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Salmanton-García J, Marchesi F, Farina F, Weinbergerová B, Itri F, Dávila-Valls J, Martín-Pérez S, Glenthøj A, Hersby DS, Gomes da Silva M, Nunes Rodrigues R, López-García A, Córdoba R, Bilgin YM, Falces-Romero I, El-Ashwah S, Emarah Z, Besson C, Kohn M, Van Doesum J, Ammatuna E, Marchetti M, Labrador J, Zambrotta GPM, Verga L, Jaksic O, Nucci M, Piukovics K, Cabirta-Touzón A, Jiménez M, Arellano E, Espigado I, Blennow O, Nordlander A, Meers S, van Praet J, Aiello TF, Garcia-Vidal C, Fracchiolla N, Sciumè M, Seval GC, Žák P, Buquicchio C, Tascini C, Gräfe SK, Schönlein M, Adžić-Vukičević T, Bonuomo V, Cattaneo C, Nizamuddin S, Čerňan M, Plantefeve G, Prin R, Szotkovski T, Collins GP, Dargenio M, Petzer V, Wolf D, Čolović N, Prezioso L, Valković T, Passamonti F, Méndez GA, Sili U, Vena A, Bavastro M, Limongelli A, Duarte RF, Ledoux MP, Cvetanoski M, Stojanoski Z, Machado M, Batinić J, Magliano G, Biernat MM, Pantić N, Poulsen CB, Cuccaro A, Del Principe MI, Kulasekararaj A, Ormazabal-Vélez I, Busca A, Demirkan F, Ijaz M, Klimko N, Stoma I, Khostelidi S, Fernández N, Omrani AS, Bergantim R, De Jonge N, Fouquet G, Navrátil M, Abu-Zeinah G, Samarkos M, Maertens J, De Ramón C, Guidetti A, Magyari F, González-López TJ, Lahmer T, Finizio O, Ali N, Pinczés LI, Lavilla-Rubira E, Romano A, Merelli M, Delia M, Calbacho M, Meletiadis J, Antić D, Hernández-Rivas JÁ, Marques de Almeida J, Al-Khabori M, Hoenigl M, Tisi MC, Khanna N, Barać A, Eisa N, Di Blasi R, Liévin R, Miranda-Castillo C, Bahr NC, Lamure S, Papa MV, Yahya A, Aujayeb A, Novák J, Erben N, Fernández-Galán M, Ribera-Santa Susana JM, Rinaldi I, Fazzi R, Piedimonte M, Duléry R, Gonzaga Y, Soto-Silva A, Sapienza G, Serris A, Drgoňa Ľ, Groh A, Serrano L, Gavriilaki E, Tragiannidis A, Prattes J, Coppola N, Otašević V, Mladenović M, Mitrović M, Mišković B, Jindra P, Zompi S, Sacchi MV, Krekeler C, Infante MS, García-Bordallo D, Çolak GM, Mayer J, Nygaard M, Hanáková M, Ráčil Z, Bonanni M, Koehler P, Rahimli L, Cornely OA, Pagano L. Decoding the historical tale: COVID-19 impact on haematological malignancy patients-EPICOVIDEHA insights from 2020 to 2022. EClinicalMedicine 2024; 71:102553. [PMID: 38533127 PMCID: PMC10963230 DOI: 10.1016/j.eclinm.2024.102553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/29/2024] [Accepted: 03/01/2024] [Indexed: 03/28/2024] Open
Abstract
Background The COVID-19 pandemic heightened risks for individuals with hematological malignancies due to compromised immune systems, leading to more severe outcomes and increased mortality. While interventions like vaccines, targeted antivirals, and monoclonal antibodies have been effective for the general population, their benefits for these patients may not be as pronounced. Methods The EPICOVIDEHA registry (National Clinical Trials Identifier, NCT04733729) gathers COVID-19 data from hematological malignancy patients since the pandemic's start worldwide. It spans various global locations, allowing comprehensive analysis over the first three years (2020-2022). Findings The EPICOVIDEHA registry collected data from January 2020 to December 2022, involving 8767 COVID-19 cases in hematological malignancy patients from 152 centers across 41 countries, with 42% being female. Over this period, there was a significant reduction in critical infections and an overall decrease in mortality from 29% to 4%. However, hospitalization, particularly in the ICU, remained associated with higher mortality rates. Factors contributing to increased mortality included age, multiple comorbidities, active malignancy at COVID-19 onset, pulmonary symptoms, and hospitalization. On the positive side, vaccination with one to two doses or three or more doses, as well as encountering COVID-19 in 2022, were associated with improved survival. Interpretation Patients with hematological malignancies still face elevated risks, despite reductions in critical infections and overall mortality rates over time. Hospitalization, especially in ICUs, remains a significant concern. The study underscores the importance of vaccination and the timing of COVID-19 exposure in 2022 for enhanced survival in this patient group. Ongoing monitoring and targeted interventions are essential to support this vulnerable population, emphasizing the critical role of timely diagnosis and prompt treatment in preventing severe COVID-19 cases. Funding Not applicable.
