Although chronic lymphocytic leukemia (CLL) predominantly affects the elderly, limited data exists about the outcomes of over 80‐year‐old patients, usually underrepresented in clinical trials. We conducted a multicenter study enrolling 79 consecutive CLL patients ≥80 years at the time of frontline therapy, all treated with ibrutinib. Nearly 48% of cases exhibited unmutated IGHV genes, 32% 17p deletion, and 39.2% TP53 mutations; 63.3% displayed a cumulative illness rating scale (CIRS) > 6. The overall response rate on ibrutinib, computed in 74/79 patients (5 patients excluded for early withdrawal), was 89.9%. After a median follow‐up of 28.9 months, the median progression‐free survival (PFS) and overall survival (OS) were 42.5 and 51.8 months, respectively. CIRS>6 and temporary discontinuation of ibrutinib lasting for 7–30 days were the only parameters associated with a significantly shorter PFS and were both relevant in predicting a shorter PFS compared to patients with CIRS≤6 and therapy discontinuation ≤7 days. The most common grade≥3 adverse events were infections (25.5%), neutropenia (10.1%), and anemia (2.5%). Eighteen patients (22.8%) experienced a cardiovascular event, including grade‐2 atrial fibrillation (n = 9; 11%), grade‐2 hypertension (n = 5; 6%), heart failure (n = 3; 3%), and acute coronary syndrome (n = 1; 1%). Mild bleeding events were observed in 27 patients (34.2%). Ibrutinib was permanently discontinued in 26 patients due to progressive disease (n = 11, including 5 Richter's syndromes), secondary malignancies (n = 6), infections (n = 3), cardiac failure (n = 3), severe bleeding (n = 2), and sudden death (n = 1). In conclusion, our analyses confirmed the overall effectiveness and favorable safety profile of the ibrutinib‐single agent therapeutic approach in CLL patients ≥80 years. [ABSTRACT FROM AUTHOR]
Chronic lymphocytic leukemia (CLL) therapies differ in efficacy, side effects, route, frequency, and duration of administration. We assessed patient preferences for treatment attributes and evaluated associations with disease stage, treatment line, and socio‐demographic characteristics in a cross sectional, observational study conducted at 16 Italian hematology centers. Study visits occurred between February and July 2020; 401 adult patients with CLL (201 Watch and Wait (W&W), 200 treated) participated in a discrete choice experiment (DCE), composed of 8 choices between pairs of treatment profiles with different levels of 5 attributes of currently available CLL treatments (length of response, route and duration of administration, risk of side effects including diarrhea, infections, or organ damage). Health‐related quality of life was assessed with the EQ‐5D‐5L, EORTC QLQ‐C30 and QLQ CLL‐16. Previously treated patients had longer disease duration (7 vs. 5 years), higher prevalence of serious comorbidities (45.5% vs. 36.2%) and high‐risk molecular markers (unmutated IGHV 55.6% vs. 17.1%; TP53 mutation 15.2% vs. 4.0%). Health‐related quality of life scores were similar between groups. In the DCE, W&W patients rated "possible occurrence of infections" highest (relative importance [RI] = 36.2%), followed by "treatment and relevant duration" (RI = 28.0%) and "progression‐free survival (PFS)" (RI = 16.9%). Previously treated patients rated "treatment and relevant duration" highest (RI = 33.3%), followed by "possible occurrence of infections" (RI = 28.8%), "possible occurrence of organ damage" (RI = 19.4%), and "PFS" (RI = 9.8%). Concern over infection was rated highest overall; unexpectedly PFS was not among the most important criteria in either group, suggesting that the first COVID‐19 pandemic wave may have influenced patient preferences and concerns about CLL therapy options. [ABSTRACT FROM AUTHOR]
