33 results on '"Allione, B"'
Search Results
2. Early consolidation with high-dose therapy and autologous stem cell transplantation is a feasible and effective treatment option in HIV-associated non-Hodgkin lymphoma at high risk
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Re, A, Gini, G, Rupolo, M, Levis, A, Bandera, A, Liberati, A M, Tozzi, P, Cattaneo, C, Casari, S, Skert, C, Bocci, C, Spina, M, Allione, B, Verga, L, Michieli, M, Almici, C, Leali, P F, Tirelli, U, and Rossi, G
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- 2018
- Full Text
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3. Impact of the type of anthracycline and of stem cell transplantation in younger patients with acute myeloid leukaemia: Long-term follow up of a phase III study
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Baron, F., Efficace, F., Cannella, L., Muus, P., Trisolini, S., Halkes, C.J., Fazi, P., Vignetti, M., Marie, J.P., Chiusolo, P., Velden, W.J. van der, La Sala, E., Vitolo, U., Thomas, X., Lefrere, F., Raimondo, F. Di, Bourhis, J.H., Specchia, G., Guimaraes, J.E., Allione, B., Vrhovac, R., Ferrara, F., Stevens-Kroef, M.J., Meert, L., Witte, T.J. de, Willemze, R., Amadori, S., Suciu, S., Baron, F., Efficace, F., Cannella, L., Muus, P., Trisolini, S., Halkes, C.J., Fazi, P., Vignetti, M., Marie, J.P., Chiusolo, P., Velden, W.J. van der, La Sala, E., Vitolo, U., Thomas, X., Lefrere, F., Raimondo, F. Di, Bourhis, J.H., Specchia, G., Guimaraes, J.E., Allione, B., Vrhovac, R., Ferrara, F., Stevens-Kroef, M.J., Meert, L., Witte, T.J. de, Willemze, R., Amadori, S., and Suciu, S.
- Abstract
Item does not contain fulltext, We provide a long-term evaluation of patients enrolled in the EORTC/GIMEMA AML-10 trial which included a total of 2157 patients, 15-60 years old, randomized to receive either daunorubicin (DNR, 50 mg/m(2) ), mitoxantrone (MXR, 12 mg/m(2) ), or idarubicin (IDA, 10 mg/m(2) ) in addition to standard-dose cytarabine and etoposide for induction chemotherapy and intermediate dose cytarabine for consolidation. Younger patients who reached complete remission with complete (CR) or incomplete (CRi) recovery were then scheduled to receive an allogeneic hematopoietic stem cell transplantation (HSCT). That was if they had a HLA-identical sibling donor; in all other cases, an autologous HSCT had to be administered. At an 11-year median follow-up, the 5-year, 10-year and 15-year overall survival (OS) rates were 33.2%, 30.1% and 28.0%, respectively. No significant difference between the three randomized groups regarding OS was observed (P = .38). In young patients, 15-45 years old, no treatment difference (P = .89) regarding OS was observed, while in patients 46-60 years old, MXR and IDA groups had a trend for a longer OS as compared to the DNR group (P = .029). Among younger patients without a favorable MRC cytogenetic risk subgroup who achieved a CR/CRi after induction chemotherapy, those with a HLA-identical sibling donor had higher 10-year and 15-year OS rates than those without. In older patients who reached CR/CRi, the long-term outcomes of those with or without a donor was similar. In conclusion, long-term outcomes of the study confirmed similar OS in the three randomized groups in the whole cohort of patients.
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- 2020
4. A phase II, multicentre trial of decitabine in higher-risk chronic myelomonocytic leukemia
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Santini, V., Allione, B., Zini Tanzi, Gina, Gioia, D., Lunghi, M., Poloni, A., Cilloni, D., Sanna, A., Masiera, E., Ceccarelli, M., Abdel-Wahab, O., Terenzi, Andrea, Angelucci, E., Finelli, C., Onida, F., Pelizzari, A., Ferrero, D., Saglio, G., Figueroa, M., Levis, A., Zini, G. (ORCID:0000-0002-8208-066X), Santini, V., Allione, B., Zini Tanzi, Gina, Gioia, D., Lunghi, M., Poloni, A., Cilloni, D., Sanna, A., Masiera, E., Ceccarelli, M., Abdel-Wahab, O., Terenzi, Andrea, Angelucci, E., Finelli, C., Onida, F., Pelizzari, A., Ferrero, D., Saglio, G., Figueroa, M., Levis, A., and Zini, G. (ORCID:0000-0002-8208-066X)
- Abstract
Chronic myelomonocytic leukemia (CMML) is a complex clonal hematological disorder classified among myelodysplastic (MDS)/myeloproliferative neoplasms. Prognosis is poor and there is a lack of effective treatments. The hypomethylating agent decitabine has shown activity against MDS and elderly acute myeloid leukemia, but there is little data focusing specifically on its efficacy in CMML. In this prospective, phase 2 Italian study, CMML patients received intravenous decitabine 20 mg/m2per day on Days 1-5 of a 28-day treatment cycle. Response was evaluated after four and six cycles; patients responding at the end of six cycles could continue treatment with decitabine. Forty-three patients were enrolled; >50% were high-risk according to four CMML-specific scoring systems. In the intent-to-treat population (n=42), the overall response rate after six cycles was 47.6%, with seven complete responses (16.6%), eight marrow responses (19%), one partial response (2.4%) and four hematological improvements (9.5%). After a median follow-up of 51.5 months (range: 44.4-57.2), median overall survival was 17 months, with responders having a significantly longer survival than non-responders (P=0.02). Grade 3/4 anemia, neutropenia and thrombocytopenia occurred in 28.6%, 50% and 38% of patients, respectively. Decitabine appears to be an effective and well-tolerated treatment for patients with high-risk CMML.
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- 2018
5. Post-Remissional And Pre-Transplant Role Of MRD Detected By WT1 In Acute Myeloid Leukemia: A Retrospective Cohort Study
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Frairia, C, Aydin, S, Audisio, E, Riera, L, Aliberti, S, Allione, B, Busca, A, D'Ardia, S, Dellacasa, Cm, Demurtas, Anna, Evangelista, A, Ciccone, G, FRANCIA DI CELLE, P, Nicolino, B, Stacchini, A, and MARMONT F AND VITOLO, U.
