Publications by authors named "Luigi Rigacci"

Article Synopsis
  • The study aimed to assess trabecular attenuation of the L1 vertebral body using low-dose CT in adult patients with multiple myeloma (MM), smoldering myeloma (SMM), and monoclonal gammopathy of undetermined significance (MGUS).
  • The study included 73 patients, with evaluations of trabecular bone density based on CT scans, showing significant differences in bone density among the different patient groups.
  • Results indicated that lower Hounsfield unit (HU) values are associated with poorer progression-free survival, highlighting the potential clinical relevance of L1 attenuation values in managing these conditions.
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  • The IELSG37 trial investigated whether patients with primary mediastinal B-cell lymphoma (PMBCL) who have a complete metabolic response (CMR) after treatment can safely skip consolidation radiotherapy.
  • It was a randomized noninferiority study involving 545 patients, focusing on progression-free survival (PFS) over 30 months, with results showing high PFS rates of 96.2% for observation and 98.5% for radiotherapy.
  • The study concluded that avoiding irradiation does not negatively impact survival, highlighting positive outcomes for patients with CMR.
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Diffuse large B-cell lymphoma (DLBCL) is the most common B-cell non-Hodgkin lymphoma (NHL). Despite the availability of clinical and molecular algorithms applied for the prediction of prognosis, in up to 30%-40% of patients, intrinsic or acquired drug resistance occurs. Constitutional genetics may help to predict R-CHOP resistance.

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  • Bullous pemphigoid (BP) is a rare blistering skin disease that may signal underlying cancers, particularly hematological malignancies like acute myeloid leukemia (AML).
  • A 28-year-old male patient with both BP and de novo AML was treated using a combination of immunosuppressive therapy and chemotherapy to effectively address both conditions.
  • After aggressive treatment, the patient achieved full remission from AML and complete resolution of BP, along with normalized BP180 antibody levels after receiving an autologous stem cell transplant.
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Achieving successful hematopoietic stem cell transplantation (HSCT) relies on two fundamental pillars: effective mobilization and efficient collection through apheresis to attain the optimal graft dose. These cornerstones pave the way for enhanced patient outcomes. The primary challenges encountered by the clinical unit and collection facility within a transplant program encompass augmenting mobilization efficiency to optimize the harvest of target cell populations, implementing robust monitoring and predictive strategies for mobilization, streamlining the apheresis procedure to minimize collection duration while ensuring adequate yield, prioritizing patient comfort by reducing the overall collection time, guaranteeing the quality and purity of stem cell products to optimize graft function and transplant success, and facilitating seamless coordination between diverse entities involved in the HSCT process.

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Introduction: Sarcopenia has been associated with chronic diseases and cancer. The aim of this study was to evaluate sarcopenia in multiple myeloma patients undergoing autologous stem cell transplantation.

Methods: In 68 eligible patients, measurement of skeletal muscle area (cm2) on computed tomography scans at the level of the L3 vertebra (L3 SMI) was performed.

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Introduction: Despite the high rate of cure in classical Hodgkin Lymphoma (cHL), some patients experienced a refractory disease, sometimes, hardly curable. In the pathogenesis of cHL, Reed Sternberg Cells (HRSC), which represent only less than 1% of tumor cells, are not the only protagonist; in fact, the role of tumor microenvironment is essential in survival, tumor growth, and progression of the disease due to the interaction between immune cells, chemokines, and cytokines.

Areas Covered: In this review, the current significant literature was discussed.

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Hematopoietic and lymphoid tumors are a heterogeneous group of diseases including lymphomas, multiple myeloma (MM), and leukemias. These diseases are associated with systemic involvement and various clinical presentations including acute neurological deficits. Adult patients with hematologic malignancies (HM) are at risk for developing a wide array of acute conditions involving the nervous system.

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Background: Positron emission tomography (PET) with the use of 18F-fluorodeoxyglucose (FDG), implemented with low-dosage computer tomography, is to be considered as the most important evolution of imaging in the management and assessment of classical Hodgkin lymphoma patients.

Summary: According to Lugano response criteria, FDG-PET is mandatory to define metabolic response to frontline therapy and moreover it is important in the definition of nonresponders or refractory disease patients. Refractory disease is reported in about 15% of patients, with some variations based on the choice of first-line chemotherapy, and particularly in advanced stages, up to 40% eventually relapse within 3 years.

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R-CHOP standard chemotherapy is successful in about 60% of diffuse large B-cell lymphoma (DLBCL) patients. Unresponsive patients have a poor prognosis, and predictive biomarkers of response to R-CHOP are lacking. We conducted the first prospective GWAS study aimed at exploring constitutional biomarkers predictive of R-CHOP efficacy and toxicity.

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Article Synopsis
  • Classical Hodgkin Lymphoma (HL) primarily affects young patients, leading to long-term survival but complications like infertility, which is simpler to manage in males than females.
  • This study encompassed 270 female HL patients to assess the impact of standard treatment (ABVD) on ovarian function and fertility through hormone levels and tissue analysis before and after chemotherapy.
  • Results showed a significant drop in Anti-Mullerian Hormone (AMH) levels 6 months post-treatment, though they returned near baseline values by 12 months, while ovarian follicles and uterine thickness also reduced but showed recovery over time.
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Background: Allogeneic transplant is an effective salvage therapy in patients with Hodgkin lymphoma (HL) relapsed or refractory (R/R) to previous treatments. In recent years, immunotherapies (conjugated antibody and checkpoint inhibitors [CPI]) showed interesting results and were used as bridge therapies to allotransplant.

