatti E., Mangiavacchi M., Cavina R., Barbieri E., Gori S., Colombo A., Curigliano G., Salvatici M., Rizzo A., Ghisoni F., Bianchi A., Falci C., Aquilina M., Rocca A., Monopoli A., Milandri C., Rossetti G., Bregni M., Malossi A., Nassiacos D., Verusio C., Giordano M., Staszewsky L., Barlera S., Nicolis E. B., Magnoli M., Masson S., Cipolla C. M., Sicuro M., Maggioni A. P., Labianca R., Tettamanti M., Senni M., Finzi A., Grosso F., Vago T., Gramenzi S., Balconi G., Bernasconi R., Nicolis E., Buratti M. G., Ojeda-Fernandez M. L., Vasami A., Thiebat B., Bare C., Corzani A., Coccolo F., Colecchia S., Pellegrini C., Appio L., Caico I., Mesenzani O., Campana C., Gilardoni M., Scognamiglio G., Corrado G., Battagin D., De Rosa F., Carpino C., Palazzo S., Giannessi P. G., Zipoli G., Pastori P., Callegari S., Sesenna C., Fodor C., Guiducci D., Mazza R., Turazza F. M., Vallerio P., Marbello L., Sala E., Fragasso G., Trinca S., Farolfi A., Andreis D., Lanzoni L., Marchetti F., Mioranza E., Banzato A., Re F., Gaibazzi N., Gullo M., Turina M. C., Gervasi E., Giaroli F., Barco B., Bertolini A., Sinagra G., Aleksova A., Guglielmi A., Pinotti G., Gueli R., Mongiardi C., Vallini I., Cardinale, D, Ciceri, F, Latini, R, Franzosi, M, Sandri, M, Civelli, M, Cucchi, G, Menatti, E, Mangiavacchi, M, Cavina, R, Barbieri, E, Gori, S, Colombo, A, Curigliano, G, Salvatici, M, Rizzo, A, Ghisoni, F, Bianchi, A, Falci, C, Aquilina, M, Rocca, A, Monopoli, A, Milandri, C, Rossetti, G, Bregni, M, Malossi, A, Nassiacos, D, Verusio, C, Giordano, M, Staszewsky, L, Barlera, S, Nicolis, E, Magnoli, M, Masson, S, Cipolla, C, Curigliano, Sicuro, M, Rossetti, Maggioni, A, Labianca, R, Tettamanti, M, Senni, M, Finzi, A, Grosso, F, Vago, T, Gramenzi, S, Balconi, G, Bernasconi, R, Buratti, M, Ojeda-Fernandez, M, Vasami, A, Thiebat, B, Bare, C, Corzani, A, Coccolo, F, Colecchia, S, Pellegrini, C, Appio, L, Caico, I, Mesenzani, O, Campana, C, Gilardoni, M, Scognamiglio, G, Corrado, G, Battagin, D, De Rosa, F, Carpino, C, Palazzo, S, Giannessi, P, Zipoli, G, Pastori, P, Callegari, S, Sesenna, C, Fodor, C, Guiducci, D, Mazza, R, Turazza, F, Vallerio, P, Marbello, L, Sala, E, Fragasso, G, Trinca, S, Farolfi, A, Andreis, D, Lanzoni, L, Marchetti, F, Mioranza, E, Banzato, A, Re, F, Gaibazzi, N, Gullo, M, Turina, M, Gervasi, E, Giaroli, F, Barco, B, Bertolini, A, Sinagra, G, Aleksova, A, Guglielmi, A, Pinotti, G, Gueli, R, Mongiardi, C, Vallini, I, Cardinale D., Ciceri F., Latini R., Franzosi M. G., Sandri M. T., Civelli M., Cucchi G., Menatti E., Mangiavacchi M., Cavina R., Barbieri E., Gori S., Colombo A., Curigliano G., Salvatici M., Rizzo A., Ghisoni F., Bianchi A., Falci C., Aquilina M., Rocca A., Monopoli A., Milandri C., Rossetti G., Bregni M., Malossi A., Nassiacos D., Verusio C., Giordano M., Staszewsky L., Barlera S., Nicolis E. B., Magnoli M., Masson S., Cipolla C. M., Sicuro M., Maggioni A. P., Labianca R., Tettamanti M., Senni M., Finzi A., Grosso F., Vago T., Gramenzi S., Balconi G., Bernasconi R., Nicolis E., Buratti M. G., Ojeda-Fernandez M. L., Vasami A., Thiebat B., Bare C., Corzani A., Coccolo F., Colecchia S., Pellegrini C., Appio L., Caico I., Mesenzani O., Campana C., Gilardoni M., Scognamiglio G., Corrado G., Battagin D., De Rosa F., Carpino C., Palazzo S., Giannessi P. G., Zipoli G., Pastori P., Callegari S., Sesenna C., Fodor C., Guiducci D., Mazza R., Turazza F. M., Vallerio P., Marbello L., Sala E., Fragasso G., Trinca S., Farolfi A., Andreis D., Lanzoni L., Marchetti F., Mioranza E., Banzato A., Re F., Gaibazzi N., Gullo M., Turina M. C., Gervasi E., Giaroli F., Barco B., Bertolini A., Sinagra G., Aleksova A., Guglielmi A., Pinotti G., Gueli R., Mongiardi C., and Vallini I.

