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S Monfardini

Publications and source records attributed to S Monfardini.

At least 109 records · Page 6Linked to original sources
PubMed1992

The epidemiology of acquired immunodeficiency syndrome and associated tumours in Europe.

By the end of September 1991, more than 60,000 cases of acquired immunodeficiency syndrome (AIDS) had been reported to the World Health Organization (WHO) by 31 countries in the WHO European region. Most of the cases (58,280/60,485-96%) were recorded in western Europe, chiefly in five countries: France (16,552 cases), Italy (10,584), Spain (10,101), Germany (6,968) and the United Kingdom (5,065). From the first reports in 1981 of European cases of AIDS until 1987, AIDS spread faster in the northern and central areas than elsewhere in the European region. Since then, the spread of the epidemic has been remarkably more rapid in southern Europe, while in eastern Europe AIDS is still in an early phase. More than 70% of the cases among homosexual or bisexual men were from the northern part of Europe, while the cases among intravenous drug users (IVDUs) were concentrated in the southern European countries, principally Italy and Spain. Over time, an increasing proportion of cases was recorded among IVDUs and in heterosexuals. More than 10,000 patients in Europe were diagnosed as having Kaposi's sarcoma (KS) (14% of all AIDS cases) or non-Hodgkin's lymphoma (NHL) (3%) as the presenting clinical manifestation of AIDS. The possibility of predicting the evolution of the epidemic in Europe depends heavily on the development of unbiased monitoring systems for HIV infection in the general population (i.e. anonymous unlinked testing).

AIDS-Related Complex↗
PubMed1992

Experience with intraperitoneal alpha-2a interferon.

Eighteen patients affected with epithelial ovarian cancer have been treated by intraperitoneal alpha 2a-Interferon. The usual single dosage was 54 x 10(6) U at weekly intervals for four times (eight times in responders): 10 histologically confirmed complete remissions and 3 partial remissions have been obtained; the toxicity was represented by fever in the majority of the cases, by abdominal discomfort in some cases, and by a mild transitory neurological complication in 1 case. Seventeen of 18 patients were pretreated, and 11 of 18 had only cytologic and/or microscopic disease. alpha 2a-Interferon has proven to be very effective and moderately toxic in microscopic peritoneal disease of ovarian epithelial cancer previously treated with extensive surgery and intravenous cytotoxic chemotherapy.

Female↗
PubMed1992

Buserelin treatment of advanced prostatic carcinoma: prognostic factor analysis.

From August 1986 to August 1990, 116 patients with prostatic carcinoma, advanced disease (stage C-D1 only in patients older than 75 years, or D2) were treated with Buserelin (0.5 mg 3 times/day subcutaneously for 7 days, followed by 0.4 mg 3 times/day intranasally) until progression. No concomitant antiandrogens were administered. Of the 108 evaluable patients, 10 had complete remission (CR), 49 partial remission (PR), 46 remained stable while 3 progressed (response rate = 54.6%). Median duration of response was 31 months, median survival was 34 months. The toxicity of treatment was mild and mainly related to the hormonal effect of the drug. Castrate testosterone levels were obtained in all patients except 7. Slight, transient pain increase was noted at day 8 in 12 patients. Absence of symptoms at the start of treatment, well- or moderately differentiated tumor and serum testosterone negativization following Buserelin were associated with a significantly higher response rate as compared to presence of symptoms, poorly differentiated tumor and failure to obtain castrate testosterone levels, respectively. The following prognostic factors were found, at univariate analysis, to be associated with a prolonged survival: stage (C-D1 versus D2), PS (greater than 80 versus equal or less than 80), symptoms (absent versus present) and histological grade (G1 + G2 versus G3). Age and basal T levels did not influence survival. Those patients who obtained a CR or PR survived significantly longer than those with stable disease or progression.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1992

A prospective study of a new combination chemotherapy regimen in patients older than 70 years with unfavorable non-Hodgkin's lymphoma.

PURPOSE: A prospective trial with a new combination of etoposide, mitoxantrone, and prednimustine (VMP), specifically devised for elderly patients with non-Hodgkin's lymphoma (NHL), was undertaken. PATIENTS AND METHODS: Between January 1987 and April 1990, 52 consecutive unselected patients older than 70 years (median age, 75.6 years) with stage I to IV intermediate- and high-grade NHL, or with stage III to IV low-grade malignancy with symptomatic disease received etoposide and prednimustine 80 mg/m2 orally for 5 days and mitoxantrone 8 to 10 mg/m2 day 1 intravenously (IV), every 21 days. Fourteen patients were previously treated. RESULTS: Among the 48 assessable patients, the objective response rate was 81%; 46% of the patients achieved a complete response (CR). The overall toxicity seemed to be acceptable, with 15 (7%) episodes of grade 4 leukopenia and 41 (18%) episodes of grade 3, over a total of 226 administered cycles. The median survival was 12 months. The patients who obtained CR have a longer survival than those who did not (34 v 8 months; P less than .001). Fifty-eight percent of patients achieving CR were free from relapse at 24 months; up to 36 months from the start of therapy, 25% were free from relapse. As far as patients affected by diffuse histiocytic lymphoma, 66% of previously untreated patients obtained a CR, and 55% of them were still disease-free at 24 months from the start of therapy. CONCLUSION: We conclude that VMP is effective, well tolerated, and feasible on an outpatient basis in an unselected, elderly population affected by unfavorable NHL.

