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9 results on '"Alessandrino, E P"'

1. Transplant results in adults with Fanconi anaemia

Author

Bierings M., Bonfim C., Peffault De Latour R., Aljurf M., Mehta P. A., Knol C., Boulad F., Tbakhi A., Esquirol A., McQuaker G., Sucak G. A., Othman T. B., Halkes C. J. M., Carpenter B., Niederwieser D., Zecca M., Kroger N., Michallet M., Risitano A. M., Ehninger G., Porcher R., Dufour C., Bonfirm C., Socie G., Gurman G., Ghavamzadeh A., Hamladji R. -M., van Lint M. T., Stepensky P., Koh M., Ozkurt Z. N., Veelken J. H., Bunjes D., Beelen D., Campos A., Robinson S., Alessandrino E. P., Unal A., Fernandez Navarro J. M., Mufti G. J., Velardi A., Passweg J., Apperley J., Sengeloev H., Ljungman P., Foa R., Alegre A., Espiga C. R., Cornelissen J. J., Di Bartolomeo P., Cordonnier C., Browne P., Jubert C., Gastl G., Pierelli L., Johansson J. -E., Fagioli F., Moraleda J., Zuckerman T., Bazarbachi A., Sedlacek P., Rossig C., Wynn R. F., Hallek M., Toren A., Zudaire T., Clausen J., Spencer A., Grazon Lopez S., Schots R., Komarnicki M., Gonzalez Muniz S., Vitek A., Rambaldi A., Merli F., Rubio M. T., Cabrera Marin J. R., Porto F., Kerre T., Metzner B., Stein J., Bertrand Y., Ciceri F., Chybicka A., Diez-Martin J. L., Bayoumy M., de la Fuente J., Fegueux N., Bierings, M., Bonfim, C., Peffault De Latour, R., Aljurf, M., Mehta, P. A., Knol, C., Boulad, F., Tbakhi, A., Esquirol, A., Mcquaker, G., Sucak, G. A., Othman, T. B., Halkes, C. J. M., Carpenter, B., Niederwieser, D., Zecca, M., Kroger, N., Michallet, M., Risitano, A. M., Ehninger, G., Porcher, R., Dufour, C., Bonfirm, C., Socie, G., Gurman, G., Ghavamzadeh, A., Hamladji, R. -M., van Lint, M. T., Stepensky, P., Koh, M., Ozkurt, Z. N., Veelken, J. H., Bunjes, D., Beelen, D., Campos, A., Robinson, S., Alessandrino, E. P., Unal, A., Fernandez Navarro, J. M., Mufti, G. J., Velardi, A., Passweg, J., Apperley, J., Sengeloev, H., Ljungman, P., Foa, R., Alegre, A., Espiga, C. R., Cornelissen, J. J., Di Bartolomeo, P., Cordonnier, C., Browne, P., Jubert, C., Gastl, G., Pierelli, L., Johansson, J. -E., Fagioli, F., Moraleda, J., Zuckerman, T., Bazarbachi, A., Sedlacek, P., Rossig, C., Wynn, R. F., Hallek, M., Toren, A., Zudaire, T., Clausen, J., Spencer, A., Grazon Lopez, S., Schots, R., Komarnicki, M., Gonzalez Muniz, S., Vitek, A., Rambaldi, A., Merli, F., Rubio, M. T., Cabrera Marin, J. R., Porto, F., Kerre, T., Metzner, B., Stein, J., Bertrand, Y., Ciceri, F., Chybicka, A., Diez-Martin, J. L., Bayoumy, M., de la Fuente, J., Fegueux, N., Clinical sciences, Hematology, Bierings, Marc, Bonfim, Carmem, Peffault De Latour, Regi, Aljurf, Mahmoud, Mehta, Parinda A., Knol, Cora, Boulad, Farid, Tbakhi, Abdelghani, Esquirol, Albert, Mcquaker, Grant, Sucak, Gulsan A., Othman, Tarek B., Halkes, Constantijn J. M., Carpenter, Ben, Niederwieser, Dietger, Zecca, Marco, Kröger, Nicolau, Michallet, Mauricette, Risitano, Antonio M., Ehninger, Gerhard, Porcher, Raphael, Dufour, Carlo, Bonfirm, Carmem, Socié, Gerard, Gurman, Gunham, Ghavamzadeh, Ardesir, Hamladji, Rise-Marie, Stepensky, Polina, Koh, Mickey, Ozkurt, Zubeyde Nur, Veelken, Joan Hendrik, Bunjes, Donald, Beelen, Dietrich, Campos, Antonio, Robinson, Stephen, Alessandrino, E. Paolo, Unal, Ali, Fernandez Navarro, José Maria, Velardi, Andrea, Passweg, Jakob, Apperley, Jane, Sengeloev, Henrik, Ljungman, Per, Foá, Roberto, Alegre, Adrián, Espiga, Carlos Richard, Di Bartolomeo, Paolo, Cordonnier, Catherine, Browne, Paul, Jubert, Charlotte, Gastl, Günther, Pierelli, Luca, Johansson, Jan-Erik, Fagioli, Franca, Moraleda, José, Zuckerman, Tsila, Bazarbachi, Ali, Sedlacek, Petr, Rössig, Claudia, Hallek, Michael, Toren, Amo, Zudaire, Teresa, Clausen, Joahanne, Spencer, Andrew, Grazon Lopez, Sebastian, Schots, Rik, González Muniz, Soledad, Vitek, Antonin, Rambaldi, Alessandro, Merli, Francesco, Rubio, Marie Thérese, Rossig, Claudia, Cabrera Marín, José Rafael, Porto, Fulvio, Kerre, Tessa, Metzner, Bernd, Stein, Jerry, Bertrand, Yve, Ciceri, Fabio, Chybicka, Alicja, Bayoumy, Mohamed, de la Fuente, Josu, and Fegueux, Nathalie