Abstract

Background: Troponin changes over time have been suggested to allow for an early diagnosis of cardiac injury ensuing cancer chemotherapy; cancer patients with troponin elevation may benefit of therapy with enalapril. It is unknown whether a preventive treatment with enalapril may further increase the benefit. Methods: The International CardioOncology Society-one trial (ICOS-ONE) was a controlled, open-label trial conducted in 21 Italian hospitals. Patients were randomly assigned to two strategies: enalapril in all patients started before chemotherapy (CT; ‘prevention’ arm), and enalapril started only in patients with an increase in troponin during or after CT (‘troponin-triggered’ arm). Troponin was assayed locally in 2596 blood samples, before and after each anthracycline-containing CT cycle and at each study visit; electrocardiogram and echocardiogram were done at baseline, and at 1, 3, 6 and 12-month follow-up. Primary outcome was the incidence of troponin elevation above the threshold. Findings: Of the 273 patients, 88% were women, mean age 51 ± 12 years. The majority (76%) had breast cancer, 3% had a history of hypertension and 4% were diabetic. Epirubicin and doxorubicin were most commonly prescribed, with median cumulative doses of 360 [270–360] and 240 [240–240] mg/m2, respectively. The incidence of troponin elevation was 23% in the prevention and 26% in the troponin-triggered group (p = 0.50). Three patients (1.1%) -two in the prevention, one in the troponin-triggered group-developed cardiotoxicity, defined as 10% point reduction of LV ejection fraction, with values lower than 50%. Interpretation: Low cumulative doses of anthracyclines in adult patients with low cardiovascular risk can raise troponins, without differences between the two strategies of giving enalapril. Considering a benefit of enalapril in the prevention of LV dysfunction, a troponin-triggered strategy may be more convenient.

Published
2018

2. Clinical management of peripherally inserted central catheters compared to conventional central venous catheters in patients with hematological malignancies: A large multicenter study of the REL GROUP (Rete Ematologica Lombarda - Lombardy Hematologic Network, Italy)

Author

Fracchiolla, N, Todisco, E, Bilancia, A, Gandolfi, S, Orofino, N, Guidotti, F, Mancini, V, Marbello, L, Assanelli, A, Bernardi, M, Santoro, A, Cairoli, R, Consonni, D, Cortelezzi, A, Fracchiolla N. S, Todisco E, Bilancia A, Gandolfi S, Orofino N, Guidotti F, Mancini V, Marbello L, Assanelli A, Bernardi M, Santoro A, Cairoli R, Consonni D, Cortelezzi A., Fracchiolla, N, Todisco, E, Bilancia, A, Gandolfi, S, Orofino, N, Guidotti, F, Mancini, V, Marbello, L, Assanelli, A, Bernardi, M, Santoro, A, Cairoli, R, Consonni, D, Cortelezzi, A, Fracchiolla N. S, Todisco E, Bilancia A, Gandolfi S, Orofino N, Guidotti F, Mancini V, Marbello L, Assanelli A, Bernardi M, Santoro A, Cairoli R, Consonni D, and Cortelezzi A.