Clinical or biological parameters useful to predict progression during treatment in real‐life setting with ibrutinib, idelalisib and venetoclax in relapsed/refractory chronic lymphocytic leukemia (CLL) are still debated. We conducted a multi‐center retrospective study on CLL patients treated with ibrutinib and/or idelalisib who were switched to venetoclax for progression or due to adverse events to identify any clinical and/or biological parameters useful to predict progression during treatment with venetoclax. Of all the 128 evaluable patients, 81 had received ibrutinib prior to switching to venetoclax, 35 had received idelalisib and 12 both. When comparing the three subgroups, we did not notice any statistical difference in terms of clinical or biological features. No variable at baseline and at different time points during the follow‐up (at 6, 12, 18 and 24 months) was found to predict progression nor to have significance for Progression Free Survival (PFS) in the ibrutinib group and in the idelalisib group and in subgroups according to the line of treatment. Analyzing the data of the venetoclax treatment, after a median follow up of 14.3 months, median PFS was not reached and estimated 3‐year PFS was 54%. Of the 128 patients treated with venetoclax, 28 (22%) experienced progressive disease. At multivariate analysis for predictive factors for progression, lymph node diameter >56.5 mm before starting treatment emerged as an independent risk factor for progression. The lymph node predictive role for progression during venetoclax treatment could be a new parameter that deserves to be investigate in future studies. [ABSTRACT FROM AUTHOR]
Ibrutinib‐associated atrial fibrillation (IRAF) emerged among the adverse events of major interests in ibrutinib‐treated patients as real‐world studies showed a higher incidence compared to clinical trials. We prospectively analyzed predictors of IRAF in 43 single‐center consecutive patients affected by chronic lymphocytic leukemia that started therapy with ibrutinib between 2015 and 2017. Key secondary endpoints were to describe the management of IRAF and survival outcomes. During a median follow‐up period of 52 months, we registered 45 CV events, with a total of 23 AF events in 13 patients (CI 30.0% (95% CI: 16.5–43.9)). Pre‐existent cardiovascular risk factors, in particular hypertension, a previous history of AF and a high Shanafelt risk score emerged as predictors of IRAF. Baseline echocardiographic evaluation of left atrial (LA) dimensions confirmed to predict IRAF occurrence and cut‐off values were identified in our cohort: 32 mm for LA diameter and 18 cm2 for LA area. No difference in progression free survival and overall survival emerged in patients experiencing IRAF. Following AF, anticoagulation was started in all eligible patients, and cardioactive therapy was accordingly modified. Echocardiography represents a highly reproducible and widespread tool to be included in the work‐up of ibrutinib candidates; the identification of IRAF predictors represents a useful guide to clinical practice. [ABSTRACT FROM AUTHOR]
The I EGR2 i gene, coding for a transcription factor that also mediates the I TP53 i dependent apoptotic pathway, was found to be mutated in 3 patients (8.6%), and further stratifies the outcome of low-risk patients. Long-term benefit of IGHV mutated patients in a real-life multicenter cohort of FCR-treated chronic lymphocytic leukemia Fludarabine, cyclophosphamide, and rituximab treatment achieves long-term disease-free survival in IGHV-mutated chronic lymphocytic leukemia. [Extracted from the article]
Keywords: chemo-immunotherapy; chronic lymphocytic leukemia; targeted agents EN chemo-immunotherapy chronic lymphocytic leukemia targeted agents 201 204 4 02/03/23 20230201 NES 230201 PEER REVIEW The peer review history for this article is available at https://publons.com/publon/10.1002/hon.3047. 1 TABLE Management of chronic lymphocytic leukemia (CLL) patients: Staging, criteria for starting treatment, response assessment and follow up HT
2020 (before first line)
2021 (before second line)
N = 35 (%)
N = 42 (%)
(1) What do you perform before starting first/second-line therapy? Dear Editor, different clinical trials on Chronic Lymphocytic Leukemia (CLL) indicate the superiority of targeted agents (TA), as ibrutinib, acalabrutinib and venetoclax, respect to chemo-immunotherapy (CIT). [Extracted from the article]
Cuneo, Antonio, Rigolin, Gian Matteo, Coscia, Marta, Quaresmini, Giulia, Scarfò, Lydia, Mauro, Francesca Romana, Motta, Marina, Quaglia, Francesca Maria, Trentin, Livio, Ferrario, Andrea, Laurenti, Luca, Reda, Gianluigi, Ferrari, Angela, Pietrasanta, Daniela, Sportoletti, Paolo, Re, Francesca, De Paoli, Lorenzo, Foglietta, Myriam, Giordano, Annamaria, and Marchetti, Monia
Subjects
COVID-19 pandemic, CHRONIC lymphocytic leukemia
Abstract
