S Guidi

Publications (55)201.67 Total impact

• Source

  Available from: Massimo Martino

  Article: SIdEM gItMo

  Dcth, G Milone, M Martino, S Leotta, S Guidi, R Saccardi, S Mercurio, G Avola, M G Camuglia, F Iacona, B Bartolozzi, C Nozzoli, A Spadaro, S Liggeri, S Disca, L Iacopino, A Bosi
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  ABSTRACT: A substantial fraction of all patients who undergo first attempt CD34+ cell mobilization and PBSC harvest, fail this process. In unselected patients Such failure may interest 10-30% (1) while in Multiple Myeloma Patients at their first attempt of mobilization failure may be seen in 5-15% of patients (1-3). A second attempt of Hematopoietic Stem Cell (HSC) mobilization is usually offered to patients experiencing mo-bilization failure, exploiting new and highly active drugs acting on CXCR4-SDF-1 axis (Plerixafor) (1, 3, 4). However, these "salvage treatments" are costly and optimization of the first mobiliz-ing attempt needs, therefore, to be actively pursued notwithstanding the availability of this new class of mobiliz-ing agents. Failure of the first attempt at mobiliza-tion in multiple Myeloma has been as- CD34+harvestat:variabilityin
  Drugs and Cell Therapies in Hematology. 10/2012; DCtH(Suppl. 2012):91-103.
• Article: The HSE indicator tool, psychological distress and work ability.

  S Guidi, S Bagnara, G P Fichera
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  ABSTRACT: The Health and Safety Executive (HSE) indicator tool is one of the most commonly used tools for assessing the risk of work-related stress. Few studies, however, have investigated whether and how its scales are related to psychological distress or other work-related health outcomes. To investigate the relationship between the HSE indicator tool, psychological distress, as measured by the General Health Questionnaire (GHQ)-12, and work ability, assessed by the Work Ability Index (WAI). All the employees of a mid-sized bank in Italy were asked to fill in an anonymous cross-sectional questionnaire. The questionnaire was structured in four sections: the first one comprised socio-demographic questions and the other three corresponded, respectively, to the Italian translations of the GHQ-12, the HSE and the WAI questionnaires. Four hundred and thirteen employees completed the questionnaire. The response rate was 99%. Controlling for age and gender, the indicator subscales were negatively associated with the adopted measures of psychological distress and work ability. The GHQ score was also highly correlated with the WAI score and able to explain ≈ 47% of its variance. The only subscale that was still significantly associated with the WAI after removing the effect of psychological distress was 'control'. The study presents new evidence for the validity of the HSE indicator tool to estimate the risk of work-related stress and suggests that most but not all the effects of psychosocial conditions on work ability might be mediated by the level of psychological distress induced by these conditions.
  Occupational Medicine 03/2012; 62(3):203-9. · 1.14 Impact Factor
• Article: Successful tigecycline lock therapy in a Lactobacillus rhamnosus catheter-related bloodstream infection.

  F Bartalesi, S Veloci, F Baragli, E Mantengoli, S Guidi, A M Bartolesi, R Mannino, P Pecile, A Bartoloni
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  ABSTRACT: Catheter-related bloodstream infections very often involve the premature removal of long-term intravascular devices (LTID). The antibiotic lock therapy (ALT) represents a conservative approach to the treatment of uncomplicated infections of tunneled LTID when catheter removal is not a feasible option. We present here the first reported case of tunneled LTID bloodstream infection due to a multidrug resistant Lactobacillus rhamnosus. The patient, who had large granular lymphocytic leukemia, was successfully treated with systemic tigecycline therapy and lock therapy. Our results confirm ALT as a valid catheter-salvage strategy for the treatment of CRBSIs in clinically stable patients when catheter removal is not a feasible option, tigecycline appear to be a good option.
  Infection 10/2011; 40(3):331-4. · 2.66 Impact Factor
• Article: Allogeneic transplantation improves the overall and progression-free survival of Hodgkin lymphoma patients relapsing after autologous transplantation: a retrospective study based on the time of HLA typing and donor availability.

