Di Bella Method in lymphoproliferative diseases - 2010

Published on Monday, 20 May 2013

Di Bella Method in lymphoproliferative diseases - Dr. Mauro Todisco - San Marino Congress - 2010


Below a complete transcription of San Marino Congress (2010):




1) Cancer Biotherapy & RadioPharmaceuticals Volume 16, Number 2, 2001 ©Mary Ann Liebert, Inc. - Cyclophosphamide plus Somatostatin, Bromocriptin, Retinoids, Melatonin and ACTH in the Treatment of Low-grade Non-Hodgkin’s Lymphomas at Advanced Stage: Results of a Phase II Trial. Mauro Todisco*, MD, Piergiorgio Casaccia, MD, and Nazzareno Rossi ASL I3 in Sondrio and ASL 106 in Teramo (Local Health Department of National Health Service);

2) American Journal of Therapeutics: January/February 2007 - Volume 14 - Issue 1 - pp 113-115 Case Report - Low-grade non-Hodgkin lymphoma at advanced stage: a case successfully treated with cyclophosphamide plus somatostatin, bromocriptine, retinoids, and melatonin. Todisco M ASL 11, Local Health Department of National Health Service, Fermo, Italy;

3) American Journal of Therapeutics: November/December 2006 - Volume 13 - Issue 6 - pp 556-557 Case Report - Relapse of High-Grade Non-Hodgkin's Lymphoma After Autologous Stem Cell Transplantation: A Case Successfully Treated With Cyclophosphamide Plus Somatostatin, Bromocriptine, Melatonin, Retinoids, and ACTH. Todisco Mauro MD, ASL 11, Local Health Department of National Health Service, Fermo, Italy;

4) Cancer Biotherapy & Radiopharmaceuticals Volume 24, Number 3, 2009 ©Mary Ann Liebert, Inc. - Chronic lymphocytic leukemia: long-lasting remission with combination of cyclophosphamide, somatostatin, bromocriptine, retinoids, melatonin, and ACTH. Todisco M. - Department of Medical Assistance Continuity, Asur Marche ZT 11, Grottamare, Italy.




Let’s continue with Dr. Mauro Todisco, who will talk about the DBM in lymphoproliferative diseases.


Hello everyone, I thank Dr. Giuseppe Di Bella for giving me this opportunity as a speaker.

For me this is a particularly welcome occasion because I consider the field of lymphoproliferative diseases one of the nosological areas in which prof. Di Bella’s multitherapy can better express its antineoplastic value.

Precisely on the result of the DBM - the multitherapy - in the treatment of 20 patients with low-grade non-Hodgkin's lymphoma at advanced stage, in 2001 I published my first scientific work, then this publication was followed by others always related to lymphomas and recently a publication on chronic lymphocytic leukemia.

The efficacy of the DBM in lymphoproliferative disorders can be explained by the activity that the individual constituents of that therapy exert against the growth of neoplastic lymphocytes. I don’t want to bore you, with a description of the works which have been added over time to demonstrate the anti lymphoproliferative potential of the various constituents of the DBM; however what I think may be of interest is, as Dr. Di Bella has already said, that in the DBM such activity is superior to that of each of its individual constituent, which authorizes to speak, in the specific case, of real synergistic therapeutic effect!

In my clinical experience, for example, I observed a remission of low-grade non-Hodgkin's lymphoma in a patient resistant to treatment with cyclophosphamide per os alone, in daily doses higher than those used in the DBM. Same could be said with regard to, for example, Witzig’s tests regarding the use of octreotide alone and its success rates on lymphoproliferative disorders.

What is striking about Prof. Di Bella’s multitherapy, both in the treatment of low-grade lymphomas and in chronic lymphocytic leukemias, is the high predictability of the events which the assumption of therapy gives rise to, because the response is observed as early as the third week and tends to perfect itself in a span of a few months.

It is a response that can sometimes amaze even for the degree, the intensity: it is very common to observe, for example, that palpable masses, even relevant, disappear in just over a month, as well as you can see in the case of chronic lymphocytic leukemia - and it is a case that happened to me - drops also of 60,000 lymphocytes in 20 days!

In the case of this patient, who was a Tuscan patient, suffering from chronic lymphocytic leukemia, this patient had been visited by an eminent French hematologist (Omissis!) who had advised a very aggressive therapy for that case, so this result, all the more reason is worthy of consideration.

It must be said also that if the patient has not been previously treated, so it's a “treatment virgin” patient, normally it does not encounter any problems in obtaining the result and it is not necessary to make major dosage changes on the various constituents of the DBM.

However what is tricky of its management is maintaining the obtained remission. When I started my experience, over ten years ago, galvanized by the ease with which one obtains the result, I used to reduce the multi-therapy as early as the third-fourth month, however the frequent observation, in these circumstances, of relapses which forced me to increase again the treatment, led me to a more cautious attitude.

Today I prefer to keep my guard up for at least 6-8 months, and possibly reducing just the cyclophosphamide during this period - the posology of cyclophosphamide - especially if in concomitance with signs of bone marrow toxicity. Then, passed this period, I proceed to gradually reduce the treatment, supporting the reductions with a check of the subsistence of the remission already obtained.

Overall, maintaining the remission, for what is my experience, requires lower dosage regimens in chronic lymphocytic leukemia in which you get to weekly quantities of cyclophosphamide and somatostatin really minimal, that is, you can - at least this is my experience – maintain a state of remission with two Endoxan per week, one milligram of somatostatin twice a week.

Still with regard to DBM in chronic lymphocytic leukemia: I mentioned a recent publication on the condition; the publication in question describes 4 cases of disease remission, 3 of which however, long-term – two over 10 years, and one case almost 8 years!

Now, it so happens that in literature no cases are described of patients with chronic lymphocytic leukemia whose responses to various chemotherapeutic approaches exceed for duration 48 months!

It is needless to recall that the relapse occurred and the subsequent ones are associated with the necessary administration of additional chemotherapy lines in an overall framework of ever increasing difficulty of treatment.

This being the case, it is not difficult to understand what benefits are deriving from DBM to the 3 patients with long-term remissions referred to the work that I have mentioned. And there should be not even doubts about whether the interesting data of the work is the long-term remissions, this data - I repeat - resulting unprecedented in literature!

Finally, one last note: I have over twenty-five years of professional work and who like me has practiced for long time, knows how rare the real therapeutic innovations in medicine are, those that work, and how frequent are instead the short-lived news, the ones that go out early because of their ineffectiveness or because burdened by risks which outweigh the potential benefits. What is missing is, in the words of Tacitus: “what enables the new to become ancient”.

Well, although Di Bella therapy may sound new to many, it is not a new treatment, having passed thirty years now, and the fact that today, long after its introduction, we talk about it in a congress, in my opinion means that this treatment has, engraved in itself, those characteristics that allow the new to become ancient. An imprimatur of which today we can explain the reasons, having access to data on the antineoplastic value of retinoids, somatostatin, and being now common the concept of neoplastic growth factor and that of the possible therapeutic utility of the inhibitors of these factors. But an imprimatur, again, that in the mid-'70s, in the vacuum of current scientific evidence, was due solely to the genius of its author, Professor Luigi di Bella.