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Anna Paola Iori,
Massimo Breccia,
Corrado Girmenia,
Salvatore Perrone, Veronica Valle,
Fiammetta Natalino,
Walter Barberi,
Emilia Scalzulli,
Giovanni Fernando Torelli,
Maria Cristina Puzzolo,
Robin Foà
Leukemia & lymphoma 10/2012; · 2.40 Impact Factor
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Leukemia research 05/2012; 36(8):e185-6. · 2.36 Impact Factor
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Anna Paola Iori, Veronica Valle,
Alfonso Piciocchi,
Giovanna Meloni,
Giovanni Fernando Torelli,
Antonella Vitale,
Anna Maria Testi,
Walter Barberi,
Roberto Ricci,
Filippo Milano,
Barbarella Lucarelli,
Maria Screnci,
Maria Paola Perrone,
Luca Laurenti,
Fiammetta Natalino,
Salvatore Perrone,
Nicoletta Sacchi,
William Arcese,
Roberto Foà
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ABSTRACT: To assess the effectiveness of the search for an unrelated donor on the outcome of patients with high-risk acute lymphoblastic leukemia, we analyzed prospectively 136 patients who underwent a search for cord blood (CB) and an unrelated volunteer donor (UD) at the same time. The probability of finding a donor was 58.2%, 70.3%, and 75.7% at 3, 6, and 12 months, respectively. The median time to find a donor was 1.8 months for CB and 3.5 months for UD. Of the 99 patients with a donor, 38.4% failed to undergo the transplant because of a relapse observed at a median of 4 months from the start of the search. In univariate analysis, absence of relapse during the search (p < 0.0001) and transplant (p = 0.004) showed a positive impact on long-term survival. In multivariate analysis, relapse during the search remained the key factor affecting survival (p < 0.0001). Since an extension of the search beyond 3 months enables only a slight increase in the probability of finding a donor compared to the increased risk of relapse, the time of the search should not exceed the 3-month time point. The simultaneous search for CB and UD increases the likelihood of performing a timely transplant.
Annals of Hematology 01/2012; 91(6):941-8. · 2.62 Impact Factor
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Giovanni F Torelli,
Barbarella Lucarelli,
Anna P Iori,
Maria S De Propris,
Angela Capobianchi,
Walter Barberi, Veronica Valle,
Emilia Iannella,
Fiammetta Natalino,
Caterina Mercanti,
Salvatore Perrone,
Giuseppe Gentile,
Anna Guarini,
Robin Foà
[show abstract]
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ABSTRACT: Aim of the study was to correlate the clinical outcome of eighteen patients who have undergone an allogeneic stem cell transplant (SCT) with the concentration in the peripheral blood (PB) of lymphocyte subpopulations evaluated at 1 year from transplant. The occurrence of acute GVHD and CMV infection correlated with the concentration of Tregs in the PB; CMV infection also correlated with the content of NK cells. The obtained results document that the concentration of Tregs in the PB after an allogeneic SCT may protect from GVHD and from CMV infection; the potential anti-viral role of NK cells is confirmed.
Leukemia research 04/2011; 35(8):1124-6. · 2.36 Impact Factor
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Leukemia research 03/2011; 35(10):1423-4. · 2.36 Impact Factor
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Corrado Girmenia,
Caterina Mercanti,
Vincenzo Federico,
Massimiliano Rea,
Annalisa De Vellis, Veronica Valle,
Alessandra Micozzi,
Roberto Latagliata,
Massimo Breccia,
Salvatore Giacomo Morano,
Gregorio Antonio Brunetti,
Michela Sali,
Giovanni Delogu,
Robin Foà,
Giuliana Alimena,
Giuseppe Gentile
[show abstract]
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ABSTRACT: Data derived from epidemiologic surveillance adopted at our center in hematologic and stem cell transplant patients during the 2009 influenza A (H1N1)v pandemic are reported. Of the 52 patients with influenza-like disease we observed, 37 underwent a real-time PCR evaluation and 21 had a confirmed diagnosis. Of the RT-PCR-confirmed cases, 23.8% were children (age <18 years) and 9.5% were >65 years; 47.6% presented with a pulmonary infiltrate and 33.3% with respiratory failure. Pulmonary involvement was observed more frequently in patients with comorbidities. All patients received a course of oseltamivir therapy starting an average of 1 day (range <1-2) after the onset of symptoms. No patient was transferred to the intensive care unit. The viral disease had a generally favorable outcome despite the high frequency of pulmonary involvement. A prompt clinical evaluation with an early antiviral and supportive therapy may have played a beneficial role in the outcome.