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- 2017
6. Randomized comparison of liposomal amphotericin B versus placebo to prevent invasive mycoses in acute lymphoblastic leukaemia
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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., and Gilead Sciences
- Subjects
0301 basic medicine ,Male ,Antifungal Agents ,Administration, Intravenous ,Adolescent ,Adult ,Aged ,Aged, 80 and over ,Amphotericin B ,Chemoprevention ,Double-Blind Method ,Europe ,Female ,Humans ,Invasive Fungal Infections ,Middle Aged ,Placebos ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,South America ,Treatment Outcome ,Young Adult ,Medizin ,law.invention ,Randomized controlled trial ,law ,hemic and lymphatic diseases ,Clinical endpoint ,80 and over ,Pharmacology (medical) ,Original Research ,hemic and immune systems ,Chemotherapy regimen ,Infectious Diseases ,Tolerability ,Administration ,Intravenous ,Inflammatory diseases Radboud Institute for Molecular Life Sciences [Radboudumc 5] ,Microbiology (medical) ,medicine.medical_specialty ,030106 microbiology ,Neutropenia ,Placebo ,03 medical and health sciences ,Internal medicine ,medicine ,Pharmacology ,Surrogate endpoint ,business.industry ,medicine.disease ,Surgery ,Regimen ,Settore MED/15 - MALATTIE DEL SANGUE ,business - 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, and was 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., This study was funded by Gilead Sciences, Inc. M. B., W. G. and M. J. H. are employees of Gilead Sciences. All other authors or their institutions have received compensation for study participation from Gilead Sciences International Ltd.
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- 2017
7. Randomized comparison of liposomal amphotericin B versus placebo to prevent invasive mycoses in acute lymphoblastic leukaemia
- Author
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Cornely, O.A., Leguay, T., Maertens, J., Vehreschild, M., 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., Donnelly, J.P., Bresnik, M., Hawkins, M.J., Garner, W., Gokbuget, N., Cornely, O.A., Leguay, T., Maertens, J., Vehreschild, M., 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., Donnelly, J.P., Bresnik, M., Hawkins, M.J., Garner, W., and Gokbuget, N.
- Abstract
Item does not contain fulltext, 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, and was 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
8. A phase II, multicentre trial of decitabine in higher-risk chronic myelomonocytic leukemia
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Santini, V, primary, Allione, B, additional, Zini, G, additional, Gioia, D, additional, Lunghi, M, additional, Poloni, A, additional, Cilloni, D, additional, Sanna, A, additional, Masiera, E, additional, Ceccarelli, M, additional, Abdel-Wahab, O, additional, Terenzi, A, additional, Angelucci, E, additional, Finelli, C, additional, Onida, F, additional, Pelizzari, A, additional, Ferrero, D, additional, Saglio, G, additional, Figueroa, M, additional, and Levis, A, additional
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- 2017
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9. Different Repo Doses (High vs Standard) for Treatment of Anemia in MDS Patients: A Survey from the Italian MDS Registry
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Balleari, E., primary, Salvetti, C., additional, Filiberti, R., additional, Allione, B., additional, Angelucci, E., additional, Cavalieri, M., additional, Cavalleri, M., additional, Cilloni, D., additional, Clavio, M., additional, Crisa’, E., additional, Da Col, A., additional, Danise, P., additional, Di Tucci, A., additional, Finelli, C., additional, Lemoli, R., additional, Miglino, M., additional, Oliva, E., additional, Pellegrino, M., additional, Poloni, A., additional, and Santini, V., additional
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- 2017
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10. MDS-Can-It: A New Validated International ESA-Response Score that Further Refines the Predictive Power of the Nordic Scoring System
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Buckstein, R., primary, Balleari, E., additional, Wells, R.A., additional, Santini, V., additional, Salvetti, C., additional, Allione, B., additional, Danise, P., additional, Finelli, C., additional, Clavio, M., additional, Zhu, N., additional, Michelle, G., additional, Sabloff, M., additional, Leitch, H., additional, Leber, B., additional, Luca, M., additional, Latagliata, R., additional, Antonietta, M., additional, Villivà, N., additional, Piccioni, A.L., additional, and Buccisano, F., additional
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- 2017
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11. Effects of Erythropoiesis-Stimulating Agents on Overall Survival of IPSS Low/INT-1 Risk Transfusion Independent Myelodysplastic Syndrome Patients, a FISM Study
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Messa, E., primary, Gioia, D., additional, Masiera, E., additional, Castiglione, A., additional, Ceccarelli, M., additional, Salvi, F., additional, Danise, P., additional, Sanna, A., additional, Allione, B., additional, Balleari, E., additional, Poloni, A., additional, Cametti, G., additional, Ferrero, D., additional, Tassara, R., additional, Finelli, C., additional, Bonferroni, M., additional, Ciccone, G., additional, Saglio, G., additional, Levis, A., additional, and Santini, V., additional
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- 2017
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12. 166 TARGETED SEQUENCING ANALYSIS OF COMMONLY MUTATED GENES IN CHRONIC MYELOMONOCYTIC LEUKEMIA USING NGS: IMPACT AND CLINICAL IMPLICATIONS
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Valencia, A., primary, Abdel-Wahab, O., additional, Buchi, F., additional, Masala, E., additional, Sanna, A., additional, Gozzini, A., additional, Figueroa, M.E., additional, Contini, E., additional, Torricelli, F., additional, Allione, B., additional, Lunghi, M., additional, Onida, F., additional, Polloni, A., additional, Angelucci, E., additional, Finelli, F., additional, Levis, A., additional, Gioia, D., additional, Bosi, A., additional, and Santini, V., additional
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- 2015
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13. 110 BIOSIMILAR EPOETIN ZETA FOR THE TREATMENT OF ANEMIA IN MYELODYSPLASTIC SYNDROMES (MDS)
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Pelizzari, A., primary, Ferrero, D., additional, Molteni, A., additional, Allione, B., additional, Mezzabotta, M., additional, Clavio, M., additional, Borlenghi, E., additional, Rossi, G., additional, Masiera, E., additional, and Santini, V., additional
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- 2015
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14. 226 - MDS-Can-It: A New Validated International ESA-Response Score that Further Refines the Predictive Power of the Nordic Scoring System
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Buckstein, R., Balleari, E., Wells, R.A., Santini, V., Salvetti, C., Allione, B., Danise, P., Finelli, C., Clavio, M., Zhu, N., Michelle, G., Sabloff, M., Leitch, H., Leber, B., Luca, M., Latagliata, R., Antonietta, M., Villivà, N., Piccioni, A.L., and Buccisano, F.
