Serena Valsami - Academia.edu (original) (raw)

Papers by Serena Valsami

European review for medical and pharmacological sciences, 2018

OBJECTIVE Endometrial cancer is increasingly prevalent in western societies and affects mainly po... more OBJECTIVE Endometrial cancer is increasingly prevalent in western societies and affects mainly postmenopausal women; notably incidence rates have been rising by 1.9% per year on average since 2005. Although the early-stage endometrial cancer can be effectively managed with surgery, more advanced stages of the disease require multimodality treatment with varying results. In recent years, endometrial cancer has been extensively studied at the molecular level in an attempt to develop effective therapies. Recently, a family of compounds that alter epigenetic expression, namely histone deacetylase inhibitors, have shown promise as possible therapeutic agents in endometrial cancer. The present review aims to discuss the therapeutic potential of these agents. MATERIALS AND METHODS This literature review was performed using the MEDLINE database; the search terms histone, deacetylase, inhibitors, endometrial, targeted therapies for endometrial cancer were employed to identify relevant studie...

Pharmacoepigenetics, 2019

Abstract Histone modification, which occurs through the process of acetylation, plays a key role ... more Abstract Histone modification, which occurs through the process of acetylation, plays a key role in the epigenetic regulation of gene expression. The balance between histone deacetylases (HDACs) and histone acetyltransferases controls this process. HDAC inhibitors (HDACi) can induce cancer cell cycle arrest, differentiation, and cell death, reduce angiogenesis, and modulate immune response. Therefore, HDACi represent a group of enzymes that can be used for the development of pharmaceutical agents against a variety of malignant neoplastic diseases. The mechanisms behind HDACi anticancer effects depend on many factors. The HDACi vorinostat, romidepsin, and belinostat have been approved for some T cell lymphomas and panobinostat for multiple myeloma. Other HDACi are in clinical trials for the treatment of hematological and solid malignancies. The results of such studies are promising but further studies on a greater scale are needed.

Journal of B.U.ON. : official journal of the Balkan Union of Oncology, 2018

Histone modification that occurs through the process of acetylation plays a key role in the epige... more Histone modification that occurs through the process of acetylation plays a key role in the epigenetic regulation of gene expression. The balance between histone deacetylases (HDACs) and histone acetyltransferases controls this process. Histone deacetylase inhibitors (HDACIs) can induce cancer cell cycle arrest, differentiation and cell death, reduce angiogenesis and modulate immune response. Therefore, HDAIs represent a group of enzymes that can be used for the development of pharmaceutical agents against a variety of malignant diseases. The mechanisms of their anticancer effect depend on many factors. HDACIs vorinostat, romidepsin and belinostat have been approved for some T-cell lymphomas and panobinostat for multiple myeloma. Other HDACIs are tested in clinical trials for the treatment of hematological and solid malignancies. The results of such studies are promising but further larger studies are needed.

AntiCancer Research, 2020

Metastasis is a process which is characterized by the existence of tumor cells in the bloodstream... more Metastasis is a process which is characterized by the existence of tumor cells in the bloodstream. This is a necessary situation in order for the malignant cells to be transported to other organs. Thus, the importance of circulating tumor cells (CTCs) in the study of carcinogenesis is widely accepted. These tumor cells are nowadays a topic of intensive research all over the world. CTCs are expressed from tumor cells and the clinical analysis of this expression may help the recognition of a tumor in an earlier stage and also there is an effort to monitor the tumor burden according to these cells. Although a plethora of clinical studies has been conducted, it is still unclear whether the use in clinical aspect will prove to be beneficial in the near future. Few animal models with neoplasia have been studied concerning the circulating tumor cells and it is likely that CTCs may have a predictive, diagnostic or therapeutic value. Herein, the authors review all studies in which human CTCs...

