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1. Daratumumab plus bortezomib or daratumumab plus lenalidomide as salvage therapy for patients with myeloma: initial follow-up of an Italian multicentre retrospective clinical experience by ‘Rete Ematologica Pugliese’

Author: Mele, G., Cascavilla, N., Di Renzo, N., Guarini, A., Mazza, P., Melillo, L., Pavone, V., Tarantini, G., Curci, P., Falcone, A. P., Germano, C., Mele, A., Palazzo, G., Palumbo, G., Reddiconto, G., Rossini, B., Specchia, G., Musto, P., and Pastore, D.
Published: 2022
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2. Pompeii and the renewed thread. Antique textures and contemporary narratives

Author: Cirafici, A., primary, Fiorentino, C.C., additional, Argenziano, P., additional, Avella, A., additional, and Melillo, L., additional
Published: 2020
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3. Clinical features and prognostic factors of Magnusiomyces (Saprochaete) infections in haematology. A multicentre study of SEIFEM/Fungiscope

Author: Del Principe, M. I., Seidel, D., Criscuolo, Marianna, Dargenio, M., Racil, Z., Piedimonte, M., Marchesi, F., Nadali, G., Koehler, P., Fracchiolla, N., Cattaneo, C., Klimko, N., Spolzino, A., Yilmaz Karapinar, D., Demiraslan, H., Duarte, R. F., Demeter, J., Stanzani, M., Melillo, L. M. A., Basilico, C., Cesaro, S., Paterno, G., Califano, C., Delia, M., Buzzatti, E., Busca, A., Alakel, N., Arsenijevi'C, V. A., Camus, V., Falces-Romero, I., Itzhak, L., Kouba, M., Martino, R., Sedlacek, P., Weinbergerova, B., Cornely, O. A., Pagano, Livio, Criscuolo M., Pagano L. (ORCID:0000-0001-8287-928X), Del Principe, M. I., Seidel, D., Criscuolo, Marianna, Dargenio, M., Racil, Z., Piedimonte, M., Marchesi, F., Nadali, G., Koehler, P., Fracchiolla, N., Cattaneo, C., Klimko, N., Spolzino, A., Yilmaz Karapinar, D., Demiraslan, H., Duarte, R. F., Demeter, J., Stanzani, M., Melillo, L. M. A., Basilico, C., Cesaro, S., Paterno, G., Califano, C., Delia, M., Buzzatti, E., Busca, A., Alakel, N., Arsenijevi'C, V. A., Camus, V., Falces-Romero, I., Itzhak, L., Kouba, M., Martino, R., Sedlacek, P., Weinbergerova, B., Cornely, O. A., Pagano, Livio, Criscuolo M., and Pagano L. (ORCID:0000-0001-8287-928X)
Abstract: Background: Our multicentre study aims to identify baseline factors and provide guidance for therapeutic decisions regarding Magnusiomyces-associated infections, an emerging threat in patients with haematological malignancies. Methods: HM patients with proven (Magnusiomyces capitatus) M. capitatus or (Magnusiomyces clavatus) M. clavatus (formerly Saprochaete capitata and Saprochaete clavata) infection diagnosed between January 2010 and December 2020 were recorded from the SEIFEM (Sorveglianza Epidemiologica Infezioni nelle Emopatie) group and FungiScope (Global Emerging Fungal Infection Registry). Cases of Magnusiomyces fungemia were compared with candidemia. Results: Among 90 Magnusiomyces cases (60 [66%] M. capitatus and 30 (34%) M. clavatus), median age was 50 years (range 2–78), 46 patients (51%) were female and 67 (74%) had acute leukaemia. Thirty-six (40%) of Magnusiomyces-associated infections occurred during antifungal prophylaxis, mainly with posaconazole (n = 13, 36%) and echinocandins (n = 12, 34%). Instead, the candidemia rarely occurred during prophylaxis (p <.0001). First-line antifungal therapy with azoles, alone or in combination, was associated with improved response compared to other antifungals (p =.001). Overall day-30 mortality rate was 43%. Factors associated with higher mortality rates were septic shock (HR 2.696, 95% CI 1.396–5.204, p =.003), corticosteroid treatment longer than 14 days (HR 2.245, 95% CI 1.151–4.376, p =.018) and lack of neutrophil recovery (HR 3.997, 95% CI 2.102–7.601, p <.001). The latter was independently associated with poor outcome (HR 2.495, 95% CI 1.192–5.222, p =.015). Conclusions: Magnusiomyces-associated infections are often breakthrough infections. Effective treatment regimens of these infections remain to be determined, but neutrophil recovery appears to play an important role in the favourable outcome.
Published: 2023

4. Multicenter Observational Retrospective Study on Febrile Events in Patients with Acute Myeloid Leukemia Treated with Cpx-351 in “Real-Life”: The SEIFEM Experience

Author: Fianchi, Luana, Guolo, F., Marchesi, F., Cattaneo, C., Gottardi, M., Restuccia, F., Candoni, A., Ortu La Barbera, E., Fazzi, R., Pasciolla, C., Finizio, O., Fracchiolla, N., Delia, M., Lessi, F., Dargenio, M., Bonuomo, V., Del Principe, M. I., Zappasodi, P., Picardi, M., Basilico, C., Piedimonte, M., Minetto, P., Giordano, A., Chiusolo, Patrizia, Prezioso, L., Buquicchio, C., Melillo, L. M. A., Zama, D., Farina, F., Mancini, V., Terrenato, I., Rondoni, M., Urbino, I., Tumbarello, Mario, Busca, A., Pagano, Livio, Fianchi L., Chiusolo P. (ORCID:0000-0002-1355-1587), Tumbarello M. (ORCID:0000-0002-9519-8552), Pagano L. (ORCID:0000-0001-8287-928X), Fianchi, Luana, Guolo, F., Marchesi, F., Cattaneo, C., Gottardi, M., Restuccia, F., Candoni, A., Ortu La Barbera, E., Fazzi, R., Pasciolla, C., Finizio, O., Fracchiolla, N., Delia, M., Lessi, F., Dargenio, M., Bonuomo, V., Del Principe, M. I., Zappasodi, P., Picardi, M., Basilico, C., Piedimonte, M., Minetto, P., Giordano, A., Chiusolo, Patrizia, Prezioso, L., Buquicchio, C., Melillo, L. M. A., Zama, D., Farina, F., Mancini, V., Terrenato, I., Rondoni, M., Urbino, I., Tumbarello, Mario, Busca, A., Pagano, Livio, Fianchi L., Chiusolo P. (ORCID:0000-0002-1355-1587), Tumbarello M. (ORCID:0000-0002-9519-8552), and Pagano L. (ORCID:0000-0001-8287-928X)
Abstract: In the present study, we aimed to evaluate the absolute risk of infection in the real-life setting of AML patients treated with CPX-351. The study included all patients with AML from 30 Italian hematology centers of the SEIFEM group who received CPX-351 from July 2018 to June 2021. There were 200 patients included. Overall, 336 CPX-351 courses were counted: all 200 patients received the first induction cycle, 18 patients (5%) received a second CPX-351 induction, while 86 patients (26%) proceeded with the first CPX-351 consolidation cycle, and 32 patients (10%) received a second CPX-351 consolidation. A total of 249 febrile events were recorded: 193 during the first or second induction, and 56 after the first or second consolidation. After the diagnostic work-up, 92 events (37%) were classified as febrile neutropenia of unknown origin (FUO), 118 (47%) were classifiable as microbiologically documented infections, and 39 (17%) were classifiable as clinically documented infections. The overall 30-day mortality rate was 14% (28/200). The attributable mortality–infection rate was 6% (15/249). A lack of response to the CPX-351 treatment was the only factor significantly associated with mortality in the multivariate analysis [p-value: 0.004, OR 0.05, 95% CI 0.01–0.39]. Our study confirms the good safety profile of CPX-351 in a real-life setting, with an incidence of infectious complications comparable to that of the pivotal studies; despite prolonged neutropenia, the incidence of fungal infections was low, as was infection-related mortality.
Published: 2023

5. Fatigue in newly diagnosed acute myeloid leukaemia: general population comparison and predictive factors

Author: Oswald, L, Venditti, A, Cella, D, Cottone, F, Candoni, A, Melillo, L, Cairoli, R, Storti, G, Salutari, P, Luppi, M, Albano, F, Martelli, M, Cuneo, A, Tafuri, A, Trisolini, S, Tieghi, A, Fazi, P, Vignetti, M, Efficace, E, Oswald LB, Venditti A, Cella D, Cottone F, Candoni A, Melillo L, Cairoli R, Storti G, Salutari P, Luppi M, Albano F, Martelli MP, Cuneo A, Tafuri A, Trisolini SM, Tieghi A, Fazi P, Vignetti M, Efficace E., Oswald, L, Venditti, A, Cella, D, Cottone, F, Candoni, A, Melillo, L, Cairoli, R, Storti, G, Salutari, P, Luppi, M, Albano, F, Martelli, M, Cuneo, A, Tafuri, A, Trisolini, S, Tieghi, A, Fazi, P, Vignetti, M, Efficace, E, Oswald LB, Venditti A, Cella D, Cottone F, Candoni A, Melillo L, Cairoli R, Storti G, Salutari P, Luppi M, Albano F, Martelli MP, Cuneo A, Tafuri A, Trisolini SM, Tieghi A, Fazi P, Vignetti M, and Efficace E.
Abstract: Objectives: This study compared the burden of fatigue between treatment-naïve patients with newly diagnosed acute myeloid leukaemia (AML) and the general population and investigated patient factors associated with fatigue severity. Methods: Pretreatment patient-reported fatigue was assessed with the Functional Assessment of Chronic Illness Therapy-Fatigue questionnaire in a sample of 463 newly diagnosed patients with AML who were enrolled in a clinical trial. Multivariable linear regression models were used to estimate the adjusted mean differences in fatigue between patients with AML and adults from the general population (n=847) by AML disease risk categories. A clinically meaningful difference in fatigue was defined as ≥3 points. Univariable and multivariable linear regression models were used to identify sociodemographic, clinical and molecular correlates of worse fatigue in patients with AML. Results: Patients with AML reported adjusted mean fatigue scores that were 7.5 points worse than the general population (95% CI -8.6 to -6.4, p<0.001). Across AML disease risk categories, adjusted mean differences in fatigue compared with the general population ranged from 6.7 points worse (patients with favourable risk: 95% CI -8.6 to -4.8, p<0.001) to 8.9 points worse (patients with poor risk, 95% CI -10.5 to -7.2, p<0.001). Overall, 91% of patients with AML reported fatigue that was equal to or worse than the general population's median fatigue score. Higher pretreatment fatigue was independently associated with female sex, WHO performance status ≥1 and lower platelet levels. Conclusions: Patients with newly diagnosed AML reported worse fatigue than the general population, and mean differences exceeded twice the threshold for clinical significance. Our findings may help to identify patients with AML most likely to benefit from supportive care interventions to reduce fatigue.
Published: 2021

6. INTERIM RESULTS OF PROSPECTIVE OBSERVATIONAL SEIFEM STUDY ON CLINICAL OUTCOME AND INFECTIOUS COMPLICATIONS IN 230 UNFIT AML PATIENTS TREATED IN FIRST-LINE WITH HYPOMETHYLATING AGENTS ALONE OR IN COMBINATION WITH VENETOCLAX

Author: Candoni, A, Piccin, M, Lazzarotto, D, Bonuomo, V, Fracchiolla, N, Dargenio, M, Riva, M, Melillo, L, Papayannidis, C, Stulle, M, Lessi, F, Dragonetti, G, Del Principe, M, Cerqui, E, Pasciolla, C, De Marchi, R, Delia, M, Tisi, M, Fanci, R, Nadali, G, Sciume, M, Di Renzo, N, Cairoli, R, Valente, D, Basilico, C, (, C., ), A, (, A., ), D, (, D., ), Pagano, L, Candoni A, Piccin M, Lazzarotto D, Bonuomo V, Fracchiolla N, Dargenio M, Riva M, Melillo L, Papayannidis C, Stulle M, Lessi F, Dragonetti G, Del Principe MI, Cerqui E, Pasciolla C, De Marchi R, Delia M, Tisi MC, Fanci R, Nadali G, Sciume M, Di Renzo N, Cairoli R, Valente D, C (Basilico, C.) 18 Spadea, A (Spadea, A.) 19 Sartor, C (Sartor, C.) 8 Griguolo, D (Griguolo, D.) 9 Sarlo, C (Sarlo, C.) 20 Olivieri, A (Olivieri, A.) 21 Piccioni AL, Pagano L, Candoni, A, Piccin, M, Lazzarotto, D, Bonuomo, V, Fracchiolla, N, Dargenio, M, Riva, M, Melillo, L, Papayannidis, C, Stulle, M, Lessi, F, Dragonetti, G, Del Principe, M, Cerqui, E, Pasciolla, C, De Marchi, R, Delia, M, Tisi, M, Fanci, R, Nadali, G, Sciume, M, Di Renzo, N, Cairoli, R, Valente, D, Basilico, C, (, C., ), A, (, A., ), D, (, D., ), Pagano, L, Candoni A, Piccin M, Lazzarotto D, Bonuomo V, Fracchiolla N, Dargenio M, Riva M, Melillo L, Papayannidis C, Stulle M, Lessi F, Dragonetti G, Del Principe MI, Cerqui E, Pasciolla C, De Marchi R, Delia M, Tisi MC, Fanci R, Nadali G, Sciume M, Di Renzo N, Cairoli R, Valente D, C (Basilico, C.) 18 Spadea, A (Spadea, A.) 19 Sartor, C (Sartor, C.) 8 Griguolo, D (Griguolo, D.) 9 Sarlo, C (Sarlo, C.) 20 Olivieri, A (Olivieri, A.) 21 Piccioni AL, and Pagano L
Published: 2021

7. P1084: CHECK-POINT INHIBITORS IN PATIENTS WITH RELAPSE/REFRACTORY HODGKIN’S LYMPHOMA: A RETROSPECTIVE ANALYSYS BY THE RETE EMATOLOGICA PUGLIESE (REP).

