194 results on '"Vittorio Stefoni"'
Search Results
2. S221: LONG-TERM RESULTS OF THE FIL MCL0208 TRIAL COMPARING LENALIDOMIDE MAINTENANCE (LEN) VS OBSERVATION (OBS) AFTER AUTOLOGOUS STEM CELL TRANSPLANTATION (ASCT) IN MANTLE CELL LYMPHOMA (MCL)
- Author
-
Marco Ladetto, Rita Tavarozzi, Andrea Evangelista, Elisa Genuardi, Daniela Drandi, Michael Mian, Manuela Zanni, Federica Cavallo, Alice DI Rocco, Vittorio Stefoni, Chiara Pagani, Alessandro Re, Annalisa Chiappella, Monica Balzarotti, Vittorio Ruggero Zilioli, Maria Gomes Da Silva, Luca Arcaini, Annalia Molinari, Filippo Ballerini, Andrés José María Ferreri, Fabio Benedetti, Piero Maria Stefani, Benedetta Puccini, Caterina Stelitano, Elisa Bossi, Mario Luppi, Giovannino Ciccone, Umberto Vitolo, Maurizio Martelli, Simone Ferrero, and Sergio Cortelazzo
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Published
- 2023
- Full Text
- View/download PDF
3. Neutralizing antibodies to Omicron after the fourth SARS-CoV-2 mRNA vaccine dose in immunocompromised patients highlight the need of additional boosters
- Author
-
Maria Rescigno, Chiara Agrati, Carlo Salvarani, Diana Giannarelli, Massimo Costantini, Alberto Mantovani, Raffaella Massafra, Pier Luigi Zinzani, Aldo Morrone, Stefania Notari, Giulia Matusali, Giuseppe Lauria Pinter, Antonio Uccelli, Gennaro Ciliberto, Fausto Baldanti, Franco Locatelli, Nicola Silvestris, Valentina Sinno, Elena Turola, Maria Teresa Lupo-Stanghellini, Giovanni Apolone, the VAX4FRAIL study Group, Fabio Ciceri, Massimo Tommasino, Giuseppe Lauri Pinter, Paolo Corradini, Daniela Fenoglio, Roberta Mortarini, Laura Conti, Chiara Mandoj, Michela Lizier, Stefania Croci, Vito Garrisi, Fulvio Baggi, Tiziana Lazzarotto, Francesca Bonifazi, Concetta Quintarelli, Rita Carsetti, Enrico Girardi, Aurora Bettini, Veronica Bordoni, Concetta Castilletti, Eleonora Cimini, Rita Casetti, Francesca Colavita, Flavia Cristofanelli, Massimo Francalancia, Simona Gili, Delia Goletti, Giulia Gramigna, Germana Grassi, Daniele Lapa, Sara Leone, Davide Mariotti, Silvia Meschi, Enzo Puro, Marika Rubino, Alessandra Sacchi, Eleonora Tartaglia, Silvia Damian, Vincenzo Marasco, Filippo de Braud, Maria Teresa Lupo Stanghellini, Lorenzo Dagna, Francesca Ogliari, Massimo Filippi, Alessandro Bruno, Gloria Catalano, Rosamaria Nitti, Andrea Mengarelli, Francesco Marchesi, Giancarlo Paoletti e Gabriele Minuti, Elena Papa, Elena Azzolini, Luca Germagnoli, Carlo Selmi, Maria De Santis, Carmelo Carlo-Stella, Alexia Bertuzzi, Francesca Motta, Angela Ceribelli, Chiara Miggiano, Giulia Fornasa, Sara Monti, Carlo Maurizio Montecucco, Dario Graceffa, Maria Grazia Catanoso, Monica Guberti, Carmine Pinto, Francesco Merli, Franco Valzania, Rosa Divella, Antonio Tufaro, Sabina Delcuratolo, Mariana Miano, Carlo Antozzi, Silvia Bonanno Rita Frangiamore, Lorenzo Maggi, Paolo Pronzato, Matilde Inglese, Carlo Genova, Caterina Lapucci, Alice Laroni, Ilaria Poiré, Marco Fusconi, Vittorio Stefoni, Maria Abbondanza Pantaleo, Serena Di Cosimo, Iolanda Pulice, Roberta Mennitto Fondazione, Stefania Trinca, Giulia Piaggio, Chiara Pozzi, Irene Cassaniti, Alessandro Barberini, Rinaldi Elena, Federica Bortone, Maria Giovanna Dal Bello, and Silvia Corazza
- Subjects
SARS-CoV-2 mRNA vaccine ,humoral response ,T cell response ,immunocompromised patients ,Omicron neutralization ,cross immunity ,Immunologic diseases. Allergy ,RC581-607 - Abstract
IntroductionImmunocompromised patients have been shown to have an impaired immune response to COVID-19 vaccines.MethodsHere we compared the B-cell, T-cell and neutralizing antibody response to WT and Omicron BA.2 SARS-CoV-2 virus after the fourth dose of mRNA COVID-19 vaccines in patients with hematological malignancies (HM, n=71), solid tumors (ST, n=39) and immune-rheumatological (IR, n=25) diseases. The humoral and T-cell responses to SARS-CoV-2 vaccination were analyzed by quantifying the anti-RBD antibodies, their neutralization activity and the IFN-γ released after spike specific stimulation.ResultsWe show that the T-cell response is similarly boosted by the fourth dose across the different subgroups, while the antibody response is improved only in patients not receiving B-cell targeted therapies, independent on the pathology. However, 9% of patients with anti-RBD antibodies did not have neutralizing antibodies to either virus variants, while an additional 5.7% did not have neutralizing antibodies to Omicron BA.2, making these patients particularly vulnerable to SARS-CoV-2 infection. The increment of neutralizing antibodies was very similar towards Omicron BA.2 and WT virus after the third or fourth dose of vaccine, suggesting that there is no preferential skewing towards either virus variant with the booster dose. The only limited step is the amount of antibodies that are elicited after vaccination, thus increasing the probability of developing neutralizing antibodies to both variants of virus.DiscussionThese data support the recommendation of additional booster doses in frail patients to enhance the development of a B-cell response directed against Omicron and/or to enhance the T-cell response in patients treated with anti-CD20.
- Published
- 2023
- Full Text
- View/download PDF
4. Real-world Outcomes of Relapsed/Refractory Diffuse Large B-cell Lymphoma Treated With Polatuzumab Vedotin-based Therapy
- Author
-
Lisa Argnani, Alessandro Broccoli, Cinzia Pellegrini, Alberto Fabbri, Benedetta Puccini, Riccardo Bruna, Maria Chiara Tisi, Francesco Masia, Leonardo Flenghi, Maria Elena Nizzoli, Maurizio Musso, Marilena Salerno, Potito Rosario Scalzulli, Daniela Dessi’, Isacco Ferrarini, Elsa Pennese, Elisa Lucchini, Francesca Gaia Rossi, Carla Minoia, Filippo Gherlinzoni, Pellegrino Musto, Caterina Patti, Vittorio Stefoni, and Pier Luigi Zinzani
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
After FDA and EMA approval of the regimen containing polatuzumab vedotin plus rituximab and bendamustine (PolaBR), eligible relapsed/refractory diffuse large B-cell lymphoma (DLBCL) patients in Italy were granted early access through a Named Patient Program. A multicentric observational retrospective study was conducted focusing on the effectiveness and safety of PolaBR in everyday clinical practice. Fifty-five patients were enrolled. There were 26 females (47.3%), 32 patients were primary refractory and 45 (81.8%) resulted refractory to their last therapy. The decision to add or not bendamustine was at physician’s discretion. Thirty-six patients underwent PolaBR, and 19 PolaR. The 2 groups did not differ in most of baseline characteristics. The final overall response rate was 32.7% (18.2% complete response rate), with a best response rate of 49.1%. Median disease-free survival was reached at 12 months, median progression-free survival at 4.9 months and median overall survival at 9 months, respectively. Overall, 88 adverse events (AEs) were registered during treatment in 31 patients, 22 of grade ≥3. Eight cases of neuropathy occurred, all of grades 1–2 and all related to polatuzumab. The two groups of treatment did not differ for effectiveness endpoints but presented statistically significant difference in AEs occurrence, especially in hematological AEs, in AEs of grade equal or greater than 3 and in incidence of neuropathy. Our data add useful information on the effectiveness of Pola(B)R in the setting of heavily pretreated DLBCL and may also suggest a better tolerability in absence of bendamustine without compromise of efficacy.
- Published
- 2022
- Full Text
- View/download PDF
5. Effectiveness of chemotherapy after anti‐PD‐1 blockade failure for relapsed and refractory Hodgkin lymphoma
- Author
-
Beatrice Casadei, Lisa Argnani, Alice Morigi, Ginevra Lolli, Alessandro Broccoli, Cinzia Pellegrini, Laura Nanni, Vittorio Stefoni, Paolo E. Coppola, Matteo Carella, Michele Cavo, and Pier Luigi Zinzani
- Subjects
checkpoint inhibitors ,chemotherapy ,Hodgkin lymphoma ,immunotherapy ,PD‐1 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Programmed death‐1 (PD1) blockade is an efficient and safe therapeutic option in patients with relapsed/refractory (R/R) classical Hodgkin lymphoma (cHL). However, a substantial proportion of patients’ progresses or loses the response to anti‐PD1 treatment. We retrospectively investigated the effectiveness of salvage chemotherapies (CHT) for unsatisfactory response to anti‐PD1, in 25 R/R cHL patients. Twenty‐three patients (92%) were refractory to the last treatment before anti‐PD1. After a median of 14 cycles (range 3‐52), 68% (17/25) of patients had unsatisfactory responses to anti‐PD1 therapy, whereas 6 had a partial response (PR) and 2 patients achieved complete response (CR), with an overall response rate (ORR) of 32%. After a median time of 1.5 months, 15 patients received a single agent treatment and 10 had a multi‐agents regimen, due to the failure of PD1 blockade. The ORR was 60% (8 CR and 7 PR). Seven patients (3 in PR and 4 in CR) underwent a consolidation strategy with stem cell transplantation. Median progression‐free survival (PFS) with salvage treatment was reached at 19.1 months, while median PFS after anti‐PD1 has been reached at 8.2 months. After a median follow‐up of 32.4 months, 6 patients died while 13 are still in CR. The median overall estimated from the start of CHT was not reached. The efficacy of treatment following anti‐PD1 is not yet established, especially in lymphoma patients. To note, in our series, a subset of heavily pre‐treated and chemo‐refractory patients increased response rates to and survival with CHT given after exposure to immune‐checkpoint inhibitors.
