Post-transplant lymphoproliferative disease (PTLD) is a serious complication occurring as a consequence of immunosuppression in the setting of allogeneic hematopoietic stem cell transplantation (alloHSCT) or solid organ transplantation (SOT). The majority of PTLD arises from B-cells, and Epstein–Barr virus (EBV) infection is present in 60–80% of the cases, revealing the central role played by the latent infection in the pathogenesis of the disease. Therefore, EBV serological status is considered the most important risk factor associated with PTLDs, together with the depth of T-cell immunosuppression pre- and post-transplant. However, despite the advances in pathogenesis understanding and the introduction of novel treatment options, PTLD arising after alloHSCT remains a particularly challenging disease, and there is a need for consensus on how to treat rituximab-refractory cases. This review aims to explore the pathogenesis, risk factors, and treatment options of PTLD in the alloHSCT setting, finally focusing on adoptive immunotherapy options, namely EBV-specific cytotoxic T-lymphocytes (EBV-CTL) and chimeric antigen receptor T-cells (CAR T).

Introduction:The prognosis of diffuse large B-cell lymphoma (DLBCL) patients with refractory or multiply relapsed (R/R) disease is disappointing. Pixantrone is currently approved as third or fourth line regimen, with encouraging results, even if long-term follow-up data are limited. Methods:In this post-hoc analysis of our observational study, we retrospectively investigated disease outcome and clinical characteristics of 16 R/R DLBCL patients who achieved a complete response with pixantrone.Results: Pixantrone was administered as third or fourth line in 12/16 (75%) and 4/16 (25%) cases. After a median follow-up of 24 months, 14/16 patients (87.5%) were alive (causes of death were progressive disease and secondary acute myeloid leukemia, one case each). Median progression-free survival was 23.8 months, median duration of response was 17.8 months and median overall survival (OS) was not reached (2-years OS was 84%). A significant proportion of patients achieved a long-lasting response >12 months (7/16 cases). Response to prior therapy did not influence longterm remission after pixantrone. Conclusion:In this real-life experience, pixantrone demonstrated long-term efficacy in a cohort of R/R DLBCL cases who had previously received at least two prior regimens; many of whom had characteristics associated with poor prognosis.complete response, diffuse large B-cell lymphoma, long-term efficacy, pixantrone Novelty statementsTo our knowledge it is the first, Italian, long-term post-hoc analysis about the possibility to achieve a durable complete response (CR) with pixantrone in its approved indication. Our real-life study confirms data obtained by clinical trials in a hard-to-treat population of relapsed/refractory (R/R) DLBCL. The clinical relevance is represented by the achievement of a durable CR in a significant proportion of R/R DLBCL patients with manageable adverse events. Furthermore, we suggest the possibility to use pixantrone as a bridging therapy to transplant or CAR-T cells.

Parole chiave: canale di Guyon, nervo ulnare, neuropatie periferiche, TC RIASSUNTO -Sono stati esaminati, mediante TC del polso e secondo una metodica standardizzata dagli autori, 50 soggetti con sindrome irritativa ej o deficitaria nel territorio del nervo ulnare al polso.In base ai rilievi TC sono stati differenziati 4 gruppi patologici: I) formazioni cistiche intra o extracanalari, 11) calcificazioni dell'arteria ulnare, Ill) deformazione del piccolo canale, IV) mancata distinzione alia TC tra nervo e arteria.Nell'ambito dei diversi gruppi sono state identificate cause dirette ed indirette di compressione. Quindici pazienti sono stati sottoposti ad intervento chirurgico. Questo nei casi appartenenti al IV gruppo patologico ha dimostrato una fibrosi del paranervio con tralci fibrosi a ponte tra nervo ed arteria.Gli autori concludono che la TC rappresenta una metodica completa e a costo contenuto per lo studio delle sindromi canalari al polso.SUMMARY -We applied our own standardized CT procedure to scan the wrists of 50 subjects with irritation and/or deficit in the ulnar nerve.The direct and indirect causes of nerve compression were identified in 43 cases and divided into 4 disease groups: I) Intra or extracanal cysts; If) Calcification of the ulnar artery; Ill) Deformation of the small canal; IV) No CT distinction between nerve and artery.Deformation of the small canal was in turn caused by different factors such as degeneration of the carpal bone following rheumatoid arthritis, trauma, surgery for carpal syndrome and syndrome of the carpal canal.Fifteen patients underwent surgery which disclosed that failure to distinguish ulnar artery and nerve at CT was due to fibrosis of the paranerve with reduced connective tissue and fibrous laces between nerve and artery. Guyon 's syndrome, carpal syndrome and so-called synovial cysts were frequently associated and seem to confirm a common degenerative origin in cases not resulting from external indirect causes.CT remains the cheapest most complete imaging procedure for diagnosis of wrist canal syndromes.Introduzione 11 nervo ulnare e un nervo misto con funzioni motorie e sensitive: regola i piccoli movimenti della mano e fornisce la sensibilita alia regione ipotenare, al V dito e alia meta ulnare del IV dito. Esso innerva il muscolo flessore ulnare del carpo ed il flessore profondo delle dita (meta ulnare del IV e V dito) e nella mano il muscolo !Jalmare breve, l'abduttore, l'opponente ed il flessore breve del V dito, il 11 e Ill lombricale, i muscoli interossei volari e dorsali, infine l'adduttore e il flessore breve del pollice. Le alterazioni del nervo ulnare al polso sono responsabili della Sindrome di Guyon. Questa si 109