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Article ; Online: Infection prevention practices among EBMT hematopoietic cell transplant centers: the EBMT Infectious Disease Working Party survey.

Yeshurun, Moshe / Rozovski, Uri / Shargian, Liat / Pasvolsky, Oren / van der Werf, Steffie / Tridello, Gloria / Knelange, Nina / Mikulska, Malgorzata / Styczynski, Jan / Averbuch, Diana / de la Camara, Rafael

Bone marrow transplantation

2023 Volume 58, Issue 4, Page(s) 414–423

Abstract: We aimed to describe the current status of infection prevention practices among EBMT centers. Questionnaires were distributed to all 553 EBMT transplant centers to capture clinical practices regarding antimicrobial prophylaxis, protective measures, ... ...

Abstract	We aimed to describe the current status of infection prevention practices among EBMT centers. Questionnaires were distributed to all 553 EBMT transplant centers to capture clinical practices regarding antimicrobial prophylaxis, protective measures, isolation procedures and growth-factor support of patients undergoing hematopoietic cell transplantation. Responses from 127 centers in 32 countries were obtained. Most centers housed patients in single rooms (autologous-82%; allogeneic-98%), with high-efficiency particulate air (HEPA)-filters (autologous-73%; allogeneic-100%) and positive pressure (autologous-61%; allogeneic-88%). Pre-engraftment G-CSF was utilized by 77 and 31% of centers after autologous and allogeneic transplantation, respectively (P < 0.00001). Antibacterial prophylaxis was provided by 57 and 69% (P = 0.086) of centers and antifungal prophylaxis by 65 and 84% (P = 0.0008) of centers, to patients undergoing autologous and allogeneic transplantation, respectively. Yet, 16 and 3% of centers provided neither antibacterial nor antifungal prophylaxis to patients undergoing autologous and allogeneic transplantation, respectively. Considerable variation existed between centers and across countries in antimicrobial prophylaxis practices, medications employed and duration of preventive therapy. There were considerable discordances between guidelines and daily practices. JACIE accredited and non-accredited centers did not differ significantly in their antimicrobial prophylaxis practices. Whether these differences between transplant centers translated into differences in infectious morbidity, mortality and financial costs, warrants further research.
MeSH term(s)	Humans ; Hematopoietic Stem Cell Transplantation/methods ; Antifungal Agents/therapeutic use ; Communicable Diseases ; Surveys and Questionnaires ; Anti-Infective Agents/therapeutic use ; Anti-Bacterial Agents/therapeutic use
Chemical Substances	Antifungal Agents ; Anti-Infective Agents ; Anti-Bacterial Agents
Language	English
Publishing date	2023-01-18
Publishing country	England
Document type	Journal Article
ZDB-ID	632854-4
ISSN	1476-5365 ; 0268-3369 ; 0951-3078
ISSN (online)	1476-5365
ISSN	0268-3369 ; 0951-3078
DOI	10.1038/s41409-023-01916-6
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Article ; Online: Investigation and Management of Bone Mineral Density Following Hematopoietic Cell Transplantation: A Survey of Current Practice by the Transplant Complications Working Party of the European Society for Blood and Marrow Transplantation.

Salooja, Nina / Greinix, Hildegaard / Ruutu, Tapani / van der Werf, Steffie / van Biezen, Anja / Lawitschka, Anita / Basak, Grzegorz / Duarte, Rafael

Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation

2020 Volume 26, Issue 10, Page(s) 1955–1962

Abstract: Reduced bone mineral density (BMD) is a well-recognized complication of hematopoietic cell transplantation (HCT), with significant drops in BMD occurring within the first 12 months after HCT. Guidance on identifying and managing this complication is ... ...