Transfusion Medicine, Aug 16, 2019

Dear Sir, The high immunogenicity of the Rh blood group accounts for its implication in transfusi... more Dear Sir, The high immunogenicity of the Rh blood group accounts for its implication in transfusion medicine and renders it second in importance only to the ABO group. Several RHD alleles have been described and are classically classified under three broad categories: weak D, partial D and DEL. These phenotypes frequently arise from various single-nucleotide polymorphisms (SNP) in the RHD gene (Flegel, 2011). The molecular basis lies on at least 493 alleles identified so far that result in 98 RHD alleles as classified by the International Society of Blood Transfusion (ISBT). The genetic diversity caused by these mutations leads to qualitative and/or quantitative changes in the expression of the D antigen. Weak D types 1, 2 and 3 are associated with quantitative changes of presentation of a complete D-epitope, whereas in weak D type 4•2 (DAR), 11, 15 and 21, qualitative differences in D-epitope presentation, typically associated with partial D phenotypes, are apparent, and cases of allo-anti-D production have been reported (Daniels, 2005). RHD alleles differ by ethnicity with weak D frequently encountered in Caucasians, partial D in African Blacks and DEL in Asians (Flegel, 2011). Approximately 90% of weak Ds in Caucasians are weak D type 1, 2 or 3, with distributions varying among different ethnic populations (Ansart-Pirenne et al., 2004). When D antigen discrepancies arise, clinicians are faced with assigning the appropriate D antigen status so that the appropriate (RhD-or RhD+) blood products can be administered. The clinical relevance of identifying subtypes is that weak D subjects belonging to weak types 1, 2 and 3 can be treated as RhD-positive and be transfused with RhD-positive red blood cells, whereas subjects with weak D type 4•2-11 and 15 should be treated as RhD-negative (Flegel, 2011). In terms of proper donor characterisation, blood donors with weak phenotypic expression of the D antigen should be typed as RhD-positive as administration of their blood can stimulate alloimunisation when transfused in RhD-negative patients. Routine serological RhD typing cannot distinguish between weak and partial D types, but detection and classification of these

Transfusion, Jun 19, 2021

BackgroundTransfusion research has recently focused on the discovery of red blood cell (RBC) stor... more BackgroundTransfusion research has recently focused on the discovery of red blood cell (RBC) storage capacity biomarkers and the elucidation of donor variation effects. This shift of focus can further strengthen personalization of transfusion therapy, by revealing probable links between donor biology, RBC storage lesion profile, and posttransfusion performance.Study design and methodsWe performed a paired correlation analysis of osmotic fragility in freshly drawn RBCs and during cold storage in different preservative solutions at weekly intervals until unit's expiration date (n = 231), or following 24 h reconstitution in allogeneic plasma (n = 32) from healthy controls or transfusion‐dependent beta‐thalassemia patients.ResultsWe observed exceptional correlation profiles (r > 0.700, p < 10−5 in most cases) of RBC osmotic fragility in the ensemble of samples, as well as in subgroups characterized by distinct genetic backgrounds (sex, beta‐thalassemia traits, glucose‐6‐phosphate dehydrogenase deficiency) and storage strategies (additive solutions, whole blood, RBC concentrates). The mean corpuscular fragility (MCF) of fresh and stored RBCs at each storage time significantly correlated with the MCF of stored RBCs measured at all subsequent time points of the storage period (e.g., MCF values of storage day 21 correlated with those of storage days 28, 35 and 42). A similar correlation profile was also observed between the osmotic hemolysis of fresh/stored RBCs before and following in vitro reconstitution in plasma from healthy controls or beta‐thalassemia patients.ConclusionOur findings highlighted the potential of osmotic fragility to serve as a donor‐signature on RBCs at every step of any individual transfusion chain (donor, blood product, and probably, recipient).

