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2. Hematopoietic stem cell transplantation for DLBCL: a report from the European Society for Blood and Marrow Transplantation on more than 40,000 patients over 32 years

Author

Berning, Philipp, Fekom, Mathilde, Ngoya, Maud, Goldstone, Anthony H., Dreger, Peter, Montoto, Silvia, Finel, Hervé, Shumilov, Evgenii, Chevallier, Patrice, Blaise, Didier, Strüssmann, Tim, Carpenter, Ben, Forcade, Edouard, Castilla-Llorente, Cristina, Trneny, Marek, Ghesquieres, Hervé, Capria, Saveria, Thieblemont, Catherine, Blau, Igor Wolfgang, Meijer, Ellen, Broers, Annoek E. C., Huynh, Anne, Caillot, Denis, Rösler, Wolf, Nguyen Quoc, Stephanie, Bittenbring, Jörg, Nagler, Arnon, Galimard, Jacques-Emmanuel, Glass, Bertram, Sureda, Anna, and Schmitz, Norbert

Published
2024
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6. ELN2017 risk stratification improves outcome prediction when applied to the prospective GIMEMA AML1310 protocol

Author

Buccisano, Francesco, Palmieri, Raffaele, Piciocchi, Alfonso, Arena, Valentina, Candoni, Anna, Melillo, Lorella, Calafiore, Valeria, Cairoli, Roberto, de Fabritiis, Paolo, Storti, Gabriella, Salutari, Prassede, Lanza, Francesco, Martinelli, Giovanni, Luppi, Mario, Capria, Saveria, Maurillo, Luca, Del Principe, Maria Ilaria, Paterno, Giovangiacinto, Irno Consalvo, Maria Antonietta, Ottone, Tiziana, Lavorgna, Serena, Voso, Maria Teresa, Fazi, Paola, Vignetti, Marco, Arcese, William, and Venditti, Adriano

Published
2022
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7. Response Rates and Transplantation Impact in Patients with Relapsed Acute Promyelocytic Leukemia.

Author

Costa, Alessandro, Gurnari, Carmelo, Scalzulli, Emilia, Cicconi, Laura, Guarnera, Luca, Carmosino, Ida, Cerretti, Raffaella, Bisegna, Maria Laura, Capria, Saveria, Minotti, Clara, Iori, Anna Paola, Torrieri, Lorenzo, Venditti, Adriano, Pulsoni, Alessandro, Martelli, Maurizio, Voso, Maria Teresa, and Breccia, Massimo

Subjects
TREATMENT of acute promyelocytic leukemia, THERAPEUTIC use of antineoplastic agents, THERAPEUTIC use of monoclonal antibodies, HEMATOPOIETIC stem cell transplantation, CANCER relapse, PATIENTS, TRANSPLANTATION of organs, tissues, etc., ACUTE promyelocytic leukemia, SALVAGE therapy, PATHOLOGIC complete response, TREATMENT effectiveness, RETROSPECTIVE studies, CANCER patients, MULTIVARIATE analysis, ARSENIC compounds, CANCER chemotherapy, MEDICAL records, ACQUISITION of data, TRETINOIN, STATISTICS, OVERALL survival, PROPORTIONAL hazards models
Abstract

Simple Summary: Relapses of acute promyelocytic leukemia (APL) remain a challenge despite the introduction of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO). Given the variability in salvage therapies and emerging evidence supporting the deferral of hematopoietic cell transplantation (HCT) in patients receiving ATO, we analyzed the outcomes of a multicentric cohort of 67 relapsed APL patients. Better outcomes were reported with ATO ± ATRA compared to chemo-based regimens and ATRA ± Gemtuzumab ozogamicin (GO). A significant survival advantage was observed for patients undergoing HCT in the chemo-based cohort (p = 0.017), but not in the ATO-based group (p = 0.12). Achieving molecular complete remission (CR) post salvage therapy emerged as the main prognostic factor for second relapses in both univariate and multivariate analyses. Our findings support the efficacy of ATO-based therapies in first relapse and enhance the role of molecular remission as an independent outcome predictor in both first and second APL relapses. Background: The introduction of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) has radically improved the prognosis of acute promyelocytic leukemia (APL), with cure rates above 80%. While relapse occurs in less than 20% of cases, addressing this issue remains challenging. Identifying effective salvage therapies for relapsed APL is crucial to improve patient outcomes. Methods: A retrospective analysis was performed on a multicentric cohort of 67 APL patients in first relapse, treated in three Italian hematology centers from June 1981 to November 2021. The overall survival (OS) and cumulative incidence of relapse (CIR) were calculated, and predictive factors were assessed using Cox regression models. Results: Overall, 61 patients (91%) received ATO ± ATRA (40.3%), chemo-based regimens (40.3%), or ATRA ± Gemtuzumab ozogamicin (GO) (10.4%). Complete remission (CR) was achieved in 98.2% of patients (molecular CR, n = 71.4%). With a median follow-up time of 54.5 months, the 5-year OS was 73% in the ATO ± ATRA group, 44% in the chemo-based group, and 29% in the ATRA ± GO group (p = 0.035). The 5-year OS rate was also higher for transplant recipients vs. non-recipients within the chemo-based cohort (50% vs. 33%, p = 0.017), but not in the ATO-based cohort (p = 0.12). ATO-based salvage therapy resulted in better OS in both univariate (p = 0.025) and multivariate analyses (p = 0.026). The 2-year CIR was higher in patients without molecular CR vs. patients in molecular CR (66% vs. 24%, p = 0.034). Molecular CR was a significant predictor of second relapse in both univariate (p = 0.035) and multivariate analyses (p = 0.036). Conclusions: Our findings support the efficacy of ATO-based therapies in first relapse of APL and confirm the achievement of molecular remission as an independent outcome predictor in both first and second APL relapse. [ABSTRACT FROM AUTHOR]

Published
2024
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8. Efficacy and safety of netupitant/palonosetron combination (NEPA) in preventing nausea and vomiting in non-Hodgkin’s lymphoma patients undergoing to chemomobilization before autologous stem cell transplantation

Author

Di Renzo, Nicola, Musso, Maurizio, Scimè, Rosanna, Cupri, Alessandra, Perrone, Tommasina, De Risi, Clara, Pastore, Domenico, Guarini, Attilio, Mengarelli, Andrea, Benedetti, Fabio, Mazza, Patrizio, Capria, Saveria, Chiusolo, Patrizia, Cupelli, Luca, Federico, Vincenzo, Bozzoli, Valentina, Messa, Anna Rita, Matera, Rosella, Seripa, Davide, Codega, Paolo, Bonizzoni, Erminio, and Specchia, Giorgina

Published
2022
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9. Hematopoietic stem cell transplantation for DLBCL:a report from the European Society for Blood and Marrow Transplantation on more than 40,000 patients over 32 years

