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1. Decoding the historical tale: COVID-19 impact on haematological malignancy patients-EPICOVIDEHA insights from 2020 to 2022

Author

Arellano-Orden, Elena [0000-0003-0581-8947], Salmanton-García, Jon, Marchesi, Francesco, Farina, Francesca, Weinbergerová, Barbora, Itri, Federico, Dávila-Valls, Julio, Martín-Pérez, Sonia, Glenthøj, Andreas, Hersby, Ditte Stampe, Gomes da Silva, Maria, Nunes Rodrigues, Raquel, López-García, Alberto, Córdoba, Raúl, Bilgin, Yavuz M., Falces-Romero, Iker, El-Ashwah, Shaimaa, Emarah, Ziad, Besson, Caroline, Kohn, Milena, Van Doesum, Jaap, Ammatuna, Emanuele, Marchetti, Monia, Labrador, Jorge, Zambrotta, Giovanni Paolo Maria, Verga, Luisa, Jaksic, Ozren, Nucci, Marcio, Piukovics, Klára, Cabirta-Touzón, Alba, Jiménez, Moraima, Arellano-Orden, Elena, Espigado, Ildefonso, Blennow, Ola, Nordlander, Anna, Meers, Stef, van Praet, Jens, Aiello, Tommaso Francesco, Garcia-Vidal, Carolina, Fracchiolla, Nicola, Sciumè, Mariarita, Seval, Guldane Cengiz, Žák, Pavel, Buquicchio, Caterina, Tascini, Carlo, Gräfe, Stefanie K., Schönlein, Martin, Adžić-Vukičević, Tatjana, Bonuomo, Valentina, Cattaneo, Chiara, Nizamuddin, Summiya, Čerňan, Martin, Plantefeve, Gaëtan, Prin, Romane, Szotkovski, Tomas, Collins, Graham P., Dargenio, Michelina, Petzer, Verena, Wolf, Dominik, Čolović, Natasha, Prezioso, Lucia, Valković, Toni, Passamonti, Francesco, Méndez, Gustavo-Adolfo, Sili, Uluhan, Vena, Antonio, Bavastro, Martina, Limongelli, Alessandro, Duarte, Rafael F., Ledoux, Marie-Pierre, Cvetanoski, Milche, Stojanoski, Zlate, Machado, Marina, Batinić, Josip, Magliano, Gabriele, Biernat, Monika M., Pantić, Nikola, Poulsen, Christian Bjørn, Cuccaro, Annarosa, Del Principe, Maria Ilaria, Kulasekararaj, Austin, Ormazabal-Vélez, Irati, Busca, Alessandro, Demirkan, Fatih, Ijaz, Marriyam, Klimko, Nikolai, Stoma, Igor, Khostelidi, Sofya, Fernández, Noemí, Omrani, Ali S, Bergantim, Rui, De Jonge, Nick, Fouquet, Guillemette, Navrátil, Milan, Abu-Zeinah, Ghaith, Samarkos, Michail, Maertens, Johan, De Ramón, Cristina, Guidetti, Anna, Magyari, Ferenc, González-López, Tomás José, Lahmer, Tobias, Finizio, Olimpia, Ali, Natasha, Pinczés, László Imre, Lavilla-Rubira, Esperanza, Romano, Alessandra, Merelli, Maria, Delia, Mario, Calbacho, Maria, Meletiadis, Joseph, Antić, Darko, Hernández-Rivas, José-Ángel, Marques de Almeida, Joyce, Al-Khabori, Murtadha, Hoenigl, Martin, Tisi, Maria Chiara, Khanna, Nina, Barać, Aleksandra, Eisa, Noha, Di Blasi, Roberta, Liévin, Raphaël, Miranda-Castillo, Carolina, Bahr, Nathan C., Lamure, Sylvain, Papa, Mario Virgilio, Yahya, Ayel, Aujayeb, Avinash, Novák, Jan, Erben, Nurettin, Fernández-Galán, María, Ribera-Santa Susana, José-María, Rinaldi, Ikhwan, Fazzi, Rita, Piedimonte, Monica, Duléry, Rémy, Gonzaga, Yung, Soto-Silva, Andrés, Sapienza, Giuseppe, Serris, Alexandra, Drgoňa, Ľuboš, Groh, Ana, Serrano, Laura, Gavriilaki, Eleni, Tragiannidis, Athanasios, Prattes, Juergen, Coppola, Nicola, Otašević, Vladimir, Mladenović, Miloš, Mitrović, Mirjana, Mišković, Bojana, Jindra, Pavel, Zompi, Sofia, Sacchi, Maria Vittoria, Krekeler, Carolin, Infante, Maria Stefania, García-Bordallo, Daniel, Çolak, Gökçe Melis, Mayer, Jiří, Nygaard, Marietta, Hanáková, Michaela, Ráčil, Zdeněk, Bonanni, Matteo, Koehler, Philipp, Rahimli, Laman, Cornely, Oliver A., Pagano, Livio, Arellano-Orden, Elena [0000-0003-0581-8947], Salmanton-García, Jon, Marchesi, Francesco, Farina, Francesca, Weinbergerová, Barbora, Itri, Federico, Dávila-Valls, Julio, Martín-Pérez, Sonia, Glenthøj, Andreas, Hersby, Ditte Stampe, Gomes da Silva, Maria, Nunes Rodrigues, Raquel, López-García, Alberto, Córdoba, Raúl, Bilgin, Yavuz M., Falces-Romero, Iker, El-Ashwah, Shaimaa, Emarah, Ziad, Besson, Caroline, Kohn, Milena, Van Doesum, Jaap, Ammatuna, Emanuele, Marchetti, Monia, Labrador, Jorge, Zambrotta, Giovanni Paolo Maria, Verga, Luisa, Jaksic, Ozren, Nucci, Marcio, Piukovics, Klára, Cabirta-Touzón, Alba, Jiménez, Moraima, Arellano-Orden, Elena, Espigado, Ildefonso, Blennow, Ola, Nordlander, Anna, Meers, Stef, van Praet, Jens, Aiello, Tommaso Francesco, Garcia-Vidal, Carolina, Fracchiolla, Nicola, Sciumè, Mariarita, Seval, Guldane Cengiz, Žák, Pavel, Buquicchio, Caterina, Tascini, Carlo, Gräfe, Stefanie K., Schönlein, Martin, Adžić-Vukičević, Tatjana, Bonuomo, Valentina, Cattaneo, Chiara, Nizamuddin, Summiya, Čerňan, Martin, Plantefeve, Gaëtan, Prin, Romane, Szotkovski, Tomas, Collins, Graham P., Dargenio, Michelina, Petzer, Verena, Wolf, Dominik, Čolović, Natasha, Prezioso, Lucia, Valković, Toni, Passamonti, Francesco, Méndez, Gustavo-Adolfo, Sili, Uluhan, Vena, Antonio, Bavastro, Martina, Limongelli, Alessandro, Duarte, Rafael F., Ledoux, Marie-Pierre, Cvetanoski, Milche, Stojanoski, Zlate, Machado, Marina, Batinić, Josip, Magliano, Gabriele, Biernat, Monika M., Pantić, Nikola, Poulsen, Christian Bjørn, Cuccaro, Annarosa, Del Principe, Maria Ilaria, Kulasekararaj, Austin, Ormazabal-Vélez, Irati, Busca, Alessandro, Demirkan, Fatih, Ijaz, Marriyam, Klimko, Nikolai, Stoma, Igor, Khostelidi, Sofya, Fernández, Noemí, Omrani, Ali S, Bergantim, Rui, De Jonge, Nick, Fouquet, Guillemette, Navrátil, Milan, Abu-Zeinah, Ghaith, Samarkos, Michail, Maertens, Johan, De Ramón, Cristina, Guidetti, Anna, Magyari, Ferenc, González-López, Tomás José, Lahmer, Tobias, Finizio, Olimpia, Ali, Natasha, Pinczés, László Imre, Lavilla-Rubira, Esperanza, Romano, Alessandra, Merelli, Maria, Delia, Mario, Calbacho, Maria, Meletiadis, Joseph, Antić, Darko, Hernández-Rivas, José-Ángel, Marques de Almeida, Joyce, Al-Khabori, Murtadha, Hoenigl, Martin, Tisi, Maria Chiara, Khanna, Nina, Barać, Aleksandra, Eisa, Noha, Di Blasi, Roberta, Liévin, Raphaël, Miranda-Castillo, Carolina, Bahr, Nathan C., Lamure, Sylvain, Papa, Mario Virgilio, Yahya, Ayel, Aujayeb, Avinash, Novák, Jan, Erben, Nurettin, Fernández-Galán, María, Ribera-Santa Susana, José-María, Rinaldi, Ikhwan, Fazzi, Rita, Piedimonte, Monica, Duléry, Rémy, Gonzaga, Yung, Soto-Silva, Andrés, Sapienza, Giuseppe, Serris, Alexandra, Drgoňa, Ľuboš, Groh, Ana, Serrano, Laura, Gavriilaki, Eleni, Tragiannidis, Athanasios, Prattes, Juergen, Coppola, Nicola, Otašević, Vladimir, Mladenović, Miloš, Mitrović, Mirjana, Mišković, Bojana, Jindra, Pavel, Zompi, Sofia, Sacchi, Maria Vittoria, Krekeler, Carolin, Infante, Maria Stefania, García-Bordallo, Daniel, Çolak, Gökçe Melis, Mayer, Jiří, Nygaard, Marietta, Hanáková, Michaela, Ráčil, Zdeněk, Bonanni, Matteo, Koehler, Philipp, Rahimli, Laman, Cornely, Oliver A., and Pagano, Livio