Leukemia Research, Jun 1, 2003

The association of monoclonal gammopathy (MG) with B-cell non-Hodgkin's lymphomas (NHL) i... more The association of monoclonal gammopathy (MG) with B-cell non-Hodgkin's lymphomas (NHL) is a well known phenomenon. The aim of the present work was to study the incidence, type of monoclonal component and prognostic significance of MG in a population of 255 cases with B-cell NHL. Among 255 evaluable patients with B-cell NHL, 145 were males and 110 females with a median age of 58 years (range 18-85). There were 166 patients with the various subtypes of aggressive (intermediate/high grade) NHL and 89 with the various subtypes of low risk. MG was detected in 44 patients (17.2%) with a median age of 61 years (range 23-79). There were 22 cases (8.6%) with IgG type (IgG/(k) 15, IgG/(lambda) 7), 4 cases (1.6%) with (IgA/(k) 3, IgA/(lambda) 1) and 18 cases (7.0%) with IgM (IgM/(k) 12 IgM/(lambda) 6). MG was found in 15.6% of the patients with aggressive NHL, while in low risk NHL the incidence was 20.2% (N.S.). The type of MG according to histological classification was as follows: Aggressive NHL: IgG 17 cases, IgA 2 cases, IgM 7 cases: low risk NHL: IgG 5 cases, IgA 2 cases, IgM 11 cases. The distribution of MG according to stage of the disease was as follows: stage I (4.5%), stage II (18%), stage III (6.8%) and stage IV (70.4%). The median survival of patients with aggressive NHL with MG was 17 months compared to 40 months of those without (P=0.22). Similarly the median survival of patients with low risk NHL and MG was 51.5 months compared to 38.5 months of those without (P=0.90). In conclusion MG was detected in 17.2% of cases with B-cell NHL. IgG-MG was more frequent in cases with aggressive NHL, while IgM in cases with low risk NHL. MG was mostly associated with advanced stage and had not any prognostic significance on survival.

haematologica/the hematology journal | 2007; 92(10) | 1343 | A clinicopathological study of B-cel... more haematologica/the hematology journal | 2007; 92(10) | 1343 | A clinicopathological study of B-cell differentiation markers and transcription factors in classical Hodgkin’s lymphoma: a potential prognostic role of MUM1/IRF4

Journal of Biomedicine, 2019

The IgG immunoglobulins are the main immunoglobulins in human beings. They have the longest half ... more The IgG immunoglobulins are the main immunoglobulins in human beings. They have the longest half time and are the most studied of all. After the Ag binding, there is a signaling through the Fc region. The post translational modification of the immunoglobulin mainly includes the N-Glycosylation and mostly the IgG one. The IgGs represent the antibodies, which are the mediators of the immunity, against extracellular bacteria and toxins. The Fcγ receptors exist in all hemopeitic cells. The extracellular parts of the receptors show high grade of homology in their amino acid sequences. Monoclonal antibodies can distinguish them. In addition to nucleic acids, proteins and lipids, sugars are also fundamental components of animal systems. Compared with advances in genomics and proteomics, the study of glycoscience is under investigation. Changes in glycosylation may be used as biological markers for screening in relation to healthy subjects. It may help in the discovery of patients in early stages of the disease and thus be used as a biological marker to select patients with better prognosis and therefore to use as chemotherapy chemotherapeutic agents with lower toxicity.

Frontiers in Physiology

Graphical SARS-CoV-2 infection has significant effects on red blood cells that seems to be associ... more Graphical SARS-CoV-2 infection has significant effects on red blood cells that seems to be associated with disease severity in these patients. (A) Non-Intensive care unit hospitalized patients due to severe COVID-19 disease were included in this study (n = 36). (B) The control group included healthy subjects without renal or hepatic impairment, no diagnosis of anemia or myeloid malignancy, and no blood transfusion over the past 3 months (n = 18). (C) Demographic data, clinical, laboratory and chest Computed Tomography (CT) findings at time of admission were recorded. Hematological tests, standard biochemical analysis of serum components were performed both in the patient and in the control group and coagulation analysis were evaluated in the patient group. A peripheral blood smear examination was also performed in all patients and control samples. (D) Plasma free hemoglobin and red blood cell (RBC) osmotic fragility and free hemoglobin (Free-Hb) after mechanical stress (MECH) by mec...

