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Article ; Online: Essential Thrombocythemia in Adolescents and Young Adults: Clinical Aspects, Treatment Options and Unmet Medical Needs.

Iurlo, Alessandra / Bucelli, Cristina / Cattaneo, Daniele

2023 Volume 24, Issue 7, Page(s) 802–820

Abstract: Opinion statement: Current treatment of essential thrombocythemia (ET) should primarily prevent thrombo-hemorrhagic events, without increasing the rate of fibrotic progression or leukemic evolution, and secondarily control microvascular symptoms. Unlike ...

Abstract	Opinion statement: Current treatment of essential thrombocythemia (ET) should primarily prevent thrombo-hemorrhagic events, without increasing the rate of fibrotic progression or leukemic evolution, and secondarily control microvascular symptoms. Unlike other classic BCR::ABL1-negative myeloproliferative neoplasms, ET is frequently diagnosed in adolescents and young adults (AYA), defined as individuals aged 15 to 39 years, in up to 20% of patients. However, since the current risk stratification of this disease is based on models, including that of ELN, IPSET-Thrombosis and its revised version, mainly applied to an older patients' population, international guidelines are needed that specifically consider how to evaluate the prognosis of AYAs with ET. Furthermore, although ET is the most frequent MPN among AYA subjects, there is a lack of specific recommendations on how to treat it in this subgroup of patients, as management decisions are typically extrapolated from those for the elderly. Accordingly, since AYAs with ET represent a unique disease subset defined by attenuated genetic risk, more indolent phenotype, and longer survival than their older counterparts, treatment selection requires special attention to specific issues such as the risk of fibrotic/leukemic transformation, carcinogenicity, and fertility. This review article will provide a comprehensive overview of the diagnosis, prognostic stratification, and possible therapeutic approaches for AYA patients with ET, including antiplatelets/anticoagulants and cytoreductive agents, with a focus on pregnancy management in real-life clinical practice.
MeSH term(s)	Humans ; Thrombocythemia, Essential/diagnosis ; Thrombocythemia, Essential/etiology ; Thrombocythemia, Essential/therapy ; Thrombosis/epidemiology ; Risk Factors ; Prognosis
Language	English
Publishing date	2023-05-17
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2057351-0
ISSN	1534-6277 ; 1527-2729
ISSN (online)	1534-6277
ISSN	1527-2729
DOI	10.1007/s11864-023-01099-8
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Article ; Online: Cardiovascular Adverse Events of Tyrosine Kinase Inhibitors in Chronic Myeloid Leukemia: Clinical Relevance, Impact on Outcome, Preventive Measures and Treatment Strategies.

Iurlo, Alessandra / Cattaneo, Daniele / Bucelli, Cristina / Spallarossa, Paolo / Passamonti, Francesco

Current treatment options in oncology

2023 Volume 24, Issue 12, Page(s) 1720–1738

Abstract: Opinion statement: The introduction of TKIs into the therapeutic armamentarium of CML has changed the disease paradigm, increasing long-term survival from 20% to over 80%, with a life expectancy now approaching that of the general population. Although ... ...

Abstract	Opinion statement: The introduction of TKIs into the therapeutic armamentarium of CML has changed the disease paradigm, increasing long-term survival from 20% to over 80%, with a life expectancy now approaching that of the general population. Although highly effective, TKIs also have a toxicity profile that is often mild to moderate, but sometimes severe, with multiple kinases involved in the development of adverse events (AEs). Among others, cardiovascular AEs observed in TKI-treated CML patients may represent a significant cause of morbidity and mortality, and their pathogenesis is still only partially understood. In view of the recent introduction into daily clinical practice of new TKIs, namely the STAMP inhibitor asciminib, with a distinct safety profile, hematologists now more than ever have the opportunity to select the most suitable TKI for each patient, an aspect that will be fundamental in terms of personalized preventive and therapeutic strategies. Furthermore, physicians should be aware of the feasibility of TKI dose modifications at all stages of the patients' treatment journey, both at diagnosis for frail or elderly subjects or with multiple comorbidities, and during follow-up for those patients who experience toxicity, as well as to prevent it, with the main objective of reducing side effects while maintaining the response. Consequently, preserving the cardiovascular health of CML patients will likely be a more urgent topic in the near future, with specific measures aimed at controlling cardiovascular risk factors through a multidisciplinary approach involving a panel of healthcare professionals together with the hematologist.
MeSH term(s)	Humans ; Aged ; Antineoplastic Agents/adverse effects ; Tyrosine Kinase Inhibitors ; Clinical Relevance ; Protein Kinase Inhibitors/adverse effects ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive/complications ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
Chemical Substances	Antineoplastic Agents ; Tyrosine Kinase Inhibitors ; Protein Kinase Inhibitors
Language	English
Publishing date	2023-12-04
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2057351-0
ISSN	1534-6277 ; 1527-2729
ISSN (online)	1534-6277
ISSN	1527-2729
DOI	10.1007/s11864-023-01149-1
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Article ; Online: Reply to: Can circulating CD34+ cells count be used for the prognosis of myelofibrosis? Probably yes, at least in patients treated with ruxolitinib.

