Eighty-three Ail sections and 17 thousand volunteers, 146 scientific research projects, 5,186 solidarity trips and 670 beds for 62,898 nights offered in Ail accommodation homes to 2,395 patients and caregivers. These are just some of the numbers that demonstrate Ail’s great commitment, a 55-year history, during which its involvement has become increasingly stronger in supporting research and assistance to patients with blood cancers. In Italy, there are around 500 thousand people living with a haematological tumor and there are 30 thousand new diagnoses – reports a note – thanks to research, patients are more likely to recover or live with the disease for years while maintaining a good quality of life. Supporting patients and making increasingly effective therapies available are objectives that can also be achieved thanks to the constant and ever-increasing collaboration between Ail, scientific societies and bodies operating in the hematological field.
Today, the press conference dedicated to National Ail Day was held in Rome, the Association’s traditional event to share the progress of hematological research and to reiterate an important message to all patients and their families: “you are not alone”. Theme of the meeting: “55 years of Ail and support for scientific research to fight blood cancers. Biomolecular technologies and innovative therapies in Hematology”. An important medical-scientific themed event with the participation of the presidents of Italian scientific societies and representatives of the third sector.
“For 55 years, Ail has been committed daily to improving the quality of life of haematological patients and their families, supporting scientific research, social and healthcare assistance, and promoting knowledge of blood cancers – states Giuseppe Toro, national president of Ail – From In 1969 we grew a lot, becoming a point of reference for Italian hematology patients and their caregivers, and in 1975 the first provincial sections were born and now we are at 83 with over 17 thousand volunteers”.
Ail “allocates millions of euros annually to support scientific research and supports Gimema (Italian Group of Adult Hematological Diseases), a clinical research group in which Italian hematological departments collaborate – adds Toro – to study the pathologies and identify the best diagnostic protocols and therapeutics, and to finance hiring and scholarships for data managers, psychologists, doctors, researchers, biologists and nurses. But support for research alone is not enough; it is also essential to be alongside patients throughout the course of the disease It often turns out to be long and tiring.”
“Ail’s support for clinical and biological research is an activity that has always gone hand in hand with that of assistance to patients and family members – explains William Arcese, president of the Ail scientific committee – Providing assistance therefore also means doing research. Ail has always collaborated with the Italian Association of Pediatric Hematology-Oncology (Aieop), the Italian Lymphoma Foundation (Fil), the Italian Bone Marrow Transplant Group (Gitmo), the Italian Society of Hematology (Sie) and the Italian Society of Experimental Hematology (Sies), which represent the main scientific societies in the Italian hematological field”.
“Every year these companies – recalls Arcese – are reserved funding for projects selected by the scientific societies themselves, which concern clinical-biological research, basic research or educational initiatives. This year Aieop and Gitmo have provided support linked to management of the respective patient registers. Gitmo, due to the large number of studies planned, needs to strengthen its Clinical Trial Office. The Sie project is the continuity of the refresher course for hematology nurses, already successfully launched last year. Finally, the Sies project proposes to develop the Guidelines in myeloproliferative diseases and chronic myelogenous leukemia according to the methodology outlined by the Institute. of health so that they become national guidelines”.
Today – it emerged from the meeting – bispecific antibodies are available in the therapeutic panorama and have proven to be very effective. “The panorama of therapies has been enriched: from acute lymphocytic leukemia to lymphomas, which represent the sixth or seventh most frequent cancer in the Western world, to myeloma, another high incidence tumor – explains Paolo Corradini, president of Sie, director of the Hematology Division , Irccs Foundation National Cancer Institute of Milan Chair of Hematology, University of Milan – Two pathologies that represent a large number of hematological patients that can be effectively treated with bispecific antibodies when all other therapies have failed. There are toxicities to be managed, but which can be controlled by promoting a good quality of life”.
The “bispecific antibodies” represent a “second revolution after Car-Ts – remarks Corradini – In the last year, Car-Ts have been approved for various haematological tumours: two in follicular lymphoma, the second most frequent type of lymphoma; one for diffuse large B-cell lymphoma, the first in incidence. Today all patients with refractory large cell lymphoma or those who relapse within one year can receive this therapy immediately after failure of first-line therapy. This allows its use to be brought forward. heal a greater number of people, save subsequent treatments for patients and also costs, but above all it allows a better quality of life for patients and their families. For acute lymphoblastic leukemia, a new Car-T has been reimbursed since last December. for people over 26 years old. There is also news for multiple myeloma: in fact, a Car-T has been available in Italy since the end of May this year and another has been approved, but not yet reimbursed by Aifa”.
“In the future, immuno-chemotherapy will be used less and less for the treatment of lymphomas and biological therapies will increasingly increase, i.e. non-chemotherapeutic drugs targeted and strictly indicated for particular mutations of the various types of lymphoma – explains Maurizio Martelli, professor of Hematology, Sapienza of Rome, Director of Uoc Hematology Aou Policlinico Umberto I of Rome, Fil Governing Council – Today, we have important results also thanks to immunotherapy alone, bispecific monoclonal antibodies that recognize a certain cellular antigen and activate the patient’s own T lymphocytes. Car-T cell therapy, in which the patient’s own T lymphocytes are taken, engineered and then reinfused into the patient to attack the disease.”