- Published
- 2020
- Full Text
- View/download PDF
6. Corrigendum: Case Report: Hodgkin Lymphoma and Refractory Systemic Lupus Erythematosus Unveil Activated Phosphoinositide 3-Kinase-δ Syndrome 2 in an Adult Patient
- Author
-
Francesca Conti, Arianna Catelli, Cristina Cifaldi, Lucia Leonardi, Rita Mulè, Marco Fusconi, Vittorio Stefoni, Maria Chiriaco, Beatrice Rivalta, Silvia Di Cesare, Gioacchino Schifino, Fabiana Sbrega, Gigliola Di Matteo, Simona Ferrari, Caterina Cancrini, and Andrea Pession
- Subjects
lymphoma ,refractory SLE ,immunodeficiency ,PIK3R1 ,PI3K signaling ,APDS2 ,Pediatrics ,RJ1-570 - Published
- 2021
- Full Text
- View/download PDF
7. Case Report: Hodgkin Lymphoma and Refractory Systemic Lupus Erythematosus Unveil Activated Phosphoinositide 3-Kinase-δ Syndrome 2 in an Adult Patient
- Author
-
Francesca Conti, Arianna Catelli, Cristina Cifaldi, Lucia Leonardi, Rita Mulè, Marco Fusconi, Vittorio Stefoni, Maria Chiriaco, Beatrice Rivalta, Silvia Di Cesare, Gioacchino Schifino, Fabiana Sbrega, Gigliola Di Matteo, Simona Ferrari, Caterina Cancrini, and Andrea Pession
- Subjects
lymphoma ,refractory SLE ,immunodeficiency ,PIK3R1 ,PI3K signaling ,APDS2 ,Pediatrics ,RJ1-570 - Abstract
Introduction: Activated phosphoinositide 3-kinase-δ syndrome 2 (APDS2) is a rare primary immune regulatory disorder caused by heterozygous gain of function mutation in the PIK3R1 gene encoding PI3Kδ regulatory p85α subunit and resulting in PI3Kδ hyperactivation. Clinical features range from recurrent infections to manifestations of immune dysregulation like autoimmunity, inflammation, systemic lymphoproliferation, and increased risk of cancer. We describe a new dominant PIK3R1 mutation causing APDS2 presenting with lymphoma and systemic refractory autoimmunity.Case Presentation: A 30-year-old woman was referred to the Immunology Unit of our hospital for uncontrolled systemic lupus erythematosus, including chilblains lesions, systemic lymphoproliferation and IgA deficiency. At 19 years of age, she was diagnosed with Hodgkin's lymphoma. Subsequently, she presented systemic lupus erythematosus onset, with episodes of severe exacerbation, including autoimmune hemolytic anemia and pleuro-pericarditis. Initial clinical response to conventional treatments was reported. Immunological investigations performed during our first observation showed severe lymphopenia, IgA deficiency, elevated IgM with reduced IgG2 levels, and low vaccination antibody titers. Quantitative real-time polymerase chain reaction (PCR) assay for Cytomegalovirus and Epstein-Barr virus showed low viral loads for both viruses in serum. An increase of serum inflammatory markers highlighted persistent systemic hyperinflammation. The next-generation sequencing (NGS)-based gene panel tests for primary immunodeficiency showed a heterozygous A>G substitution in the splice acceptor site at c.1300-2 position of PIK3R1, leading to exon-skipping.Conclusion: This case emphasizes the importance of suspecting primary immune regulatory disorders in young adults, predominantly showing a severe, aggressive, and refractory to treatment immune dysregulation phenotype, even in the absence of major infectious diseases at the onset. Different treatments can be promptly started, and a delayed diagnosis can highly impact the outcome. Targeted therapy against PI3Kδ pathway defect effectively improves drug-resistant autoimmunity, lymphoproliferation, and risk of progression to malignancy; eligible patients could benefit from its use even as a bridge therapy to transplantation, currently the only definitive curative treatment. Therefore, identifying genetic mutation and prompt targeted treatment are essential to control disease manifestations, prevent long-term sequelae, and enable curative HSCT in APDS2 patients.
- Published
- 2021
- Full Text
- View/download PDF
8. Treatment with Idelalisib in Patients with Relapsed or Refractory Follicular Lymphoma: The Observational Italian Multicenter FolIdela Study
- Author
-
Beatrice Casadei, Lisa Argnani, Alessandro Broccoli, Caterina Patti, Piero Maria Stefani, Antonio Cuneo, Gloria Margiotta Casaluci, Carlo Visco, Guido Gini, Fabrizio Pane, Francesco D’Alò, Debora Luzi, Maria Cantonetti, Samantha Pozzi, Gerardo Musuraca, Chiara Rosignoli, Annalisa Arcari, Sofya Kovalchuk, Monica Tani, Maria Chiara Tisi, Mario Petrini, Vittorio Stefoni, and Pier Luigi Zinzani
- Subjects
follicular lymphoma ,relapsed ,refractory ,idelalisib ,phosphatidylinositol 3-kinase inhibitor ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Follicular lymphoma (FL) is an indolent hematological disease, often responsive to the first line of treatment, but characterized by repeated relapses. The therapeutic algorithm for relapsed/refractory FL patients comprises phosphatidylinositol 3-kinase inhibitors. Idelalisib showed anticancer activity, while inducing a significant rate of toxicities. Since the evidence in the literature on its use in normal clinical practice is scarce, a retrospective multicenter study was conducted to evaluate effectiveness and tolerability in a real-life context. Seventy-two patients with a median age at diagnosis of 57.2 years—mostly with an advanced stage (88.9%) and relapsed to the most recent therapy (79.1%)—were enrolled. The median number of prior therapies was three (20.8% refractory to the last therapy before idelalisib). With a median number of 4 months of treatment, the overall response rate was 41.7% (20.8% complete responses). Median disease-free survival and overall survival were achieved at 8.4 months and at 4 years, respectively. Forty-four percent of patients experienced at least one drug-related toxicity: 6.9% hematological ones and 43% non-hematological. The study confirmed that idelalisib has anticancer effectiveness and an acceptable safety profile in relapsed/refractory FL with unfavorable prognostic characteristics, even in the context of normal clinical practice.
- Published
- 2022
- Full Text
- View/download PDF
9. KMT2D mutations and TP53 disruptions are poor prognostic biomarkers in mantle cell lymphoma receiving high-dose therapy: a FIL study
- Author
-
Simone Ferrero, Davide Rossi, Andrea Rinaldi, Alessio Bruscaggin, Valeria Spina, Christian W. Eskelund, Andrea Evangelista, Riccardo Moia, Ivo Kwee, Christina Dahl, Alice Di Rocco, Vittorio Stefoni, Fary Diop, Chiara Favini, Paola Ghione, Abdurraouf Mokhtar Mahmoud, Mattia Schipani, Arne Kolstad, Daniela Barbero, Domenico Novero, Marco Paulli, Alberto Zamò, Mats Jerkeman, Maria Gomes da Silva, Armando Santoro, Annalia Molinari, Andres Ferreri, Kirsten Grønbæk, Andrea Piccin, Sergio Cortelazzo, Francesco Bertoni, Marco Ladetto, and Gianluca Gaidano
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
In recent years, the outcome of mantle cell lymphoma (MCL) has improved, especially in younger patients, receiving cytarabine-containing chemoimmunotherapy and autologous stem cell transplantation. Nevertheless, a proportion of MCL patients still experience early failure. To identify biomarkers anticipating failure of intensive chemotherapy in MCL, we performed target resequencing and DNA profiling of purified tumor samples collected from patients enrolled in the prospective FIL-MCL0208 phase 3 trial (high-dose chemoimmunotherapy followed by autologous transplantation and randomized lenalidomide maintenance). Mutations of KMT2D and disruption of TP53 by deletion or mutation associated with an increased risk of progression and death, both in univariate and multivariate analysis. By adding KMT2D mutations and TP53 disruption to the MIPI-c backbone, we derived a new prognostic index, the “MIPI-genetic” (“MIPI- g”). The “MIPI-g” improved the model discrimination ability compared to the MIPI-c alone, defining three risk groups: i) low-risk patients (4-year progression free survival and overall survival of 72.0% and 94.5%); ii) inter-mediate-risk patients (4-year progression free survival and overall survival of 42.2% and 65.8%) and iii) high-risk patients (4-year progression free survival and overall survival of 11.5% and 44.9%). Our results: i) confirm that TP53 disruption identifies a high-risk population characterized by poor sensitivity to conventional or intensified chemotherapy; ii) provide the pivotal evidence that patients harboring KMT2D mutations share the same poor outcome as patients harboring TP53 disruption; and iii) allow to develop a tool for the identification of high-risk MCL patients for whom novel therapeutic strategies need to be investigated. (Trial registered at clinicaltrials.gov identifier: NCT02354313).
- Published
- 2020
- Full Text
- View/download PDF
10. Brentuximab vedotin in the treatment of elderly Hodgkin lymphoma patients at first relapse or with primary refractory disease: a phase II study of FIL ONLUS
- Author
-
Vittorio Stefoni, Miriam Marangon, Alessandro Re, Arben Lleshi, Maurizio Bonfichi, Antonello Pinto, Nicola Bianchetti, Cinzia Pellegrini, Lisa Argnani, and Pier Luigi Zinzani
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Published
- 2020
- Full Text
- View/download PDF
11. PD-1 blockade as bridge to allogeneic stem cell transplantation in relapsed/refractory Hodgkin lymphoma patients: a retrospective single center case series
- Author
-
Beatrice Casadei, Alessandro Broccoli, Vittorio Stefoni, Cinzia Pellegrini, Miriam Marangon, Alice Morigi, Laura Nanni, Ginevra Lolli, Matteo Carella, Lisa Argnani, Michele Cavo, and Pier Luigi Zinzani
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Published
- 2019
- Full Text
- View/download PDF
12. A patient with plasmablastic lymphoma achieving long-term complete remission after thalidomide-dexamethasone induction and double autologous stem cell transplantation: a case report
- Author
-
Alessandro Broccoli, Laura Nanni, Vittorio Stefoni, Claudio Agostinelli, Lisa Argnani, Michele Cavo, and Pier Luigi Zinzani
- Subjects
Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background No standard of care is established for plasmablastic lymphoma (PBL) and prognosis remains extremely poor, given that patients relapse early after chemotherapy and display resistance to commonly applied cytostatic drugs. Case presentation We report a case of nodal, HIV-unrelated PBL in a patient who achieved and maintained a very long lasting complete remission after an intensive therapy consisting consisting of thalidomide plus dexamethasone followed by a consolidation with double autologous stem cell transplantation. Our approach was based on the full application of a standard multiple myeloma treatment and, to the best of our knowledge, it represents the only reported experience so far. This treatment was overall well tolerated. Conclusions Multiple myeloma-like treatment may represent a possible alternative to intensive lymphoma-directed therapies.
- Published
- 2018
- Full Text
- View/download PDF
13. Long-Term Efficacy and Safety of Ibrutinib in the Treatment of CLL Patients: A Real Life Experience
- Author
-
Alessandro Broccoli, Lisa Argnani, Alice Morigi, Laura Nanni, Beatrice Casadei, Cinzia Pellegrini, Vittorio Stefoni, and Pier Luigi Zinzani
- Subjects
chronic lymphocytic leukemia ,ibrutinib ,Richter transformation ,Medicine - Abstract
Ibrutinib has demonstrated a significant clinical impact in patients with de novo and relapsed/refractory chronic lymphocytic leukemia (CLL), even in cases with unfavorable cytogenetics and molecular markers. All CLL patients’ data treated at our Institute with ibrutinib have been retrospectively reviewed. Forty-six patients received ibrutinib either as frontline (10) or second or more advanced treatment (36). Five patients presented with TP53 mutations; 11 had the deletion of chromosome 17p; 17 displayed an unmutated immunoglobulin variable heavy chain status. The median number of cycles administered was 26. Among patients treated frontline, the best overall response rate (ORR) was 90.0%. In patients receiving ibrutinib as a second or later line ORR was 97.2%. Median progression-free survival was 28.8 and 21.1 months for patients treated frontline and as second/later line, respectively. Median overall survival was not reached for those treated frontline and resulted in 4.9 years for patients treated as second/later line. Grade 3–4 hematological toxicities were neutropenia, thrombocytopenia, and anemia. Grade 3–4 extrahematological toxicities included diarrhea, cutaneous rash, utero-vesical prolapse, vasculitis, and sepsis. Ibrutinib is effective and well tolerated in CLL. Responses obtained in a real-life setting are durable and the safety profile of the drug is favorable.
