ASL Alessandria

Tortona, Italy

ASL Alessandria

Tortona, Italy
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Ceresoli G.L.,Cliniche Humanitas Gavazzeni | Grosso F.,Ospedale SS Antonio e Biagio | Zucali P.A.,Humanitas Cancer Center | Mencoboni M.,Ospedale Villa Scassi | And 12 more authors.
British Journal of Cancer | Year: 2014

Background:The incidence of malignant pleural mesothelioma (MPM) in elderly patients is increasing. There are no specific guidelines for their management.Methods:The clinical records of elderly patients (≥70 years old) with MPM referred from January 2005 to November 2011 to six Italian Centres were reviewed. Age, gender, histology, International Mesothelioma Interest Group (IMIG) stage, Eastern Cooperative Oncology Group Performance Status (ECOG-PS), Charlson Comorbidity Index (CCI) and treatment modalities were analysed and correlated to overall survival (OS).Results:In total, 241 patients were identified. Charlson Comorbidity Index was ≥1 in 92 patients (38%). Treatment was multimodality therapy including surgery in 18, chemotherapy alone in 180 (75%) and best supportive care in 43 cases (18%). Chemotherapy was mainly pemetrexed based. Median OS was 11.4 months. Non-epithelioid histology (HR 2.32; 95% CI 1.66-3.23, P<0.001), age ≥75 years (HR 1.44; 95% CI 1.08-1.93, P=0.014), advanced (III-IV) stage (HR 1.47; 95% CI 1.09-1.98, P=0.011) and CCI≥1 (HR 1.38; 95% CI 1.02-1.85, P=0.034) were associated to a shorter OS. Treatment with pemetrexed was associated with improved OS (HR 0.40; 95% CI 0.28-0.56, P<0.001).Conclusions:Non-epithelioid histology, age ≥75 years, advanced IMIG stage and presence of comorbidities according to CCI were significant prognostic factors in elderly patients with MPM. Treatment with pemetrexed-based chemotherapy was feasible in this setting. Prospective dedicated trials in MPM elderly patients selected according to prognostic factors including comorbidity scales are warranted. © 2014 Cancer Research UK.

Rocco V.,A.O. Rummo | Maconi M.,ASL Alessandria | Gioia M.,Cervello | Catalano T.,A.O. Rummo | And 4 more authors.
Leukemia Research | Year: 2011

Diagnosis of MDS has changed during the last years because of the 2008 WHO classification. Complete blood cell count (CBC) is a very important tool both for diagnosis of MDS.The aim of this study was to evaluate if it is possible to use the abnormal signals produced by dysplastic cells to produce a flag "dysplasia" able to identify the patients needing further hematological investigations. The proposed flag has been tested in a large group of patients to evaluate the sensibility and specificity. We create 5 patterns of MDS. Our study demonstrated that the flag "dysplasia" is specific and sensible for MDS. © 2011 Elsevier Ltd.

Danise P.,University of Salerno | MacOni M.,ASL Alessandria | Barrella F.,University of Salerno | Di Palma A.,University of Salerno | And 4 more authors.
Clinical Chemistry and Laboratory Medicine | Year: 2012

Background: Nucleated red blood cells (NRBCs) are present in the peripheral blood of several hematological and non-hematological conditions, usually associated with bad prognosis. The lack of an easy, rapid and reliable NRBCs count method did no't allow one to know the incidence of NRBCs and to quantify them: the count was usually done during the microscopic revision of a blood smear; this is the reason we found few studies on NRBCs automated count in the literature. The aim of this study was the evaluation of the presence and the quantification of NRBCs in some onco-hematological disorders. Methods: This study analyzed 478 patients with the automated hematology analyzer Sysmex XE2100. The range of NRBCs were calculated in the peripheral blood at diagnosis, at hematological remission and during therapy. Results: NRBCs are present in the peripheral blood of a high number of hematological diseases and are related to ineffective erythropoiesis or stress erythropoiesis or primary alterations of hematopoiesis. NRBCs were found in nearly all onco-hematological diseases at diagnosis, but not in all patients. NRBCs were frequently found during chemotherapy and absent at remission. Conclusions: To the authors' knowledge, this is the first study that gives a range for NRBCs count in the peripheral blood of these diseases. © 2012 by Walter de Gruyter Berlin Boston.

Maconi M.,ASL Alessandria | Cardaropoli S.,University of Turin | Cenci A.M.,University of Modena and Reggio Emilia
Journal of Clinical Laboratory Analysis | Year: 2012

Changes in platelet count (PLT) are very important during pregnancy. Many platelet disorders occur during pregnancy and a reduction in PLT is the most common hemostasis abnormality identified, and this has important implications for mother and foetus. Many of these disorders share clinical and laboratory features, making accurate diagnosis difficult. The aim of this study was to establish reference intervals of platelet parameters for some of the more important pathologies associated to pregnancy (pre-eclampsia, gestational diabetes, autoimmune disorders, viral infections) using the automated hematology analyzer Sysmex XE-2100 and to evaluate the difference between healthy and pathological pregnancy. We enrolled in our study 100 pregnant women in the third trimester of pregnancy. The parameters analyzed included PLT, platelet distribution width, and mean platelet volume (MPV). We found statistically significant difference in PLT in pre-eclampsia, autoimmune disorders, and viral infections. Our results demonstrated also a statistically significant difference in MPV in pre-eclampsia and gestational diabetes. Our results allow the clinicians to detect hematologic change by simple complete blood count useful for the management of the pathological pregnancies. In conclusion, the overall picture of platelet disorders is extremely variegated, leading to numerous diagnostic and therapeutic problems whose solutions require close collaboration between clinicians and laboratory specialists. © 2012 Wiley Periodicals, Inc.

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