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Affiliation(s)
- Jon Salmanton-García
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | - Barbora Weinbergerová
- Masaryk University and University Hospital Brno - Department of Internal Medicine, Hematology and Oncology, Brno, Czech Republic
| | - Federico Itri
- San Luigi Gonzaga Hospital - Orbassano, Orbassano, Italy
| | | | | | - Andreas Glenthøj
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Ditte Stampe Hersby
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | | | | | - Alberto López-García
- Fundación Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Raúl Córdoba
- Fundación Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | | | - Iker Falces-Romero
- Microbiology and Parasitology Department, University Hospital La Paz, Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Ziad Emarah
- Oncology Center, Mansoura University, Mansoura, Egypt
- King Abdullah Medical City, Makkah, Saudi Arabia
| | - Caroline Besson
- Centre Hospitalier de Versailles, Le Chesnay, France
- Université Paris-Saclay, UVSQ, Inserm, Équipe “Exposome et Hérédité”, CESP, Villejuif, France
| | - Milena Kohn
- Centre Hospitalier de Versailles, Le Chesnay, France
- Université Paris-Saclay, UVSQ, Inserm, Équipe “Exposome et Hérédité”, CESP, Villejuif, France
| | | | | | - Monia Marchetti
- Hematology and Transplant Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Jorge Labrador
- Department of Hematology, Research Unit, Hospital Universitario de Burgos, Burgos, Spain
| | | | - Luisa Verga
- Azienda Ospedaliera San Gerardo - Monza, Monza, Italy
- Università Milano-Bicocca, Milan, Italy
| | | | - Marcio Nucci
- Department of Internal Medicine, Federal University of Rio de Janeiro and Grupo Oncoclinicas, Rio de Janeiro, Brazil
| | - Klára Piukovics
- Department of Internal Medicine, South Division Faculty of Medicine University of Szeged, Szeged, Hungary
| | - Alba Cabirta-Touzón
- Department of Hematology, Vall d’Hebron Hospital Universitari, Experimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Moraima Jiménez
- Department of Hematology, Vall d’Hebron Hospital Universitari, Experimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Elena Arellano
- Department of Hematology, University Hospital Virgen Macarena - University Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS/CSIC), Universidad de Sevilla (Departamento de Medicina), Seville, Spain
| | - Ildefonso Espigado
- Department of Hematology, University Hospital Virgen Macarena - University Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS/CSIC), Universidad de Sevilla (Departamento de Medicina), Seville, Spain
| | - Ola Blennow
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Anna Nordlander
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | | | - Jens van Praet
- Department of Nephrology and Infectious diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | - Tommaso Francesco Aiello
- Department of Infectious Diseases, Hospital Clinic de Barcelona, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Carolina Garcia-Vidal
- Department of Infectious Diseases, Hospital Clinic de Barcelona, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Nicola Fracchiolla
- Hematology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Mariarita Sciumè
- Hematology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Pavel Žák
- University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | | | - Carlo Tascini
- Azienda Sanitaria Universitaria del Friuli Centrale, Udine, Italy
| | | | - Martin Schönlein
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | | | | | - Summiya Nizamuddin
- Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Martin Čerňan
- University Hospital Olomouc, Olomouc, Czech Republic
| | - Gaëtan Plantefeve
- Head ICU and CRC, Centre Hospitalier Victor DUPOUY, Argenteuil, France
| | - Romane Prin
- CRA from CRC Centre Hospitalier Victor DUPOUY, Argenteuil, France
| | | | | | | | - Verena Petzer
- Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck (MUI), Innsbruck, Austria
| | - Dominik Wolf
- Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck (MUI), Innsbruck, Austria
| | | | - Lucia Prezioso
- Hospital University of Parma - Hematology and Bone Marrow Unit, Parma, Italy
| | - Toni Valković
- University Hospital Centre Rijeka, Rijeka, Croatia
- Croatian Cooperative Group for Hematological Diseases (CROHEM), Croatia
- Faculty of Medicine and Faculty of Health Studies of University of Rijeka, Rijeka, Croatia
| | - Francesco Passamonti
- Department of Medicine and Surgery, University of Insubria and ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | | | - Uluhan Sili
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Turkey
| | | | | | | | | | | | | | | | - Marina Machado
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Josip Batinić
- Croatian Cooperative Group for Hematological Diseases (CROHEM), Croatia
- University Hospital Centre Zagreb, Zagreb, Croatia
- Faculty of Medicine University of Zagreb, Zagreb, Croatia
| | | | | | - Nikola Pantić
- University Clinical Center of Serbia, Belgrade, Serbia
| | | | - Annarosa Cuccaro
- Hematology Unit, Center for Translational Medicine, Azienda USL Toscana NordOvest, Livorno, Italy
- National Cancer Institute, Fondazione ‘G. Pascale’, IRCCS, Hematology-Oncology and Stem Cell Transplantation Unit, Naples, Italy
| | | | - Austin Kulasekararaj
- Department of Hematological Medicine, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | | | - Alessandro Busca
- Stem Cell Transplant Center, AOU Citta’ della Salute e della Scienza, Turin, Italy
| | - Fatih Demirkan
- Dokuz Eylul University, Division of Hematology, Izmir, Turkey
| | - Marriyam Ijaz
- Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Nikolai Klimko
- North-Western State Medical University Named after Iliá Ilich Méchnikov, Saint-Petersburg, Russia
| | - Igor Stoma
- Gomel State Medical University, Gomel, Belarus
| | - Sofya Khostelidi
- North-Western State Medical University Named after Iliá Ilich Méchnikov, Saint-Petersburg, Russia
| | - Noemí Fernández
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | - Rui Bergantim
- Centro Hospitalar e Universitário São João, Porto, Portugal
| | - Nick De Jonge
- Amsterdam UMC, Location VUmc, Amsterdam, Netherlands
| | | | | | | | - Michail Samarkos
- Laikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Anna Guidetti
- University of Milan and Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Ferenc Magyari