Author: Gaudio, F., primary, Loseto, G., additional, Bozzoli, V., additional, Scalzulli, P. R., additional, Mazzone, A. M., additional, Tonialini, L., additional, Fesce, V., additional, Quintana, G., additional, De santis, G., additional, Masciopinto, P., additional, Arcuti, E., additional, Clemente, F., additional, Scardino, S., additional, Tarantini, G., additional, Pastore, D., additional, Melillo, L., additional, Pavone, V., additional, Mazza, P., additional, Carella, A. M., additional, Cascavilla, N., additional, Di Renzo, N., additional, Guarini, A., additional, and Musto, P., additional
Published: 2022
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8. PB2016: COMPARISON BETWEEN DRD VS KRD AS SALVAGE THERAPY FOR MULTIPLE MYELOMA PATIENTS IN FIRST RELAPSE: THE REAL LIFE EXPERIENCE OF RETE EMATOLOGICA PUGLIESE (REP)

Author: Mele, A., primary, Prete, E., additional, Citiso, S., additional, Mele, G., additional, Pastore, D., additional, Sgherza, N., additional, Curci, P., additional, Musto, P., additional, Falcone, A. P., additional, Cascavilla, N., additional, Germano, C., additional, Giuseppe, T., additional, Reddiconto, G., additional, Di Renzo, N., additional, Palazzo, G., additional, Mazza, P., additional, Rossini, B., additional, Guarini, A., additional, Palumbo, G., additional, Melillo, L. M. A., additional, and Pavone, V., additional
Published: 2022
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9. Long-term results of all-trans retinoic acid and arsenic trioxide in non-high-risk acute promyelocytic leukemia: update of the APL0406 Italian-German randomized trial

Author: Cicconi, L, Platzbecker, U, Avvisati, G, Paoloni, F, Thiede, C, Vignetti, M, Fazi, P, Ferrara, F, Divona, M, Albano, F, Efficace, F, Sborgia, M, Di Bona, E, Breccia, M, Borlenghi, E, Cairoli, R, Rambaldi, A, Melillo, L, La Nasa, G, Fiedler, W, Brossart, P, Hertenstein, B, Salih, H, Annibali, O, Wattad, M, Lubbert, M, Brandts, C, Hanel, M, Rollig, C, Schmitz, N, Lin, H, Frairia, C, Fozza, C, Maria D’Arco, A, Di Renzo, N, Cortelezzi, A, Fabbiano, F, Dohner, K, Ganser, A, Dohner, H, Amadori, S, Mandelli, F, Teresa Voso, M, Ehninger, G, Schlenk, R, Lo-Coco, F, Cicconi L, Platzbecker U, Avvisati G, Paoloni F, Thiede C, Vignetti M, Fazi P, Ferrara F, Divona M, Albano F, Efficace F, Sborgia M, Di Bona E, Breccia M, Borlenghi E, Cairoli R, Rambaldi A, Melillo L, La Nasa G, Fiedler W, Brossart P, Hertenstein B, Salih HR, Annibali O, Wattad M, Lubbert M, Brandts C, Hanel M, Rollig C, Schmitz N, Lin H, Frairia C, Fozza C, Maria D’Arco A, Di Renzo N, Cortelezzi A, Fabbiano F, Dohner K, Ganser A, Dohner H, Amadori S, Mandelli F, Teresa Voso M, Ehninger G, Schlenk RF, Lo-Coco F., Cicconi, L, Platzbecker, U, Avvisati, G, Paoloni, F, Thiede, C, Vignetti, M, Fazi, P, Ferrara, F, Divona, M, Albano, F, Efficace, F, Sborgia, M, Di Bona, E, Breccia, M, Borlenghi, E, Cairoli, R, Rambaldi, A, Melillo, L, La Nasa, G, Fiedler, W, Brossart, P, Hertenstein, B, Salih, H, Annibali, O, Wattad, M, Lubbert, M, Brandts, C, Hanel, M, Rollig, C, Schmitz, N, Lin, H, Frairia, C, Fozza, C, Maria D’Arco, A, Di Renzo, N, Cortelezzi, A, Fabbiano, F, Dohner, K, Ganser, A, Dohner, H, Amadori, S, Mandelli, F, Teresa Voso, M, Ehninger, G, Schlenk, R, Lo-Coco, F, Cicconi L, Platzbecker U, Avvisati G, Paoloni F, Thiede C, Vignetti M, Fazi P, Ferrara F, Divona M, Albano F, Efficace F, Sborgia M, Di Bona E, Breccia M, Borlenghi E, Cairoli R, Rambaldi A, Melillo L, La Nasa G, Fiedler W, Brossart P, Hertenstein B, Salih HR, Annibali O, Wattad M, Lubbert M, Brandts C, Hanel M, Rollig C, Schmitz N, Lin H, Frairia C, Fozza C, Maria D’Arco A, Di Renzo N, Cortelezzi A, Fabbiano F, Dohner K, Ganser A, Dohner H, Amadori S, Mandelli F, Teresa Voso M, Ehninger G, Schlenk RF, and Lo-Coco F.
Published: 2020

10. Linfoma folicular: evaluación de índices pronósticos, variables clínicas y metabólicas al diagnóstico como predictores de progresión de enfermedad antes de los 2 años de iniciada la inmunoquimioterapia (POD24).

Author: Penalba, R., Fiad, L., Otero, V., Korin, J, Pavlovsky, Miguel Arturo, Mahuad, C., Arizo, A., Pavlovsky, Astrid, Courreges, V., Rodriguez, A., Trucco, J., Pereyra, P., Gilli, V., Gomez, M.S., Macchiavello, E., Masachessi, N., Marquez, M., Arriola, J., Cristaldo, N., Kalmus, E., Villarreal, P., Alfonso, G., Gonzalez Mercado, F., Vallejo, R., Enrrique, M., Melillo, L., Fernandez, D., Cugliari, María Silvana, Zerga, Marta, Sackmann, Federico, Penalba, R., Fiad, L., Otero, V., Korin, J, Pavlovsky, Miguel Arturo, Mahuad, C., Arizo, A., Pavlovsky, Astrid, Courreges, V., Rodriguez, A., Trucco, J., Pereyra, P., Gilli, V., Gomez, M.S., Macchiavello, E., Masachessi, N., Marquez, M., Arriola, J., Cristaldo, N., Kalmus, E., Villarreal, P., Alfonso, G., Gonzalez Mercado, F., Vallejo, R., Enrrique, M., Melillo, L., Fernandez, D., Cugliari, María Silvana, Zerga, Marta, and Sackmann, Federico
Abstract: Follicular lymphoma is an indolent lymphoma with potential relapses in the course of its evolution. In the last few years, new therapeutic strategies have improved patient ́s survival. However, a high risk subgroup progresses early with a shorter overall survival. Our primary objective is to report the inci-dence of POD24 and its impact on OS and, as a sec-ondary objective, to evaluate the association of the FLIPI 1, FLIPI 2 and PRIMA PI scores and the clin-ical-metabolic variables with the risk of a POD24 event. Three hundred and thirty-two patients were included, 46 patients (13.8%) with a POD24 event. Factors independently associated with greater prob-ability of a POD24 event were: presence of B symp-toms (OR 2.09) and elevated LDH (OR 1.27). In this study we report a significant difference in OS between POD24 vs NO POD24 (at 60 months, 63 vs 95% with p <0.001) reinforcing the POD24 impact as a negative prognostic factor. Despite being a retrospective study and the limited number of patients, we report local data not available to date. New clinical and/or biological markers will be necessary to identify the subgroup with POD24 risk, which could benefit from an adapted therapy., El linfoma folicular es un linfoma indolente con re-caídas potenciales en el curso de su evolución. En los últimos años nuevas estrategias terapéuticas han mejorado la sobrevida de los pacientes. Sin embargo, un subgrupo de alto riesgo progresa en forma temprana con una menor sobrevida global (SG). Nuestro objetivo primario es reportar la incidencia de POD24 y su impacto en SG y, como objetivo secundario, evaluar la asociación de los índices FLIPI 1, FLIPI 2 y PRIMA PI y las variables clíni-co-metabólicas con el riesgo de evento POD24. Se incluyeron 332 pacientes, 46 pacientes (13,8%) con evento POD24. Los factores asociados en forma in-dependiente a POD24 fueron: presencia de síntomas B (OR 2.09) y LDH elevada (OR 1.27). En este estu-dio reportamos diferencia significativa en SG entre POD24 vs NO POD24 (a 60 meses, 63 vs 95% con p <0.001) reforzando el impacto de POD24 como factor pronóstico negativo. A pesar de tratarse de un estudio retrospectivo y de número limitado de pacientes, reportamos datos locales no disponibles a la fecha. Serán necesarios nuevos marcadores clínicos y/o biológicos que permitan identificar el subgrupo con riesgo POD24 y que podría beneficiarse de una terapia adaptada.
Published: 2022

11. ELN2017 risk stratification improves outcome prediction when applied to the prospective GIMEMA AML1310 protocol

Author: Buccisano, F, Palmieri, R, Piciocchi, A, Arena, V, Candoni, A, Melillo, L, Calafiore, V, Cairoli, R, de Fabritiis, P, Storti, G, Salutari, P, Lanza, F, Martinelli, G, Luppi, M, Capria, S, Maurillo, L, Del Principe, M, Paterno, G, Consalvo, M, Ottone, T, Lavorgna, S, Voso, M, Fazi, P, Vignetti, M, Arcese, W, Venditti, A, Del Principe, MI, Consalvo, MAI, Voso, MT, Buccisano, F, Palmieri, R, Piciocchi, A, Arena, V, Candoni, A, Melillo, L, Calafiore, V, Cairoli, R, de Fabritiis, P, Storti, G, Salutari, P, Lanza, F, Martinelli, G, Luppi, M, Capria, S, Maurillo, L, Del Principe, M, Paterno, G, Consalvo, M, Ottone, T, Lavorgna, S, Voso, M, Fazi, P, Vignetti, M, Arcese, W, Venditti, A, Del Principe, MI, Consalvo, MAI, and Voso, MT
Abstract: The 2017 version of the European LeukemiaNet (ELN) recommendations, by integrating cytogenetics and mutational status of specific genes, divides patients with acute myeloid leukemia into 3 prognostically distinct risk categories: favorable (ELN2017-FR), intermediate (ELN2017-IR), and adverse (ELN2017-AR). We performed a post hoc analysis of the GIMEMA (Gruppo Italiano Malattie EMatologiche dell’Adulto) AML1310 trial to investigate the applicability of the ELN2017 risk stratification to our study population. In this trial, after induction and consolidation, patients in complete remission were to receive an autologous stem cell transplant (auto-SCT) if categorized as favorable risk or an allogeneic stem cell transplant (allo-SCT) if adverse risk. Intermediate-risk patients were to receive auto-SCT or allo-SCT based on the postconsolidation levels of measurable residual disease as measured by using flow cytometry. Risk categorization was originally conducted according to the 2009 National Comprehensive Cancer Network recommendations. Among 500 patients, 445 (89%) were reclassified according to the ELN2017 criteria: ELN2017-FR, 186 (41.8%) of 455; ELN2017-IR, 179 (40.2%) of 445; and ELN2017-AR, 80 (18%) of 455. In 55 patients (11%), ELN2017 was not applicable. Two-year overall survival (OS) was 68.8%, 51.3%, 45.8%, and 42.8% for the ELN2017-FR, ELN2017-IR, ELN2017-not classifiable, and ELN2017-AR groups, respectively (P, .001). When comparing the 2 different transplant strategies in each ELN2017 risk category, a significant benefit of auto-SCT over allo-SCT was observed among ELN2017-FR patients (2-year OS of 83.3% vs 66.7%; P 5 .0421). The 2 transplant procedures performed almost equally in the ELN2017-IR group (2-year OS of 73.9% vs 70.8%; P 5 .5552). This post hoc analysis of the GIMEMA AML1310 trial confirms that the ELN2017 classification is able to accurately discriminate patients with different outcomes and who may benefit from different transplant strategies. Th
Published: 2022

