Umberto Falcone
Seconda Università degli Studi di Napoli
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Featured researches published by Umberto Falcone.
Leukemia Research | 2009
Salvatore Guastafierro; Umberto Falcone; Maria Celentano; Milena Coppola; Maria Giovanna Ferrara; Antonello Sica
Imatinib mesylate (IM) therapy leads to a complete cytogenetic response (CCyR) in 75-90% of Chronic Myeloid Leukemia (CML) patients in chronic phase, but only a small percentage of patients achieve complete molecular response (CMR). Very little is known about IM discontinuation. We report the case of a 20-years-old male patient in chronic phase CML who maintained undetectable BCR/ABL mRNA levels, despite IM discontinuation over a period of 15 months after achieving CMR. Our patient reached CCyR and CMR after 3 and 6 months of IM treatment, respectively. We also reviewed the published literature concerning cases of IM discontinuation.
The American Journal of the Medical Sciences | 2009
Giuseppe Colella; Amerigo Giudice; Umberto Falcone; Giovanni Siniscalchi; Salvatore Guastafierro
The numb chin syndrome (NCS) is characterized by facial numbness along the distribution of the mental branch of the trigeminal nerve. Most cases of this syndrome that are not dental in origin have been associated with malignant tumors or diffuse metastatic disease, particularly with underlying lymphoproliferative diseases and breast cancer. NCS can appear together with other signs of neoplastic dissemination or constitute the presenting symptom of the disease. The appearance of this mental nerve neuropathy should be considered as a significant symptom for clinicians, and investigations to detect a possible cancer should be mandatory. We report 12 patients with the NCS as the presenting and isolated symptom of a generalized malignancy.
International Journal of Hematology | 2008
Salvatore Guastafierro; Umberto Falcone; Maria Celentano; Salvatore Cappabianca; Amerigo Giudice; Giuseppe Colella
The evaluation of tongue swellings often represents a diagnostic challenge, because of the wide spectrum of benign and malignant possible lesions. We report a case of a patient presenting a tongue mass. An incisional biopsy was performed. Diagnosis of primary Mantle Cell non-Hodgkin’s Lymphoma of the tongue was made by histological, immunohistochemical and cytogenetic studies. Our patient was treated with Rituximab–Cyclophosphamide, Epirubicine, Vincristine, Prednisone polychemotherapy plus Rituximab as single agent maintenance. Complete remission was achieved and no relapse has occurred during a follow-up of 53 months. We emphasize the importance of including also NHL in differential diagnosis of a tongue mass.
Leukemia Research | 2012
Salvatore Guastafierro; Maria Giovanna Ferrara; Antonello Sica; Rita Rosaria Parascandola; Sara Santangelo; Umberto Falcone
A double monoclonal component (MC) detected in the serum and/or urine represents a very rare occurrence (2-6% of monoclonal gammopathies). In this study, we report 34 patients with double serum MCs, focusing on the associated diseases. The diagnosis was made using high-resolution serum protein electrophoresis and immunofixation. Of the 1214 patients with monoclonal gammopathies, 49 had a double MC but only 34 (2.8%) were included in our study. A double MC was associated with hematological malignancies in 20/34 cases. Based on our experience, a double MC is more often associated with other diseases, especially an oncohematological one.