Age Factors↗
PubMed1991

Pattern and determinants of diagnostic interval in cancers of the prostate, bladder and kidney.

The present study examined the pattern of presentation and diagnostic interval, i.e. number of months between first cancer symptom or sign and first medical visit, in 444 cases of urological cancer (122 of prostate cancer, 187 of bladder cancer and 135 of kidney cancer). The mean diagnostic interval was 7.6 months for prostate, 5.6 for bladder and 4.5 kidney cancer. A chance diagnosis, i.e. in absence of any symptom or sign, was reported by 16%, 8% and 18% of patients with cancer of the prostate, bladder and kidney respectively. We observed on significant differences in diagnostic intervals according to patients' demographic, sociocultural, and life-style characteristics, or tumor stage. Better quantitative and qualitative data on the pattern and determinants of delay in cancer diagnosis are clearly warranted, and the present study, although largely negative, shows the possibility of using large-scale epidemiological investigations for this purpose.

Aged↗
PubMed1991

A clinicopathologic study of lymphoid neoplasias associated with human immunodeficiency virus infection in Italy.

The clinicopathologic features of 45 human immunodeficiency virus (HIV)-infected patients (mainly intravenous drug users [IVDU]) with lymphoid neoplasias seen from September 1984 through July 1990 at an Italian cancer center are reviewed. Thirty-five had systemic non-Hodgkin's lymphoma (NHL), and ten had Hodgkin's disease (HD). Histologically, 27 NHL cases were intermediate grade (five cases) or high grade (22 cases, 14 of the small noncleaved cell type), according to the Working Formulation. Eight NHL cases, including four anaplastic large cell (ALC) BerH2 (CD30)-positive lymphomas, were in the miscellaneous group. Immunohistologic and/or gene rearrangement analysis showed the B-cell origin of 20 of the 24 NHL cases studied. At presentation, 71% of NHL patients had advanced stages (Stage III or IV), and 85% had extranodal disease (predominantly gastrointestinal tract and marrow). Of the 23 patients evaluable for treatment, only seven had a complete clinical response after lymphoma therapy; the median survival of 34 evaluable patients was 22 months after the diagnosis of NHL. Fifteen patients died; most deaths were attributable to progressive lymphoma and opportunistic infections. As with NHL, advanced disease, extranodal involvement, aggressive histologic findings, and poor response to therapy were also observed in patients with HD. This study shows that lymphoid neoplasias occurring in Italian IVDU with HIV infection and those previously reported in North American homosexual men with HIV infection share similar clinicopathologic features. However, some features such as the absence of history of Kaposi's sarcoma at diagnosis, the lack of detection of primary brain and rectal NHL, and the occurrence of B-cell ALC BerH2 (CD30)-positive NHL were observed uniquely in this series of patients.

Adult↗
PubMed1991

Expression of myelomonocytic antigens is associated with unfavourable clinicoprognostic factors in B-cell chronic lymphocytic leukaemia.

The cross-lineage expression of five myelomonocytic antigens (CD11b, CD11c, CD13, CD14, and CD15) was analysed in neoplastic lymphocytes from 100 consecutive B-cell chronic lymphocytic leukaemia (B-CLL) patients. CD14 antigen was detected on lymphocytes from more than 50% of patients whilst smaller percentages of samples were positive for CD11b (21%), CD11c (26%), CD13 (22%), and CD15 (7%). The presence of the CD13 antigen on neoplastic lymphocytes showed a statistically significant association with the two most important unfavourable clinicoprognostic factors in B-CLL: advanced clinical stage (CD13, P less than 0.01 by the Rai staging system; P less than 0.05 by the Binet staging system) and the diffuse pattern of bone marrow infiltration (CD13, P less than 0.001). A multiple logistic regression analysis showed that the increased risk for CD13-positive patients (13.7-fold higher than CD13-negative cases; P = 0.001) of presenting a diffuse pattern of bone marrow infiltration is independent of all other prognostic factors analysed including sex, age, lymphocyte counts, and clinical stage. A statistically significant association of CD11c (P = 0.002) and CD11b (P = 0.032) expression with the pattern of bone marrow infiltration was also found. Our results indicate for the first time a statistically significant association of CD13, CD11c, and CD11b antigens with unfavourable prognostic factors in B-CLL. They suggest that the cross-lineage expression of myeloid-associated surface peptidase (CD13-aminopeptidase N) and/or cell adhesion molecules (CD11c-LeuCAMc, CD11b-LeuCAMb) may influence the biological and clinical behaviour of chronic lymphoproliferative disorders of B cells.

Age Factors↗
PubMed1991

Hodgkin's disease in 63 intravenous drug users infected with human immunodeficiency virus. Gruppo Italiano Cooperativo AIDS & Tumori (GICAT).