Abstract	Reduced bone mineral density (BMD) is a well-recognized complication of hematopoietic cell transplantation (HCT), with significant drops in BMD occurring within the first 12 months after HCT. Guidance on identifying and managing this complication is available in several published guidelines. In this study, we investigated current practices in the investigation and management of low BMD in centers registered with the European Society for Blood and Marrow Transplantation (EBMT). A questionnaire about bone health was sent to all registered centers, and responses were received from 99 centers in 25 countries (52%) currently registered with the EBMT. Our data highlight considerable heterogeneity in practices across European centers in relation to investigations, management, and use of guidelines. Our data demonstrate the need for better dissemination and implementation of existing guidelines and also for the development of multidisciplinary guidelines with input from all relevant stakeholders.
MeSH term(s)	Bone Density ; Bone Marrow ; Bone Marrow Transplantation ; Hematopoietic Stem Cell Transplantation/adverse effects ; Surveys and Questionnaires
Language	English
Publishing date	2020-07-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	1474865-4
ISSN	1523-6536 ; 1083-8791
ISSN (online)	1523-6536
ISSN	1083-8791
DOI	10.1016/j.bbmt.2020.06.022
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Article: Nutritional support in stem cell transplantation programs: Results from a multicenter survey of nurses on behalf of the Nurses Group and Transplant Complications Working Party of the European Society for Blood and Marrow Transplantation and the Gruppo Italiano Trapianto di Midollo Osseo

Botti, Stefano / van der Werf, Steffie / Stringer, Jacqui / Eeltink, Corien / Murray, John / Ciceri, Fabio / Babic, Aleksandra / Duarte, Rafael F / Labopin, Myriam / Peczynski, Christophe / Basak, Grzegorz Wladyslaw / Liptrott, Sarah Jayne

Nutrition. 2020 Nov., Dec., v. 79-80

2020

Abstract: Malnutrition in patients undergoing hematopoietic stem cell transplant (HSCT) can develop rapidly without appropriate nutritional support and affect morbidity and mortality. Guidance to monitor and manage nutrition status is described within the ... ...

Abstract	Malnutrition in patients undergoing hematopoietic stem cell transplant (HSCT) can develop rapidly without appropriate nutritional support and affect morbidity and mortality. Guidance to monitor and manage nutrition status is described within the literature; however, whether this is applied in clinical practice is unclear.This paper describes a cross-sectional survey to explore current practice approaches in nutrition support management and adherence to international guidelines.A total of 108 nurses from 108 centers across 16 countries replied to the questionnaire. A significant variation was observed regarding the availability of documents supporting the monitoring and management of nutrition status, application of recommendations, and nutritional practices.The findings revealed that country was the most important factor influencing the differences in practice; however, significant differences were also observed based on patient age group (pediatrics vs. adults), department composition (hematology + HSCT unit vs. HSCT unit alone), and availability of nutrition health care professionals. Behavioral differences regarding nutritional practice approaches could be indicative of differences in knowledge or subject awareness, as well as a reflection of diversity across health care system policies.Guideline dissemination and raising awareness through educational campaigns are suggested approaches to improve health care professionals’ knowledge and sensitivity to this important topic.
Keywords	blood ; cell transplantation ; cross-sectional studies ; health services ; hematology ; hematopoietic stem cells ; malnutrition ; morbidity ; mortality ; nutritional status ; nutritional support ; patients ; pediatrics ; questionnaires ; surveys
Language	English
Dates of publication	2020-11
Publishing place	Elsevier Inc.
Document type	Article
Note	NAL-AP-2-clean
ZDB-ID	639259-3
ISSN	1873-1244 ; 0899-9007
ISSN (online)	1873-1244
ISSN	0899-9007
DOI	10.1016/j.nut.2020.110998
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Nutritional support in stem cell transplantation programs: Results from a multicenter survey of nurses on behalf of the Nurses Group and Transplant Complications Working Party of the European Society for Blood and Marrow Transplantation and the Gruppo Italiano Trapianto di Midollo Osseo.

Nutrition (Burbank, Los Angeles County, Calif.)

2020 Volume 79-80, Page(s) 110998

Abstract: Objectives: Malnutrition in patients undergoing hematopoietic stem cell transplant (HSCT) can develop rapidly without appropriate nutritional support and affect morbidity and mortality. Guidance to monitor and manage nutrition status is described within ...

