Author: "Chiusolo, Patrizia (ORCID:0000-0002-1355-1587)" - Searchworks@Jio Institute Digital Library Search Results

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114 results on '"Chiusolo, Patrizia (ORCID:0000-0002-1355-1587)"'

1. Haploidentical bone marrow transplantation for AML in remission following TBF conditioning: a long-term follow up

Author: Raiola, Anna Maria, Di Grazia, Carmen, Dominietto, Alida, Bregante, Stefania, Giammarco, Sabrina, Varaldo, Riccardo, Sora', Federica, Metafuni, Elisabetta, Limongiello, Maria Assunta, Laudisi, Antonella, Passannante, Monica, Galli, Eugenio, Gambella, Massimiliano, Sica, Simona, Bacigalupo, Andrea, Angelucci, Emanuele, Chiusolo, Patrizia, Sora', Federica (ORCID:0000-0002-9607-5298), Sica, Simona (ORCID:0000-0003-2426-3465), Bacigalupo, Andrea (ORCID:0000-0002-9119-567X), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Raiola, Anna Maria, Di Grazia, Carmen, Dominietto, Alida, Bregante, Stefania, Giammarco, Sabrina, Varaldo, Riccardo, Sora', Federica, Metafuni, Elisabetta, Limongiello, Maria Assunta, Laudisi, Antonella, Passannante, Monica, Galli, Eugenio, Gambella, Massimiliano, Sica, Simona, Bacigalupo, Andrea, Angelucci, Emanuele, Chiusolo, Patrizia, Sora', Federica (ORCID:0000-0002-9607-5298), Sica, Simona (ORCID:0000-0003-2426-3465), Bacigalupo, Andrea (ORCID:0000-0002-9119-567X), and Chiusolo, Patrizia (ORCID:0000-0002-1355-1587)
Abstract: N/A
Published: 2024

2. Unselected donor-derived hematopoietic stem cells boost for Chimeric Antigen Receptor T-cell associated hematotoxicity

Author: Galli, Eugenio, Limongiello, Maria Assunta, Metafuni, Elisabetta, Giammarco, Sabrina, Fresa, Alberto, Piccirillo, Nicola, Bianchi, Maria, Laurenti, Luca, Sora', Federica, Chiusolo, Patrizia, Sica, Simona, Piccirillo, Nicola (ORCID:0000-0002-1688-1987), Laurenti, Luca (ORCID:0000-0002-8327-1396), Sora', Federica (ORCID:0000-0002-9607-5298), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Sica, Simona (ORCID:0000-0003-2426-3465), Galli, Eugenio, Limongiello, Maria Assunta, Metafuni, Elisabetta, Giammarco, Sabrina, Fresa, Alberto, Piccirillo, Nicola, Bianchi, Maria, Laurenti, Luca, Sora', Federica, Chiusolo, Patrizia, Sica, Simona, Piccirillo, Nicola (ORCID:0000-0002-1688-1987), Laurenti, Luca (ORCID:0000-0002-8327-1396), Sora', Federica (ORCID:0000-0002-9607-5298), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), and Sica, Simona (ORCID:0000-0003-2426-3465)
Abstract: Hematological toxicity following Chimeric Antigen Receptor-T therapy in a patient with a prior allogeneic stem cell transplantation was resolved by the infusion of unselected donor-derived stem cell boost. Due to the donor's lymphocytes, the patient experienced a well-controlled flare-up of acute graft versus host disease.
Published: 2024

3. Hematopoiesis and immune reconstitution after CD19 directed chimeric antigen receptor T‐cells (CAR‐T): A comprehensive review on incidence, risk factors and current management

Author: Galli, Eugenio, Fresa, Alberto, Bellesi, Silvia, Metafuni, Elisabetta, Maiolo, Elena, Pansini, Ilaria, Frioni, Filippo, Autore, Francesco, Limongiello, Maria Assunta, Innocenti, Idanna, Giammarco, Sabrina, Chiusolo, Patrizia, Zini Tanzi, Gina, Sora', Federica, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Zini, Gina (ORCID:0000-0002-8208-066X), Sora', Federica (ORCID:0000-0002-9607-5298), Galli, Eugenio, Fresa, Alberto, Bellesi, Silvia, Metafuni, Elisabetta, Maiolo, Elena, Pansini, Ilaria, Frioni, Filippo, Autore, Francesco, Limongiello, Maria Assunta, Innocenti, Idanna, Giammarco, Sabrina, Chiusolo, Patrizia, Zini Tanzi, Gina, Sora', Federica, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Zini, Gina (ORCID:0000-0002-8208-066X), and Sora', Federica (ORCID:0000-0002-9607-5298)
Abstract: Impaired function of hematopoiesis after treatment with chimeric antigen T-cells (CAR-T) is a frequent finding and can interest a wide range of patients, regardless of age and underlying disease. Trilinear cytopenias, as well as hypogammaglobulinemia, B-cell aplasia, and T-cell impairment, can severely affect the infectious risk of CAR-T recipients, as well as their quality of life. In this review, we provide an overview of defects in hematopoiesis after CAR-T, starting with a summary of different definitions and thresholds. We then move to summarize the main pathogenetic mechanisms of cytopenias, and we offer insight into cytomorphological aspects, the role of clonal hematopoiesis, and the risk of secondary myeloid malignancies. Subsequently, we expose the major findings and reports on T-cell and B-cell quantitative and functional impairment after CAR-T. Finally, we provide an overview of current recommendations and leading experiences regarding the management of cytopenias and defective B- and T-cell function.
Published: 2024

4. Coagulopathy in Patients with Low/Intermediate Risk Acute Promyelocytic Leukemia treated with First Line Arsenic Trioxide in Combination with All-Trans Retinoic Acid: A Monocentric Experience

Author: Autore, Francesco, Chiusolo, Patrizia, Sora', Federica, Laurenti, Luca, Pagano, Livio, Bacigalupo, Andrea, De Stefano, Valerio, Sica, Simona, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Sora', Federica (ORCID:0000-0002-9607-5298), Laurenti, Luca (ORCID:0000-0002-8327-1396), Pagano, Livio (ORCID:0000-0001-8287-928X), Bacigalupo, Andrea (ORCID:0000-0002-9119-567X), De Stefano, Valerio (ORCID:0000-0002-5178-5827), Autore, Francesco, Chiusolo, Patrizia, Sora', Federica, Laurenti, Luca, Pagano, Livio, Bacigalupo, Andrea, De Stefano, Valerio, Sica, Simona, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Sora', Federica (ORCID:0000-0002-9607-5298), Laurenti, Luca (ORCID:0000-0002-8327-1396), Pagano, Livio (ORCID:0000-0001-8287-928X), Bacigalupo, Andrea (ORCID:0000-0002-9119-567X), and De Stefano, Valerio (ORCID:0000-0002-5178-5827)
Abstract: NA
Published: 2023

5. Spontaneous resolution of “therapy-related myelodysplasia” occurred after treatment with CAR-T cells: All that glitters is not gold

Author: Frioni, Filippo, Galli, Eugenio, Sora', Federica, Zini Tanzi, Gina, Sica, Simona, Chiusolo, Patrizia, Frioni Filippo, Galli Eugenio, Sora' Federica (ORCID:0000-0002-9607-5298), Zini Gina (ORCID:0000-0002-8208-066X), Sica Simona (ORCID:0000-0003-2426-3465), Chiusolo Patrizia (ORCID:0000-0002-1355-1587), Frioni, Filippo, Galli, Eugenio, Sora', Federica, Zini Tanzi, Gina, Sica, Simona, Chiusolo, Patrizia, Frioni Filippo, Galli Eugenio, Sora' Federica (ORCID:0000-0002-9607-5298), Zini Gina (ORCID:0000-0002-8208-066X), Sica Simona (ORCID:0000-0003-2426-3465), and Chiusolo Patrizia (ORCID:0000-0002-1355-1587)
Abstract: N/A
Published: 2023

6. Acute graft versus host disease 1976-2020: reduced incidence and predictive factors

Author: Di Francesco, Alessandra, Raiola, Anna Maria, Dominietto, Alida, Di Grazia, Carmen, Gualandi, Francesca, Van Lint, Maria Teresa, Bregante, Stefania, Chiusolo, Patrizia, Laurenti, Luca, Sora', Federica, Giammarco, Sabrina, Metafuni, Elisabetta, Fresa, Alberto, Sica, Simona, Angelucci, Emanuele, Bacigalupo, Andrea, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Laurenti, Luca (ORCID:0000-0002-8327-1396), Sora', Federica (ORCID:0000-0002-9607-5298), Sica, Simona (ORCID:0000-0003-2426-3465), Bacigalupo, Andrea (ORCID:0000-0002-9119-567X), Di Francesco, Alessandra, Raiola, Anna Maria, Dominietto, Alida, Di Grazia, Carmen, Gualandi, Francesca, Van Lint, Maria Teresa, Bregante, Stefania, Chiusolo, Patrizia, Laurenti, Luca, Sora', Federica, Giammarco, Sabrina, Metafuni, Elisabetta, Fresa, Alberto, Sica, Simona, Angelucci, Emanuele, Bacigalupo, Andrea, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Laurenti, Luca (ORCID:0000-0002-8327-1396), Sora', Federica (ORCID:0000-0002-9607-5298), Sica, Simona (ORCID:0000-0003-2426-3465), and Bacigalupo, Andrea (ORCID:0000-0002-9119-567X)
Abstract: We studied the incidence of acute graft versus host disease (GvHD) and its outcome in three consecutive time frames (year <2000; 2000-2010; >2010), in 3,120 patients allografted in two transplant Centers between 1976 and 2020. The median age increased over the three periods from 32 to 42 to 54 years (p < 0.00001). The median day of onset of GvHD in the three periods was day +14, day +16, and day +30, respectively (p < 0.0001). The cumulative incidence (CI) of GvHD grades II-IV in the three periods was 47, 24, and 16%, respectively (p < 0.00001). The CI of GvHD grades III-IV was 13, 5, and 4% (p < 0.001). In multivariate analysis, significant predictive factors for GvHD II-IV, on top of year of transplant, were anti-thymocyte globulin (ATG) (RR 0.67, p > 0.001); post-transplant cyclophosphamide (PTCY) (RR 0.41, p < 0.001), a family mismatched donor (RR 1.31, p = 0.03) a matched unrelated donor (RR 2.1, p < 0.001), an unrelated mismatched donor (RR1.8, p = 0.001), donor age above 40 years (RR 1.27, p < 0.001), hematological malignancy-as compared to aplastic anemia (RR 2.3, p < 0.001). When selecting only GvHD grade II, in a multivariate analysis, there was a significant reduction of transplant-related mortality (TRM) for patients grafted in 2001-2010 (RR 0.62, p < 0.0001) and for patients grafted in 2011-2020 (RR 0.35, p < 0.0001) as compared to grafts before the year 2000. A similar reduction in time was seen for patients with GvHD grades III-IV. The overall TRM in the three periods was 30, 22, and 16% (p < 0.0001) and survival was 47, 51, and 58% (p < 0.0001). Relapse risk was unchanged. In conclusion, we showed improved prevention of acute GvHD with time, together with a significant delay in the onset of the disease. Treatment of GvHD has also improved over time, as suggested by both reduced TRM and improved survival in more recent transplant periods.
Published: 2023

7. Safety and efficacy of SARS-Cov2 neutralizing monoclonal antibodies after stem cell transplant or CAR-T cell infusion

Author: Metafuni, Elisabetta, Cingolani, Antonella, Fantoni, Massimo, Chiusolo, Patrizia, Giammarco, Sabrina, Sorà, Federica, Galli, Eugenio, Hohaus, Stefan, D'Alò, Francesco, Bellesi, Silvia, Maiolo, Elena, Alma, Eleonora, Laurenti, Luca, Innocenti, Idanna, Autore, Francesco, Limongiello, Maria Assunta, Santangelo, Rosaria, Marchetti, Simona, Ricci, Rosalba, Sica, Simona, Cingolani, Antonella (ORCID:0000-0002-3793-2755), Fantoni, Massimo (ORCID:0000-0001-6913-8460), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Hohaus, Stefan (ORCID:0000-0002-5534-7197), Laurenti, Luca (ORCID:0000-0002-8327-1396), Santangelo, Rosaria (ORCID:0000-0002-8056-218X), Metafuni, Elisabetta, Cingolani, Antonella, Fantoni, Massimo, Chiusolo, Patrizia, Giammarco, Sabrina, Sorà, Federica, Galli, Eugenio, Hohaus, Stefan, D'Alò, Francesco, Bellesi, Silvia, Maiolo, Elena, Alma, Eleonora, Laurenti, Luca, Innocenti, Idanna, Autore, Francesco, Limongiello, Maria Assunta, Santangelo, Rosaria, Marchetti, Simona, Ricci, Rosalba, Sica, Simona, Cingolani, Antonella (ORCID:0000-0002-3793-2755), Fantoni, Massimo (ORCID:0000-0001-6913-8460), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Hohaus, Stefan (ORCID:0000-0002-5534-7197), Laurenti, Luca (ORCID:0000-0002-8327-1396), and Santangelo, Rosaria (ORCID:0000-0002-8056-218X)
Abstract: NA
Published: 2022

8. Predicting the outcome for patients with myelofibrosis undergoing an allogeneic hemopoietic stem cell transplant

Author: Sora', Federica, Giammarco, Sabrina, Raiola, Anna Maria, Di Grazia, Carmen, Bregante, Stefania, Gualandi, Francesca, Varaldo, Riccardo, Chiusolo, Patrizia, Sica, Simona, Laurenti, Luca, Innocenti, Idanna, Autore, Francesco, Metafuni, Elisabetta, Galli, Eugenio, Bacigalupo, Andrea, Angelucci, Emanuele, Sora, Federica (ORCID:0000-0002-9607-5298), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Laurenti, Luca (ORCID:0000-0002-8327-1396), Bacigalupo, Andrea (ORCID:0000-0002-9119-567X), Sora', Federica, Giammarco, Sabrina, Raiola, Anna Maria, Di Grazia, Carmen, Bregante, Stefania, Gualandi, Francesca, Varaldo, Riccardo, Chiusolo, Patrizia, Sica, Simona, Laurenti, Luca, Innocenti, Idanna, Autore, Francesco, Metafuni, Elisabetta, Galli, Eugenio, Bacigalupo, Andrea, Angelucci, Emanuele, Sora, Federica (ORCID:0000-0002-9607-5298), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Laurenti, Luca (ORCID:0000-0002-8327-1396), and Bacigalupo, Andrea (ORCID:0000-0002-9119-567X)
Abstract: NA
Published: 2022

