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57 SCIENTIFIC REPORT 2012 UNITS Hematology and Allogeneic Bone Marrow Transplantation PAOLO CORRADINI Pediatric Oncology MAURA MASSIMINO Immunohematology and Transfusion Medicine (SIMT) FERNANDO RAVAGNANI HEMATOLOGY AND PEDIATRIC ONCO-HEMATOLOGY DEPARTMENT DIRECTOR OF DEPARTMENT Paolo Corradini Professor of Hematology, University of Milan +39 02 2390 2950 [email protected] The Department comprises two clinical divisions (38 beds) together with a laboratory area for clinical cell manipulation, flow cytometry, clinical pharmacology, and molecular biology. In 2012, following organizational changes at INT, the Immunohematology and Transfusion Medicine (SIMT) Unit was assigned to this Department. Routine clinical activity is focused on the treatment of adult and pediatric patients with solid tumors and hematologic malignancies. Several clinical programs are ongoing in areas ranging from conventional chemotherapy to phase I studies and transplantation of hematopoietic cells. The Department is organized in the following Units: Hematology: treatment of hematologic malignancies, autologous and allogeneic transplantation Pediatric Oncology: pediatric patients with solid cancers Immunohematology and Transfusion Medicine (SIMT): this Unit responsible for laboratory diagnosis as well as donation, testing, processing, preservation, storage, distribution, and transfusion safety of blood components. A donor center, apheresis center, and HLA typing laboratory are also part of this Unit. Clinical and laboratory areas have been accredited by JACIE.

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Page 1: HEMATOLOGY AND PEDIATRIC ONCO-HEMATOLOGY DEPARTMENT · HEMATOLOGY AND PEDIATRIC ONCO-HEMATOLOGY DEPARTMENT ... Hematology and Pediatric onco-Hematology department HEAD ... elena Maggioni

scientific report 2012

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scientific report 2012scientific report 2012

UNITSHematology and Allogeneic Bone Marrow TransplantationPaolo Corradini

Pediatric OncologyMaura MassiMino

Immunohematology and Transfusion Medicine (SIMT)Fernando ravagnani

HEMATOLOGY AND PEDIATRIC ONCO-HEMATOLOGY DEPARTMENTDIRECTOR OF DEPARTMENT Paolo CorradiniProfessor of Hematology, university of Milan+39 02 2390 [email protected]

The department comprises two clinical divisions (38 beds) together with a laboratory area for clinical cell manipulation, flow cytometry, clinical pharmacology, and molecular biology. in 2012, following organizational changes at inT, the immunohematology and Transfusion Medicine (siMT) unit was assigned to this department.routine clinical activity is focused on the treatment of adult and pediatric patients with solid tumors and hematologic malignancies. several clinical programs are ongoing in areas ranging from conventional chemotherapy to phase i studies and transplantation of hematopoietic cells.The department is organized in the following units:• Hematology: treatment of hematologic malignancies, autologous and

allogeneic transplantation• Pediatric Oncology: pediatric patients with solid cancers• Immunohematology and Transfusion Medicine (SIMT): this unit

responsible for laboratory diagnosis as well as donation, testing, processing, preservation, storage, distribution, and transfusion safety of blood components. a donor center, apheresis center, and Hla typing laboratory are also part of this unit. Clinical and laboratory areas have been accredited by JaCie.

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Hematology and Pediatric Onco-Hematology Department

HEADPaolo Corradini, Md

CLINICAL RESEARCH STAFFanna dodero, Mdlucia Farina, Mdvittorio Montefusco, MdFrancesco spina, Md

RESEARCH STAFFCristiana Carniti, Phd

CLINICAL FELLOWgiulia Perrone, Md

RESIDENTSserena dalto, MdFrancesco Maura, Mdalberto Mussetti, Md Francesca rezzonico, Mdluisa roncari, Md

POSTDOCTORAL FELLOW antonio vendramin, Biol sci d, Phd

PHD STUDENTS anisa Bermema, Biol sci dsilvia gimondi, Biol sci d

DATA MANAGER liana Bevilacqua, debora degl’innocenti

ADMINISTRATIVE PERSONNELMarialuisa longhi, elena Maggioni

NURSESgiorgia gobbi (coordinator), rosa abate, sonia Citro, riccardo de stefano, david guiote Pertierra, donatella luongo, simona Mazzella, elisabetta Martinell, Francesco Murana, rita russo, leonardo orsini, alfonso Parisi, rita sciancalepore, serafina Tomasicchio, giuseppe Torregrossa, anna vernone

HEALTHCARE ASSISTANTSnunzio Bovello, Carmelo Fede, evelina Palella, Jose noboa velasco

