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1. Age, successive waves, immunization, and mortality in elderly COVID-19 hematological patients: EPICOVIDEHA findings

Author

Giuseppe Rossi, Jon Salmanton-García, Chiara Cattaneo, Francesco Marchesi, Julio Dávila-Valls, Sonia Martín-Pérez, Federico Itri, Alberto López-García, Andreas Glenthøj, Maria Gomes da Silva, Caroline Besson, Monia Marchetti, Barbora Weinbergerová, Ozren Jaksic, Moraima Jiménez, Yavuz M. Bilgin, Jaap Van Doesum, Francesca Farina, Pavel Žák, Luisa Verga, Graham P. Collins, Valentina Bonuomo, Jens Van Praet, Marcio Nucci, Stef Meers, Ildefonso Espigado, Nicola S. Fracchiolla, Toni Valković, Christian Bjørn Poulsen, Natasha Čolović, Giulia Dragonetti, Marie-Pierre Ledoux, Carlo Tascini, Caterina Buquicchio, Ola Blennow, Francesco Passamonti, Marina Machado, Jorge Labrador, Rafael F. Duarte, Martin Schönlein, Lucia Prezioso, Iker Falces-Romero, Austin Kulasekararaj, Carolina Garcia-Vidal, Noemí Fernández, Ghaith Abu-Zeinah, Irati Ormazabal-Vélez, Tatjana Adžić-Vukičević, Klára Piukovics, Igor Stoma, Annarosa Cuccaro, Gabriele Magliano, Tomáš Szotkowski, Tomás-José González-López, Shaimaa El-Ashwah, Rui Bergantim, Uluhan Sili, Johan Maertens, Fatih Demirkan, Cristina De Ramón, Verena Petzer, Maria Ilaria Del Principe, Milan Navrátil, Michelina Dargenio, Guldane Cengiz Seval, Michail Samarkos, Zdeněk Ráčil, László Imre Pinczés, Tobias Lahmer, Alessandro Busca, Gustavo-Adolfo Méndez, Antonio Vena, Monika M. Biernat, Maria Merelli, Maria Calbacho, Aleksandra Barać, Martina Bavastro, Alessandro Limongelli, Osman Ilhan, Dominik Wolf, Gökçe Melis Çolak, Ramón García-Sanz, Ziad Emarah, Bojana Mišković, Stefanie K. Gräfe, Miloš Mladenović, Tommaso Francesco Aiello, Lucía Núñez-Martín-Buitrago, Anna Nordlander, Elena Arellano, Giovanni Paolo Maria Zambrotta, Emanuele Ammatuna, Alba Cabirta, Maria Vittoria Sacchi, Raquel Nunes Rodrigues, Ditte Stampe Hersby, Michaela Hanakova, Laman Rahimli, Raul Cordoba, Oliver A. Cornely, Livio Pagano, Joyce MARQUES DE ALMEIDA, José-Ángel HERNÁNDEZ-RIVAS, Anna GUIDETTI, Olimpia FINIZIO, Zlate STOJANOSKI, Milche CVETANOSKI, Joseph MELETIADIS, Nick DE JONGE, Darko ANTIĆ, Natasha ALI, Maria Chiara TISI, Laura SERRANO, Gaëtan PLANTEFEVE, Nina KHANNA, Martin HOENIGL, Martin ČERŇAN, Carolina MIRANDA-CASTILLO, María FERNÁNDEZ-GALÁN, Alexandra SERRIS, Nurettin ERBEN, Rémy DULÉRY, Avinash AUJAYEB, Mario Virgilio PAPA, Jan NOVÁK, Mario DELIA, Giuseppe SAPIENZA, Florian REIZINE, Ali S. OMRANI, Roberta DI BLASI, Sylvain LAMURE, Ľuboš DRGOŇA, Nicola COPPOLA, Josip BATINIĆ, Murtadha AL-KHABORI, José-María RIBERA-SANTA SUSANA, Monica PIEDIMONTE, Jorge LOUREIRO-AMIGO, Guillemette FOUQUET, Rita FAZZI, François DANION, Jörg SCHUBERT, Baerbel HOELL-NEUGEBAUER, Nathan C. BAHR, Ayel Omar YAHIA, Ana TORRES-ATIENZA, Ikhwan RINALDI, Marina POPOVA, Hans-Beier OMMEN, Maria Enza MITRA, Malgorzata MIKULSKA, Ira LACEJ, Sofya KHOSTELIDI, Sein WIN, Donald VINH, Modar SALEH, Juergen PRATTES, Pavel JINDRA, Fabio GUOLO, Roberta DELLA PEPA, Ekaterina CHELYSHEVA, Przemyslaw ZDZIARSKI, Vivien WAI-MAN, Andrés SOTO-SILVA, Hans Martin ORTH, Sandra MALAK, Lisset LORENZO DE LA PEÑA, Martin KOLDITZ, Chi Shan KHO, Christopher H. HEATH, Ana GROH, Eleni GAVRIILAKI, Monica FUNG, Matthias EGGER, Elizabeth DE KORT, Erik DE CABO, Tania CUSHION, Fazle Rabbi CHOWDHURY, M. Mansour CEESAY, Mathias BREHON, Gina VARRICCHIO, Agostino TAFURI, María-Josefa JIMÉNEZ-LORENZO, Nikolai KLIMKO, Panagiotis TSIRIGOTIS, Anastasia ANTONIADOU, and Maria VEHRESCHILD