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- 2017
- Full Text
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15. 93 - Effects of Erythropoiesis-Stimulating Agents on Overall Survival of IPSS Low/INT-1 Risk Transfusion Independent Myelodysplastic Syndrome Patients, a FISM Study
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Messa, E., Gioia, D., Masiera, E., Castiglione, A., Ceccarelli, M., Salvi, F., Danise, P., Sanna, A., Allione, B., Balleari, E., Poloni, A., Cametti, G., Ferrero, D., Tassara, R., Finelli, C., Bonferroni, M., Ciccone, G., Saglio, G., Levis, A., and Santini, V.
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- 2017
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16. 91 - Different Repo Doses (High vs Standard) for Treatment of Anemia in MDS Patients: A Survey from the Italian MDS Registry
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Balleari, E., Salvetti, C., Filiberti, R., Allione, B., Angelucci, E., Cavalieri, M., Cavalleri, M., Cilloni, D., Clavio, M., Crisa’, E., Da Col, A., Danise, P., Di Tucci, A., Finelli, C., Lemoli, R., Miglino, M., Oliva, E., Pellegrino, M., Poloni, A., and Santini, V.
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- 2017
- Full Text
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17. A phase II, multicentre trial of decitabine in higher-risk chronic myelomonocytic leukemia
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Santini, V, Allione, B, Zini, G, Gioia, D, Lunghi, M, Poloni, A, Cilloni, D, Sanna, A, Masiera, E, Ceccarelli, M, Abdel-Wahab, O, Terenzi, A, Angelucci, E, Finelli, C, Onida, F, Pelizzari, A, Ferrero, D, Saglio, G, Figueroa, M, and Levis, A
- Abstract
Chronic myelomonocytic leukemia (CMML) is a complex clonal hematological disorder classified among myelodysplastic (MDS)/myeloproliferative neoplasms. Prognosis is poor and there is a lack of effective treatments. The hypomethylating agent decitabine has shown activity against MDS and elderly acute myeloid leukemia, but there is little data focusing specifically on its efficacy in CMML. In this prospective, phase 2 Italian study, CMML patients received intravenous decitabine 20 mg/m2per day on Days 1–5 of a 28-day treatment cycle. Response was evaluated after four and six cycles; patients responding at the end of six cycles could continue treatment with decitabine. Forty-three patients were enrolled; >50% were high-risk according to four CMML-specific scoring systems. In the intent-to-treat population (n=42), the overall response rate after six cycles was 47.6%, with seven complete responses (16.6%), eight marrow responses (19%), one partial response (2.4%) and four hematological improvements (9.5%). After a median follow-up of 51.5 months (range: 44.4–57.2), median overall survival was 17 months, with responders having a significantly longer survival than non-responders (P=0.02). Grade 3/4 anemia, neutropenia and thrombocytopenia occurred in 28.6%, 50% and 38% of patients, respectively. Decitabine appears to be an effective and well-tolerated treatment for patients with high-risk CMML.
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- 2018
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18. SAFETY AND EFFICACY OF THE “CARMEN” REGIMEN, A NEW DOSE‐DENSE SHORT‐TERM THERAPY IN PATIENTS WITH AGGRESSIVE B‐CELL LYMPHOMA AND MYC REARRANGEMENT.
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Ferreri, A. J. M, Angelillo, P, Erbella, F, Liberatore, C, Cattaneo, C, Verga, L, Lleshi, A, Allione, B, Facchetti, F, Ponzoni, M, Pagani, C, Foppoli, M, Pecciarini, L, Sassone, M. C, Flospergher, E, Rossi, G, Spina, M, and A. Re
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- 2021
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19. Safety and efficacy of a dose-dense short-term therapy in patients with MYC-translocated aggressive lymphoma.
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Ferreri AJM, Angelillo P, Erbella F, Cattaneo C, Verga L, Lleshi A, Allione B, Ponzoni M, Facchetti F, Pagani C, Foppoli M, Pecciarini L, Sassone M, Steffanoni S, Flospergher E, Rossi G, Spina M, and Re A
- Subjects
- Humans, Rituximab therapeutic use, Vincristine adverse effects, Etoposide adverse effects, Retrospective Studies, In Situ Hybridization, Fluorescence, Antibodies, Monoclonal, Murine-Derived, Antineoplastic Combined Chemotherapy Protocols adverse effects, Transplantation, Autologous, Cyclophosphamide adverse effects, Prednisone therapeutic use, Cytarabine adverse effects, Doxorubicin adverse effects, Hematopoietic Stem Cell Transplantation, COVID-19, Burkitt Lymphoma drug therapy, Burkitt Lymphoma genetics, Lymphoma, B-Cell drug therapy, Lymphoma drug therapy, HIV Infections drug therapy
- Abstract
Patients with aggressive B-cell lymphoma and MYC rearrangement at fluorescence in situ hybridization exhibit poor outcome after R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone). In the last decade, 68 patients with Burkitt lymphoma ([BL] n = 46) or high-grade B-cell lymphoma ([HGBCL] single, double, or triple hit; n = 22) were treated with a dose-dense, short-term therapy termed "CARMEN regimen" at 5 Italian centers. Forty-six (68%) patients were HIV+. CARMEN included a 36-day induction with sequential, single weekly doses of cyclophosphamide, vincristine, rituximab, methotrexate, etoposide, and doxorubicin plus intrathecal chemotherapy, followed by high-dose-cytarabine-based consolidation. Patients who did not achieve complete remission (CR) after induction received BEAM (carmustina, etoposide, cytarabine, melfalan)-conditioned autologous stem cell transplantation (ASCT) after consolidation. Sixty-one (90%) patients completed induction, and 59 (87%) completed consolidation. Seventeen patients received ASCT. Grade 4 hematological toxicity was common but did not cause treatment discontinuation; grade 4 nonhematological toxicity was recorded in 11 (16%) patients, with grade 4 infections in 6 (9%). Six (9%) patients died of toxicity (sepsis in 4, COVID-19, acute respiratory distress syndrome). CR rate after the whole treatment was 73% (95% confidence interval [CI], 55% to 91%) for patients with HGBCL and 78% (95% CI, 66% to 90%) for patients with BL. At a median follow-up of 65 (interquartile range, 40-109) months, 48 patients remain event free, with a 5-year progression-free survival of 63% (95% CI, 58% to 68%) for HGBCL and 72% (95% CI, 71% to 73%) for BL, with a 5-year overall survival (OS) of 63% (95% CI, 58% to 68%) and 76% (95% CI, 75% to 77%), respectively. HIV seropositivity did not have a detrimental effect on outcome. This retrospective study shows that CARMEN is a safe and active regimen both in HIV-negative and -positive patients with MYC-rearranged lymphomas. Encouraging survival figures, attained with a single dose of doxorubicin and cyclophosphamide, deserve further investigation in HGBCL and other aggressive lymphomas., (© 2022 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved.)
