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1
Miao, Miao, Wu Depei, Aining Sun, Ying Wang, Lingzhi Yan, and Qian Wu. "The Efficacy and Safety of Recombinant Human Thrombopoietin in Patients with Hematological Malgnancies After Allogeneic Hematopoietic Stem Cell Transplantation." Blood 118, no. 21 (November 18, 2011): 4565. http://dx.doi.org/10.1182/blood.v118.21.4565.4565.
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Abstract Abstract 4565 OBJECTIVE: To evaluate the efficacy and sefety of recombinant human thrombopoietin(rhTPO) prior to engraftment in adults with hematological malignancie who received allogeneic haematopoietil stem cell transplantation(Allo-HSCT). METHODS: This sutdy was a randomized, controlled clinical trial,38 patients were hematological malignancie, inclulding acute and chrinic myeloid leukemia, acute lymphoblastic leukemia, lymphoma.They received Allo-HSCT and were randomly divided into groups(group A 19 cases, group B 19 cases).The group A was no-rhTPO as control, the group B were received rhTPO 15000U/d from +1 day, and continued until the untransfused platelet count was >70×109/L for two consecutived days. Patients received platelete transfusion when they developed severe thrombocytopenia<20×109/L. Efficacy and sefety of rhTPO on the outcome of Allo-HSCT were evaluated. RESULTS: In both group A and B, platelet decrease after Allo-HSCT had no sognificant difference. The platelet engraftment duration of group A and B was 15.68±1.36(range 11–31) days and 13.47±0.72(range 9–21) days, respectively. The amount of platelet transfusion of group A and B was 4±0.55(range 20–130) units and 2.89±0.36(range 0–50) units, respectively. The effects of rhTPO on neutrophil engraftment, hepatic function, renal function, alloergic reations and acute GVHD were not found. CONCLUSION: The platelet engraftment duration of group B was shorter than that of group A(t=27.2, p<0.001), the amount of need platelet transfusion was significently less than those in the group A.There was a statistically significant difference in platelet engraftment and platelet transfusion needed(t=2.523, p<0.05). Administration of rhTPO prior to platelet engraftment after Allo-HSCT seem to be efficacy and safe. Disclosures: No relevant conflicts of interest to declare.
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Dong, L., X.-Y. Zhai, Y.-L. Yang, L. Wang, Y. Zhou, H.-Y. Shi, B.-H. Tang, et al. "P110 Population pharmacokinetics and dosing optimisation of imipenem in children with haematological malignancie." Archives of Disease in Childhood 104, no. 6 (May 17, 2019): e63.3-e63. http://dx.doi.org/10.1136/archdischild-2019-esdppp.148.
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BackgroundImipenem/cilastatin is widely used for the treatment of children with serious infections. Currently, there is lack of pharmacokinetic studies of imipenem in children with hematological malignancies. Given the significant impact of disease on pharmacokinetics and increased resistance, we aimed to conduct a population based pharmacokinetic study of imipenem and optimize the dosage regimens for this vulnerable population.MethodsAfter treated with IMP/CS, blood samples of children were collected and the concentration of imipenem were quantified using HPLC-UV. Then, population level pharmacokinetic analysis was conducted using NONMEM software.ResultsData from 56 children (age range: 2.03–11.82 years) with haematological malignancies were collected to conduct a population based pharmacokinetic analysis. In this study, a two-compartment model that followed first-order elimination was found to be best suitable. The parameters of current weight, age and creatinine elimination rate were significant covariates that influenced imipenem pharmacokinetics. As a result, 52.0%, 65.2% and 76.6% of children reached the pharmacodynamic target (70% fT>MIC) against sensitive pathogens with an MIC of 0.5 mg/L at 15, 20 and 25 mg/kg q6h of imipenem, respectively. However, only 17.2% of children achieved the pharmacodynamic target against Pseudomonas aeruginosa with an MIC of 2 mg/L at a dose of 25 mg/kg q6h.ConclusionPopulation pharmacokinetics of imipenem was assessed in children. The current dosage regimens of imipenem are underdose for resistant pathogens including Pseudomonas aeruginosa and Acinetobacter baumannii. However, for sensitive pathogens, imipenem has an acceptable pharmacodynamic target rate at a dosage of 25 mg/kg q6h.Disclosure(s)Nothing to disclose.
