{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T21:03:27Z","timestamp":1768251807345,"version":"3.49.0"},"reference-count":39,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,8,9]],"date-time":"2019-08-09T00:00:00Z","timestamp":1565308800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Bronchoalveolar lavage (BAL) is recommended for diagnosing lung infiltrates (LI) in patients with hematologic malignancy (HM). Prospective data on the impact of BAL on survival are still lacking. We conducted a prospective observational study on patients who performed BAL for LI among 3055 HM patients hospitalized from January to September 2018. The BAL was performed in 145 out of 434 patients who developed LI, at a median time of four days from LI detection. The median age was 60 (1\u201083). Most patients had an acute myeloid leukemia\/myelodisplastic syndrome (81), followed by lymphoma (41), acute lymphoblastic leukemia (27), and other types of HM (36). A putative causal agent was detected in 111 cases (76%), and in 89 cases (61%) the BAL results provided guidance to antimicrobial treatment. We observed a significantly improved outcome of LI at day +30 in patients who could receive a BAL\u2010driven antimicrobial treatment (improvement\/resolution rate: 71% vs 55%; <jats:italic>P<\/jats:italic> = .04). Moreover, we observed a significantly improved outcome in 120\u2010day overall survival (120d\u2010OS) (78% vs 59%; <jats:italic>P<\/jats:italic> =\u2009.009) and 120\u2010day attributable mortality (120d\u2010AM) (11% vs 30%; <jats:italic>P<\/jats:italic> = 0.003) for patients who could receive a BAL\u2010driven treatment. The multivariate analysis showed that BAL\u2010driven antimicrobial treatment was significantly associated with better 120d\u2010OS and lower 120d\u2010AM. We did not observe any severe adverse events. In conclusion BAL allows detection of a putative agent of LI in about 75% of cases, it is feasible and well tolerated in most cases, demonstrating that a BAL\u2010driven antimicrobial treatment allows improvement of clinical outcome and survival.<\/jats:p>","DOI":"10.1002\/ajh.25585","type":"journal-article","created":{"date-parts":[[2019,7,19]],"date-time":"2019-07-19T06:58:25Z","timestamp":1563519505000},"page":"1104-1112","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["A bronchoalveolar lavage\u2010driven antimicrobial treatment improves survival in hematologic malignancy patients with detected lung infiltrates: A prospective multicenter study of the SEIFEM group"],"prefix":"10.1002","volume":"94","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6353-2272","authenticated-orcid":false,"given":"Francesco","family":"Marchesi","sequence":"first","affiliation":[{"name":"Hematology and Stem Cell Transplant Unit IRCCS Regina Elena National Cancer Institute  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Cattaneo","sequence":"additional","affiliation":[{"name":"Hematology Division ASST\u2010Spedali Civili di Brescia  Brescia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5661-2338","authenticated-orcid":false,"given":"Marianna","family":"Criscuolo","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Agostino Gemelli \u2013 IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6486-8912","authenticated-orcid":false,"given":"Mario","family":"Delia","sequence":"additional","affiliation":[{"name":"Hematology and Bone Marrow Transplantation Unit, Department of Emergency and Organ Transplantation University of Bari  Bari Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelina","family":"Dargenio","sequence":"additional","affiliation":[{"name":"Hematology and Stem Cell Transplantation Unit 'Vito Fazzi' Hospital  Lecce Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Ilaria","family":"Del Principe","sequence":"additional","affiliation":[{"name":"Hematology, Department of Biomedicine and Prevention Tor Vergata University  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Spadea","sequence":"additional","affiliation":[{"name":"Hematology and Stem Cell Transplant Unit IRCCS Regina Elena National Cancer Institute  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5356-8690","authenticated-orcid":false,"given":"Nicola Stefano","family":"Fracchiolla","sequence":"additional","affiliation":[{"name":"Hematology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorella","family":"Melillo","sequence":"additional","affiliation":[{"name":"UO of Hematology, Foundation IRCSS Casa Sollievo della Sofferenza Hospital  San Giovanni Rotondo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katia","family":"Perruccio","sequence":"additional","affiliation":[{"name":"Pediatric Hematology Oncology University Hospital Santa Maria della Misericordia  Perugia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caterina","family":"Alati","sequence":"additional","affiliation":[{"name":"Hematology Unit Bianchi\u2010Melacrino\u2010Morelli Hospital  Reggio Calabria Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Domenico","family":"Russo","sequence":"additional","affiliation":[{"name":"Bone Marrow Transplant Unit University of Brescia and ASST\u2010Spedali Civili  Brescia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariagrazia","family":"Garzia","sequence":"additional","affiliation":[{"name":"Hematology San Camillo\u2010Forlanini Hospital  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Brociner","sequence":"additional","affiliation":[{"name":"Division of Hematology Foundation IRCCS Policlinico San Matteo, University of Pavia  Pavia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariagiovanna","family":"Cefalo","sequence":"additional","affiliation":[{"name":"Hematology