12. A High-Risk Profile for Invasive Fungal Infections Is Associated with Altered Nasal Microbiota and Niche Determinants

Author: Costantini, C., Nunzi, E., Spolzino, A., Merli, F., Facchini, L., Spadea, A., Melillo, L., Codeluppi, K., Marchesi, F., Marchesini, G., Valente, D., Dragonetti, Giulia, Nadali, G., Englmaier, L., Coufalikova, K., Spacil, Z., Bellet, M. M., Pariano, M., Renga, G., Stincardini, C., D'Onofrio, F., Bozza, S., Pagano, Livio, Aversa, F., Romani, L., Dragonetti G., Pagano L. (ORCID:0000-0001-8287-928X), Costantini, C., Nunzi, E., Spolzino, A., Merli, F., Facchini, L., Spadea, A., Melillo, L., Codeluppi, K., Marchesi, F., Marchesini, G., Valente, D., Dragonetti, Giulia, Nadali, G., Englmaier, L., Coufalikova, K., Spacil, Z., Bellet, M. M., Pariano, M., Renga, G., Stincardini, C., D'Onofrio, F., Bozza, S., Pagano, Livio, Aversa, F., Romani, L., Dragonetti G., and Pagano L. (ORCID:0000-0001-8287-928X)
Abstract: It is becoming increasingly clear that the communities of microorganisms that populate the surfaces exposed to the external environment, termed microbiota, are key players in the regulation of pathogen-host cross talk affecting the onset as well as the outcome of infectious diseases. We have performed a multicenter, prospective, observational study in which nasal and oropharyngeal swabs were collected for microbiota predicting the risk of invasive fungal infections (IFIs) in patients with hematological malignancies. Here, we demonstrate that the nasal and oropharyngeal microbiota are different, although similar characteristics differentiate high-risk from low-risk samples at both sites. Indeed, similar to previously published results on the oropharyngeal microbiota, high-risk samples in the nose were characterized by low diversity, a loss of beneficial bacteria, and an expansion of potentially pathogenic taxa, in the presence of reduced levels of tryptophan (Trp). At variance with oropharyngeal samples, however, low Trp levels were associated with defective host-derived kynurenine production, suggesting reduced tolerance mechanisms at the nasal mucosal surface. This was accompanied by reduced levels of the chemokine interleukin-8 (IL-8), likely associated with a reduced recruitment of neutrophils and impaired fungal clearance. Thus, the nasal and pharyngeal microbiomes of hematological patients provide complementary information that could improve predictive tools for the risk of IFI in hematological patients.
Published: 2022

13. Invasive aspergillosis in relapsed/refractory acute myeloid leukaemia patients: Results from SEIFEM 2016-B survey

Author: Del Principe, M. I., Dragonetti, Giulia, Conti, A., Verga, L., Ballanti, S., Fanci, R., Candoni, A., Marchesi, F., Cattaneo, C., Lessi, F., Fracchiolla, N., Spolzino, A., Prezioso, L., Delia, M., Potenza, L., Decembrino, N., Castagnola, C., Nadali, G., Picardi, M., Zama, D., Orciulo, E., Veggia, B., Garzia, M., Dargenio, M., Melillo, L., Manetta, S., Russo, D., Mancini, V., Piedimonte, M., Tisi, M. C., Toschi, N., Busca, A., Pagano, Livio, Dragonetti G., Pagano L. (ORCID:0000-0001-8287-928X), Del Principe, M. I., Dragonetti, Giulia, Conti, A., Verga, L., Ballanti, S., Fanci, R., Candoni, A., Marchesi, F., Cattaneo, C., Lessi, F., Fracchiolla, N., Spolzino, A., Prezioso, L., Delia, M., Potenza, L., Decembrino, N., Castagnola, C., Nadali, G., Picardi, M., Zama, D., Orciulo, E., Veggia, B., Garzia, M., Dargenio, M., Melillo, L., Manetta, S., Russo, D., Mancini, V., Piedimonte, M., Tisi, M. C., Toschi, N., Busca, A., Pagano, Livio, Dragonetti G., and Pagano L. (ORCID:0000-0001-8287-928X)
Abstract: Background: In patients with relapsed/refractory acute myeloid leukaemia (R/R AML) who received salvage chemotherapy, limited and not updated studies explored the incidence of invasive aspergillosis (IA) and the role of antifungal prophylaxis (AP). The aims of this multicentre retrospective ‘SEIFEM 2016-B’ study were as follows: (1) to evaluate the current rate and the outcome of proven/probable IA and (2) to assess the efficacy of AP, in a large ‘real life’ series of patient with R/R AML submitted to salvage chemotherapy. Results: Of 2250 R/R AML patients, a total of 74 cases of IA (5.1%) were recorded as follows: 10 (0.7%) proven and 64 (4.3%) probable. Information about AP were available in 73/74 (99%) patients. Fifty-eight (79%) breakthrough infections occurred, mainly during AP with posaconazole [25 (43%)]. The patients who received AP during salvage chemotherapy showed a benefit from antifungal therapy (AT) than patients who did not received AP [43 (86%) vs 7 (14%); p <.033]. In a multivariate analysis, AP and absence of severe mucositis had a significant favourable effect on overall response rate. Conclusion: Our data demonstrated that the incidence of IA during the salvage chemotherapy is similar to the past. Nevertheless, the attributable mortality rate (AMR) appears to be lower than that previously reported in R/R AML. Further prospective studies should be performed to confirm our preliminary observation and understand and the why a decreased AMR is reported in this setting of high-risk patients.
Published: 2022

14. P18: DARATUMUMAB (D) PLUS BORTEZOMIB (V) AND DEXAMETHASONE (D) AS SALVAGE THERAPY FOR PATIENTS WITH REFRACTORY/RELAPSED MULTIPLE MYELOMA (RRMM): INITIAL FOLLOW-UP OF AN ITALIAN MULTICENTER RETROSPECTIVE CLINICAL EXPERIENCE BY “RETE EMATOLOGICA PUGLIESE”

Author: Mele, G, primary, Cascavilla, N, additional, Di Renzo, N, additional, Guarini, A, additional, Mazza, P, additional, Melillo, L, additional, Pavone, V, additional, Tarantini, G, additional, Curci, P, additional, Falcone, AP, additional, Germano, C, additional, Mele, A, additional, Palazzo, G, additional, Palumbo, G, additional, Reddiconto, G, additional, Rossini, B, additional, Specchia, G, additional, Musto, P, additional, and Pastore, D, additional
Published: 2022
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15. P17: DARATUMUMAB (D) PLUS LENALIDOMIDE (R) AND DEXAMETHASONE (D) AS SALVAGE THERAPY FOR PATIENTS WITH REFRACTORY-RELAPSED MULTIPLE MYELOMA (RRMM): INITIAL FOLLOW-UP OF AN ITALIAN MULTICENTER RETROSPECTIVE CLINICAL EXPERIENCE BY “RETE EMATOLOGICA PUGLIESE”

Author: Mele, G, primary, Cascavilla, N, additional, Di Renzo, N, additional, Guarini, A, additional, Mazza, P, additional, Melillo, L, additional, Pavone, V, additional, Tarantini, G, additional, Curci, P, additional, Falcone, AP, additional, Germano, C, additional, Mele, A, additional, Palazzo, G, additional, Palumbo, G, additional, Reddiconto, G, additional, Rossini, B, additional, Specchia, G, additional, Musto, P, additional, and Pastore, D, additional
Published: 2022
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16. INTERIM RESULTS OF PROSPECTIVE OBSERVATIONAL SEIFEM STUDY ON CLINICAL OUTCOME AND INFECTIOUS COMPLICATIONS IN 230 UNFIT AML PATIENTS TREATED IN FIRST-LINE WITH HYPOMETHYLATING AGENTS ALONE OR IN COMBINATION WITH VENETOCLAX

Author: Candoni A, Piccin M, Lazzarotto D, Bonuomo V, Fracchiolla N, Dargenio M, Riva M, Melillo L, Papayannidis C, Stulle M, Lessi F, Dragonetti G, Del Principe MI, Cerqui E, Pasciolla C, De Marchi R, Delia M, Tisi MC, Fanci R, Nadali G, Sciume M, Di Renzo N, Cairoli R, Valente D, Basilico, C (Basilico, C.) 18 Spadea, A (Spadea, A.) 19 Sartor, C (Sartor, C.) 8 Griguolo, D (Griguolo, D.) 9 Sarlo, C (Sarlo, C.) 20 Olivieri, A (Olivieri, A.) 21 Piccioni AL, Pagano L, Candoni, A, Piccin, M, Lazzarotto, D, Bonuomo, V, Fracchiolla, N, Dargenio, M, Riva, M, Melillo, L, Papayannidis, C, Stulle, M, Lessi, F, Dragonetti, G, Del Principe, M, Cerqui, E, Pasciolla, C, De Marchi, R, Delia, M, Tisi, M, Fanci, R, Nadali, G, Sciume, M, Di Renzo, N, Cairoli, R, Valente, D, Basilico, C,, C., ), A,, A., ), D,, D., ), and Pagano, L
Subjects: Hematology
Published: 2021

17. VERY LONG-TERM RESULTS OF ALL-TRANS RETINOIC ACID AND ARSENIC TRIOXIDE IN NON-HIGH RISK ACUTE PROMYELOCYTIC LEUKEMIA: LATEST UPDATE OF THE ITALIAN-GERMAN APL0406 RANDOMIZED TRIAL

Author: Cicconi, L, Platzbecker, U, Avvisati, G, Paoloni, F, Thiede, C, Vignetti, M, Fazi, P, Ferrara, F, Divona, M, Albano, F, Efficace, F, Sborgia, M, Di Bona, E, Breccia, M, Borlenghi, E, Cairoli, R, Rambaldi, A, Melillo, L, La Nasa, G, Fiedler, W, Brossart, P, Hertenstein, B, Salih, H, Annibali, O, Wattad, M, Lubbert, M, Brandts, C, Hanel, M, Rollig, C, Schmitz, N, Lin, H, Frairia, C, Fozza, C, Maria D’Arco, A, Di Renzo, N, Cortelezzi, A, Fabbiano, F, Dohner, K, Ganser, A, Dohner, H, Amadori, S, Mandelli, F, Teresa Voso, M, Ehninger, G, Schlenk, R, Lo-Coco, F, Cicconi L, Platzbecker U, Avvisati G, Paoloni F, Thiede C, Vignetti M, Fazi P, Ferrara F, Divona M, Albano F, Efficace F, Sborgia M, Di Bona E, Breccia M, Borlenghi E, Cairoli R, Rambaldi A, Melillo L, La Nasa G, Fiedler W, Brossart P, Hertenstein B, Salih HR, Annibali O, Wattad M, Lubbert M, Brandts C, Hanel M, Rollig C, Schmitz N, Lin H, Frairia C, Fozza C, Maria D’Arco A, Di Renzo N, Cortelezzi A, Fabbiano F, Dohner K, Ganser A, Dohner H, Amadori S, Mandelli F, Teresa Voso M, Ehninger G, Schlenk RF, Lo-Coco F., Cicconi, L, Platzbecker, U, Avvisati, G, Paoloni, F, Thiede, C, Vignetti, M, Fazi, P, Ferrara, F, Divona, M, Albano, F, Efficace, F, Sborgia, M, Di Bona, E, Breccia, M, Borlenghi, E, Cairoli, R, Rambaldi, A, Melillo, L, La Nasa, G, Fiedler, W, Brossart, P, Hertenstein, B, Salih, H, Annibali, O, Wattad, M, Lubbert, M, Brandts, C, Hanel, M, Rollig, C, Schmitz, N, Lin, H, Frairia, C, Fozza, C, Maria D’Arco, A, Di Renzo, N, Cortelezzi, A, Fabbiano, F, Dohner, K, Ganser, A, Dohner, H, Amadori, S, Mandelli, F, Teresa Voso, M, Ehninger, G, Schlenk, R, Lo-Coco, F, Cicconi L, Platzbecker U, Avvisati G, Paoloni F, Thiede C, Vignetti M, Fazi P, Ferrara F, Divona M, Albano F, Efficace F, Sborgia M, Di Bona E, Breccia M, Borlenghi E, Cairoli R, Rambaldi A, Melillo L, La Nasa G, Fiedler W, Brossart P, Hertenstein B, Salih HR, Annibali O, Wattad M, Lubbert M, Brandts C, Hanel M, Rollig C, Schmitz N, Lin H, Frairia C, Fozza C, Maria D’Arco A, Di Renzo N, Cortelezzi A, Fabbiano F, Dohner K, Ganser A, Dohner H, Amadori S, Mandelli F, Teresa Voso M, Ehninger G, Schlenk RF, and Lo-Coco F.
Published: 2019