Iurlo, Alessandra / Galli, Nicole / Bucelli, Cristina / Artuso, Silvia / Consonni, Dario / Cattaneo, Daniele

British journal of haematology

2023 Volume 200, Issue 6, Page(s) e53–e55

MeSH term(s)	Humans ; Primary Myelofibrosis ; Prognosis ; Nitriles ; Pyrimidines
Chemical Substances	ruxolitinib (82S8X8XX8H) ; Nitriles ; Pyrimidines
Language	English
Publishing date	2023-01-04
Publishing country	England
Document type	Letter ; Research Support, Non-U.S. Gov't ; Comment
ZDB-ID	80077-6
ISSN	1365-2141 ; 0007-1048
ISSN (online)	1365-2141
ISSN	0007-1048
DOI	10.1111/bjh.18641
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Article ; Online: The molecular landscape of myeloproliferative neoplasms associated with splanchnic vein thrombosis: Current perspective.

Pescia, Carlo / Lopez, Gianluca / Cattaneo, Daniele / Bucelli, Cristina / Gianelli, Umberto / Iurlo, Alessandra

Leukemia research

2023 Volume 136, Page(s) 107420

Abstract: BCR::ABL1-negative myeloproliferative neoplasms (MPNs) are classically represented by polycythemia vera, essential thrombocythemia, and primary myelofibrosis. BCR::ABL1-negative MPNs are significantly associated with morbidity and mortality related to an ...

Abstract	BCR::ABL1-negative myeloproliferative neoplasms (MPNs) are classically represented by polycythemia vera, essential thrombocythemia, and primary myelofibrosis. BCR::ABL1-negative MPNs are significantly associated with morbidity and mortality related to an increased risk of thrombo-hemorrhagic events. They show a consistent association with splanchnic vein thrombosis (SVT), either represented by the portal, mesenteric or splenic vein thrombosis, or Budd-Chiari Syndrome. SVT is also a frequent presenting manifestation of MPN. MPNs associated with SVT show a predilection for younger women, high association with JAK2V617F mutation, low JAK2V617F variant allele frequency (generally <10 %), and low rates of CALR, MPL, or JAK2 exon 12 mutations. Next-Generation Sequencing techniques have contributed to deepening our knowledge of the molecular landscape of such cases, with potential diagnostic and prognostic implications. In this narrative review, we analyze the current perspective on the molecular background of MPN associated with SVT, pointing as well future directions in this field.
MeSH term(s)	Humans ; Female ; Myeloproliferative Disorders/complications ; Myeloproliferative Disorders/genetics ; Myeloproliferative Disorders/diagnosis ; Venous Thrombosis/genetics ; Polycythemia Vera/complications ; Thrombocythemia, Essential/genetics ; Mutation ; Calreticulin/genetics ; Janus Kinase 2/genetics
Chemical Substances	Calreticulin ; Janus Kinase 2 (EC 2.7.10.2)
Language	English
Publishing date	2023-11-10
Publishing country	England
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	752396-8
ISSN	1873-5835 ; 0145-2126
ISSN (online)	1873-5835
ISSN	0145-2126
DOI	10.1016/j.leukres.2023.107420
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Zs.A 1321: Show issues

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Article: Dose Optimization of Tyrosine Kinase Inhibitors in Chronic Myeloid Leukemia: A New Therapeutic Challenge.