Interestingly, the percentage of patients treated with chemo-immunotherapy (CIT) at the time of the COVID-19 infection did not change in the phase 1 (15%) compared to the phase 3 (15.7%), suggesting that this treatment modality maintained its role in a distinct minority of CLL patients. COVID-19 severity and mortality in patients with chronic lymphocytic leukemia: a joint study by ERIC, the European Research Initiative on CLL, and CLL Campus. Keywords: chronic lymphocytic leukemia; COVID-19; targeted agents; vaccination EN chronic lymphocytic leukemia COVID-19 targeted agents vaccination 570 574 5 10/08/21 20211001 NES 211001 TRANSPARENT PEER REVIEW The peer review history for this article is available at https://publons.com/publon/10.1002/hon.2899. [Extracted from the article]
Because the efficacy of new drugs reported in trials may not translate into similar results when used in the real‐life, we analyzed the efficacy of idelalisib and rituximab (IR) in 149 patients with relapsed/refractory chronic lymphocytic leukemia treated at 34 GIMEMA centers. Median progression‐free survival (PFS) and overall survival were 22.9 and 44.5 months, respectively; performance status (PS) ≥2 and ≥3 previous lines of therapy were associated with shorter PFS and overall survival (OS). 48% of patients were on treatment at 12 months; the experience of the centers (≥5 treated patients) and PS 0–1 were associated with a significantly longer treatment duration (p = 0.015 and p = 0.002, respectively). TP53 disruption had no prognostic significance. The overall response rate to subsequent treatment was 49.2%, with median OS of 15.5 months and not reached in patients who discontinued, respectively, for progression and for toxicity (p < 0.01). Treatment breaks ≥14 days were recorded in 96% of patients and adverse events mirrored those reported in trials. In conclusion, this real‐life analysis showed that IR treatment duration was longer at experienced centers, that the ECOG PS and ≥3 lines of previous therapy are strong prognostic factor and that the overall outcome with this regimen was superimposable to that reported in a randomized trial. [ABSTRACT FROM AUTHOR]
Wnt/Fzd signaling has been implicated in hematopoietic stem cell maintenance and in acute leukemia establishment. In our previous work, we described a recurrent rearrangement involving the WNT10B locus (WNT10BR), characterized by the expression of WNT10BIVS1 transcript variant, in acute myeloid leukemia. To determine the occurrence of WNT10BR in T‐cell acute lymphoblastic leukemia (T‐ALL), we retrospectively analyzed an Italian cohort of patients (n = 20) and detected a high incidence (13/20) of WNT10BIVS1 expression. To address genes involved in WNT10B molecular response, we have designed a Wnt‐targeted RNA sequencing panel. Identifying Wnt agonists and antagonists, it results that the expression of FZD6, LRP5, and PROM1 genes stands out in WNT10BIVS1 positive patients compared to negative ones. Using MOLT4 and MUTZ‐2 as leukemic cell models, which are characterized by the expression of WNT10BIVS1, we have observed that WNT10B drives major Wnt activation to the FZD6 receptor complex through receipt of ligand. Additionally, short hairpin RNAs (shRNAs)‐mediated gene silencing and small molecule‐mediated inhibition of WNTs secretion have been observed to interfere with the WNT10B/FZD6 interaction. We have therefore identified that WNT10BIVS1 knockdown, or pharmacological interference by the LGK974 porcupine (PORCN) inhibitor, reduces WNT10B/FZD6 protein complex formation and significantly impairs intracellular effectors and leukemic expansion. These results describe the molecular circuit induced by WNT10B and suggest WNT10B/FZD6 as a new target in the T‐ALL treatment strategy. [ABSTRACT FROM AUTHOR]
CHRONIC leukemia, LYMPHOCYTIC leukemia, DRUG efficacy, IMMUNOGLOBULIN heavy chains, PROGNOSIS
Abstract
Summary: The manageable toxicity profile of obinutuzumab (GA101; G) alone or with chemotherapy in first‐line (1L; fit and non‐fit) and relapsed/refractory (R/R) patients with chronic lymphocytic leukaemia (CLL) was established in the primary analysis of the Phase IIIb GREEN trial (Clinicaltrials.gov: NCT01905943). The final analysis (cut‐off, 31 January 2019) is reported here. Patients received G (1000 mg) alone (G‐mono; fit and non‐fit patients) or with chemotherapy [fludarabine and cyclophosphamide (FC; fit patients); chlorambucil (non‐fit patients); bendamustine (any patient)]. Study endpoints were safety (primary) and efficacy (secondary). Subgroup analyses were performed on prognostic biomarkers in 1L CLL. Overall, 630 patients received 1L and 341 received R/R