Search

Your search keyword '"Perruccio K"' showing total 185 results
Start Over Author "Perruccio K"
185 results on '"Perruccio K"'

1. HLA-haploidentical hematopoietic stem cells transplantation with regulatory and conventional T-cell adoptive immunotherapy in pediatric patients with very high-risk acute leukemia

Author

Massei, M. S., Capolsini, I., Mastrodicasa, E., Perruccio, K., Arcioni, F., Cerri, C., Gurdo, G., Sciabolacci, S., Falzetti, F., Zei, T., Iacucci Ostini, R., Brogna, M., Panizza, B. M., Saldi, S., Merluzzi, M., Tognellini, R., Marchesi, M., Minelli, O., Aristei, C., Velardi, A., Pierini, A., Ruggeri, L., Martelli, M. F., Carotti, A., and Caniglia, M.

Published
2023
Full Text
View/download PDF

2. An expert consensus on prevention, diagnosis, and management of hemorrhagic cystitis in pediatric hematopoietic cell transplantation, on behalf of the Infectious Disease and Hematopoietic Cell Transplant Working groups of Italian Pediatric Hematology Oncology Association (AIEOP)

Author

Dell'Orso, G, Carlucci, M, Cesaro, S, Olcese, E, Balduzzi, A, Vendemini, F, Catti, M, Saglio, F, Compagno, F, Maximova, N, Rabusin, M, Menconi, M, Perruccio, K, Soncini, E, Tambaro, F, Tintori, V, Pagliara, D, Faraci, M, Dell'Orso G., Carlucci M., Cesaro S., Olcese E., Balduzzi A., Vendemini F., Catti M., Saglio F., Compagno F., Maximova N., Rabusin M., Menconi M. C., Perruccio K., Soncini E., Tambaro F. P., Tintori V., Pagliara D., Faraci M., Dell'Orso, G, Carlucci, M, Cesaro, S, Olcese, E, Balduzzi, A, Vendemini, F, Catti, M, Saglio, F, Compagno, F, Maximova, N, Rabusin, M, Menconi, M, Perruccio, K, Soncini, E, Tambaro, F, Tintori, V, Pagliara, D, Faraci, M, Dell'Orso G., Carlucci M., Cesaro S., Olcese E., Balduzzi A., Vendemini F., Catti M., Saglio F., Compagno F., Maximova N., Rabusin M., Menconi M. C., Perruccio K., Soncini E., Tambaro F. P., Tintori V., Pagliara D., and Faraci M.

Abstract

The optimal management of hemorrhagic cystitis (HC) in hematopoietic stem cell transplantation (HCT) is debated, both for early onset HC (EOHC) secondary to chemotherapy toxicity and BK Polyomavirus (BKPyV)-related HC, due to the lack of controlled trials, particularly referred to pediatric setting. Actually, clinical practice is mainly based on guidelines of the European Conference on Infections in Leukemia, 6th edition, which considers both adult and pediatric populations but concludes that, despite much progress in understanding the pathogenesis, epidemiology, and risk factors, this complication still represents a disabling unmet clinical need with limited prophylactic and therapeutic options. Additionally, the Guidelines of the American Society of Clinical Oncology define the management of chemotherapeutic toxicity independently from the patients’ population. A panel of experts belonging to the Hematopoietic Cell Transplant and Infectious Disease Working Group (WG) of Associazione Italiana di Emato-Oncologia Pediatrica (AIEOP) developed a consensus to define the best practices in prevention, diagnosis, and management of HC in pediatric HCT setting.

Published
2024

3. Quantitative diffusion-weighted MRI response assessment in rhabdomyosarcoma: an international retrospective study on behalf of the European paediatric Soft tissue sarcoma Study Group Imaging Committee.

Author

Ewijk, R. van, Chatziantoniou, C., Adams, M., Bertolini, P., Bisogno, G., Bouhamama, A., Caro-Dominguez, P., Charon, V., Coma, A., Dandis, R., Devalck, C., Donno, G. De, Ferrari, Andrea, Fiocco, M., Gallego, S., Giraudo, C., Glosli, H., Horst, S.A.J. Ter, Jenney, M., Klein, W.M., Leemans, A., Leseur, J., Mandeville, H.C., McHugh, K., Merks, J.H.M., Minard-Colin, V., Moalla, S., Morosi, C., Orbach, D., Ording Muller, L.S., Pace, E., Paolo, P.L. Di, Perruccio, K., Quaglietta, L., Renard, M., Rijn, R.R. van, Ruggiero, A., Sirvent, S.I., Luca, A. De, Schoot, R.A., Ewijk, R. van, Chatziantoniou, C., Adams, M., Bertolini, P., Bisogno, G., Bouhamama, A., Caro-Dominguez, P., Charon, V., Coma, A., Dandis, R., Devalck, C., Donno, G. De, Ferrari, Andrea, Fiocco, M., Gallego, S., Giraudo, C., Glosli, H., Horst, S.A.J. Ter, Jenney, M., Klein, W.M., Leemans, A., Leseur, J., Mandeville, H.C., McHugh, K., Merks, J.H.M., Minard-Colin, V., Moalla, S., Morosi, C., Orbach, D., Ording Muller, L.S., Pace, E., Paolo, P.L. Di, Perruccio, K., Quaglietta, L., Renard, M., Rijn, R.R. van, Ruggiero, A., Sirvent, S.I., Luca, A. De, and Schoot, R.A.

Abstract

Contains fulltext : 300161.pdf (Publisher’s version ) (Open Access), OBJECTIVE: To investigate the feasibility of diffusion-weighted magnetic resonance imaging (DW-MRI) as a predictive imaging marker after neoadjuvant chemotherapy in patients with rhabdomyosarcoma. MATERIAL AND METHODS: We performed a multicenter retrospective study including pediatric, adolescent and young adult patients with rhabdomyosarcoma, Intergroup Rhabdomyosarcoma Study group III/IV, treated according to the European paediatric Soft tissue sarcoma Study Group (EpSSG) RMS2005 or MTS2008 studies. DW-MRI was performed according to institutional protocols. We performed two-dimensional single-slice tumor delineation. Areas of necrosis or hemorrhage were delineated to be excluded in the primary analysis. Mean, median and 5th and 95th apparent diffusion coefficient (ADC) were extracted. RESULTS: Of 134 included patients, 82 had measurable tumor at diagnosis and response and DW-MRI scans of adequate quality and were included in the analysis. Technical heterogeneity in scan acquisition protocols and scanners was observed. Mean ADC at diagnosis was 1.1 (95% confidence interval [CI]: 1.1-1.2) (all ADC expressed in * 10(-3) mm(2)/s), versus 1.6 (1.5-1.6) at response assessment. The 5th percentile ADC was 0.8 (0.7-0.9) at diagnosis and 1.1 (1.0-1.2) at response. Absolute change in mean ADC after neoadjuvant chemotherapy was 0.4 (0.3-0.5). Exploratory analyses for association between ADC and clinical parameters showed a significant difference in mean ADC at diagnosis for alveolar versus embryonal histology. Landmark analysis at nine weeks after the date of diagnosis showed no significant association (hazard ratio 1.3 [0.6-3.2]) between the mean ADC change and event-free survival. CONCLUSION: A significant change in the 5th percentile and the mean ADC after chemotherapy was observed. Strong heterogeneity was identified in DW-MRI acquisition protocols between centers and in individual patients., 01 november 2023