Subjects
Elderly, SARS-CoV-2, Hematological malignancy, High-risk patient, COVID-19, Infectious and parasitic diseases, RC109-216
Abstract

Objectives: Elderly patients with hematologic malignancies face the highest risk of severe COVID-19 outcomes. The infection's impact on different age groups remains unstudied in detail. Methods: We analyzed elderly patients (age groups: 65-70, 71-75, 76-80, and >80 years old) with hematologic malignancies included in the EPICOVIDEHA registry between January 2020 and July 2022. Univariable and multivariable Cox regression models were conducted to identify factors influencing death in COVID-19 patients with hematological malignancy. Results: The study included data from 3,603 elderly patients (aged 65 or older) with hematological malignancy, with a majority being male (58.1%) and a significant proportion having comorbidities. The patients were divided into four age groups, and the analysis assessed COVID-19 outcomes, vaccination status, and other variables in relation to age and pandemic waves. The 90-day survival rate for patients with COVID-19 was 71.2%, with significant differences between groups. The pandemic waves had varying impacts, with the first wave affecting patients over 80 years old, the second being more severe in 65-70, and the third being the least severe in all age groups. Factors contributing to 90-day mortality included age, comorbidities, lymphopenia, active malignancy, acute leukemia, less than three vaccine doses, severe COVID-19, and using only corticosteroids as treatment. Conclusion: These data underscore the heterogeneity of elderly hematological patients, highlight the different impacts of COVID-19 waves and the pivotal importance of vaccination, and may help in planning future healthcare efforts.

Published
2023
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2. Decoding the historical tale: COVID-19 impact on haematological malignancy patients—EPICOVIDEHA insights from 2020 to 2022Research in context

Author

Jon Salmanton-García, Francesco Marchesi, Francesca Farina, Barbora Weinbergerová, Federico Itri, Julio Dávila-Valls, Sonia Martín-Pérez, Andreas Glenthøj, Ditte Stampe Hersby, Maria Gomes da Silva, Raquel Nunes Rodrigues, Alberto López-García, Raúl Córdoba, Yavuz M. Bilgin, Iker Falces-Romero, Shaimaa El-Ashwah, Ziad Emarah, Caroline Besson, Milena Kohn, Jaap Van Doesum, Emanuele Ammatuna, Monia Marchetti, Jorge Labrador, Giovanni Paolo Maria Zambrotta, Luisa Verga, Ozren Jaksic, Marcio Nucci, Klára Piukovics, Alba Cabirta-Touzón, Moraima Jiménez, Elena Arellano, Ildefonso Espigado, Ola Blennow, Anna Nordlander, Stef Meers, Jens van Praet, Tommaso Francesco Aiello, Carolina Garcia-Vidal, Nicola Fracchiolla, Mariarita Sciumè, Guldane Cengiz Seval, Pavel Žák, Caterina Buquicchio, Carlo Tascini, Stefanie K. Gräfe, Martin Schönlein, Tatjana Adžić-Vukičević, Valentina Bonuomo, Chiara Cattaneo, Summiya Nizamuddin, Martin Čerňan, Gaëtan Plantefeve, Romane Prin, Tomas Szotkovski, Graham P. Collins, Michelina Dargenio, Verena Petzer, Dominik Wolf, Natasha Čolović, Lucia Prezioso, Toni Valković, Francesco Passamonti, Gustavo-Adolfo Méndez, Uluhan Sili, Antonio Vena, Martina Bavastro, Alessandro Limongelli, Rafael F. Duarte, Marie-Pierre Ledoux, Milche Cvetanoski, Zlate Stojanoski, Marina Machado, Josip Batinić, Gabriele Magliano, Monika M. Biernat, Nikola Pantić, Christian Bjørn Poulsen, Annarosa Cuccaro, Maria Ilaria Del Principe, Austin Kulasekararaj, Irati Ormazabal-Vélez, Alessandro Busca, Fatih Demirkan, Marriyam Ijaz, Nikolai Klimko, Igor Stoma, Sofya Khostelidi, Noemí Fernández, Ali S. Omrani, Rui Bergantim, Nick De Jonge, Guillemette Fouquet, Milan Navrátil, Ghaith Abu-Zeinah, Michail Samarkos, Johan Maertens, Cristina De Ramón, Anna Guidetti, Ferenc Magyari, Tomás José González-López, Tobias Lahmer, Olimpia Finizio, Natasha Ali, László Imre Pinczés, Esperanza Lavilla-Rubira, Alessandra Romano, Maria Merelli, Mario Delia, Maria Calbacho, Joseph Meletiadis, Darko Antić, José-Ángel Hernández-Rivas, Joyce Marques de Almeida, Murtadha Al-Khabori, Martin Hoenigl, Maria Chiara Tisi, Nina Khanna, Aleksandra Barać, Noha Eisa, Roberta Di Blasi, Raphaël Liévin, Carolina Miranda-Castillo, Nathan C. Bahr, Sylvain Lamure, Mario Virgilio Papa, Ayel Yahya, Avinash Aujayeb, Jan Novák, Nurettin Erben, María Fernández-Galán, José-María Ribera-Santa Susana, Ikhwan Rinaldi, Rita Fazzi, Monica Piedimonte, Rémy Duléry, Yung Gonzaga, Andrés Soto-Silva, Giuseppe Sapienza, Alexandra Serris, Ľuboš Drgoňa, Ana Groh, Laura Serrano, Eleni Gavriilaki, Athanasios Tragiannidis, Juergen Prattes, Nicola Coppola, Vladimir Otašević, Miloš Mladenović, Mirjana Mitrović, Bojana Mišković, Pavel Jindra, Sofia Zompi, Maria Vittoria Sacchi, Carolin Krekeler, Maria Stefania Infante, Daniel García-Bordallo, Gökçe Melis Çolak, Jiří Mayer, Marietta Nygaard, Michaela Hanáková, Zdeněk Ráčil, Matteo Bonanni, Philipp Koehler, Laman Rahimli, Oliver A. Cornely, Livio Pagano, Francisco Javier Martín-Vallejo, Przemyslaw Zdziarski, Hossein Zarrinfer, Jana Wittig, Sein Win, Vivien Wai-Man, Benjamín Víšek, Donald C. Vinh, Maria Vehreschild, Gina Varricchio, Panagiotis Tsirigotis, Ana Torres-Tienza, Alina Daniela Tanase, Agostino Tafuri, Maria Stamouli, Jiří Sramek, Carole Soussain, Ayten Shirinova, Jörg Schubert, Enrico Schalk, Mohammad Reza Salehi, Modar Saleh, Giorgio Rosati, Elisa Roldán, Florian Reizine, Mayara Rêgo, Isabel Regalado-Artamendi, Marina Popova, Fernando Pinto, Laure Philippe, Hans Martin Orth, Hans-Beier Ommen, Aleš Obr, Lucía Núñez-Martín-Buitrago, Nicolas Noël, Julia Neuhann, Gianpaolo Nadali, Julia A. Nacov, Ana M. Munhoz Alburquerque, Maria Enza Mitra, Malgorzata Mikulska, Sibylle Mellinghoff, Ben Mechtel, Juan-Alberto Martín-González, Sandra Malak, Jorge Loureiro-Amigo, Lisset Lorenzo De La Peña, Giulia Liberti, Marianne Landau, Ira Lacej, Martin Kolditz, Chi Shan Kho, Reham Abdelaziz Khedr, Meinolf Karthaus, Linda Katharina Karlsson, María-Josefa Jiménez-Lorenzo, Macarena Izuzquiza, Baerbel Hoell-Neugebauer, Raoul Herbrecht, Christopher H. Heath, Fabio Guolo, Jan Grothe, Antonio Giordano, Sergey Gerasymchuk, Ramón García-Sanz, Nicole García-Poutón, Vaneuza Araújo Moreira Funke, Monica Fung, Charlotte Flasshove, Luana Fianchi, Jenna Essame, Matthias Egger, Bernard Drenou, Giulia Dragonetti, Maximilian Desole, Roberta Della Pepa, Bénédicte Deau Fischer, Elizabeth De Kort, Erik De Cabo, François Danion, Etienne Daguindau, Tania Cushion, Louise Cremer, Marianna Criscuolo, Gregorio Cordini, Antonella Cingolani, Fabio Ciceri, Fazle Rabbi Chowdhury, Ekaterina Chelysheva, Adrien Chauchet, Louis Yi Ann Chai, M. Mansour Ceesay, Elena Busch, Mathias Brehon, Davimar M.M. Borducchi, Stephen Booth, Serge Bologna, Caroline Berg Venemyr, Rebeca Bailén-Almorox, Anastasia Antoniadou, Amalia N. Anastasopoulou, and Fevzi Altuntaş

