D’ANGELO, Paolo Fiscal Code DNGPLA59L30G273F
Palermo, Italy, 1959 July 30th
A.R.N.A.S. – Pediatric Hematology and Oncology Unit, Piazza Nicola Leotta n. 4, 90127 Palermo.
Medical doctor in Pediatric Hematology and Oncology since 2001 November 1th
Head of the staff since 2011 September 1th
1988 Febbruary - 1988 October fellowship “L. Marangoni”
Division of Pediatric Hematology, S. Gerardo Hospital, Monza, Italy
1989 April - 1991 March, fellowship “Fondazione Tettamanti”
Division of Pediatric Hematology, S. Gerardo Hospital, Monza, Italy
1991 March 18th - 2001 October 31th
Azienda Ospedaliera “Villa via Fattori 61, Palermo.
Assistant of Pediatric Division from 1991 March 18th to 1993 December 31th
Hospital Aid of Pediatric Division from 1994 Jannuary to 2001 October 31th
2001 November 1th to 2009 March 31th
Azienda ARNAS Civico, Di Cristina e Benfratelli, Palermo. Piazza Nicola Leotta, 4 - 90127 Palermo, Italy.
Medical director of first level – Pediatric Hematology
EDUCATION
1985 November 7th
Faculty of Medicine and Surgery of the University of Palermo, Italy
Degree in Medicine and Surgery
1989 November 15th
Faculty of Medicine and Surgery, University of Palermo, Italy.
Pediatrics
1995 November 9th
Catholic University of the Sacred Hearth – Rome, Italy
Pediatric Hematology and Oncology
RESEARCH INTERESTS
Pediatric Oncology and Hematology. Palliative Care. Rare Tumors.
111
Scopus Publications
Scopus Publications
Diagnostic Delay and Survival in Pediatric Rhabdomyosarcoma: Is Time a Critical Factor? Maria C. Affinita, Stefano Chiaravalli, Giuseppe M. Milano, Ida Russo, Katia Perruccio, et al. Journal of Pediatric Hematology Oncology, 2026 Background: Timely diagnosis is considered critical in pediatric oncology to optimize treatment outcomes, as delays may impact tumor extension and prognosis. We aimed to assess whether the time to diagnosis and treatment initiation for pediatric patients with rhabdomyosarcoma (RMS) improved over time in Italy and whether longer delays were associated with tumor extension and prognosis. Methods: We analyzed 749 pediatric patients diagnosed with RMS between 1996 and 2016. Diagnostic interval (DI) was defined as the number of days from symptom onset to diagnosis, while treatment interval (TI) was defined as the time from symptom onset to treatment initiation. DI was correlated with tumor characteristics at diagnosis, and TI was analyzed in relation to survival, using Kaplan-Meier analysis. Results: The median DI was 32 days, showing a decreasing trend from 39.5 days in 1996 to 2000 to 30 days in 2011 to 2016. A longer DI was associated with age, unfavorable histology, and metastatic disease in univariate analysis, but these were not confirmed in multivariate analysis. The median TI was 48 days. Five-year event-free survival (EFS) and overall survival (OS) were 59.7% and 69.3%. In multivariate analysis, prognosis was negatively associated with age at diagnosis, unfavorable site, nodal involvement, and metastatic disease. TI was not associated with survival. Conclusions: In our national cohort, the time from symptom onset to diagnosis showed a trend toward shortening in recent years. While a timely diagnosis can provide clarity on the child’s condition and potentially reduce parental anxiety, it does not substantially impact tumor characteristics or patient outcomes.
Metachronous Bilateral Adrenal Neuroblastoma: A Case Report and Literature Review Serena Tropia, Angela Guarina, Giulia Angela Restivo, Fabrizio Di Francesco, Angela Trizzino, et al. Journal of Pediatric Hematology Oncology, 2024 A baby presented with a large right adrenal mass, multiple hepatic lesions and diffuse bone marrow infiltration when she was just over 1 month old. After needle biopsy and a histologic definition of neuroblastoma, she underwent chemotherapy and a subsequent complete resection. Three years after diagnosis, a large left adrenal localized mass was detected. The patient underwent complete surgical excision, and a diagnosis of poorly differentiated neuroblastoma with multiple lymph nodes involvement was defined. Adjuvant chemotherapy was initiated. To our knowledge, it is the first case report of metachronous bilateral adrenal neuroblastomas harboring completely different genetic expression profiles.
Role of 18F-Fluorodeoxyglucose Positron Emission Tomography in Children With Germ Cell Tumor After Chemotherapy Maria Debora De Pasquale, Paolo D’Angelo, Alessandro Crocoli, Stefano G. Vallero, Patrizia Bertolini, et al. Journal of Pediatric Hematology Oncology, 2024 Background/Aim: 18F-fluoro-2-deoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) is a diagnostic tool widely used in adult oncology and some pediatric oncological settings. There are no established recommendations for the use of this imaging modality in pediatric malignant germ cell tumors (mGCT), however. Our aim is to evaluate the role of 18F-FDG PET/CT in the restaging of mGCT after chemotherapy in children and adolescents. Methods: We retrospectively reviewed patients with mGCT treated in Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP) centers who underwent 18F-FDG PET/CT between 2011 and 2021. Results: Seventeen patients (median age 13 y) were included in the study. In 14 patients, 18F-FDG PET/CT was performed at diagnosis; 12 showed pathologic uptake. The 2 18F-FDG PET/CT negative cases were histologically defined as yolk sac tumor (YST) and mixed (chorioncarcinoma, YST). Nine of the 12 patients who had pathologic 18F-FDG PET/CT at diagnosis repeated the examination after neoadjuvant chemotherapy, before, second look surgery. In 5 cases, no pathologic uptake was evident. Histology showed necrosis alone in 4 cases and necrosis and mature teratoma in 1. In 3 of the 6 cases with pathologic uptake (2 of 6 patients did not perform the examination at diagnosis), histology showed persistence of malignant component, whereas in the remaining 3 cases, necrosis and mature teratoma were present. Conclusion: In our review of a series of children with mGCT, 18F-FDG PET/CT after neoadjuvant chemotherapy showed 1 of 5 false negatives and was unable to discriminate between residual malignant component and mature teratoma.