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Zinzani, Pier Luigi, Enrico Derenzini, Cinzia Pellegrini, Luigi Rigacci, Alberto Fabbri, Federica Quirini, Vittorio Stefoni, et al. "Fludarabine and Mitoxantrone Followed by Yttrium-90 Ibritumumab Tiuxetan in Untreated Patients with Follicular Lymphoma. Long Term Efficacy and Toxicity Results of the FLUMIZ Trial." Blood 118, no. 21 (November 18, 2011): 1604. http://dx.doi.org/10.1182/blood.v118.21.1604.1604.
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Abstract Abstract 1604 We previously reported the results of a multicenter non-randomized phase II trial of fludarabine and mitoxantrone plus radioimmunotherapy (RIT) [FLUMIZ (Fludarabine, Mitoxantrone, Zevalin) trial], demonstrating that this combination was safe and very effective in untreated patients with follicular non-Hodgkin lymphoma. We are now providing long term efficacy and toxicity results of this combination strategy. Sixty-one patients with stage III and IV untreated follicular lymphoma were enrolled between June 2004 and April 2006, at 13 Italian institutions. Briefly, treatment schedule was the following: oral fludarabine 40 mg/m2 on days 1–3, intravenous mitoxantrone 10 mg/m2 on day 1 every 28 days for six cycles, followed by one course of yttrium-90 (90Y)-labelled ibritumumab tiuxetan (Zevalin), which consisted in two weekly infusions of Rituximab 250 mg/m2 followed by a weight based dose of 90Y-ibritumumab tiuxetan. Primary endpoints at the time of the first analysis were complete response and hematological toxic effects, secondary endpoints were overall survival (OS) and progression free survival (PFS). Fifty-seven patients were treated with RIT after the completion of six courses of fludarabine and mitoxantrone (FN) regimen. Four patients were excluded because of disease progression (n=1) and bone marrow infiltration > 25% (n=3) at the end of the FN regimen. Median follow up at the time of the last analysis was 52 months (range 24–75). Five-year PFS was estimated to be 68%, 5-year OS was estimated to be 93.0%. Noteworthy, late hematological side effects such as myelodisplastic syndromes or acute myeloid leukemias have not been observed so far. All patients had a complete hematological recovery after the completion of the sequential treatment. 16 patients relapsed during the follow-up period and 4 patients died due to disease progression. 22 patients (38%) are in first complete remission after more than 4 years of follow-up. All relapsed patients underwent second line chemotherapy and high dose chemotherapy with stem cell rescue was performed in 4 patients. These results confirm the long term efficacy and safety of 6 cycles of fludarabine and mitoxantrone followed by consolidation with 90Y-ibritumumab tiuxetan: the 5-year PFS and OS compare favourably with the results of chemoimmunotherapy alone in untreated follicular lymphoma, with no increased incidence of secondary hematologic malignancie Disclosures: No relevant conflicts of interest to declare.
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Clemmensen, Signe B., Jennifer R. Harris, Jonas Mengel-From, Wagner H. Bonat, Henrik Frederiksen, Jaakko Kaprio, and Jacob v. B. Hjelmborg. "Familial Risk and Heritability of Hematologic Malignancies in the Nordic Twin Study of Cancer." Cancers 13, no. 12 (June 16, 2021): 3023. http://dx.doi.org/10.3390/cancers13123023.
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We aimed to explore the genetic and environmental contributions to variation in the risk of hematologic malignancies and characterize familial dependence within and across hematologic malignancies. The study base included 316,397 individual twins from the Nordic Twin Study of Cancer with a median of 41 years of follow-up: 88,618 (28%) of the twins were monozygotic, and 3459 hematologic malignancies were reported. We estimated the cumulative incidence by age, familial risk, and genetic and environmental variance components of hematologic malignancies accounting for competing risk of death. The lifetime risk of any hematologic malignancy was 2.5% (95% CI 2.4–2.6%), as in the background population. This risk was elevated to 4.5% (95% CI 3.1–6.5%) conditional on hematologic malignancy in a dizygotic co-twin and was even greater at 7.6% (95% CI 4.8–11.8%) if a monozygotic co-twin had a hematologic malignancy. Heritability of the liability to develop any hematologic malignancy was 24% (95% CI 14–33%). This estimate decreased across age, from approximately 55% at age 40 to about 20–25% after age 55, when it seems to stabilize. In this largest ever studied twin cohort with the longest follow-up, we found evidence for familial risk of hematologic malignancies. The discovery of decreasing familial predisposition with increasing age underscores the importance of cancer surveillance in families with hematological malignancies.