Published
2023

4. GD2-CART01 for Relapsed or Refractory High-Risk Neuroblastoma

Author

Del Bufalo, F., De Angelis, B., Caruana, I., Del Baldo, G., De Ioris, M. A., Serra, A., Mastronuzzi, A., Cefalo, M. G., Pagliara, D., Amicucci, M., Li Pira, G., Leone, G., Bertaina, V., Sinibaldi, M., Di Cecca, S., Guercio, M., Abbaszadeh, Z., Iaffaldano, L., Gunetti, M., Iacovelli, S., Bugianesi, R., Macchia, S., Algeri, M., Merli, P., Galaverna, F., Abbas, R., Garganese, M. C., Villani, M. F., Colafati, G. S., Bonetti, F., Rabusin, M., Perruccio, K., Folsi, V., Quintarelli, C., Locatelli, Franco, Locatelli F. (ORCID:0000-0002-7976-3654), Del Bufalo, F., De Angelis, B., Caruana, I., Del Baldo, G., De Ioris, M. A., Serra, A., Mastronuzzi, A., Cefalo, M. G., Pagliara, D., Amicucci, M., Li Pira, G., Leone, G., Bertaina, V., Sinibaldi, M., Di Cecca, S., Guercio, M., Abbaszadeh, Z., Iaffaldano, L., Gunetti, M., Iacovelli, S., Bugianesi, R., Macchia, S., Algeri, M., Merli, P., Galaverna, F., Abbas, R., Garganese, M. C., Villani, M. F., Colafati, G. S., Bonetti, F., Rabusin, M., Perruccio, K., Folsi, V., Quintarelli, C., Locatelli, Franco, and Locatelli F. (ORCID:0000-0002-7976-3654)

Abstract

Background: Immunotherapy with chimeric antigen receptor (CAR)-expressing T cells that target the disialoganglioside GD2 expressed on tumor cells may be a therapeutic option for patients with high-risk neuroblastoma. Methods: In an academic, phase 1-2 clinical trial, we enrolled patients (1 to 25 years of age) with relapsed or refractory, high-risk neuroblastoma in order to test autologous, third-generation GD2-CAR T cells expressing the inducible caspase 9 suicide gene (GD2-CART01). Results: A total of 27 children with heavily pretreated neuroblastoma (12 with refractory disease, 14 with relapsed disease, and 1 with a complete response at the end of first-line therapy) were enrolled and received GD2-CART01. No failure to generate GD2-CART01 was observed. Three dose levels were tested (3-, 6-, and 10×106 CAR-positive T cells per kilogram of body weight) in the phase 1 portion of the trial, and no dose-limiting toxic effects were recorded; the recommended dose for the phase 2 portion of the trial was 10×106 CAR-positive T cells per kilogram. Cytokine release syndrome occurred in 20 of 27 patients (74%) and was mild in 19 of 20 (95%). In 1 patient, the suicide gene was activated, with rapid elimination of GD2-CART01. GD2-targeted CAR T cells expanded in vivo and were detectable in peripheral blood in 26 of 27 patients up to 30 months after infusion (median persistence, 3 months; range, 1 to 30). Seventeen children had a response to the treatment (overall response, 63%); 9 patients had a complete response, and 8 had a partial response. Among the patients who received the recommended dose, the 3-year overall survival and event-free survival were 60% and 36%, respectively. Conclusions: The use of GD2-CART01 was feasible and safe in treating high-risk neuroblastoma. Treatment-related toxic effects developed, and the activation of the suicide gene controlled side effects. GD2-CART01 may have a sustained antitumor effect. (Funded by the Italian Medicines Agency and others

Published
2023

5. Antibiotic prophylaxis and management of infections in pediatric hematopoietic stem cell transplantation: a survey from the Stem Cell Transplant and the Infectious Disease Working Groups of the AIEOP network

Author

Zama, D., Masetti, R., Baccelli, F., Leardini, D., Muratore, E., Abram, N., Vendemini, F., Biffi, A., Perruccio, K., D'Amico, M. R., Faraci, M., Tintori, V., Spirito, A., Lo Nigro, L., Locatelli, Franco, Luksch, R., Saglio, F., Santoro, N., Soncini, E., Zecca, M., Ziino, O., Prete, A., Pagliara, D., Cesaro, S., Locatelli F. (ORCID:0000-0002-7976-3654), Zama, D., Masetti, R., Baccelli, F., Leardini, D., Muratore, E., Abram, N., Vendemini, F., Biffi, A., Perruccio, K., D'Amico, M. R., Faraci, M., Tintori, V., Spirito, A., Lo Nigro, L., Locatelli, Franco, Luksch, R., Saglio, F., Santoro, N., Soncini, E., Zecca, M., Ziino, O., Prete, A., Pagliara, D., Cesaro, S., and Locatelli F. (ORCID:0000-0002-7976-3654)

Abstract

NO ABSTRACT

Published
2022

6. Safety and efficacy of brincidofovir for Adenovirus infection in children receiving allogeneic stem cell transplantation: an AIEOP retrospective analyses

Author

Perruccio, K., Menconi, M., Galaverna, F., Pagliara, D., Carraro, F., Fagioli, F., Calore, E., Biffi, A., Baretta, V., Massei, M. S., Capolsini, I., Faraci, M., Verna, M., Soncini, E., Caniglia, M., Locatelli, Franco, and Cesaro, S.