Published
2017

3. Clofarabine-based chemotherapy as a bridge to transplant in the setting of refractory or relapsed acute myeloid leukemia, after at least one previous unsuccessful salvage treatment containing fludarabine: a single institution experience

Author

Molteni, A, Riva, M, Ravano, E, Marbello, L, Mancini, V, Grillo, G, Zucchetti, E, Greco, R, Cairoli, R, Molteni A., Riva M., Ravano E., Marbello L., Mancini V., Grillo G., Zucchetti E., Greco R., Cairoli R., Molteni, A, Riva, M, Ravano, E, Marbello, L, Mancini, V, Grillo, G, Zucchetti, E, Greco, R, Cairoli, R, Molteni A., Riva M., Ravano E., Marbello L., Mancini V., Grillo G., Zucchetti E., Greco R., and Cairoli R.

Abstract

For refractory or relapsed acute myeloid leukemia patients, allogeneic hematopoietic stem cell transplantation is the only curative treatment option, but the disease must be in remission before this can be attempted. “Salvage” therapy regimens containing high-dose cytarabine plus fludarabine or cladribine with or without anthracyclines or plus mitoxantrone and etoposide fail in 30–50% of cases. We report the outcome of 14 patients treated with a clofarabine-based treatment administered after at least one failed fludarabine-based “salvage” attempt in a “real life” (outside a clinical trial) context. No death related to the clofarabine-based treatment was observed. Four of the 14 patients (29%) reached complete remission and one (7%) achieved a reduction of marrow blasts to fewer than 10%. Three of these five patients were successfully transplanted and have shown a long-term survival. The small number of this group of patients does not permit the identification of clinical features clearly related to a favorable outcome, but we note that all the three long-term survivals were FLT3 wild type. Clofarabine-based “salvage therapy” in patients with very poor expectancy is feasible even after a fludarabine-based salvage attempt, albeit with success only in a small percentage of cases (3/14 = 21%).

Published
2017

4. SAFETY AND FEASIBILITY OF CONSOLIDATION CHEMOTHERAPY WITH HIGH DOSES OF CYTARABINE IN OLDER PATIENTS WITH ACUTE MYELOID LEUKAEMIA

Author

Ravano, E, Marbello, L, Greco, R, Mancini, M, Nosari, A, Nichelatti, M, Meli, E, Ferrari, S, Deodato, M, Molteni, A, Riva, M, Cairoli, R, Ravano E, Marbello L, Greco R, Mancini M, Nosari AM, Nichelatti M, Meli E, Ferrari S, Deodato M, Molteni A, Riva M, Cairoli R, Ravano, E, Marbello, L, Greco, R, Mancini, M, Nosari, A, Nichelatti, M, Meli, E, Ferrari, S, Deodato, M, Molteni, A, Riva, M, Cairoli, R, Ravano E, Marbello L, Greco R, Mancini M, Nosari AM, Nichelatti M, Meli E, Ferrari S, Deodato M, Molteni A, Riva M, and Cairoli R

Published
2015

5. MOLECULAR RELEVANCE OF THE NERVE GROWTH FACTOR RECEPTOR GENE (NTRK1) EXPRESSION IN AML-RELATED MYELOID SARCOMA

Author

Lazzaroni, F, Zucchetti, E, Turrini, M, Bernardi, M, Fracchiolla, N, Rossi, M, Zappasodi, P, Cattaneo, C, Marbello, L, Cairoli, R, Lazzaroni F, Zucchetti E, Turrini M, Bernardi M, Fracchiolla N, Rossi M, Zappasodi P, Cattaneo C, Marbello L, Cairoli R, Lazzaroni, F, Zucchetti, E, Turrini, M, Bernardi, M, Fracchiolla, N, Rossi, M, Zappasodi, P, Cattaneo, C, Marbello, L, Cairoli, R, Lazzaroni F, Zucchetti E, Turrini M, Bernardi M, Fracchiolla N, Rossi M, Zappasodi P, Cattaneo C, Marbello L, and Cairoli R

Published
2014

6. Randomized comparison of liposomal amphotericin B versus placebo to prevent invasive mycoses in acute lymphoblastic leukaemia