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Asare, Mariette, Jeanne E. Hendrickson, and Christopher A. Tormey. "Determination of Red Blood Cell Alloimmunization Rates in Transfused Patients with Hematologic and Oncologic Malignancies." Blood 128, no. 22 (December 2, 2016): 1463. http://dx.doi.org/10.1182/blood.v128.22.1463.1463.
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Abstract Introduction: Patients with hematological and oncological malignancies are among the most frequent recipients of chronic red blood cell (RBC) transfusion therapy. One of the risks associated with chronic RBC exposure is the development of blood group antibodies. However, there are few extensive studies of alloimmunization rates associated with hematological or oncological malignancies in adult patients despite the frequency with which they are transfused. As such, the aims of this study were: 1) to determine the alloimmunization rate associated with malignant conditions in general, 2) to establish and compare alloimmunization rates for individuals with different forms of hematological and oncological neoplasia, and 3) to determine if any oncological disorder(s) appeared to predispose individuals to alloimmunization such that antibody mitigation measures could be employed for these diagnoses. Methods: Patients included were those undergoing type and screen testing at the study site (n=18,750 unique, active subjects in our facility's transfusion record database). For each of these subjects, the electronic medical record was retrospectively reviewed to determine if a history of a hematologic or oncologic malignancy was present. Disorders grouped as 'hematologic malignancies' in this study included: acute leukemia (myeloid or lymphoid), mast cell diseases, multiple myeloma, myelodysplastic syndromes, myeloproliferative disorders, and non-Hodgkin lymphoma (T- or B-cell). 'Non-hematologic' cancers in this study were broadly grouped as follows: bladder, colon, head/neck, lung, prostate, skin, soft tissue/sarcoma. If a patient had a history of any of the above neoplastic diseases, further inclusion in the study required: 1) that the patient undergo at least one RBC unit transfusion after their diagnosis was established and 2) that at least one follow-up antibody screen test be performed after their first RBC transfusion post-diagnosis. When these additional inclusion criteria were met, the following data were collected for each subject: malignancy type, race/ethnicity, gender, and the number and specificity of antibodies detected. Ratio data were compared using the chi-square test with Yates' correction for continuity; P values <0.05 were considered significant. Results: A total of 69 patients became alloimmunized after their diagnosis of a malignancy; these patients were overwhelmingly male (66/69; 95.7%) and most identified as white, non-Hispanic (50/69; 72.5%). The alloimmunization rate among patients with any malignancy diagnosis was 1.5% (69/4687), which was significantly lower than the general, historical alloimmunization rate at our facility (443/18750; 2.4%; P=0.0019). Of total transfused patients with a malignancy, most were diagnosed with a non-hematological disorder(4371/4687; 93.3%) and such malignancies were associated with an alloimmunization rate of 1.3% (55/4371) following transfusion. By comparison, the alloimmunization rate for transfused patients with hematological malignancies was 2.8% (14/501), which was significantly higher (P=0.011). When alloantibody development was analyzed on a disorder-by-disorder basis, the five highest alloimmunization rates were seen in: myelodysplastic syndromes (8/71; 11.2%), soft tissue cancers (3/50; 6.0%), acute leukemia (1/34; 2.9%), renal cancer (3/113; 2.7%), and myeloproliferative disorders (2/75; 2.7%). Alloimmunization rates under 2% were observed for all other hematological and non-hematological malignancies encountered in our patient population. Conclusions: RBC alloimmunization rates in transfused patients with malignancy were significantly lower than historical controls, suggesting that the immunosuppressive nature of these disorders and/or their associated therapies may play a role in limiting blood group antibody development. Hematologic disorders were associated with higher alloimmunization rates than non-hematologic malignancies, which may reflect a larger transfusion burden in these illnesses (a factor to be evaluated in future analyses). Overall, only myelodysplastic syndromes and soft tissue malignancies were associated with antibody formation rates substantially higher than historical controls. Therefore, consideration for prophylactic antigen matching to prevent alloimmunization may be warranted for these conditions. Disclosures No relevant conflicts of interest to declare.