Frontiers in Pediatrics

BackgroundPlatelet function of fetal growth restricted (FGR) neonates remains a field of debate. ... more BackgroundPlatelet function of fetal growth restricted (FGR) neonates remains a field of debate. Platelet function analyzer (PFA-100) offers a quantitative in vitro assessment of primary, platelet-related hemostasis. Our aim was to examine platelet function using PFA-100 in FGR neonates and associate our results with perinatal parameters.MethodsPFA-100 was applied on 74 FGR neonates, 48 full-term (>37 weeks' gestation) and 26 preterm neonates (<37 weeks). The control group consisted of 118 healthy neonates. Two closure times (CTs) with COL/EPI and COL/ADP cartridges were determined on cord blood samples for each subject. Statistical analysis was performed by SAS 9.4. The statistical significance level was set at 0.05 and all tests were two-tailed.ResultsCOL/EPI CTs were prolonged in FGR (median 132 s, IQR 95–181 s) compared with control neonates (median 112.5 s, IQR 93–145 s), p = 0.04. Median COL/EPI CT for term and preterm FGR neonates was 126 s (IQR 90–157 s) and 137 s ...

Children

Background: Thromboelastometry (ROTEM), as a point of care test, is an attractive tool for rapid ... more Background: Thromboelastometry (ROTEM), as a point of care test, is an attractive tool for rapid evaluation of hemostasis. Currently, no reference ranges exist for all ROTEM assays in neonates, limiting its use in this vulnerable population. The aim of the present study was: (1) to establish reference ranges for standard extrinsically activated (EXTEM), intrinsically activated (INTEM), and fibrinogen polymerization (FIBTEM) ROTEM assays in whole blood samples of healthy term neonates; (2) to determine the impact of gender, delivery mode, and hematocrit on ROTEM parameters. Methods: EXTEM, INTEM, and FIBTEM ROTEM assays were performed simultaneously with complete blood count in 215 healthy term neonates. Results: Reference ranges (2.5th and 97.5th percentiles) were obtained for clotting time (CT), clot formation time (CFT), α-angle, clot firmness at 10 min (A10), maximum clot firmness (MCF), and lysis index at 60 min (LI60, %). Reference ranges for EXTEM were CT 38–78 s, CFT 49–148 s...

Diagnostics

Neonatal platelet hemostasis, although it has been well described over the recent years, remains ... more Neonatal platelet hemostasis, although it has been well described over the recent years, remains elusive in specific patient populations, including neonates from high-risk pregnancies, such as those complicated with gestational diabetes mellitus (GDM). We aimed at evaluating the platelet function of neonates born to mothers with GDM using the platelet function analyzer (PFA-100). Cord blood samples were drawn from each subject and tested with two different agonists to provide two closure time (CT) values (collagen with epinephrine (COL/EPI) and collagen with adenosine diphosphate (COL/ADP)). A total of 84 and 118 neonates formed the GDM and the control group (neonates from uncomplicated pregnancies), respectively. COL/EPI CTs were prolonged in neonates from the GDM group compared to neonates from the control group, while no statistically significant difference of COL/ADP CTs was noted between the two groups, GDM and the control. Higher COL/ADP CTs were demonstrated in neonates born ...

Transfusion and Apheresis Science

Children, 2022

Background: ROTEM assay has gained increasing acceptance as a method for rapid and specific coagu... more Background: ROTEM assay has gained increasing acceptance as a method for rapid and specific coagulation pathway assessment. However, its use in the neonatal population remains limited since reference ranges have not yet been established. Aims: (1) to determine reference ranges for healthy term neonates of ROTEM parameters using non-activated assay (NATEM) in cord blood samples; (2) to assess whether delivery mode, gender, gestational age, birth weight and blood group (ABO and Rhesus) of the neonate, coagulation disorder and anticoagulant medication of the mother have an impact on NATEM parameters. Methods: NATEM assay was conducted in cord blood samples of 189 term neonates without any medical history. Results: Reference ranges (2.5th and 97.5th percentiles) are established for clotting time (CT), clot formation time (CFT), α-angle, clot amplitude at 5, 10 and 20 min (A5, A10, A20), maximum clot firmness (MCF), lysis index at 30 and 60 min (LI30, LI60, %) and maximum clot elasticity...

