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1. Outcome of 421 adult patients with Philadelphia-negative acute lymphoblastic leukemia treated under an intensive program inspired by the GIMEMA LAL1913 clinical trial: a Campus ALL study

Author: Davide Lazzarotto, Marco Cerrano, Cristina Papayannidis, Sabina Chiaretti, Federico Mosna, Nicola Fracchiolla, Patrizia Zappasodi, Silvia Imbergamo, Maria Ilaria Del Principe, Monia Lunghi, Federico Lussana, Matteo Piccini, Monica Fumagalli, Michelina Dargenio, Prassede Salutari, Fabio Forghieri, Teresa Giulia Da Molin, Massimiliano Bonifacio, Matteo Olivi, Fabio Giglio, Silvia Trappolini, Matteo Leoncin, Antonino Mule, Mario Delia, Crescenza Pasciolla, Francesco Grimaldi, Benedetta Cambo, Lidia Santoro, Fabio Guolo, Paola Minetto, Marzia Defina, Patrizia Chiusolo, Matteo Fanin, Endri Mauro, Lara Aprile, Carla Mazzone, Fabio Trastulli, Maria Ciccone, Marco De Gobbi, Alessandro Cignetti, Eleonora De Bellis, Valentina Mancini, Alfonso Piciocchi, Marco Vignetti, Giovanni Marsili, Irene Della Starza, Renato Fanin, Mario Luppi, Felicetto Ferrara, Giovanni Pizzolo, Renato Bassan, Robin Foa, and Anna Candoni
Subjects: Diseases of the blood and blood-forming organs, RC633-647.5
Abstract: The introduction of pediatric-inspired regimens in adult Philadelphia-negative acute lymphoblastic leukemia (Ph-ALL) has significantly improved patients’ prognosis. Within the Campus ALL network we analyzed the outcome of adult Ph-ALL patients treated according to the GIMEMA LAL1913 protocol outside the clinical trial, to compare the real-life data with the study results. We included 421 consecutive patients, with a median age of 42 years. The complete remission (CR) rate after the first course of chemotherapy was 94% and a measurable residual disease (MRD) negativity after the third course was achieved in 72% of patients. The 3-year overall survival (OS) and disease-free survival (DFS) were 67% and 57%, respectively. In a multivariate analysis, MRD positivity negatively influenced DFS. In a time-dependent analysis including only very high risk (VHR) and MRD positive cases, transplanted (HSCT) patients had a significantly better DFS than non-HSCT ones (P=0.0017). During induction, grade ≥2 pegaspargase-related hepato-toxicity was observed in 25% of patients (vs 12% in the GIMEMA LAL1913 trial, P=0.0003). In this large real-life cohort of Ph-ALL, we confirmed the very high CR rate and a superimposable OS and DFS compared to the GIMEMA LAL1913 clinical trial: CR rate after C1 94% vs 85%, P=0.0004; 3-year OS 67% vs 67%, P=0.94; 3-year DFS 57% vs 63%, P=0.17. HSCT confirms its important role in VHR and MRD-positive patients. The rate of pegaspargase-related toxicity was significantly higher in the real-life setting, emphasizing the importance of dose adjustment in the presence of risk factors to avoid excessive toxicity.
Published: 2024
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2. ACUTE LEUKEMIA AND LATENT TUBERCULOSIS INFECTION IN ITALY: QUANTIFERON-TB TEST SCREENING IN A LOW TUBERCULOSIS INCIDENCE COUNTRY

Author: Andrea Nunzi, Luigi Della Valle, Elisa Linnea Lindfors Rossi, Giorgia Ranucci, Flavia Mallegni, Federico Moretti, Elisa Meddi, Luca Guarnera, Ilaria Tiravanti, Kristian Taka, Elisa Buzzatti, Fabiana Esposito, Roberto Secchi, Francesca Di Giuliano, Flavia Chirico, Raffaele Palmieri, Luca Maurillo, Francesco Buccisano, Carmelo Gurnari, Giovangiacinto Paterno, Adriano Venditti, and Maria Ilaria Del Principe
Subjects: Acute Leukemia, tubercolosis, latent tuberculosis infection, prophylaxis, Acute Myeloid Leukemia, Acute Lymphoblastic Leukemia, Diseases of the blood and blood-forming organs, RC633-647.5
Abstract: Background and objectives Identification of latent tuberculosis infection (LTBI) is a critical step of tuberculosis surveillance, especially in low incidence countries, and is limited to situations with a higher probability of developing active disease, e.g., patients with hematological malignancies. According to guidelines, in TB non-endemic countries no clear screening program is established at diagnosis for patients with acute leukemia (AL). The primary endpoint of this study was to establish the LTBI incidence in patients with diagnosis of AL using QuantiFERON (QFT)-TB. Secondarily, TB-specific prophylaxis efficacy and safety, and features driving increased risk of LTBI were evaluated. Methods QFT-TB screening was performed before induction, consolidation or during follow-up, in all patients with AL (myeloid and lymphoid), treated at our Institution between October 2019 and August 2023. Results We accrued 62 patients, of whom 7 (11,3%) tested positive, without any symptoms or signs of active TB, and 2 (3,2%) resulted as indeterminate. All positive patients started prophylaxis with isoniazid 300 mg/die, while patients whose test was indeterminate did not receive any prophylaxis. Active TB was excluded by imaging, as well as microscopic, cultural, and molecular examination on bronchoalveolar lavage. During the 46-month period of observation, none of the patients developed TB reactivation. Conclusions In our country, LTBI is not uncommon as expected. Despite the low sample size, 1 out of 10 of our patients had prior TB exposure. This finding suggests implementing TB screening in the pre-treatment setting, particularly in a time when more numerous active treatments are becoming available also for patients ineligible to intensive chemotherapy.
Published: 2024
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3. 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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4. 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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5. Dexamethasone treatment for COVID-19 is related to increased mortality in hematologic malignancy patients: results from the EPICOVIDEHA Registry

Author: Tommaso Francesco Aiello, Jon Salmanton-Garcia, Francesco Marchesi, Barbora Weinbergerova, Andreas Glenthoj, Jens Van Praet, Francesca Farina, Julio Davila-Valls, Sonia Martin-Perez, Shaimaa El-Ashwah, Martin Schonlein, Iker Falces-Romero, Jorge Labrador, Uluhan Sili, Caterina Buquicchio, Antonio Vena, Gaetan Plantefeve, Verena Petzer, Monika M. Biernat, Tobias Lahmer, Ildefonso Espigado, Jaap Van Doesum, Ola Blennow, Klara Piukovics, Carlo Tascini, Michail Samarkos, Yavuz M. Bilgin, Luana Fianchi, Federico Itri, Toni Valković, Nicola S. Fracchiolla, Michelina Dargenio, Moraima Jimenez, Ferenc Magyari, Alberto Lopez-Garcia, Lucia Prezioso, Natasha Čolović, Evgenii Shumilov, Ghaith Abu-Zeinah, Carolin Krekeler, Esperanza Lavilla-Rubira, Mario Virgilio Papa, Tomas Jose Gonzalez-Lopez, Laszlo Imre Pinczes, Fatih Demirkan, Natasha Ali, Caroline Besson, Guillemette Fouquet, Alessandra Romano, Jose-Angel Hernandez-Rivas, Maria Ilaria Del Principe, Avinash Aujayeb, Maria Merelli, Sylvain Lamure, Joyce Marques De Almeida, Maria Gomes Da Silva, Noha Eisa, Joseph Meletiadis, Ikhwan Rinaldi, Olimpia Finizio, Ozren Jaksic, Mario Delia, Summiya Nizamuddin, Monia Marchetti, Marriyam Ijaz, Marina Machado, Rebeca Bailen-Almorox, Martin Čerňan, Nicola Coppola, Eleni Gavriilaki, Chiara Cattaneo, Ana Groh, Zlate Stojanoski, Nurettin Erben, Nicola Pantic, Gustavo-Adolfo Mendez, Roberta Di Blasi, Stef Meers, Cristina De Ramon, Nathan C. Bahr, Ziad Emarah, Gina Varricchio, Milche Cvetanoski, Ramon Garcia-Sanz, Mirjana Mitrovic, Raphael Lievin, Michaela Hanakova, Zdeněk Račil, Maria Vehreschild, Athanasios Tragiannidis, Raquel Nunes Rodrigues, Daniel Garcia-Bordallo, Raul Cordoba, Alba Cabirta, Anna Nordlander, Emanuele Ammatuna, Elena Arellano, Dominik Wolf, Romane Prin, Alessandro Limongelli, Martina Bavastro, Gokce Melis Colak, Stefanie Grafe, Ditte Stampe Hersby, Laman Rahimli, Oliver A. Cornely, Carolina Garcia-Vidal, Livio Pagano, and EPICOVIDEHA study group
Subjects: Diseases of the blood and blood-forming organs, RC633-647.5
Published: 2024
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6. Posaconazole and midostaurin in patients with FLT3‐mutated acute myeloid leukemia: Pharmacokinetic interactions and clinical facts in a real life study