  Barbara Sarina, Luca Castagna, Lucia Farina, Francesca Patriarca, Fabio Benedetti, Angelo M Carella, Michele Falda, Stefano Guidi, Fabio Ciceri, Alessandro Bonini, [......], Michele Malagola, Enrico Morello, Giuseppe Milone, Benedetto Bruno, Nicola Mordini, Simonetta Viviani, Alessandro Levis, Laura Giordano, Armando Santoro, Paolo Corradini
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  ABSTRACT: Hodgkin lymphoma relapsing after autologous transplantation (autoSCT) has a dismal outcome. Allogeneic transplantation (alloSCT) using reduced intensity conditioning (RIC) is a salvage option, but its effectiveness is still unclear. To evaluate the role of RIC alloSCT, we designed a retrospective study based on the commitment of attending physicians to perform a salvage alloSCT; thus, only Hodgkin lymphoma patients having human leukocyte antigen-typing immediately after the failed autoSCT were included. Of 185 patients, 122 found an identical sibling (55%), a matched unrelated (32%) or a haploidentical sibling (13%) donor; 63 patients did not find any donor. Clinical features of both groups did not differ. Two-year progression-free (PFS) and overall survival (OS) were better in the donor group (39.3% vs 14.2%, and 66% vs 42%, respectively, P < .001) with a median follow-up of 48 months. In multivariable analysis, having a donor was significant for better PFS and OS (P < .001). Patients allografted in complete remission showed a better PFS and OS. This is the largest study comparing RIC alloSCT versus conventional treatment after a failed autoSCT, indicating a survival benefit for patients having a donor.
  Blood 03/2010; 115(18):3671-7. · 9.90 Impact Factor
• Article: BU/melphalan and auto-SCT in AML patients in first CR: a 'Gruppo Italiano Trapianto di Midollo Osseo (GITMO)' retrospective study.

  R M Lemoli, A D'Addio, G Marotta, L Pezzullo, E Zuffa, M Montanari, A De Vivo, A Bonini, P Galieni, A M Carella, S Guidi, M Michieli, A Olivieri, A Bosi
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  ABSTRACT: AML patients (total 129; median age =50 years; range 16-72) in first CR received BU and melphalan (BU/Mel) as conditioning regimen before auto-SCT. In all, 82 patients (63.6%) received PBSCs and 47 patients (36.4%) received BM cells. The distribution of cytogenetic categories was conventionally defined as favorable (15.5%), intermediate (60.1%) and unfavorable (24.3%). With a median follow-up of 31 months, the 8-year projected OS and disease-free survival (DFS) was 62 and 56% for the whole population, respectively. The relapse rate was 46% and the non-relapse mortality was 4.65%. Although PBSC transplantation led to a faster hematological recovery than BM transplantation, in univariate analysis the stem cell source, cytogenetics and different BU formulations did not significantly affect OS and DFS, whereas age and the number of post-remission chemotherapy cycles did have a significant effect on the clinical outcome. Multivariate analysis identified age <55 years as the only important independent predictor for OS and DFS. Our data suggest that BU/Mel, being associated with a low toxicity profile (mainly mucositis) and mortality, is an effective conditioning regimen even for high-risk AML patients in first CR undergoing auto-SCT.
  Bone marrow transplantation 10/2009; 45(4):640-6. · 3.00 Impact Factor
• Article: Molecular epidemiological investigation of an outbreak of Pseudomonas aeruginosa infection in an SCT unit.