Abstract	Objectives: Malnutrition in patients undergoing hematopoietic stem cell transplant (HSCT) can develop rapidly without appropriate nutritional support and affect morbidity and mortality. Guidance to monitor and manage nutrition status is described within the literature; however, whether this is applied in clinical practice is unclear. Methods: This paper describes a cross-sectional survey to explore current practice approaches in nutrition support management and adherence to international guidelines. Results: A total of 108 nurses from 108 centers across 16 countries replied to the questionnaire. A significant variation was observed regarding the availability of documents supporting the monitoring and management of nutrition status, application of recommendations, and nutritional practices. Discussion: The findings revealed that country was the most important factor influencing the differences in practice; however, significant differences were also observed based on patient age group (pediatrics vs. adults), department composition (hematology + HSCT unit vs. HSCT unit alone), and availability of nutrition health care professionals. Behavioral differences regarding nutritional practice approaches could be indicative of differences in knowledge or subject awareness, as well as a reflection of diversity across health care system policies. Conclusions: Guideline dissemination and raising awareness through educational campaigns are suggested approaches to improve health care professionals' knowledge and sensitivity to this important topic.
MeSH term(s)	Adult ; Bone Marrow ; Child ; Cross-Sectional Studies ; Hematopoietic Stem Cell Transplantation/adverse effects ; Humans ; Nurses ; Nutritional Support ; Surveys and Questionnaires
Language	English
Publishing date	2020-08-28
Publishing country	United States
Document type	Journal Article ; Multicenter Study
ZDB-ID	639259-3
ISSN	1873-1244 ; 0899-9007
ISSN (online)	1873-1244
ISSN	0899-9007
DOI	10.1016/j.nut.2020.110998
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Article ; Online: Decrease of lethal infectious complications in the context of causes of death (COD) after hematopoietic cell transplantation: COD-2 and COD-1 study of the Infectious Diseases Working Party EBMT.

Styczynski, Jan / Tridello, Gloria / Koster, Linda / Knelange, Nina / Wendel, Lotus / van Biezen, Anja / van der Werf, Steffie / Mikulska, Malgorzata / Gil, Lidia / Cordonnier, Catherine / Ljungman, Per / Averbuch, Diana / Cesaro, Simone / Baldomero, Helen / Chabannon, Christian / Corbacioglu, Selim / Dolstra, Harry / Glass, Bertram / Greco, Raffaella /

Kröger, Nicolaus / de Latour, Régis Peffault / Mohty, Mohamad / Neven, Benedicte / Peric, Zinaida / Snowden, John A / Sureda, Anna / Yakoub-Agha, Ibrahim / de la Camara, Rafael

Bone marrow transplantation

2023 Volume 58, Issue 8, Page(s) 881–892

Abstract: We previously analyzed trends in incidence and factors associated with lethal complications in ALL/AML/CML patients (causes of deaths; COD-1 study). The objective of this study was the analysis of incidence and specific causes of death after HCT, with ... ...

Abstract	We previously analyzed trends in incidence and factors associated with lethal complications in ALL/AML/CML patients (causes of deaths; COD-1 study). The objective of this study was the analysis of incidence and specific causes of death after HCT, with focus on infectious deaths in two time periods, 1980-2001 (cohort-1) and 2002-2015 (cohort-2). All patients with HCT for lymphoma, plasma cell disorders, chronic leukemia (except CML), myelodysplastic/myeloproliferative disorders, registered in the EBMT-ProMISe-database were included (n = 232,618) (COD-2 study). Results were compared to those in the ALL/AML/CML COD-1 study. Mortality from bacterial, viral, fungal, and parasitic infections decreased in very early, early and intermediate phases. In the late phase, mortality from bacterial infections increased, while mortality from fungal, viral, or unknown infectious etiology did not change. This pattern was similar for allo- and auto-HCT in COD-1 and COD-2 studies, with a distinct and constant lower incidence of all types of infections at all phases, after auto-HCT. In conclusion, infections were the main cause of death before day +100, followed by relapse. Mortality from infectious deaths significantly decreased, except late phase. Post-transplant mortality has significantly decreased in all phases, from all causes after auto-HCT; it has decreased in all phases after allo-HCT except late phase.
MeSH term(s)	Humans ; Cause of Death ; Hematopoietic Stem Cell Transplantation/methods ; Communicable Diseases/etiology ; Lymphoma ; Chronic Disease ; Leukemia, Myeloid, Acute/etiology ; Retrospective Studies
Language	English
Publishing date	2023-05-06
Publishing country	England
Document type	Journal Article
ZDB-ID	632854-4
ISSN	1476-5365 ; 0268-3369 ; 0951-3078
ISSN (online)	1476-5365
ISSN	0268-3369 ; 0951-3078
DOI	10.1038/s41409-023-01998-2
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Article ; Online: Reduced Calcium Signaling Is Associated With Severe Graft-Versus-Host Disease: Results From Preclinical Models and From a Prospective EBMT Study.