Abstract

The COVID-19 pandemic heightened risks for individuals with hematological malignancies due to compromised immune systems, leading to more severe outcomes and increased mortality. While interventions like vaccines, targeted antivirals, and monoclonal antibodies have been effective for the general population, their benefits for these patients may not be as pronounced.

Published
2024

2. COVID-19 in adult acute myeloid leukemia patients:a long-term follow-up study from the European Hematology Association survey (EPICOVIDEHA)

Author

Marchesi, Francesco, Salmanton-García, Jon, Emarah, Ziad, Piukovics, Klára, Nucci, Marcio, López-García, Alberto, Ráčil, Zdeněk, Farina, Francesca, Popova, Marina, Zompi, Sofia, Audisio, Ernesta, Ledoux, Marie Pierre, Verga, Luisa, Weinbergerová, Barbora, Szotkovski, Tomas, Da Silva, Maria Gomes, Fracchiolla, Nicola, De Jonge, Nick, Collins, Graham, Marchetti, Monia, Magliano, Gabriele, García-Vidal, Carolina, Biernat, Monika M., Van Doesum, Jaap, Machado, Marina, Demirkan, Fatih, Al-Khabori, Murtadha, Žák, Pavel, Víšek, Benjamín, Stoma, Igor, Méndez, Gustavo Adolfo, Maertens, Johan, Khanna, Nina, Espigado, Ildefonso, Dragonetti, Giulia, Fianchi, Luana, Del Principe, Maria Ilaria, Cabirta, Alba, Ormazabal-Vélez, Irati, Jaksic, Ozren, Buquicchio, Caterina, Bonuomo, Valentina, Batinić, Josip, Omrani, Ali S., Lamure, Sylvain, Finizio, Olimpia, Fernández, Noemí, Falces-Romero, Iker, Blennow, Ola, Bergantim, Rui, Ali, Natasha, Win, Sein, Van Praet, Jens, Tisi, Maria Chiara, Shirinova, Ayten, Schönlein, Martin, Prattes, Juergen, Piedimonte, Monica, Petzer, Verena, Navrátil, Milan, Kulasekararaj, Austin, Jindra, Pavel, Sramek, Jiří, Glenthøj, Andreas, Fazzi, Rita, De Ramón-Sánchez, Cristina, Cattaneo, Chiara, Calbacho, Maria, Bahr, Nathan C., El-Ashwah, Shaimaa, Cordoba, Raul, Hanakova, Michaela, Zambrotta, Giovanni Paolo Maria, Zambrotta, Giovanni, Sciumè, Mariarita, Booth, Stephen, Rodrigues, Raquel Nunes, Sacchi, Maria Vittoria, García-Poutón, Nicole, Martín-González, Juan Alberto, Khostelidi, Sofya, Gräfe, Stefanie, Rahimli, Laman, Ammatuna, Emanuele, Busca, Alessandro, Corradini, Paolo, Hoenigl, Martin, Klimko, Nikolai, Koehler, Philipp, Pagliuca, Antonio, Passamonti, Francesco, Cornely, Oliver A., Pagano, Livio, Marchesi, Francesco, Salmanton-García, Jon, Emarah, Ziad, Piukovics, Klára, Nucci, Marcio, López-García, Alberto, Ráčil, Zdeněk, Farina, Francesca, Popova, Marina, Zompi, Sofia, Audisio, Ernesta, Ledoux, Marie Pierre, Verga, Luisa, Weinbergerová, Barbora, Szotkovski, Tomas, Da Silva, Maria Gomes, Fracchiolla, Nicola, De Jonge, Nick, Collins, Graham, Marchetti, Monia, Magliano, Gabriele, García-Vidal, Carolina, Biernat, Monika M., Van Doesum, Jaap, Machado, Marina, Demirkan, Fatih, Al-Khabori, Murtadha, Žák, Pavel, Víšek, Benjamín, Stoma, Igor, Méndez, Gustavo Adolfo, Maertens, Johan, Khanna, Nina, Espigado, Ildefonso, Dragonetti, Giulia, Fianchi, Luana, Del Principe, Maria Ilaria, Cabirta, Alba, Ormazabal-Vélez, Irati, Jaksic, Ozren, Buquicchio, Caterina, Bonuomo, Valentina, Batinić, Josip, Omrani, Ali S., Lamure, Sylvain, Finizio, Olimpia, Fernández, Noemí, Falces-Romero, Iker, Blennow, Ola, Bergantim, Rui, Ali, Natasha, Win, Sein, Van Praet, Jens, Tisi, Maria Chiara, Shirinova, Ayten, Schönlein, Martin, Prattes, Juergen, Piedimonte, Monica, Petzer, Verena, Navrátil, Milan, Kulasekararaj, Austin, Jindra, Pavel, Sramek, Jiří, Glenthøj, Andreas, Fazzi, Rita, De Ramón-Sánchez, Cristina, Cattaneo, Chiara, Calbacho, Maria, Bahr, Nathan C., El-Ashwah, Shaimaa, Cordoba, Raul, Hanakova, Michaela, Zambrotta, Giovanni Paolo Maria, Zambrotta, Giovanni, Sciumè, Mariarita, Booth, Stephen, Rodrigues, Raquel Nunes, Sacchi, Maria Vittoria, García-Poutón, Nicole, Martín-González, Juan Alberto, Khostelidi, Sofya, Gräfe, Stefanie, Rahimli, Laman, Ammatuna, Emanuele, Busca, Alessandro, Corradini, Paolo, Hoenigl, Martin, Klimko, Nikolai, Koehler, Philipp, Pagliuca, Antonio, Passamonti, Francesco, Cornely, Oliver A., and Pagano, Livio