  R Fanci, B Bartolozzi, S Sergi, E Casalone, P Pecile, D Cecconi, R Mannino, F Donnarumma, A G Leon, S Guidi, P Nicoletti, G Mastromei, A Bosi
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  ABSTRACT: From May to October 2006, six severe Pseudomonas aeruginosa infections were diagnosed in patients undergoing SCT in the SCT unit of the Careggi hospital (Florence, Italy). Four of the infected patients were treated consecutively in the same room (room N). On the hypothesis of a possible environmental source of infection, samples were collected from different sites that had potential for cross-contamination throughout the SCT unit, including the electrolytic chloroxidant disinfectant used for hand washing (Irgasan) and the disinfectant used for facilities cleaning. Four of the environmental samples were positive for P. aeruginosa: three Irgansan soap samples and a tap swab sample from the staff cleaning and dressing room. The AFLP (amplified fragment length polymorphism) typing method employed to evaluate strain clonality showed that the isolates from the patients who had shared the same room and an isolate from Irgasan soap had a significant molecular similarity (dice index higher than 0.93). After adequate control measures, no subsequent environmental sample proved positive for P. aeruginosa. These data strongly support the hypothesis of the clonal origin of the infective strains and suggest an environmental source of infection. The AFLP method was fast enough to allow a 'real-time' monitoring of the outbreak, permitting additional preventive measures.
  Bone marrow transplantation 11/2008; 43(4):335-8. · 3.00 Impact Factor
• Article: Human herpesvirus 6-associated limbic encephalitis in adult recipients of unrelated umbilical cord blood transplantation.

  S Matà, S Guidi, C Nozzoli, A Orsi, A Pratesi, M Mascalchi, M Moretti, L Letizia, G Rombolà, S Sorbi, A Bosi
  Bone marrow transplantation 09/2008; 42(10):693-5. · 3.00 Impact Factor
• Article: Immunohistochemical and FISH analyses identify synovitis associated with chronic GVHD after allogeneic hematopoietic SCT.

  C Nozzoli, S Guidi, M Paglierani, E Wnekowicz, R Saccardi, A Bosi, M Santucci, D Massi
  Bone Marrow Transplantation 07/2008; 42(4):289-91. · 3.75 Impact Factor
• Article: Significance of CTLA-4 and CD14 genetic polymorphisms in clinical outcome after allogeneic stem cell transplantation.

  A M Vannucchi, S Guidi, P Guglielmelli, S Glinz, L Lombardini, A Busca, F Locatelli, A M Dall'Omo, A Bosi
  Bone Marrow Transplantation 12/2007; 40(10):1001-2. · 3.75 Impact Factor
• Article: Autologous hematopoietic stem cell transplantation for very active relapsing-remitting multiple sclerosis: report of two cases.

  E Portaccio, M P Amato, G Siracusa, F Pagliai, S Sorbi, S Guidi, A Bosi, R Saccardi
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  ABSTRACT: Autologous hematopoietic stem cell transplantation (AHSCT) has been proposed as a rescue treatment in multiple sclerosis (MS) patients not responding to first- or second-line therapies. To date, most of the treated cases had a secondary progressive disease course. However, patients with high inflammatory activity, but no secondary progression of the disease, could be candidates to take greater advantage of AHSCT. In this paper, we report two cases with very active, relapsing-remitting (RR) MS, who underwent AHSCT, and obtained a dramatic resolution to disease activity.
  Multiple Sclerosis 07/2007; 13(5):676-8. · 4.26 Impact Factor
• Article: Epstein-Barr virus-associated post-transplant lymphoproliferative disease with central nervous system involvement after unrelated allogeneic hematopoietic stem cell transplantation.

  C Nozzoli, B Bartolozzi, S Guidi, A Orsi, A M Vannucchi, F Leoni, A Bosi
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  ABSTRACT: Post-transplant lymphoproliferative disorders (PTLD) represent an heterogeneous group of abnormal lymphoid proliferation related to Epstein-Barr virus (EBV) reactivation that arise early after allogeneic hematopoietic stem cell transplant (HSCT). PLTD with central nervous system (CNS) involvement has been reported in few cases. We describe the case of a 31-year-old-man who developed an EBV-related PTLD with CNS involvement 2 months after an allogeneic unrelated HSCT for acute myeloid leukemia in first complete remission who was successfully treated with rituximab, cidofovir and intrathecal infusion of methotrexate and methylprednisolone.
  Leukemia and Lymphoma 02/2006; 47(1):167-9. · 2.58 Impact Factor
• Article: Role of extracorporeal photochemotherapy in patients with refractory chronic graft-versus-host disease.

