Massimo Eraldo Abate
@santobonopausilipon.it
Director of Pediatric Oncology Dept
Santobono-Pausilipon Children Hospital
EDUCATION
University of Bologna Medical Degree 1989
University of Bologna, Specialization School of Pediatrics Board of Pediatrics 1993
University of Paris XI Diplome of Pediatric Oncology 2000
University of Bologna II Level Master 2015
RESEARCH INTERESTS
Bone and soft tissues sarcoma (all fields)
Neuroblastoma (new drug development)
Pediatric Rare Tumors (all fields)
Scopus Publications
Scopus Publications
Francesco Fiz, Gianluca Bottoni, Martina Ugolini, Sergio Righi, Alessio Cirone, Maria Carmen Garganese, Antonio Verrico, Andrea Rossi, Claudia Milanaccio, Antonia Ramaglia,et al.
Springer Science and Business Media LLC
Emma Coppola, Giuliana Giardino, Massimo Abate, Francesco Paolo Tambaro, Delfina Bifano, Elisabetta Toriello, Antonio De Rosa, Francesca Cillo, Claudio Pignata, and Emilia Cirillo
Frontiers Media SA
Background and aimsWiskott–Aldrich syndrome (WAS) is an X-linked recessive primary immunodeficiency disorder characterized by severe eczema, recurrent infections, and micro-thrombocytopenia. Allogeneic hematopoietic stem cell transplantation (HSCT) is a potentially curative therapeutic option for patients with classic form. The risk of developing post-transplant tumors appears to be higher in patients with WAS than in other inborn errors of immunity (IEIs), but the actual incidence is not well defined, due to the scarcity of published data.MethodsHerein, we describe a 10-year-old patient diagnosed with WAS, treated with HSCT in the first year of life, who subsequently developed two rare solid tumors, kaposiform hemangioendothelioma and desmoid tumor. A review of the literature on post-HSCT tumors in WAS patients has been performed.ResultsThe patient received diagnosis of classic WAS at the age of 2 months (Zhu score = 3), confirmed by WAS gene sequencing, which detected the nonsense hemizygous c.37C>T (Arg13X) mutation. At 9 months, patient underwent HSCT from a matched unrelated donor with an adequate immune reconstitution, characterized by normal lymphocyte subpopulations and mitogen proliferation tests. Platelet count significantly increased, even though platelet count never reached reference values. A mixed chimerism was also detected, with a residual WASP− population on monocytes (27.3%). The patient developed a kaposiform hemangioendothelioma at the age of 5. A second abdominal tumor was identified, histologically classified as a desmoid tumor when he reached the age of 10 years. Both hematopoietic and solid tumors were identified in long-term WAS survivors after HSCT.ConclusionHere, we describe the case of a patient with WAS who developed two rare solid tumors after HSCT. An active surveillance program for the risk of tumors is necessary in the long-term follow-up of post-HSCT WAS patients.
Pietro Spennato, Lucia De Martino, Carmela Russo, Maria Elena Errico, Alessia Imperato, Federica Mazio, Giovanni Miccoli, Lucia Quaglietta, Massimo Abate, Eugenio Covelli,et al.
Springer International Publishing
Emanuela Palmerini, Cristina Meazza, Angela Tamburini, Gianni Bisogno, Virginia Ferraresi, Sebastian D. Asaftei, Giuseppe M. Milano, Luca Coccoli, Carla Manzitti, Roberto Luksch,et al.
Wiley
According to retrospective osteosarcoma series, ABCB1/P‐glycoprotein (Pgp) overexpression predicts for poor outcomes. A prospective trial to assess a risk‐adapted treatment strategy using mifamurtide in Pgp+ patients was performed.
Giovanni Torino, Agnese Roberti, Francesco Turrà, Vittoria Donofrio, Delfina Bifano, Massimo Abate, and Giovanni Di Iorio
Elsevier BV
Giacomo Talenti, Stefania Picariello, Caroline Robson, Livja Mertiri, Carmela Russo, Olga Slater, Sotirios Bisdas, Massimo Eraldo Abate, Silverio Perrotta, Richard Hewitt,et al.
