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  • 1
    Online Resource
    Online Resource
    Carboplatin and Gemcitabine in the Palliative Treatment of Stage IV Non-Small Cell Lung Cancer: Definitive Results of a Phase II Trial
    SAGE Publications ; 2004
    In:  Tumori Journal Vol. 90, No. 1 ( 2004-01), p. 54-59
    Details
    In: Tumori Journal, SAGE Publications, Vol. 90, No. 1 ( 2004-01), p. 54-59
    Abstract: Cisplatin-containing regimens represent the gold standard in the treatment of advanced non-small cell lung cancer, but carboplatin is often preferred for its better toxic profile when palliation is the aim of the treatment. The synergistic effect and tolerability of carboplatin-gemcitabine combination are well known. In this phase II trial, we evaluated the activity and safety of a schedule with carboplatin and gemcitabine, defined in our previous phase I trial. Methods Thirty-seven patients with measurable stage IV non-small cell lung cancer were treated with carboplatin, AUC 4.5 mg/ml/min on day 1, and gemcitabine, 800 mg/m 2 on days 1 and 8, every 21 days. All patients were treated until disease progression or intractable toxicity and were evaluated before each course of chemotherapy for toxicity and after every 3 courses for response. Results After a median follow-up of over 10 months, complete response, partial response, and stabilization of the disease were observed in 3 (8.1%), 9 (24.3%), and 15 patients (40.5%), respectively. Median time to progression was 7 months. At this writing, 27 patients have died, with a median survival of 10 months, and 29 (78.3%), 16 (43.2%), and 11 (29.7%) patients are alive after 6, 12, and 15 months of follow-up, respectively. Toxicity was mild, and mainly hematological, with a significant correlation with the number of courses of chemotherapy (P = 0.0003). Conclusions Our results are comparable with those reported in the literature and confirm the good activity and tolerability of the carboplatin-gemcitabine combination. Up to 4 courses of chemotherapy with carboplatin and gemcitabine may represent an interesting option in the palliative treatment of non-small cell lung cancer.
    Type of Medium: Online Resource
    ISSN: 0300-8916 , 2038-2529
    URL: Article
    DOI: 10.1177/030089160409000113
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2004
    detail.hit.zdb_id: 280962-X
    detail.hit.zdb_id: 2267832-3
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  • 2
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    Online Resource
    UPDATE ON THE ROLE OF AUTOLOGOUS HEMATOPOIETIC STEM CELL TRANSPLANTATION IN MULTIPLE MYELOMA
    Hematology Section, Dept. of Radiological Science and Hematology, Catholic University, Rome, Italy ; 2012
    In:  Mediterranean Journal of Hematology and Infectious Diseases Vol. 4, No. 1 ( 2012-11-05), p. e2012069-
    Details
    In: Mediterranean Journal of Hematology and Infectious Diseases, Hematology Section, Dept. of Radiological Science and Hematology, Catholic University, Rome, Italy, Vol. 4, No. 1 ( 2012-11-05), p. e2012069-
    Abstract: Autologous stem cell transplantation is considered the standard of care for multiple myeloma patients aged 〈 65 years with no relevant comorbidities. The addition of drugs acting both on bone marrow microenvironment and on neoplastic plasma cells has significantly increased the proportion of patients achieving a complete remission after induction therapy, and these results are mantained after high-dose melphalan, leading to a prolonged disease control. Studies are being carried out in order to evaluate whether short term consolidation or long-term maintenance therapy can result into disease eradication at the molecular level thus increasing also patients survival. The efficacy of these new drugs has raised the issue of deferring the transplant after achivng a second response upon relapse. Another controversial point is the optimal treatment strategy for high-risk patients, that do not benefit from autologous stem cell transplantation and for whom the efficacy of new drugs is still matter of debate.
    Type of Medium: Online Resource
    ISSN: 2035-3006
    URL: Article
    DOI: 10.4084/mjhid.2012.069
    Language: Unknown
    Publisher: Hematology Section, Dept. of Radiological Science and Hematology, Catholic University, Rome, Italy
    Publication Date: 2012
    detail.hit.zdb_id: 2674750-9
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  • 3
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    Online Resource
    Multiple Myeloma and Renal Failure
    European Medical Group ; 2015
    In:  EMJ Oncology
    Details
    In: EMJ Oncology, European Medical Group
    Abstract: Renal failure (RF) occurs in approximately 20-30% of multiple myeloma (MM) patients at diagnosis and in more than 50% of patients with advanced disease. The pathogenesis of RF is related to the production of monoclonal light chains that can damage either the tubule (myeloma kidney) or the glomeruli (light chain deposition disease or amyloid light-chain amyloidosis). In the past, the prognosis of patients with MM and RF was considered poor due to the limited number of effective and non-nephrotoxic drugs that were available. At present, novel drugs acting both on MM clone and on bone marrow microenvironment have been introduced into clinical practice; among them, bortezomib-containing regimens have proved to be the most effective. High-dose myeloablative therapy followed by autologous stem cell rescue can also be proposed in younger patients with no other relevant comorbidities.
