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2. Lymphadenopathy as a predictor of progression during venetoclax treatment in chronic lymphocytic leukemia. A campus chronic lymphocytic leukemia study

Author

Autore, Francesco, Innocenti, Idanna, Reda, G., Visentin, A., Vitale, C., Piciocchi, A., Fresa, Alberto, Leone, M. M. A., Farina, L., Quaresmini, G., Barate, C., Giordano, A., Ferrari, A., Angeletti, I., De Paolis, M. R., Malerba, L., Chiurazzi, F., Loseto, G., Catania, G., Sportoletti, P., Scortechini, I., Moia, R., Gentile, M., Rigolin, G. M., Mattiello, V., Gattei, V., Coscia, M., Trentin, L., Foa, Robin, Cuneo, A., Laurenti, Luca, Autore F., Innocenti I., Fresa A., Foa R., Laurenti L. (ORCID:0000-0002-8327-1396), Autore, Francesco, Innocenti, Idanna, Reda, G., Visentin, A., Vitale, C., Piciocchi, A., Fresa, Alberto, Leone, M. M. A., Farina, L., Quaresmini, G., Barate, C., Giordano, A., Ferrari, A., Angeletti, I., De Paolis, M. R., Malerba, L., Chiurazzi, F., Loseto, G., Catania, G., Sportoletti, P., Scortechini, I., Moia, R., Gentile, M., Rigolin, G. M., Mattiello, V., Gattei, V., Coscia, M., Trentin, L., Foa, Robin, Cuneo, A., Laurenti, Luca, Autore F., Innocenti I., Fresa A., Foa R., and Laurenti L. (ORCID:0000-0002-8327-1396)

Abstract

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.

Published
2023

5. Chronic lymphocytic leukemia management in Italy during the COVID-19 pandemic: a Campus CLL report

Author

Cuneo, A., Scarfo, L., Reda, G., Varettoni, M., Quaglia, F. M., Marchetti, M., De Paoli, L., Re, F., Pietrasanta, D., Rigolin, G. M., Orsucci, L., Ibatici, A., Gattei, V., Mauro, F. R., Trentin, L., Laurenti, L., Marasca, R., Foa, R., Angeletti, I., Chiurazzi, F., Del Poeta, G., Rosaria De Paolis, M., Farina, L., Ferrari, A., Gentile, M., Gottardi, D., Gozzetti, A., Leone, M., Levato, L., Maccaferri, M., Malerba, L., Motta, M., Murru, R., Nocilli, L., Olivieri, J., Stefoni, V., Cuneo, A., Scarfo', L., Reda, G., Varettoni, M., Quaglia, F. M., Marchetti, M., De Paoli, L., Re, F., Pietrasanta, D., Rigolin, G. M., Orsucci, L., Ibatici, A., Gattei, V., Mauro, F. R., Trentin, L., Laurenti, L., Marasca, R., Foa, R., Angeletti, I., Chiurazzi, F., Del Poeta, G., Rosaria De Paolis, M., Farina, L., Ferrari, A., Gentile, M., Gottardi, D., Gozzetti, A., Leone, M., Levato, L., Maccaferri, M., Malerba, L., Motta, M., Murru, R., Nocilli, L., Olivieri, J., and Stefoni, V.

Subjects
Aged, Aged, 80 and over, Betacoronavirus, COVID-19, Coronavirus Infections, Disease Management, Humans, Italy, Leukemia, Lymphocytic, Chronic, B-Cell, Middle Aged, Pandemics, Pneumonia, Viral, SARS-CoV-2, Chronic lymphocytic leukemia, Biochemistry, chemistry.chemical_compound, Pandemic, 80 and over, Viral, Chronic, Disease management (health), Letter to Blood, Leukemia, Hematology, Lymphocytic, Ibrutinib, CLL, COVID-19, Campus CLL, medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Immunology, Cancer therapy, NO, Internal medicine, medicine, business.industry, B-Cell, Pneumonia, Cell Biology, Campus CLL, medicine.disease, Settore MED/15 - MALATTIE DEL SANGUE, chemistry, business, CLL
Published
2020
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8. Thrombotic and bleeding complications in patients with chronic lymphocytic leukemia and severe COVID-19: a study of ERIC, the European Research Initiative on CLL

