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Cremona, Italy

Olivieri A.,Unita Operativa di Ematologia e Trapianto di Cellule Staminali | Marchetti M.,Hematology Unit | Lemoli R.,University of Bologna | Tarella C.,University of Turin | And 2 more authors.
Bone Marrow Transplantation | Year: 2012

Many lymphoma and myeloma patients fail to undergo ASCT owing to poor mobilization. Identification of poor mobilizers (PMs) would provide a tool for early intervention with new mobilization agents. The Gruppo italianoTrapianto di Midollo Osseo working group proposed a definition of PMs applicable to clinical trials and clinical practice. The analytic hierarchy process, a method for group decision making, was used in setting prioritized criteria. Lymphoma or myeloma patients were defined as 'proven PM' when: (1) after adequate mobilization (G-CSF 10 μg/kg if used alone or ≥5 μg/kg after chemotherapy) circulating CD34 + cell peak is <20/μL up to 6 days after mobilization with G-CSF or up to 20 days after chemotherapy and G-CSF or (2) they yielded <2.0 × 10 6 CD34 + cells per kg in ≤3 apheresis. Patients were defined as predicted PMs if: (1) they failed a previous collection attempt (not otherwise specified); (2) they previously received extensive radiotherapy or full courses of therapy affecting SC mobilization; and (3) they met two of the following criteria: advanced disease (≥2 lines of chemotherapy), refractory disease, extensive BM involvement or cellularity <30% at the time of mobilization; age ≥65 years. This definition of proven and predicted PMs should be validated in clinical trials and common clinical practice. © 2012 Macmillan Publishers Limited All rights reserved.

Bocchi F.,Cremona Hospital
Urologia | Year: 2013

The aim of our study is to assess the incidence of the surgical approach in scrotal trauma. We retrospectively assessed both penetrating and blunt cases of scrotal trauma observed from 2002 to 2012. For each case we considered various parameters such as the age of the patient, whether the type of trauma was penetrating or blunt, whether or not a surgical approach was taken, whether or not there were polytrauma, whether or not an orchiectomy was performed, and how many days had elapsed since the first urological observation of the trauma. 43 cases of scrotal trauma were assessed, of which 39 were blunt traumas (90%) and four penetrating traumas (10%). The median age of all patients was 29 years (range 4-88). Of these patients, eight underwent surgical procedures, of which three were cases of penetrating scrotal trauma and five were cases of blunt trauma, with an average age of 20. We only found it necessary to carry out an orchiectomy in two of these patients, of which one was after penetrating trauma and the other after blunt trauma. Most of the blunt traumas did not require surgery (8 versus 35, p<0.05). In our case studies, in the majority of cases early exploratory intervention in scrotal trauma allows the testicle to be saved in its entirety or at least in part.

Chabannon C.,French Institute of Health and Medical Research | Pamphilon D.,JACIE Accreditation Office | Vermylen C.,JACIE Accreditation Office | Vermylen C.,Catholic University of Louvain | And 8 more authors.
Bone Marrow Transplantation | Year: 2012

In 2010, JACIE, the Joint Accreditation Committee of ISCT (International Society for Cell Therapy) Europe and EBMT (European group for Blood and Marrow Transplantation) celebrated the tenth anniversary of the first inspection of a European hematopoietic SCT program. JACIE standards establish the criteria for a comprehensive quality management program that covers all three major domains of activity that are necessary for the delivery of HSCT: clinical, collection and processing, as well as their interactions with ancillary and supportive activities. Although more than 200 European programs have applied for JACIE accreditation, and more than 100 have been granted accreditation, a recent retrospective analysis of the large-size EBMT registry of autologous and allogenic hematopoietic HSCT demonstrates that one of the factors affecting the overall survival of recipients of allogenic transplantation is the status of the transplant program regarding JACIE accreditation. This provides one of the first demonstrations that introduction of a quality management system contributes to the overall survival of patients treated with a highly specific medical procedure, and represents a milestone in the implementation of JACIE. © 2012 Macmillan Publishers Limited All rights reserved.

