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1. 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

2. Role of radiotherapy to bulky sites of advanced Hodgkin lymphoma treated with ABVD: Final results of FIL HD0801 trial

Author

Alessandro Re, Luca Nassi, Armando Santoro, Daniela Gioia, Vittorio Ruggero Zilioli, Paola Franzone, Alessandro Pulsoni, Pier Luigi Zinzani, Luigi Rigacci, Monica Tani, Francesco Zaja, Mario Levis, Gabriele Simontacchi, Umberto Ricardi, Manuela Zanni, Antonio Nardella, Vincenzo Pavone, Michela Buglione, Andrea Riccardo Filippi, Delia Rota-Scalabrini, Manuel Gotti, Barbara Botto, Giovanni Frezza, Elisabetta Abruzzese, Gian Mauro Sacchetti, Lavinia Grapulin, Roberto Freilone, Giovannino Ciccone, Andrea Evangelista, Ricardi, U., Levis, M., Evangelista, A., Gioia, D. M., Sacchetti, G. M., Gotti, M., Re, A., Buglione, M., Pavone, V., Nardella, A., Nassi, L., Zanni, M., Franzone, P., Frezza, G. P., Pulsoni, A., Grapulin, L., Santoro, A., Rigacci, L., Simontacchi, G., Tani, M., Zaja, F., Abruzzese, E., Botto, B., Zilioli, V. R., Rota-Scalabrini, D., Freilone, R., Ciccone, G., Filippi, A. R., Zinzani, P. L., Ricardi U., Levis M., Evangelista A., Gioia D.M., Sacchetti G.M., Gotti M., Re A., Buglione M., Pavone V., Nardella A., Nassi L., Zanni M., Franzone P., Frezza G.P., Pulsoni A., Grapulin L., Santoro A., Rigacci L., Simontacchi G., Tani M., Zaja F., Abruzzese E., Botto B., Zilioli V.R., Rota-Scalabrini D., Freilone R., Ciccone G., Filippi A.R., and Zinzani P.L.

Subjects
Clinical Trials and Observations, Dacarbazine, Bleomycin, Vinblastine, law.invention, chemistry.chemical_compound, Randomized controlled trial, law, Antineoplastic Combined Chemotherapy Protocols, medicine, Clinical endpoint, Doxorubicin, Humans, Neoplasm Staging, Hodgkin Disease, Antineoplastic Combined Chemotherapy Protocol, business.industry, Hazard ratio, Hematology, Confidence interval, chemistry, ABVD, business, Nuclear medicine, medicine.drug, Human
Abstract

Key Points The prognosis of patients with advanced HL who achieved CMR after both 2 and 6 ABVD cycles is excellent without consolidation RT.An additional benefit of consolidation RT of sites >5 cm is likely to be small and could not be proved for this small sample size., Visual Abstract, The role of consolidation radiotherapy (RT) for bulky lesions is controversial in patients with advanced-stage Hodgkin lymphoma who achieve complete metabolic response (CMR) after doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD)–based chemotherapy. We present the final results of the Fondazione Italiana Linfomi HD0801 trial, which investigated the potential benefit of RT in that setting. In this phase 3 randomized study, patients with a bulky lesion at baseline (a mass with largest diameter ≥5 cm) who have CMR after 2 and 6 ABVD cycles were randomly assigned 1:1 to RT vs observation (OBS) with a primary endpoint of event-free survival (EFS) at 2 years. The sample size was calculated estimating an EFS improvement for RT of 20% (from 60% to 80%). The secondary end point was progression-free survival (PFS). One hundred sixteen patients met the inclusion criteria and were randomly assigned to RT or OBS. Intention-to-treat (ITT) analysis showed a 2-year EFS of 87.8% vs 85.8% for RT vs OBS (hazard ratio [HR], 1.5; 95% confidence interval [CI], 0.6-3.5; P = .34). At 2 years, ITT-PFS was 91.3% vs 85.8% (HR, 1.2; 95% CI, 0.5-3; P = .7). Patients in CMR randomly assigned to OBS had a good outcome, and the primary end point of a 20% benefit in EFS for RT was not met. However, the sample size was underpowered to detect a benefit of 10% or less, keeping open the question of a potential, more limited role of RT in this setting. This trial was registered at www.clinicaltrials.gov as #NCT00784537.