Author

Antic, D., Milic, N., Chatzikonstantinou, T., Scarfo, L., Otasevic, V., Rajovic, N., Allsup, D., Alonso Cabrero, A., Andres, M., Baile Gonzales, M., Capasso, A., Collado, R., Cordoba, R., Cuellar-Garcia, C., Correa, J. G., De Paoli, L., De Paolis, M. R., Del Poeta, G., Dimou, M., Doubek, M., Efstathopoulou, M., El-Ashwah, S., Enrico, A., Espinet, B., Farina, L., Ferrari, A., Foglietta, M., Lopez-Garcia, A., Garcia-Marco, J. A., Garcia-Serra, R., Gentile, Marino, Gimeno, E., da Silva, M. G., Gutwein, O., Hakobyan, Y. K., Herishanu, Y., Hernandez-Rivas, J. A., Herold, T., Itchaki, G., Jaksic, O., Janssens, A., Kalashnikova, O. B., Kalicinska, E., Kater, A. P., Kersting, S., Koren-Michowitz, M., Labrador, J., Lad, D., Laurenti, Luca, Fresa, Alberto, Levin, M. -D., Mayor Bastida, C., Malerba, L., Marasca, R., Marchetti, M., Marquet, J., Mihaljevic, B., Milosevic, I., Miras, F., Morawska, M., Motta, M., Munir, T., Murru, R., Nunes, R., Olivieri, J., Pavlovsky, M. A., Piskunova, I., Popov, V. M., Quaglia, F. M., Quaresmini, G., Reda, G., Rigolin, G. M., Shrestha, A., Simkovic, M., Smirnova, S., Spacek, M., Sportoletti, P., Stanca, O., Stavroyianni, N., Te Raa, D., Tomic, K., Tonino, S., Trentin, L., Van Der Spek, E., van Gelder, M., Varettoni, M., Visentin, A., Vitale, C., Vukovic, Vladimir, Wasik-Szczepanek, E., Wrobel, T., Segundo, L. Y. S., Yassin, M., Coscia, M., Rambaldi, A., Montserrat, E., Foa, Robin, Cuneo, A., Carrier, M., Ghia, P., Stamatopoulos, K., Gentile M., Laurenti L. (ORCID:0000-0002-8327-1396), Fresa A., Vukovic V. (ORCID:0000-0002-9561-7825), Foa R., Antic, D., Milic, N., Chatzikonstantinou, T., Scarfo, L., Otasevic, V., Rajovic, N., Allsup, D., Alonso Cabrero, A., Andres, M., Baile Gonzales, M., Capasso, A., Collado, R., Cordoba, R., Cuellar-Garcia, C., Correa, J. G., De Paoli, L., De Paolis, M. R., Del Poeta, G., Dimou, M., Doubek, M., Efstathopoulou, M., El-Ashwah, S., Enrico, A., Espinet, B., Farina, L., Ferrari, A., Foglietta, M., Lopez-Garcia, A., Garcia-Marco, J. A., Garcia-Serra, R., Gentile, Marino, Gimeno, E., da Silva, M. G., Gutwein, O., Hakobyan, Y. K., Herishanu, Y., Hernandez-Rivas, J. A., Herold, T., Itchaki, G., Jaksic, O., Janssens, A., Kalashnikova, O. B., Kalicinska, E., Kater, A. P., Kersting, S., Koren-Michowitz, M., Labrador, J., Lad, D., Laurenti, Luca, Fresa, Alberto, Levin, M. -D., Mayor Bastida, C., Malerba, L., Marasca, R., Marchetti, M., Marquet, J., Mihaljevic, B., Milosevic, I., Miras, F., Morawska, M., Motta, M., Munir, T., Murru, R., Nunes, R., Olivieri, J., Pavlovsky, M. A., Piskunova, I., Popov, V. M., Quaglia, F. M., Quaresmini, G., Reda, G., Rigolin, G. M., Shrestha, A., Simkovic, M., Smirnova, S., Spacek, M., Sportoletti, P., Stanca, O., Stavroyianni, N., Te Raa, D., Tomic, K., Tonino, S., Trentin, L., Van Der Spek, E., van Gelder, M., Varettoni, M., Visentin, A., Vitale, C., Vukovic, Vladimir, Wasik-Szczepanek, E., Wrobel, T., Segundo, L. Y. S., Yassin, M., Coscia, M., Rambaldi, A., Montserrat, E., Foa, Robin, Cuneo, A., Carrier, M., Ghia, P., Stamatopoulos, K., Gentile M., Laurenti L. (ORCID:0000-0002-8327-1396), Fresa A., Vukovic V. (ORCID:0000-0002-9561-7825), and Foa R.

Abstract

Background: Patients with chronic lymphocytic leukemia (CLL) may be more susceptible to COVID-19 related poor outcomes, including thrombosis and death, due to the advanced age, the presence of comorbidities, and the disease and treatment-related immune deficiency. The aim of this study was to assess the risk of thrombosis and bleeding in patients with CLL affected by severe COVID-19. Methods: This is a retrospective multicenter study conducted by ERIC, the European Research Initiative on CLL, including patients from 79 centers across 22 countries. Data collection was conducted between April and May 2021. The COVID-19 diagnosis was confirmed by the real-time polymerase chain reaction (RT-PCR) assay for SARS-CoV-2 on nasal or pharyngeal swabs. Severe cases of COVID-19 were defined by hospitalization and the need of oxygen or admission into ICU. Development and type of thrombotic events, presence and severity of bleeding complications were reported during treatment for COVID-19. Bleeding events were classified using ISTH definition. STROBE recommendations were used in order to enhance reporting. Results: A total of 793 patients from 79 centers were included in the study with 593 being hospitalized (74.8%). Among these, 511 were defined as having severe COVID: 162 were admitted to the ICU while 349 received oxygen supplementation outside the ICU. Most patients (90.5%) were receiving thromboprophylaxis. During COVID-19 treatment, 11.1% developed a thromboembolic event, while 5.0% experienced bleeding. Thrombosis developed in 21.6% of patients who were not receiving thromboprophylaxis, in contrast to 10.6% of patients who were on thromboprophylaxis. Bleeding episodes were more frequent in patients receiving intermediate/therapeutic versus prophylactic doses of low-molecular-weight heparin (LWMH) (8.1% vs. 3.8%, respectively) and in elderly. In multivariate analysis, peak D-dimer level and C-reactive protein to albumin ratio were poor prognostic factors for thrombosis occu

Published
2022

28. Development and Management of Massive Subcutaneous Metastases with Unusual Clinical Course from Uterine Leiomyosarcoma

Author

Filippini Dm, Maria Abbondanza Pantaleo, De Leo A, Margherita Nannini, De Paolis M, Anna Myriam Perrone, Maristella Saponara, De Iaco P, Cammelli S, Nuvola G, and Annalisa Astolfi

Subjects
Chemotherapy, Pathology, medicine.medical_specialty, Lung, business.industry, medicine.medical_treatment, Soft tissue, medicine.disease, Metastasis, Radiation therapy, medicine.anatomical_structure, Peritoneum, Medicine, Lymph, business, Endocrine gland
Abstract

Uterine leiomyosarcoma (U-LMS) is the most common histotype among all primary uterine sarcomas. The lung, peritoneum, pelvic or para-aortic lymph nodes, bone and liver are the most common metastatic sites involved. However, some case series of atypical sites of metastasis such as heart, brain and different endocrine glands have been described. Here we report the clinical presentation and therapeutic management of two patients affected by U-LMS with a very atypical behavior, characterized by soft tissue metastases with an impressive and massive enlargement during chemotherapy despite a good control of the other sites of disease.