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- 2022
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20. Overall survival of myelodysplastic syndrome patients after azacitidine discontinuation and applicability of the North American MDS Consortium scoring system in clinical practice.
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Clavio M, Crisà E, Miglino M, Guolo F, Ceccarelli M, Salvi F, Allione B, Ferrero D, Balleari E, Finelli C, Poloni A, Selleri C, Danise P, Cilloni D, Di Tucci AA, Cametti G, Freilone R, Fanin R, Bigazzi C, Zambello R, Crugnola M, Oliva EN, Centurioni R, Alesiani F, Catarini M, Castelli A, Abbadessa A, Capalbo SF, Musto P, Angelucci E, and Santini V
- Subjects
- Antimetabolites, Antineoplastic, Azacitidine, Humans, North America, Treatment Outcome, Hematopoietic Stem Cell Transplantation, Myelodysplastic Syndromes therapy
- Abstract
Background: Azacitidine (AZA) is the standard treatment for myelodysplastic syndromes (MDS); however, many patients prematurely stop therapy and have a dismal outcome., Methods: The authors analyzed outcomes after AZA treatment for 402 MDS patients consecutively enrolled in the Italian MDS Registry of the Fondazione Italiana Sindromi Mielodisplastiche, and they evaluated the North American MDS Consortium scoring system in a clinical practice setting., Results: At treatment discontinuation, 20.3% of the patients were still responding to AZA, 35.4% of the cases had primary resistance, and 44.3% developed adaptive resistance. Overall survival (OS) was better for patients who discontinued treatment while in response because of planned allogeneic hematopoietic stem cell transplantation (HSCT; median OS, not reached) in comparison with patients with primary resistance (median OS, 4 months) or adaptive resistance (median OS, 5 months) or patients responsive but noncompliant/intolerant to AZA (median OS, 4 months; P = .004). After AZA discontinuation, 309 patients (77%) received best supportive care (BSC), 60 (15%) received active treatments, and 33 (8%) received HSCT. HSCT was associated with a significant survival advantage, regardless of the response to AZA. The North American MDS Consortium scoring system was evaluable in 278 of the 402 cases: patients at high risk had worse OS than patients at low risk (3 and 7 months, respectively; P < .001). The score was predictive of survival both in patients receiving BSC (median OS, 2 months for high-risk patients vs 5 months for low-risk patients) and in patients being actively treated (median OS, 8 months for high-risk patients vs 16 months for low-risk patients; P < .001), including transplant patients., Conclusions: Real-life data confirm that this prognostic scoring system for MDS patients failing a hypomethylating agent seems to be a useful tool for optimal prognostic stratification and for choosing a second-line treatment after AZA discontinuation., (© 2021 American Cancer Society.)
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- 2021
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21. A dose-dense short-term therapy for human immunodeficiency virus/acquired immunodeficiency syndrome patients with high-risk Burkitt lymphoma or high-grade B-cell lymphoma: safety and efficacy results of the "CARMEN" phase II trial.
- Author
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Ferreri AJM, Cattaneo C, Lleshi A, Verga L, Allione B, Facchetti F, Ponzoni M, Foppoli M, Ferrari D, Rigacci L, Pecciarini L, Donadoni G, Fumagalli L, Sassone M, Calimeri T, Rossi G, Spina M, and Re A
- Subjects
- Adult, Antimetabolites, Antineoplastic administration & dosage, Antimetabolites, Antineoplastic adverse effects, Antineoplastic Combined Chemotherapy Protocols administration & dosage, Antineoplastic Combined Chemotherapy Protocols adverse effects, Antiviral Agents administration & dosage, Antiviral Agents adverse effects, Antiviral Agents therapeutic use, Burkitt Lymphoma complications, Carmustine administration & dosage, Carmustine adverse effects, Carmustine therapeutic use, Cytarabine administration & dosage, Cytarabine adverse effects, Etoposide administration & dosage, Etoposide adverse effects, Etoposide therapeutic use, Female, HIV Infections complications, Hematopoietic Stem Cell Transplantation adverse effects, Humans, Lymphoma, B-Cell complications, Male, Melphalan administration & dosage, Melphalan adverse effects, Melphalan therapeutic use, Middle Aged, Transplantation, Autologous adverse effects, Acquired Immunodeficiency Syndrome complications, Acquired Immunodeficiency Syndrome therapy, Antimetabolites, Antineoplastic therapeutic use, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Burkitt Lymphoma therapy, Cytarabine therapeutic use, Lymphoma, B-Cell therapy
- Abstract
A few prospective trials in HIV-positive patients with Burkitt lymphoma (BL) or high-grade B-cell lymphoma (HGBL) have been reported. Investigated therapies have shown good efficacy but relevant safety problems, with high rates of interruptions, severe mucositis, septic complications, and fungal infections. Here, we report the results of a multicentre phase II trial addressing a new dose-dense, short-term therapy aimed at maintaining efficacy and improving tolerability. The experimental programme included a 36-day polychemotherapy induction followed by high-dose cytarabine-based consolidation and response-tailored BEAM (carmustine, etoposide, cyatarabine, and melphalan)- conditioned autologous stem cell transplantation (ASCT). This therapy would be considered active if ≥11 complete remissions (CR) after induction (primary endpoint) were recorded among 20 assessable patients. HIV-positive adults (median age 42, range 26-58; 16 males) with untreated BL (n = 16), HGBL (n = 3) or double-hit lymphoma (n = 1) were enrolled. All patients had high-risk features, with meningeal and bone marrow infiltration in five and nine patients respectively. The experimental programme was safe and active in a multicentre setting, with only two episodes of grade 4 non-haematological toxicity (hepatotoxicity and mucositis), and no cases of systemic fungal infections; two patients died of toxicity (bacterial infections). Response after induction (median duration: 47 days; interquartile range 41-54), was complete in 13 patients and partial in five [overall response rate = 90%; 95% confidence interval (CI) = 77-100]. All responders received consolidation, and five required autologous stem cell transplant. At a median follow-up of 55 (41-89) months, 14 patients are relapse-free and 15 are alive, with a five-year progression-free survival and an overall survival of 70% (95% CI = 60-80%) and 75% (95% CI = 66-84) respectively. No patient with cerebrospinal fluid (CSF)/meningeal lymphoma experienced central nervous system recurrence. With respect to previously reported regimens, this programme was delivered in a shorter period, and achieved the main goal of maintaining efficacy and improving tolerability., (© 2020 British Society for Haematology and John Wiley & Sons Ltd.)
