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  • 1
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    Incidence of Early Thrombosis in Myeloproliferative Neoplasms (MPN): A Prospective Analysis from the Gruppo Laziale of Ph-Negative MPN
    American Society of Hematology ; 2016
    In:  Blood Vol. 128, No. 22 ( 2016-12-02), p. 1951-1951
    Details
    In: Blood, American Society of Hematology, Vol. 128, No. 22 ( 2016-12-02), p. 1951-1951
    Abstract: Background Thrombotic episodes are the major complication in the follow-up of Philadelphia negative Myeloproliferative Neoplasms (MPN), with high morbidity and mortality, as reported in several retrospective studies. At present, however, few prospective data are available on the early incidence of these complications. Methods To address this issue, we report on 1087 patients [M/F 508/579, median age 67.6 years, interquartile range (IQR) 55.2 - 75.9] with newly diagnosed MPN enrolled in the prospective database of our regional cooperative group since January 2011. Of them, 571 (52.5%) had Essential Thrombocythemia (ET), 303 (27.9%) Polycythemia Vera (PV) and 213 (19.6%) Primary Myelofibrosis (PMF). The main clinical features at diagnosis of the whole cohort and according to the different MPNs are reported in the Table 1. Results On the whole, 22 episodes of thrombotic complications were reported in 1087 patients (2.0%) at a median interval from diagnosis of 18.2 months (IQR 7.4 - 29.7): in particular, 15 (68.1%) were arterial (8 cerebral, 2 coronaric, 4 in the lower limbs, 1 splancnic) and 7 (31.9%) venous (5 in the lower limbs and 2 in the upper limbs). As to the incidence of early thrombosis in the different MPNs, they were 13/571 (2.2%) in ET patients, 5/303 (1.6%) in PV patients and 4/213 (1.8%) in PMF patients (p=0.810): median time from diagnosis to thrombotic event was also similar in the 3 MPNs (p=0.311). The 4-year cumulative Thrombosis-Free Survival (TFS) of the whole cohort was 97.3% (95%CI 96.0 - 98.6): there was no difference among the 3 MPNs as to 4-year TFS [96.7% (95%CI 94.8 - 98.6) in ET, 97.8% (95%CI 95.9 - 99.7) in PV and 98.7% (95%CI 96.9 - 100) in PMF, respectively, p=0.668). Several clinical features at diagnosis (age, gender, Hb levels, WBC and PLT counts, spleen enlargement, JAK-2 V617F mutation and previous thrombotic events) were evaluated for a role in predicting thrombotic events: only age (p=0.009) and previous thrombotic events (p=0.009) were significant. Conclusions The incidence of early thrombosis seems low in the first 4 years after diagnosis of MPN based on our prospective database, without any difference among ET, PV and PMF: it is worth of note that only age and previous thrombotic events had a predictive role, thus confirming many retrospective reported data and reinforcing the prognostic value of old scoring system for thrombotic risk in MPN. Table 1 Table 1. Disclosures Breccia: Ariad: Honoraria; Pfizer: Honoraria; Novartis: Consultancy, Honoraria; Bristol Myers Squibb: Honoraria; Celgene: Honoraria. Latagliata:Novartis: Consultancy, Honoraria; Bristol Myers Squibb: Honoraria; Celgene: Honoraria; Janssen: Consultancy, Honoraria; Shire: Honoraria.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V128.22.1951.1951
    RVK:
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2016
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  • 2
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    Thrombosis and survival in essential thrombocythemia: A regional study of 1,144 patients
    Wiley ; 2014
    In:  American Journal of Hematology Vol. 89, No. 5 ( 2014-05), p. 542-546
    Details
    In: American Journal of Hematology, Wiley, Vol. 89, No. 5 ( 2014-05), p. 542-546
