Review
Medical Laboratory Technology
Wen Zhao, Xi-Shan Cao, Yu-Ling Han, Xu-Hui Wen, Wen-Qi Zheng, Zhi-De Hu
Summary: Pleural effusion is a common symptom of various disorders, and the current diagnostic tools have limitations. Cell-free nucleic acids in pleural fluid may serve as potential diagnostic markers, as they are non-invasive, cost-effective, and objective.
CLINICAL CHEMISTRY AND LABORATORY MEDICINE
(2022)
Article
Critical Care Medicine
Rachelle Asciak, Nikolaos I. Kanellakis, Anna Bibby, Andrew Kidd, Stephen Gerry, Rachel Mercer, Nick Maskell, Kevin G. Blyth, Peter Fsadni, Stephen Montefort, Ioannis Psallidas, Najib M. Rahman
Summary: This study investigated the association between pleural fluid exposure and survival in patients with malignant pleural mesothelioma. The findings suggest that successful pleurodesis may be associated with improved survival, but the relationship between MPM exposure duration to pleural fluid and survival remains unclear within the limitations of this retrospective study. Future prospective studies are needed to further evaluate this potentially important mechanism.
Review
Biology
Sean P. F. Foley, John Scott Parrish
Summary: Pleural space infections have been a well-recognized clinical syndrome for over 4000 years and continue to cause significant morbidity and mortality worldwide. Our understanding of the causative pathophysiology has greatly expanded over the last few decades, as have our treatment options. This paper aims to review recent updates in our understanding of pleural space infections and provide updates on treatment modalities.
Article
Medicine, General & Internal
Syed Alishan Nasir, Hugo Calavia Liano, Christopher Manfredi
Summary: Dasatinib is a second-generation TKI used to treat CML. It is more effective than first-generation TKIs and can target mutation products resistant to them. Pleural effusion is a common side effect of dasatinib but tends to resolve upon discontinuation. However, there have been reports of chylous effusions associated with dasatinib, which may persist even after discontinuation.
CUREUS JOURNAL OF MEDICAL SCIENCE
(2022)
Article
Oncology
Eiji Takeuchi, Yoshio Okano, Hisanori Machida, Katsuhiro Atagi, Yoshihiro Kondou, Naoki Kadota, Nobuo Hatakeyama, Keishi Naruse, Tsutomu Shinohara
Summary: This study retrospectively analyzed lung cancer patients with malignant pleural effusion (MPE) and found that those with eosinophilic pleural effusion (EPE) had a better prognosis than those without EPE. Factors such as EPE, Eastern Cooperative Oncology Group (ECOG) Performance Status, sex, and the neutrophil-to-lymphocyte ratio in the serum were identified as independent prognostic factors affecting survival.
CANCER IMMUNOLOGY IMMUNOTHERAPY
(2022)
Article
Biotechnology & Applied Microbiology
Qian Xu, Juanjuan Tian, Lin Huang, Qilin Zhong, Yulin Xu, Linlin Liu, Jian Shi
Summary: Invasion of the pleural membrane by a malignant tumor can lead to the production of malignant pleural effusion, causing symptoms such as dyspnea and cough, which can be easily confused with pneumonia. It is important to conduct examinations for malignant tumors in patients with unexplained symptoms of bloody pleural effusion. This includes thoracentesis and drainage, examination of malignant cells in the fluid, pleural biopsy tissue examination, and determination of the type and source of lung malignancy. Treatment options may include surgery or immunotherapy.
ONCOTARGETS AND THERAPY
(2022)
Article
Medicine, General & Internal
Zeng-hua Ren, Ling Xu
Summary: The study evaluated the accuracy of pfADA, pfLDH, and other parameters in the differential diagnosis of Neutrophil-predominant Tuberculous Pleural Effusion (NP-TPE) and Parapneumonic Pleural Effusion (PPE). The results showed that combining different parameters can improve diagnostic performance in different age groups.
AMERICAN JOURNAL OF THE MEDICAL SCIENCES
(2021)
Article
Medical Laboratory Technology
Yanqing Liu, Weina Huang, Jing Yang, Songbo Yuan, Congcong Li, Weiwei Wang, Zhigang Liang, Aihua Wu
Summary: A decision tree algorithm was used to differentiate between different types of pleural effusion, resulting in a set of diagnostic indicators with good accuracy.
