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A retrospective survey was conducted in hematologic centres of the Rete Ematologica Lombarda (REL) on 529 older AML patients seen between 2020–2022. Compared to 2008–2016, the use of intensive chemotherapy (ICT) decreased from 40% to 18.1% and of hypomethylating agents (HMAs) from 19.5% to 13%, whereas the combination of Venetoclax/HMA, initially not available, increased from 0% to 36.7%. Objective treatment-specific fitness criteria proposed by SIE/SIES/GITMO in 2013 allow an appropriate choice between ICT and HMAs by balancing their efficacy and toxicity. Venetoclax/HMA, registered for patients unfit to ICT, has a unique toxicity profile because of prolonged granulocytopenia and increased infectious risk. Aiming at defining specific fitness criteria for the safe use of Venetoclax/HMA, a preliminary investigation was conducted among expert REL hematologists, asking for modifications of SIE/SIES/GITMO criteria they used to select candidates for Venetoclax/HMA. While opinions among experts varied, a general consensus emerged on restricting SIE/SIES/GITMO criteria for ICT-unfit patients to an age limit of 80–85, cardiac function > 40%, and absence of recurrent lung infections, bronchiectasis, or exacerbating COPD. Also, the presence of an adequate caregiver was considered mandatory. Such expert opinions may be clinically useful and may be considered when treatment-specific fitness criteria are updated to include Venetoclax/HMA.

Central nervous system (CNS) lesions, especially invasive fungal diseases (IFDs), in immunocompromised patients pose a great challenge in diagnosis and treatment. We report the case of a 48-year-old man with acute myeloid leukaemia and probable pulmonary aspergillosis, who developed hyposthenia of the left upper limb, after achieving leukaemia remission and while on voriconazole. Magnetic resonance imaging (MRI) showed oedematous CNS lesions with a haemorrhagic component in the right hemisphere with lepto-meningitis. After 2 weeks of antibiotics and amphotericin-B, brain biopsy revealed chronic inflammation with abscess and necrosis, while cultures were negative. Clinical recovery was attained, he was discharged on isavuconazole and allogeneic transplant was postponed, introducing azacitidine as a maintenance therapy. After initial improvement, MRI worsened; brain biopsy was repeated, showing similar histology; and 16S metagenomics sequencing analysis was positive (Veilonella, Pseudomonas). Despite 1 month of meropenem, MRI did not improve. The computer tomography and PET scan excluded extra-cranial infectious–inflammatory sites, and auto-immune genesis (sarcoidosis, histiocytosis, CNS vasculitis) was deemed unlikely due to the histological findings and unilateral lesions. We hypothesised possible IFD with peri-lesion inflammation and methyl-prednisolone was successfully introduced. Steroid tapering is ongoing and isavuconazole discontinuation is planned with close follow-up. In conclusion, the management of CNS complications in immunocompromised patients needs an interdisciplinary approach.

Purpose: Myelodysplastic syndromes (MDS) are heterogeneous myeloid neoplasms in which a risk-adapted treatment strategy is needed. Recently, a new clinical-molecular prognostic model, the Molecular International Prognostic Scoring System (IPSS-M) was proposed to improve the prediction of clinical outcome of the currently available tool (Revised International Prognostic Scoring System [IPSS-R]). We aimed to provide an extensive validation of IPSS-M. Methods: A total of 2,876 patients with primary MDS from the GenoMed4All consortium were retrospectively analyzed. Results: IPSS-M improved prognostic discrimination across all clinical end points with respect to IPSS-R (concordance was 0.81 v 0.74 for overall survival and 0.89 v 0.76 for leukemia-free survival, respectively). This was true even in those patients without detectable gene mutations. Compared with the IPSS-R based stratification, the IPSS-M risk group changed in 46% of patients (23.6% and 22.4% of subjects were upstaged and downstaged, respectively).In patients treated with hematopoietic stem cell transplantation (HSCT), IPSS-M significantly improved the prediction of the risk of disease relapse and the probability of post-transplantation survival versus IPSS-R (concordance was 0.76 v 0.60 for overall survival and 0.89 v 0.70 for probability of relapse, respectively). In high-risk patients treated with hypomethylating agents (HMA), IPSS-M failed to stratify individual probability of response; response duration and probability of survival were inversely related to IPSS-M risk.Finally, we tested the accuracy in predicting IPSS-M when molecular information was missed and we defined a minimum set of 15 relevant genes associated with high performance of the score. Conclusion: IPSS-M improves MDS prognostication and might result in a more effective selection of candidates to HSCT. Additional factors other than gene mutations can be involved in determining HMA sensitivity. The definition of a minimum set of relevan