    Abstract: To identify prognostic factors affecting thrombosis‐free survival (TFS) and overall survival (OS), we report the experience of a Regional cooperative group in a real‐life cohort of 1,144 patients with essential thrombocythemia (ET) diagnosed from January 1979 to December 2010. There were 107 thrombotic events (9.4%) during follow‐up [60 (5.3%) arterial and 47 (4.1%) venous thromboses]. At univariate analysis, risk factors for a shorter TFS were: age 〉 60 years ( P   〈  0.0054, 95% CI 1.18–2.6), previous thrombosis ( P   〈  0.0001, 95% CI 1.58–4.52) and the presence of at least one cardiovascular risk factor ( P  = 0.036, 95% CI 1.15–3.13). Patients with a previous thrombosis occurred ≥24 months before ET diagnosis had a shorter TFS compared to patients with a previous thrombosis occurred 〈 24 months ( P  = 0.0029, 95% CI 1.5–6.1); furthermore, patients with previous thrombosis occurred 〈 24 months did not show a shorter TFS compared with patients without previous thrombosis ( P  = 0.303, 95% CI 0.64–3.21). At multivariate analysis for TFS, only the occurrence of a previous thrombosis maintained its prognostic impact ( P  = 0.0004, 95% CI 1.48–3.79, RR 2.36). The 10‐year OS was 89.9% (95% CI 87.3–92.5): at multivariate analysis for OS, age 〉 60 years ( P   〈  0.0001), anemia ( P   〈  0.0001), male gender ( P  = 0.0019), previous thromboses ( P  = 0.0344), and white blood cell 〉 15 × 10 9 /l ( P  = 0.0370) were independent risk factors. Previous thrombotic events in ET patients are crucial for TFS but their importance seems related not to the occurrence per se but mainly to the interval between the event and the diagnosis. Am. J. Hematol. 89:542–546, 2014. © 2014 Wiley Periodicals, Inc.
    Type of Medium: Online Resource
    ISSN: 0361-8609 , 1096-8652
    URL: Issue
    URL: Article
    DOI: 10.1002/ajh.v89.5
    DOI: 10.1002/ajh.23685
    Language: English
    Publisher: Wiley
    Publication Date: 2014
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  • 3
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    Impact on Mental Health, Disease Management and Socioeconomic Modifications in Hematological Patients during COVID-19 Pandemia in Italy
    American Society of Hematology ; 2020
    In:  Blood Vol. 136, No. Supplement 1 ( 2020-11-5), p. 35-37
    Details
    In: Blood, American Society of Hematology, Vol. 136, No. Supplement 1 ( 2020-11-5), p. 35-37
    Abstract: The SARS-CoV-2 (COVID-19) outbreak is upending current life and generating much anxiety and uncertainty. The effects of home confinement, social isolation, cancelled schools, closed businesses, and negative economic impacts have had serious consequences. Hematologic patients (HP) are a subset of highly vulnerable population with increased risk of developing severe COVID-19 symptoms due to their immunocompromised status. These risks have been augmented during the COVID outbreak because of deviations from current standards of care, e.g., reduced visits, treatment supply and access to routine exams. This study investigated the impact of the current pandemic on HP assessing demographics, medical information, mental health and caregiver practical management. In collaboration with AIL (Italian Association against Leukemia) and CNR (National Research Council), a survey was generated and distributed to Italian HP. The general population (GP) were used as controls. The assessment used the DASS-21 questionnaire, a self-reported, 21 item screening instrument that provides independent measures of depression, stress and anxiety with recommended severity thresholds subscales. The survey was self-administered between April and August, 2020. The questionnaires' reliability was verified based on an analysis of its internal consistency using Cronbach's alpha. As of 30 June 2020, 1113 HP and 1125 GP completed the survey from 20 Italian Regions. The two population groups were homogeneous by age, gender and distribution and included regions at both high (CHP) and low (CLP) prevalence of infections at the time of the survey. HP and GP median age was 50 years (range: HP 11- 93; GP 13-85). 