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  1. Article ; Online: Editorial

    Alessandro Busca

    Reviews in Health Care, Vol 3, Iss 1S, Pp 3-

    2013  Volume 4

    Keywords Invasive fungal disease ; Epidemiology ; Hematology ; Public aspects of medicine ; RA1-1270 ; Medicine ; R ; DOAJ:Public Health ; DOAJ:Health Sciences
    Language Italian
    Publishing date 2013-01-01T00:00:00Z
    Publisher SEEd
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Editorial

    Alessandro Busca

    Reviews in Health Care, Vol 3, Iss 1S, Pp 3-

    2013  Volume 4

    Keywords Invasive fungal disease ; Epidemiology ; Hematology ; Public aspects of medicine ; RA1-1270 ; Medicine ; R
    Language Italian
    Publishing date 2013-01-01T00:00:00Z
    Publisher SEEd
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

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  3. Article ; Online: Use of Letermovir for CMV Prophylaxis after Allogeneic Hematopoietic Stem Cell Transplantation

    Jessica Gill / Davide Stella / Irene Dogliotti / Chiara Dellacasa / Luisa Giaccone / Alessandro Busca

    Hemato, Vol 4, Iss 13, Pp 158-

    Review of the Literature and Single-Center Real-Life Experience

    2023  Volume 169

    Abstract: Cytomegalovirus (CMV) reactivation after allogeneic hematopoietic stem cell transplant (allo-HSCT) is mainly due to an increase of latent viremia in previously exposed patients. Furthermore, CMV reactivation in this setting has a significant impact on ... ...

    Abstract Cytomegalovirus (CMV) reactivation after allogeneic hematopoietic stem cell transplant (allo-HSCT) is mainly due to an increase of latent viremia in previously exposed patients. Furthermore, CMV reactivation in this setting has a significant impact on patient survival. Traditional approach to CMV reactivation post allo-HSCT was a pre-emptive treatment with antivirals in the case of increased viremia. However, since 2017, a new antiviral compound, letermovir, has been introduced in clinical practice and is deeply changing the common CMV approach. The toxicity profile of letermovir allowed its use in prophylaxes in patients at high risk of CMV reactivation. This review will focus on the present role of letermovir post allo-HSCT and discuss some possible future applications of the drug. Finally, our single center CMV management in view of the recent introduction of letermovir will be discussed.
    Keywords allogeneic hematopoietic stem cell transplant ; CMV ; pre-emptive therapy ; letermovir ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2023-04-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Editorial

    Alessandro Busca

    Reviews in Health Care, Vol 3, Iss 1S, Pp 3-

    2012  Volume 4

    Keywords Invasive fungal disease ; Epidemiology ; Hematology ; Public aspects of medicine ; RA1-1270
    Language English
    Publishing date 2012-10-01T00:00:00Z
    Publisher SEEd
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

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    Inter-library loan at ZB MED

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  5. Article ; Online: Bacterial Bloodstream Infections after Allogeneic Hematopoietic Stem Cell Transplantation

    Jessica Gill / Alessandro Busca / Natascia Cinatti / Roberto Passera / Chiara Maria Dellacasa / Luisa Giaccone / Irene Dogliotti / Sara Manetta / Silvia Corcione / Francesco Giuseppe De Rosa

    Microorganisms, Vol 11, Iss 742, p

    Etiology, Risk Factors and Outcome in a Single-Center Study

    2023  Volume 742

    Abstract: Background—Allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients are subject to major risks for bacterial bloodstream infections (BSIs), including emergent multidrug-resistant (MDR) organisms, which still represent the main cause of ... ...