  P Rubegni, A Cuccia, P Sbano, G Cevenini, M R Carcagnì, G D'Ascenzo, G De Aloe, S Guidi, P Guglielmelli, P Guglielmetti, G Marotta, F Lauria, A Bosi, M Fimiani
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  ABSTRACT: Recent studies suggest that extracorporeal photochemotherapy (ECP) may be beneficial in patients with steroid-refractory chronic graft-versus-host disease (cGvHD). However, it is not yet clear whether certain conditions, such as age, mode of onset of cGvHD etc., influence clinical response and whether certain affected organs are more sensitive to ECP than others. We analysed the main clinical and laboratory parameters related to evolution of the disease in 32 steroid-refractory cGvHD patients, to identify any useful response predictors to ECP. ECP affected the course of the disease positively in 78% (25/32) of our cases.
  British Journal of Haematology 08/2005; 130(2):271-5. · 4.94 Impact Factor
• Article: Candida krusei fungemia in an unrelated allogeneic hematopoietic stem cell transplant patient successfully treated with Caspofungin.

  R Fanci, S Guidi, M Bonolis, A Bosi
  Bone Marrow Transplantation 07/2005; 35(12):1215-6. · 3.75 Impact Factor
• Article: Extracorporeal photochemotherapy for treatment of fasciitis in chronic graft-versus-host disease.

  P Sbano, P Rubegni, G B De Aloe, S Guidi, M Fimiani
  Bone Marrow Transplantation 05/2004; 33(8):869-70. · 3.75 Impact Factor
• Article: Antithymocyte globulin for graft-versus-host disease prophylaxis in transplants from unrelated donors: 2 randomized studies from Gruppo Italiano Trapianti Midollo Osseo (GITMO).

  A Bacigalupo, T Lamparelli, P Bruzzi, S Guidi, P E Alessandrino, P di Bartolomeo, R Oneto, B Bruno, M Barbanti, N Sacchi, M T Van Lint, A Bosi
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  ABSTRACT: One hundred nine patients with hematologic malignancies, undergoing bone marrow transplants (BMT) from unrelated donors, were randomized in 2 consecutive trials to receive or not to receive antithymocyte globulin (ATG) in the conditioning regimen, as follows: (A) 54 patients (median age, 28 years; 39% with advanced disease) were randomized to no ATG (n = 25) versus 7.5 mg/kg rabbit ATG (Thymoglobulin; Sangstat, Lyon, France) (n = 29); (B) 55 patients (median age, 31 years, 71% with advanced disease) were randomized to no ATG (n = 28) versus 15 mg/kg rabbit ATG (n = 27). Grade III-IV graft-versus-host disease (GVHD) was diagnosed in 36% versus 41% (P =.8) in the first and in 50% versus 11% (P =.001) in the second trial. Transplant-related mortality (TRM), relapse, and actuarial 3-year survival rates were comparable in both trials. In fact, despite the reduction of GVHD in the second trial, a higher risk for lethal infections (30% vs 7%; P =.02) was seen in the arm given 15 mg/kg ATG. Extensive chronic GVHD developed overall more frequently in patients given no ATG (62% vs 39%; P =.04), as confirmed by multivariate analysis (P =.03). Time to 50 x 10(9)/L platelets was comparable in the first trial (21 vs 24 days; P =.3) and delayed in the ATG arm in the second trial (23 vs 38 days; P =.02). These trials suggest that (1) 15 mg/kg ATG before BMT significantly reduces the risk for grade III-IV acute GVHD, (2) this does not translate to a reduction in TRM because of the increased risk for infections, and (3) though survival is unchanged, extensive chronic GVHD is significantly reduced in patients receiving ATG.
  Blood 12/2001; 98(10):2942-7. · 9.90 Impact Factor
• Article: An open evaluation of triple antibiotic therapy including vancomycin for febrile bone marrow transplant recipients with severe neutropenia.