Author: Pierantonio Menna, Francesco Marchesi, Chiara Cattaneo, Anna Candoni, Mario Delia, Gianpaolo Nadali, Alessandra Vatteroni, Crescenza Pasciolla, Salvatore Perrone, Luisa Verga, Daniele Armiento, Maria Ilaria Del Principe, Nicola S. Fracchiolla, Emanuela Salvatorelli, Santina Lupisella, Irene Terrenato, Alessandro Busca, Giorgio Minotti, and Livio Pagano
Subjects: Therapeutics. Pharmacology, RM1-950, Public aspects of medicine, RA1-1270
Abstract: Abstract Midostaurin is used in combination with chemotherapy to treat patients with newly diagnosed FLT3‐mutated acute myeloid leukemia. Chemotherapy‐induced neutropenia exposes these patients to a significant risk of invasive fungal infections (IFIs). International guidelines recommend primary antifungal prophylaxis with posaconazole (PCZ) but nested analysis of a phase III trial showed that strong PCZ inhibition of CYP3A4 diminished midostaurin metabolism and increased midostaurin plasma levels; however, midostaurin‐related adverse events (AEs) were only moderately exacerbated. We conducted a prospective multicenter real‐life study to evaluate (i) how often concerns around PCZ‐midostaurin interactions made the hematologist prescribe antifungals other than PCZ, (ii) how remarkably PCZ increased midostaurin plasma levels, and (iii) how significantly PCZ‐midostaurin interactions influenced hematologic and safety outcomes of induction therapy. Although the hematologists were blinded to pharmacokinetic findings, as many as 16 of 35 evaluable patients were prescribed antifungal prophylaxis with micafungin, weak CYP3A4 inhibitor, in place of PCZ (p
Published: 2023
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7. S143: NATURAL CLONAL EVOLUTION OF CHRONIC LYMPHOCYTIC LEUKEMIA WITH BIMODAL CD49D EXPRESSION REVEALS CD49D PLASTICITY

Author: Erika Tissino, Nicola Calonaci, Federico Pozzo, Filippo Vit, Annalisa Gaglio, Lodovico Terzi DI Bergamo, Tamara Bittolo, Francesca Maria Rossi, Robel Papotti, Ilaria Catarossi, Eva Zaina, Paola Nanni, Riccardo Bergamin, Leonardo Egidi, Giovanni Santacatterina, Salvatore Milite, Maria Ilaria Del Principe, Roberta Laureana, Jacopo Olivieri, Francesco Zaja, Annalisa Chiarenza, Davide Rossi, Riccardo Bomben, Valter Gattei, Antonella Zucchetto, and Giulio Caravagna
Subjects: Diseases of the blood and blood-forming organs, RC633-647.5
Published: 2023
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8. P372: CMV REACTIVATIONS/INFECTIONS IN PH+ ALL PATIENTS TREATED WITH DASATINIB WITH OR WITHOUT BLINATUMOMAB. A RETROSPECTIVE MULTICENTER CAMPUS ALL STUDY

Author: Mario Annunziata, Monia Lunghi, Fabio Giglio, Matteo Leoncin, Michelina Dargenio, Massimiliano Bonifacio, Marco De Gobbi, Carla Mazzone, Roberta Agrippino, Davide Lazzarotto, Elisa Roncoroni, Marzia Defina, Nicola Fracchiolla, Fabio Guolo, Maria Ilaria Del Principe, Barbara Scappini, Antonino Mulè, Maria Ciccone, Crescenza Pasciolla, Felicetto Ferrara, Giovanni Pizzolo, Robin Foà, and Sabina Chiaretti
Subjects: Diseases of the blood and blood-forming organs, RC633-647.5
Published: 2023
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9. S292: NIRMATRELVIR/RITONAVIR IN COVID-19 PATIENTS WITH HAEMATOLOGICAL MALIGNANCIES: A REPORT FROMTHE EPICOVIDEHA REGISTRY

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, Laszlo Imre Pinczes, Ildefonso Espigado, Zlate Stojanoski, Alberto Lopez-Garcia, Lucia Prezioso, Ozren Jaksic, Antonio Vena, Nicola Stefano Fracchiolla, Tomas Jose Gonzalez-Lopez, Natasa Čolović, Mario Delia, Barbora Weinbergerová, Monia Marchetti, Joyce Marques DE Almeida, Olimpia Finizio, Caroline Besson, Monika M. Biernat, Toni Valkovic, Tobias Lahmer, Annarosa Cuccaro, Irati Ormazabal Velez, Josip Batinic, Noemí Fernández, Nick de Jonge, Carlo Tascini, Amalia N. Anastasopoulou, Rémy Duléry, Maria Ilaria DEL Principe, Gaëtan Plantefeve, Mario Virgilio Papa, Marcio Nucci, Moraima Carmen Jimenez Balarezo, Avinash Aujayeb, Jose Angel Hernandez Rivas, Maria Merelli, Chiara Cattaneo, Ola Blennow, Anna Nordlander, Alba Cabirta, Gina Varricchio, Maria Vittoria Sacchi, Raul Cordoba, Elena Arellano, Stefanie Gräfe, Dominik Wolf, Ziad Emarah, Emanuele Ammatuna, Ditte Stampe Hersby, Sonia Martín-Pérez, Raquel Nunes Rodrigues, Laman Rahimli, Livio Pagano, and Oliver A. Cornely
Subjects: Diseases of the blood and blood-forming organs, RC633-647.5
Published: 2023
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10. P487: MIDOSTAURIN PLASMA EXPOSURE IN PATIENTS WITH FLT3-MUT ACUTE MYELOID LEUKEMIA UNDERGOING POSACONAZOLE PROPHYLAXIS DURING INDUCTION TREATMENT: A PROSPECTIVE MULTICENTRE STUDY FROM THE SEIFEM GROUP

Author: Francesco Marchesi, Pierantonio Menna, Chiara Cattaneo, Anna Candoni, Mario Delia, Gianpaolo Nadali, Crescenza Pasciolla, Salvatore Perrone, Luisa Verga, Daniele Armiento, Maria Ilaria DEL Principe, Nicola Stefano Fracchiolla, Emanuela Salvatorelli, S Lupisella, Irene Terrenato, Alessandro Busca, and Livio Pagano
Subjects: Diseases of the blood and blood-forming organs, RC633-647.5
Published: 2023
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11. P505: GIMEMA AML1819 TRIAL: GEMTUZUMAB OZOGAMICIN PLUS INTENSIVE CHEMOTHERAPY IMPACTS ON THE LEVEL OF POST-CONSOLIDATION MEASURABLE RESIDUAL DISEASE (MRD) IN ACUTE MYELOID LEUKEMIA

Author: Adriano Venditti, Alfonso Piciocchi, Luca Maurillo, Maria Ilaria Del Principe, Raffaele Palmieri, Stefano Soddu, Federico Moretti, Prassede Salutari, Maurizio Martelli, Maria Paola Martelli, Mario Luppi, Alessandro Pulsoni, Francesco Zaja, Roberto Cairoli, Fabrizio Pane, Sergio Siragusa, Renato Bassan, Michela Rondoni, Milena Mirabile, Antonino Mulè, Germana Beltrami, Patrizia Zappasodi, Laura Cudillo, Andrea Mengarelli, Antonio Curti, Felicetto Ferrara, Giovanni Rossi, Ernesta Audisio, Giuseppina Spinosa, Alessia Tieghi, Monica Bocchia, Vincenza Martini, Catello Califano, Luigi Rigacci, Agostino Tafuri, Michele Gottardi, Paola Fazi, Marco Vignetti, and Francesco Buccisano
Subjects: Diseases of the blood and blood-forming organs, RC633-647.5
Published: 2023
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12. P594: THE CXCR4-LOW/CD5-HIGH PROLIFERATIVE FRACTION IS ENRICHED IN BTK MUTATIONS AND ANTICIPATES RELAPSE IN IBRUTINIB-TREATED CLL

Author: Federico Pozzo, Gabriela Forestieri, Giulia Ianna, Filippo Vit, Erika Tissino, Tamara Bittolo, Robel Papotti, Lodovico Terzi DI Bergamo, Agostino Steffan, Roberta Laureana, Agostino Tafuri, Annalisa Chiarenza, Francesco DI Raimondo, Jacopo Olivieri, Francesco Zaja, Luca Laurenti, Maria Ilaria DEL Principe, Riccardo Bomben, Antonella Zucchetto, Davide Rossi, and Valter Gattei
Subjects: Diseases of the blood and blood-forming organs, RC633-647.5
Published: 2023
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13. P597: XPO1 MUTATIONS IDENTIFY EARLY STAGE CLL CHARACTERIZED BY SHORTER TIME TO FIRST TREATMENT AND ENHANCED BCR SIGNALING

Author: Donatella Talotta, Riccardo Moia, Lodovico Terzi DI Bergamo, Riccardo Bomben, Gabriela Forestieri, Valeria Spina, Alessio Bruscaggin, Chiara Cosentino, Mohammad Almasri, Riccardo Dondolin, Tamara Bittolo, Antonella Zucchetto, Stefano Baldoni, Ilaria Del Giudice, Francesca Romana Mauro, Rossana Maffei, Annalisa Chiarenza, Agostino Tafuri, Roberta Laureana, Maria Ilaria Del Principe, Francesco Zaja, Giovanni D’arena, Jacopo Olivieri, Silvia Rasi, Abdurraouf Mahmoud, Wael Al Essa, Bassel Awikeh, Sreekar Kogila, Matteo Bellia, Samir Mouhssine, Paolo Sportoletti, Roberto Marasca, Lydia Scarfò, Paolo Ghia, Valter Gattei, Robin Foà, Davide Rossi, and Gianluca Gaidano
Subjects: Diseases of the blood and blood-forming organs, RC633-647.5
Published: 2023
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14. P606: MEASUREMENT OF INTRACLONAL DIVERSIFICATION REFINES THE PROGNOSTIC IMPACT OF IGHV MUTATIONS IN CLL

Author: Filippo Vit, Tamara Bittolo, Robel Papotti, Federico Pozzo, Antonella Zucchetto, Erika Tissino, Eva Zaina, Ilaria Catarossi, Roberta Laureana, Jacopo Olivieri, Pietro Bulian, Luciano Levato, Giovanni D’arena, Daniele Armiento, Alberto Zamò, Ellen Leich, Andreas Rosenwald, Evgeny Arons, Robert J. Kreitman, Massimo Gentile, Luca Laurenti, Francesco Zaja, Agostino Tafuri, Annalisa Chiarenza, Maria Ilaria DEL Principe, Valter Gattei, and Riccardo Bomben
Subjects: Diseases of the blood and blood-forming organs, RC633-647.5
Published: 2023
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15. PB1942: PARTIAL RESPONSE WITH LYMPHOCYTOSIS (PR-L) IS NOT APPLICABLE FOR ACALABRUTINIB. AN ITALIAN MULTICENTER EXPERIENCE OF REAL LIFE.

