1,721,234 research outputs found
How do we sequence therapy for marginal zone lymphomas?
No full textMarginal zone lymphomas are indolent diseases. Overall survival rates are very good, but patients tend to relapse and may do so several times. The concept of treatment sequencing is therefore important and necessary to preserve adequate organ function and to avoid excessive toxicity, with the final goal of achieving long survival times. Systemic treatments and chemotherapy are considered to be an option in multiply relapsing disease, in cases that are in an advanced stage at presentation or relapse, and in cases where initial local treatments lack efficacy. Targeted agents and new drugs can provide chemotherapy-free alternatives in heavily pretreated patients
Radioimmunotherapy: Is There Any Future Role?
No full textRadioimmunotherapy targeting CD20 with 90 yttrium-ibritumomab tiuxetan (90 Y-IT) is approved for the treatment of relapsed and refractory follicular lymphoma patients. Radioimmunotherapy has also been explored as a component of the chemotherapy administered in preparation to autologous stem cell transplantation. The use of 90 Y-IT has significantly declined in the last decade after an initial excitement, mainly because of logistic and commercial reasons. 117-lutetium (117 Lu) lilotomab satetraxetan (117 Lu-LS) is an anti-CD37 murine monoclonal antibody (lilotomab) linking to the beta-emitter 117 Lu was granted fast track designation for relapsed and refractory follicular lymphoma by the Food and Drug Administration in June 2018 and for patients with marginal zone lymphoma who have failed at least two prior therapies in June 2020. Interest in agents targeting CD37 may help invigorate interest in the use of radioimmunoconjugates
Invited Review: Will Consolidation with ASCT Be a Thing of the Past for MCL and PTCL?
No full textPurpose of Review: The treatment landscape of mantle cell (MCL) and peripheral T-cell lymphomas (PTCL) is rapidly changing; however, despite improvement in patients’ survival, they still remain a largely incurable diseases. Treatment choice is dependent on patient factors, prior therapy, remission duration, and candidacy for stem cell transplantation (SCT). There are subsets of high-risk patients who do not benefit substantially from autologous SCT (ASCT) and for whom alternative targeted approaches are being examined. Here, we critically analyze the actual role of ASCT in PTCL and MCL. Recent Findings: Research in areas of maintenance therapy and minimal residual disease is ongoing to identify MCL patients who may not require ASCT for durable response. Moreover, there are subsets of high-risk MCL patients who do not benefit substantially from ASCT and for whom alternative, targeted approaches are being examined. Much less clear evidence exists regarding the impact of consolidative ASCT in PTCL, mainly for the heterogeneity of these lymphomas: it is still controversial whether patients who achieved a complete response significantly take advantage of this procedure over active surveillance only. Summary: Several clinical and biologic markers are available to predict prognosis; however, despite improvements in outcomes, standard therapeutic approaches have not been able to overcome high-risk disease features for PTCL and MCL. Thus, the need of ASCT for these diseases is still matter of debate among hematologists
T-Cell Lymphoproliferative Disorders
No full textT-cell lymphoproliferative disorders, a group of neoplastic disease that result from the clonal proliferation of mature post-thymic T-lymphocytes, are classified on the basis of their clinical behaviour (indolent or aggressive) and presentation (nodal, extranodal and leukaemic diseases). They are infrequent diseases, with a peculiar geographic distribution, and they represent a big challenge for haematologists, since their prognosis is still rather disappointing with the currently available treatment strategies. A precise clinical diagnosis and histological classification is important in terms of patient management, prognosis and therapy. The application of molecular techniques and immunological markers has clarified some aspects of the pathogenesis of these diseases and has provided the rationale for the development of new specific treatment approaches, which are now being tested in international clinical trials
Peripheral T‐cell lymphomas
No full textThe treatment of peripheral T-cell lymphomas is challenging, as they often display a severe prognosis and lack effective treatment strategies. We will try to answer three burning questions: can we differentiate the initial treatment based on the histotype and the clinical presentation of peripheral T-cell lymphoma patients? Do we require an autologous stem cell transplantation in all patients? Is there room for improvement in the setting of relapsed and refractory disease?
