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Patients with hematological malignancies and serological signs of prior resolved hepatitis B

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World Journal of Gastrointestinal Oncology 2012年第3期4卷 37-45页

作者： Massimo Marignani elia gigante Paola Begini Alfredo Marzano Michela di Fonzo Ilaria Deli Sara Gallina Maria Christina Cox Gianfranco Delle Fave Digestive and Liver Disease Department School of Medicine and Psychology University "Sapienza" Azienda Ospedaliera S. Andrea Via Grottarossa 1035-1039 00189 Rome Italy SCDU of Gastroenterology and Hepatology AO San Giovanni Battista Corso Bramante 88 10125 Torino Italy Haematology Department School of Medicine and Psychology University "Sapienza" Azienda Ospedaliera S. Andrea Via Grottarossa 1035-1039 00189 Rome Italy

Hepatitis B virus (HBV) infection affects a large part of the world population. Within the different virological HBV categories that have been identified, patients with occult HBV infection represent a peculiar group. These individuals harbor a replication competent virus, inhibited in its replicative function. Accordingly, cases of reactivations have been observed in immunosuppressed individuals who lose immunological control over the infection. Patients with hematological malignancies (HM) are treated with intense myeloand immunosuppres-sive chemotherapy regimens which favor HBV reactivation. This event can have severe consequences, such as hepatitis flare, hepatic failure and even death. In addition, it can lead to delays or interruptions of curative treatments, resulting in a decreased disease free and overall survival. In this review, we will examine the event of HBV reactivation in patients with signs of resolved HBV infection undergoing treatment for HM and propose possible management strategies.

关键词： Occult hepatitis B Hematological malignancies Hepatitis B virus Chemotherapy Hepatitis B reactivation

HCV infection, B-cell non-Hodgkin's lymphoma and immunochemotherapy: Evidence and open questions

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World Journal of Gastrointestinal Oncology 2012年第3期4卷 46-53页

作者： Maria Christina Cox Maria Antonietta Aloe-Spiriti Elena Cavalieri Eleonora Alma elia gigante Paola Begini Caterina Rebecchini Gianfranco Delle Fave Massimo Marignani Department of Haematology Sant'Andrea Hospital La Sapienza University Department of Gastroenterology and Liver Disease Sant'Andrea Hospital La Sapienza University

There is plenty of data confirming that hepatitis C virus (HCV) infection is a predisposing factor for a B-cell non-Hodgkin's lymphoma (B-NHL) outbreak, while relatively few reports have addressed the role of HCV in affecting B-NHL patients' outcome. HCV infection may influence the short-term outcome of B-NHL because of the emergence of severe hepatic toxicity (HT) during immunochemotherapy. Furthermore, the long term outcome of HCV-related liver disease and patients' quality of life will possibly be affected by Rituximab maintenance, multiple-lines of toxicity during chemotherapy and hematopoietic stem cell transplantation. In this review, data dealing with aggressive and low-grade B-NHL were separately analyzed. The few retrospective papers reporting on aggressive B-NHL patients showed that HCV infection is a risk factor for the outbreak of severe HT during treatment. This adverse event not infrequently leads to the reduction of treatment density and intensity. Existing papers report that low-grade B-NHL patients with HCV infection may have a more widespread disease, more frequent relapses or a lower ORR compared to HCV-negative patients. Notwithstanding, there is no statistical evidence that the prognosis of HCV-positive patients is inferior to that of HCV-negative subjects. HCV-positive prospective studies and longer follow-up are necessary to ascertain if HCV-positive B-NHL patients have inferior outcomes and if there are long term sequels of immunochemotherapies on the progression of liver disease.

关键词： Marginal zone lymphoma Diffuse large B cell lymphoma Hepatitis C virus Non-Hodgkin’s lymphomas Hepatotoxicity Chemotherapy Immunochemotherapy Prognosis Rituximab

Impact of sarcopenia on tumor response and survival outcomes in patients with hepatocellular carcinoma treated by trans-arterial (chemo)-embolization

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World Journal of Gastroenterology 2022年第36期28卷 5324-5337页

作者： Gael Roth Yann Teyssier Maxime Benhamou Mélodie Abousalihac Stefano Caruso Christian Sengel Olivier Seror Julien Ghelfi Arnaud Seigneurin Nathalie Ganne-Carrie elia gigante Lorraine Blaise Olivier Sutter Thomas Decaens Jean-Charles Nault Univ.Grenoble-Alpes Grenoble 38058France Department of Hepatology Gastroenterology and Digestive OncologyCHU Grenoble AlpesGrenoble 38043France Institute for Advanced Biosciences INSERM U1209/CNRS UMR 5309Grenoble 38043France Department of Radiology CHU Grenoble AlpesGrenoble 38043France Department of Radiology CHU Avicenne-APHPBobigny 93000France Functional Genomics of Solid Tumors Laboratory Centre de Recherche des Cordeliers-INSERM UMR 1138InsermUniversitéParisParis 75006France Unitéde Formation et de Recherche SantéMédecine et Biologie Humaine UniversitéParis NordParis 93430France Service d'Epidémiologie et Evaluation Médicale CHU Grenoble AlpesGrenoble 38043France Department of Hepatology CHU Avicenne-APHPBobigny 93000France