- Published
- 2021
- Full Text
- View/download PDF
22. Impact of the type of anthracycline and of stem cell transplantation in younger patients with acute myeloid leukaemia: Long-term follow up of a phase III study.
- Author
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Baron F, Efficace F, Cannella L, Muus P, Trisolini S, Halkes CJM, Fazi P, Vignetti M, Marie JP, Chiusolo P, van der Velden W, La Sala E, Vitolo U, Thomas X, Lefrère F, Di Raimondo F, Bourhis JH, Specchia G, Guimarães JE, Allione B, Vrhovac R, Ferrara F, Stevens-Kroef M, Meert L, de Witte T, Willemze R, Amadori S, and Suciu S
- Subjects
- Adolescent, Adult, Age Factors, Allografts, Cytarabine administration & dosage, Cytarabine adverse effects, Daunorubicin administration & dosage, Daunorubicin adverse effects, Etoposide administration & dosage, Etoposide adverse effects, Female, Follow-Up Studies, Humans, Idarubicin administration & dosage, Idarubicin adverse effects, Male, Middle Aged, Mitoxantrone administration & dosage, Mitoxantrone adverse effects, Antineoplastic Combined Chemotherapy Protocols administration & dosage, Hematopoietic Stem Cell Transplantation, Induction Chemotherapy, Leukemia, Myeloid, Acute mortality, Leukemia, Myeloid, Acute therapy
- Abstract
We provide a long-term evaluation of patients enrolled in the EORTC/GIMEMA AML-10 trial which included a total of 2157 patients, 15-60 years old, randomized to receive either daunorubicin (DNR, 50 mg/m
2 ), mitoxantrone (MXR, 12 mg/m2 ), or idarubicin (IDA, 10 mg/m2 ) in addition to standard-dose cytarabine and etoposide for induction chemotherapy and intermediate dose cytarabine for consolidation. Younger patients who reached complete remission with complete (CR) or incomplete (CRi) recovery were then scheduled to receive an allogeneic hematopoietic stem cell transplantation (HSCT). That was if they had a HLA-identical sibling donor; in all other cases, an autologous HSCT had to be administered. At an 11-year median follow-up, the 5-year, 10-year and 15-year overall survival (OS) rates were 33.2%, 30.1% and 28.0%, respectively. No significant difference between the three randomized groups regarding OS was observed (P = .38). In young patients, 15-45 years old, no treatment difference (P = .89) regarding OS was observed, while in patients 46-60 years old, MXR and IDA groups had a trend for a longer OS as compared to the DNR group (P = .029). Among younger patients without a favorable MRC cytogenetic risk subgroup who achieved a CR/CRi after induction chemotherapy, those with a HLA-identical sibling donor had higher 10-year and 15-year OS rates than those without. In older patients who reached CR/CRi, the long-term outcomes of those with or without a donor was similar. In conclusion, long-term outcomes of the study confirmed similar OS in the three randomized groups in the whole cohort of patients., (© 2020 Wiley Periodicals, Inc.)- Published
- 2020
- Full Text
- View/download PDF
23. Effects of different doses of erythropoietin in patients with myelodysplastic syndromes: A propensity score-matched analysis.
- Author
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Balleari E, Filiberti RA, Salvetti C, Allione B, Angelucci E, Bruzzone M, Calzamiglia T, Cavaliere M, Cavalleri M, Cilloni D, Clavio M, Crisà E, Da Col A, Danise P, Pilo F, Ferrero D, Finelli C, Gioia D, Lemoli RM, Masiera E, Messa E, Miglino M, Musto P, Natalie Oliva E, Poloni A, Salvi F, Sanna A, Scudeletti M, Tassara R, and Santini V
- Subjects
- Aged, Aged, 80 and over, Anemia blood, Disease Progression, Erythrocyte Indices, Female, Humans, Male, Middle Aged, Myelodysplastic Syndromes drug therapy, Myelodysplastic Syndromes mortality, Propensity Score, Proportional Hazards Models, Recombinant Proteins administration & dosage, Retrospective Studies, Treatment Outcome, Anemia drug therapy, Anemia etiology, Erythropoietin administration & dosage, Myelodysplastic Syndromes complications
- Abstract
Background: Erythropoiesis-stimulating agents effectively improve the hemoglobin levels in a fraction of anemic patients with myelodysplastic syndromes (MDS). Higher doses (HD) of recombinant human erythropoietin (rhEPO) have been proposed to overcome suboptimal response rates observed in MDS patients treated with lower "standard doses" (SD) of rhEPO. However, a direct comparison between the different doses of rhEPO is lacking., Methods: A cohort of 104 MDS patients treated with HD was retrospectively compared to 208 patients treated with SD in a propensity score-matched analysis to evaluate hematological improvement-erythroid (HI-E) rate induced by the different doses of rhEPO. The impact of rhEPO doses on survival and progression to leukemia was also investigated., Results: Overall HI-E rate was 52.6%. No difference was observed between different rhEPO doses (P = .28) in matched cohorts; in a subgroup analysis, transfusion-dependent patients and patients with higher IPSS-R score obtained a higher HI-E rate with HD, although without significant impact on overall survival (OS). Achievement of HI-E resulted in superior OS. At univariate analysis, a higher HI-E rate was observed in transfusion-independent patients (P < .001), with a lower IPSS-R score (P < .001) and lower serum EPO levels (P = .027). Multivariate analysis confirmed that rhEPO doses were not significantly related to HI-E (P = .26). There was no significant difference in OS or progression to leukemia in patients treated with HD vs SD., Conclusion: SD are substantially equally effective to HD to improve anemia and influencing survival in MDS patients stratified according to similar propensity to be exposed to rhEPO treatment., (© 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
- Published
- 2019
- Full Text
- View/download PDF
24. Effects of erythropoiesis-stimulating agents on overall survival of International Prognostic Scoring System Low/Intermediate-1 risk, transfusion-independent myelodysplastic syndrome patients: a cohort study.