- Published
- 2021
- Full Text
- View/download PDF
14. Real World Evidence of CAR T-Cell Therapies for the Treatment of Relapsed/Refractory B-Cell Non-Hodgkin Lymphoma: A Monocentric Experience
- Author
-
Beatrice Casadei, Lisa Argnani, Serafina Guadagnuolo, Cinzia Pellegrini, Vittorio Stefoni, Alessandro Broccoli, Laura Nanni, Alice Morigi, Ginevra Lolli, Maria Guarino, Luca Spinardi, Elisabetta Pierucci, Stefano Fanti, Michele Bartoletti, Michele Dicataldo, Elena Sabattini, Francesca Bonifazi, and Pier Luigi Zinzani
- Subjects
large B-cell non-Hodgkin lymphoma ,relapsed/refractory lymphoma ,CAR T-cell therapy ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Large B-cell lymphomas (LBCL) are the most common types of non-Hodgkin lymphoma. Although outcomes have improved thanks to the introduction of rituximab-based chemoimmunotherapy, certain LBCL still represents a challenge because of initial resistance to therapy or recurrent relapses. Axicabtagene ciloleucel (axi-cel) and tisagenlecleucel (tisa-cel) are second-generation autologous CD19-targeted chimeric antigen receptor (CAR) T-cell therapies approved for patients with relapsed/refractory (R/R) LBCL, based on the results of phase II pivotal single-arm trials ZUMA-1 (for axi-cel) and JULIET (for tisa-cel). Here, we report patients outcomes with axi-cel and tisa-cel in the standard of care (SoC) setting for R/R LBCL, treated at our Institution. Data were collected from patients who underwent leukapheresis between August 2019 and February 2021. Toxicities were graded and managed according to the institution’s guidelines. Responses were assessed as per Lugano 2014 classification. Of the 30 patients who underwent leukapheresis, 18 (60%) received axi-cel, while 12 (40%) tisa-cel. Grade 3 or higher cytokine release syndrome and neurotoxicity occurred in 10% and 16% patients, respectively. Best objective and complete response rates were 73.3% and 40%, respectively. Treatment in SoC setting with CD19 CAR T-cell therapies for R/R LBCL showed a manageable safety profile and high objective response rate.
- Published
- 2021
- Full Text
- View/download PDF
15. The treatment of primary mediastinal large B-cell lymphoma: a two decades monocentric experience with 98 patients
- Author
-
Alessandro Broccoli, Beatrice Casadei, Vittorio Stefoni, Cinzia Pellegrini, Federica Quirini, Lorenzo Tonialini, Alice Morigi, Miriam Marangon, Lisa Argnani, and Pier Luigi Zinzani
- Subjects
Chemotherapy ,MACOP-B ,primary mediastinal lymphoma ,radiotherapy ,rituximab ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background The purpose of this study is to investigate the most suitable first-line approach and the best combination treatment for primary mediastinal large B-cell lymphoma (PMLBCL) as they have been matter of debate for at least two decades. Methods Our single centre experience in the treatment of 98 de novo PMLBCL patients over the last 20 years is reviewed. All patients received MACOP-B chemotherapy. Thirty-seven received both rituximab and mediastinal radiotherapy; 30 were irradiated after chemotherapy, although not receiving rituximab and 20 received rituximab without radiotherapy consolidation. Eleven patients received chemotherapy only. Results Sixty-one (62.2%) patients achieved a complete response after MACOP-B (with or without rituximab); among the 27 (27.6%) partial responders, 21 obtained a complete response after radiotherapy. At the end of their scheduled treatment, 82 patients (83.7%) had a complete and 6 a partial response (6.1%). Eleven patients relapsed within the first 2 years of follow-up. The 17-year overall survival is 72.0% (15 patients died); progression-free and disease-free survival are 67.6% and 88.4%, respectively. A statistically significant difference in overall and progression-free survival was noted among treatment groups, although no disease-free survival difference was documented. Conclusions Our data indicate that a third-generation regimen like MACOP-B could be considered a suitable first-line treatment. Mediastinal consolidation radiotherapy impacts on survival and complete response rates and remains a good strategy to convert partial into complete responses. Data suggest that radiotherapy may be avoided in patients obtaining a complete response after (immuno)chemotherapy, but this requires confirmation with further ad hoc studies.
- Published
- 2017
- Full Text
- View/download PDF
16. Italian real-life experience with brentuximab vedotin: results of a large observational study of 40 cases of relapsed/refractory systemic anaplastic large cell lymphoma
- Author
-
Alessandro Broccoli, Cinzia Pellegrini, Alice Di Rocco, Benedetta Puccini, Caterina Patti, Guido Gini, Donato Mannina, Monica Tani, Chiara Rusconi, Alessandra Romano, Anna Vanazzi, Barbara Botto, Carmelo Carlo-Stella, Stefan Hohaus, Pellegrino Musto, Patrizio Mazza, Stefano Molica, Paolo Corradini, Angelo Fama, Francesco Gaudio, Michele Merli, Angela Gravetti, Giuseppe Gritti, Annalisa Arcari, Patrizia Tosi, Anna Marina Liberati, Antonello Pinto, Vincenzo Pavone, Filippo Gherlinzoni, Virginia Naso, Stefano Volpetti, Livio Trentin, Maria Cecilia Goldaniga, Maurizio Bonfichi, Amalia De Renzo, Corrado Schiavotto, Michele Spina, Sergio Storti, Angelo Michele Carella, Vittorio Stefoni, Lisa Argnani, and Pier Luigi Zinzani
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Between November 2012 and July 2014, in accordance with national law 648/96, brentuximab vedotin was available in Italy for patients with relapsed systemic anaplastic large cell lymphoma outside a clinical trial context. A large Italian observational retrospective study was conducted on the use of brentuximab vedotin in everyday clinical practice to check whether clinical trial results are confirmed in a real-life context. The primary endpoint of this study was best response; secondary endpoints were the overall response rate at the end of the treatment, duration of response, survival and safety profile. A total of 40 heavily pretreated patients were enrolled. Best response was observed after a median of four cycles in 77.5%: globally, 47.5% patients obtained a complete response, 64.2% in the elderly subset. The overall response rate was 62.5%. At the latest follow up, 15/18 patients are still in complete remission (3 with consolidation). The progression-free survival rate at 24 months was 39.1% and the disease-free survival rate at the same time was 54% (median not reached). All the long-term responders were aged
- Published
- 2017
- Full Text
- View/download PDF
17. Histological verification of positive positron emission tomography findings in the follow-up of patients with mediastinal lymphoma
- Author
-
Pier Luigi Zinzani, Monica Tani, Rocco Trisolini, Stefano Fanti, Vittorio Stefoni, Marco Alifano, Paolo Castellucci, Gerardo Musuraca, Giorgia Dalpiaz, Lapo Alinari, Enrica Marchi, Mariapaola Fina, Cinzia Pellegrini, Mohsen Farsad, Alessandra Cancellieri, Annalisa Busca, Romeo Canini, Stefano Pileri, Michele Baccarani, and Maurizio Boaron
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Background and Objectives Follow-ups of patients with mediastinal lymphoma are not accurate if they rely on computed tomography (CT). Positron emission tomography (PET) has been suggested to be useful in several lymphoma settings, such as initial staging, evaluation of residual masses after therapy, and assessment of response early in the course of treatment. The aim of this retrospective study was to verify the reliability of positive PET scans of the mediastinum in following up patients wirh mediastinal lymphoma, using histological findings as a comparison.Design and Methods From January 2002 to July 2005, 151 patients with mediastinal lymphoma (57 with Hodgkin’s disease [HD] and 94 with aggressive non-Hodgkin’s lymphoma [NHL]) were followed-up after the end of front-line treatment. Patients with a positive PET scan of the mediastinum underwent CT scanning and surgical biopsy.Results In 30 (21 HD and 9 NHL) out of 151 patients (20%) a suspicion of lymphoma relapse was raised based on positive mediastinal PET scanning. Histology confirmed this suspicion in 17 (10 HD and 7 NHL) out of 30 patients (57%), whereas either benign (9 fibrosis, 3 sarcoid-like granulomatosis) or unrelated neoplastic conditions (1 thymoma) were demonstrated in the remaining 13 patients (43%). SUVmax was significantly higher among patients who had signs of relapse (17 true positive cases) than among those who stayed in remission (13 false positive cases), the median values being 5.95 (range, 3.5–26.9) and 2.90 (range, 1.4–3.3), respectively (p=0.01).Interpretation and Conclusions We suggest that a positive PET scan of the mediastinum of a patient being followed-up for a mediastinal lymphoma should not be considered sufficient for diagnostic purposes in view of its lack of discrimination. Histological confirmation can safely be carried out with various biopsy techniques, the choice of which should be made on the basis of the findings of the clinical and imaging studies of the individual case.
- Published
- 2007
- Full Text
- View/download PDF
18. ABCL-298 Diffuse Large B-Cell Lymphoma During the Covid-19 Pandemic in Two Tertiary Centers: The Israeli/Italian Study
- Author
-
Giladi, Odil, Bagnato, Gianmarco, Gentilini, Marianna, Shimony, Shai, Pasvolsky, Oren, Berger, Tamar, Itchaki, Gilad, Raanani, Pia, Broccoli, Alessandro, Stefoni, Vittorio Stefoni, Lolli, Ginevra, Argnani, Lisa, Zinzani, Pier Luigi, and Gurion, Ronit
- Published
- 2022
- Full Text
- View/download PDF
19. Candidate germline biomarkers of lenalidomide efficacy in mantle cell lymphoma: the FIL MCL0208 trial
- Author
-
Simone Ferrero, Daniele Grimaldi, Elena Arrigoni, Mariapia Pironti, Gian Maria Zaccaria, Beatrice Alessandria, Elisa Genuardi, Gabriele De Luca, Marco Ghislieri, Rita Tavarozzi, Alice Di Rocco, Alessandro Re, Vittorio Stefoni, Federica Cavallo, Carola Boccomini, Monica Balzarotti, Vittorio Ruggero Zilioli, Filipa Moita, Luca Arcaini, Elisa Lucchini, Filippo Ballerini, Andrés J. M. Ferreri, Benedetta Puccini, Giuseppe A Palumbo, Sara Galimberti, Sergio Cortelazzo, Antonello Di Paolo, and Marco Ladetto
- Subjects
lenalidomide, mantle cell lymphoma, germline biomarkers, efficacy, Fondazione Italiana Linfomi ,Clinical trial ,efficacy ,lenalidomide ,mantle cell lymphoma ,lymphoid neoplasia ,biomarkers ,Fondazione Italiana Linfomi ,Hematology ,germline biomarkers - Abstract
In the FIL MCL0208 phase III trial, lenalidomide maintenance (LEN) after transplantation (ASCT) in mantle cell lymphoma (MCL) improved progression-free survival (PFS) vs observation (OBS). The host pharmacogenetic background was analyzed to decipher whether single nucleotide polymorphisms (SNPs) of genes encoding transmembrane transporters, metabolic enzymes, or cell surface receptors might predict drug efficacy. Genotypes were obtained by real-time polymerase chain reaction (RT-PCR) in peripheral blood (PB) germ line DNA. Polymorphisms of either ABCB1 or VEGF were found in 69% and 79% of 278 patients and predicted favorable PFS vs homozygous wild type (WT) in the LEN arm: 3-year PFS 85% vs 70% (p < 0.05) and 85% vs 60% (p < 0.01), respectively. Patients carrying both ABCB1 and VEGF WT had the poorest 3-year PFS (46%) and overall survival (OS, 76%): in fact, in these patients LEN did not improve PFS vs OBS (3-year PFS 44% vs 60%, p = 0.62). Moreover, CRBN polymorphism (n = 28) was associated with lenalidomide dose reduction or discontinuation. Finally, ABCB1, NCF4, and GSTP1 polymorphisms predicted lower hematological toxicity during induction, while ABCB1 and CRBN polymorphisms predicted lower risk of grade ≥3 infections. This study demonstrates that specific SNPs represent candidate predictive biomarkers of immunochemotherapy toxicity and LEN efficacy after ASCT in MCL. This trial is registered at eudract.ema.europa.eu as 2009-012807-25.