Subjects
Vaccination, ICU, COVID-19, Haematological malignancy, Immunosuppression, Medicine (General), R5-920
Abstract

Summary: Background: 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. Methods: The EPICOVIDEHA registry (National Clinical Trials Identifier, NCT04733729) gathers COVID-19 data from hematological malignancy patients since the pandemic's start worldwide. It spans various global locations, allowing comprehensive analysis over the first three years (2020–2022). Findings: The EPICOVIDEHA registry collected data from January 2020 to December 2022, involving 8767 COVID-19 cases in hematological malignancy patients from 152 centers across 41 countries, with 42% being female. Over this period, there was a significant reduction in critical infections and an overall decrease in mortality from 29% to 4%. However, hospitalization, particularly in the ICU, remained associated with higher mortality rates. Factors contributing to increased mortality included age, multiple comorbidities, active malignancy at COVID-19 onset, pulmonary symptoms, and hospitalization. On the positive side, vaccination with one to two doses or three or more doses, as well as encountering COVID-19 in 2022, were associated with improved survival. Interpretation: Patients with hematological malignancies still face elevated risks, despite reductions in critical infections and overall mortality rates over time. Hospitalization, especially in ICUs, remains a significant concern. The study underscores the importance of vaccination and the timing of COVID-19 exposure in 2022 for enhanced survival in this patient group. Ongoing monitoring and targeted interventions are essential to support this vulnerable population, emphasizing the critical role of timely diagnosis and prompt treatment in preventing severe COVID-19 cases. Funding: Not applicable.