Author

Berning, Philipp, Fekom, Mathilde, Ngoya, Maud, Goldstone, Anthony H., Dreger, Peter, Montoto, Silvia, Finel, Hervé, Shumilov, Evgenii, Chevallier, Patrice, Blaise, Didier, Strüssmann, Tim, Carpenter, Ben, Forcade, Edouard, Castilla-Llorente, Cristina, Trneny, Marek, Ghesquieres, Hervé, Capria, Saveria, Thieblemont, Catherine, Blau, Igor Wolfgang, Meijer, Ellen, Broers, Annoek E.C., Huynh, Anne, Caillot, Denis, Rösler, Wolf, Nguyen Quoc, Stephanie, Bittenbring, Jörg, Nagler, Arnon, Galimard, Jacques Emmanuel, Glass, Bertram, Sureda, Anna, Schmitz, Norbert, Berning, Philipp, Fekom, Mathilde, Ngoya, Maud, Goldstone, Anthony H., Dreger, Peter, Montoto, Silvia, Finel, Hervé, Shumilov, Evgenii, Chevallier, Patrice, Blaise, Didier, Strüssmann, Tim, Carpenter, Ben, Forcade, Edouard, Castilla-Llorente, Cristina, Trneny, Marek, Ghesquieres, Hervé, Capria, Saveria, Thieblemont, Catherine, Blau, Igor Wolfgang, Meijer, Ellen, Broers, Annoek E.C., Huynh, Anne, Caillot, Denis, Rösler, Wolf, Nguyen Quoc, Stephanie, Bittenbring, Jörg, Nagler, Arnon, Galimard, Jacques Emmanuel, Glass, Bertram, Sureda, Anna, and Schmitz, Norbert

Abstract

Autologous(auto-) and allogeneic(allo-) hematopoietic stem cell transplantation (HSCT) are key treatments for relapsed/refractory diffuse large B-cell lymphoma (DLBCL), although their roles are challenged by CAR-T-cells and other immunotherapies. We examined the transplantation trends and outcomes for DLBCL patients undergoing auto-/allo-HSCT between 1990 and 2021 reported to EBMT. Over this period, 41,148 patients underwent auto-HSCT, peaking at 1911 cases in 2016, while allo-HSCT saw a maximum of 294 cases in 2018. The recent decline in transplants corresponds to increased CAR-T treatments (1117 cases in 2021). Median age for auto-HSCT rose from 42 (1990–1994) to 58 years (2015–2021), with peripheral blood becoming the primary stem cell source post-1994. Allo-HSCT median age increased from 36 (1990–1994) to 54 (2015–2021) years, with mobilized blood as the primary source post-1998 and reduced intensity conditioning post-2000. Unrelated and mismatched allo-HSCT accounted for 50% and 19% of allo-HSCT in 2015–2021. Three-year overall survival (OS) after auto-HSCT improved from 56% (1990–1994) to 70% (2015–2021), p < 0.001, with a decrease in relapse incidence (RI) from 49% to 38%, while non-relapse mortality (NRM) remained unchanged (4%). After allo-HSCT, 3-year-OS increased from 33% (1990–1999) to 46% (2015–2021) (p < 0.001); 3-year RI remained at 39% and 1-year-NRM decreased to 19% (p < 0.001). Our data reflect advancements over 32 years and >40,000 transplants, providing insights for evaluating emerging DLBCL therapies.

Published
2024

10. Real-Life Management of FLT3-Mutated AML: Single-Centre Experience over 24 Years.

Author

Capria, Saveria, Trisolini, Silvia Maria, Torrieri, Lorenzo, Amabile, Elena, Marsili, Giovanni, Piciocchi, Alfonso, Barberi, Walter, Iori, Anna Paola, Diverio, Daniela, Carmini, Daniela, Breccia, Massimo, Martelli, Maurizio, and Minotti, Clara

Subjects
*LEUCOCYTES, *HEMATOPOIETIC stem cell transplantation, *PROTEIN-tyrosine kinase inhibitors, *TREATMENT effectiveness, *DESCRIPTIVE statistics, *MULTIVARIATE analysis, *CANCER chemotherapy, *STATISTICS, *GENETIC mutation
Abstract

Simple Summary: FLT3 mutations are common in acute myeloid leukemia (AML) and are often associated with poorer outcomes and higher relapse rates. This study examined the long-term outcomes of FLT3-mutated (FLT3m) AML patients who received intensive treatment at our institution over the past 24 years, comparing the results in patients who received standard chemotherapy alone with those who received a FLT3 inhibitor (FLT3i). Our single-center, real-life experience confirms the impact of FLT3i administration on survival, both in frontline and salvage settings. In addition, our results underline that the proper positioning of allogeneic stem cell transplantation in the therapeutic algorithm is still an unmet need. These findings suggest that incorporating FLT3-targeting agents into treatment plans may improve outcomes for AML patients while highlighting the need for the continued optimization of treatment strategies to enhance patient survival and quality of life. We analyzed 140 patients with a median age of 51 years; 21% had WBC ≥ 100 × 109/L, and 52% had an NPM1 co-mutation. Until 2018, 101 patients received chemotherapy; thereafter, 39 received 3+7+midostaurin. The overall CR rate was 64%, higher in NPM1 mutant patients (73%). Univariate analysis showed that NPM1 mutation (p = 0.032) and WBC < 100 × 109/L (p = 0.013) positively influenced the response, with a trend for FLT3i administration (p = 0.052). Multivariate analysis confirmed WBC count as an independent prognostic factor (p = 0.017). In CR1, 41/90 patients underwent allogeneic and 18 autologous transplantation. The median EFS was 1.1 vs. 1.6 years in autografted and allografted patients, respectively (p = 0.9). The one-year non-relapse mortality was 0.00% for autologous and 28% for allogeneic transplants (p = 0.007); CIR at 1 and 3 years was higher in autologous transplants (39% vs. 15% and 57% vs. 21%, p = 0.004). The median survival was not reached in the FLT3i group. Overall, 69 patients received stem cell transplantation (18 autologous, 51 allogeneic). Post-transplant FLT3i was resumed in eight patients, all alive after a median of 65 months. Allogeneic transplantation is crucial in FLT3-mutated AML, but the next challenge will be to identify which patients can benefit from transplants in CR1 and in which to intensify post-transplant therapy. [ABSTRACT FROM AUTHOR]

Published
2024
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14. Predicting failure of hematopoietic stem cell mobilization before it starts: the predicted poor mobilizer (pPM) score

Author

Olivieri, Jacopo, Attolico, Immacolata, Nuccorini, Roberta, Pascale, Sara Pasquina, Chiarucci, Martina, Poiani, Monica, Corradini, Paolo, Farina, Lucia, Gaidano, Gianluca, Nassi, Luca, Sica, Simona, Piccirillo, Nicola, Pioltelli, Pietro Enrico, Martino, Massimo, Moscato, Tiziana, Pini, Massimo, Zallio, Francesco, Ciceri, Fabio, Marktel, Sarah, Mengarelli, Andrea, Musto, Pellegrino, Capria, Saveria, Merli, Francesco, Codeluppi, Katia, Mele, Giuseppe, Lanza, Francesco, Specchia, Giorgina, Pastore, Domenico, Milone, Giuseppe, Saraceni, Francesco, Di Nardo, Elvira, Perseghin, Paolo, and Olivieri, Attilio

