Trial reportHaematologica2011
The use and efficacy of empirical versus pre-emptive therapy in the management of fungal infections: the HEMA e-Chart Project.
Trial report in Haematologica, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01069887 (A Non-interventional Multicentre Prospective Registry to Monitor the Incidence of Invasive Fungal Infections and to Monitor the Diagnostic and Therapeutic Management of Suspected Fungal-related Febrile Episodes in Patients With Malignant Hemopathies or Subjected to Haematopoietic Cell Transplant for the Treatment of Onco-haematological Diseases), which is not on this map. Cited by 21 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Non-interventional Multicentre Prospective Registry to Monitor the Incidence of Invasive Fungal Infections and to Monitor the Diagnostic and Therapeutic Management of Suspected Fungal-related Febrile Episodes in Patients With Malignant Hemopathies or Subjected to Haematopoietic Cell Transplant for the Treatment of Onco-haematological Diseases (HEMA E-CHART REGISTRY)
Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 70 citations in OpenAlex.
- Pooled it
- A pilot study on nasal wash galactomannan as a surrogate marker for invasive aspergillosis among hematology patients in Thailand.Scientific reports · 2024Article
- Amphotericin B in the Era of New Antifungals: Where Will It Stand?Journal of fungi (Basel, Switzerland) · 2024Review
- Real-World Financial and Clinical Impact of Diagnostic-Driven and Empirical-Treatment Strategies in High-Risk Immunocompromised Patients with Suspected Aspergillus Infection in the United Kingdom.Microbiology spectrum · 2022Article
- Review
- Clinical risk score for invasive fungal diseases in patients with hematological malignancies undergoing chemotherapy: China Assessment of Antifungal Therapy in Hematological Diseases (CAESAR) study.Frontiers of medicine · 2019Article
- Strategies for the management of invasive fungal infections due to filamentous fungi in high-risk hemato-oncological patients.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2019Article
- Article
- Management of Invasive Fungal Infections in Adult Patients with Hematological Malignancies in Greece during the Financial Crisis: Challenges and Recommendations.Journal of fungi (Basel, Switzerland) · 2018Article
- Epidemiology and treatment of invasive fungal diseases in patients with multiple myeloma: findings from a multicenter prospective study from China.Tumour biology : the journal of the International Society for Oncodevelopmental Biology and Medicine · 2016Observational
- Economic analysis of empiric versus diagnostic-driven strategies for immunocompromised patients with suspected fungal infections in the People's Republic of China.ClinicoEconomics and outcomes research : CEOR · 2016Article
- Recommendations for the Treatment of Invasive Fungal Infections in Hematological Malignancies: A Critical Review of Evidence and Turkish Expert Opinion (TEO-1).Turkish journal of haematology : official journal of Turkish Society of Haematology · 2014Review
- Treatment of febrile neutropenia and prophylaxis in hematologic malignancies: a critical review and update.Advances in hematology · 2014Review
- Epidemiology of invasive fungal diseases on the basis of autopsy reports.F1000prime reports · 2014Review
- The Role of Biomarkers for Diagnosis of and Therapeutic Decisions Related to Invasive Aspergillosis in Children.Current fungal infection reports · 2013Article
- The management of febrile neutropenia in the posaconazole era: a new challenge?Haematologica · 2012Article
- Empirical versus pre-emptive antifungal therapy for persistent febrile neutropenia.Haematologica · 2012Article
- Outcome of Antifungal Combination Therapy for Invasive Mold Infections in Hematological Patients is Independent of the Chosen Combination.Mediterranean journal of hematology and infectious diseases · 2012Article
- Corrigendum to "Treatment of Febrile Neutropenia and Prophylaxis in Hematologic Malignancies: A Critical Review and Update".Advances in hematologyArticle
- Diagnostic-driven antifungal therapy in neutropenic patients using the D-index and serial serum galactomannan testing.The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious DiseasesArticle
Corrections and comments
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Authors and funding
15 authors at 8 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNeutropenic patients with persistent fever despite antibiotic therapy are managed with empirical or pre-emptive antifungal therapy. The aim of the present study was to evaluate the current clinical use and efficacy of these two approaches in patients with high risk hematologic conditions. DESIGN AND
methodsAn electronic medical record system, the "Hema e-Chart", was designed and implemented to collect information prospectively on infectious complications, particularly on invasive fungal diseases, in patients with hematologic malignancies treated with chemotherapy and/or autologous or allogenic hemopoietic stem cell transplantation. The patients were enrolled from Hematology units distributed widely across Italy.
resultsThree hundred and ninety-seven adults with hematologic malignancies treated with chemotherapy with persistent fever and suspected invasive fungal disease were evaluable for the study (190 treated had been treated with empirical antifungal therapy and 207 with preemptive antifungal therapy). There was a significantly lower incidence of proven/probable invasive fungal diseases in patients treated with empirical antifungal therapy (n=14, 7.4%) than in patients treated with pre-emptive therapy (n=49, 23.7%) (P<0.001). The rate of deaths attributable to invasive fungal diseases was significantly lower in subjects treated with empirical antifungal therapy (1 case; 7.1%) than in subjects treated with pre-emptive therapy (11 cases; 22.5%) (P=0.002).
conclusionsThese data indicate that empirical antifungal treatment decreased the incidence of invasive fungal disease and of attributable mortality with respect to a pre-emptive antifungal approach in neutropenic febrile patients with hematologic malignancies. (ClinicalTrials.gov Identifier: NCT01069887).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.