18. IN ADULT ACUTE MYELOID LEUKEMIA (AML) PERIPHERAL BLOOD MEASURABLE RESIDUAL DISEASE (MRD) BY FLOW CYTOMETRY (FC) IS FEASIBLE AND IS PROGNOSTICALLY RELEVANT

Author: Maurillo, L, Buccisano, F, Piciocchi, A, Del Principe, M, Candoni, A, Melillo, L, Calafiore, V, Cairoli, R, De Fabritiis, P, Storti, G, Salutari, P, Lanza, F, Martinelli, G, Luppi, M, Mazza, P, Martelli, M, Cuneo, A, Albano, F, Fabbiano, F, Tafuri, A, Chierichini, A, Tieghi, A, Fracchiolla, N, Capelli, D, Foa, R, Alati, C, La Sala, E, Voso, M, Fazi, P, Vignetti, M, Consalvo, M, Ottone, T, Lavorgna, S, Arcese, W, Lo Coco, F, Amadori, S, Venditti, A, Maurillo L, Buccisano F, Piciocchi A, Del Principe MI, Candoni A, Melillo L, Calafiore V, Cairoli R, De Fabritiis P, Storti G, Salutari P, Lanza F, Martinelli G, Luppi M, Mazza P, Martelli MP, Cuneo A, Albano F, Fabbiano F, Tafuri A, Chierichini A, Tieghi A, Fracchiolla NS, Capelli D, Foa R, Alati C, La Sala E, Voso MT, Fazi P, Vignetti M, Consalvo MI, Ottone T, Lavorgna S, Arcese W, Lo Coco F, Amadori S, Venditti a., Maurillo, L, Buccisano, F, Piciocchi, A, Del Principe, M, Candoni, A, Melillo, L, Calafiore, V, Cairoli, R, De Fabritiis, P, Storti, G, Salutari, P, Lanza, F, Martinelli, G, Luppi, M, Mazza, P, Martelli, M, Cuneo, A, Albano, F, Fabbiano, F, Tafuri, A, Chierichini, A, Tieghi, A, Fracchiolla, N, Capelli, D, Foa, R, Alati, C, La Sala, E, Voso, M, Fazi, P, Vignetti, M, Consalvo, M, Ottone, T, Lavorgna, S, Arcese, W, Lo Coco, F, Amadori, S, Venditti, A, Maurillo L, Buccisano F, Piciocchi A, Del Principe MI, Candoni A, Melillo L, Calafiore V, Cairoli R, De Fabritiis P, Storti G, Salutari P, Lanza F, Martinelli G, Luppi M, Mazza P, Martelli MP, Cuneo A, Albano F, Fabbiano F, Tafuri A, Chierichini A, Tieghi A, Fracchiolla NS, Capelli D, Foa R, Alati C, La Sala E, Voso MT, Fazi P, Vignetti M, Consalvo MI, Ottone T, Lavorgna S, Arcese W, Lo Coco F, Amadori S, and Venditti a.
Published: 2019

19. Pharyngeal microbial signatures are predictive of the risk of fungal pneumonia in hematologic patients

Author: Costantini, C., Nunzi, E., Spolzino, A., Palmieri, M., Renga, G., Zelante, T., Englmaier, L., Coufalikova, K., Spacil, Z., Borghi, M., Bellet, M. M., Acerbi, E., Puccetti, M., Giovagnoli, S., Spaccapelo, R., Talesa, V. N., Lomurno, G., Merli, F., Facchini, L., Spadea, A., Melillo, L., Codeluppi, K., Marchesi, F., Marchesini, G., Valente, D., Dragonetti, G., Nadali, G., Pagano, L., Aversa, F., Romani, L., Dragonetti G., Pagano L. (ORCID:0000-0001-8287-928X), Costantini, C., Nunzi, E., Spolzino, A., Palmieri, M., Renga, G., Zelante, T., Englmaier, L., Coufalikova, K., Spacil, Z., Borghi, M., Bellet, M. M., Acerbi, E., Puccetti, M., Giovagnoli, S., Spaccapelo, R., Talesa, V. N., Lomurno, G., Merli, F., Facchini, L., Spadea, A., Melillo, L., Codeluppi, K., Marchesi, F., Marchesini, G., Valente, D., Dragonetti, G., Nadali, G., Pagano, L., Aversa, F., Romani, L., Dragonetti G., and Pagano L. (ORCID:0000-0001-8287-928X)
Abstract: The ability to predict invasive fungal infections (IFI) in patients with hematological malignancies is fundamental for successful therapy. Although gut dysbiosis is known to occur in hematological patients, whether airway dysbiosis also contributes to the risk of IFI has not been investigated. Nasal and oropharyngeal swabs were collected for functional microbiota characterization in 173 patients with hematological malignancies recruited in a multicenter, prospective, observational study and stratified according to the risk of developing IFI. A lower microbial richness and evenness were found in the pharyngeal microbiota of high-risk patients that were associated with a distinct taxonomic and metabolic profile. A murine model of IFI provided biologic plausibility for the finding that loss of protective anaerobes, such as Clostridiales and Bacteroidetes, along with an apparent restricted availability of tryptophan, is causally linked to the risk of IFI in hematologic patients and indicates avenues for antimicrobial stewardship and metabolic reequilibrium in IFI.
Published: 2021

20. Fungal infections of the central nervous system and paranasal sinuses in onco-haematologic patients. Epidemiological study reporting the diagnostic-therapeutic approach and outcome in 89 cases

Author: Candoni A, Klimko N, Busca A, Di Blasi R, Shadrivova O, Cesaro S, Zannier ME, Verga L, Forghieri F, Calore E, Nadali G, Simonetti E, Muggeo P, Quinto AM, Castagnola C, Cellini M, Del Principe MI, Fracchiolla N, Melillo L, Piedimonte M, Zama D, Farina F, Giusti D, Mosna F, Capelli D, Delia M, Picardi M, Decembrino N, Perruccio K, Vallero S, Aversa F, Fanin R, Pagano L, SEIFEM Group (Epidemiological Surveillance of Infections in Haematological Diseases), Candoni, A., Klimko, N., Busca, A., Di Blasi, R., Shadrivova, O., Cesaro, S., Zannier, M. E., Verga, L., Forghieri, F., Calore, Aldo, Nadali, G., Simonetti, E., Muggeo, P., Quinto, A. M., Castagnola, C., Cellini, M., Del Principe, M. I., Fracchiolla, N., Melillo, L., Piedimonte, M., Zama, D., Farina, F., Giusti, D., Mosna, F., Capelli, D., Delia, M., Picardi, M., Decembrino, N., Perruccio, K., Vallero, S., Aversa, F., Fanin, R., Pagano, L., Candoni A, Klimko N, Busca A, Di Blasi R, Shadrivova O, Cesaro S, Zannier ME, Verga L, Forghieri F, Calore E, Nadali G, Simonetti E, Muggeo P, Quinto AM, Castagnola C, Cellini M, Del Principe MI, Fracchiolla N, Melillo L, Piedimonte M, Zama D, Farina F, Giusti D, Mosna F, Capelli D, Delia M, Picardi M, Decembrino N, Perruccio K, Vallero S, Aversa F, Fanin R, Pagano L, and SEIFEM Group (Epidemiological Surveillance of Infections in Haematological Diseases)
Subjects: 0301 basic medicine, Male, Antifungal Agents, haematological disease, Aspergillosis, fungal CNS infectious, haematological diseases, leukaemia, neurologic complications, Zygomicosis, 030207 dermatology & venereal diseases, 0302 clinical medicine, Central Nervous System Fungal Infections, Epidemiology, Paranasal Sinuses, Sinusitis, Child, Adolescent, Adult, Aged, Cerebrospinal Fluid, Child, Preschool, Epidemiologic Studies, Female, Fungi, Hematologic Neoplasms, Humans, Middle Aged, Survival Analysis, Treatment Outcome, Young Adult, Debridement, medicine.diagnostic_test, aspergillosis, fungal cns infectious, zygomicosis, neurologic complication, General Medicine, medicine.anatomical_structure, Infectious Diseases, Cohort, medicine.drug, medicine.medical_specialty, fungal CNS infectiou, Aspergillosi, 030106 microbiology, Dermatology, 03 medical and health sciences, Internal medicine, Biopsy, medicine, Preschool, Invasive fungal infection, central nervous system, onco-haematologic patients, Survival analysis, Voriconazole, business.industry, Zygomicosi, medicine.disease, Paranasal sinuses, 2708, business, Settore MED/15 - Malattie del Sangue
Abstract: Invasive fungal infections (IFI) of the Central Nervous System (IFI-CNS) and Paranasal Sinuses (IFI-PS) are rare, life-threatening infections in haematologic patients, and their management remains a challenge despite the availability of new diagnostic techniques and novel antifungal agents. In addition, analyses of large cohorts of patients focusing on these rare IFI are still lacking. Between January 2010 and December 2016, 89 consecutive cases of Proven (53) or Probable (36) IFI-CNS (71/89) and IFI-PS (18/89) were collected in 34 haematological centres. The median age was 40 years (range 5-79); acute leukaemia was the most common underlying disease (69%) and 29% of cases received a previous allogeneic stem cell transplant. Aspergillus spp. were the most common pathogens (69%), followed by mucormycetes (22%), Cryptococcus spp. (4%) and Fusarium spp. (2%). The lung was the primary focus of fungal infection (48% of cases). The nervous system biopsy was performed in 10% of IFI-CNS, and a sinus biopsy was performed in 56% of IFI-PS (P = 0.03). The Galactomannan test on cerebrospinal fluid has been performed in 42% of IFI-CNS (30/71), and it was positive in 67%. Eighty-four pts received a first-line antifungal therapy with Amphotericine B in 58% of cases, Voriconazole in 31% and both in 11%. Moreover, 58% of patients received 2 or more lines of therapy and 38% were treated with a combination of 2 or more antifungal drugs. The median duration of antifungal therapy was 60 days (range 5-835). A surgical intervention was performed in 26% of cases but only 10% of IFI-CNS underwent neurosurgical intervention. The overall response rate to antifungal therapy (complete or partial response) was 57%, and 1-year overall survival was 32% without significant differences between IFI-CNS and IFI-PS. The overall mortality was 69% but the IFI attributable mortality was 33%. Mortality of IFI-CNS/PS remains high but, compared to previous historical data, it seems to be reduced probably due to the availability of newer antifungal drugs. The results arising from this large contemporary cohort of cases may allow a more effective diagnostic and therapeutic management of these very rare IFI complications in haematologic patients.
Published: 2018

21. Multicentre surveillance study on feasibility, safety and efficacy of antifungal combination therapy for proven or probable invasive fungal diseases in haematological patients: the SEIFEM real-life combo study

Author: Candoni, A., Caira, M., Cesaro, S., Busca, A., Giacchino, M., Fanci, R., Delia, M., Nosari, A., Bonini, A., Cattaneo, C., Melillo, L., Caramatti, C., Milone, G., Scimeʼ, R., Picardi, M., Fanin, R., and Pagano, L.
Published: 2014
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22. VERY LONG-TERM RESULTS OF ALL-TRANS RETINOIC ACID AND ARSENIC TRIOXIDE IN NON-HIGH RISK ACUTE PROMYELOCYTIC LEUKEMIA: LATEST UPDATE OF THE ITALIAN-GERMAN APL0406 RANDOMIZED TRIAL

Author: Cicconi L, Platzbecker U, Avvisati G, Paoloni F, Thiede C, Vignetti M, Fazi P, Ferrara F, Divona M, Albano F, Efficace F, Sborgia M, Di Bona E, Breccia M, Borlenghi E, Cairoli R, Rambaldi A, Melillo L, La Nasa G, Fiedler W, Brossart P, Hertenstein B, Salih HR, Annibali O, Wattad M, Lubbert M, Brandts C, Hanel M, Rollig C, Schmitz N, Lin H, Frairia C, Fozza C, Maria D’Arco A, Di Renzo N, Cortelezzi A, Fabbiano F, Dohner K, Ganser A, Dohner H, Amadori S, Mandelli F, Teresa Voso M, Ehninger G, Schlenk RF, Lo-Coco F., Cicconi, L, Platzbecker, U, Avvisati, G, Paoloni, F, Thiede, C, Vignetti, M, Fazi, P, Ferrara, F, Divona, M, Albano, F, Efficace, F, Sborgia, M, Di Bona, E, Breccia, M, Borlenghi, E, Cairoli, R, Rambaldi, A, Melillo, L, La Nasa, G, Fiedler, W, Brossart, P, Hertenstein, B, Salih, H, Annibali, O, Wattad, M, Lubbert, M, Brandts, C, Hanel, M, Rollig, C, Schmitz, N, Lin, H, Frairia, C, Fozza, C, Maria D’Arco, A, Di Renzo, N, Cortelezzi, A, Fabbiano, F, Dohner, K, Ganser, A, Dohner, H, Amadori, S, Mandelli, F, Teresa Voso, M, Ehninger, G, Schlenk, R, and Lo-Coco, F
Subjects: Hematology
Published: 2019