- Division of Hematology, Department of Internal Medicine, University of Debrecen, Debrecen, Hungary
| | | | - Tobias Lahmer
- Medizinische Klinik II, Klinikum Rechts der Isar, TU München, Munich, Germany
| | | | | | - László Imre Pinczés
- Division of Hematology, Department of Internal Medicine, University of Debrecen, Debrecen, Hungary
| | | | | | - Maria Merelli
- Azienda Sanitaria Universitaria del Friuli Centrale, Udine, Italy
| | - Mario Delia
- Hematology and Stem Cell Transplantation Unit, AOUC Policlinico, Bari, Italy
| | | | - Joseph Meletiadis
- Clinical Microbiology Laboratory, Medical School, “Attikon” University General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Darko Antić
- University Clinical Center of Serbia, Belgrade, Serbia
| | | | | | | | - Martin Hoenigl
- Division of Infectious Diseases, ECMM Excellence Center for Clinical Mycology, Department of Internal Medicine, Medical University of Graz, Austria
- BioTechMed, Graz, Austria
| | | | - Nina Khanna
- University Hospital of Basel, Basel, Switzerland
| | | | - Noha Eisa
- Aseer Central Hospital, Abha, Saudi Arabia
- Oncology Center Mansoura University, Mansoura, Egypt
| | | | | | | | - Nathan C. Bahr
- University of Kansas Medical Center, Kansas City, United States
| | - Sylvain Lamure
- Department of Clinical Hematology, Montpellier University Hospital, IGMM UMR5535 CNRS, University of Montpellier, Montpellier, France
| | | | - Ayel Yahya
- Aseer Central Hospital, Abha, Saudi Arabia
| | | | - Jan Novák
- University Hospital of Královské Vinohrady, Prague, Czech Republic
| | - Nurettin Erben
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine Eskisehir Osmangazi University, Eskisehir, Turkey
| | | | | | | | - Rita Fazzi
- Hematology and Stem Cell Transplant Unit, Osperadiela University Pisana Company, Pisa, Italy
| | | | - Rémy Duléry
- Service d'Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Inserm UMRs 938, Paris, France
| | - Yung Gonzaga
- Instituto Nacional do Cancer, Rio de Janeiro, Brazil
| | - Andrés Soto-Silva
- Faculty of Medicine, University of Chile. Infectious Diseases Unity, Salvador Hospital of Santiago, Santiago de Chile, Chile
| | - Giuseppe Sapienza
- Azienda Ospedaliera “Ospedali Riuniti Villa Sofia-Cervello”, Palermo, Italy
| | | | - Ľuboš Drgoňa
- Comenius University and National Cancer Institute, Bratislava, Slovakia
| | - Ana Groh
- Universitätsklinikum Frankfurt am Main, Frankfurt am Main, Germany
| | | | - Eleni Gavriilaki
- General Hospital of Thessaloniki “George Papanikolaou”, Thessaloniki, Greece
| | | | | | - Nicola Coppola
- Department of Mental Health and Public Medicine, University of Campania, Naples, Italy
| | | | | | | | - Bojana Mišković
- Center for Radiology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Pavel Jindra
- University Hospital Pilsen, Pilsen, Czech Republic
| | - Sofia Zompi
- Stem Cell Transplant Center, AOU Citta’ della Salute e della Scienza, Turin, Italy
| | - Maria Vittoria Sacchi
- Hematology and Transplant Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Carolin Krekeler
- Department of Medicine A for Hematology, Oncology and Pneumology, University Hospital Münster, Münster, Germany
| | | | | | - Gökçe Melis Çolak
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Jiří Mayer
- Masaryk University and University Hospital Brno - Department of Internal Medicine, Hematology and Oncology, Brno, Czech Republic
| | | | - Michaela Hanáková
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
- Department of Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Zdeněk Ráčil
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
- Department of Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Matteo Bonanni
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
- Hematology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Philipp Koehler
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Laman Rahimli
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Oliver A. Cornely
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany
| | - Livio Pagano
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
- Hematology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
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Lo Schirico M, Passera R, Gill J, Dellacasa C, Dogliotti I, Giaccone L, Zompi S, Busca A. Graft-Versus-Host Disease Prophylaxis with Antithymocyte Globulin in Patients Receiving Stem Cell Transplantation from Unrelated Donors: An Observational Retrospective Single-Center Study. Cancers (Basel) 2023; 15:2761. [PMID: 37345098 DOI: 10.3390/cancers15102761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 06/23/2023] Open
Abstract
Graft-versus-host disease (GVHD) is one of the most important complications of allogeneic hematopoietic stem cell transplantation. Rabbit antilymphocyte serum (ATG/ATLG) is recommended for GVHD prophylaxis, while its appropriate dosing is debated. We performed a retrospective single-center study to examine the outcome of patients receiving ATG at the dose of 5 mg/kg as GVHD prophylaxis for unrelated donor (URD) HSCT. We collected data from all consecutive adult patients with hematological malignancies who had undergone allogeneic HSCT from URDs at the Stem Cell Transplant Center of the Città della Salute e della Scienza Hospital of Torino between July 2008 and July 2021. The primary aim was to ascertain the cumulative incidence (CI) for acute GVHD (aGVHD) and chronic GVHD (cGVHD); the secondary aim was to ascertain the CI for NRM (Non-Relapse Mortality) and RI (Relapse Incidence), as well the overall survival (OS) and infection incidence within 30 days of transplantation. We included in the analysis 226 patients who collectively underwent 231 HSCTs. The CI of grade II-IV aGVHD was found to be 29.9%, while that of moderate to severe cGVHD was 29.8%. The CI of NRM recorded at 1, 2, and 3 years after transplant was 18.2%, 19.6%, and 20.2%, respectively. The CI of RI at 1, 2, and 3 years from transplant was recorded to be 17.8%, 21.0%, and 21.6%, respectively. The median follow-up was 56 months, while the median OS for the whole cohort was not established; the OS at 1, 3, and 5 years from transplant was 69.6%, 59.3%, and 57.2%, respectively. We registered 88 bacteremias in 82/231 patients (35.5%), while invasive fungal infections occurred in 12/231 patients (5.2%). Our study suggests that the use of ATG at 5 mg/kg is highly effective in limiting the occurrence of both aGVHD and cGVHD, ensuring a low NRM, RI, and infection incidence.