Springer Science and Business Media LLC
Giacomo Talenti, Stefania Picariello, Caroline Robson, Livja Mertiri, Carmela Russo, Olga Slater, Sotirios Bisdas, Massimo Eraldo Abate, Silverio Perrotta, Richard Hewitt,et al.
Springer Science and Business Media LLC
R. Fabbri, R. Vicenti, R. Paradisi, MariaMacciocca, ValentinaMagnani, L. DeMeis, S. Rossi, M. Abate, S. Benini and R. Seracchioli
MRE Press
Background: Ovarian tissue cryopreservation (OTC) is a valid procedure that may allow to preserve endocrine and reproductive health in girls and young women at high risk of premature ovarian failure. At disease remission, the OTC may be transplanted in the woman, allowing recovery of the production of oocytes and reproductive hormones. Case: This report describes the case of a Ewing Sarcoma/Primitive Neuroectodermal Tumor (ES/PNET) survivor who cryopreserved ovarian tissue after the first line of chemotherapy. After completion of treatment the patient experienced premature ovarian failure. Seven years later ovarian tissue autotransplantation was performed and ovarian function recovery was obtained in a few months. The woman had a shoulder ES/PNET recurrence and restarted the chemotherapy. The menstrual cycle reappeared 4 months after the second line of treatment and the patient spontaneously conceived 10 months later giving birth to a healthy girl. Conclusions: In malignancies OTC performed even after the start of chemotherapy seems to be effective in preserving fertility and allows more women to become candidates for ovarian function preservation.
Adele Civino, Giovanni Alighieri, Eleonora Prete, Anna Maria Caroleo, Silvia Magni-Manzoni, Luciana Vinti, Micol Romano, Nicola Santoro, Giovanni Filocamo, Tamara Belotti,et al.
Elsevier BV
Massimo E. Abate, Silvia Cammelli, Letizia Ronchi, Barbara Diletto, Lorenza Gandola, Anna Paioli, Alessandra Longhi, Emanuela Palmerini, Nadia Puma, Angela Tamburini,et al.
MDPI AG
Purpose: To analyze toxicity and outcome predictors in Ewing sarcoma patients with lung metastases treated with busulfan and melphalan (BU-MEL) followed by whole-lung irradiation (WLI). Methods: This retrospective study included 68 lung metastatic Ewing Sarcoma patients who underwent WLI after BU-MEL with autologous stem cell transplantation, as part of two prospective and consecutive treatment protocols. WLI 12 Gy for <14 years old and 15 Gy for ≥14 years old patients were applied at least eight weeks after BU-MEL. Toxicity, overall survival (OS), event-free survival (EFS) and pulmonary relapse-free survival (PRFS) were estimated and analyzed. Results: After WLI, grade 1–2 and grade 3 clinical toxicity was reported in 16.2% and 5.9% patients, respectively. The five-year OS, EFS and PRFS with 95% confidence interval (CI) were 69.8% (57.1–79.3), 61.2% (48.4–71.7) and 70.5% (56.3–80.8), respectively. Patients with good histological necrosis of the primary tumor after neoadjuvant chemotherapy showed a significant decreased risk of pulmonary relapse or death compared to patients with poor histological necrosis. Conclusions: WLI at recommended doses and time interval after BU-MEL is feasible and might contribute to the disease control in Ewing sarcoma with lung metastases and responsive disease. Further studies are needed to explore the treatment stratification based on the histological response of the primary tumor.
Emanuela Palmerini, Elisa Torricelli, Stefano Cascinu, Michela Pierini, Massimiliano Paolis, Davide Donati, Marilena Cesari, Alessandra Longhi, Massimo Abate, Anna Paioli,et al.