Abstract

Patients with acute myeloid leukemia (AML) are at high risk of dying from coronavirus disease 2019 (COVID-19). The optimal management of AML patients with COVID-19 has not been established. Our multicenter study included 388 adult AML patients diagnosed with COVID-19 between February 2020 and October 2021. The vast majority were receiving or had received AML treatment in the preceding 3 months. COVID-19 was severe in 41.2% and critical in 21.1% of cases. The chemotherapeutic schedule was modified in 174 patients (44.8%), delayed in 68 and permanently discontinued in 106. After a median follow-up of 325 days, 180 patients (46.4%) had died; death was attributed to COVID-19 (43.3%), AML (26.1%) or to a combination of both (26.7%), whereas in 3.9% of cases the reason was unknown. Active disease, older age, and treatment discontinuation were associated with death, whereas AML treatment delay was protective. Seventy-nine patients had a simultaneous AML and COVID-19 diagnosis, with better survival when AML treatment could be delayed (80%; P<0.001). Overall survival in patients with a diagnosis of COVID-19 between January 2020 and August 2020 was significantly lower than that in patients diagnosed between September 2020 and February 2021 and between March 2021 and September 2021 (39.8% vs. 60% vs. 61.9%, respectively; P=0.006). COVID-19 in AML patients was associated with a high mortality rate and modifications of therapeutic algorithms. The best approach to improve survival was to delay AML treatment, whenever possible.

Published
2023

3. Outcome of COVID-19 in allogeneic stem cell transplant recipients:Results from the EPICOVIDEHA registry

Author

Busca, Alessandro, Salmanton-García, Jon, Marchesi, Francesco, Farina, Francesca, Seval, Guldane Cengiz, Van Doesum, Jaap, De Jonge, Nick, Bahr, Nathan C., Maertens, Johan, Meletiadis, Joseph, Fracchiolla, Nicola S., Weinbergerová, Barbora, Verga, Luisa, Ráčil, Zdeněk, Jiménez, Moraima, Glenthøj, Andreas, Blennow, Ola, Tanase, Alina Daniela, Schönlein, Martin, Prezioso, Lucia, Khanna, Nina, Duarte, Rafael F., Žák, Pavel, Nucci, Marcio, Machado, Marina, Kulasekararaj, Austin, Espigado, Ildefonso, De Kort, Elizabeth, Ribera-Santa Susana, José María, Marchetti, Monia, Magliano, Gabriele, Falces-Romero, Iker, Ilhan, Osman, Ammatuna, Emanuele, Zompi, Sofia, Tsirigotis, Panagiotis, Antoniadou, Anastasia, Zambrotta, Giovanni Paolo Maria, Nordlander, Anna, Karlsson, Linda Katharina, Hanakova, Michaela, Dragonetti, Giulia, Cabirta, Alba, Berg Venemyr, Caroline, Gräfe, Stefanie, Van Praet, Jens, Tragiannidis, Athanasios, Petzer, Verena, López-García, Alberto, Itri, Federico, Groh, Ana, Gavriilaki, Eleni, Dargenio, Michelina, Rahimli, Laman, Cornely, Oliver A., Pagano, Livio, Busca, Alessandro, Salmanton-García, Jon, Marchesi, Francesco, Farina, Francesca, Seval, Guldane Cengiz, Van Doesum, Jaap, De Jonge, Nick, Bahr, Nathan C., Maertens, Johan, Meletiadis, Joseph, Fracchiolla, Nicola S., Weinbergerová, Barbora, Verga, Luisa, Ráčil, Zdeněk, Jiménez, Moraima, Glenthøj, Andreas, Blennow, Ola, Tanase, Alina Daniela, Schönlein, Martin, Prezioso, Lucia, Khanna, Nina, Duarte, Rafael F., Žák, Pavel, Nucci, Marcio, Machado, Marina, Kulasekararaj, Austin, Espigado, Ildefonso, De Kort, Elizabeth, Ribera-Santa Susana, José María, Marchetti, Monia, Magliano, Gabriele, Falces-Romero, Iker, Ilhan, Osman, Ammatuna, Emanuele, Zompi, Sofia, Tsirigotis, Panagiotis, Antoniadou, Anastasia, Zambrotta, Giovanni Paolo Maria, Nordlander, Anna, Karlsson, Linda Katharina, Hanakova, Michaela, Dragonetti, Giulia, Cabirta, Alba, Berg Venemyr, Caroline, Gräfe, Stefanie, Van Praet, Jens, Tragiannidis, Athanasios, Petzer, Verena, López-García, Alberto, Itri, Federico, Groh, Ana, Gavriilaki, Eleni, Dargenio, Michelina, Rahimli, Laman, Cornely, Oliver A., and Pagano, Livio

Abstract

Background: The outcome of COVID-19 in allogeneic hematopoietic stem cell transplantation (HSCT) recipients is almost uniformely considered poor. The aim of present study was to retrospectively analyse the outcome and risk factors for mortality in a large series of patients who developed COVID-19 infection after an allogeneic HSCT. Methods: This multicenter retrospective study promoted by the European Hematology Association – Infections in Hematology Study Working Group, included 326 adult HSCT patients who had COVID-19 between January 2020 and March 2022. Results: The median time from HSCT to the diagnosis of COVID-19 was 268 days (IQR 86-713; range 0-185 days). COVID-19 severity was mild in 21% of the patients, severe in 39% and critical in 16% of the patients. In multivariable analysis factors associated with a higher risk of mortality were, age above 50 years, presence of 3 or more comorbidities, active hematologic disease at time of COVID-19 infection, development of COVID-19 within 12 months of HSCT, and severe/critical infections. Overall mortality rate was 21% (n=68): COVID-19 was the main or secondary cause of death in 16% of the patients (n=53). Conclusions: Mortality in HSCT recipients who develop COVID-19 is high and largely dependent on age, comorbidities, active hematologic disease, timing from transplant and severity of the infection.

Published
2023

4. COVID-19 in adult acute myeloid leukemia patients: a long-term follow-up study from the European Hematology Association survey (EPICOVIDEHA)