Iurlo, Alessandra / Cattaneo, Daniele / Bucelli, Cristina / Breccia, Massimo

Journal of clinical medicine

2021 Volume 10, Issue 3

Abstract: The chronic myeloid leukemia (CML) therapeutic landscape has dramatically changed with tyrosine kinase inhibitor (TKI) development, which allows a near-normal life expectancy. However, long-term TKI exposure has been associated with persistent adverse ... ...

Abstract	The chronic myeloid leukemia (CML) therapeutic landscape has dramatically changed with tyrosine kinase inhibitor (TKI) development, which allows a near-normal life expectancy. However, long-term TKI exposure has been associated with persistent adverse events (AEs) which negatively impact on quality of life (QoL) and have the potential to cause significant morbidity and mortality. In clinical practice, TKI dose reduction is usually considered to reduce AEs and improve QoL, but dose optimization could have also another aim, i.e., the achievement and maintenance of cytogenetic and molecular responses. While therapy cessation appeared as a safe option for about half of the patients achieving an optimal response, no systematic assessment of long-term TKI dose de-escalation has been made. The present review is focused on the most recent evidences for TKIs dose modifications in CML clinical studies and in the real-life setting. It will consider TKI dose modifications in newly diagnosed patients, dose reduction for AEs, or in deep molecular response, either as a prelude to treatment-free remission (TFR) or as continuous maintenance therapy in those patients not wishing to attempt TFR. In addition, it will focus on patients not achieving a molecular response deep enough to go to TFR, and for whom dose reduction could be an option to avoid AEs.
Language	English
Publishing date	2021-02-01
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm10030515
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Article ; Online: Trend of circulating CD34

Iurlo, Alessandra / Galli, Nicole / Bucelli, Cristina / Artuso, Silvia / Consonni, Dario / Cattaneo, Daniele

British journal of haematology

2022 Volume 200, Issue 3, Page(s) 315–322

Abstract: We evaluated ... ...

Abstract	We evaluated CD34
MeSH term(s)	Humans ; Nitriles ; Primary Myelofibrosis/diagnosis ; Retrospective Studies ; Spleen ; Treatment Outcome ; Antigens, CD34
Chemical Substances	Nitriles ; ruxolitinib (82S8X8XX8H) ; Antigens, CD34
Language	English
Publishing date	2022-10-20
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80077-6
ISSN	1365-2141 ; 0007-1048
ISSN (online)	1365-2141
ISSN	0007-1048
DOI	10.1111/bjh.18526
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Article: Successful Imatinib Treatment for Systemic Mastocytosis Associated With Myelodysplastic/Myeloproliferative Neoplasm: Report of a Case and Literature Review.

Barozzi, Enrico / Bucelli, Cristina / Grifoni, Federica Irene / Gianelli, Umberto / Iurlo, Alessandra / Cattaneo, Daniele

Frontiers in oncology

2022 Volume 11, Page(s) 819097

Abstract: Systemic mastocytosis (SM) is a heterogeneous disease characterized by the expansion of mast cells in one or more tissues, frequently characterized by the presence ... ...

Abstract	Systemic mastocytosis (SM) is a heterogeneous disease characterized by the expansion of mast cells in one or more tissues, frequently characterized by the presence of
Language	English
Publishing date	2022-01-12
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2021.819097
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Article ; Online: Impact of diagnosis and treatment on response to COVID-19 vaccine in patients with BCR-ABL1-negative myeloproliferative neoplasms. A single-center experience.

Cattaneo, Daniele / Bucelli, Cristina / Cavallaro, Francesca / Consonni, Dario / Iurlo, Alessandra

Blood cancer journal

2021 Volume 11, Issue 11, Page(s) 185

MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; COVID-19/genetics ; COVID-19/immunology ; COVID-19/prevention & control ; COVID-19/virology ; COVID-19 Vaccines/therapeutic use ; Female ; Fusion Proteins, bcr-abl/genetics ; Humans ; Male ; Middle Aged ; Myeloproliferative Disorders/diagnosis ; Myeloproliferative Disorders/drug therapy ; Myeloproliferative Disorders/immunology ; Myeloproliferative Disorders/virology ; SARS-CoV-2/immunology ; SARS-CoV-2/isolation & purification
Chemical Substances	BCR-ABL1 fusion protein, human ; COVID-19 Vaccines ; Fusion Proteins, bcr-abl (EC 2.7.10.2)
Language	English
Publishing date	2021-11-26
Publishing country	United States
Document type	Letter
ZDB-ID	2600560-8
ISSN	2044-5385 ; 2044-5385
ISSN (online)	2044-5385
ISSN	2044-5385
DOI	10.1038/s41408-021-00579-0
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Management of Myelofibrosis: from Diagnosis to New Target Therapies.

