Haematology

The Complex Unit (S.C.) of Haematology at the IRCCS National Cancer Institute (INT) is responsible for the diagnosis and treatment of haematological cancers in adult patients. The Unit provides outpatient consultations, diagnostic procedures such as bone marrow biopsies and lumbar punctures, treatment on an outpatient basis, in the Day Hospital and in the inpatient ward, as well as clinical and experimental research thanks to the availability of a dedicated laboratory.

The Complex Unit of Haematology is strongly focused on the use of innovative treatments, through the use of new drugs, new immunotherapies (bispecific antibodies, antibody-drug conjugates, checkpoint inhibitors, immunomodulators, Bruton’s tyrosine kinase inhibitors), autologous and allogeneic haematopoietic stem cell transplantation, and chimeric antigen receptor T-cell (CAR-T) therapies; thanks to access to innovative therapies, it has become a national centre of excellence for the treatment of patients with advanced and difficult-to-treat disease.  

The department aims to provide patients with the best available care and to develop innovative therapeutic strategies for onco-haematological conditions.

The mission of the Haematology Department is not only to provide the best available treatments, but also to ensure that patients receive the human support and understanding that those affected by the serious conditions treated at the Institute undoubtedly require. The comprehensiveness, adequacy and effectiveness of patient care are confirmed by patient satisfaction surveys conducted regularly by the Lombardy Region, which show a high level of appreciation for the Haematology Department among users. Physiotherapy and psychological support form part of the treatment programmes.

Inpatient wards and outpatient clinics: The Complex Haematology Unit has 8 outpatient clinics, a day hospital, and two inpatient wards with a total of 18 beds, dedicated to the treatment of haematological malignancies and the management of their complications; all 18 beds are suitable for Phase I trials, 6 for allogeneic transplantation, and 10 for CAR-T therapy. Inpatient treatment includes conventional-dose chemotherapy, high-dose chemotherapy, autologous bone marrow transplantation, and haematopoietic stem cell transplantation from a family donor (HLA-identical or HLA-haploidentical) or from a bank donor. The Haematology Department is accredited to perform all types of transplants and has been approved for seven different CAR-T therapies (axi-cel, tisa-cel, brexu-cel, liso-cel, ide-cel, cilta-cel, anito-cel). [Accreditations: JACIE (Joint Accreditation Committee-ISCT (Europe) & EBMT), EBMT (European Group for Blood and Marrow Transplantation), GITMO (Italian Bone Marrow Transplant Group) and CNT (National Transplant Centre)]. 

With regard to cell therapies and transplant procedures, between 2019 and the end of 2024, the following were carried out:

• 158 CAR-T treatments, 141 in patients with non-Hodgkin’s lymphoma (diffuse large B-cell or high-grade lymphoma, primary mediastinal lymphoma, mantle cell lymphoma, follicular lymphoma), and 17 in patients with multiple myeloma;
• 90 allogeneic transplants from MUD donors, identical relatives, and haploidentical relatives, in 33 patients with myeloid disorders, 19 with Hodgkin’s lymphoma, 37 with non-Hodgkin’s lymphoma, and 1 with multiple myeloma;
• 295 high-dose chemotherapy regimens with autologous transplant reinfusion, 172 in patients with multiple myeloma, 82 with non-Hodgkin’s lymphoma and 41 with Hodgkin’s lymphoma. 

The Experimental Haematology Research Laboratory

The Haematology Department laboratory, located on the mezzanine floor of Block 2B, comprises rooms furnished and equipped with laminar flow hoods for cell cultures, incubators, thermostatic baths, direct and inverted light microscopes, thermal cyclers for nucleic acid amplification, and electrophoresis chambers. It is a facility dedicated to the diagnostic and prognostic assessment and monitoring of haematological malignancies (acute and chronic leukaemias, lymphomas, multiple myeloma). The laboratory provides significant support to clinical practice through the use of methods involving NGS technologies for the most advanced oncohaematological diagnostics. It is also involved in monitoring CAR-T cells and lymphocyte populations activated by immunotherapies, as well as monitoring minimal residual disease via liquid biopsy.
In the field of allogeneic transplantation, the laboratory performs serial monitoring of B- and T-cell reconstitution using molecular and flow cytometric methods. 

Clinical Research Activities

The clinical research activities of the Haematology Unit are aimed at improving conventional treatments and developing innovative therapeutic approaches and transplant strategies. The Haematology Division participates in numerous clinical trials (Phase I, II and III), both as a coordinating centre and as a participating centre, with the aim of studying and improving new cell therapies using CAR-T, bispecific antibodies or new drugs for the treatment of haematological malignancies. 

Teaching Activities

Prof. Paolo Corradini, Head of the Haematology Department, is a Full Professor of Haematology at the University of Milan. The Department of Haematology serves as a teaching and training centre for students on the Haematology Specialisation programme, for students at the Faculty of Medicine and Surgery of the University of Milan (UniMI) and for students at UniMI’s International Medical School. Furthermore, the laboratory provides training for students on the Medical Biotechnology degree programme at the University of Milan. (http://www.unimi.it).