HeMAtoLoGY AnD ALLoGeneic Bone MArroW trAnspLAntAtion (etMo)The eTMo unit coordinates and takes part in several clinical trials testing new combinations of drugs and monoclonal antibodies for the treatment of lymphoid and myeloid malignancies with the aim of enhancing anti-tumor activity while reducing the toxic effects of treatment. several new trials started in 2012: • a phase iii, randomized, open-

label trial of lenalidomide/dexamethasone with or without elotuzumab in relapsed or refractory multiple myeloma;

• an open-label, multicenter, expanded access study of inC424 for patients with primary myelofibrosis (PMF), post-polycythemia myelofibrosis (PPv MF) or post-essential thrombocythemia myelofibrosis (PeT-MF);

• an open-label phase ii study of BKM120 in patients with relapsed and refractory diffuse large B-cell lymphoma, mantle cell lymphoma, and follicular lymphoma.

The unit also conducted:• a phase iii trial for MM patients at first relapse comparing the activit of

a regimen including either bortezomib or lenalinomide combined with cyclophosphamide and dexamethasone. The biological section of the study is evaluating simple biomarkers that might be useful to predict long-term response in the relapsed setting;

• a phase iii randomized trial comparing the efficacy of ga101-CHoP versus r-CHoP in previously-untreated patients with Cd20-positive dlBCl;

• a randomized phase iii study to compare bortezomib, melphalan, prednisone (vMP) with high dose melphalan followed by bortezomib, lenalidomide, dexamethasone (vrd) consolidation and lenalidomide maintenance in patients with newly diagnosed multiple myeloma;

• a phase i study of a new protein kinase C inhibitor in patients with Cd79-mutant diffuse large B-cell lymphoma.

other research projects involve:• Phenotypic, functional, and molecular characterization of post-

transplant T-cell and B-cell recovery to elucidate the kinetics of immune reconstitution after stem cell transplantation;

• analysis of markers predictive of acute graft-versus-host disease (agvHd) onset;

• study of new treatment strategies for agvHd using mouse models;• study of new treatment strategies for peripheral T-cell lymphomas (PTCls).Keywords: myeloma, bone marrow transplantation, lymphoma

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Hematology and Pediatric Onco-Hematology Department

during 2012, 277 patients were accrued; 233 with malignant tumors.Brain tumors. The unit became the national coordinator for trials in localized medulloblastoma currently in the pipeline and continued to coordinate the second national study on ependymoma (137 patients) and the development of an upcoming european protocol.Brain stem gliomas. a pilot study with concomitant radiotherapy, anti-egFr nimotuzumab and vinorelbine enrolled 27 patients whose Mris were reviewed demonstrating an improvement on previous results in PFs and os.Neuroblastoma. The unit is the coordinator for italy of the pan-european trial for high-risk neuroblastoma; over 430 italian patients have been enrolled to date (55 by the unit). Wilms tumor. The unit chairs the national Working group for clinical and biological studies and the relapse program in europe.Soft tissue sarcomas. accrual for the european epssg trials is ongoing: so far 2538 patients have been enrolled from 18 countries, including 244 from our center (the highest accrual). The unit is the coordinator of the epssg nrsTs protocol.Rare childhood tumors. The unit co-coordinates a nation-wide cooperative project on extremely rare pediatric cancers. since the project started, 650 patients have been enrolled (one third from our center). a member of our center co-coordinates the european network on rare tumors “eXPerT” (european Cooperative study group on Pediatric rare Tumors). The unit also coordinates at a national level the multicenter Phase i study in pediatric patients with surgically incurable melanoma.Bone tumors. The unit coordinates the Bone Tumors Working group in the italian association of Pediatric oncology (associazione italiana ematologia oncologia Pediatrica-aieoP).Germ cell malignancies. The unit is the national coordinator of a trial that, to date, has enrolled 184 malignant germ cell tumors and 204 teratomas.New drugs. The phase 1 “first-in-child” trial with lde225 (anti-sMo) was completed and phase ii activated; a gene signature predictive for response was identified.Two front-line randomized trials in metastatic sarcoma and high-grade glioma with bevacizumab are ongoing.The unit is a board member of Pan-european network for Care of survivors after Childhood and adolescent Cancer (Pan-Care), and leads the aieoP

national Working group. Finally, a project on fertility preservation (ovarian cryopreservation) and an out-patient clinic for late effects have been recently launched by our unit.Keywords: international trials, new drugs,

adolescents

HEADMaura Massimino, Md

CLINICAL RESEARCH STAFFMichela Casanova, Md, andrea Ferrari, Md

roberto luksch, Md, Cristina Meazza, Md daniela Polastri, Md, Filippo spreafico, Md