    Abstract Background—Allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients are subject to major risks for bacterial bloodstream infections (BSIs), including emergent multidrug-resistant (MDR) organisms, which still represent the main cause of morbidity and mortality in transplanted patients. Methods: We performed an observational, retrospective, single-center study on patients undergoing allo-HSCT between 2004 and 2020 at the Stem Cell Transplant Unit in Turin to assess the incidence, etiology, and outcomes of BSIs and to explore any risk factors for bacteriaemia. Results: We observed a total of 178 bacterial BSIs in our cohort of 563 patients, resulting in a cumulative incidence of 19.4%, 23.8%, and 28.7% at 30, 100, and 365 days, respectively. Among isolated bacteria, 50.6% were Gram positive (GPB), 41.6% were Gram negative (GNB), and 7.9% were polymicrobial infections. Moreover, BSI occurrence significantly influenced 1-year overall survival. High and very high Disease Risk Index (DRI), an haploidentical donor, and antibacterial prophylaxis were found as results as independent risk factors for bacterial BSI occurrence in multivariate analysis. Conclusions: In our experience, GNB have overwhelmed GPB, and fluoroquinolone prophylaxis has contributed to the emergence of MDR pathogens. Local resistance patterns and patients’ characteristics should therefore be considered for better management of bacteremia in patients receiving an allogeneic HSCT.
    Keywords bloodstream infections ; allogeneic hematopoietic stem cell transplantation ; multidrug-resistant bacteria ; anti-bacterial prophylaxis ; fluoroquinolones ; antimicrobial stewardship ; Biology (General) ; QH301-705.5
    Subject code 610
    Language English
    Publishing date 2023-03-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Cost-Effectiveness of Targeted Prophylaxis among Allogenic Stem Cell Transplant Recipients

    Nour Shbaklo / Costanza Vicentini / Alessandro Busca / Luisa Giaccone / Chiara Dellacasa / Irene Dogliotti / Tommaso Lupia / Carla M. Zotti / Silvia Corcione / Francesco Giuseppe De Rosa

    Pharmaceuticals, Vol 16, Iss 466, p

    2023  Volume 466

    Abstract: Bloodstream infections (BSI) are life-threatening complications for onco-hematologic patients. Fluoroquinolones prophylaxis (FQP) was recommended for patients with neutropenia. Later, it was correlated with increased resistance rates among this ... ...

    Abstract Bloodstream infections (BSI) are life-threatening complications for onco-hematologic patients. Fluoroquinolones prophylaxis (FQP) was recommended for patients with neutropenia. Later, it was correlated with increased resistance rates among this population and its role became debated. While the role of FQ prophylaxis is still being studied, its cost-effectiveness is also unknown. The objective of this study was to evaluate the costs and effects associated with two alternative strategies (FQP vs. no prophylaxis) for patients with hematological malignancies undergoing allogenic stem cell transplant (HSCT). A decision-tree model was built integrating retrospectively collected data from a single transplant center, part of a tertiary teaching hospital in Northern Italy. Probabilities, costs and effects were considered in the assessment of the two alternative strategies. Probabilities of colonization, BSIs, extended-spectrum beta lactamase (ESBL) and Klebsiella pneumoniae carbapenemase (KPC) BSIs and mortality associated with infection, as well as median duration of length of stay (LOS) were calculated based on data collected between 2013 and 2021. The center applied the strategy of FQP between 2013 and 2016, and of no prophylaxis between 2016 and 2021. Data on 326 patients were collected during the considered time period. Overall, the rates of colonization, BSI, KPC/ESBL BSI, and mortality were 6.8% (95% confidence interval (CI) 2.7–13.5), 42% (9.9–81.4) and 20.72 (16.67–25.26), respectively. A mean bed-day cost of 132€ was estimated. Considering no prophylaxis vs. prophylaxis, the difference in costs ranged between additional 33.61 and 80.59€ per patient, whereas the difference in effects ranged between 0.11 and 0.03 life-years (LYs) lost (around 40 and 11 days). Given the small differences in terms of costs and effects between the two strategies, no prophylaxis seems an appropriate choice. Furthermore, this analysis did not consider the broader effect on hospital ecology of multiple doses of FQP, which could provide ...
    Keywords antibiotic prophylaxis ; bloodstream infections ; onco-hematologic transplant ; multi-drug resistant infections ; cost-effectiveness analysis ; Medicine ; R ; Pharmacy and materia medica ; RS1-441
    Subject code 610
    Language English
    Publishing date 2023-03-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

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    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  7. Article ; Online: Prophylaxis and treatment of invasive fungal infections in hematological patients

    Alessandro Busca / Anna Candoni / Livio Pagano / Francesco Scaglione / Claudio Viscoli

    Reviews in Health Care, Vol 3, Iss 1S, Pp 27-

    2013  Volume 40

    Abstract: The evidence from the literature strongly support antifungal prophylaxis in high risk haematological patients, such as patients with AML during remission induction chemotherapy and alloHSCT patients. Current antifungal prophylaxis guidelines for high ... ...