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Liao, Yongkang, Shijun Xiong, Zaid Ur Rehman, Xiaoli He, Hongling Peng, Jing Liu, and Shuming Sun. "The Research Advances of Aptamers in Hematologic Malignancies." Cancers 15, no. 1 (January 1, 2023): 300. http://dx.doi.org/10.3390/cancers15010300.
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Currently, research for hematological malignancies is very intensive, with many breakthroughs. Among them, aptamer-based targeted therapies could be counted. Aptamer is a targeting tool with many unique advantages (easy synthesis, low toxicity, easy modification, low immunogenicity, nano size, long stability, etc.), therefore many experts screened corresponding aptamers in various hematological malignancies for diagnosis and treatment. In this review, we try to summarize and provide the recent progress of aptamer research in the diagnosis and treatment of hematologic malignancies. Until now, 29 aptamer studies were reported in hematologic malignancies, of which 12 aptamers were tested in vivo and the remaining 17 aptamers were only tested in vitro. In this case, 11 aptamers were combined with chemotherapeutic drugs for the treatment of hematologic malignancies, 4 aptamers were used in combination with nanomaterials for the diagnosis and treatment of hematologic malignancies, and some studies used aptamers for the targeted transportation of siRNA and miRNA for targeted therapeutic effects. Their research provides multiple approaches to achieve more targeted goals. These findings show promising and encouraging future for both hematological malignancies basic and clinical trials research.
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Yang, Xiao-Jing, Ya-Ming Xi, and Zi-Jian Li. "Icaritin: A Novel Natural Candidate for Hematological Malignancies Therapy." BioMed Research International 2019 (March 28, 2019): 1–7. http://dx.doi.org/10.1155/2019/4860268.
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Hematological malignancies including leukemia and lymphoma can severely impact human health. With the current therapies combined with chemotherapy, stem cell transplantation, radiotherapy, and immunotherapy, the prognosis of hematologic malignancies improved significantly. However, most hematological malignancies are still incurable. Therefore, research for novel treatment options was continuing with the natural product as one source. Icaritin is a compound extracted from a traditional Chinese herb,Epimedium Genus, and demonstrated an antitumor effect in various neoplasms including hematological malignancies such as leukemia, lymphoma, and multiple myeloma. In hematological malignancies, icaritin showed multiple cytotoxic effects to induce apoptosis, arrest the cell cycle, inhibit proliferation, promote differentiation, restrict metastasis and infiltration, and suppress the oncogenic virus. The proved underlying mechanisms of the cytotoxic effects of icaritin are different in various cell types of hematological malignancies but associated with the critical cell signal pathway, including PI3K/Akt, JAK/STAT3, and MAPK/ERK/JNK. Although the primary target of icaritin is still unspecified, the existing evidence indicates that icaritin is a potential novel therapeutic agent for neoplasms as with hematological malignancies. Here, in the field of hematology, we reviewed the reported activity of icaritin in hematologic malignancies and the underlying mechanisms and recognized icaritin as a candidate for therapy of hematological malignancies.
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Ren, Anqi, Xiqin Tong, Na Xu, Tongcun Zhang, Fuling Zhou, and Haichuan Zhu. "CAR T-Cell Immunotherapy Treating T-ALL: Challenges and Opportunities." Vaccines 11, no. 1 (January 12, 2023): 165. http://dx.doi.org/10.3390/vaccines11010165.