Iurlo, Alessandra / Cattaneo, Daniele / Bucelli, Cristina

Current treatment options in oncology

2020 Volume 21, Issue 6, Page(s) 46

Abstract: Opinion statement: Myelofibrosis (MF) is a clonal disorder of the pluripotent hematopoietic stem cell, whose clinical manifestations can be extremely heterogeneous, including cytopenias, organomegaly, constitutional symptoms, and cachexia. Median ... ...

Abstract	Opinion statement: Myelofibrosis (MF) is a clonal disorder of the pluripotent hematopoietic stem cell, whose clinical manifestations can be extremely heterogeneous, including cytopenias, organomegaly, constitutional symptoms, and cachexia. Median survival ranges from approximately 3.5 to 5.5 years; while the most frequent cause of death is the evolution to acute myeloid leukemia, also other conditions such as progression without transformation, complications due to cytopenias including infections or bleeding, and cardiovascular events may be fatal. Myelofibrosis is still orphan of curative treatments: allogeneic hematopoietic stem cell transplant (HSCT), the only therapeutic approach that has clearly demonstrated an impact on disease progression, is associated with relevant morbidity and mortality and only a minority of patients is eligible for such an intensive procedure. While the discovery of the crucial role of JAK2 mutations and the consequent clinical use of JAK inhibitors has led to a dramatic improvement of symptoms control and quality of life, yet these drugs do not significantly modify the natural history of the disease. A better understanding of the molecular pathogenesis will hopefully foster the development of new targeted therapies aimed at improving MF prognosis. Herein, we review the most recent advances about JAK inhibitors and other molecules which are under investigation.
MeSH term(s)	Algorithms ; Biomarkers ; Clinical Decision-Making ; Combined Modality Therapy/methods ; Disease Management ; Disease Susceptibility ; Drug Therapy, Combination ; Genetic Predisposition to Disease ; Humans ; Molecular Targeted Therapy/adverse effects ; Molecular Targeted Therapy/methods ; Primary Myelofibrosis/diagnosis ; Primary Myelofibrosis/etiology ; Primary Myelofibrosis/therapy ; Protein Kinase Inhibitors/administration & dosage ; Protein Kinase Inhibitors/adverse effects ; Protein Kinase Inhibitors/therapeutic use ; Treatment Outcome
Chemical Substances	Biomarkers ; Protein Kinase Inhibitors
Language	English
Publishing date	2020-04-30
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2057351-0
ISSN	1534-6277 ; 1527-2729
ISSN (online)	1534-6277
ISSN	1527-2729
DOI	10.1007/s11864-020-00734-y
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Article: Case report: Pleural effusion during tyrosine-kinase inhibitor treatment in chronic myeloid leukemia: Not only a dasatinib-related adverse event.

Pasquale, Raffaella / Bucelli, Cristina / Bellani, Valentina / Zappa, Manuela / Iurlo, Alessandra / Cattaneo, Daniele

Frontiers in oncology

2022 Volume 12, Page(s) 1012268

Abstract: The spectrum of TKI-related adverse events (AEs) is variable. Pleural effusion (PE) is a frequent AE attributable to dasatinib treatment, while it is only rarely associated with nilotinib. The pathogenetic mechanism leading to PE during nilotinib therapy ...

Abstract	The spectrum of TKI-related adverse events (AEs) is variable. Pleural effusion (PE) is a frequent AE attributable to dasatinib treatment, while it is only rarely associated with nilotinib. The pathogenetic mechanism leading to PE during nilotinib therapy is still unknown and its management has not yet been defined. To the best of our knowledge, only a limited number of similar case reports have already been reported in the literature so far. Here, we describe the case of a 41-year-old CML patient who developed PE during first-line nilotinib, successfully treated with steroids and nilotinib permanent discontinuation. We highlight the differences among our patient and the others, proposing therapeutic strategies to solve this rare but still possible AE, of which physicians should be aware.
Language	English
Publishing date	2022-09-13
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2022.1012268
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