506 results on '"Catalano, Lucio"'
Search Results
152. Detection of increased left ventricular filling pressure by pulsed tissue Doppler in cardiac amyloidosis
- Author
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Innelli, Pasquale, primary, Galderisi, Maurizio, additional, Catalano, Lucio, additional, Martorelli, Maria Carmen, additional, Olibet, Marinella, additional, Pardo, Moira, additional, Rotoli, Bruno, additional, and de Divitiis, Oreste, additional
- Published
- 2006
- Full Text
- View/download PDF
153. Oral Melphalan, Prednisone and Thalidomide for Multiple Myeloma.
- Author
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Palumbo, Antonio, primary, Bringhen, Sara, primary, Musto, Pellegrino, primary, Caravita, Tommaso, primary, Capozzi, Rosanna, primary, Callea, Vincenzo, primary, Cangialosi, Clotilde, primary, Montanaro, Marco, primary, Catalano, Lucio, primary, Grasso, Mariella, primary, Petti, Maria Concetta, primary, Merla, Manuela, primary, Falchi, Lorenzo, primary, Omedè, Paola, primary, Ceccarelli, Manuela, primary, Ambrosini, Maria Teresa, primary, Avonto, Ilaria, primary, Gay, Francesca, primary, Falco, Patrizia, primary, and Boccadoro, Mario, primary
- Published
- 2005
- Full Text
- View/download PDF
154. Tc99m-sestaMIBI uptake in nonsecretory multiple myeloma
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Catalano, Lucio, primary, Andretta, Claudia, additional, Pace, Leonardo, additional, Vecchio, Silvana Del, additional, Salvatore, Barbara, additional, De Rosa, Gennaro, additional, Buonanno, Maria Teresa, additional, Paone, Gaetano, additional, and Rotoli, Bruno, additional
- Published
- 2005
- Full Text
- View/download PDF
155. Rapid Reversion of Loeffler's Endocarditis by Imatinib in Early Stage Clonal Hypereosinophilic Syndrome
- Author
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Rotoli, Bruno, primary, Catalano, Lucio, additional, Galderisi, Maurizio, additional, Luciano, Luigia, additional, Pollio, Giuditta, additional, Guerriero, Anna, additional, D'Errico, Arcangelo, additional, Mecucci, Cristina, additional, La Starza, Roberta, additional, Frigeri, Ferdinando, additional, Di Francia, Raffaele, additional, and Pinto, Antonio, additional
- Published
- 2004
- Full Text
- View/download PDF
156. A Prospective Randomized Trial of Oral Melphalan, Prednisone, Thalidomide (MPT) vs Oral Melphalan, Prednisone (MP): An Interim Analysis.
- Author
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Palumbo, Antonio, primary, Bertola, Alessandra, additional, Musto, Pellegrino, additional, Caravita, Tommaso, additional, Callea, Vincenzo, additional, Cangialosi, Clotilde, additional, Liberati, Anna Marina, additional, Niscola, Pasquale, additional, Catalano, Lucio, additional, Grasso, Mariella, additional, Lauta, Vito Michele, additional, Petti, Maria Concetta, additional, Morandi, Sergio, additional, Galli, Monica, additional, Bringhen, Sara, additional, Cavallo, Federica, additional, Falco, Patrizia, additional, and Boccadoro, Mario, additional
- Published
- 2004
- Full Text
- View/download PDF
157. Platelet-Derived Growth Factor Receptor Beta (PDGFRb) Expression in Langerhans Cell Histiocytosis (LCH).
- Author
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Palmieri, Giovannella, primary, Montella, Liliana, additional, Strazzullo, Viviana, additional, De Vizio, Dolores, additional, Catalano, Lucio, additional, Rotoli, Bruno, additional, and Insabato, Luigi, additional
- Published
- 2004
- Full Text
- View/download PDF
158. Perspective study on pamidronate in stage I multiple myeloma
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Caparrotti, Giuseppe, primary, Catalano, Lucio, additional, Feo, Costanzo, additional, Vallone, Roberto, additional, Pagnini, David, additional, and Rotoli, Bruno, additional
- Published
- 2003
- Full Text
- View/download PDF
159. 99mTc-sestaMIBI Scintigraphy in Thalidomide-treated Refractory or Relapsed Multiple Myeloma Patients
- Author
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Andretta, Claudia, primary, Catalano, Lucio, additional, Pace, Leonardo, additional, Fonti, Rosa, additional, Annunziata, Gaetana, additional, and Rotoli, Bruno, additional
- Published
- 2003
- Full Text
- View/download PDF
160. Functional imaging of Langerhans cell histiocytosis by 111In‐DTPA‐D‐Phe1‐octreotide scintigraphy
- Author
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Lastoria, Secondo, primary, Montella, Liliana, additional, Catalano, Lucio, additional, Rotoli, Bruno, additional, Muto, Pietro, additional, and Palmieri, Giovannella, additional
- Published
- 2002
- Full Text
- View/download PDF
161. Tc-99m Sestamibi Scintigraphy in Multiple Myeloma
- Author
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DI GENNARO, FRANCESCA, primary, CATALANO, LUCIO, additional, PACE, LEONARDO, additional, DE RENZO, AMALIA, additional, PINTO, ANNA MARIA, additional, DEL VECCHIO, SILVANA, additional, ROTOLI, BRUNO, additional, and SALVATORE, MARCO, additional
- Published
- 1999
- Full Text
- View/download PDF
162. Metabolic Tumor Volume Assessed by 18F-FDG PET/CT for the Prediction of Outcome in Patients with Multiple Myeloma.
- Author
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Fonti, Rosa, Larobina, Michele, Del Vecchio, Silvana, De Luca, Serena, Fabbricini, Rossella, Catalano, Lucio, Pane, Fabrizio, Salvatore, Marco, and Pace, Leonardo
- Published
- 2012
- Full Text
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163. DANAZOL FOR MYELODYSPLASTIC SYNDROMES
- Author
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Catalano, Lucio, primary, Selleri, Carmine, additional, Montuori, Nunzia, additional, Fratellanza, Giorgio, additional, Notaro, Rosario, additional, Fontana, Raffaele, additional, Formisano, Salvatore, additional, and Rotoli, Bruno, additional
- Published
- 1993
- Full Text
- View/download PDF
164. Trisomy 13 in a patient with leukemic progression of myelodysplasia
- Author
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Luciano, Luigia, primary, Polito, Pietro, additional, Catalano, Lucio, additional, Selleri, Carmine, additional, Alfinito, Fiorella, additional, and Rotoli, Bruno, additional
- Published
- 1993
- Full Text
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165. 18F-FDG PET/CT, 99mTc-MIBI, and MRI in Evaluation of Patients with Multiple Myeloma.
- Author
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Fonti, Rosa, Salvatore, Barbara, Quarantelli, Mario, Sirignano, Cesare, Segreto, Sabrina, Petruzziello, Fara, Catalano, Lucio, Liuzzi, Raffaele, Rotoli, Bruno, Del Vecchio, Silvana, Pace, Leonardo, and Salvatore, Marco
- Published
- 2008
- Full Text
- View/download PDF
166. Poster: MM-418: Pegfilgrastim in the Supportive Care of Heavily Pretreated Multiple Myeloma in Pomalidomide-Based Treatment.
- Author
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Cerchione, Claudio, Catalano, Lucio, Nappi, Davide, Pane, Fabrizio, and Martinelli, Giovanni
- Published
- 2021
- Full Text
- View/download PDF
167. Bendamustine-Bortezomib-Dexamethasone (BVD) in Heavily Pretreated Multiple Myeloma: Old/New in NOVEL Agents' Era
- Author
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Cerchione, Claudio, Catalano, Lucio, Nappi, Davide, Rocco, Stefano, Palmieri, Salvatore, Pareto, Anna Emanuele, Musuraca, Gerardo, Lucchesi, Alessandro, Pane, Fabrizio, Ferrara, Felicetto, and Martinelli, Giovanni
- Abstract
Introduction
- Published
- 2020
- Full Text
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168. Bendamustine-Bortezomib-Dexamethasone in Heavily Pretreated Multiple Myeloma: Old PLUS New Drugs in NOVEL Agents' Era
- Author
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Cerchione, Claudio, Catalano, Lucio, Nappi, Davide, Pareto, Anna Emanuele, Pane, Fabrizio, and Martinelli, Giovanni
- Abstract
Bendamustine is an old bi-functional alkylating agent which has proved to be effective in relapsed, refractory and in new diagnosed Multiple Myeloma (MM). Thus, aiming to provide further insights in this field, also in novel agents'era, we present here a retrospective, real-life analysis of patients with relapsed/refractory MM (rrMM), who had received salvage therapy with bendamustine in combination with bortezomib and dexamethasone (BVD)
- Published
- 2021
- Full Text
- View/download PDF
169. Pomalidomide-Dexamethasone in the Management of Heavily Pretreated Multiple Myeloma
- Author
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Cerchione, Claudio, Catalano, Lucio, Nappi, Davide, Pareto, Anna Emanuele, Pane, Fabrizio, and Martinelli, Giovanni
- Abstract
Pomalidomide is a new generation IMID, with a very good compliance, thanks to oral administration, which can be used also in heavily pretreated patients, in a domestic setting.