Published
2018
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16. Acute leukemia diagnosis during the COVID-19 pandemic

Author

GUARNERA, Luca, primary, BUZZATTI, Elisa, additional, MARCHESI, Francesco, additional, ARMIENTO, Daniele, additional, MAZZONE, Carla, additional, CAPRIA, Saveria, additional, SCALZULLI, Emilia, additional, MALFONA, Francesco, additional, CHIARETTI, Sabina, additional, PALMIERI, Raffaele, additional, PATERNO, Giovangiacinto, additional, FRANZESE, Chiara, additional, BONANNI, Fabrizio, additional, SAVI, Arianna, additional, PASQUALONE, Gianmario, additional, MORETTI, Federico, additional, MAURILLO, Luca, additional, BUCCISANO, Francesco, additional, VENDITTI, Adriano, additional, and DEL PRINCIPE, Maria Ilaria, additional

Published
2023
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17. Benefits and Safety of Empiric Antibiotic Treatment Active Against KPC-K. pneumoniae in Febrile Neutropenic Patients with Acute Leukemia Who are Colonized with KPC-K. pneumoniae. A 7-Years Retrospective Observational Cohort Study

Author

Micozzi,Alessandra, Minotti,Clara, Capria,Saveria, Cartoni,Claudio, Trisolini,Silvia Maria, Assanto,Giovanni Manfredi, Barberi,Walter, Moleti,Maria Luisa, Santilli,Stefania, Martelli,Maurizio, Gentile,Giuseppe, Micozzi,Alessandra, Minotti,Clara, Capria,Saveria, Cartoni,Claudio, Trisolini,Silvia Maria, Assanto,Giovanni Manfredi, Barberi,Walter, Moleti,Maria Luisa, Santilli,Stefania, Martelli,Maurizio, and Gentile,Giuseppe

Abstract

Alessandra Micozzi,1 Clara Minotti,2 Saveria Capria,2 Claudio Cartoni,2 Silvia Maria Trisolini,2 Giovanni Manfredi Assanto,1 Walter Barberi,2 Maria Luisa Moleti,2 Stefania Santilli,3 Maurizio Martelli,1 Giuseppe Gentile1 1Haematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy; 2Department of Haematology, Oncology and Dermatology, Azienda Policlinico Umberto I, Rome, Italy; 3Department of Diagnostics, Azienda Policlinico Umberto I, Rome, ItalyCorrespondence: Alessandra Micozzi, Haematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Via Benevento 6, Rome, 00161, Italy, Tel +39 6 857951, Fax +39 6 44241984, Email alessandra.micozzi@uniroma1.itPurpose: To evaluate the benefits and safety of the empiric antibiotic treatment (EAT) active against KPC-K. pneumoniae in febrile neutropenic patients with acute leukaemia (AL) who are colonised by KPC-K. pneumoniae.Patients and Methods: A 7-year (2013– 2019) retrospective observational cohort study was conducted at the Haematology, Sapienza Rome University (Italy) on 94 febrile neutropenia episodes (FNE) in AL patients KPC-K. pneumoniae carriers treated with active EAT.Results: Eighty-two (87%) FNE were empirically treated with antibiotic combinations [38 colistin-based and 44 ceftazidime-avibactam (CAZAVI)-based], 12 with CAZAVI monotherapy. Successful outcomes were observed in 88/94 (94%) FNE, 46/49 (94%) microbiologically documented infections, and 24/27 (89%) gram-negative bloodstream infections (GNB-BSI). Mortality due to infective causes was 4.2% (2.1% within 1 week). KPC-K. pneumoniae infections caused 28/94 FNE (30%) and KPC-K. pneumoniae-BSI was documented in 22 FNE (23.4%) (85% of GNB-BSI), in all cases patients received active EAT, and 21 survived. KPC-K.pneumoniae-BSI mortality rate was 4.5%. CAZAVI-based EAT showed better results than colistin-based EAT (55/56 vs 33/38, p = 0.037), overall and without EAT modification (41/56

Published
2023

18. Pediatric Autologous Hematopoietic Stem Cell Transplantation: Safety, Efficacy, and Patient Outcomes. Literature Review

Author

Testi,Anna Maria, Moleti,Maria Luisa, Angi,Alessia, Bianchi,Simona, Barberi,Walter, Capria,Saveria, Testi,Anna Maria, Moleti,Maria Luisa, Angi,Alessia, Bianchi,Simona, Barberi,Walter, and Capria,Saveria

Abstract

Anna Maria Testi, Maria Luisa Moleti, Alessia Angi, Simona Bianchi, Walter Barberi, Saveria Capria Department of Translational and Precision Medicine, Sapienza, University of Rome, Rome, ItalyCorrespondence: Anna Maria Testi, Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Via Benevento 6, Rome, 00161, Italy, Tel +39-06-49974731, Fax +39-06-44241984, Email testi@bce.uniroma1.itAbstract: Autologous stem cell transplantation (auto-HSCT) is a part of the therapeutic strategy for various oncohematological diseases. The auto-HSCT procedure enables hematological recovery after high-dose chemotherapy, otherwise not tolerable, by the infusion of autologous hematopoietic stem cells. Unlike allogeneic transplant (allo-HSCT), auto-HSCT has the advantage of lacking acute-graft-versus-host disease (GVHD) and prolonged immunosuppression, however, these advantages are counterbalanced by the absence of graft-versus-leukemia. Moreover, in hematological malignancies, the autologous hematopoietic stem cell source may be contaminated by neoplastic cells, leading to disease reappearance. In recent years, allogeneic transplant-related mortality (TRM) has progressively decreased, almost approaching auto-TRM, and many alternative donor sources are available for the majority of patients eligible for transplant procedures. In adults, the role of auto-HSCT compared to conventional chemotherapy (CT) in hematological malignancies has been well defined in many extended randomized trials; however, such trials are lacking in pediatric cohorts. Therefore, the role of auto-HSCT in pediatric oncohematology is limited, in both first- and second-line therapies and still remains to be defined. Nowadays, the accurate stratification in risk groups, according to the biological characteristics of the tumors and therapy response, and the introduction of new biological therapies, have to be taken into account in order to assign auto-HSCT a precise role in the thera

Published
2023

20. Benefits and Safety of Empiric Antibiotic Treatment Active Against KPC-K. pneumoniae in Febrile Neutropenic Patients with Acute Leukemia Who are Colonized with KPC-K. pneumoniae. A 7-Years Retrospective Observational Cohort Study