9. The day 100 score predicts moderate to severe cGVHD, transplant mortality, and survival after hematopoietic cell transplantation

Author: Metafuni, Elisabetta, Cavattoni, Irene Maria, Lamparelli, Teresa, Raiola, Anna Maria, Ghiso, Anna, Galaverna, Federica, Gualandi, Francesca, Di Grazia, Carmen, Dominietto, Alida, Varaldo, Riccardo, Signori, Alessio, Chiusolo, Patrizia, Sora', Federica, Giammarco, Sabrina, Laurenti, Luca, Sica, Simona, Angelucci, Emanuele, Bacigalupo, Andrea, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Sora', Federica (ORCID:0000-0002-9607-5298), Laurenti, Luca (ORCID:0000-0002-8327-1396), Bacigalupo, Andrea (ORCID:0000-0002-9119-567X), Metafuni, Elisabetta, Cavattoni, Irene Maria, Lamparelli, Teresa, Raiola, Anna Maria, Ghiso, Anna, Galaverna, Federica, Gualandi, Francesca, Di Grazia, Carmen, Dominietto, Alida, Varaldo, Riccardo, Signori, Alessio, Chiusolo, Patrizia, Sora', Federica, Giammarco, Sabrina, Laurenti, Luca, Sica, Simona, Angelucci, Emanuele, Bacigalupo, Andrea, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Sora', Federica (ORCID:0000-0002-9607-5298), Laurenti, Luca (ORCID:0000-0002-8327-1396), and Bacigalupo, Andrea (ORCID:0000-0002-9119-567X)
Abstract: The aim of this study was to develop a predictive score for moderate-severe chronic graft-versus-host disease (cGVHD) on day +100 after allogeneic stem cell transplantation (HSCT). We studied 1292 patients allografted between 1990 and 2016, alive on day +100 after transplant, without cGVHD, and with full biochemistry laboratory values available. Patients were randomly assigned to a training and a validation cohort (ratio 1:1). In the training cohort, a multivariate analysis identified 4 independent predictors of moderate-severe cGVHD: gamma-glutamyl transferase >= 75 UI/l, creatinine >= 1 mg/dl, cholinesterase <= 4576 UI/l, and albumin <= 4 g/dl. A score of 1 was assigned to each variable, producing a low (0 to 1), intermediate (2 to 3), and high (4) score. The cumulative incidence of moderate-severe cGVHD was 12%, 20%, and 52% (P<.0001) in the training cohort, and 13%, 24%, and 33% (P = .002) in the validation cohort, respectively. The 5-year cumulative incidence of transplant-related mortality (TRM) was 5%, 14%, 27% (P<.0001) and 5%, 16%, 31% (P<.0001), respectively. The 5-year survival was 64%, 57%, 54% (P = .009) and 70%, 59%, 42% (P = .0008) in the 2 cohorts, respectively. In conclusion, Day100 score predicts cGVHD, TRM, and survival and, if validated in a separate group of patients, could be considered for trials of preemptive therapy.
Published: 2022

10. Hemorrhagic cystitis in allogeneic stem cell transplantation: a role for age and prostatic hyperplasia

Author: Galli, Eugenio, Sorà, Federica, Di Gianfrancesco, Luca, Giammarco, Sabrina, Metafuni, Elisabetta, Limongiello, Maria Assunta, Innocenti, Idanna, Autore, Francesco, Laurenti, Luca, Chiusolo, Patrizia, Bacigalupo, Andrea, Sica, Simona, Laurenti, Luca (ORCID:0000-0002-8327-1396), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Bacigalupo, Andrea (ORCID:0000-0002-9119-567X), Galli, Eugenio, Sorà, Federica, Di Gianfrancesco, Luca, Giammarco, Sabrina, Metafuni, Elisabetta, Limongiello, Maria Assunta, Innocenti, Idanna, Autore, Francesco, Laurenti, Luca, Chiusolo, Patrizia, Bacigalupo, Andrea, Sica, Simona, Laurenti, Luca (ORCID:0000-0002-8327-1396), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), and Bacigalupo, Andrea (ORCID:0000-0002-9119-567X)
Abstract: Purpose Hemorrhagic cystitis (HC) is a frequent complication of allogeneic hematopoietic stem-cell transplantation (HSCT). HC worsens transplant outcomes and patient wellbeing in terms of pain, hospitalization, and need for supportive care. A deeper understanding of the risk factors of HC may lead to more intensive prevention in high-risk patients. Methods In this report, we analyzed 237 consecutive patients who received HSCT with the aim of identifying possible risk factors for HC and their consequences, with a particular focus on transplant- and gender-related risk factors. Results HC occurred in 17% of patients, with a higher incidence in males (21% vs 11%, p = 0.03). Risk factors identified for HC included age over 55 years, male recipient, HLA mismatch, reduced intensity conditioning, and cyclophosphamide-based graft-versus-host disease (GVHD) prophylaxis. Increased HC was seen in patients with grade II-IV acute GVHD and detectable BKV and JCV viruria. In a multivariate model, increased age remained significant (p = 0.013). Patients with HC had longer hospitalizations and increased non-relapse mortality (NRM). Among male recipients, independent risk factors for HC included age (p = 0.016) and prostate volume (p = 0.016). Prostatic hyperplasia (volume more than 40 cm(3)) occurred in 33% of male patients, of which 32% developed HC (compared with 16% of patients without prostatic hyperplasia; p = 0.032). Conclusions Age is the most important risk factor for HC. Additional potential risk factors include cyclophosphamide-based GVHD prophylaxis and HLA mismatch. Among male recipients, prostatic hyperplasia is an additional independent risk factor. As HC is common and associated with prolonged hospitalization, more intensive prophylactic strategies should be considered in high-risk patients.
Published: 2022

11. Immunogenicity of SARS-CoV-2 vaccination in patients undergoing autologous stem cell transplantation. A multicentric experience

Author: Autore, Francesco, Stirparo, Luca, Innocenti, Idanna, Papa, Elena, Marchesi, Francesco, Togni, Chiara, Mariani, Sabrina, Torrieri, Lorenzo, Salvatori, Martina, Fazio, Francesca, Metafuni, Elisabetta, Giammarco, Sabrina, Sora', Federica, Falcucci, Paolo, Ferrari, Antonella, Trisolini, Silvia Maria, Capria, Saveria, Tafuri, Agostino, Chiusolo, Patrizia, Sica, Simona, Laurenti, Luca, Sora, Federica (ORCID:0000-0002-9607-5298), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Sica, Simona (ORCID:0000-0003-2426-3465), Laurenti, Luca (ORCID:0000-0002-8327-1396), Autore, Francesco, Stirparo, Luca, Innocenti, Idanna, Papa, Elena, Marchesi, Francesco, Togni, Chiara, Mariani, Sabrina, Torrieri, Lorenzo, Salvatori, Martina, Fazio, Francesca, Metafuni, Elisabetta, Giammarco, Sabrina, Sora', Federica, Falcucci, Paolo, Ferrari, Antonella, Trisolini, Silvia Maria, Capria, Saveria, Tafuri, Agostino, Chiusolo, Patrizia, Sica, Simona, Laurenti, Luca, Sora, Federica (ORCID:0000-0002-9607-5298), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Sica, Simona (ORCID:0000-0003-2426-3465), and Laurenti, Luca (ORCID:0000-0002-8327-1396)
Abstract: COVID-19 disease has a strong impact on hematological patients; those receiving autologous hematopoietic stem cell transplantation (aHSCT) represent a particularly vulnerable group, in which the effectiveness of vaccination is very variable. Chiarucci et al. showed that patients affected by non-Hodgkin lymphoma (NHL) and treated with rituximab experienced a lower rate of immunization against SARS-CoV-2 (54%), as well as significantly lower IgG antibody titers. In our multicenter retrospective observational study, we included 82 patients who underwent aHSCT, divided into two groups: 58 patients vaccinated after aHSCT (group A) and 24 vaccinated before getting transplantation (group B). In group A, 39 (67%) patients had positive serology, and the rate of positivity increased with time after aHSCT. In the subgroup of patients with NHL the administration of rituximab predicted negative serology, particularly when administered in the 6 months before vaccination (13% response rate). Patients affected by plasma cells had a higher rate of positivity (83% overall), independently of the time to aHSCT. In group B, no patient who initially showed positive serology became negative after transplantation, so the aHSCT did not affect the response to the vaccination. Our study confirmed the role of rituximab as a negative predictor of response to SARS-CoV-2 vaccination, whereas the conditioning and transplantation procedure itself seemed to be less important.
Published: 2022

12. A common pattern of somatic mutations in t-MDS/AML of patients treated with PARP inhibitors for metastatic ovarian cancer

Author: Chiusolo, Patrizia, Marchetti, Claudia, Rossi, Monica, Minnella, Gessica, Salutari, Vanda, Distefano, Mariagrazia, Giammarco, Sabrina, Metafuni, Elisabetta, Minucci, Angelo, Frioni, Filippo, Gasbarrino, Cristiana, Colangelo, Maria, Orteschi, Daniela, Fagotti, Anna, Lorusso, Domenica, Pagano, Livio, De Stefano, Valerio, Scambia, Giovanni, Sica, Simona, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Marchetti, Claudia (ORCID:0000-0001-7098-8956), Fagotti, Anna (ORCID:0000-0001-5579-335X), Pagano, Livio (ORCID:0000-0001-8287-928X), De Stefano, Valerio (ORCID:0000-0002-5178-5827), Scambia, Giovanni (ORCID:0000-0003-2758-1063), Sica, Simona (ORCID:0000-0003-2426-3465), Chiusolo, Patrizia, Marchetti, Claudia, Rossi, Monica, Minnella, Gessica, Salutari, Vanda, Distefano, Mariagrazia, Giammarco, Sabrina, Metafuni, Elisabetta, Minucci, Angelo, Frioni, Filippo, Gasbarrino, Cristiana, Colangelo, Maria, Orteschi, Daniela, Fagotti, Anna, Lorusso, Domenica, Pagano, Livio, De Stefano, Valerio, Scambia, Giovanni, Sica, Simona, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Marchetti, Claudia (ORCID:0000-0001-7098-8956), Fagotti, Anna (ORCID:0000-0001-5579-335X), Pagano, Livio (ORCID:0000-0001-8287-928X), De Stefano, Valerio (ORCID:0000-0002-5178-5827), Scambia, Giovanni (ORCID:0000-0003-2758-1063), and Sica, Simona (ORCID:0000-0003-2426-3465)
Abstract: inglese
Published: 2022

13. Day +60 WT1 assessment on CD34 selected bone marrow better predicts relapse and mortality after allogeneic stem cell transplantation in acute myeloid leukemia patients

Author: Chiusolo, Patrizia, Metafuni, Elisabetta, Minnella, Gessica, Giammarco, Sabrina, Bellesi, Silvia, Rossi, Monica, Sorà, Federica, Limongiello, Maria Assunta, Frioni, Filippo, Piccirillo, Nicola, Bianchi, Maria, Valentini, Caterina Giovanna, Teofili, Luciana, Sica, Simona, Bacigalupo, Andrea, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Piccirillo, Nicola (ORCID:0000-0002-1688-1987), Teofili, Luciana (ORCID:0000-0002-7214-1561), Bacigalupo, Andrea (ORCID:0000-0002-9119-567X), Chiusolo, Patrizia, Metafuni, Elisabetta, Minnella, Gessica, Giammarco, Sabrina, Bellesi, Silvia, Rossi, Monica, Sorà, Federica, Limongiello, Maria Assunta, Frioni, Filippo, Piccirillo, Nicola, Bianchi, Maria, Valentini, Caterina Giovanna, Teofili, Luciana, Sica, Simona, Bacigalupo, Andrea, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Piccirillo, Nicola (ORCID:0000-0002-1688-1987), Teofili, Luciana (ORCID:0000-0002-7214-1561), and Bacigalupo, Andrea (ORCID:0000-0002-9119-567X)
Abstract: The aim of this study was to evaluate the role of WT1 expression after allogeneic stem cell transplantation (alloHSCT) in patients with acute myeloid leukemia (AML). We studied WT1 expression in bone marrow cells from 50 patients in complete remission on day +60 after transplant. WT1 was assessed on unfractionated bone marrow mononuclear cells (MNC) and on CD34+ selected cells (CD34+). A ROC curve analysis identified 800 WT1 copies on CD34+ selected cells, as the best cut-off predicting relapse (AUC 0.842, p=0.0006, 85.7% sensitivity and 81.6% specificity) and 100 copies in MNC (AUC 0.819, p=0.007, 83.3% sensitivity and 88.2% specificity). Using the 800 WT1 copy cut off in CD34+ cells, the 2 year cumulative incidence of relapse was 12% vs 38% (p=0.005), and 2 year survival 88% vs 55% (p=0.02). Using the 100 WT1 copy cut off in unfractionated MNC, the 2 year cumulative incidence of relapse 13% vs 44% (p=0.01) and the 2 year survival 88% vs 55% (p=0.08). In a multivariate Cox analysis WT1 expression in CD34 cells proved to highly predictive of relapse (p=0.004); also WT1 expression on unfractionated cells predicted relapse (p=0.03). In conclusion, day-60 WT1 expression after allogeneic HSCT is a significant predictor of relapse, particularly when tested on CD34+ selected bone marrow cells.
Published: 2022