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T-cell acute lymphoblastic leukemia (T-ALL), a form of T-cell malignancy, is a typically aggressive hematological malignancy with high rates of disease relapse and a poor prognosis. Current guidelines do not recommend any specific treatments for these patients, and only allogeneic stem cell transplant, which is associated with potential risks and toxicities, is a curative therapy. Recent clinical trials showed that immunotherapies, including monoclonal antibodies, checkpoint inhibitors, and CAR T therapies, are successful in treating hematologic malignancies. CAR T cells, which specifically target the B-cell surface antigen CD19, have demonstrated remarkable efficacy in the treatment of B-cell acute leukemia, and some progress has been made in the treatment of other hematologic malignancies. However, the development of CAR T-cell immunotherapy targeting T-cell malignancies appears more challenging due to the potential risks of fratricide, T-cell aplasia, immunosuppression, and product contamination. In this review, we discuss the current status of and challenges related to CAR T-cell immunotherapy for T-ALL and review potential strategies to overcome these limitations.
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YAEGASHI, HIROSHI, TAKAHIRO NOHARA, KAZUYOSHI SHIGEHARA, KOUJI IZUMI, YOSHIFUMI KADONO, TOMOYUKI MAKINO, KANAME YAMASHITA, KOUSHIRO OHTSUBO, HIROKO IKEDA, and ATSUSHI MIZOKAMI. "Survival Outcomes of Patients With Primary Mediastinal Germ Cell Tumors: A Retrospective Single-institutional Experience." Cancer Diagnosis & Prognosis 2, no. 3 (May 3, 2022): 352–59. http://dx.doi.org/10.21873/cdp.10116.
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Background/Aim: Primary mediastinal non-seminomatous germ cell tumors (PMNSGCTs) are occasionally complicated by a hematologic malignancy, as with somatic-type malignant tumors called germ cell tumors with somatic-type malignancy (GCTSTM) and are known to have a poor prognosis. Patients and Methods: Data obtained between September 1997 and February 2020 for patients with mediastinal germ cell tumor at our institution were retrospectively analyzed. Key outcome measures included survival rates and the clinical features of non-seminoma cases. Results: Of 16 patients, 9 had pure seminoma, and 7 had non-seminoma. At the median follow-up of 56.2 months, the 5-year survival rate was significantly higher in patients with seminoma (100%) than in those with non-seminoma (37%) (log-rank test, p=0.0153). Regarding PMNSGCT, two patients evolved into GCTSTM and three had concomitant hematological malignancies. Conclusion: Patients with PMNSGCTs, GCTSTM complications, and hematologic malignancies showed poor survival, suggesting the need for the development of treatment strategies.
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Krishnan, Gayathri, and Anupam Pande. "985. Fusarium Infections in Patients with Hematological Malignancies." Open Forum Infectious Diseases 8, Supplement_1 (November 1, 2021): S583—S584. http://dx.doi.org/10.1093/ofid/ofab466.1179.
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Abstract Background Fusarium is a ubiquitous mold that can cause invasive and disseminated fusariosis in immunosuppressed patients, especially those with hematological malignancies. The risk factors associated with mortality of patients with Fusarium infections have not been adequately assessed in literature. In this study, we sought to explore the characteristics, clinical outcomes, and risk factors for mortality in Fusarium infections in patients with hematological malignancies. Methods This is a retrospective study of adult hematological malignancy patients admitted to surgical/medical wards or critical units at an academic medical center from January 2010 to January 2021 and diagnosed with proven invasive Fusarium infections through positive microbiological culture data from a biopsy, surgical specimen or sterile site. Primary end point was 30-day mortality. Statistical analysis was done using Fischer’s exact test and Mann-Whitney U test. Results 31 patients with hematological malignancies were identified with proven Fusarium infections during the 10-year period (13,390 total unique patients with diagnosis of hematologic malignancies). Two were excluded due to incomplete data. Demographic characteristics, type and status of hematological malignancy, chemotherapy, exposure to steroids, neutropenia, lymphopenia, antifungal prophylaxis, and other factors were analyzed. Mean age at diagnosis was 52.6 years. 16/29 (55.2%) had undergone stem cell transplant prior to infection with median duration of 150.5 days (range 12 to 1503) prior to infection. The most common pathologies were invasive sinusitis and disseminated cutaneous infection in 13/29 (44.8%) patients. Blood culture was positive in 5/29 (17.2%). Overall mortality was 86.2% with 30-day mortality of 44.8% and 1-year mortality of 83%. Death was attributed to fusariosis in 12/25 (48%). Median duration to death was 56 days (range 2 to 1627 days). Risk factors for 30-day mortality were assessed (table 1). The table describes risk factors for 30-day mortaity for fusarium infections in patients with hematological malignancies. statistical analysis done using fischer’s exact test Conclusion Fusarium infections result in morbidity and mortality in patients with hematological malignancies. A variety of host and disease factors dictate eventual outcome of Fusarium infections in these patients. Lack of neutrophil recovery is a significant risk factor for 30-day mortality in this population. Disclosures All Authors: No reported disclosures
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Iftikhar, Raheel, and Uzma Zaidi. "Interim-Guidelines for COVID-19 Vaccination in Hematological Malignancies and Hematopoietic Stem Cell Transplant Recipients." National Journal of Health Sciences 6, no. 1 (October 29, 2021): 38–43. http://dx.doi.org/10.21089/njhs.61.0038.