- Published
- 2021
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170. Carfilzomib-Lenalidomide-Dexamethasone in the Management of Lenalidomide-Refractory Multiple Myeloma
- Author
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Cerchione, Claudio, Nappi, Davide, Pareto, Anna Emanuele, Pane, Fabrizio, Catalano, Lucio, and Martinelli, Giovanni
- Abstract
Carfilzomib is an epoxyketone proteasome inhibitor of second generation, proved to be effective and safe in relapsed and refractory Multiple Myeloma (rrMM), in combination with dexamethasone or lenalidomide and dexamethasone.
- Published
- 2021
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171. Role of Pegfilgrastim in the Supportive Care of Heavily Pretreated Multiple Myeloma in Treatment with Pomalidomide-Dexamethasone
- Author
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Cerchione, Claudio, Catalano, Lucio, Nappi, Davide, Pareto, Anna Emanuele, Pane, Fabrizio, and Martinelli, Giovanni
- Abstract
Pegfilgrastim is a pegylated long-acting recombinant form of G-CSF that extends the half-life and allows for once-per-cycle dosing, requiring less frequent dosing than nonpegylated G-CSF.
- Published
- 2021
- Full Text
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172. Oral melphalan and prednisone chemotherapy plus thalidomide compared with melphalan and prednisone alone in elderly patients with multiple myeloma: randomised controlled trial
- Author
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Palumbo, Antonio, Bringhen, Sara, Caravita, Tommaso, Merla, Emanuela, Capparella, Vincenzo, Callea, Vincenzo, Cangialosi, Clotilde, Grasso, Mariella, Rossini, Fausto, Galli, Monica, Catalano, Lucio, Zamagni, Elena, Petrucci, Maria Teresa, De Stefano, Valerio, Ceccarelli, Manuela, Ambrosini, Maria Teresa, Avonto, Ilaria, Falco, Patrizia, Ciccone, Giovannino, Liberati, Anna Marina, Musto, Pellegrino, and Boccadoro, Mario
- Published
- 2006
- Full Text
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173. Pegfilgrastim in primary prophylaxis of febrile neutropenia in elderly patients with hematological malignancies-bendamustine and G-CSF support.
- Author
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Cerchione, Claudio, De Renzo, Amalia, Nappi, Davide, Di Perna, Maria, Della Pepa, Roberta, Pugliese, Novella, Catalano, Lucio, Pane, Fabrizio, and Picardi, Marco
- Subjects
FEBRILE neutropenia ,HEMATOLOGIC malignancies ,OLDER patients ,PREVENTIVE medicine ,MANTLE cell lymphoma - Published
- 2019
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174. Functional imaging of Langerhans cell histiocytosis by <SUP>111</SUP>In-DTPA-<SC>D</SC>-Phe<SUP>1</SUP>-octreotide scintigraphy
- Author
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Lastoria, Secondo, Montella, Liliana, Catalano, Lucio, Rotoli, Bruno, Muto, Pietro, and Palmieri, Giovannella
- Abstract
Langerhans cell histiocytosis is a rare group of diseases of unknown pathogenesis, variable clinical presentation, and behavior. It encompasses highly aggressive, often fatal, and indolent diseases, with a variety of intermediate forms between the two extremes. Localization and monitoring of Langerhans cell histiocytosis deposits are based on the combined use of different imaging modalities, which include magnetic resonance, computed tomography, and nuclear medicine procedures. Somatostatin receptor scintigraphy recently has been used to image immune-mediated diseases with excellent results. In this study, the authors have evaluated the potential role of somatostatin receptor scintigraphy by using 111In-DTPA-
D -Phe1-octreotide in a series of patients with Langerhans cell histiocytosis. Eight consecutive patients (2 males, 6 females; mean age, 43 years; age range, 2960 years) with histologically proven Langerhans cell histiocytosis, in various phases of their disease, were imaged 24 hours after intravenous injection of 111222 MBq of 111In-DTPA-D -Phe1-octreotide, by using total body and spot view images. The objective of the study was to preliminarly evaluate this technique in the evaluation of Langerhans cell histiocytosis. Most Langerhans cell histiocytosis deposits were clearly documented by somatostatin receptor scintigraphy, independently from the anatomic location (i.e., skeleton, mucosae, soft tissue, etc.). The correlation between conventional imaging modalities and somatostatin receptor scintigraphy results was fairly good, though this was not considered a primary objective of the study. Among the various imaging modalities for Langerhans cell histiocytosis, somatostatin receptor scintigraphy is unique, becuase it accurately depicts the active sites of disease and thus can help in monitoring the response to treatment, together with conventional imaging modalities. Further studies are necessary to confirm the diagnostic value of this technique and clarify the biologic significance of the expression of somatostatin receptors in Langerhans cell histiocytosis. Cancer 2002;94:63340. © 2002 American Cancer Society. DOI 10.1002/cncr.10276- Published
- 2002
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175. Predictive value of technetium-99m sestamibi in patients with multiple myeloma and potential role in the follow-up
- Author
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Pace, Leonardo, Catalano, Lucio, Vecchio, Silvana, Gennaro, Francesca, Renzo, Amalia, Sica, Giulia, Califano, Catello, Tedesco, Nicolina, Borrelli, Giovanni, Rotoli, Bruno, and Salvatore, Marco
- Abstract
Technetium-99m 2-methoxyisobutylisonitrile (99mTc-MIBI or setamibi) has recently been proposed for use in the evaluation of multiple myeloma (MM). The aims of this study were to investigate its potential predictive value in patients with MM and its possible role in the follow-up. Thirty patients with MM who had undergone two 99mTc-MIBI scintigraphic studies at least 2 months apart constituted the study group; 22 of them received chemotherapy in the interval between the two scans. The scans were classified as showing pattern N when only physiological uptake was present, pattern D when diffuse bone marrow uptake was observed, pattern F when areas of focal uptake of the tracer were evident, and pattern F+D when both D and F patterns were observed. Comparative 99mTc-MIBI scintigraphy was considered indicative of disease progression when there was a worsening of the pattern (i.e. from N to D, or from N or D to F or to F+D) or an increase in the pattern D semiquantitative score. It was considered indicative of disease improvement when the opposite trend was observed; otherwise, it was considered to document a stable condition. A significant association was observed between the baseline scintigraphic pattern and clinical status at follow-up in the group of patients evaluated after chemotherapy (?2=16.7, P<0.05). A negative baseline 99mTc-MIBI scintigram showed a high predictive accuracy (100%) for remission, while the presence of pattern F or F+D was often associated with a less favourable outcome. A multivariate analysis showed that 99mTc-MIBI uptake pattern has an added value in relation to known prognostic variables such as C-reactive protein. 99mTc-MIBI scintigraphy patterns at follow-up were significantly associated with the clinical status evaluated after chemotherapy (?2=32.6, P<0.0001). Considering pattern N as indicating remission, pattern D stable condition, and pattern F or F+D progressive disease, a high concordance between scintigraphic findings and clinical status was found in the 22 patients undergoing chemotherapy (91%). Variation in 99mTc-MIBI findings comparing baseline and follow-up evaluations was significantly associated with clinical status both in patients undergoing chemotherapy (?2=26.5, P<0.0005) and in those not undergoing chemotherapy (?2=8.0, P<0.005). In conclusion, the results of this study suggest a prognostic value of 99mTc-MIBI scintigraphy in patients with MM and a potential role during the follow-up.
- Published
- 2001
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- View/download PDF
176. Carfilzomib-Lenalidomide-Dexamethasone in the Management of Lenalidomide-Refractory Multiple Myeloma
- Author
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Cerchione, Claudio, Catalano, Lucio, Nappi, Davide, Musuraca, Gerardo, Lucchesi, Alessandro, Pane, Fabrizio, and Martinelli, Giovanni
- Abstract
Background
- Published
- 2020
- Full Text
- View/download PDF
177. Pomalidomide-Dexamethasone in the Management of Heavily Pretreated Multiple Myeloma
- Author
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Cerchione, Claudio, Catalano, Lucio, Nappi, Davide, Pareto, Anna Emanuele, Musuraca, Gerardo, Lucchesi, Alessandro, Ronconi, Sonia, Ceccolini, Michela, Cangini, Delia, Giannini, Maria Benedetta, Di Battista, Valeria, Simonetti, Giorgia, Ghelli Luserna Di Rorà, Andrea, Pane, Fabrizio, and Martinelli, Giovanni
- Abstract
Background
- Published
- 2020
- Full Text
- View/download PDF
178. Pegfilgrastim Versus Filgrastim in the Supportive Care of Heavily Pretreated Multiple Myeloma in Treatment with Pomalidomide-Dexamethasone
- Author
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Cerchione, Claudio, Catalano, Lucio, Nappi, Davide, Pareto, Anna Emanuele, Musuraca, Gerardo, Lucchesi, Alessandro, Pane, Fabrizio, and Martinelli, Giovanni
- Abstract
Background
- Published
- 2020
- Full Text
- View/download PDF
179. Bendamustine-Bortezomib-Desametasone (BVD) in the Management of Relapsed and Refractory Multiple Myeloma : A REAL-Life Experience
- Author
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Claudio Cerchione, Catalano, Lucio, Pareto, Anna Emanuele, Basile, Santina, Marano, Luana, Peluso, Ilaria, Simeone, Luigia, Vitagliano, Orsola, Palmieri, Salvatore, Rocco, Stefano, Ferrara, Felicetto, and Pane, Fabrizio
- Subjects
Immunology ,Cell Biology ,Hematology ,Biochemistry - Abstract
Introduction: Bendamustine is a bifunctional alkylating agent, with low toxicity, proved to be effective in relapsed, refractory and in new diagnosed Multiple Myeloma (MM). It has been evaluated efficacy and tolerance of Bendamustine, in combination with bortezomib-dexametasone (BVD) in patients with relapsed and refractory MM (rrMM), whose prognosis is particularly severe. A regional retrospective real-life analysis of patients with rrMM who had been treated with BVD as salvage therapy has been performed. Methods: 35 patients (19 M/16 F), with rrMM, median age at diagnosis 57 years (r. 36-82), median age at start of treatment 62 years (r.37-83) treated with several lines of treatments (median 6, r. 2-11), every refractory to all the drugs previously received (also Bortezomib), received BVD (Bendamustine 90mg/sqm days 1,2; Bortezomib 1.3mg/sqm days 1,4,8,11, Desametasone 20mg days 1,2,4,5,8,9,11,12, Pegfilgrastim day +4) every 28 days, until progression. ISS was equally distributed, and cytogenetic was evaluable in 9 patients, and in particular one del13q and one t(11;14). All the patients had previously been treated with schedule containing bortezomib and IMIDs, 90% of them with melphalan, 77% with cyclophosphamide, 34% with antracyclines and 30% had also received radiotherapy. 58% of them had undergone at least to a single auSCT. All patients were relapsed and refractory to last therapies received before BVD. Results: Bendamustine was well tolerated, with grade 3 transfusion-dependent anemia in 29% of patients, and 41% grade 3 neutropenia (no ospedalization was required, no septic shocks were observed). No severe extrahematologic toxicity was observed, only grade 1 gastrointestinal side effect (nausea), treated by common antiemetic drugs. According to IMWG, after a median follow-up of 9 months (r.2-36), ORR was 54% (1 CR, 1 VGPR, 9 PR, 8 MR) with 7 PD and 9 patients in SD, which can be considered as an impressive result in this subset of rrMM patients. In particular, for 4 patients, BVD was, after having achieved a PR, a bridge to second auSCT, and for one patient a bridge to auSCT. Median OS from diagnosis was 61.4 months (range 6-151), median OS from start of Bendamustine was 7.2 months (range 2-36). Conclusion: BVD has shown significant efficacy (ORR 54%) in a particular severe setting of patients, relapsed and refractory to all avaiable therapeutic resources, and in particular cases it could be considered as a bridge to a second autologous or allogenic BMT. Disclosures No relevant conflicts of interest to declare.