Subjects
Oncology, medicine.medical_specialty, allogeneic stem cell transpantaiton, Adenoviridae Infections, MEDLINE, Organophosphonates, Brincidofovir, allogeneic stem cell transpantaiton, adenovirus infection, Antiviral Agents, ADENOVIRUS, adenovirus infection, Cytosine, Internal medicine, medicine, Humans, Adenovirus infection, Retrospective Studies, Transplantation, business.industry, Hematopoietic Stem Cell Transplantation, Hematology, medicine.disease, Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA, HSCT, Stem cell, brincidofovir, business, medicine.drug
Published
2021

8. 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

9. 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

11. Lymphocyte-Predominant Hodgkin Lymphoma Variant: Long Term Outcome. Data From The Lh-2004 Protocol Of The Italian Association Of Pediatric Hematology And Oncology (Aieop)

Author

Mazzocco, M, additional, Mura, R, additional, De Santis, R, additional, Casini, T, additional, Porta, F, additional, Pierani, P, additional, Cellini, M, additional, Sau, A, additional, Verzegnassi, F, additional, Perruccio, K, additional, Cesaro, S, additional, Bertolini, P, additional, Pericoli, R, additional, Sperlì, D, additional, Mascarin, M, additional, and Burnelli, R, additional

Published
2020
Full Text
View/download PDF

12. HLA haplotype on outcomes in pediatric Hodgkin patients enrolled in the italian AIEOP-LH2004 trial

Author

De Re, V, additional, Caggiari, L, additional, De Zorzi, M, additional, Repetto, O, additional, Lovisa, F, additional, Gaffo, E, additional, Damanti, C C, additional, Mussolin, L, additional, d’Amore, E S, additional, Elia, C, additional, Pillon, M, additional, Muggeo, P, additional, Pierani, P, additional, Mura, R, additional, D’Amico, S, additional, Farruggia, P, additional, Vinti, L, additional, Casini, T, additional, Garaventa, A, additional, Perruccio, K, additional, Bernasconi, S, additional, Moleti, M L, additional, Burnelli, R, additional, and Mascarin, M, additional

Published
2020
Full Text
View/download PDF

13. The prognostic value of HLA-G genetic marker in paediatric Hodgkin lymphoma patients enrolled in the italian AIEOP-LH2004 trial

Author

De Re, V, additional, Caggiari, L, additional, De Zorzi, M, additional, Repetto, O, additional, Elia, C, additional, Lovisa, F, additional, Mussolin, L, additional, d’Amore, E S, additional, Pillon, M, additional, Muggeo, P, additional, Pierani, P, additional, Mura, R, additional, D’Amico, S, additional, Farruggia, P, additional, Vinti, L, additional, Casini, T, additional, Garaventa, A, additional, Perruccio, K, additional, Bernasconi, S, additional, Moleti, M L, additional, Burnelli, R, additional, and Mascarin, M, additional

Published
2020
Full Text
View/download PDF

14. A Case Series and Literature Review of Isavuconazole Use in Pediatric Patients with Hemato-oncologic Diseases and Hematopoietic Stem Cell Transplantation

Author

Decembrino, N., primary, Perruccio, K., additional, Zecca, M., additional, Colombini, A., additional, Calore, E., additional, Muggeo, P., additional, Soncini, E., additional, Comelli, A., additional, Molinaro, M., additional, Goffredo, B. M., additional, De Gregori, S., additional, Giardini, I., additional, Scudeller, L., additional, and Cesaro, S., additional

Published
2020
Full Text
View/download PDF

17. '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, Maria Ilaria, Dragonetti, Giulia, Verga, Luisa, Candoni, Anna, Marchesi, Francesco, Cattaneo, Chiara, Delia, Mario, Potenza, Leonardo, Farina, Francesca, Ballanti, Stelvio, Decembrino, Nunzia, Castagnola, Carlo, Nadali, Gianpaolo, Fanci, Rosa, Orciulo, Enrico, Veggia, Barbara, Offidani, Massimo, Melillo, Lorella, Manetta, Sara, Tumbarello, Mario, Venditti, Adriano, Busca, Alessandro, Aversa, Franco, Pagano, Livio, Picardi, M, Della Pepa, R, Ferrari, A, Piedimonte, M, Fracchiolla, Ns, Sciumè, M, Lessi, F, Prezioso, L, Spolzino, A, Rambaldi, B, Russo, D, Maracci, L, di Ematologia, C, Sarlo, C, Annibali, O, Cefalo, M, Zizzari, A, Di Blasi, R, di Ematologia, I, Zama, D, Mancini, V, Salutari, P, Cesaro, S, Chiara Tisi, M, Garzia, Mg, Vacca, A, Dargenio, M, Invernizzi, R, Perruccio, K, Mitra, Me, Quinto, Am, Chierichini, A, and Spadea, A.

Subjects
0301 basic medicine, Microbiology (medical), Adult, Male, medicine.medical_specialty, Antifungal Agents, AML, SEIFEM, Invasive Aspergillosis, consolidation therapy, antifumgal prophylaxis, antifungal therapy, 030106 microbiology, SEIFEM, antifumgal prophylaxis, Comorbidity, Aspergillosis, 03 medical and health sciences, 0302 clinical medicine, AML, Risk Factors, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, Medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, Prospective cohort study, Aged, Pharmacology, business.industry, Incidence (epidemiology), Mortality rate, Consolidation Chemotherapy, Induction Chemotherapy, Middle Aged, medicine.disease, antifungal therapy, Leukemia, Myeloid, Acute, Infectious Diseases, Number needed to treat, Cytarabine, Invasive Aspergillosis, Female, business, consolidation therapy, Settore MED/15 - Malattie del Sangue, Invasive Fungal Infections, medicine.drug
Abstract

Background We evaluated the incidence of proven/probable invasive aspergillosis (IA) and the role of antifungal prophylaxis (AP) in a 'real-life' setting of patients with AML receiving intensive consolidation therapy. Methods Cases of IA, observed during consolidation in adult/paediatric patients with AML between 2011 and 2015, were retrospectively collected in a multicentre Italian study. Results Of 2588 patients, 56 (2.2%) developed IA [43 probable (1.7%) and 13 proven (0.5%)]. IA was diagnosed in 34 of 1137 (2.9%) patients receiving no AP and in 22 of 1451 (1.5%) who were given AP (P = 0.01). Number-needed-to-treat calculation indicates that, on average, 71 patients should have received AP (instead of no AP) for one additional patient to not have IA. Initial antifungal therapy was 'pre-emptive' in 36 (64%) patients and 'targeted' in 20 (36%) patients. A good response to first-line therapy was observed in 26 (46%) patients, mainly those who received AP [16 of 22 (73%) versus 10 of 34 (29%); P = 0.001]. The overall mortality rate and the mortality rate attributable to IA by day 120 were 16% and 9%, respectively. In multivariate analysis, age ≥60 years (OR = 12.46, 95% CI = 1.13-136.73; P = 0.03) and high-dose cytarabine treatment (OR = 10.56, 95% CI = 1.95-116.74; P = 0.04) independently affected outcome. Conclusions In our experience, AP appears to prevent IA from occurring during consolidation. However, although the incidence of IA was low, mortality was not negligible among older patients. Further prospective studies should be carried out particularly in elderly patients treated with high-dose cytarabine to confirm our data and to identify subsets of individuals who may require AP.