61% HP and 68% GP were female; the rest were male. The year of diagnosis of hematological disease ranged from 1965 to 2020; 21.9% had chronic myeloid leukemia, followed by Hodgkin (15.7%) and non-Hodgkin (15.9%) lymphomas, chronic myeloproliferative neoplasms (15.9%), multiple myeloma (8.9%), chronic lymphocytic leukemia (4.9%), acute myeloid (5.6%) and lymphoblastic (3.25%) leukemias, other (7%). 1071 HP and 1125 GP responded about their occupation as follows: employed full/part time (38.7% HP , 47.7% GP), retired (19.2% HP,10.8% GP), freelancer (9.2% HP, 12.2% GP), unemployed (6.2% HP, 3.4% GP) , students (4.6% HP, 3.2% GP), company executive (4.1% HP, 4.8% GP), manager (2% HP, 4.7 % GP), cooperative member (0.7% HP , 0.7% GP), housewife (8.5% HP 4.8% GP), other (6.8% HP,7.7% GP). During the pandemic 63.7% HP didn't work and 36.3% did work compared to the GP group (33.8% didn't; 66.2 % did). Where specified, the reasons for not working were: layoffs (10.9% HP, 15.9% GP), lack of work (8.1%HP, 15.6 % GP), vacation/ parental leave (4.4% HP, 3.5% GP), reduced business activity for economic reasons (2.2% HP, 3.3% GP), occasional work (2.1% HP, 5.7% GP), seasonal employment, (0.6% HP,1.1 % GP). 625/1073 HP (58.2%) were in active treatment. Of these, 40.1% were in Day Hospital, 56.4% were outpatient; and 3.5% inpatients. The remaining HP were off therapy (448/1073; 41.8%). 1105 HP and 1127 GP responded to the DASS questionnaire. Extremely severe depression was found in 12.9% HP vs 7% GP; 18.1% HP expressed severe anxiety vs 9.6% GP and extremely severe stress was present in 7.1% HP and 5.3% GP. The Cronbach's alpha coefficient for the internal homogeneity of the questionnaire was 0.95, confirming the cohorts correctness (0.8 or greater, indicates a very good level of reliability). Providing care to HP during the pandemic has been challenging for both patients and doctors. Restrictions on visits and lab/instrumental exams, reduced equipment supply and a paucity of personal protection equipment (PPEs) for health care providers and patients have penalized normal routine care. As a result, 38.2% HP postponed or did not attend scheduled therapy and & gt;50% had difficulty obtaining PPEs through normal sources; 57% in CHP and 36% in CLP regions had to buy them themselves. To our knowledge this is the first report of the impact of the pandemic on psychological distress, work consequences and illness management in HP. Most of HP in this study are outpatients in active treatment. Interesting data emerged from job losses, which is more common among HP. The DASS-21 instrument revealed higher anxiety and depression levels in HP. Detailed results including longitudinal analysis and high versus low geographic prevalence of COVID-19 infections will be presented. Figure 1 Disclosures Abruzzese: Incyte: Consultancy, Membership on an entity's Board of Directors or advisory committees; Novartis: Consultancy, Membership on an entity's Board of Directors or advisory committees; Pfizer: Consultancy, Membership on an entity's Board of Directors or advisory committees; Bms: Honoraria.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood-2020-141599
    RVK:
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    RVK:
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2020
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  • 4