Published
2021

3. Efficacy, safety and feasibility of treatment of chronic HCV infection with directly acting agents in hematopoietic stem cell transplant recipients - Study of infectious diseases working party of EBMT

Author

Gloria Tridello, Stella Santarone, Ewa Karakulska-Prystupiuk, Paolo Bartolomeo, Jan Maciej Zaucha, Katia Perruccio, Simone Cesaro, Mariacristina Menconi, Laura Ambra Nicolini, Andrea Velardi, Malgorzata Mikulska, Clara Cuéllar, Per Ljungman, Fabio Ciceri, Grzegorz W. Basak, Jan Styczyński, Igor Wolfgang Blau, Luca Nassi, Nina Knelange, Irene García-Cadenas, Rafael de la Cámara, Agnieszka Piekarska, Emanuele Angelucci, Maria Teresa Lupo-Stanghellini, Loic Fouillard, Mikulska, M., Knelange, N., Nicolini, L. A., Tridello, G., Santarone, S., Di Bartolomeo, P., de la Camara, R., Cuellar, C., Velardi, A., Perruccio, K., Ljungman, P., Zaucha, J., Piekarska, A., Basak, G., Karakulska-Prystupiuk, E., Angelucci, E., Ciceri, F., Lupo-Stanghellini, M. T., Fouillard, L., Garcia-Cadenas, I., Menconi, M., Blau, I. W., Nassi, L., Cesaro, S., and Styczynski, J.

Subjects
Microbiology (medical), Male, medicine.medical_specialty, Cirrhosis, Sofosbuvir, Hepacivirus, Transplant, sofosbuvir, Antiviral Agents, Internal medicine, medicine, Humans, business.industry, Hematopoietic Stem Cell Transplantation, Hematopoietic stem cell, DAAs, Middle Aged, medicine.disease, Hepatitis C, Treatment efficacy, Transplant Recipients, Discontinuation, Lymphoma, Treatment, Infectious Diseases, medicine.anatomical_structure, Treatment Outcome, HCV, HSCT, Cohort, Feasibility Studies, Observational study, Drug Therapy, Combination, business, medicine.drug
Abstract

Objectives: Limited data is available on HCV directly acting agents (DAAs) in haematopoietic stem cell transplant (HSCT) recipients. This study aimed at reporting the characteristics, treatment practices and treatment efficacy in HSCT recipients with chronic HCV. Methods: Prospective observational study from EBMT Infectious Diseases Working Party (IDWP). Patients with chronic HCV infection were included. Results: Between 12/2015 and 07/2018, 45 patients were included: male in 53%; median age 49 years (range, 8-75); acute leukaemia in 48.9%, lymphoma in 17.7%, non-malignant disorders in 22.3%; allogeneic HSCT in 84%; 77.8% no immunosuppressive treatment. Genotypes 1, 2, 3 and 4 were detected in 54.5%, 20.5%, 13.6% and 11.4%, respectively; advanced fibrosis in 40%, including cirrhosis in 11.4%. Overall, 37 (82.2%) patients received DAAs, at a median of 8.4 years after HSCT (16.2% within 6 months from HSCT). Sofosbuvir-based treatment was given to 62.2%. Thirty-five patients completed planned treatment course, with sustained virological response (SVR) of 89.1%, and 94.3% (33/35) in those who completed the treatment. Side effects possibly related to DAAs were reported in 5 (14%) and did not require treatment discontinuation. Conclusions: DAAs treatment was effective, saf e and feasible in this cohort of mainly allogeneic HSCT recipients with mild/moderate liver damage. (c) 2021 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Published
2021

4. Interferon-free compared to interferon-based antiviral regimens as first-line therapy for B-cell lymphoproliferative disorders associated with hepatitis C virus infection

