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Hepatitis B in patients with hematological diseases: An update 被引量:5
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作者 Chiara Coluccio paola begini +5 位作者 Alfredo Marzano Adriano Pellicelli Barbara Imperatrice Giulia Anania Gianfranco Delle Fave Massimo Marignani 《World Journal of Hepatology》 CAS 2017年第25期1043-1053,共11页
Hepatitis B virus(HBV) reactivation(HBVr) in patients undergoing immunosuppressive therapy is still a hot topic worldwide. Its prevention and management still represents a challenge for specialists dealing with immuno... Hepatitis B virus(HBV) reactivation(HBVr) in patients undergoing immunosuppressive therapy is still a hot topic worldwide. Its prevention and management still represents a challenge for specialists dealing with immunosuppressed patients. Aim of this paper is to provide a critical review of the relevant information emerged in the recent literature regarding HBV reactivation following immunosuppressive treatments for oncohematological tumors. A computerized literature search in MEDLINE was performed using appropriate terms arrangement, including English-written literature only or additional relevant articles. Articles published only in abstract form and case reports not giving considerable news were excluded. Clinical manifestation of HBVr can be manifold, ranging from asymptomatic self-limiting anicteric hepatitis to life-threatening fulminant liver failure. In clusters of patients adverse outcomes are potentially predictable. Clinicians should be aware of the inherent risk of HBVr among the different virological categories(active carriers, occult HBV carriers and inactive carriers, the most intriguing category), and classes of immunosuppressive drugs. We recommend that patients undergoing immunosuppressive treatments for hematological malignancies should undergo HBV screening. In case of serological sign(s) of current or past infection with the virus, appropriate therapeutic or preventive strategies are suggested, according to both virological categories, risk of HBVr by immunosuppressive drugsand liver status. Either antiviral drug management and surveillance and pre-emptive approach are examined, commenting the current international recommendations about this debated issue. 展开更多
关键词 REACTIVATION Lymphoma HEMATOLOGY Immunosuppressive therapy PROPHYLAXIS Hepatitis B virus Chemotherapy Occult/active/inactive carrier ENTECAVIR LAMIVUDINE
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Patients with hematological malignancies and serological signs of prior resolved hepatitis B 被引量:3
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作者 Massimo Marignani Elia Gigante +6 位作者 paola begini Alfredo Marzano Michela di Fonzo Ilaria Deli Sara Gallina Maria Christina Cox Gianfranco Delle Fave 《World Journal of Gastrointestinal Oncology》 SCIE CAS 2012年第3期37-45,共9页
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.... 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. 展开更多
关键词 OCCULT HEPATITIS B HEMATOLOGICAL MALIGNANCIES HEPATITIS B virus Chemotherapy HEPATITIS B REACTIVATION
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HCV infection, B-cell non-Hodgkin's lymphoma and immunochemotherapy: Evidence and open questions 被引量:1
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作者 Maria Christina Cox Maria Antonietta Aloe-Spiriti +6 位作者 Elena Cavalieri Eleonora Alma Elia Gigante paola begini Caterina Rebecchini Gianfranco Delle Fave Massimo Marignani 《World Journal of Gastrointestinal Oncology》 SCIE CAS 2012年第3期46-53,共8页
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 ... 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. 展开更多
关键词 Marginal zone LYMPHOMA Diffuse large B cell LYMPHOMA Hepatitis C virus Non-Hodgkin’s LYMPHOMAS HEPATOTOXICITY Chemotherapy IMMUNOCHEMOTHERAPY Prognosis RITUXIMAB
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Liver biopsy:analysis of results of two specialist teams
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作者 Giulia Anania Elia Gigante +10 位作者 Matteo Piciucchi Emanuela Pilozzi Eugenio Pucci Adriano Maria Pellicelli Carlo Capotondi Michele Rossi Flavia Baccini Giulio Antonelli paola begini Gianfranco Delle Fave Massimo Marignani 《World Journal of Gastrointestinal Pathophysiology》 CAS 2014年第2期114-119,共6页
