Publications by authors named "Larcher L"

Background: Allogeneic haematopoietic stem-cell transplantation is the standard treatment for bone marrow failure (BMF) in patients with Fanconi anaemia, but transplantation-associated complications such as an increased incidence of subsequent cancer are frequent. The aim of this study was to evaluate the safety and efficacy of the infusion of autologous gene-corrected haematopoietic stem cells as an alternative therapy for these patients.

Methods: This was an open-label, investigator-initiated phase 1/2 clinical trial (FANCOLEN-1) and long-term follow-up trial (up to 7 years post-treatment) in Spain.

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Two human induced pluripotent stem cell lines, LEIi021-A and LEIi021-B, were derived from dermal fibroblasts from a healthy control subject from an Australian Aboriginal family with retinitis pigmentosa-11. Reprogramming was performed using episomal vectors expressing OCT4, SOX2, LIN28, L-MYC, KLF4 and mp53DD. Pluripotency markers were expressed in both LEIi021-A and LEIi021-B lines.

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  • The study aimed to find risk factors for bladder injury during cesarean sections (CS).
  • It involved a case-control study at a hospital, which analyzed data from 2009 to 2024, and included a systematic review of other relevant studies.
  • Key risk factors identified include previous cesarean sections, adhesions, being in the second stage of labor, large babies (macrosomia), failed attempts at vaginal birth after cesarean (VBAC), and emergency procedures.
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  • The study examines the blood-related characteristics and overall prognosis of 127 patients with telomere biology disorders (TBD) who were diagnosed after age 15, highlighting a lack of data on this topic.
  • At diagnosis, significant haematological issues were present in nearly 76% of patients, with bone marrow failure (BMF) being the most common, affecting 46.5% of the cases, while some patients also developed additional complications over time.
  • The findings suggest that BMF patients tend to be younger and have a better survival rate compared to those with higher-risk blood cancers, indicating TBD as a complex multi-organ disease needing further research on its evolutionary nature and outcomes.
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  • The genomics era has led to the identification of the ERG gene as a new autosomal dominant predisposition factor for bone marrow failure (BMF) and hematological malignancies (HM), crucial for blood cell development and function.
  • Research found several rare ERG variants associated with thrombocytopenia and various forms of HM, showing onset typically before age 40.
  • Functional studies indicated that many ERG variants disrupt its role as a transcription factor, leading to ineffective blood cell production, with implications for clinical diagnosis and treatment strategies for affected patients and families.
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Objectives: To describe the sonographic features of the caudothalamic groove in the third trimester of pregnancy in a group of structurally normal fetuses and to report a small series of cases with abnormal appearance of the caudothalamic groove at antenatal cranial ultrasound.

Methods: This was an observational study conducted at two fetal medicine referral units in Italy. A non-consecutive cohort of pregnant women with a singleton non-anomalous pregnancy were recruited prospectively and underwent three-dimensional (3D) ultrasound assessment of the fetal brain at 28-32 weeks' gestation.

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  • * In a study of 1091 adult patients, 12.9% had KMT2A-r, with a 5-year relapse rate of 40.7% and overall survival rate of 53.3%. The presence of specific gene alterations like TP53 and IKZF1 correlated with significantly worse outcomes.
  • * The analysis showed that measuring minimal residual disease (MRD) using KMT2A markers was more reliable than other methods, indicating that patients responding well early
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Fanconi anemia (FA) is a genetic disorder associated with developmental defects, bone marrow failure and cancer. The FA pathway is crucial for the repair of DNA interstrand crosslinks (ICLs). In this study, we have developed and characterized a new tool to investigate ICL repair: a clickable version of the crosslinking agent melphalan which we name click-melphalan.

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Objectives: To describe the appearance and size of the ganglionic eminence (GE) in normal fetuses on midtrimester three-dimensional (3D) neurosonography and to report on the association between GE alterations (cavitation or enlargement) and malformation of cortical development (MCD).

Methods: This was a prospective multicenter cohort study of normal fetuses and a retrospective analysis of pathological cases with MCD. From January 2022 to June 2022, patients attending our tertiary centers for an expert fetal brain scan were recruited for the purpose of the study.

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Nucleic acids drugs have been proven in the clinic as a powerful modality to treat inherited and acquired diseases. However, key challenges including drug stability, renal clearance, cellular uptake, and movement across biological barriers (foremost the blood-brain barrier) limit the translation and clinical efficacy of nucleic acid-based therapies, both systemically and in the central nervous system. In this study we provide an overview of an emerging class of nucleic acid therapeutic, called DNAzymes.

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Biallelic germ line excision repair cross-complementing 6 like 2 (ERCC6L2) variants strongly predispose to bone marrow failure (BMF) and myeloid malignancies, characterized by somatic TP53-mutated clones and erythroid predominance. We present a series of 52 subjects (35 families) with ERCC6L2 biallelic germ line variants collected retrospectively from 11 centers globally, with a follow-up of 1165 person-years. At initial investigations, 32 individuals were diagnosed with BMF and 15 with a hematological malignancy (HM).