Author

Sara Rattotti, Roberto Rossotti, Marcella Visentini, Michele Merli, Maria Goldaniga, Angela Ferrari, Luca Nassi, Francesco Piazza, Raffaele Bruno, Harrys A. Torres, Luigi Rigacci, Luca Arcaini, Mario Pirisi, Annamaria Frustaci, Virginia Valeria Ferretti, Francesco Zaja, Hélène Fontaine, Céline Dorival, Irene Defrancesco, Olivier Hermine, Carlo Visco, Caroline Besson, Marco Frigeni, Massimo Gentile, Camille Alric, Emanuele Cencini, Alessandro Pulsoni, Jan Peveling-Oberhag, Michele Milella, Frigeni, M., Besson, C., Visco, C., Fontaine, H., Goldaniga, M., Visentini, M., Pulsoni, A., Torres, H. A., Peveling-Oberhag, J., Rossotti, R., Zaja, F., Rigacci, L., Merli, M., Dorival, C., Alric, C., Piazza, F., Gentile, M., Ferrari, A., Pirisi, M., Nassi, L., Rattotti, S., Frustaci, A., Milella, M., Cencini, E., Defrancesco, I., Ferretti, V. V., Bruno, R., Hermine, O., and Arcaini, L.

Subjects
Cancer Research, Hepatitis C virus, Hepacivirus, Alpha interferon, Lymphoproliferative disorders, medicine.disease_cause, NHL, Interferon, Medicine, hepatitis C virus infection, B-cell lymphoproliferative disorders, B cell, treatment, biology, business.industry, Hematology, Hepatitis C, medicine.disease, biology.organism_classification, treatment, HCV infection, Virology, IFN-free, HCV infection, medicine.anatomical_structure, Oncology, business, Diffuse large B-cell lymphoma, medicine.drug
Abstract

not available

Published
2019

5. Primary follicular and marginal-zone lymphoma of the breast: clinical features, prognostic factors and outcome: a study by the International Extranodal Lymphoma Study Group

Author

M. Kuper-Hommel, Pier Luigi Zinzani, Gail Ryan, Richard W. Tsang, L. Santoro, Luca Calabrese, Alessandra Alietti, Sara Steffanoni, Emanuele Zucca, Luca Nassi, Giovanni Martinelli, F. Cavalli, Alphonse G. Taghian, Giancarlo Pruneri, John F. Seymour, Martinelli G, Ryan G, Seymour JF, Nassi L, Steffanoni S, Alietti A, Calabrese L, Pruneri G, Santoro L, Kuper-Hommel M, Tsang R, Zinzani PL, Taghian A, Zucca E, and Cavalli F.

Subjects
Oncology, Male, Pathology, medicine.medical_specialty, Follicular lymphoma, Breast Neoplasms, Breast Neoplasms, Male, Extranodal Disease, Breast cancer, Internal medicine, medicine, Humans, Progression-free survival, Stage (cooking), Lymphoma, Follicular, business.industry, Hematology, Lymphoma, B-Cell, Marginal Zone, medicine.disease, Prognosis, Chemotherapy regimen, Lymphoma, Treatment Outcome, Female, Breast disease, business
Abstract

Background Primary breast lymphoma (PBL) of low-grade histology is a rare disease. This multicentric retrospective study was carried out to determine clinical features, prognosis and relapse. Patients and methods Patients with histologically proven, previously untreated follicular or marginal-zone PBL (MZL PBL) diagnosed from 1980 to 2003 were included in the study. Major end points were progression-free survival (PFS), overall survival (OS) and potential prognostic factors. Results We collected data on 60 cases of PBL [36 follicular and 24 marginal-zone lymphoma (MZL)]. Stage was IE or IIE in 57 patients and IVE in three patients due to bilateral breast involvement. Surgery, chemotherapy and radiotherapy (RT), alone or in combination, were used as first-line treatments in 67%, 42% and 52% of patients, respectively. Overall response rate was 98%, with a 93% complete response rate. Five-year PFS were 56% for MZL and 49% for follicular PBL (P = 0.62). Relapses were mostly in distant sites (18 of 23 cases); no patients relapsed within RT fields. Conclusions Our data showed an indolent behaviour of MZL PBL, comparable to other primary extranodal MZL. Conversely, patients with follicular PBL had inferior PFS and OS when compared with limited-stage nodal follicular non-Hodgkin's lymphomas, suggesting an adverse prognostic role of primary breast localisation in this histological subgroup.