Published
2024
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3. Influence of invasive aspergillosis during acute leukaemia treatment on survival after allogeneic stem cell transplantation: a prospective study of the EBMT Infectious Diseases Working PartyResearch in context

Author

Olaf Penack, Gloria Tridello, Urpu Salmenniemi, Rodrigo Martino, Nina Khanna, Katia Perruccio, Franca Fagioli, Monika Richert-Przygonska, Hélène Labussière-Wallet, Johan Maertens, Charlotte Jubert, Mahmoud Aljurf, Herbert Pichler, Gergely Kriván, Desiree Kunadt, Marina Popova, Melissa Gabriel, Elisabetta Calore, Igor Wolfgang Blau, Fabio Benedetti, Maija Itäla-Remes, Elizabeth de Kort, Domenico Russo, Maura Faraci, Anne-Lise Ménard, Peter von dem Borne, Xavier Poiré, Akif Yesilipek, Jolanta Gozdzik, Zeynep Arzu Yeğin, Lucrecia Yañez, Luca Facchini, Gwendolyn Van Gorkom, Lorenz Thurner, Ulker Kocak, Antònia Sampol, Tsila Zuckerman, Marc Bierings, Stephan Mielke, Fabio Ciceri, Lotus Wendel, Nina Knelange, Malgorzata Mikulska, Dina Averbuch, Jan Styczynski, Rafael de la Camara, and Simone Cesaro

Subjects
Invasive, Aspergillosis, Stem cell transplantation, Mortality, Medicine (General), R5-920
Abstract

Summary: Background: Infections are the main reason for mortality during acute leukaemia treatment and invasive aspergillosis (IA) is a major concern. Allogeneic stem cell transplantation (alloSCT) is a standard therapy and often is the only live-saving procedure in leukaemia patients. The profound immunodeficiency occurring after alloSCT led to high IA-associated mortality in the past. Therefore, patients with IA were historically considered transplant-ineligible. Recently, there has been improvement of anti-fungal management including novel anti-fungal agents. As a result, more leukaemia patients with IA are undergoing alloSCT. Outcome has not been prospectively assessed. Methods: We performed a prospective study in acute leukaemia patients undergoing alloSCT to analyse the impact of a prior history of probable or proven IA (pre-SCT IA). The primary endpoint was 1-year non-relapse mortality (NRM). Relapse free survival and overall survival were analysed as secondary endpoints. Findings: 1439 patients were included between 2016 and 2021. The incidence of probable or proven pre-SCT IA was 6.0% (n = 87). The cumulative incidence of 1-year NRM was 17.3% (95% CI 10.2–26.0) and 11.2% (9.6–13.0) for patients with and without pre-SCT IA. In multivariate analyses the hazard ratio (HR) for 1-year NRM was 2.1 (1.2–3.6; p = 0.009) for patients with pre-SCT IA. One-year relapse-free survival was inferior in patients with pre-SCT IA (59.4% [48.3–68.9] vs. 70.4 [67.9–72.8]; multivariate HR 1.5 [1.1–2.1]; p = 0.02). Consequently, 1-year overall survival was lower in patients with pre-SCT IA: (68.8% [57.8–77.4] vs. 79.0% [76.7–81.1]; multivariate HR 1.7 [1.1–2.5]; p = 0.01). Interpretation: Pre-SCT IA remains to be significantly associated with impaired alloSCT outcome. On the other hand, more than two thirds of patients with pre-SCT IA were alive at one year after alloSCT. IA is not anymore an absolute contraindication for alloSCT because the majority of patients with IA who undergo alloSCT benefit from this procedure. Funding: There was no external funding source for this study.

Published
2024
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5. Nirmatrelvir/ritonavir in COVID-19 patients with haematological malignancies: a report from the EPICOVIDEHA registryResearch in context

Author

Jon Salmanton-García, Francesco Marchesi, Maria Gomes da Silva, Francesca Farina, Julio Dávila-Valls, Yavuz M. Bilgin, Andreas Glenthøj, Iker Falces-Romero, Jaap Van Doesum, Jorge Labrador, Caterina Buquicchio, Shaimaa El-Ashwah, Verena Petzer, Jens Van Praet, Martin Schönlein, Michelina Dargenio, Gustavo-Adolfo Méndez, Stef Meers, Federico Itri, Antonio Giordano, László Imre Pinczés, Ildefonso Espigado, Zlate Stojanoski, Alberto López-García, Lucia Prezioso, Ozren Jaksic, Antonio Vena, Nicola S. Fracchiolla, Tomás José González-López, Natasa Colović, Mario Delia, Barbora Weinbergerová, Monia Marchetti, Joyce Marques de Almeida, Olimpia Finizio, Caroline Besson, Monika M. Biernat, Toni Valković, Tobias Lahmer, Annarosa Cuccaro, Irati Ormazabal-Vélez, Josip Batinić, Noemí Fernández, Nick De Jonge, Carlo Tascini, Amalia N. Anastasopoulou, Rémy Duléry, Maria Ilaria Del Principe, Gaëtan Plantefeve, Mario Virgilio Papa, Marcio Nucci, Moraima Jiménez, Avinash Aujayeb, José-Ángel Hernández-Rivas, Maria Merelli, Chiara Cattaneo, Ola Blennow, Anna Nordlander, Alba Cabirta, Gina Varricchio, Maria Vittoria Sacchi, Raul Cordoba, Elena Arellano, Stefanie K. Gräfe, Dominik Wolf, Ziad Emarah, Emanuele Ammatuna, Ditte Stampe Hersby, Sonia Martín-Pérez, Raquel Nunes Rodrigues, Laman Rahimli, Livio Pagano, Oliver A. Cornely, Klára Piukovics, Cristina De Ramón, François Danion, Ayel Yahya, Anna Guidetti, Carolina Garcia-Vidal, Uluhan Sili, Joseph Meletiadis, Elizabeth De Kort, Luisa Verga, Laura Serrano, Nurettin Erben, Roberta Di Blasi, Athanasios Tragiannidis, José-María Ribera-Santa Susana, Hans-Beier Ommen, Alessandro Busca, Nicola Coppola, Rui Bergantim, Giulia Dragonetti, Marianna Criscuolo, Luana Fianchi, Matteo Bonanni, Andrés Soto-Silva, Malgorzata Mikulska, Marina Machado, Chi Shan Kho, Nazia Hassan, Eleni Gavriilaki, Gregorio Cordini, Louis Yi Ann Chi, Matthias Eggerer, Martin Hoenigl, Juergen Prattes, María-Josefa Jiménez-Lorenzo, Sofia Zompi, Giovanni Paolo Maria Zambrotta, Gökçe Melis Çolak, Nicole García-Poutón, Tommaso Francesco Aiello, Romane Prin, Maria Stamouli, and Michail Samarkos