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  • The role and timing of allogeneic hematopoietic stem cell transplantation (HSCT) in treating acute myelogenous leukemia (AML) have been debated for decades, with reliance on the European LeukemiaNet classification for treatment strategies.
  • A study found that HSCT significantly improved overall survival for intermediate- and poor-risk AML patients, particularly younger patients, while showing low cumulative incidence rates for older groups due to factors like comorbidities and eligibility.
  • With increasing access to various donor types, including haploidentical ones, the role of HSCT in AML treatment may evolve, potentially increasing transplant numbers in adult patients.
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  • The study investigates the relationship between the diameter of the remaining umbilical artery in fetuses with an isolated single umbilical artery (SUA) and fetal growth patterns, given the uncertain risks associated with SUA.
  • Conducted on 164 fetuses with SUA and 200 controls, the research measured cord vessel diameters and explored factors like maternal BMI and parity through logistic regression and ROC analysis.
  • Results showed that fetuses with SUA had a significantly larger mean diameter of the remaining artery, and an artery diameter greater than 3.1 mm may correlate with a lower risk of fetal growth restriction (FGR), although the finding was not statistically significant.
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Myelodysplastic syndromes (MDS) are clonal hematopoietic disorders, representing high risk of progression to acute myeloid leukaemia, and frequently associated to somatic mutations, notably in the epigenetic regulator TET2. Natural Killer (NK) cells play a role in the anti-leukemic immune response via their cytolytic activity. Here we show that patients with MDS clones harbouring mutations in the TET2 gene are characterised by phenotypic defects in their circulating NK cells.

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  • Patients with Fanconi anemia (FA) show chromosome instability, leading to exhaustion of hematopoietic stem cells and a higher risk of developing poor-prognosis myeloid leukemia.
  • A study involving 62 patients revealed unique mutations and structural variants that resemble BRCA-related cancers, with many patients showing chromosome 1q gain linked to MDM4 trisomy, which downregulates p53 signaling.
  • MDM4 triplication not only enhances the survival of FA stem cells but also promotes leukemia development, suggesting that targeting MDM4 could be a potential therapeutic strategy to disrupt this pathway.
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  • Germline mutations in the GATA2 gene increase the risk of developing myeloid cancers, particularly as patients acquire additional genetic mutations over time.
  • An analysis of 78 patients revealed an exhaustion of myeloid progenitor cells and frequent somatic mutations in specific genes (STAG2, ASXL1, SETBP1) along with notable chromosomal abnormalities.
  • Patients were categorized into three groups based on their bone marrow cell composition, with each group's mutations corresponding to their disease stage, indicating that understanding these mutations can improve patient management and illuminate cancer progression associated with GATA2 mutations.
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Biallelic germline mutations in BRCA2 occur in the Fanconi anemia (FA)-D1 subtype of the rare pediatric disorder, FA, characterized clinically by severe congenital abnormalities and a very high propensity to develop malignancies early in life. Clinical and genetic data from 96 FA-D1 patients with biallelic BRCA2 mutations were collected and used to develop a new cancer risk prediction score system based on the specific mutations in BRCA2. This score takes into account the location of frameshift/stop and missense mutations relative to exon 11 of BRCA2, which encodes the major sites for interaction with the RAD51 recombinase, and uses the MaxEnt and HBond splicing scores to analyze potential splice site perturbations.

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Unlabelled: Low hypodiploidy defines a rare subtype of B-cell acute lymphoblastic leukemia (B-ALL) with a dismal outcome. To investigate the genomic basis of low-hypodiploid ALL (LH-ALL) in adults, we analyzed copy-number aberrations, loss of heterozygosity, mutations, and cytogenetics data in a prospective cohort of Philadelphia (Ph)-negative B-ALL patients (n = 591, ages 18-84 years), allowing us to identify 80 LH-ALL cases (14%). Genomic analysis was critical for evidencing low hypodiploidy in many cases missed by cytogenetics.

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Patients with paroxysmal nocturnal hemoglobinuria (PNH) are susceptible to complement-mediated intravascular hemolysis and thrombosis. Factor H (FH) is the main regulator of the complement alternative pathway, which protects cells from unwanted complement-mediated damage. Although FH is not a glycosylphosphatidylinositol-linked molecule, it may play a role in PNH.

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Introduction: placental anomalies can affect fetal and maternal outcome due to severe maternal hemorrhage potentially resulting in hysterectomy and cord accident including abruption that can determine fetal damage or death. The aims of our study are to determine if the rate of placental and umbilical cord anomalies are more common in IVF singleton pregnancies compared to spontaneous pregnancies; to evaluate the role of ultrasound in screening for these anomalies and to investigate if oocyte donor fertilization is an additional risk factor for the development of these anomalies.

Methods: this was a prospective cohort study involving two tertiary centers.

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Purpose: The status and associated factors of the health-related quality of life of non-small-cell lung cancer (NSCLC) patients under targeted anti-cancer therapy have not been investigated. Self-management and coping style have been proven to be closely related to patients' health-related quality of life. Based on these observations, this study was designed to firstly assess the status of health-related quality of life, and then explore the relationships among coping styles, self-management, and health-related quality of life of NSCLC patients with skin adverse drug reactions under targeted therapy.

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