14. Allogeneic Hemopoietic Stem Cell Transplantation for Myelofibrosis: 2021

Author: Bacigalupo, Andrea, Innocenti, Idanna, Rossi, Elena, Sora', Federica, Galli, Eugenio, Autore, Francesco, Metafuni, Elisabetta, Chiusolo, Patrizia, Giammarco, Sabrina, Laurenti, Luca, Benintende, Giulia, Sica, Simona, De Stefano, Valerio, Bacigalupo, Andrea (ORCID:0000-0002-9119-567X), Rossi, Elena (ORCID:0000-0002-7572-9379), Sora, Federica (ORCID:0000-0002-9607-5298), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Laurenti, Luca (ORCID:0000-0002-8327-1396), Sica, Simona (ORCID:0000-0003-2426-3465), De Stefano, Valerio (ORCID:0000-0002-5178-5827), Bacigalupo, Andrea, Innocenti, Idanna, Rossi, Elena, Sora', Federica, Galli, Eugenio, Autore, Francesco, Metafuni, Elisabetta, Chiusolo, Patrizia, Giammarco, Sabrina, Laurenti, Luca, Benintende, Giulia, Sica, Simona, De Stefano, Valerio, Bacigalupo, Andrea (ORCID:0000-0002-9119-567X), Rossi, Elena (ORCID:0000-0002-7572-9379), Sora, Federica (ORCID:0000-0002-9607-5298), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Laurenti, Luca (ORCID:0000-0002-8327-1396), Sica, Simona (ORCID:0000-0003-2426-3465), and De Stefano, Valerio (ORCID:0000-0002-5178-5827)
Abstract: The aim of this review is to update the current status of allogeneic hemopoietic stem cell transplants (HSCT) for patients with myelofibrosis (MF). We have first summarized the issue of an indication for allogeneic HSCT, discussing several prognostic scoring systems, developed to predict the outcome of MF, and therefore to identify patients who will benefit of an allogeneic HSCT. Patients with low risk MF are usually not selected for a transplant, whereas patients with intermediate or high risk MF are eligible. A separate issue, is how to predict the outcome of HSCT: we will outline a clinical molecular myelofibrosis transplant scoring system (MTSS), which predicts overall survival, ranging from 90% for low risk patients, to 20% for very high risk patients. We will also discuss transfusion burden and spleen size, as predictors of transplant outcome. The choice of a transplant platform including the conditioning regimen, the stem cell source and GvHD prophylaxis, are crucial for a successful program in MF, and will be outlined. Complications such as poor graft function, graft failure, GvHD and relapse of the disease, will also be reviewed. Finally we discuss monitoring the disease after HSCT with donor chimerism, driver mutations and hematologic data. We have made an effort to make this review as comprehensive and up to date as possible, and we hope it will provide some useful data for the clinicians.
Published: 2021

15. Blinatumomab as a successful and safe therapy in Down syndrome patients with relapsed/refractory b-precursor acute lymphoblastic leukaemia: Case reports and literature review

Author: Sora', Federica, Annunziata, Mario, Laurenti, Luca, Giammarco, Sabrina, Chiusolo, Patrizia, Innocenti, Idanna, Autore, Francesco, Metafuni, Elisabetta, Galli, Eugenio, Bacigalupo, Andrea, Ferrara, Felicetto, Sica, Simona, Sora, Federica (ORCID:0000-0002-9607-5298), Laurenti, Luca (ORCID:0000-0002-8327-1396), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Bacigalupo, Andrea (ORCID:0000-0002-9119-567X), Sora', Federica, Annunziata, Mario, Laurenti, Luca, Giammarco, Sabrina, Chiusolo, Patrizia, Innocenti, Idanna, Autore, Francesco, Metafuni, Elisabetta, Galli, Eugenio, Bacigalupo, Andrea, Ferrara, Felicetto, Sica, Simona, Sora, Federica (ORCID:0000-0002-9607-5298), Laurenti, Luca (ORCID:0000-0002-8327-1396), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), and Bacigalupo, Andrea (ORCID:0000-0002-9119-567X)
Abstract: NOT AVAILABLE
Published: 2021

16. Full donor chimerism after allogeneic hematopoietic stem cells transplant for myelofibrosis: The role of the conditioning regimen

Author: Chiusolo, Patrizia, Bregante, Stefania, Giammarco, Sabrina, Lamparelli, Teresa, Casarino, Lucia, Dominietto, Alida, Raiola Anna, Maria, Metafuni, Elisabetta, Di Grazia, Carmen, Gualandi, Francesca, Sora', Federica, Laurenti, Luca, Sica, Simona, Barosi, Gianni, Guolo, Fabio, Rossi, Monica, Rossi, Elena, Vannucchi, Alessandro, Signori, Alessio, De Stefano, Valerio, Bacigalupo, Andrea, Angelucci, Emanuele, Chiusolo Patrizia (ORCID:0000-0002-1355-1587), Metafuni Elisabetta, Sora Federica (ORCID:0000-0002-9607-5298), Laurenti Luca (ORCID:0000-0002-8327-1396), Sica Simona (ORCID:0000-0003-2426-3465), Rossi Monica, Rossi Elena (ORCID:0000-0002-7572-9379), De Stefano Valerio (ORCID:0000-0002-5178-5827), Bacigalupo Andrea (ORCID:0000-0002-9119-567X), Chiusolo, Patrizia, Bregante, Stefania, Giammarco, Sabrina, Lamparelli, Teresa, Casarino, Lucia, Dominietto, Alida, Raiola Anna, Maria, Metafuni, Elisabetta, Di Grazia, Carmen, Gualandi, Francesca, Sora', Federica, Laurenti, Luca, Sica, Simona, Barosi, Gianni, Guolo, Fabio, Rossi, Monica, Rossi, Elena, Vannucchi, Alessandro, Signori, Alessio, De Stefano, Valerio, Bacigalupo, Andrea, Angelucci, Emanuele, Chiusolo Patrizia (ORCID:0000-0002-1355-1587), Metafuni Elisabetta, Sora Federica (ORCID:0000-0002-9607-5298), Laurenti Luca (ORCID:0000-0002-8327-1396), Sica Simona (ORCID:0000-0003-2426-3465), Rossi Monica, Rossi Elena (ORCID:0000-0002-7572-9379), De Stefano Valerio (ORCID:0000-0002-5178-5827), and Bacigalupo Andrea (ORCID:0000-0002-9119-567X)
Abstract: The aim of this retrospective study was to assess the rate of full donor chimerism (F-DC) in patients with myelofibrosis, prepared for an allogeneic stem cell transplant, with one or two alkylating agents. We analyzed 120 patients with myelofibrosis, for whom chimerism data were available on day +30. There were two groups: 42 patients were conditioned with one alkylating agent (ONE-ALK), either thiotepa or busulfan or melphalan, in combination with fludarabine, whereas 78 patients were prepared with two alkylating agents, thiotepa busulfan and fludarabine (TBF). Patients receiving TBF were older (57 vs 52 years), were less frequently splenectomized pre-HSCT (31% vs 59%), had more frequently intermediate-2/high DIPSS scores (90% vs 74%), were grafted more frequently from alternative donors (83% vs 33%) and received more frequently ruxolitinib pre-HSCT (26% vs 7%). The proportion of patients with F-DC on day +30, in the TBF vs the ONE-ALK group, was respectively 87% vs 45% (P < .001). The 5-year cumulative incidence of relapse was 9% in the TBF group, vs 43% for the ONE-ALK group (P < .001). The 5-year actuarial disease-free survival was 63% for TBF and 38% for the ONE-ALK group (P = .004). In conclusion, early full donor chimerism is a prerequisite for long term control of disease in patients with myelofibrosis, undergoing an allogeneic HSCT. The combination of two alkylating agents in the conditioning regimen, provides a higher chance of achieving full donor chimerism on day+30, and thus a higher chance of long term disease free survival.
Published: 2021