Subjects
Nirmatrelvir, SARS-CoV-2, Haematology, Malignancy, COVID-19, Medicine (General), R5-920
Abstract

Summary: Background: Nirmatrelvir/ritonavir treatment decreases the hospitalisation rate in immunocompetent patients with COVID-19, but data on efficacy in patients with haematological malignancy are scarce. Here, we describe the outcome of nirmatrelvir/ritonavir treatment in a large cohort of the latter patients. Methods: This is a retrospective cohort study from the multicentre EPICOVIDEHA registry (NCT04733729) on patients with haematological malignancy, who were diagnosed with COVID-19 between January and September 2022. Patients receiving nirmatrelvir/ritonavir were compared to those who did not. A logistic regression was run to determine factors associated with nirmatrelvir/ritonavir administration in our sample. Mortality between treatment groups was assessed with Kaplan–Meier survival plots after matching all the patients with a propensity score. Additionally, a Cox regression was modelled to detect factors associated with mortality in patients receiving nirmatrelvir/ritonavir. Findings: A total of 1859 patients were analysed, 117 (6%) were treated with nirmatrelvir/ritonavir, 1742 (94%) were treated otherwise. Of 117 patients receiving nirmatrelvir/ritonavir, 80% had received ≥1 anti-SARS-CoV-2 vaccine dose before COVID-19 onset, 13% of which received a 2nd vaccine booster. 5% were admitted to ICU. Nirmatrelvir/ritonavir treatment was associated with the presence of extrapulmonary symptoms at COVID-19 onset, for example anosmia, fever, rhinitis, or sinusitis (aOR 2.509, 95%CI 1.448–4.347) and 2nd vaccine booster (aOR 3.624, 95%CI 1.619–8.109). Chronic pulmonary disease (aOR 0.261, 95%CI 0.093–0.732) and obesity (aOR 0.105, 95%CI 0.014–0.776) were not associated with nirmatrelvir/ritonavir use. After propensity score matching, day-30 mortality rate in patients treated with nirmatrelvir/ritonavir was 2%, significantly lower than in patients with SARS-CoV-2 directed treatment other than nirmatrelvir/ritonavir (11%, p = 0.036). No factor was observed explaining the mortality difference in patients after nirmatrelvir/ritonavir administration. Interpretation: Haematological malignancy patients were more likely to receive nirmatrelvir/ritonavir when reporting extrapulmonary symptoms or 2nd vaccine booster at COVID-19 onset, as opposed to chronic pulmonary disease and obesity. The mortality rate in patients treated with nirmatrelvir/ritonavir was lower than in patients with targeted drugs other than nirmatrelvir/ritonavir. Funding: EPICOVIDEHA has received funds from Optics COMMIT (COVID-19 Unmet Medical Needs and Associated Research Extension) COVID-19 RFP program by GILEAD Science, United States (Project 2020-8223).

Published
2023
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6. Outcome of COVID-19 in allogeneic stem cell transplant recipients: Results from the EPICOVIDEHA registry

Author

Alessandro Busca, Jon Salmanton-García, Francesco Marchesi, Francesca Farina, Guldane Cengiz Seval, Jaap Van Doesum, Nick De Jonge, Nathan C. Bahr, Johan Maertens, Joseph Meletiadis, Nicola S. Fracchiolla, Barbora Weinbergerová, Luisa Verga, Zdeněk Ráčil, Moraima Jiménez, Andreas Glenthøj, Ola Blennow, Alina Daniela Tanase, Martin Schönlein, Lucia Prezioso, Nina Khanna, Rafael F. Duarte, Pavel Žák, Marcio Nucci, Marina Machado, Austin Kulasekararaj, Ildefonso Espigado, Elizabeth De Kort, José-María Ribera-Santa Susana, Monia Marchetti, Gabriele Magliano, Iker Falces-Romero, Osman Ilhan, Emanuele Ammatuna, Sofia Zompi, Panagiotis Tsirigotis, Anastasia Antoniadou, Giovanni Paolo Maria Zambrotta, Anna Nordlander, Linda Katharina Karlsson, Michaela Hanakova, Giulia Dragonetti, Alba Cabirta, Caroline Berg Venemyr, Stefanie Gräfe, Jens Van Praet, Athanasios Tragiannidis, Verena Petzer, Alberto López-García, Federico Itri, Ana Groh, Eleni Gavriilaki, Michelina Dargenio, Laman Rahimli, Oliver A. Cornely, Livio Pagano, EPICOVIDEHA Consortium, Juergen Prattes, Malgorzata Mikulska, Gustavo-Adolfo Méndez, Tobias Lahmer, Pavel Jindra, Anna Guidetti, Rita Fazzi, Maria Ilaria Del Principe, Cristina De Ramón, Maria Calbacho, Zlate Stojanoski, Andrés Soto, Alexandra Serris, Irati Ormazabal-Vélez, Ali S. Omrani, Milan Navrátil, Sonia Martín-Pérez, Joyce Marques De Almeida, Sylvain Lamure, Martin Kolditz, Ozren Jaksic, Martin Hoenigl, Carolina Garcia-Vidal, Noemí Fernández, Shaimaa El-Ashwah, Natasha Čolović, Martin Čerňan, Caterina Buquicchio, Valentina Bonuomo, Josip Batinić, Murtadha Al-Khabori, Tatjana Adžić-Vukičević, Juan-Alberto Martín-González, Maria Vittoria Sacchi, María-Josefa Jiménez-Lorenzo, Dominik Wolf, Maria Vehreschild, Raul Cordoba, Ramón García-Sanz, Toni Valković, Miloš Mladenović, Nicole García-Poutón, Ziad Emarah, and Julio Dávila-Valls