Monica Terenziani, Md

RESEARCH STAFFluca Bergamaschi, resident

veronica Biassoni, Md serena Catania, Md

stefano Chiaravalli, Md Marco vajna de Pava, Md

Francesca Favini, resident Barbara giacon, Psy d

Marta Podda, Md nadia Puma, Md

elisabetta schiavello, Md Fabio simonetti, Md

ADMINISTRATIVE PERSONNELelena Barzanò, luna Boschetti, Mattia Bussi,

Chiara secco, gabriella vighi

SOCIAL WORKER giovanna Casiraghi

TEACHERSstefania Benedetti, anna Bernasconi,

Franca Bertola, antonia Biasi, Cinzia Cassanelli, silvia dragone,

Manuela Farina, andrea gazzi, lucia Toniolo

NURSESMariangela armiraglio (coordinator), Cecilia alberti, iris Baranella, Morena Berti, daniela

Bruno, Cristina Comelli, Patrizia Conti, domenica Costeri, lucia Curelli, laura de

Porras, ruggero Fauro, Marta Ferrante, Carmelo Fiorello, giuseppe Forzini, Marinella

gaidolfi, rossana ghezzi, laura lottaroli, simone Macchi, rossana Marra, Manuela

oriani, elisa Procopio, silvana saverino, elisa Triglia

HEALTHCARE ASSISTANTSannamaria Bilanzuoli, gisella Cancedda,

rita Carulli, silvana Celauro, rita Marina Tamburro, stella uzzardi

peDiAtric oncoLoGY

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siMt, iMMUnoHeMAtoLoGY AnD trAnsfUsion MeDicineThe unit is responsible for laboratory diagnosis as well as for donation, testing, processing, preservation, storage, distribution, and transfusion safety of blood components. Clinical work and laboratory testing are constantly being improved according to european and american technologies and standards. other activities are: immunohematology, virological diagnosis (serological and molecular), Hla typing of patients and donors (related/unrelated), hematologic diagnosis, and therapeutic apheresis. This latter activity is particularly focused on peripheral blood stem cell (PBsC) harvesting for autologous and allogeneic stem cell transplantation and therapeutic procedures such as extracorporeal photopheresis (eCP).The radio frequency identification project (rFid) for total traceability and enhanced safety of the transfusion process through electronic matches (item identification, data transfer and chance to implement workflow management rules) has been applied in most clinical contexts of the institute, improving both the efficiency and safety of the transfusion process. The possibility to apply rFid procedures to PBsC process has been evaluated in terms of biological and strategical compatibility.a new method of blood collection and processing has been established to obtain leucocyte-depleted red blood cell units. This approach should reduce the number of adverse transfusion reactions. Moreover, rFid technology allowed us to better monitor signs of transfusion reaction. Production and clinical application of platelet gel for topical use has continued.The siMT collaborates with:• Medical oncology unit we are evaluating the serum levels of CC

Thymus and activation-related Chemokine (TarC) in Hodgkin’s lymphoma patients to prospectively investigate the prognostic role of this chemokine in disease outcome

• department of Predictive and Preventive Medicine we evaluated the involvement of HPv in lung cancer. no HPv was detected in tumor specimens or in normal lung tissue of any patient, suggesting that HPv is not associated with the risk of lung cancer

• Prostate Program we are evaluating the relationship between urinary prostate cancer antigen 3 (PCa3) and different characteristics of tumor aggressiveness to assess the impact of PCa3 score as an active surveillance (as) criterion instead of and in addition to the current criteria to optimize selection of prostate cancer patients for as.

Keywords: transfusion medicine, HLA, virology

HEADFernando ravagnani, Md

CLINICAL STAFFFlavio arienti, Mdannalisa Birolini, MdPaola Coluccia, MdCarmela guarino, Mdlaura r. Terranova, Mdelisabetta di giuseppe, Biol sci dClaudia lombardo, Biol sci darabella Mazzocchi, Biol sci d

FELLOWSFrancesca r. Taverna, Biol sci d

ADMINISTRATIVE PERSONNELorietta C. Polisena, elide spinelli, Maria C. Zanetti, giovanni veronese

TECHNICIANSMario avella, Cinzia l. Biasuz, alvaro Bompadre, laura M. Bonizzoni, antonella Falanga, daniela Ferrari, Marina galbiati, annamaria gorla, silvia larghi, roberto losa, antonia Morleo, ernestina Pigliafreddo, lara Pusterla, roberta serpi, lorena sfreddo, Barbara strada, Tiziano P. Tattanelli, ornella Zanaboni

NURSESdonata Bertolesi, roberta Colombo, Marisa dentella, Filomena Fedele, rita Fiorito, Cristina i. lasala, Monica Pedretti, Carmela santolla

HEALTHCARE ASSISTANTSantonella atzeni, Carmela gizzi, Maria a. somma, Maria Tamburriello

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