Migrations and development continue to be crossed by inequalities that prevail throughout time and history. The interconnections that arise when integrating the gender variable show the need to include richer approaches with other time scales that allow us to reflect on complex phenomena with tools that have the power of transformation. Migrations and development continue to be crossed by inequalities that prevail throughout time and history, the interconnections that arise when integrating the gender variable show the need to include richer approaches with other time scales that allow us to reflect on complex phenomena with tools that have the power to transform. Short-term or conjunctural approaches established in the approximations and approaches do not seem to have been sufficient to achieve this, nor to alter the patriarchal structure on which the development, configuration and articulation of the flows and dynamics of the individuals that compose them are based., Migraciones y desarrollo siguen estando atravesados por desigualdades que prevalecen a lo largo del tiempo y la historia, las interconexiones que se presentan al integrar la variable género evidencian la necesidad de incluir abordajes más ricos con otras escalas temporales que nos permitan reflexionar sobre fenómenos complejos con utillajes que tengan poder de transformación. El corto plazo o las coyunturas, instauradas en las aproximaciones y enfoques, no parecen haber sido suficientes para lograrlo, ni para alterar la estructura patriarcal sobre la que descansa el desarrollo, la configuración, articulación de los flujos y dinámicas de los individuos que los componen., Les migrations et le développement continuent d’être traversés par des inégalités qui prévalent à travers le temps et l’histoire, les interconnexions qui apparaissent en intégrant la variable genre montrent la nécessité d’inclure des approches plus riches avec d’autres échelles de temps qui permettent de réfléchir sur des phénomènes complexes avec des outils qui ont le pouvoir de transformer. Les approches et les démarches à court terme ou conjoncturelles ne semblent pas avoir été suffisantes pour y parvenir, ni pour modifier la structure patriarcale sur laquelle reposent le développement, la configuration et l’articulation des flux et des dynamiques des individus qui les composent.

The following article is an aproach to waht is oficially called co-development, focusing in a formative action, a Co-Development program, directed to latin-american migrants. The abovementioned action is framed by the proposals of Greco Plan in it’s 1.4 point and, specifically “Education of migrants that could be an agent of development on their return to their countries”. As a new idea it could be considered interesting the disconection between education and return, looking at the concept co-development from diferent parameters than those included in the Plan so far., El presente artículo se acerca a lo que se ha denominado codesarrollo de manera oficial, centrándose en una acción formativa, un Programa de Codesarrollo, dirigido a migrantes latinoamericanos. Dicha acción queda enmarcada dentro de lo propuesto por el Plan Greco, en su medida 1.4, y concretamente: “Formación de inmigrantes que puedan ser agentes de desarrollo a su vuelta a su país de origen”. Como novedoso resultaría la desvinculación de la formación al retorno, entendiendo el término codesarrollo desde otros parámetros que los contemplados hasta ahora en el Plan., Le présent article s’approche à ce que l’on a appelé codéveloppement de manière officielle, et présente une action formative, un Programme de Codéveloppement, adressé a des migrants latino-americains. Cette action est encadrée dans ce qui est proposé par le Plan Greco, dans le point 1.4, et plus particulièrement: “Formation d’immigrants qui peuvent être des agents de développement à leur retour à leur pays d’origine”. Comme nouveauté on peut signaler la libération de la formation au retour, en comprenant le terme codéveloppement à partir d’autres paramètres que ceux considérés jusqu’à présent dans le Plan.

The interaction between microfinance, migration and global public goods reveals the existence of new edges of study within microfinance by linking it to other fields with potential national, regional and international impacts. The article presents examples of this triangulation and identifies new lines of thought that allow the study of microfinance from a broader perspective.

This article analyses the evolution of some of the mayor theories in migration and development, and the beginnings of the concept of codevelopment, intending to find a coherent analytical framework. It is offered as well a picture of the current discourse, when migration and development, as a binomial set, is placed under international and European debates. Finally, this discourse is compared with the actual practice, which seams to forget too often vital elements in this field, as rights, integration and citizenship., Este artículo analiza la evolución de algunas de las principales teorías de las migraciones y el desarrollo, así como el surgimiento del concepto de codesarrollo, tratando de buscar un marco de análisis coherente. Se muestra a continuación el discurso actual, en un momento en que el binomio migraciones y desarrollo está en el debate internacional y europeo. Finalmente, se compara este discurso con la práctica imperante, que parece olvidar demasiado a menudo cuestiones centrales en este campo, como son los derechos, la integración o la ciudadanía., Cet article analyse l’évolution des principales théories des migrations et du développement, et l’apparition du concept de co-développent, en essayant de trouver un cadre d’étude cohérent. Les auteurs présentent à continuation le discours actuel, dans un moment où le binôme migration-developpement se trouve au centre du débat international et européen. Finalement, ce discours est comparé avec la pratique actuelle, qui semble oublier trop souvent des question essentielles dans ce domaine, comme les droits, l’intégration ou la citoyenneté.