Author

Micozzi, Alessandra, primary, Minotti, Clara, additional, Capria, Saveria, additional, Cartoni, Claudio, additional, Trisolini, Silvia Maria, additional, Assanto, Giovanni Manfredi, additional, Barberi, Walter, additional, Moleti, Maria Luisa, additional, Santilli, Stefania, additional, Martelli, Maurizio, additional, and Gentile, Giuseppe, additional

Published
2023
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22. Immunogenicity of SARS-CoV-2 vaccination in patients undergoing autologous stem cell transplantation. A multicentric experience

Author

Autore, Francesco, primary, Stirparo, Luca, additional, Innocenti, Idanna, additional, Papa, Elena, additional, Marchesi, Francesco, additional, Togni, Chiara, additional, Mariani, Sabrina, additional, Torrieri, Lorenzo, additional, Salvatori, Martina, additional, Fazio, Francesca, additional, Metafuni, Elisabetta, additional, Giammarco, Sabrina, additional, Sora, Federica, additional, Falcucci, Paolo, additional, Ferrari, Antonella, additional, Trisolini, Silvia Maria, additional, Capria, Saveria, additional, Tafuri, Agostino, additional, Chiusolo, Patrizia, additional, Sica, Simona, additional, and Laurenti, Luca, additional

Published
2022
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24. High dose chemotherapy and autologous stem cell transplantation in nodular lymphocyte‐predominant Hodgkin lymphoma: A retrospective study by the European society for blood and marrow transplantation‐lymphoma working party

Author

Akhtar, Saad, Montoto, Silvia, Boumendil, Ariane, Finel, Herve, Masszi, Tamas, Jindra, Pavel, Nemet, Damir, Fuhrmann, Stephan, Beguin, Yves, Castagna, Luca, Ferrara, Felicetto, Capria, Saveria, Malladi, Ram, Moraleda, Jose Maria, Bloor, Adrian, Ghesquières, Hervé, Meissner, Julia, Sureda, Anna, and Dreger, Peter

Published
2018
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25. Immunogenicity of SARS-CoV-2 vaccination in patients undergoing autologous stem cell transplantation. A multicentric experience

Author

Autore, Francesco, Stirparo, Luca, Innocenti, Idanna, Papa, Elena, Marchesi, Francesco, Togni, Chiara, Mariani, Sabrina, Torrieri, Lorenzo, Salvatori, Martina, Fazio, Francesca, Metafuni, Elisabetta, Giammarco, Sabrina, Sora', Federica, Falcucci, Paolo, Ferrari, Antonella, Trisolini, Silvia Maria, Capria, Saveria, Tafuri, Agostino, Chiusolo, Patrizia, Sica, Simona, Laurenti, Luca, Sora, Federica (ORCID:0000-0002-9607-5298), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Sica, Simona (ORCID:0000-0003-2426-3465), Laurenti, Luca (ORCID:0000-0002-8327-1396), Autore, Francesco, Stirparo, Luca, Innocenti, Idanna, Papa, Elena, Marchesi, Francesco, Togni, Chiara, Mariani, Sabrina, Torrieri, Lorenzo, Salvatori, Martina, Fazio, Francesca, Metafuni, Elisabetta, Giammarco, Sabrina, Sora', Federica, Falcucci, Paolo, Ferrari, Antonella, Trisolini, Silvia Maria, Capria, Saveria, Tafuri, Agostino, Chiusolo, Patrizia, Sica, Simona, Laurenti, Luca, Sora, Federica (ORCID:0000-0002-9607-5298), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Sica, Simona (ORCID:0000-0003-2426-3465), and Laurenti, Luca (ORCID:0000-0002-8327-1396)

Abstract

COVID-19 disease has a strong impact on hematological patients; those receiving autologous hematopoietic stem cell transplantation (aHSCT) represent a particularly vulnerable group, in which the effectiveness of vaccination is very variable. Chiarucci et al. showed that patients affected by non-Hodgkin lymphoma (NHL) and treated with rituximab experienced a lower rate of immunization against SARS-CoV-2 (54%), as well as significantly lower IgG antibody titers. In our multicenter retrospective observational study, we included 82 patients who underwent aHSCT, divided into two groups: 58 patients vaccinated after aHSCT (group A) and 24 vaccinated before getting transplantation (group B). In group A, 39 (67%) patients had positive serology, and the rate of positivity increased with time after aHSCT. In the subgroup of patients with NHL the administration of rituximab predicted negative serology, particularly when administered in the 6 months before vaccination (13% response rate). Patients affected by plasma cells had a higher rate of positivity (83% overall), independently of the time to aHSCT. In group B, no patient who initially showed positive serology became negative after transplantation, so the aHSCT did not affect the response to the vaccination. Our study confirmed the role of rituximab as a negative predictor of response to SARS-CoV-2 vaccination, whereas the conditioning and transplantation procedure itself seemed to be less important.

Published
2022

26. Catheter-associated bloodstream infections and thrombotic risk in hematologic patients with peripherally inserted central catheters (PICC)

Author

Morano, Salvatore Giacomo, Latagliata, Roberto, Girmenia, Corrado, Massaro, Fulvio, Berneschi, Paola, Guerriero, Alfonso, Giampaoletti, Massimo, Sammarco, Arianna, Annechini, Giorgia, Fama, Angelo, Di Rocco, Alice, Chistolini, Antonio, Micozzi, Alessandra, Molica, Matteo, Barberi, Walter, Minotti, Clara, Brunetti, Gregorio Antonio, Breccia, Massimo, Cartoni, Claudio, Capria, Saveria, Rosa, Giovanni, Alimena, Giuliana, and Foà, Robin

Published
2015
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29. Results of the 6-Year Follow-up of the Gimema AML1310 Trial: A Risk-Adapted, MRD-Directed Therapy for Young Adults with Newly Diagnosed Acute Myeloid Leukemia

Author

Venditti, Adriano, primary, Piciocchi, Alfonso, additional, Palmieri, Raffaele, additional, Arena, Valentina, additional, Candoni, Anna, additional, Calafiore, Valeria, additional, Melillo, Lorella MA, additional, Cairoli, Roberto, additional, De Fabritiis, Paolo, additional, Storti, Gabriella, additional, Salutari, Prassede, additional, Lanza, Francesco, additional, Martinelli, Giovanni, additional, Luppi, Mario, additional, Capria, Saveria, additional, Maurillo, Luca, additional, Del Principe, Maria Ilaria, additional, Paterno, Giovangiacinto, additional, Buzzatti, Elisa, additional, Voso, Maria Teresa, additional, Ottone, Tiziana, additional, irno Consalvo, Maria, additional, Fazi, Paola, additional, Vignetti, Marco, additional, Arcese, William, additional, Amadori, Sergio, additional, and Buccisano, Francesco, additional

Published
2021
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30. Reduced transmission of Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP) in patients with haematological malignancies hospitalized in an Italian hospital during the COVID-19 pandemic

