Carella A.M.,Unita Operativa Complessa Ematologia
Expert Review of Hematology
ESH International Conference on Lymphomas Marseille, France, 28-30 October 2012 The ESH International Conference on Lymphomas gathered clinicians and scientists involved in all aspects of clinical treatment and biology of lymphomas. The 2012 International Conference was held in Marseille, France, and presented an appealing program. Of particular interest was the session dedicated to Hodgkin lymphoma. Our knowledge on the pathology of Hodgkin lymphoma and on the new therapeutic possibilities has changed greatly during the last three decades. During the session, the speakers focused on the results of conventional chemotherapy and on the new drugs for resistant/relapsed patients. © 2013 Expert Reviews Ltd. Source
Sequential alternating deferiprone and deferoxamine treatment compared to deferiprone monotherapy: Main findings and clinical follow-up of a large multicenter randomized clinical trial in β-thalassemia major patients
Pantalone G.R.,Cervello |
Maggio A.,Cervello |
Vitrano A.,Cervello |
Capra M.,Centro Of Prevenzione Diagnosi E Cura Della Talassemia |
And 22 more authors.
In β-thalassemia major (β-TM) patients, iron chelation therapy is mandatory to reduce iron overload secondary to transfusions. Recommended first line treatment is deferoxamine (DFO) from the age of 2 and second line treatment after the age of 6 is deferiprone (L1). A multicenter randomized open-label trial was designed to assess the effectiveness of long-term alternating sequential L1-DFO vs. L1 alone iron chelation therapy in β-TM patients. Deferiprone 75 mg/kg 4 days/week and DFO 50 mg/kg/day for 3 days/week was compared with L1 alone 75 mg/kg 7 days/week during a 5-year follow-up. A total of 213 thalassemia patients were randomized and underwent intention-to-treat analysis. Statistically, a decrease of serum ferritin level was significantly higher in alternating sequential L1-DFO patients compared with L1 alone patients (p = 0.005). Kaplan-Meier survival analysis for the two chelation treatments did not show statistically significant differences (log-rank test, p = 0.3145). Adverse events and costs were comparable between the groups. Alternating sequential L1-DFO treatment decreased serum ferritin concentration during a 5-year treatment by comparison to L1 alone, without significant differences of survival, adverse events or costs. These findings were confirmed in a further 21-month follow-up. These data suggest that alternating sequential L1-DFO treatment may be useful for some β-TM patients who may not be able to receive other forms of chelation treatment. Copyright © Informa Healthcare USA, Inc. Source
Cavalcanti E.,Italian National Cancer Institute |
Barchiesi V.,Italian National Cancer Institute |
Cuomo M.,Italian National Cancer Institute |
Di Paola F.,Italian National Cancer Institute |
And 2 more authors.
The measurement of serum free light chains (FLC) is recommended for diagnosis, monitoring and prognosis of monoclonal gammopathies and specific assays on automated nephelometers and turbidimeters are available. We reported a case study about a 47-years old woman with bone pain, admitted to the Orthopedic Day Surgery. Serum protein electrophoresis (SPE) both on agarose gel (AGE) and capillary zone electrophoresis (CZE) did not show abnormalities and nephelometric assays of intact immunoglobulins and total light chains were within the respective reference intervals. A relevant difference between the λ FLC results was obtained using two serum FLC assays, resulting highly abnormal by the Freelite (The Binding Site) and within the reference interval by the N Latex FLC (Siemens Healthcare Diagnostics). A home-made high resolution AGE, performed both in serum and urine samples, detected a monoclonal component (MC) in the γ-region and serum and urine immunofixation electrophoresis (IFE) showed a free λ MC. Immunoblotting and SDS-PAGE confirmed the presence of a FLC and showed that the MC consisted of λ FLC with MW of 22,000 and 44,000 Da. Bone biopsy confirmed the diagnosis of λ chain multiple myeloma. The woman was admitted to the Hematology-Oncology Unit and one month after the start of the therapy, serum and urine IFE showed the MC disappearance and the serum FLC results by Freelite assays returned within the reference interval. Source