AIM:To analyze the safety and the adequacy of a sample of liver biopsies(LB)obtained by gastroenterologist(G)and interventional radiologist(IR)teams.METHODS:Medical records of consecutive patients evaluated at our GI ... AIM:To analyze the safety and the adequacy of a sample of liver biopsies(LB)obtained by gastroenterologist(G)and interventional radiologist(IR)teams.METHODS: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 database.Patients 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 team.For the first group,an intercostal approach(US-assisted) and a Menghini modified type needle 16 G(length 90 mm) were used.The 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 guidelines.The number of portal tracts present in each biopsy was assessed by a revision performed by a single pathologist unaware of the previous pathology report.Clinical,laboratory and demographic patient characteristics,the adverse events rate and the diagnostic adequacy of LB were analyzed.RESULTS: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 team.LB 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 parameters.Complications 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 1-20)(P = 0.0192) and a longer mean length(G team 22 mm ± 8.8 vs IR team 15 ± 6.5 mm)(P = 0.0001).CONCLUSION:LB can be performed with similar outcomes both by G and IR.Use of larger dimension needles allows obtaining better samples,with a similar rate of adverse events. 展开更多
关键词 Liver BIOPSY ULTRASOUND-GUIDED BIOPSY Ultrasound-assisted BIOPSY Menghini needle Sample ADEQUACY PORTAL tracts
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‘Les liaisons dangereuses’: Hepatitis C, Rituximab and B-cell non-Hodgkin’s lymphomas
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作者 Massimo Marignani Michela di Fonzo +7 位作者 paola begini Elia Gigante Ilaria Deli Adriano M Pellicelli Sara Gallina Emanuela de Santis Gianfranco Delle Fave M Christina Cox 《World Journal of Gastrointestinal Pharmacology and Therapeutics》 CAS 2012年第2期21-28,共8页
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... 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. 展开更多
关键词 RITUXIMAB B-CELL non-Hodgkin’s LYMPHOMA Hepatitis C virus IMMUNOCHEMOTHERAPY Methodology
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COVID-19 emergency: Changes in quality of life perception in patients with chronic liver disease-An Italian single-centre study
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作者 Alessandra Zannella Silvia Fanella +1 位作者 Massimo Marignani paola begini 《World Journal of Hepatology》 2022年第1期274-286,共13页
BACKGROUND In December 2019,the coronavirus disease-2019(COVID-19)emerged and rapidly spread worldwide,becoming a global health threat and having a tremendous impact on the quality of life(QOL)of individuals.AIM To ev... BACKGROUND In December 2019,the coronavirus disease-2019(COVID-19)emerged and rapidly spread worldwide,becoming a global health threat and having a tremendous impact on the quality of life(QOL)of individuals.AIM To evaluate the awareness of patients with chronic liver disease(CLD)regarding the COVID-19 emergency and how it impacted on their QOL.METHODS Patients with an established diagnosis of CLD(cirrhosis,autoimmune hepatitis,primary biliary cholangitis,and primary sclerosing cholangitis)who had been evaluated at our Outpatient Liver Disease Clinic during the 6-mo period preceding the start of Italian lockdown(March 8,2020)were enrolled.Participants were asked to complete a two-part questionnaire,administered by telephone according to governmental restrictions:The first section assessed patients’basic knowledge regarding COVID-19,and the second evaluated the impact of the COVID-19 emergency on their QOL.We used the Italian version of the CLD questionnaire(CLDQ-I).With the aim of evaluating possible changes in the QOL items addressed,the questionnaire was administered to patients at the time of telephone contact with the specific request to recall their QOL perceptions during two different time points.In detail,patients were asked to recall these perceptions first during time 0(t0),a period comprising the 2 wk preceding the date of ministerial lockdown decree(from February 23 to March 7,2020);then,in the course of the same phone call,they were asked to recall the same items as experienced throughout time 1(t1),the second predetermined time frame encompassing the 2 wk(from April 6 to April 19)preceding our telephone contact and questionnaire administration.All data are expressed as number(%),and continuous variables are reported as the median(interquartile range).The data were compared using the Wilcoxon paired non-parametric test.RESULTS A total of 111 patients were enrolled,of whom 81 completed the questionnaire.Forty-nine had liver cirrhosis,and all of them had compensated disease;32 patients had autoimmune liver disease.The majority(93.8%)of patients were aware of COVID-19 transmission modalities and on how to recognize the most common alarm symptoms(93.8%).Five of 32(15.6%)patients with autoimmune liver disease reported having had the need to receive more information about the way to manage their liver disease therapy during lockdown and nine(28.2%)thought about modifying their therapy without consulting their liver disease specialist.About the impact on QOL,all CLDQ-I total scores were significantly worsened during time t1 as compared to time t0.CONCLUSION The COVID-19 epidemic has had a significant impact on the QOL of our population of patients,despite a good knowledge of preventive measure and means of virus transmission. 展开更多
关键词 COVID-19 Liver disease Quality of life Liver cirrhosis Chronic liver disease questionnaire
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