Author

Micozzi, Alessandra, primary, Assanto, Giovanni Manfredi, additional, Cesini, Laura, additional, Minotti, Clara, additional, Cartoni, Claudio, additional, Capria, Saveria, additional, Ciotti, Giulia, additional, Alunni Fegatelli, Danilo, additional, Donzelli, Livia, additional, Martelli, Maurizio, additional, and Gentile, Giuseppe, additional

Published
2021
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31. Efficacy and safety of netupitant/palonosetron combination (NEPA) in preventing nausea and vomiting in non-Hodgkin’s lymphoma patients undergoing to chemomobilization before autologous stem cell transplantation

Author

Di Renzo, Nicola, primary, Musso, Maurizio, additional, Scimè, Rosanna, additional, Cupri, Alessandra, additional, Perrone, Tommasina, additional, De Risi, Clara, additional, Pastore, Domenico, additional, Guarini, Attilio, additional, Mengarelli, Andrea, additional, Benedetti, Fabio, additional, Mazza, Patrizio, additional, Capria, Saveria, additional, Chiusolo, Patrizia, additional, Cupelli, Luca, additional, Federico, Vincenzo, additional, Bozzoli, Valentina, additional, Messa, Anna Rita, additional, Matera, Rosella, additional, Seripa, Davide, additional, Codega, Paolo, additional, Bonizzoni, Erminio, additional, and Specchia, Giorgina, additional

Published
2021
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32. Single centre experience on Acquired Haemophilia A patients: Diagnosis, clinical management and analysis of factors predictive of response and outcome

Author

Porrazzo, Marika, primary, Baldacci, Erminia, additional, Ferretti, Antonietta, additional, De Luca, Maria Lucia, additional, Barone, Francesco, additional, Serrao, Alessandra, additional, Aprile, Simona Michela, additional, Capria, Saveria, additional, Minotti, Clara, additional, Martelli, Maurizio, additional, Mazzucconi, Maria Gabriella, additional, Chistolini, Antonio, additional, and Santoro, Cristina, additional

Published
2021
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34. Efficacy and Safety of Nepa in Preventing Nausea and Vomiting Induced by Multiple-day Chemotherapy in Patients With Refractory/relapsed Aggressive Non-hodgkin’s Lymphoma Undergoing Stem Cell Mobilization Prior to Autologous Hematopoietic Stem Cell Transplantation

Author

Renzo, Nicola Di, primary, Musso, Maurizio, additional, Scimè, Rosanna, additional, Cupri, Alessandra, additional, Perrone, Tommasina, additional, De Risi, Clara, additional, Pastore, Domenico, additional, Guarini, Attilio, additional, Mengarelli, Andrea, additional, Benedetti, Fabio, additional, Mazza, Patrizio, additional, Capria, Saveria, additional, Chiusolo, Patrizia, additional, Cupelli, Luca, additional, Federico, Vincenzo, additional, Bozzoli, Valentina, additional, Messa, Anna Rita, additional, Matera, Rosella, additional, Seripa, Davide, additional, Codega, Paolo, additional, Bonizzoni, Erminio, additional, and Specchia, Giorgina, additional

Published
2021
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36. Validation of ELN2017 Risk Stratification in a Post-Hoc Analysis of the Prospective Biomarker-Based Gimema AML1310 Protocol

Author

Palmieri, Raffaele, primary, Buccisano, Francesco, additional, Piciocchi, Alfonso, additional, Arena, Valentina, additional, Candoni, Anna, additional, Melillo, Lorella MA, additional, Calafiore, Valeria, additional, Cairoli, Roberto, additional, De Fabritiis, Paolo, additional, Storti, Gabriella, additional, Salutari, Prassede, additional, Lanza, Francesco, additional, Martinelli, Giovanni, additional, Luppi, Mario, additional, Capria, Saveria, additional, Maurillo, Luca, additional, Del Principe, Maria Ilaria, additional, Paterno, Giovangiacinto, additional, Voso, Maria Teresa, additional, Ottone, Tiziana, additional, Lavorgna, Serena, additional, Fazi, Paola, additional, Vignetti, Marco, additional, Arcese, William, additional, and Venditti, Adriano, additional

Published
2020
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37. The HLA Variant rs6903608 Is Associated with Disease Onset and Relapse of Immune-Mediated Thrombotic Thrombocytopenic Purpura in Caucasians

Author

Mancini, Ilaria, primary, Giacomini, Elisa, additional, Pontiggia, Silvia, additional, Artoni, Andrea, additional, Ferrari, Barbara, additional, Pappalardo, Emanuela, additional, Gualtierotti, Roberta, additional, Trisolini, Silvia Maria, additional, Capria, Saveria, additional, Facchini, Luca, additional, Codeluppi, Katia, additional, Rinaldi, Erminia, additional, Pastore, Domenico, additional, Campus, Simona, additional, Caria, Cinzia, additional, Caddori, Aldo, additional, Nicolosi, Daniela, additional, Giuffrida, Gaetano, additional, Agostini, Vanessa, additional, Roncarati, Umberto, additional, Mannarella, Clara, additional, Fragasso, Alberto, additional, Podda, Gian Marco, additional, Birocchi, Simone, additional, Cerbone, Anna Maria, additional, Tufano, Antonella, additional, Menna, Giuseppe, additional, Pizzuti, Michele, additional, Ronchi, Michela, additional, De Fanti, Alessandro, additional, Amarri, Sergio, additional, Defina, Marzia, additional, Bocchia, Monica, additional, Cerù, Silvia, additional, Gattillo, Salvatore, additional, Rosendaal, Frits R., additional, and Peyvandi, Flora, additional

Published
2020
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38. Reduced Mortality From KPC-K.Pneumoniae Bloodstream Infection in High-Risk Patients With&nbsp;Hematological Malignancies Colonized by KPC-K.Pneumoniae

Author

Micozzi, Alessandra, primary, Gentile, Giuseppe, additional, Santilli, Stefania, additional, Minotti, Clara, additional, Capria, Saveria, additional, Moleti, Maria Luisa, additional, Barberi, Walter, additional, Cartoni, Claudio, additional, Trisolini, Silvia Maria, additional, Testi, Anna Maria, additional, Iori, Anna Paola, additional, Bucaneve, Giampaolo, additional, and Foa, Robin, additional

Published
2020
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40. BEAM conditioning regimen ensures better progression-free survival compared with TEAM but not with FEAM in lymphoma patients undergoing autologous stem cell transplant

Author

Marchesi, Francesco, primary, Capria, Saveria, additional, Pedata, Mariangela, additional, Terrenato, Irene, additional, Ballotta, Laura, additional, Riccardi, Cira, additional, Papa, Elena, additional, Riemma, Costantino, additional, Trisolini, Silvia, additional, Celentano, Maria, additional, Regazzo, Giulia, additional, Ferrara, Felicetto, additional, Mengarelli, Andrea, additional, and Picardi, Alessandra, additional

Published
2020
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41. Very late acute myeloid leukemia relapse: clinical features, treatment and outcome

Author

Mariani, Sabrina, primary, Trisolini, Silvia Maria, additional, Minotti, Clara, additional, Breccia, Massimo, additional, Cartoni, Claudio, additional, De Propris, Maria Stefania, additional, Loglisci, Giovanna, additional, Latagliata, Roberto, additional, Limongi, Maria Zaira, additional, Testi, Anna Maria, additional, Foà, Robin, additional, and Capria, Saveria, additional

Published
2020
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45. Myeloid Sarcoma: Diagnostic and Treatment Tools from a Monocentric Retrospective Experience.