180. Visual and volumetric parameters by 18F-FDG-PET/CT: a head to head comparison for the prediction of outcome in patients with multiple myeloma.
- Author
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Fonti, Rosa, Pellegrino, Sara, Catalano, Lucio, Pane, Fabrizio, Del Vecchio, Silvana, and Pace, Leonardo
- Subjects
- *
MULTIPLE myeloma , *RECEIVER operating characteristic curves , *CLINICAL trials , *COMPARATIVE studies , *COMPUTED tomography , *DEOXY sugars , *RESEARCH methodology , *MEDICAL cooperation , *RADIOPHARMACEUTICALS , *RESEARCH , *EVALUATION research , *RETROSPECTIVE studies - Abstract
In multiple myeloma (MM) patients, 18F-FDG-PET/CT allows either the detection of disease spread by using visual parameters based on the Italian Myeloma criteria for PET Use (IMPeTUs) or the direct measurement of metabolic tumor burden by volume-based parameters such as metabolic tumor volume (MTV). The purpose is to evaluate the contribution of visual and volumetric parameters in the prediction of progression-free survival (PFS) and overall survival (OS) in MM patients. Forty-seven patients in stage IIIA who had undergone whole-body 18F-FDG-PET/CT were retrospectively evaluated. In each patient, visual parameters were determined and compared with volumetric parameters for PFS and OS prediction after a mean follow-up period of 53 months. Among the visual and volumetric parameters tested, a statistically significant difference was found between maximum standardized uptake value, MTV, total lesion glycolysis, and number of lytic lesions of patients with (n = 26) or without (n = 21) progression (p = 0.0400, p = 0.0065, p = 0.015, and p = 0.0220, respectively) and of dead (n = 24) vs survivors (n = 23) (p = 0.0171, p = 0.0037, p = 0.0060, and p = 0.0270, respectively). At univariate and multivariate analysis, MTV and hemoglobin were predictive of both PFS (p = 0.008) and OS (p = 0.0026). The best MTV discriminative value assessed by receiver operating characteristic curve analysis for predicting both PFS and OS was 39.4 ml. By Kaplan-Meier analysis and log-rank test, PFS and OS were significantly better in patients with MTV ≤ 39.4 ml (p = 0.0004 and p = 0.0001, respectively) as compared with those having an MTV higher than the cutoff. The volume-based parameter MTV determined by 18F-FDG-PET/CT may be used in the prediction of PFS and OS in myeloma patients. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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181. Salvage therapy with pegylated liposomial doxorubicin-based regimen in relapsed/refractory multiple myeloma: comments to the article by Romano et al.
- Author
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Cerchione, Claudio, Lucignano, Mariano, Pane, Fabrizio, and Catalano, Lucio
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SALVAGE therapy ,DOXORUBICIN ,MULTIPLE myeloma ,PATIENTS ,PHARMACODYNAMICS - Abstract
A letter to the editor is presented in response to the article "Salvage therapy with pegylated liposomial doxorubicin, bortezomib, cyclophosphamide, and dexamethasone in relapsed/ refractory myeloma patients," by A. Romano and colleagues in the 2014 issue.
- Published
- 2016
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182. Granulocyte Colony-Stimulating Factor and Erythropoietin for the Anemia of Myelodysplastic Syndromes: A Real Improvement With Respect to Erythropoietin Alone?
- Author
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Musto, Pellegrino, Falcone, Antonietta, Carotenuto, Mario, Catalano, Lucio, Cennamo, Antonia, and Rotoli, Bruno
- Published
- 1994
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- View/download PDF
183. Adjusted comparison between elotuzumab and carfilzomib in combination with lenalidomide and dexamethasone as salvage therapy for multiple myeloma patients.
- Author
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Morabito, Fortunato, Zamagni, Elena, Conticello, Concetta, Pavone, Vincenzo, Palmieri, Salvatore, Bringhen, Sara, Galli, Monica, Mangiacavalli, Silvia, Derudas, Daniele, Rossi, Elena, Ria, Roberto, Catalano, Lucio, Tacchetti, Paola, Mele, Giuseppe, Donatella Vincelli, Iolanda, Antonia Martino, Enrica, Vigna, Ernesto, Botta, Cirino, Bruzzese, Antonella, and Mele, Anna
- Subjects
- *
MULTIPLE myeloma , *SALVAGE therapy , *LENALIDOMIDE , *LACTATE dehydrogenase , *DEXAMETHASONE - Abstract
The lack of a randomized trial comparing carfilzomib (K) versus elotuzumab (Elo) associated with lenalidomide and dexamethasone (Rd) prompted us to assess the relative usefulness of one triplet over the other. Five independent retrospective cohorts of 883 relapsed/refractory multiple myeloma (RRMM) patients, including 300 EloRd and 583 KRd cases, outside clinical trials, entered this non‐randomized comparison. KRd cohort accounted for a higher incidence of younger patients, cases with ≥3 lines of therapy, already exposed to lenalidomide, International Staging System (ISS) stage III, and abnormal lactic dehydrogenase (LDH) level compared with EloRd cohort. Moreover, cytogenetic risk categories, detected in roughly one‐third of cases, were equally distributed between the two therapy arms. The probability of CR+VGPR response was significantly higher in KRd (n = 314, 53.9%) than in EloRd patients (n = 111, 37.0%). Likewise, the cumulative incidence function of CR+VGPR, taking into account the competitive risk of death, was significantly higher in KRd arm patients than those in the EloRd arm (p =.003). Moreover, KRd treatment significantly reduced the progression or death risk by 46% in an adjusted multivariate analysis (HR: 0.54, 95% CI 0.42–0.69, p <.0001). Finally, in an adjusted illness‐progression/death model, the effect of KRd versus EloRd was of higher magnitude among those who achieved CR+VGPR (−39% hazard ratio reduction, p =.02) than among those who achieved < VGPR (−29% hazard ratio reduction, p =.007). With limitations characteristic to any retrospective analysis, this current clinical practice study's overall results demonstrated potential benefits of KRd therapy compared with EloRd. This observation may help the daily clinical practice. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
184. Amyloid in bone marrow smears of patients affected by multiple myeloma.
- Author
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Petruzziello, Fara, Zeppa, Pio, Catalano, Lucio, Cozzolino, Immacolata, Gargiulo, Giuseppe, Musto, Pellegrino, D'Auria, Fiorella, Liso, Vincenzo, Rizzi, Rita, Caruso, Nadia, Califano, Catello, Piro, Eugenio, Musso, Maurizio, Bonanno, Vincenza, Falcone, Antonietta Pia, Tafuto, Salvatore, Di Raimondo, Francesco, De Laurentiis, Michelino, Pane, Fabrizio, and Palombini, Lucio
- Subjects
- *
AMYLOIDOSIS , *MULTIPLE myeloma , *BONE marrow , *PATIENTS , *LYMPHOID tissue - Abstract
Systemic AL amyloidosis is associated with nearly 15% of cases of multiple myeloma, but data on the frequency and significance of amyloid deposits in the bone marrow of patients affected by multiple myeloma without clinical signs of systemic amyloidosis are scanty. Bone marrow smears of 166 unselected patients affected by multiple myeloma (126 at diagnosis and 40 after treatment) were stained with Congo red and studied by transmission and birefringence microscopy. Both focal and diffuse storages were considered positive. Overall, 67 patients were positive and 99 were negative to Congo red and apple-green birefringence. In particular, 51 of the 126 patients studied at diagnosis and 16 of the 40 patients with advanced disease were positive. Seventeen patients were reassessed after a mean follow-up of 32 months (range: 6–91): disappearance of amyloid deposits was verified in three cases, all responsive to bortezomib-based regimens. The preliminary data available suggest that amyloid deposition in the marrow of myeloma patients is frequent, as it can be traced in nearly 40% of cases. We failed to find correlations between bone marrow amyloid deposits and immunoglobulin type, disease stage, plasma cells percentage, hemoglobin, calcium, creatinine, albumin, or β2microglobulin. Significantly higher incidence of moderate/severe peripheral neuropathy was found in patients with marrow amyloid exposed to potentially neurotoxic antineoplastic agents. Further studies and prolonged follow-up are needed to validate our findings and to define possible prognostic aspects. [ABSTRACT FROM AUTHOR]
- Published
- 2010
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185. Continuous therapy in standard- and high-risk newly-diagnosed multiple myeloma: A pooled analysis of 2 phase III trials.
