Publications by authors named "Papayannidis C"

Unlabelled: This phase 2 study investigated pevonedistat + azacitidine + venetoclax ( = 83) versus azacitidine + venetoclax ( = 81) in patients with newly diagnosed acute myeloid leukemia (AML) ineligible for intensive chemotherapy. The study was stopped early following negative results from PANTHER, which evaluated pevonedistat in higher-risk myelodysplastic syndromes/chronic myelomonocytic leukemia or low-blast AML. Outcomes were analyzed up to the datacut.

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Objectives: To evaluate clinical impact of ceftazidime/avibactam on treating infections due to MDR Gram-negative bacteria in patients with haematological malignancies (HMs).

Methods: We conducted a retrospective, observational study at 17 Italian haematological wards that included patients with HMs receiving ceftazidime/avibactam for the treatment of suspected or proven infections. The primary endpoint was all-cause mortality 30 days after infection onset.

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Vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic (VEXAS) is a haemato-inflammatory syndrome genetically defined by somatic mutations in the X-linked UBA1 gene, typically Val/Thr/Leu substitutions at the Met41 hotspot. Clinical manifestations are heterogeneous and refractory to most haemato-rheumatological treatments. To date, no guidelines exist for the management of VEXAS, and scarce is the evidence on methodology and clinical significance of longitudinal UBA1 clonal burden evaluation upon therapy.

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Article Synopsis
  • - The study analyzed data from 229 elderly patients with core binding factor acute myeloid leukemia (CBF-AML) to assess treatment outcomes over two decades, finding a 5-year overall survival (OS) rate of 44.2% and event-free survival (EFS) rate of 32.9%.
  • - In patients over 70 who underwent intensive therapy, those who completed treatment had a median EFS of 11.8 months and a 5-year OS of 40%.
  • - Key factors impacting survival included age, achieving remission after initial treatment, and the number of consolidation therapy cycles, indicating that intensive therapy could be beneficial for selected older patients and should not be overlooked in clinical studies. *
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We evaluated response to VEN/HMA in 46 patients with acute myeloid leukemia (AML) characterized by extramedullary disease (EMD). Median age was 65 (range, 19-81) years. Patients had a median of two EMD sites (range, 1-5) and 35 (76%) patients had concurrent bone marrow involvement.

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  • * The study, called KOMET-001, was conducted in multiple countries and involved dose-escalation and validation phases, with patients in specific molecular subtypes receiving varying doses of ziftomenib over 28-day cycles.
  • * Results indicated that 83 patients were treated with ziftomenib from September 2019 to August 2022, and the findings are crucial for determining the drug's safety and effectiveness for future phases of clinical testing.
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Philadelphia-like (Ph-like) or BCR::ABL1-like acute lymphoblastic leukemia (ALL) is a common high-risk subtype of B-cell precursor ALL (B-ALL) characterized by a diverse range of genetic alterations that challenge diagnose and converge on distinct kinase and cytokine receptor-activated gene expression profiles, resembling those from BCR::ABL1-positive ALL from which its nomenclature. The presence of kinase-activating genetic drivers has prompted the investigation in preclinical models and clinical settings of the efficacy of tyrosine kinase inhibitor (TKI)-based treatments. This was further supported by an inadequate response to conventional chemotherapy, high rates of induction failure and persistent measurable residual disease (MRD) positivity, which translate in lower survival rates compared to other B-ALL subtypes.

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The introduction of pediatric-inspired regimens in adult Philadelphia-negative acute lymphoblastic leukemia (Ph- ALL) has significantly improved patients' prognosis. Within the Campus ALL network, we analyzed the outcome of adult Ph- ALL patients treated according to the GIMEMA LAL1913 protocol outside the clinical trial to compare the real-life data with the study results. We included 421 consecutive patients; median age 42 years.

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Inotuzumab ozogamicin (InO) is an antibody-drug conjugate approved for the treatment of relapsed/refractory B-cell acute lymphoblastic leukemia (ALL). Several clinical trials are investigating InO in combination with low-intensity chemotherapy or other anti-ALL-targeted therapies in the salvage and frontline settings, notably in older adults who often cannot tolerate intensive chemotherapy and tend to have higher-risk disease. InO is also increasingly used to bridge patients to hematopoietic stem cell transplantation (HSCT), in sequence with chimeric antigen receptor T-cell therapy, to eliminate measurable residual disease and to prevent post-HSCT relapse.

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Article Synopsis
  • - Hypereosinophilic syndrome (HES) is a group of diverse disorders characterized by high levels of eosinophils, with ongoing challenges in diagnosis, understanding, and personalized treatment still needing attention.
  • - There is an urgent need to reduce the time it takes to diagnose and begin treatment for HES, as the condition significantly affects patients' quality of life.
  • - The Italian Society of Allergy, Asthma, and Clinical Immunology (SIAAIC) has launched a national initiative, the InHES network, to unify medical efforts and improve communication about HES, including sharing recent research findings and treatment recommendations.
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The administration of TKIs after Allo-SCT in Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph + ALL) remains controversial, and the TKI approach (prophylactic, pre-emptive or salvage) is still heterogeneous in transplant centers. In this context, very little is known about the feasibility and safety of third-generation TKIs. In this paper, we analyze the efficacy and safety of ponatinib (PONA) administered after Allo-SCT to prevent cytologic relapse of Ph + ALL.