CLL treatment. At the final analysis, no new safety signals were observed [Grade ≥ 3 adverse events (AEs): 1L 82·7%, R/R 84·5%; serious AEs: 1L 58·1%, R/R 62·5%]. Neutropenia (1L 50·5%, R/R 53·4%) and thrombocytopenia (1L 14·6%, R/R 19·1%) were the most common Grade 3–5 AEs. G‐mono‐, G‐bendamustine and G‐FC‐treated patients with unmutated immunoglobulin heavy chain trended towards shorter progression‐free survival. Achievement of minimal residual disease negativity was greatest in 1L patients treated with G‐FC. In this final analysis of the GREEN trial, the safety profile of G was consistent with current risk management strategies. Biomarker analyses supported efficacy in the specific subgroups. [ABSTRACT FROM AUTHOR]
Objectives: To compare the capacity of ibrutinib (IB) and idelalisib‐rituximab (IDELA‐R) of prolonging overall survival (OS) as in CLL patients, previously treated with chemotherapy only. Methods: A real‐life cohort of 675 cases has been identified and investigated in the database of the groups participating in the study. Results: At an unadjusted univariate analysis, a significant death risk reduction was observed favoring IB (IDELA‐R vs IB HR = 0.5, 95% CI = 0.36‐0.71) although with some limitations due to the non‐randomized and retrospective nature of the study and to the lower number of patients in the IDELA‐R group (112 cases) related to the current prescribing practice. To overcome the potential problem of confounding by indication, we adjusted the association between the type of therapy and mortality for all variables significantly associated with OS at Cox univariate analysis. Furthermore, those variables, differently distributed between the two study groups, were introduced into the multivariate Cox model to improve the effectiveness of the analysis. By introducing all these variables into the multiple Cox regression model, we confirmed the protective effect of IB vs IDELA‐R (HR = 0.67, 95% CI = 0.45‐0.98, P =.04) independent of potential confounders. Conclusions: Although our analysis presents some constraints, that is, the unavailability of additional potential confounders, and the retrospective nature of the study, this observation may be of help for the daily clinical practice, particularly in the absence of randomized trials comparing the two schedules. [ABSTRACT FROM AUTHOR]
IMMUNOGLOBULIN A, CHRONIC lymphocytic leukemia, AGAMMAGLOBULINEMIA, FLUORESCENCE in situ hybridization
Abstract
After 6 months of therapy 46 patients had IgA < 70 mg/dl and 58 patients had IgA > 70 mg/dl. However, we observed a correlation between IgA>70 mg/dl and fewer previous lines: in fact IgA baseline values > 70 mg/dl were observed in 58.3% of patients treated with a median of two lines, while only in 27.7% of patients treated with more than two therapy lines ( I p i = 0.002). Keywords: ibrutinib; infections rate; IgA EN ibrutinib infections rate IgA 141 144 4 02/25/21 20210201 NES 210201 PEER REVIEW The peer review history for this article is available at https://publons.com/publon/10.1002/hon.2814. [Extracted from the article]
Summary: The relationship between chronic lymphocytic leukaemia (CLL) and qualitative/quantitative gammaglobulin abnormalities is well established. Nevertheless, in order to better understand this kind of connection, we examined 1505 patients with CLL and divided them into four subgroups on the basis of immunoglobulin (Ig) aberrations at diagnosis. A total of 73 (4·8%), 149 (10%), 200 (13·2%) and 1083 (72%) patients were identified with IgM monoclonal gammopathy (IgM/CLL), IgG monoclonal gammopathy (IgG/CLL), hypogammaglobulinaemia (hypo‐γ) and normal Ig levels (γ‐normal) respectively. IgM paraprotein was significantly associated with a more advanced Binet/Rai stage and del(17p)/TP53 mutation, while IgG abnormalities correlated with a higher occurrence of trisomy 12. Patients with any type of Ig abnormality had shorter treatment‐free survival (TFS) but no significant impact affecting overall survival (OS) compared to those with normal Ig levels. [ABSTRACT FROM AUTHOR]