Author

Cornely, O. A., Leguay, T., Maertens, J., Vehreschild, M. J. G. T., Anagnostopoulos, A., Castagnola, C., Verga, L., Rieger, C., Kondakci, M., Harter, G., Duarte, R. F., Allione, B., Cordonnier, C., Heussel, C. P., Morrissey, C. O., Agrawal, S. G., Peter Donnelly, J., Bresnik, M., Hawkins, M. J., Garner, W., Gokbuget, N., Jarchum, G., Dictar, M., Ramirez Borga, S., Valledor, A., Knoebl, P., Greil, R., Linkesch, W., Sill, H., De Prijck, B., Sonet, A., Theunissen, K., Selleslag, D., Vargas Schwarzbold, A., Nucci, M. L. M., Lopes de Castro Lobo, C., Fogliatto, L., Bonmati, C., Turlure, P., Herbrecht, R., Thiebaut, A., Michallet, M., Egerer, G., Silling, G., Pfreundschuh, M., Hasenkamp, J., Kraemer, D. M., Topp, M., Heinz, W., Junghanss, C., Schaich, M. A., Parmentier, S., Roellig, C., Beck, H. J., Huttmann, A., Mousset, S., Duenzinger, U. N., Schwartz, S., Haerter, G., Ostermann, H., Tsirigotis, P., Matsouka, P., Angelopoulou, M. K., Karakantza, M., Spyridonidis, A., Kolomansky, A., Moses, A., Horowitz, N., Rahav, G., Aversa, F., Velardi, A., Pagano, Livio, Gentile, Giuseppe, Gobbi, M., Luppi, M., Nosari, A. M., Rambaldi, A., Candoni, A., Marbello, L., Rossi, G., Pogliani, E., Moreira, I., Nunes, A., Botelho de Sousa, A., Rubio Tejero, A. I., Vallejo, C., Vazquez, L., Besalduch Vidal, J., Gomez-Garcia de Soria, V., Jurado Chacon, M., Gonzalez Campos, J., Olavarria, E., Barba, P., de la Serna Torroba, J., Duarte, R., Heim, D., Zimmerli, S., Gerber, B., Akova, M., Bolaman, A. Z., Tabak, F., Akan, H., Senol, E., Pagano L. (ORCID:0000-0001-8287-928X), Gentile G., Cornely, O. A., Leguay, T., Maertens, J., Vehreschild, M. J. G. T., Anagnostopoulos, A., Castagnola, C., Verga, L., Rieger, C., Kondakci, M., Harter, G., Duarte, R. F., Allione, B., Cordonnier, C., Heussel, C. P., Morrissey, C. O., Agrawal, S. G., Peter Donnelly, J., Bresnik, M., Hawkins, M. J., Garner, W., Gokbuget, N., Jarchum, G., Dictar, M., Ramirez Borga, S., Valledor, A., Knoebl, P., Greil, R., Linkesch, W., Sill, H., De Prijck, B., Sonet, A., Theunissen, K., Selleslag, D., Vargas Schwarzbold, A., Nucci, M. L. M., Lopes de Castro Lobo, C., Fogliatto, L., Bonmati, C., Turlure, P., Herbrecht, R., Thiebaut, A., Michallet, M., Egerer, G., Silling, G., Pfreundschuh, M., Hasenkamp, J., Kraemer, D. M., Topp, M., Heinz, W., Junghanss, C., Schaich, M. A., Parmentier, S., Roellig, C., Beck, H. J., Huttmann, A., Mousset, S., Duenzinger, U. N., Schwartz, S., Haerter, G., Ostermann, H., Tsirigotis, P., Matsouka, P., Angelopoulou, M. K., Karakantza, M., Spyridonidis, A., Kolomansky, A., Moses, A., Horowitz, N., Rahav, G., Aversa, F., Velardi, A., Pagano, Livio, Gentile, Giuseppe, Gobbi, M., Luppi, M., Nosari, A. M., Rambaldi, A., Candoni, A., Marbello, L., Rossi, G., Pogliani, E., Moreira, I., Nunes, A., Botelho de Sousa, A., Rubio Tejero, A. I., Vallejo, C., Vazquez, L., Besalduch Vidal, J., Gomez-Garcia de Soria, V., Jurado Chacon, M., Gonzalez Campos, J., Olavarria, E., Barba, P., de la Serna Torroba, J., Duarte, R., Heim, D., Zimmerli, S., Gerber, B., Akova, M., Bolaman, A. Z., Tabak, F., Akan, H., Senol, E., Pagano L. (ORCID:0000-0001-8287-928X), and Gentile G.

