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  • 1
    Language: English
    In: Leukemia, 2010-02, Vol.24 (2), p.255-264
    Description: We analyzed the long-term outcome of 4865 patients treated in Studies 82, 87, 88, 91 and 95 for childhood acute lymphoblastic leukemia (ALL) of the Italian Association of Pediatric Hematology and Oncology (AIEOP). Treatment was characterized by progressive intensification of systemic therapy and reduction of cranial radiotherapy. A progressive improvement of results with reduction of isolated central nervous system relapse rate was obtained. Ten-year event-free survival increased from 53% in Study 82 to 72% in Study 95, whereas survival improved from 64 to 82%. Since 1991, all patients were treated according to Berlin-Frankfurt-Muenster (BFM) ALL treatment strategy. In Study 91, reduced treatment intensity (25%) yielded inferior results, but intensification of maintenance with high-dose (HD)-L-asparaginase (randomized) allowed to compensate for this disadvantage; in high-risk patients (HR, 15%), substitution of intensive polychemotherapy blocks for conventional BFM backbone failed to improve results. A marked improvement of results was obtained in HR patients when conventional BFM therapy was intensified with three polychemotherapy blocks and double delayed intensification (Study 95). The introduction of minimal residual disease monitoring and evaluation of common randomized questions by AIEOP and BFM groups in the protocol AIEOP-BFM-ALL 2000 are expected to further ameliorate treatment of children with ALL.
    Subject(s): Hematology - organization & administration ; Prognosis ; Follow-Up Studies ; Humans ; Risk Factors ; Child, Preschool ; Infant ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - mortality ; Survival Rate ; Treatment Outcome ; Cranial Irradiation ; Remission Induction ; Medical Oncology - organization & administration ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy ; Time Factors ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Adolescent ; Female ; Italy ; Child ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - radiotherapy ; Pediatrics ; Care and treatment ; Chemotherapy ; Acute lymphocytic leukemia ; Research ; Radiotherapy ; Health aspects ; Cancer ; Index Medicus
    ISSN: 0887-6924
    E-ISSN: 1476-5551
    Source: Nature Open Access
    Source: Academic Search Ultimate
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 2
    Language: English
    In: Leukemia, 2014-05, Vol.28 (5), p.1132-1134
    Subject(s): Core Binding Factors - genetics ; Leukemia, Myeloid, Acute - diagnosis ; Prognosis ; Leukemia, Myeloid, Acute - pathology ; Humans ; Proto-Oncogene Proteins c-kit - genetics ; Mutation ; Leukemia, Myeloid, Acute - genetics ; Development and progression ; Transcription factors ; Genetic aspects ; Gene mutations ; Health aspects ; Leukemia in children ; Index Medicus
    ISSN: 0887-6924
    E-ISSN: 1476-5551
    Source: Nature Open Access
    Source: Academic Search Ultimate
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 3
    Language: English
    In: Bone marrow transplantation (Basingstoke), 2015-02, Vol.50 (2), p.181-188
    Description: We analyzed the outcome of 243 children with high-risk (HR) AML in first CR1 enrolled in the AIEOP-2002/01 protocol, who were given either allogeneic (ALLO; n=141) or autologous (AUTO; n=102) hematopoietic SCT (HSCT), depending on the availability of a HLA-compatible sibling. Infants, patients with AML-M7, or complex karyotype or those with FLT3-ITD, were eligible to be transplanted also from alternative donors. All patients received a myeloablative regimen combining busulfan, cyclophosphamide and melphalan; [corrected] AUTO-HSCT patients received BM cells in most cases, while in children given ALLO-HSCT stem cell source was BM in 96, peripheral blood in 19 and cord blood in 26. With a median follow-up of 57 months (range 12-130), the probability of disease-free survival (DFS) was 73% and 63% in patients given either ALLO- or AUTO-HSCT, respectively (P=NS). Although the cumulative incidence (CI) of relapse was lower in ALLO- than in AUTO-HSCT recipients (17% vs 28%, respectively; P=0.043), the CI of TRM was 7% in both groups. Patients transplanted with unrelated donor cord blood had a remarkable 92.3% 8-year DFS probability. Altogether, these data confirm that HSCT is a suitable option for preventing leukemia recurrence in HR children with CR1 AML.