- Author
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D'Agostino, Mattia, De Paoli, Lorenzo, Conticello, Concetta, Offidani, Massimo, Ria, Roberto, Petrucci, Maria Teresa, Spada, Stefano, Marcatti, Magda, Catalano, Lucio, Gilestro, Milena, Guglielmelli, Tommasina, Baldini, Luca, Gamberi, Barbara, Rizzi, Rita, De Sabbata, Giovanni, Di Renzo, Nicola, Patriarca, Francesca, Pezzatti, Sara, Siniscalchi, Agostina, and Ribolla, Rossella
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MULTIPLE myeloma , *HEMATOLOGIC malignancies , *BLOOD diseases , *SPONTANEOUS cancer regression , *DISEASE remission - Abstract
Abstract Background Risk-adapted therapy is a common strategy in curable hematologic malignancies: standard-risk patients receive less intensive treatment, whereas high-risk patients require a more intensive approach. This model cannot be applied in multiple myeloma (MM), which is still incurable. Continuous treatment (CT) is a key strategy for MM treatment, since it improves duration of remission. However, the role of CT according to standard- or high-risk baseline prognosis remains an open question. Patients and methods We performed a pooled analysis of 2 phase III trials (GIMEMA-MM-03-05 and RV-MM-PI-209) that randomized patients to CT vs fixed-duration therapy (FDT). Results In the overall patient population (n = 550), CT improved progression-free survival1 (PFS1) (HR 0.54), PFS2 (HR 0.61) and overall survival (OS) (HR 0.71) vs FDT. CT improved PFS1 both in R-ISS I (HR 0.49) and R-ISS II/III patients (HR 0.55). Four-year PFS1 was 38% in R-ISS II/III patients receiving CT and 25% in R-ISS I patients receiving FDT, with similar trends for PFS2 and OS. High-risk patients benefited more from proteasome-inhibitor plus immunomodulatory-based CT than immunomodulatory alone. Conclusion Good prognosis patients receiving FDT lose their prognostic advantage over high-risk patients receiving CT and high-risk patients may benefit from more intensive maintenance including proteasome inhibitors and immunomodulators. [ABSTRACT FROM AUTHOR]
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- 2018
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186. Safety and comfort of domestic bortezomib injection in real-life experience.
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Cerchione, Claudio, Nappi, Davide, Pareto, Anna Emanuele, Di Perna, Maria, Zacheo, Irene, Picardi, Marco, Pane, Fabrizio, and Catalano, Lucio
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BORTEZOMIB , *MEDICATION safety , *DRUG efficacy , *MULTIPLE myeloma treatment , *QUALITY of life , *ANTINEOPLASTIC agents , *SUBCUTANEOUS injections , *MULTIPLE myeloma , *TREATMENT effectiveness - Abstract
Despite novel agents, multiple myeloma is still an incurable disease, especially for elderly and frail patients, who are difficult to manage for concomitant comorbidities as the therapeutic options are limited and the response to chemotherapy is often short. We report our evaluations upon safety and efficacy of domestic subcutaneous bortezomib in elderly and frail patients candidate to bortezomib-melphalan-prednisone (VMP) regimen. We confirmed that overall incidence of adverse events, including peripheral neuropathy, was low, and in no case required admission to emergency service, contributing to reduce the rate of therapy discontinuation. These results confirm the effectiveness and safety of subcutaneous bortezomib, in a real-life-experience, and define a new possibility of safe auto-administration in a comfortable domestic setting. We suggest that domestic treatment can significantly improve the quality of life of the patients, avoiding unnecessary transfer to the hospital without reducing treatment efficacy. [ABSTRACT FROM AUTHOR]
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- 2018
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187. Carfilzomib combined with lenalidomide and dexamethasone (KRd) as salvage therapy for multiple myeloma patients: italian, multicenter, retrospective clinical experience with 600 cases outside of controlled clinical trials
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Enrica Antonia Martino, Concetta Conticello, Elena Zamagni, Vincenzo Pavone, Salvatore Palmieri, Maurizio Musso, Paola Tacchetti, Anna Mele, Lucio Catalano, Ernesto Vigna, Antonella Bruzzese, Francesco Mendicino, Cirino Botta, Iolanda Donatella Vincelli, Giuliana Farina, Marialucia Barone, Clotilde Cangialosi, Katia Mancuso, Ilaria Rizziello, Serena Rocchi, Antonietta Pia Falcone, Giuseppe Mele, Giovanni Reddiconto, Bruno Garibaldi, Enrico Iaccino, Giovanni Tripepi, Barbara Gamberi, Francesco Di Raimondo, Pellegrino Musto, Antonino Neri, Michele Cavo, Fortunato Morabito, Massimo Gentile, Martino, Enrica Antonia, Conticello, Concetta, Zamagni, Elena, Pavone, Vincenzo, Palmieri, Salvatore, Musso, Maurizio, Tacchetti, Paola, Mele, Anna, Catalano, Lucio, Vigna, Ernesto, Bruzzese, Antonella, Mendicino, Francesco, Botta, Cirino, Vincelli, Iolanda Donatella, Farina, Giuliana, Barone, Marialucia, Cangialosi, Clotilde, Mancuso, Katia, Rizziello, Ilaria, Rocchi, Serena, Falcone, Antonietta Pia, Mele, Giuseppe, Reddiconto, Giovanni, Garibaldi, Bruno, Iaccino, Enrico, Tripepi, Giovanni, Gamberi, Barbara, Di Raimondo, Francesco, Musto, Pellegrino, Neri, Antonino, Cavo, Michele, Morabito, Fortunato, and Gentile, Massimo
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Salvage Therapy ,Cancer Research ,Oncology ,Humans ,Hematology ,General Medicine ,KRd regimen, multiple myeloma, salvage therapy ,Multiple Myeloma ,Lenalidomide ,Dexamethasone ,Retrospective Studies - Abstract
In combination with lenalidomide and dexamethasone (KRd), Carfilzomib has been approved for the treatment of relapsed and refractory multiple myeloma (RRMM) on ASPIRE trial. Efficacy and safety of the triplet are still the object of investigation by many groups to confirm ASPIRE results in the setting of RRMM treated in real-life who don't meet trial restrictive inclusion criteria. Therefore, we report a retrospective multicenter analysis of 600 RRMM patients treated with KRd between December 2015 and December 2018. The median age was 64 years (range 33-85), and the median number of previous therapies was two (range 1-11). After a median of 11 KRd cycles, the overall response rate was 79.9%. The median progression-free survival (PFS) was 22 months, and the 2-year probability of PFS was 47.6%. Creatinine clearance30 ml/min,1 line of previous therapy, and high-risk FISH were all associated with a poor prognosis in multivariate analysis. The median overall survival (OS) was 34.8 months; the 2-year probability of OS was 63.5%. At multivariate analysis, creatinine clearance30 ml/min,1 line of previous therapy, and high-risk FISH were significantly associated with poor prognosis. After a median follow-up of 16 months (range 1-50), 259 withdrew from therapy. The main discontinuation reason was progressive disease (81.8%). Seventy-four patients (12.3%) discontinued therapy for toxicity. The most frequent side effects were hematological (anemia 49.3%, neutropenia 42.7%, thrombocytopenia 42.5%) and cardiovascular (hypertension 14.5%, heart failure 2.5%, arrhythmias 3.6%). Our study confirms the safety and efficacy of KRd in the real-life setting of RRMM patients and encourages its use in clinical practice.