Subjects
Transplantation Conditioning, Graft vs Host Disease, Disease, Gastroenterology, 0302 clinical medicine, Retrospective Studie, Risk Factors, Inborn bone marrow failure syndrome, Neoplasms, Cause of Death, risk factors, inborn bone marrow failure syndrome, Transplantation, Homologou, Medicine(all), allogeneic transplant, Fanconi anaemia, myelodysplasia, Adolescent, Adult, Fanconi Anemia, Humans, Middle Aged, Neoplasms, Second Primary, Prognosis, Retrospective Studies, Survival Analysis, Tissue Donors, Transplantation, Homologous, Treatment Outcome, Young Adult, Hematopoietic Stem Cell Transplantation, Hematology, Incidence (epidemiology), Fludarabine, Second Primary, medicine.anatomical_structure, surgical procedures, operative, 030220 oncology & carcinogenesis, young adult, Survival Analysi, Human, medicine.drug, Homologous, medicine.medical_specialty, Cyclophosphamide, Prognosi, Myelodysplasia, Tissue Donor, Graft vs Host Disease/etiology, 03 medical and health sciences, Internal medicine, medicine, Hematopoietic Stem Cell Transplantation/adverse effects, Sibling, Transplantation, business.industry, Risk Factor, Neoplasms, Second Primary/etiology, Confidence interval, Allogeneic transplant, Surgery, Bone marrow, business, Fanconi Anemia/diagnosis, 030215 immunology
Abstract

The outcomes of adult patients transplanted for Fanconi anaemia (FA) have not been well described. We retrospectively analysed 199 adult patients with FA transplanted between 1991 and 2014. Patients were a median of 16years of age when diagnosed with FA, and underwent transplantation at a median age of 23years. Time between diagnosis and transplant was shortest (median 2years) in those patients who had a human leucocyte antigen identical sibling donor. Fifty four percent of patients had bone marrow (BM) failure at transplantation and 46% had clonal disease (34% myelodysplasia, 12% acute leukaemia). BM was the main stem cell source, the conditioning regimen included cyclophosphamide in 96% of cases and fludarabine in 64%. Engraftment occurred in 82% (95% confidence interval [CI] 76–87%), acute graft-versus-host disease (GvHD) grade II–IV in 22% (95% CI 16–28%) and the incidence of chronic GvHD at 96months was 26% (95% CI 20–33). Non-relapse mortality at 96months was 56% with an overall survival of 34%, which improved with more recent transplants. Median follow-up was 58months. Patients transplanted after 2000 had improved survival (84% at 36months), using BM from an identical sibling and fludarabine in the conditioning regimen. Factors associated with improved outcome in multivariate analysis were use of fludarabine and an identical sibling or matched non-sibling donor. Main causes of death were infection (37%), GvHD (24%) and organ failure (12%). The presence of clonal disease at transplant did not significant impact on survival. Secondary malignancies were reported in 15 of 131 evaluable patients.