Subjects
allogeneic HSCT, COVID-19 infection, immunocompromised patients, SARS-CoV-2, hematological malignances, Immunologic diseases. Allergy, RC581-607
Abstract

BackgroundThe 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.MethodsThis 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.ResultsThe 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).ConclusionsMortality 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
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7. Retrospective Multicenter Evaluation of the VirClia Galactomannan Antigen Assay for the Diagnosis of Pulmonary Aspergillosis with Bronchoalveolar Lavage Fluid Samples from Patients with Hematological Disease

Author

Jochem B. Buil, Sammy Huygens, Albert Dunbar, Alexander Schauwvlieghe, Marijke Reynders, Diana Langerak, Karin van Dijk, Anke Bruns, Pieter-Jan Haas, Douwe F. Postma, Bart Biemond, Fatima Zohra Delma, Elizabeth de Kort, Willem J. G. Melchers, Paul E. Verweij, Bart Rijnders, Medical Microbiology and Infection Prevention, AII - Infectious diseases, AII - Inflammatory diseases, Internal Medicine, and Medical Microbiology & Infectious Diseases

Subjects
Microbiology (medical), Cancer development and immune defence Radboud Institute for Health Sciences [Radboudumc 2], All institutes and research themes of the Radboud University Medical Center, Women's cancers Radboud Institute for Molecular Life Sciences [Radboudumc 17], SDG 3 - Good Health and Well-being, lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4]
Abstract

Item does not contain fulltext Galactomannan (GM) testing of bronchoalveolar lavage (BAL) fluid samples has become an essential tool to diagnose invasive pulmonary aspergillosis (IPA) and is part of diagnostic guidelines. Enzyme-linked immunosorbent assays (ELISAs) (enzyme immunoassays [EIAs]) are commonly used, but they have a long turnaround time. In this study, we evaluated the performance of an automated chemiluminescence immunoassay (CLIA) with BAL fluid samples. This was a multicenter retrospective study in the Netherlands and Belgium. BAL fluid samples were collected from patients with underlying hematological diseases with a suspected invasive fungal infection. Diagnosis of IPA was based on the 2020 European Organisation for Research and Treatment of Cancer (EORTC)/Mycoses Study Group Education and Research Consortium (MSGERC) consensus definitions. GM results were reported as optical density index (ODI) values. ODI cutoff values for positive results that were evaluated were 0.5, 0.8, and 1.0 for the EIA and 0.16, 0.18, and 0.20 for the CLIA. Probable IPA cases were compared with two control groups, one with no evidence of IPA and another with no IPA or possible IPA. Qualitative agreement was analyzed using Cohen's κ, and quantitative agreement was analyzed by Spearman's correlation. We analyzed 141 BAL fluid samples from 141 patients; 66 patients (47%) had probable IPA, and 56 cases remained probable IPA when the EIA GM result was excluded as a criterion, because they also had positive culture and/or duplicate positive PCR results. Sixty-three patients (45%) had possible IPA and 12 (8%) had no IPA. The sensitivity and specificity of the two tests were quite comparable, and the overall qualitative agreement between EIA and CLIA results was 81 to 89%. The correlation of the actual CLIA and EIA values was strong at 0.72 (95% confidence interval, 0.63 to 0.80). CLIA has similar performance, compared to the gold-standard EIA, with the benefits of faster turnaround because batching is not required. Therefore, CLIA can be used as an alternative GM assay for BAL fluid samples.

Published
2023

8. Outcome of infection with omicron SARS-CoV-2 variant in patients with hematological malignancies: An EPICOVIDEHA survey report

