Publications by authors named "Chiara Elena"

: Respiratory tract infections (RTIs) are a leading cause of pediatric emergency department (PED) visits, especially in children under five. These infections are primarily viral, complicating diagnosis and management. This study assesses the impact of point-of-care (POC) rapid diagnostic tests for respiratory viruses on clinical and economic outcomes in a PED setting.

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  • Up to 30% of chronic myeloid leukemia (CML) patients may need a treatment change due to issues with first-line tyrosine kinase inhibitors (TKIs), and bosutinib (BOS) emerges as an effective and safe alternative.
  • A study analyzed 132 CML patients treated with BOS across 18 hematology centers, finding that most patients switched due to intolerance to previous TKIs, with a significant number achieving positive treatment outcomes.
  • The findings suggest that BOS is a preferred treatment choice, particularly for patients who cannot tolerate previous TKIs, demonstrating its safety and effectiveness in real-life settings.
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Nerve sheath myxoma (NSM) is a rare benign peripheral nerve sheath tumor that affects young adults. NSMs are asymptomatic, slow-growing swellings located in the upper extremities, more rarely in the lower extremities. Given the high risk of recurrence, it is recommended to perform a complete exeresis.

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Clonal cytopenia of undetermined significance (CCUS) represents a distinct disease entity characterized by myeloid-related somatic mutations with a variant allele fraction of ≥2% in individuals with unexplained cytopenia(s) but without a myeloid neoplasm (MN). Notably, CCUS carries a risk of progressing to MN, particularly in cases featuring high-risk mutations. Understanding CCUS requires dedicated studies to elucidate its risk factors and natural history.

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Background: The Molecular International Prognostic Scoring System (IPSS-M) is the new gold standard for diagnostic outcome prediction in patients with myelodysplastic syndromes (MDS). This study was designed to assess the additive prognostic impact of dynamic transfusion parameters during early follow-up.

Methods: We retrieved complete transfusion data from 677 adult Swedish MDS patients included in the IPSS-M cohort.

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  • Hypersensitivity reactions (HR) are common in mastocytosis, a condition analyzed using data from the European Competence Network on Mastocytosis (ECNM), involving 2485 adults.
  • About 38.1% of patients reported HR, with Hymenoptera venoms being the primary trigger for cutaneous mastocytosis and indolent systemic mastocytosis, while drug reactions were more common in advanced systemic mastocytosis.
  • Key risk factors for HR include lower tryptase levels, minimal mast cell infiltration in bone marrow, and a diagnosis of indolent systemic mastocytosis, with new reactions occurring in 4.8% of patients over four years.
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Certain laboratory abnormalities correlate with subvariants of systemic mastocytosis (SM) and are often prognostically relevant. To assess the diagnostic and prognostic value of individual serum chemistry parameters in SM, 2607 patients enrolled within the European Competence Network on Mastocytosis and 575 patients enrolled within the German Registry on Eosinophils and Mast Cells were analyzed. For screening and diagnosis of SM, tryptase was identified as the most specific serum parameter.

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Systemic Mastocytosis (SM) is a multifaceted clinically heterogeneous disease. Advanced SM (AdvSM) comprises three entities: aggressive SM (ASM), mast cell leukaemia (MCL) and SM with an associated hematologic neoplasm (SM-AHN), the latter accounting for 60-70% of all AdvSM cases. Detection of a disease-triggering mutation in the KIT gene (esp.

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  • - Patients with chronic myeloid leukemia (CML) treated with nilotinib or ponatinib have a risk of arterial occlusive events (AOEs), prompting recommendations for cardiovascular risk assessments before starting treatment.
  • - A study of 455 CML patients showed that using the updated SCORE2/SCORE2-OP algorithm, which accounts for various cardiovascular risk factors, identified a greater percentage of patients at high risk compared to the older SCORE method.
  • - Those classified as high to very high risk under SCORE2/SCORE2-OP experienced a significantly higher incidence of AOEs, emphasizing the algorithm's importance in guiding treatment decisions and enhancing patient care management.
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  • The study investigates the risk of disease progression to accelerated/blast phase (AP/BP) in patients with chronic myeloid leukemia (CML) after stopping treatment, addressing concerns raised by recent case reports.
  • A total of 870 patients were analyzed, with 505 in the treatment discontinuation (TD) cohort and 365 in a reference cohort, and the primary focus was on the time-adjusted rate (TAR) of progression and molecular relapse.
  • Findings showed that progression to AP/BP was extremely rare in the TD cohort, with no significant difference in TAR between the cohorts, suggesting that the risk of disease progression after stopping treatment should not be a major concern.
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Systematic studies of germ line genetic predisposition to myeloid neoplasms in adult patients are still limited. In this work, we performed germ line and somatic targeted sequencing in a cohort of adult patients with hypoplastic bone marrow (BM) to study germ line predisposition variants and their clinical correlates. The study population included 402 consecutive adult patients investigated for unexplained cytopenia and reduced age-adjusted BM cellularity.