Abstract

Objectives: To prevent invasive fungal disease (IFD) in adult patients undergoing remission-induction chemotherapy for newly diagnosed acute lymphoblastic leukaemia (ALL). Patients and methods: In a double-blind multicentre Phase 3 study, patients received prophylactic liposomal amphotericin B (L-AMB) at 5 mg/kg intravenously or placebo twice weekly in a 2:1 random allocation during remission-induction treatment. The primary endpoint was the development of proven or probable IFD. Secondary endpoints included those focused on the safety and tolerability of prophylactic L-AMB. Results: Three hundred and fifty-five patients from 86 centres in Europe and South America received at least one dose of L-AMB (n = 237) or placebo (n = 118). Rates of proven and probable IFD assessed independently were 7.9%(18/228) in the L-AMB group and 11.7%(13/111) in the placebo group (P = 0.24). Rates of possible IFD were 4.8% (11/228) in the L-AMB and 5.4% (6/111) in the placebo group (P = 0.82). The remission-induction phase was a median of 22 days for both groups. Overall mortality was similar between the groups: 7.2% (17/237) for L-AMB and 6.8% (8/118) for placebo (P = 1.00). Hypokalaemia and creatinine increase were significantly more frequent with L-AMB. Conclusions: The IFD rate among adult patients undergoing remission-induction chemotherapy for newly diagnosed ALL was 11.7%in the placebo group, andwas not significantly different in patients receiving L-AMB, suggesting that the L-AMB regimen studied is not effective as prophylaxis against IFD. The IFD rate appears higher than previously reported, warranting further investigation. Tolerability of L-AMB was what might be expected. Further studies are needed to determine the optimal antifungal strategy during remission-induction chemotherapy of ALL.

Published
2017

7. VALIDATING THE PATIENT'S 'FITNESS' CRITERIA PROPOSED TO GUIDE TREATMENT DECISION IN ELDERLY AML: A MULTICENTER STUDY ON A SERIES OF 699 PATIENTS BY THE NETWORK 'RETE EMATOLOGICA LOMBARDA'

Author

Borlenghi, E, Pagani, C, Basilico, C, Bernardi, M, Cairoli, R, Cortelezzi, A, Davia, M, Ferrario, A, Fracchiolla, N, Marbello, L, Messina, C, Santoro, A, Todisco, E, Turrini, M, Zappasodi, P, Cattaneo, C, Lamorgese, C, Rossi, G, Borlenghi, E, Pagani, C, Basilico, C, Bernardi, M, Cairoli, R, Cortelezzi, A, Davia, M, Ferrario, A, Fracchiolla, N, Marbello, L, Messina, C, Santoro, A, Todisco, E, Turrini, M, Zappasodi, P, Cattaneo, C, Lamorgese, C, and Rossi, G

Published
2016

8. INFECTIOUS AND THROMBOTIC COMPLICATIONS IN PERIPHERALLY INSERTED (PICCS) COMPARED TO SHORT TERM CENTRAL VENOUS CATHETERS IN ONCOHEMATOLOGIC PATIENTS: A REL GROUP (RETE EMATOLOGICA LOMBARDA) STUDY

Author

Fracchiolla, N, Todisco, E, Bilancia, A, Gandolfi, S, Mancini, V, Marbello, L, Bernardi, M, Assanelli, A, Orofino, N, Guidotti, F, Cairoli, R, Ciceri, F, Santoro, A, Rossi, G, Cortelezzi, A, Fracchiolla, NS, Fracchiolla, N, Todisco, E, Bilancia, A, Gandolfi, S, Mancini, V, Marbello, L, Bernardi, M, Assanelli, A, Orofino, N, Guidotti, F, Cairoli, R, Ciceri, F, Santoro, A, Rossi, G, Cortelezzi, A, and Fracchiolla, NS

Published
2016

9. Surgical resection of persistent pulmonary fungus nodules and secondary prophylaxis are effective in preventing fungal relapse in patients receiving chemotherapy or bone marrow transplantation for leukemia

Author

Nosari, A, Ravini, M, Cairoli, R, Cozzi, P, Marbello, L, Marenco, P, Grillo, G, Morra, E, Nosari A, Ravini M, Cairoli R, Cozzi P, Marbello L, Marenco P, Grillo G, Morra E., Nosari, A, Ravini, M, Cairoli, R, Cozzi, P, Marbello, L, Marenco, P, Grillo, G, Morra, E, Nosari A, Ravini M, Cairoli R, Cozzi P, Marbello L, Marenco P, Grillo G, and Morra E.