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Abstract: Objective: Hematologic malignancies such as Acute Leukemias, Myelodysplastic Syndromes (MDS), Myeloproliferative Neoplasms (MPNs), Lymphomas and Multiple Myeloma (MM) can be treated with chemotherapy, Hematopoietic Stem Cell Transplant (HSCT) or Chimeric Antigen Receptor T-cell (CAR-T) therapies with either a curative intent or to prolong survival. The hematologic malignancy itself or the anti-cancer therapies can result in long-term immunodeficiency; COVID-19 infection in this population is associated with a significantly higher risk of hospitalization and death [1]. Given lack of available data on COVID-19 vaccination from Pakistan, this guidance is based on the review of safety and efficacy of FDA and CDC approved vaccines for the prevention of COVID-19 disease and recommendations of European Society for Blood and Marrow Transplant (EBMT), American Society for Transplantation and Cellular Therapies (ASTCT) and British Society of Hematology (BSH) for the use of COVID vaccination in HSCT recipients and those with hematological malignancies. The American Society of Hematology (ASH), EBMT, ASTCT and BSH recommends the desired access to vaccines for this highly susceptible group along with care takers, family members, and domestic& everyday contacts when vaccine supply is available. Keywords: COVID-19 vaccination, Hematological malignancies, Hematopoietic stem cell transplant, mRNA vaccine, Acute leukemia, Chemotherapy.
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Andi Cahyadi, Esthy Poespitaningtyas, Diah Kusuma Arumsari, Maria Christina Shanty Larasati, Mia Ratwita Andarsini, and I Dewa Gede Ugrasena. "Region Variation of Hematological Malignancies and Solid Tumors in Children in East Java." Asian Journal of Health Research 2, no. 1 (March 7, 2023): 27–33. http://dx.doi.org/10.55561/ajhr.v2i1.71.
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Introduction: The prevalence of childhood cancer in East Java is unevenly associated with differences in exposure to carcinogens in urban-industrial areas, agricultural chemicals, industrial waste along the river, and socio-culture. However, there are no data on regional variations in childhood cancer in East Java. We describe the regional variation of hematological malignancies and solid tumors in East Java. Material and Methods: The study was conducted by cross-sectional on children with cancer aged <18 years in dr. Soetomo General Academic Hospital in 2014-2015. The data evaluated were gender, age, and cancer type (hematological malignancy and solid tumor). They came from Mataraman, Madura Island, industrial-urban areas (Surabaya-Sidoarjo-Gresik), and Tapal Kuda. We used the Chi-square test and Logistic Regression for data analysis (p<0.05 for two-tailed test). Results: During the study period, there were 353 children with cancer, consisting of 56.9% hematological malignancies and 43.1% solid tumors: 60.9% boys, and 82.4% aged <10 years. Hematological malignancies in industries-urban areas are more numerous than in Mataraman, Madura Island, and Tapal Kuda; 67.8%, 52.8%, 47.2%, and 50.9%, respectively (p=0.031). Hematologic malignancies were also more common in aged <10 years (60.5% vs 40.3%; p=0.004 OR=2.265; 95% CI=1.295-3.362) and Javanese race (p=0.025; OR=3.257; 95% CI=1.121-5.263). Children in industrial-urban areas had more hematological malignancies than Mataraman (p=0.027; OR=2.353; 95% CI=1.101-5.030) also Tapal Kuda (p=0.015; OR=1.881; 95% CI=1.132-3.124) and Madura Island (p=0.032; OR=2.033; 95% CI=1.064-3.882). Conclusion: Hematological malignancies in industry and urban areas are more numerous than Mataraman, Madura Island, and Tapal Kuda area. Solid tumors were mostly found on Madura Island.