23. Fungal infections in recipients of hematopoietic stem cell transplants: results of the SEIFEM B-2004 study - Sorveglianza Epidemiologica Infezioni Fungine Nelle Emopatie Maligne

Author: Pagano, L., Caira, M., Nosari, A., Van Lint, M.T., Candoni, A., Offidani, M., Aloisi, T., Irrera, G., Bonini, A., Picardi, M., Caramatti, C., Invernizzi, R., Mattei, D., Melillo, L., de Waure, C., Reddiconto, G., Fianchi, L., Valentini, C.G., Girmenia, C., Leone, G., and Aversa, F.
Subjects: Mycoses -- Causes of, Mycoses -- Health aspects, Mycoses -- Care and treatment, Mycoses -- Research, Organ transplant recipients -- Health aspects, Organ transplant recipients -- Patient outcomes, Hematopoietic stem cells -- Transplantation, Hematopoietic stem cells -- Methods, Hematopoietic stem cells -- Complications and side effects, Health, Health care industry
Published: 2007

24. Central nervous system fungal infections in allogeneic stem cell transplantation. Outcome of 24 recent cases and literature review

Author: Candoni, A., Facchin, G., Busca, A., Lazzarotto, D., Cattaneo, C., Nadali, G., Klimko, N., Del Principe, M. I., Castagnola, C., Verga, L., Zannier, M. E., Calore, E., Capelli, D., Perruccio, K., Melillo, L., Fanin, R., Pagano, Livio, Pagano L. (ORCID:0000-0001-8287-928X), Candoni, A., Facchin, G., Busca, A., Lazzarotto, D., Cattaneo, C., Nadali, G., Klimko, N., Del Principe, M. I., Castagnola, C., Verga, L., Zannier, M. E., Calore, E., Capelli, D., Perruccio, K., Melillo, L., Fanin, R., Pagano, Livio, and Pagano L. (ORCID:0000-0001-8287-928X)
Abstract: nd
Published: 2020

25. Evaluation on ‘real life’ prescriptions of antifungal prophylaxis in acute myeloid leukemia: Final results from a prospective survey: C12-3

Author: Caira, M., Busca, A., Candoni, A., Melillo, L., Blasi, R. Di, Cuccaro, A., Caramatti, C., Specchia, G., Fanci, R., Rossi, G., Vacca, A., Quintavalle, C., Picardi, M., Mitra, M. E., Delia, M., Landini, B., Aversa, F., Gasbarrino, C., Invernizzi, R., Salutari, P., Martino, B., Garzia, M. G., Chierichini, A., Caprio, L. Di, Vianelli, N., Nadali, G., Luppi, M., Nosari, A., and Pagano, L.
Published: 2012

26. Fludarabine, cytarabine, and G-CSF (FLAG) for the treatment of acute myeloid leukemia relapsing after autologous stem cell transplantation

Author: Ferrara, F., Melillo, L., Montillo, M., Leoni, F., Pinto, A., Mele, G., and Mirto, S.
Published: 1999
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27. Improved outcomes with retinoic acid and arsenic trioxide compared with retinoic acid and chemotherapy in non-high-risk acute promyelocytic leukemia: Final results of the randomized Italian-German APL0406 trial

Author: Platzbecker, U, Avvisati, G, Cicconi, L, Thiede, C, Paoloni, F, Vignetti, M, Ferrara, F, Divona, M, Albano, F, Efficace, F, Fazi, P, Sborgia, M, Di Bona, E, Breccia, M, Borlenghi, E, Cairoli, R, Rambaldi, A, Melillo, L, La Nasa, G, Fiedler, W, Brossart, P, Hertenstein, B, Salih, H, Wattad, M, Lübbert, M, Brandts, C, Hänel, M, Röllig, C, Schmitz, N, Link, H, Frairia, C, Pogliani, E, Fozza, C, D'Arco, A, Di Renzo, N, Cortelezzi, A, Fabbiano, F, Döhner, K, Ganser, A, Döhner, H, Amadori, S, Mandelli, F, Ehninger, G, Schlenk, R, Lo-Coco, F, Platzbecker U, Avvisati G, Cicconi L, Thiede C, Paoloni F, Vignetti M, Ferrara F, Divona M, Albano F, Efficace F, Fazi P, Sborgia M, Di Bona E, Breccia M, Borlenghi E, Cairoli R, Rambaldi A, Melillo L, La Nasa G, Fiedler W, Brossart P, Hertenstein B, Salih HR, Wattad M, Lübbert M, Brandts CH, Hänel M, Röllig C, Schmitz N, Link H, Frairia C, Pogliani EM, Fozza C, D'Arco AM, Di Renzo N, Cortelezzi A, Fabbiano F, Döhner K, Ganser A, Döhner H, Amadori S, Mandelli F, Ehninger G, Schlenk RF, Lo-Coco F., Platzbecker, U, Avvisati, G, Cicconi, L, Thiede, C, Paoloni, F, Vignetti, M, Ferrara, F, Divona, M, Albano, F, Efficace, F, Fazi, P, Sborgia, M, Di Bona, E, Breccia, M, Borlenghi, E, Cairoli, R, Rambaldi, A, Melillo, L, La Nasa, G, Fiedler, W, Brossart, P, Hertenstein, B, Salih, H, Wattad, M, Lübbert, M, Brandts, C, Hänel, M, Röllig, C, Schmitz, N, Link, H, Frairia, C, Pogliani, E, Fozza, C, D'Arco, A, Di Renzo, N, Cortelezzi, A, Fabbiano, F, Döhner, K, Ganser, A, Döhner, H, Amadori, S, Mandelli, F, Ehninger, G, Schlenk, R, Lo-Coco, F, Platzbecker U, Avvisati G, Cicconi L, Thiede C, Paoloni F, Vignetti M, Ferrara F, Divona M, Albano F, Efficace F, Fazi P, Sborgia M, Di Bona E, Breccia M, Borlenghi E, Cairoli R, Rambaldi A, Melillo L, La Nasa G, Fiedler W, Brossart P, Hertenstein B, Salih HR, Wattad M, Lübbert M, Brandts CH, Hänel M, Röllig C, Schmitz N, Link H, Frairia C, Pogliani EM, Fozza C, D'Arco AM, Di Renzo N, Cortelezzi A, Fabbiano F, Döhner K, Ganser A, Döhner H, Amadori S, Mandelli F, Ehninger G, Schlenk RF, and Lo-Coco F.
Abstract: Purpose: The initial results of the APL0406 trial showed that the combination of all-trans-retinoic acid (ATRA) and arsenic trioxide (ATO) is at least not inferior to standard ATRA and chemotherapy (CHT) in first-line therapy of low- or intermediate-risk acute promyelocytic leukemia (APL). We herein report the final analysis on the complete series of patients enrolled onto this trial. Patients and Methods: The APL0406 study was a prospective, randomized, multicenter, open-label, phase III noninferiority trial. Eligible patients were adults between 18 and 71 years of age with newly diagnosed, low- or intermediate-risk APL (WBC at diagnosis ≤ 10 × 109/L). Overall, 276 patients were randomly assigned to receive ATRA-ATO or ATRA-CHT between October 2007 and January 2013. Results: Of 263 patients evaluable for response to induction, 127 (100%) of 127 patients and 132 (97%) of 136 patients achieved complete remission (CR) in the ATRA-ATO and ATRA-CHT arms, respectively (P = .12). After a median follow-up of 40.6 months, the event-free survival, cumulative incidence of relapse, and overall survival at 50 months for patients in the ATRA-ATO versus ATRA-CHT arms were 97.3% v 80%, 1.9% v 13.9%, and 99.2% v 92.6%, respectively (P < .001, P = .0013, and P = .0073, respectively). Postinduction events included two relapses and one death in CR in the ATRA-ATO arm and two instances of molecular resistance after third consolidation, 15 relapses, and five deaths in CR in the ATRA-CHT arm. Two patients in the ATRA-CHT arm developed a therapy-related myeloid neoplasm. Conclusion: These results show that the advantages of ATRA-ATO over ATRA-CHT increase over time and that there is significantly greater and more sustained antileukemic efficacy of ATO-ATRA compared with ATRA-CHT in low- and intermediate-risk APL.
Published: 2017

28. Invasive aspergillosis in acute myeloid leukaemia: report of Seifem-2008 multi-centre survey: O241

Author: Caira, M., Candoni, A., Picardi, M., Offidani, M., Specchia, G., Stanzani, M., Cattaneo, C., Fanci, R., Caramatti, C., Rossini, F., Potenza, L., Ferrara, F., Mitra, M. E., Invernizzi, R., Aloisi, T., Martino, B., Bonini, A., Lanasa, G., Chierichini, A., Melillo, L., de Waure, C., Fianchi, L., Riva, M., Aversa, F., Leone, G., and Nosari, A.
Published: 2009

29. 'Real-life' analysis of the role of antifungal prophylaxis in preventing invasive aspergillosis in AML patients undergoing consolidation therapy: Sorveglianza Epidemiologica Infezioni nelle Emopatie (SEIFEM) 2016 study

Author: Del Principe MI, Dragonetti, G, Verga, L, Candoni, A, Marchesi, F, Cattaneo, C, Delia, M, Potenza, L, Farina, F, Ballanti, S, Decembrino, N, Castagnola, C, Nadali, G, Fanci, R, Orciulo, E, Veggia, B, Offidani, M, Melillo, L, Manetta, S, Tumbarello, M, Venditti, A, Busca, A, Aversa, F, and Pagano, L
Subjects: antifungal prophylaxis , consolidation therapy. AML
Published: 2019

30. A bronchoalveolar lavage-driven antimicrobial treatment improves survival in hematologic malignancy patients with detected lung infiltrates: A prospective multicenter study of the SEIFEM group

Author: Marchesi, F., Cattaneo, C., Criscuolo, Marianna, Delia, M., Dargenio, M., Del Principe, M. I., Spadea, A., Fracchiolla, N. S., Melillo, L., Perruccio, K., Alati, C., Russo, D., Garzia, M., Brociner, M., Cefalo, M., Armiento, D., Cesaro, S., Decembrino, N., Mengarelli, A., Tumbarello, Mario, Busca, A., Pagano, Livio, Criscuolo M., Tumbarello M. (ORCID:0000-0002-9519-8552), Pagano L. (ORCID:0000-0001-8287-928X), Marchesi, F., Cattaneo, C., Criscuolo, Marianna, Delia, M., Dargenio, M., Del Principe, M. I., Spadea, A., Fracchiolla, N. S., Melillo, L., Perruccio, K., Alati, C., Russo, D., Garzia, M., Brociner, M., Cefalo, M., Armiento, D., Cesaro, S., Decembrino, N., Mengarelli, A., Tumbarello, Mario, Busca, A., Pagano, Livio, Criscuolo M., Tumbarello M. (ORCID:0000-0002-9519-8552), and Pagano L. (ORCID:0000-0001-8287-928X)
Abstract: Bronchoalveolar lavage (BAL) is recommended for diagnosing lung infiltrates (LI) in patients with hematologic malignancy (HM). Prospective data on the impact of BAL on survival are still lacking. We conducted a prospective observational study on patients who performed BAL for LI among 3055 HM patients hospitalized from January to September 2018. The BAL was performed in 145 out of 434 patients who developed LI, at a median time of four days from LI detection. The median age was 60 (1-83). Most patients had an acute myeloid leukemia/myelodisplastic syndrome (81), followed by lymphoma (41), acute lymphoblastic leukemia (27), and other types of HM (36). A putative causal agent was detected in 111 cases (76%), and in 89 cases (61%) the BAL results provided guidance to antimicrobial treatment. We observed a significantly improved outcome of LI at day +30 in patients who could receive a BAL-driven antimicrobial treatment (improvement/resolution rate: 71% vs 55%; P = .04). Moreover, we observed a significantly improved outcome in 120-day overall survival (120d-OS) (78% vs 59%; P = .009) and 120-day attributable mortality (120d-AM) (11% vs 30%; P = 0.003) for patients who could receive a BAL-driven treatment. The multivariate analysis showed that BAL-driven antimicrobial treatment was significantly associated with better 120d-OS and lower 120d-AM. We did not observe any severe adverse events. In conclusion BAL allows detection of a putative agent of LI in about 75% of cases, it is feasible and well tolerated in most cases, demonstrating that a BAL-driven antimicrobial treatment allows improvement of clinical outcome and survival.
Published: 2019