Abstract

Antifungal therapy may be unable to eradicate invasive mycosis in leukemia patients. The presence of persisting pulmonary nodules owing to mycosis seems to increase the risk of fungal relapse after chemotherapy and transplant procedures. Between 1997 and 2004, 10 acute leukemia patients underwent pulmonary surgery for invasive mycosis. The median time from diagnosis of mycosis to surgery was 135 days (range 21-147). Three patients underwent emergency surgery, owing to hemoptysis. In the other seven patients with nodule/cavitation remaining after antifungal treatment, surgery (three wedge resections, four lobectomies) was scheduled before transplant. Pathologic examination confirmed two aspergillosis and three zygomycosis. The only side effect was pneumothorax in one case. Nine patients were considered cured. Six patients underwent bone marrow transplantation (three allogeneic, three autologous) with antifungal prophylaxis without relapse during the transplant procedure. In selected patients scheduled for bone marrow transplantation, surgical resection of localized pulmonary fungus nodules combined with antifungal prophylaxis seem to be an effective treatment for preventing mycotic relapse.

Published
2007

10. Aggressive systemic mastocytosis mimicking sclerosing cholangitis

Author

Marbello, L, Anghilieri, M, Nosari, A, Minola, E, Cairoli, R, Ricci, F, Morra, E, Marbello L, Anghilieri M, Nosari A, Minola E, Cairoli R, Ricci F, Morra E., Marbello, L, Anghilieri, M, Nosari, A, Minola, E, Cairoli, R, Ricci, F, Morra, E, Marbello L, Anghilieri M, Nosari A, Minola E, Cairoli R, Ricci F, and Morra E.

Abstract

A 43 year-old woman presented with fever, abdominal pain, epato-splenomegaly, ascites, cholestasis, anemia, thrombocytopenia and previous diagnosis of sclerosing cholangitis based on liver biopsy and endoscopic retrograde cholangiopancreatography(ERCP). The bone marrow biopsy and the revision of liver biopsy using antitryptase stain diagnosed systemic mastocytosis. Because of the aggressive course of the disease the patient was treated with an acute myeloid leukaemia chemotherapy regimen without success.

Published
2004

11. Invasive aspergillosis in haematological malignancies: clinical findings and management for intensive chemotherapy completion

Author

Nosari, A, Oreste, P, Cairoli, R, Montillo, M, Carrafiello, G, Astolfi, A, Muti, G, Marbello, L, Tedeschi, A, Magliano, E, Morra, E, Nosari A, Oreste P, Cairoli R, Montillo M, Carrafiello G, Astolfi A, Muti G, Marbello L, Tedeschi A, Magliano E, Morra E, Nosari, A, Oreste, P, Cairoli, R, Montillo, M, Carrafiello, G, Astolfi, A, Muti, G, Marbello, L, Tedeschi, A, Magliano, E, Morra, E, Nosari A, Oreste P, Cairoli R, Montillo M, Carrafiello G, Astolfi A, Muti G, Marbello L, Tedeschi A, Magliano E, and Morra E

Abstract

Sixty-one cases of Aspergillus infection (35 acute myeloid leukemia, 15 acute lymphoid leukemia, one myelodysplastic syndrome, two aplastic anemia, eight non-Hodgkin's lymphoma) seen in our department between January 1989 and July 1999 were studied retrospectively to evaluate the clinical characteristics, to ascertain the factors that influenced the outcome from mycotic infections, and whether early diagnosis and prolonged therapy permitted completion of scheduled intensive chemotherapy and bone marrow transplantation (BMT) without fungal recurrence. The patients were divided into three diagnostic categories: proven aspergillosis (autoptic or histologic diagnosis) n = 39, probable aspergillosis (radiological diagnosis with positive microbiology) n = 9, and possible aspergillosis (radiological diagnosis alone) n = 13. In the same period among 675 acute leukemia patients the incidence of proven or probable aspergillosis was 7.1%. At onset of infection 92% of patients were neutropenic (<0.5 × 109/L). The most frequent site of infection was the lung (90%); disseminated disease was present in 20 patients. Among 44 assessable patients, 12 (27%) failed to respond to early antifungal therapy and died. Thirty-two patients were cured with antifungal treatment, three of five nonneutropenic with only itraconazole, the others with amphotericin B 1 mg/Kg/day with or without itraconazole subsequently or with liposomal amphotericin, Ambisome, if renal toxicity occurred. Twenty-four of 29 neutropenic responders, all affected by acute leukemia, continued scheduled intensive chemotherapies. Pulmonary lobectomy was successfully combined with medical treatment in two cases before scheduled BMT. After infection nine patients were submitted to BMT (six allo, one marrow unrelated donor (MUD), two auto) with Ambisome or itraconazole as secondary prophylaxis without fungal relapse (follow-up: 25-99 months). The median time from fungal infection to transplant was five months, range 3-10. T