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    Risk Factors for Thrombosis Vary According to Age in Patients with Essential Thrombocythemia: a Retrospective Analysis of 1090 Patients from the “Gruppo Laziale SMPC Ph Negative “,
    American Society of Hematology ; 2011
    In:  Blood Vol. 118, No. 21 ( 2011-11-18), p. 3854-3854
    Details
    In: Blood, American Society of Hematology, Vol. 118, No. 21 ( 2011-11-18), p. 3854-3854
    Abstract: Abstract 3854 Increasing age is a well-recognised risk factor for thrombotic events in patients with Essential Thrombocythemia (ET): however, few data exist on the role of other clinical and biological features in different age groups. To address this issue, we analysed retrospectively 1090 ET patients (M/F 403/687, median age 63 years, IR 17 – 96) diagnosed at 11 Hematological Institutions in the Lazio region from 1980 to 2010 and with a median period of follow-up of 84 months (IR 1 – 371). Based on the commonly adopted age threshold, 480 patients (44 %) were 〈 60 years (Group A) and 610 (56 %) were ≥ 60 years (Group B). Clinical and biological features as well as cardiovascular risk factors analyzed for the impact on the thrombotic risk in the two age groups are reported in the Table.Group A 〈 60 yearsGroup B ≥ 60 yearsPutative risk factorsRisk ratio (95% CI)P valueRisk ratio (95% CI)P valueM/F167/3132.68 (1.03–6.94)0.0029236/3741.12 (0.17–2.59)0.73WBC median (range) x 109/l8.9 (4.29–22.35)0.387 (0.149–1,004)0.06458.9 (1.2–57.7)0.79 (0.41–1.47)0.445PLTS median (range) x 109/l837 (451–3582)0.37 (0.258–1.70)0.66802 (450–3104)0.52 (0.28–0.99)0.0052Hb median, g/dL (range)14.1 (6.0–18.4)0.86 (0.33–2.24)0.76914.0 (7.0–17.8)0.87 (0.45–1.67)0.674*JAK-2 mutational status: wild type/mutated (%)53.2/46.81.57 (0.50–4.87)0.4434.1/65.90.498 (0.17–1.48)0.209Previous thrombotic events: n° (%)· All events72 (15)2.18 (0.59–7.96)0.12149 (24.4)3.01 (1.38–6.57)0.0004· within 24 months from diagnosis48 (10)1.43 (0.19–10.4)0.7464 (10.5)0.506 (0.18–1.39)0.189· within 60 months from diagnosis60 (12.5)NA0.5191 (14.9)0.323 (0.11–0.95)0.023Cardiovascular risk factors: Y/N %○ Arterial hypertension41.7/58.31.68(0.64–4.36)0.2880.7/19.30.96 (0.36–2.57)0.935○ Diabetes10.2/89.81.11 (0.23–5.15)0.8925.0/75.01.09 (0.38–3.11)0.86○ Smoking attitude45.6/54.42.78 (1.01–7.65)0.06758.3/41.71.04 (0.35–3.09)0.94○ Hyperlipidemia31.0/69.03.11(0.917–10.592)0.03951.6/48.42.31 (0.70–7.55)0.203 In Group A, 39 patients (8.1%) had at least one thrombotic event during follow-up; there were 20 (51.3%) arterial thrombosis and 19 (48.7%) venous thrombosis. In Group B, 63 patients (10.3%) had at least one thrombotic event during follow-up; there were 38 (69.4%) arterial thromboses and 25 (39.6%) venous thromboses. In group A univariate analysis for thrombosis-free survival performed by Kaplan-Meier method, disclosed a significant impact of male gender (p=0.0029, CI 1.03–6.94, HR 2.68), 〉 2 cardiovascular risk factors (p=0.0002, CI 1.87 – 190, HR 18.94) and isolated hyperlipidemia (p=0.039, CI 0.917 – 10.59, HR 3.11), while previous thrombotic events had no significant impact (p=0.27). By contrast, the presence of a previous thrombotic event was the only feature with a significant impact on thrombotic risk in Group B (p=0.0004, CI 1.38 – 6.55, HR 3.01). WBC and PLTS values at different cut-off levels as well as JAK-2 mutational status did not have any impact on thrombosis in either age groups. However, in group B, we observed a trend (p=0.052, CI 0.28–0.99, HR 0.52) towards a protective effect of higher PLTS values ( 〉 800 × 109/l). In conclusion, our data seem to reinforce the need of a different thrombotic risk assessment in distinct age groups: in particular, younger patients could benefit from early recognition and treatment of well-known cardiovascular risk factors. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V118.21.3854.3854