Franzetti M.,University of Milan | Lai A.,University of Milan | Roberto Simonetti F.,University of Milan | Bozzi G.,University of Milan | And 8 more authors.
Journal of Antimicrobial Chemotherapy | Year: 2012

Background: Transmitted drug resistance (TDR) is mainly restricted to individuals carrying B subtype, with low prevalence among non-B subtypes when grouped together. Subtype F1 is the most frequent non-B variant found in subjects living in Italy, allowing a specific assessment of TDR associated with this clade. Methods: We analysed pol sequences of HIV-1-positive individuals carrying the F1 variant included in the Antiretroviral Resistance Cohort Analysis database in the 1998-2009 period. Mutations were analysed with the Surveillance Drug Resistance Mutation and the International AIDS Society lists for naive and treated patients, respectively. Results: Among 343 HIV-1-infected patients carrying an F1 subtype, resistance was evaluated in a subset of 221 patients whose treatment status was known (169 drug naive and 52 drug experienced). The prevalence of TDR was 15.4% (11.8% for nucleoside/nucleotide reverse transcriptase inhibitors, 6.5% for non-nucleoside reverse transcriptase inhibitors and 7.1% for protease inhibitors). Among the 169 naive patients, 75.1%, 10.1% and 7.1% were Italians, South Americans and Romanians, respectively. Heterosexuals were prevalent among Italians and Romanians, while men who have sex with men were predominant among South Americans. The overall frequency of TDR declined from 21.4% to 7.1% in the 1998-2009 period. Although no statistical difference was detected, the frequency of TDR was higher in South Americans (23.5%) compared with Italian and Romanian naive patients (15% and 8.3%, respectively). Discussion: Our study shows a remarkable frequency of TDR in the F1 subtype-infected population. The high prevalence of TDR detected in South American subjects is linked to the homosexual route of infection. However, TDR was considerably high also in Italian subjects harbouring the F1 subtype, deserving careful monitoring. © The Author 2012. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.

Barni S.,Treviglio Hospital | Labianca R.,Medical Oncology Unit | Agnelli G.,University of Perugia | Bonizzoni E.,University of Milan | And 7 more authors.
Journal of Translational Medicine | Year: 2011

Background: Cancer patients receiving chemotherapy are at increased risk of thrombosis. Nadroparin has been demonstrated to reduce the incidence of venous and arterial thrombotic events (TEs) by about 50% in cancer outpatients receiving chemotherapy. The aims of this retrospective analysis were to evaluate the thromboembolic risk and the benefit of thromboprophylaxis according to type of chemotherapy.Methods: Cancer outpatients were randomly assigned to receive subcutaneous injections of nadroparin or placebo. The incidence of symptomatic TEs was assessed according to the type of chemotherapy. Results were reported as risk ratios with associated 95% CI and two-tailed probability values.Results: 769 and 381 patients have been evaluated in the nadroparin and placebo group, respectively. In the absence of thromboprophylaxis, the highest rate of TEs was found in patients receiving gemcitabine- (8.1%) or cisplatin-based chemotherapy (7.0%). The combination of gemcitabine and cisplatin or carboplatin increased the risk to 10.2%. Thromboprophylaxis reduced TE risk by 68% in patients receiving gemcitabine; with a further decrease to 78% in those receiving a combination of gemcitabine and platinum.Conclusions: This retrospective analysis confirms that patients undergoing chemotherapy including gemcitabine, platinum analogues or their combination are at higher risk of TEs. Our results also suggest that outpatients receiving chemotherapy regimens including these agents might achieve an increased benefit from thromboprophylaxis with nadroparin. Clinical Trial registration number: NCT 00951574. © 2011 Barni et al; licensee BioMed Central Ltd.

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