Author: Idanna Innocenti, Antonio Mosca, Annamaria Tomasso, Andrea Galitzia, Lydia Scarfò, Eugenio Galli, Roberta Laureana, Giulia Benintende, Veronica Mattiello, Francesca Morelli, Sabrina Chiriu, Maria Ilaria Del Principe, Giulia Zamprogna, Massimo Gentile, Nicole Fabbri, Francesco Autore, Paolo Sportoletti, Alberto Fresa, Gioacchino Catania, Marta Coscia, Alessandra Tedeschi, Alessandro Sanna, Marzia Varettoni, Paolo Ghia, Roberta Murru, and Luca Laurenti
Subjects: Diseases of the blood and blood-forming organs, RC633-647.5
Published: 2023
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16. P1509: CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND PREVIOUS INFECTIONS HAD IMPACT ON INFECTIOUS COMPLICATIONS IN PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKEMIA TREATED WITH VENETOCLAX: A MULTICENTRE SEIFEM STUDY

Author: Francesco Autore, Andrea Visentin, Marina Deodato, Candida Vitale, Eugenio Galli, Alberto Fresa, Rita Fazzi, Alessandro Sanna, Jacopo Olivieri, Ilaria Scortechini, Maria Ilaria DEL Principe, Paolo Sportoletti, Luana Schiattone, Nilla Maschio, Davide Facchinelli, Marta Coscia, Alessandra Tedeschi, Livio Trentin, Idanna Innocenti, Anna Candoni, Alessandro Busca, Livio Pagano, and Luca Laurenti
Subjects: Diseases of the blood and blood-forming organs, RC633-647.5
Published: 2023
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17. 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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18. TP53 Mutations and Clinical Outcome in Chronic Lymphocytic Leukemia: Is a Threshold Still Needed?

Author: Riccardo Bomben, Antonella Zucchetto, Federico Pozzo, Erika Tissino, Tamara Bittolo, Jacopo Olivieri, Annalisa Chiarenza, Francesco Zaja, Maria Ilaria Del Principe, Davide Rossi, and Valter Gattei
Subjects: Diseases of the blood and blood-forming organs, RC633-647.5
Published: 2023
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19. 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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20. FEVER OF UNKNOWN ORIGIN AND MULTIDRUG-RESISTANT ORGANISMS COLONIZATION IN AML PATIENTS.

Author: Luca Guarnera, Gentiana Elena Trotta, Valentina Boldrini, Lucia Cardillo, Ilaria Cerroni, Valeria Mezzanotte, Gianmario Pasqualone, Arianna Savi, Beatrice Borsellino, Elisa Buzzatti, Raffaele Palmieri, Giovangiacinto Paterno, Luca Maurillo, Francesco Buccisano, Adriano Venditti, and Maria Ilaria Del Principe
Subjects: Acute Myeloid leukemia, fever of unknown origin, Colonization, Multidrug-resistant organisms, Diseases of the blood and blood-forming organs, RC633-647.5
Abstract: Abstract. Background: Colonization by multidrug-resistant organisms (MDRO) is a frequent complication in hematologic departments, which puts patients at risk of life-threatening bacterial sepsis. Fever of unknown origin (FUO) is a condition related to the delivery of chemotherapy in hematologic malignancies, in which the use of antibiotics is debated. The incidence, risk factors, and influence on the outcome of these conditions in patients with acute myeloid leukemia (AML) are not clearly defined. Methods: We retrospectively analyzed 132 consecutive admissions of non-promyelocytic AML patients at the Hematology Unit of the University Tor Vergata in Rome between June 2019 and February 2022. MDRO swab-based screening was performed in all patients on the day of admission and once weekly after that. FUO was defined as fever with no evidence of infection. Results: Of 132 consecutive hospitalizations (69 AML patients), MDRO colonization was observed in 35 cases (26%) and resulted independently related to a previous MDRO colonization (p=0.001) and length of hospitalization (p=0.03). The colonization persistence rate in subsequent admissions was 64%. MDRO-related bloodstream infection was observed in 8 patients (23%) and correlated with grade III/IV mucositis (p=0.008) and length of hospitalization (p=0.02). FUO occurred in 68 cases (51%) and correlated with an absolute neutrophilic count
Published: 2023
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21. COVID-19 infection in adult patients with hematological malignancies: a European Hematology Association Survey (EPICOVIDEHA)

Author: Livio Pagano, Jon Salmanton-García, Francesco Marchesi, Alessandro Busca, Paolo Corradini, Martin Hoenigl, Nikolai Klimko, Philipp Koehler, Antonio Pagliuca, Francesco Passamonti, Luisa Verga, Benjamin Víšek, Osman Ilhan, Gianpaolo Nadali, Barbora Weinbergerová, Raúl Córdoba-Mascuñano, Monia Marchetti, Graham P. Collins, Francesca Farina, Chiara Cattaneo, Alba Cabirta, Maria Gomes-Silva, Federico Itri, Jaap van Doesum, Marie-Pierre Ledoux, Martin Čerňan, Ozren Jakšić, Rafael F. Duarte, Gabriele Magliano, Ali S. Omrani, Nicola S. Fracchiolla, Austin Kulasekararaj, Toni Valković, Christian Bjørn Poulsen, Marina Machado, Andreas Glenthøj, Igor Stoma, Zdeněk Ráčil, Klára Piukovics, Milan Navrátil, Ziad Emarah, Uluhan Sili, Johan Maertens, Ola Blennow, Rui Bergantim, Carolina García-Vidal, Lucia Prezioso, Anna Guidetti, Maria Ilaria del Principe, Marina Popova, Nick de Jonge, Irati Ormazabal-Vélez, Noemí Fernández, Iker Falces-Romero, Annarosa Cuccaro, Stef Meers, Caterina Buquicchio, Darko Antić, Murtadha Al-Khabori, Ramón García-Sanz, Monika M. Biernat, Maria Chiara Tisi, Ertan Sal, Laman Rahimli, Natasa Čolović, Martin Schönlein, Maria Calbacho, Carlo Tascini, Carolina Miranda-Castillo, Nina Khanna, Gustavo-Adolfo Méndez, Verena Petzer, Jan Novák, Caroline Besson, Rémy Duléry, Sylvain Lamure, Marcio Nucci, Giovanni Zambrotta, Pavel Žák, Guldane Cengiz Seval, Valentina Bonuomo, Jiří Mayer, Alberto López-García, Maria Vittoria Sacchi, Stephen Booth, Fabio Ciceri, Margherita Oberti, Marco Salvini, Macarena Izuzquiza, Raquel Nunes-Rodrigues, Emanuele Ammatuna, Aleš Obr, Raoul Herbrecht, Lucía Núñez-Martín-Buitrago, Valentina Mancini, Hawraa Shwaylia, Mariarita Sciumè, Jenna Essame, Marietta Nygaard, Josip Batinić, Yung Gonzaga, Isabel Regalado-Artamendi, Linda Katharina Karlsson, Maryia Shapetska, Michaela Hanakova, Shaimaa El-Ashwah, Zita Borbényi, Gökçe Melis Çolak, Anna Nordlander, Giulia Dragonetti, Alessio Maria Edoardo Maraglino, Amelia Rinaldi, Cristina De Ramón-Sánchez, Oliver A. Cornely, and EPICOVIDEHA working group
Subjects: COVID-19, Pandemic, Hematological malignancies, Epidemiology, EHA, Diseases of the blood and blood-forming organs, RC633-647.5, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract: Abstract Background Patients with hematological malignancies (HM) are at high risk of mortality from SARS-CoV-2 disease 2019 (COVID-19). A better understanding of risk factors for adverse outcomes may improve clinical management in these patients. We therefore studied baseline characteristics of HM patients developing COVID-19 and analyzed predictors of mortality. Methods The survey was supported by the Scientific Working Group Infection in Hematology of the European Hematology Association (EHA). Eligible for the analysis were adult patients with HM and laboratory-confirmed COVID-19 observed between March and December 2020. Results The study sample includes 3801 cases, represented by lymphoproliferative (mainly non-Hodgkin lymphoma n = 1084, myeloma n = 684 and chronic lymphoid leukemia n = 474) and myeloproliferative malignancies (mainly acute myeloid leukemia n = 497 and myelodysplastic syndromes n = 279). Severe/critical COVID-19 was observed in 63.8% of patients (n = 2425). Overall, 2778 (73.1%) of the patients were hospitalized, 689 (18.1%) of whom were admitted to intensive care units (ICUs). Overall, 1185 patients (31.2%) died. The primary cause of death was COVID-19 in 688 patients (58.1%), HM in 173 patients (14.6%), and a combination of both COVID-19 and progressing HM in 155 patients (13.1%). Highest mortality was observed in acute myeloid leukemia (199/497, 40%) and myelodysplastic syndromes (118/279, 42.3%). The mortality rate significantly decreased between the first COVID-19 wave (March–May 2020) and the second wave (October–December 2020) (581/1427, 40.7% vs. 439/1773, 24.8%, p value
Published: 2021
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22. Case report: A Saprochaete clavata (Magnusiomyces clavatus) severe infection effectively treated with granulocyte transfusion in a young patient with myeloid sarcoma