  A Bosi, D Laszlo, S Bacci, R Fanci, S Guidi, R Saccardi, A M Vannucchi, P Rossi-Ferrini
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  ABSTRACT: Infectious complications still represent a major problem in patients submitted to bone marrow transplant (BMT); approximately 40% of febrile episodes are associated with infection and one-third of these are bacteremias. Opinions about the best appropriate empiric regimens are based on evaluation of cost, potential for adverse side-effects, development of bacterial resistance, prevalent nosocomial infections. In order to assess the clinical and microbiological effectiveness of an aggressive approach, we performed a prospective open study in 72 neutropenic febrile BMT patients, employing a triple antibiotic association including amikacin 500 mg x 8h, ceftazidime 2 g x 8 h, vancomycin 500 mg x 8 h as first-line empiric treatment. For the purpose of this study, a lasting return of temperature to normal and complete disappearance of either clinical or bacteriological signs of infection without any modification of therapy was considered as success; the persistence of fever after 72 hours or a protocol change was considered as failure. Eighty episodes were enrolled during the course of the study; bacteriological evidence of infection was obtained in 23 (28.7%) febrile episodes. Median duration of antibiotic administration and of febrile episodes were 5 and 2 days respectively. Overall response rate based on clinical responses was 87% and 91% in microbiological documented infections. Death due to sepsis nor toxicity were observed. This triple antibiotic combination appears to be a very effective regimen for the empiric treatment of febrile episodes in severely neutropenic BMT recipients.
  Journal of chemotherapy (Florence, Italy) 09/1999; 11(4):287-92. · 1.08 Impact Factor
• Article: Evaluation of breast tumour cell contamination in the bone marrow and leukapheresis collections by RT-PCR for cytokeratin-19 mRNA.

  A M Vannucchi, A Bosi, S Glinz, P Pacini, S Linari, R Saccardi, R Alterini, L Rigacci, S Guidi, L Lombardini, G Longo, M P Mariani, P Rossi-Ferrini
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  ABSTRACT: There is considerable interest in an autologous transplantation (AT) programme for patients with high-risk breast cancer; however, the issue of the incidence of occult bone marrow (BM) micrometastasis at diagnosis, and the cancer contamination of peripheral blood stem cell (PBSC) collections used for haematological rescue, is still debated. The presence of BM micrometastasis was evaluated in bilateral BM biopsies obtained at diagnosis of 33 patients with stage II/IIIA breast cancer using: (i) a 'nested' reverse transcriptase-polymerase chain reaction (RT-PCR) assay for cytokeratin 19 (K19) mRNA, (ii) histology, and (iii) immunohistochemistry (IHC) analysis with a panel of three monoclonal antibodies. The RT-PCR assay only was used to determine contamination of PBSC collections obtained after priming with recombinant human granulocyte-colony stimulating factor (rhG-CSF). K19 transcripts in one or both BM samples were detected in 48% of patients at diagnosis, with an overall 85% concordance with the results of IHC analysis. On the other hand, 56% of PCR- and IHC-positive BM samples were diagnosed as 'normal' on histological analysis. 57% of patients showed K19 mRNA in at least one PBSC collection; the possibility to have contaminated PBSC collections was significantly higher in patients with K19 positivity in BM at diagnosis. In four patients who had shown K19 positivity in BM and in PBSC collections, immunoselected CD34+ cells used for haematological rescue were K19-negative. There was a trend towards longer relapse free survival (RFS) in patients transplanted with K19-negative PBSC collections as compared to the others. In conclusion, a substantial proportion of patients with high-risk non-metastatic breast cancer present occult BM micrometastasis at diagnosis and also show cancer contamination of PBSC collections used for AT. These might represent a category of patients with poorer prognosis after AT, and possible candidates for more intensive and/or alternative therapeutic regimens, including AT with purged PBSCs.
  British Journal of Haematology 01/1999; 103(3):610-7. · 4.94 Impact Factor
• Article: Fatal herpesvirus 6 encephalitis after unrelated bone marrow transplant.