Although ibrutinib is generally well tolerated, it has been associated with atrial fibrillation (AF) in 6-16% of cases.[1] Most CLL patients are elderly and suffer of several comorbidities[[2]] that may trigger AF regardless of ibrutinib. A prior history of AF was present in only 21 patients (2.4%) at CLL diagnosis, while, among the remaining 839 patients without a previous history of AF, 47 (5.6%) developed AF after a median follow-up of 9.4 years (Figure A). Although none of the 137 patients at score 0 developed AF, the 545 patients with score of 1-2 had a 10-year TTAF of 6%, while the risk for the 103 and 75 patients at score 3-4 and >=5 was 12% and 29%, respectively ( I p i < 0.001, Figure C). Our model was also able to identify patients at a higher risk of AF during ibrutinib; in fact, the 2-year risk of AF was 0%, 5%, 17%, and 40% for patients with score 0, 1-2, 3-4, and >=5, respectively ( I p i < 0.001, Figure F). [Extracted from the article]
Venetoclax in CLL patients who progress after B-cell Receptor inhibitor treatment: a retrospective multi-centre Italian experience The median duration of the first BCRi treatment was 14-5 months (range 1-59) in patients who received only one BCRi and 16 months (range 1-46) in patients who received two BCRi treatments. GLO:1XW/01oct19:bjh16123-fig-0001.jpg PHOTO (COLOR): Kaplan-Meier survival curves for patients stratified according to number of prior BCRi treatments or reason for discontinuation of BCRi treatment. [Extracted from the article]
The article presents a study which examined the influence of idelalisib on platelet aggregation and coagulation tests in patients with chronic lymphocytic leukaemia (CLL). In the study, the subjects took either ibrutinib or idelalisib based on their baseline characteristics, drug interactions, and side effects. Also cited is the use of the validated questionnaire for bleeding diathesis, the International Society on Thrombosis and Haemostasis bleeding assessment tool (ISTH BAT), in the study.
The article discusses a study on the predictive value of the chronic lymphocytic leukemia-international prognostic index (CLL-IPI), determined at the time of first treatment, for progression-free survival (PFS) in CLL patients who underwent different frontline chemo-immunotherapy treatment regimens. Topics include the treatment regimens undergone by the patients, capability of the CLL-IPI score to predict PFS, and prognostic power of CLL-IPI when evaluated at the time of first-line therapy.
Richter syndrome (RS) is the transformation of chronic lymphocytic leukemia in a high-grade lymphoma usually presenting nodal and bone marrow involvement. Richter syndrome can be localized at extranodal sites including the gastrointestinal tract, lungs, and skin. Cutaneous RS is an extremely rare disease apparently showing a less aggressive course than common presentations. While nodal RS has been extensively investigated in literature, pathogenesis and prognosis of cutaneous RS are still partially unknown, even if a role of Epstein-Barr virus infection and p53 disruption has been suggested. Herein, we characterized the histopathological, immunohistochemical features and cytogenetics and molecular alterations of a case of cutaneous RS developed after 8 years chronic lymphocytic leukemia history. Moreover, we reviewed the literature reports concerning cutaneous RS and made a focus on biological patterns and prognostic implications. [ABSTRACT FROM AUTHOR]
Atypical chronic myeloid leukemia (aCML) is a myelodysplastic (MDS)/myeloproliferative (MPN) neoplasm according to WHO 2016 classification.[1] This rare hematological malignancy portends a poor prognosis, with a median survival of 14 to 30 months and a 40% rate of acute myeloid leukemia (AML) transformation.[2] No standard treatment exists, and poor outcomes are reported with chemotherapies, hydroxyurea (HU), and busulfan, while hypomethilating agents (HMA) or kinase inhibitors may be considered although experience is limited.[[3]] To date, aCML has been reported as isolated disease or in association with other myeloid neoplasms, while no coexistence of aCML and a lymphoproliferative disease has been described. No severe hematological toxicity nor severe infections are described.[[6]] Our patient was the oldest and the only one with an associated lymphoproliferative disease; infectious diathesis could be also related to CLL-associated immune dysregulation. Bone marrow re-evaluation after last cycle showed celluarity decreasing to 40%, aCML complete remission (CR), and a rising CLL infiltrate (30% clonal B-lymphocytes) (Figure B). [Extracted from the article]