Author: Gianmario Pasqualone, Elisa Buzzatti, Raffaele Palmieri, Arianna Savi, Maria Rosaria Pascale, Beatrice Borsellino, Luca Guarnera, Francesco Buccisano, Maria Teresa Voso, Luca Maurillo, Giuseppe Sconocchia, Adriano Venditti, and Maria Ilaria Del Principe
Subjects: acute myeloid leukemia, invasive fungal infection, granulocyte transfusion, Saprochaeta clavata, Magnusiomyces clavatus, case report, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract: Myeloid sarcoma is a hematologic malignancy consisting of extramedullary tissue involvement by myeloid blasts, usually considered as acute myeloid leukemia and treated accordingly. The disease itself, together with chemotherapy and disease-associated factors, may have an impact in increasing the risk of developing severe and frequently life-threatening infections. Herein, we describe the case of a patient with a right breast skin lesion, histologically diagnosed myeloid sarcoma, who developed a severe disseminated fungal infection by Saprochaete clavata (Magnusiomyces clavatus), during the first consolidation course of chemotherapy. Despite maximum antifungal therapy, the infection progressed and the fungus continued to be isolated until granulocyte transfusion therapy was initiated. Our experience suggests that patients with profound and long-lasting neutropenia could benefit from granulocyte transfusions as additional therapy in severe fungal infections resistant to broad-spectrum antimicrobial therapy.
Published: 2022
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23. Pulmonary function testing for fitness assessment in asymptomatic adults with newly diagnosed acute myeloid leukemia

Author: Raffaele Palmieri, Megan Othus, Guang-Shing Cheng, Francesco Buccisano, Giovangiacinto Paterno, Luca Maurillo, Maria Ilaria Del Principe, Giuseppe Sconocchia, Adriano Venditti, and Roland B. Walter
Subjects: Diseases of the blood and blood-forming organs, RC633-647.5
Published: 2022
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24. Revision of antifungal strategies definitions for invasive fungal infections (proven/probable/possible) in 461 patients with haematological malignancies (REDEFI‐SEIFEM).

Author: Marianna, Criscuolo, Matteo, Bonanni, Alfonso, Piciocchi, Francesca, Farina, Luisa, Verga, Francesco, Marchesi, Claudia, Basilico, Maria Ilaria, Del Principe, Maria Chiara, Tisi, Chiara, Cattaneo, Marco, Picardi, Valentina, Bonuomo, Nicola, Fracchiolla, Anna, Candoni, Katia, Perruccio, Marta, Stanzani, Anna Rita, Larici, Maurizio, Sanguinetti, Alessandro, Busca, and Livio, Pagano
Subjects: MYCOSES, REVIEW committees, LONGITUDINAL method, MEDICAL personnel, TUMORS
Abstract: Background: Invasive fungal infections (IFI) are a relevant cause of morbidity and mortality among patients with haematological neoplasms (HMs). Since 2002, a classification of IFI based on host factors, clinical and radiological features and mycological tests was published for research purpose. Objectives: These criteria are widely used in clinical practice to identify patients at risk for IFI. The aim of the study was to evaluate the clinical applicability of EORTC/MSG 2008 criteria for the diagnosis of IFI in daily practice. Patients/Methods: This multicentre, non‐interventional, observational, prospective study gathered all consecutive inpatients with HMs in which an intravenous antifungal treatment was started. Exclusion criteria were a previous or concomitant transplant procedure, outpatient status and oral antifungal therapy. EORTC/MSG 2008 criteria were used to classify patients at the beginning of antifungal therapy and at 30 days. An independent board reviewed the classification of IFI given by local clinicians at T0 and T30. Results: The highest percentage of agreement was found for possible IFI (96%), while a lower agreement was reported for proven IFI (74%), and the highest variability was observed for probable IFI (56%). At T30, the board re‐evaluation confirmed a strict agreement for possible IFI only (98%). Among 306 patients classified as possible, 156 (51%) patients showed non‐typical radiological findings and 45 (15%) patients presented host factors only. Conclusions: In real life, the EORTC/MSG criteria can be applicable only for possible IFI. As non‐typical radiological findings are reported in possible IFI, introducing a new IFI category should be considered. [ABSTRACT FROM AUTHOR]
Published: 2024
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25. COVID-19 in adult acute myeloid leukemia patients: a long-term follow-up study from the European Hematology Association survey (EPICOVIDEHA)

Author: Francesco Marchesi, Jon Salmanton-García, Ziad Emarah, Klára Piukovics, Marcio Nucci, Alberto López-García, Zdeněk Ráčil, Francesca Farina, Marina Popova, Sofia Zompi, Ernesta Audisio, Marie-Pierre Ledoux, Luisa Verga, Barbora Weinbergerová, Tomas Szotkovski, Maria Gomes Da Silva, Nicola Fracchiolla, Nick De Jonge, Graham Collins, Monia Marchetti, Gabriele Magliano, Carolina García-Vidal, Monika M. Biernat, Jaap Van Doesum, Marina Machado, Fatih Demirkan, Murtadha Al-Khabori, Pavel Žák, Benjamín Víšek, Igor Stoma, Gustavo-Adolfo Méndez, Johan Maertens, Nina Khanna, Ildefonso Espigado, Giulia Dragonetti, Luana Fianchi, Maria Ilaria Del Principe, Alba Cabirta, Irati Ormazabal-Vélez, Ozren Jaksic, Caterina Buquicchio, Valentina Bonuomo, Josip Batinić, Ali S. Omrani, Sylvain Lamure, Olimpia Finizio, Noemí Fernández, Iker Falces-Romero, Ola Blennow, Rui Bergantim, Natasha Ali, Sein Win, Jens Van Praet, Maria Chiara Tisi, Ayten Shirinova, Martin Schönlein, Juergen Prattes, Monica Piedimonte, Verena Petzer, Milan Navrátil, Austin Kulasekararaj, Pavel Jindra, Jiří Sramek, Andreas Glenthøj, Rita Fazzi, Cristina De Ramón-Sánchez, Chiara Cattaneo, Maria Calbacho, Nathan C. Bahr, Shaimaa El-Ashwah, Raul Cordoba, Michaela Hanakova, Giovanni Zambrotta, Mariarita Sciumè, Stephen Booth, Raquel Nunes Rodrigues, Maria Vittoria Sacchi, Nicole García-Poutón, Juan-Alberto Martín-González, Sofya Khostelidi, Stefanie Gräfe, Laman Rahimli, Emanuele Ammatuna, Alessandro Busca, Paolo Corradini, Martin Hoenigl, Nikolai Klimko, Philipp Koehler, Antonio Pagliuca, Francesco Passamonti, Oliver A. Cornely, and Livio Pagano
Subjects: Diseases of the blood and blood-forming organs, RC633-647.5
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
Published: 2022
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26. COVID-19 infection in acute lymphoblastic leukemia over 15 months of the pandemic. A Campus ALL report

Author: Sabina Chiaretti, Massimiliano Bonifacio, Roberta Agrippino, Fabio Giglio, Mario Annunziata, Antonio Curti, Maria Ilaria Del Principe, Prassede Salutari, Mariarita Sciumè, Mario Delia, Marco Armenio, Valentina Mancini, Antonino Mulè, Francesco Grimaldi, Giovanna Rege-Cambrin, Lidia Santoro, Federico Lussana, Patrizia Chiusolo, Crescenza Pasciolla, Anna Maria Scattolin, Marco Cerrano, Maria Ciccone, Marzia Defina, Fabio Forghieri, Carla Mazzone, Matteo Piccini, Felicetto Ferrara, Giovanni Pizzolo, and Robin Foà
Subjects: Diseases of the blood and blood-forming organs, RC633-647.5
Published: 2022
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27. Clinical relevance of an objective flow cytometry approach based on limit of detection and limit of quantification for measurable residual disease assessment in acute myeloid leukemia. A post-hoc analysis of the GIMEMA AML1310 trial

Author: Francesco Buccisano, Raffaele Palmieri, Alfonso Piciocchi, Valentina Arena, Luca Maurillo, Maria-Ilaria Del Principe, Giovangiacinto Paterno, Maria-Antonietta Irno-Consalvo, Tiziana Ottone, Mariadomenica Divona, Consuelo Conti, Daniela Fraboni, Serena Lavorgna, William Arcese, Maria Teresa Voso, and Adriano Venditti
Subjects: Diseases of the blood and blood-forming organs, RC633-647.5
Abstract: Using a multiparametric flow cytometry assay, we assessed the predictive power of a threshold calculated applying the criteria of limit of detection (LOD) and limit of quantitation (LOQ) in adult patients with acute myeloid leukemia. This was a post-hoc analysis of 261 patients enrolled in the GIMEMA AML1310 prospective trial. According to the protocol design, using the predefined measurable residual disease (MRD) threshold of 0.035% bone marrow residual leukemic cells (RLC) calculated on mononuclear cells, 154 (59%) of the 261 patients were negative (MRD
Published: 2022
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28. Daratumumab with or without chemotherapy in relapsed and refractory acute lymphoblastic leukemia. A retrospective observational Campus ALL study

Author: Marco Cerrano, Massimiliano Bonifacio, Matteo Olivi, Antonio Curti, Michele Malagola, Michelina Dargenio, Anna Maria Scattolin, Cristina Papayannidis, Fabio Forghieri, Carmela Gurrieri, Ilaria Tanasi, Patrizia Zappasodi, Roberta La Starza, Nicola Stefano Fracchiolla, Patrizia Chiusolo, Luisa Giaccone, Maria Ilaria Del Principe, Fabio Giglio, Marzia Defina, Claudio Favre, Carmelo Rizzari, Barbara Castella, Giovanni Pizzolo, Felicetto Ferrara, Sabina Chiaretti, and Robin Foà
Subjects: Diseases of the blood and blood-forming organs, RC633-647.5
Published: 2022
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29. High Incidence of Invasive Fungal Diseases in Patients with FLT3-Mutated AML Treated with Midostaurin: Results of a Multicenter Observational SEIFEM Study