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- 2022
188. Survival Risk Scores for Real-Life Relapsed/Refractory Multiple Myeloma Patients Receiving Elotuzumab or Carfilzomib In Combination With Lenalidomide and Dexamethasone as Salvage Therapy: Analysis of 919 Cases Outside Clinical Trials
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Fortunato Morabito, Elena Zamagni, Concetta Conticello, Vincenzo Pavone, Salvatore Palmieri, Sara Bringhen, Monica Galli, Silvia Mangiacavalli, Daniele Derudas, Elena Rossi, Roberto Ria, Lucio Catalano, Paola Tacchetti, Giuseppe Mele, Iolanda Donatella Vincelli, Enrica Antonia Martino, Ernesto Vigna, Antonella Bruzzese, Francesco Mendicino, Cirino Botta, Anna Mele, Lucia Pantani, Serena Rocchi, Bruno Garibaldi, Nicola Cascavilla, Stelvio Ballanti, Giovanni Tripepi, Ferdinando Frigeri, Antonetta Pia Falcone, Clotilde Cangialosi, Giovanni Reddiconto, Giuliana Farina, Marialucia Barone, Ilaria Rizzello, Enrico Iaccino, Selena Mimmi, Paola Curci, Barbara Gamberi, Pellegrino Musto, Valerio De Stefano, Maurizio Musso, Maria Teresa Petrucci, Massimo Offidani, Francesco Di Raimondo, Mario Boccadoro, Michele Cavo, Antonino Neri, Massimo Gentile, Morabito, Fortunato, Zamagni, Elena, Conticello, Concetta, Pavone, Vincenzo, Palmieri, Salvatore, Bringhen, Sara, Galli, Monica, Mangiacavalli, Silvia, Derudas, Daniele, Rossi, Elena, Ria, Roberto, Catalano, Lucio, Tacchetti, Paola, Mele, Giuseppe, Vincelli, Iolanda Donatella, Martino, Enrica Antonia, Vigna, Ernesto, Bruzzese, Antonella, Mendicino, Francesco, Botta, Cirino, Mele, Anna, Pantani, Lucia, Rocchi, Serena, Garibaldi, Bruno, Cascavilla, Nicola, Ballanti, Stelvio, Tripepi, Giovanni, Frigeri, Ferdinando, Falcone, Antonetta Pia, Cangialosi, Clotilde, Reddiconto, Giovanni, Farina, Giuliana, Barone, Marialucia, Rizzello, Ilaria, Iaccino, Enrico, Mimmi, Selena, Curci, Paola, Gamberi, Barbara, Musto, Pellegrino, De Stefano, Valerio, Musso, Maurizio, Petrucci, Maria Teresa, Offidani, Massimo, Di Raimondo, Francesco, Boccadoro, Mario, Cavo, Michele, Neri, Antonino, and Gentile, Massimo
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multiple myeloma ,Cancer Research ,carfilzomib ,Oncology ,lenalidomide ,survival ,elotuzumab ,prognosi ,prognostic score ,relapsed/refractory - Abstract
The present study aimed to develop two survival risk scores (RS) for overall survival (OS, SRSKRd/EloRd) and progression-free survival (PFS, PRSKRd/EloRd) in 919 relapsed/refractory multiple myeloma (RRMM) patients who received carfilzomib, lenalidomide, and dexamethasone (KRd)/elotuzumab, lenalidomide, and dexamethasone (EloRd). The median OS was 35.4 months, with no significant difference between the KRd arm versus the EloRd arm. In the multivariate analysis, advanced ISS (HR = 1.31; P = 0.025), interval diagnosis–therapy (HR = 1.46; P = 0.001), number of previous lines of therapies (HR = 1.96; P < 0.0001), older age (HR = 1.72; P < 0.0001), and prior lenalidomide exposure (HR = 1.30; P = 0.026) remained independently associated with death. The median PFS was 20.3 months, with no difference between the two strategies. The multivariate model identified a significant progression/death risk increase for ISS III (HR = 1.37; P = 0.002), >3 previous lines of therapies (HR = 1.67; P < 0.0001), older age (HR = 1.64; P < 0.0001), and prior lenalidomide exposure (HR = 1.35; P = 0.003). Three risk SRSKRd/EloRd categories were generated: low-risk (134 cases, 16.5%), intermediate-risk (467 cases, 57.3%), and high-risk categories (213 cases, 26.2%). The 1- and 2-year OS probability rates were 92.3% and 83.8% for the low-risk (HR = 1, reference category), 81.1% and 60.6% (HR = 2.73; P < 0.0001) for the intermediate-risk, and 65.5% and 42.5% (HR = 4.91; P < 0.0001) for the high-risk groups, respectively. Notably, unlike the low-risk group, which did not cross the median timeline, the OS median values were 36.6 and 18.6 months for the intermediate- and high-risk cases, respectively. Similarly, three PRSKRd/EloRd risk categories were engendered. Based on such grouping, 338 (41.5%) cases were allocated in the low-, 248 (30.5%) in the intermediate-, and 228 (28.0%) in the high-risk groups. The 1- and 2-year PFS probability rates were 71.4% and 54.5% for the low-risk (HR = 1, reference category), 68.9% and 43.7% (HR = 1.95; P < 0.0001) for the intermediate-risk, and 48.0% and 27.1% (HR = 3.73; P < 0.0001) for the high-risk groups, respectively. The PFS median values were 29.0, 21.0, and 11.7 months for the low-, intermediate-, and high-risk cases. This analysis showed 2.7- and 4.9-fold increased risk of death for the intermediate- and high-risk cases treated with KRd/EloRd as salvage therapy. The combined progression/death risks of the two categories were increased 1.3- and 2.2-fold compared to the low-risk group. In conclusion, SRSKRd/EloRd and PRSKRd/EloRd may represent accessible and globally applicable models in daily clinical practice and ultimately represent a prognostic tool for RRMM patients who received KRd or EloRd.
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- 2022
189. Pegfilgrastim in primary prophylaxis of febrile neutropenia following frontline bendamustine plus rituximab treatment in patients with indolent non-Hodgkin lymphoma: a single center, real-life experience.
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Cerchione, Claudio, De Renzo, Amalia, Di Perna, Maria, Della Pepa, Roberta, Pugliese, Novella, Catalano, Lucio, Pane, Fabrizio, and Picardi, Marco
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LYMPHOMA treatment , *RITUXIMAB , *FILGRASTIM , *FEBRILE neutropenia , *CANCER chemotherapy , *COMBINATION drug therapy , *QUALITY of life , *PREVENTIVE medicine , *THERAPEUTICS , *RECOMBINANT proteins , *ANTINEOPLASTIC agents , *LONGITUDINAL method , *LYMPHOMAS , *NEUTROPENIA , *PREVENTION - Abstract
Background: In this prospective study, the impact of granulocyte colony-stimulating factors (G-2 CSF) administered during induction treatment with bendamustine plus rituximab for indolent non- Hodgkin Llymphoma (NHL) was evaluated by comparing patients who received secondary prophylaxis with filgrastim (control group) versus. patients who received pegfilgrastim as primary prophylaxis (peg-group). The primary endpoint was the incidence rate of febrile neutropenia (FN)- related chemotherapy disruptions (regarding dose-dense and/or dose-intensity of schedule). The Ssecondary endpoint included days of hospitalization due to FN, and G-CSF-related side effects (grade ≥3 WHO toxicity criteria) in each group.Methods: One hundred twenty-two: 122 consecutive patients, with untreated indolent NHL, were referred to our outpatient unit for remission induction immuno-chemotherapy with bendamustine-rituximab. During the first period, 61 patients received secondary prophylaxis with filgrastim, given "on demand" if ANC was <1000/mm3. During the second period, 61 patients received primary prophylaxis with pegfilgrastim in a single administration.Results: Pegfilgrastim was significantly associated with fewer incidence rate of FN-related chemotherapy disruptions (11.4% in the control group vs. 1.6% in the peg-group, p = 0.04) and fewer days of hospitalization due to FN (median number 18 days in the control group vs. 6 in the peg-group, p = 0.04). In terms of G-CSF-related extra-hematological grade III side effects, no significant difference has been found in the two groups (9.8% in the control group vs. 11.5% in the peg-group, p = 0.77). Only one patient stopped the treatment in the peg-group due to intolerance.Conclusions: In patients with indolent NHL, in front-line treatment with bendamustine plus rituximab, primary prophylaxis with pegfilgrastim seems to reduce the incidence of chemotherapy disruptions due to FN, and the days of hospitalization. Moreover, it is well- tolerated and may increase the opportunity to maintain the planned schedule of treatment. These results make pegfilgrastim an advantageous option in most cases both in terms of cost-effectiveness and quality of life. These preliminary observations need to be validated by controlled clinical trials. [ABSTRACT FROM AUTHOR]- Published
- 2017
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190. Chemotherapy plus lenalidomide versus autologous transplantation, followed by lenalidomide plus prednisone versus lenalidomide maintenance, in patients with multiple myeloma: a randomised, multicentre, phase 3 trial.
