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A prospective survey of febrile events in hematological malignancies

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Abstract

The Hema e-Chart prospectively collected data on febrile events (FEs) in hematological malignancy patients (HMs). The aim of the study was to assess the number, causes and outcome of HM-related FEs. Data were collected in a computerized registry that systematically approached the study and the evolution of FEs developing in a cohort of adult HMs who were admitted to 19 hematology departments in Italy from March 2007 to December 2008. A total of 869 FEs in 3,197 patients with newly diagnosed HMs were recorded. Fever of unidentified origin (FUO) was observed in 386 cases (44.4%). The other causes of FE were identified as noninfectious in 48 cases (5.5%) and infectious in 435 cases (50.1%). Bacteria were the most common cause of infectious FEs (301 cases), followed by fungi (95 cases), and viruses (7 cases). Mixed agents were isolated in 32 episodes. The attributable mortality rate was 6.7% (58 FEs). No deaths were observed in viral infection or in the noninfectious groups, while 25 deaths were due to FUO, 16 to bacterial infections, 14 to fungal infections, and three to mixed infections. The Hema e-Chart provided a complete system for the epidemiological study of infectious complications in HMs.

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Acknowledgments

This project was supported by an unrestricted grant from Merck Sharp & Dohme, Italy. The project was made possible thanks to the support from Roberto Florenzano, Jelena Petrovic, and Chiara Scerch on behalf of MSD-Italy. The DIES Group contributed to the development of the project, and individual contributions were made by the Scientific Advisory Board. The authors gratefully acknowledge the many dedicated coordinators who ultimately made this project a success.

L. Pagano, (Aggiungi Il Tuo Nome Nel Board) S. Cesaro, A. Nosari, G. Rossi, P. Viale and F. Aversa constitute the Scientific Advisory Board. M. Caira and M. Tumbarello analyzed the data. All other authors collected the data.

Disclosures

LP and FA received research support and honoraria from Pfizer, Gilead, and Merck. AN received research support and honoraria from Pfizer, Gilead, Cephalon and Merck. MC received research support and honoraria from Schering Ploug, Gilead, and Merck. GR received research support and honoraria from Gilead, Roche, Cephalon, Genzyme, Celgene, Shire and Merck. PV received research support and honoraria from Pfizer, Gilead, Astellas and Merck. All other authors reported no potential conflicts of interest.

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Authors and Affiliations

  1. Istituto di Ematologia, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, I-00168, Roma, Italy

    L. Pagano & M. Caira

  2. U.O. Ematologia, Spedali Civili, Brescia, Italy

    G. Rossi & C. Cattaneo

  3. Istituto di Malattie Infettive, Università Cattolica S. Cuore, Roma, Italy

    M. Tumbarello

  4. Azienda Osp. Univ. Careggi, Ematologia, Firenze, Italy

    R. Fanci

  5. Divisione di Ematologia Az. Osp. S. Camillo Forlanini, Roma, Italy

    M. G. Garzia

  6. Istituto Seragnoli, Università di Bologna, Bologna, Italy

    N. Vianelli

  7. Ematologia, Azienda Osp. Osp. S. Carlo, Potenza, Italy

    N. Filardi

  8. Ematologia, Ospedale S. Eugenio, Roma, Italy

    P. De Fabritiis

  9. U.O. Ematologia Pol. Univ. Tor Vergata, Roma, Italy

    A. Beltrame

  10. Dipartimento di Ematoncologia ed Unità Trap. Mid. Osseo, La Maddalena, Palermo, Italy

    M. Musso

  11. Divione di Ematologia, Ospedale Generale di Bolzano, Bologna, Italy

    A. Piccin

  12. Istituto di Ematologia, Az. Osp. Univ. Arcispedale S. Anna, Ferrara, Italy

    A. Cuneo

  13. Istituto di Ematologia, Università di Perugia, Perugia, Italy

    T. Aloisi & F. Aversa

  14. Divisione di Ematologia e Centro Trapianti Midollo, Ospedale Niguarda Ca’ Granda, Milano, Italy

    M. Riva & A. Nosari

  15. Unità di Ematologia, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy

    G. Rossi

  16. Divisione di Ematologia, Ospedale Civile “Ca Foncello”, Treviso, Italy

    U. Salvadori

  17. Ematologia, Ospedale Papardo, Messina, Italy

    M. Brugiatelli

  18. Divisione di Ematologia, Umberto I, Mestre, Italy

    S. Sannicolò

  19. Divisione di Ematologia, Policlinico Universitario di Modena e Reggio, Modena, Italy

    M. Morselli

  20. Divisione di Ematologia, Arciospedale S. Maria Nuova, Reggio Emilia, Italy

    A. Bonini

  21. Clinica di Malattie Infettive, Università di Bologna, Bologna, Italy

    P. Viale

Authors
  1. L. Pagano
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  2. M. Caira
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  3. G. Rossi
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  4. M. Tumbarello
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  5. R. Fanci
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  6. M. G. Garzia
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  7. N. Vianelli
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  8. N. Filardi
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  9. P. De Fabritiis
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  10. A. Beltrame
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  11. M. Musso
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  12. A. Piccin
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  13. A. Cuneo
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  14. C. Cattaneo
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  15. T. Aloisi
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  16. M. Riva
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  17. G. Rossi
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  18. U. Salvadori
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  19. M. Brugiatelli
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  20. S. Sannicolò
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  21. M. Morselli
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  22. A. Bonini
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  23. P. Viale
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  24. A. Nosari
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  25. F. Aversa
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for the Hema e-Chart Group, Italy

Corresponding author

Correspondence to L. Pagano.

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Pagano, L., Caira, M., Rossi, G. et al. A prospective survey of febrile events in hematological malignancies. Ann Hematol 91, 767–774 (2012). https://doi.org/10.1007/s00277-011-1373-2

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  • DOI: https://doi.org/10.1007/s00277-011-1373-2

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