    Type of Medium: Online Resource
    ISSN: 2054-619X
    URL: Journal
    URL: Article
    DOI: 10.33590/emjoncol
    DOI: 10.33590/emjoncol/10312540
    Language: English
    Publisher: European Medical Group
    Publication Date: 2015
    detail.hit.zdb_id: 3052837-9
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  • 4
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    Online Resource
    Incidence, Risk Factors and Outcome of Pre-engraftment Gram-Negative Bacteremia After Allogeneic and Autologous Hematopoietic Stem Cell Transplantation: An Italian Prospective Multicenter Survey
    Oxford University Press (OUP) ; 2017
    In:  Clinical Infectious Diseases Vol. 65, No. 11 ( 2017-11-13), p. 1884-1896
    Details
    In: Clinical Infectious Diseases, Oxford University Press (OUP), Vol. 65, No. 11 ( 2017-11-13), p. 1884-1896
    Abstract: Gram-negative bacteremia (GNB) is a major cause of illness and death after hematopoietic stem cell transplantation (HSCT), and updated epidemiological investigation is advisable. Methods We prospectively evaluated the epidemiology of pre-engraftment GNB in 1118 allogeneic HSCTs (allo-HSCTs) and 1625 autologous HSCTs (auto-HSCTs) among 54 transplant centers during 2014 (SIGNB-GITMO-AMCLI study). Using logistic regression methods. we identified risk factors for GNB and evaluated the impact of GNB on the 4-month overall-survival after transplant. Results The cumulative incidence of pre-engraftment GNB was 17.3% in allo-HSCT and 9% in auto-HSCT. Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa were the most common isolates. By multivariate analysis, variables associated with GNB were a diagnosis of acute leukemia, a transplant from a HLA-mismatched donor and from cord blood, older age, and duration of severe neutropenia in allo-HSCT, and a diagnosis of lymphoma, older age, and no antibacterial prophylaxis in auto-HSCT. A pretransplant infection by a resistant pathogen was significantly associated with an increased risk of posttransplant infection by the same microorganism in allo-HSCT. Colonization by resistant gram-negative bacteria was significantly associated with an increased rate of infection by the same pathogen in both transplant procedures. GNB was independently associated with increased mortality at 4 months both in allo-HSCT (hazard ratio, 2.13; 95% confidence interval, 1.45–3.13; P 〈 .001) and auto-HSCT (2.43; 1.22–4.84; P = .01). Conclusions Pre-engraftment GNB is an independent factor associated with increased mortality rate at 4 months after auto-HSCT and allo-HSCT. Previous infectious history and colonization monitoring represent major indicators of GNB. Clinical Trials registration NCT02088840.
    Type of Medium: Online Resource
    ISSN: 1058-4838 , 1537-6591
    URL: Article
    DOI: 10.1093/cid/cix690
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    XA 10000
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2017
    detail.hit.zdb_id: 2002229-3
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  • 5
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    Online Resource
    Long Term Efficacy of Percutaneous Vertebroplasty in Multiple Myeloma (MM) Patients: Experience of the “Gruppo Ematologico Di Romagna” (GER)
    American Society of Hematology ; 2011
    In:  Blood Vol. 118, No. 21 ( 2011-11-18), p. 5123-5123
    Details
    In: Blood, American Society of Hematology, Vol. 118, No. 21 ( 2011-11-18), p. 5123-5123
    Abstract: Abstract 5123 Vertebral compression fractures occur in approximately 60% of MM patients and can cause pain, persistent disability and dismail quality of life. Appropriate therapy of MM or radiotherapy can lead to improvement of symptoms in a significant percentage of patients, but these positive effects can take time to be perceived. Vertebral agumentation techniques have been recently proposed as suitable options to relieve bone pain from vertebral compression fractures in patients with benign osteoporosis or neoplastic diseases such as MM. Aim of this study was to analyze the clinical course and outcome of 40 consecutive MM patients (23M, 17F, median age = 67.6yrs) treated in the Centers referring to GER, who underwent percutaneous vertebroplasty from 2006 to 2010. Seventeen patients (43%) were newly diagnosed while 23 patients were relapsed or refractory after 1–3 lines of therapy. All the patients were treated because of severe pain, the extent of vertebral fractures was assessed by nuclear magnetic resonance imaging. Sixty-nine procedures were performed at C2-L5 levels, 51% of the patients were treated at a single level, a maximum of three levels were treated in 6 patients, 13 procedures (32%) were performed at L1 level. Thirty seven patients (92%) experienced reduction of pain, with 55% showing complete disapperance of symptoms prior to any further treatment, 3 patients reported no or little improvement. Responses were durable, after a median follow-up of 14 months no further collapse of the treated vertebrae was observed. After vertebroplasty, first line or salvage therapy was administered to 35 patients, 10 newly diagnosed patients were scheduled to receive autologous stem cell transplant, and peripheral blood stem cell collection was not affected by the procedure. In conclusion, percutaneous vertebroplasty appears to be useful in MM patients with painful vertebral fractures as it allows rapid and durable achievement of pain control, without interfering with further therapeutic programs Work supported in part by RiminiAIL Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V118.21.5123.5123
    RVK:
    XA 33000
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2011
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 6
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    Online Resource
    5-Azacytidine for the Treatment of Acute Myeloid Leukemia: A Retrospective, Multicenter Study of 55 Patients.