CLINICAL BIOCHEMISTRY
(2023)
Article
Cardiac & Cardiovascular Systems
Amit Chopra, Llewellyn Foulke, Marc A. Judson
Summary: A sarcoidosis associated pleural effusion (SAPE) is a pleural effusion caused by active granulomatous inflammation from sarcoidosis. SAPE commonly occurs at the initial presentation of sarcoidosis or within the first year, with dyspnea being the most common presenting symptom. Clinical features and pleural fluid analysis are essential for diagnosing SAPE. Corticosteroids are the preferred treatment and have rapid effectiveness, with a low rate of recurrence.
RESPIRATORY MEDICINE
(2022)
Editorial Material
Critical Care Medicine
Chuan T. Foo, Anna Paterson, Adam Duckworth, Jurgen Herre
Summary: Malignant pleural effusion is common in mesothelioma, with the presence of hyaluronic acid contributing to its viscosity. Intrapleural hyaluronidase can effectively reduce fluid viscosity and drainage duration, demonstrating feasibility and safety in managing hyaluronic acid-rich viscous malignant pleural effusion.
Article
Immunology
Hongxia Jia, Hongping Liu, Meng Tu, Yan Wang, Xudong He, Guojun Zhang
Summary: This study reports a rare case of isolated pleural cryptococcosis in a patient with thymoma combined with myasthenia gravis, who developed pleural effusion of unknown origin after long-term glucocorticoids and tacrolimus therapy. Pleural biopsy confirmed the diagnosis and the patient's condition improved with antifungal treatment.
FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY
(2023)
Article
Immunology
Neda Dalil Roofchayee, Ian M. Adcock, Majid Marjani, Neda K. Dezfuli, Mohammad Varahram, Johan Garssen, Esmaeil Mortaz
Summary: Flow cytometry analysis revealed that Treg cells, CD4+IL-9+ cells, and adenosine deaminase levels may be valuable in differentiating tuberculous pleural effusion from non-tuberculous pleural effusion patients.
FRONTIERS IN IMMUNOLOGY
(2021)
Article
Medicine, General & Internal
Jaehee Lee, Jongmin Park, Ji Eun Park, Yong Hoon Lee, Sun Ha Choi, Hyewon Seo, Seung Soo Yoo, Shin Yup Lee, Seung-Ick Cha, Jae Yong Park, Jae Kwang Lim, Chang Ho Kim
Summary: This study compared the characteristics of pleural abnormalities on CT between tuberculous pleural effusion (TPE) and malignant pleural effusion (MPE). The study found that the size, number, and contour of pleural thickening in MPE were significantly different from those in TPE. These characteristics can help differentiate MPE from TPE.
AMERICAN JOURNAL OF THE MEDICAL SCIENCES
(2023)
Article
Multidisciplinary Sciences
Jang Ho Lee, Chang-Min Choi, Namu Park, Hyung Jun Park
Summary: This study utilized deep learning models and contrastive-loss approach to classify the etiology of pleural effusion. The contrastive-loss model demonstrated the highest accuracy and provided visualization of typical and atypical effusion results. These findings offer valuable insights for clinicians in etiology diagnosis.
SCIENTIFIC REPORTS
(2022)
Article
Medicine, General & Internal
Chang Ho Kim, Jaehee Lee
Summary: Parapneumonic effusions are common complications of Mycoplasma pneumoniae infection, affecting approximately 20-25% of adult patients. Pleural fluid analysis typically shows mononuclear leukocyte predominance and elevated ADA activity, similar to tuberculous pleural effusion. Differential diagnosis between MPPE and TPE relies on the levels of ADA and serum inflammatory biomarkers. Early diagnosis of MP infection can be achieved through positive IgM and PCR results, guiding the selection of appropriate antibiotic treatment based on local antibiotic resistance data.
JOURNAL OF CLINICAL MEDICINE
(2022)
Letter
Hematology
Mario Tiribelli, Eleonora Toffoletti, Sara Di Giusto, Renato Fanin, Daniela Damiani
EUROPEAN JOURNAL OF HAEMATOLOGY
(2023)
Article
Oncology
Roberto Mina, Pellegrino Musto, Delia Rota-Scalabrini, Laura Paris, Barbara Gamberi, Angelo Palmas, Sara Aquino, Paolo de Fabritiis, Nicola Giuliani, Luca De Rosa, Alessandro Gozzetti, Claudia Cellini, Luca Bertamini, Andrea Capra, Daniela Oddolo, Iolanda Donatella Vincelli, Sonia Ronconi, Vincenzo Pavone, Norbert Pescosta, Michele Cea, Francesca Fioritoni, Stelvio Ballanti, Mariella Grasso, Elena Zamagni, Angelo Belotti, Mario Boccadoro, Francesca Gay
Summary: Maintenance treatment with carfilzomib plus lenalidomide for two years prolongs progression-free survival in patients with multiple myeloma. However, patients with two or more high-risk cytogenetic abnormalities still have an increased risk of progression and death.