Author

Bianchi, Simona, Capria, Saveria, Trisolini, Silvia Maria, Crisanti, Erica, De Propris, Maria Stefania, Diverio, Daniela, Moleti, Maria Luisa, Foà, Robin, and Testi, Anna Maria

Subjects
*MYELOID sarcoma, *CANCER treatment, *EXTRAMEDULLARY diseases, *ACUTE myeloid leukemia, *STEM cell transplantation
Abstract

Myeloid sarcoma (MS) is a very rare disease in both adults and children. Prognosis is poor in adults; in the pediatric age, the prognostic impact of extramedullary disease is controversial. Systemic therapy represents the mainstay of treatment even in isolated MS, but a comparison between different induction regimens is very limited in the literature. To date, it is still not clear if induction treatment should differ from that of other acute myeloid leukemias and stem cell transplant is considered for consolidation in both leukemic patients and in those with isolated disease. Our study describes a retrospective series of 13 cases of MS (adults and children), diagnosed and treated at our institute over 18 years. We report the results of immunophenotypic, cytogenetic and molecular studies, therapeutic approaches, and outcome, in order to establish the best strategy for patients' workup. [ABSTRACT FROM AUTHOR]

Published
2022
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46. Has Hematopoietic Stem Cell Transplantation a Role in the Treatment of Children and Adolescents with Acute Promyelocytic Leukemia?

Author

Testi, Anna Maria, Musiu, Paolo, Moleti, Maria Luisa, Capria, Saveria, and Barberi, Walter

Subjects
ACUTE promyelocytic leukemia, HEMATOPOIETIC stem cell transplantation, STEM cell transplantation, HEMATOPOIETIC stem cells, TEENAGERS
Abstract

The past three decades have brought major therapeutic advances in treating acute promyelocytic leukemia (APL) both in adults and children. The current state-of-the-art treatment with all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) in combination or not with chemotherapy results in long-lasting remission and cure in more than 90% of newly diagnosed patients. These treatments have made relapse a rare event. The detection of PML-RARA transcript by polymerase chain reaction (PCR) during treatment and follow-up can predict a hematological relapse. All studies have suggested a survival benefit in patients with molecular relapse given pre-emptive therapy compared with those treated at the time of overt hematological relapse. ATO-based regimens seem to be effective for achieving a second molecular complete remission (CR). Patients in second molecular CR are generally considered candidates for autologous hematopoietic stem cell transplant (HSCT), while for those with a persistent molecular disease, allogeneic HSCT should be offered if a suitable donor is identified. Except for sporadic pediatric reports, most of the evidence for using HSCT to treat relapsed/refractory APL comes from adult literature. Therefore, we now provide a review of published pediatric data that evaluated the role of HSCT in children with refractory/recurrent APL disease. [ABSTRACT FROM AUTHOR]

Published
2022
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47. Individualized prediction of leukemia-free survival after autologous stem cell transplantation in acute myeloid leukemia

Author

Shouval, Roni, Labopin, Myriam, Gorin, Norbert C, Bomze, David, Houhou, Mohamed, Blaise, Didier, Zuckerman, Tsila, Baerlocher, Gabriela M., Capria, Saveria, Forcade, Edouard, Huynh, Anne, Saccardi, Riccardo, Martino, Massimo, Schaap, Michel, Wu, Depei, Mohty, Mohamad, and Nagler, Arnon

Subjects
610 Medicine & health
Abstract

BACKGROUND Autologous stem cell transplantation (ASCT) is a potential consolidation therapy for acute myeloid leukemia (AML). This study was designed to develop a prediction model for leukemia-free survival (LFS) in a cohort of patients with de novo AML treated with ASCT during their first complete remission. METHODS This was a registry study of 956 patients reported to the European Society for Blood and Marrow Transplantation. The primary outcome was LFS. Multivariate Cox regression modeling with backward selection was used to select variables for the construction of the nomogram. The nomogram's performance was evaluated with discrimination (the area under the receiver operating characteristic curve [AUC]) and calibration. RESULTS Age and cytogenetic risk (with or without FMS-like tyrosine kinase 3 internal tandem duplication) were predictive of LFS and were used for the construction of the nomogram. Each factor in the nomogram was ascribed points according to its predictive weight. Through the calculation of the total score, the probability of LFS at 1, 3, and 5 years for each patient could be estimated. The discrimination of the nomogram, measured as the AUC, was 0.632 (95% confidence interval [CI], 0.595-0.669), 0.670 (95% CI, 0.635-0.705), and 0.687 (95% CI, 0.650-0.724), respectively. Further validation with bootstrapping showed similar AUCs (0.629 [95% CI, 0.597-0.657], 0.667 [95% CI, 0.633-0.699], and 0.679 [95% CI, 0.647-0.712], respectively), and this suggested that the model was not overfitted. Calibration was excellent. Patients were stratified into 4 incremental 5-year prognostic groups, with the probabilities of LFS and overall survival ranging from 25% to 64% and from 33% to 79%, respectively. CONCLUSIONS The Auto-AML nomogram score is a tool integrating individual prognostic factors to provide a probabilistic estimation of LFS after ASCT for patients with AML.