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Gay, Francesca, Oliva, Stefania, Petrucci, Maria Teresa, Conticello, Concetta, Catalano, Lucio, Corradini, Paolo, Siniscalchi, Agostina, Magarotto, Valeria, Pour, Luděk, Carella, Angelo, Malfitano, Alessandra, Petrò, Daniela, Evangelista, Andrea, Spada, Stefano, Pescosta, Norbert, Omedè, Paola, Campbell, Philip, Liberati, Anna Marina, Offidani, Massimo, and Ria, Roberto
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MULTIPLE myeloma treatment , *CANCER chemotherapy , *STEM cell transplantation , *THALIDOMIDE , *PREDNISONE , *RANDOMIZED controlled trials , *THERAPEUTICS , *MULTIPLE myeloma diagnosis , *CYCLOPHOSPHAMIDE , *DEXAMETHASONE , *MELPHALAN , *ANTINEOPLASTIC agents , *AUTOGRAFTS , *DRUG therapy , *COMBINED modality therapy , *COMPARATIVE studies , *HEMATOPOIETIC stem cell transplantation , *RESEARCH methodology , *MEDICAL cooperation , *MULTIPLE myeloma , *PROGNOSIS , *RESEARCH , *TIME , *EVALUATION research , *TREATMENT effectiveness , *PROPORTIONAL hazards models , *DISEASE progression , *KAPLAN-Meier estimator - Abstract
Background: High-dose melphalan plus autologous stem-cell transplantation (ASCT) is the standard approach in transplant-eligible patients with newly diagnosed myeloma. Our aims were to compare consolidation with high-dose melphalan plus ASCT versus chemotherapy (cyclophosphamide and dexamethasone) plus lenalidomide, and maintenance with lenalidomide plus prednisone versus lenalidomide alone.Methods: We did an open-label, randomised, multicentre, phase 3 study at 59 centres in Australia, Czech Republic, and Italy. We enrolled transplant-eligible patients with newly diagnosed myeloma aged 65 years or younger. Patients received a common induction with four 28-day cycles of lenalidomide (25 mg, days 1-21) and dexamethasone (40 mg, days 1, 8, 15, and 22) and subsequent chemotherapy with cyclophosphamide (3 g/m(2)) followed by granulocyte colony-stimulating factor for stem-cell mobilisation and collection. Using a 2 × 2 partial factorial design, we randomised patients to consolidation with either chemotherapy plus lenalidomide (six cycles of cyclophosphamide [300 mg/m(2), days 1, 8, and 15], dexamethasone [40 mg, days 1, 8, 15, and 22], and lenalidomide [25 mg, days 1-21]) or two courses of high-dose melphalan (200 mg/m(2)) and ASCT. We also randomised patients to maintenance with lenalidomide (10 mg, days 1-21) plus prednisone (50 mg, every other day) or lenalidomide alone. A simple randomisation sequence was used to assign patients at enrolment into one of the four groups (1:1:1:1 ratio), but the treatment allocation was disclosed only when the patient reached the end of the induction and confirmed their eligibility for consolidation. Both the patient and the treating clinician did not know the consolidation and maintenance arm until that time. The primary endpoint was progression-free survival assessed by intention-to-treat. The trial is ongoing and some patients are still receiving maintenance. This study is registered at ClinicalTrials.gov, number NCT01091831.Findings: 389 patients were enrolled between July 6, 2009, and May 6, 2011, with 256 eligible for consolidation (127 high-dose melphalan and ASCT and 129 chemotherapy plus lenalidomide) and 223 eligible for maintenance (117 lenalidomide plus prednisone and 106 lenalidomide alone). Median follow-up was 52·0 months (IQR 30·4-57·6). Progression-free survival during consolidation was significantly shorter with chemotherapy plus lenalidomide compared with high-dose melphalan and ASCT (median 28·6 months [95% CI 20·6-36·7] vs 43·3 months [33·2-52·2]; hazard ratio [HR] for the first 24 months 2·51, 95% CI 1·60-3·94; p<0·0001). Progression-free survival did not differ between maintenance treatments (median 37·5 months [95% CI 27·8-not evaluable] with lenalidomide plus prednisone vs 28·5 months [22·5-46·5] with lenalidomide alone; HR 0·84, 95% CI 0·59-1·20; p=0·34). Fewer grade 3 or 4 adverse events were recorded with chemotherapy plus lenalidomide than with high-dose melphalan and ASCT; the most frequent were haematological (34 [26%] of 129 patients vs 107 [84%] of 127 patients), gastrointestinal (six [5%] vs 25 [20%]), and infection (seven [5%] vs 24 [19%]). Haematological serious adverse events were reported in two (2%) patients assigned chemotherapy plus lenalidomide and no patients allocated high-dose melphalan and ASCT. Non-haematological serious adverse events were reported in 13 (10%) patients assigned chemotherapy plus lenalidomide and nine (7%) allocated high-dose melphalan and ASCT. During maintenance, adverse events did not differ between groups. The most frequent grade 3 or 4 adverse events were neutropenia (nine [8%] of 117 patients assigned lenalidomide plus prednisone vs 14 [13%] of 106 allocated lenalidomide alone), infection (eight [8%] vs five [5%]), and systemic toxicities (seven [6%] vs two [2%]). Non-haematological serious adverse events were reported in 13 (11%) patients assigned lenalidomide plus prednisone versus ten (9%) allocated lenalidomide alone. Four patients died because of adverse events, three from infections (two during induction and one during consolidation) and one because of cardiac toxic effects.Interpretation: Consolidation with high-dose melphalan and ASCT remains the preferred option in transplant-eligible patients with multiple myeloma, despite a better toxicity profile with chemotherapy plus lenalidomide.Funding: Celgene. [ABSTRACT FROM AUTHOR]- Published
- 2015
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191. Is re-challenge still an option as salvage therapy in multiple myeloma? The case of REal-life BOrtezomib re-Use as secoND treatment for relapsed patients exposed frontline to bortezomib-based therapies (the REBOUND Study)
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Nicola Di Renzo, Concetta Conticello, Lucia Mastrullo, Giovanni Reddiconto, Alberto Fragasso, Daniele Scapicchio, Roberto Ria, Maria Teresa Petrucci, Gioacchino Marziano, Nicola Cascavilla, Alfredo Gagliardi, Vittorio Simeon, Silvia Mangiacavalli, Alessandro Corso, Giovanni D'Arena, Francesco Di Raimondo, Giovanna Mansueto, Lucio Catalano, Antonietta Falcone, Pellegrino Musto, Laura Cesini, Tommaso Caravita, Sara Bringhen, Giuseppe Pietrantuono, Oreste Villani, Dalila Salvatore, Mariella Genuardi, Mario Boccadoro, Musto, Pellegrino, Simeon, Vittorio, Cascavilla, Nicola, Falcone, Antonietta, Petrucci, Maria Teresa, Cesini, Laura, Di Raimondo, Francesco, Conticello, Concetta, Ria, Roberto, Catalano, Lucio, Salvatore, Dalila, Mastrullo, Lucia, Gagliardi, Alfredo, Villani, Oreste, Pietrantuono, Giuseppe, D'Arena, Giovanni, Mansueto, Giovanna, Bringhen, Sara, Genuardi, Mariella, Di Renzo, Nicola, Reddiconto, Giovanni, Fragasso, Alberto, Caravita, Tommaso, Scapicchio, Daniele, Marziano, Gioacchino, Boccadoro, Mario, Mangiacavalli, Silvia, and Corso, Alessandro
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Male ,Oncology ,medicine.medical_specialty ,Salvage therapy ,Myeloma ,First relapse ,Disease-Free Survival ,Bortezomib ,Re-treatment ,03 medical and health sciences ,0302 clinical medicine ,Recurrence ,Internal medicine ,medicine ,Humans ,Survival rate ,Multiple myeloma ,Aged ,Retrospective Studies ,Salvage Therapy ,Hematology ,business.industry ,Female ,Follow-Up Studies ,Middle Aged ,Multiple Myeloma ,Survival Rate ,Retrospective cohort study ,General Medicine ,medicine.disease ,030220 oncology & carcinogenesis ,Observational study ,business ,030215 immunology ,medicine.drug - Abstract
Therapeutic re-challenge is currently a debated issue in the field of multiple myeloma (MM), given the recent availability of several new drugs and combinations. However, very few specific evidences are available about bortezomib re-use at first relapse. This multicenter, observational, retrospective study enrolled 134 MM patients with significant response after bortezomib-based frontline regimens and who had received a first salvage treatment containing bortezomib at relapse. The overall response rate was 71%, including 40% partial responses, 24% very good partial responses, and 7% complete responses. Re-treatment was well-tolerated, with no significant new or unexpected toxicities observed. The median duration of second progression-free survival (PFS) was 15 months, while median PFS2 was 55 months. With a median follow-up of 56 months, overall survival was 94 months for the entire series, without significant differences between patients undergoing or not undergoing transplant procedures. This real-life survey indicates that re-treatment including bortezomib as a first salvage therapy could be still considered in MM patients achieving durable response after initial exposure to bortezomib.