Review
Oncology
Daniela Damiani, Mario Tiribelli
Summary: Despite advances in understanding the biological mechanisms of AML, the prognosis remains poor. The bone marrow microenvironment and immune system play important roles in AML cell persistence and can be targeted for novel therapies. Potential immune-based treatments include monoclonal antibodies, immune checkpoint inhibitors, and cellular therapies. However, identifying optimal targets on leukemic stem cells remains a challenge, impacting the results of ongoing clinical trials.
Article
Oncology
Francesca Palandri, Massimo Breccia, Camilla Mazzoni, Giuseppe Auteri, Elena Maria Elli, Malgorzata M. M. Trawinska, Nicola Polverelli, Mario Tiribelli, Giulia Benevolo, Alessandra Iurlo, Alessia Tieghi, Florian H. H. Heidel, Giovanni Caocci, Eloise Beggiato, Gianni Binotto, Francesco Cavazzini, Maurizio Miglino, Costanza Bosi, Monica Crugnola, Monica Bocchia, Bruno Martino, Novella Pugliese, Mattia Biondo, Marta Venturi, Luigi Scaffidi, Alessandro Isidori, Daniele Cattaneo, Mauro Krampera, Fabrizio Pane, Daniela Cilloni, Gianpietro Semenzato, Roberto M. M. Lemoli, Antonio Cuneo, Elisabetta Abruzzese, Daniela Bartoletti, Simona Paglia, Nicola Vianelli, Michele Cavo, Massimiliano Bonifacio, Giuseppe A. A. Palumbo
Summary: This study explored the prognostic factors of cytopenic myelofibrosis (MF) and found that high molecular risk mutations, intermediate 2/high Dynamic International Prognostic Score System, and intermediate 2/high Myelofibrosis Secondary to Polycythemia Vera and Essential Thrombocythemia Prognostic Model were associated with cytopenic MF. Patients with cytopenia received lower doses of ruxolitinib and had worse treatment outcomes, suggesting the need for alternative therapeutic strategies.
Article
Oncology
Mario Tiribelli, Roberto Latagliata, Massimo Breccia, Isabella Capodanno, Maria Cristina Miggiano, Francesco Cavazzini, Cristina Bucelli, Immacolata Attolico, Sabrina Leonetti Crescenzi, Sabina Russo, Mario Annunziata, Federica Sora, Massimiliano Bonifacio, Olga Mulas, Giuseppina Loglisci, Alessandro Maggi, Gianni Binotto, Elena Crisa, Anna Rita Scortechini, Anna Paola Leporace, Rosaria Sancetta, Pamela Murgano, Elisabetta Abruzzese, Fabio Stagno, Davide Rapezzi, Debora Luzi, Iolanda Vincelli, Monica Bocchia, Carmen Fava, Alessandra Malato, Monica Crugnola, Michele Pizzuti, Francesca Lunghi, Sara Galimberti, Matteo Dalmazzo, Renato Fanin, Emilia Scalzulli, Robin Foa, Alessandra Iurlo, Giuseppe Saglio, Giorgina Specchia
Summary: This study analyzed the use of frontline TKI therapy in Italian patients with CP-CML and found that 55% of patients chose imatinib as their first-line treatment, while second-generation TKIs were predominantly used in younger patients and those without comorbidities.