BACKGROUND At the diagnosis of hepatocellular carcinoma(HCC),more than 90%of HCC patients present cirrhosis,a clinical condition often associated to *** is an indirect marker of malnutrition assessable on computed tomography(CT).AIM To evaluate the prognostic value of sarcopenia in patients with HCC treated by trans-arterial(chemo)-*** Patients with HCC treated by a first session of trans-arterial(chemo)embolization and an available CT scan before treatment were *** was assessed using skeletal muscle index at baseline and at the first radiological *** response was recorded after the first session of treatment using *** Of 225 patients treated by trans-arterial bland embolization(n=71)or trans-arterial chemoembolization(n=154)for HCC between 2007 and 2013,Barcelona Clinic of Liver Cancer stage was A,B,and C in 27.5%,55%,and 16.8%of cases,*** was present in 57.7%of the *** with sarcopenia presented a higher rate of progressive disease(19%vs 8%,P=0.0236),a shorter progression-free survival(8.3 vs 13.2 mo,P=0.0035),and a shorter median overall survival(19.4 mo vs 35.5 mo,P=0.0149)compared with non-sarcopenic ***,patients whose sarcopenia appeared after first transarterial treatment had the worst prognosis(P=0.0004).CONCLUSION Sarcopenia is associated with tumor progression and poor survival outcomes after trans-arterial(chemo)-embolization for HCC.

关键词： Hepatocellular carcinoma Transarterial chemoembolization Bland embolization Sarcopenia Skeletal muscle index

‘Les liaisons dangereuses’: Hepatitis C, Rituximab and B-cell non-Hodgkin’s lymphomas

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2012年第2期3卷 21-28页

作者： Massimo Marignani Michela di Fonzo Paola Begini elia gigante Ilaria Deli Adriano M Pellicelli Sara Gallina Emanuela de Santis Gianfranco Delle Fave M Christina Cox Department of Digestive and Liver Disease School of Medicine and Psychology University "Sapienza" Azienda Ospedaliera S. Andrea Via Grottarossa 1035-1039 00189 Rome Italy Liver Unit Azienda Ospedaliera San Camillo Forlanini 000149 Rome Italy Department of Haematology School of Medicine and Psychology University "Sapienza" Azienda Ospedaliera S. Andrea Via Grottarossa 1035-1039 00189 Rome Italy

Rituximab has provided a revolutionary contribution to the treatment of B-cell non-Hodgkin’s lymphomas (NHL). A high prevalence of hepatitis C virus (HCV) infection has been described in B-cell NHL patients. Cases of liver dysfunction in HCV-positive patients have been reported with Rituximab-containing regimens. In this paper we review the recent data regarding the effects of Rituximab in NHL patients with HCV infection. We also added a section devoted to improving communication between oncohaematologists and hepatologists. Furthermore, we propose a common methodological ground to study hepatic toxicity emerging during chemotherapy.

关键词： Rituximab B-cell non-Hodgkin’s lymphoma Hepatitis C virus Immunochemotherapy Methodology

Liver biopsy:analysis of results of two specialist teams

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World Journal of Gastrointestinal Pathophysiology 2014年第2期5卷 114-119页

作者： Giulia Anania elia gigante Matteo Piciucchi Emanuela Pilozzi Eugenio Pucci Adriano Maria Pellicelli Carlo Capotondi Michele Rossi Flavia Baccini Giulio Antonelli Paola Begini Gianfranco Delle Fave Massimo Marignani Department of Digestive and Liver Disease School of Medicine and Psychology University "Sapienza" Department of Pathology School of Medicine and Psychology University "Sapienza" Azienda Ospedaliera Liver Unit Azienda Ospedaliera San Camillo Department of Radiology School of Medicine and Psychology University "Sapienza" Azienda Ospedaliera

AIM:To analyze the safety and the adequacy of a sample of liver biopsies(LB)obtained by gastroenterologist(G)and interventional radiologist(IR)***:Medical records of consecutive patients evaluated at our GI unit from 01/01/2004 to31/12/2010 for whom LB was considered necessary to diagnose and/or stage liver disease,both in the setting of day hospital and regular admission(RA) care,were retrieved and the data entered in a *** were divided into two groups:one undergoing an ultrasonography(US)-assisted procedure by the G team and one undergoing US-guided biopsy by the IR *** the first group,an intercostal approach(US-assisted) and a Menghini modified type needle 16 G(length 90 mm) were *** IR team used a subcostal approach(US-guided) and a semiautomatic modified Menghini type needle 18 G(length 150 mm).All the biopsies were evaluated for appropriateness according to the current *** number of portal tracts present in each biopsy was assessed by a revision performed by a single pathologist unaware of the previous pathology ***,laboratory and demographic patient characteristics,the adverse events rate and the diagnostic adequacy of LB were ***:During the study period,226 patients,126 males(56%) and 100 females(44%),underwent LB:167(74%) were carried out by the G team,whereas 59(26%) by the IR *** was mostly performed in a day hospital setting by the G team,while IR completed more procedures on inpatients(P < 0.0001).The groups did not differ in median age,body mass index(BMI),presence of comorbidities and coagulation *** occurred in 26 patients(16 G team vs 10 IR team,P = 0.15).Most gross samples obtained were considered suitable for basal histological evaluation,with no difference among the two teams(96.4% G team vs 91.5% IR,P = 0.16).However,the samples obtained by the G team had a higher mean number of portal tracts(G team 9.5 ± 4.8; range 1-29 vs IR team 7.8 ± 4.1; range 1-2

关键词： Liver biopsy Ultrasound-guided biopsy Ultrasound-assisted biopsy Menghini needle Sample adequacy Portal tracts