Should we reduce routine surveillance imaging in pediatric germ cell tumors? Monica Terenziani, Francesco Barretta, Giovanna Gattuso, Gianni Bisogno, Massimo Conte, et al. Pediatric Blood and Cancer, 2023 This paper retrospectively investigated the site and the detection method of relapses in children and adolescents with malignant germ cell tumors enrolled in the TCGM‐AIEOP‐2004 Study and subsequently developed a relapse, in order to evaluate a possible reduction in radiological exposure during follow‐up. Including all malignant cases, serum tumor markers identified a relapse in more than 70% and, according to the selection criteria published by Children Oncology Group in 2018, in more than 90% of cases. These results confirm the importance of serum tumor markers as a relapse detection method, with possible reduction of radiology exams in specific subgroups.
Role of centers with different patient volumes in the management of rhabdomyosarcoma. An analysis by the Italian Pediatric Soft Tissue Sarcoma Committee Gianni Bisogno, Giovanna Congiu, Maria Carmen Affinita, Giuseppe Maria Milano, Ilaria Zanetti, et al. Pediatric Blood and Cancer, 2021 The survival of children with rhabdomyosarcoma (RMS) has gradually improved as a result of the adoption of multidisciplinary treatments. Dedicated skills and facilities are indispensable and more readily available at reference centers. In this study, we examined the role of centers’ experience (based on the number of patients treated) in their management of patients with RMS.
Rasburicase-induced Methemoglobinemia: A Case Report and Literature Review Ilaria Pirrone, Piero Farruggia, Francesca Cacciatore, Antonino Giambona, Angela Guarina, et al. Journal of Pediatric Hematology Oncology, 2021 Rasburicase is a recombinant urate oxidase enzyme indicated for tumor lysis syndrome, a potential life-threatening oncologic emergency that occurs most commonly during initial chemotherapy for hematological malignancies. As a result of the defects in the physiological antioxidant pathway, erythrocytes of patients with glucose-6-phosphate dehydrogenase deficiency are not protected against the oxidizing stress exerted by hydrogen peroxide generated with the administration of rasburicase. The authors report a 14-year-old patient, diagnosed with T-cell acute lymphoblastic leukemia, who developed methemoglobinemia and hemolytic anemia with low oxygen saturation after starting steroids, hyperhydratation, and rasburicase administration. The complications resolved with supportive therapy only.
Extra-appendicular neuroendocrine tumors: A report from the TREP project (2000-2020) Calogero Virgone, Andrea Ferrari, Stefano Chiaravalli, Maria Debora De Pasquale, Alessandro Inserra, et al. Pediatric Blood and Cancer, 2021 Extra‐appendicular neuroendocrine tumors (NETs) are very rare tumors. While diagnostic and therapeutic guidelines are well established for adults, data on children and adolescents are lacking.
Pheochromocytomas and paragangliomas in children: Data from the Italian Cooperative Study (TREP) Calogero Virgone, Marina Andreetta, Stefano Avanzini, Stefano Chiaravalli, Maria Debora De Pasquale, et al. Pediatric Blood and Cancer, 2020 Pheochromocytomas (PCs) are neuroendocrine tumors arising from the chromaffin cells of the adrenal gland, and paragangliomas (PGLs) are their extra‐adrenal counterparts arising from ganglia along the sympathetic/parasympathetic chain. Surgery is the cornerstone of treatment. A sporatic or inherited germline mutation is commonly associated.
Genetic and epigenetic analyses guided by high resolution whole-genome SNP array reveals a possible role of CHEK2 in Wilms tumour susceptibility Oncotarget, 2018
Bone Sarcomas in Children and Adolescents Floriana Di Marco, Fabrizia Ferraro, Clara Mosa, Angela Trizzino, Serena Tropia, et al. Journal of Pediatric Biochemistry, 2015
Pleuropulmonary blastoma: A differential diagnosis of chronic cough. Long-term survival after multimodal aggressive therapy Italian Journal of Pediatrics, 2006
Neuroblastoma in the first year of life. The Italian contribution to a study of the Internation Society of Paediatric Oncology Europe Neuroblastoma Group Italian Journal of Pediatrics, 2006
Cardiac and pulmonary function abnormalities in thalassemia major patients Cardiovascular Imaging, 1998
Zinc deficiency and cell-mediated and humoral autoimmunity of insulin- dependent diabetes in thalassemic subjects Journal of Pediatric Endocrinology and Metabolism, 1998
The heart in β-thalassemia major patients. An MR study Radiologia Medica, 1998
High-dose cytosine arabinoside and fractionated total body irradiation as a preparative regimen for the treatment of children with acute lymphoblastic leukemia and Down syndrome by allogeneic bone marrow transplantation Bone Marrow Transplantation, 1996
Acute lymphoblastic leukaemia in a child with cystic fibrosis Haematologica, 1992
Central venous catheter-related complications after bone marrow transplantation in children with hematological malignancies Bone Marrow Transplantation, 1992