    Abstract The evidence from the literature strongly support antifungal prophylaxis in high risk haematological patients, such as patients with AML during remission induction chemotherapy and alloHSCT patients. Current antifungal prophylaxis guidelines for high risk patients recommend azoles (fluconazole, posaconazole, voriconazole) and echinocandins (micafungin) with the strongest level of evidence. In terms of treatment, the choice between empiric therapy (or fever driven) and pre-emptive therapy (or diagnostic driven) is still debated. Not a single therapeutic strategy is appropriate in every patients, in particular empirical antifungal therapy may be recommended in patients at very high risk, while a pre-emptive approach may be advised for those at standard risk. In order to exploit the synergistic and/or additive effect of two antifungal drugs it’s possible to combine two agents that work with different mechanisms of action (e.g. echinocandins + azoles or polyenes). Once the treatment has been initiated we should consider the therapeutic drug monitoring (TDM) of the drugs, especially when the pharmacokinetic variability is high and the dose-concentration effect relationships is not predictable (e.g. for itraconazole, voriconazole and posaconazole).
    Keywords Prophylaxis ; Therapy ; Invasive fungal disease ; Public aspects of medicine ; RA1-1270
    Subject code 610
    Language English
    Publishing date 2013-01-01T00:00:00Z
    Publisher SEEd
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

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    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  8. Article ; Online: Prophylaxis and treatment of invasive fungal infections in hematological patients

    Claudio Viscoli / Francesco Scaglione / Anna Candoni / Livio Pagano / Alessandro Busca

    Reviews in Health Care, Vol 3, Iss 1S, Pp 27-

    2013  Volume 40

    Abstract: The evidence from the literature strongly support antifungal prophylaxis in high risk haematological patients, such as patients with AML during remission induction chemotherapy and alloHSCT patients. Current antifungal prophylaxis guidelines for high ... ...

    Abstract The evidence from the literature strongly support antifungal prophylaxis in high risk haematological patients, such as patients with AML during remission induction chemotherapy and alloHSCT patients. Current antifungal prophylaxis guidelines for high risk patients recommend azoles (fluconazole, posaconazole, voriconazole) and echinocandins (micafungin) with the strongest level of evidence. In terms of treatment, the choice between empiric therapy (or fever driven) and pre-emptive therapy (or diagnostic driven) is still debated. Not a single therapeutic strategy is appropriate in every patients, in particular empirical antifungal therapy may be recommended in patients at very high risk, while a pre-emptive approach may be advised for those at standard risk. In order to exploit the synergistic and/or additive effect of two antifungal drugs it’s possible to combine two agents that work with different mechanisms of action (e.g. echinocandins + azoles or polyenes). Once the treatment has been initiated we should consider the therapeutic drug monitoring (TDM) of the drugs, especially when the pharmacokinetic variability is high and the dose-concentration effect relationships is not predictable (e.g. for itraconazole, voriconazole and posaconazole).
    Keywords Prophylaxis ; Therapy ; Invasive fungal disease ; Public aspects of medicine ; RA1-1270
    Subject code 610
    Language English
    Publishing date 2013-01-01T00:00:00Z
    Publisher SEEd
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

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    Inter-library loan at ZB MED

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  9. Article ; Online: High Incidence of Invasive Fungal Diseases in Patients with FLT3-Mutated AML Treated with Midostaurin

    Chiara Cattaneo / Francesco Marchesi / Irene Terrenato / Valentina Bonuomo / Nicola Stefano Fracchiolla / Mario Delia / Marianna Criscuolo / Anna Candoni / Lucia Prezioso / Davide Facchinelli / Crescenza Pasciolla / Maria Ilaria Del Principe / Michelina Dargenio / Caterina Buquicchio / Maria Enza Mitra / Francesca Farina / Erika Borlenghi / Gianpaolo Nadali / Vito Pier Gagliardi /
    Luana Fianchi / Mariarita Sciumè / Pierantonio Menna / Alessandro Busca / Giuseppe Rossi / Livio Pagano