Aim: The aim of this retrospective study in Lazio region was to evaluate the impact of these new therapies on outcome after allogeneic hematopoietic stem cell transplantation (allo-SCT) in comparison with standard chemotherapies used in the past.

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Elderly patients represent the most challenging and hard-to-treat patient population due to dismal characteristics of the disease, such as secondary-acute myeloid leukemia (AML), enrichment of unfavorable molecular genes () and comorbidities. We conducted a multicentric retrospective study to evaluate activity and safety in a real-life setting of hypomethylating drugs (HMAs) in patients older than 75 years with AML. Between September 2010 and December 2021, 220 patients were treated, 164 (74.

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  • The T-cell Lymphoma Project is a global study that examined clinical features and treatment outcomes of patients with newly diagnosed peripheral T-cell and NK-cell lymphomas, enrolling 1553 patients from 74 institutions across 14 countries between 2006 and 2018.
  • Among the participants, 131 (8.4%) were identified with anaplastic large cell lymphoma - kinase positive (ALCL, ALK+), mostly in young adults with a median age of 39; many patients had advanced-stage disease but a majority had low-risk scores.
  • Treatment with anthracycline chemotherapy yielded an 81% overall response rate, with 70% achieving complete remission, and three- and five-year overall survival rates
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  • The study examined secondary infections (SI) in COVID-19 patients with hematological malignancies (HM), finding that 7.7% of 1741 patients experienced SI, mostly occurring around 16 days after COVID-19 diagnosis.* -
  • Patients with SI tended to be older, had more comorbidities, and exhibited a higher rate of critical COVID-19 cases compared to those without SI.* -
  • The 30-day mortality rate for patients with SI was significantly higher at 69%, emphasizing the need for prompt diagnosis and treatment to enhance outcomes in this vulnerable population.*
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Salvage immunochemotherapy and transplant consolidation is the standard treatment for relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL). We tested a combination of Obinutuzumab and DHAP for treating R/R DLBCL. The primary end point was the rate of complete metabolic response (CMR).

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What's already known about this topic? Discordant NIPT results can rarely unravel maternal malignancies, especially when multiple chromosomal imbalances are reported. Both solid and hematological neoplasms have been described. What does this study add? This is the first case of a discordant NIPT result due to Chronic Lymphocytic Leukemia associated with trisomy of the chromosome 12.

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Acute myeloid leukemia is a malignant disorder of the bone marrow, characterized by differentiation, clonal expansion, and uncontrolled proliferation of malignant myeloid progenitor cells and by several molecular and genetic abnormalities. A mutation of FMS-like tyrosine kinase 3 gene can be observed in about one-third of cases of acute myeloid leukemia. Two FLT3 inhibitors are actually approved for FLT3 mutated acute myeloid leukemia: midostaurin, a multikinase first generation inhibitor with lower affinity for FLT3 binding, and gilteritinib fumarate, a potent second-generation inhibitor of both FLT3-ITD and TKD.

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Digital health tools are increasingly being used in cancer care and may include electronic patient-reported outcome (ePRO) monitoring systems. We examined physicians' perceptions of usability and clinical utility of a digital health tool (GIMEMA-ALLIANCE platform) for ePRO monitoring in the real-life practice of patients with hematologic malignancies. This tool allows for the collection and assessment of ePROs with real-time graphical presentation of results to medical staff.

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Optimal conditioning for adults with acute lymphoblastic leukemia (ALL) treated with haploidentical hematopoietic cell transplantation (haplo-HCT) and post-transplant cyclophosphamide has not been established so far. We retrospectively compared outcomes for two myeloablative regimens: fludarabine + total body irradiation (Flu-TBI, n = 117) and thiotepa + iv. busulfan + fludarabine (TBF, n = 119).

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Background: Overweight and obese patients with solid tumors receiving anti-programmed cell death-1 (PD-1)/PD-ligand-1(PD-L1) immune checkpoint inhibitors exhibit improved survival and higher risk of immune-related adverse events (irAEs) than those with a normal body mass index (BMI). In classic Hodgkin lymphoma (cHL), the impact of BMI on survival and immune-related toxicity is unknown. We evaluated for the first time associations of BMI with survival and irAEs in patients with relapsed/refractory (RR)-cHL undergoing PD-1 blockade.

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Background: Patients with relapsed or refractory classical Hodgkin lymphoma (R/R cHL) have limited opportunities for curative therapy. High-dose therapy followed by autologous stem cell transplantation (HDT-ASCT) produces cure rates of 50% to 60%. Patients relapsing after, or ineligible for HDT-ASCT have limited therapeutic options and long-term remission is uncommon.

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Lymphoma represents a heterogeneous hematological malignancy (HM), which is characterized by severe immunosuppression. Patients diagnosed of coronavirus disease 2019 (COVID-19) during the course of HM have been described to have poor outcome, with only few reports specifically addressing lymphoma patients. Here, we investigated the clinical behavior and clinical parameters of a large multicenter cohort of adult patients with different lymphoma subtypes, with the aim of identifying predictors of death.

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