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    XA 33000
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2011
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  • 5
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    Clinical Follow-up of Patients with Myeloproliferative Neoplasms Presenting Skin Ulcers During Treatment with Hydroxyurea
    American Society of Hematology ; 2011
    In:  Blood Vol. 118, No. 21 ( 2011-11-18), p. 5157-5157
    Details
    In: Blood, American Society of Hematology, Vol. 118, No. 21 ( 2011-11-18), p. 5157-5157
    Abstract: Abstract 5157 Hydroxyurea (HU) is widely employed in the treatment of Myeloproliferative Neoplasms (MPN); however, painful skin ulcers are a limiting toxicity during HU treatment in 〉 5% of patients. To evaluate the clinical impact of such complication on the outcome of these patients, we retrospectively revised 1001 cases (M/F 437/564, median age 65.6 years, IR 55.6 – 73.7) with MPN consecutively diagnosed at 6 Centers in Rome who received HU treatment during the course of disease. There were 537 patients with Essential Thrombocythemia (ET), 336 with Polycythemia Vera (PV), 102 with Primary Myelofibrosis (PMF) and 26 with unclassifiable Chronic Myeloproliferative Disorders (CMPD-u); 863 patients (86.2%) received HU as 1st line treatment while 138 (13.8%) as 2nd or 3rd line treatment. On the whole, 71 patients (7.1%) developed painful skin ulcers after a median period of 54.1 months (IR 27.7 – 97.6) from HU start; as concerns the site, in 56/71 patients (78.8%) skin ulcers were located in the perimalleolar area while in the remaining 15 patients in other skin areas (localized to the head or to the extremities in 8 and 7 patients, respectively). When the skin ulcers occurred, HU treatment was continued at the same dosage in 11 patients (15.4%), was reduced in 13 patients (18.4%) and temporarily interrupted in 11 patients (15.4%): the remaining 36 patients (50.8%) needed a permanent drug discontinuation. Among these latter patients, pipobroman was started in 20 patients, anagrelide in 5, alpha-interferon in 3, melphalan in 3; in addition, no further treatment was given in 1 patient and 4 patients were lost to follow-up. As to ulcer resolution, 11/71 patients were not evaluable (2 too early, 9 lost to follow-up). Among the 60 evaluable patients, after a median period of 6.3 months (IR 3.6 – 11.3) from the onset of the skin ulcers, 43 patients (71.6%) had a complete resolution and 17 patients (28.4%) had an improvement without complete resolution. The incidence of 2nd neoplasia [3/71 (4.2%) patients with skin ulcers vs 73/930 (7.8%) patients without skin ulcers] and blastic phase evolution [2/71 (2.8%) patients with skin ulcers vs 41/930 (4.4%) patients without skin ulcers] were not increased after the skin ulcer occurrence. After a median period from skin toxicity of 30.7 months (IR 14.3 – 63.6), 9 patients were lost to follow-up, 11 patients died and 51 patients are still alive. In conclusion, painful skin ulcers during HU treatment are a relatively common complication in MPN patients, require HU discontinuation in 〉 50% of cases and in a sizable rate of patients there is only a partial healing of skin lesion: however, this complication and the requested treatment changes do not seem to impact on the subsequent clinical follow-up of MPN patients. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V118.21.5157.5157
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2011
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  • 6
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    Are ET and PV Patients Two Similar Populations As Concern Thrombotic Risk Factors?