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Importance: In newly diagnosed Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL), disease progression due to acquired resistance to first- or second-generation BCR::ABL1 tyrosine kinase inhibitors is common. Ponatinib inhibits BCR::ABL1 and all single-mutation variants, including T315I.

Objective: To compare frontline ponatinib vs imatinib in adults with newly diagnosed Ph+ ALL.

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Article Synopsis
  • VEXAS is a unique disease that combines symptoms of rheumatologic and hematologic disorders, and this study aimed to better understand its diagnosis and genetic features while tracking changes over time with different treatments.
  • Researchers gathered data from various centers in Italy, finding that 41 male patients had significant mutations in the UBA1 gene, mostly diagnosed around age 67, all presenting with anemia and common rheumatologic issues like polychondritis.
  • A high percentage of these patients also had myelodysplastic syndrome (MDS), showcasing diverse genetic mutations, and the study noted that after treatment like hematopoietic cell transplants, some mutations were cleared.
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We evaluated 58 patients with relapsed or refractory (r/r) acute B-lymphoblastic leukemia (B-ALL; median age 42.5 years; range, 16-69 years), treated with inotuzumab ozogamicin (INO) between 2016-2022 and who received an allogeneic hematopoietic stem cell transplantation (allo-HCT) consecutively. Forty-seven (81%) of the 58 patients were heavily pretreated receiving intensive chemotherapy +/- tyrosine kinase inhibitor, blinatumomab in 24 (41%) and allo-HCT at first-line in 11 (19%) patients.

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In the phase 3 QUAZAR AML-001 trial (NCT01757535) of patients with acute myeloid leukaemia (AML) in remission following intensive chemotherapy (IC) and ineligible for haematopoietic stem cell transplant (HSCT), oral azacitidine (Oral-AZA) maintenance significantly prolonged overall survival (OS) versus placebo. The impact of subsequent treatment following maintenance has not been evaluated. In this post hoc analysis, OS was estimated for patients who received subsequent AML therapy, and by regimen received (IC or lower-intensity therapy).

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  • The study investigated the effectiveness and optimal dosage of cusatuzumab, an anti-CD70 antibody, combined with azacitidine for treating acute myeloid leukaemia in patients not eligible for intensive chemotherapy.
  • Conducted across 40 hospitals in seven countries, the randomized trial assigned 103 adult patients to receive either 10 mg/kg or 20 mg/kg doses of cusatuzumab alongside azacitidine in 28-day cycles, aiming to evaluate complete remission rates.
  • Although 55% of patients experienced significant treatment results, the study was halted after part one due to changes in the treatment landscape that made continuing with further phases impractical.
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  • Blinatumomab (Blina) and inotuzumab ozogamicin (InO) show effectiveness in treating relapsed/refractory B-lymphoblastic leukemia, though outcomes after recurrence and re-treatment are not well understood.
  • In a study of 71 patients, those treated with Blina achieved a 63% complete remission (CR) rate, while InO led to an 82% CR rate, highlighting the drugs' potential in handling multiple relapses.
  • Overall survival (OS) was 19 months for the Blina/InO group and 9.4 months for the InO/Blina group, with a significant percentage of patients achieving minimal residual disease negativity, indicating promising results as
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NPM1-mutated acute myeloid leukaemia (NPM1 AML) represents a mostly favourable/intermediate risk disease that benefits from allogeneic haematopoietic stem cell transplantation (HSCT) in case of measurable residual disease (MRD) relapse or persistence after induction chemotherapy. Although the negative prognostic role of pre-HSCT MRD is established, no recommendations are available for the management of peri-transplant molecular failure (MF). Based on the efficacy data of venetoclax (VEN)-based treatment in NPM1 AML older patients, we retrospectively analysed the off-label combination of VEN plus azacitidine (AZA) as bridge-to-transplant strategy in 11 NPM1 MRD-positive fit AML patients.

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Article Synopsis
  • Scientists studied older patients with a type of leukemia called acute myeloid leukemia (AML) to find out what factors affect their survival chances.
  • They found that early response to treatment and specific health risks can help predict which patients will do better.
  • They also discovered that having other health problems, like lung disease or low albumin levels, can make patients weaker and more likely to face complications, influencing how long they might live.
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Chimeric antigen receptor (CAR) T-cell therapy is a promising approach for some relapse/refractory hematological B-cell malignancies; however, in most patients, cytokine release syndrome (CRS) may occur. CRS is associated with acute kidney injury (AKI) that may affect the pharmacokinetics of some beta-lactams. The aim of this study was to assess whether the pharmacokinetics of meropenem and piperacillin may be affected by CAR T-cell treatment.

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Mixed-phenotype acute leukemia (MPAL) is a rare disease. Treatment is often similar to that of acute lymphoblastic leukemia (ALL), but the outcome in adults and the role of allogeneic stem cell transplantation (AlloSCT) are not well defined. We report on 77 adult patients diagnosed with MPAL over the last 10 years and treated with a curative intent.

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