Sixty-three cases of Hodgkin's disease in intravenous drug users (IVDUs) have been collected by the Italian Cooperative Group on AIDS-Related Tumors (GICAT). In most patients (74%) the histological pattern was that of mixed cellularity and lymphocyte depletion. In 39% of patients the initial symptom was a persistent lymph node enlargement due to persistent generalized lymphadenopathy (PGL). Unusual presentations included Waldeyer's ring, skin, meninges, colon, and pleura. After MOPP alternated or followed by ABVD, MOPP alone, or ABVD alone, 15 of 32 patients (47%) had a complete remission (CR) and 15 of 32 (47%) had a partial remission (PR). The median duration of CR was 14 months, while the median survival of patients with CR has not been reached; the median survival of patients treated with chemotherapy who had CD4 levels at presentation greater than or equal to 400/mm3 was significantly superior to that of those who had CD4 less than 400/mm3. The overall median survival was only 14 months. Forty-four percent of patients receiving chemotherapy, with or without radiotherapy, developed opportunistic as well as nonopportunistic infections. Lethal hepatic toxicity was observed in one patient. Among IVDUs, unusual presentations of Hodgkin's disease occurred at a lower rate than was previously reported for homosexuals. Complete remissions could be achieved in almost half the patients, but non opportunistic infections, in addition to parenchymal function impairment due to drug abuse, may limit treatment administration in IVDUs.

Acquired Immunodeficiency Syndrome↗
PubMed1991

A phase II study of oral idarubicin (4-demethoxidaunorubicin) in previously untreated elderly patients with non-Hodgkin's lymphoma.

Eighteen untreated elderly patients (median age 75 years) with non-Hodgkin's lymphoma (NHL) entered a phase II study with oral Idarubicin (4-demethoxidaunorubicin) at a dosage of 30-35 mg/m2 on day 1 and every 3 weeks thereafter. The medium number of cycles administered was three (range one to nine). We obtained one (6%) complete response and four (25%) partial responses in 16 evaluable patients. Toxicity was mild and no cardiotoxicity was found. At this dosage Idarubicin showed little anticancer activity in NHL.

Administration, Oral↗
PubMed1991

Evaluation of two consecutive regimens in advanced gastric cancer.

Treatment of gastric cancer still presents a challenge in cancer chemotherapy. In our Institute, from January 1981 to November 1984, 45 patients were given 5-fluorouracil (5FU) 600 mg/m2 Days 1, 8, 29, and 36; doxorubicin (A) 30 mg/m2 Days 1 and 29; mitomycin-C 10 mg/m2 Day 1 (FAM regimen) every 8 weeks. From December 1984 to October 1986, 26 patients were treated with 5FU 300 mg/m2 on Days 1-5, A 40 mg/m2 on Day 1, cisplatin (P) 100 mg/m2 on Day 1 (FAP regimen) every 3 weeks. In the FAM group, 42 patients are evaluable for response; 5 (12%) partial remission (PR), 9 stable disease (SD), and 28 progressions (PRO) were observed. Median duration of response (MDR) was 21 weeks (range 13-45) and the median survival (MS) in the whole group was 27 weeks. In the FAP group, 23 patients are evaluable: 2 CR (9%), 11 PR (47%), 2 SD (9%), and 8 PRO (34%) were observed; CR duration was 24 and 107+ weeks, respectively, MDR of PR was 22 weeks (5-35). The MS of all patients was 16 weeks. Toxicity (WHO criteria) was mild in the FAM group and severe in the FAP group. In spite of a higher objective response rate, the short MS and the severe toxicity observed in the FAP group do not merit recommendation of this regimen in patients with gastric cancer; therefore neither FAM nor FAP appear to be an ideal standard therapy.

Adult↗
PubMed1990

Non-Hodgkin's lymphoma in the elderly. I. Pathologic features at presentation.

The pathologic findings of 118 patients aged 70 years or older with non-Hodgkin's lymphoma (NHL) are reported. These patients formed 27.2% of 433 consecutive cases of NHL seen in a single institution over a 5-year period. Thirty-one of 433 NHL cases were histologically not classified, whereas the remaining 402 could be classified according to the International Working Formulation (WF) of NHL for clinical usage. Immunophenotypic analyses were carried out in 112 NHL cases; of this group 28 were NHL in elderly patients. Of the 95 elderly NHL that could be classified in the histologic categories of the WF 28 cases were in the low-grade, 41 in the intermediate-grade, and 26 in the high-grade categories. Eighty-one cases had diffuse histologic types and 14 had follicular/nodular histologic types. Thirty-five cases were of the G (diffuse large cell) + H (large cell, immunoblastic) categories. No significant differences in the prevalence of the different subtypes were observed among patients younger or older than 70 years. Immunohistologically, most NHL cases in the elderly expressed B-cell phenotype. Sixty-two NHL in the elderly were extranodal at presentation. The results of this study indicate that elderly patients form a relevant proportion of patients developing NHL and thereby present a very difficult management problem. The pathologic features of NHL in the elderly does not differ significantly from those of their younger counterparts, although an increase in diffuse versus follicular histologic patterns, and in extranodal versus nodal disease was observed with advancing age.

Aged↗