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Salem, Ahmed Ebada, Harsh R. Shah, Matthew F. Covington, Bhasker R. Koppula, Gabriel C. Fine, Richard H. Wiggins, John M. Hoffman, and Kathryn A. Morton. "PET-CT in Clinical Adult Oncology: I. Hematologic Malignancies." Cancers 14, no. 23 (November 30, 2022): 5941. http://dx.doi.org/10.3390/cancers14235941.
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PET-CT is an advanced imaging modality with many oncologic applications, including staging, assessment of response to therapy, restaging and evaluation of suspected recurrence. The goal of this 6-part series of review articles is to provide practical information to providers and imaging professionals regarding the best use of PET-CT for the more common adult malignancies. In the first article of this series, hematologic malignancies are addressed. The classification of these malignancies will be outlined, with the disclaimer that the classification of lymphomas is constantly evolving. Critical applications, potential pitfalls, and nuances of PET-CT imaging in hematologic malignancies and imaging features of the major categories of these tumors are addressed. Issues of clinical importance that must be reported by the imaging professionals are outlined. The focus of this article is on [18F] fluorodeoxyglucose (FDG), rather that research tracers or those requiring a local cyclotron. This information will serve as a resource for the appropriate role and limitations of PET-CT in the clinical management of patients with hematological malignancy for health care professionals caring for adult patients with hematologic malignancies. It also serves as a practical guide for imaging providers, including radiologists, nuclear medicine physicians and their trainees.
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Abbagoni, Sujith, Thuy Le, Locke J. Bryan, Mohammad A. H. Mian, Danielle Bradshaw, Ashley D. Fox, Anand P. Jillella, et al. "Central Line Associated Bloodstream Infection Rate Among Hematologic Malignant Patients Who Received Antimicrobial Prophylaxis in the Inpatient Setting." Blood 138, Supplement 1 (November 5, 2021): 4390. http://dx.doi.org/10.1182/blood-2021-154524.
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Abstract Introduction: Patients with hematological malignancies are at increased risk of infections which leads to increased morbidity and mortality. Particularly, they are at an increased risk of developing central line associated bloodstream infection (CLABSI) since they frequently require central venous catheters for various essential reasons including chemotherapy, blood transfusions, and parenteral nutrition. Prophylaxis with antibiotics is the key in the management for these patients but is not always effective and sometimes associated with complications. Hence, the main objective of the study is to examine the rate of developing CLABSI in patients with hematological malignancies receiving antimicrobial prophylaxis and in those who did not receive prophylaxis. Methods We conducted a retrospective study involving patients diagnosed with a hematological malignancy admitted to the Augusta University Medical Center from 2002 to 2019. IRB approval was obtained to review the patients' charts. Patients who developed CLABSI are defined as those who had positive blood cultures after central venous catheter had been placed. Percentage of patients who received prophylaxis and those who didn't get antimicrobial prophylaxis were calculated. The difference between the two percentages was examined to determine whether or not it is statistically significant. Results The charts of 268 patients admitted for hematological malignancies were reviewed. Among 173 patients receiving antibiotic prophylaxis (65.0%), 78 (45.1%) developed CLABSI. Among the patients who didn't receive prophylaxis, 64 (68.8%) developed CLABSI. The difference between the two groups was statistically significant (p<0.01), and the relative risk of developing CLABSI in patients who did not receive prophylaxis is 0.57 (95% confidence interval 0.41 - 0.79). Conclusion Patients who had been diagnosed with a hematologic malignancy and admitted at the academic institution from 2002 to 2019 were analyzed for the risk of developing CLABSI that was associated with the use of antibiotic prophylaxis. We found that the non-prophylactic group has statistically significant higher risk of developing CLABSI than the prophylactic group. Thus prophylaxis with antibiotics may play a major role in decreasing the rate of CLABSI in patients admitted with hematological malignancy. Disclosures No relevant conflicts of interest to declare.
