Publications by authors named "Maurizio Martelli"

This study aims to evaluate the impact of levetiracetam (LVT) prophylaxis on the incidence and severity of Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS) in patients undergoing anti-CD19 CAR-T therapy for large B-cell lymphoma (LBCL). A propensity score-matched cohort of 254 patients was analyzed, comparing those receiving LVT prophylaxis with those not receiving it in a 1:1 ratio. The results showed no significant difference in the occurrence of ICANS of any grade between the two groups (32.

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Thrombosis Lymphoma (ThroLy) and Khorana scores have been conceived to predict the thrombotic risk in oncohematologic patients. Currently, there is no univocal indication to perform thromboprophylaxis in classical Hodgkin lymphoma (cHL). We performed a retrospective study to validate scores and risk factors in a cohort of consecutive patients with cHL, treated from 2014 to 2022 outside clinical trials.

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Background: Treatment free remission (TFR) is a key treatment goal in chronic-phase chronic myeloid leukemia (CP-CML) patients with sustained deep molecular response (DMR). While clinical trials report that approximately 40%-50% of such patients can discontinue tyrosine kinase inhibitors (TKIs) without presenting a molecular relapse (MRec), real-world data remain limited. Optimizing patient selection before TKI discontinuation is crucial for CML management and resource allocation.

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Internal tandem duplications of FLT3 (FLT3-ITD) in acute myeloid leukemia (AML) are associated with poor outcomes. CD99 is frequently overexpressed in AML and emerged as potential diagnostic marker. Ninety consecutive newly diagnosed AML patients were retrospectively analyzed.

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Background: Myelofibrosis (MF) significantly impacts patients' overall survival (OS) and quality of life (QOL). This prospective study analyzed ruxolitinib dosing patterns and associated clinical outcomes in patients with MF over 12 months.

Methods: ROMEI, a multicenter, observational, ongoing study, enrolled 508 adult patients with MF treated with ruxolitinib.

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Background: Discrimination between clonal and reactive cell proliferation is critical for the correct management of T-cell lymphocytosis. Multiparametric flow cytometry (MFC) represents a valuable tool, particularly because it allows the evaluation of the T-cell receptor (TCR) Vβ repertoire to pinpoint eventual clonality in T-cell lymphocytosis. A restricted expansion of a single out of the 24 evaluable families or a "clonogram-off" pattern is highly suggestive of the presence of a clonal T-cell population.

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Primary mediastinal large B-cell lymphoma (PMBCL) is a distinct subtype of B-cell lymphoma, representing a clinical and therapeutic challenge due to its unique presentation, histopathological features, and treatment response. It primarily affects young adults, with a significant female preponderance, and is characterized by a large anterior mediastinal mass that causes compressive symptoms. Despite its aggressive nature, PMBCL patients have a favorable prognosis, with a 5-year survival rate exceeding 80% when early remission is achieved through first-line therapy.

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Background/objectives: Treatments for multiple myeloma (MM) have expanded in the last decade, and the overall survival (OS) of MM patients (pts) is in continuous improvement. With the availability of new treatments and the use of high-dose chemotherapy, followed by autologous hematopoietic stem cell transplantation (ASCT), the median OS of newly diagnosed MM (NDMM) pts is 6-8 years. To date, approximately 50% and 28% of MM patients are still alive at 5 years and 10 years.

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Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare form of non-Hodgkin T-cell lymphoma diagnosed in patients with a history of breast implants. Most patients develop a periprosthetic effusion at early stages of disease while less common presentations include a palpable mass, severe capsular contracture, lymphadenopathy, or cutaneous erythema. Due to the complex nature of this disease, a multidisciplinary approach is necessary for optimal management, particularly in locally advanced disease or inoperable patients.

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Background: Clonal mature B-cell lymphoproliferative disorders (B-LPDs) are a heterogeneous group of neoplasia characterized by the proliferation of mature B lymphocytes in the peripheral blood, bone marrow and/or lymphoid tissues. B-LPDs classification into different subtypes and their diagnosis is based on a multiparametric approach. However, accurate diagnosis may be challenging, especially in cases of ambiguous interpretation.

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Circulating tumor DNA (ctDNA) levels can help predict outcomes in diffuse large B-cell lymphoma (DLBCL), but its integration with DLBCL molecular clusters remains unexplored. Using the LymphGen tool in 77 DLBCL cases with both ctDNA and tissue biopsy, a 95.8% concordance rate in molecular cluster assignment was observed, showing the reproducibility of molecular clustering on ctDNA.

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Introduction: Myelofibrosis (MF) is often characterized by a multifactorial anemia determined, in part, by bone marrow (BM) fibrosis, extramedullary erythropoiesis and splenomegaly. Ruxolitinib (RUX) is the first-in-class janus kinase 2 (JAK2) inhibitor approved for treatment of MF, proved to reduce spleen volume and decrease symptom burden. The red cell distribution width (RDW) is the measure of erythrocyte volume variability (anisocytosis).