- Published
- 2023
20. Design of New Personalized Therapeutic Approaches for Diffuse Large B-Cell Lymphoma through Gut Microbiome Profiling
- Author
-
Laura Nanni, Gerardo Musuraca, Alice Morigi, Vittorio Stefoni, Monica Barone, Gabriele Conti, Marco Fabbrini, Silvia Turroni, Alessandro Broccoli, Lisa Argnani, Patrizia Brigidi, and Pier Luigi Zinzani
- Subjects
Immunology ,Cell Biology ,Hematology ,Biochemistry - Published
- 2022
21. Romidepsin-CHOEP followed by high-dose chemotherapy and stem-cell transplantation in untreated Peripheral T-Cell Lymphoma: results of the PTCL13 phase Ib/II study
- Author
-
Annalisa Chiappella, Anna Dodero, Andrea Evangelista, Alessandro Re, Lorella Orsucci, Sara Veronica Usai, Claudia Castellino, Vittorio Stefoni, Antonio Pinto, Manuela Zanni, Rosanna Ciancia, Chiara Ghiggi, Francesca Gaia Rossi, Annalisa Arcari, Fiorella Ilariucci, Vittorio Ruggero Zilioli, Leonardo Flenghi, Melania Celli, Stefano Volpetti, Fabio Benedetti, Filippo Ballerini, Gerardo Musuraca, Riccardo Bruna, Caterina Patti, Francesco Leonardi, Luca Arcaini, Massimo Magagnoli, Federica Cavallo, Anisa Bermema, Alessandra Tucci, Carola Boccomini, Giovannino Ciccone, Cristiana Carniti, Stefano Aldo Pileri, and Paolo Corradini
- Subjects
Cancer Research ,Oncology ,Hematology - Abstract
The standard treatment for young patients with untreated PTCLs is based on anthracycline containing-regimens followed by high-dose-chemotherapy and stem-cell-transplantation (HDT + SCT), but only 40% of them can be cured. Romidepsin, a histone-deacetylase inhibitor, showed promising activity in relapsed PTCLs; in first line, Romidepsin was added with CHOP. We designed a study combining romidepsin and CHOEP as induction before HDT + auto-SCT in untreated PTCLs (PTCL-NOS, AITL/THF, ALK-ALCL), aged 18–65 years. A phase Ib/II trial was conducted to define the maximum tolerated dose (MTD) of Ro-CHOEP, and to assess efficacy and safety of 6 Ro-CHOEP as induction before HDT. The study hypothesis was to achieve a 18-month PFS of 70%. Twenty-one patients were enrolled into phase Ib; 7 dose-limiting toxicities were observed, that led to define the MTD at 14 mg/ms. Eighty-six patients were included in the phase II. At a median follow-up of 28 months, the 18-month PFS was 46.2% (95%CI:35.0–56.7), and the 18-month overall survival was 73.1% (95%CI:61.6–81.7). The overall response after induction was 71%, with 62% CRs. No unexpected toxicities were reported. The primary endpoint was not met; therefore, the enrollment was stopped at a planned interim analysis. The addition of romidepsin to CHOEP did not improve the PFS of untreated PTCL patients.
- Published
- 2023
22. Poster: ABCL-298 Diffuse Large B-Cell Lymphoma During the Covid-19 Pandemic in Two Tertiary Centers: The Israeli/Italian Study
- Author
-
Giladi, Odil, primary, Bagnato, Gianmarco, additional, Gentilini, Marianna, additional, Shimony, Shai, additional, Pasvolsky, Oren, additional, Berger, Tamar, additional, Itchaki, Gilad, additional, Raanani, Pia, additional, Broccoli, Alessandro, additional, Stefoni, Vittorio Stefoni, additional, Lolli, Ginevra, additional, Argnani, Lisa, additional, Zinzani, Pier Luigi, additional, and Gurion, Ronit, additional
- Published
- 2022
- Full Text
- View/download PDF
23. 665 THE UNFORSEEN MECHANISM: A CASE OF DISTRIBUTIVE SHOCK SECONDARY TO REACTIVE HAEMOPHAGOCYTIC SYNDROME LEADING TO SEVERE REVERSIBLE BIVENTRICULAR DYSFUNCTION
- Author
-
Michele Bertelli, Alberto Foa´, Alessandro Broccoli, Pier Luigi Zinzani, Vittorio Stefoni, Franco Semprini, Samuele Nanni, Francesco Barberini, Anna Corsini, Paola Battistini, and Nazzareno Galie´
- Subjects
Cardiology and Cardiovascular Medicine - Abstract
Distributive shock comprises a variety of processes causing dysregulated vasodilation with consequent life-threatening end-organ dysfunction. While sepsis constitutes by far its most common aetiology, other pathological mechanisms with different therapeutic targets may lead to a similar haemodynamic picture. We hereby present the case of a 35-year-old male with no past cardiological history and a recent diagnosis of stage IVsB Hodgkin's lymphoma relapse 10 years after effective disease eradication with first-line chemotherapy. Shortly after a single cycle of second-line chemotherapy, the patient presented with high fever, acute chest pain and dyspnea associated with marked hypotension and sinus tachycardia. Laboratory tests revealed pancytopenia and raised inflammatory markers as well as evidence of acute kidney injury and hepatocellular damage. Urgent thoracic CT revealed no signs of pneumonia while echocardiography demonstrated severe biventricular dysfunction with 25% left ventricular ejection fraction and severe functional mitral regurgitation. Due to worsening tachypnea and desaturation the patient was intubated and transferred to our Intensive Cardiac Care Unit where urgent instatement of circulatory support with iv fluids, blood transfusions, adrenaline and intra-aortic balloon pump were performed and empirical broad-spectrum antibiotic therapy was started after performing blood cultures from peripheral and central veins. Concurrent right ventricular catheterisation demonstrated high-output cardiac failure (Qs Fick 7.89 Qp/m2, Qs thermodilution 8.0 Qp/m2) with mild increase in biventricular filling pressures and post-capillary pulmonary hypertension. Endomyocardial biopsy in turn revealed only mild subendocardial fibrosis and oedema thus excluding myocarditis as a potential cause for the severe biventricular dysfunction. Due to worsening of renal function with persistent anuria despite circulatory support the patient required continuous veno-venous haemofiltration. Notably, over the coming days no pathogen was isolated from any of the cultures with haemodynamic and respiratory parameters gradually improving, allowing for weaning from circulatory and respiratory support. On further examination of blood tests on admission, hypertriglyceridemia, raised ferritin levels and thrombin consumption were noted. These biochemical features, together with the history of Hodgkin's lymphoma relapse, recent chemotherapy, pancytopenia and splenomegaly, suggestive of natural killer cell dysfunction-related haemophagocytosis, pointed to reactive haemophagocytic syndrome as a potential aetiology of the severe distributive shock (> 99% probability on recently published “HS Score” for Reactive Haemophagocytic Syndrome). This hypothesis was further corroborated by the gradual albeit not complete regression of the severe biventricular dysfunction after haemodynamic support suggesting that this may have represented a byproduct of the patient's high-output state. Unfortunately, due to lymphoma progression with severe multiorgan involvement the patient was admitted shortly after discharge and deceased thereafter. This case provides an example of the diversity of potential disease mechanisms underlying distributive shock where biventricular dysfunction may represent a reversible albeit severe bystander rather than the true driving factor of its life-threatening haemodynamic compromise.
- Published
- 2022
24. A Case of Bing-Neel Syndrome Treated Successfully With Ibrutinib Monotherapy Following Intensive Chemoimmunotherapy
- Author
-
Vittorio Stefoni, Matteo Carella, Alessandro Broccoli, Pier Luigi Zinzani, Lisa Argnani, Carella M., Stefoni V., Broccoli A., Argnani L., and Zinzani P.L.
- Subjects
Oncology ,Cancer Research ,medicine.medical_specialty ,Induction therapy ,Lymphoplasmacytic Lymphoma ,chemistry.chemical_compound ,Piperidine ,Chemoimmunotherapy ,Internal medicine ,medicine ,Central nervous system lymphoma ,Aged ,Bing–Neel syndrome ,business.industry ,Adenine ,BTK inhibitor ,Brain Disease ,Central Nervous System Neoplasm ,Syndrome ,Hematology ,MaTrix regimen ,Clinical Practice ,Regimen ,chemistry ,Ibrutinib ,Lymphoplasmacytic lymphoma ,Female ,Immunotherapy ,business ,Human - Abstract
Clinical Practice Points • The Bing-Neel syndrome is a rare clinicopathological entity which refers to central nervous system localization by lymphoplasmacytic lymphoma. • The treatment of Bing-Neel syndrome remains non‐standardized and further data about patient long‐term outcome is needed. • This case-report supports the evidence of effectiveness and safety of MaTrix regimen as induction therapy in Bing-Neel syndrome patients.
- Published
- 2021
25. Rituximab As an Effective Salvage Therapy in Pretreated Hairy Cell Leukemia Patients: The Bologna Experience
- Author
-
Alessandro Broccoli, Lisa Argnani, Laura Nanni, Gianmarco Bagnato, Matteo Carella, Beatrice Casadei, Paolo Elia Coppola, Gabriele Gugliotta, Ginevra Lolli, Marianna Gentilini, Alice Morigi, Cinzia Pellegrini, Vittorio Stefoni, and Pier Luigi Zinzani
- Subjects
Immunology ,Cell Biology ,Hematology ,Biochemistry - Published
- 2022
26. The Addition of Romidepsin to CHOEP and High-Dose Chemotherapy Plus Stem Cell Transplantation Did Not Ameliorate the Outcome of Untreated Angioimmunoblastic T-Cell or Follicular T-Helper Lymphoma: Subgroup Analysis of Phase II FIL-PTCL13 Study
- Author
-
Annalisa Chiappella, Anna Dodero, Andrea Evangelista, Alessandro Re, Lorella Orsucci, Sara Veronica Usai, Claudia Castellino, Vittorio Stefoni, Antonio Pinto, Manuela Zanni, Rosanna Ciancia, Chiara Ghiggi, Francesca Gaia Rossi, Annalisa Arcari, Fiorella Ilariucci, Vittorio Ruggero Zilioli, Leonardo Flenghi, Melania Celli, Stefano Volpetti, Fabio Benedetti, Filippo Ballerini, Gerardo Musuraca, Riccardo Bruna, Caterina Patti, Francesco Leonardi, Luca Arcaini, Massimo Magagnoli, Federica Cavallo, Valentina Tabanelli, Giovannino Ciccone, Stefano A Pileri, and Paolo Corradini
- Subjects
Immunology ,Cell Biology ,Hematology ,Biochemistry - Published
- 2022
27. ABCL-298 Diffuse Large B-Cell Lymphoma During the Covid-19 Pandemic in Two Tertiary Centers: The Israeli/Italian Study
- Author
-
Odil Giladi, Gianmarco Bagnato, Marianna Gentilini, Shai Shimony, Oren Pasvolsky, Tamar Berger, Gilad Itchaki, Pia Raanani, Alessandro Broccoli, Vittorio Stefoni Stefoni, Ginevra Lolli, Lisa Argnani, Pier Luigi Zinzani, and Ronit Gurion
- Subjects
Cancer Research ,Oncology ,Hematology - Published
- 2022
28. BEGEV salvage regimen in relapsed/refractory classical Hodgkin lymphoma: a real-life experience
- Author
-
Vittorio Stefoni, Lisa Argnani, Matteo Carella, Beatrice Casadei, Alice Morigi, Ginevra Lolli, Alessandro Broccoli, Cinzia Pellegrini, Laura Nanni, Paolo Elia Coppola, Pier Luigi Zinzani, Stefoni V., Argnani L., Carella M., Casadei B., Morigi A., Lolli G., Broccoli A., Pellegrini C., Nanni L., Coppola P.E., and Zinzani P.L.