Published
2018

2. Nonpermissive HLA-DPB1 disparity is a significant independent risk factor for mortality after unrelated hematopoietic stem cell transplantation

Author

Crocchiolo, R., Zino, E., Vago, L., Oneto, R., Bruno, B., Pollichieni, S., Sacchi, N., Sormani, M. P., Marcon, J., Lamparelli, T., Fanin, R., Garbarino, L., Miotti, V., Bandini, G., Bosi, A., Ciceri, F., Bacigalupo, A., Fleischhauer, K., Midollo Osseo Gruppo Italiano Trapianto, D. I., Terapia Cellulare, Cellule Staminali Ematopoietiche Cse E., Italian Bone Marrow Donor Registry Collaboratori, Scalari P., Bontempelli, M., Prinoth, O., Carcassi, C., Marceno, R., Porfirio, Rombola, G., Lombardo, Ferrioli, G., Poli, F., Scalamogna, M., Mazzi, B., Rossi, F., Mascaretti, L., Albergoni, Salvaneschi, L., Salvaneschi, M., Valentini, Nesci, S., Papola, F., Scatena, Mariotti, Perrone, Laurenti, Grammatico, Paola, Mariani, M., Favoino, B., Guizzardi, Pontiero, Leoni, P., Rambaldi, A., Casini, M., Angelucci, E., Baronciani, D., La Nasa, G., Milone, G., Guidi, S., Van Lint, M. T., Dini, G., Corradini, P., Milani, R., Morra, E., Marenco, P., Deliliers, Lambretenghi G., Onida, F., Marcatti, M., Castagna, L., Pioltelli, P., Selleri, C., Zanesco, L., Scime, R., Musso, M., Alessandrino, E. P., Locatelli, F., Visani, G., Di Bartolomeo, P., Papineschi, F., Favre, C., Iori, A. P., Foa, Roberto, Locasciulli, A., Majolino, I., Majolino, P., Leone, G., Arcese, W., Cerretti, R., Carella, A. M., Cascavilla, N., Lauria, F., Mazza, P., Cerno, M., Benedetti, F., Crocchiolo, R, Zino, E, Vago, L, Oneto, R, Bruno, B, Pollichieni, S, Sacchi, N, Sormani, Mp, Marcon, J, Lamparelli, T, Fanin, R, Garbarino, L, Miotti, V, Bandini, G, Bosi, A, Ciceri, F, Bacigalupo, A, and Fleischhauer, K

Subjects
Adult, Disease-Free Survival, Donor Selection, Female, HLA-DRB1 Chains, Hematologic Neoplasms, Humans, Italy, Male, Middle Aged, Recurrence, Registries, Retrospective Studies, Risk Factors, Survival Rate, Transplantation, Homologous, Algorithms, HLA-DR Antigens, Hematopoietic Stem Cell Transplantation, Tissue Donors, Biochemistry, Immunology, Hematology, Cell Biology, Homologous, medicine.medical_treatment, Human leukocyte antigen, Hematopoietic stem cell transplantation, Medicine, Risk factor, Survival rate, Transplantation, HLA-DPB1, business.industry, Hazard ratio, Confidence interval, business, Settore MED/15 - Malattie del Sangue
Abstract

The importance of donor-recipient human leukocyte antigen (HLA)-DPB1 matching for the clinical outcome of unrelated hematopoietic stem cell transplantation (HSCT) is controversial. We have previously described an algorithm for nonpermissive HLA-DPB1 disparities involving HLA-DPB1*0901,*1001,*1701,*0301,*1401,*4501, based on T-cell alloreactivity patterns. By revisiting the immunogenicity of HLA-DPB1*02, a modified algorithm was developed and retrospectively tested in 621 unrelated HSCTs facilitated through the Italian Registry for onco-hematologic adult patients. The modified algorithm proved to be markedly more predictive of outcome than the original one, with significantly higher KaplanMeier probabilities of 2-year survival in permissive compared with nonpermissive transplantations (55% vs 39%, P = .005). This was the result of increased adjusted hazards of nonrelapse mortality (hazard ratio [HR] = 1.74; confidence interval [CI], 1.19-2.53; P = .004) but not of relapse (HR = 1.02; CI, 0.73-1.42; P = .92). The increase in the hazards of overall mortality by nonpermissive HLA-DPB1 disparity was similar in 10 of 10 (HR = 2.12; CI, 1.23-3.64; P = .006) and 9 of 10 allele-matched transplantations (HR = 2.21; CI, 1.28-3.80; P = .004), both in early-stage and in advanced-stage disease. These data call for revisiting current HLA matching strategies for unrelated HSCT, suggesting that searches should be directed up-front toward identification of HLA-DPB1 permissive, 10 of 10 or 9 of 10 matched donors. (Blood. 2009; 114:1437-1444) RI Porfirio, Berardino/I-1988-2012