Wiley
High‐grade bone osteosarcoma has a high relapse rate. The best treatment of local recurrence (LR) is under discussion. The aim of this study is to analyze LR patterns and factors prognostic for survival.
Lucia De Martino, Piero Spennato, Simona Vetrella, Maria Capasso, Carolina Porfito, Serena Ruotolo, Massimo Eraldo Abate, Giuseppe Cinalli, and Lucia Quaglietta
Springer Science and Business Media LLC
Marilena Cesari, Alberto Righi, Marco Colangeli, Marco Gambarotti, Paolo Spinnato, Andrea Ferraro, Alessandra Longhi, Massimo Eraldo Abate, Emanuela Palmerini, Anna Paioli,et al.
Wiley
Ewing sarcoma (ES) is the second most common bone tumor in adolescents and children. Staging workup for ES includes imaging and bone marrow biopsy (BMB). The effective role of BMB is now under discussion.
Alessandra Longhi, Anna Paioli, Emanuela Palmerini, Marilena Cesari, Massimo E. Abate, Elisabetta Setola, Paolo Spinnato, Davide Donati, Ivar Hompland, and Kjetil Boye
Informa UK Limited
Osteosarcoma is a rare bone tumor that occurs in young adults with a subsequent peak in the fifth decade. Neoadjuvant and adjuvant chemotherapy and surgery cure approximately 60% of patients with l...
LETIZIA RONCHI, MILLY BUWENGE, ANNALISA CORTESI, ILARIO AMMENDOLIA, REZARTA FRAKULLI, MASSIMO E. ABATE, ALESSANDRA ARCELLI, COSTANZA M. DONATI, GABRIELLA MACCHIA, ALESSIO G. MORGANTI,et al.
Anticancer Research USA Inc.
Background/Aim: Whole lung irradiation (WLI) represents standard therapy for patients with pulmonary metastases from Ewing sarcoma although the impact on clinical outcomes and toxicity is still unclear. The aim of this study was to evaluate toxicity after WLI in patients with Ewing sarcoma and osteosarcoma as well as overall survival (OS) and event-free survival (EFS). Materials and Methods: A systematic review of studies on bilateral pulmonary irradiation treatments for prophylactic or curative therapy was performed based on PRISMA methodology. Data base searches on PubMed and Cochrane Library from the earliest time possible through 31st March 2018 were carried out. Combination with other treatments, such as chemotherapy and surgery were allowed. Only articles published in English were considered. Results: Toxicity was evaluated in 13 of the 14 analyzed studies (640 patients). Reported lung acute toxicity grade ≥3 ranged between 0.0 and 12.2%. Three studies reported 12 cases (1.8%) of severe pneumonitis. Grade ≥2 late toxicity was mainly recorded in patients who received boost irradiation, previous thoracic surgery, chemotherapy or who were smokers. Lack of a significant impact of WLI on OS was reported in comparative studies although patients treated with WLI showed higher survival in most individual studies. Conclusion: Although the rate of severe toxicity was very low, the real impact of WLI on patients' outcomes remains unproven, probably due to the narrow dose limits that can be delivered to the whole lung parenchyma. New strategies to prevent or treat lung metastases in these patients should be tested. Ultra-fractionated radiotherapy concurrent with modern chemotherapy protocols could be tested in this setting due to the chemo-sensitizing effect and negligible radio-induced toxicity of fraction doses <0.5 Gy.
E. Palmerini, R. L. Jones, E. Setola, P. Picci, E. Marchesi, R. Luksch, G. Grignani, M. Cesari, A. Longhi, M. E. Abate,et al.