Published
2019
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48. Incidence, Risk Factors and Outcome of Pre-engraftment Gram-Negative Bacteremia After Allogeneic and Autologous Hematopoietic Stem Cell Transplantation: An Italian Prospective Multicenter Survey

Author

Girmenia, Corrado, Bertaina, Alice, Piciocchi, Alfonso, Perruccio, Katia, Algarotti, Alessandra, Busca, Alessandro, Cattaneo, Chiara, Raiola, Anna Maria, Guidi, Stefano, Iori, Anna Paola, Candoni, Anna, Irrera, Giuseppe, Milone, Giuseppe, Marcacci, Giampaolo, Scimè, Rosanna, Musso, Maurizio, Cudillo, Laura, Sica, Simona, Castagna, Luca, Corradini, Paolo, Marchesi, Francesco, Pastore, Domenico, Alessandrino, Emilio Paolo, Annaloro, Claudio, Ciceri, Fabio, Santarone, Stella, Nassi, Luca, Farina, Claudio, Viscoli, Claudio, Rossolini, Gian Maria, Bonifazi, Francesca, Rambaldi, Alessandro, Capria, Saveria, Bertaina, A., Mastronuzzi, Angela, Pagliara, Daria, Bernaschi, Paola, Amico, Lucia, Carotti, Alessandra, Mencacci, Antonella, Busca, A., Bruno, Benedetto, Costa, Cristina, Passi, Angela, Ravizzola, Giuseppe, Angelucci, Emanuele, Marchese, Anna, Pecile, Patrizia, Candoni, A., Ventura, Giovanna, Fanin, Renato, Scarparo, Claudio, Barbaro, Angelo, Milone, G., Leotta, Salvatore, Marchese, Anna Elisa, Marcacci, G., Becchimanzi, Cristina, Donnarumma, Daniela, Tringali, Stefania, Baldi, Maria Teresa, Scalone, Renato, Cudillo, L., Picardi, Alessandra, Arcese, William, Fontana, Carla, Sica, S., Giammarco, Sabrina, Spanu, Teresa, Castagna, L., Crocchiolo, Roberto, Casari, Erminia, Mussetti, Alberto, Conte, Eutilia, Ensoli, Fabrizio, Miragliotta, Giuseppe, Marone, Piero, Arghittu, Milena, Greco, Raffaella, Forcina, Alessandra, Chichero, Paola, Santarone, S., Di Bartolomeo, Paolo, Fazii, Paolo, Kroumova, Vesselina, Decembrino, Nunzia, Zecca, Marco, Pisapia, Giovanni, Palazzo, Giulia, Lanino, Edoardo, Faraci, Maura, Castagnola, Elio, Bandettini, Roberto, Pastano, Rocco, Sammassimo, Simona, Passerini, Rita, Stefani, Piero Maria, Gherlinzoni, Filippo, Rigoli, Roberto, Prezioso, Lucia, Cambò, Benedetta, Calderaro, Adriana, Carella, Angelo Michele, Cascavilla, Nicola, Labonia, Maria Teresa, Celeghini, Ivana, Mordini, Nicola, Piana, Federica, Vacca, Adriana, Sanna, Marco, Podda, Giovanni, Corsetti, Maria Teresa, Rocchetti, Andrea, Cilloni, Daniela, De Gobbi, Marco, Bianco, Ornella, Fagioli, Franca, Carraro, Francesca, De Intinis, Gianfranco, Severino, Alessandro, Proia, Anna, Parisi, Gabriella, Vallisa, Daniele, Confalonieri, Massimo, Russo, Domenico, Malagola, Michele, Galieni, Piero, Falcioni, Sadia, Travaglini, Valeria, Raimondi, Roberto, Borghero, Carlo, Pavan, Giacomina, Prete, Arcangelo, Belotti, Tamara, Ambretti, Simone, Imola, Manuela, Mianulli, Anna Maria, Pedna, Maria Federica, Cesaro, Simone, Lo Cascio, Giuliana, Ferrari, Antonella, Piedimonte, Monica, Santino, Iolanda, Calandrelli, Monica, Olivieri, Attilio, Orecchioni, Francesca, Mirabile, Milena, Centurioni, Riccardo, Gironacci, Luciana, Caravelli, Daniela, Gallo, Susanna, De Filippi, Marco, Cupelli, Luca, Dentamaro, Teresa, Falco, Silvana, Eugenio, Ospedale S, Marotta, Serena, Risitano, Antonio, Lula, Dora, Musto, Pellegrino, Pietrantuono, Giuseppe, Traficante, Antonio, Cerchiara, Elisabetta, Tirindelli, Maria Cristina, Dicuonzo, Giordano, Chierichini, Anna, Anaclerico, Barbara, Placanica, Paola, Girmenia, C, Bertaina, A, Piciocchi, A, Perruccio, K, Algarotti, A, Busca, A, Cattaneo, C, Raiola, Am, Guidi, S, Iori, Ap, Candoni, A, Irrera, G, Milone, G, Marcacci, G, Scimè, R, Musso, M, Cudillo, L, Sica, S, Castagna, L, Corradini, P, Marchesi, F, Pastore, D, Alessandrino, Ep, Annaloro, C, Ciceri, F, Santarone, S, Nassi, L, Farina, C, Viscoli, C, Rossolini, Gm, Bonifazi, F, Rambaldi, A, for the Gruppo Italiano Trapianto di Midollo Osseo, (GITMO), Associazione Microbiologi Clinici Italiani, (AMCLI), Girmenia, Corrado, Bertaina, Alice, Piciocchi, Alfonso, Perruccio, Katia, Algarotti, Alessandra, Busca, Alessandro, Cattaneo, Chiara, Raiola, Anna Maria, Guidi, Stefano, Iori, Anna Paola, Candoni, Anna, Irrera, Giuseppe, Milone, G., Marcacci, Giampaolo, Scimè, Rosanna, Musso, Maurizio, Cudillo, Laura, Sica, Simona, Castagna, Luca, Corradini, Paolo, Marchesi, Francesco, Pastore, Domenico, Alessandrino, Emilio Paolo, Annaloro, Claudio, Ciceri, Fabio, Santarone, Stella, Nassi, Luca, Farina, Claudio, Viscoli, Claudio, Rossolini, Gian Maria, Bonifazi, Francesca, Rambaldi, Alessandro, Capria, Saveria, Bertaina, A., Mastronuzzi, Angela, Pagliara, Daria, Bernaschi, Paola, Amico, Lucia, Carotti, Alessandra, Mencacci, Antonella, Busca, A., Bruno, Benedetto, Costa, Cristina, Passi, Angela, Ravizzola, Giuseppe, Angelucci, Emanuele, Marchese, Anna, Pecile, Patrizia, Candoni, A., Ventura, Giovanna, Fanin, Renato, Scarparo, Claudio, Barbaro, Angelo, Leotta, Salvatore, Marchese, Anna Elisa, Marcacci, G., Becchimanzi, Cristina, Donnarumma, Daniela, Tringali, Stefania, Baldi, Maria Teresa, Scalone, Renato, Cudillo, L., Picardi, Alessandra, Arcese, William, Fontana, Carla, Sica, S., Giammarco, Sabrina, Spanu, Teresa, Castagna, L., Crocchiolo, Roberto, Casari, Erminia, Mussetti, Alberto, Conte, Eutilia, Ensoli, Fabrizio, Miragliotta, Giuseppe, Marone, Piero, Arghittu, Milena, Greco, Raffaella, Forcina, Alessandra, Chichero, Paola, Santarone, S., Di Bartolomeo, Paolo, Fazii, Paolo, Kroumova, Vesselina, Decembrino, Nunzia, Zecca, Marco, Pisapia, Giovanni, Palazzo, Giulia, Lanino, Edoardo, Faraci, Maura, Castagnola, Elio, Bandettini, Roberto, Pastano, Rocco, Sammassimo, Simona, Passerini, Rita, Stefani, Piero Maria, Gherlinzoni, Filippo, Rigoli, Roberto, Prezioso, Lucia, Cambò, Benedetta, Calderaro, Adriana, Carella, Angelo Michele, Cascavilla, Nicola, Labonia, Maria Teresa, Celeghini, Ivana, Mordini, Nicola, Piana, Federica, Vacca, Adriana, Sanna, Marco, Podda, Giovanni, Corsetti, Maria Teresa, Rocchetti, Andrea, Cilloni, Daniela, De Gobbi, Marco, Bianco, Ornella, Fagioli, Franca, Carraro, Francesca, De Intinis, Gianfranco, Severino, Alessandro, Proia, Anna, Parisi, Gabriella, Vallisa, Daniele, Confalonieri, Massimo, Russo, Domenico, Malagola, Michele, Galieni, Piero, Falcioni, Sadia, Travaglini, Valeria, Raimondi, Roberto, Borghero, Carlo, Pavan, Giacomina, Prete, Arcangelo, Belotti, Tamara, Ambretti, Simone, Imola, Manuela, Mianulli, Anna Maria, Pedna, Maria Federica, Cesaro, Simone, Lo Cascio, Giuliana, Ferrari, Antonella, Piedimonte, Monica, Santino, Iolanda, Calandrelli, Monica, Olivieri, Attilio, Orecchioni, Francesca, Mirabile, Milena, Centurioni, Riccardo, Gironacci, Luciana, Caravelli, Daniela, Gallo, Susanna, De Filippi, Marco, Cupelli, Luca, Dentamaro, Teresa, Falco, Silvana, Eugenio, Ospedale S, Marotta, Serena, Risitano, Antonio, Lula, Dora, Musto, Pellegrino, Pietrantuono, Giuseppe, Traficante, Antonio, Cerchiara, Elisabetta, Tirindelli, Maria Cristina, Dicuonzo, Giordano, Chierichini, Anna, Anaclerico, Barbara, and Placanica, Paola