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- 2018
192. Adjusted comparison between elotuzumab and carfilzomib in combination with lenalidomide and dexamethasone as salvage therapy for multiple myeloma patients
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Valerio De Stefano, Lucio Catalano, Lucia Pantani, Pellegrino Musto, Elena Rossi, Enrica Antonia Martino, Antonetta Pia Falcone, Ernesto Vigna, Iolanda Vincelli, Salvatore Palmieri, Paola Tacchetti, Fortunato Morabito, Sara Bringhen, Giovanni Tripepi, Maria Teresa Petrucci, Serena Rocchi, Bruno Garibaldi, Vincenzo Pavone, Francesco Di Raimondo, Giuliana Farina, Nicola Cascavilla, Monica Galli, Antonino Neri, Stelvio Ballanti, Silvia Mangiacavalli, Maurizio Musso, Ilaria Rizzello, Ferdinando Frigeri, Massimo Offidani, Clotilde Cangialosi, Massimo Gentile, Antonella Bruzzese, Elena Zamagni, Anna Mele, Cirino Botta, Mario Boccadoro, Daniele Derudas, Marialucia Barone, Nicola Di Renzo, Concetta Conticello, Giovanni Reddiconto, Roberto Ria, Michele Cavo, Giuseppe Mele, Morabito, Fortunato, Zamagni, Elena, Conticello, Concetta, Pavone, Vincenzo, Palmieri, Salvatore, Bringhen, Sara, Galli, Monica, Mangiacavalli, Silvia, Derudas, Daniele, Rossi, Elena, Ria, Roberto, Catalano, Lucio, Tacchetti, Paola, Mele, Giuseppe, Vincelli, Iolanda Donatella, Martino, Enrica Antonia, Vigna, Ernesto, Botta, Cirino, Bruzzese, Antonella, Mele, Anna, Pantani, Lucia, Rocchi, Serena, Garibaldi, Bruno, Cascavilla, Nicola, Ballanti, Stelvio, Tripepi, Giovanni, Frigeri, Ferdinando, Falcone, Antonetta Pia, Cangialosi, Clotilde, Reddiconto, Giovanni, Farina, Giuliana, Barone, Marialucia, Rizzello, Ilaria, Musto, Pellegrino, De Stefano, Valerio, Musso, Maurizio, Petrucci, Maria Teresa, Offidani, Massimo, Neri, Antonino, Di Renzo, Nicola, Di Raimondo, Francesco, Boccadoro, Mario, Cavo, Michele, and Gentile, Massimo
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Oncology ,medicine.medical_specialty ,Salvage therapy ,Antibodies, Monoclonal, Humanized ,Dexamethasone ,Settore MED/15 - Malattie Del Sangue ,chemistry.chemical_compound ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Elotuzumab ,Lenalidomide ,Multiple myeloma ,Retrospective Studies ,Salvage Therapy ,carfilzomib ,business.industry ,Hazard ratio ,Hematology ,General Medicine ,medicine.disease ,Carfilzomib ,elotuzumab ,multiple myeloma ,chemistry ,Cohort ,business ,Oligopeptides ,medicine.drug - Abstract
The lack of a randomized trial comparing carfilzomib (K) versus elotuzumab (Elo) associated with lenalidomide and dexamethasone (Rd) prompted us to assess the relative usefulness of one triplet over the other. Five independent retrospective cohorts of 883 relapsed/refractory multiple myeloma (RRMM) patients, including 300 EloRd and 583 KRd cases, outside clinical trials, entered this non-randomized comparison. KRd cohort accounted for a higher incidence of younger patients, cases with ≥3 lines of therapy, already exposed to lenalidomide, International Staging System (ISS) stage III, and abnormal lactic dehydrogenase (LDH) level compared with EloRd cohort. Moreover, cytogenetic risk categories, detected in roughly one-third of cases, were equally distributed between the two therapy arms. The probability of CR+VGPR response was significantly higher in KRd (n = 314, 53.9%) than in EloRd patients (n = 111, 37.0%). Likewise, the cumulative incidence function of CR+VGPR, taking into account the competitive risk of death, was significantly higher in KRd arm patients than those in the EloRd arm (p = .003). Moreover, KRd treatment significantly reduced the progression or death risk by 46% in an adjusted multivariate analysis (HR: 0.54, 95% CI 0.42-0.69, p .0001). Finally, in an adjusted illness-progression/death model, the effect of KRd versus EloRd was of higher magnitude among those who achieved CR+VGPR (-39% hazard ratio reduction, p = .02) than among those who achieved VGPR (-29% hazard ratio reduction, p = .007). With limitations characteristic to any retrospective analysis, this current clinical practice study's overall results demonstrated potential benefits of KRd therapy compared with EloRd. This observation may help the daily clinical practice.
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- 2021
193. MET dysregulation is a hallmark of aggressive disease in multiple myeloma patients.
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Rocci, Alberto, Gambella, Manuela, Aschero, Simona, Baldi, Ileana, Trusolino, Livio, Cavallo, Federica, Gay, Francesca, Larocca, Alessandra, Magarotto, Valeria, Omedè, Paola, Isaia, Gianluca, Bertotti, Andrea, Liberati, Anna M., Catalano, Lucio, De Rosa, Luca, Musto, Pellegrino, Vallone, Roberto, Falcone, Antonietta, Drandi, Daniela, and Ladetto, Marco
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HEPATOCYTE growth factor , *MYELOMA proteins , *RNA , *GENE expression , *MICROGLOBULINS - Abstract
Abnormal activation of MET/ HGF ( Hepatocyte Growth Factor) pathway has been described in several tumours and increased HGF plasmatic levels have been detected in patients with aggressive multiple myeloma (MM). MET and HGF m RNA expression was investigated in 105 samples of purified plasma cells derived from newly diagnosed MM patients treated with bortezomib-based induction therapy. Gene expression was compared with response to therapy and clinical outcome. MET gene copy number was also evaluated. MET m RNA expression was higher in CD138+ than in CD138− cells (median 76·90 vs. 11·24; P = 0·0009). Low MET m RNA expression characterized patients with better response (complete response or very good partial response) compared to other patients (median 56·10 vs. 134·83; P = 0·0006). After a median follow-up of 50 months, patients with high MET m RNA expression displayed a worse progression-free survival ( PFS; P = 0·0029) and overall survival ( OS; P = 0·0023) compared to those with low MET m RNA levels. Patients with both high MET m RNA expression and high β2-microglobulin level (>5·5 mg/l) had further worse median PFS ( P < 0·0001) and OS ( P < 0·0001). Patients carrying 4 MET gene copies (8 out of 82, 9·8%) also had a short PFS. High MET m RNA expression identifies patients with dismal PFS and OS and the combination with high β2-microglobulin further characterizes patients with worse outcome. [ABSTRACT FROM AUTHOR]
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- 2014
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194. Mieloma multiplo: da plasmocitoma a coinvolgimento multiorgano
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Alessandra Vasco, Lidia Sierchio, Fiorenza De Gregorio, Massimo Mascolo, Lucio Catalano, Marcella Savoia, Vasco, Alessandra, Sierchio, Lidia, De Gregorio, Fiorenza, Mascolo, Massimo, Catalano, Lucio, and Savoia, Marcella
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Mieloma multiplo, plasmocitoma, Componente Monoclonale - Abstract
Multiple myeloma: from plasmacytoma to multi-organic involvement. Solitary plasmacytoma is a rare form of plasma cell dyscrasia characterized by localized proliferation of neoplasticmonoclonal plasmacells. The lesion can originate in bone or in soft tissue, with no or minimal evidence of bonemarrow plasmacytosis (
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- 2020
195. An 1H NMR study of the cytarabine degradation in clinical conditions to avoid drug waste, decrease therapy costs and improve patient compliance in acute leukemia
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Sonia Ronconi, Giovanni Martinelli, Giorgia Simonetti, Lucio Catalano, Nicoletta Marra, Sara Bravaccini, Marco Picardi, Ugo De Giorgi, Mauro De Nisco, Mattia Altini, Francesco Pagano, Novella Pugliese, Claudio Cerchione, Adele Bolognese, Silvana Pedatella, Andrea Ghelli Luserna di Rorà, Fabrizio Pane, Michele Manfra, Vincenzo Martinelli, Vita Dora Iula, Cerchione, Claudio, Martinelli, Giovanni, Pedatella, Silvana, De Nisco, Mauro, Pugliese, Novella, Manfra, Michele, Marra, Nicoletta, Ronconi, Sonia, De Giorgi, Ugo, Altini, Mattia, Simonetti, Giorgia, Di Rorà, Andrea Ghelli Luserna, Bravaccini, Sara, Catalano, Lucio, Dora Iula, Vita, Pagano, Francesco, Picardi, Marco, Bolognese, Adele, Pane, Fabrizio, and Martinelli, Vincenzo
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0301 basic medicine ,Drug ,Cancer Research ,Antimetabolites, Antineoplastic ,medicine.drug_class ,media_common.quotation_subject ,Drug Storage ,Fungal contamination ,Vial ,Antimetabolite ,Drug Costs ,Medication Adherence ,03 medical and health sciences ,0302 clinical medicine ,Drug Stability ,Cost Savings ,Pharmaceutical Preparations, acute leukemia,cytarabine, supportive care ,Medicine ,Humans ,Pharmacology (medical) ,acute leukemia ,Patient compliance ,Nuclear Magnetic Resonance, Biomolecular ,Chromatography, High Pressure Liquid ,media_common ,Pharmacology ,Acute leukemia ,Clinical Report ,business.industry ,Cytarabine ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,Solutions ,supportive care ,Leukemia, Myeloid, Acute ,030104 developmental biology ,Oncology ,Drug Package ,030220 oncology & carcinogenesis ,Anesthesia ,business ,medicine.drug - Abstract
Cytarabine, the 4-amino-1-(β-D-arabinofuranosyl)-2(1H)-pyrimidinone, (ARA-C) is an antimetabolite cytidine analogue used worldwide as key drug in the management of leukaemia. As specified in the manufacturers' instructions, once the components-sterile water and cytarabine powder-are unpackaged and mixed, the solution begins to degrade after 6 hours at room temperature and 12 hours at 4°C. To evaluate how to avoid wasting the drug in short-term, low-dose treatment regimens, the reconstituted samples, stored at 25°C and 4°C, were analyzed every day of the test week by reversed-phase HPLC and high-field NMR spectroscopy. All the samples remained unchanged for the entire week, which corresponds to the time required to administer the entire commercial drug package during low-dose therapeutic regimens. The drug solution was stored in a glass container at 4°C in an ordinary freezer and drawn with sterile plastic syringes; during this period, no bacterial or fungal contamination was observed. Our findings show that an cytarabine solution prepared and stored in the original vials retains its efficacy and safety and can, therefore, be divided into small doses to be administered over more days, thus avoiding unnecessary expensive and harmful waste of the drug preparation. Moreover, patients who require daily administration of the drug could undergo the infusion at home without need to go to hospital. The stability of the aliquots would help decrease hospitalization costs.