Published
2001

12. Peripherally Inserted Central Catheters (PICCs) Implantation in the Clinical Management of Oncohematologic Patients: Results of a Large Multicenter, Retrospective Study of the REL Group (Rete Ematologica Lombarda - Lombardy Hematologic Network, Italy)

Author

Fracchiolla, N, Todisco, E, Bilancia, A, Gandolfi, S, Mancini, V, Marbello, L, Bernardi, M, Assanelli, A, Orofino, N, Cassin, R, Sciume, M, Guidotti, F, Cairoli, R, Ciceri, F, Santoro, A, Cortelezzi, A, Rossi, G, Fracchiolla, NS, Fracchiolla, N, Todisco, E, Bilancia, A, Gandolfi, S, Mancini, V, Marbello, L, Bernardi, M, Assanelli, A, Orofino, N, Cassin, R, Sciume, M, Guidotti, F, Cairoli, R, Ciceri, F, Santoro, A, Cortelezzi, A, Rossi, G, and Fracchiolla, NS

Published
2015

14. Mast cell leukemia: A report of ten cases

Author

Valentini, C, Rondoni, M, Pogliani, E, Van Lint, M, Cattaneo, C, Marbello, L, Pulsoni, A, Giona, F, Martinelli, G, Leone, G, Pagano, L, Valentini, CG, Van Lint, MT, Pagano, L., POGLIANI, ENRICO MARIA, Valentini, C, Rondoni, M, Pogliani, E, Van Lint, M, Cattaneo, C, Marbello, L, Pulsoni, A, Giona, F, Martinelli, G, Leone, G, Pagano, L, Valentini, CG, Van Lint, MT, Pagano, L., and POGLIANI, ENRICO MARIA

Published
2008

15. Advanced mast cell disease: an Italian Hematological Multicenter experience

Author

Pagano, L, Valentini, C, Caira, M, Rondoni, M, Van Lint, M, Candoni, A, Allione, B, Cattaneo, C, Marbello, L, Caramatti, C, Pogliani, E, Iannitto, E, Giona, F, Ferrara, F, Invernizzi, R, Fanci, R, Lunghi, M, Fianchi, L, Sanpaolo, G, Stefani, P, Pulsoni, A, Martinelli, G, Leone, G, Musto, P, Valentini, CG, Van Lint, MT, Stefani, PM, Musto, P., POGLIANI, ENRICO MARIA, Pagano, L, Valentini, C, Caira, M, Rondoni, M, Van Lint, M, Candoni, A, Allione, B, Cattaneo, C, Marbello, L, Caramatti, C, Pogliani, E, Iannitto, E, Giona, F, Ferrara, F, Invernizzi, R, Fanci, R, Lunghi, M, Fianchi, L, Sanpaolo, G, Stefani, P, Pulsoni, A, Martinelli, G, Leone, G, Musto, P, Valentini, CG, Van Lint, MT, Stefani, PM, Musto, P., and POGLIANI, ENRICO MARIA

Abstract

The aim of the study is to evaluate clinical features, treatments and outcome of patients with systemic mast cell disease (MCD) who arrived to the attention of hematologists. A retrospective study was conducted over 1995-2006 in patients admitted in 18 Italian hematological divisions. Twenty-four cases of advanced MCD were collected: 12 aggressive SM (50%), 8 mast cell leukemia (33%), 4 SM with associated clonal non-mast cell-lineage hematologic disease (17%). Spleen and liver were the principal extramedullary organ involved. The c-kit point mutation D816V was found in 13/18 patients in which molecular biology studies were performed (72%). Treatments were very heterogeneous: on the whole Imatinib was administered in 17 patients, alpha-Interferon in 8, 2-CdA in 3; 2 patients underwent allogeneic hematopoietic stem cell transplantation. The overall response rate to Imatinib, the most frequently employed drugs, was of 29%, registering one complete remission and four partial remission; all responsive patients did not present D816V c-kit mutation. Overall three patients (12%) died for progression of disease. We conclude that MCD is characterized by severe mediator-related symptoms but with a moderate mortality rate. D816V c-kit mutation is frequent and associated with resistance against Imatinib. Because of the rarity of these forms, an effective standard of care is lacking. More data are needed to find new and successful therapeutic strategies.