Review
Biochemistry & Molecular Biology
Daniela Damiani, Mario Tiribelli
Summary: The prognosis of acute myeloid leukemia (AML) remains unsatisfactory due to poor response to therapy or relapse, which can be attributed to the over-expression of multidrug resistance (MDR) proteins. ABCG2, an efflux transporter responsible for inducing MDR in leukemic cells, has the ability to extrude many antineoplastic drugs, leading to AML resistance and/or relapse. This review focuses on the expression and role of ABCG2, as well as its regulation and potential inhibition to counteract drug resistance and improve outcomes in AML patients.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Review
Biochemistry & Molecular Biology
Elisa Parciante, Cosimo Cumbo, Luisa Anelli, Antonella Zagaria, Immacolata Redavid, Angela Minervini, Maria Rosa Conserva, Giuseppina Tota, Nicoletta Coccaro, Francesco Tarantini, Crescenzio Francesco Minervini, Maria Giovanna Macchia, Giorgina Specchia, Pellegrino Musto, Francesco Albano
Summary: NLRP3 is an extensively studied inflammasome member that, when overactivated, can drive several carcinomas. It is activated by different signals and plays a crucial role in metabolic disorders, inflammatory diseases, and autoimmune diseases. NLRP3 belongs to the pattern recognition receptors (PRRs) family, is expressed in various immune cells, and primarily functions in myeloid cells. Investigating the NLRP3 inflammasome complex is a novel horizon for exploration, and inhibiting IL-1 beta or NLRP3 could be a beneficial therapeutic strategy for cancer, improving existing protocols.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Review
Biochemistry & Molecular Biology
Maria Rosa Conserva, Immacolata Redavid, Luisa Anelli, Antonella Zagaria, Francesco Tarantini, Cosimo Cumbo, Giuseppina Tota, Elisa Parciante, Nicoletta Coccaro, Crescenzio Francesco Minervini, Angela Minervini, Giorgina Specchia, Pellegrino Musto, Francesco Albano
Summary: One key process controlling leukemogenesis is the regulation of oncogenic gene expression by transcription factors acting as tumor suppressors. In this review, the role of IKAROS and the molecular pathway involving IKZF1 gene lesions in acute leukemias are discussed. IKAROS, as a zinc finger transcription factor, plays a crucial role in hematopoiesis and leukemogenesis by activating or repressing tumor suppressors or oncogenes. The involvement of IKAROS in both acute lymphoblastic leukemia and acute myeloid leukemia suggests its importance in understanding leukemia pathophysiology and developing targeted treatments.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Review
Oncology
Evangelos Terpos, Pellegrino Musto, Monika Engelhardt, Michel Delforge, Gordon Cook, Francesca Gay, Niels W. C. J. van de Donk, Ioannis Ntanasis-Stathopoulos, Annette Juul Vangsted, Christoph Driessen, Fredrik Schjesvold, Claudio Cerchione, Sonja Zweegman, Roman Hajek, Philippe Moreau, Hermann Einsele, Jesus San-Miguel, Mario Boccadoro, Meletios A. A. Dimopoulos, Pieter Sonneveld, Heinz Ludwig
Summary: In the post-pandemic COVID-19 period, patients with multiple myeloma (MM) are at increased risk for severe COVID-19 outcomes. The European Myeloma Network recommends vaccination with variant-specific booster vaccines every 6-12 months to overcome the emergence of novel strains. Evaluation of immune response after vaccination can identify vulnerable patients who may need additional boosters and preventive measures. Certain antiviral drugs are effective against specific Omicron subvariants and should be administered in MM patients with positive COVID-19 tests or symptoms.
Article
Virology
Davide Fiore Bavaro, Lucia Diella, Alessandra Belati, Giuliana Metrangolo, Laura De Santis, Vito Spada, Michele Camporeale, Angelo Dargenio, Gaetano Brindicci, Flavia Balena, Deborah Fiordelisi, Fabio Signorile, Giacomo Loseto, Crescenza Pasciolla, Carla Minoia, Immacolata Attolico, Tommasina Perrone, Simona Simone, Maria Rendina, Nicoletta Giovine, Francesco Di Gennaro, Pellegrino Musto, Attilio Guarini, Alfredo Di Leo, Loreto Gesualdo, Maria Dell'Aera, Annalisa Saracino
Summary: Remdesivir (REM) and monoclonal antibodies (mAbs) may alleviate severe COVID-19 in at-risk hospitalized patients, particularly in elderly or immunocompromised hosts. The use of REM and mAbs was associated with a reduced risk of severe COVID-19, and the combination therapy was particularly beneficial for immunocompromised patients.
Article
Oncology
Esther Natalie Oliva, Anna Candoni, Prassede Salutari, Giuseppe A. Palumbo, Gianluigi Reda, Giuseppe Ianni, Giovanni Tripepi, Maria Cuzzola, Debora Capelli, Corrado Mammi, Caterina Alati, Maria Concetta Cannata, Pasquale Niscola, Bianca Serio, Pellegrino Musto, Ernesto Vigna, Antonio Volpe, Lorella Maria Antonia Melillo, Maria Teresa Arcadi, Donato Mannina, Maria Elena Zannier, Roberto Latagliata
Summary: Azacitidine (AZA) is a hypomethylating agent used for frontline treatment of acute myeloid leukemia (AML) in patients unfit for intensive chemotherapy. Recent research showed that maintenance therapy with AZA during complete remission improved disease-free survival (DFS) up to 2 and 5 years in AML patients aged >68 years.