    Subject(s): Autografts ; Follow-Up Studies ; Leukemia, Myeloid, Acute - pathology ; Humans ; Child, Preschool ; Hematopoietic Stem Cell Transplantation ; Infant ; Male ; Survival Rate ; Abnormal Karyotype ; Cord Blood Stem Cell Transplantation ; Leukemia, Myeloid, Acute - mortality ; fms-Like Tyrosine Kinase 3 - genetics ; Disease-Free Survival ; Allografts ; Adolescent ; Myeloablative Agonists - administration & dosage ; Female ; Transplantation Conditioning - methods ; Child ; Leukemia, Myeloid, Acute - therapy ; Leukemia, Myeloid, Acute - genetics ; Transplantation ; Health aspects ; Patient outcomes ; Hematopoietic stem cells ; Index Medicus
    ISSN: 0268-3369
    E-ISSN: 1476-5365
    Source: Nature Open Access
    Source: Academic Search Ultimate
    Source: Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 4
    Language: English
    In: Leukemia, 2017-04, Vol.31 (4), p.974-977
    Subject(s): Daunorubicin - therapeutic use ; Prognosis ; Cytarabine - therapeutic use ; Humans ; Up-Regulation - genetics ; Methotrexate - therapeutic use ; Mutation - genetics ; Cyclophosphamide - therapeutic use ; Down-Regulation - genetics ; Nuclear Pore Complex Proteins - genetics ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Mercaptopurine - therapeutic use ; Oncogene Proteins, Fusion - genetics ; Vincristine - therapeutic use ; Leukemia, Myeloid, Acute - drug therapy ; Biomarkers, Tumor - genetics ; Asparaginase - therapeutic use ; Prednisone - therapeutic use ; Leukemia, Myeloid, Acute - genetics ; Translocation, Genetic - genetics ; Index Medicus
    ISSN: 0887-6924
    E-ISSN: 1476-5551
    Source: Nature Open Access
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 5
    Language: English
    In: Leukemia, 2017-01, Vol.31 (1), p.18-25
    Description: Recurrent molecular markers have been routinely used in acute myeloid leukemia (AML) for risk assessment at diagnosis, whereas their post-induction monitoring still represents a debated issue. We evaluated the prognostic value and biological impact of minimal residual disease (MRD) and of the allelic ratio (AR) of FLT3-internal-tandem duplication (ITD) in childhood AML. We retrospectively screened 494 children with de novo AML for FLT3-ITD mutation, identifying 54 harboring the mutation; 51% of them presented high ITD-AR at diagnosis and had worse event-free survival (EFS, 19.2 versus 63.5% for low ITD-AR, 〈0.05). Forty-one percent of children with high levels of MRD after the 1st induction course, measured by a patient-specific real-time-PCR, had worse EFS (22.2 versus 59.4% in low-MRD patients, P〈0.05). Next, we correlated these parameters with gene expression, showing that patients with high ITD-AR or persistent MRD had characteristic expression profiles with deregulated genes involved in methylation and acetylation. Moreover, patients with high CyclinA1 expression presented an unfavorable EFS (20.3 versus 51.2% in low CyclinA1 group, P〈0.01). Our results suggest that ITD-AR levels and molecular MRD should be considered in planning clinical management of FLT3-ITD patients. Different transcriptional activation of epigenetic and oncogenic profiles may explain variability in outcome among these patients, for whom novel therapeutic approaches are desirable.