    American Society of Hematology ; 2008
    In:  Blood Vol. 112, No. 11 ( 2008-11-16), p. 1947-1947
    Details
    In: Blood, American Society of Hematology, Vol. 112, No. 11 ( 2008-11-16), p. 1947-1947
    Abstract: 5-Azacytidine (AZA) is an hypomethylating agent approved in US for the treatment of all FAB subtypes of myelodysplastic syndromes (MDS). Some recent reports have raised the question of a possible efficacy of AZA in selected patients with acute myeloid leukaemia (AML). In September 2007, we started a retrospective study aiming to register and analyse all Italian patients with MDS or AML who had received AZA for the treatment of their disease outside of clinical trials, on the basis of a national patient named program. Among a total of 246 patients treated in 31 different Italian Institutions since 2005, 55 AML diagnosed according to WHO criteria were collected. Median age was 72 years (range 29–87) and 28 patients were male. Poor karyotype was present in 11 patients (20%), while 14 patients (25%) had secondary AML. Median time from diagnosis was 5 months (range 0–72). Eighteen patients (33%) received AZA as front-line treatment, as they were considered not eligible for intensive chemotherapy due to age, co-morbidities or poor performance status. Thirty-seven patients (67%) were pre-treated with growth factors (3 patients) or with one or more lines of chemotherapy (11 and 23 patients, respectively); most of the pre-treated patients (22 out of 34) had received high dose chemotherapy, including autologous or allogeneic stem cell transplantation. Low dose chemotherapy had been employed in the remaining cases. The median number of monthly AZA cycles administered was 4 (range 1–22). Thirty-nine patients (71%) received AZA at the fixed dose of 100 mg/d s.c., 16 patients (29%) received a dose of 75 mg/sqm/d s.c.. A seven-day per month schedule was employed in 43 patients (78%), while 11 patients (20%) received AZA for more than 7 days and one patient for 5 days. Twenty-nine patients (52.8%) received AZA alone, twenty-six (47.2%) in various combinations with growth factors (1), valproic acid +/− ATRA (21) or gentuzumab-ozogamycin (4).The most relevant toxicities observed (grade 3–4) were represented by further myelosuppression (15%), infections (24%: in particular, 1 fungal lung infection, 3 pneumonia and 1 septic shock) and gastrointestinal adverse events (20%). The overall response rate was 35.3% (18/51): 8 patients achieved a complete remission (CR) (15.7%), while a partial response (PR) was observed in 5 patients (9.8%). Five haematological improvements were also seen (9.8%). Response rate was significantly higher in untreated patients compared to pre-treated ones (p=0.02). A statistically significant difference (p=0.04) in response rate in favour of 75 mg/sqm/d versus 100 mg fixed dose was also observed. The actuarial probability of overall survival (OS) at 16 months was 45% for patients responding to AZA and 10% for those non responding (p=0.0027). In conclusion, our data show that: AZA can induce significant responses in about one third of AML patients; the “standard” dose of 75 mg/sqm/d seems to be more effective than 100 mg/d (one single vial) fixed dose; AZA is more effective in de novo as compared to pre-treated (refractory and/or relapsed) disease; AML patients responding to AZA have a significant survival advantage compared to non responders.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V112.11.1947.1947
    RVK:
    XA 33000
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2008
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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