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Standardizing tumor measurement on F-FDG PET is crucial for the routine clinical use of powerful PET-derived lymphoma prognostic factors such as metabolic tumor volume (MTV) and total lesion glycolysis (TLG). The recent proposal of an SUV of 4 as a new reference segmentation threshold for most aggressive lymphomas may homogenize volume-based metrics and facilitate their clinical application. This study compared MTV and TLG in primary mediastinal B-cell lymphoma (PMBCL) patients estimated using an SUV of 4 and the current threshold at 25% of SUV Baseline PET metrics were evaluated in 501 PMBCL patients from the IELSG37 trial.

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In diffuse large B-cell lymphoma (DLBCL) treatment response relies on imaging. We investigated the potential value of molecular measurable residual disease (MRD) on circulating tumor DNA (ctDNA) to predict the outcome of 73 DLBCL patients. At baseline, next-generation sequencing was used to detect clonal immunoglobulin (IG) gene rearrangements on tumor biopsies (N=57) and ctDNA (N=73).

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Introduction: Chronic myeloid leukemia (CML) represents one of the first neoplasms whose molecular pathogenesis was successfully unraveled, with tyrosine kinase inhibitors (TKIs) representing one of the first-targeted therapies. TKIs have revolutionized long-term outcomes of CML patients and their life expectancy. Nonetheless, a minority of patients will develop TKI resistance due to a complex and multifactorial process that ultimately leads to the emergence of an unresponsive cancer clone.

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Managing acute myeloid leukemia (AML) and its critical complications requires understanding the complex interplay between disease biology, treatment strategies, and patient characteristics. Complications like sepsis, acute respiratory failure (ARF), hyperleukocytosis, coagulopathy, tumor lysis syndrome (TLS) and central nervous system (CNS) involvement present unique challenges needing precise evaluation and tailored interventions. Venetoclax-induced TLS and differentiation syndrome (DS) from IDH1/IDH2 or menin inhibitors highlight the need for ongoing research and innovative approaches.

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A comprehensive analysis of 220 patients diagnosed with APL between 1993 and 2022 is here reported. Overall, 214 patients (97.2%) received induction therapy.

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Background: The introduction of all- retinoic acid (ATRA) and arsenic trioxide (ATO) has radically improved the prognosis of acute promyelocytic leukemia (APL), with cure rates above 80%. While relapse occurs in less than 20% of cases, addressing this issue remains challenging. Identifying effective salvage therapies for relapsed APL is crucial to improve patient outcomes.

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Article Synopsis
  • ATRA and ATO are the main treatments for low to medium risk acute promyelocytic leukaemia (APL), but many patients (60%) can have a side effect called leucocytosis, which means very high white blood cell counts.
  • Researchers studied 65 APL patients and found that those with lower levels of important blood proteins (like fibrinogen) and higher amounts of cancer cells in their bone marrow were more likely to have leucocytosis when treated with ATRA and ATO.
  • Leucocytosis can lead to other serious problems, so doctors need to keep a close eye on patients with these risk factors to help prevent issues and give extra treatments if needed.
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Background: B-lineage acute lymphoblastic leukemias (B-ALL) harboring the t(9;22)(q34;q11)/BCR::ABL1 rearrangement represent a category with previously dismal prognosis whose management and outcome dramatically changed thanks to the use of tyrosine kinase inhibitors (TKIs) usage and more recently full chemo-free approaches. The prompt identification of these cases represents an important clinical need.

Objectives: We sought to identify an optimized cytofluorimetric diagnostic panel to predict the presence of Philadelphia chromosome (Ph) in B-ALL cases by the introduction of CD146 in our multiparametric flow cytometry (MFC) panels.

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Article Synopsis
  • The study analyzed 140 patients with a median age of 51, finding that 21% had high white blood cell counts and 52% had an NPM1 co-mutation, which influenced treatment responses.
  • Chemotherapy was administered to 101 patients until 2018, after which 39 patients received a combination treatment including FLT3 inhibitors, resulting in a 64% overall complete response rate.
  • Transplant outcomes varied, with a notably higher non-relapse mortality in allogeneic transplants compared to autologous ones, and the importance of identifying patients who would benefit from transplant in CR1 was emphasized for future treatment strategies.
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Article Synopsis
  • 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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Introduction: Chronic myeloid leukemia (CML) prevalence is currently increasing due to the great efficacy of tyrosine kinase inhibitor (TKI) therapy. Discontinuation of treatment in the long-term, owing to avoid off-target side effects or treatment-free remission (TFR), has become an additional treatment goal in CML patients who achieved a deep molecular response (DMR). Second-generation TKIs (2 G-TKIs) have a significantly higher rate of DMR than imatinib.

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