    American Society of Hematology ; 2015
    In:  Blood Vol. 126, No. 23 ( 2015-12-03), p. 2811-2811
    Details
    In: Blood, American Society of Hematology, Vol. 126, No. 23 ( 2015-12-03), p. 2811-2811
    Abstract: Thrombotic events are major complications in patients (pts) affected by Essential Thrombocytemia (ET) and Polycytemia Vera (PV). To compare thrombotic risk in these 2 groups, we evaluated retrospectively our database of 1249 ET and 623 PV pts diagnosed and followed in 11 hematological centers in the Latium region between 1/1980 and 12/2010: the diagnosis was done according to PVSG, WHO 2001 and 2008criteria based on the time of first observation. Baseline features of ET pts: 797F/452M,median age 62.9 yrs (range 19-96),median WBC count 8.8 x 109/L (range 1.2-57.7), median PLT count 812 x 109/L (range 457-3582), median Hb level 14.0 g/dl (range 6-20.5), JAK-2V617F positivity 59.7% with a median allele burden of 19,6% (range 0.2- 99.9), spleen enlargement in 18.7% of pts, previous thrombosis223/1239 evaluable pts (17.9%) [arterial 176/223 (14.1%), venous 47/223 (3.8%)]. Baseline features of PV pts: 289F/334M, median age 63.0yrs (range 21-91), median WBC count 10.1 x 109/L (range 3.5-37.6), median PLT count 457 x 109/L (range 169-1790), median Hb level 18.2 g/dl (range 10.5-24.8), JAK-2V617F positivity 94.3% with a median allele burden of 59.1% (range 0.3-99.9), spleen enlargement in 42% of patients, previous thrombosis 146/617 evaluable pts (23.7%)[arterial 114/617 (18.5%), venous 32/617 (5,2%)] .in the ET cohort, after a median follow-up of 7.7 yrs, thrombotic complications were seen in 107/1141 evaluable pts (9.4%) [arterial60 (5.25%), venous 47 (4.11%)]; in the PV cohort, after a median follow-up of 8.5 yrs, thrombotic complications were seen in 107/623pts (17.2%) [arterial 67 (10.8%),venous 40 (6.4%)] .All common risk factors for thrombosis were evaluated in multivariate analysis, searching the cut-off number for continuous variables with ROC curves. The significant variables at multivariate analysis for ET and PV pts are shown in the table; age, previous thromboses and spleen enlargement were risk factors in ET pts, while previous thromboses and JAK-2V617F allele burden were risk factors in PV pts. PLT count above ROC value seemed to be a protective factor in both cohorts. In conclusion, in contrast with the tendency to evaluate in a similar manner the thrombotic risk of PV and ET, data from our retrospective database showed that these 2 groups should be considered populations with different risk factors for thrombosis. Table 1.Putative prognostic factorsPolycythemia VeraEssential ThrombocythemiaHR95% C.I.pHR95% C.I .pPrevious thromboses2,311,13 - 4,740,021,871,08 -3,230,026Age ≥ 60 y1,540,79 - 2,990,211,901,18 - 3,060,009JAK2V617FPV: allelic burden ≥ 81% ET: pos1,951,03 - 3,710,040,760,48 - 1,210,25Plt countPV ≥ 452.109/L ET ≥ 944.109/L0,490,25 - 0,950,040,520,31 - 0,890,017Spleen enlargement0,670,34 -1,310,241,711,02 - 2,890,04CV risk factors (at least 1)0,920,41 - 2,030,830,870,51 - 1,490,62WBCPV ≥ 10,175.109/L ET ≥ 9,630.109/L1,090,57 - 2,080,801,410,89 -2,260,15 Disclosures No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V126.23.2811.2811
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2015
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  • 7
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    Latium (Italy) Epidemiology of Philadelphia Chromosome-Negative Myeloproliferative Neoplasms (MPNs) from 2011 to 2015: A Prospective Analysis from Gruppo Laziale of Ph Negative MPN
    American Society of Hematology ; 2016
    In:  Blood Vol. 128, No. 22 ( 2016-12-02), p. 5473-5473
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    In: Blood, American Society of Hematology, Vol. 128, No. 22 ( 2016-12-02), p. 5473-5473