Published
2017
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6. Incidence, Risk Factors and Outcome of Pre-engraftment Gram-Negative Bacteremia After Allogeneic and Autologous Hematopoietic Stem Cell Transplantation: An Italian Prospective Multicenter Survey

Author

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

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

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

Published
2017

7. Role of bone marrow biopsy in staging of patients with classical Hodgkin's lymphoma undergoing positron emission tomography/computed tomography

Author

A. Di Rocco, R. Guariglia, S. Falorio, P. C. Riccomagno, G. Doa, Benedetta Puccini, Erica Finolezzi, Rosanna Ciancia, A. Mulè, C. Filì, C. Toldo, S. Zanon, Stefano Volpetti, Carla Minoia, Francesco Zaja, A. Furlan, Marianna Sassone, Luca Nassi, Puccini, B., Nassi, L., Minoia, C., Volpetti, S., Ciancia, R., Riccomagno, P. C., Di Rocco, A., Mulè, A., Toldo, C., Sassone, M. C., Guariglia, R., Filì, C., Finolezzi, E., Falorio, S., Zanon, S., Furlan, A., Doa, G., and Zaja, F.

Subjects
Male, Staging, Biopsy, Bone marrow biopsy, Computed tomography, Hodgkin’s lymphoma, Positron emission tomography, Adolescent, Adult, Aged, 80 and over, Bone Marrow, Bone Marrow Examination, Female, Hodgkin Disease, Humans, Middle Aged, Neoplasm Staging, Positron Emission Tomography Computed Tomography, Reproducibility of Results, Retrospective Studies, Sensitivity and Specificity, Young Adult, Hematology, 0302 clinical medicine, Retrospective Studie, Positive predicative value, Stage (cooking), Radiation treatment planning, Hodgkinâ s lymphoma, Aged, 80 and over, medicine.diagnostic_test, General Medicine, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Radiology, Human, medicine.medical_specialty, Reproducibility of Result, 03 medical and health sciences, medicine, business.industry, medicine.disease, Hodgkin's lymphoma, Lymphoma, Bone marrow, Nuclear medicine, business, Role of bone marrow biopsy in staging of patients with classical Hodgkin’s lymphoma undergoing positron emission tomography/computed tomography, 030215 immunology
Abstract

Several studies suggested that staging bone marrow biopsy (BMB) could be omitted in patients with classical Hodgkin's lymphoma (cHL) when a positron emission tomography/computed tomography (PET/CT) is performed at baseline.To address the concordance between BMB and PET/CT in the detection of bone marrow involvement (BMI) and the BMB role in determining the Ann Arbor stage, we retrospectively collected data on 1244 consecutive patients with cHL diagnosed from January 2007 to December 2013. One thousand eighty-five patients who had undergone both BMB and PET/CT were analyzed, comparing the Ann Arbor stage assessed with PET/CT only to that resulting from PET/CT combined with BMB.One hundred sixty-nine patients (16%) showed at least one focal skeletal lesion (FSL) at PET/CT evaluation. Only 55 patients had a positive BMB (5.1%); 34 of them presented at least one FSL at PET/CT. To the contrary, 895 out of 1030 patients with a negative BMB did not show any FSL (86.9%). Positive and negative predictive values of PET/CT for BMI were 20 and 98%, respectively; sensitivity and specificity were 62 and 87%, respectively. Fifty-four out of 55 patients with a positive BMB could have been evaluated as an advanced stage just after PET/CT; only one patient (0.1%) would have been differently treated without BMB.Our data showed a very high negative predictive value of PET/CT for BMI and a negligible influence of BMB on treatment planning, strengthening the recent indications that BMB could be safely omitted in cHL patients staged with PET/CT.

Published
2016

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