Informa UK Limited
Abstract Background: Data on temozolomide (TEM) and irinotecan (IRI) activity in recurrent Ewing sarcoma (EWS), especially in adult patients, are limited. Methods: Patients receiving TEM 100 mg/m2/day oral, and IRI 40 mg/m2/day intravenous, days 1–5, every 21 days, were included in this multi-institutional retrospective study. Disease control rate (DCR) [overall response rate (ORR) [complete response (CR) + partial response (PR)] + stable disease (SD)], 6-months progression-free survival (6-mos PFS) and 1-year overall survival (OS) were assessed. Results: The median age of the 51 patients was 21 years (range 3–65 years): 34 patients (66%) were adults (≥18 years of age), 24 (48%) had ECOG 1 and 35 (69%) were presented with multiple site recurrence. TEMIRI was used at first relapse/progression in 13 (25%) patients, while the remainder received TEMIRI for second or greater relapse/progression. Fourteen (27%) patients had received prior myeloablative therapy with busulfan and melphalan. We observed five (10%) CR, 12 (24%) PR and 19 (37%) SD, with a DCR of 71%. 6-mos PFS was 49% (95% CI 35–63) and it was significantly influenced by ECOG (6-mos PFS 64% [95% CI 45–83] for ECOG 0, 34% [95% CI 14–54] for ECOG ≥1; p = .006) and LDH (6-mos PFS 62% [95% CI 44–79] for normal LDH, 22% [95% CI 3–42] for high LDH; p = .02), with no difference according to line of treatment, age and metastatic pattern. One-year OS was 55% (95% CI 39–70), with RECIST response (p = .001) and ECOG (p = .0002) independently associated with outcome. Grade 3 and 4 toxicity included neutropenia in 12% of patients, thrombocytopenia in 4%, diarrhea in 4%. Conclusions: This series confirms the activity of TEMIRI in both adults and pediatric patients. This schedule offers a 71% DCR, independently of the line of chemotherapy. Predictive factors of response are ECOG and LDH.
Massimo Eraldo Abate, Anna Paioli, Sivlia Cammelli, Marilena Cesari, Alessandra Longhi, Emanuela Palmerini, Stefano Ferrari, Elisa Carretta, Piero Picci, and Fabio Piscaglia
Springer Science and Business Media LLC
Emanuela Palmerini, Pietro Ruggieri, Andrea Angelini, Stefano Boriani, Domenico Campanacci, Giuseppe M. Milano, Marilena Cesari, Anna Paioli, Alessandra Longhi, Massimo E. Abate,et al.
SAGE Publications
Purpose: Aneurysmal bone cyst (ABC) is a rare skeletal tumor usually treated with surgery/embolization. We hypothesized that owing to similarities with giant cell tumor of bone (GCTB), denosumab was active also in ABC. Methods: In this observational study, a retrospective analysis of ABC patients treated with denosumab was performed. Patients underwent radiologic disease assessment every 3 months. Symptoms and adverse events were noted. Results: Nine patients were identified (6 male, 3 female), with a median age of 17 years (range 14–42 years). Primary sites were 6 spine–pelvis, 1 ulna, 1 tibia, and 1 humerus. Patients were followed for a median time of 23 months (range 3–55 months). Patients received a median of 8 denosumab administrations (range 3–61). All symptomatic patients had pain relief and 1 had paresthesia improvement. Signs of denosumab activity were observed after 3 to 6 months of administration: bone formation by computed tomography scan was demonstrated in all patients and magnetic resonance imaging gadolinium contrast media decrease was observed in 7/9 patients. Adverse events were negligible. At last follow-up, all patients were progression-free: 5 still on denosumab treatment, 2 off denosumab were disease-free 11 and 17 months after surgery, and the last 2 patients reported no progression 12 and 24 months after denosumab interruption and no surgery. Conclusions: Denosumab has substantial activity in ABCs, with favorable toxicity profile. We strongly support the use of surgery and/or embolization for the treatment of ABC, but denosumab could have a role as a therapeutic option in patients with uncontrollable, locally destructive, or recurrent disease.
Rezarta Frakulli, Silvia Cammelli, Fabrizio Salvi, Damiano Balestrini, Antonella Baldissera, Claudio Degli Esposti, Ombretta Martelli, Massimo Abate, Anna Piaoli, Stefano Ferrari,et al.