European Journal of Haematology | 2013
Salvatore Guastafierro; Umberto Falcone; Giuseppe Colella
A 56-year-old woman presented with dyspnea and a large swelling in the upper vestibular region (Fig. 1A), which appeared 6 weeks before and continued to grow. Physical examination suggested pleural effusion, subsequently confirmed by chest X-ray (Fig. 1B). Complete blood cell count and biochemistry values were all within normal ranges, except for LDH (2620 IU/L) and b2-microglobulin (9.4 mg/L). A gingival biopsy and the following histological and immunohistochemical examinations showed a diffuse infiltration by cells with a blastic appearance, with high mitotic rate. They were CD45+, CD68+, lysozyme+, myeloperoxidase+, CD34 , S100 , CD3 , CD10 , CD19 , CD20 , CD30 , CD56 , CD79a , and chloroacetate esterase . Bone marrow aspirate and biopsy, and also the lumbar puncture were negative for leukemic infiltration. Thoracentesis showed 82% myeloid blasts in the pleural fluid. The final diagnosis was non-leukemic myeloid sarcoma (MS). Induction chemotherapy was started, but the patient got worse and she died immediately. MS is a rare hematologic malignancy occurring as extramedullary mass composed of myeloid lineage cells. It develops in 2–8% of patients with acute myeloid leukemia (AML) and, less commonly, in patients with myelodysplastic or myeloproliferative disorders. Very rarely, MS occurs without evidence of AML also after an extensive work-up, representing a diagnostic challenge. The neoplasm may involve a wide variety of sites, including gastrointestinal tract, upper respiratory tract, mediastinum, breast, bones, skin, female genital tract, urinary bladder, and testis. MS in the head and neck has been reported in 16% of cases, and it is usually limited to the periosteum and soft tissues of the orbit, nasal cavity, and paranasal sinus, but it is rare in the oral cavity. In the clinical practice, intraoral non-leukemic MS is often misdiagnosed as NHL (1) or, less frequently, as Ewing’s sarcoma. The majority of MS variants can be diagnosed with an immunohistochemical panel including MPO, lysozyme, CD43, CD117, CD68 (or CD163), CD3, and CD20 (2). The high rate of misdiagnosis often delays the correct treatment. Patients with non-leukemic MS achieve the best results (EFS and OS) with an early start of antiAML therapy (3), because neither surgery nor radiotherapy improves the prognosis.
Acta Haematologica | 2012
Salvatore Guastafierro; Amando Tedeschi; Clelia Criscuolo; Maria Celentano; Luigi Cobellis; Raffaele Rossiello; Umberto Falcone
Primary lymphoma of the female genital tract is very rare. We report the case of a 36-year-old woman who was referred to our hospital because of an indeterminate Pap smear test. The colposcopy showed a thickening of the posterior vaginal wall and various irregular ulcerated nodular lesions. Histological examination, immunohistochemistry and the staging procedures were conclusive of diffuse large B-cell lymphoma of the vagina, stage IEA. Complete remission was achieved after 6 cycles of immunopolychemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone). No relapse has occurred during a follow-up of 71 months. Moreover, we reviewed the 62 previously reported cases of primary extranodal non-Hodgkin’s lymphoma of the vagina, focusing on clinicopathological and therapeutic aspects, to better characterize this unusual disease.
The American Journal of the Medical Sciences | 2011
Salvatore Guastafierro; Umberto Falcone; Luca Petriccione; Luigi Rossiello; Salvatore Cappabianca; Raffaele Rossiello; Giuseppe Colella
Nearly 25% of non-Hodgkin lymphomas (NHLs) arise in extranodal locations. The involvement of soft tissue by NHL is uncommon. Primary extranodal NHL of the skeletal muscle is even rarer. The authors report a 49-year-old man with a 3-month history of progressive asymmetry of the face caused by swelling in the right cheek with paresthesia and burning. He underwent an excisional biopsy of the lesion. Histologic examination, immunohistochemistry and cytogenetic analysis were performed. The final diagnosis was primary large B-cell NHL of the masseter muscle, stage IEA. Rituximab-cyclophosphamide, epirubicin, vincristine and prednisone regimen was started. Restaging procedures after immunopolychemotherapy showed no evidence of disease. No relapse has occurred during a follow-up of 72 months. Although primary muscle lymphoma represents a rare entity, it can involve every muscle. Thus, when patients present with cheek swelling, physicians should always consider the possibility of lymphoma. The authors also reviewed the published literature concerning primary muscle lymphoma.
