Position paper of the Italian Association of Medical Oncology on the impact of COVID-19 on Italian oncology and the path forward: the 2021 Matera statement.

The coronavirus disease 2019 (COVID-19) pandemic has severely affected cancer care and research by disrupting the prevention and treatment paths as well as the preclinical, clinical, and translational research ecosystem. In Italy, this has been particularly significant given the severity of the pandemic's impact and the intrinsic vulnerabilities of the national health system. However, whilst detrimental, disruption can also be constructive and may stimulate innovation and progress. The Italian Association of Medical Oncology (AIOM) has recognized the impact of COVID-19 on cancer care continuum and research and proposes the '2021 Matera statement' which aims at providing pragmatic guidance for policymakers and health care institutions to mitigate the impact of the global health crisis on Italian oncology and design the recovery plan for the post-pandemic scenario. The interventions are addressed both to the pillars (prevention, diagnosis, treatment, follow-up, health care professionals) and foundations of cancer care (communication and care relationship, system organization, resources, research, networking). The priorities to be implemented can be summarized in the MATERA acronym: Multidisciplinarity; Access to cancer care; Telemedicine and Territoriality; Equity, ethics, education; Research and resources; Alliance between stakeholders and patients.

Cytochemical profile of lymphocytes in haemophilia patients at risk of AIDS.

We report the cytochemical and immunologic features of lymphocytes of 31 patients (26 with haemophilia A and 5 with haemophilia B) chronically treated with commercial clotting factor concentrates. 6 patients, asymptomatic for AIDS were anti-HIV positive. In comparison to aged cross-matched male controls, significant increases of absolute number of lymphocytes and of T and B cell subpopulations with significant reduction of the percentages of CD3, CD4, CD2, CD5, sIg, and CD16 cells was found in haemophiliacs. PAS reaction showed a lower grading score in haemophiliacs and the staining for NBE, AP, NABG revealed a significant reduction of the percentage of the lymphocytes with dot-like positivity in the same patients. The percentage number of AP reactive lymphocytes with dot-like positivity was directly related to the percentage of CD3, and CD4 cells. The anti-HIV positive patients presented lower percentages of CD4 and of dot-like reactive lymphocytes.

Effect of chronic anticonvulsant monotherapy on lymphocyte subpopulations in adult epileptic patients.

Sixty-five patients undergoing long-term monotherapy for at least 3 months with phenytoin, carbamazepine or phenobarbital were screened for lymphocyte and immunoglobulin abnormalities. In 57% of patients the duration of therapy was longer than 12 months. The control subjects were matched for sex and age and none of them was taking drugs. The average serum immunoglobulin (IgG, IgA, IgM) values did not differ in control and patient groups. A significant decrease of OKT4+ cells was seen with all drugs, while other lymphocyte subpopulations were differently affected depending on the drug used. It is concluded that long-term single-drug treatment with phenytoin, carbamazepine and phenobarbital exhibits immunosuppressant effects through a complex action which involves more than one lymphocyte subpopulation. Moreover, the possible interference of the disease state with the immune functions of epileptic patients is discussed.

[Plasmapheresis and survival of patients with myeloma and secondary renal insufficiency]. / Plasmaferesi e sopravvivenza del paziente mielomatoso con insufficienza renale secondaria.

The mortality rate due to renal insufficiency in patients with myelomas was studied and the results obtained compared with figures on patients given plasmapheresis to correct the insufficiency. The results of the comparison confirm the value of the immediate use of plasmapheresis on patients with myelomas. In a large percentage of cases, the technique either completely cured or significantly improved renal dysfunction, thus normalizing the blood and urine situation and improving the patients' chances of survival.

[Behavior of the principal protein hormones in normal and leukemic leukocytes]. / Comportamento dei principali ormoni proteici nei leucociti normali e leucemici.

GH, LH, insulin and glucagon patterns were studied in the peripheral leukocytes of normal subjects (granulocytes and lymphocytes separated on a Ficoll-Hypaque gradient) and leukaemic patients (CML, AML, CLL, and ALL), using a double antibody RIA on whole cells. The uptake of 125I-labelled insulin and GH by these cells was also assessed. The results showed that in leukaemia, particularly CLL, ALL and AML, though not in CML, there was a constant reduction in hormone values, plus depressed GH and insulin uptake. The only exceptions were glucagon and insulin in CML, and LH in CLL, since their concentrations were normal or clearly enhanced. The data are seen as an expression of a membrane receptor block extending to several hormones with structural differences (protein, steroid, T3 and T4), capable of altering the ability of leukaemic cells to respond to ordinary factors modulating their differentiation, functional activity, and the expansion of the corresponding stem cell compartment.

[Analysis of erythrocytic spectrin in thalassemia and in Lepore hemoglobinosis]. / Analisi della spettrina eritrocitaria nella talassemia e nell'emoglobinosi lepore.

Total proteins and red cell membrane spectrin were determined in normal subjects, patients with hyperhaemolytic and anhaemolytic thalassaemia, and Hb Lepore from a single family. Electrophoresis on acrylamide gels was performed after solubilisation of the material in SDS using the whole membrane and spectrin. Amino acid composition was also determined after hot acid hydrolysis. Resin chromatography was employed to recognise acid, neutral and basic aminoo acids, glucosamine, and galactosamine. It was found that the significant changes in spectrin amino acid composition observed in thalassaemic subjects with peripheral hyperhaemolysis were not apparent in anhaemolytic patients, nor in the heterozygote, clinically asymptomatic carriers of Hb Lepore. These changes are certainly of importance on account of the structural alterations noted in the spectrin of the subjects concerned.

[Behavior of several prostaglandins (PGA, PGB, PGE 1, PGE 2, PGF 1, PGF 2) in normal and leukemic leukocytes. Radioimmunological method on intact cells]. / Comportamento di alcune prostaglandine (PGA, PGB, PGE 1, PGE 2, PGF 1, PGF 2) nei leucociti normali e leucemici. Metodo radioimmunologico su cellule integre.

The behaviour of prostaglandins A, B, E 1, E 2, F 1 and F 2 has been examined in the granulocytes and lymphocytes of the peripheral blood of normal subjects and in circulating leucocytes of patients with CML, AML, CLL and ALL. At the same time, modifications of PGE 2 in the granulocytes of normal subjects and in patients with CML or AML before and after phagocytosis of latex particles were monitored. The general observation was a lowering in PGE and PGF in acute myeloid and lymphatic leukaemia, while the variations in CML and CLL were rather complex. Also observed was a reduction in PGE 2 in AML but not in CML, including a reduced response to phagocytosis in granulocytes. The data are compared with previous reports of AMPc and GMPc in the same cells and commented on, taking into consideration their possible reflexion on the proliferative and functional activity of the cells examined.