Author

Marchesi, Francesco, Salmanton-García, Jon, Emarah, Ziad, Piukovics, Klára, Nucci, Marcio, López-García, Alberto, Ráčil, Zdeněk, Farina, Francesca, Popova, Marina, Zompi, Sofia, Audisio, Ernesta, Ledoux, Marie-Pierre, Verga, Luisa, Weinbergerová, Barbora, Szotkovski, Toma, Da Silva, Maria Gome, Fracchiolla, Nicola, De Jonge, Nick, Collins, Graham, Marchetti, Monia, Magliano, Gabriele, García-Vidal, Carolina, Biernat, Monika M, Van Doesum, Jaap, Machado, Marina, Demirkan, Fatih, Al-Khabori, Murtadha, Žák, Pavel, Víšek, Benjamín, Stoma, Igor, Méndez, Gustavo-Adolfo, Maertens, Johan, Khanna, Nina, Espigado, Ildefonso, Dragonetti, Giulia, Fianchi, Luana, Del Principe, Maria Ilaria, Cabirta, Alba, Ormazabal-Vélez, Irati, Jaksic, Ozren, Buquicchio, Caterina, Bonuomo, Valentina, Batinić, Josip, Omrani, Ali S, Lamure, Sylvain, Finizio, Olimpia, Fernández, Noemí, Falces-Romero, Iker, Blennow, Ola, Bergantim, Rui, Ali, Natasha, Win, Sein, Van Praet, Jen, Tisi, Maria Chiara, Shirinova, Ayten, Schönlein, Martin, Prattes, Juergen, Piedimonte, Monica, Petzer, Verena, Navrátil, Milan, Kulasekararaj, Austin, Jindra, Pavel, Sramek, Jiří, Glenthøj, Andrea, Fazzi, Rita, De Ramón-Sánchez, Cristina, Cattaneo, Chiara, Calbacho, Maria, Bahr, Nathan C, El-Ashwah, Shaimaa, Cordoba, Raul, Hanakova, Michaela, Zambrotta, Giovanni, Sciumè, Mariarita, Booth, Stephen, Rodrigues, Raquel Nune, Sacchi, Maria Vittoria, García-Poutón, Nicole, Martín-González, Juan-Alberto, Khostelidi, Sofya, Gräfe, Stefanie, Rahimli, Laman, Ammatuna, Emanuele, Busca, Alessandro, Corradini, Paolo, Hoenigl, Martin, Klimko, Nikolai, Koehler, Philipp, Pagliuca, Antonio, Passamonti, Francesco, Cornely, Oliver A, Pagano, Livio, Pagano, Livio (ORCID:0000-0001-8287-928X), Marchesi, Francesco, Salmanton-García, Jon, Emarah, Ziad, Piukovics, Klára, Nucci, Marcio, López-García, Alberto, Ráčil, Zdeněk, Farina, Francesca, Popova, Marina, Zompi, Sofia, Audisio, Ernesta, Ledoux, Marie-Pierre, Verga, Luisa, Weinbergerová, Barbora, Szotkovski, Toma, Da Silva, Maria Gome, Fracchiolla, Nicola, De Jonge, Nick, Collins, Graham, Marchetti, Monia, Magliano, Gabriele, García-Vidal, Carolina, Biernat, Monika M, Van Doesum, Jaap, Machado, Marina, Demirkan, Fatih, Al-Khabori, Murtadha, Žák, Pavel, Víšek, Benjamín, Stoma, Igor, Méndez, Gustavo-Adolfo, Maertens, Johan, Khanna, Nina, Espigado, Ildefonso, Dragonetti, Giulia, Fianchi, Luana, Del Principe, Maria Ilaria, Cabirta, Alba, Ormazabal-Vélez, Irati, Jaksic, Ozren, Buquicchio, Caterina, Bonuomo, Valentina, Batinić, Josip, Omrani, Ali S, Lamure, Sylvain, Finizio, Olimpia, Fernández, Noemí, Falces-Romero, Iker, Blennow, Ola, Bergantim, Rui, Ali, Natasha, Win, Sein, Van Praet, Jen, Tisi, Maria Chiara, Shirinova, Ayten, Schönlein, Martin, Prattes, Juergen, Piedimonte, Monica, Petzer, Verena, Navrátil, Milan, Kulasekararaj, Austin, Jindra, Pavel, Sramek, Jiří, Glenthøj, Andrea, Fazzi, Rita, De Ramón-Sánchez, Cristina, Cattaneo, Chiara, Calbacho, Maria, Bahr, Nathan C, El-Ashwah, Shaimaa, Cordoba, Raul, Hanakova, Michaela, Zambrotta, Giovanni, Sciumè, Mariarita, Booth, Stephen, Rodrigues, Raquel Nune, Sacchi, Maria Vittoria, García-Poutón, Nicole, Martín-González, Juan-Alberto, Khostelidi, Sofya, Gräfe, Stefanie, Rahimli, Laman, Ammatuna, Emanuele, Busca, Alessandro, Corradini, Paolo, Hoenigl, Martin, Klimko, Nikolai, Koehler, Philipp, Pagliuca, Antonio, Passamonti, Francesco, Cornely, Oliver A, Pagano, Livio, and Pagano, Livio (ORCID:0000-0001-8287-928X)

Abstract

Patients with acute myeloid leukemia (AML) are at high risk of dying from coronavirus disease 2019 (COVID-19). The optimal management of AML patients with COVID-19 has not been established. Our multicenter study included 388 adult AML patients diagnosed with COVID-19 between February 2020 and October 2021. The vast majority were receiving or had received AML treatment in the preceding 3 months. COVID-19 was severe in 41.2% and critical in 21.1% of cases. The chemotherapeutic schedule was modified in 174 patients (44.8%), delayed in 68 and permanently discontinued in 106. After a median follow-up of 325 days, 180 patients (46.4%) had died; death was attributed to COVID-19 (43.3%), AML (26.1%) or to a combination of both (26.7%), whereas in 3.9% of cases the reason was unknown. Active disease, older age, and treatment discontinuation were associated with death, whereas AML treatment delay was protective. Seventy-nine patients had a simultaneous AML and COVID-19 diagnosis, with better survival when AML treatment could be delayed (80%; P<0.001). Overall survival in patients with a diagnosis of COVID-19 between January 2020 and August 2020 was significantly lower than that in patients diagnosed between September 2020 and February 2021 and between March 2021 and September 2021 (39.8% vs. 60% vs. 61.9%, respectively; P=0.006). COVID-19 in AML patients was associated with a high mortality rate and modifications of therapeutic algorithms. The best approach to improve survival was to delay AML treatment, whenever possible.

Published
2023

5. COVID-19 in adult acute myeloid leukemia patients: a long-term followup study from the European Hematology Association survey (EPICOVIDEHA)