- Author
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Messa E, Gioia D, Masiera E, Castiglione A, Ceccarelli M, Salvi F, Danise P, Sanna A, Allione B, Balleari E, Poloni A, Cametti G, Ferrero D, Tassara R, Finelli C, Bonferroni M, Musto P, Saglio G, Levis A, and Santini V
- Subjects
- Aged, Aged, 80 and over, Disease-Free Survival, Female, Humans, Male, Middle Aged, Myelodysplastic Syndromes blood, Retrospective Studies, Risk Factors, Survival Rate, Hematinics administration & dosage, Myelodysplastic Syndromes drug therapy, Myelodysplastic Syndromes mortality
- Published
- 2019
- Full Text
- View/download PDF
25. Haplo-identical allografting with post-transplant cyclophosphamide in high-risk patients.
- Author
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Brunello L, Passera R, Dellacasa CM, Giaccone L, Audisio E, Ferrero D, D'Ardia S, Allione B, Aydin S, Festuccia M, Lia G, Crisà E, Maffini E, Butera S, Busca A, and Bruno B
- Subjects
- Adult, Aged, Allografts, Disease-Free Survival, Female, Humans, Incidence, Male, Middle Aged, Mycophenolic Acid administration & dosage, Retrospective Studies, Risk Factors, Survival Rate, Tacrolimus administration & dosage, Cyclophosphamide administration & dosage, Graft vs Host Disease mortality, Graft vs Host Disease pathology, Graft vs Host Disease prevention & control, Hematologic Neoplasms mortality, Hematologic Neoplasms pathology, Hematologic Neoplasms therapy, Hematopoietic Stem Cell Transplantation, Leukemia mortality, Leukemia pathology, Leukemia therapy, Registries
- Abstract
Haplo-identical transplants (Haplo-Tx) are an important alternative for patients with hematological malignancies who lack a HLA-identical donor. Seventy-one T-replete Haplo-Tx were performed in 70 high-risk patients at our center; 22/70 (31%) patients with refractory/relapsed leukemia received sequential salvage therapy (SeqTh) with high-dose chemotherapy followed by Haplo-Tx during the chemotherapy-induced neutropenia. Graft-versus-host disease (GVHD) prophylaxis consisted of post-transplant cyclophosphamide (days + 3 and + 4) with tacrolimus and mycophenolic acid. After a median follow-up of 29.2 months, 3-year overall survival (OS) and event-free survival (EFS) were 43.8 and 40.2%, while 3-year cumulative incidences (CIs) of non-relapse mortality (NRM) and relapse (RI) were 27 and 33%. Day 100 and day 400 CI of grade III-IV acute and moderate-severe chronic GVHD were 11 and 15%. Three-year RI was significantly lower in patients in complete remission (CR) versus those not in CR at the time of transplant (21.5 vs. 48%, p = 0.009) and in patients who received PBSC as compared to BM (22 vs. 45%, p = 0.009). In patients treated with SeqTh, 3-year OS was 19%, while 3-year RI and NRM were 52 and 28% at a median follow-up of 50 months. Overall, Haplo-Tx was feasible in heavily pretreated high-risk patients without a suitable HLA-identical donor.
- Published
- 2018
- Full Text
- View/download PDF
26. Erythroid response during iron chelation therapy in a cohort of patients affected by hematologic malignancies and aplastic anemia with transfusion requirement and iron overload: a FISM Italian multicenter retrospective study.
- Author
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Messa E, Biale L, Castiglione A, Lunghi M, Bonferroni M, Salvi F, Allione B, Ferrero D, Calabrese C, De Gobbi M, Nicoli P, Gioia D, Levis A, Saglio G, and Cilloni D
- Subjects
- Anemia, Aplastic blood, Anemia, Aplastic diagnosis, Anemia, Aplastic therapy, Chelation Therapy, Female, Hematologic Neoplasms blood, Hematologic Neoplasms diagnosis, Hematologic Neoplasms therapy, Humans, Iron Chelating Agents administration & dosage, Iron Overload diagnosis, Male, Retrospective Studies, Treatment Outcome, Anemia, Aplastic complications, Blood Transfusion, Hematologic Neoplasms complications, Iron Chelating Agents therapeutic use, Iron Overload drug therapy, Iron Overload etiology
- Published
- 2017
- Full Text
- View/download PDF
27. ITACA: A new validated international erythropoietic stimulating agent-response score that further refines the predictive power of previous scoring systems.