17. A machine-learning parsimonious multivariable predictive model of mortality risk in patients with Covid-19

Author: Murri, Rita, Lenkowicz, Jacopo, Masciocchi, Carlotta, Iacomini, Chiara, Fantoni, Massimo, Damiani, Andrea, Marchetti, Antonio, Sergi, Paolo Domenico Angelo, Arcuri, Giovanni, Cesario, Alfredo, Patarnello, Stefano, Antonelli, Massimo, Bellantone, Rocco Domenico Alfonso, Bernabei, Roberto, Boccia, Stefania, Calabresi, Paolo, Cambieri, Andrea, Cauda, Roberto, Colosimo, Cesare, Crea, Filippo, De Maria Marchiano, Ruggero, De Stefano, Valerio, Franceschi, Francesco, Gasbarrini, Antonio, Parolini, Ornella, Richeldi, Luca, Sanguinetti, Maurizio, Urbani, Andrea, Zega, Maurizio, Scambia, Giovanni, Valentini, Vincenzo, Armuzzi, Alessandro, Barba, Marta, Baroni, Silvia, Bellesi, Silvia, Bentivoglio, Annarita, Biasucci, Luigi Marzio, Biscetti, Federico, Candelli, Marcello, Capalbo, Gennaro, Cattani Franchi, Paola, Chiusolo, Patrizia, Cingolani, Antonella, Corbo, Giuseppe Maria, Covino, Marcello, Cozzolino, Angela Maria, D’Alfonso, Marilena, De Angelis, Giulia, De Pascale, Gennaro, Frisullo, Giovanni, Gabrielli, Maurizio, Gambassi, Giovanni, Garcovich, Matteo, Gremese, Elisa, Grieco, Domenico Luca, Iaconelli, Amerigo, Iorio, Raffaele, Landi, Francesco, Larici, Annarita, Liuzzo, Giovanna, Maviglia, Riccardo, Miele, Luca, Montalto, Massimo, Natale, Luigi, Nicolotti, Nicola, Ojetti, Veronica, Pompili, Maurizio, Posteraro, Brunella, Rapaccini, Gianni, Rinaldi, Riccardo, Rossi, Elena, Santoliquido, Angelo, Sica, Simona, Tamburrini, Enrica, Teofili, Luciana, Testa, Antonia Carla, Tosoni, Alberto, Trani, Carlo, Varone, Francesco, Zileri Dal Verme, Lorenzo, Null, Null, Murri, Rita (ORCID:0000-0003-4263-7854), Fantoni, Massimo (ORCID:0000-0001-6913-8460), Cesario, Alfredo (ORCID:0000-0003-4687-0709), Antonelli, Massimo (ORCID:0000-0003-3007-1670), Bellantone, Rocco (ORCID:0000-0002-0844-3469), Bernabei, Roberto (ORCID:0000-0002-9197-004X), Boccia, Stefania (ORCID:0000-0002-1864-749X), Calabresi, Paolo (ORCID:0000-0003-0326-5509), Cauda, Roberto (ORCID:0000-0002-1498-4229), Colosimo, Cesare (ORCID:0000-0003-3800-3648), Crea, Filippo (ORCID:0000-0001-9404-8846), De Maria, Ruggero (ORCID:0000-0003-2255-0583), De Stefano, Valerio (ORCID:0000-0002-5178-5827), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Parolini, Ornella (ORCID:0000-0002-5211-6430), Richeldi, Luca (ORCID:0000-0001-8594-1448), Sanguinetti, Maurizio (ORCID:0000-0002-9780-7059), Zega, Maurizio (ORCID:0000-0002-7821-2615), Scambia, Giovanni (ORCID:0000-0003-2758-1063), Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Armuzzi, Alessandro (ORCID:0000-0003-1572-0118), Barba, Marta (ORCID:0000-0001-6084-7666), Baroni, Silvia (ORCID:0000-0002-3410-2617), Biasucci, Luigi Marzio (ORCID:0000-0002-6921-6497), Biscetti, Federico (ORCID:0000-0001-7449-657X), Candelli, Marcello (ORCID:0000-0001-8443-7880), Cattani, Paola (ORCID:0000-0003-4678-4763), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Cingolani, Antonella (ORCID:0000-0002-3793-2755), Corbo, Giuseppe (ORCID:0000-0002-8104-4659), Covino, Marcello (ORCID:0000-0002-6709-2531), De Angelis, Giulia (ORCID:0000-0002-7087-7399), De Pascale, Gennaro (ORCID:0000-0002-8255-0676), Gambassi, Giovanni (ORCID:0000-0002-7030-9359), Gremese, Elisa (ORCID:0000-0002-2248-1058), Grieco, Domenico Luca (ORCID:0000-0002-4557-6308), Iorio, Raffaele (ORCID:0000-0002-6270-0956), Landi, Francesco (ORCID:0000-0002-3472-1389), Liuzzo, Giovanna (ORCID:0000-0002-5714-0907), Miele, Luca (ORCID:0000-0003-3464-0068), Montalto, Massimo (ORCID:0000-0001-8819-3684), Natale, Luigi (ORCID:0000-0002-7949-5119), Ojetti, Veronica (ORCID:0000-0002-8953-0707), Pompili, Maurizio (ORCID:0000-0001-6699-7980), Posteraro, Brunella (ORCID:0000-0002-1663-7546), Rossi, Elena (ORCID:0000-0002-7572-9379), Santoliquido, Angelo (ORCID:0000-0003-1539-4017), Tamburrini, Enrica (ORCID:0000-0003-4930-426X), Teofili, Luciana (ORCID:0000-0002-7214-1561), Testa, Antonia (ORCID:0000-0003-2217-8726), Trani, Carlo (ORCID:0000-0001-9777-013X), Verme, Lorenzo Zileri Dal, Murri, Rita, Lenkowicz, Jacopo, Masciocchi, Carlotta, Iacomini, Chiara, Fantoni, Massimo, Damiani, Andrea, Marchetti, Antonio, Sergi, Paolo Domenico Angelo, Arcuri, Giovanni, Cesario, Alfredo, Patarnello, Stefano, Antonelli, Massimo, Bellantone, Rocco Domenico Alfonso, Bernabei, Roberto, Boccia, Stefania, Calabresi, Paolo, Cambieri, Andrea, Cauda, Roberto, Colosimo, Cesare, Crea, Filippo, De Maria Marchiano, Ruggero, De Stefano, Valerio, Franceschi, Francesco, Gasbarrini, Antonio, Parolini, Ornella, Richeldi, Luca, Sanguinetti, Maurizio, Urbani, Andrea, Zega, Maurizio, Scambia, Giovanni, Valentini, Vincenzo, Armuzzi, Alessandro, Barba, Marta, Baroni, Silvia, Bellesi, Silvia, Bentivoglio, Annarita, Biasucci, Luigi Marzio, Biscetti, Federico, Candelli, Marcello, Capalbo, Gennaro, Cattani Franchi, Paola, Chiusolo, Patrizia, Cingolani, Antonella, Corbo, Giuseppe Maria, Covino, Marcello, Cozzolino, Angela Maria, D’Alfonso, Marilena, De Angelis, Giulia, De Pascale, Gennaro, Frisullo, Giovanni, Gabrielli, Maurizio, Gambassi, Giovanni, Garcovich, Matteo, Gremese, Elisa, Grieco, Domenico Luca, Iaconelli, Amerigo, Iorio, Raffaele, Landi, Francesco, Larici, Annarita, Liuzzo, Giovanna, Maviglia, Riccardo, Miele, Luca, Montalto, Massimo, Natale, Luigi, Nicolotti, Nicola, Ojetti, Veronica, Pompili, Maurizio, Posteraro, Brunella, Rapaccini, Gianni, Rinaldi, Riccardo, Rossi, Elena, Santoliquido, Angelo, Sica, Simona, Tamburrini, Enrica, Teofili, Luciana, Testa, Antonia Carla, Tosoni, Alberto, Trani, Carlo, Varone, Francesco, Zileri Dal Verme, Lorenzo, Null, Null, Murri, Rita (ORCID:0000-0003-4263-7854), Fantoni, Massimo (ORCID:0000-0001-6913-8460), Cesario, Alfredo (ORCID:0000-0003-4687-0709), Antonelli, Massimo (ORCID:0000-0003-3007-1670), Bellantone, Rocco (ORCID:0000-0002-0844-3469), Bernabei, Roberto (ORCID:0000-0002-9197-004X), Boccia, Stefania (ORCID:0000-0002-1864-749X), Calabresi, Paolo (ORCID:0000-0003-0326-5509), Cauda, Roberto (ORCID:0000-0002-1498-4229), Colosimo, Cesare (ORCID:0000-0003-3800-3648), Crea, Filippo (ORCID:0000-0001-9404-8846), De Maria, Ruggero (ORCID:0000-0003-2255-0583), De Stefano, Valerio (ORCID:0000-0002-5178-5827), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Parolini, Ornella (ORCID:0000-0002-5211-6430), Richeldi, Luca (ORCID:0000-0001-8594-1448), Sanguinetti, Maurizio (ORCID:0000-0002-9780-7059), Zega, Maurizio (ORCID:0000-0002-7821-2615), Scambia, Giovanni (ORCID:0000-0003-2758-1063), Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Armuzzi, Alessandro (ORCID:0000-0003-1572-0118), Barba, Marta (ORCID:0000-0001-6084-7666), Baroni, Silvia (ORCID:0000-0002-3410-2617), Biasucci, Luigi Marzio (ORCID:0000-0002-6921-6497), Biscetti, Federico (ORCID:0000-0001-7449-657X), Candelli, Marcello (ORCID:0000-0001-8443-7880), Cattani, Paola (ORCID:0000-0003-4678-4763), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Cingolani, Antonella (ORCID:0000-0002-3793-2755), Corbo, Giuseppe (ORCID:0000-0002-8104-4659), Covino, Marcello (ORCID:0000-0002-6709-2531), De Angelis, Giulia (ORCID:0000-0002-7087-7399), De Pascale, Gennaro (ORCID:0000-0002-8255-0676), Gambassi, Giovanni (ORCID:0000-0002-7030-9359), Gremese, Elisa (ORCID:0000-0002-2248-1058), Grieco, Domenico Luca (ORCID:0000-0002-4557-6308), Iorio, Raffaele (ORCID:0000-0002-6270-0956), Landi, Francesco (ORCID:0000-0002-3472-1389), Liuzzo, Giovanna (ORCID:0000-0002-5714-0907), Miele, Luca (ORCID:0000-0003-3464-0068), Montalto, Massimo (ORCID:0000-0001-8819-3684), Natale, Luigi (ORCID:0000-0002-7949-5119), Ojetti, Veronica (ORCID:0000-0002-8953-0707), Pompili, Maurizio (ORCID:0000-0001-6699-7980), Posteraro, Brunella (ORCID:0000-0002-1663-7546), Rossi, Elena (ORCID:0000-0002-7572-9379), Santoliquido, Angelo (ORCID:0000-0003-1539-4017), Tamburrini, Enrica (ORCID:0000-0003-4930-426X), Teofili, Luciana (ORCID:0000-0002-7214-1561), Testa, Antonia (ORCID:0000-0003-2217-8726), Trani, Carlo (ORCID:0000-0001-9777-013X), and Verme, Lorenzo Zileri Dal
Abstract: The COVID-19 pandemic is impressively challenging the healthcare system. Several prognostic models have been validated but few of them are implemented in daily practice. The objective of the study was to validate a machine-learning risk prediction model using easy-to-obtain parameters to help to identify patients with COVID-19 who are at higher risk of death. The training cohort included all patients admitted to Fondazione Policlinico Gemelli with COVID-19 from March 5, 2020, to November 5, 2020. Afterward, the model was tested on all patients admitted to the same hospital with COVID-19 from November 6, 2020, to February 5, 2021. The primary outcome was in-hospital case-fatality risk. The out-of-sample performance of the model was estimated from the training set in terms of Area under the Receiving Operator Curve (AUROC) and classification matrix statistics by averaging the results of fivefold cross validation repeated 3-times and comparing the results with those obtained on the test set. An explanation analysis of the model, based on the SHapley Additive exPlanations (SHAP), is also presented. To assess the subsequent time evolution, the change in paO2/FiO2 (P/F) at 48 h after the baseline measurement was plotted against its baseline value. Among the 921 patients included in the training cohort, 120 died (13%). Variables selected for the model were age, platelet count, SpO2, blood urea nitrogen (BUN), hemoglobin, C-reactive protein, neutrophil count, and sodium. The results of the fivefold cross-validation repeated 3-times gave AUROC of 0.87, and statistics of the classification matrix to the Youden index as follows: sensitivity 0.840, specificity 0.774, negative predictive value 0.971. Then, the model was tested on a new population (n=1463) in which the case-fatality rate was 22.6%. The test model showed AUROC 0.818, sensitivity 0.813, specificity 0.650, negative predictive value 0.922. Considering the first quartile of the predicted risk score (low-risk score gro
Published: 2021

18. SARS CoV 2 infection in chronic myelogenous leukemia: Severe hematological presentation

Author: Sora', Federica, Chiusolo, Patrizia, Laurenti, Luca, Innocenti, Idanna, Autore, Francesco, Alma, Eleonora, Viscovo, Marcello, Fusco, Domernico, Maresca, Maddalena, Tumbarello, Mario, Sica, Simona, Sorà, Federica (ORCID:0000-0002-9607-5298), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Laurenti, Luca (ORCID:0000-0002-8327-1396), Tumbarello, Mario (ORCID:0000-0002-9519-8552), Sica, Simona (ORCID:0000-0003-2426-3465), Sora', Federica, Chiusolo, Patrizia, Laurenti, Luca, Innocenti, Idanna, Autore, Francesco, Alma, Eleonora, Viscovo, Marcello, Fusco, Domernico, Maresca, Maddalena, Tumbarello, Mario, Sica, Simona, Sorà, Federica (ORCID:0000-0002-9607-5298), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Laurenti, Luca (ORCID:0000-0002-8327-1396), Tumbarello, Mario (ORCID:0000-0002-9519-8552), and Sica, Simona (ORCID:0000-0003-2426-3465)
Abstract: N/A
Published: 2020

19. Bone marrow megakaryocytic activation predicts fibrotic evolution of Philadelphia-negative myeloproliferative neoplasms

Author: Schino, Mattia, Fiorentino, Vincenzo, Rossi, Elena, Betti, Silvia, Di Cecca, Monica, Ranucci, Valentina, Chiusolo, Patrizia, Martini, Maurizio, De Stefano, Valerio, Larocca, Luigi Maria, Rossi, Elena (ORCID:0000-0002-7572-9379), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Martini, Maurizio (ORCID:0000-0002-6260-6310), De Stefano, Valerio (ORCID:0000-0002-5178-5827), Larocca, Luigi Maria (ORCID:0000-0003-1739-4758), Schino, Mattia, Fiorentino, Vincenzo, Rossi, Elena, Betti, Silvia, Di Cecca, Monica, Ranucci, Valentina, Chiusolo, Patrizia, Martini, Maurizio, De Stefano, Valerio, Larocca, Luigi Maria, Rossi, Elena (ORCID:0000-0002-7572-9379), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Martini, Maurizio (ORCID:0000-0002-6260-6310), De Stefano, Valerio (ORCID:0000-0002-5178-5827), and Larocca, Luigi Maria (ORCID:0000-0003-1739-4758)
Abstract: Philadelphia-negative chronic myeloproliferative neoplasms (MPNs) have been traditionally considered as indistinctly slowly progressing conditions; recent evidence proves that a subset of cases have a rapid evolution, so that MPNs' prognosis needs to be personalized. We identified a new morphological parameter, defined as Megakaryocytic Activation (M-ACT) based on the coexistence of megakaryocytic emperipolesis, megakaryocytes (MK) clusters formation and evidence of arrangement of collagen fibers around the perimeter of MK. We retrospectively analyzed the bone marrow biopsy of two MPNs cohorts of patients with polycythemia (PV) (n=64) and non-PV patients [including essential thrombocythemia (ET), and early/prefibrotic primary myelofibrosis (PMF)] (n=222). M-ACT showed a significant correlation with splenomegaly, white blood cell (WBC) count, and LDH serum levels in both groups, with JAK2 V617F allele burden in PV patients, and with CALR mutations, and platelet count in non-PV patients. Progression-free survival, defined as PV-to-secondary MF progression and non-PV-to-overt PMF, was worse in both PV and early/prefibrotic PMF patients with M-ACT in comparison to those without M-ACT (P<.0001). Interestingly, M-ACT was not found in the subgroup of ET patients. In conclusion, M-ACT can be helpful in the differential diagnosis of MPNs and can represent a new morphologic parameter with a predictive value for progression of MPNs.
Published: 2020

20. Bone marrow haploidentical transplant with post-transplantation cyclophosphamide :does graft cell content have an impact on main clinical outcomes?

Author: Bacigalupo, Andrea, Teofili, Luciana, Chiusolo, Patrizia, Valentini, Giovanna, Metafuni, Elisabetta, Bellesi, Silvia, Orlando, Nicoletta, Bianchi, Maria, Sica, Simona, Bacigalupo andrea (ORCID:0000-0002-9119-567X), Teofili Lucian (ORCID:0000-0002-7214-1561), Chiusolo Patrizia (ORCID:0000-0002-1355-1587), Metafuni Elisabetta, Bellesi Silvia, Orlando Nicoletta, Bianchi Maria, Sica Simona (ORCID:0000-0003-2426-3465), Bacigalupo, Andrea, Teofili, Luciana, Chiusolo, Patrizia, Valentini, Giovanna, Metafuni, Elisabetta, Bellesi, Silvia, Orlando, Nicoletta, Bianchi, Maria, Sica, Simona, Bacigalupo andrea (ORCID:0000-0002-9119-567X), Teofili Lucian (ORCID:0000-0002-7214-1561), Chiusolo Patrizia (ORCID:0000-0002-1355-1587), Metafuni Elisabetta, Bellesi Silvia, Orlando Nicoletta, Bianchi Maria, and Sica Simona (ORCID:0000-0003-2426-3465)
Abstract: We analyzed data relative to cell content in 88 consecutive patients receiving HLA haploidentical bone marrow (BM) transplants with post-transplantation cyclophosphamide (PT-CY). Median age was 54.5 (range, 17-72); diagnoses were acute leukemia (n = 46), lymphoproliferative disorders (n = 24), myelofibrosis (n = 11) and myelodysplastic syndromes (n = 5). Total nucleated cell (TNC) and CD34+, CD3+, CD4+ and CD8+ cell doses were stratified as higher than first, second and third quartile and the dose effect on various clinical outcomes was assessed. Median time to engraftment was 17 days for neutrophils and 24 days for platelets. To receive a dose of TNC ≥3.2 x 106/kg or CD34+ cells ≥2.7 x 106/kg significantly shortened the time to neutrophil and platelet engraftment and reduced the blood product requirements in the 30-day period after transplantation. Overall, TNC and CD34+ cell doses had no effect on acute graft-versus-host disease (GVHD) incidence, whereas patients receiving higher CD3+ and CD8+ cell doses seemed to have less chronic GVHD. No effect on non-relapse mortality, progression-free survival and overall survival was observed at different cell dose thresholds. These data suggest that in HLA haploidentical BM transplant with PT-CY, appropriate cell doses are relevant to the engraftment. The association between low CD3+/CD8+ cells and chronic GVHD deserves further investigation.
Published: 2020