Published
2019

18. 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

19. 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

23. Fungaemia in haematological malignancies: SEIFEM-2015 survey

Author

Criscuolo, M., Marchesi, F., Candoni, A., Cattaneo, C., Nosari, A., Veggia, B., Verga, L., Fracchiolla, N., Vianelli, N., Del Principe, M. I., Picardi, M., Tumbarello, M., Aversa, F., Busca, A., Pagano, L., Dragonetti, G., Ballanti, S., Delia, M., Nadali, G., Sciume, M., Castagnola, C., Ferrari, A., Mancini, V., Decembrino, N., Spolzino, A., Iovino, L., Martino, B., Vacca, A., Calore, E., Fanci, R., Lessi, F., Vallero, S., Zama, D., Cesaro, S., De Paolis, M. R., Facchini, L., Muggeo, P., Offidani, M., Perruccio, K., Russo, D., Criscuolo M, Marchesi F, Candoni A, Cattaneo C, Nosari A, Veggia B, Verga L, Fracchiolla N, Vianelli N, Del Principe MI, Picardi M, Tumbarello M, Aversa F, Busca A, Pagano L, SEIFEM Group: Giulia Dragonetti, Stelvio Ballanti, Mario Delia, Gianpaolo Nadali, Sciumè M, Castagnola C, Ferrari A, Mancini V, Decembrino N, Spolzino A, Iovino L, Martino B, Vacca A, Calore E, Fanci R, Lessi F, Vallero S, Zama D, Cesaro S, De Paolis M, Facchini L, Muggeo P, Offidani M, Perruccio K, Russo D., Criscuolo, Marianna, Marchesi, Francesco, Candoni, Anna, Cattaneo, Chiara, Nosari, Annamaria, Veggia, Barbara, Verga, Luisa, Fracchiolla, Nicola, Vianelli, Nicola, Del Principe, Maria Ilaria, Picardi, Marco, Tumbarello, Mario, Aversa, Franco, Busca, Alessandro, and Pagano, Livio

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Clinical Biochemistry, Prevalence, 030204 cardiovascular system & hematology, Biochemistry, Young Adult, 03 medical and health sciences, acute leukaemias, candidemia, fungaemia, 0302 clinical medicine, Risk Factors, Yeasts, Internal medicine, acute leukemias, Epidemiology, Fungemia, Hematological malignancies, medicine, Aged, Candidemia, Child, Female, Fungemia, Hematologic Neoplasms, Humans, Italy, Middle Aged, Prognosis, Retrospective Studies, acute leukemia, 030212 general & internal medicine, Cause of death, Hematology, business.industry, Septic shock, Mortality rate, General Medicine, bacterial infections and mycoses, medicine.disease, Settore MED/15 - MALATTIE DEL SANGUE, fungemia, business, Central venous catheter
Abstract

BACKGROUND: Fungal infections are still a relevant challenge for clinicians involved in the cure of patients with cancer. We retrospectively reviewed charts of hospitalized patients with hematological malignancies (HMs), in which a documented fungemia was diagnosed between January 2011 and December 2015 at 28 adult and 6 pediatric Italian Hematology Departments. METHODS: During the study period we recorded 215 fungal blood stream infections (BSI). Microbiological analyses documented that BSI was due to molds in 17 patients (8%) and yeasts in 198 patients (92%), being Candida spp identified in 174 patients (81%). RESULTS: Mortality rates were 70% and 39% for mold and yeast infections, respectively. Infection was the main cause of death in 53% of the mold and 18% of the yeast groups. At the multivariate analysis, ECOG ≥2 and septic shock were significantly associated with increased mortality, and removal of CVC survival was found to be protective. When considering patients with candidemia only, ECOG >2 and removal of CVC were statistically associated with overall mortality. CONCLUSIONS: Although candidemia represents a group of BSI with a good prognosis, its risk factors largely overlap with those identified for all fungemias, even though the candidemia-related mortality is lower when compared to other fungal BSI. Management of fungal BSI is still a complex issue, in which both patients and disease characteristics should be focused to address a personalized approach. This article is protected by copyright. All rights reserved.

Published
2019

27. 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
Full Text
View/download PDF

28. 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
Full Text
View/download PDF

31. Rischio di recidiva nel linfoma di Hodgkin pediatrico: dalla esperienza AIEOP ad una strategia europea

Author

Mascarin, M., Bernasconi, S., Bertolini, P., Bianchi, M., Buffardi, S., Casale, F., Casini, T., Cellini, M., Cesaro, S., Civino, A., Consarino, C., Cosmi, C., D’Amico, S., De Santis, R., Facchini, E., Fagioli, F., Farruggia, P., Favre, C., Felici, L., Galimberti, D., Garaventa, A., Iaria, G., Indolfi, P., Locatelli, F., Moleti, M. L., Muggeo, P., Mura, R. M., Pericoli, R., Perruccio, K., Pierani, P., Pillon, M., Porta, F., Provenzi, M., Rinieri, S., Rondelli, R., Russo, G., Sala, A., Santoro, N., Sau, A., Sperli, D., Todesco, A., Tolva, A., Varasso, G., Verzegnassi, F., Vinti, L., Zecca, M., Lopci, E., Elia, C., Birri, S., Sabattini, E., D’Amore, E., and Burnelli, R.