Essential thrombocytosis (ET) and FV Leiden heterozygosity represent an acquired and hereditable ... more Essential thrombocytosis (ET) and FV Leiden heterozygosity represent an acquired and hereditable hypercoagulable state, respectively. An uncommon case of coexistence of ET and FV Leiden heterozygosity in a 36-year-old pregnant woman and her successful pregnancy outcome is described. She was considered to be at high risk of thrombosis during her pregnancy and she was treated with both prophylactic dose of LMWH and aspirin daily throughout her pregnancy and for a 6-week period postpartum. The efficacy of the anticoagulation treatment was monitored in various time points not only by measuring anti-Xa levels and D-Dimers but also with new coagulation methods such as rotation thromboelastometry and multiplate. Global assessment of coagulation using additional newer laboratory tests might prove useful in monitoring coagulation pregnancies at high risk for thrombosis.

Journal of Clinical Medicine, 2021

Objectives: Our aim was to assess blood utilization after implementation of a patient blood manag... more Objectives: Our aim was to assess blood utilization after implementation of a patient blood management (PBM) program in a Greek tertiary hospital. Methods: An electronic transfusion request form and a prospective audit of transfusion practice were implemented. After the one-year implementation period, a retrospective review was performed to assess transfusion practice in medical patients. Results: Pre-PBM, a total of 9478 RBC units were transfused (mean: 1.75 units per patient) compared with 9289 transfused units (mean: 1.57 units per patient) post-PBM. Regarding the post-PBM period, the mean hemoglobin (Hb) level of the 3099 medical patients without comorbidities transfused was 7.19 ± 0.79 gr/dL. Among them, 2065 (66.6%) had Hb levels >7.0 gr/dL, while 167 (5.3%) had Hb levels >8.0 gr/dL. In addition, 331 (25.3%) of the transfused patients with comorbidities had Hb >8.0 gr/dL. The Hb transfusion thresholds significantly differed across the clinics (p < 0.001), while 21....

Case Reports in Obstetrics and Gynecology, 2018

Thalassemia intermedia (TI) is a clinical definition which represents a wide spectrum of thalasse... more Thalassemia intermedia (TI) is a clinical definition which represents a wide spectrum of thalassemia genotypes but mainly includes patients who do not require or only occasionally require transfusion. An uncommon case of a 32-year-old Greek woman, para 1, at the 22nd week + day 3 of gestation with thalassemia intermedia (she was splenectomized), where her pregnancy was complicated with portal vein thrombosis, splenic thrombosis, and partial HELLP, is described. This is a generally uncommon event in thalassemia intermedia. She had no transfusion as her hematologist consulted and she took anticoagulation therapy. Thus, we present for the first time in the literature a case of HbH a-thalassemia pregnant woman whose pregnancy was complicated with portal vein thrombosis, splenic vein thrombosis, and partial HELLP; she was treated with anticoagulation therapy and she had a successful outcome.

Asian Journal of Transfusion Science, 2020

Background: Platelet transfusion is among the most useful therapeutic tools in modern clinical se... more Background: Platelet transfusion is among the most useful therapeutic tools in modern clinical settings which mean that ensuring an adequate supply is of paramount importance. Aim: The aim of our study was to record the use and wastage of platelet concentrates (PCs) in Greece, so as to come up with evidence-based interventions. Methods: The study was conducted during May and June 2015. We evaluated the use of random-donor platelets (RDPs) and single-donor apheresis platelets (SDPs). We analyzed such parameters as hospital department and diagnosis, indication for transfusion, PCs' age at the time of transfusion, and wastage rate. Results: We used data from 21 hospitals across the country. A total of 12,061 RDPs and 1189 SDPs were transfused, with an average of 4.84 (±2.72) and 1.12 (±2.73) units per episode, respectively. Most patients had been admitted to the internal medicine and hematology departments. The transfusions were mostly given prophylactically, usually in cases of ac...