21. Unrelated cord blood transplantation and post-transplant cyclophosphamide

Author: Bacigalupo, Andrea, Sica, Simona, Laurenti, Luca, Sora’, Federica, Giammarco, Sabrina, Metafuni, Elisabetta, Innocenti, Idanna, Autore, Francesco, Teofili, Luciana, Bianchi, Maria, Chiusolo, Patrizia, Bacigalupo, Andrea (ORCID:0000-0002-9119-567X), Sica, Simona (ORCID:0000-0003-2426-3465), Laurenti, Luca (ORCID:0000-0002-8327-1396), Sora’, Federica (ORCID:0000-0002-9607-5298), Teofili, Luciana (ORCID:0000-0002-7214-1561), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Bacigalupo, Andrea, Sica, Simona, Laurenti, Luca, Sora’, Federica, Giammarco, Sabrina, Metafuni, Elisabetta, Innocenti, Idanna, Autore, Francesco, Teofili, Luciana, Bianchi, Maria, Chiusolo, Patrizia, Bacigalupo, Andrea (ORCID:0000-0002-9119-567X), Sica, Simona (ORCID:0000-0003-2426-3465), Laurenti, Luca (ORCID:0000-0002-8327-1396), Sora’, Federica (ORCID:0000-0002-9607-5298), Teofili, Luciana (ORCID:0000-0002-7214-1561), and Chiusolo, Patrizia (ORCID:0000-0002-1355-1587)
Abstract: The number of unrelated cord blood transplants (UCBT) are declining in Europe, despite comparable outcome with grafts using unrelated donor peripheral bloodor bone marrow. The reasons for the decline may be due to the well-known slow engraftment and delayed immune reconstitution of UCBT, which may result in a significant risk of infections and non-relapse mortality (NRM).Neutrophil and platelet recovery can be shortened by direct intra-bone injection of CB cells, but immune recovery remains an issue, especially when anti-thymocyte globulin (ATG) is used in the conditioning regimen In the absence of ATG, grade III-IV acute graft versus host disease (GvHD) is reported to be 21%,6 and when ATG is added in the transplant platform, GvHD is reduced (15%), but immune reconstitution is delayed,leading to infectious complications, and late viral infections.4,7,8 The crucial role of ATG and the risk of over orunder exposure is further proven by the attempt to optimize ATG dose based on lymphocyte counts, rather thanpatient’s weight, and by carefully assessing the speed of CD4 recovery according to ATG dosing pre-transplant.An additional reason for the decline in numbers of UCBT is the competition of HLA haploidentical transplants(HAPLO), especially performed with post-transplant cyclophosphamide (PT-CY), as first described by the Baltimore group. We have been particularly impressedwith the speed of immune recovery of HAPLO transplants with PT-CY,13 with median CD4 counts on day +100 (190/µl) comparable to CD4 counts after HLA identical sibling grafts (229/µl), and significantly higher as compared to unrelated and cord blood grafts receiving ATG for GvHD prophylaxis.13 We therefore hypothesized that PT-CY would be an effective GvHD prophylaxis regimen for patients undergoing an UCBT and, by preventing GvHD in the absence of ATG, hematologic and immune recovery could be accelerated, as seen in the HAPLO setting. We are nowreporting a first case.
Published: 2019

22. 'Secondary chronic myeloid leukemia': comparison between patients previously exposed or not to chemo- and/or radiotherapy

Author: Autore, Francesco, Sora', Federica, Chiusolo, Patrizia, Annunziata, Mario, Iurlo, Alessandra, Cattaneo, Daniele, Galimberti, Sara, Bajer, Jolanta Alina, Sica, Simona, Sorà, Federica (ORCID:0000-0002-9607-5298), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Sica, Simona (ORCID:0000-0003-2426-3465), Autore, Francesco, Sora', Federica, Chiusolo, Patrizia, Annunziata, Mario, Iurlo, Alessandra, Cattaneo, Daniele, Galimberti, Sara, Bajer, Jolanta Alina, Sica, Simona, Sorà, Federica (ORCID:0000-0002-9607-5298), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), and Sica, Simona (ORCID:0000-0003-2426-3465)
Abstract: no abstract
Published: 2019

23. Reduction of hospitalization and transfusion support in patients with acute promyelocytic leukemia treated with arsenic trioxide plus all-trans retinoic acid compared to chemotherapy plus all-trans retinoic acid

Author: Autore, Francesco, Chiusolo, Patrizia, Sora', Federica, Giammarco, Sabrina, Laurenti, Luca, Innocenti, Idanna, Metafuni, Elisabetta, Piccirillo, Nicola, Pagano, Livio, Bacigalupo, Andrea, Leone, Giuseppe, Sica, Simona, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Sorà, Federica (ORCID:0000-0002-9607-5298), Laurenti, Luca (ORCID:0000-0002-8327-1396), Piccirillo, Nicola (ORCID:0000-0002-1688-1987), Pagano, Livio (ORCID:0000-0001-8287-928X), Bacigalupo, Andrea (ORCID:0000-0002-9119-567X), Sica, Simona (ORCID:0000-0003-2426-3465), Autore, Francesco, Chiusolo, Patrizia, Sora', Federica, Giammarco, Sabrina, Laurenti, Luca, Innocenti, Idanna, Metafuni, Elisabetta, Piccirillo, Nicola, Pagano, Livio, Bacigalupo, Andrea, Leone, Giuseppe, Sica, Simona, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Sorà, Federica (ORCID:0000-0002-9607-5298), Laurenti, Luca (ORCID:0000-0002-8327-1396), Piccirillo, Nicola (ORCID:0000-0002-1688-1987), Pagano, Livio (ORCID:0000-0001-8287-928X), Bacigalupo, Andrea (ORCID:0000-0002-9119-567X), and Sica, Simona (ORCID:0000-0003-2426-3465)
Abstract: nd
Published: 2019

24. Role of flow-cytometric immunophenotyping in prediction of BCR/ABL1 gene rearrangement in adult B-cell acute lymphoblastic leukemia

Author: Corrente, Francesco, Bellesi, Silvia, Metafuni, Elisabetta, Puggioni, Pier Luigi, Marietti, Sara, Ciminello, Angela Maria, Za, Tommaso, Sora', Federica, Fianchi, Luana, Sica, Simona, De Stefano, Valerio, Chiusolo, Patrizia, Sorà, Federica (ORCID:0000-0002-9607-5298), Sica, Simona (ORCID:0000-0003-2426-3465), De Stefano, Valerio (ORCID:0000-0002-5178-5827), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Corrente, Francesco, Bellesi, Silvia, Metafuni, Elisabetta, Puggioni, Pier Luigi, Marietti, Sara, Ciminello, Angela Maria, Za, Tommaso, Sora', Federica, Fianchi, Luana, Sica, Simona, De Stefano, Valerio, Chiusolo, Patrizia, Sorà, Federica (ORCID:0000-0002-9607-5298), Sica, Simona (ORCID:0000-0003-2426-3465), De Stefano, Valerio (ORCID:0000-0002-5178-5827), and Chiusolo, Patrizia (ORCID:0000-0002-1355-1587)
Abstract: We performed a retrospective analysis of 88 adult patients with B-ALL diagnosed in our center by a flow-cytometric assessment. Immunophenotypic expression of leukemic cells was explored by simultaneous evaluation of positivity, percentage of expressing cells and median fluorescence intensity (MFI). BCR/ABL1 fusion transcripts were assessed by RT-PCR analysis and were identified in 36 patients (40.9%). CD10 and CD34 were positive in the totality of BCR/ABL1-positive cases. Patients with gene rearrangement had a greater frequency of CD66c, CD13 and CD33 positivity compared with BCR/ABL1-negative cases. Moreover, BCR/ABL1-positive cases exhibited a greater median percentage and MFI values of CD13, CD33, CD66c, CD10, CD34 and CD25 expressions, but a lower median percentage and MFI values of CD38 and CD22 expressions than patients without gene rearrangement. Multivariate logistic regression analysis showed that CD10, CD38 and CD13 expressions were independent predictors for the presence of BCR/ABL1 rearrangement. Predictive probabilities of molecular occurrence based on these markers are proposed. © 2017 International Clinical Cytometry Society.
Published: 2018

25. A Modified Post-Transplant Cyclophosphamide Regimen, for Unmanipulated Haploidentical Marrow Transplantation, in Acute Myeloid Leukemia: A Multicenter Study

Author: Chiusolo, Patrizia, Bug, Gesine, Olivieri, Attilio, Brune, Mat, Mordini, Nicola, Alessandrino, Paolo Emilio, Dominietto, Alida, Raiola, Anna Maria, Di Grazia, Carmen, Gualandi, Francesca, Van Lint, Maria Teresa, Ferrara, Felicetto, Finizio, Olimpia, Angelucci, Emanuele, Bacigalupo, Andrea, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Bacigalupo, Andrea (ORCID:0000-0002-9119-567X), Chiusolo, Patrizia, Bug, Gesine, Olivieri, Attilio, Brune, Mat, Mordini, Nicola, Alessandrino, Paolo Emilio, Dominietto, Alida, Raiola, Anna Maria, Di Grazia, Carmen, Gualandi, Francesca, Van Lint, Maria Teresa, Ferrara, Felicetto, Finizio, Olimpia, Angelucci, Emanuele, Bacigalupo, Andrea, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), and Bacigalupo, Andrea (ORCID:0000-0002-9119-567X)
Abstract: We report a modified post-transplant cyclophosphamide (PT-CY) regimen, for unmanipulated haploidentical marrow transplants, in 150 patients with acute myeloid leukemia (AML). All patients received a myeloablative regimen, cyclosporine A (CsA) on day 0, mycophenolate on day +1, and PT-CY 50 mg/kg on days +3 and +5. The median age was 51 (range, 17–74) years, 51 (34%) patients had active disease at transplant, and the median follow-up of surviving patients 903 (range, 150-1955) days. The cumulative incidence (CI) of engraftment, acute graft-versus-host disease (GVHD) grade II to IV, and moderate/severe chronic GVHD was 92%, 17%, and 15%, respectively. The 4-year CI of transplant-related mortality (TRM) and relapse was 20% and 24%, respectively. Four-year survival for remission patients was 72% (74% versus 67% for <60 or ≥60 years of age) and 26% for advanced patients (17% versus 41% for <60 or ≥60 years of age). In a multivariate analysis, active disease at transplant was the only negative predictor of survival, TRM and relapse. The original PT-CY regimen can be modified with CsA on day 0, still providing protection against GVHD, low toxicity, and encouraging low relapse incidence in AML patients, also over 60 years of age.
Published: 2018

26. Allogeneic hematopoietic stem cell transplantation in therapy-related myeloid neoplasms (t-MN) of the adult: Monocentric observational study and review of the literature

Author: Metafuni, Elisabetta, Chiusolo, Patrizia, Laurenti, Luca, Sora', Federica, Giammarco, Sabrina, Bacigalupo, Andrea, Leone, Giuseppe, Sica, Simona, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Laurenti, Luca (ORCID:0000-0002-8327-1396), Sorà, Federica (ORCID:0000-0002-9607-5298), Bacigalupo, Andrea (ORCID:0000-0002-9119-567X), Sica, Simona (ORCID:0000-0003-2426-3465), Metafuni, Elisabetta, Chiusolo, Patrizia, Laurenti, Luca, Sora', Federica, Giammarco, Sabrina, Bacigalupo, Andrea, Leone, Giuseppe, Sica, Simona, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Laurenti, Luca (ORCID:0000-0002-8327-1396), Sorà, Federica (ORCID:0000-0002-9607-5298), Bacigalupo, Andrea (ORCID:0000-0002-9119-567X), and Sica, Simona (ORCID:0000-0003-2426-3465)
Abstract: Background: Therapy related myeloid neoplasms (t-MN) occur due to direct mutational events of chemotherapeutic agents and radiotherapy. Disease latency, mutational events and prognosis vary with drugs categories. Methods: We describe a cohort of 30 patients, 18 females and 12 males, with median age of 52.5 years (range, 20 to 64), submitted to allogeneic stem cell transplantation (HSCT) in our department between September 1999 and March 2017. Patients had a history of solid tumour in 14 cases, haematological disease in 15 cases and both of them in one case. After a median of 36.5 months (range, 4 to 190) from first neoplasm, patients developed t-AML in 19 cases and t-MDS in 11 cases. Molecular abnormalities were detected in 5 patients, while karyotype aberrations were found in 17 patients. Patients received conventional chemotherapy in 14 cases, azacitidine in 10 cases and both of them in one case. Five patients were submitted to HSCT without previous treatment except for supportive therapy. Results: Seventeen patients obtained sustained CR after SCT, while 8 patients showed resistant or relapsed disease. The remaining five patients died early after SCT. At follow up time (May 2017) 13 patients were alive with a median OS of 48 months (range 3-195), while 17 patients died after a median of 4 months (range 1-27) by relapse mortality in 6 cases and non-relapse mortality in the other 11 patients. Conclusions: Global OS was 43%. After SCT, 72.2% of patients with t-MN maintained a sustained CR.
Published: 2018

27. Allogeneic Transplant for Mycosis Fungoides in Patient with Wiskott-Aldrich Syndrome

Author: Criscuolo, Marianna, Fianchi, Luana, Chiusolo, Patrizia, Giammarco, Sabrina, Bacigalupo, Andrea, Pagano, Livio, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Bacigalupo, Andrea (ORCID:0000-0002-9119-567X), Pagano, Livio (ORCID:0000-0001-8287-928X), Criscuolo, Marianna, Fianchi, Luana, Chiusolo, Patrizia, Giammarco, Sabrina, Bacigalupo, Andrea, Pagano, Livio, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Bacigalupo, Andrea (ORCID:0000-0002-9119-567X), and Pagano, Livio (ORCID:0000-0001-8287-928X)
Abstract: na
Published: 2018

28. Steroid treatment of acute graft-versus-host disease grade I: A randomized trial

Author: Bacigalupo, Andrea, Milone, Giuseppe, Cupri, Alessandra, Salvemini, Severino Antonio, Fagioli, Franca, Berger, Massimo, Santarone, Stella, Chiusolo, Patrizia, Sica, Simona, Mammoliti, Sonia, Sorasio, Roberto, Massi, Daniela, Van Lint, Maria Teresa, Raiola, Anna Maria, Gualandi, Francesca, Selleri, Carmine, Sormani, Maria Pia, Signori, Alessio, Risitano, Antonio, Bonifazi, Francesca, Bacigalupo, Andrea (ORCID:0000-0002-9119-567X), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Sica, Simona (ORCID:0000-0003-2426-3465), Bacigalupo, Andrea, Milone, Giuseppe, Cupri, Alessandra, Salvemini, Severino Antonio, Fagioli, Franca, Berger, Massimo, Santarone, Stella, Chiusolo, Patrizia, Sica, Simona, Mammoliti, Sonia, Sorasio, Roberto, Massi, Daniela, Van Lint, Maria Teresa, Raiola, Anna Maria, Gualandi, Francesca, Selleri, Carmine, Sormani, Maria Pia, Signori, Alessio, Risitano, Antonio, Bonifazi, Francesca, Bacigalupo, Andrea (ORCID:0000-0002-9119-567X), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), and Sica, Simona (ORCID:0000-0003-2426-3465)
Abstract: Patients with acute graft-versus-host disease (GvHD) grade I were randomized to an observation arm (n=85) or to a treatment arm (n=86) consisting of 6-methylprednisolone 1 mg/kg/day, after stratification for age and donor type. The primary end point was development of grade II-IV GvHD. The cumulative incidence of grade II-IV GvHD was 50% in the observation arm and 33% in the treatment arm (P=0.005). However, grade III-IV GvHD was comparable (13% vs. 10%, respectively; P=0.6), and this was true for sibling and alternative donor transplants. Moderate/severe chronic GvHD was also comparable (17% vs. 9%). In multivariate analysis, an early interval between transplant and randomization (
Published: 2017