Subjects
0301 basic medicine, Male, Transplantation Conditioning, Drug Resistance, Bacteremia, 0302 clinical medicine, epidemiology, Gram negative bacteremia, multidrug resistance, stem cell transplant, survival, Risk Factors, Drug Resistance, Multiple, Bacterial, Epidemiology, Medicine, Age Factor, Prospective Studies, Prospective cohort study, Child, Transplantation, Homologou, education.field_of_study, Incidence (epidemiology), Incidence, Bacterial, Age Factors, Hematopoietic Stem Cell Transplantation, Middle Aged, Transplantation, Autologou, surgical procedures, operative, Infectious Diseases, Italy, Child, Preschool, Female, medicine.symptom, Multiple, Autologous, Human, Homologous, Microbiology (medical), Adult, medicine.medical_specialty, Adolescent, 030106 microbiology, Population, Transplantation, Autologous, 03 medical and health sciences, Young Adult, Internal medicine, Gram-Negative Bacteria, Gram-Negative Bacterial Infection, Escherichia coli, Humans, Transplantation, Homologous, Preschool, education, Aged, Gram-Negative Bacterial Infections, Infant, Transplantation, business.industry, Risk Factor, medicine.disease, Prospective Studie, Carriage, Otitis, business, Settore MED/15 - Malattie del Sangue, 030215 immunology
Abstract

Background Gram-negative bacteremia (GNB) is a major cause of illness and death after hematopoietic stem cell transplantation (HSCT), and updated epidemiological investigation is advisable. Methods We prospectively evaluated the epidemiology of pre-engraftment GNB in 1118 allogeneic HSCTs (allo-HSCTs) and 1625 autologous HSCTs (auto-HSCTs) among 54 transplant centers during 2014 (SIGNB-GITMO-AMCLI study). Using logistic regression methods. we identified risk factors for GNB and evaluated the impact of GNB on the 4-month overall-survival after transplant. Results The cumulative incidence of pre-engraftment GNB was 17.3% in allo-HSCT and 9% in auto-HSCT. Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa were the most common isolates. By multivariate analysis, variables associated with GNB were a diagnosis of acute leukemia, a transplant from a HLA-mismatched donor and from cord blood, older age, and duration of severe neutropenia in allo-HSCT, and a diagnosis of lymphoma, older age, and no antibacterial prophylaxis in auto-HSCT. A pretransplant infection by a resistant pathogen was significantly associated with an increased risk of posttransplant infection by the same microorganism in allo-HSCT. Colonization by resistant gram-negative bacteria was significantly associated with an increased rate of infection by the same pathogen in both transplant procedures. GNB was independently associated with increased mortality at 4 months both in allo-HSCT (hazard ratio, 2.13; 95% confidence interval, 1.45–3.13; P Conclusions Pre-engraftment GNB is an independent factor associated with increased mortality rate at 4 months after auto-HSCT and allo-HSCT. Previous infectious history and colonization monitoring represent major indicators of GNB. Clinical Trials registration NCT02088840.

Published
2017

49. Nutritional and metabolic support in patients undergoing bone marrow transplantation. (Review Article)

Author

Muscaritoli, Maurizio, Grieco, Gabriella, Capria, Saveria, Iori, Anna Paola, and Fanelli, Filippo Rossi

Subjects
Bone marrow -- Transplantation, Organ transplant recipients -- Food and nutrition, Transplantation of organs, tissues, etc. -- Physiological aspects, Food/cooking/nutrition, Health
Abstract

Bone marrow transplantation (BMT) is a sophisticated procedure consisting of the administration of high-dose chemoradiotherapy followed by intravenous infusion of hemopoietic stem cells to reestablish marrow function when bone marrow is damaged or defective. BMT is used in the treatment of solid tumors, hematologic diseases, and autoimmune disorders. Artificial nutrition, total parenteral nutrition in particular, is provided to patients undergoing BMT to minimize the nutritional consequences of both the conditioning regimens (eg, mucositis of the gastrointestinal tract) and complications resulting from the procedure (eg, graft versus host disease and venoocclusive disease of the liver). Although artificial nutrition is now recognized as the standard of care for BMT patients, defined guidelines for the use of artificial nutrition in this clinical setting are lacking. During the past 2 decades, artificial nutrition in BMT patients has moved from simple supportive care to adjunctive therapy because of the possible benefits, not strictly nutritional, of specialized nutritional intervention. Although data exist documenting the beneficial role of special nutrients, such as lipids and glutamine, in the management of BMT recipients, the results obtained to date are controversial. The reasons for this controversy may reside in the heterogeneity of the patients studied and of the study designs. This review focuses on the need to correctly identify the different patterns of BMT to achieve reproducible and reliable data, which may in turn be used to devise precise guidelines for the use of specialized artificial nutrition in BMT patients. KEY WORDS Artificial nutrition, bone marrow transplantation, glutamine, fatty acids

Published
2002

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