Publications by authors named "Elena Crisa"

Background/objectives: The aim of this study was to assess the unmet needs of myelodysplastic neoplasm (MDS) patients and their caregivers, focusing on how these needs impact quality of life (QoL) and daily functioning. MDS predominantly affects older adults. It is often complicated by severe red blood cell transfusion-dependent anemia and may require frequent hospital visits, conferring a substantial burden on patients and caregivers.

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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
  • Lenalidomide (LEN) can help 60-70% of patients with del(5q) myelodysplastic neoplasm achieve independence from red blood cell transfusions (RBC-TI), but there's a concern about its toxicity and cost.
  • The HARMONY Alliance study followed 118 low-intermediate risk MDS patients who discontinued LEN, finding that 50 lost RBC-TI after a median of 49 months.
  • Factors like having a low transfusion burden before treatment, completing at least 12 LEN cycles, being younger, and having higher hemoglobin levels at withdrawal were linked to longer RBC-TI duration after discontinuing LEN.
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Toxocariasis is a zoonosis transmitted by the nematode spp. Immunocompromised hosts are more susceptible than general population to bacterial, viral, fungal and parasitic infections. In this population toxocariasis may present as exacerbation or reactivation and could have severe or atypical manifestations being a diagnostic challenge for healthcare providers.

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  • * The case series involved 10 patients with an average age of 67, most of whom had significant health issues and common blood disorders like acute myeloid leukaemia and non-Hodgkin's lymphoma.
  • * Despite a 90% improvement rate after starting treatment, the study reported high mortality rates of 30% within 30 days and 50% during hospital stays for these patients.
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  • 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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  • Cytomegalovirus (CMV) co-infections are infrequently documented but pose significant health risks, particularly for immunocompromised individuals, with substantial morbidity and mortality rates.
  • The literature review indicates that most affected patients are middle-aged males who often received steroid treatments before their CMV diagnosis, typically linked to conditions like solid organ transplants or hematological diseases.
  • Common early symptoms include gastrointestinal and respiratory issues, with high treatment mortality rates of about 52.4%, while secondary bacterial infections often accompany CMV infections.
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To our knowledge, we have described the first case of /Cytomegalovirus (CMV) concomitant infection that occurred in a European country. The patient was a 76-year-old woman affected by relapsed non-Hodgkin lymphoma who presented interstitial pneumonia with a rapidly progressive worsening of respiratory insufficiency, leading to cardiac dysfunction and consequent death. CMV reactivation is a common complication in immunocompromised patients, while hyperinfection/disseminated strongyloidiasis (HS/DS) is rare in low endemic regions, but has been widely described in Southeast Asia and American countries.

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Background: Imatinib, dasatinib, and nilotinib are tyrosine kinase inhibitors (TKIs) approved in Italy for frontline treatment of chronic-phase chronic myeloid leukemia (CP-CML). The choice of TKI is based on a combined evaluation of the patient's and the disease characteristics. The aim of this study was to analyze the use of frontline TKI therapy in an unselected cohort of Italian patients with CP-CML to correlate the choice with the patient's features.

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Purpose: In myelodysplastic syndromes (MDS), severe thrombocytopenia is associated with poor prognosis. This multicenter trial presents the second-part long-term efficacy and safety results of eltrombopag in patients with low-risk MDS and severe thrombocytopenia.

Methods: In this single-blind, randomized, placebo-controlled, phase-II trial of adult patients with International Prognostic Scoring System low- or intermediate-1-risk MDS, patients with a stable platelet (PLT) count (<30 × 10/mm) received eltrombopag or placebo until disease progression.

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Article Synopsis
  • Erythropoiesis-stimulating agents (ESA), particularly biosimilars (B-ESA), show promise in treating anemia in myelofibrosis (MF), although their effectiveness is not fully established.
  • A study of 96 MF patients indicated an 80% anemia response rate with B-ESA, where important factors for response included being transfusion-independent and having low ferritin levels at the start of treatment.
  • The treatment was generally well-tolerated, with only 2.5% discontinuing due to toxicity, and those who responded to B-ESA had better survival rates compared to non-responders, suggesting the need for further research on its clinical benefits.
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Acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) represent an unmet clinical need whose prognosis is still dismal. Alterations of immune response play a prominent role in AML/MDS pathogenesis, revealing novel options for immunotherapy. Among immune system regulators, CD47, immune checkpoints, and toll-like receptor 2 (TLR2) are major targets.