Subjects
pediatria, linfoma hodgkin, risultati, linfoma hodgkin, pediatria, risultati
Published
2017

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

Author

Girmenia, C, Bertaina, A, Piciocchi, A, Perruccio, K, Algarotti, A, Busca, A, Cattaneo, C, Raiola, Am, Guidi, S, Iori, Ap, Candoni, A, Irrera, G, Milone, G, Marcacci, G, Scimè, R, Musso, M, Cudillo, L, Sica, S, Castagna, L, Corradini, P, Marchesi, F, Pastore, D, Alessandrino, Ep, Annaloro, C, Ciceri, F, Santarone, S, Nassi, L, Farina, C, Viscoli, C, Rossolini, Gm, Bonifazi, F, Rambaldi, A, Capria, S, Mastronuzzi, A, Pagliara, D, Bernaschi, P, Amico, L, Carotti, A, Mencacci, A, Bruno, B, Costa, C, Passi, A, Ravizzola, G, Angelucci, E, Marchese, A, Pecile, P, Ventura, G, Fanin, R, Scarparo, C, Barbaro, A, Leotta, S, Marchese, Ae, Becchimanzi, C, Donnarumma, D, Tringali, S, Baldi, Mt, Scalone, R, Picardi, A, Arcese, W, Fontana, C, Giammarco, S, Spanu, T, Crocchiolo, R, Casari, E, Mussetti, A, Conte, E, Ensoli, F, Miragliotta, G, Marone, P, Arghittu, M, Greco, R, Forcina, A, Chichero, P, Di Bartolomeo, P, Fazii, P, Kroumova, V, Decembrino, N, Zecca, M, Pisapia, G, Palazzo, G, Lanino, E, Faraci, M, Castagnola, E, Bandettini, R, Pastano, R, Sammassimo, S, Passerini, R, Stefani, Pm, Gherlinzoni, F, Rigoli, R, Prezioso, L, Cambò, B, Calderaro, A, Carella, Am, Cascavilla, N, Labonia, Mt, Celeghini, I, Mordini, N, Piana, F, Vacca, A, Sanna, M, Podda, G, Corsetti, Mt, Rocchetti, A, Cilloni, D, De Gobbi, M, Bianco, O, Fagioli, F, Carraro, F, De Intinis, G, Severino, A, Proia, A, Parisi, G, Vallisa, D, Confalonieri, M, Russo, D, Malagola, M, Galieni, P, Falcioni, S, Travaglini, V, Raimondi, R, Borghero, C, Pavan, G, Prete, A, Belotti, T, Ambretti, S, Imola, M, Mianulli, Am, Pedna, Mf, Cesaro, S, Lo Cascio, G, Ferrari, A, Piedimonte, M, Santino, I, Calandrelli, M, Olivieri, A, Orecchioni, F, Mirabile, M, Centurioni, R, Gironacci, L, Caravelli, D, Gallo, S, De Filippi, M, Cupelli, L, Dentamaro, T, Falco, S, Eugenio, Os, Marotta, S, Risitano, A, Lula, D, Musto, P, Pietrantuono, G, Traficante, A, Cerchiara, E, Tirindelli, Mc, Dicuonzo, G, Chierichini, A, Anaclerico, B, and Placanica, P.

Published
2017

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

Author

Girmenia, C., Bertaina, A., Piciocchi, A., Perruccio, K., Algarotti, A., Busca, A., Cattaneo, C., Raiola, A. M., Guidi, S., Iori, A. P., Candoni, A., Irrera, G., Milone, G., Marcacci, G., Scime, R., Musso, M., Cudillo, L., Sica, Simona, Castagna, Luigi, Corradini, P., Marchesi, F., Pastore, D., Alessandrino, E. P., Annaloro, C., Ciceri, F., Santarone, S., Nassi, L., Farina, C., Viscoli, C., Rossolini, G. M., Bonifazi, F., Rambaldi, A., Capria, S., Mastronuzzi, A., Pagliara, D., Bernaschi, P., Amico, L., Carotti, A., Mencacci, A., Bruno, Brunella, Costa, C., Passi, A., Ravizzola, G., Angelucci, E., Marchese, Alessandra Maria, Pecile, P., Ventura, Giulio, Fanin, R., Scarparo, C., Barbaro, A., Leotta, Salvatore Nuccio, Marchese, A. E., Becchimanzi, C., Donnarumma, D., Tringali, S., Baldi, M. T., Scalone, R., Picardi, A., Arcese, W., Fontana, Cecilia Alejandra, Giammarco, S., Spanu, Teresa, Crocchiolo, R., Casari, E., Mussetti, A., Conte, Eliana, Ensoli, F., Miragliotta, G., Marone, P., Arghittu, M., Greco, R., Forcina, A., Chichero, P., Di Bartolomeo, P., Fazii, P., Kroumova, V., Decembrino, N., Zecca, M., Pisapia, Giovanni, Palazzo, G., Lanino, E., Faraci, M., Castagnola, E., Bandettini, R., Pastano, R., Sammassimo, S., Passerini, R., Stefani, P. M., Gherlinzoni, F., Rigoli, R., Prezioso, L., Cambo, B., Calderaro, A., Carella, A. M., Cascavilla, N., Labonia, M. T., Celeghini, I., Mordini, N., Piana, F., Vacca, A., Sanna, Maria Maddalena, Podda, G., Corsetti, M. T., Rocchetti, A., Cilloni, D., De Gobbi, M., Bianco, O., Fagioli, F., Carraro, F., De Intinis, G., Severino, A., Proia, Anna Silvia, Parisi, G., Vallisa, D., Confalonieri, Marco, Russo, D., Malagola, M., Galieni, P., Falcioni, S., Travaglini, V., Raimondi, Maria Rosa, Borghero, C., Pavan, Giuseppe, Prete, A., Belotti, T., Ambretti, S., Imola, M., Mianulli, A. M., Pedna, M. F., Cesaro, S., Lo Cascio, G., Ferrari, A., Piedimonte, M., Santino, I., Calandrelli, M., Olivieri, Alessandra, Orecchioni, F., Mirabile, M., Centurioni, R., Gironacci, L., Caravelli, D., Gallo, S., De Filippi, M., Cupelli, L., Dentamaro, T., Falco, S., Eugenio, O. S., Marotta, S., Risitano, A., Lula, D., Musto, P., Pietrantuono, G., Traficante, A., Cerchiara, E., Tirindelli, M. C., Dicuonzo, G., Chierichini, A., Anaclerico, B., Placanica, P., Sica S. (ORCID:0000-0003-2426-3465), Castagna L., Bruno B., Marchese A., Ventura G. (ORCID:0000-0002-0304-7264), Leotta S., Fontana C., Spanu T. (ORCID:0000-0003-1864-5184), Conte E., Pisapia G., Sanna M., Proia A., Confalonieri M. (ORCID:0000-0002-3708-379X), Raimondi R., Pavan G., Olivieri A., Girmenia, C., Bertaina, A., Piciocchi, A., Perruccio, K., Algarotti, A., Busca, A., Cattaneo, C., Raiola, A. M., Guidi, S., Iori, A. P., Candoni, A., Irrera, G., Milone, G., Marcacci, G., Scime, R., Musso, M., Cudillo, L., Sica, Simona, Castagna, Luigi, Corradini, P., Marchesi, F., Pastore, D., Alessandrino, E. P., Annaloro, C., Ciceri, F., Santarone, S., Nassi, L., Farina, C., Viscoli, C., Rossolini, G. M., Bonifazi, F., Rambaldi, A., Capria, S., Mastronuzzi, A., Pagliara, D., Bernaschi, P., Amico, L., Carotti, A., Mencacci, A., Bruno, Brunella, Costa, C., Passi, A., Ravizzola, G., Angelucci, E., Marchese, Alessandra Maria, Pecile, P., Ventura, Giulio, Fanin, R., Scarparo, C., Barbaro, A., Leotta, Salvatore Nuccio, Marchese, A. E., Becchimanzi, C., Donnarumma, D., Tringali, S., Baldi, M. T., Scalone, R., Picardi, A., Arcese, W., Fontana, Cecilia Alejandra, Giammarco, S., Spanu, Teresa, Crocchiolo, R., Casari, E., Mussetti, A., Conte, Eliana, Ensoli, F., Miragliotta, G., Marone, P., Arghittu, M., Greco, R., Forcina, A., Chichero, P., Di Bartolomeo, P., Fazii, P., Kroumova, V., Decembrino, N., Zecca, M., Pisapia, Giovanni, Palazzo, G., Lanino, E., Faraci, M., Castagnola, E., Bandettini, R., Pastano, R., Sammassimo, S., Passerini, R., Stefani, P. M., Gherlinzoni, F., Rigoli, R., Prezioso, L., Cambo, B., Calderaro, A., Carella, A. M., Cascavilla, N., Labonia, M. T., Celeghini, I., Mordini, N., Piana, F., Vacca, A., Sanna, Maria Maddalena, Podda, G., Corsetti, M. T., Rocchetti, A., Cilloni, D., De Gobbi, M., Bianco, O., Fagioli, F., Carraro, F., De Intinis, G., Severino, A., Proia, Anna Silvia, Parisi, G., Vallisa, D., Confalonieri, Marco, Russo, D., Malagola, M., Galieni, P., Falcioni, S., Travaglini, V., Raimondi, Maria Rosa, Borghero, C., Pavan, Giuseppe, Prete, A., Belotti, T., Ambretti, S., Imola, M., Mianulli, A. M., Pedna, M. F., Cesaro, S., Lo Cascio, G., Ferrari, A., Piedimonte, M., Santino, I., Calandrelli, M., Olivieri, Alessandra, Orecchioni, F., Mirabile, M., Centurioni, R., Gironacci, L., Caravelli, D., Gallo, S., De Filippi, M., Cupelli, L., Dentamaro, T., Falco, S., Eugenio, O. S., Marotta, S., Risitano, A., Lula, D., Musto, P., Pietrantuono, G., Traficante, A., Cerchiara, E., Tirindelli, M. C., Dicuonzo, G., Chierichini, A., Anaclerico, B., Placanica, P., Sica S. (ORCID:0000-0003-2426-3465), Castagna L., Bruno B., Marchese A., Ventura G. (ORCID:0000-0002-0304-7264), Leotta S., Fontana C., Spanu T. (ORCID:0000-0003-1864-5184), Conte E., Pisapia G., Sanna M., Proia A., Confalonieri M. (ORCID:0000-0002-3708-379X), Raimondi R., Pavan G., and Olivieri A.