Author

Ola Blennow, Jon Salmanton‐García, Piotr Nowak, Federico Itri, Jaap Van Doesum, Alberto López‐García, Francesca Farina, Ozren Jaksic, László Imre Pinczés, Yavuz M. Bilgin, Iker Falces‐Romero, Moraima Jiménez, Irati Ormazabal‐Vélez, Barbora Weinbergerová, Rémy Duléry, Zlate Stojanoski, Tobias Lahmer, Noemí Fernández, José‐Ángel Hernández‐Rivas, Verena Petzer, Nick De Jonge, Andreas Glenthøj, Cristina De Ramón, Monika M. Biernat, Nicola Fracchiolla, Avinash Aujayeb, Jens Van Praet, Martin Schönlein, Gustavo‐Adolfo Méndez, Chiara Cattaneo, Anna Guidetti, Mariarita Sciumè, Emanuele Ammatuna, Raul Cordoba, Nicole García‐Poutón, Stefanie Gräfe, Alba Cabirta, Dominik Wolf, Anna Nordlander, Ramón García‐Sanz, Mario Delia, Caroline Berg Venemyr, Clara Brones, Roberta Di Blasi, Elizabeth De Kort, Stef Meers, Sylvain Lamure, Laura Serrano, Maria Merelli, Nicola Coppola, Rui Bergantim, Caroline Besson, Milena Kohn, Jessica Petiti, Carolina Garcia‐Vidal, Michelina Dargenio, François Danion, Marina Machado, Rebeca Bailén‐Almorox, Martin Hoenigl, Giulia Dragonetti, Louis Yi Ann Chai, Chi Shan Kho, Matteo Bonanni, Raphaël Liévin, Francesco Marchesi, Oliver A. Cornely, Livio Pagano, Institut Català de la Salut, [Blennow O, Nowak P] Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden. [Salmanton-García J] Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany. Faculty of Medicine and University Hospital Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany. [Itri F] Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital – Orbassano, Orbassano, Italy. [Van Doesum J] Department of Hematology, University Medical Center Groningen, Groningen, The Netherlands. [López-García A] Health Research Institute IIS-FJD, Fundacion Jimenez Diaz University Hospital, Madrid, Spain. [Jiménez M, Cabirta A] Servei d’Hematologia, Vall d'Hebron Hospital Universitari, Barcelona, Spain. Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain. Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain, Vall d'Hebron Barcelona Hospital Campus, Stem Cell Aging Leukemia and Lymphoma (SALL), Blennow, Ola, Salmanton-García, Jon, Nowak, Piotr, Itri, Federico, Van Doesum, Jaap, López-García, Alberto, Farina, Francesca, Jaksic, Ozren, Pinczés, László Imre, Bilgin, Yavuz M, Falces-Romero, Iker, Jiménez, Moraima, Ormazabal-Vélez, Irati, Weinbergerová, Barbora, Duléry, Rémy, Stojanoski, Zlate, Lahmer, Tobia, Fernández, Noemí, Hernández-Rivas, José-Ángel, Petzer, Verena, De Jonge, Nick, Glenthøj, Andrea, De Ramón, Cristina, Biernat, Monika M, Fracchiolla, Nicola, Aujayeb, Avinash, Van Praet, Jen, Schönlein, Martin, Méndez, Gustavo-Adolfo, Cattaneo, Chiara, Guidetti, Anna, Sciumè, Mariarita, Ammatuna, Emanuele, Cordoba, Raul, García-Poutón, Nicole, Gräfe, Stefanie, Cabirta, Alba, Wolf, Dominik, Nordlander, Anna, García-Sanz, Ramón, Delia, Mario, Berg Venemyr, Caroline, Brones, Clara, Di Blasi, Roberta, De Kort, Elizabeth, Meers, Stef, Lamure, Sylvain, Serrano, Laura, Merelli, Maria, Coppola, Nicola, Bergantim, Rui, Besson, Caroline, Kohn, Milena, Petiti, Jessica, Garcia-Vidal, Carolina, Dargenio, Michelina, Danion, Françoi, Machado, Marina, Bailén-Almorox, Rebeca, Hoenigl, Martin, Dragonetti, Giulia, Chai, Louis Yi Ann, Kho, Chi Shan, Bonanni, Matteo, Liévin, Raphaël, Marchesi, Francesco, Cornely, Oliver A, Pagano, Livio, and Hematology

Subjects
Science & Technology, SARS-CoV-2, COVID-19, Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES], Hematology, Neoplasms::Neoplasms by Site::Hematologic Neoplasms [DISEASES], Humans, Surveys and Questionnaires, Hematologic Neoplasms, COVID-19 (Malaltia), Cancer development and immune defence Radboud Institute for Health Sciences [Radboudumc 2], Settore MED/15 - MALATTIE DEL SANGUE, Sang - Malalties, Medicine and Health Sciences, virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES], Surveys and Questionnaire, neoplasias::neoplasias por localización::neoplasias hematológicas [ENFERMEDADES], Life Sciences & Biomedicine, Human
Abstract

SARS-CoV-2; Hematological malignancies SARS-CoV-2; Neoplasias hematológicas SARS-CoV-2; Neoplasies hematològiques Optics COMMIT (COVID-19 Unmet Medical Needs and Associated Research Extension) COVID-19 RFP program by GILEAD Science, United States, Grant/Award Number: Project 2020-8223.

Published
2022

9. Monoclonal gammopathy of renal significance presenting with cryoglobulinaemia type I associated severe thrombotic microangiopathy

Author

Eva Hesius, Kim Bunthof, Eric Steenbergen, Elizabeth de Kort, Inge Klein, and Jack Wetzels

Subjects
Transplantation, Cancer development and immune defence Radboud Institute for Health Sciences [Radboudumc 2], Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11], Nephrology, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11], Rare cancers Radboud Institute for Health Sciences [Radboudumc 9]
Abstract

Contains fulltext : 251628.pdf (Publisher’s version ) (Open Access) We report a 53-year-old man who presented with acute renal failure. His medical history revealed a spondyloarthropathy, for which secukinumab was started recently, and a monoclonal gammopathy of unknown significance. Kidney function deteriorated despite the withdrawal of secukinumab and dialysis was started. In the serum, type 1 cryoglobulins were present and a kidney biopsy showed ischaemic glomeruli, with thrombosis of the larger interlobular arteries. Other causes of thrombotic microangiopathy were excluded. Bone marrow immunophenotyping showed 1% monoclonal plasma cells. A diagnosis of monoclonal gammopathy of renal significance was made. Haematological treatment resulted in haematological and renal response.