Author: Chiara Cattaneo, Francesco Marchesi, Irene Terrenato, Valentina Bonuomo, Nicola Stefano Fracchiolla, Mario Delia, Marianna Criscuolo, Anna Candoni, Lucia Prezioso, Davide Facchinelli, Crescenza Pasciolla, Maria Ilaria Del Principe, Michelina Dargenio, Caterina Buquicchio, Maria Enza Mitra, Francesca Farina, Erika Borlenghi, Gianpaolo Nadali, Vito Pier Gagliardi, Luana Fianchi, Mariarita Sciumè, Pierantonio Menna, Alessandro Busca, Giuseppe Rossi, and Livio Pagano
Subjects: invasive fungal disease, acute myeloid leukemia, midostaurin, antifungal prophylaxis, Biology (General), QH301-705.5
Abstract: The potential drug-drug interactions of midostaurin may impact the choice of antifungal (AF) prophylaxis in FLT3-positive acute myeloid leukemia (AML) patients. To evaluate the incidence of invasive fungal diseases (IFD) during the treatment of FLT3-mutated AML patients and to correlate it to the different AF prophylaxis strategies, we planned a multicenter observational study involving 15 SEIFEM centers. One hundred fourteen patients treated with chemotherapy + midostaurin as induction/reinduction, consolidation or both were enrolled. During induction, the incidence of probable/proven and possible IFD was 10.5% and 9.7%, respectively; no statistically significant difference was observed according to the different AF strategy adopted. The median duration of neutropenia was similar in patients with or without IFD. Proven/probable and possible IFD incidence was 2.4% and 1.8%, respectively, during consolidation. Age was the only risk factor for IFD (OR, 95% CI, 1.10 [1.03–1.19]) and complete remission achievement after first induction the only one for survival (OR, 95% CI, 5.12 [1.93–13.60]). The rate of midostaurin discontinuation was similar across different AF strategies. The IFD attributable mortality during induction was 8.3%. In conclusion, the 20.2% overall incidence of IFD occurring in FLT3-mutated AML during induction with chemotherapy + midostaurin, regardless of AF strategy type, was noteworthy, and merits further study, particularly in elderly patients.
Published: 2022
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30. Clinical impact of TP53 disruption in chronic lymphocytic leukemia patients treated with ibrutinib: a campus CLL study

Author: Riccardo Bomben, Francesca Maria Rossi, Filippo Vit, Tamara Bittolo, Antonella Zucchetto, Robel Papotti, Erika Tissino, Federico Pozzo, Massimo Degan, Jerry Polesel, Pietro Bulian, Roberto Marasca, Gianluigi Reda, Luca Laurenti, Jacopo Olivieri, Annalisa Chiarenza, Roberta Laureana, Massimiliano Postorino, Maria Ilaria Del Principe, Antonio Cuneo, Massimo Gentile, Fortunato Morabito, Gilberto Fronza, Agostino Tafuri, Francesco Zaja, Robin Foà, Francesco Di Raimondo, Giovanni Del Poeta, and Valter Gattei
Subjects: Settore MED/15 - MALATTIE DEL SANGUE, Cancer Research, Oncology, Chronic Lymphocytic Leukemia, Hematology, Settore MED/15
Published: 2023
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31. Impaired nodal shrinkage and apoptosis define the independent adverse outcome of NOTCH1 mutated patients under ibrutinib therapy in chronic lymphocytic leukaemia

Author: Giovanni Del Poeta, Annalisa Biagi, Luca Laurenti, Annalisa Chiarenza, Federico Pozzo, Idanna Innocenti, Massimiliano Postorino, Francesca Maria Rossi, Maria Ilaria Del Principe, Riccardo Bomben, Paolo de Fabritiis, Antonio Bruno, Maria Cantonetti, Francesco Di Raimondo, Antonella Zucchetto, and Valter Gattei
Subjects: Diseases of the blood and blood-forming organs, RC633-647.5
Abstract: The introduction of agents inhibiting the BCR-associated kinases such as ibrutinib has dramatically changed treatments algorithms of chronic lymphocytic leukaemia (CLL) as well as the role of different adverse prognosticators. We evaluated the efficacy of ibrutinib as single agent, in a real-life context, on 180 patients with CLL mostly pre-treated, recruited from three independent cohorts from Italy. Patients received 420 mg oral ibrutinib once daily until progression or occurrence of unacceptable side effects. Seventy-three patients discontinued ibrutinib for progression or for adverse events. NOTCH1 mutations (M) were correlated with a reduced redistribution lymphocytosis, calculated at 3 months on ibrutinib (p=0.022). Moreover, NOTCH1 mutated patients showed inferior nodal response at 6 months on ibrutinib compared to NOTCH1 wild type patients (p
Published: 2020
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32. Front-Line Therapy for Elderly Chronic Lymphocytic Leukemia Patients: Bendamustine Plus Rituximab or Chlorambucil Plus Rituximab? Real-Life Retrospective Multicenter Study in the Lazio Region

Author: Francesco Autore, Idanna Innocenti, Francesco Corrente, Maria Ilaria Del Principe, Serena Rosati, Paolo Falcucci, Alberto Fresa, Esmeralda Conte, Maria Assunta Limongiello, Daniela Renzi, Laura De Padua, Alessandro Andriani, Francesco Pisani, Giuseppe Cimino, Agostino Tafuri, Marco Montanaro, Francesca Romana Mauro, Giovanni Del Poeta, and Luca Laurenti
Subjects: chronic lymphocytic leukemia, bendamustine, chlorambucil, rituximab, chemoimmunotherapy, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract: Previous studies investigated the efficacy and the safety of bendamustine (B) vs. chlorambucil (Chl) associated with rituximab (R) in fludarabine-ineligible patients with treated and untreated chronic lymphocytic leukemia (CLL). We conducted a retrospective multicenter study in the Lazio region to further evaluate and compare the efficacy and the toxicity of Chl-R and B-R regimen in CLL patients over the age of 65. We enrolled 192 untreated CLL patients: 111 treated with B-R and 81 with Chl-R. The overall response rates (ORR; 93.6% in B-R and 86.5% in Chl-R) were not statistically different between the two groups, such as progression-free survival (PFS), time to retreatment (TTR), and overall survival (OS). The B-R group showed a higher hematological (p = 0.007) and extra-hematological (p = 0.008) toxicity. When comparing the toxicities according to age, we noted that the extra-hematological toxicity was higher in patients over the age of 75 who were treated with B-R than those treated with Chl-R (p = 0.03). This retrospective study confirms the feasibility of B-R and Chl-R in elderly untreated CLL patients. Currently, patients who are over 75 and unfit are usually treated with Chl-R. This scheme allows achieving the same ORR, PFS, TTR, and OS when compared with B-R because of hematological and extra-hematological toxicities due to B, in which a greater dose reduction has been shown in comparison to Chl.
Published: 2020
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33. When Viruses Meet Fungi: Tackling the Enemies in Hematology

Author: Alessandro Busca, Francesco Marchesi, Chiara Cattaneo, Enrico Maria Trecarichi, Mario Delia, Maria Ilaria Del Principe, Anna Candoni, and Livio Pagano
Subjects: viral infections, invasive fungal infections, immunocompromised host, stem cell transplantation, Biology (General), QH301-705.5
Abstract: The association of invasive fungal infections (IFI) and viral infections has been described in patients with hematologic malignancies (HM), in particular in hematopoietic stem cell transplant recipients. Regrettably, the diagnosis is often challenging, making the treatment inappropriate in some circumstances. The present review takes into consideration the viral infections commonly associated with IFI. Clinical presentation of IFI and viral infections, risk factors, and impact on the outcome of HM patients are discussed throughout the paper.
Published: 2022
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34. Clinical significance of occult central nervous system disease in adult acute lymphoblastic leukemia. A multicenter report from the Campus ALL Network

Author: Maria Ilaria Del Principe, Elisa Buzzatti, Alfonso Piciocchi, Fabio Forghieri, Massimiliano Bonifacio, Federica Lessi, Silvia Imbergamo, Enrico Orciuolo, Giovanni Rossi, Nicola Fracchiolla, Silvia Trappolini, Benedetta Neri, Chiara Sarlo, Patrizia Zappasodi, Michelina Dargenio, Mariagiovanna Cefalo, Maria Antonietta Irno-Consalvo, Consuelo Conti, Giovangiacinto Paterno, Gottardo De Angelis, Mariarita Sciumè, Irene Della Starza, Adriano Venditti, Robin Foà, and Anna Rita Guarini
Subjects: Diseases of the blood and blood-forming organs, RC633-647.5
Abstract: In acute lymphoblastic leukemia, flow cytometry detects more accurately leukemic cells in patients' cerebrospinal fluid compared to conventional cytology. However, the clinical significance of flow cytometry positivity with a negative cytology - occult central nervous system disease - is not clear. In the framework of the national Campus ALL program, we retrospectively evaluated the incidence of occult central nervous system disease and its impact on outcome in 240 adult patients with newly diagnosed acute lymphoblastic leukemia. All cerebrospinal fluid samples were investigated by conventional cytology and flow cytometry. The presence of ≥10 phenotypically abnormal events, forming a cluster, was considered as flow cytometry positivity. No central nervous system involvement was documented in 179 patients, while 18 were positive by conventional morphology and 43 were occult central nervous system disease positive. The relapse rate was significantly lower in central nervous system disease negative patients and the disease-free and overall survival were significantly longer in central nervous system disease negative patients than in those with manifest or occult central nervous system disease positive. In multivariate analysis, the status of manifest and occult central nervous system disease positivity was independently associated with a worse overall survival. In conclusion, we demonstrate that in adult acute lymphoblastic leukemia patients at diagnosis flow cytometry can detect occult central nervous system disease at high sensitivity and that the status of occult central nervous system disease positivity is associated with an adverse outcome. (Clinicaltrials.gov NCT03803670)
Published: 2019
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35. Isavuconazole in Hematological Patients: Results of a Real-Life Multicentre Observational Seifem Study