Published
2009

3. Myelodysplastic syndromes: recent advances

Author

Alessandrino, E. P., Amadori, S., Cazzola, M., Locatelli, F., Mecucci, C., Morra, E., Giuseppe Saglio, Visani, G., and Tura, S.

Subjects
Myelodysplastic Syndromes, Cytogenetic Analysis, Age Factors, Hematopoietic Stem Cell Transplantation, Humans, Antineoplastic Agents, Combined Modality Therapy
Published
2001

4. Autologous bone marrow transplantation for acute myeloblastic leukemia in Europe: further evidence of the role of marrow purging by mafosfamide. European Co-operative Group for Bone Marrow Transplantation (EBMT)

Author

Gorin, N. C., Labopin, M., Meloni, Giovanna, Korbling, M., Carella, A., Herve, P., Burnett, A., Rizzoli, V., Alessandrino, E. P., and Bjorkstrand, B.

Subjects
Adult, Male, Time Factors, Adolescent, Bone Marrow Purging, Infant, Antineoplastic Agents, Middle Aged, Prognosis, Combined Modality Therapy, Leukemia, Myeloid, Acute, Meta-Analysis as Topic, Risk Factors, Child, Preschool, Multivariate Analysis, Humans, Female, Child, Busulfan, Cyclophosphamide, Whole-Body Irradiation, Aged, Bone Marrow Transplantation, Follow-Up Studies
Abstract

Fifty-nine European teams have reported 919 autografts for the consolidation of acute myelocytic leukemia (AML) up to December 31, 1989. The distribution for autologous bone marrow transplantation (ABMT) was 671 in first complete remission (CR1) and 196 in CR2. Pretransplantation regimes were: total-body irradiation (TBI), 456; busulfan plus cyclophosphamide (BU-CY) 174; marrow purging with mafosfamide, 269 (corresponding to 26% of all patients in CR1 and 41% in CR2). Patients autografted in CR1 with no high risk factor (standard risk) had a leukemia-free survival (LFS) and relapse rate at 7 years of 48 +/- 2 and 41 +/- 3%, respectively. Of all the prognostic factors studied, only secondary leukemia was correlated with a poorer LFS (19 +/- 9% at 1 year) and a higher relapse rate (76 +/- 11%) (p less than 0.0001). For patients autografted in CR2, the LFS and relapse rate were 34 +/- 4 and 54 +/- 5%. With the restriction of a shorter follow-up, the results achieved with the BU-CY combinations (LFS and relapse rate at 3 years, CR1 47 +/- 6 and 45 +/- 7%; CR2, 37 +/- 9 and 50 +/- 10%) did not differ from those with TBI or other chemotherapy combinations. LFS and relapse rates were correlated with several pretransplant intervals: in CR1, patients reaching CR more rapidly (less than or equal to 40 days) had a better LFS (53 +/- 3 versus 42 +/- 3%; p = 0.03) and a lower relapse rate (46 +/- 3 versus 57 +/- 3%; p = 0.03). In patients autografted less than 3 months, 3-6 months and more than 6 months after CR, the LFS was 26 +/- 5, 49 +/- 3, and 55 +/- 4%, respectively, and the relapse rates 63 +/- 5, 38 +/- 3, and 36 +/- 4% (p less than 0.0001 for both). In CR2, patients autografted more than 18 months after the initial diagnosis had a better LFS (42 +/- 5 versus 24 +/- 5%; p less than 0.001) and a lower relapse rate (45 +/- 6 versus 65 +/- 6%; p less than 0.001). For those autografted less than 3 months, 3-6 months and more than 6 months after CR, the probability of LFS was 30 +/- 5, 30 +/- 7, and 50 +/- 9% (p = 0.06), respectively and the relapse rates 63 +/- 6, 50 +/- 8, and 36 +/- 8% (p = 0.01).(ABSTRACT TRUNCATED AT 400 WORDS)

Published
1991

5. Treatment of relapsed and refractory acute myeloid leukemia in adults

Author

Lazzarino, M., Morra, E., Alessandrino, E. P., Merante, S., Paolo Bernasconi, Bonfichi, M., Caldera, D., and Bernasconi, C.