Published
2021
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29. Midline catheters for extracorporeal photopheresis in hematological patients

Author

Marche, Bruno, D'Arrigo, Sonia, Annetta, Maria Giuseppina, Musaro, A., Emoli, Alessandro, Sica, Simona, Piccirillo, Nicola, Putzulu, Rossana, De Paolis, M., Bernoldi, M., Pittiruti, Mauro, Marche B., D'Arrigo S. (ORCID:0000-0001-6740-3195), Annetta M. G. (ORCID:0000-0001-7574-1311), Emoli A., Sica S. (ORCID:0000-0003-2426-3465), Piccirillo N. (ORCID:0000-0002-1688-1987), Putzulu R., Pittiruti M. (ORCID:0000-0003-4541-7566), Marche, Bruno, D'Arrigo, Sonia, Annetta, Maria Giuseppina, Musaro, A., Emoli, Alessandro, Sica, Simona, Piccirillo, Nicola, Putzulu, Rossana, De Paolis, M., Bernoldi, M., Pittiruti, Mauro, Marche B., D'Arrigo S. (ORCID:0000-0001-6740-3195), Annetta M. G. (ORCID:0000-0001-7574-1311), Emoli A., Sica S. (ORCID:0000-0003-2426-3465), Piccirillo N. (ORCID:0000-0002-1688-1987), Putzulu R., and Pittiruti M. (ORCID:0000-0003-4541-7566)

Abstract

Introduction: Peripheral venous access for extracorporeal photopheresis (ECP) may be difficult in graft versus host disease (GVHD) patients, because of previous intravenous therapies and multiple peripheral cannulations; in this population of patients, ultrasound guided midline catheters may be an alternative option to central venous access. Methods: In this single-center, prospective preliminary study, we enrolled all consecutive patients with a diagnosis of GVHD and candidate to ECP, over a period of 10 months. We used inserted power injectable, non-valved, polyurethane, 20–25 cm single lumen midline catheters (MC). Results: Sixty-nine ECP procedures were carried out in six patients, using single-lumen MCs for outflow (5Fr in 74% and 4Fr in 26% of cases). For inflow, we used 5Fr or 4Fr MCs, or central venous access devices previously placed for other clinical reasons. There were no catheter-related complications during the entire period of ECP treatment. Mean outflow was significantly higher for 5Fr than for 4Fr MCs (35.8 ± 7.3 vs 29.2 ± 7.8 ml/min; p = 0.0008) and the procedure time was significantly shorter (92.9 ± 9.2 vs 108 ± 13.2 min; p < 0.0001). Conclusion: In GVHD patients, ECP can be performed efficiently and safely using single lumen polyurethane power injectable MCs. The best results are obtained with 5Fr rather than with 4Fr catheters. This strategy of venous access should be implemented in DIVA patients requiring ECP treatments, and probably also in other types of apheresis.

Published
2021

30. 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

Author

Scarfo, L., Chatzikonstantinou, T., Rigolin, G. M., Quaresmini, G., Motta, M., Vitale, C., Garcia-Marco, J. A., Hernandez-Rivas, J. A., Miras, F., Baile, M., Marquet, J., Niemann, C. U., Reda, G., Munir, T., Gimeno, E., Marchetti, M., Quaglia, F. M., Varettoni, M., Delgado, J., Iyengar, S., Janssens, A., Marasca, R., Ferrari, A., Cuellar-Garcia, C., Itchaki, G., Spacek, M., De Paoli, L., Laurenti, Luca, Levin, M. -D., Lista, E., Mauro, F. R., Simkovic, M., Van Der Spek, E., Vandenberghe, E., Trentin, L., Wasik-Szczepanek, E., Ruchlemer, R., Bron, D., De Paolis, M. R., Del Poeta, G., Farina, L., Foglietta, M., Gentile, Marino, Herishanu, Y., Herold, T., Jaksic, O., Kater, A. P., Kersting, S., Malerba, L., Orsucci, L., Popov, V. M., Sportoletti, P., Yassin, M., Pocali, B., Barna, G., Chiarenza, A., dos Santos, G., Nikitin, E., Andres, M., Dimou, M., Doubek, M., Enrico, A., Hakobyan, Y., Kalashnikova, O., Ortiz Pareja, M., Papaioannou, M., Rossi, Dario, Shah, N., Shrestha, A., Stanca, O., Stavroyianni, N., Strugov, V., Tam, C., Zdrenghea, M., Coscia, M., Stamatopoulos, K., Rossi, G., Rambaldi, A., Montserrat, E., Foa, Robin, Cuneo, A., Ghia, P., Laurenti L. (ORCID:0000-0002-8327-1396), Gentile M., Rossi D., Foa R., Scarfo, L., Chatzikonstantinou, T., Rigolin, G. M., Quaresmini, G., Motta, M., Vitale, C., Garcia-Marco, J. A., Hernandez-Rivas, J. A., Miras, F., Baile, M., Marquet, J., Niemann, C. U., Reda, G., Munir, T., Gimeno, E., Marchetti, M., Quaglia, F. M., Varettoni, M., Delgado, J., Iyengar, S., Janssens, A., Marasca, R., Ferrari, A., Cuellar-Garcia, C., Itchaki, G., Spacek, M., De Paoli, L., Laurenti, Luca, Levin, M. -D., Lista, E., Mauro, F. R., Simkovic, M., Van Der Spek, E., Vandenberghe, E., Trentin, L., Wasik-Szczepanek, E., Ruchlemer, R., Bron, D., De Paolis, M. R., Del Poeta, G., Farina, L., Foglietta, M., Gentile, Marino, Herishanu, Y., Herold, T., Jaksic, O., Kater, A. P., Kersting, S., Malerba, L., Orsucci, L., Popov, V. M., Sportoletti, P., Yassin, M., Pocali, B., Barna, G., Chiarenza, A., dos Santos, G., Nikitin, E., Andres, M., Dimou, M., Doubek, M., Enrico, A., Hakobyan, Y., Kalashnikova, O., Ortiz Pareja, M., Papaioannou, M., Rossi, Dario, Shah, N., Shrestha, A., Stanca, O., Stavroyianni, N., Strugov, V., Tam, C., Zdrenghea, M., Coscia, M., Stamatopoulos, K., Rossi, G., Rambaldi, A., Montserrat, E., Foa, Robin, Cuneo, A., Ghia, P., Laurenti L. (ORCID:0000-0002-8327-1396), Gentile M., Rossi D., and Foa R.