    Journal of Fungi, Vol 8, Iss 583, p

    Results of a Multicenter Observational SEIFEM Study

    2022  Volume 583

    Abstract: The potential drug-drug interactions of midostaurin may impact the choice of antifungal (AF) prophylaxis in FLT3-positive acute myeloid leukemia (AML) patients. To evaluate the incidence of invasive fungal diseases (IFD) during the treatment of FLT3- ... ...

    Abstract The potential drug-drug interactions of midostaurin may impact the choice of antifungal (AF) prophylaxis in FLT3-positive acute myeloid leukemia (AML) patients. To evaluate the incidence of invasive fungal diseases (IFD) during the treatment of FLT3-mutated AML patients and to correlate it to the different AF prophylaxis strategies, we planned a multicenter observational study involving 15 SEIFEM centers. One hundred fourteen patients treated with chemotherapy + midostaurin as induction/reinduction, consolidation or both were enrolled. During induction, the incidence of probable/proven and possible IFD was 10.5% and 9.7%, respectively; no statistically significant difference was observed according to the different AF strategy adopted. The median duration of neutropenia was similar in patients with or without IFD. Proven/probable and possible IFD incidence was 2.4% and 1.8%, respectively, during consolidation. Age was the only risk factor for IFD (OR, 95% CI, 1.10 [1.03–1.19]) and complete remission achievement after first induction the only one for survival (OR, 95% CI, 5.12 [1.93–13.60]). The rate of midostaurin discontinuation was similar across different AF strategies. The IFD attributable mortality during induction was 8.3%. In conclusion, the 20.2% overall incidence of IFD occurring in FLT3-mutated AML during induction with chemotherapy + midostaurin, regardless of AF strategy type, was noteworthy, and merits further study, particularly in elderly patients.
    Keywords invasive fungal disease ; acute myeloid leukemia ; midostaurin ; antifungal prophylaxis ; Biology (General) ; QH301-705.5
    Subject code 610
    Language English
    Publishing date 2022-05-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

    More links

    Kategorien

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  10. Article ; Online: Prophylaxis and treatment of invasive fungal infections in hematological patients

    Alessandro Busca / Anna Candoni / Livio Pagano / Francesco Scaglione / Claudio Viscoli

    Reviews in Health Care, Vol 3, Iss 1S, Pp 27-

    2012  Volume 40

    Abstract: The evidence from the literature strongly support antifungal prophylaxis in high risk haematological patients, such as patients with AML during remission induction chemotherapy and alloHSCT patients. Current antifungal prophylaxis guidelines for high ... ...

    Abstract The evidence from the literature strongly support antifungal prophylaxis in high risk haematological patients, such as patients with AML during remission induction chemotherapy and alloHSCT patients. Current antifungal prophylaxis guidelines for high risk patients recommend azoles (fluconazole, posaconazole, voriconazole) and echinocandins (micafungin) with the strongest level of evidence. In terms of treatment, the choice between empiric therapy (or fever driven) and pre-emptive therapy (or diagnostic driven) is still debated. Not a single therapeutic strategy is appropriate in every patients, in particular empirical antifungal therapy may be recommended in patients at very high risk, while a pre-emptive approach may be advised for those at standard risk. In order to exploit the synergistic and/or additive effect of two antifungal drugs it’s possible to combine two agents that work with different mechanisms of action (e.g. echinocandins + azoles or polyenes). Once the treatment has been initiated we should consider the therapeutic drug monitoring (TDM) of the drugs, especially when the pharmacokinetic variability is high and the dose-concentration effect relationships is not predictable (e.g. for itraconazole, voriconazole and posaconazole).
    Keywords Prophylaxis ; Therapy ; Invasive fungal disease ; Public aspects of medicine ; RA1-1270
    Subject code 610
    Language English
    Publishing date 2012-10-01T00:00:00Z
    Publisher SEEd
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

    More links

    Kategorien

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

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