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Affiliation(s)
- Mariella Lo Schirico
- Department of Medicine (DIMED), Hematology and Clinical Immunology Section, Padua University School of Medicine, 35121 Padova, Italy
- Onco Hematology, Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, 31033 Castelfranco Veneto, Italy
| | - Roberto Passera
- Department of Medical Sciences, Division of Nuclear Medicine, University of Torino, Corso AM Dogliotti 18, 10126 Torino, Italy
| | - Jessica Gill
- Department of Oncology, SSD Trapianto Allogenico di Cellule Staminali, Azienda Ospedaliera Universitaria (A.O.U.) Città della Salute e della Scienza di Torino, 10126 Torino, Italy
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, 10124 Torino, Italy
| | - Chiara Dellacasa
- Department of Oncology, SSD Trapianto Allogenico di Cellule Staminali, Azienda Ospedaliera Universitaria (A.O.U.) Città della Salute e della Scienza di Torino, 10126 Torino, Italy
| | - Irene Dogliotti
- Department of Oncology, SSD Trapianto Allogenico di Cellule Staminali, Azienda Ospedaliera Universitaria (A.O.U.) Città della Salute e della Scienza di Torino, 10126 Torino, Italy
| | - Luisa Giaccone
- Department of Oncology, SSD Trapianto Allogenico di Cellule Staminali, Azienda Ospedaliera Universitaria (A.O.U.) Città della Salute e della Scienza di Torino, 10126 Torino, Italy
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, 10124 Torino, Italy
| | - Sofia Zompi
- Department of Oncology, SSD Trapianto Allogenico di Cellule Staminali, Azienda Ospedaliera Universitaria (A.O.U.) Città della Salute e della Scienza di Torino, 10126 Torino, Italy
| | - Alessandro Busca
- Department of Oncology, SSD Trapianto Allogenico di Cellule Staminali, Azienda Ospedaliera Universitaria (A.O.U.) Città della Salute e della Scienza di Torino, 10126 Torino, Italy
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Busca A, Salmanton-García J, Marchesi F, Farina F, Seval GC, Van Doesum J, De Jonge N, Bahr NC, Maertens J, Meletiadis J, Fracchiolla NS, Weinbergerová B, Verga L, Ráčil Z, Jiménez M, Glenthøj A, Blennow O, Tanase AD, Schönlein M, Prezioso L, Khanna N, Duarte RF, Žák P, Nucci M, Machado M, Kulasekararaj A, Espigado I, De Kort E, Ribera-Santa Susana JM, Marchetti M, Magliano G, Falces-Romero I, Ilhan O, Ammatuna E, Zompi S, Tsirigotis P, Antoniadou A, Zambrotta GPM, Nordlander A, Karlsson LK, Hanakova M, Dragonetti G, Cabirta A, Berg Venemyr C, Gräfe S, Van Praet J, Tragiannidis A, Petzer V, López-García A, Itri F, Groh A, Gavriilaki E, Dargenio M, Rahimli L, Cornely OA, Pagano L. Outcome of COVID-19 in allogeneic stem cell transplant recipients: Results from the EPICOVIDEHA registry. Front Immunol 2023; 14:1125030. [PMID: 36911708 PMCID: PMC9999728 DOI: 10.3389/fimmu.2023.1125030] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/01/2023] [Indexed: 03/04/2023] Open
Abstract
Background The outcome of COVID-19 in allogeneic hematopoietic stem cell transplantation (HSCT) recipients is almost uniformely considered poor. The aim of present study was to retrospectively analyse the outcome and risk factors for mortality in a large series of patients who developed COVID-19 infection after an allogeneic HSCT. Methods This multicenter retrospective study promoted by the European Hematology Association - Infections in Hematology Study Working Group, included 326 adult HSCT patients who had COVID-19 between January 2020 and March 2022. Results The median time from HSCT to the diagnosis of COVID-19 was 268 days (IQR 86-713; range 0-185 days). COVID-19 severity was mild in 21% of the patients, severe in 39% and critical in 16% of the patients. In multivariable analysis factors associated with a higher risk of mortality were, age above 50 years, presence of 3 or more comorbidities, active hematologic disease at time of COVID-19 infection, development of COVID-19 within 12 months of HSCT, and severe/critical infections. Overall mortality rate was 21% (n=68): COVID-19 was the main or secondary cause of death in 16% of the patients (n=53). Conclusions Mortality in HSCT recipients who develop COVID-19 is high and largely dependent on age, comorbidities, active hematologic disease, timing from transplant and severity of the infection.