Abstract

Chronic lymphocytic leukemia (CLL) is a disease of the elderly, characterized by immunodeficiency. Hence, patients with CLL might be considered more susceptible to severe complications from COVID-19. We undertook this retrospective international multicenter study to characterize the course of COVID-19 in patients with CLL and identify potential predictors of outcome. Of 190 patients with CLL and confirmed COVID-19 diagnosed between 28/03/2020 and 22/05/2020, 151 (79%) presented with severe COVID-19 (need of oxygen and/or intensive care admission). Severe COVID-19 was associated with more advanced age (≥65 years) (odds ratio 3.72 [95% CI 1.79–7.71]). Only 60 patients (39.7%) with severe COVID-19 were receiving or had recent (≤12 months) treatment for CLL at the time of COVID-19 versus 30/39 (76.9%) patients with mild disease. Hospitalization rate for severe COVID-19 was lower (p < 0.05) for patients on ibrutinib versus those on other regimens or off treatment. Of 151 patients with severe disease, 55 (36.4%) succumbed versus only 1/38 (2.6%) with mild disease; age and comorbidities did not impact on mortality. In CLL, (1) COVID-19 severity increases with age; (2) antileukemic treatment (particularly BTK inhibitors) appears to exert a protective effect; (3) age and comorbidities did not impact on mortality, alluding to a relevant role of CLL and immunodeficiency.

Published
2020

31. Candidaemia in haematological malignancy patients from a SEIFEM study: Epidemiological patterns according to antifungal prophylaxis

Author

Posteraro, Brunella, De Carolis, Elena, Criscuolo, Marianna, Ballanti, S., De Angelis, Giulia, Del Principe, M. I., Delia, M., Fracchiolla, N., Marchesi, F., Nadali, G., Picardi, Stefano Maria, Piccioni, A. L., Verga, L., Candoni, A., Busca, A., Sanguinetti, Maurizio, Pagano, Livio, Muggeo, P., Stanzani, M., Cattaneo, C., Russo, D., Vacca, A., Fanci, R., De Paolis, M. R., Mancini, V., Lessi, F., Rossetti, E., Decembrino, N., Facchini, L., Dragonetti, Giulia, Ferrari, A., Vallero, S., Posteraro B. (ORCID:0000-0002-1663-7546), De Carolis E. (ORCID:0000-0003-4757-7256), Criscuolo M., De Angelis G. (ORCID:0000-0002-7087-7399), Picardi M., Sanguinetti M. (ORCID:0000-0002-9780-7059), Pagano L. (ORCID:0000-0001-8287-928X), Dragonetti G., Posteraro, Brunella, De Carolis, Elena, Criscuolo, Marianna, Ballanti, S., De Angelis, Giulia, Del Principe, M. I., Delia, M., Fracchiolla, N., Marchesi, F., Nadali, G., Picardi, Stefano Maria, Piccioni, A. L., Verga, L., Candoni, A., Busca, A., Sanguinetti, Maurizio, Pagano, Livio, Muggeo, P., Stanzani, M., Cattaneo, C., Russo, D., Vacca, A., Fanci, R., De Paolis, M. R., Mancini, V., Lessi, F., Rossetti, E., Decembrino, N., Facchini, L., Dragonetti, Giulia, Ferrari, A., Vallero, S., Posteraro B. (ORCID:0000-0002-1663-7546), De Carolis E. (ORCID:0000-0003-4757-7256), Criscuolo M., De Angelis G. (ORCID:0000-0002-7087-7399), Picardi M., Sanguinetti M. (ORCID:0000-0002-9780-7059), Pagano L. (ORCID:0000-0001-8287-928X), and Dragonetti G.