Abstract

Background Gram-negative bacteremia (GNB) is a major cause of illness and death after hematopoietic stem cell transplantation (HSCT), and updated epidemiological investigation is advisable. Methods We prospectively evaluated the epidemiology of pre-engraftment GNB in 1118 allogeneic HSCTs (allo-HSCTs) and 1625 autologous HSCTs (auto-HSCTs) among 54 transplant centers during 2014 (SIGNB-GITMO-AMCLI study). Using logistic regression methods. we identified risk factors for GNB and evaluated the impact of GNB on the 4-month overall-survival after transplant. Results The cumulative incidence of pre-engraftment GNB was 17.3% in allo-HSCT and 9% in auto-HSCT. Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa were the most common isolates. By multivariate analysis, variables associated with GNB were a diagnosis of acute leukemia, a transplant from a HLA-mismatched donor and from cord blood, older age, and duration of severe neutropenia in allo-HSCT, and a diagnosis of lymphoma, older age, and no antibacterial prophylaxis in auto-HSCT. A pretransplant infection by a resistant pathogen was significantly associated with an increased risk of posttransplant infection by the same microorganism in allo-HSCT. Colonization by resistant gram-negative bacteria was significantly associated with an increased rate of infection by the same pathogen in both transplant procedures. GNB was independently associated with increased mortality at 4 months both in allo-HSCT (hazard ratio, 2.13; 95% confidence interval, 1.45-3.13; P <.001) and auto-HSCT (2.43; 1.22-4.84; P =.01). Conclusions Pre-engraftment GNB is an independent factor associated with increased mortality rate at 4 months after auto-HSCT and allo-HSCT. Previous infectious history and colonization monitoring represent major indicators of GNB. Clinical Trials registration NCT02088840.

Published
2017

35. Incidence of colonization and bloodstream infection with carbapenem-resistant Enterobacteriaceae in children receiving antineoplastic chemotherapy in Italy

Author

Caselli, Desiree, Cesaro, Simone, Fagioli, Franca, Carraro, Francesca, Ziino, Ottavio, Zanazzo, Giulio, Meazza, Cristina, Colombini, Antonella, Castagnola, Elio, Muggeo, P., Mura, Raffaella, Orofino, M. G., Giacchino, M., La Spina, M., Consarino, C., Tucci, F., Barone, A., Cellini, M., Perruccio, K., Bandettini, R., Rondelli, R., De Masi, S., and Aricò, M.