Leukemia Research | 2014
Salvatore Guastafierro; Antonello Sica; Rita Rosaria Parascandola; Maria Giovanna Ferrara; Anna Di Martino; Luciano Pezone; Umberto Falcone
A serum multiple monoclonal component (MC) is very rare. We here report 6 patients with 3 MCs. The triple MC was detected in all of them by immunofixation. 2/6 patients did not present hematological or oncological associated disease, while in the remaining 4, Waldenström macroglobulinaemia (2 cases), Polycythemia Vera and non-Hodgkin lymphoma were diagnosed. Of the 49 global patients reported in the literature (6+43), 64.6% had a lymphoproliferative disorder and only in 3 cases there was no associated disease. Therefore, the detection of such laboratory evidence should propel physicians to a deeper investigation.
The American Journal of the Medical Sciences | 2015
Umberto Falcone; Rita Rosaria Parascandola; Maria Giovanna Ferrara; Antonello Sica; Anna Di Martino; Salvatore Guastafierro
A 73-year-old woman presented with a rapidly growing bilateral orbital swelling, causing diplopia and epiphora. During physical examination, there were exophthalmos and orbital edema, both more prominent in the right eye (Figures 1A and 1B). The conjunctiva of both eyes was swollen. The lesions extended to the right iris and partially covered the left one. Computed tomography revealed, in both eyes, a mass (right eye: 2.7 cm 3 2.14 cm; left eye: 1.88 cm 3 1 cm) involving the lacrimal gland and adjacent to the superior rectus and lateral rectus muscles. Histological and immunohistochemical analyses showed a population of small atypical lymphocytes, with slightly irregular indented nuclei and moderately dispersed chromatin. Malignant cells were CD19+, CD20+, CD5+, CD232, CD102, and hyperexpression of cyclin D1 was detected. Cytogenetic analysis demonstrated the presence of a complex karyotype: t(11; 14)(q13; q32), t(7; 10)(q21; p12), dup (11)(q25, q13), and 217. The final diagnosis was mantle cell lymphoma (MCL), stage IV-A. The patient underwent 6 cycles of R-GIFOX (Rituximab-Gemcitabine, Ifosfamide, Oxaliplatin) achieving a complete response. Unfortunately, 18 months later, her disease relapsed (although at a different site), and she died 29 months after the initial diagnosis. Ocular adnexal lymphoma (OAL) accounts for approximately 1% to 2% of all non–Hodkgin’s lymphomas (NHL). OAL comprises both primary extranodal NHL and secondary involvement in systemic lymphomas. Although mucosa-associated lymphoid tissue represents the most common histology, MCL is observed in only very small percentages. MCL represents between 2% to 10% of all NHLs, and it has often an aggressive clinical behavior. The chromosomal translocation t(11; 14)(q13, q32), that juxtaposes the cyclin D1 and the immunoglobulin heavy chain genes, is detected in almost all cases, and it represents the molecular hallmark of MCL. The aim of treatment for younger patients still remains a long-lasting complete remission. In elderly patients treatment still represents a challenge. For fit elderly patients, long progression-free survival and molecular remissions are possible, whereas for the frail patients, the treatment should aim at reducing symptoms and maintaining quality of life (3).
Gastroenterology Research | 2013
Ag Gravina; Alessandro Federico; Antonello Sica; Fp D’Armiento; Mg Ferrara; Umberto Falcone; Marcello Dallio; Domenico Cozzolino; Salvatore Guastafierro; C. Loguercio; Marco Romano
We describe an unusual case (a 79-year-old woman) of secondary extramedullary plasmacytoma (EMP) involving the duodenum. While all the previously reported cases of duodenal involvement by EMP (namely 20 cases) were characterized by the presence of ulcerative masses or ischemic necrotic lesions, in our case EMP led to the unusual finding of several non-polypoid lesions with a depressed central area. The final diagnosis was multiple myeloma IgA lambda, stage II A, with secondary duodenal EMP. To our knowledge this is the first report showing duodenal involvement by EMP with the aspect of multiple non-polypoid lesions.