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Affiliation(s)
- Alessandro Busca
- Stem Cell Transplant Center, AOU Citta’ della Salute e della Scienza, Turin, Italy
| | - Jon Salmanton-García
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | | | | | | | - Nathan C. Bahr
- University of Kansas Medical Center, Kansas, KS, United States
| | - Johan Maertens
- Department of Microbiology, Immunology, and Transplantation, KULeuven, Leuven, Belgium
- Department of Hematology, UZ Leuven, Leuven, Belgium
| | - Joseph Meletiadis
- Clinical Microbiology Laboratory, Medical School, “Attikon” University General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Barbora Weinbergerová
- Department of Internal Medicine - Hematology and Oncology, Masaryk University Hospital Brno, Brno, Czechia
| | - Luisa Verga
- Azienda Ospedaliera San Gerardo - Monza, Monza, Italy
- Università Milano-Bicocca, Milan, Italy
| | - Zdeněk Ráčil
- Institute of Hematology and Blood Transfusion, Prague, Czechia
| | - Moraima Jiménez
- Department of Hematology, Vall d’Hebron Hospital Universitari, Experimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron Barcelona Hospital, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Andreas Glenthøj
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Ola Blennow
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Alina Daniela Tanase
- Fundeni Clinical Institute, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
| | - Martin Schönlein
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lucia Prezioso
- Hospital University of Parma - Hematology and Bone Marrow Unit, Parma, Italy
| | - Nina Khanna
- Division of Infectious Diseases and Hospital Epidemiology, and Department of Clinical Research, University and University Hospital of Basel, Basel, Switzerland
| | | | - Pavel Žák
- University Hospital Hradec Králové, Hradec Králové, Czechia
| | - Marcio Nucci
- Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marina Machado
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Austin Kulasekararaj
- King’s College Hospital, London, United Kingdom
- King’s College London, London, United Kingdom
| | - Ildefonso Espigado
- Department of Hematology, University Hospital Virgen Macarena - University Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS/CSIC), Universidad de Sevilla (Departamento de Medicina), Seville, Spain
| | | | | | - Monia Marchetti
- Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | | | | | | | | | - Sofia Zompi
- Stem Cell Transplant Center, AOU Citta’ della Salute e della Scienza, Turin, Italy
| | - Panagiotis Tsirigotis
- Clinical Microbiology Laboratory, Medical School, “Attikon” University General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasia Antoniadou
- Clinical Microbiology Laboratory, Medical School, “Attikon” University General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Anna Nordlander
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | | | | | - Giulia Dragonetti
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
| | - Alba Cabirta
- Department of Hematology, Vall d’Hebron Hospital Universitari, Experimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron Barcelona Hospital, Barcelona, Spain
| | - Caroline Berg Venemyr
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Stefanie Gräfe
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Jens Van Praet
- Department of Nephrology and Infectious diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | | | - Verena Petzer
- Department of Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria
| | - Alberto López-García
- Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Federico Itri
- San Luigi Gonzaga Hospital - Orbassano, Orbassano, Italy
| | - Ana Groh
- Infektiologie, Universitätsklinikum Frankfurt am Main, Frankfurt am Main, Germany
| | - Eleni Gavriilaki
- General Hospital of Thessaloniki “George Papanikolaou”, Thessaloniki, Greece
| | | | - Laman Rahimli
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Oliver A. Cornely
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Molecular Medicine Cologne (CMMC), Cologne, Germany
- German Centre for Infection Research (DZIF) , Cologne, Germany
| | - Livio Pagano
- Hematology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
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4
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Marchesi F, Salmanton-García J, Emarah Z, Piukovics K, Nucci M, López-García A, Rácil Z, Farina F, Popova M, Zompi S, Audisio E, Ledoux MP, Verga L, Weinbergerová B, Szotkovski T, Da Silva MG, Fracchiolla N, De Jonge N, Collins G, Marchetti M, Magliano G, García-Vidal C, Biernat MM, Van Doesum J, Machado M, Demirkan F, Al-Khabori M, Žák P, Víšek B, Stoma I, Méndez GA, Maertens J, Khanna N, Espigado I, Dragonetti G, Fianchi L, Del Principe MI, Cabirta A, Ormazabal-Vélez I, Jaksic O, Buquicchio C, Bonuomo V, Batinié J, Omrani AS, Lamure S, Finizio O, Fernández N, Falces-Romero I, Blennow O, Bergantim R, Ali N, Win S, Van Praet J, Tisi MC, Shirinova A, Schönlein M, Prattes J, Piedimonte M, Petzer V, Navrátil M, Kulasekararaj A, Jindra P, Sramek J, Glenthøj A, Fazzi R, De Ramón-Sánchez C, Cattaneo C, Calbacho M, Bahr NC, El-Ashwah S, Cordoba R, Hanakova M, Zambrotta GPM, Zambrotta G, Sciumè M, Booth S, Rodrigues RN, Sacchi MV, García-Poutón N, Martín-González JA, Khostelidi S, Gräfe S, Rahimli L, Ammatuna E, Busca A, Corradini P, Hoenigl M, Klimko N, Koehler P, Pagliuca A, Passamonti F, Cornely OA, Pagano L. COVID-19 in adult acute myeloid leukemia patients: a long-term follow-up study from the European Hematology Association survey (EPICOVIDEHA). Haematologica 2022; 108:22-33. [PMID: 35545919 PMCID: PMC9827164 DOI: 10.3324/haematol.2022.280847] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Indexed: 02/04/2023] Open
Abstract
Patients with acute myeloid leukemia (AML) are at high risk of dying from coronavirus disease 2019 (COVID-19). The optimal management of AML patients with COVID-19 has not been established. Our multicenter study included 388 adult AML patients diagnosed with COVID-19 between February 2020 and October 2021. The vast majority were receiving or had received AML treatment in the preceding 3 months. COVID-19 was severe in 41.2% and critical in 21.1% of cases. The chemotherapeutic schedule was modified in 174 patients (44.8%), delayed in 68 and permanently discontinued in 106. After a median follow-up of 325 days, 180 patients (46.4%) had died; death was attributed to COVID-19 (43.3%), AML (26.1%) or to a combination of both (26.7%), whereas in 3.9% of cases the reason was unknown. Active disease, older age, and treatment discontinuation were associated with death, whereas AML treatment delay was protective. Seventy-nine patients had a simultaneous AML and COVID-19 diagnosis, with better survival when AML treatment could be delayed (80%; P<0.001). Overall survival in patients with a diagnosis of COVID-19 between January 2020 and August 2020 was significantly lower than that in patients diagnosed between September 2020 and February 2021 and between March 2021 and September 2021 (39.8% vs. 60% vs. 61.9%, respectively; P=0.006). COVID-19 in AML patients was associated with a high mortality rate and modifications of therapeutic algorithms. The best approach to improve survival was to delay AML treatment, whenever possible.