Subjects
Adult, Leukemia, Myeloid, Acute, Antineoplastic Combined Chemotherapy Protocols, Remission Induction, Cytarabine, Drug Resistance, Humans, Mitoxantrone, Idarubicin, Etoposide

6. Unrelated donor marrow transplantation: An update of the experience of the Italian Bone Marrow Transplant Group (GITMO)

Author

Dini, G., Cancedda, R., Locatelli, F., Bosi, A., Bandini, G., Alessandrino, E. P., Porta, F., Uderzo, C., Messina, C., Fagioli, F., Arcese, W., Marenco, P., Fanin, R., Falda, M., Soligo, D., La Nasa, G., Giardini, C., Pession, A., Scimè, R., Di Bartolomeo, P., Bruno, B., Garbarino, L., Lamparelli, T., Giorgiani, G., Lanino, E., Carla Manzitti, and Bacigalupo, A.

Subjects
Homologous, Transplantation, Italian Bone Marrow Transplant Group (GITMO), Hematologic Diseases, Survival Analysis, Humans, Transplantation, Homologous, Italy, Bone Marrow Transplantation, Bone marrow transplant from unrelated donor (UD BMT), Italian Bone Marrow Donor Registry (IBMDR), Settore MED/15 - Malattie del Sangue
Abstract

Unrelated donor bone marrow transplant (UD-BMT) has become an attractive alternative source of hematopoietic cells for patients lacking a matched sibling. The aim of this paper was to report on results of the 696 UD BMTs performed in 31 Italian institutions during the first 10 years of activity of the Italian Bone Marrow Donor Registry (IBMDR). In 1989 the Italian Bone Marrow Transplant Group (GITMO) established the IBMDR to facilitate donor search and marrow procurement for patients lacking an HLA identical sibling. By end of December 1999, 260,000 HLA-A, B typed volunteer donors had been cumulatively registered and 2,620 searches had been activated for Italian patients. At least one HLA-A, B, DRB1 matched donor was found for 54% of the patients and 696 UD BMTs were performed. In 50% of cases the donor was found in the IBMDR and in 50% in 15 other Registries. The average time from search activation to transplant was 6 months for disease other than CML. For CML it was 14 months. Actuarial 12-month transplant-related mortality (TRM) was 68% in patients grafted between 1979 and 1992 and 44% for patients grafted after 1993. Twenty-eight per cent of patients developed grade III or IV acute GvHD and 24% developed extensive chronic GvHD. The rate of disease free survival at three years was 57% for patients with 1st chronic phase CML, 37% for patients with 1st or 2nd CR ALL, 31% for AML or MDS patientsor = 18 years of age and 54% for patients with inborn errors. We conclude that the IBMDR has benefited a substantial number of patients lacking a matched sibling and has facilitated the recruitment of UDs into the international donor pool. The long time required for the search is the major obstacle to the success of this programme. This suggests that early transplant and a decrease in TRM could further improve these encouraging results.

7. The VAD-DCEP sequence is an effective pre-transplant therapy in untreated multiple myeloma

Author

Corso, A., Barbarano, L., Zappasodi, P., Cairoli, R., Alessandrino, E. P., Mangiacavalli, S., Ferrari, D., Fava, S., Fiumanò, M., Frigerio, G., Isa, L., Luraschi, A., Catherine Klersy, Paoli, A., Vergani, C., Banfi, L., Perego, D., Ucci, G., Pinotti, G., Savarè, M., Uziel, L., Vismara, A., Morra, E., Lazzarino, M., Corso, A, Barbarano, L, Zappasodi, P, Cairoli, R, Alessandrino, E, Mangiacavalli, S, Ferrari, D, Fava, S, Fiumanò, M, Frigerio, G, Isa, L, Luraschi, A, Klersy, C, De Paoli, A, Vergani, C, Banfi, L, Perego, D, Ucci, G, Pinotti, G, Savarè, M, Uziel, L, Vismara, A, Morra, E, and Lazzarino, M