  A Bosi, M Zazzi, A Amantini, M Cellerini, A M Vannucchi, A De Milito, S Guidi, R Saccardi, L Lombardini, D Laszlo, P Rossi Ferrini
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  ABSTRACT: A complex pattern of neurological dysfunctions with generalized seizures and visual allucinations, but without focal signs, suddenly arose 20 days after an unrelated bone marrow transplant for chronic myelogenous leukemia (CML) in a 13-year-old girl, accompanied by signs of acute skin graft-versus-host disease (GVHD). Magnetic resonance imaging (MRI) revealed multiple bilateral foci of signal abnormalities, which were exclusively localized in the grey matter, sparing the white. Extensive microbiological and virological assays of cerebrospinal fluid (CSF) allowed the identification of HHV-6, variant A, DNA. Further progression of both neurological alterations and of skin and gut GVHD led to a fatal outcome 2 weeks later. A retrospective analysis of both the recipient and donor mononuclear cell suspensions supported the hypothesis that HHV-6 had been acquired from the donor with the bone marrow graft. This report suggests a pathogenetic role of HHV-6 in viral encephalitis in immunocompromised bone marrow transplant (BMT) recipients, and its possible association with GVHD.
  Bone Marrow Transplantation 09/1998; 22(3):285-8. · 3.75 Impact Factor
• Article: Unrelated donor marrow transplantation for chronic myelogenous leukaemia.

  G Dini, T Lamparelli, R Rondelli, E Lanino, M Barbanti, C Costa, L Manfredini, S Guidi, G Rosti, E P Alessandrino, F Locatelli, P Marenco, D Soligo, P Di Bartolomeo, F Aversa, G La Nasa, A Busca, I Majolino, A De Laurenzi, A Bacigalupo
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  ABSTRACT: Between January 1989 and July 1995 the search for an unrelated donor (UD) was started for 379 consecutive Italian patients with Philadelphia positive (Ph+) chronic myelogenous leukaemia (CML). 89 (23%) were transplanted. The overall probability of transplant before and after December 1991 was 16% and 49%, respectively (P=0.0001), and average interval between search activation and graft was 23 months and 13 months, respectively (P=0.0001). Disease-free survival (DFS) following 60 consecutive transplants performed before February 1996 was 41.5% at 48 months and was 64% for patients grafted after January 1993. In univariate analysis, five variables had a favourable effect on DFS: year of bone marrow transplantation (BMT) after 1993 (P=0.0002), HLA-DRB1 donor/recipient (D/R) match (P=0.0006), total body irradiation (TBI) containing regimen (P=0.0006), graft-versus-host disease (GvHD) prophylaxis including 'early' cyclosporin before the transplant, and a marrow cell dose > 3 x 10(8)/kg of recipient body weight (P=0.04). Multivariate analysis confirmed that HLA identity (P=0.006), TBI-containing regimen (P=0.0001) and 'early cyclosporin' (P=0.04) were associated with higher DFS. Transplant-related mortality (TRM) was 67% in patients grafted before January 1993 and 30% in patients grafted subsequently (P=0.002). Multivariate analysis confirmed DRB1 identity (P=0.03) and TBI-containing regimen (P=0.0005) to be independent factors predictive of low TRM. This suggests that the outcome of patients transplanted from an HLA DRB1 matched donor, after a TBI-containing preparative regimen, is similar to results recently reported in patients transplanted from geno-identical siblings. These results indicate that the search should be initiated at diagnosis for patients < 45 years of age and UD BMT should be considered early in the disease course for those with an available DRB1-matched unrelated donor.
  British Journal of Haematology 07/1998; 102(2):544-52. · 4.94 Impact Factor
• Article: Graft-versus-host antibody reactions in ABO unmatched renal transplants.

  E Bertoni, A Rosati, M Zanazzi, L Moscarelli, L Di Maria, P Tosi, S Bandini, S Guidi, F Truschi, M Salvadori
  Transplantation Proceedings 07/1998; 30(4):1333-4. · 1.00 Impact Factor