Article
Oncology
Roberto Tamma, Giuseppe Ingravallo, Francesco Gaudio, Antonio d'Amati, Pierluigi Masciopinto, Emilio Bellitti, Loredana Lorusso, Tiziana Annese, Vincenzo Benagiano, Pellegrino Musto, Giorgina Specchia, Domenico Ribatti
Summary: Although classical Hodgkin lymphoma (CHL) is generally curable, a significant percentage of patients experience relapse and succumb to the disease. The cellular microenvironment in CHL consists of a small number of H/RS tumor cells surrounded by various inflammatory cells. Understanding the interaction between H/RS cells and immune cells in the microenvironment could lead to new targeted immunotherapies. This study analyzed the microenvironment composition in CHL patients with responsive disease (RESP) and relapsed/refractory disease (REL). The results revealed differences in the abundance of specific immune cells and microvessels between RESP and REL patients.
Review
Biochemistry & Molecular Biology
Daniela Damiani, Mario Tiribelli
Summary: The prognosis of acute myeloid leukemia (AML) is poor due to tumor cell immune escape, which weakens T-cells. Inhibiting immune checkpoints (ICs) through immune checkpoint inhibitors (ICIs) has emerged as a promising therapeutic strategy for AML. However, the results of clinical trials testing ICIs, alone or in combination with other treatments, in AML are conflicting.
Article
Oncology
Francesca Palandri, Elena Rossi, Giuseppe Auteri, Massimo Breccia, Simona Paglia, Giulia Benevolo, Elena M. Elli, Francesco Cavazzini, Gianni Binotto, Alessia Tieghi, Mario Tiribelli, Florian H. Heidel, Massimiliano Bonifacio, Novella Pugliese, Giovanni Caocci, Monica Crugnola, Francesco Mendicino, Alessandra D'Addio, Simona Tomassetti, Bruno Martino, Nicola Polverelli, Sara Ceglie, Camilla Mazzoni, Rikard Mullai, Alessia Ripamonti, Bruno Garibaldi, Fabrizio Pane, Antonio Cuneo, Mauro Krampera, Gianpietro Semenzato, Roberto M. Lemoli, Nicola Vianelli, Giuseppe A. Palumbo, Alessandro Andriani, Michele Cavo, Roberto Latagliata, Valerio De Stefano
Summary: The prognostic relevance of complete response to hydroxyurea, predictors of response, and patients' triggers for switching to ruxolitinib in polycythemia vera are uncertain. Many PV patients receive underdosed hydroxyurea, leading to lower response and toxicity rates. Splenomegaly and other symptoms are the main drivers for early switch to ruxolitinib despite poor response to hydroxyurea.
Article
Oncology
Francesca Palandri, Giuseppe A. Palumbo, Massimiliano Bonifacio, Elena M. Elli, Mario Tiribelli, Giuseppe Auteri, Malgorzata M. Trawinska, Nicola Polverelli, Giulia Benevolo, Alessia Tieghi, Fabrizio Cavalca, Giovanni Caocci, Eloise Beggiato, Gianni Binotto, Francesco Cavazzini, Maurizio Miglino, Costanza Bosi, Monica Crugnola, Monica Bocchia, Bruno Martino, Novella Pugliese, Marta Venturi, Alessandro Isidori, Daniele Cattaneo, Mauro Krampera, Fabrizio Pane, Daniela Cilloni, Gianpietro Semenzato, Roberto M. Lemoli, Antonio Cuneo, Elisabetta Abruzzese, Filippo Branzanti, Nicola Vianelli, Michele Cavo, Florian Heidel, Alessandra Iurlo, Massimo Breccia
Summary: Predictors of early discontinuation of ruxolitinib therapy and death on therapy were investigated in patients with myelofibrosis. Low platelet and hemoglobin levels, primary myelofibrosis, no spleen response at 3 months, and low starting dose of ruxolitinib were associated with a higher probability of therapy failure. A predictive model was built to identify patients at higher risk of failure with ruxolitinib monotherapy, who should consider alternative frontline strategies.