Author: Chiara Cattaneo, Alessandro Busca, Doriana Gramegna, Francesca Farina, Anna Candoni, Monica Piedimonte, Nicola Fracchiolla, Chiara Pagani, Maria Ilaria Del Principe, Maria Chiara Tisi, Massimo Offidani, Rosa Fanci, Stelvio Ballanti, Angelica Spolzino, Marianna Criscuolo, Francesco Marchesi, Gianpaolo Nadali, Mario Delia, Marco Picardi, Margherita Sciumé, Valentina Mancini, Attilio Olivieri, Mario Tumbarello, Giuseppe Rossi, and Livio Pagano
Subjects: Diseases of the blood and blood-forming organs, RC633-647.5
Abstract: Abstract. Invasive fungal diseases (IFDs) remain a major clinical issue in patients with hematological malignancies (HMs). To confirm the efficacy and safety of the new azole isavuconazole (ISV) in a clinical care setting, we planned a multicenter retrospective study; we collected data on all possible/probable/proven IFDs in patients with HMs treated with ISV in 17 centers. Between July 2016 and November 2018, 128 patients were enrolled, and 122 were fully evaluable. ISV was employed as the 1st line therapy in 43 (35%) patients and as a subsequent therapy in 79 (65%) patients. The response rate was 82/122 patients (67.2%); it was similar when using ISV as a 1st or 2nd line treatment (60.5% vs 70.9%, respectively; p = 0.24). In multivariate analysis, both female sex (OR: 2.992; CI: 1.22–7.34) and induction phase of treatment (OR: 3.953; CI: 1.085–14.403) were predictive of a favorable response. At a median follow-up of 5 months, 43 (35.2%) patients were dead; the 1-year overall survival (OS) was 49.9%. In multivariate analysis, the response to ISV (OR: 0.103; CI: 0.041–0.262) and IFD refractoriness to previous antifungals (OR: 3.413; CI: 1.318–8.838) were statistically significant for OS. Adverse events (AEs) were reported in 15/122 patients (12.3%); grade 3–4 AEs were reported in 5 (4%) and led to ISV discontinuation. Our study confirms the safety and tolerability of ISV, also in diseases other than acute leukemia. Phase of hematological disease, gender and refractoriness to previous antifungals are the main predictive factors for the aforementioned response and outcome.
Published: 2019
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36. DIAGNOSTIC PERFORMANCE AND SAFETY OF BRONCHOALVEOLAR LAVAGE IN THROMBOCYTOPENIC HAEMATOLOGICAL PATIENTS FOR ASPERGILLOSIS DIAGNOSIS: A MONOCENTRIC, RETROSPECTIVE EXPERIENCE.

Author: Mariagiovanna Cefalo, Ermanno Puxeddu, Loredana Sarmati, giovangiacinto paterno, Carla Fontana, Daniela Nassa, Gloria Pane, Eleonora De Bellis, Raffaele Palmieri, Elisa Buzzatti, Federico Meconi, Roberta Laureana, Paola Casciani, Anna Giulia Zizzari, Paola Rogliani, Paolo de Fabritiis, Luca Maurillo, Francesco Buccisano, Maria Cantonetti, William Arcese, Adriano Venditti, and Maria Ilaria Del Principe
Subjects: bronchoalveolar lavage, galactomannan antigen, pulmonary aspergillosis, hematologic malignancies, thrombocytopenia, Diseases of the blood and blood-forming organs, RC633-647.5
Abstract: Background: although bronchoalveolar lavage (BAL) measurements of galactomannan antigen (GM) seems to be more sensitive than serum testing to detect invasive pulmonary aspergillosis (IPA), a consensus on the most appropriate diagnostic threshold of the BAL GM test is still unclear. Moreover, there is uncertainty as to whether BAL is a safe procedure in patients with hematological malignancies (HM) and thrombocytopenia (TC). Objectives: based on this background, 102 adult patients with HM and associated thrombocytopenia were retrospectively analyzed with the twin aims of 1) determining whether BAL is a safe and feasible procedure; and, 2) identifying the most appropriate threshold for GM positivity in the diagnosis of IPA. Patients/Methods: each BAL was considered as one case/patient. One hundred twelve BALs were carried out in 102 HM patients: at the time of the BAL, the median platelets count (PLTs) in all patients was 47x109/L (1-476) and 31 patients (27%) had PLTs< 20x109/L. Results: complications from the BAL were infrequent (3.5%) and mild. No bleeding was reported. The BAL GM cut off of >0.8 was associated with the best diagnostic accuracy (sensitivity 72.97% and specificity 80%). Antifungal treatment of patients with BAL GM >0.8resulted in a clinical-radiological improvement in 35/41patients (85%). Conclusions: BAL was a safe procedure also in thrombocytopenic patients, permitting an IPA diagnosis not otherwise identifiable using EORTC/MSG criteria. Our data suggest that a BAL GM value of>0.8 represents the most useful cut-off in terms of sensibility and specificity. Further prospective studies on a larger number of patients are needed to confirm these results.
Published: 2019
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37. Bloodstream infections caused by Escherichia coli in onco-haematological patients: Risk factors and mortality in an Italian prospective survey.

Author: Enrico Maria Trecarichi, Gabriele Giuliano, Chiara Cattaneo, Stelvio Ballanti, Marianna Criscuolo, Anna Candoni, Francesco Marchesi, Marica Laurino, Michelina Dargenio, Rosa Fanci, Mariagiovanna Cefalo, Mario Delia, Angelica Spolzino, Laura Maracci, Gianpaolo Nadali, Alessandro Busca, Maria Ilaria Del Principe, Rosa Daffini, Edoardo Simonetti, Giulia Dragonetti, Maria Elena Zannier, Livio Pagano, Mario Tumbarello, and Haematologic Malignancies Associated Bloodstream Infections Surveillance (HEMABIS) registry–Sorveglianza Epidemiologica Infezioni Fungine in Emopatie Maligne (SEIFEM) group, Italy
Subjects: Medicine, Science
Abstract: Bloodstream infections (BSIs) remain life-threatening complications in the clinical course of patients with haematological malignancies (HM) and Escherichia coli represent one of the most frequent cause of such infections. In this study, we aimed to describe risk factors for resistance to third generation cephalosporins and prognostic factors, including the impact of third generation cephalosporins resistance, in patients with HM and BSIs caused by E. coli. Three hundred forty-two cases of E. coli BSIs were collected during the study period (from January 2016 to December 2017). The percentage of resistance to third generation cephalosporins was 25.7%. In multivariate analysis, the variables recent endoscopic procedures, culture-positive surveillance rectal swabs for multidrug-resistant bacteria, antibiotic prophylaxis with fluoroquinolones, and prolonged neutropenia were independently associated with bloodstream infections caused by a third generation cephalosporins resistant E. coli. The overall 30-day mortality rate was 7.1%. Cox regression revealed that significant predictors of mortality were acute hepatic failure, septic shock, male sex, refractory/relapsed HM, and third generation cephalosporins resistance by E. coli isolate. In conclusion, resistance to third generation cephalosporins adversely affected the outcomes of bloodstream infections caused by E. coli in our cohort of HM patients. We also found a significant correlation between prophylaxis with fluoroquinolones and resistance to third generation cephalosporins by E. coli isolates.
Published: 2019
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38. CCR Translation for this Article from Expression of Mutated IGHV3-23 Genes in Chronic Lymphocytic Leukemia Identifies a Disease Subset with Peculiar Clinical and Biological Features

Author: Valter Gattei, Gianluca Gaidano, Giovanni Del Poeta, Dimitar G. Efremov, Roberto Marasca, Massimo Degan, Milena S. Nicoloso, Emanuele Zucca, Pietro Bulian, Francesca Maria Rossi, Antonella Zucchetto, Ilaria Cattarossi, Elisa Sozzi, Fabrizio Luciano, Maria Ilaria Del Principe, Davide Rossi, Luca Laurenti, Rossana Maffei, Francesco Bertoni, Daniela Marconi, Francesco Forconi, Daniela Capello, Dania Benedetti, Michele Dal-Bo, and Riccardo Bomben
Abstract: CCR Translation for this Article from Expression of Mutated IGHV3-23 Genes in Chronic Lymphocytic Leukemia Identifies a Disease Subset with Peculiar Clinical and Biological Features
Published: 2023
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39. Supplementary Data from Expression of Mutated IGHV3-23 Genes in Chronic Lymphocytic Leukemia Identifies a Disease Subset with Peculiar Clinical and Biological Features

Author: Valter Gattei, Gianluca Gaidano, Giovanni Del Poeta, Dimitar G. Efremov, Roberto Marasca, Massimo Degan, Milena S. Nicoloso, Emanuele Zucca, Pietro Bulian, Francesca Maria Rossi, Antonella Zucchetto, Ilaria Cattarossi, Elisa Sozzi, Fabrizio Luciano, Maria Ilaria Del Principe, Davide Rossi, Luca Laurenti, Rossana Maffei, Francesco Bertoni, Daniela Marconi, Francesco Forconi, Daniela Capello, Dania Benedetti, Michele Dal-Bo, and Riccardo Bomben
Abstract: Supplementary Data from Expression of Mutated IGHV3-23 Genes in Chronic Lymphocytic Leukemia Identifies a Disease Subset with Peculiar Clinical and Biological Features
Published: 2023
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40. Data from Expression of Mutated IGHV3-23 Genes in Chronic Lymphocytic Leukemia Identifies a Disease Subset with Peculiar Clinical and Biological Features