Subjects
Adult, Male, DCEP, Neutropenia, Transplantation Conditioning, Mobilization, Transplantation, Autologous, Dexamethasone, Drug Administration Schedule, Cohort Studies, CD34+ cell, Antineoplastic Combined Chemotherapy Protocols, Humans, High-dose therapy, Cyclophosphamide, Melphalan, Aged, Etoposide, HDCTX, Middle Aged, Combined Modality Therapy, Thrombocytopenia, Hematopoietic Stem Cell Mobilization, Neoadjuvant Therapy, Treatment Outcome, Doxorubicin, Vincristine, Female, Cisplatin, Multiple Myeloma
Abstract

Background and Objectives. Standard treatment for patients with multiple myeloma is debulking chemotherapy with non-alkylating agents followed by a regimen to mobilize peripheral blood stem cells (PBSC) and the transplantation of the mobilized, autologous PBSC. The aim of this study was to evaluate the efficacy of a new regimen and compare it with that of a previous regimen. Design and Methods. In a large cohort of 106 patients (group I) we administered a new pre-transplant program which includes 2 courses of pulsed-VAD (vincristine, adriamycin, dexamethasone) followed by 2 courses of DCEP (dexamethasone, cyclophosphamide, etoposide and cis-platinum). We compared the efficacy of this new VAD-DCEP sequence, in terms of mobilizing capacity, toxicity and anti-myeloma activity in comparison with that of the previous VAD-high-dose cyclophosphamide program (group II, 40 patients). Results. In group I 81/106 (76.4%) patients yielded ≥ 4×106/kg CD34+ cells, as did 30/40 (75%) in group II but with a significantly higher toxicity in this latter group. In detail, 9 patients in group I (8.5%) had WHO grade III neutropenia versus 35 in group II (87.5%), 5 patients of group I (4.7%) had grade III thrombocytopenia versus 12 patients in group II (30%), and 8 patients in group I (7.5%) experienced an infections fever versus 9 patients in group II (22.5%). Therefore, nearly all patients in group II had to be admitted to hospital (39/40, 97.5%). There was a higher percentage of responses (CR+VGPR+PR) in group I than in group II: 73% versus 50% (p=0.02). Interpretation and Conclusions. the VAD-DCEP sequence has an adequate mobilizing capacity, without significant toxicity, and a good anti-myeloma activity, and therefore represents a safe and effective therapeutic approach for multiple myeloma patients at the onset of their disease.

8. Factors predicting outcome after allogeneic transplant in refractory acute myeloid leukemia: a retrospective analysis of Gruppo Italiano Trapianto di Midollo Osseo (GITMO)

Author

Alberto Bosi, A. P. Iori, Patrizia Chiusolo, Fabio Giglio, Emilio Paolo Alessandrino, Irene Cavattoni, Bénédicte Bruno, Andrea Bacigalupo, Elisabetta Terruzzi, Cristina Boschini, Armando Santoro, Paola Marenco, L. Castagna, Elisabetta Todisco, Irene Donnini, William Arcese, Elena Oldani, Francesca Patriarca, Fabio Ciceri, Francesca Bonifazi, Alessandro Rambaldi, Todisco, E., Ciceri, F., Boschini, C., Giglio, F., Bacigalupo, A., Patriarca, F., Donnini, I., Alessandrino, E. P., Arcese, W., Iori, A. P., Marenco, P., Cavattoni, I., Chiusolo, P., Terruzzi, E., Castagna, L., Santoro, A., Bosi, A., Oldani, E., Bruno, B., Bonifazi, F., and Rambaldi, A.

Subjects
Adult, Male, medicine.medical_specialty, Myeloid, Adolescent, medicine.medical_treatment, Hematopoietic stem cell transplantation, Disease-Free Survival, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Survival rate, Aged, Retrospective Studies, Transplantation, business.industry, Siblings, Hazard ratio, Hematopoietic Stem Cell Transplantation, Hematology, Middle Aged, Allografts, medicine.disease, Surgery, Survival Rate, Leukemia, Myeloid, Acute, Leukemia, medicine.anatomical_structure, Graft-versus-host disease, 030220 oncology & carcinogenesis, Female, Cord Blood Stem Cell Transplantation, Bone marrow, Unrelated Donors, business, Settore MED/15 - Malattie del Sangue, 030215 immunology
Abstract