Published
2008

16. Bone Marrow Hypoplasia Complicating Tacrolimus (FK506) Therapy

Author

Nosari, A, Marbello, L, De Carlis, L, De Gasperi, A, Muti, G, Mancini, V, Morra, E, Nosari, Annamaria, Marbello, Laura, De Carlis, Luciano G., De Gasperi, Andrea, Muti, Giuliana, Mancini, Valentina, Morra, Enrica, Nosari, A, Marbello, L, De Carlis, L, De Gasperi, A, Muti, G, Mancini, V, Morra, E, Nosari, Annamaria, Marbello, Laura, De Carlis, Luciano G., De Gasperi, Andrea, Muti, Giuliana, Mancini, Valentina, and Morra, Enrica

Abstract

Tacrolimus (FK506)-induced hematological toxicity, which has rarely been reported in transplant recipients, may result in anemia episodes, reported mainly in kidney and heart transplant recipients, sporadic cases of thrombotic thrombocytopenic purpura/hemolytic uremic syndrome, red cell aplasia (4 reported cases), and generalized bone marrow suppression (only 1 reported case). We describe a case of a liver transplant recipient with pancytopenia that appeared during immunosuppressive therapy with tacrolimus. This patient suffered from progressive anemia, leukopenia with severe neutropenia, and mild thrombocytopenia; bone marrow biopsy showed hypoplasia (20% of cellularity) without dysplasia. Bone marrow recovery was made possible by suspending tacrolimus and changing to immunosuppression with cyclosporine A, despite the two drugs being very similar in their mechanism of immunosuppression. Contrary to previously reported cases (pure red cell aplasia and bone marrow hypoplasia), the recovery of hemoglobin and neutrophil values was slow after tacrolimus suspension, even though in the first month transfusions were no longer necessary. ©2004 The Japanese Society of Hematology, Indications:Graft rejection prophylaxis in 1 patient who underwent orthotopic liver transplantation. Concomitant disease: bone marrow hypoplasia caused by tacrolimus.Patients:One 17-year-old girl.TypeofStudy:Bone marrow hypoplasia in liver transplant recipient during tacrolimus therapy, characterized by a slow but complete recovery with replacement of tacrolimus with Sandimmun was described. Case report.DosageDuration:Dosage not stated. Duration for 15 months.ComparativeDrug:Tacrolimus 0.15 mg/kg, bid. Duration not stated.Results:In the following month after replacement of tacrolimus with Sandimmun, hemoglobin levels increased slowly but constantly, and the patient was no longer blood-transfusion dependent within a month after suspension. At the 12th month after tacrolimus suspension, her hemoglobin level reached 12.5 g/dL; neutrophils were 2.9 x 109/L, and platelets 245 x 109/L. A bone marrow biopsy performed 15 months after discontinuation of tacrolimus showed normal cellularity (>70%).AdverseEffects:No adverse events were mentioned.AuthorsConclusions:Finally, it is important to emphasize that the change to cyclosporin A permitted recovery from pancytopenia, a result showing that, despite the two drugs being very similar as to mechanism of immunosuppression, the side effects impacting on bone marrow probably do not have the same etiologic mechanism, as in patients affected by tacrolimus-induced TTP [thrombocytopenic purpura].FreeText:The patient underwent urgent orthotopic liver transplantation. Postoperative course was regular; the prophylactic treatment, consisted of gancyclovir, 15 mg/kg daily for 2 weeks, and oral pyrimethamine-sulfadiazine 500 mg daily with coadministration of folate for 1 month. Immunosuppression therapy with steroids, tacrolimus (0.15 mg/kg, bid), and azathioprine (50 mg daily). Thirteen days after transplantation, normochromic normocytic anemia (hemoglobin 7.2 g/dL) with low reticulocytes (10 x 109/L ) appeared. Azathioprine was suspended

Published
2004

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