Author: Valter Gattei, Gianluca Gaidano, Giovanni Del Poeta, Dimitar G. Efremov, Roberto Marasca, Massimo Degan, Milena S. Nicoloso, Emanuele Zucca, Pietro Bulian, Francesca Maria Rossi, Antonella Zucchetto, Ilaria Cattarossi, Elisa Sozzi, Fabrizio Luciano, Maria Ilaria Del Principe, Davide Rossi, Luca Laurenti, Rossana Maffei, Francesco Bertoni, Daniela Marconi, Francesco Forconi, Daniela Capello, Dania Benedetti, Michele Dal-Bo, and Riccardo Bomben
Abstract: Purpose: B-cell chronic lymphocytic leukemia (CLL) is a clinically heterogeneous disease whose outcome can be foreseen by investigating the mutational status of immunoglobulin heavy chain variable (IGHV) genes. Moreover, a different prognosis was reported for CLL expressing specific IGHV genes in the context or not of stereotyped B-cell receptors. Here we investigated novel associations between usage of specific IGHV genes and clinical features in CLL.Experimental Design: Among 1,426 CLL-specific IG-rearrangements, stereotyped B-cell receptor clusters never utilized the IGHV3-23 gene. Given this notion, this study was aimed at characterizing the IGHV3-23 gene in CLL, and identifying the properties of IGHV3-23–expressing CLL.Results: IGHV3-23 was the second most frequently used (134 of 1,426) and usually mutated (M; 109 of 134) IGHV gene in our CLL series. In the vast majority of M IGHV3-23 sequences, the configuration of the 13 amino acids involved in superantigen recognition was consistent with superantigen binding. Clinically, M IGHV3-23 CLL had shorter time-to-treatment than other M non–IGHV3-23 CLL, and multivariate analyses selected IGHV3-23 gene usage, Rai staging, and chromosomal abnormalities as independent prognosticators for M CLL. Compared with M non–IGHV3-23 CLL, the gene expression profile of M IGHV3-23 CLL was deprived in genes, including the growth/tumor suppressor genes PDCD4, TIA1, and RASSF5, whose downregulation is under control of miR-15a and miR-16-1. Accordingly, relatively higher levels of miR-15a and miR-16-1 were found in M IGHV3-23 compared with M non–IGHV3-23 CLL.Conclusions: Altogether, expression of the IGHV3-23 gene characterizes a CLL subset with distinct clinical and biological features. Clin Cancer Res; 16(2); 620–8
Published: 2023
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41. Clonal Evolution of Chronic Lymphocytic Leukemia with Bimodal CD49d Expression Reveals CD49d Plasticity

Author: Erika Tissino, Nicola Calonaci, Federico Pozzo, Gabriela Forestieri, Lodovico Terzi Di Bergamo, Filippo Vit, Annalisa Gaglio, Riccardo Bergamin, Salvatore Milite, Stefano Cozzini, Maria Ilaria Del Principe, Roberta Laureana, Annalisa Chiarenza, Jacopo Olivieri, Francesco Zaja, Cristoforo Fabbris, Valentina Lupato, Riccardo Bomben, Davide Rossi, Valter Gattei, Antonella Zucchetto, and Giulio Caravagna
Subjects: Immunology, Cell Biology, Hematology, Biochemistry
Published: 2022
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42. COVID‐19 vaccination: Evaluation of humoral and cellular immunity after the booster dose in chronic lymphocytic leukemia patients

Author: Giovanni Del Poeta, Roberta Laureana, Riccardo Bomben, Francesca Maria Rossi, Federico Pozzo, Eva Zaina, Ilaria Cattarossi, Paola Varaschin, Paola Nanni, Romina Boschian Boschin, Andrea Nunzi, Massimiliano Postorino, Gianmario Pasqualone, Giulia Brisotto, Agostino Steffan, Elena Muraro, Antonella Zucchetto, Maria Ilaria Del Principe, and Valter Gattei
Subjects: Cancer Research, Oncology, SARS-CoV-2, vaccine, Hematology, General Medicine, Settore MED/15, CLL, COVID
Published: 2023
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43. The time to first treatment is an independent predictor of overall survival in chronic lymphocytic leukemia

Author: Fortunato Morabito, Giovanni Tripepi, Francesca Romana Mauro, Luca Laurenti, Gianluigi Reda, Riccardo Moia, Adalgisa Condoluci, Iolanda Vincelli, Annalisa Chiarenza, Ernesto Vigna, Enrica Antonia Martino, Antonella Bruzzese, Sabrina Mezzatesta, Roberta Laureana, Giovanna Cutrona, Francesco Di Raimondo, Gilberto Fronza, Antonella Zucchetto, Riccardo Bomben, Francesca Maria Rossi, Jacopo Olivieri, Francesco Zaja, Davide Rossi, Gianluca Gaidano, Maria Ilaria Del Principe, Fiorella Ilariucci, Giovanni Del Poeta, Manlio Ferrarini, Antonino Neri, Valter Gattei, and Massimo Gentile
Subjects: Settore MED/15 - MALATTIE DEL SANGUE, Chronic Lymphocytic Leukemia, Hematology, Settore MED/15
Published: 2023

44. Molnupiravir Compared to Nirmatrelvir/Ritonavir for COVID-19 in High-Risk Patients with Haematological Malignancy in Europe. A Matched-Paired Analysis from the Epicovideha Registry

Author: Jon Salmanton-Garcia, Francesco Marchesi, Philipp Koehler, Barbora Weinbergerova, Natasa Čolovic, Iker Falces-Romero, Caterina Buquicchio, Francesca Farina, Jens Van Praet, Monika M. Biernat, Federico Itri, Lucia Prezioso, Carlo Tascini, Antonio Vena, Alessandra Romano, Mario Delia, Julio Davila-Valls, Sonia Martín-Pérez, Esperanza Lavilla-Rubira, Tatjana N. Adzic, Daniel Garcia-Bordado, Alberto Lopez-Garcia, Mariana Criscuolo, Verena Petzer, Nicola S. Fracchiolla, Ildefonso Espigado, Uluhan Sili, Stef Meers, Nurettin Erben, Chiara Cattaneo, Athanasios Tragiannidis, Eleni Gavriilaki, Martin Schönlein, Mirjana Mitrovic, Nikola Pantic, Maria Merelli, Jorge Labrador, Jose Angel Hernández-Rivas, Andreas Glenthoj, Guillemette Fouquet, Maria Ilaria del Principe, Michelina Dargenio, Maria Calbacho, Caroline Besson, Milena Kohn, Stefanie K. Grafe, Ditte Stampe Hersby, Elena Arellano, Gökçe Melis Çolak, Dominik Wolf, Monia Marchetti, Anna Nordlander, Ola Blennow, Raul Cordoba, Bojana Miskovic, Miloš Mladenovic, Martina Bavastro, Alessandro LIMONGELLI, Laman Rahimli, Livio Pagano, and Oliver A. Cornely
Published: 2023
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45. Bloodstream infections due to Gram-negative bacteria in patients with hematologic malignancies: updated epidemiology and risk factors for multidrug-resistant strains in an Italian perspective survey

Author: Enrico Maria Trecarichi, Gabriele Giuliano, Chiara Cattaneo, Stelvio Ballanti, Marianna Criscuolo, Anna Candoni, Francesco Marchesi, Marica Laurino, Michelina Dargenio, Rosa Fanci, Mariagiovanna Cefalo, Mario Delia, Angelica Spolzino, Laura Maracci, Valentina Bonuomo, Alessandro Busca, Maria Ilaria Del Principe, Rosa Daffini, Edoardo Simonetti, Giulia Dragonetti, Maria Elena Zannier, Livio Pagano, and Mario Tumbarello
Subjects: Microbiology (medical), bloodstream infections, Epidemiology, Hematological cancer, General Medicine, hematological cancer, Multidrug resistance, Antimicrobial resistance, Settore MED/15, Gram-negative bacteria, antimicrobial resistance, epidemiology, multidrug resistance, Infectious Diseases, Pharmacology (medical), Bloodstream infections
Published: 2023

46. Prospective multicenter study on infectious complications and clinical outcome of 230 unfit acute myeloid leukemia patients receiving first-line therapy with hypomethylating agents alone or in combination with Venetoclax

Author: Anna Candoni, Davide Lazzarotto, Cristina Papayannidis, Matteo Piccini, Giampaolo Nadali, Michelina Dargenio, Marta Riva, Nicola Fracchiolla, Lorella Mellillo, Giulia Dragonetti, Maria Ilaria Del Principe, Chiara Cattaneo, Manuela Stulle, Crescenza Pasciolla, Roberta De Marchi, Mario Delia, Maria Chiara Tisi, Valentina Bonuomo, Mariarita Sciumè, Antonio Spadea, Chiara Sartor, Davide Griguolo, Elisa Buzzatti, Claudia Maria Basilico, Chiara Sarlo, Anna Lina Piccioni, Elisa Cerqui, Federica Lessi, Attilio Olivieri, Renato Fanin, Mario Luppi, and Livio Pagano
Subjects: Settore MED/15 - MALATTIE DEL SANGUE, leukemia, Hematology, Settore MED/15
Published: 2023

47. Efficacy of front-line ibrutinib versus fludarabine, cyclophosphamide, and rituximab in patients with chronic lymphocytic leukemia: A retrospective multicenter 'Real-World' study

Author: Shai Levi, Yotam Bronstein, Neta Goldschmidt, Fortunato Morabito, Tomer Ziv‐Baran, Giovanni Del Poeta, Osnat Bairey, Maria Ilaria Del Principe, Riva Fineman, Francesca Romana Mauro, Odit Gutwein, Gianluigi Reda, Rosa Ruchlemer, Paolo Sportoletti, Luca Laurenti, Lev Shvidel, Marta Coscia, Tamar Tadmor, Marzia Varettoni, Ariel Aviv, Roberta Murru, Andrei Braester, Annalisa Chiarenza, Andrea Visentin, Daniela Pietrasanta, Giacomo Loseto, Antonella Zucchetto, Riccardo Bomben, Jacopo Olivieri, Antonio Neri, Davide Rossi, Gianluca Gaidano, Livio Trentin, Robin Foà, Antonio Cuneo, Chava Perry, Valter Gattei, Massimo Gentile, and Yair Herishanu
Subjects: Settore MED/15 - MALATTIE DEL SANGUE, Ibrutinib, Hematology
Published: 2023