Emerging New Small Molecules in Peripheral T‐cell Lymphomas
No full textSurvival outcomes for patients with peripheral T-cell lymphomas (PTCLs) who relapse or progress after first-line treatment are very poor. Newer agents targeting specific molecular hallmarks of the disease entities are urgently needed and may represent a rational approach to improve the treatment for patients with relapsed and refractory PTCL. This chapter reviews the mechanisms of action and the potential clinical role of some of the more promising emerging new small molecules. The Janus-associated kinase-signal transducers and activators of transcription (JAK-STAT) pathway is commonly deregulated in PTCL and mutations in the JAK and STAT system in T-cell neoplasms have been detected in the SH2 domain of STAT3 and STAT5 and in the pseudokinase domain of JAK1 and JAK3. The phosphatidylinositol 3 kinases may represent an important class of drugs that require further study in the T-cell malignancies
Costruire la fiducia in classe attraverso la promozione di pratiche valutative formative e condivise.
No full textQuattro passi nella speranza. Interventi educativi per ragazzi difficili
No full textIl saggio struttura una riflessione in quattro tappe; tratteggia preliminarmente, come origine della speranza i tratti del 'desiderio' in Heidegger introducendo il carattere pedagogico del desiderio come motore del sapere e della conoscenza; successivamente si sofferma sul pensiero agostiniano in cui il desiderio, e la speranza che ne deriva, trova una via e un approdo In Cristo e nel riposo confidente in Dio.
Nel contesto specifico dell'educazione però la speranza si traduce in esperienza educativa concreta in risposta a di-sperazione, rassegnazione e cinismo. Nella misura in cui l'adulto perderà la fonte del senso dell'esistenza e tenderà ad inaridire, il minore non troverà luoghi a cui abbeverarsi e si perderà nel processo di individuazione. Questo terzo punto richiamerà l'opera di P. Bertolini e le fondamenta del lavoro educativo coni ragazzi difficili.
Questa esperienza si intreccia infine con l'opera di A. Alfano che negli anni Novanta ha formulato un intervento educativo per minori con procedimenti penali attuato a Roma e a Napoli e tuttora in essere
Sapienza e saggezza: linee guida inattuali per l’educazione in età adulta nei contesti professionali, del tempo libero e dell’impegno civile
No full textSi propone una riflessione sui costrutti di sapienza e di saggezza in prospettiva educativa, considerandoli inattuali nella misura in cui interpretano istanze che, nella temperie storico-culturale che stiamo vivendo, non paiono essere quelle richieste o valorizzate, se non in termini retorici o estremamente vaghi. Se, infatti, a livello di generici proclami, sapienza e saggezza sono non solo valori da ammirare, ma anche degli ideali ai quali ambire, di fatto e in svariate circostanze vengono disattesi, se non ostacolati o addirittura negati. Ci riferiamo, in particolare, a diversi contesti professionali, del tempo libero e dell’impegno politico-sociale che, nel nome dell’utilitarismo, della performance, del presenzialismo e dell’adesione ai trend più diffusi sviliscono la potenziale portata educativa di situazioni, relazioni o vere e proprie attività formative. Significare la sapienza e la saggezza quali linee guida per l’educazione degli adulti, invece, consente di mettere a tema gli aspetti sostanziali del processo educativo e delle sue caratteristiche/finalità peculiari: qualità della vita, cura, condivisione, solidarietà, bellezza, sviluppo individuale e civile.We introduce some reflections on the concepts of knowledge and wisdom in educational perspective, considering them upstream because they interpret instances that, to this day, do not seem to be those required or appreciated, if not in rhetorical or extremely vague terms. In particular, we refer to various professional, leisure and community involvement contexts, which, in the name of utilitarianism, performance, presenteeism and adherence to mainstream trends demean the potentiality of education that can be found in different situations, relationships or training activities. On the other hand, to give meaning to knowledge and wisdom as guidelines for adult education makes it possible to focus on the substantial aspects of the educational process and its peculiar characteristics/purposes: quality of life, care, sharing, solidarity, beauty, personal and community development
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