29. Autologous peripheral blood stem cell transplantation and the role of lenalidomide in patients affected by poems syndrome

Author: Autore, Francesco, Innocenti, Idanna, Luigetti, Marco, Piccirillo, Nicola, Sora', Federica, Chiusolo, Patrizia, Sica, Simona, Bacigalupo, Andrea, Laurenti, Luca, Luigetti, Marco (ORCID:0000-0001-7539-505X), Piccirillo, Nicola (ORCID:0000-0002-1688-1987), Sorà, Federica (ORCID:0000-0002-9607-5298), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Sica, Simona (ORCID:0000-0003-2426-3465), Bacigalupo, Andrea (ORCID:0000-0002-9119-567X), Laurenti, Luca (ORCID:0000-0002-8327-1396), Autore, Francesco, Innocenti, Idanna, Luigetti, Marco, Piccirillo, Nicola, Sora', Federica, Chiusolo, Patrizia, Sica, Simona, Bacigalupo, Andrea, Laurenti, Luca, Luigetti, Marco (ORCID:0000-0001-7539-505X), Piccirillo, Nicola (ORCID:0000-0002-1688-1987), Sorà, Federica (ORCID:0000-0002-9607-5298), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Sica, Simona (ORCID:0000-0003-2426-3465), Bacigalupo, Andrea (ORCID:0000-0002-9119-567X), and Laurenti, Luca (ORCID:0000-0002-8327-1396)
Abstract: POEMS syndrome is a rare paraneoplastic condition, with a poorly understood pathogenesis. High dose chemotherapy followed by autologous stem cell transplantation (ASCT) has been reported to be an effective therapeutic option for patients with good performance status. Here, we review the role of ASCT for POEMS syndrome and discuss indications together with advantages and disadvantages, and related issues such lenalidomide given before or after ASCT, VEGF levels as a marker of disease, and different regimens for stem cell mobilization.
Published: 2017

30. Mononuclear cell collection for extracorporeal photopheresis: Concentrate characteristics for off-line UV-A irradiation procedure

Author: Piccirillo, Nicola, Putzulu, Rossana, Massini, Giuseppina, Fiore, Assunta Gessica, Chiusolo, Patrizia, Sica, Simona, Zini Tanzi, Gina, Piccirillo, Nicola (ORCID:0000-0002-1688-1987), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Sica, Simona (ORCID:0000-0003-2426-3465), Zini, Gina (ORCID:0000-0002-8208-066X), Piccirillo, Nicola, Putzulu, Rossana, Massini, Giuseppina, Fiore, Assunta Gessica, Chiusolo, Patrizia, Sica, Simona, Zini Tanzi, Gina, Piccirillo, Nicola (ORCID:0000-0002-1688-1987), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Sica, Simona (ORCID:0000-0003-2426-3465), and Zini, Gina (ORCID:0000-0002-8208-066X)
Abstract: Background and objective: Extracorporeal photopheresis (ECP) is the most represented cell therapy for treatment of cutaneous T-cell lymphoma, graft-versus host disease and organ rejection. We analyzed our experience in ECP using 2 cell separators (Cobe Spectra and Spectra Optia) focusing on leukapheretic product characteristics, UV-A irradiation procedure and entire ECP process. Materials and methods: We collected data of patients undergoing ECP between January 2012 and February 2015 in order to evaluate collection procedures performed using Cobe Spectra and Spectra Optia, mononuclear cell product, UV-A photoirradiation procedure by Pit System. Results: We performed 484 ECP procedures in 27 patients. Cobe-derived mononuclear cell products were characterized by higher cell yields while Optia-derived mononuclear cell products were characterized by smaller volume, comparable mononuclear cell content but lower erythrocytes, granulocytes, and platelets contamination. Conclusion: Our study confirms good results for both cell separators. Blood volume processed being equal, Cobe collects a number of total nucleated cells significantly higher than Optia. Optia, collecting only target cells without significant erythrocytes, granulocytes and platelets contamination, is able to collect a leukapheretic product particularly suitable for ECP.
Published: 2017

31. Fecal but not serum calprotectin is a potential marker of GVHD after stem cell transplantation.

Author: Metafuni, Elisabetta, Giammarco, Sabrina, De Ritis, Daniela Giovanna, Rossi, M, De Michele, T, Zuppi, Cecilia, Bacigalupo, Andrea, Sica, Simona, Chiusolo, Patrizia, Zuppi, Cecilia (ORCID:0000-0003-4710-4934), Bacigalupo, Andrea (ORCID:0000-0002-9119-567X), Sica, Simona (ORCID:0000-0003-2426-3465), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Metafuni, Elisabetta, Giammarco, Sabrina, De Ritis, Daniela Giovanna, Rossi, M, De Michele, T, Zuppi, Cecilia, Bacigalupo, Andrea, Sica, Simona, Chiusolo, Patrizia, Zuppi, Cecilia (ORCID:0000-0003-4710-4934), Bacigalupo, Andrea (ORCID:0000-0002-9119-567X), Sica, Simona (ORCID:0000-0003-2426-3465), and Chiusolo, Patrizia (ORCID:0000-0002-1355-1587)
Abstract: Gastrointestinal graft-versus-host disease (GvHD) represents a life-threatening complication after stem cell transplantation. Differential diagnosis between gut GvHD and other causes of diarrhea after HSCT is still subjected to endoscopy and histological findings. The research for a reliable biomarker for gut GvHD might allow an early diagnosis of this condition and a consequent prompt treatment that could reduce unfavorable outcomes. Recently, fecal calprotectin was reported as reliable marker of gut involvement. We would evaluate if serum instead of fecal calprotectin could be considered a possible biomarker of gut GvHD. Serum calprotectin was measured in a cohort of 54 patients submitted to allogeneic stem cell transplantation using ELISA assay. For a subset of 21 patients, calprotectin serum levels were compared with fecal calprotectin detection. Contrary to fecal calprotectin, we found only a trend to high level of serum calprotectin for GvHD development and gut involvement, but statistical difference was not reached. Fecal but not serum calprotectin could be considered as possible biomarker for gut GvHD.
Published: 2017

32. H1N1 Influenza among Hematological Patients: Monocentric Influenza Cases from 2011 to 2016

Author: Metafuni, Elisabetta, Santangelo, Rosaria, Chiusolo, Patrizia, Laurenti, Luca, Sora', Federica, Giammarco, Sabrina, Sica, Simona, Santangelo, Rosaria (ORCID:0000-0002-8056-218X), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Laurenti, Luca (ORCID:0000-0002-8327-1396), Sora', Federica (ORCID:0000-0002-9607-5298), Sica, Simona (ORCID:0000-0003-2426-3465), Metafuni, Elisabetta, Santangelo, Rosaria, Chiusolo, Patrizia, Laurenti, Luca, Sora', Federica, Giammarco, Sabrina, Sica, Simona, Santangelo, Rosaria (ORCID:0000-0002-8056-218X), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Laurenti, Luca (ORCID:0000-0002-8327-1396), Sora', Federica (ORCID:0000-0002-9607-5298), and Sica, Simona (ORCID:0000-0003-2426-3465)
Abstract: We read with interest the paper by La Torre et al.,1 which conducted two systematic reviews and a meta-analysis to summarize the results of scientific works about influenza and pneumococcal vaccines in oncohematological patients. We paid specific attention to influenza vaccine results. The protection rate of H1N1 vaccine resulted in 31% and 30% after the first dose and booster dose, respectively. Protection rate of H3N2 and influenza B first dose was 42.6% and 39.6%, respectively. Considering the response rate, the pooled prevalence for H1N1 was 30% and 35% after the first dose and booster dose, respectively. The response rate for H3N2 was 21.7% after first dose and 24% after booster dose. Finally, the response rate for influenza B was 23.6% after the first dose and 29% after booster dose. Only a minority of patients experienced adverse events, most of them were mild and did not require treatment. Even though influenza vaccine elicits a low response rate among oncohematological patients, particularly in those who received transplantation, splenectomy or rituximab, it is an inexpensive intervention with few side effects. However, the first vaccine dose induces a small response, and the booster dose induces additional antibodies.
Published: 2017

33. Hyperleukocytosis and leukostasis: management of a medical emergency

Author: Giammarco, Sabrina, Chiusolo, Patrizia, Piccirillo, Nicola, Di Giovanni, Alessia, Metafuni, Elisabetta, Laurenti, Luca, Sica, Simona, Pagano, Livio, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Piccirillo, Nicola (ORCID:0000-0002-1688-1987), Laurenti, Luca (ORCID:0000-0002-8327-1396), Sica, Simona (ORCID:0000-0003-2426-3465), Pagano, Livio (ORCID:0000-0001-8287-928X), Giammarco, Sabrina, Chiusolo, Patrizia, Piccirillo, Nicola, Di Giovanni, Alessia, Metafuni, Elisabetta, Laurenti, Luca, Sica, Simona, Pagano, Livio, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Piccirillo, Nicola (ORCID:0000-0002-1688-1987), Laurenti, Luca (ORCID:0000-0002-8327-1396), Sica, Simona (ORCID:0000-0003-2426-3465), and Pagano, Livio (ORCID:0000-0001-8287-928X)
Abstract: Introduction: Hyperleukocytosis is defined as a white blood cell count greater than 100,000/mL in patients affected by acute leukemia and often it is associated with increased morbidity and mortality, that can be up to 40% if unrecognized. Areas covered: Risk factors include younger age, myelomonocytic or monocytic/monoblastic morphology, microgranular variant of acute promyelocitic leukemia and T-cell ALL, and some cytogenetic abnormalities. Poor prognosis due to high early death rate secondary to leukostasis. The mechanisms at the origin of leukostasis are still poorly understood. The management of acute hyperleukocytosis and leukostasis involves supportive measures and reducing the number of circulating leukemic blast cells, with careful monitoring of fluid balance, control of uric acid production and control of urine pH to prevent tumour lysis syndrome. Expert commentary: Several studies have been performed to ameliorate the outcome of this setting of patients. The high number of leukocytes may cause 3 main complications: disseminated intravascular coagulation (DIC), tumor lysis syndrome (TLS), and leukostasis. Although hyperleukocytosis and tumour lysis syndrome are still a challenge for clinicians, a better prognosis for these conditions is emerging in the last years.
Published: 2017

34. Low risk of hepatitis B virus reactivation in patients with resolved infection and chronic myeloid leukemia treated with tyrosine kinase inhibitors

Author: Sora', Federica, Ponziani, Francesca Romana, Laurenti, Luca, Chiusolo, Patrizia, Autore, Francesco, Gasbarrini, Antonio, Sica, Simona, Pompili, Maurizio, Sora', Federica (ORCID:0000-0002-9607-5298), Ponziani, Francesca Romana (ORCID:0000-0002-5924-6238), Laurenti, Luca (ORCID:0000-0002-8327-1396), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Sica, Simona (ORCID:0000-0003-2426-3465), Pompili, Maurizio (ORCID:0000-0001-6699-7980), Sora', Federica, Ponziani, Francesca Romana, Laurenti, Luca, Chiusolo, Patrizia, Autore, Francesco, Gasbarrini, Antonio, Sica, Simona, Pompili, Maurizio, Sora', Federica (ORCID:0000-0002-9607-5298), Ponziani, Francesca Romana (ORCID:0000-0002-5924-6238), Laurenti, Luca (ORCID:0000-0002-8327-1396), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Sica, Simona (ORCID:0000-0003-2426-3465), and Pompili, Maurizio (ORCID:0000-0001-6699-7980)
Abstract: Low risk of hepatitis B virus reactivation in patients with resolved infection and chronic myeloid leukemia treated with tyrosine kinase i
Published: 2017

35. Cytokine profile of autologous platelet-derived eye drops in patients with ocular chronic graft-versus-host disease

Author: Valentini, Cg, Nuzzolo, Er, Orlando, N, Metafuni, Elisabetta, Bianchi, Maria, Chiusolo, Patrizia, Zini Tanzi, Gina, Teofili, Luciana, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Zini, Gina (ORCID:0000-0002-8208-066X), Teofili, Luciana (ORCID:0000-0002-7214-1561), Valentini, Cg, Nuzzolo, Er, Orlando, N, Metafuni, Elisabetta, Bianchi, Maria, Chiusolo, Patrizia, Zini Tanzi, Gina, Teofili, Luciana, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Zini, Gina (ORCID:0000-0002-8208-066X), and Teofili, Luciana (ORCID:0000-0002-7214-1561)
Abstract: Ocular chronic GVHD is efficaciously treated with autologous platelet-derived eye drops. We investigated the cytokine content of eye drops produced using a non-gelified lysate obtained from autologous platelet-rich plasma in six patients with ocular GVHD. In both the responding (n = 4) and the resistant (n = 2) patients, the eye drops were significantly enriched with various growth factors, in amounts proportional with the platelet counts. In contrast, chemokine ligand and interleukin levels were similar to those of plasma. The non-responding patients showed the highest levels of chemokine (C-X-C motif) ligand (CXCL)10. These findings provide possible explanations for beneficial or detrimental effects of eye drops.
Published: 2016