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Affiliation(s)
- Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy,FM and JSG contributed equally as co-first authors
| | - Jon Salmanton-García
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany,University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany,FM and JSG contributed equally as co-first authors
| | - Ziad Emarah
- Oncology Center, Mansoura University, Mansoura, Egypt
| | - Klára Piukovics
- Department of Internal Medicine, South Division Faculty of Medicine University of Szeged, Szeged, Hungary
| | - Marcio Nucci
- Department of Internal Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Alberto López-García
- Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Zdenék Rácil
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | | | - Marina Popova
- RM Gorbacheva Research Institute, Pavlov University, St. Petersburg, Russia
| | - Sofia Zompi
- Stem Cell Transplant Center, AOU Citta' della Salute e della Scienza, Turin, Italy
| | - Ernesta Audisio
- Stem Cell Transplant Center, AOU Citta' della Salute e della Scienza, Turin, Italy
| | | | - Luisa Verga
- Azienda Ospedaliera San Gerardo - Monza, Monza, Italy,Università Milano-Bicocca, Milan, Italy
| | - Barbora Weinbergerová
- Department of Internal Medicine, Hematology and Oncology, University Hospital Brno, Brno, Czech Republic
| | | | | | - Nicola Fracchiolla
- Hematology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Nick De Jonge
- Amsterdam UMC, location VUmc, Amsterdam, the Netherlands
| | | | - Monia Marchetti
- Azienda Ospedaliera Nazionale “SS. Antonio e Biagio e Cesare Arrigo”, Alessandria, Italy
| | | | - Carolina García-Vidal
- Department of Infectious Diseases, Hospital Clinic de Barcelona, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Monika M. Biernat
- Department of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Jaap Van Doesum
- University Medical Center Groningen, Groningen, the Netherlands
| | - Marina Machado
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Fatih Demirkan
- Division of Hematology, Dokuz Eylul University, Izmir, Turkey
| | | | - Pavel Žák
- University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Benjamín Víšek
- University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Igor Stoma
- Gomel State Medical University, Gomel, Belarus
| | | | - Johan Maertens
- Department of Microbiology, Immunology, and Transplantation, KULeuven and Department of Hematology, UZ Leuven, Leuven, Belgium
| | - Nina Khanna
- Division of Infectious Diseases and Hospital Epidemiology, and Department of Clinical Research, University and University Hospital of Basel, Basel, Switzerland
| | - Ildefonso Espigado
- Department of Hematology, University Hospital Virgen Macarena - University Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS/CSIC), Universidad de Sevilla, Seville, Spain
| | - Giulia Dragonetti
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
| | - Luana Fianchi
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
| | | | - Alba Cabirta
- Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain,Department of Hematology, Vall d’Hebron Hospital Universitari, Experimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | | | | | | | - Valentina Bonuomo
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Josip Batinié
- Croatian Cooperative Group for Hematological Diseases (CROHEM), Zagreb, Croatia,Faculty of Medicine University of Zagreb, Zagreb, Croatia,University Hospital Centre Zagreb, Zagreb, Croatia
| | - Ali S. Omrani
- Hamad Medical Corporation, Division of Infectious Diseases, Doha, Qatar
| | - Sylvain Lamure
- Département d’Hématologie Clinique, CHU de Montpellier, UMR-CNRS 5535, Universite de Montpellier, Montpellier, France
| | | | - Noemí Fernández
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | - Ola Blennow
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Rui Bergantim
- Centro Hospitalar e Universitário São João, Porto, Portugal
| | - Natasha Ali
- Aga Khan University Hospital, Karachi, Pakistan
| | - Sein Win
- Department of Clinical Hematology, Yangon General Hospital, University of Medicine, Yangon, Myanmar
| | - Jens Van Praet
- Department of Nephrology and Infectious Diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | | | - Ayten Shirinova
- Azerbaijan Scientific Research Hematology and Transfusiology Institute, Baku, Azerbaijan
| | - Martin Schönlein
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Juergen Prattes
- Medical University of Graz, Department for Infectious Diseases, Graz, Austria
| | | | - Verena Petzer
- Department of Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria
| | - Milan Navrátil
- Head of the ICU and Transplant Unit, Department of Hematooncology, University Hospital of Ostrava, Ostrava-Poruba, Czech Republic
| | | | - Pavel Jindra
- University Hospital Pilsen, Pilsen, Czech Republic
| | - Jirí Sramek
- Department of Hematology and Oncology, University Hospital Pilsen, Pilsen, Czech Republic,Department of Histology and Embryology, Faculty of Medicine, Pilsen, Czech Republic
| | - Andreas Glenthøj
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Rita Fazzi
- AOUP - Azienda Ospedaliera Università Pisana - Cisanello, Pisa, Italy
| | - Cristina De Ramón-Sánchez
- Hematology Department, Hospital Universitario de Salamanca, Salamanca, Spain,IBSAL, Centro de Investigación del Cáncer-IBMCC (USAL-CSIC), Salamanca, Spain
| | | | | | | | | | - Raul Cordoba
- Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Michaela Hanakova
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | | | | | - Mariarita Sciumè
- Hematology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | | | - Maria Vittoria Sacchi
- Azienda Ospedaliera Nazionale “SS. Antonio e Biagio e Cesare Arrigo”, Alessandria, Italy
| | - Nicole García-Poutón
- Department of Infectious Diseases, Hospital Clinic de Barcelona, University of Barcelona, IDIBAPS, Barcelona, Spain
| | | | - Sofya Khostelidi
- North-Western State Medical University named after Iliá Ilich Méchnikov, Saint-Petersburg, Russia
| | - Stefanie Gräfe
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany,University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany,Universitätsklinikum Hamburg Eppendorf, Hamburg, Germany
| | - Laman Rahimli
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany,University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | | | - Alessandro Busca
- Stem Cell Transplant Center, AOU Citta' della Salute e della Scienza, Turin, Italy