Abstract

Background: Candidaemia is an important infectious complication for haematological malignancy patients. Antifungal prophylaxis reduces the incidence of candidaemia but may be associated with breakthrough candidaemia. Objective: To analyse the Candida species’ distribution and relative antifungal susceptibility profiles of candidaemia episodes in relation to the use of antifungal prophylaxis among Italian SEIFEM haematology centres. Methodology: This multicentre retrospective observational SEIFEM study included 133 single-species candidaemia episodes of haematological malignancy patients for whom antifungal susceptibility testing results of blood Candida isolates were available between 2011 and 2015. Each participating centre provided both clinical and microbiological data. Results: Non-Candida albicans Candida (NCAC) species were the mostly isolated species (89, 66.9%), which accounted for C parapsilosis (35, 26.3%), C glabrata (16, 12.0%), C krusei (14, 10.5%), C tropicalis (13, 9.8%) and uncommon species (11, 8.3%). C albicans caused the remaining 44 (33.1%) episodes. Excluding 2 C albicans isolates, 23 of 25 fluconazole-resistant isolates were NCAC species (14 C krusei, 6 C glabrata, 2 C parapsilosis and 1 C tropicalis). Fifty-six (42.1%) of 133 patients developed breakthrough candidaemia. Systemic antifungal prophylaxis consisted of azoles, especially fluconazole and posaconazole, in 50 (89.3%) of 56 patients in whom a breakthrough candidaemia occurred. Interestingly, all these patients tended to develop a C krusei infection (10/56, P =.02) or a fluconazole-resistant isolate’s infection (14/50, P =.04) compared to patients (4/77 and 10/77, respectively) who did not have a breakthrough candidaemia. Conclusions: Optimisation of prophylactic strategies is necessary to limit the occurrence of breakthrough candidaemia and, importantly, the emergence of fluconazole-resistant NCAC isolates’ infections in

Published
2020

33. Fungaemia in haematological malignancies: SEIFEM-2015 survey

Author

Criscuolo, M., Marchesi, F., Candoni, A., Cattaneo, C., Nosari, A., Veggia, B., Verga, L., Fracchiolla, N., Vianelli, N., Del Principe, M. I., Picardi, M., Tumbarello, M., Aversa, F., Busca, A., Pagano, L., Dragonetti, G., Ballanti, S., Delia, M., Nadali, G., Sciume, M., Castagnola, C., Ferrari, A., Mancini, V., Decembrino, N., Spolzino, A., Iovino, L., Martino, B., Vacca, A., Calore, E., Fanci, R., Lessi, F., Vallero, S., Zama, D., Cesaro, S., De Paolis, M. R., Facchini, L., Muggeo, P., Offidani, M., Perruccio, K., Russo, D., Criscuolo M, Marchesi F, Candoni A, Cattaneo C, Nosari A, Veggia B, Verga L, Fracchiolla N, Vianelli N, Del Principe MI, Picardi M, Tumbarello M, Aversa F, Busca A, Pagano L, SEIFEM Group: Giulia Dragonetti, Stelvio Ballanti, Mario Delia, Gianpaolo Nadali, Sciumè M, Castagnola C, Ferrari A, Mancini V, Decembrino N, Spolzino A, Iovino L, Martino B, Vacca A, Calore E, Fanci R, Lessi F, Vallero S, Zama D, Cesaro S, De Paolis M, Facchini L, Muggeo P, Offidani M, Perruccio K, Russo D., Criscuolo, Marianna, Marchesi, Francesco, Candoni, Anna, Cattaneo, Chiara, Nosari, Annamaria, Veggia, Barbara, Verga, Luisa, Fracchiolla, Nicola, Vianelli, Nicola, Del Principe, Maria Ilaria, Picardi, Marco, Tumbarello, Mario, Aversa, Franco, Busca, Alessandro, and Pagano, Livio

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Clinical Biochemistry, Prevalence, 030204 cardiovascular system & hematology, Biochemistry, Young Adult, 03 medical and health sciences, acute leukaemias, candidemia, fungaemia, 0302 clinical medicine, Risk Factors, Yeasts, Internal medicine, acute leukemias, Epidemiology, Fungemia, Hematological malignancies, medicine, Aged, Candidemia, Child, Female, Fungemia, Hematologic Neoplasms, Humans, Italy, Middle Aged, Prognosis, Retrospective Studies, acute leukemia, 030212 general & internal medicine, Cause of death, Hematology, business.industry, Septic shock, Mortality rate, General Medicine, bacterial infections and mycoses, medicine.disease, Settore MED/15 - MALATTIE DEL SANGUE, fungemia, business, Central venous catheter
Abstract

BACKGROUND: Fungal infections are still a relevant challenge for clinicians involved in the cure of patients with cancer. We retrospectively reviewed charts of hospitalized patients with hematological malignancies (HMs), in which a documented fungemia was diagnosed between January 2011 and December 2015 at 28 adult and 6 pediatric Italian Hematology Departments. METHODS: During the study period we recorded 215 fungal blood stream infections (BSI). Microbiological analyses documented that BSI was due to molds in 17 patients (8%) and yeasts in 198 patients (92%), being Candida spp identified in 174 patients (81%). RESULTS: Mortality rates were 70% and 39% for mold and yeast infections, respectively. Infection was the main cause of death in 53% of the mold and 18% of the yeast groups. At the multivariate analysis, ECOG ≥2 and septic shock were significantly associated with increased mortality, and removal of CVC survival was found to be protective. When considering patients with candidemia only, ECOG >2 and removal of CVC were statistically associated with overall mortality. CONCLUSIONS: Although candidemia represents a group of BSI with a good prognosis, its risk factors largely overlap with those identified for all fungemias, even though the candidemia-related mortality is lower when compared to other fungal BSI. Management of fungal BSI is still a complex issue, in which both patients and disease characteristics should be focused to address a personalized approach. This article is protected by copyright. All rights reserved.