AME Publishing Company
Cardiac metastases from sarcoma are uncommon. Due to their rarity there is not a standard of care. However, complete cardiac metastases resection is the best option but most of patients has widespread disease. In these patients palliative radiotherapy (RT) might improve symptoms and prevent further cardiac function decline. Here we present the case of a symptomatic 30-year-old woman with spindle cell sarcoma metastasis of right ventriculum and widespread disease. The patient received radiotherapy to the heart with palliative intent. Cardiac metastases represent a challenging clinic problem. Treatment should be individualized in a multidisciplinary setting, when possible surgery seems to be the best options. However, radiotherapy even in case of widespread disease can improve clinical control symptoms by reducing the mass effect.
Marilena Cesari, Alberto Righi, Luca Cevolani, Emanuela Palmerini, Daniel Vanel, Davide M. Donati, Silvia Cammelli, Marco Gambarotti, Cristina Ferrari, Anna Paioli,et al.
SAGE Publications
Purpose Patients with Ewing sarcoma who are 40 years old or older are usually excluded from clinical trials. For this reason, information on this subset of patients is limited. Methods Clinical characteristics and treatment-related variables of patients aged 40 years or more, with a diagnosis of Ewing sarcoma, treated at the authors’ institution had been prospectively collected since 1999. Results Thirty-one patients were identified, with ages ranging from 40 to 70 years (median 45 years). Twenty-six (84%) had localized disease, 4 patients presented with lung metastases, and 1 patient had multiple metastases (bone, lung, abdominal nodes, and bone marrow). The primary tumors were skeletal in 19 (61%) patients, while 12 (39%) had extraskeletal disease. All patients received chemotherapy according to regimens similar to those adopted in younger patients, based on doxorubicin, cyclophosphamide, etoposide, vincristine, dactinomycin, and ifosfamide. All patients experienced grade 4 leukopenia (100%); red blood cells or platelets transfusions were needed in 50% and 16% of patients, respectively. Toxicity-related dose reduction was required in 13 patients (43%). The 5-year overall survival (OS) was 54% for the whole group. In patients with complete remission, 5-year disease-free survival was 57%. Survival was different for patients with skeletal and extraskeletal Ewing sarcoma (5-year OS: 64% vs 40%, p = 0.2). Conclusions In older patients, the incidence of extraskeletal Ewing sarcoma is high. Intensive chemotherapy treatment can be recommended in this group. The high chemotherapy toxicity can be justified by expected results, similar to those of younger patients.
Stefano Ferrari, Roberto Luksch, Kirsten Sundby Hall, Franca Fagioli, Arcangelo Prete, Angela Tamburini, Amelia Tienghi, Stefania DiGirolamo, Anna Paioli, Massimo Eraldo Abate,et al.
Wiley
Post‐relapse survival (PRS) was evaluated in patients with Ewing sarcoma (EWS) enrolled in chemotherapy protocols based on the use of high‐dose chemotherapy with busulfan and melfalan (HDT) as a first‐line consolidation treatment in high‐risk patients.
Massimo Eraldo Abate, Olga Escobosa Sánchez, Rita Boschi, Cinzia Raspanti, Loretta Loro, Domenico Affinito, Marilena Cesari, Anna Paioli, Emanuela Palmerini, and Stefano Ferrari
Ovid Technologies (Wolters Kluwer Health)
Background: The incidence of central venous catheter (CVC)–related complications reported in pediatric sarcoma patients is not established as reports in available literature are limited. The analysis of risk factors is part of the strategy to reduce the incidence of CVC complications. Objective: The objective of this study was to determine the incidence of CVC complications in children with bone sarcomas and if defined clinical variables represent a risk factor. Methods: During an 8-year period, 155 pediatric patients with bone sarcomas were prospectively followed up for CVC complications. Incidence and correlation with clinical features including gender, age, body mass index, histology, disease stage, and use of thromboprophylaxis with low-molecular-weight heparin were analyzed. Results: Thirty-three CVC complications were recorded among 42 687 CVC-days (0.77 per 1000 CVC-days). No correlation between the specific clinical variables and the CVC complications was found. A high incidence of CVC-related sepsis secondary to gram-negative bacteria was observed. Conclusions: The analysis of CVC complications and their potential risk factors in this sizable and relatively homogeneous pediatric population with bone sarcomas has led to the implementation of a multimodal approach by doctors and nurses to reduce the incidence and morbidity of the CVC-related infections, particularly those related to gram-negative bacteria. Implications for Practice: As a result of this joint medical and nursing study, a multimodal approach that included equipping faucets with water filters, the reeducation of doctors and nurses, and the systematic review of CVC protocol was implemented.