- Author
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Buckstein R, Balleari E, Wells R, Santini V, Sanna A, Salvetti C, Crisà E, Allione B, Danise P, Finelli C, Clavio M, Poloni A, Salvi F, Cilloni D, Oliva EN, Musto P, Houston B, Zhu N, Geddes M, Leitch H, Leber B, Sabloff M, Nevill TJ, Yee KW, Storring JM, Francis J, Maurillo L, Latagliata R, Spiriti MAA, Andriani A, Piccioni AL, Fianchi L, Fenu S, Gumenyuk S, and Buccisano F
- Subjects
- Aged, Aged, 80 and over, Canada epidemiology, Databases, Factual, Female, Humans, International Cooperation, Italy epidemiology, Logistic Models, Male, Predictive Value of Tests, Prognosis, Prospective Studies, Registries, Survival Rate, Hematinics therapeutic use, Myelodysplastic Syndromes diagnosis, Myelodysplastic Syndromes drug therapy, Myelodysplastic Syndromes mortality
- Abstract
Background: In 'real-life', the Nordic score guides Erythropoietic stimulating agent (ESA) use in lower-risk myelodysplastic syndrome (MDS) with predicted response rates of 25% or 74%. As new treatments emerge, a more discriminating score is needed., Objectives: To validate existing ESA predictive scores and develop a new score that identifies non-responders., Methods: ESA-treated patients were identified in 3 MDS registries in Italy and Canada (FISM 555, GROM 233, and MDS-CAN 208). Clinical and disease-related variables were captured. Nordic, MDS-CAN, and IPSS-R-based ESA scores were calculated and documented ESA responses compared., Results: 996 ESA-treated patients were identified. Overall response rate (ORR) was 59%. The database was randomly divided into balanced derivation (n = 463) and validation (n = 462) cohorts. By multivariate analysis, transfusion independence, erythropoietin (EPO) level <100 IU/L, and IPSS low-risk were independently predictive of response. Assigning a score of 1 to each resulted in a scoring system of 0-3 with response rates of 23%, 43%, 67%, and 85%. ORR was concordant in the validation cohort. The 'ITACA' score had the highest discriminating power of response., Conclusion: ITACA is an internally-validated predictive SS of ESA response in real-life 'good risk' MDS patients derived from a large international dataset that surpasses others. The incorporation of biologic markers to better identify non-responders is still needed., (© 2017 Wiley Periodicals, Inc.)
- Published
- 2017
- Full Text
- View/download PDF
28. Post-remissional and pre-transplant role of minimal residual disease detected by WT1 in acute myeloid leukemia: A retrospective cohort study.
- Author
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Frairia C, Aydin S, Audisio E, Riera L, Aliberti S, Allione B, Busca A, D'Ardia S, Dellacasa CM, Demurtas A, Evangelista A, Ciccone G, Francia di Celle P, Nicolino B, Stacchini A, Marmont F, and Vitolo U
- Subjects
- Adult, Aged, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Disease-Free Survival, Female, Hematopoietic Stem Cell Transplantation, Humans, Induction Chemotherapy, Leukemia, Myeloid, Acute mortality, Leukemia, Myeloid, Acute therapy, Male, Middle Aged, Neoplasm, Residual mortality, Prognosis, Real-Time Polymerase Chain Reaction, Remission Induction, Retrospective Studies, Risk Factors, WT1 Proteins analysis, Young Adult, Biomarkers, Tumor analysis, Leukemia, Myeloid, Acute pathology, Neoplasm, Residual pathology, WT1 Proteins biosynthesis
- Abstract
In acute myeloid leukemia (AML), the detection of minimal residual disease (MRD) is still under investigation. The aim of the present retrospective study was to assess the role of Wilms tumor gene 1 (WT1) overexpression in a large monocentric cohort of AML patients. Among 255 enrolled patients, MRD was investigated in those in complete remission (CR) with an available WT1 at baseline (>250 copies) and at two further time-points: after induction (n=117) and prior allogeneic hematopoietic cell transplantation (allo-HCT), n=65. Baseline BM WT1 overexpression was not associated with response to induction (p=0.244). Median overall survival (OS) and disease-free survival (DFS) were significantly shorter in patients with >350 WT1 copies after induction compared to those with ≤350 (HR for mortality 2.13; 95% CI 1.14-3.97, p=0.018 and HR for relapse 2.81; 95% CI 1.14-6.93, p=0.025). Patients with WT1>150 copies pre allo-HCT had a significantly higher 2-year cumulative incidence of relapse (CIR) compared to those with WT1≤150 (HR 4.61; 95% CI 1.72-12.31, p=0.002). The prognostic role of WT1 overexpression resulted independent from other well-established risk factors. According to these results, WT1 overexpression might represent an additional MRD tool for risk stratification in patients classified nowadays in CR., (Copyright © 2017 Elsevier Ltd. All rights reserved.)
- Published
- 2017
- Full Text
- View/download PDF
29. Randomized comparison of liposomal amphotericin B versus placebo to prevent invasive mycoses in acute lymphoblastic leukaemia.
- Author
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Cornely OA, Leguay T, Maertens J, Vehreschild MJGT, Anagnostopoulos A, Castagnola C, Verga L, Rieger C, Kondakci M, Härter G, Duarte RF, Allione B, Cordonnier C, Heussel CP, Morrissey CO, Agrawal SG, Donnelly JP, Bresnik M, Hawkins MJ, Garner W, and Gökbuget N
- Subjects
- Administration, Intravenous, Adolescent, Adult, Aged, Aged, 80 and over, Double-Blind Method, Europe, Female, Humans, Male, Middle Aged, Placebos administration & dosage, South America, Treatment Outcome, Young Adult, Amphotericin B administration & dosage, Antifungal Agents administration & dosage, Chemoprevention methods, Invasive Fungal Infections prevention & control, Precursor Cell Lymphoblastic Leukemia-Lymphoma complications
- 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, and was 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., (© The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)
- Published
- 2017
- Full Text
- View/download PDF
30. Clinical Effects of Driver Somatic Mutations on the Outcomes of Patients With Myelodysplastic Syndromes Treated With Allogeneic Hematopoietic Stem-Cell Transplantation.
- Author
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Della Porta MG, Gallì A, Bacigalupo A, Zibellini S, Bernardi M, Rizzo E, Allione B, van Lint MT, Pioltelli P, Marenco P, Bosi A, Voso MT, Sica S, Cuzzola M, Angelucci E, Rossi M, Ubezio M, Malovini A, Limongelli I, Ferretti VV, Spinelli O, Tresoldi C, Pozzi S, Luchetti S, Pezzetti L, Catricalà S, Milanesi C, Riva A, Bruno B, Ciceri F, Bonifazi F, Bellazzi R, Papaemmanuil E, Santoro A, Alessandrino EP, Rambaldi A, and Cazzola M
- Abstract
Purpose: The genetic basis of myelodysplastic syndromes (MDS) is heterogeneous, and various combinations of somatic mutations are associated with different clinical phenotypes and outcomes. Whether the genetic basis of MDS influences the outcome of allogeneic hematopoietic stem-cell transplantation (HSCT) is unclear., Patients and Methods: We studied 401 patients with MDS or acute myeloid leukemia (AML) evolving from MDS (MDS/AML). We used massively parallel sequencing to examine tumor samples collected before HSCT for somatic mutations in 34 recurrently mutated genes in myeloid neoplasms. We then analyzed the impact of mutations on the outcome of HSCT., Results: Overall, 87% of patients carried one or more oncogenic mutations. Somatic mutations of ASXL1, RUNX1, and TP53 were independent predictors of relapse and overall survival after HSCT in both patients with MDS and patients with MDS/AML (P values ranging from .003 to .035). In patients with MDS/AML, gene ontology (ie, secondary-type AML carrying mutations in genes of RNA splicing machinery, TP53-mutated AML, or de novo AML) was an independent predictor of posttransplantation outcome (P = .013). The impact of ASXL1, RUNX1, and TP53 mutations on posttransplantation survival was independent of the revised International Prognostic Scoring System (IPSS-R). Combining somatic mutations and IPSS-R risk improved the ability to stratify patients by capturing more prognostic information at an individual level. Accounting for various combinations of IPSS-R risk and somatic mutations, the 5-year probability of survival after HSCT ranged from 0% to 73%., Conclusion: Somatic mutation in ASXL1, RUNX1, or TP53 is independently associated with unfavorable outcomes and shorter survival after allogeneic HSCT for patients with MDS and MDS/AML. Accounting for these genetic lesions may improve the prognostication precision in clinical practice and in designing clinical trials.