Author

Gilead Sciences, Marchesi, Francesco, Salmanton-García, Jon, Emarah, Ziad, Piukovics, Klára, Nucci, Marcio, López-García, Alberto, Ráčil, Zdeněk, Farina, Francesca, Popova, Marina, Zompi, Sofia, Audisio, Ernesta, Ledoux, Marie-Pierre, Verga, Luisa, Weinbergerová, Barbora, Szotkovski, Tomas, Gomes-Silva, Maria, Fracchiolla, Nicola S., Jonge, Nick de, Collins, Graham P., Marchetti, Monia, Magliano, Gabriel, García-Vidal, Carolina, Biernat, Monika, Doesum, Jaap van, Machado, Marina, Demirkan, Fatih, Al-Khabori, Murtadha, Žák, Pavel, Víšek, Benjamin, Stoma, Igor, Méndez, Gustavo-Adolfo, Maertens, Johan, Khanna, Nina, Espigado, Ildefonso, Dragonetti, Giulia, Fianchi, Luana, Príncipe, María Ilaria del, Cabirta, Alba, Ormazabal-Vélez, Irati, Jakšić, Ozren, Buquicchio, Caterina, Bonuomo, Valentina, Batinić, Josip, Omrani, Ali S., Lamure, Sylvain, Finizio, Olimpia, Fernández, Noemí, Falces-Romero, Iker, Blennow, Ola, Bergantim, Rui, Ali, Natasha, Win, Sein, Praet, Jens van, Tisi, Maria Chiara, Shirinova, Ayten, Schönlein, Martin, Prattes, Juergen, Piedimonte, Monica, Petzer, Verena, Navrátil, Milan, Kulasekararaj, Austin G., Jindra, Pavel, Sramek, Jiří, Glenthøj, Andrea, Fazzi, Rita, Ramón, Cristina de, Cattaneo, Chiara, Calbacho, María, Bahr, Nathan C., El-Ashwah, Shaimaa, Córdoba, Raúl, Hanakova, Michaela, Zambrotta, Giovanni, Sciumè, Mariarita, Booth, Stephen, Nunes-Rodrigues, Raquel, Sacchi, Maria Vittoria, García-Poutón, Nicole, Martín-González, Juan-Alberto, Khostelidi, Sofya, Gräfe, Stefanie, Rahimli, Laman, Ammatuna, Emanuele, Busca, Alessandro, Corradini, Paolo, Hoenigl, Martin, Klimko, Nikolay, Koehler, Philipp, Pagliuca, Antonio, Passamonti, Francesco, Cornely, Oliver A., Pagano, Livio, Gilead Sciences, Marchesi, Francesco, Salmanton-García, Jon, Emarah, Ziad, Piukovics, Klára, Nucci, Marcio, López-García, Alberto, Ráčil, Zdeněk, Farina, Francesca, Popova, Marina, Zompi, Sofia, Audisio, Ernesta, Ledoux, Marie-Pierre, Verga, Luisa, Weinbergerová, Barbora, Szotkovski, Tomas, Gomes-Silva, Maria, Fracchiolla, Nicola S., Jonge, Nick de, Collins, Graham P., Marchetti, Monia, Magliano, Gabriel, García-Vidal, Carolina, Biernat, Monika, Doesum, Jaap van, Machado, Marina, Demirkan, Fatih, Al-Khabori, Murtadha, Žák, Pavel, Víšek, Benjamin, Stoma, Igor, Méndez, Gustavo-Adolfo, Maertens, Johan, Khanna, Nina, Espigado, Ildefonso, Dragonetti, Giulia, Fianchi, Luana, Príncipe, María Ilaria del, Cabirta, Alba, Ormazabal-Vélez, Irati, Jakšić, Ozren, Buquicchio, Caterina, Bonuomo, Valentina, Batinić, Josip, Omrani, Ali S., Lamure, Sylvain, Finizio, Olimpia, Fernández, Noemí, Falces-Romero, Iker, Blennow, Ola, Bergantim, Rui, Ali, Natasha, Win, Sein, Praet, Jens van, Tisi, Maria Chiara, Shirinova, Ayten, Schönlein, Martin, Prattes, Juergen, Piedimonte, Monica, Petzer, Verena, Navrátil, Milan, Kulasekararaj, Austin G., Jindra, Pavel, Sramek, Jiří, Glenthøj, Andrea, Fazzi, Rita, Ramón, Cristina de, Cattaneo, Chiara, Calbacho, María, Bahr, Nathan C., El-Ashwah, Shaimaa, Córdoba, Raúl, Hanakova, Michaela, Zambrotta, Giovanni, Sciumè, Mariarita, Booth, Stephen, Nunes-Rodrigues, Raquel, Sacchi, Maria Vittoria, García-Poutón, Nicole, Martín-González, Juan-Alberto, Khostelidi, Sofya, Gräfe, Stefanie, Rahimli, Laman, Ammatuna, Emanuele, Busca, Alessandro, Corradini, Paolo, Hoenigl, Martin, Klimko, Nikolay, Koehler, Philipp, Pagliuca, Antonio, Passamonti, Francesco, Cornely, Oliver A., and Pagano, Livio

Abstract

Patients with acute myeloid leukemia (AML) are at high risk of mortality from coronavirus disease 2019 (COVID-19). The optimal management of AML patients with COVID-19 has not been established. Our multicenter study included 388 adult AML patients with COVID-19 diagnosis between February 2020 and October 2021. The vast majority were receiving or had received AML treatment in the prior 3 months. COVID-19 was severe in 41.2% and critical in 21.1% of cases. The chemotherapeutic schedule was modified in 174 patients (44.8%), delayed in 68 and permanently discontinued in 106. After a median follow-up of 325 days, 180 patients (46.4%) had died; death was attributed to COVID-19 (43.3%), AML (26.1%) or to a combination of both (26.7%), whereas in 3.9% of cases the reason was unknown. Active disease, older age, and treatment discontinuation were associated with death, whereas AML treatment delay was protective. Seventy-nine patients had a simultaneous AML and COVID-19 diagnosis, with an improved survival when AML treatment could be delayed (80%; p<0.001). Overall survival in patients with COVID-19 diagnosis between January 2020 and August 2020 was significantly lower than those who were diagnosed between September 2020 and February 2021 and between March 2021 and September 2021 (39.8% vs 60% vs 61.9%, respectively; p=0.006). COVID-19 in AML patients was associated with a high mortality rate and modifications of therapeutic algorithms. The best approach to improve survival was to delay AML treatment, whenever possible.

Published
2023

6. Outcome of COVID-19 in allogeneic stem cell transplant recipients: Results from the EPICOVIDEHA registry

Author

Gilead Sciences, Busca, Alessandro, Salmanton-García, Jon, Marchesi, Francesco, Farina, Francesca, Cengiz-Seval, Guldane, Doesum, Jaap van, Jonge, Nick de, Bahr, Nathan C., Maertens, Johan, Meletiadis, Joseph, Fracchiolla, Nicola S., Weinbergerová, Barbora, Verga, Luisa, Ráčil, Zdeněk, Jiménez, Moraima, Glenthøj, Andreas, Blennow, Ola, Tanase, Alina Daniela, Schönlein, Martin, Prezioso, Lucia, Khanna, Nina, Duarte, Rafael F., Žák, Pavel, Nucci, Marcio, Machado, Marina, Kulasekararaj, Austin, Espigado, Ildefonso, Kort, Elizabeth de, Ribera-Santa Susana, José-María, Marchetti, Monia, Magliano, Gabriele, Falces-Romero, Iker, Ilhan, Osman, Ammatuna, Emanuele, Zompi, Sofia, Tsirigotis, Panagiotis, Antoniadou, Anastasia, Zambrotta, Giovanni Paolo Maria, Nordlander, Anna, Karlsson, Linda Katharina, Hanakova, Michaela, Dragonetti, Giulia, Cabirta, Alba, Berg Venemyr, Caroline, Gräfe, Stefanie, Praet, Jens van, Tragiannidis, Athanasios, Petzer, Verena, López-García, Alberto, Itri, Federico, Groh, Ana, Gavriilaki, Eleni, Dargenio, Michelina, Rahimli, Laman, Cornely, Oliver A., Pagano, Livio, EPICOVIDEHA Consortium, Gilead Sciences, Busca, Alessandro, Salmanton-García, Jon, Marchesi, Francesco, Farina, Francesca, Cengiz-Seval, Guldane, Doesum, Jaap van, Jonge, Nick de, Bahr, Nathan C., Maertens, Johan, Meletiadis, Joseph, Fracchiolla, Nicola S., Weinbergerová, Barbora, Verga, Luisa, Ráčil, Zdeněk, Jiménez, Moraima, Glenthøj, Andreas, Blennow, Ola, Tanase, Alina Daniela, Schönlein, Martin, Prezioso, Lucia, Khanna, Nina, Duarte, Rafael F., Žák, Pavel, Nucci, Marcio, Machado, Marina, Kulasekararaj, Austin, Espigado, Ildefonso, Kort, Elizabeth de, Ribera-Santa Susana, José-María, Marchetti, Monia, Magliano, Gabriele, Falces-Romero, Iker, Ilhan, Osman, Ammatuna, Emanuele, Zompi, Sofia, Tsirigotis, Panagiotis, Antoniadou, Anastasia, Zambrotta, Giovanni Paolo Maria, Nordlander, Anna, Karlsson, Linda Katharina, Hanakova, Michaela, Dragonetti, Giulia, Cabirta, Alba, Berg Venemyr, Caroline, Gräfe, Stefanie, Praet, Jens van, Tragiannidis, Athanasios, Petzer, Verena, López-García, Alberto, Itri, Federico, Groh, Ana, Gavriilaki, Eleni, Dargenio, Michelina, Rahimli, Laman, Cornely, Oliver A., Pagano, Livio, and EPICOVIDEHA Consortium

