Browsing by Author "Spanoudakis, Michail"
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- European guidelines on treatment and supportive measures in chronic neutropenias: a consensus between the European Hematology Association and the EuNet-INNOCHRON COST Action based on a systematic evidence reviewPublication . Fioredda, Francesca; Spanoudakis, Michail; Skokowa, Julia; Tamary, Hannah; Farruggia, Piero; Almeida, António; Guardo, Daniela; Palmblad, Jan; Höglund, Petter; Touw, Ivo P.; Zeidler, Cornelia; Warren, Alan J.; Csenar, Mario; Skoetz, Nicole; Castagnola, Elio; Ricci, Erica; Dale, David C.; Newburger, Peter E.; Welte, Karl; Papadaki, Helen A.; Dufour, CarloThe treatment of chronic neutropenias and control of neutropenia-related infections remain challenging topics for pediatric and adult hematologists. This article aims to fill the gap in the treatment of neutropenias and, in combination with the previously published European guidelines on diagnosis of neutropenias, gives complete and comprehensive guidance on the whole management of patients with neutropenia. In terms of methodology, an Evidence-Based Medicine team produced an evidence synthesis of the literature on the treatment of neutropenias. Then, according to the robustness of the evidence, consensus recommendations were elaborated and voted by an expert's panel from the Cooperation in Science and Technology European Network for the Innovative Diagnosis and Treatment of Chronic Neutropenias (https://eunet-innochron.eu/) and the Specialized Working Group on Granulocytes and Constitutional Bone Marrow Failure Syndromes of the European Hematology Association. Whenever evidence was not available, recommendations were based on the expert's panel opinion. Consensus-based recommendations are related to granulocyte colony-stimulating factor indications and schedule of administration, indications for hematopoietic stem cell transplantation, supportive treatments and measures, and new treatments that have been evolving over the recent years. These guidelines, rather than a numerical correction of the absolute neutrophil count, suggest a holistic, patient-centered approach aiming at optimizing the management of chronic neutropenic patients and offering valuable and practical guidance to the hematologists for their daily clinical practice.
- The European guidelines on diagnosis and management of neutropenia in adults and children: a consensus between the European Hematology Association and the EuNet-INNOCHRON COST ActionPublication . Fioredda, Francesca; Skokowa, Julia; Tamary, Hannah; Spanoudakis, Michail; Farruggia, Piero; Almeida, António; Guardo, Daniela; Höglund, Petter; Newburger, Peter E.; Palmblad, Jan; Touw, Ivo P.; Zeidler, Cornelia; Warren, Alan J.; Dale, David C.; Welte, Karl; Dufour, Carlo; Papadaki, Helen A.Neutropenia, as an isolated blood cell deficiency, is a feature of a wide spectrum of acquired or congenital, benign or premalignant disorders with a predisposition to develop myelodysplastic neoplasms/acute myeloid leukemia that may arise at any age. In recent years, advances in diagnostic methodologies, particularly in the field of genomics, have revealed novel genes and mechanisms responsible for etiology and disease evolution and opened new perspectives for tailored treatment. Despite the research and diagnostic advances in the field, real world evidence, arising from international neutropenia patient registries and scientific networks, has shown that the diagnosis and management of neutropenic patients is mostly based on the physicians' experience and local practices. Therefore, experts participating in the European Network for the Innovative Diagnosis and Treatment of Chronic Neutropenias have collaborated under the auspices of the European Hematology Association to produce recommendations for the diagnosis and management of patients across the whole spectrum of chronic neutropenias. In the present article, we describe evidence-and consensus-based guidelines for the definition and classification, diagnosis, and follow-up of patients with chronic neutropenias including special entities such as pregnancy and the neonatal period. We particularly emphasize the importance of combining the clinical findings with classical and novel laboratory testing, and advanced germline and/or somatic mutational analyses, for the characterization, risk stratification, and monitoring of the entire spectrum of neutropenia patients. We believe that the wide clinical use of these practical recommendations will be particularly beneficial for patients, families, and treating physicians.