- Subjects
Cancer Research ,Oncology ,Salvage regimen ,Real life ,General Medicine ,Autologous stem cell transplantation ,BEGEV ,Hodgkin lymphoma - Abstract
Purpose One of the most critical issues in the management of Hodgkin lymphoma (HL) patients who resulted as primary relapsed or refractory is to obtain a minimal disease status before autologous stem cell transplantation (ASCT). Finding a salvage regimen able to induce this status without severe toxicity would represent a major achievement in this setting. Methods A single‐center retrospective study was conducted to assess effectiveness and safety of BEGEV (bendamustine, gemcitabine, and vinorelbine) regimen as first salvage setting prior to ASCT in HL patients. Results Forty-three patients were treated in our institution between October 2017 and November 2020. Median age at BEGEV therapy was 35.0 years (range 17.2– 70.0), and the median time from frontline therapy to the first cycle of BEGEV was 79.5 days (range 4–2267). At the end of treatment, 31 patients achieved a complete response (CR), with an overall response rate of 76.7%. Forty-one patients harvested CD34+ cells and 35/43 (81.4%) patients underwent ASCT. With a median follow‐up of 22 months, 4 CR patients had disease relapse, yielding an estimated disease-free survival of 73.9% at 34 months. The estimated 2‐year progression-free survival was 66.7%. Response to first-line chemotherapy did not significantly influence prognosis. Conclusions BEGEV regimen was well tolerated, and reversible haematological toxic effects were the most common adverse events. Real-life data on BEGEV regimen as first salvage setting showed a relevant rate of objective responses and a limited myelotoxicity with no impairment of a subsequent mobilization of peripheral blood stem cells.
- Published
- 2022
29. Author response for 'Brentuximab vedotin in The Treatment of Relapsed/Refractory CD30+ Peripheral T‐cell Lymphoma: a FIL Phase 2 Study'
- Author
-
null Vittorio Stefoni, null Cinzia Pellegrini, null Lisa Argnani, null Paolo Corradini, null Anna Dodero, null Lorella Orsucci, null Stefano Volpetti, and null Pier Luigi Zinzani
- Published
- 2022
30. Prolonged responses to brentuximab vedotin as last therapy in Hodgkin lymphoma failing autologous transplantation: A case series
- Author
-
Alessandro Broccoli, Lisa Argnani, Paolo Elia Coppola, Marianna Gentilini, Gianmarco Bagnato, Ginevra Lolli, Matteo Carella, Laura Nanni, Alice Morigi, Beatrice Casadei, Cinzia Pellegrini, Vittorio Stefoni, Pier Luigi Zinzani, Broccoli, Alessandro, Argnani, Lisa, Coppola, Paolo Elia, Gentilini, Marianna, Bagnato, Gianmarco, Lolli, Ginevra, Carella, Matteo, Nanni, Laura, Morigi, Alice, Casadei, Beatrice, Pellegrini, Cinzia, Stefoni, Vittorio, and Zinzani, Pier Luigi
- Subjects
relapsed ,Cancer Research ,prolonged response ,refractory ,Oncology ,allogeneic stem cell transplantation ,Brentuximab vedotin ,General Medicine ,Hodgkin lymphoma - Abstract
The follow-up of the pivotal trial and large case series reports of a proportion of patients, between 5% and 9%, with relapsed or refractory Hodgkin lymphoma failing autologous stem cell transplantation and treated with brentuximab vedotin, achieving and maintaining long lasting complete responses with no further treatment. Very long-term data on the outcomes of such patients are indeed underreported. Our institutional experience with patients meeting these characteristics and in continuous complete response for more than 5 years after brentuximab vedotin was reviewed. Five patients achieved a median duration of complete response of 7.4 (range 5.1-8.1) years, and none of them encountered disease relapse or received any subsequent consolidation, including allogeneic transplantation. A proportion of patients failing autologous transplantation and receiving subsequent brentuximab vedotin may reach a long-lasting complete response with no need of further treatment. These patients are therefore considered cured. The role of allogeneic transplantation in such patients is matter of debate.
- Published
- 2022
31. Dissecting MRD Kinetics By Automated Computational Analysis to Improve Outcome Prediction in Mantle Cell Lymphoma: A Bioinformatic Substudy from the Fondazione Italiana Linfomi (FIL) MCL0208 Clinical Trial
- Author
-
Francesca Cordero, Simone Ferrero, Simone Pernice, Elisa Genuardi, Roberta Sirovich, Beatrice Alessandria, Andrea Evangelista, Simone Ragaini, Maurizio Martelli, Alice Di Rocco, Alessandro Re, Chiara Pagani, Vittorio Stefoni, Federica Cavallo, Carola Boccomini, Monica Balzarotti, Vittorio Ruggero Zilioli, Maria Gomes da Silva, Luca Arcaini, Melania Celli, Gian Maria Zaccaria, Dora Tortarolo, Sergio Cortelazzo, and Marco Ladetto
- Subjects
Immunology ,Cell Biology ,Hematology ,Biochemistry - Published
- 2022
32. Romidepsin Plus CHOP Versus CHOP in Patients With Previously Untreated Peripheral T-Cell Lymphoma : Results of the Ro-CHOP Phase III Study (Conducted by LYSA)
- Author
-
Marc André, Laurence de Leval, Gandhi Damaj, Franck Morschhauser, Judith Trotman, Philippe Gaulard, Michel Meignan, Emmanuel Bachy, Gian Matteo Pica, David Sibon, Vittorio Stefoni, Vincent Camus, Won Seog Kim, Marie-Hélène Delfau-Larue, María Jesús Peñarrubia, Andreas Hüttmann, Catherine Thieblemont, J. Li, Alessandro Re, Soon Thye Lim, Stéphanie Guidez, Alejandro Martin Garcia-Sancho, Loic Ysebaert, R. Delarue, René-Olivier Casasnovas, and Philipp B. Staber
- Subjects
Adult ,Male ,Cancer Research ,Asia ,Time Factors ,genetic structures ,Cyclophosphamide ,medicine.drug_class ,Medizin ,CHOP ,Romidepsin ,Refractory ,Depsipeptides ,hemic and lymphatic diseases ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Doxorubicin ,Aged ,Aged, 80 and over ,business.industry ,Histone deacetylase inhibitor ,Australia ,Lymphoma, T-Cell, Peripheral ,Middle Aged ,medicine.disease ,Progression-Free Survival ,Peripheral T-cell lymphoma ,Lymphoma ,Europe ,Histone Deacetylase Inhibitors ,Oncology ,Vincristine ,Disease Progression ,Cancer research ,Prednisone ,Female ,business ,medicine.drug - Abstract
PURPOSE Romidepsin, a histone deacetylase inhibitor, has demonstrated activity in relapsed or refractory peripheral T-cell lymphoma (PTCL) as a single agent. Cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) therapy is widely used as first-line treatment of PTCL; however, it has limited efficacy. Results from a phase Ib and II study showed the feasibility of combining romidepsin with CHOP (Ro-CHOP). METHODS This study is a randomized phase III study of Ro-CHOP versus CHOP in adult patients with previously untreated PTCL. All patients received CHOP in 3-week cycles for six cycles. Romidepsin, 12 mg/m2, was administered intravenously over a 4-hour period on days 1 and 8 of each 3-week cycle for six cycles. The primary end point was progression-free survival (PFS) according to International Working Group 1999 criteria. RESULTS Between January 2013 and December 2017, 421 patients were enrolled (Ro-CHOP, n = 211; CHOP, n = 210). The median PFS for Ro-CHOP versus CHOP was 12.0 months (95% CI, 9.0 to 25.8) versus 10.2 months (95% CI, 7.4 to 13.2) with a hazard ratio of 0.81 ( P = .096). In the Ro-CHOP versus CHOP arms, the median overall survival was 51.8 versus 42.9 months and the objective response rate was 63% versus 60% with complete response plus unconfirmed complete response rates of 41% versus 37% ( P > .1 in all comparisons), respectively. Grade 3 or 4 treatment-emergent adverse events occurring in ≥ 30% of patients in the Ro-CHOP arm included thrombocytopenia (50% v 10% in the Ro-CHOP v CHOP arms, respectively), neutropenia (49% v 33%), anemia (47% v 17%), and leukopenia (32% v 20%). CONCLUSION The addition of romidepsin to CHOP did not improve PFS, response rates, nor overall survival and increased the frequency for grade ≥ 3 treatment-emergent adverse events. Ro-CHOP does not represent a significant advance in the standard of care for patients with previously untreated PTCL.
- Published
- 2022
33. Droplet digital polymerase chain reaction for the assessment of disease burden in hairy cell leukemia
- Author
-
Carolina Terragna, Pier Luigi Zinzani, Alessandro Broccoli, Marina Martello, Cinzia Pellegrini, Silvia Armuzzi, Elena Sabattini, Claudio Agostinelli, Alice Morigi, Laura Nanni, Vittorio Stefoni, Lisa Argnani, Beatrice Casadei, Broccoli A., Terragna C., Nanni L., Martello M., Armuzzi S., Agostinelli C., Morigi A., Casadei B., Pellegrini C., Stefoni V., Sabattini E., Argnani L., and Zinzani P.L.