31. Fungal infections of the central nervous system and paranasal sinuses in onco-haematologic patients. Epidemiological study reporting the diagnostic-therapeutic approach and outcome in 89 cases

Author: Candoni, A., Klimko, N., Busca, A., Di Blasi, Roberta, Shadrivova, O., Cesaro, S., Zannier, M. E., Verga, L., Forghieri, F., Calore, E., Nadali, G., Simonetti, E., Muggeo, P., Quinto, A. M., Castagnola, C., Cellini, M., Del Principe, M. I., Fracchiolla, N., Melillo, L., Piedimonte, M., Zama, D., Farina, F., Giusti, D., Mosna, F., Capelli, D., Delia, M., Picardi, M., Decembrino, N., Perruccio, K., Vallero, S., Aversa, F., Fanin, R., Pagano, Livio, Di Blasi, R., Pagano, L. (ORCID:0000-0001-8287-928X), Candoni, A., Klimko, N., Busca, A., Di Blasi, Roberta, Shadrivova, O., Cesaro, S., Zannier, M. E., Verga, L., Forghieri, F., Calore, E., Nadali, G., Simonetti, E., Muggeo, P., Quinto, A. M., Castagnola, C., Cellini, M., Del Principe, M. I., Fracchiolla, N., Melillo, L., Piedimonte, M., Zama, D., Farina, F., Giusti, D., Mosna, F., Capelli, D., Delia, M., Picardi, M., Decembrino, N., Perruccio, K., Vallero, S., Aversa, F., Fanin, R., Pagano, Livio, Di Blasi, R., and Pagano, L. (ORCID:0000-0001-8287-928X)
Abstract: Invasive fungal infections (IFI) of the Central Nervous System (IFI-CNS) and Paranasal Sinuses (IFI-PS) are rare, life-threatening infections in haematologic patients, and their management remains a challenge despite the availability of new diagnostic techniques and novel antifungal agents. In addition, analyses of large cohorts of patients focusing on these rare IFI are still lacking. Between January 2010 and December 2016, 89 consecutive cases of Proven (53) or Probable (36) IFI-CNS (71/89) and IFI-PS (18/89) were collected in 34 haematological centres. The median age was 40 years (range 5-79); acute leukaemia was the most common underlying disease (69%) and 29% of cases received a previous allogeneic stem cell transplant. Aspergillus spp. were the most common pathogens (69%), followed by mucormycetes (22%), Cryptococcus spp. (4%) and Fusarium spp. (2%). The lung was the primary focus of fungal infection (48% of cases). The nervous system biopsy was performed in 10% of IFI-CNS, and a sinus biopsy was performed in 56% of IFI-PS (P = 0.03). The Galactomannan test on cerebrospinal fluid has been performed in 42% of IFI-CNS (30/71), and it was positive in 67%. Eighty-four pts received a first-line antifungal therapy with Amphotericine B in 58% of cases, Voriconazole in 31% and both in 11%. Moreover, 58% of patients received 2 or more lines of therapy and 38% were treated with a combination of 2 or more antifungal drugs. The median duration of antifungal therapy was 60 days (range 5-835). A surgical intervention was performed in 26% of cases but only 10% of IFI-CNS underwent neurosurgical intervention. The overall response rate to antifungal therapy (complete or partial response) was 57%, and 1-year overall survival was 32% without significant differences between IFI-CNS and IFI-PS. The overall mortality was 69% but the IFI attributable mortality was 33%. Mortality of IFI-CNS/PS remains high but, compared to previous historical data, it seems to be reduced probably due
Published: 2019

32. Acute myeloid leukemia in patients previously diagnosed with breast cancer: Experience of the GIMEMA group

Author: Pagano, L., Pulsoni, A., Mele, L., Tosti, M. E., Cerri, R., Visani, G., Melillo, L., Candoni, A., Clavio, M., Nosari, A., Petti, M. C., Martino, B., Mele, A., Levis, A., Allione, B., Almici, C., Equitani, F., Leone, G., and Mandelli, F.
Published: 2001

33. S1637 A BAL-DRIVEN ANTIMICROBIAL TREATMENT IMPROVES CLINICAL OUTCOME IN HEMATOLOGIC MALIGNANCIES PATIENTS WITH LUNG INFILTRATES DETECTION: A PROSPECTIVE MULTICENTER STUDY OF THE SEIFEM GROUP

Author: Marchesi, F., primary, Cattaneo, C., additional, Criscuolo, M., additional, Delia, M., additional, Dargenio, M., additional, Del Principe, M.I., additional, Spadea, A., additional, Fracchiolla, N. S., additional, Melillo, L., additional, Perruccio, K., additional, Alati, C., additional, Russo, D., additional, Garzia, M., additional, Zappasodi, P., additional, Cefalo, M.G., additional, Armiento, D., additional, Cesaro, S., additional, Decembrino, N., additional, Mengarelli, A., additional, Busca, A., additional, and Pagano, L., additional
Published: 2019
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34. PS1276 EPIDEMIOLOGY AND CLINICAL OUTCOME OF FUNGAL INFECTIONS OF THE CENTRAL NERVOUS SYSTEM IN ALLOGENEIC STEM CELL TRANSPLANTATION RECIPIENTS

Author: Facchin, G., primary, Candoni, A., additional, Busca, A., additional, Lazzarotto, D., additional, Cattaneo, C., additional, Nadali, G., additional, Klimko, N., additional, Principe, M.I. Del, additional, Castagnola, C., additional, Verga, L., additional, Calore, E., additional, Capelli, D., additional, Perruccio, K., additional, Melillo, L., additional, and Pagano, L., additional
Published: 2019
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35. RELATIONSHIP BETWEEN SOCIOECONOMIC FACTORS AND DELAY IN DIAGNOSIS AND INITIAL TREATMENT IN PATIENTS WITH DIFUSSE LARGE B CELL LYMPHOMA (DLBCL). DO THESE FACTORS IMPACT ON THE RESPONSE RATE? RESULTS OF A MULTICENTRIC ARGENTINIAN STUDY

Author: Zerga, M.E., primary, Dragosky, M., additional, Isnardi, S., additional, Stemmelin, G., additional, Yantorno, S., additional, Caccione, R., additional, Otero, V., additional, Marquez, M., additional, Gotta, D., additional, Suero, A., additional, Alfonso, G., additional, Beligoy, L., additional, Flores, G., additional, Fischman, L., additional, Martinez, M., additional, Rodriguez, A., additional, Diaz Velez, N., additional, Luchetta, P., additional, Welsh, V., additional, Tartas, N., additional, Schutz, N., additional, Zoppegno, L., additional, Bonnacorso, S., additional, Pujol, M., additional, Garate, G., additional, Mahuad, C., additional, Vicente, A., additional, De stefano, G., additional, Cugliari, S., additional, Miodosky, M., additional, Melillo, L., additional, Fernandez, D., additional, Kornblihtt, L., additional, Casali, C., additional, and Aizpuria, F., additional
Published: 2019
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36. Functional Imaging of Visuospatial Processing in Alzheimer's Disease

Author: Prvulovic, D., Hubl, D., Sack, A.T., Melillo, L., Maurer, K., Frölich, L., Lanfermann, H., Zanella, F.E., Goebel, R., Linden, D.E.J., and Dierks, T.
Published: 2002
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37. RISK-ADAPTED, MRD-DIRECTED THERAPY FOR YOUNG ADULTS WITH NEWLY DIAGNOSED ACUTE MYELOID LEUKEMIA: RESULTS OF THE AML1310 TRIAL OF THE GIMEMA GROUP

Author: Venditti, A, Piciocchi, A, Candoni, A, Melillo, L, Calafiore, V, Cairoli, R, De Fabritiis, P, Storti, G, Salutari, P, Lanza, F, Martinelli, G, Luppi, M, Mazza, P, Falini, B, Cuneo, A, Specchia, G, Fabbiano, F, Tafuri, A, Ronci, B, Tieghi, A, Fracchiolla, N, Capelli, D, Foa, R, Ronco, F, La Sala, E, Fazi, P, Maurillo, L, Buccisano, F, Del Principe, M, Lo Coco, F, Arcese, W, Amadori, S, Fracchiolla, NS, Del Principe, MI, Venditti, A, Piciocchi, A, Candoni, A, Melillo, L, Calafiore, V, Cairoli, R, De Fabritiis, P, Storti, G, Salutari, P, Lanza, F, Martinelli, G, Luppi, M, Mazza, P, Falini, B, Cuneo, A, Specchia, G, Fabbiano, F, Tafuri, A, Ronci, B, Tieghi, A, Fracchiolla, N, Capelli, D, Foa, R, Ronco, F, La Sala, E, Fazi, P, Maurillo, L, Buccisano, F, Del Principe, M, Lo Coco, F, Arcese, W, Amadori, S, Fracchiolla, NS, and Del Principe, MI
Published: 2017

38. Multicentre surveillance study on feasibility, safety and efficacy of antifungal combination therapy for proven or probable invasive fungal diseases in haematological patients: the SEIFEM real-life combo study

Author: Candoni A, Caira M, Simone Cesaro, Busca A, Giacchino M, Fanci R, Delia M, Nosari A, Bonini A, Cattaneo C, Melillo L, Caramatti C, Milone G, Scime' R, Picardi M, Fanin R, Pagano L, SEIFEM GROUP (Sorveglianza Epidemiologica Infezioni Fungine nelle Emopatie Maligne), Candoni, A, Caira, M., Cesaro, S., Busca, A., Giacchino, M., Fanci, R., Delia, M., Nosari, A., Bonini, A., Cattaneo, C., Melillo, L., Caramatti, C., Milone, G., Scime', R., Picardi, Marco, Fanin, R., and Pagano, L.
Subjects: Male, Posaconazole, Antifungal Agents, HAEMATOLOGICAL MALIGANANCY, Amphothericin, Caspofungin, Combined antifungal therapy, Invasive fungal disease, Voriconazole, medicine.medical_treatment, COMBO, Mycose, Gastroenterology, chemistry.chemical_compound, Amphotericin B, Antifungal Agent, caspofungin, FUNGAL INFECTION, Child, Medicine (all), Incidence, leukemia, General Medicine, Middle Aged, Infectious Diseases, Treatment Outcome, Italy, fungal, Child, Preschool, Hematologic Neoplasms, Combination, Drug Therapy, Combination, Female, Survival Analysi, Human, medicine.drug, Adult, medicine.medical_specialty, Combination therapy, Adolescent, Drug-Related Side Effects and Adverse Reactions, Infectious Disease, Dermatology, Young Adult, Drug Therapy, Internal medicine, medicine, voriconazole, Humans, Adverse effect, Preschool, Hematologic Neoplasm, Aged, Chemotherapy, business.industry, Infant, Survival Analysis, posaconazole, Surgery, invasive fungal disease, Transplantation, Settore MED/15 - MALATTIE DEL SANGUE, chemistry, Mycoses, amphothericin, Drug-Related Side Effects and Adverse Reaction, business
Abstract: Summary This multicentre observational study evaluated the feasibility, efficacy and toxicity of antifungal combination therapy (combo) as treatment of proven or probable invasive fungal diseases (IFDs) in patients with haematological malignancies. Between January 2005 and January 2010, 84 cases of IFDs (39 proven and 45 probable) treated with combo were collected in 20 Hematological Italian Centres, in patients who underwent chemotherapy or allogeneic haematopoietic stem cell transplantation for haematological diseases. Median age of patients was 34 years (range 1–73) and 37% had less than 18 years. Acute leukaemia was the most common underlying haematological disease (68/84; 81%). The phase of treatment was as follows: first induction in 21/84 (25%), consolidation phase in 18/84 (21%) and reinduction/salvage in 45/84 (54%). The main site of infection was lung with or without other sites. The principal fungal pathogens were as follows: Aspergillus sp. 68 cases (81%), Candida sp. six cases (8%), Zygomycetes four cases (5%) and Fusarium sp. four cases (5%). The most used combo was caspofungin+voriconazole 35/84 (42%), caspofungin + liposomal amphotericin B (L-AmB) 20/84 (24%) and L-AmB+voriconazole 15/84 (18%). The median duration of combo was 19 days (range 3–180). The overall response rate (ORR) was 73% (61/84 responders) without significant differences between the combo regimens. The most important factor that significantly influenced the response was granulocyte (PMN) recovery (P 0.009). Only one patient discontinued therapy (voriconazole-related neurotoxicity) and 22% experienced mild and reversible adverse events (hypokalaemia, ALT/AST increase and creatinine increase). The IFDs-attributable mortality was 17%. This study indicates that combo was both well tolerated and effective in haematological patients. The most used combo regimens were caspofungin + voriconazole (ORR 80%) and caspofungin + L-AmB (ORR 70%). The ORR was 73% and the mortality IFD related was 17%. PMN recovery during combo predicts a favourable outcome. Clinical Trials Registration: NCT00906633.
Published: 2014