Subjects
0301 basic medicine, Male, Pediatrics, Immunology and Microbiology (all), Bacteremia, Carbapenem-resistant enterobacteriaceae, Drug resistance, Neoplasms, Colonization, Prospective Studies, Child, immunosuppression, Incidence (epidemiology), Mortality rate, Incidence, Enterobacteriaceae Infections, General Medicine, Infectious Diseases, Italy, Child, Preschool, Female, Microbiology (medical), medicine.medical_specialty, Adolescent, 030106 microbiology, Antineoplastic Agents, beta-Lactams, beta-Lactam Resistance, 03 medical and health sciences, Pharmacotherapy, children, Enterobacteriaceae, medicine, cancer, Humans, Preschool, Carbapenemase-producing Enterobacteriaceae, Retrospective Studies, General Immunology and Microbiology, business.industry, Klebsiella pneumoniae carbapenemase, Infant, Newborn, Infant, Retrospective cohort study, Newborn, medicine.disease, Survival Analysis, business, Cancer, Children, Immunosuppression
Abstract

Few data are available on the incidence of carbapenemase-producing Enterobacteriaceae (CPE) infection or colonization in children receiving anticancer chemotherapy. We performed a nationwide survey among centers participating in the pediatric hematology-oncology cooperative study group (Associazione Italiana Ematologia Oncologia Pediatrica, AIEOP). During a 2-year observation period, we observed a threefold increase in the colonization rate, and a fourfold increase of bloodstream infection episodes, caused by CPE, with a 90-day mortality of 14%. This first nationwide Italian pediatric survey shows that the circulation of CPE strains in the pediatric hematology-oncology environment is increasing. Given the mortality rate, which is higher than for other bacterial strains, specific monitoring should be applied and the results should have implications for health-care practice in pediatric hematology-oncology.

Published
2015

36. Infections by carbapenem-resistant Klebsiella pneumoniae in SCT recipients: a nationwide retrospective survey from Italy

Author

Girmenia, C, Rossolini, Gm, Piciocchi, A, Bertaina, A, Pisapia, G, Pastore, D, Sica, S, Severino, A, Cudillo, L, Ciceri, F, Scimè, R, Lombardini, L, Viscoli, C, Rambaldi, A, the Gruppo Italiano Trapianto Midollo Osseo (GITMO), Frigeni, M, Corti, C, Mometto, G, Annaloro, C, Casari, E, Castagna, L, Rossi, G, Cattaneo, C, Russo, D, Cancelli, V, Alessandrino, Ep, Ripamonti, F, Pavan, F, Rovelli, A, Pecoraro, C, Busca, A, Carraro, F, Fagioli, F, Gallo, S, Caravelli, D, De Gobbi, M, Saglio, G, Castellino, C, Mordini, N, Gaidano, G, Nassi, L, Raimondi, R, Vespignani, M, Scattolin, Am, Panizzolo, Is, Cesaro, S, Candoni, A, Patriarca, F, Bacigalupo, A, Raiola, A, Castagnola, E, Lanino, E, Stanzani, M, Bandini, G, Massaccesi, E, Prete, A, Bassi, S, Vallisa, D, Caramatti, C, Aversa, F, Zuffa, E, Guidi, S, Bosi, A, Tintori, V, Iori, Ap, Capria, S, Arcese, W, Dentamaro, T, Fabritiis, Pd, Anaclerico, B, Chierichini, A, Piedimonte, M, Ferrari, A, Marchesi, F, Mengarelli, A, Cerchiara, E, Tirindelli, Mc, Gaziev, J, Majolino, I, Chiusolo, P, Lucarelli, B, Massei, Ms, Carotti, A, Perruccio, K, Caniglia, M, Santarone, S, Bartolomeo, Pd, Mazzotta, S, Galieni, P, Olivieri, A, Rosa, Gd, Risitano, A, Delia, M, Specchia, G, Palazzo, G, Messina, G, Irrera, G, Angelucci, E, Baronciani, D, Vacca, A, Crescimanno, A, Musso, M, Imbriani, A, Milone, G., Girmenia, C, Rossolini, Gm, Piciocchi, A, Bertaina, A, Pisapia, G, Pastore, D, Sica, S, Severino, A, Cudillo, L, Ciceri, Fabio, Scime, R, Lombardini, L, Viscoli, C, Rambaldi, A, and and the Gruppo Italiano Trapianto Midollo Osseo, (GITMO)

Subjects
Male, Klebsiella pneumoniae, Carbapenem resistant Klebsiella pneumoniae, Drug Resistance, carbapenem-resistant Klebsiella pneumoniae, colonization, sepsis, Allogeneic Hematopoietic Stem Cell Transplantation, Hematologic Diseases, hemic and lymphatic diseases, polycyclic compounds, Medicine, Adolescent, Adult, Aged, Allografts, Autografts, Female, Humans, Italy, Klebsiella Infections, Middle Aged, Retrospective Studies, Carbapenems, Drug Resistance, Bacterial, Stem Cell Transplantation, Hematology, Transplantation, biology, Bacterial, humanities, surgical procedures, operative, medicine.medical_specialty, Retrospective survey, Internal medicine, business.industry, Retrospective cohort study, Klebsiella infections, biology.organism_classification, Settore MED/15, infection, body regions, Settore MED/15 - MALATTIE DEL SANGUE, Immunology, business
Abstract

Infections by carbapenem-resistant Klebsiella pneumoniae (CRKp) represent a challenging problem after SCT. A retrospective survey (January 2010 to July 2013) involving 52 Italian centers was performed to assess the epidemiology and the prognostic factors of CRKp infections in auto- and allo-SCT. Cases of CRKp infection were reported in 53.4% of centers. CRKp infections were documented in 25 auto-SCTs and 87 allo-SCTs, with an incidence of 0.4% (from 0.1% in 2010 to 0.7% in 2013) and 2% (from 0.4% in 2010 to 2.9% in 2013), respectively. A CRKp colonization documented before or after transplant was followed by an infection in 25.8% of auto-SCT and 39.2% of allo-SCT patients. The infection-related mortality rates were 16% and 64.4%, respectively. A pre-transplant CRKp infection (hazard ratio (HR) 0.33, 95% confidence intervals (CIs) 0.15-0.74; P = 0.007) and a not CRKp-targeted first-line treatment (HR 2.67, 95% CI 1.43-4.99; P = 0.002) were independent factors associated with an increased mortality in allo-SCT patients who developed a CRKp infection. Our study shows challenging findings of CRKp infections in SCT patients in Italy particularly after allo-SCT. The detection of carriers and the definition of early therapeutic strategies represent critical aspects of the management of CRKp infections after SCT. OI Aversa, Franco/0000-0002-8871-6817; de Fabritiis, Paolo/0000-0002-1835-0581; TIRINDELLI, MARIA CRISTINA/0000-0003-4645-4465; cudillo, laura/0000-0002-6828-9707

Published
2015

37. C. Cimino, E. Carraro, L. Mussolin, E.S. d’Amore,S. Buffardi, A. Garaventa, A. Lombardi, R. De Santis, P. D’Angelo, P. Bulian, N. Santoro, F. Porta, R. Mura, A. Tondo, M. Cellini, A. Sala, P. Bertolini, K. Perruccio, M. Nardi, M. Piglione, S. Cesaro, M. Pillon, L. Lo Nigro

Author

Cimino, C., Carraro, E., Mussolin, L., D’Amore, E. S., Buffardi, S., Garaventa, A., Lombardi, A., De Santis, R., D’Angelo, P., Bulian, P., Santoro, N., Porta, F., Mura, R., Tondo, A., Cellini, M., Sala, A., Bertolini, P., Perruccio, K., Nardi, M., Piglione, M., Cesaro, Simone, Pillon, M., and Lo Nigro, L.