- Subjects
Proto-Oncogene Proteins B-raf ,Cancer Research ,medicine.medical_specialty ,Prognosi ,Disease ,medicine.disease_cause ,Gastroenterology ,Polymerase Chain Reaction ,complete response ,droplet digital PCR ,Internal medicine ,BRAF-V600E mutation ,Biomarkers, Tumor ,Humans ,Medicine ,hairy cell leukemia ,Hairy cell leukemia ,Digital polymerase chain reaction ,Allele ,Complete response ,Disease burden ,Mutation ,Leukemia, Hairy Cell ,business.industry ,Hematology ,General Medicine ,Prognosis ,medicine.disease ,medicine.anatomical_structure ,Oncology ,Bone marrow ,Neoplasm Recurrence, Local ,business ,Human - Abstract
BRAFV600E mutation is the pathogenic driver of hairy cell leukemia (HCL) found in the vast majority of cases both at onset and during recurrences. The identification of the mutated allele in blood and marrow correlates with the presence of neoplastic cells and can be considered a marker of active disease. Likewise, the absence of themutation after treatment may indicate a state of deep response. The BRAFV600E burden was measured by droplet digital polymerase chain reaction (ddPCR) and expressed as fractional abundance in 35 HCL patients at different stages of disease (onset, relapse, complete response [CR] after treatment, long-term remission) in peripheral blood and/or bone marrow (when available). Mean values of fractional abundance for patients at diagnosis, relapse and response, respectively, were 12.26%, 16.52% and 0.02% in peripheral blood and 23.51%, 13.96% and 0.26% in bone marrow. Four patients out of 6 evaluated at response were molecularly negative for BRAFV600E in peripheral blood. Mean fractional abundance in peripheral blood tested in 14 patients with long lasting CR was 0.05%, and 10 patients were BRAFV600E negative. These preliminary results suggest that ddPCR permits to assess the active tumor burden in HCL at different disease phases and support the hypothesis that some patients in CR qualify for a molecular CR.
- Published
- 2022
34. Brentuximab vedotin in the treatment of relapsed/refractory CD30+ peripheral T-cell lymphoma: A FIL phase 2 study
- Author
-
Vittorio Stefoni, Cinzia Pellegrini, Lisa Argnani, Paolo Corradini, Anna Dodero, Lorella Orsucci, Stefano Volpetti, Pier Luigi Zinzani, Stefoni V., Pellegrini C., Argnani L., Corradini P., Dodero A., Orsucci L., Volpetti S., and Zinzani P.L.
- Subjects
novel agent ,Brentuximab Vedotin ,Cancer Research ,Ki-1 Antigen ,Lymphoma, T-Cell, Peripheral ,Hematology ,General Medicine ,relapsed ,refractory ,Oncology ,Immunoconjugate ,Neoplasm Recurrence, Local ,peripheral T-cell lymphoma ,Human - Abstract
Not available
- Published
- 2022
35. Hepatosplenic T-cell non-Hodgkin lymphoma cured with tandem autologous and allogeneic stem cell transplantation
- Author
-
Ginevra Lolli, Beatrice Casadei, Vittorio Stefoni, Lisa Argnani, Francesca Bonifazi, Pier Luigi Zinzani, Lolli, Ginevra, Casadei, Beatrice, Stefoni, Vittorio, Argnani, Lisa, Bonifazi, Francesca, and Zinzani, Pier Luigi
- Subjects
Pharmacology ,Infectious Diseases ,Oncology ,hemic and lymphatic diseases ,Drug Discovery ,Pharmacology (medical) ,General Medicine ,Hepatosplenic T-cell lymphoma, Tandem consolidation, auto- stem cell transplan, allo- stem cell transplant - Abstract
Hepatosplenic T-cell lymphoma is a very difficult lymphoma to deal with, almost impossible to cure. “Tandem” consolidation therapy with auto-stem cell transplant and allo-stem cell transplant can induce a long-lasting response and potentially cure this disease.
- Published
- 2022
36. Bendamustine‐rituximab regimen in untreated indolent marginal zone lymphoma: experience on 65 patients
- Author
-
Ginevra Lolli, Michele Cavo, Alessandro Broccoli, Paolo Elia Coppola, Vittorio Stefoni, Cinzia Pellegrini, Lisa Argnani, Matteo Carella, Alice Morigi, Elena Sabattini, Laura Nanni, Pier Luigi Zinzani, Beatrice Casadei, Morigi A., Argnani L., Lolli G., Broccoli A., Pellegrini C., Nanni L., Stefoni V., Coppola P.E., Carella M., Casadei B., Sabattini E., Cavo M., and Zinzani P.L.
- Subjects
Adult ,Male ,Bendamustine ,Cancer Research ,medicine.medical_specialty ,untreated ,Nausea ,Neutropenia ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Bendamustine Hydrochloride ,Humans ,Progression-free survival ,bendamustine ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Remission Induction ,Lymphoma, B-Cell, Marginal Zone ,Hematology ,General Medicine ,Middle Aged ,Prognosis ,medicine.disease ,marginal zone lymphoma ,Lymphoma ,Survival Rate ,Regimen ,Oncology ,030220 oncology & carcinogenesis ,Female ,Rituximab ,medicine.symptom ,business ,Progressive disease ,Follow-Up Studies ,030215 immunology ,medicine.drug - Abstract
First line therapy of patients with marginal zone lymphomas (MZL) is not well established and various regimens with chemo-immunotherapy can be used. Rituximab plus bendamustine (BR) is an effective and manageable treatment option for patients affected by indolent non-Hodgkin lymphoma. The aim of this monocentric retrospective study was to analyze the effectiveness and safety of the use of BR regimen in MZL patients in first line in daily clinical practice. The treatment schedule was rituximab at the dose of 375 mg/m2 on day 1 of each cycle and bendamustine at the dose of 90 mg/m2 on day 2 and 3, every 28 days for a maximum of 6 cycles. We analyzed 65 MZL patients (28 extranodal [EMZL], 23 splenic [SMZL], and 14 nodal [NMZL]) who underwent BR regimen as first line treatment. The median time from diagnosis to therapy was 2.5 months. Final responses were: 38 complete response (CR, 58.5%), 20 partial response and 7 progressive disease, leading to an overall response rate (ORR) of 89.2%. With respect to the histology, the ORR was 89.3% for EMZL, 82.6% for SMZL and 100% for NMZL, respectively (difference not statistically significant). With a median follow-up time of 44.6 months (range, 3.3-175.0 months), 2 (one EMZL after 42 months and one SMZL after 10 months) of 38 (5.2%) CR patients had disease relapse, yielding an estimated disease free survival of 89.2% at 61.1 months. The estimated 6-year progression free survival was 71.8% with 15 relapsed/progressed patients showing lymphoma recurrence within 48 months from end of treatment. The most frequently reported adverse events (any grade) were neutropenia (N = 35, 53.8%), fatigue (N = 15, 23.0%), and nausea (N = 12, 18.4%). All toxicities quickly resolved and no treatment-related death occurred. The BR regimen is effective and feasible in MZL patients inducing prolonged disease control with manageable toxicities.
- Published
- 2020
37. First salvage treatment with bendamustine and brentuximab vedotin in Hodgkin lymphoma: a phase 2 study of the Fondazione Italiana Linfomi
- Author
-
Umberto Vitolo, Vittorio Stefoni, Pier Luigi Zinzani, Alessandro Broccoli, Paolo Corradini, Stefano Fanti, Fondazione Italiana Linfomi Onlus, Alessandro Re, Antonello Pinto, Lisa Argnani, Barbara Botto, Broccoli, A, Argnani, L, Botto, B, Corradini, P, Pinto, A, Re, A, Vitolo, U, Fanti, S, Stefoni, V, Zinzani, P L, and Fondazione Italiana Linfomi ONLUS
- Subjects
Bendamustine ,Oncology ,Adult ,Male ,medicine.medical_specialty ,Phases of clinical research ,Salvage therapy ,Neutropenia ,lcsh:RC254-282 ,Article ,Young Adult ,Autologous stem-cell transplantation ,Refractory ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Bendamustine Hydrochloride ,Humans ,Brentuximab vedotin ,Aged ,Brentuximab Vedotin ,Salvage Therapy ,business.industry ,Hematology ,Middle Aged ,medicine.disease ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Combined Modality Therapy ,Hodgkin Disease ,Magnetic Resonance Imaging ,Clinical trial design ,Regimen ,Treatment Outcome ,Female ,Neoplasm Grading ,bendamustine, brentuximab, vedotin, Hodgkin lymphoma ,business ,Tomography, X-Ray Computed ,Haematological diseases ,medicine.drug - Abstract
Effective salvage options inducing high complete metabolic response (CMR) rates without significant toxicity are needed for Hodgkin lymphoma (HL) patients failing induction treatment and who are candidate to autologous stem cell transplantation (ASCT). Brentuximab vedotin (BV) and bendamustine are active monotherapies in the relapsed/refractory setting and their combination (the BBV regimen) possibly enhances their activity. This single-arm multicenter phase 2 study investigated the efficacy and safety of BBV as first salvage therapy in 40 patients with relapsed/refractory HL. Thirty-eight patients were evaluable for efficacy: 30 (78.9%) had a CMR and 2 (5.3%) a partial response, leading to an overall response rate (ORR) of 84.2%. The ORR in the primary refractory subset was 75.0%, among relapsed patients it was 94.4%. Thirty-five patients could mobilize peripheral blood stem cells and 33 underwent ASCT. At a median follow-up of 23 months, the estimated 3-year overall survival and progression-free survival are 88.1% and 67.3%. During therapy, only 3 grade IV cases of neutropenia occurred and resolved within a week. No grade 4 extrahematologic toxicities were reported; skin reactions were however rather frequent (65%). These results suggest that the BBV regimen exhibits promising efficacy and a manageable toxicity in a challenging subpopulation of HL patients.
- Published
- 2019
38. Poster: ABCL-298 Diffuse Large B-Cell Lymphoma During the Covid-19 Pandemic in Two Tertiary Centers: The Israeli/Italian Study
- Author
-
Odil Giladi, Gianmarco Bagnato, Marianna Gentilini, Shai Shimony, Oren Pasvolsky, Tamar Berger, Gilad Itchaki, Pia Raanani, Alessandro Broccoli, Vittorio Stefoni Stefoni, Ginevra Lolli, Lisa Argnani, Pier Luigi Zinzani, and Ronit Gurion
- Subjects
Cancer Research ,Oncology ,Hematology - Published
- 2022
39. Real World Evidence of CAR T-Cell Therapies for the Treatment of Relapsed/Refractory B-Cell Non-Hodgkin Lymphoma: A Monocentric Experience
- Author
-
Serafina Guadagnuolo, Michele Bartoletti, Alessandro Broccoli, Ginevra Lolli, Elena Sabattini, Vittorio Stefoni, Michele Dicataldo, Lisa Argnani, Beatrice Casadei, Maria Guarino, Alice Morigi, Stefano Fanti, Elisabetta Pierucci, Laura Nanni, Pier Luigi Zinzani, Francesca Bonifazi, Cinzia Pellegrini, Luca Spinardi, and Casadei B, Argnani L, Guadagnuolo S, Pellegrini C, Stefoni V, Broccoli A, Nanni L, Morigi A, Lolli G, Guarino M, Spinardi L, Pierucci E, Fanti S, Bartoletti M, Dicataldo M, Sabattini E, Bonifazi F, Zinzani PL.