In 2023, approximately 5,600 allogeneic and autologous transplants were carried out in Italy. “Last year, approximately 2,000 allogeneic transplants were carried out and in 50% of cases it was necessary to use a donor from the registry. The pathology most treated was acute myeloid leukemia (40%) followed by lymphoblastic leukemia (18%) – underlines Massimo Martino, president of Gitmo, director of the Bone Marrow Transplant Center and interim director of the Hematology Unit, Oncohaematology and Radiotherapy Department, Great Metropolitan Hospital ‘Bianchi-Melacrino-Morelli’ of Reggio Calabria – As regards autologous transplants, approximately 3,600 have been carried out and multiple myeloma is the pathology where it finds the greatest application, followed by non-Hodgkin and Hodgkin lymphomas and leukemias. Furthermore, for the first time, a greater number of autologous transplants have been carried out in people over 60 years of age compared to those over the age of 60. subjects under 60, and allogeneic ones have also increased”.
The most frequent childhood hematological tumors are acute, lymphoid and myeloid leukemias, Hodgkin’s and non-Hodgkin’s lymphomas. In Italy, approximately 1400-1500 children are diagnosed with cancer in the 0-14 year age group and 800-900 in the 15-18 year age group. “Molecular biology identifies the molecular alterations that define the pathology in a specific and radical way. This means that protocols with a higher risk of recurrence are intensified and the intensity and aggressiveness of therapies for those pathologies that have a ‘better evolution – points out Arcangelo Prete, president of AIEOP and director of SSD Pediatric Oncohematology AOU of Bologna Policlinico S. Orsola Malpighi – This produces fewer side effects and greater results in terms of recovery and survival. The best results are obtained in leukemia and in lymphomas. In particular, for leukemia, liquid immunotherapy with blinatumomab has proven to be so effective that it is also used on an experimental basis in the front line. Car-Ts are an extremely targeted and specific treatment for the neoplastic cell they are a personalized therapy that produces fewer medium and long-term side effects. This is fundamental when it comes to children who, once recovered, have a life expectancy equal to that of their peers.”
Chronic myeloproliferative neoplasms are tumor pathologies associated with specific DNA alterations with some recurrent mutations and include different entities. They are rare diseases that globally have an incidence of less than 5 cases per 100 thousand per year.
“The main ones are three: essential thrombocythemia, polycythemia vera and myelofibrosis, of which two entities are known. The prefibrotic form and the frank form of fibrosis which can occur both as a primary and secondary form and represents the evolution from a previous essential thrombocythemia or polycythemia true – highlights Alessandro Vannucchi, president of Sies, professor of hematology, director of the Sod Hematology Crimm Research and innovation center for myeloproliferative diseases, director of the Aou Careggi School of Specialization in Hematology, University of Florence – For just under twenty years it has been known that they stand out due to the presence, in 90% of cases, of a mutation, and the three most recurrent ones are due to a mutation of the Jak2, Mpl and Carl genes, variously expressed in the different forms. These mutations all affect one, albeit to a different extent altered signaling within hematopoietic stem cells which leads to their dysregulated proliferation. But above all, this same altered intracellular signaling contributes to the more general systemic inflammatory impairment and accounts for many of the symptoms and clinical manifestations of these diseases.”
At the beginning of the 1980s – it was recalled in the meeting – the Italian Adult Hematological Diseases Group was born and over the decades it has evolved and expanded. Today, almost all Italian hematology centers belong to the Gimema Franco Mandelli Foundation, around 150 “Today Gimema manages around 20 thousand patients with its protocols, with dozens of clinical projects – informs Marco Vignetti, president of the Gimema Franco Mandelli Foundation -. And LabNet, the network of laboratories that work according to a shared quality system, has allowed approximately 25 thousand patients to carry out 200 thousand genetic tests, necessary to accurately diagnose or monitor the pathology from which they are affected. Diagnosis protocols and monitoring of the progress of therapy together with constantly updated therapeutic protocols are what make the quality of the assistance offered high. from Gimema in the centers belonging to the National Health Service”.
On Thursday 27 June at 5pm a delegation from Ail will be received at the Quirinale Palace in an audience by the President of the Republic Sergio Mattarella, to celebrate the National Day for the fight against leukemia, lymphoma and myeloma and the 55 years of activity of the Association. Like every year, on the occasion of the National Day for the fight against leukemia, lymphoma and myeloma, Ail promotes an initiative which is now a tradition and which is always eagerly awaited by patients and their families: the Ail Hematological Problems toll-free number 800.22. 65.24, active on Friday 21 June from 8am to 8pm, which offers patients the opportunity to speak with expert haematologists, asking for clarifications on their pathologies and therapies, without problems of time and privacy that they might have with the doctors who usually follow them in their treatment centers.
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