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Start Over Author "Scimè, Rosanna" Topic melphalan
2 results on '"Scimè, Rosanna"'

1. Reduced intensity conditioning with thiotepa, fludarabine, and melphalan is effective in advanced multiple myeloma.

Author

Majolino I, Davoli M, Carnevalli E, Locasciulli A, Di Bartolomeo P, Scimè R, Corradini P, Selleri C, Narni F, Musso M, Bregni M, Olivieri A, De Fabritiis P, Pogliani L, Arbelaez JE, Ruscio C, and Bacigalupo A

Subjects
Adult, Aged, Disease-Free Survival, Female, Humans, Male, Middle Aged, Transplantation, Homologous, Vidarabine administration & dosage, Melphalan administration & dosage, Multiple Myeloma drug therapy, Myeloablative Agonists administration & dosage, Stem Cell Transplantation methods, Thiotepa administration & dosage, Transplantation Conditioning methods, Vidarabine analogs & derivatives
Abstract

Fifty-three patients with multiple myeloma (MM) underwent an allogeneic stem cell transplant (HSCT) from their HLA identical siblings using a reduced-intensity conditioning consisting of thioteopa 5 mg/kg, fludarabine 90 mg/m(2), and melphalan 80 mg/m(2). Their median age was 52 years (range 38 - 68) and the interval from diagnosis 12 months. Forty-three patients (82%) had advanced disease and 33 had previously been treated with high-dose therapy with one (N = 21), or more (N = 12) autologus transplants. Ten (18%) had their allograft programmed after induction chemotherapy. The majority (N = 44) received peripheral blood as stem cell source. Acute graft-versus-host disease (GVHD) grade II - IV developed in 45%, but grade III - IV in only 5%. Cumulative incidence of chronic GVHD was 64%. Sixty-two per cent were in complete remission (CR) following transplantation. Transplant-related mortality was 13%. Relapse incidence was 32%. With a median follow-up of 22 months, 3-year overall survival is 45% and progression free survival (PFS) 37%. The thiotepa, fludarabine, and melphalan conditioning regimen can produce remissions in the majority of MM patients with a limited transplant mortality rate. When used as first line treatment the results of transplantation appear even more encouraging.

Published
2007
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2. Long-term Clinical Outcomes of Hematopoietic Stem Cell Transplantation in Multiple Sclerosis

Author

Maria Pia Sormani, Marco Capobianco, Matilde Inglese, Emanuele Angelucci, Rosanna Scimè, Raffaella Greco, Salvatore Cottone, Giancarlo Comi, Antonio Bertolotto, Alessio Signori, Riccardo Saccardi, Luca Massacesi, Lucia Moiola, Jessica Frau, Antonio Uccelli, Marco De Gobbi, Anna Maria Repice, Maria Pia Amato, Fabio Ciceri, Alice Mariottini, G. B. Zimatore, Francesca Gualandi, Gianluigi Mancardi, Giacomo Boffa, Chiara Innocenti, Boffa, Giacomo, Massacesi, Luca, Inglese, Matilde, Mariottini, Alice, Capobianco, Marco, Lucia, Moiola, Amato, Maria Pia, Cottone, Salvatore, Gualandi, Francesca, De Gobbi, Marco, Greco, Raffaella, Scimè, Rosanna, Frau, Jessica, Zimatore, Giovanni Bosco, Bertolotto, Antonio, Comi, Giancarlo, Uccelli, Antonio, Signori, Alessio, Angelucci, Emanuele, Innocenti, Chiara, Ciceri, Fabio, Repice, Anna Maria, Sormani, Maria Pia, Saccardi, Riccardo, and Mancardi, Gianluigi

Subjects
Oncology, 0301 basic medicine, Melphalan, medicine.medical_specialty, Expanded Disability Status Scale, business.industry, Multiple sclerosis, medicine.medical_treatment, Hazard ratio, Hematopoietic stem cell transplantation, medicine.disease, Confidence interval, Term (time), Transplantation, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Internal medicine, Medicine, Neurology (clinical), business, 030217 neurology & neurosurgery, Etoposide, medicine.drug
Abstract

ObjectiveTo determine whether autologous hematopoietic stem cell transplantation (aHSCT) is able to induce durable disease remission in people with multiple sclerosis (MS), we analyzed the long-term outcomes after transplantation in a large cohort of patients with MS.MethodsTo be included, a minimum dataset (consisting of age, MS phenotype, Expanded Disability Status Scale [EDSS] score at baseline, information on transplantation technology, and at least 1 follow-up visit after transplantation) was required.ResultsTwo hundred ten patients were included (relapsing-remitting [RR] MS 122 [58%]). Median baseline EDSS score was 6 (1–9); mean follow-up was 6.2 (±5.0) years. Among patients with RRMS, disability worsening–free survival (95% confidence interval [CI]) was 85.5% (76.9%–94.1%) at 5 years and 71.3% (57.8%–84.8%) at 10 years. In patients with progressive MS, disability worsening–free survival was 71.0% (59.4%–82.6%) and 57.2% (41.8%–72.7%) at 5 and 10 years, respectively. In patients with RRMS, EDSS significantly reduced after aHSCT (p = 0.001; mean EDSS change per year −0.09 [95% CI −0.15% to −0.04%]). In patients with RRMS, the use of the BCNU+Etoposide+Ara-C+Melphalan (BEAM) + anti-thymocyte globulin (ATG) conditioning protocol was independently associated with a reduced risk of no evidence of disease activity 3 failure (hazard ratio 0.27 [95% CI 0.14–0.50], p < 0.001). Three patients died within 100 days from aHSCT (1.4%); no deaths occurred in patients transplanted after 2007.ConclusionsaHSCT prevents disability worsening in the majority of patients and induces durable improvement in disability in patients with RRMS. The BEAM + ATG conditioning protocol is associated with a more pronounced suppression of clinical relapses and MRI inflammatory activity.Classification of EvidenceThis study provides Class IV evidence that for people with MS, aHSCT induces durable disease remission in most patients.

Published
2021
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