- Subjects
Oncology ,large B-cell non-Hodgkin lymphoma ,Cancer Research ,medicine.medical_specialty ,business.industry ,CAR T-cell therapy ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Leukapheresis ,medicine.disease ,Chimeric antigen receptor ,Article ,Lymphoma ,Cytokine release syndrome ,Refractory ,Chemoimmunotherapy ,Internal medicine ,medicine ,B-Cell Non-Hodgkin Lymphoma ,Rituximab ,business ,RC254-282 ,relapsed/refractory lymphoma ,medicine.drug - Abstract
Simple Summary CAR T-cell therapies have undoubtedly revolutionized the treatment of relapsed/refractory B-cell non-Hodgkin lymphoma. These therapies represent a valuable new treatment option, yielding impressive complete remission rates and improving survival. The aim of this article is to give an overview of emerging real-world evidence since data from every-day clinical practice are still scarce. We report effectiveness and safety data on 30 patients treated at our Institution. Treatment in this setting with CD19-targeted CAR T-cell therapies for relapsed/refractory B-cell non-Hodgkin lymphoma showed a manageable safety profile and high objective response rate, confirming the encouraging results of the pivotal clinical trials. Abstract Large B-cell lymphomas (LBCL) are the most common types of non-Hodgkin lymphoma. Although outcomes have improved thanks to the introduction of rituximab-based chemoimmunotherapy, certain LBCL still represents a challenge because of initial resistance to therapy or recurrent relapses. Axicabtagene ciloleucel (axi-cel) and tisagenlecleucel (tisa-cel) are second-generation autologous CD19-targeted chimeric antigen receptor (CAR) T-cell therapies approved for patients with relapsed/refractory (R/R) LBCL, based on the results of phase II pivotal single-arm trials ZUMA-1 (for axi-cel) and JULIET (for tisa-cel). Here, we report patients outcomes with axi-cel and tisa-cel in the standard of care (SoC) setting for R/R LBCL, treated at our Institution. Data were collected from patients who underwent leukapheresis between August 2019 and February 2021. Toxicities were graded and managed according to the institution’s guidelines. Responses were assessed as per Lugano 2014 classification. Of the 30 patients who underwent leukapheresis, 18 (60%) received axi-cel, while 12 (40%) tisa-cel. Grade 3 or higher cytokine release syndrome and neurotoxicity occurred in 10% and 16% patients, respectively. Best objective and complete response rates were 73.3% and 40%, respectively. Treatment in SoC setting with CD19 CAR T-cell therapies for R/R LBCL showed a manageable safety profile and high objective response rate.
- Published
- 2021
40. Author response for 'Management of chronic lymphocytic leukemia in Italy during a one year of the COVID‐19 pandemic and at the start of the vaccination program. A Campus CLL report'
- Author
-
null Antonio Cuneo, null Gian Matteo Rigolin, null Marta Coscia, null Giulia Quaresmini, null Lydia Scarfò, null Francesca Romana Mauro, null Marina Motta, null Francesca Maria Quaglia, null Livio Trentin, null Andrea Ferrario, null Luca Laurenti, null Gianluigi Reda, null Angela Ferrari, null Daniela Pietrasanta, null Paolo Sportoletti, null Francesca Re, null Lorenzo De Paoli, null Myriam Foglietta, null Annamaria Giordano, null Monia Marchetti, null Lucia Farina, null Giovanni Del Poeta, null Marzia Varettoni, null Federico Chiurazzi, null Roberto Marasca, null Lara Malerba, null Adalberto Ibatici, null Maria Chiara Tisi, null Vittorio Stefoni, null Monica Leone, null Claudia Baratè, null Jacopo Olivieri, null Roberta Murru, null Massimo Gentile, null Alessandro Sanna, null Alessandro Gozzetti, null Valter Gattei, null Daniela Gottardi, null Enrico Derenzini, null Luciano Levato, null Lorella Orsucci, null Giuseppa Penna, null Annalisa Chiarenza, and null Robin Foà
- Published
- 2021
41. BEGEV SALVAGE REGIMEN IN RELAPSED/REFRACTORY CLASSICAL HODGKIN LYMPHOMA: A REAL‐LIFE EXPERIENCE
- Author
-
G. Bagnato, Vittorio Stefoni, Laura Nanni, M. Gentilini, Paolo Elia Coppola, Alice Morigi, P. L. Zinzani, Lisa Argnani, Alessandro Broccoli, Cinzia Pellegrini, Matteo Carella, Beatrice Casadei, and Ginevra Lolli
- Subjects
Oncology ,Cancer Research ,medicine.medical_specialty ,business.industry ,Internal medicine ,Relapsed refractory ,Salvage regimen ,medicine ,Classical Hodgkin lymphoma ,Hematology ,General Medicine ,business - Published
- 2021
42. ROMIDEPSIN‐CHOEP PLUS UP‐FRONT STEM‐CELL TRANSPLANTATION IN PERIPHERAL T‐CELL LYMPHOMA (PTCL): FIRST ANALYSIS OF THE PHASE II FIL‐PTCL13 STUDY
- Author
-
Vittorio Stefoni, C. Carniti, Fabio Benedetti, Filippo Ballerini, Annalisa Chiappella, Vittorio Ruggero Zilioli, Andrea Evangelista, C. Castellino, Stefano Volpetti, Monica Tani, Agnese Re, Manuela Zanni, C. Patti, Annalisa Arcari, L. Flenghi, A. L. Molinari, Francesca Re, C. Ghiggi, Antonello Pinto, G. Ciccone, Gerardo Musuraca, Francesca Gaia Rossi, Marzia Varettoni, Paolo Corradini, Lorella Orsucci, R. Ciancia, Stefano Pileri, Sara Veronica Usai, Federica Cavallo, Fiorella Ilariucci, Anna Dodero, and Riccardo Bruna
- Subjects
Cancer Research ,Chemistry ,Hematology ,General Medicine ,medicine.disease ,Peripheral T-cell lymphoma ,Romidepsin ,Transplantation ,Oncology ,Phase (matter) ,medicine ,Cancer research ,Stem cell ,medicine.drug - Published
- 2021
43. BRAF V600E-positive monomorphic epitheliotropic intestinal T-cell lymphoma complicating the course of hairy cell leukemia
- Author
-
Lisa Argnani, Claudio Agostinelli, Michelangelo Fiorentino, Alessandro Broccoli, Clara Bertuzzi, Michele Cavo, Vittorio Stefoni, Alice Morigi, and Pier Luigi Zinzani
- Subjects
0301 basic medicine ,Intestinal T-cell lymphoma ,business.industry ,Mutant ,medicine.disease ,Lymphoma ,BRAF V600E ,Pathogenesis ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Oncology ,hemic and lymphatic diseases ,030220 oncology & carcinogenesis ,Cancer research ,medicine ,Immunohistochemistry ,Pharmacology (medical) ,Hairy cell leukemia ,Cladribine ,business ,medicine.drug - Abstract
Hairy cell leukemia (HCL) is an uncommon B-cell chronic lymphoproliferative disorder whose pathogenesis and recurrence are strictly dependent on the presence of the BRAF V600E mutant. A 65-year-old male presented a monomorphic epitheliotropic intestinal T-cell lymphoma (formerly enteropathy-associated T-cell lymphoma, type II) with HCL not responding to first-line induction with cladribine. The intestinal lymphoma bears the BRAF V600E mutant, which is the molecular hallmark of HCL, being implicated in its pathogenesis. The case is of interest, as it provides the first description of a BRAF V600E-positive intestinal T-cell lymphoma, along with immunohistochemical and molecular demonstration, occurring in concomitance with HCL. A novel digital PCR-base method for HCL disease assessment is also suggested.
- Published
- 2019
44. Role of 18F-FLT PET/CT in suspected recurrent or residual lymphoma: final results of a pilot prospective trial
- Author
-
Cristina Fonti, Alessandro Broccoli, Cinzia Pellegrini, Alessandro Lambertini, Pier Luigi Zinzani, Cristina Nanni, Vittorio Stefoni, Filippo Lodi, Stefano Fanti, Lucia Zanoni, and Zanoni L, Broccoli A, Lambertini A, Pellegrini C, Stefoni V, Lodi F, Fonti C, Nanni C, Zinzani PL, Fanti S
- Subjects
Adult ,Male ,Positron emission tomography ,medicine.medical_specialty ,Lymphoma ,Sensitivity and Specificity ,030218 nuclear medicine & medical imaging ,F-18-FDG ,Lesion ,03 medical and health sciences ,0302 clinical medicine ,Fluorodeoxyglucose F18 ,Positron Emission Tomography Computed Tomography ,Biopsy ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,F-18-FLT ,Relapse ,music ,Aged ,PET-CT ,music.instrument ,medicine.diagnostic_test ,business.industry ,Histology ,General Medicine ,Middle Aged ,medicine.disease ,Follicular hyperplasia ,Dideoxynucleosides ,Prospective trial ,030220 oncology & carcinogenesis ,Female ,Radiology ,Neoplasm Recurrence, Local ,Radiopharmaceuticals ,medicine.symptom ,business - Abstract
Purpose: To evaluate the role of F-18-Fluorothymidine (FLT) PET/CT in lymphoma patients with suspected recurrent or residual disease. Methods: Adult lymphoma patients presenting with positive or equivocal F-18-FDG PET/CT at end-treatment or follow-up were prospectively addressed to an additional F-18-FLT-PET/CT. SUV max and tumour-to-background ratios (TBRs) were recorded for the most avid lesion. Biopsy or, when not available, clinical or imaging assessment were employed as standard of reference. Results: Overall 52 patients were recruited. Histology was available in 20/52 patients (38%), proliferation-index (Ki-67) in 14/20. Disease was excluded in 13/52 patients (25%) (one reactive follicular hyperplasia, five reactive-inflammatory tissues, four reactive nodes, two nodal sarcoid-like and one non-specific peri-caecal finding). FDG and FLT scans were concordant in disease restaging in 34/52 patients (65%), whereas in 18/52 cases (35%) relevant discrepancies were recorded. SUV max and TBR were significantly higher in the disease versus the disease-free group, with both tracers (p = 0.0231 and 0.0219 for FDG; p = 0.0008 and 0.0016 for FLT). FLT-SUVmax demonstrated slightly better performance in discriminating benign from malignant lesions (ROC-AUC: 0.8116 and 0.7949 for FLT-SUV max and TBR; 0.7120 and 0.7140 for FDG). Optimal FLT-SUV max cut-offs were searched: three would lead to 95% sensitivity, 81% accuracy, and 39% specificity, whereas seven led to 100%, 41%, and 56% respectively. No statistically significant correlation was observed between the two FLT indices and Ki-67. Conclusions: According to our results in a clinical setting of recurrent or residual lymphoma, FLT is not significantly superior to FDG and it is unlikely that it will be employed independently. FLT may be restricted to a few specific cases, as complementary to standard FDG imaging, to confirm a diagnosis or to define a better target to biopsy. However, due to FLT suboptimal performance, many findings would remain inconclusive, requiring further diagnostic procedures and reducing the effectiveness of performing an additional FLT scan.
- Published
- 2019
45. The treatment of hairy cell leukemia with a focus on long lasting responses to cladribine: A 30-year experience
- Author
-
Vittorio Stefoni, Ginevra Lolli, Pier Luigi Zinzani, Alice Morigi, Giulia Gabrielli, Beatrice Casadei, Cinzia Pellegrini, Matteo Carella, Alessandro Broccoli, Carolina Terragna, Paolo Elia Coppola, Elena Sabattini, Laura Nanni, Lisa Argnani, Broccoli A., Argnani L., Nanni L., Terragna C., Sabattini E., Gabrielli G., Stefoni V., Pellegrini C., Casadei B., Morigi A., Lolli G., Carella M., Coppola P.E., and Zinzani P.L.