San Eugenio Hospital  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniele","family":"Armiento","sequence":"additional","affiliation":[{"name":"Hematology and Stem Cell Transplantation Unit University Campus Bio\u2010Medico  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone","family":"Cesaro","sequence":"additional","affiliation":[{"name":"Pediatric Hematology Oncology Azienda Ospedaliera Universitaria Integrata  Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nunzia","family":"Decembrino","sequence":"additional","affiliation":[{"name":"Pediatric Hematology Oncology IRCCS Policlinico San Matteo, University of Pavia  Pavia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Mengarelli","sequence":"additional","affiliation":[{"name":"Hematology and Stem Cell Transplant Unit IRCCS Regina Elena National Cancer Institute  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Tumbarello","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Agostino Gemelli \u2013 IRCCS  Rome Italy"},{"name":"Istituto di Malattie Infettive, Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Busca","sequence":"additional","affiliation":[{"name":"Stem Cell Transplant Center, AOU Citta' della Salute e Della Scienza  Turin Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8287-928X","authenticated-orcid":false,"given":"Livio","family":"Pagano","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Agostino Gemelli \u2013 IRCCS  Rome Italy"},{"name":"Istituto di Ematologia, Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on behalf of the Sorveglianza Epidemiologica Infezioni nelle Emopatie (SEIFEM) Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,8,9]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.13934"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccm.2016.12.008"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201304-097OC"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/10428194.2016.1195499"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-007-0391-6"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-02-378976"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2009.203"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beha.2013.10.012"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1702335"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2006.04.021"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.25905"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/03009734.2016.1237595"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/10428194.2017.1315116"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2014.151"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000295590.33145.C4"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1086\/588660"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2013.091025"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2016.0093"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2462070712"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-198510000-00009"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkw156"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2018.01.002"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.2012.01806.x"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.3109\/1040841X.2013.804033"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0043347"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw668"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.56.5.379"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-014-2172-3"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1705505"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arbres.2012.11.012"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/hon.923"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12941-015-0111-3"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.12867"},{"key":"e_1_2_8_35_1","first-page":"986","article-title":"Invasive fungal infections in patients with hematologic malignancies in a tertiary care cancer center: an autopsy study over a 15\u2010year period (1989\u20102003)","volume":"91","author":"Chamilos G","year":"2006","journal-title":"Haematologica"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21755"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3062.2007.00264.x"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-002-0599-4"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1086\/657065"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2011.03685.x"}],"container-title":["American Journal of Hematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fajh.25585","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ajh.25585","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ajh.25585","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ajh.25585","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T02:39:45Z","timestamp":1694140785000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.25585"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,9]]},"references-count":39,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2019,10]]}},"alternative-id":["10.1002\/ajh.25585"],"URL":"https:\/\/doi.org\/10.1002\/ajh.25585","archive":["Portico"],"relation":{},"ISSN":["0361-8609","1096-8652"],"issn-type":[{"value":"0361-8609","type":"print"},{"value":"1096-8652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8,9]]},"assertion":[{"value":"2019-06-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-07-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-08-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}