Abstract

Background: The outcome of COVID-19 in allogeneic hematopoietic stem cell transplantation (HSCT) recipients is almost uniformely considered poor. The aim of present study was to retrospectively analyse the outcome and risk factors for mortality in a large series of patients who developed COVID-19 infection after an allogeneic HSCT. Methods: This multicenter retrospective study promoted by the European Hematology Association – Infections in Hematology Study Working Group, included 326 adult HSCT patients who had COVID-19 between January 2020 and March 2022. Results: The median time from HSCT to the diagnosis of COVID-19 was 268 days (IQR 86-713; range 0-185 days). COVID-19 severity was mild in 21% of the patients, severe in 39% and critical in 16% of the patients. In multivariable analysis factors associated with a higher risk of mortality were, age above 50 years, presence of 3 or more comorbidities, active hematologic disease at time of COVID-19 infection, development of COVID-19 within 12 months of HSCT, and severe/critical infections. Overall mortality rate was 21% (n=68): COVID-19 was the main or secondary cause of death in 16% of the patients (n=53). Conclusions: Mortality in HSCT recipients who develop COVID-19 is high and largely dependent on age, comorbidities, active hematologic disease, timing from transplant and severity of the infection.

Published
2023

7. COVID-19 in adult acute myeloid leukemia patients:a long-term follow-up study from the European Hematology Association survey (EPICOVIDEHA)

Author

Marchesi, Francesco, Salmanton-García, Jon, Emarah, Ziad, Piukovics, Klára, Nucci, Marcio, López-García, Alberto, Ráčil, Zdeněk, Farina, Francesca, Popova, Marina, Zompi, Sofia, Audisio, Ernesta, Ledoux, Marie Pierre, Verga, Luisa, Weinbergerová, Barbora, Szotkovski, Tomas, Da Silva, Maria Gomes, Fracchiolla, Nicola, De Jonge, Nick, Collins, Graham, Marchetti, Monia, Magliano, Gabriele, García-Vidal, Carolina, Biernat, Monika M., Van Doesum, Jaap, Machado, Marina, Demirkan, Fatih, Al-Khabori, Murtadha, Žák, Pavel, Víšek, Benjamín, Stoma, Igor, Méndez, Gustavo Adolfo, Maertens, Johan, Khanna, Nina, Espigado, Ildefonso, Dragonetti, Giulia, Fianchi, Luana, Del Principe, Maria Ilaria, Cabirta, Alba, Ormazabal-Vélez, Irati, Jaksic, Ozren, Buquicchio, Caterina, Bonuomo, Valentina, Batinić, Josip, Omrani, Ali S., Lamure, Sylvain, Finizio, Olimpia, Fernández, Noemí, Falces-Romero, Iker, Blennow, Ola, Bergantim, Rui, Ali, Natasha, Win, Sein, Van Praet, Jens, Tisi, Maria Chiara, Shirinova, Ayten, Schönlein, Martin, Prattes, Juergen, Piedimonte, Monica, Petzer, Verena, Navrátil, Milan, Kulasekararaj, Austin, Jindra, Pavel, Sramek, Jiří, Glenthøj, Andreas, Fazzi, Rita, De Ramón-Sánchez, Cristina, Cattaneo, Chiara, Calbacho, Maria, Bahr, Nathan C., El-Ashwah, Shaimaa, Cordoba, Raul, Hanakova, Michaela, Zambrotta, Giovanni Paolo Maria, Zambrotta, Giovanni, Sciumè, Mariarita, Booth, Stephen, Rodrigues, Raquel Nunes, Sacchi, Maria Vittoria, García-Poutón, Nicole, Martín-González, Juan Alberto, Khostelidi, Sofya, Gräfe, Stefanie, Rahimli, Laman, Ammatuna, Emanuele, Busca, Alessandro, Corradini, Paolo, Hoenigl, Martin, Klimko, Nikolai, Koehler, Philipp, Pagliuca, Antonio, Passamonti, Francesco, Cornely, Oliver A., Pagano, Livio, Marchesi, Francesco, Salmanton-García, Jon, Emarah, Ziad, Piukovics, Klára, Nucci, Marcio, López-García, Alberto, Ráčil, Zdeněk, Farina, Francesca, Popova, Marina, Zompi, Sofia, Audisio, Ernesta, Ledoux, Marie Pierre, Verga, Luisa, Weinbergerová, Barbora, Szotkovski, Tomas, Da Silva, Maria Gomes, Fracchiolla, Nicola, De Jonge, Nick, Collins, Graham, Marchetti, Monia, Magliano, Gabriele, García-Vidal, Carolina, Biernat, Monika M., Van Doesum, Jaap, Machado, Marina, Demirkan, Fatih, Al-Khabori, Murtadha, Žák, Pavel, Víšek, Benjamín, Stoma, Igor, Méndez, Gustavo Adolfo, Maertens, Johan, Khanna, Nina, Espigado, Ildefonso, Dragonetti, Giulia, Fianchi, Luana, Del Principe, Maria Ilaria, Cabirta, Alba, Ormazabal-Vélez, Irati, Jaksic, Ozren, Buquicchio, Caterina, Bonuomo, Valentina, Batinić, Josip, Omrani, Ali S., Lamure, Sylvain, Finizio, Olimpia, Fernández, Noemí, Falces-Romero, Iker, Blennow, Ola, Bergantim, Rui, Ali, Natasha, Win, Sein, Van Praet, Jens, Tisi, Maria Chiara, Shirinova, Ayten, Schönlein, Martin, Prattes, Juergen, Piedimonte, Monica, Petzer, Verena, Navrátil, Milan, Kulasekararaj, Austin, Jindra, Pavel, Sramek, Jiří, Glenthøj, Andreas, Fazzi, Rita, De Ramón-Sánchez, Cristina, Cattaneo, Chiara, Calbacho, Maria, Bahr, Nathan C., El-Ashwah, Shaimaa, Cordoba, Raul, Hanakova, Michaela, Zambrotta, Giovanni Paolo Maria, Zambrotta, Giovanni, Sciumè, Mariarita, Booth, Stephen, Rodrigues, Raquel Nunes, Sacchi, Maria Vittoria, García-Poutón, Nicole, Martín-González, Juan Alberto, Khostelidi, Sofya, Gräfe, Stefanie, Rahimli, Laman, Ammatuna, Emanuele, Busca, Alessandro, Corradini, Paolo, Hoenigl, Martin, Klimko, Nikolai, Koehler, Philipp, Pagliuca, Antonio, Passamonti, Francesco, Cornely, Oliver A., and Pagano, Livio