The clinical outcome of primary refractory (PRF) AML patients is poor and only a minor proportion of patients is rescued by allogenic hematopoietic stem cell transplantation (HSCT). The identification of pre-HSCT variables may help to determine PRF AML patients who can most likely benefit from HSCT. We analyzed PRF AML patients transplanted between 1999 and 2012 from a sibling, unrelated donor or a cord blood unit. Overall, 227 patients from 26 Gruppo Italiano Trapianto di Midollo Osseo e Terapia cellulare centers were included in the analysis. At 3 years, the overall survival was 14%. By multivariate analysis, the number of chemotherapy cycles, (hazard ratio (HR): 1.87; 95% confidence interval (CI): 1.24-2.85; P=0.0028), the percentage of bone marrow or peripheral blood blasts (HR: 1.75; 95% CI: 1.16-2.64; P=0.0078), the adverse cytogenetic (HR: 1.44; 95% CI: 1.00-2.07; P=0.0508) and the age of patients (HR: 1.77; 95% CI: 1.08-2.88; P=0.0223) remained significantly associated with survival. Thus, we set up a new score predicting at 3 years after transplantation, an overall survival probability of 32% for patients with score 0 (no or 1 prognostic factor), 10% for patients with score 1 (2 prognostic factors) and 3% for patients with score 2 (3 or 4 prognostic factors).

Published
2017

9. Hepatitis reactivation and liver failure in haemopoietic stem cell transplants for hepatitis B virus (HBV)/hepatitis C virus (HCV) positive recipients: a retrospective study by the Italian group for blood and marrow transplantation

Author

Locasciulli, A, Bruno, B, Alessandrino, Ep, Meloni, G, Arcese, W, Bandini, G, Cassibba, V, Rotoli, B, Morra, E, Majolino, I, Alberti, Alfredo, Bacigalupo, A, Italian Cooperative Group for Blood, Marrow, Transplantation, Locasciulli, A., Bruno, B., Alessandrino, E. P., Meloni, G., Arcese, W., Bandini, C., Cassibba, V., Rotoli, Bruno, Morra, E., Majolino, I., Alberti, A., and Bacicalupo, A.

Subjects
Homologous, Adult, Male, Hepatitis B virus, Allogeneic transplantation, Time Factors, Transplantation Conditioning, Hepatitis C virus, Hepacivirus, medicine.disease_cause, Transplantation, Autologous, Liver disease, Liver Function Tests, Recurrence, Hepatitis B Surface Antigens, Liver Failure, Humans, Retrospective Studies, Transplantation, Homologous, Virus Activation, Patient Selection, Hepatitis B, Hepatitis C, Stem Cell Transplantation, Female, medicine, Hepatitis, Transplantation, medicine.diagnostic_test, business.industry, virus diseases, Hematology, medicine.disease, digestive system diseases, surgical procedures, operative, Immunology, hbv, hcv, hsct, Viral disease, business, Liver function tests, Autologous, Settore MED/15 - Malattie del Sangue
Abstract

Hepatitis B virus/hepatitis C virus (HBV/HCV) positive patients undergoing haemopoietic stem cell transplantation (HSCT) are at risk of hepatitis reactivation and fatal liver failure: we have conducted a retrospective study to assess the risk in 20 Italian transplant centres. A total of 90 patients infected with HBV (n=33) or HCV (n=57) receiving allogeneic (n=36) or autologous (n=54) haemotopoietic stem cell transplant (HSCT) between 1996 and 2000 were reviewed. The biochemical profiles and outcomes of infection-related liver disease were also analysed. The risk of death at 2 years was comparable when considering type of infection (3% for HBV vs 8% for HCV, P=0.6) or type of HSCT (7% for allogeneic vs 5% for autologous HHSCT, P=0.34). Hepatitis reactivation followed by resolution was more frequent in HCV+ than in HBV+ patients receiving an allograft (100% vs 16%, P=0.004). In HBV+ cases, risk of reactivation was comparable after autologous or allogeneic transplantation (66 vs 81%, P=0.3), but liver disease was more severe and occurred earlier in the autologous group. Our results indicate that HBV and HCV infection should not be taken as an absolute contraindication for HSCT and the risk of life-threatening liver complications are similar after allogeneic or autologous transplants.

Published
2003

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