39. Outcome of 122 pregnancies in essential thrombocythemia patients: A report from the Italian registry

Author: Melillo, L., Tieghi, A., Candoni, A., Radaelli, F., Ciancia, R., Specchia, G., Martino, B., Scalzulli, P. R., Latagliata, R., Palmieri, F., Usala, E., Valente, D., Valvano, M. R., Cedrone, M., Comitini, G., Martinelli, V., Cascavilla, N., Gugliotta, L., Fanin, R., Iurlo, A., Zanella, A., Rotoli, B., Carluccio, P., Liso, V., Nobile, F., Santoro, C., Mazzucconi, M. G., Cantore, N., Angelucci, E., Annino, L., Cacciola, E., Cacciola, R., Giustolisi, R., Fanci, R., Bosi, A., Frungillo, N., Corradini, P., Patriarca, A., Dragani, A., De Muro, M., and Avvisati, G.
Subjects: Adult, Pediatrics, medicine.medical_specialty, Multivariate analysis, Adolescent, Alpha interferon, Abortion, Young Adult, Pregnancy, medicine, Humans, Registries, Retrospective Studies, Aspirin, Platelet Count, business.industry, Essential thrombocythemia, Obstetrics, Pregnancy Outcome, Retrospective cohort study, Hematology, Janus Kinase 2, Middle Aged, medicine.disease, Recombinant Proteins, Pregnancy Complications, Parity, Italy, Interferon Type I, Multivariate Analysis, Mutation, Gestation, Female, business, Live birth, Thrombocythemia, Essential
Abstract: Pregnancy is a high-risk event in women with essential thrombocythemia (ET). This observational study evaluated pregnancy outcome in ET patients focusing on the potential impact of aspirin (ASA) or interferon alpha (IFN) treatment during pregnancy. We retrospectively analyzed 122 pregnancies in 92 women consecutively observed in the last 10 years in 17 centers of the Italian thrombocythemia registry (RIT). The live birth rate was 75.4% (92/122 pregnancies). The risk of spontaneous abortion was 2.5-fold higher than in the control population (P < 0.01). ASA did not affect the live birth rate (71/93, 76.3% vs. 21/29, 72.4%, P = 0.67). However, IFN treatment during pregnancy was associated with a better outcome than was management without IFN (live births 19/20, 95% vs. 73/102, 71.6%, P = 0.025), and this finding was supported by multivariate analysis (OR: 0.10; 95% CI: 0.013-0.846, P = 0.034). The JAK2 V617F mutation was associated with a poorer outcome (fetal losses JAK2 V617F positive 9/25, 36% vs. wild type 2/24, 8.3%, P = 0.037), and this association was still significant after multivariate analysis (OR: 6.19; 95% CI: 1.17-32.61; P = 0.038). No outcome concordance between first and second pregnancies was found (P = 0.30). Maternal complications occurred in 8% of cases. In this retrospective study, in consecutively observed pregnant ET patients, IFN treatment was associated with a higher live birth rate, while ASA treatment was not. In addition, the JAK2 V617F mutation was confirmed to be an adverse prognostic factor.
Published: 2009

40. Pre-chemotherapy risk factors for invasive fungal diseases: prospective analysis of 1,192 patients with newly diagnosed acute myeloid leukemia (SEIFEM 2010-a multicenter study)

Author: Caira, M., Candoni, A., Verga, L., Busca, A., Delia, M., Nosari, A., Caramatti, C., Castagnola, C., Cattaneo, C., Fanci, R., Chierichini, A., Melillo, L., Mitra, M. E., Picardi, M., Potenza, L., Salutari, P., Vianelli, N., Facchini, L., Cesarini, M., De Paolis, M. R., Di Blasi, R., Farina, F., Venditti, A., Ferrari, A., Garzia, M., Gasbarrino, C., Invernizzi, R., Lessi, F., Manna, A., Martino, B., Nadali, G., Offidani, M., Paris, L., Pavone, V., Rossi, G., Spadea, A., Specchia, G., Trecarichi, E. M., Vacca, A., Cesaro, S., Perriello, V., Aversa, F., Tumbarello, M., Pagano, L., Ragionieri, R., Orsola Malpighi, O. S., Antoniazzi, F., Storti, S., Luppi, M., Pagliuca, S., Rossetti, E., Da Vià, M., Di Caprio, L., Majolino, I., Cascavilla, N., Turri, G., Fanin, Renato, Sorveglianza Epidemiologica Infezioni Fungine in Emopatie Maligne, Caira, Morena, Candoni, Anna, Verga, Luisa, Busca, Alessandro, Delia, Mario, Nosari, Annamaria, Caramatti, Cecilia, Castagnola, Carlo, Cattaneo, Chiara, Fanci, Rosa, Chierichini, Anna, Melillo, Lorella, Mitra, Maria Enza, Picardi, Marco, Potenza, Leonardo, Salutari, Prassede, Vianelli, Nicola, Facchini, Luca, Cesarini, Monica, De Paolis, Maria Rosaria, Di Blasi, Roberta, Farina, Francesca, Venditti, Adriano, Ferrari, Antonella, Garzia, Mariagrazia, Gasbarrino, Cristina, Invernizzi, Rosangela, Lessi, Federica, Manna, Annunziata, Martino, Bruno, Nadali, Gianpaolo, Offidani, Massimo, Paris, Laura, Pavone, Vincenzo, Rossi, Giuseppe, Spadea, Antonio, Specchia, Giorgina, Trecarichi, Enrico Maria, Vacca, Adriana, Cesaro, Simone, Perriello, Vincenzo, Aversa, Franco, Tumbarello, Mario, and Pagano, Livio
Subjects: Myeloid, Male, Antifungal Agents, invasive fungal diseases, Mycose, Risk Factors, Epidemiology, Antineoplastic Combined Chemotherapy Protocols, Antifungal Agent, Prospective Studies, Prospective cohort study, Univariate analysis, leukemia, Myeloid leukemia, Hematology, Environmental exposure, Articles, Middle Aged, Prognosis, Survival Rate, Leukemia, Leukemia, Myeloid, Acute, Female, Case-Control Studie, Human, Adult, medicine.medical_specialty, Prognosi, risk factors, acute myeloid leukemia, Neutropenia, Acute, Settore MED/17 - MALATTIE INFETTIVE, Aged, Case-Control Studies, Follow-Up Studies, Humans, Mycoses, Neoplasm Staging, Immunocompromised Host, Follow-Up Studie, Internal medicine, medicine, Antineoplastic Combined Chemotherapy Protocol, Performance status, business.industry, Risk Factor, medicine.disease, Surgery, Prospective Studie, Settore MED/15 - MALATTIE DEL SANGUE, Fungal Disease, business
Abstract: Correct definition of the level of risk of invasive fungal infections is the first step in improving the targeting of preventive strategies. We investigated the potential relationship between pre-hospitalization exposure to sources of fungi and the development of invasive fungal infections in adult patients with newly diagnosed acute myeloid leukemia after their first course of chemotherapy. From January 2010 to April 2012, all consecutive acute myeloid leukemia patients in 33 Italian centers were prospectively registered. Upon first admission, information about possible pre-chemotherapy risk factors and environmental exposure was collected. We recorded data regarding comorbid conditions, employment, hygienic habits, working and living environment, personal habits, hobbies, and pets. All invasive fungal infections occurring within 30 days after the first course of chemotherapy were recorded. Of the 1,192 patients enrolled in this study, 881 received intensive chemotherapy and were included in the present analysis. Of these, 214 developed an invasive fungal infection, including 77 proven/probable cases (8.7%). Of these 77 cases, 54 were proven/probable invasive mold infections (6.1%) and 23 were proven yeast infections (2.6%). Upon univariate analysis, a significant association was found between invasive mold infections and age, performance status, diabetes, chronic obstructive pulmonary disease, smoking, cocaine use, job, hobbies, and a recent house renovation. Higher body weight resulted in a reduced risk of invasive mold infections. Multivariate analysis confirmed the role of performance status, job, body weight, chronic obstructive pulmonary disease, and house renovation. In conclusion, several hospital-independent variables could potentially influence the onset of invasive mold infections in patients with acute myeloid leukemia. Investigation of these factors upon first admission may help to define a patient's risk category and improve targeted prophylactic strategies. (Clinicaltrial.gov: NCT01315925)
Published: 2015

41. Studio prospettico, multicentrico, osservazionale sugli eventi febbrili nelle leucemie linfoblastiche acute

Author: Di Blasi, R, Lewis, Re, Busca, A, Candoni, A, Caramatti, C, Cattaneo, C, Cesarini, M, Cesaro, Simone, Delia, M, Dragonetti, G, Fanci, R, Garzia, Mg, Giordano, A, Martino, B, Melillo, L, Nadali, G, Offidani, M, Perriello, V, Picardi, M, Quinro, Am, Salutari, P, Vacca, A, Vetro, C, Zancanella, M, and Pagano, L.
Subjects: neutropenia febbrile, neutropenia febbrile, terapia empirica, leucemia, terapia empirica, leucemia
Published: 2014

42. Studio prospettico, multicentrico, osservazionale sugli eventi febbrili fungini nelle leucemie linfoblastiche acute

Author: Di Blasi, R., Lewis, R. E., Busca, A., Candoni, A., Caramatti, C., Cattaneo, C., Cesarini, M., Cesaro, Simone, Delia, M., Dragonetti, G., Fanci, R., Garzia, M. G., Giordano, A., Martino, B., Melillo, L., Nadali, G., Offidani, M., Perriello, V., Picardi, M., Quinto, A. M., Salutari, P., Vacca, A., Vetro, C., Zancanella, M., and Pagano, L.
Subjects: leucemia linfoblastica acuta, Febbre, Infezioni fungine
Published: 2014

43. Beneficial Effects of Applying Low-Level Laser Therapy to Surgical Wounds After Bariatric Surgery

Author: Ojea, Alecsander R., primary, Madi, Otavio, additional, Neto, Rafael Melillo L., additional, Lima, Sizenando E., additional, de Carvalho, Bruno T., additional, Ojea, Maria Juliana M.R., additional, Marcos, Rodrigo L., additional, da Silva, Fabricio S., additional, Zamuner, Stella R., additional, and Chavantes, Maria Cristina, additional
Published: 2016
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44. Pre-chemotherapy risk factors for invasive fungal diseases: prospective analysis of 1,192 patients with newly diagnosed acute myeloid leukemia (SEIFEM 2010-a multicenter study)

Author: CAIRA, MORENA, Candoni, A, Verga, L, Busca, A, Delia, M, Nosari, A, Caramatti, C, Castagnola, C, Cattaneo, C, Fanci, R, Chierichini, A, Melillo, L, Mitra, ME, Picardi, M, Potenza, L, Salutari, P, Vianelli, N, Facchini, L, Cesarini, M, De Paolis, MR, Di Blasi, R, Farina, F, Venditti, A, Ferrari, A, Garzia, M, Gasbarrino, C, Invernizzi, R, Lessi, F, Manna, A, Martino, B, Nadali, G, Offidani, M, Paris, L, Pavone, V, Rossi, G, Spadea, A, Specchia, G, Trecarichi, EM, Vacca, A, Cesaro, S, Perriello, V, Aversa, F, TUMBARELLO, MARIO, PAGANO, LIVIO, CAIRA, MORENA, Candoni, A, Verga, L, Busca, A, Delia, M, Nosari, A, Caramatti, C, Castagnola, C, Cattaneo, C, Fanci, R, Chierichini, A, Melillo, L, Mitra, ME, Picardi, M, Potenza, L, Salutari, P, Vianelli, N, Facchini, L, Cesarini, M, De Paolis, MR, Di Blasi, R, Farina, F, Venditti, A, Ferrari, A, Garzia, M, Gasbarrino, C, Invernizzi, R, Lessi, F, Manna, A, Martino, B, Nadali, G, Offidani, M, Paris, L, Pavone, V, Rossi, G, Spadea, A, Specchia, G, Trecarichi, EM, Vacca, A, Cesaro, S, Perriello, V, Aversa, F, TUMBARELLO, MARIO, and PAGANO, LIVIO
Published: 2015

45. Risk of invasive fungal infection in patients affected by acute promyelocytic leukaemia. A report by the SEIFEM-D registry