Acta Haematologica 03/2011; 126(1):1-7. · 1.35 Impact Factor
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Giovanni F Torelli,
Fiammetta Natalino,
Walter Barberi,
Roberta Maggio,
Nadia Peragine,
Maria S De Propris,
Alfonso Piciocchi, Veronica Valle,
Emilia Iannella,
Anna P Iori,
Anna Guarini,
Robin Foà
British Journal of Haematology 10/2010; 151(1):86-9. · 4.94 Impact Factor
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Massimo Breccia,
Francesca Palandri,
Anna Paola Iori,
Elisabetta Colaci,
Roberto Latagliata,
Fausto Castagnetti,
Giovanni Fernando Torelli,
Sara Usai, Veronica Valle,
Giovanni Martinelli,
Gianantonio Rosti,
Robin Foà,
Michele Baccarani,
Giuliana Alimena
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ABSTRACT: Philadelphia-positive chronic myeloid leukemia (Ph+ CML) patients who are resistant to imatinib are commonly treated with second-generation tyrosine kinase inhibitors (TKIs). Limited data exist on the possible effects of these drugs on subsequent allogeneic hematopoietic stem cell transplantation (allo-HSCT).The outcome of 12 imatinib-resistant CML patients treated with dasatinib or nilotinib or both before allo-HSCT, was retrospectively analyzed. Patients were treated with second-generation TKIs for 1-17 months (median, 8). At the time of transplant, 3 patients were in complete cytogenetic response (CCgR), 3 patients in partial cytogenetic response (PCgR) and 6 patients were in less than PCgR. Donors were HLA-matched related in 4 cases and unrelated in 8 cases. Stem cell source was peripheral blood, bone marrow or cord blood in 6, 5 and 1 cases, respectively. All patients engrafted successfully and all but one achieved a full donor chimerism. Three patients experienced acute and chronic graft-versus-host disease. No cases of transplant-related mortality were recorded. Best response to allo-HSCT was complete molecular response (CMR) in 9 patients, major molecular response (MMR) in 1 patient and CCgR in 2 patients. Median follow-up was 16.5 months. At the last evaluation, 9 patients were in continuous CMR and 1 patient was in MMR; 2 patients had died of disease progression. Second-generation TKIs given before allo-HSCT do not negatively affect transplant engraftment and response rate, nor increases transplant-related toxicity.
Leukemia research 06/2009; 34(2):143-7. · 2.36 Impact Factor
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Anna P Iori,
Giovanni F Torelli,
Maria S De Propris,
Filippo Milano,
Simonetta Pupella,
Maria Gozzer,
Francesca Mancini,
Maria L Milani,
Stefania Intoppa,
Raffaella Cerretti,
Barbarella Lucarelli, Veronica Valle,
Luigi Malandruccolo,
Emilia Iannella,
Eva Arleo,
Anna Guarini,
Robin Foà
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ABSTRACT: The influence of the graft composition on the clinical outcome after allogeneic peripheral blood stem cell (PBSC) transplantation is not well established.
The cellular composition of the apheretic products obtained from 63 human leukocyte antigen-identical siblings was prospectively correlated with the outcome of patients with hematological malignancies undergoing an allogeneic PBSC transplant after myeloablative conditioning. The concentration of nuclear, mononuclear, CD34+, T-cell subsets, B cells, and natural killer cells in the graft has been analyzed.
In univariate analysis, acute graft-versus-host disease (GVHD) correlated with the disease (P=0.002), with the phase of disease at transplant (P=0.01), and with the number of CD20+ cells infused (P=0.05). In multivariate analysis, a dose of CD20+ cells in the graft higher than the median dose remained the only factor negatively affecting the incidence of acute GVHD (P=0.01; 95% confidence interval [CI]: 0.12-0.78). In univariate analysis, treatment-related mortality (TRM) correlated with the disease (P=0.04) and was negatively affected by a dose of infused B cells greater than the median value (28% versus 50%; P=0.02). In multivariate analysis, TRM was close to statistical correlation with the dose of CD20+ cells (P=0.06; 95% CI: 0.02-1.05). No other clinical parameter was influenced by the composition of the graft.
Our results suggest that the concentration of B cells in the apheretic product may predict the incidence of acute GVHD and TRM in patients undergoing an allogeneic PBSC transplantation and open the way to the new preventive and therapeutic strategies for the management of GVHD.
Transplantation 03/2008; 85(3):386-90. · 4.00 Impact Factor
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ABSTRACT: The prognostic impact of the presence of a familial trait was analyzed in 1449 patient with chronic lymphocytic leukemia (CLL). A family history of hematologic malignancy (HM) was identified in 181 cases (12.5%) and recorded more frequently among female than male patients (HM: p < 0.05; CLL: p < 0.05). The relative was affected by CLL in 89 cases (6%). Familial and sporadic cases showed non-statistically different proportions of advanced stages (10.8 vs 7.1%) and patients requiring therapy (55 vs 60%) and a similar survival probability at 10 years (67 vs 66%). These data suggest that in CLL the presence of a familial trait does not imply an adverse prognosis.
Haematologica 08/2006; 91(8):1117-20. · 6.42 Impact Factor