Subjects
pediatria, sopravvivenza, Linfomi non-Hodgkin, Linfomi non-Hodgkin, pediatria, sopravvivenza
Published
2015

38. COLONIZZAZIONE ED INFEZIONE DA ENTEROBACTERIACEAE RESISTENTI AI CARBAPENEMICI NEI BAMBINI ITALIANI INTRATTAMENTO CON CHEMIOTERAPIA

Author

Caselli, D., Cesaro, Simone, Fagioli, F., Carraro, F., Ziino, O., Zanazzo, G., Meazza, C., Colombini, A., Muggeo, P. E., Mura, R., Orofino, M. G., Giacchino, M., La Spina, M., Consarino, C., Tucci, F., Barone, A., Cellini, M., Perruccio, K., Bandettini, R., Rondelli, R., De Masi, S., Aricò, M., and Castagnola, E. .

Subjects
antibiotico-resistenza, infezioni batteriche, sepsi, infezioni batteriche, antibiotico-resistenza, sepsi
Published
2015

39. STUDIO DELLA RICOSTITUZIONE IMMUNOLOGICAASPERGILLO-SPECIFICA IN TRAPIANTI DICELLULE STAMINALI EMOPOIETICHE T-REPLETI E T-DEPLETI. XL Congresso Nazionale Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP). Lecce 24-26 maggio 2015

Author

Perruccio, K., Topini, F., Tosti, A., Gazzola, M. V., Messina, C., Martelli, M. F., Caniglia, M., Velardi, A., and Cesaro, Simone

Subjects
infezioni fungine, T-deplezione, infezioni fungine, trapianto di cellule staminali emopoietiche, T-deplezione, trapianto di cellule staminali emopoietiche
Published
2015

40. STUDIO RETROSPETTIVO SULL’INCIDENZA E LE MANIFESTAZIONI CLINICHE DELL’INFEZIONE DA CLOSTRIDIUM DIFFICILE IN PAZIENTI PEDIATRICI IN TRATTAMENTO PER PATOLOGIE ONCO-EMATOLOGICHE NEI CENTRI AIEOP

Author

Caselli, D., Castagnola, E., Colombini, A., Zanazzo, G., De Santis, R., Muggeo, P. E., Mura, R., Orofino, M. G., Barone, A., Cellini, M., Consarino, C., Perruccio, K., De Masi, S., and Cesaro, Simone

Subjects
oncoematologia pediatrica, infezioni da Clostrium, incidenza, oncoematologia pediatrica, infezioni da Clostrium, incidenza
Published
2015

42. Thymosin alpha1 to harness immunity to pathogens after haploidentical hematopoietic transplantation

Author

Perruccio, K, Bonifazi, P, Topini, F, Tosti, A, Bozza, Silvia, Aloisi, T, Carotti, A, Aversa, F, Martelli, Massimo Fabrizio, Romani, Luigina, and Velardi, Andrea

Subjects
Thymosin, Aspergillus, Haplotypes, Thymalfasin, Hematologic Neoplasms, T-Lymphocytes, Immunity, Graft vs Host Disease, Humans, Simplexvirus, Dendritic Cells, Hematopoietic Stem Cells, Infections
Abstract

We designed a phase I/II clinical study to determine safety and efficacy of thymosin alpha1 (Talpha1) administration in recipients of one HLA haplotype (haploidentical) stem cell transplants for hematologic malignancies. Talpha1 administration did not cause acute or chronic graft versus host disease and was associated with significant improvement in polymorphonuclear (phagocytosis) and dendritic cell (phagocytosis, expression of costimulatory molecules, and cytokine production) functions. It was also associated with increased T-cell counts and earlier appearance of functional pathogen-specific T cell responses (by a sensitive limiting dilution assay that detects frequency of T cells specific for Aspergillus, Candida, CMV, ADV, VZV, HSV, Toxoplasma). Five of six haploidentical transplant recipients who received Talpha1 are alive and disease free at a median follow-up of 10 months after transplantation (range: 5-20). They experienced only a single nonlethal infectious episode and one patient developed fatal immune hemolytic anemia. At this very early stage of the clinical trial, we conclude Talpha1 administration is safe and may impact favorably on immune function. Larger numbers of patients and longer follow-up are, of course, needed to assess its impact on survival.

Published
2010

45. Clinical impact of natural killer cell reconstitution after allogeneic hematopoietic transplantation

Author

Velardi, Andrea, Ruggeri, Loredana, Mancusi, Antonella, Burchielli, E, Perruccio, K, Aversa, F, Martelli, Massimo Fabrizio, Immunobiology Working Party of the European Group for Blood, and Marrow, Transplantation

Subjects
Graft Rejection, medicine.medical_treatment, Immunology, Graft vs Host Disease, Hematopoietic stem cell transplantation, Human leukocyte antigen, Major histocompatibility complex, Natural killer cell, Cancer immunotherapy, MHC class I, medicine, Immunology and Allergy, Animals, Humans, Transplantation, Homologous, Allorecognition, Leukemia, biology, Histocompatibility Antigens Class I, Hematopoietic Stem Cell Transplantation, Transplantation, Killer Cells, Natural, medicine.anatomical_structure, Haplotypes, biology.protein
Abstract

Although the optimal donor for allogeneic hematopoietic stem cell transplantation is a human leukocyte antigen (HLA)-matched sibling, 75% of patients do not have a match and alternatives are matched unrelated volunteers, unrelated umbilical cord blood units, and full HLA-haplotype-mismatched family members. This review will focus on the open issues of allogeneic hematopoietic transplantation and on the benefits of natural killer (NK) cell alloreactivity and its underlying mechanisms. Donor-versus-recipient NK cell alloreactivity derives from a mismatch between inhibitory receptors for self major histocompatibility complex (MHC) class I molecules on donor NK clones and the MHC class I ligands on recipient cells. These NK clones sense the missing expression of the self MHC class I allele on the allogeneic targets (“missing self”) and mediate alloreactions. Here, we review the translation of NK cell allorecognition into the clinical practice of allogeneic hematopoietic transplantation and discuss how it has opened innovative perspectives in the cure of leukemia.

Published
2008

Catalog

Books, media, physical & digital resources
See catalog results