| | - Paolo Corradini
- University of Milan and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Martin Hoenigl
- Clinical and Translational Fungal-Working Group, University of California San Diego, La Jolla, CA, USA,Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, San Diego, CA, USA,Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Nikolai Klimko
- North-Western State Medical University named after Iliá Ilich Méchnikov, Saint-Petersburg, Russia
| | - Philipp Koehler
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany,University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Antonio Pagliuca
- Department of Haematological Medicine, Kings College Hospital NHS Foundation Trust, London, UK
| | - Francesco Passamonti
- Department of Medicine and Surgery, University of Insubria and ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Oliver A. Cornely
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany,University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany,University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany,OAC and LP contributed equally as co-senior authors
| | - Livio Pagano
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy,Hematology Unit, Università Cattolica del Sacro Cuore, Rome, Italy,OAC and LP contributed equally as co-senior authors
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5
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Zompi S, Colucci F. Anatomy of a murder—signal transduction pathways leading to activation of natural killer cells. Immunol Lett 2005; 97:31-9. [PMID: 15626473 DOI: 10.1016/j.imlet.2004.10.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2004] [Revised: 09/15/2004] [Accepted: 10/08/2004] [Indexed: 01/08/2023]
Abstract
Natural killer (NK) cells control the early phases of viral infections, modulate antigen-specific immune responses, and participate in the rejection of tumours and bone marrow grafts. A fine balance between inhibitory and activating receptors tightly regulates NK cell activation. Biochemical studies in human cell lines and primary cells have revealed some of the activating NK cell signalling pathways, however animal models are instrumental to understand the physiological implications of these findings for immune responses in vivo. Gene targeting in mice and biochemical studies in cells are helping to dissect out the various signal transduction pathways that control NK cell activation. A clearer view of these pathways may eventually help designing more effective immune therapies based on the use of NK cells.
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Affiliation(s)
- S Zompi
- Cytokines and Lymphoid Development Unit, Institut Pasteur, 25-28 rue Dr Roux, 75015 Paris, France
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6
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Bouscary D, Lecoq-Lafon C, Chrétien S, Zompi S, Fichelson S, Muller O, Porteu F, Dusanter-Fourt I, Gisselbrecht S, Mayeux P, Lacombe C. Role of Gab proteins in phosphatidylinositol 3-kinase activation by thrombopoietin (Tpo). Oncogene 2001; 20:2197-204. [PMID: 11402314 DOI: 10.1038/sj.onc.1204317] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2000] [Revised: 01/22/2001] [Accepted: 01/30/2001] [Indexed: 12/18/2022]
Abstract
In this study, we show that upon thrombopoietin (Tpo) stimulation the two adapter proteins Gab1 and Gab2 are strongly tyrosine phosphorylated and associated with Shc, SHP2, PI 3-kinase and Grb2 in mpl-expressing UT7 cells. Although Gab1 and Gab2 seem to mediate overlapping biological signals in many cells, only Gab1 is expressed and phosphorylated in response to Tpo in primary human megakaryocytic progenitors; furthermore, it associates with the same proteins. Although a low level of tyrosine phosphorylated IRS-2 protein is also detected in PI 3-kinase immunoprecipitates, Gab proteins are the essential proteins associated with PI 3-kinase after Tpo stimulation. We demonstrate that, albeit no association is detected between the Tpo receptor mpl and Gab proteins, Y112 located in the C-terminal cytoplasmic domain of mpl is required for Gab1/2 tyrosine phosphorylation. Gab proteins are not tyrosine phosphorylated after Tpo stimulation of UT-7 and Ba/F3 cells expressing a mpl mutant lacking Y112. Moreover, no activation of the PI 3-kinase/Akt pathway is observed in cells expressing this mpl mutant. Finally, we show that this mutant does not allow cell proliferation, thereby confirming that PI 3-kinase activation is required for Tpo-induced cell proliferation.
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Affiliation(s)
- D Bouscary
- Institut Cochin de Génétique Moléculaire (ICGM), Institut National de la Santé et de la Recherche Médicale (INSERM U363), Université René Descartes, France
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7
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Zompi S, Delfau-Larue MH, Stern M, Blanche P, Lahet C, Farcet JP, Couderc LJ. Lymphoid interstitial pneumonitis in patients with the human immunodeficiency virus: usefulness of alveolar lymphocytes gene by polymerase chain reaction. Arch Intern Med 2001; 161:124. [PMID: 11146709 DOI: 10.1001/archinte.161.1.124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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8
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Zompi S, Legrand O, Bouscary D, Blanc CM, Picard F, Casadevall N, Dreyfus F, Marie JP, Viguié F. Therapy-related acute myeloid leukaemia after successful therapy for acute promyelocytic leukaemia with t(15;17): a report of two cases and a review of the literature. Br J Haematol 2000; 110:610-3. [PMID: 10997972 DOI: 10.1046/j.1365-2141.2000.02240.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We describe two patients with positive t(15;17) acute promyelocytic leukaemia (APL) that developed into a therapy-related myelodysplasia 2-2.5 years after complete remission (CR) and then evolved into therapy-related acute myeloid leukaemia (t-AML). Both patients received anthracyclines as potential leukaemogenic drugs. In both cases, cytogenetic changes usually occurring after use of alkylating agents were noticed: monosomy 7 associated with monosomy 5 or 5q- chromosome. A review of the literature on t-AML occurring after successful therapy for APL showed only one report similar to these two cases. These observations suggest that anthracyclines can cause t-AML similar to that induced by alkylating agents.