- Subjects
Long lasting ,Adult ,Male ,medicine.medical_specialty ,Purine analogue ,Antineoplastic Agents ,Gastroenterology ,Follow-Up Studie ,Antineoplastic Agent ,Internal medicine ,medicine ,Humans ,Hairy cell leukemia ,Cladribine ,Complete response ,Aged ,Response rate (survey) ,Aged, 80 and over ,Leukemia, Hairy Cell ,business.industry ,Hematology ,Middle Aged ,medicine.disease ,First line treatment ,Treatment Outcome ,Significant response ,Female ,business ,Follow-Up Studies ,medicine.drug ,Human - Abstract
The treatment of hairy cell leukemia (HCL) has considerably changed over years. Purine analogues, namely cladribine, now represent the treatment of choice. One hundred and eighty-four patients were followed between 1986 and 2018 and treated according to era-specific guidelines. Responses were classified by combining Consensus Resolution criteria and marrow immunohistochemistry. Patients were grouped according to the number of treatment lines they received. Patients treated first line responded in 86% of cases, with complete response (CR) in 44% of cases. Response rates remained high throughout the first four lines (84%, 81%, 79% for the second line onward, with CR in 38%, 37%, 15% of cases respectively). One hundred and twenty-two patients received cladribine as first line treatment, with a response rate of 86% and a CR rate of 54%. Among the 66 CR patients, 45 (68%) have never received further therapy: 11 patients are in continuous CR between 5 and 10 years after treatment, 14 between 10 and 20 years and three patients at more than 20 years. Median time-to-next treatment (TTNT) for frontline cladribine-treated patients was 8.2 years: partial responders had a significantly shorter median TTNT than CR patients (5.3 years vs median not reached at 25.8 years, p< 0.001). Patients with HCL require subsequent lines of therapy in more than 50% of cases. Purine analogues allow significant response rates when applied first line and upon retreatment. Some patients may enjoy long lasting treatment-free intervals after one course of cladribine.
- Published
- 2021
46. Treatment and outcomes of primary mediastinal B cell lymphoma: a three-decade monocentric experience with 151 patients
- Author
-
Laura Nanni, Matteo Carella, Beatrice Casadei, Lisa Argnani, Cinzia Pellegrini, Paolo Elia Coppola, Ginevra Lolli, Vittorio Stefoni, Pier Luigi Zinzani, Alessandro Broccoli, Michele Cavo, Alice Morigi, Casadei B., Argnani L., Morigi A., Lolli G., Broccoli A., Pellegrini C., Nanni L., Stefoni V., Coppola P.E., Carella M., Cavo M., and Zinzani P.L.
- Subjects
Oncology ,Adult ,Male ,medicine.medical_specialty ,Vincristine ,Lymphoma, B-Cell ,Cyclophosphamide ,Adolescent ,medicine.medical_treatment ,Leucovorin ,Mediastinal Neoplasms ,MACOP-B ,Bleomycin ,Young Adult ,Antineoplastic Agents, Immunological ,Prednisone ,Internal medicine ,Checkpoint inhibitor ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Aged ,Retrospective Studies ,Aged, 80 and over ,Radiotherapy ,business.industry ,Hematology ,General Medicine ,Middle Aged ,medicine.disease ,Chemotherapy regimen ,Radiation therapy ,Regimen ,Methotrexate ,Treatment Outcome ,Doxorubicin ,Primary mediastinal B cell lymphoma ,Rituximab ,Female ,Original Article ,Primary mediastinal B-cell lymphoma ,business ,medicine.drug - Abstract
Primary mediastinal B cell lymphoma is a rare entity and often should be promptly treated as a hematological emergency: The initial treatment decision is crucial for the management of this disease. An observational retrospective study was conducted with the aim to improve information on treatment and outcomes of primary mediastinal B cell lymphoma in real practice. After 12 cycles of MACOP-B regimen (methotrexate, doxorubicin, cyclophosphamide, vincristine, bleomycin, and prednisone) with or without rituximab, 120 patients out of 151 (79.5%) achieved a complete response and 12 (7.9%) a partial response leading to a global response of 87.4%. The 21-year overall survival is 82.6%; progression-free and disease-free survivals are 69.3% and 86.4%, respectively. Regarding the role of radiotherapy (RT), patients with a negative PET scan after MACOP-B did not undergo RT: One out of these 48 (2.1%) showed a relapse at 11 months. All relapsed/refractory patients who achieved a response with checkpoint inhibitors are still in continuous complete response with a median follow-up of 14 months. Data that we have gathered over a 30-year experience in the treatment of primary mediastinal B cell lymphoma patients clearly indicate that a third-generation chemotherapy regimen such as MACOP-B is feasible and easily deliverable on an outpatient basis. Regarding the unmet medical need of relapsed/refractory patients, new encouraging results occurred with the advent of the checkpoint inhibitors.
- Published
- 2021
47. Intravascular Large B-cell Lymphoma Successfully Treated with Autologous Transplantation
- Author
-
Vittorio Stefoni, Lisa Argnani, Alice Morigi, Alessandro Broccoli, Pier Luigi Zinzani, Morigi A., Stefoni V., Argnani L., Broccoli A., and Zinzani P.L.
- Subjects
Oncology ,Cancer Research ,medicine.medical_specialty ,Aggressive lymphoma ,Aggressive disease ,03 medical and health sciences ,0302 clinical medicine ,Autologous stem-cell transplantation ,autologous transplatation ,Internal medicine ,medicine ,Autologous transplantation ,Complete remission ,blodd vessel ,Intravascular large B-cell lymphoma ,Antineoplastic Combined Chemotherapy Protocol ,business.industry ,Hematopoietic Stem Cell Transplantation ,Hematology ,Middle Aged ,Vascular Neoplasm ,medicine.disease ,Lymphoma ,Consolidation Chemotherapy ,Transplantation, Autologou ,Treatment Outcome ,030220 oncology & carcinogenesis ,Rituximab ,Female ,Lymphoma, Large B-Cell, Diffuse ,business ,030215 immunology ,medicine.drug ,Human - Abstract
Clinical Practice Points • Intravascular large B-cell lymphoma is an aggressive disease with a poor outcome, and the use of autologous stem cell transplantation is still a matter of debate. • In our case, autologous stem cell transplantation was a winning choice, as it allowed the achievement of a lasting complete remission.
- Published
- 2021
48. Management of chronic lymphocytic leukemia in Italy during a one year of the COVID-19 pandemic and at the start of the vaccination program. A Campus CLL report
- Author
-
Marina Motta, Daniela Gottardi, Vittorio Stefoni, Daniela Pietrasanta, Gianluigi Reda, Lydia Scarfò, Gian Matteo Rigolin, Annalisa Chiarenza, Francesca Maria Quaglia, Maria Chiara Tisi, Alessandro Sanna, Luciano Levato, Robin Foà, Monica Leone, Livio Trentin, Massimo Gentile, Monia Marchetti, Adalberto Ibatici, Enrico Derenzini, Roberta Murru, Antonio Cuneo, Angela Ferrari, Giulia Quaresmini, Francesca Romana Mauro, Annamaria Giordano, Lucia Farina, Myriam Foglietta, Paolo Sportoletti, Lara Malerba, Alessandro Gozzetti, Roberto Marasca, Federico Chiurazzi, Lorenzo De Paoli, Francesca Re, Giovanni Del Poeta, Andrea Ferrario, Marta Coscia, Luca Laurenti, Lorella Orsucci, Marzia Varettoni, Claudia Baratè, Giuseppa Penna, Valter Gattei, Jacopo Olivieri, Cuneo, A., Rigolin, G. M., Coscia, M., Quaresmini, G., Scarfo', L., Mauro, F. R., Motta, M., Quaglia, F. M., Trentin, L., Ferrario, A., Laurenti, L., Reda, G., Ferrari, A., Pietrasanta, D., Sportoletti, P., Re, F., De Paoli, L., Foglietta, M., Giordano, A., Marchetti, M., Farina, L., Del Poeta, G., Varettoni, M., Chiurazzi, F., Marasca, R., Malerba, L., Ibatici, A., Tisi, M. C., Stefoni, V., Leone, M., Barate, C., Olivieri, J., Murru, R., Gentile, M., Sanna, A., Gozzetti, A., Gattei, V., Gottardi, D., Derenzini, E., Levato, L., Orsucci, L., Penna, G., Chiarenza, A., and Foa, R.
- Subjects
Male ,Cancer Research ,2019-20 coronavirus outbreak ,Time Factors ,targeted agents ,Coronavirus disease 2019 (COVID-19) ,Chronic lymphocytic leukemia ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,NO ,COVID‐19 ,Pandemic ,medicine ,Humans ,Chronic ,chronic lymphocytic leukemia ,COVID-19 ,vaccination ,Letter to the Editor ,Aged ,Leukemia ,business.industry ,SARS-CoV-2 ,Vaccination ,B-Cell ,Disease Management ,Hematology ,General Medicine ,Middle Aged ,medicine.disease ,Prognosis ,Virology ,Leukemia, Lymphocytic, Chronic, B-Cell ,Lymphocytic ,Settore MED/15 - MALATTIE DEL SANGUE ,Oncology ,Italy ,Female ,business - Published
- 2021
49. Rapid but reversible progression and transformation of chronic lymphocytic leukemia after temporary ibrutinib discontinuation due to off-target toxicity: two interesting cases
- Author
-
Alessandro Broccoli, Elena Sabattini, Clara Bertuzzi, Lisa Argnani, Pier Luigi Zinzani, Vittorio Stefoni, Paolo Elia Coppola, Beatrice Casadei, Coppola P.E., Broccoli A., Argnani L., Casadei B., Stefoni V., Bertuzzi C., Sabattini E., and Zinzani P.L.
- Subjects
Cancer Research ,Chronic lymphocytic leukemia ,chemistry.chemical_compound ,Piperidines ,immune system diseases ,hemic and lymphatic diseases ,Humans ,Medicine ,Protein Kinase Inhibitors ,business.industry ,Adenine ,Hematology ,medicine.disease ,Leukemia, Lymphocytic, Chronic, B-Cell ,chronic lymphocytic leukemia, ibrutinib discontinuation, off-target toxicity ,Discontinuation ,Transformation (genetics) ,medicine.anatomical_structure ,Oncology ,chemistry ,Ibrutinib ,Toxicity ,Cancer research ,Bone marrow ,CD5 ,business - Abstract
Chronic lymphocytic leukemia (CLL) is a lymphoproliferative disorder caused by the clonal proliferation and accumulation of small, mature-appearing CD5+ B-lymphocytes in the blood, bone marrow and ...
- Published
- 2021
50. Successful stem cell harvest and autologous transplantation in a patient with cold agglutinin syndrome and aggressive lymphoma
- Author
-
Pier Luigi Zinzani, Vittorio Stefoni, Lisa Argnani, Alice Morigi, Michele Cavo, Beatrice Casadei, Emanuela Sergio, Morigi A., Casadei B., Argnani L., Stefoni V., Sergio E., Cavo M., and Zinzani P.L.
- Subjects
Cancer Research ,Stem cell harvest ,Anemia ,Aggressive lymphoma ,Uncommon disorder ,Transplantation, Autologous ,03 medical and health sciences ,0302 clinical medicine ,hemic and lymphatic diseases ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Autologous transplantation ,Humans ,Cryoglobulins ,Cold agglutinin syndrome ,business.industry ,Lymphoma, Non-Hodgkin ,Stem Cells ,Hematopoietic Stem Cell Transplantation ,Hematology ,stem cell harvest, autologous transplantation, cold agglutinin syndrome, aggressive lymphoma ,medicine.disease ,Cold Agglutinin ,Oncology ,030220 oncology & carcinogenesis ,Immunology ,Anemia, Hemolytic, Autoimmune ,Autoimmune hemolytic anemia ,business ,030215 immunology ,Stem Cell Transplantation - Abstract
Cold agglutinin mediated autoimmune hemolytic anemia is an uncommon disorder characterized by the presence of cold agglutinins and it is associated with clinical symptoms caused by anemia and agglu...
- Published
- 2020
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.