Summary Low-dose alemtuzumab has shown a favourable toxicity profile coupled with good results in terms of efficacy in relapsed/refractory chronic lymphocytic leukaemia (CLL). We conducted a multicentre retrospective study on the routine clinical use of low-dose alemtuzumab in this patient setting. One hundred and eight relapsed/refractory CLL patients from 11 Italian centres were included in the analysis. All patients had an Eastern Cooperative Oncology Group performance status ≤2 and the majority (84%) had adenopathies <5cm. Low-dose alemtuzumab was defined as a total weekly dose ≤45 mg and a cumulative dose ≤600 mg given for up to 18 weeks. The overall response rate was 56% (22% complete remissions). After a median follow-up of 42·2 months, the median overall survival and progression-free survival were 39·0 and 19·4 months, respectively. In univariate analysis, response was inversely associated with lymph node ( P = 0·01) and spleen ( P = 0·02) size, fludarabine-refractoriness ( P = 0·01) and del(11q) ( P = 0·009). Advanced age and del(17p) were not associated with a worse outcome. Cumulative dose of alemtuzumab was not associated to response. Toxicities were usually mild and manageable; severe infections occurred in seven patients (7%) during therapy. This retrospective analysis confirms that low-dose alemtuzumab is a valid and currently used therapeutic option for the treatment of relapsed/refractory CLL. [ABSTRACT FROM AUTHOR]
Cortelezzi, Agostino, Sciumé, Mariarita, and Reda, Gianluigi
Subjects
CHRONIC lymphocytic leukemia treatment, CANCER chemotherapy, IMMUNOTHERAPY, RITUXIMAB, ALEMTUZUMAB, RESPONSE rates, CLINICAL trials, DRUG interactions
Abstract
The application of nucleoside analogue-based chemotherapy and immunotherapy with rituximab or alemtuzumab has increased both response rate and survival in patients with Chronic Lymphocytic Leukemia (CLL). However, because none of these therapies is curative, sequential therapeutic regimens are required. The majority of patients with relapsed or refractory CLL carry poor prognostic factors and show shorter overall survival and resistance to standard treatment. Numerous drugs have recently been approved for CLL therapy and many novel agents are under clinical investigation. The role of the tumor microenvironment and of immune dysfunction in CLL have allowed to enlarge the therapeutic armamentarium for CLL patients. This article will provide a comprehensive summary regarding mechanism of action, efficacy and safety of lenalidomide in CLL patients. Relevant clinical trials using lenalidomide alone or in combinations are discussed. Lenalidomide shows good activity also in relapsed/refractory or treatment-naive CLL patients. Definitive data from ongoing studies are needed to validate overall and progression-free survival. The toxicity profile might limit lenalidomide use because it can result in serious side effects, but largely controlled by gradual dose escalation. Further understanding of the exact mechanism of action in CLL will allow more efficacious use of lenalidomide alone or in combination regimens. [ABSTRACT FROM AUTHOR]
Visentin A, Chatzikonstantinou T, Scarfò L, Kapetanakis A, Demosthenous C, Karakatsoulis G, Minga E, Chamou D, Allsup D, Cabrero AA, Andres M, Antic D, Baile M, Baliakas P, Besikli-Dimou S, Bron D, Chatzileontiadou S, Cordoba R, Correa JG, Cuéllar-García C, De Paoli L, De Paolis MR, Delgado J, Dimou M, Donaldson D, Catherwood M, Doubek M, Efstathopoulou M, Eichhorst B, Elashwah S, Enrico A, Espinet B, Farina L, Ferrari A, Foglietta M, Frederiksen H, Fürstenau M, García-Marco JA, García-Serra R, Collado R, Gentile M, Gimeno E, Glenthøj A, da Silva MG, Hakobyan YK, Herishanu Y, Hernández-Rivas JÁ, Herold T, Innocenti I, Itchaki G, Jaksic O, Janssens A, Kalashnikova ОB, Kalicińska E, Kater AP, Kersting S, Labrador J, Lad D, Laurenti L, Levin MD, Lista E, Lopez-Garcia A, Malerba L, Marasca R, Marchetti M, Marquet J, Mattsson M, Mauro FR, Morawska M, Motta M, Munir T, Murru R, Niemann CU, Rodrigues RN, Olivieri J, Orsucci L, Papaioannou M, Pavlovsky MA, Piskunova I, Popov VM, Quaglia FM, Quaresmini G, Qvist K, Rigolin GM, Ruchlemer R, Šimkovič M, Špaček M, Sportoletti P, Stanca O, Tadmor T, Capasso A, Del Poeta G, Gutwein O, Karlsson LK, Milosevic I, Mirás F, Reda G, Saghumyan G, Shrestha A, Te Raa D, Tonino SH, Van Der Spek E, van Gelder M, van Kampen R, Wasik-Szczepanek E, Wróbel T, Segundo LYS, Yassin M, Pocali B, Vandenberghe E, Iyengar S, Varettoni M, Vitale C, Coscia M, Rambaldi A, Montserrat E, Cuneo A, Stavroyianni N, Trentin L, Stamatopoulos K, and Ghia P