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- 2020
196. Safety and comfort of domestic bortezomib injection in real-life experience
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Maria Di Perna, Anna Emanuele Pareto, Lucio Catalano, Claudio Cerchione, Irene Zacheo, Davide Nappi, Fabrizio Pane, Marco Picardi, Cerchione, Claudio, Nappi, Davide, Pareto, Anna Emanuele, Di Perna, Maria, Zacheo, Irene, Picardi, Marco, Pane, Fabrizio, and Catalano, Lucio
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Male ,medicine.medical_specialty ,Injections, Subcutaneous ,Antineoplastic Agents ,Disease ,Bortezomib ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,medicine ,Humans ,Subcutaneou ,Intensive care medicine ,Adverse effect ,Multiple myeloma ,Aged ,Aged, 80 and over ,business.industry ,Middle Aged ,medicine.disease ,Discontinuation ,Regimen ,Treatment Outcome ,Oncology ,030220 oncology & carcinogenesis ,Concomitant ,Quality of Life ,Female ,Safety ,Multiple Myeloma ,business ,Supportive care ,030215 immunology ,medicine.drug - Abstract
Despite novel agents, multiple myeloma is still an incurable disease, especially for elderly and frail patients, who are difficult to manage for concomitant comorbidities as the therapeutic options are limited and the response to chemotherapy is often short. We report our evaluations upon safety and efficacy of domestic subcutaneous bortezomib in elderly and frail patients candidate to bortezomib-melphalan-prednisone (VMP) regimen. We confirmed that overall incidence of adverse events, including peripheral neuropathy, was low, and in no case required admission to emergency service, contributing to reduce the rate of therapy discontinuation. These results confirm the effectiveness and safety of subcutaneous bortezomib, in a real-life-experience, and define a new possibility of safe auto-administration in a comfortable domestic setting. We suggest that domestic treatment can significantly improve the quality of life of the patients, avoiding unnecessary transfer to the hospital without reducing treatment efficacy.
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- 2018
197. Pegfilgrastim in primary prophylaxis of febrile neutropenia following frontline bendamustine plus rituximab treatment in patients with indolent non-Hodgkin lymphoma: a single center, real-life experience
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Marco Picardi, Claudio Cerchione, Roberta Della Pepa, Maria Di Perna, Fabrizio Pane, Lucio Catalano, Novella Pugliese, Amalia De Renzo, Cerchione, Claudio, DE RENZO, Amalia, DI PERNA, Maria, Pepa, Roberta Della, Pugliese, Novella, Catalano, Lucio, Pane, Fabrizio, and Picardi, Marco
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Adult ,Male ,Bendamustine ,medicine.medical_specialty ,Filgrastim ,medicine.medical_treatment ,Polyethylene Glycols ,03 medical and health sciences ,0302 clinical medicine ,hemic and lymphatic diseases ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,Granulocyte Colony-Stimulating Factor ,medicine ,Indolent Non-Hodgkin Lymphoma ,Clinical endpoint ,Bendamustine Hydrochloride ,Humans ,Prospective Studies ,030212 general & internal medicine ,Aged ,Febrile Neutropenia ,Chemotherapy ,business.industry ,Lymphoma, Non-Hodgkin ,Middle Aged ,medicine.disease ,Recombinant Proteins ,Oncology ,030220 oncology & carcinogenesis ,Immunology ,Quality of Life ,Female ,Original Article ,Rituximab ,business ,Febrile neutropenia ,Pegfilgrastim ,medicine.drug - Abstract
Background In this prospective study, the impact of granulocyte colony-stimulating factors (G-2 CSF) administered during induction treatment with bendamustine plus rituximab for indolent non- Hodgkin Llymphoma (NHL) was evaluated by comparing patients who received secondary prophylaxis with filgrastim (control group) versus. patients who received pegfilgrastim as primary prophylaxis (peg-group). The primary endpoint was the incidence rate of febrile neutropenia (FN)- related chemotherapy disruptions (regarding dose-dense and/or dose-intensity of schedule). The Ssecondary endpoint included days of hospitalization due to FN, and G-CSF-related side effects (grade ≥3 WHO toxicity criteria) in each group. Methods One hundred twenty-two: 122 consecutive patients, with untreated indolent NHL, were referred to our outpatient unit for remission induction immuno-chemotherapy with bendamustine-rituximab. During the first period, 61 patients received secondary prophylaxis with filgrastim, given “on demand” if ANC was
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- 2016
198. Longitudinal strain of left ventricular basal segments and E /e ′ ratio differentiate primary cardiac amyloidosis at presentation from hypertensive hypertrophy: an automated function imaging study
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Giuseppe Cerciello, Agostino Buonauro, Vincenzo Schiano-Lomoriello, Bruno Trimarco, Maurizio Galderisi, Fabrizio Pane, Donato Mele, Roberta Esposito, Roberta Della Pepa, Lucio Catalano, Marco Picardi, SCHIANO LOMORIELLO, Vincenzo, Galderisi, Maurizio, Mele, Donato, Esposito, Roberta, Cerciello, Giuseppe, Buonauro, Agostino, DELLA PEPA, Roberta, Picardi, Marco, Catalano, Lucio, Trimarco, Bruno, and Pane, Fabrizio
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Male ,Pathology ,medicine.medical_specialty ,Diastolic function ,Longitudinal strain ,Heart Ventricles ,Population ,030204 cardiovascular system & hematology ,Sensitivity and Specificity ,Muscle hypertrophy ,Diagnosis, Differential ,Ventricular Dysfunction, Left ,03 medical and health sciences ,Basal (phylogenetics) ,0302 clinical medicine ,Doppler tissue imaging ,Left ventricular filling pressure ,Elastic Modulus ,Cardiac amyloidosi ,Internal medicine ,Image Interpretation, Computer-Assisted ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,030212 general & internal medicine ,education ,education.field_of_study ,Ejection fraction ,Receiver operating characteristic ,business.industry ,Amyloidosis ,Reproducibility of Results ,Middle Aged ,Myocardial strain ,medicine.disease ,Cardiac amyloidosis ,Echocardiography ,Hypertension ,Cardiology ,Elasticity Imaging Techniques ,Female ,Hypertrophy, Left Ventricular ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Longitudinal strain is an early marker of left ventricular (LV) dysfunction in several cardiac diseases. Our aim was to differentiate cardiac amyloidosis (CA) at diagnosis from hypertensive LV hypertrophy (LVH) by analysis of longitudinal myocardial deformation. Methods Thirty healthy controls (C), 30 newly diagnosed, never treated hypertensives with LVH (H-LVH), and 33 patients with CA at diagnosis underwent echo Doppler including speckle tracking–based automated function imaging (AFI). Averaged peak systolic global longitudinal strain (GLS, 18 segments) and basal, middle, and apical longitudinal strain (BLS, MLS, and ALS, respectively, six segments each) were calculated. Results Left ventricular mass index, relative wall thickness, and ejection fraction did not differ between H-LVH and CA. E/e′ ratio was higher in CA than in H-LVH (P
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- 2016
199. A case of efficacy of bendamustine in heavily pretreated multiple myeloma, refractory to pomalidomide
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Lucio Catalano, Irene Zacheo, Davide Nappi, Maria Di Perna, Dalila Salvatore, Fabrizio Pane, Marco Picardi, Ilaria Migliaccio, Claudio Cerchione, Cerchione, Claudio, Nappi, Davide, DI PERNA, Maria, Zacheo, Irene, Migliaccio, Ilaria, Salvatore, Dalila, Picardi, Marco, Pane, Fabrizio, and Catalano, Lucio
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Bendamustine ,Oncology ,medicine.medical_specialty ,business.industry ,Case Report ,pomalidomide ,General Medicine ,Case Reports ,medicine.disease ,Pomalidomide ,multiple myeloma ,relapsed ,03 medical and health sciences ,refractory ,0302 clinical medicine ,Refractory ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,heavily pretreated ,business ,Multiple myeloma ,030215 immunology ,medicine.drug - Abstract
Key Clinical Message In this report, we would like to highlight the efficacy of bendamustine in a heavily pretreated patient, also refractory to pomalidomide. It is conceivable that different therapy combinations in heavily treated Multiple myeloma (MM) have to be explored, without “a priori” exclusion of ancient drugs, even after failure of the ultimate pharmacological options., In this report, we would like to highlight the efficacy of bendamustine in a heavily pretreated patient, also refractory to pomalidomide. It is conceivable that different therapy combinations in heavily treated Multiple myeloma (MM) have to be explored, without “a priori” exclusion of ancient drugs, even after failure of the ultimate pharmacological options.
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- 2017
200. Managing neutropenia by pegfilgrastim in patients affected by relapsed/refractory multiple myeloma treated with bendamustine-bortezomib-dexamethasone
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Fabrizio Pane, Claudio Cerchione, Ilaria Migliaccio, Dalila Salvatore, Maria Di Perna, Marco Picardi, Lucio Catalano, Davide Nappi, Ilaria Peluso, Cerchione, Claudio, Catalano, Lucio, Peluso, Ilaria, Nappi, Davide, DI PERNA, Maria, Salvatore, Dalila, Migliaccio, Ilaria, Picardi, Marco, and Pane, Fabrizio
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Oncology ,Bendamustine ,medicine.medical_specialty ,business.industry ,Neutropenia ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Internal medicine ,Relapsed refractory ,medicine ,In patient ,030212 general & internal medicine ,business ,Letter to the Editor ,Bortezomib/dexamethasone ,Pegfilgrastim ,Multiple myeloma ,medicine.drug - Published
- 2016
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