Published
2019
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34. PB2347 NIVOLUMAB AS A BRIDGE TO ALLOGENEIC TRASPLANTATION IN PATIENT WITH RELAPSED/REFRACTORY HODGKIN LYMPHOMA: EXPERIENCE OF A SINGLE CENTER

Author

Federico, V., primary, Matera, R., additional, Forese, P., additional, Rossini, B., additional, Loglisci, G., additional, Messa, A., additional, D’Argenio, M., additional, Carlino, D., additional, Luponio, S., additional, Fina, M., additional, Cristofalo, C., additional, Bozzoli, V., additional, Reddiconto, G., additional, De Paolis, M. R., additional, Pugliese, G., additional, Vergine, C., additional, and Di Renzo, N., additional

Published
2019
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39. Pre-chemotherapy risk factors for invasive fungal diseases: prospective analysis of 1,192 patients with newly diagnosed acute myeloid leukemia (SEIFEM 2010-a multicenter study)

Author

Caira, M., Candoni, A., Verga, L., Busca, A., Delia, M., Nosari, A., Caramatti, C., Castagnola, C., Cattaneo, C., Fanci, R., Chierichini, A., Melillo, L., Mitra, M. E., Picardi, M., Potenza, L., Salutari, P., Vianelli, N., Facchini, L., Cesarini, M., De Paolis, M. R., Di Blasi, R., Farina, F., Venditti, A., Ferrari, A., Garzia, M., Gasbarrino, C., Invernizzi, R., Lessi, F., Manna, A., Martino, B., Nadali, G., Offidani, M., Paris, L., Pavone, V., Rossi, G., Spadea, A., Specchia, G., Trecarichi, E. M., Vacca, A., Cesaro, S., Perriello, V., Aversa, F., Tumbarello, M., Pagano, L., Ragionieri, R., Orsola Malpighi, O. S., Antoniazzi, F., Storti, S., Luppi, M., Pagliuca, S., Rossetti, E., Da Vià, M., Di Caprio, L., Majolino, I., Cascavilla, N., Turri, G., Fanin, Renato, Sorveglianza Epidemiologica Infezioni Fungine in Emopatie Maligne, Caira, Morena, Candoni, Anna, Verga, Luisa, Busca, Alessandro, Delia, Mario, Nosari, Annamaria, Caramatti, Cecilia, Castagnola, Carlo, Cattaneo, Chiara, Fanci, Rosa, Chierichini, Anna, Melillo, Lorella, Mitra, Maria Enza, Picardi, Marco, Potenza, Leonardo, Salutari, Prassede, Vianelli, Nicola, Facchini, Luca, Cesarini, Monica, De Paolis, Maria Rosaria, Di Blasi, Roberta, Farina, Francesca, Venditti, Adriano, Ferrari, Antonella, Garzia, Mariagrazia, Gasbarrino, Cristina, Invernizzi, Rosangela, Lessi, Federica, Manna, Annunziata, Martino, Bruno, Nadali, Gianpaolo, Offidani, Massimo, Paris, Laura, Pavone, Vincenzo, Rossi, Giuseppe, Spadea, Antonio, Specchia, Giorgina, Trecarichi, Enrico Maria, Vacca, Adriana, Cesaro, Simone, Perriello, Vincenzo, Aversa, Franco, Tumbarello, Mario, and Pagano, Livio

Subjects
Myeloid, Male, Antifungal Agents, invasive fungal diseases, Mycose, Risk Factors, Epidemiology, Antineoplastic Combined Chemotherapy Protocols, Antifungal Agent, Prospective Studies, Prospective cohort study, Univariate analysis, leukemia, Myeloid leukemia, Hematology, Environmental exposure, Articles, Middle Aged, Prognosis, Survival Rate, Leukemia, Leukemia, Myeloid, Acute, Female, Case-Control Studie, Human, Adult, medicine.medical_specialty, Prognosi, risk factors, acute myeloid leukemia, Neutropenia, Acute, Settore MED/17 - MALATTIE INFETTIVE, Aged, Case-Control Studies, Follow-Up Studies, Humans, Mycoses, Neoplasm Staging, Immunocompromised Host, Follow-Up Studie, Internal medicine, medicine, Antineoplastic Combined Chemotherapy Protocol, Performance status, business.industry, Risk Factor, medicine.disease, Surgery, Prospective Studie, Settore MED/15 - MALATTIE DEL SANGUE, Fungal Disease, business
Abstract

Correct definition of the level of risk of invasive fungal infections is the first step in improving the targeting of preventive strategies. We investigated the potential relationship between pre-hospitalization exposure to sources of fungi and the development of invasive fungal infections in adult patients with newly diagnosed acute myeloid leukemia after their first course of chemotherapy. From January 2010 to April 2012, all consecutive acute myeloid leukemia patients in 33 Italian centers were prospectively registered. Upon first admission, information about possible pre-chemotherapy risk factors and environmental exposure was collected. We recorded data regarding comorbid conditions, employment, hygienic habits, working and living environment, personal habits, hobbies, and pets. All invasive fungal infections occurring within 30 days after the first course of chemotherapy were recorded. Of the 1,192 patients enrolled in this study, 881 received intensive chemotherapy and were included in the present analysis. Of these, 214 developed an invasive fungal infection, including 77 proven/probable cases (8.7%). Of these 77 cases, 54 were proven/probable invasive mold infections (6.1%) and 23 were proven yeast infections (2.6%). Upon univariate analysis, a significant association was found between invasive mold infections and age, performance status, diabetes, chronic obstructive pulmonary disease, smoking, cocaine use, job, hobbies, and a recent house renovation. Higher body weight resulted in a reduced risk of invasive mold infections. Multivariate analysis confirmed the role of performance status, job, body weight, chronic obstructive pulmonary disease, and house renovation. In conclusion, several hospital-independent variables could potentially influence the onset of invasive mold infections in patients with acute myeloid leukemia. Investigation of these factors upon first admission may help to define a patient's risk category and improve targeted prophylactic strategies. (Clinicaltrial.gov: NCT01315925)

Published
2015

40. Spontaneous-Idiopathic Left Anterior Descending Artery Dissection: Is Watchful Waiting Better Than Immediate Stenting?

