Publications by authors named "Giorgio Orofino"
Biology of post-transplant relapse: actionable features.
Hematology Am Soc Hematol Educ Program
December 2024
In patients receiving allogeneic hematopoietic cell transplantation to cure acute myeloid leukemia (AML), recurrence of the underlying disease, or relapse, represents a crucial unanswered issue and prominent cause of mortality. Still, over recent years, advancements in omic technologies have allowed us to gain new insights into the dynamic changes occurring in cancer and the host over the course of treatments, providing a novel evolutionary perspective on the issue of disease relapse. In this review, we summarize current knowledge on the molecular features of relapsing AML, with a specific focus on changes in the mutational asset of the disease and in the interplay between the tumor and the donor-derived immune system.
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- Invasive fungal infections (IFIs) are a significant health issue for patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT), and Isavuconazole (ISA) is a safe antifungal treatment option being studied in combination with sirolimus.
- This retrospective analysis looked at 51 allo-HSCT patients treated with both ISA and sirolimus over about five years, focusing on the effectiveness, safety, and monitoring of drug levels.
- Results showed that ISA was effective in treating IFIs, with a 68% response rate after 90 days, and no significant drug interaction toxicities were reported when both drugs were administered at therapeutic levels.
Cytomegalovirus (CMV) reactivations are strong stimulators of immune-reconstitution (IR) in hematopoietic stem cell transplantation (HSCT) recipients. Herein, we analyzed 317 CMV-seropositive consecutive patients (n = 109 letermovir, LTV; n = 208 no-LTV), undergoing HSCT with post-transplant cyclophosphamide (PTCy) and calcineurin inhibitor- (CNI) free graft-versus-host-disease (GvHD) prophylaxis. At day+90, median CD19/mm was higher in LTV-cohort: 5.
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- Allogeneic stem cell transplantation is a strong treatment for Myelofibrosis (MF), and splenic irradiation can help shrink the spleen and improve symptoms.
- A study looked at 14 MF patients who had this treatment from June 2016 to March 2021, and most had successful results, with many seeing a decrease in spleen size after three months.
- After about 25 months, some patients were no longer needing transfusions, but a few had relapses or sadly passed away, showing that more research is needed to confirm these results.
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) in SARS-CoV-2 positive candidates is usually delayed until the clinical resolution of the infection's symptoms and a negative nasopharyngeal molecular test. However, prolonged SARS-CoV-2 positivity has been frequently observed in haematological malignancies, thus representing a challenge for the timing of transplant procedures. Here, we report on the case of a 34-year-old patient with recent pauci-symptomatic COVID-19 undergoing transplant for high-risk acute B-lymphoblastic leukemia before achieving viral clearance.
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- A 59-year-old woman had serious problems with her organs after getting a special stem cell transplant, and later she showed signs of brain issues.
- Doctors figured out she had a weird condition called posterior reversible encephalopathy syndrome (PRES) after doing tests and scans.
- They stopped some of her medication, managed her blood pressure, gave her strong medicine, and after two weeks, her brain problems improved and tests showed she was getting better.