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Background: Organomegaly, including splenomegaly, hepatomegaly, and/or lymphadenopathy, are important diagnostic and prognostic features in patients with cutaneous mastocytosis (CM) or systemic mastocytosis (SM).

Objectives: To investigate the prevalence and prognostic impact of 1 or more organomegalies on clinical course and survival in patients with CM/SM.

Methods: Therefore, 3155 patients with CM (n = 1002 [32%]) or SM (n = 2153 [68%]) enrolled within the registry of the European Competence Network on Mastocytosis were analyzed.

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Purpose: Patients with chronic myeloid leukemia (CML) who present a sustained deep molecular response (DMR) for a stable period of time might benefit from discontinuing tyrosine kinase inhibitors (TKIs). A significant number of patients seem able to reach this stage due to the availability of TKIs. However, many patients remain reluctant about TKI discontinuation and may refuse treatment interruption.

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Background: Systemic mastocytosis (SM) encompasses a heterogeneous group of clonal disorders characterized by abnormal expansion of mast cells (MCs). Beyond KIT and other genes recurrently mutated in myeloid neoplasms, several genetic variants have been described as predisposing to the development of the disease and influencing its clinical phenotype. Increased copy number variants of the TPSAB1 gene were identified as a cause of nonclonal elevated tryptasemia and defined as hereditary α-tryptasemia (HαT).

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Background: Myelodysplastic/myeloproliferative neoplasms (MDS/MPN) comprise several rare hematologic malignancies with shared concomitant dysplastic and proliferative clinicopathologic features of bone marrow failure and propensity of acute leukemic transformation, and have significant impact on patient quality of life. The only approved disease-modifying therapies for any of the MDS/MPN are DNA methyltransferase inhibitors (DNMTi) for patients with dysplastic CMML, and still, outcomes are generally poor, making this an important area of unmet clinical need. Due to both the rarity and the heterogeneous nature of MDS/MPN, they have been challenging to study in dedicated prospective studies.

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Mast cell leukemia (MCL) is a rare subtype of systemic mastocytosis defined by ≥20% mast cells (MC) on a bone marrow aspirate. We evaluated 92 patients with MCL from the European Competence Network on Mastocytosis registry. Thirty-one (34%) patients had a diagnosis of MCL with an associated hematologic neoplasm (MCL-AHN).

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Mastocytosis encompasses a subset of rare diseases, characterized by the presence and accumulation of abnormal neoplastic MC in various organ systems, including skin, bone marrow, spleen and gastrointestinal tract. Clinical manifestations are highly heterogeneous, as they result from both MC mediator release and MC organ infiltration. Both pregnancy, a lifetime dominated by huge physiological changes, and labor can provide triggers that could induce worsening of mastocytosis symptoms.

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Limited information is available on the impact of the COVID-19 pandemic on the management of chronic myeloid leukaemia (CML). The Campus CML network collected retrospective information on 8 665 CML patients followed at 46 centres throughout Italy during the pandemic between February 2020 and January 2021. Within this cohort, we recorded 217 SARS-CoV-2-positive patients (2·5%).

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  • Diagnosing myeloid malignancies is difficult and often varies between doctors, so researchers created a machine learning model using clinical and next-generation sequencing (NGS) data from an international group of patients to assist in the diagnosis without relying on bone marrow biopsies.
  • The model shows strong performance and reveals that it considers similar factors as human clinicians do during diagnosis.
  • Additionally, the study explores connections between NGS results and important clinical traits, using machine learning to better understand the relationships between clinical and genetic information.
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In the current classification of the World Health Organization (WHO), bone marrow mastocytosis (BMM) is a provisional variant of indolent systemic mastocytosis (ISM) defined by bone marrow involvement and absence of skin lesions. However, no additional diagnostic criteria for BMM have been proposed. Within the registry dataset of the European Competence Network on Mastocytosis, we compared characteristics and outcomes of 390 patients with BMM and 1175 patients with typical ISM.

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Purpose Of Review: Clinical and experimental studies have uncovered relevant clinical implications of clonal hematopoiesis. However, the true magnitude of this process, clonal dynamics over time and mechanisms of progression into overt malignancy remain to be largely elucidated. In this article, the consequences of clonal hematopoiesis, its significance in the context of cytopenia, and its implications in the clinical management of patients with myeloid malignancies are reviewed and discussed.

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  • Clonal cytopenia of undetermined significance (CCUS) is linked to a higher risk of developing myeloid neoplasms, and a study of various patient cohorts revealed that about 30% of individuals with idiopathic cytopenia carry genetic mutations associated with CCUS.
  • The presence of clonal hematopoiesis (CH) was found in nearly 20% of non-anemic individuals and around 28% of those with unexplained anemia, with distinct mutation patterns indicating differing levels of disease progression risk.
  • Two main mutation clusters were identified, with one showing isolated DNMT3A mutations and the other characteristic combinatorial patterns, impacting both overall survival rates and the likelihood of progression to myeloid ne
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