    Subject(s): fms-Like Tyrosine Kinase 3 - genetics ; Disease-Free Survival ; Leukemia, Myeloid, Acute - diagnosis ; Prognosis ; Epigenesis, Genetic - genetics ; Humans ; Child, Preschool ; Retrospective Studies ; Gene Expression Regulation, Leukemic ; Child ; Neoplasm, Residual - genetics ; Leukemia, Myeloid, Acute - genetics ; Molecular targeted therapy ; Gene mutations ; Gene expression ; Health aspects ; Innovations ; Index Medicus
    ISSN: 0887-6924
    E-ISSN: 1476-5551
    Source: Nature Open Access
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 6
    Language: English
    In: Bone marrow transplantation (Basingstoke), 2014-12, Vol.49 (12), p.1538-1540
    Subject(s): Hematologic Diseases - complications ; Humans ; Risk Factors ; Kaplan-Meier Estimate ; Proportional Hazards Models ; Child, Preschool ; Infant ; Male ; Treatment Outcome ; Syndrome ; Transplantation, Homologous ; Hematologic Diseases - therapy ; Hematopoietic Stem Cell Transplantation - adverse effects ; Female ; Posterior Leukoencephalopathy Syndrome - etiology ; Child ; Pediatrics ; Stem cell research ; Encephalopathy ; Transplantation ; Research ; Risk factors ; Hematopoietic stem cells ; Index Medicus
    ISSN: 0268-3369
    E-ISSN: 1476-5365
    Source: Nature Open Access
    Source: Academic Search Ultimate
    Source: Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 7
    Article
    Article
    2008
    ISSN: 0268-3369 
    Language: English
    In: Bone marrow transplantation (Basingstoke), 2008-06, Vol.41 (S2), p.S35-S38
    Description: Advanced Multicenter Research (AMR) is a Web-based information technology infrastructure, fully integrated to manage every single part of a clinical trial, but with 'independent' and 'customizable' components to wholly meet each team's requirements. The AIEOP group utilizes AMR for the management and analyses of the majority of the expected nationwide oncology cases and the most common primary immunodeficiencies, and for all the AIEOP protocols, studies and registries centralized at the AIEOP Operation Office. Standard for data quality control is applied to each AIEOP database according to the AMR standard procedures. The AMR AIEOP network represents a model of Information Based Medicine, a crucial tool for well-informed pediatricians, essential to guarantee better childcare in a setting of patients such as children with cancer.
    Subject(s): Multicenter Studies as Topic - methods ; Database Management Systems ; Humans ; Bone Marrow Transplantation ; Italy ; Registries ; Internet ; Child ; Hematologic Diseases - therapy ; Prevention ; Services ; Tumors in children ; Care and treatment ; Diagnosis ; Medical societies ; Index Medicus
    ISSN: 0268-3369
    E-ISSN: 1476-5365
    Source: Nature Open Access
    Source: Academic Search Ultimate
    Source: Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 8
    Language: English
    In: Leukemia, 2005-12, Vol.19 (12), p.2043-2053
    Description: Since 1982, four consecutive studies on childhood acute myeloid leukaemia (AML) (namely LAM-82, -87, -87M and -92) have been conducted in Italy by the Associazione Italiana di Ematologia e Oncologia Pediatrica (AIEOP) group. The induction therapy of the first three studies consisted of daunorubicin and cytarabine structured in a 3+7 backbone. In the most recent protocol (LAM92), patients received two induction courses including idarubicin, cytarabine and etoposide. Patients with acute promyelocytic leukaemia (20% of diagnoses) were included in LAM-87 and 87M studies. Postremissional therapy significantly changed over time, with an ever-increasing role given to stem cell transplantation (SCT). The long-term outcome of patients enrolled in the LAM-82, 87 and 87M studies was comparable, whereas that of children treated according to LAM-92 study was significantly better (P〈0.005). Either allogeneic or autologous SCT was employed as consolidation therapy in more than 75% of cases enrolled in this latter study. Patients enrolled in the LAM-92 study were stratified in standard and high-risk groups with different outcome (67 vs 47%, respectively, P=0.04). Altogether, the results obtained in these four studies have permitted a progressive refinement of treatment, contributing to the structure of the ongoing LAM-2002 protocol that stratifies patients according to the presence of definite genetic anomalies and response to induction therapy.