Abstract

Patients with acute myeloid leukemia (AML) are at high risk of dying from coronavirus disease 2019 (COVID-19). The optimal management of AML patients with COVID-19 has not been established. Our multicenter study included 388 adult AML patients diagnosed with COVID-19 between February 2020 and October 2021. The vast majority were receiving or had received AML treatment in the preceding 3 months. COVID-19 was severe in 41.2% and critical in 21.1% of cases. The chemotherapeutic schedule was modified in 174 patients (44.8%), delayed in 68 and permanently discontinued in 106. After a median follow-up of 325 days, 180 patients (46.4%) had died; death was attributed to COVID-19 (43.3%), AML (26.1%) or to a combination of both (26.7%), whereas in 3.9% of cases the reason was unknown. Active disease, older age, and treatment discontinuation were associated with death, whereas AML treatment delay was protective. Seventy-nine patients had a simultaneous AML and COVID-19 diagnosis, with better survival when AML treatment could be delayed (80%; P<0.001). Overall survival in patients with a diagnosis of COVID-19 between January 2020 and August 2020 was significantly lower than that in patients diagnosed between September 2020 and February 2021 and between March 2021 and September 2021 (39.8% vs. 60% vs. 61.9%, respectively; P=0.006). COVID-19 in AML patients was associated with a high mortality rate and modifications of therapeutic algorithms. The best approach to improve survival was to delay AML treatment, whenever possible.

Published
2023

8. Outcome of COVID-19 in allogeneic stem cell transplant recipients:Results from the EPICOVIDEHA registry

Author

Busca, Alessandro, Salmanton-García, Jon, Marchesi, Francesco, Farina, Francesca, Seval, Guldane Cengiz, Van Doesum, Jaap, De Jonge, Nick, Bahr, Nathan C., Maertens, Johan, Meletiadis, Joseph, Fracchiolla, Nicola S., Weinbergerová, Barbora, Verga, Luisa, Ráčil, Zdeněk, Jiménez, Moraima, Glenthøj, Andreas, Blennow, Ola, Tanase, Alina Daniela, Schönlein, Martin, Prezioso, Lucia, Khanna, Nina, Duarte, Rafael F., Žák, Pavel, Nucci, Marcio, Machado, Marina, Kulasekararaj, Austin, Espigado, Ildefonso, De Kort, Elizabeth, Ribera-Santa Susana, José María, Marchetti, Monia, Magliano, Gabriele, Falces-Romero, Iker, Ilhan, Osman, Ammatuna, Emanuele, Zompi, Sofia, Tsirigotis, Panagiotis, Antoniadou, Anastasia, Zambrotta, Giovanni Paolo Maria, Nordlander, Anna, Karlsson, Linda Katharina, Hanakova, Michaela, Dragonetti, Giulia, Cabirta, Alba, Berg Venemyr, Caroline, Gräfe, Stefanie, Van Praet, Jens, Tragiannidis, Athanasios, Petzer, Verena, López-García, Alberto, Itri, Federico, Groh, Ana, Gavriilaki, Eleni, Dargenio, Michelina, Rahimli, Laman, Cornely, Oliver A., Pagano, Livio, Busca, Alessandro, Salmanton-García, Jon, Marchesi, Francesco, Farina, Francesca, Seval, Guldane Cengiz, Van Doesum, Jaap, De Jonge, Nick, Bahr, Nathan C., Maertens, Johan, Meletiadis, Joseph, Fracchiolla, Nicola S., Weinbergerová, Barbora, Verga, Luisa, Ráčil, Zdeněk, Jiménez, Moraima, Glenthøj, Andreas, Blennow, Ola, Tanase, Alina Daniela, Schönlein, Martin, Prezioso, Lucia, Khanna, Nina, Duarte, Rafael F., Žák, Pavel, Nucci, Marcio, Machado, Marina, Kulasekararaj, Austin, Espigado, Ildefonso, De Kort, Elizabeth, Ribera-Santa Susana, José María, Marchetti, Monia, Magliano, Gabriele, Falces-Romero, Iker, Ilhan, Osman, Ammatuna, Emanuele, Zompi, Sofia, Tsirigotis, Panagiotis, Antoniadou, Anastasia, Zambrotta, Giovanni Paolo Maria, Nordlander, Anna, Karlsson, Linda Katharina, Hanakova, Michaela, Dragonetti, Giulia, Cabirta, Alba, Berg Venemyr, Caroline, Gräfe, Stefanie, Van Praet, Jens, Tragiannidis, Athanasios, Petzer, Verena, López-García, Alberto, Itri, Federico, Groh, Ana, Gavriilaki, Eleni, Dargenio, Michelina, Rahimli, Laman, Cornely, Oliver A., and Pagano, Livio

Abstract

Background: The outcome of COVID-19 in allogeneic hematopoietic stem cell transplantation (HSCT) recipients is almost uniformely considered poor. The aim of present study was to retrospectively analyse the outcome and risk factors for mortality in a large series of patients who developed COVID-19 infection after an allogeneic HSCT. Methods: This multicenter retrospective study promoted by the European Hematology Association – Infections in Hematology Study Working Group, included 326 adult HSCT patients who had COVID-19 between January 2020 and March 2022. Results: The median time from HSCT to the diagnosis of COVID-19 was 268 days (IQR 86-713; range 0-185 days). COVID-19 severity was mild in 21% of the patients, severe in 39% and critical in 16% of the patients. In multivariable analysis factors associated with a higher risk of mortality were, age above 50 years, presence of 3 or more comorbidities, active hematologic disease at time of COVID-19 infection, development of COVID-19 within 12 months of HSCT, and severe/critical infections. Overall mortality rate was 21% (n=68): COVID-19 was the main or secondary cause of death in 16% of the patients (n=53). Conclusions: Mortality in HSCT recipients who develop COVID-19 is high and largely dependent on age, comorbidities, active hematologic disease, timing from transplant and severity of the infection.

Published
2023

9. Noninvasive Testing and Surrogate Markers in Invasive Fungal Diseases.

Author

Thompson, George R, Thompson, George R, Boulware, David R, Bahr, Nathan C, Clancy, Cornelius J, Harrison, Thomas S, Kauffman, Carol A, Le, Thuy, Miceli, Marisa H, Mylonakis, Eleftherios, Nguyen, M Hong, Ostrosky-Zeichner, Luis, Patterson, Thomas F, Perfect, John R, Spec, Andrej, Kontoyiannis, Dimitrios P, Pappas, Peter G, Thompson, George R, Thompson, George R, Boulware, David R, Bahr, Nathan C, Clancy, Cornelius J, Harrison, Thomas S, Kauffman, Carol A, Le, Thuy, Miceli, Marisa H, Mylonakis, Eleftherios, Nguyen, M Hong, Ostrosky-Zeichner, Luis, Patterson, Thomas F, Perfect, John R, Spec, Andrej, Kontoyiannis, Dimitrios P, and Pappas, Peter G

Abstract

Invasive fungal infections continue to increase as at-risk populations expand. The high associated morbidity and mortality with fungal diseases mandate the continued investigation of novel antifungal agents and diagnostic strategies that include surrogate biomarkers. Biologic markers of disease are useful prognostic indicators during clinical care, and their use in place of traditional survival end points may allow for more rapid conduct of clinical trials requiring fewer participants, decreased trial expense, and limited need for long-term follow-up. A number of fungal biomarkers have been developed and extensively evaluated in prospective clinical trials and small series. We examine the evidence for these surrogate biomarkers in this review and provide recommendations for clinicians and regulatory authorities.