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Article Synopsis
  • - Deferasirox (DFX) is used to treat iron overload in myelofibrosis (MF) patients receiving ruxolitinib (RUX), and a study evaluated the safety and efficacy of the RUX-DFX combination in 69 MF patients.
  • - Results showed that 47.8% of patients achieved iron chelation response (ICR) and 46.4% had an erythroid response (ER), with 18.9% becoming transfusion-independent; no unexpected toxicities were reported.
  • - Factors predicting improved survival included the absence of leukocytosis and achieving ICR, indicating that the RUX-DFX regimen may benefit MF patients and warrants further research.
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Mastocytosis is a rare hematological neoplasm characterized by the proliferation of abnormal clonal mast cells (MCs) in different cutaneous and extracutaneous organs. Its diagnosis is based on well-defined major and minor criteria, including the pathognomonic dense infiltrate of MCs detected in bone marrow (BM), elevated serum tryptase level, abnormal MCs CD25 expression, and the identification of D816V mutation. The World Health Organization (WHO) classification subdivides mastocytosis into a cutaneous form (CM) and five systemic variants (SM), namely indolent/smoldering (ISM/SSM) and advanced SM (AdvSM) including aggressive SM (ASM), SM associated to hematological neoplasms (SM-AHN), and mast cell leukemia (MCL).

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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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Data on the use of azacytidine and decitabine as salvage therapy for acute myeloid leukemia are limited. We retrospectively reviewed clinical records of 100 patients treated with hypomethylating agents (HMA) as salvage therapy in nine Italian institutions. A total of 24% of patients obtained a response to HMA (CR, PR, or CRi), while 26% showed a stable disease (SD); 50% of patients experienced progressive disease.

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Myelodysplastic syndromes (MDS) arising in the context of inherited bone marrow failure syndromes (IBMFS) differ in terms of prognosis and treatment strategy compared to MDS occurring in the adult population without an inherited genetic predisposition. The main molecular pathways affected in IBMFS involve telomere maintenance, DNA repair, biogenesis of ribosomes, control of proliferation and others. The increased knowledge on the genes involved in MDS pathogenesis and the wider availability of molecular diagnostic assessment have led to an improvement in the detection of IBMFS genetic predisposition in MDS patients.

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Background: Azacitidine (AZA) is the standard treatment for myelodysplastic syndromes (MDS); however, many patients prematurely stop therapy and have a dismal outcome.

Methods: The authors analyzed outcomes after AZA treatment for 402 MDS patients consecutively enrolled in the Italian MDS Registry of the Fondazione Italiana Sindromi Mielodisplastiche, and they evaluated the North American MDS Consortium scoring system in a clinical practice setting.

Results: At treatment discontinuation, 20.

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Atypical chronic myeloid leukemia, negative (aCML) is a rare myelodysplastic syndrome (MDS)/myeloproliferative neoplasm (MPN) with a high rate of transformation to acute myeloid leukemia, and poor survival. Until now, the diagnosis has been based on morphological grounds only, possibly making the real frequency of the disease underestimated. Only recently, new insights in the molecular biology of MDS/MPN syndromes have deepened our knowledge of aCML, enabling us to have a better molecular profile of the disease.

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Monosomy 7 [-7] and/or partial loss of chromosome 7 [del(7q)] are associated with poor and intermediate prognosis, respectively, in myelodysplastic syndromes (MDS), but somatic mutations may also play a key complementary role. We analyzed the impact on the outcomes of deep targeted mutational screening in 280 MDS patients with -7/del(7q) as isolated cytogenetic abnormality (86 with del(7q) and 194 with -7). Patients with del(7q) or -7 had similar demographic and disease-related characteristics.

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