- Published
- 2016
- Full Text
- View/download PDF
31. Efficacy of plasmapheresis for the treatment of pure red blood cell aplasia after allogeneic stem cell transplantation.
- Author
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Dellacasa CM, D'Ardia S, Allione B, Aydin S, Tassi V, Francisci T, Pecoraro C, and Busca A
- Subjects
- Female, Humans, Middle Aged, Transplantation, Homologous, Hematopoietic Stem Cell Transplantation adverse effects, Plasmapheresis, Red-Cell Aplasia, Pure therapy
- Abstract
Background: Pure red blood cell aplasia (PRCA) is a complication of ABO major-incompatible stem cell transplantation, likely due to the persistence of memory B lymphocytes of recipient origin, which produce hemagglutinins against ABO antigens on donor RBCs. At present no standard of care is established for this complication., Case Report: We report a case of PRCA after allogeneic bone marrow transplantation, successfully treated with plasma exchange (PEX) after failing erythropoietin administration., Results: The patient fully recovered from RBC aplasia., Conclusion: This case suggests a role for PEX in the treatment of PRCA after allogeneic stem cell transplantation., (© 2015 AABB.)
- Published
- 2015
- Full Text
- View/download PDF
32. Specific molecular signatures predict decitabine response in chronic myelomonocytic leukemia.
- Author
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Meldi K, Qin T, Buchi F, Droin N, Sotzen J, Micol JB, Selimoglu-Buet D, Masala E, Allione B, Gioia D, Poloni A, Lunghi M, Solary E, Abdel-Wahab O, Santini V, and Figueroa ME
- Subjects
- Aged, Aged, 80 and over, Antimetabolites, Antineoplastic pharmacology, Azacitidine pharmacology, Azacitidine therapeutic use, Bone Marrow pathology, DNA Methylation drug effects, DNA Mutational Analysis, DNA, Intergenic genetics, Decitabine, Enhancer Elements, Genetic genetics, Female, Humans, Leukemia, Myelomonocytic, Chronic genetics, Leukemia, Myelomonocytic, Chronic metabolism, Male, Middle Aged, Neoplasm Proteins biosynthesis, Neoplasm Proteins genetics, Platelet Factor 4 biosynthesis, Platelet Factor 4 genetics, Platelet Factor 4 physiology, Treatment Outcome, beta-Thromboglobulin biosynthesis, beta-Thromboglobulin genetics, beta-Thromboglobulin physiology, Antimetabolites, Antineoplastic therapeutic use, Azacitidine analogs & derivatives, Drug Resistance, Neoplasm genetics, Gene Expression Profiling, Gene Expression Regulation, Neoplastic genetics, Genes, Neoplasm, Leukemia, Myelomonocytic, Chronic drug therapy
- Abstract
Myelodysplastic syndromes and chronic myelomonocytic leukemia (CMML) are characterized by mutations in genes encoding epigenetic modifiers and aberrant DNA methylation. DNA methyltransferase inhibitors (DMTis) are used to treat these disorders, but response is highly variable, with few means to predict which patients will benefit. Here, we examined baseline differences in mutations, DNA methylation, and gene expression in 40 CMML patients who were responsive or resistant to decitabine (DAC) in order to develop a molecular means of predicting response at diagnosis. While somatic mutations did not differentiate responders from nonresponders, we identified 167 differentially methylated regions (DMRs) of DNA at baseline that distinguished responders from nonresponders using next-generation sequencing. These DMRs were primarily localized to nonpromoter regions and overlapped with distal regulatory enhancers. Using the methylation profiles, we developed an epigenetic classifier that accurately predicted DAC response at the time of diagnosis. Transcriptional analysis revealed differences in gene expression at diagnosis between responders and nonresponders. In responders, the upregulated genes included those that are associated with the cell cycle, potentially contributing to effective DAC incorporation. Treatment with CXCL4 and CXCL7, which were overexpressed in nonresponders, blocked DAC effects in isolated normal CD34+ and primary CMML cells, suggesting that their upregulation contributes to primary DAC resistance.
- Published
- 2015
- Full Text
- View/download PDF
33. Prevention of invasive fungal infections in patients with acute myeloid leukaemia: results of a single centre retrospective observational study with the use of posaconazole versus conventional mould-active azoles.
- Author
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Dellacasa CM, Busca A, Audisio E, Marmont F, Barbui AM, Falda M, De Rosa FG, Frairia C, Allione B, D'Ardia S, Aydin S, Pecoraro C, Manetta S, and Vitolo U
- Subjects
- Administration, Oral, Adolescent, Adult, Aged, Antifungal Agents administration & dosage, Cohort Studies, Female, Humans, Itraconazole administration & dosage, Leukemia, Myeloid, Acute drug therapy, Leukemia, Myeloid, Acute microbiology, Male, Middle Aged, Mycoses microbiology, Retrospective Studies, Triazoles administration & dosage, Young Adult, Antifungal Agents therapeutic use, Itraconazole therapeutic use, Leukemia, Myeloid, Acute complications, Mycoses complications, Mycoses prevention & control, Triazoles therapeutic use
- Published
- 2014
- Full Text
- View/download PDF
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