Author

Arrivi, A., Bazzucchi, M., De Paolis, M., Placanica, A., Bock, C., Milici, C., Boschetti, E., and Dominici, M.

Subjects
Article Subject
Abstract

Spontaneous coronary artery dissection (SCAD) is a rare, complex disease, nowadays poorly understood yet. The lack of firm recommendations about this issue is a great limitation which makes any therapeutic decision controversial. The case described is that of a young, otherwise healthy woman, who presented with an ostial dissection of the left anterior descending (LAD) artery. Due to patient’s stable clinical and hemodynamic parameters, we used a cautious approach based on watchful waiting and medical therapy, postponing stenting in order to achieve a partial vessel reopening with a more comfortable access to PCI.

Published
2013
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41. Left radial versus right radial approach for coronary artery catheterization: a prospective comparison

Author

Dominici, M, Diletti, Roberto, Milici, C, Bock, C, Garg, S, De Paolis, M, Ambrosio, Giuseppe, and Boschetti, Enrico

Subjects
Cardiac Catheterization, Fluoroscopy, Radial Artery, Humans, Prospective Studies, Coronary Angiography
Abstract

Despite several advantages of the transradial over the transfemoral approach, the use of transradial access for coronary interventions in daily practice is still low. Major limitations are the technical and anatomical issues related with right radial artery access. The left radial approach may have an advantage from the point of view of the vascular anatomy. The aim of this study was to evaluate the safety and feasibility of routinely using the left radial compared to the right radial approach.This is a prospective single center study comparing left radial to right radial access for coronary artery catheterization. The overall in-hospital major adverse cardiac and cerebral events (MACCE), procedural success rate, bleeding, vascular and procedural complications, fluoroscopy time, number of catheters, and amount of contrast agent used were assessed.A total of 1,032 coronary angiograms were performed: 420 were performed using the right radial artery and 612 the left radial artery. No differences were observed in MACCE and success rate between the two groups. No cases of major or minor bleeding and vascular complications requiring surgical intervention were reported. Fluoroscopy time and the number of catheters used were significantly less in the left radial group (P = 0.001 and P = 0.007, respectively), while the volume of contrast was similar (P = 0.264).The left radial approach in our series was demonstrated to be safe and feasible in daily practice, and in this study was associated with a reduction in fluoroscopy time and number of catheters used.

Published
2012

42. Nani sulle spalle di giganti. Alcune lezioni di metodo della Filologia italiana e le prospettive dell’edizione critica digitale dello Zibaldone laurenziano di Giovanni Boccaccio

Author

Mordenti, R, David, Pa, Pianta, M, Buiatti, M, Orsenigo, L, Roncaglia, A, Branzini, M, Bogliacino, F, Rischi, Gi, Freguglia, P, Bazzani, A, Dallacasa, V, Mastromatteo, U, Rinaldi, A, Araneo, R, Pea, M, Notargiacomo, A, Ciofani, G, Falconi, C, Barbante, C, Pezzino, P, De Paolis, M, Stabili, Mr, Gabriele, M, Schieder, W, and Monella, P

Subjects
Settore L-FIL-LET/14 - Critica Letteraria e Letterature Comparate, filologia digitale
Published
2012

43. Segreti di Stato e Stato di diritto

Author

BUZZELLI, SILVIA, Buzzelli, S, De Maria, A, De Paolis, M, Speranzoni, A, Meliconi, M, Bolognesi, P, Grassi, L, Nunziata, C, Scardova, R, Beccaria, A, BUZZELLI, SILVIA, Beccaria, A., BUZZELLI, SILVIA, Buzzelli, S, De Maria, A, De Paolis, M, Speranzoni, A, Meliconi, M, Bolognesi, P, Grassi, L, Nunziata, C, Scardova, R, Beccaria, A, BUZZELLI, SILVIA, and Beccaria, A.

Published
2014

44. La ricostruzione giudiziale dei crimini nazifascisti in Italia. Questioni preliminari

Author

Buzzelli, S, De Paolis, M, Speranzoni, A, BUZZELLI, SILVIA, Speranzoni, A., Buzzelli, S, De Paolis, M, Speranzoni, A, BUZZELLI, SILVIA, and Speranzoni, A.

Abstract

Nel libro si è cercato di impostare una riflessione sul tema della ricostruzione giudiziale dei crimini di guerra nazifascisti in Italia che ponesse in evidenza tre aspetti fondamentali: la genesi e lo sviluppo dell'attività giudiziaria italiana (dall'immediato dopoguerra a oggi); l'analisi e la valorizzazione del testimone-persona offesa; il collegamento con l'attualità dell'odierno diritto internazionale e umanitario.