    Abstract: Background: MPNs including Polycythemia Vera (PV), Essential Thrombocythemia (ET) and Primary Myelofibrosis (PMF), are clonal hematopoietic diseases in which the discovery of molecular driver mutations (JAK2, CALR, MPL) has deeply modified diagnostic approach in recent years. To date available data on epidemiology of MPNs and perspective analysis are rare. Our aim is to study the incidence of MPN Ph negative in a specific region of Italy named Latium and its variability across five years. Moreover we prospectively report the general features of our population. Method: We present here the prospective epidemiologic analysis of 1116 adult patients affected by MPNs (PV=289, ET=550, PMF=209) diagnosed according to 2008 WHO criteria, from January 2011 to December 2015 in 15 hematological Centers (5 academic and 10 community-based Hospitals) in Latium. A total of 289 PV, 550 ET and 209PMF were identified. The overall incidence rate of 289PV was 1.0/105 in 2011 and 2012, 1.1/105 in 2013, 0.9/105 in 2014 and 2015. The overall incidence rate of 550ET was 2.0/105 in 2011, 2.4/105 in 2012, 2.2/105 in 2013, 1.8/105 in 2014 and 1,2/105 in 2015 and the overall incidence rate of 209PMF was 0.7/105 in 2011 and 2012, 1.0/105 in 2013, 0.7/105 in 2014 and 0.5/105 in 2015. We have observed also 63 cases of MPNu (36M/32F) and the incidence rate was 0.3/105 in 2011 and 2012, 0.14/105 in 2013, 0.24/105 in 2014 and 0.22/105 in 2015. Baseline features of PV, ET and PMF patients are summarized in table 1. We have also analyzed the presence of comorbidities including obesity, arhythmia and neoplasia observed at the diagnosis in 1.6, 6.2 and 4% of all population, respectively; thirty-five percent of 1116 pts presented other comorbidities such as diabetes, inflammatory bowel disease, renal and liver failure. As thrombotic risk factors we considered diabetes, dislipidemia, smoke, essential hypertension and thrombophilia observed in 11,8, 16,2, 13,2, 51,7 and 3% of total pts, respectively. Conclusions: We confirm in our prospective observational protocol the overall incidence of MPN Ph negative, previously reported in the literature and the major incidence of male gender in PV and PMF, female in of ET. The annual incidence from 2011-2015 in Latium is remained substantially the same during the observation period. The decreasing trend observed in 2015 is probably due to the different update of some Centers that was done in October 2015 not including patients diagnosed in the last two months. Disclosures Latagliata: Novartis: Consultancy, Honoraria; Bristol Myers Squibb: Honoraria; Celgene: Honoraria; Janssen: Consultancy, Honoraria; Shire: Honoraria. Breccia:Pfizer: Honoraria; Novartis: Consultancy, Honoraria; Bristol Myers Squibb: Honoraria; Celgene: Honoraria; Ariad: Honoraria. Cimino:Celgene: Honoraria; Bristol-Mayer: Honoraria.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V128.22.5473.5473
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2016
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  • 8
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    Characterization of three novel pathogenic SLC40A1 mutations and genotype/phenotype correlations in 7 Italian families with type 4 hereditary hemochromatosis
    Elsevier BV ; 2018
    In:  Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease Vol. 1864, No. 2 ( 2018-02), p. 464-470
    Details
    In: Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease, Elsevier BV, Vol. 1864, No. 2 ( 2018-02), p. 464-470
    Type of Medium: Online Resource
    ISSN: 0925-4439
    URL: Article
    DOI: 10.1016/j.bbadis.2017.11.006
    RVK:
    WA 15000
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2018
    detail.hit.zdb_id: 2209528-7
    SSG: 12
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  • 9
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    Role of treatment on the development of secondary malignancies in patients with essential thrombocythemia
    Wiley ; 2017
    In:  Cancer Medicine Vol. 6, No. 6 ( 2017-06), p. 1233-1239
    Details
    In: Cancer Medicine, Wiley, Vol. 6, No. 6 ( 2017-06), p. 1233-1239