48. Real-life experience of secondary prophylaxis with DOACs in splanchnic venous thrombosis during COVID-19 pandemic

Author: Luca Guarnera, Elisa Buzzatti, Fabrizio Bonanni, Giovangiacinto Paterno, Antonella Riccitelli, Vittorio Forte, Adriano Venditti, and Maria Ilaria Del Principe
Subjects: Hematology, General Medicine, Settore MED/15
Published: 2023
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49. Predictors of Early Thrombotic Events in Adult Patients with Acute Myeloid Leukemia: A Real-World Experience

Author: Giovangiacinto Paterno, Raffaele Palmieri, Vittorio Forte, Valentina Del Prete, Carmelo Gurnari, Luca Guarnera, Flavia Mallegni, Maria Rosaria Pascale, Elisa Buzzatti, Valeria Mezzanotte, Ilaria Cerroni, Arianna Savi, Francesco Buccisano, Luca Maurillo, Adriano Venditti, and Maria Ilaria Del Principe
Subjects: Cancer Research, Oncology, acute myeloid leukemia, thrombosis, venous thromboembolism, thrombosis risk score, survival, Settore MED/15
Abstract: Information regarding the incidence and the prognostic impact of thrombotic events (TE) in non-promyelocytic acute myeloid leukemia (AML) is sparse. Although several risk factors associated with an increased risk of TE development have been recognized, we still lack universally approved guidelines for identification and management of these complications. We retrospectively analyzed 300 consecutive patients with newly diagnosed AML. Reporting the incidence of venous TE (VTE) and arterial TE (ATE) was the primary endpoint. Secondarily, we evaluated baseline patient- and disease-related characteristics with a possible influence of VTE-occurrence probability. Finally, we evaluated the impact of TE on survival. Overall, the VTE incidence was 12.3% and ATE incidence was 2.3%. We identified three independent predictors associated with early-VTE: comorbidities (p = 0.006), platelets count >50 × 109/L (p = 0.006), and a previous history of VTE (p = 0.003). Assigning 1 point to each variable, we observed an overall cumulative incidence of VTE of 18.4% in the high-risk group (≥2 points) versus 6.4% in the low-risk group (0–1 point), log-rank = 0.002. Overall, ATE, but not VTE, was associated with poor prognosis (p < 0.001). In conclusion, TE incidence in AML patients is not negligible. We proposed an early-VTE risk score that could be useful for a proper management of VTE prophylaxis.
Published: 2022

50. Simultaneous Onset of Haematological Malignancy and COVID: An Epicovideha Survey

Author: Chiara Cattaneo, Jon Salmanton-García, Francesco Marchesi, Shaimaa El-Ashwah, Federico Itri, Barbora Weinbergerová, Maria Gomes Da Silva, Michelina Dargenio, Julio Dávila-Valls, Sonia Martín-Pérez, Francesca Farina, Jaap Van Doesum, Toni Valković, Caroline Besson, Christian Bjørn Poulsen, Alberto López-García, Pavel Žák, Martin Schönlein, Klára Piukovics, Ozren Jaksic, Alba Cabirta, Natasha Ali, Uluhan Sili, Nicola Fracchiolla, Giulia Dragonetti, Tatjana Adžić-Vukičević, Monia Marchetti, Marina Machado, Andreas Glenthøj, Olimpia Finizio, Fatih Demirkan, Ola Blennow, Maria Chiara Tisi, Ali S. Omrani, Milan Navrátil, Zdeněk Ráčil, Jan Novák, Gabriele Magliano, Moraima Jiménez, Carolina Garcia-Vidal, Nurettin Erben, Maria Ilaria Del Principe, Caterina Buquicchio, Rui Bergantim, Josip Batinić, Murtadha Al-Khabori, Luisa Verga, Tomáš Szotkowski, Michail Samarkos, Irati Ormazabal-Vélez, Stef Meers, Johan Maertens, László Imre Pinczés, Martin Hoenigl, Ľuboš Drgoňa, Annarosa Cuccaro, Yavuz M. Bilgin, Avinash Aujayeb, Laman Rahimli, Stefanie Gräfe, Mariarita Sciumè, Miloš Mladenović, Gökçe Melis Çolak, Maria Vittoria Sacchi, Anna Nordlander, Caroline Berg Venemyr, Michaela Hanáková, Nicole García-Poutón, Ziad Emarah, Giovanni Paolo Maria Zambrotta, Raquel Nunes Rodrigues, Raul Cordoba, Gustavo-Adolfo Méndez, Monika M. Biernat, Oliver A. Cornely, Livio Pagano, Institut Català de la Salut, [Cattaneo C] Hematology Unit, ASST-Spedali Civili, Brescia, Italy. [Salmanton-García J] University of Cologne, Faculty of Medicine, University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany. University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany. [Marchesi F] Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy. [El-Ashwah S] Oncology Center, Mansoura University, Mansoura, Egypt. [Itri F] San Luigi Gonzaga Hospital, Orbassano, Italy. [Weinbergerová B] Masaryk University and University Hospital Brno—Department of Internal Medicine, Hematology and Oncology, Brno, Czech Republic. [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. [Jiménez M] Servei d’Hematologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain, Vall d'Hebron Barcelona Hospital Campus, Cattaneo C., Salmanton-García J., Marchesi F., El-Ashwah S., Itri F., Weinbergerová B., Gomes Da Silva M., Dargenio M., Dávila-Valls J., Martín-Pérez S., et al., Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, EPICOVIDEHA has received funds from Optics COMMITTM (COVID-19 Unmet Medical Needs and Associated Research Extension) COVID-19 RFP program by GILEAD Science, United States (Project 2020-8223)., and HAL UVSQ, Équipe
Subjects: Internal Diseases, Cancer Research, Sağlık Bilimleri, Other subheadings::Other subheadings::/drug therapy [Other subheadings], İç Hastalıkları, Clinical Medicine (MED), RECOMMENDATIONS, Sang - Càncer - Tractament, BİYOKİMYA VE MOLEKÜLER BİYOLOJİ, INFECTION, virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES], haematological malignancy onset, Klinik Tıp (MED), 03.02. Klinikai orvostan, Klinik Tıp, treatment, Temel Bilimler, COVID-19, outcome, prognostic factors, Life Sciences, Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES], Onkoloji, Tıp, MOLECULAR BIOLOGY & GENETICS, Oncology, Medicine, ONKOLOJİ, Natural Sciences, BIOCHEMISTRY & MOLECULAR BIOLOGY, Life Sciences & Biomedicine, Sitogenetik, Life Sciences (LIFE), Otros calificadores::Otros calificadores::/farmacoterapia [Otros calificadores], [SDV.CAN]Life Sciences [q-bio]/Cancer, Molecular Biology and Genetics, PANEL, [SDV.CAN] Life Sciences [q-bio]/Cancer, Yaşam Bilimleri, Health Sciences, Cytogenetic, neoplasias::neoplasias por localización::neoplasias hematológicas [ENFERMEDADES], Moleküler Biyoloji ve Genetik, ACUTE LYMPHOBLASTIC-LEUKEMIA, Internal Medicine Sciences, Science & Technology, diagnóstico::pronóstico::resultado del tratamiento [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Dahili Tıp Bilimleri, CLINICAL MEDICINE, Neoplasms::Neoplasms by Site::Hematologic Neoplasms [DISEASES], Diagnosis::Prognosis::Treatment Outcome [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Settore MED/15, Settore MED/15 - MALATTIE DEL SANGUE, Sang - Càncer - Diagnòstic, Yaşam Bilimleri (LIFE), Avaluació de resultats (Assistència sanitària), COVID-19 (Malaltia) - Diagnòstic, Kanser Araştırmaları
Abstract: Simple Summary Patients with simultaneous diagnosis of haematological malignancies (HM) and COVID-19 are an even greater challenge for hematologists. To better clarify their outcome, we describe the clinical features and outcome of a cohort of 450 patients with simultaneous diagnosis of HM and COVID-19 registered in the EPICOVIDEHA registry between March 2020 to February 2022. Overall, 343 (76.2%) patients received treatment for HM, and an overall response rate was observed in 140 (40.8%) patients after the first line of treatment. Thirty-day mortality was significantly higher in patients not receiving HM treatment (42.1%) than in those receiving treatment (27.4%, p = 0.004). Statistical analysis showed that, together with age, severe/critical COVID-19, >= 2 comorbidities, lack of HM treatment was an independent risk factors for mortality. These observations suggest the importance of HM treatment in these patients; therefore, it should be delivered as soon as possible for patients requiring immediate therapy. Background: The outcome of patients with simultaneous diagnosis of haematological malignancies (HM) and COVID-19 is unknown and there are no specific treatment guidelines. Methods: We describe the clinical features and outcome of a cohort of 450 patients with simultaneous diagnosis of HM and COVID-19 registered in the EPICOVIDEHA registry between March 2020 to February 2022. Results: Acute leukaemia and lymphoma were the most frequent HM (35.8% and 35.1%, respectively). Overall, 343 (76.2%) patients received treatment for HM, which was delayed for longer than one month since diagnosis in 57 (16.6%). An overall response rate was observed in 140 (40.8%) patients after the first line of treatment. After a median follow-up of 35 days, overall mortality was 177/450 (39.3%); 30-day mortality was significantly higher in patients not receiving HM treatment (42.1%) than in those receiving treatment (27.4%, p = 0.004), either before and/or after COVID-19, or compared to patients receiving HM treatment at least after COVID-19 (15.2%, p < 0.001). Age, severe/critical COVID-19, >= 2 comorbidities, and lack of HM treatment were independent risk factors for mortality, whereas a lymphocyte count >500/mcl at COVID-19 onset was protective. Conclusions: HM treatment should be delivered as soon as possible for patients with simultaneous diagnosis of COVID-19 and HM requiring immediate therapy.
Published: 2022
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