Riesner, Katarina / Cordes, Steffen / Peczynski, Christophe / Kalupa, Martina / Schwarz, Constanze / Shi, Yu / Mertlitz, Sarah / Mengwasser, Jörg / van der Werf, Steffie / Peric, Zinaida / Koenecke, Christian / Schoemans, Helene / Duarte, Rafael F / Basak, Grzegorz W / Penack, Olaf

Frontiers in immunology

2020 Volume 11, Page(s) 1983

Abstract: Despite its involvement in various immune functions, including the allogeneic activation of T-lymphocytes, the relevance of calcium ( ... ...

Abstract	Despite its involvement in various immune functions, including the allogeneic activation of T-lymphocytes, the relevance of calcium (Ca
MeSH term(s)	Animals ; Biomarkers ; Calcium/blood ; Calcium Signaling ; Disease Models, Animal ; Disease Susceptibility ; Female ; Graft vs Host Disease/diagnosis ; Graft vs Host Disease/etiology ; Graft vs Host Disease/metabolism ; Hematopoietic Stem Cell Transplantation/adverse effects ; Immunophenotyping ; Incidence ; Leukocytes/immunology ; Leukocytes/metabolism ; Mice, Knockout ; Mice, Transgenic ; Prognosis ; Receptors, G-Protein-Coupled/genetics ; Receptors, G-Protein-Coupled/metabolism ; Recurrence ; Transplantation, Homologous
Chemical Substances	Biomarkers ; GPRC6A protein, mouse ; Receptors, G-Protein-Coupled ; Calcium (SY7Q814VUP)
Language	English
Publishing date	2020-08-11
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2020.01983
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Article ; Online: Natural killer cell alloreactivity in HLA-haploidentical hematopoietic transplantation: a study on behalf of the CTIWP of the EBMT.

Bone marrow transplantation

2021 Volume 56, Issue 8, Page(s) 1900–1907

Abstract: Human leukocyte antigen (HLA) class-I mismatches that trigger donor-versus-recipient natural killer (NK)-cell alloreactivity reduce the incidence of leukemia relapse and improve survival of acute myeloid leukemia patients after T-cell-depleted HLA- ... ...

Abstract	Human leukocyte antigen (HLA) class-I mismatches that trigger donor-versus-recipient natural killer (NK)-cell alloreactivity reduce the incidence of leukemia relapse and improve survival of acute myeloid leukemia patients after T-cell-depleted HLA-haplotype mismatched ("haploidentical") hematopoietic transplantation. In murine graft-versus-host disease (GvHD) models, alloreactive NK-cells also prevent GvHD. Here we report the results of a non-interventional, prospective study performed on behalf of the Cellular Therapy and Immunobiology Working Party of the European Society for Blood and Marrow Transplantation. The study was aimed at re-assessing the role of NK-cell alloreactivity in a cohort of haploidentical transplants performed in Europe between 2012 and 2015 and composed of unmanipulated, as well as T-cell-depleted transplants. One hundred thirty-eight patients with acute myeloid or lymphoid leukemias were analyzed. Eighty-six patients received ex-vivo T-cell-depleted transplants, 52 patients received unmanipulated transplants. Fifty patients were transplanted from NK alloreactive donors, 88 from non-NK alloreactive donors. NK cell alloreactivity did not impact on GvHD/relapse-free survival (GRFS) in unmanipulated transplants (HR: 1.66 (0.9-3.1), p = 0.1). In contrast, it did impact beneficially on GRFS in T-cell-depleted transplants (HR: 0.6, (0.3-1.2), p = 0.14, interaction p < 0.001). This effect was the consequence of reduced incidences of acute and chronic GvHD and non-relapse mortality.
MeSH term(s)	Animals ; Graft vs Host Disease/prevention & control ; Hematopoietic Stem Cell Transplantation ; Humans ; Killer Cells, Natural ; Leukemia, Myeloid, Acute/therapy ; Mice ; Prospective Studies ; Transplantation, Haploidentical
Language	English
Publishing date	2021-03-25
Publishing country	England
Document type	Journal Article
ZDB-ID	632854-4
ISSN	1476-5365 ; 0268-3369 ; 0951-3078
ISSN (online)	1476-5365
ISSN	0268-3369 ; 0951-3078
DOI	10.1038/s41409-021-01259-0
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Article ; Online: A survey on incidence and management of adenovirus infection after allogeneic HSCT.