36. Cytokine profile of autologous platelet-derived eye drops in patients with ocular chronic graft-versus-host disease

Author: Valentini, Caterina Giovanna, Nuzzolo, Eugenia Rosa, Orlando, N., Metafuni, Elisabetta, Bianchi, M., Chiusolo, Patrizia, Zini Tanzi, Gina, Teofili, Luciana, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Zini, Gina (ORCID:0000-0002-8208-066X), Teofili, Luciana (ORCID:0000-0002-7214-1561), Valentini, Caterina Giovanna, Nuzzolo, Eugenia Rosa, Orlando, N., Metafuni, Elisabetta, Bianchi, M., Chiusolo, Patrizia, Zini Tanzi, Gina, Teofili, Luciana, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Zini, Gina (ORCID:0000-0002-8208-066X), and Teofili, Luciana (ORCID:0000-0002-7214-1561)
Abstract: Ocular chronic GVHD is efficaciously treated with autologous platelet-derived eye drops. We investigated the cytokine content of eye drops produced using a non-gelified lysate obtained from autologous platelet-rich plasma in six patients with ocular GVHD. In both the responding (n = 4) and the resistant (n = 2) patients, the eye drops were significantly enriched with various growth factors, in amounts proportional with the platelet counts. In contrast, chemokine ligand and interleukin levels were similar to those of plasma. The non-responding patients showed the highest levels of chemokine (C-X-C motif) ligand (CXCL)10. These findings provide possible explanations for beneficial or detrimental effects of eye drops.
Published: 2016

37. Extracorporeal Photopheresis for Treatment of Acute and Chronic Graft Versus Host Disease: An Italian Multicentric Retrospective Analysis on 94 Patients on Behalf of the Gruppo Italiano Trapianto di Midollo Osseo

Author: Malagola, Michele, Cancelli, Valeria, Skert, Cristina, Leali, Pierino Ferremi, Ferrari, Emilio, Tiburzi, Alessandra, Sala, Maria Luisa, Donnini, Irene, Chiusolo, Patrizia, Mussetti, Alberto, Battista, Marta, Turra, Alessandro, Cattina, Federica, Rambaldi, Benedetta, Schieppati, Francesca, Polverelli, Nicola, Bernardi, Simona, Perucca, Simone, Marini, Mirella, Laszlo, Daniele, Savignano, Chiara, Patriarca, Francesca, Corradini, Paolo, Piccirillo, Nicola, Sica, Simona, Bosi, Alberto, Russo, Domenico, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Piccirillo, Nicola (ORCID:0000-0002-1688-1987), Sica, Simona (ORCID:0000-0003-2426-3465), Malagola, Michele, Cancelli, Valeria, Skert, Cristina, Leali, Pierino Ferremi, Ferrari, Emilio, Tiburzi, Alessandra, Sala, Maria Luisa, Donnini, Irene, Chiusolo, Patrizia, Mussetti, Alberto, Battista, Marta, Turra, Alessandro, Cattina, Federica, Rambaldi, Benedetta, Schieppati, Francesca, Polverelli, Nicola, Bernardi, Simona, Perucca, Simone, Marini, Mirella, Laszlo, Daniele, Savignano, Chiara, Patriarca, Francesca, Corradini, Paolo, Piccirillo, Nicola, Sica, Simona, Bosi, Alberto, Russo, Domenico, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Piccirillo, Nicola (ORCID:0000-0002-1688-1987), and Sica, Simona (ORCID:0000-0003-2426-3465)
Abstract: Background Extracorporeal photopheresis (ECP) is considered a valid second-line treatment for acute and chronic graft versus host disease (GVHD). Methods Ninety-four patients with acute GVHD (aGVHD) (n = 45) and chronic GVHD (cGVHD) (n = 49), retrospectively recruited in 6 Italian centers, were submitted to ECP for second-line treatment. At the time of ECP, 22 (49%) and 23 (51%) of 45 patients with aGHVD were nonresponsive and in partial remission (PR) after steroids, respectively, and all the 49 patients with cGVHD were steroid refractory. Results Forty-one (91%) of 45 patients with aGVHD achieved complete remission (CR) after ECP. Fifteen (33%) of 45 patients developed cGVHD. The CR rate in patients who started ECP being nonresponsive and in PR after steroid was 86% and 96%, respectively. After a median follow-up of 20 months (range, 2-72), 15 (33%) of 45 patients developed cGHVD and 16 (35%) of 45 patients died, in 3 cases for aGVHD. A trend for a better survival was seen among patients who started ECP in PR after steroid (80% vs 50% at 2 years; P = 0.07). Overall, 22 (45%) of 49 patients and 17 (35%) of 49 patients with steroid refractory cGHVD achieved CR and PR after ECP, respectively. After a median follow-up of 27 months, 44 (90%) of 49 patients are alive, 21 of whom (48%) are on steroid. Conclusions Extracorporeal photopheresis is confirmed as an effective second-line treatment in both aGVHD and cGVHD, because it can induce a response in more than 80% of the patients and a long-term survival in at least 50% of the cases.
Published: 2016

38. Autoimmune hemolytic anemia during bendamustine plus rituximab treatment in CLL patients: multicenter experience

Author: Laurenti, Luca, Autore, Francesco, Innocenti, Idanna, D’Arena, Giovanni, Coscia, Marta, Mondello, Patrizia, Chiusolo, Patrizia, Bellesi, Silvia, Efremov, Dimitar G., Sica, Simona, Mauro, Francesca Romana, Laurenti, Luca (ORCID:0000-0002-8327-1396), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Sica, Simona (ORCID:0000-0003-2426-3465), Laurenti, Luca, Autore, Francesco, Innocenti, Idanna, D’Arena, Giovanni, Coscia, Marta, Mondello, Patrizia, Chiusolo, Patrizia, Bellesi, Silvia, Efremov, Dimitar G., Sica, Simona, Mauro, Francesca Romana, Laurenti, Luca (ORCID:0000-0002-8327-1396), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), and Sica, Simona (ORCID:0000-0003-2426-3465)
Abstract: Autoimmune hemolytic anemia during bendamustine plus rituximab treatment in CLL patients
Published: 2016

39. THE GUT MICROBIOTA AND IMMUNE SYSTEM RELATIONSHIP IN HUMAN GRAFT-VERSUS-HOST DISEASE

Author: Laterza, Lucrezia, Rizzatti, Gianenrico, Gaetani, Eleonora, Chiusolo, Patrizia, Gasbarrini, Antonio, Gaetani, Eleonora (ORCID:0000-0002-7808-1491), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Laterza, Lucrezia, Rizzatti, Gianenrico, Gaetani, Eleonora, Chiusolo, Patrizia, Gasbarrini, Antonio, Gaetani, Eleonora (ORCID:0000-0002-7808-1491), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
Abstract: of Gut microbiota has gained increasing interest in the pathogenesis immune-related diseases. In this context, graft-versus-host disease is a condition characterized by an immune response which frequently complicates and limits the outcomes of hematopoietic stem cell transplantations. Past studies, carried mostly in animals, already supported a relationship between gut microbiota and graft-versus-host disease. However, the possible mechanisms underlying this connection remain elusory. Moreover, strategies to prevent graft-versus-host disease are of great interest as well as the potential role of gut microbiota modulation. We reviewed the role of gut microbiota in the development of immune system and its involvement in the graft-versus-host disease, focusing on data available on humans.
Published: 2016

40. Massive Pulmonary Embolism at the Onset of Acute Promyelocytic Leukemia

Author: Sora', Federica, Chiusolo, Patrizia, Laurenti, Luca, Autore, Francesco, Giammarco, Sabrina, Sica, Simona, Sora', Federica (ORCID:0000-0002-9607-5298), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Laurenti, Luca (ORCID:0000-0002-8327-1396), Sica, Simona (ORCID:0000-0003-2426-3465), Sora', Federica, Chiusolo, Patrizia, Laurenti, Luca, Autore, Francesco, Giammarco, Sabrina, Sica, Simona, Sora', Federica (ORCID:0000-0002-9607-5298), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Laurenti, Luca (ORCID:0000-0002-8327-1396), and Sica, Simona (ORCID:0000-0003-2426-3465)
Abstract: Life-threatening bleeding is a major and early complication of acute promyelocytic leukemia (APL), but in the last years there is a growing evidence of thromboses in APL. We report the first case of a young woman with dyspnea as the first symptom of APL due to massive pulmonary embolism (PE) successfully treated with thrombolysis for PE and heparin. APL has been processed with a combination of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) obtaining complete remission
Published: 2016

41. Low risk of hepatitis B virus reactivation in patients with resolved infection and chronic myeloid leukemia treated with tyrosine kinase inhibitors

Author: Sora', Federica, Ponziani, Francesca Romana, Laurenti, Luca, Chiusolo, Patrizia, Autore, Francesco, Gasbarrini, Antonio, Sica, Simona, Pompili, Maurizio, Sora', Federica (ORCID:0000-0002-9607-5298), Ponziani, Francesca Romana (ORCID:0000-0002-5924-6238), Laurenti, Luca (ORCID:0000-0002-8327-1396), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Sica, Simona (ORCID:0000-0003-2426-3465), Pompili, Maurizio (ORCID:0000-0001-6699-7980), Sora', Federica, Ponziani, Francesca Romana, Laurenti, Luca, Chiusolo, Patrizia, Autore, Francesco, Gasbarrini, Antonio, Sica, Simona, Pompili, Maurizio, Sora', Federica (ORCID:0000-0002-9607-5298), Ponziani, Francesca Romana (ORCID:0000-0002-5924-6238), Laurenti, Luca (ORCID:0000-0002-8327-1396), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Sica, Simona (ORCID:0000-0003-2426-3465), and Pompili, Maurizio (ORCID:0000-0001-6699-7980)
Abstract: Low risk of hepatitis B virus reactivation in patients with resolved infection and chronic myeloid
Published: 2016

42. Autoimmune hemolytic anemia during bendamustine plus rituximab treatment in CLL patients: multicenter experience

Author: Laurenti, Luca, Autore, Francesco, Innocenti, Idanna, D’Arena, Giovanni, Coscia, Marta, Mondello, Patrizia, Chiusolo, Patrizia, Bellesi, Silvia, Efremov, Dimitar G., Sica, Simona, Mauro, Francesca Romana, Laurenti, Luca (ORCID:0000-0002-8327-1396), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Sica, Simona (ORCID:0000-0003-2426-3465), Laurenti, Luca, Autore, Francesco, Innocenti, Idanna, D’Arena, Giovanni, Coscia, Marta, Mondello, Patrizia, Chiusolo, Patrizia, Bellesi, Silvia, Efremov, Dimitar G., Sica, Simona, Mauro, Francesca Romana, Laurenti, Luca (ORCID:0000-0002-8327-1396), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), and Sica, Simona (ORCID:0000-0003-2426-3465)
Abstract: utoimmune hemolytic anemia during bendamustine plus rituximab treatment in CLL patients
Published: 2016

43. Massive Pulmonary Embolism at the Onset of Acute Promyelocytic Leukemia

Author: Sora', Federica, Chiusolo, Patrizia, Laurenti, Luca, Autore, Francesco, Giammarco, Sabrina, Sica, Simona, Sora', Federica (ORCID:0000-0002-9607-5298), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Laurenti, Luca (ORCID:0000-0002-8327-1396), Sica, Simona (ORCID:0000-0003-2426-3465), Sora', Federica, Chiusolo, Patrizia, Laurenti, Luca, Autore, Francesco, Giammarco, Sabrina, Sica, Simona, Sora', Federica (ORCID:0000-0002-9607-5298), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Laurenti, Luca (ORCID:0000-0002-8327-1396), and Sica, Simona (ORCID:0000-0003-2426-3465)
Abstract: Life-threatening bleeding is a major and early complication of acute promyelocytic leukemia (APL), but in the last years there is a growing evidence of thromboses in APL. We report the first case of a young woman with dyspnea as the first symptom of APL due to massive pulmonary embolism (PE) successfully treated with thrombolysis for PE and heparin. APL has been processed with a combination of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) obtaining complete remission.
Published: 2016

44. Extracorporeal Photopheresis for Treatment of Acute and Chronic Graft Versus Host Disease: An Italian Multicentric Retrospective Analysis on 94 Patients on Behalf of the Gruppo Italiano Trapianto di Midollo Osseo

Author: Malagola, Michele, Cancelli, Valeria, Skert, Cristina, Leali, Pierino Ferremi, Ferrari, Emilio, Tiburzi, Alessandra, Sala, Maria Luisa, Donnini, Irene, Chiusolo, Patrizia, Mussetti, Alberto, Battista, Marta, Turra, Alessandro, Cattina, Federica, Rambaldi, Benedetta, Schieppati, Francesca, Polverelli, Nicola, Bernardi, Simona, Perucca, Simone, Marini, Mirella, Laszlo, Daniele, Savignano, Chiara, Patriarca, Francesca, Corradini, Paolo, Piccirillo, Nicola, Sica, Simona, Bosi, Alberto, Russo, Domenico, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Piccirillo, Nicola (ORCID:0000-0002-1688-1987), Sica, Simona (ORCID:0000-0003-2426-3465), Malagola, Michele, Cancelli, Valeria, Skert, Cristina, Leali, Pierino Ferremi, Ferrari, Emilio, Tiburzi, Alessandra, Sala, Maria Luisa, Donnini, Irene, Chiusolo, Patrizia, Mussetti, Alberto, Battista, Marta, Turra, Alessandro, Cattina, Federica, Rambaldi, Benedetta, Schieppati, Francesca, Polverelli, Nicola, Bernardi, Simona, Perucca, Simone, Marini, Mirella, Laszlo, Daniele, Savignano, Chiara, Patriarca, Francesca, Corradini, Paolo, Piccirillo, Nicola, Sica, Simona, Bosi, Alberto, Russo, Domenico, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Piccirillo, Nicola (ORCID:0000-0002-1688-1987), and Sica, Simona (ORCID:0000-0003-2426-3465)
Abstract: Background Extracorporeal photopheresis (ECP) is considered a valid second-line treatment for acute and chronic graft versus host disease (GVHD). Methods Ninety-four patients with acute GVHD (aGVHD) (n = 45) and chronic GVHD (cGVHD) (n = 49), retrospectively recruited in 6 Italian centers, were submitted to ECP for second-line treatment. At the time of ECP, 22 (49%) and 23 (51%) of 45 patients with aGHVD were nonresponsive and in partial remission (PR) after steroids, respectively, and all the 49 patients with cGVHD were steroid refractory. Results Forty-one (91%) of 45 patients with aGVHD achieved complete remission (CR) after ECP. Fifteen (33%) of 45 patients developed cGVHD. The CR rate in patients who started ECP being nonresponsive and in PR after steroid was 86% and 96%, respectively. After a median follow-up of 20 months (range, 2-72), 15 (33%) of 45 patients developed cGHVD and 16 (35%) of 45 patients died, in 3 cases for aGVHD. A trend for a better survival was seen among patients who started ECP in PR after steroid (80% vs 50% at 2 years; P = 0.07). Overall, 22 (45%) of 49 patients and 17 (35%) of 49 patients with steroid refractory cGHVD achieved CR and PR after ECP, respectively. After a median follow-up of 27 months, 44 (90%) of 49 patients are alive, 21 of whom (48%) are on steroid. Conclusions Extracorporeal photopheresis is confirmed as an effective second-line treatment in both aGVHD and cGVHD, because it can induce a response in more than 80% of the patients and a long-term survival in at least 50% of the cases.
Published: 2016