Published
2022

10. End-organ function in patients on long-term circulatory support with continuous- or pulsatile-flow assist devices

Author

Elizabeth de Kort, O.H. Frazier, Rajko Radovancevic, Igor D. Gregoric, Branislav Radovancevic, and Bojan Vrtovec

Subjects
Pulmonary and Respiratory Medicine, Male, medicine.medical_specialty, Time Factors, Waiting Lists, medicine.medical_treatment, Heart Ventricles, Pulsatile flow, Cardiac index, Renal function, Ventricular Function, Left, Prosthesis Implantation, chemistry.chemical_compound, Internal medicine, medicine, Humans, Blood urea nitrogen, Retrospective Studies, Heart transplantation, Heart Failure, Transplantation, Creatinine, Ejection fraction, business.industry, Stroke Volume, Middle Aged, equipment and supplies, Surgery, Survival Rate, Treatment Outcome, chemistry, Cardiology, Heart Transplantation, Female, Heart-Assist Devices, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
Abstract

Background Limited data exist about the long-term effects of continuous-flow vs pulsatile-flow left ventricular assist devices (LVADs) on end-organ function. Methods We reviewed the data of patients who underwent LVAD implantation at our institution between 1989 and 2004 and who were supported for >6 months. The continuous-flow (C-LVAD) group included 12 patients bridged to transplant with either a Jarvik 2000 or a Thoratec HeartMate II LVAD. The pulsatile (P-LVAD) group included 58 patients supported by a Thoratec HeartMate I LVAD. Follow-up was up to 15 months after LVAD implantation. Average duration of LVAD support was 370 ± 182 days (range 180 to 754) for the C-LVAD group and 315 ± 111 days (range 180 to 1,334) for the P-LVAD group. Results Patients from both groups were comparable for age, gender, body weight, cardiac index, ejection fraction, creatinine, blood urea nitrogen, creatinine clearance, albumin, total bilirubin, and transaminase levels before implantation. C-LVAD patients had a lower pre-operative hemoglobin than did P-LVAD patients (10.5 ± 1.7 g/dl vs 12.2 ± 1.9 g/dl; p = 0.01). In both groups, albumin, blood urea nitrogen, creatinine, creatinine clearance, total bilirubin, and transminase levels either improved or stayed within the normal range at 6, 9, 12, and 15 months after LVAD implantation. Four of the 12 C-LVAD patients and 28 of the 58 P-LVAD patients underwent cardiac transplantation. Actuarial survival, censored for transplant, at 9, 12, and 15 months was 90% for the C-LVAD group and 88%, 78%, and 74% for the P-LVAD group ( p = not statistically significant). Conclusions On the basis of these data, it appears that continuous- and pulsatile-type LVADs provide adequate blood flow to maintain proper end-organ function during prolonged circulatory support.

Published
2006

11. Dexamethasone treatment for COVID-19 is related to increased mortality in hematologic malignancy patients: results from the EPICOVIDEHA registry.

Author

Aiello TF, Salmanton-Garcia J, Marchesi F, Weinbergerova B, Glenthoj A, Van Praet J, Farina F, Davila-Valls J, Martin-Perez S, El-Ashwah S, Schonlein M, Falces-Romero I, Labrador J, Sili U, Buquicchio C, Vena A, Plantefeve G, Petzer V, Biernat MM, Lahmer T, Espigado I, Van Doesum J, Blennow O, Piukovics K, Tascini C, Samarkos M, Bilgin YM, Fianchi L, Itri F, Valković T, Fracchiolla NS, Dargenio M, Jimenez M, Magyari F, Lopez-Garcia A, Prezioso L, Čolović N, Shumilov E, Abu-Zeinah G, Krekeler C, Lavilla-Rubira E, Papa MV, Gonzalez-Lopez TJ, Pinczes LI, Demirkan F, Ali N, Besson C, Fouquet G, Romano A, Hernandez-Rivas JA, Del Principe MI, Aujayeb A, Merelli M, Lamure S, De Almeida JM, Da Silva MG, Eisa N, Meletiadis J, Rinaldi I, Finizio O, Jaksic O, Delia M, Nizamuddin S, Marchetti M, Ijaz M, Machado M, Bailen-Almorox R, Čerňan M, Coppola N, Gavriilaki E, Cattaneo C, Groh A, Stojanoski Z, Erben N, Pantic N, Mendez GA, Di Blasi R, Meers S, De Ramon C, Bahr NC, Emarah Z, Varricchio G, Cvetanoski M, Garcia-Sanz R, Mitrovic M, Lievin R, Hanakova M, Račil Z, Vehreschild M, Tragiannidis A, Rodrigues RN, Garcia-Bordallo D, Cordoba R, Cabirta A, Nordlander A, Ammatuna E, Arellano E, Wolf D, Prin R, Limongelli A, Bavastro M, Colak GM, Grafe S, Hersby DS, Rahimli L, Cornely OA, Garcia-Vidal C, Pagano L, and Study Group E

Subjects
Humans, Male, Female, Aged, Middle Aged, Adult, Aged, 80 and over, Dexamethasone therapeutic use, Hematologic Neoplasms mortality, Hematologic Neoplasms drug therapy, Registries, COVID-19 mortality, COVID-19 complications, SARS-CoV-2 isolation & purification, COVID-19 Drug Treatment
Published
2024
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