Cesaro, Simone / Berger, Massimo / Tridello, Gloria / Mikulska, Malgorzata / Ward, Katherine Nora / Ljungman, Per / Van Der Werf, Steffie / Averbuch, Dina / Styczynski, Jan

Bone marrow transplantation

2018 Volume 54, Issue 8, Page(s) 1275–1280

Abstract: To determine the current practices on the management of Adenovirus (ADV) infection after allogenic stem cell transplantation, a survey was undertook among EBMT centres. The response rate was 20% (91/446): 46% were adult, 44% were paediatric and 10% were ... ...

Abstract	To determine the current practices on the management of Adenovirus (ADV) infection after allogenic stem cell transplantation, a survey was undertook among EBMT centres. The response rate was 20% (91/446): 46% were adult, 44% were paediatric and 10% were mixed centres, respectively. The overall incidence of ADV infection was 7.1%: 4.1% in adult, 15.4% in paediatric, and 3.6% in mixed population. The determination of ADV-DNA in biological samples was used in 96% of centres; 58% of them monitored asymptomatic patients with a frequency of twice a week in 9%, once a week in 45%, every two weeks in 4% of centres. The treatment of ADV infection was mainly based on the administration of cidofovir (87%), being the schedule of 5 mg/kg/week with probenecid the most used, and the reduction of immunosuppression (84%). The threshold of ADV-DNAemia to start cidofovir in high-risk patients was most frequently >1000 copies/ml. Innovative treatments, such as brincidofovir and adoptive ADV-cytotoxic-T-lymphocytes, were used in 27% and 20% of centres, respectively. Almost all responding centres consider ADV infection serious enough to deserve testing asymptomatic or symptomatic patients. Cidofovir and reduction of immunosuppression represent the main therapeutic options but one fourth of responding centres experimented novel therapies.
MeSH term(s)	Adenoviridae Infections/etiology ; Adenoviridae Infections/therapy ; Hematopoietic Stem Cell Transplantation/adverse effects ; Hematopoietic Stem Cell Transplantation/methods ; Humans ; Incidence ; Transplantation Conditioning/adverse effects ; Transplantation Conditioning/methods
Language	English
Publishing date	2018-12-13
Publishing country	England
Document type	Journal Article
ZDB-ID	632854-4
ISSN	1476-5365 ; 0268-3369 ; 0951-3078
ISSN (online)	1476-5365
ISSN	0268-3369 ; 0951-3078
DOI	10.1038/s41409-018-0421-0
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Article ; Online: Variability of nutritional practices in peritransplant period after allogeneic hematopoietic stem cell transplantation: a survey by the Complications and Quality of Life Working Party of the EBMT.

Peric, Zinaida / Botti, Stefano / Stringer, Jacqui / Krawczyk, Joanna / van der Werf, Steffie / van Biezen, Anja / Aljurf, Mahmoud / Murray, John / Liptrott, Sarah / Greenfield, Diana M / Duarte, Rafael F / Ruutu, Tapani / Basak, Grzegorz W

Bone marrow transplantation

2018 Volume 53, Issue 8, Page(s) 1030–1037

Abstract: Recommendations on screening and nutritional support for patients undergoing hematopoietic stem cell transplantation (HSCT) have been presented by international nutritional societies, but nutritional practices remain poorly standardized. Following the ... ...