Author: Pagano, Livio, Stamouli, M, Tumbarello, Mario, Verga, L, Candoni, A, Cattaneo, C, Nadali, G, Mitra, Me, Mancini, V, Nosari, A, Garzia, Mg, Delia, M, Storti, S, Spadea, A, Caramatti, C, Perriello, V, Sanna, M, Vacca, A, De Paolis, Mr, Potenza, L, Salutari, P, Castagnola, C, Fanci, R, Chierichini, A, Melillo, L, Picardi, M, Facchini, L, Martino, B, Di Blasi, R, Cesarini, M, Offidani, M, Vianelli, N, Caira, M, Lessi, F, Ferrari, A, Venditti, A, Pavone, V, Lo Coco, F, Aversa, F, Busca, A., Pagano, Livio (ORCID:0000-0001-8287-928X), Tumbarello, Mario (ORCID:0000-0002-9519-8552), Storti, S (ORCID:0000-0002-4374-3985), Pagano, Livio, Stamouli, M, Tumbarello, Mario, Verga, L, Candoni, A, Cattaneo, C, Nadali, G, Mitra, Me, Mancini, V, Nosari, A, Garzia, Mg, Delia, M, Storti, S, Spadea, A, Caramatti, C, Perriello, V, Sanna, M, Vacca, A, De Paolis, Mr, Potenza, L, Salutari, P, Castagnola, C, Fanci, R, Chierichini, A, Melillo, L, Picardi, M, Facchini, L, Martino, B, Di Blasi, R, Cesarini, M, Offidani, M, Vianelli, N, Caira, M, Lessi, F, Ferrari, A, Venditti, A, Pavone, V, Lo Coco, F, Aversa, F, Busca, A., Pagano, Livio (ORCID:0000-0001-8287-928X), Tumbarello, Mario (ORCID:0000-0002-9519-8552), and Storti, S (ORCID:0000-0002-4374-3985)
Published: 2015

46. Pre-chemotherapy risk factors for invasive fungal diseases: prospective analysis of 1,192 patients with newly diagnosed acute myeloid leukemia (SEIFEM 2010-a multicenter study)

Author: Caira, M, Candoni, A, Verga, L, Busca, A, Delia, M, Nosari, A, Caramatti, C, Castagnola, C, Cattaneo, C, Fanci, R, Chierichini, A, Melillo, L, Mitra, Me, Picardi, M, Potenza, L, Salutari, P, Vianelli, N, Facchini, L, Cesarini, M, De Paolis, Mr, Di Blasi, R, Farina, F, Venditti, A, Ferrari, A, Garzia, M, Gasbarrino, C, Invernizzi, R, Lessi, F, Manna, A, Martino, B, Nadali, G, Offidani, M, Paris, L, Pavone, V, Rossi, G, Spadea, A, Specchia, G, Trecarichi, Em, Vacca, A, Cesaro, S, Perriello, V, Aversa, F, Tumbarello, Mario, Pagano, Livio, Tumbarello, M (ORCID:0000-0002-9519-8552), Pagano, Livio (ORCID:0000-0001-8287-928X), Caira, M, Candoni, A, Verga, L, Busca, A, Delia, M, Nosari, A, Caramatti, C, Castagnola, C, Cattaneo, C, Fanci, R, Chierichini, A, Melillo, L, Mitra, Me, Picardi, M, Potenza, L, Salutari, P, Vianelli, N, Facchini, L, Cesarini, M, De Paolis, Mr, Di Blasi, R, Farina, F, Venditti, A, Ferrari, A, Garzia, M, Gasbarrino, C, Invernizzi, R, Lessi, F, Manna, A, Martino, B, Nadali, G, Offidani, M, Paris, L, Pavone, V, Rossi, G, Spadea, A, Specchia, G, Trecarichi, Em, Vacca, A, Cesaro, S, Perriello, V, Aversa, F, Tumbarello, Mario, Pagano, Livio, Tumbarello, M (ORCID:0000-0002-9519-8552), and Pagano, Livio (ORCID:0000-0001-8287-928X)
Abstract: Correct definition of the level of risk of invasive fungal infections is the first step in improving the targeting of preventive strategies. We investigated the potential relationship between pre-hospitalization exposure to sources of fungi and the development of invasive fungal infections in adult patients with newly diagnosed acute myeloid leukemia after their first course of chemotherapy. From January 2010 to April 2012, all consecutive acute myeloid leukemia patients in 33 Italian centers were prospectively registered. Upon first admission, information about possible pre-chemotherapy risk factors and environmental exposure was collected. We recorded data regarding comorbid conditions, employment, hygienic habits, working and living environment, personal habits, hobbies, and pets. All invasive fungal infections occurring within 30 days after the first course of chemotherapy were recorded. Of the 1,192 patients enrolled in this study, 881 received intensive chemotherapy and were included in the present analysis. Of these, 214 developed an invasive fungal infection, including 77 proven/probable cases (8.7%). Of these 77 cases, 54 were proven/probable invasive mold infections (6.1%) and 23 were proven yeast infections (2.6%). Upon univariate analysis, a significant association was found between invasive mold infections and age, performance status, diabetes, chronic obstructive pulmonary disease, smoking, cocaine use, job, hobbies, and a recent house renovation. Higher body weight resulted in a reduced risk of invasive mold infections. Multivariate analysis confirmed the role of performance status, job, body weight, chronic obstructive pulmonary disease, and house renovation. In conclusion, several hospital-independent variables could potentially influence the onset of invasive mold infections in patients with acute myeloid leukemia. Investigation of these factors upon first admission may help to define a patient's risk category and improve targeted prophylactic stra
Published: 2015

47. Extended-chain crystals: VIII. Morphology of polytetrafluoroethylene

Author: Melillo, L. and Wunderlich, B.
Published: 1972
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48. Infections caused by filamentous fungi in patients with hematologic malignancies. A report of 391 cases by GIMEMA Infection Program

Author: Pagano L, Girmenia C, Mele L, Ricci P, Tosti ME, Nosari A, Buelli M, Allione B, Corvatta L, D'Antonio D, Montillo M, Melillo L, Chierichini A, Cenacchi A, Tonso A, Cudillo L, Candoni A, Savignano C, Bonini A, Martino P, Del Favero A, GIMEMA Infection Program, Gruppo Italiano Malattie Ematologiche dell'Adulto, PICARDI, MARCO, Pagano, L, Girmenia, C, Mele, L, Ricci, P, Tosti, Me, Nosari, A, Buelli, M, Picardi, Marco, Allione, B, Corvatta, L, D'Antonio, D, Montillo, M, Melillo, L, Chierichini, A, Cenacchi, A, Tonso, A, Cudillo, L, Candoni, A, Savignano, C, Bonini, A, Martino, P, Del Favero, A, GIMEMA Infection, Program, and Gruppo Italiano Malattie Ematologiche, Dell'Adulto
Subjects: Adult, Aged, 80 and over, Male, Leukemia, Adolescent, Fungi, Filamentous fungi infection, Middle Aged, Prognosis, Survival Rate, Aspergillus, Treatment Outcome, Mycoses, Risk Factors, Hematologic Neoplasms, Humans, Hematologic malignancies, Female, Prospective Studies, Child, Aged, Retrospective Studies
Abstract: BACKGROUND AND OBJECTIVES: To evaluate the clinical characteristics of patients with hematologic malignancies developing a filamentous fungi infection (FFI) and to define the prognostic factors for their outcome. DESIGN AND METHODS: A retrospective study, conducted on patients admitted to 14 Hematology divisions of tertiary care or university hospitals, participating in the GIMEMA Infection Program, over a ten-year period (1988-1997). The study included patients with hematological malignancies and a histologically and/or microbiologically proven or probable FFI. RESULTS: We included 391 patients (male/female: 262/129, median age 49 years) with hematologic malignancies (225 acute myeloid leukemia, 67 acute lymphocytic leukemia, 30 chronic myeloid leukemia, 22 non-Hodgkin's lymphoma, 12 myelodysplastic syndrome, 10 aplastic anemia, 7 Hodgkin's disease, 8 chronic lymphocytic leukemia, 5 multiple myeloma, and 5 hairy cell leukemia) who developed a proven FFI. Eighty percent of the patients had been neutropenic for an average of 14 days before the infection, and 71% had an absolute neutrophil count lower than 0.5 x 10(9)/L at the time of FFI diagnosis. The primary sites of infection were: lungs (85%), nose and paranasal sinus (10%), and other sites (5%). The diagnosis was made while still alive in 310 patients (79%), and at autopsy in the remaining 81 patients (21%). Chest X-ray was diagnostic in 77% of patients with pulmonary FFI, while computed tomography (CT) scan of the thorax was positive in 95% of cases. A significant diagnostic advantage for CT scan was observed in 145 patients who had both a chest X-ray and CT scan. Aspergillus was identified as the cause of FFI in 296 patients, Mucorales in 45 patients, Fusarium in 6 patients and other filamentous fungi species in 4 patients, while in a further 40 patients no agent was identifiable. The overall mortality rate three months after the diagnosis of FFI was 74%, and fungal infection had been the cause of death in 51% of patients. INTERPRETATION AND CONCLUSIONS: Our retrospective study shows that FFI still remains a life-threatening complication in neutropenic patients. Despite appropriate treatment, half of the patients die due to this complication. The use of glucocorticoids and recovery from neutropenia are the most important prognostic factors. Mucorales infections are associated with a significantly poorer prognosis than those due to Aspergillus spp.
Published: 2001

49. Comparative molecular analysis of therapy-related and de novo acute promyelocytic leukemia

Author: Ottone, T., Cicconi, L., Hasan, S.K., Lavorgna, S., Divona, M., Voso, M.T., Montefusco, E., Melillo, L., Barragán, E., Platzbecker, U., Giannì, L., Hubmann, M., Pagoni, M., Amadori, S., and Lo-Coco, F.
Published: 2012
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50. Evaluation of the Practice of Antifungal Prophylaxis Use in Patients With Newly Diagnosed Acute Myeloid Leukemia: Results From the SEIFEM 2010-B Registry

Author: Pagano, L, Caira, M, Candoni, A, Aversa, F, Castagnola, C, Caramatti, C, Cattaneo, C, Delia, M, De Paolis MR, Di Blasi, R, Di Caprio, L, Fanci, R, Garzia, M, Martino, B, Melillo, L, Mitra, Me, Nadali, Gianpaolo, Nosari, A, Picardi, M, Potenza, L, Salutari, P, Trecarichi, Em, Tumbarello, M, Verga, L, Vianelli, N, Busca, A, Seifem, Group, L., Pagano, M., Caira, A., Candoni, F., Aversa, C., Castagnola, C., Caramatti, C., Cattaneo, M., Delia, M. R., De Paoli, R., Di Blasi, L., Di Caprio, R., Fanci, M., Garzia, B., Martino, L., Melillo, M. E., Mitra, G., Nadali, A., Nosari, Picardi, Marco, L., Potenza, P., Salutari, E. M., Trecarichi, M., Tumbarello, L., Verga, N., Vianelli, and A., Busca
Subjects: Microbiology (medical), Myeloid, Male, medicine.medical_specialty, Posaconazole, Antifungal Agents, Itraconazole, SEIFEM, Acute, acute myeloid leukemia, Settore MED/17 - MALATTIE INFETTIVE, antifungal prophylaxis, Internal medicine, medicine, Humans, Aged, Female, Leukemia, Myeloid, Acute, Middle Aged, Mycoses, Triazoles, Leukemia, antigungal prophylaxis, business.industry, Mortality rate, Incidence (epidemiology), SEIFEM 2010-B registry, antifungal agents, PROPHYLAXIS, Chemotherapy regimen, Surgery, invasive fungal disease, Clinical trial, Settore MED/15 - MALATTIE DEL SANGUE, Infectious Diseases, medicine.anatomical_structure, business, Fluconazole, medicine.drug
Abstract: Background. To analyze the efficacy of antifungal prophylaxis (AFP) with posaconazole and itraconazole in a real-life setting of patients with acute myeloid leukemia (AML) during the first induction of remission. Methods. From January 2010 to June 2011, all patients with newly diagnosed AML were consecutively registered and prospectively monitored at 30 Italian hematological centers. Our analysis focused on adult patients who received intensive chemotherapy and a mold-active AFP for at least 5 days. To determine the efficacy of prophylaxis, invasive fungal disease (IFD) incidence, IFD-attributable mortality, and overall survival were evaluated. Results. In total, 515 patients were included in the present analysis. Posaconazole was the most frequently prescribed drug (260 patients [50%]) followed by fluconazole (148 [29%]) and itraconazole (93 [18%]). When comparing the groups taking posaconazole and itraconazole, there were no significant differences in the baseline clinical characteristics, whereas there were significant differences in the percentage of breakthrough IFDs (18.9% with posaconazole and 38.7% with itraconazole, P< .001). The same trend was observed when only proven/ probable mold infections were considered (posaconazole, 2.7% vs itraconazole, 10.7%, P= .02). There were no significant differences in the IFD-associated mortality rate, while posaconazole prophylaxis had a significant impact on overall survival at day 90 (P= .002). Conclusions. During the last years, the use of posaconazole prophylaxis in high-risk patients has significantly increased. Although our study was not randomized, it demonstrates in a real-life setting that posaconazole prophylaxis confers an advantage in terms of both breakthrough IFDs and overall survival compared to itraconazole prophylaxis. Clinical Trials Registration. NCT01315925.
Published: 2012

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