    Abstract: Aim of this study is to explore the role of different treatments on the development of secondary malignancies ( SM s) in a large cohort of essential thrombocythemia ( ET ) patients. We report the experience of a regional cooperative group in a real‐life cohort of 1026 patients with ET . We divided our population into five different groups: group 0, no treatment; group 1, hydroxyurea ( HU ); group 2, alkylating agents ( ALK ); group 3, ALK  +  HU sequentially or in combination; and group 4, anagrelide ( ANA ) and/or α ‐interferon ( IFN ) only. Patients from groups 1, 2, and 3 could also have been treated either with ANA and/or IFN in their medical history, considering these drugs not to have an additional cytotoxic potential. In all, 63 of the 1026 patients (6%) developed 64 SM during the follow‐up, after a median time of 50 months (range: 2–158) from diagnosis. In univariate analysis, a statistically significant difference was found only for gender ( P  = 0.035) and age ( P  = 0.0001). In multivariate analysis, a statistically significant difference was maintained for both gender and age (gender HR 1.7 [ CI 95% 1.037–2.818] P  = 0.035; age HR 4.190 [ CI 95% 2.308–7.607] P  = 0.0001). The impact of different treatments on SM s development was not statistically significant. In our series of 1026 ET patients, diagnosed and followed during a 30‐year period, the different therapies administered, comprising HU and ALK , do not appear to have impacted on the development of SM . A similar rate of SM s was observed also in untreated patients. The only two variables which showed a statistical significance were male gender and age 〉 60 years.
    Type of Medium: Online Resource
    ISSN: 2045-7634 , 2045-7634
    URL: Issue
    URL: Article
    DOI: 10.1002/cam4.2017.6.issue-6
    DOI: 10.1002/cam4.1081
    Language: English
    Publisher: Wiley
    Publication Date: 2017
    detail.hit.zdb_id: 2659751-2
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  • 10
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    Impact on mental health, disease management, and socioeconomic modifications in hematological patients during the COVID-19 pandemic in Italy
    SAGE Publications ; 2023
    In:  Therapeutic Advances in Hematology Vol. 14 ( 2023-01)
    Details
    In: Therapeutic Advances in Hematology, SAGE Publications, Vol. 14 ( 2023-01)
    Abstract: Hematological patients are a highly vulnerable population with an increased risk of developing severe COVID-19 symptoms due to their immunocompromised status. COVID-19 has proven to cause serious mental health issues, such as stress, anxiety, and depression in the general population. However, data on the psycho-social impact of COVID-19 on hematological patients are lacking. Objectives: This study aims to examine the psychological well-being of hematological patients in Italy during the initial period of the COVID-19 pandemic. Furthermore, it seeks to explore the association between modifications in the management of hematological diseases and employment status of these patients during the COVID-19 pandemic and the resulting mental health outcomes. Design and Methods: A survey using the DASS-21 questionnaire was administered to 1105 hematological patients. Data analysis was conducted using the R software, and logistic regression analysis was performed to predict the association between hematological patient/general population and employment status with DASS scores. Results: The hematological patient population reported significantly higher levels of depression (OR 0.947, 95% CI 0.966–0.982, p  〈  0.001), anxiety (OR 0.948, 95% CI 0.939–0.958, p  〈  0.001), and stress (OR 0.984, 95% CI 0.977–0.992, p  〈  0.001) compared with the general population. A significant relationship has been found in stress between employed and unemployed patients (OR 1.015, 95% CI 1.000–1.030, p = 0.044), as well as in the control group (OR 1.024, 95% CI 1.010–1.039, p = 0.001). In addition, employment status is significantly related to depression, anxiety, and stress in both the hematological patient group and the general population. Conclusion: During the initial phase of the COVID-19 pandemic, hematological patients had elevated levels of depression, anxiety, and stress compared with the general population. The delay in their treatment and employment status played a role in their mental health outcomes. These findings emphasize the importance of further research to gain deeper insight into the long-term psychological effects and explore effective strategies for managing mental health in similar crises.
    Type of Medium: Online Resource
    ISSN: 2040-6207 , 2040-6215
    URL: Article
    DOI: 10.1177/20406207231190683
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2585183-4
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