45. Extracorporeal Photopheresis for Treatment of Acute and Chronic Graft Versus Host Disease: An Italian Multicentric Retrospective Analysis on 94 Patients on Behalf of the Gruppo Italiano Trapianto di Midollo Osseo

Author: Malagola, Michele, Cancelli, Valeria, Skert, Cristina, Leali, Pierino Ferremi, Ferrari, Emilio, Tiburzi, Alessandra, Sala, Maria Luisa, Donnini, Irene, Chiusolo, Patrizia, Mussetti, Alberto, Battista, Marta, Turra, Alessandro, Cattina, Federica, Rambaldi, Benedetta, Schieppati, Francesca, Polverelli, Nicola, Bernardi, Simona, Perucca, Simone, Marini, Mirella, Laszlo, Daniele, Savignano, Chiara, Patriarca, Francesca, Corradini, Paolo, Piccirillo, Nicola, Sica, Simona, Bosi, Alberto, Russo, Domenico, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Piccirillo, Nicola (ORCID:0000-0002-1688-1987), Sica, Simona (ORCID:0000-0003-2426-3465), Malagola, Michele, Cancelli, Valeria, Skert, Cristina, Leali, Pierino Ferremi, Ferrari, Emilio, Tiburzi, Alessandra, Sala, Maria Luisa, Donnini, Irene, Chiusolo, Patrizia, Mussetti, Alberto, Battista, Marta, Turra, Alessandro, Cattina, Federica, Rambaldi, Benedetta, Schieppati, Francesca, Polverelli, Nicola, Bernardi, Simona, Perucca, Simone, Marini, Mirella, Laszlo, Daniele, Savignano, Chiara, Patriarca, Francesca, Corradini, Paolo, Piccirillo, Nicola, Sica, Simona, Bosi, Alberto, Russo, Domenico, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Piccirillo, Nicola (ORCID:0000-0002-1688-1987), and Sica, Simona (ORCID:0000-0003-2426-3465)
Abstract: Background Extracorporeal photopheresis (ECP) is considered a valid second-line treatment for acute and chronic graft versus host disease (GVHD). Methods Ninety-four patients with acute GVHD (aGVHD) (n = 45) and chronic GVHD (cGVHD) (n = 49), retrospectively recruited in 6 Italian centers, were submitted to ECP for second-line treatment. At the time of ECP, 22 (49%) and 23 (51%) of 45 patients with aGHVD were nonresponsive and in partial remission (PR) after steroids, respectively, and all the 49 patients with cGVHD were steroid refractory. Results Forty-one (91%) of 45 patients with aGVHD achieved complete remission (CR) after ECP. Fifteen (33%) of 45 patients developed cGVHD. The CR rate in patients who started ECP being nonresponsive and in PR after steroid was 86% and 96%, respectively. After a median follow-up of 20 months (range, 2-72), 15 (33%) of 45 patients developed cGHVD and 16 (35%) of 45 patients died, in 3 cases for aGVHD. A trend for a better survival was seen among patients who started ECP in PR after steroid (80% vs 50% at 2 years; P = 0.07). Overall, 22 (45%) of 49 patients and 17 (35%) of 49 patients with steroid refractory cGHVD achieved CR and PR after ECP, respectively. After a median follow-up of 27 months, 44 (90%) of 49 patients are alive, 21 of whom (48%) are on steroid. Conclusions Extracorporeal photopheresis is confirmed as an effective second-line treatment in both aGVHD and cGVHD, because it can induce a response in more than 80% of the patients and a long-term survival in at least 50% of the cases.
Published: 2016

46. Extracorporeal Photopheresis for Treatment of Acute and Chronic Graft Versus Host Disease: An Italian Multicentric Retrospective Analysis on 94 Patients on Behalf of the Gruppo Italiano Trapianto di Midollo Osseo

Author: Malagola, Michele, Cancelli, Valeria, Skert, Cristina, Leali, Pierino Ferremi, Ferrari, Emilio, Tiburzi, Alessandra, Sala, Maria Luisa, Donnini, Irene, Chiusolo, Patrizia, Mussetti, Alberto, Battista, Marta, Turra, Alessandro, Cattina, Federica, Rambaldi, Benedetta, Schieppati, Francesca, Polverelli, Nicola, Bernardi, Simona, Perucca, Simone, Marini, Mirella, Laszlo, Daniele, Savignano, Chiara, Patriarca, Francesca, Corradini, Paolo, Piccirillo, Nicola, Sica, Simona, Bosi, Alberto, Russo, Domenico, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Piccirillo, Nicola (ORCID:0000-0002-1688-1987), Sica, Simona (ORCID:0000-0003-2426-3465), Malagola, Michele, Cancelli, Valeria, Skert, Cristina, Leali, Pierino Ferremi, Ferrari, Emilio, Tiburzi, Alessandra, Sala, Maria Luisa, Donnini, Irene, Chiusolo, Patrizia, Mussetti, Alberto, Battista, Marta, Turra, Alessandro, Cattina, Federica, Rambaldi, Benedetta, Schieppati, Francesca, Polverelli, Nicola, Bernardi, Simona, Perucca, Simone, Marini, Mirella, Laszlo, Daniele, Savignano, Chiara, Patriarca, Francesca, Corradini, Paolo, Piccirillo, Nicola, Sica, Simona, Bosi, Alberto, Russo, Domenico, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Piccirillo, Nicola (ORCID:0000-0002-1688-1987), and Sica, Simona (ORCID:0000-0003-2426-3465)
Abstract: Background Extracorporeal photopheresis (ECP) is considered a valid second-line treatment for acute and chronic graft versus host disease (GVHD). Methods Ninety-four patients with acute GVHD (aGVHD) (n = 45) and chronic GVHD (cGVHD) (n = 49), retrospectively recruited in 6 Italian centers, were submitted to ECP for second-line treatment. At the time of ECP, 22 (49%) and 23 (51%) of 45 patients with aGHVD were nonresponsive and in partial remission (PR) after steroids, respectively, and all the 49 patients with cGVHD were steroid refractory. Results Forty-one (91%) of 45 patients with aGVHD achieved complete remission (CR) after ECP. Fifteen (33%) of 45 patients developed cGVHD. The CR rate in patients who started ECP being nonresponsive and in PR after steroid was 86% and 96%, respectively. After a median follow-up of 20 months (range, 2-72), 15 (33%) of 45 patients developed cGHVD and 16 (35%) of 45 patients died, in 3 cases for aGVHD. A trend for a better survival was seen among patients who started ECP in PR after steroid (80% vs 50% at 2 years; P = 0.07). Overall, 22 (45%) of 49 patients and 17 (35%) of 49 patients with steroid refractory cGHVD achieved CR and PR after ECP, respectively. After a median follow-up of 27 months, 44 (90%) of 49 patients are alive, 21 of whom (48%) are on steroid. Conclusions Extracorporeal photopheresis is confirmed as an effective second-line treatment in both aGVHD and cGVHD, because it can induce a response in more than 80% of the patients and a long-term survival in at least 50% of the cases.
Published: 2016

47. Massive Pulmonary Embolism at the Onset of Acute Promyelocytic Leukemia

Author: Sora', Federica, Chiusolo, Patrizia, Laurenti, Luca, Autore, Francesco, Giammarco, Sabrina, Sica, Simona, Sora', Federica (ORCID:0000-0002-9607-5298), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Laurenti, Luca (ORCID:0000-0002-8327-1396), Sica, Simona (ORCID:0000-0003-2426-3465), Sora', Federica, Chiusolo, Patrizia, Laurenti, Luca, Autore, Francesco, Giammarco, Sabrina, Sica, Simona, Sora', Federica (ORCID:0000-0002-9607-5298), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Laurenti, Luca (ORCID:0000-0002-8327-1396), and Sica, Simona (ORCID:0000-0003-2426-3465)
Abstract: Massive Pulmonary Embolism at the Onset of Acute Promyelocytic Leukemi
Published: 2016

48. Low risk of hepatitis B virus reactivation in patients with resolved infection and chronic myeloid leukemia treated with tyrosine kinase inhibitors

Author: Sora', Federica, Ponziani, Francesca Romana, Laurenti, Luca, Chiusolo, Patrizia, Autore, Francesco, Gasbarrini, Antonio, Sica, Simona, Pompili, Maurizio, Sora', Federica (ORCID:0000-0002-9607-5298), Ponziani, Francesca Romana (ORCID:0000-0002-5924-6238), Laurenti, Luca (ORCID:0000-0002-8327-1396), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Sica, Simona (ORCID:0000-0003-2426-3465), Pompili, Maurizio (ORCID:0000-0001-6699-7980), Sora', Federica, Ponziani, Francesca Romana, Laurenti, Luca, Chiusolo, Patrizia, Autore, Francesco, Gasbarrini, Antonio, Sica, Simona, Pompili, Maurizio, Sora', Federica (ORCID:0000-0002-9607-5298), Ponziani, Francesca Romana (ORCID:0000-0002-5924-6238), Laurenti, Luca (ORCID:0000-0002-8327-1396), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Sica, Simona (ORCID:0000-0003-2426-3465), and Pompili, Maurizio (ORCID:0000-0001-6699-7980)
Abstract: Low risk of hepatitis B virus reactivation in patients with resolved infection and chronic
Published: 2016

49. Low risk of hepatitis B virus reactivation in patients with resolved infection and chronic myeloid leukemia treated with tyrosine kinase inhibitors

Author: Sora', Federica, Ponziani, Francesca Romana, Laurenti, Luca, Chiusolo, Patrizia, Autore, Francesco, Gasbarrini, Antonio, Sica, Simona, Pompili, Maurizio, Sora', Federica (ORCID:0000-0002-9607-5298), Ponziani, Francesca Romana (ORCID:0000-0002-5924-6238), Laurenti, Luca (ORCID:0000-0002-8327-1396), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Sica, Simona (ORCID:0000-0003-2426-3465), Pompili, Maurizio (ORCID:0000-0001-6699-7980), Sora', Federica, Ponziani, Francesca Romana, Laurenti, Luca, Chiusolo, Patrizia, Autore, Francesco, Gasbarrini, Antonio, Sica, Simona, Pompili, Maurizio, Sora', Federica (ORCID:0000-0002-9607-5298), Ponziani, Francesca Romana (ORCID:0000-0002-5924-6238), Laurenti, Luca (ORCID:0000-0002-8327-1396), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Sica, Simona (ORCID:0000-0003-2426-3465), and Pompili, Maurizio (ORCID:0000-0001-6699-7980)
Abstract: Low risk of hepatitis B virus reactivation in patients with resolved infection and chronic myeloid leukemia treated with tyrosine kinase inhibitors.
Published: 2016

50. Hyperleukocytosis and leukostasis: management of a medical emergency

Author: Giammarco, Sabrina, Chiusolo, Patrizia, Piccirillo, Nicola, Di Giovanni, Alessia, Metafuni, Elisabetta, Laurenti, Luca, Sica, Simona, Pagano, Livio, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Piccirillo, Nicola (ORCID:0000-0002-1688-1987), Laurenti, Luca (ORCID:0000-0002-8327-1396), Sica, Simona (ORCID:0000-0003-2426-3465), Pagano, Livio (ORCID:0000-0001-8287-928X), Giammarco, Sabrina, Chiusolo, Patrizia, Piccirillo, Nicola, Di Giovanni, Alessia, Metafuni, Elisabetta, Laurenti, Luca, Sica, Simona, Pagano, Livio, Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Piccirillo, Nicola (ORCID:0000-0002-1688-1987), Laurenti, Luca (ORCID:0000-0002-8327-1396), Sica, Simona (ORCID:0000-0003-2426-3465), and Pagano, Livio (ORCID:0000-0001-8287-928X)
Abstract: Hyperleukocytosis is defined as a white blood cell count greater than 100,000/mL in patients affected by acute leukemia and often it is associated with increased morbidity and mortality, that can be up to 40% if unrecognized. Areas covered: Risk factors include younger age, myelomonocytic or monocytic/monoblastic morphology, microgranular variant of acute promyelocitic leukemia and T-cell ALL, and some cytogenetic abnormalities. Poor prognosis due to high early death rate secondary to leukostasis. The mechanisms at the origin of leukostasis are still poorly understood. The management of acute hyperleukocytosis and leukostasis involves supportive measures and reducing the number of circulating leukemic blast cells, with careful monitoring of fluid balance, control of uric acid production and control of urine pH to prevent tumour lysis syndrome. Expert commentary: Several studies have been performed to ameliorate the outcome of this setting of patients. The high number of leukocytes may cause 3 main complications: disseminated intravascular coagulation (DIC), tumor lysis syndrome (TLS), and leukostasis. Although hyperleukocytosis and tumour lysis syndrome are still a challenge for clinicians, a better prognosis for these conditions is emerging in the last years.
Published: 2016

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