Abstract	Recommendations on screening and nutritional support for patients undergoing hematopoietic stem cell transplantation (HSCT) have been presented by international nutritional societies, but nutritional practices remain poorly standardized. Following the general policy of the European Society for Blood and Marrow Transplantation (EBMT) to standardize transplantation procedures, the Complications and Quality of Life Working Party and Nursing Research Group carried out a survey among all EBMT centers about their current nutritional practices. The aim of this study was to better understand current practices, differences from available guidelines, and possible barriers for recommended nutritional therapy. Responses from 90 centers (19%) from 23 countries were received. We observed a marked variability in nutritional care between EBMT centers and a substantial lack of standardized operating procedures in screening patients for malnutrition and management of gastrointestinal GVHD. Furthermore, our study confirmed neutropenic diet as standard of care in most centers as well a preference for parenteral nutritional support over enteral. On the basis of these findings, future EBMT efforts will focus on better implementation of international nutritional guidelines into clinical practice.
MeSH term(s)	Female ; Hematopoietic Stem Cell Transplantation/methods ; Humans ; Male ; Nutritional Support/methods ; Quality of Life/psychology ; Surveys and Questionnaires ; Transplantation Conditioning/methods ; Transplantation, Homologous/methods
Language	English
Publishing date	2018-03-07
Publishing country	England
Document type	Journal Article ; Multicenter Study
ZDB-ID	632854-4
ISSN	1476-5365 ; 0268-3369 ; 0951-3078
ISSN (online)	1476-5365
ISSN	0268-3369 ; 0951-3078
DOI	10.1038/s41409-018-0137-1
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Article ; Online: Incidence and outcome of Kaposi sarcoma after hematopoietic stem cell transplantation: a retrospective analysis and a review of the literature, on behalf of infectious diseases working party of EBMT.

Cesaro, Simone / Tridello, Gloria / van der Werf, Steffie / Bader, Peter / Sociè, Gerard / Ljungman, Per / McQuaker, Grant / Giardino, Stefano / Uckan-Cetinkaya, Duygu / Anagnostopoulos, Achilles / Ozdogu, Hakan / Schots, Rik / Jindra, Pavel / Ladetto, Marco / Schroyens, Wilfried / Mikulska, Malgorzata / Styczynski, Jan

Bone marrow transplantation

2019 Volume 55, Issue 1, Page(s) 110–116

Abstract: The incidence, the clinical characteristics, and the outcome of Kaposi sarcoma (KS) in patients after hematopoietic stem cell transplantation (HSCT) were assessed. During the period 1987-2018, 13 cases of KS were diagnosed, 3 females and 10 males, median ...

Abstract	The incidence, the clinical characteristics, and the outcome of Kaposi sarcoma (KS) in patients after hematopoietic stem cell transplantation (HSCT) were assessed. During the period 1987-2018, 13 cases of KS were diagnosed, 3 females and 10 males, median age of 50 years, median time from HSCT of 7 months. KS had an incidence of 0.17% in allogeneic and 0.05% in autologous HSCT. HHV-8 was documented in eight of nine tumor tissue samples assessed. The organ involvement was: skin in nine, lymph nodes in six, oral cavity in four, and visceral in three patients, respectively; seven patients had >1 organ involved. Five patients had immunosuppression withdrawn, whereas four and three patients received radiotherapy and chemotherapy, respectively. Eight patients are alive (median follow-up 48 months, range 5-128), whereas five patients died after a median time of 8 months from the diagnosis of KS. However, no death was caused by KS. We conclude that the incidence of KS after HSCT is very low. Although KS can be managed with the reduction of immunosuppression, visceral forms may require chemotherapy and/or radiotherapy. The low prevalence of KS indicates that screening for HHV-8 serology and surveillance for HHV-8 viremia are not indicated in HSCT patients.
MeSH term(s)	Communicable Diseases ; Female ; Hematopoietic Stem Cell Transplantation/adverse effects ; Humans ; Incidence ; Male ; Middle Aged ; Retrospective Studies ; Sarcoma, Kaposi
Language	English
Publishing date	2019-08-21
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	632854-4
ISSN	1476-5365 ; 0268-3369 ; 0951-3078
ISSN (online)	1476-5365
ISSN	0268-3369 ; 0951-3078
DOI	10.1038/s41409-019-0644-8
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