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MESH Headings
- Adult
- Antibiotics, Antineoplastic/adverse effects
- Antibiotics, Antineoplastic/therapeutic use
- Child
- Chromosomes, Human, Pair 15
- Chromosomes, Human, Pair 17
- Chromosomes, Human, Pair 5
- Chromosomes, Human, Pair 7
- Female
- Humans
- Karyotyping
- Leukemia, Myeloid/chemically induced
- Leukemia, Myeloid/complications
- Leukemia, Myeloid/genetics
- Leukemia, Promyelocytic, Acute/complications
- Leukemia, Promyelocytic, Acute/drug therapy
- Leukemia, Promyelocytic, Acute/genetics
- Male
- Middle Aged
- Monosomy
- Recurrence
- Translocation, Genetic
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Affiliation(s)
- S Zompi
- Services d'Hématologie biologique et clinique, Hôpital Hôtel-Dieu, and Services d'Hématologie biologique et clinique, Hôpital Cochin, Paris, France
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9
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Zompi S, Tulliez M, Conti F, Leblond V, Gaulard P, Blanche P, Durand F, Ghandi D, Dreyfus F, Louvel A, Calmus Y, Bouscary D. Rituximab (anti-CD20 monoclonal antibody) for the treatment of patients with clonal lymphoproliferative disorders after orthotopic liver transplantation: a report of three cases. J Hepatol 2000; 32:521-7. [PMID: 10735625 DOI: 10.1016/s0168-8278(00)80406-7] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
BACKGROUND/AIMS Post-transplant lymphoproliferative disorders (PT-LPD) are a well-known complication of organ transplantation. Their incidence after liver transplantation in adults ranges from 1.8 to 4%. Reduction of immunosuppression led to remission in a few cases. Other treatments include chemotherapy, interferon alpha therapy and/or intravenous-immunoglobulins, or antiviral drugs. However, monoclonal antibodies directed against B-cell specific antigens have rarely been used in those patients. Our aim was to study the feasibility and efficacy of Rituximab, a new, promising human chimeric antibody that recognizes the CD20 antigen, for the treatment of patients with clonal lymphoproliferative disorders after orthotopic liver transplantation. METHODS Rituximab (IDEC-C2HB8; Roche Laboratories, Neuilly-sur-Seine, France) was administered at a 375 mg/m2 dose on days 1, 8, 15, and 22, in an outpatient setting, in three patients with PT-LPD. The tumor was classified as polymorphic PT-LPD in two cases and PT-LPD with features of large cell lymphoma in one case. All the tumors expressed the CD20 antigen and were EBV-related, and the clonality was confirmed in all three cases. The 4 injections of the anti-CD20 monoclonal antibody were associated with reduced immunosuppression in the three patient. RESULTS The treatment with Rituximab was well tolerated without any side effects. The two patients with polymorphic PT-LPDs underwent rapid complete remission, whereas the treatment modalities were ineffective in the patient with the large-cell non-Hodgkin-lymphoma. CONCLUSION These results must be confirmed in a larger cohort of liver transplant recipients suffering from lymphoproliferation. However, they indicate rapid efficiency of Rituximab in association with reduced immunosuppression in these disorders.
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Affiliation(s)
- S Zompi
- Service d'Hématologie, Hôpital Cochin, Paris, France
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Breban M, Dougados M, Picard F, Zompi S, Marolleau JP, Bocaccio C, Heshmati F, Mezieres M, Dreyfus F, Bouscary D. Intensified-dose (4 gm/m2) cyclophosphamide and granulocyte colony-stimulating factor administration for hematopoietic stem cell mobilization in refractory rheumatoid arthritis. Arthritis Rheum 1999; 42:2275-80. [PMID: 10555020 DOI: 10.1002/1529-0131(199911)42:11<2275::aid-anr3>3.0.co;2-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To evaluate the feasibility, safety, and efficacy of intensified-dose cyclophosphamide (ID-CYC), followed by granulocyte colony-stimulating factor (G-CSF) administration for collection of peripheral blood hematopoietic stem cells (HSC), for patients with severe, refractory rheumatoid arthritis (RA). METHODS Four patients with severe refractory RA were enrolled in this open study. They received a single infusion of CYC (4 gm/m2) at day 0 followed by G-CSF (5 microg/kg/day) from day 6 until the last day of leukapheresis (performed at the time of hematopoietic recovery) to harvest peripheral blood HSC. Patients were monitored for disease activity, adverse effects, and hematopoietic reconstitution following this procedure. RESULTS For all patients, administration of ID-CYC induced an early, dramatic improvement of disease activity. Long-term followup indicates that partial disease relapse was observed for all patients. No adverse effect was directly attributable to the treatment procedure. For most patients, HSC collection was sufficient to provide a graft enriched in CD34+ cells by positive selection as well as an unselected rescue graft. CONCLUSION Patients with severe, refractory RA can benefit from ID-CYC. This procedure, followed by G-CSF administration, appears safe and technically suitable. In addition, it allows immediate improvement of RA activity that can occasionally persist beyond 6 months.
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Affiliation(s)
- M Breban
- Cochin Hospital, Université René Descartes, Paris, France
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Bouscary D, Jondeau K, Viguié F, Zompi S, Fontenay-Roupie M, Quarre MC, Vassilief D, Dreyfus F, Casadevall N. Aplastic anemia responsive to cyclosporine complicating the evolution of polycythemia vera. Leuk Lymphoma 1999; 33:607-11. [PMID: 10342591 DOI: 10.3109/10428199909058468] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We report here a very unusual patient with Polycythemia vera treated with Pipobroman who developed severe aplastic anemia following administration of the drug. Six months later, because of lack of response, cyclosporine therapy was given there was rapid and complete hematological recovery, highly suggestive of an immune-mediated mechanism, in this case.
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Affiliation(s)
- D Bouscary
- Service d'Hématologie, Hôpital Cochin, Paris, France
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