Published
2012

45. Oblio illecito e verità giudiziale

Author

De Paolis, M, Speranzoni, A, Buzzelli, S, BUZZELLI, SILVIA, De Paolis, M, Speranzoni, A, Buzzelli, S, and BUZZELLI, SILVIA

Published
2012

49. Is there a role for chemotherapy after local relapse in high-grade osteosarcoma?

Author

Massimo Eraldo Abate, Elisa Torricelli, Marilena Cesari, Davide Maria Donati, Stefano Ferrari, Michela Pierini, Stefano Cascinu, Elisabetta Setola, Alessandra Longhi, Anna Paioli, Emanuela Palmerini, Massimiliano De Paolis, Palmerini E., Torricelli E., Cascinu S., Pierini M., De Paolis M., Donati D., Cesari M., Longhi A., Abate M., Paioli A., Setola E., Ferrari S., Palmerini, E., Torricelli, E., Cascinu, S., Pierini, M., De Paolis, M., Donati, D., Cesari, M., Longhi, A., Abate, M., Paioli, A., Setola, E., and Ferrari, S.

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Prognosi, medicine.medical_treatment, Early Relapse, Bone Neoplasms, Relapse rate, LR, Bone Neoplasm, Gastroenterology, Follow-Up Studie, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Retrospective Studie, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, Chemotherapy, Child, Retrospective Studies, Aged, Osteosarcoma, Antineoplastic Combined Chemotherapy Protocol, business.industry, local relapse-free interval, Complete remission, LRFI, Hematology, Middle Aged, medicine.disease, Prognosis, Neoadjuvant Therapy, Survival Rate, Oncology, 030220 oncology & carcinogenesis, Pediatrics, Perinatology and Child Health, Female, local recurrence, Neoplasm Recurrence, Local, business, 030215 immunology, Follow-Up Studies, Human
Abstract

Background: High-grade bone osteosarcoma has a high relapse rate. The best treatment of local recurrence (LR) is under discussion. The aim of this study is to analyze LR patterns and factors prognostic for survival. Methods: LR diagnostic modality (clinical or imaging), pattern of recurrence, and post-LR survival (PLRS) were assessed. Results: Sixty-two patients were identified, with median age 21 years (range, 9–75 years), including 11 (18%) ≤15 years, 30 (48%) from 16 to 29 years; 21 (34%) were older. Patterns of relapse were LR only 58%, LR + distant metastases (DM) 42%. Seventy-nine percent of patients relapsed within 24 months, and diagnosis was clinical in 88%. LR treatment was surgery 85%, chemotherapy 55%, chemotherapy + surgery 45%. Surgical complete remission after LR (CR2) was achieved in 60% (LR 86%; LR + DM 23%). With a median follow-up of 43 months (range, 5–235 months), the five-year PLRS was 37%, significantly better for patients with longer LR-free interval (LRFI; ≤24 months 31% vs>24 months 61.5%, P=0.03), absence of DM (no DM 56%vs DM 11.5%, P=0.0001), and achievement of CR2 (no CR2 0%vs CR2 58.5%, P=0.0001). No difference was found according to age and chemotherapy (LR only: five-year PLRS: 53% without chemotherapy vs 58% with chemotherapy, P=0.9; LR + DM: five-year PLRS: 25% without chemotherapy vs 9% with chemotherapy, P=0.7). Conclusions: Early relapse is detected by symptoms in 90% of cases and associated with worse outcome. The achievement of CR2, not age, is crucial for survival. For patients with LR only, better survival was demonstrated, as compared with DM, and no improvement with chemotherapy after surgery was found.

Published
2019

50. Pathological fracture does not affect prognosis in dedifferentiated chondrosarcoma of the limbs

Author

Giuseppe Bianchi, Gianmarco Tuzzato, Massimiliano De Paolis, Davide Maria Donati, Andrea Sambri, Sambri A., Tuzzato G., Donati D.M., De Paolis M., and Bianchi G.

Subjects
Adult, medicine.medical_specialty, medicine.medical_treatment, Chondrosarcoma, Bone Neoplasms, Metastasis, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Orthopedics and Sports Medicine, In patient, Femur, Dedifferentiated chondrosarcoma, Pathological, Aged, Retrospective Studies, pathological fracture, 030222 orthopedics, business.industry, Retrospective cohort study, Prognosis, medicine.disease, Surgery, Fractures, Spontaneous, Amputation, Localized disease, Neoplasm Recurrence, Local, business, 030217 neurology & neurosurgery
Abstract

Background: The aim of this retrospective study is to analyze history and treatment outcomes of pathological fracture (PF) in dedifferentiated chondrosarcoma (DdChS) of the limbs. Methods: We retrospectively reviewed 175 adult patients with primary DdChS of the limbs.Disease-specific survival (OS) and local recurrence (LR) were analyzed. Results: Median age was 66 years (range, 29–91). Most DdChS (121, 69.1%) were localized in the femur. Forty-nine (28.0%) had metastasis at diagnosis; thirty-nine DdChS (22.3%) had a PF.OS rate was lower in patients with metastasis at diagnosis (8.6% Vs 41.0% at 10 years, p < 0.001). A similar OS was observed among patients with localized disease, whether with/without PF (p = 0.638), with/without chemotherapy (p = 0.543) and independently from the type of surgery (resection/amputation) (p = 0.877). Amputation reduces the risk of LR (80.0% vs 63.1% at 5 years, p = 0.039), particularly in the PF group. Conclusion: Patients with metastases have a particularly poor prognosis in DdChS, but pathological fracture does not influence prognosis in terms of survival and local control. Initial curative resection is essential in order to reduce the chance of recurrences. Amputation might be an option in patients with localized disease and a PF to reduce the risk of LR..

Published
2021
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