    Subject(s): Acute Disease ; Follow-Up Studies ; Humans ; Child, Preschool ; Hematopoietic Stem Cell Transplantation ; Infant ; Male ; Treatment Outcome ; Antineoplastic Protocols - standards ; Adolescent ; Survival Analysis ; Female ; Remission Induction - methods ; Leukemia, Myeloid - mortality ; Child ; Leukemia, Myeloid - therapy ; Infant, Newborn ; Index Medicus
    ISSN: 0887-6924
    E-ISSN: 1476-5551
    Source: Nature Open Access
    Source: Academic Search Ultimate
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 9
    Language: English
    In: Bone marrow transplantation (Basingstoke), 2015-02-01, Vol.50 (2), p.320
    ISSN: 0268-3369
    E-ISSN: 1476-5365
    Source: Nature Open Access
    Source: Academic Search Ultimate
    Source: Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
    Source: Alma/SFX Local Collection
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  • 10
    Language: English
    In: Leukemia, 2002, Vol.16 (11), p.2228-2237
    Description: Aims of this study were to verify whether reduction in transplant-related mortality (TRM) of children with acute lymphoblastic leukemia (ALL) in second complete remission (CR) given allogeneic hematopoietic stem cell transplantation (HSCT) from unrelated volunteers has occurred over time and to investigate the role of other variables on the probabilities of relapse, TRM and event-free survival (EFS). We compared results obtained in 26 children given HSCT before January 1998 with those of 37 patients transplanted beyond that date. In all donor-recipient pairs, histocompatibility was determined by serology for HLA-A and -B antigens and by high-resolution DNA typing for DRB1 antigen. High-resolution molecular typing of HLA class I antigens was employed in 20 of the 37 children transplanted more recently. Probability of both acute and chronic GVHD was comparable in the two groups of patients. In multivariate analysis, children transplanted before January 1998, those with T-lineage ALL and those experiencing grade II-IV acute GVHD had a higher relative risk of TRM at 6 months after transplantation. Relapse rate was unfavorably affected by a time interval between diagnosis and relapse 〈30 months. The 2-year probability of EFS for children transplanted before and after 1 January 1998 was 27% (10-44) and 58% (42-75), respectively (P = 0.02), this difference remaining significant in multivariate analysis. EFS of unrelated donor HSCT in children with ALL in second CR has improved in the last few years, mainly due to a decreased TRM. This information is of value for counseling of patients with relapsed ALL.
    Subject(s): Hematologic and hematopoietic diseases ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Bone marrow, stem cells transplantation. Graft versus host reaction ; Transfusions. Complications. Transfusion reactions. Cell and gene therapy ; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis ; Biological and medical sciences ; Medical sciences ; Cyclophosphamide - administration & dosage ; Antineoplastic Combined Chemotherapy Protocols - administration & dosage ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - immunology ; Humans ; Child, Preschool ; Infant ; Male ; Living Donors ; Transplantation, Homologous ; Graft vs Host Disease ; HLA-DR Antigens - genetics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy ; Time Factors ; Vincristine - administration & dosage ; Female ; Registries ; DNA, Neoplasm - analysis ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - pathology ; Child ; Daunorubicin - administration & dosage ; Prednisone - administration & dosage ; HLA-B Antigens - immunology ; Mercaptopurine - administration & dosage ; Hematopoietic Stem Cell Transplantation ; Survival Rate ; Treatment Outcome ; Remission Induction ; Cytarabine - administration & dosage ; Asparaginase - administration & dosage ; Disease-Free Survival ; HLA-A Antigens - immunology ; HLA-DRB1 Chains ; Adolescent ; Methotrexate - administration & dosage
    ISSN: 0887-6924
    E-ISSN: 1476-5551
    Source: Nature Open Access
    Source: Academic Search Ultimate
    Source: Alma/SFX Local Collection
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