G. Cefalo, M. Massimino, A. Ruggiero, G. Barone, V. Ridola, F. Spreafico, P. Potepan, M. E. Abate, M. Mascarin, M. L. Garre,et al.
Oxford University Press (OUP)
BACKGROUND
The aim of this study was to assess the objective response rate (ORR) of children and young adults with recurrent medulloblastoma/primitive neuroectodermal tumor (MB/PNET) treated with temozolomide (TMZ). The secondary purpose was to analyze the toxicity profile of TMZ when administered orally for 5 days in 3 divided daily doses every 28 days.
METHODS
Forty-two patients with recurrent MB/PNET, aged 21 years and younger, were recruited. Patients were treated with oral TMZ. Starting doses ranged from 120 to 200 mg/m(2)/day based on previous treatments. A craniospinal MRI was performed prior to the first cycle of TMZ and following every 2 cycles of treatment.
RESULTS
Median age was 10 years (range, 2-21 years). Forty of 42 patients were assessed for response and toxicity. The objective response rate was 42.5%: 6 patients achieved a complete response, 11 had a partial response, and 10 had stable disease. Progression-free survival rates for all patients at 6 and 12 months were 30% and 7.5%, respectively. Their median overall survival rates at 6 and 12 months were 42.5% and 17.5%, respectively. No major extrahematological effects or life-threatening events were reported. The most common grade 3/4 toxicity included thrombocytopenia (17.5%), neutropenia (7.5%), and anemia (2.5%).
CONCLUSIONS
TMZ proved to be an effective agent in children and young adults with MB/PNET, heavily pre-treated, with a tolerable toxicity profile.
Anna Paioli, Roberto Luksch, Franca Fagioli, Angela Tamburini, Marilena Cesari, Emanuela Palmerini, Massimo Eraldo Abate, Emanuela Marchesi, Alba Balladelli, Loredana Pratelli,et al.
Informa UK Limited
Abstract Influence of age and sex on chemotherapy-related toxicity was evaluated in children (3–9 years), adolescents (10–17 years), and adults (up to 40 years) with localized Ewing sarcoma (ES) enrolled in the ISG/SSG III protocol. Treatment was based on vincristine, doxorubicin, cyclophosphamide, ifosfamide, dactinomycin, and etoposide. High-dose chemotherapy with busulfan and melphalan was given in poor responder patients. The analysis was based on 2191 courses of standard chemotherapy and 230 patients. A lower risk of G4 leukopenia and thrombocytopenia, hospitalization, febrile neutropenia, and red blood cell (RBC) transfusions was observed in males. Use of granulocyte colony-stimulating factor (G-CSF) was more frequent in adults, while children more often received RBC transfusions. A significant correlation between sex and chemotherapy-related toxicity was observed in the study, whereas no significant differences in terms of bone marrow toxicity can be expected according to patient age. Further studies should analyse the role of pharmacokinetics, pharmacogenomics, and clinical characteristics.
Massimo Berger, Franca Fagioli, Massimo Abate, Riccardo Riccardi, Arcangelo Prete, Raffaele Cozza, Rossella Bertulli, Marta Podda, Stefano Ferrari, and Roberto Luksch
Elsevier BV