Published
2022

10. Xpert MTB/RIF Ultra for the Diagnosis of Tuberculous Meningitis: A Small Step Forward.

Author

Donovan, Joseph, Donovan, Joseph, Cresswell, Fiona V, Thuong, Nguyen Thuy Thuong, Boulware, David R, Thwaites, Guy E, Bahr, Nathan C, Tuberculous Meningitis International Research Consortium, Donovan, Joseph, Donovan, Joseph, Cresswell, Fiona V, Thuong, Nguyen Thuy Thuong, Boulware, David R, Thwaites, Guy E, Bahr, Nathan C, and Tuberculous Meningitis International Research Consortium

Abstract

The delayed diagnosis of tuberculous meningitis (TBM) leads to poor outcomes, yet the current diagnostic methods for identifying Mycobacterium tuberculosis in cerebrospinal fluid (CSF) are inadequate. The first comparative study of the new GeneXpert MTB/RIF Ultra (Xpert Ultra) for TBM diagnosis suggested increased sensitivity of Xpert Ultra. Two subsequent studies have shown Xpert Ultra has improved sensitivity, but has insufficient negative predictive value to exclude TBM. Collecting and processing large volumes of CSF for mycobacterial testing are important for optimal diagnostic test performance. But clinical, radiological, and laboratory parameters remain essential for TBM diagnosis and empiric therapy is often needed. We therefore caution against the use of Xpert Ultra as a single diagnostic test for TBM; it cannot be used to "rule out" TBM.

Published
2020

11. Xpert MTB/RIF Ultra for the Diagnosis of Tuberculous Meningitis: A Small Step Forward.

Author

Donovan, Joseph, Donovan, Joseph, Cresswell, Fiona V, Thuong, Nguyen Thuy Thuong, Boulware, David R, Thwaites, Guy E, Bahr, Nathan C, Tuberculous Meningitis International Research Consortium, Donovan, Joseph, Donovan, Joseph, Cresswell, Fiona V, Thuong, Nguyen Thuy Thuong, Boulware, David R, Thwaites, Guy E, Bahr, Nathan C, and Tuberculous Meningitis International Research Consortium

Abstract

The delayed diagnosis of tuberculous meningitis (TBM) leads to poor outcomes, yet the current diagnostic methods for identifying Mycobacterium tuberculosis in cerebrospinal fluid (CSF) are inadequate. The first comparative study of the new GeneXpert MTB/RIF Ultra (Xpert Ultra) for TBM diagnosis suggested increased sensitivity of Xpert Ultra. Two subsequent studies have shown Xpert Ultra has improved sensitivity, but has insufficient negative predictive value to exclude TBM. Collecting and processing large volumes of CSF for mycobacterial testing are important for optimal diagnostic test performance. But clinical, radiological, and laboratory parameters remain essential for TBM diagnosis and empiric therapy is often needed. We therefore caution against the use of Xpert Ultra as a single diagnostic test for TBM; it cannot be used to "rule out" TBM.

Published
2020

12. GeneXpert MTB/Rif to Diagnose Tuberculous Meningitis: Perhaps the First Test but not the Last.

Author

Bahr, Nathan C, Bahr, Nathan C, Marais, Suzaan, Caws, Maxine, van Crevel, Reinout, Wilkinson, Robert J, Tyagi, Jaya S, Thwaites, Guy E, Boulware, David R, Tuberculous Meningitis International Research Consortium, Bahr, Nathan C, Bahr, Nathan C, Marais, Suzaan, Caws, Maxine, van Crevel, Reinout, Wilkinson, Robert J, Tyagi, Jaya S, Thwaites, Guy E, Boulware, David R, and Tuberculous Meningitis International Research Consortium

Abstract

Tuberculous meningitis (TBM) is the most severe form of tuberculous with substantial mortality. In May 2015, 54 researchers from 10 countries met in Da Lat, Vietnam, to discuss advances in TBM. Among the attendees were researchers involved in pivotal studies on the use of Xpert MTB/Rif for TBM diagnosis. Attendees discussed the 2014 World Health Organization strong recommendation favoring the use of Xpert "in preference to conventional microscopy and culture as the initial diagnostic test for cerebrospinal fluid (CSF) if the sample volume is low or if additional specimens cannot be obtained to make a quick diagnosis." Attendees were concerned that the limitations of Xpert testing for TBM are not emphasized. Clear guidance is needed for the investigational pathway for TBM, including recommendations on the diagnostic package of investigations, which does not stop with Xpert testing. Second, emphasis on the large CSF volumes (ideally 8-10 mL) needed for Xpert testing is required. Guidelines should also emphasize that TBM is a medical emergency and early treatment reduces mortality.

Published
2016

13. Cutaneous infection with Mycobacterium fortuitum after subcutaneous injection of human chorionic gonadotropin

Author

Neill, Brett C, Neill, Brett C, Bahr, Nathan C, Bryan, Zachary, Aires, Daniel J, Neill, Brett C, Neill, Brett C, Bahr, Nathan C, Bryan, Zachary, and Aires, Daniel J

Abstract

Background: Weight loss clinics are common in the United States. Unfortunately, some offer dubious weight loss methods such as self-administered human chorionic gonadotropin (HCG) injections. HCG products are unregulated, yet, widely available. Infection is among the risks potentially associated with this treatment. We report a case of skin infection caused by Mycobacterium fortuitum after HCGinjection.Case Presentation: A 51-year-old woman with a history of hypogammaglobulinemia presented with an eight week history of a tender abdominal lesion. The lesion was at the site of a previous HCG injection.Acid-fast bacilli (AFB) culture grew Mycobacterium fortuitum. Based on the organism’s susceptibility profile, sulfamethoxazole-trimethoprim 800-160mg and ciprofloxacin 500 mg were both prescribed. The case was referred to the Missouri Department of Health. Based on clinical progress treatment was continued for a total of six months.Conclusions: This case illustrates the potential for cutaneous infection by Mycobacterium fortuitum and other rapidly growing mycobacteria after HCGinjections. Clinicians should maintain a high index for suspicion for rapidly growing mycobacteria when evaluating persistent skin lesions at sites of trauma or skin puncture.

Published
2017

14. Cutaneous infection with Mycobacterium fortuitum after subcutaneous injection of human chorionic gonadotropin

Author

Neill, Brett C, Neill, Brett C, Bahr, Nathan C, Bryan, Zachary, Aires, Daniel J, Neill, Brett C, Neill, Brett C, Bahr, Nathan C, Bryan, Zachary, and Aires, Daniel J

Abstract

Background: Weight loss clinics are common in the United States. Unfortunately, some offer dubious weight loss methods such as self-administered human chorionic gonadotropin (HCG) injections. HCG products are unregulated, yet, widely available. Infection is among the risks potentially associated with this treatment. We report a case of skin infection caused by Mycobacterium fortuitum after HCGinjection.Case Presentation: A 51-year-old woman with a history of hypogammaglobulinemia presented with an eight week history of a tender abdominal lesion. The lesion was at the site of a previous HCG injection.Acid-fast bacilli (AFB) culture grew Mycobacterium fortuitum. Based on the organism’s susceptibility profile, sulfamethoxazole-trimethoprim 800-160mg and ciprofloxacin 500 mg were both prescribed. The case was referred to the Missouri Department of Health. Based on clinical progress treatment was continued for a total of six months.Conclusions: This case illustrates the potential for cutaneous infection by Mycobacterium fortuitum and other rapidly growing mycobacteria after HCGinjections. Clinicians should maintain a high index for suspicion for rapidly growing mycobacteria when evaluating persistent skin lesions at sites of trauma or skin puncture.

Published
2017

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