12th Congress of the European Hematology ... - Haematologica

12 th Congress of the European Hematology Association
months. At the end of alemtuzumab treatment the median Hb concentration
was 12.7 g/dL. Regarding clinical responses, one patient obtained
SD, the other two patients achieved PR. All three patients underwent further
treatment because of disease progression after 9,10 and 26 months
from the end of alemtuzumab therapy. We show considerable efficacy in
the treatment of transfusion-dependent and resistant AIHA in pretreated
BCLL patients. Our study demonstrates that an identical AIHA response
can be obtained with a lower dose of subcutaneous alemtuzumab respect
to the standard dose with a similar duration of response, less
hemato/extrahematological complications even if a prolonged treatment
was required to achieve the same response. Alemtuzumab may be worthwhile
to consider before rituximab if AIHA is accompanied by progressive
CLL in need of cytoreductive therapy. Therefore, further studies with
alemtuzumab in the setting of CLL/AIHA are warranted considering that
this monoclonal antibody appears effective in the treatment of both the
leukaemia and the autoimmune complication.
0991
PROHYLAXIS OF INVASIVE FUNGAL INFECTIOTNS (IFI) WITH HIGH DOSE LIPOSOMIAL
AMPHOTERICINE-B (L-AMB) IN ACUTE NON LYMPHOID LEUKEMIA (ANLL): A SINGLE
CENTRE EXPERIENCE
A. Chierichini, 1 B. Anaclerico, 1 S. Fenu, 1 M. Cedrone, 1 V. Bongarzoni, 1
P.M. Placanica, 1 S. Fallani, 2 M.I. Cassetta, 2 A. Novelli, 2 L. Annino1 1 S.Giovanni-Addolorata, ROME, Italy; 2 Pharmacology, FLORENCE, Italy
The efficacy of L-AmB seems to be related both to improved tissue
penetration and to sustained bioactivity of drug levels in lung, brain, kidney,
liver, spleen. (Walsh et al. 2001; Anaissie et al. 2004). On the basis of
this issue, we have planned a pilot study for IFI prophylaxis in adult ANLL
with a single dose of L-AmB (15 mg/Kg) during post induction neutropenia.
Primary endpoint: to valuate the incidence of fungal infection according
to International Consensus (Ascioglu et al. 2002) during and up to four
weeks after prophylaxis. Protocol prophylaxis: patients received a single
dose of L-AmB at 15 mg/Kg i.v on the day after the end of induction. A
single dos was repeated 15 days later in those cases with persistent neutropenia.
L-AmB PK profile was tested at following times: 1st day (0,1,4,24
hours), 7st and 14st days from drug administration. Inclusion criteria were:
1) neutropenia (PMN 2 WHO have not been
reported ;overall median duration of neutropenia was 21 days (range 11-
42). 17/28 pts (60%) achieved complete haematological remission, 5 was
resistant and 6 died during induction aplasia; 3 cases had proven IFI (2
Aspergillus Flavus, 1 Candida Albicans) and 1 probable infection. The
median L-AmB PK results are available in 15 pts: h0: 0.0; h1: 5.57; h 4:
16.72; g 2°: 10.08; g 7° : 0.43; g 14°:0.0. The results obtained in this study
showed that L-AmB single large dose is an effective and safe approach in
IFI prophylaxis. Further studies might demonstrate the correlation
between PK, plasmatic clearance, uptake in reticulo-endothelial system
and IFI prophylaxis.
0992
EVALUATION OF THE COMBINATION EFFECT OF FACTOR V G1691A, FACTOR II G20210A
AND HYPERHOMOCYSTEINEMIA ON THE INCIDENCE OF DEEP VENOUS THROMBOSIS
A. Agorasti, 1 D. Margaritis, 2 I. Bazdiara, 2 D. Pantelidou, 2
A. Anastasiadis, 2 T. Trivellas, 3 D. Konstantinidou, 1 C. Tsatalas2 1 General Hospital of Xanthi, XANTHI; 2 Democritus University of Thrace,
ALEXANDROUPOLIS; 3 Institute of Thechnology of Kavala, KAVALA, Greece
Backrgound. Inherited predisposition to venous thromboembolic disease
are the mutations in gene encoding factor V (G1691A) and
G20210A variation of the factor II gene. Hyperhomocysteinemia is a recognized
independent risk factor for occlusive vascular disease. Aim. The
aim of this study was to evaluate the combined effect of factor V
G1691A (FV-Leiden, FVL), factor II G20210A (PTH) and hyperhomocysteinemia
on the incidence of deep venous thrombosis (DVT). Patients
and Methods. We enrolled 102 patients (aged 41.59±14.11, 54 male-48
female) with first episode of deep venous thrombosis and 46 healthy
individuals (aged 45.99±14.98, 20 male-26 female). Factor V and factor
II genotypes were analyzed using PCR amplification. Total homocysteine
(tHcy) levels were determined with ADVIA Centaur ® GP
Immunoassay System (Chemiluminescence, Bayer). Total homocysteine
levels above the upper limit of the laboratory ranges (>13.9 µmol/L)
368 | haematologica/the hematology journal | 2007; 92(s1)
were considered as hyperhomocysteinemia. We calculated the genotypes
frequency, odds ratio (OR) with 95% confidence intervals (CI)
and we performed logistic regression analysis. Statistical significance
was set at p