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Tsering, Lama Tamang, Sindhu Barola, and Abhinav B. Chandra. "Assessing Bacterial Isolates in Bloodstream Infections and Trend of the Antimicrobial Resistance in the Hematological and Solid Malignancies." Blood 126, no. 23 (December 3, 2015): 5628. http://dx.doi.org/10.1182/blood.v126.23.5628.5628.
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Abstract Introduction: Infection is a common cause of morbidity and mortality in hemato-oncologic patients receiving chemotherapy. The empiric broad spectrum antibiotic given to patients with fever and features of sepsis has reduced infection related complications and shortened hospital stay. However, the use of empirical antibiotic prophylaxis has caused changes in the spectrum of organisms and emergence of drug resistance. We evaluated the type of bacterial isolates and the resistance patterns in cancer patients. Method: We examined data from cancer patients aged 18 years and older with positive blood cultures from 2012-2014. We estimated the frequency and percentage of blood culture positives bacteria and resistance pattern in hematological and solid malignancy and compared hospital stay and death during admission. Results: 1334 patients were admitted 2012 to 2014 who received at least one course of chemotherapy. We found 167 positive blood cultures among 122 patients from137 admissions. Of these 122 patients, 72.7% had solid malignancy and 27.3% had hematological malignancy. Patients with hematological malignancy had 81.8% gram positive cultures and 19.2% gram negative cultures compared to 78.4% and 21.6%, respectively for patients with solid malignancies. Out of the gram positives, 22.2% were Staphylococcus aureus and 33.3% were coagulase negative staphylococcus in patients with hematological malignancies as opposed to 17.4% and 15.9% respectively in patients with solid malignancies. Among the gram negative positive blood cultures 17.6% grew Escherichia coli and 27.7% grew Klebsiella in patients with hematological malignancies. These numbers were 35.2% and 44.4% in patients with solid malignancies. 59.9% of culture positive bacteria developed resistance to one or more antibiotics in hematological malignancy group where as 56.9% developed it in in solid malignancy group. The percentage of bacterial resistance to 1, 2 and 3 or more antibiotics in hematological and solid malignancies were 18.8 Vs 21.9, 15.9 Vs 13.8 and 22.7 Vs 21.9 respectively. Percentage of extended-spectrum β-lactamases (ESBL), methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) were 6.6%, 3.6 and 4.7% respectively. Having positive blood cultures was associated with increased length of hospital stay - 56.3% of patients with hematological malignancies spent 10 or more days in the hospital as compared to 48.8% of patients with solid malignancy. More deaths were seen in patients with positive blood cultures with hematological malignancies (15.6%) as compared to patients with positive blood cultures with solid malignancies (14.5%). Conclusion: We observed that gram positive bacteremia was more common in our patient population. There seems to be no difference in the incidence and pattern of bacteremia between solid and hematological malignancies. Bacteremia is associated with increased length of stay and mortality. More than one third of bacteria are resistant to 2 or more antibiotics. Therefore, the careful analysis of the types of organisms and pattern of antimicrobial resistance of the isolates at each particular institution is important to develop strategy for empiric antimicrobial therapy for patients with febrile neutropnia and treatment of bacteremia. Disclosures No relevant conflicts of interest to declare.
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Sud, Amit, Subhayan Chattopadhyay, Hauke Thomsen, Kristina Sundquist, Jan Sundquist, Richard S. Houlston, and Kari Hemminki. "Analysis of 153 115 patients with hematological malignancies refines the spectrum of familial risk." Blood 134, no. 12 (August 8, 2019): 960–69. http://dx.doi.org/10.1182/blood.2019001362.
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Abstract Sud and colleagues interrogated the familial risk of hematological malignancy in association with over 150 000 patients. The majority of hematological malignancies showed increased familial relative risk, most prominently in association with B-cell malignancies.
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Banerjee, Suvankar, Sk Abdul Amin, and Tarun Jha. "Therapies of Hematological Malignancies: An Overview of the Potential Targets and Their Inhibitors." Current Chemical Biology 15, no. 1 (April 27, 2021): 19–49. http://dx.doi.org/10.2174/2212796815666210203104446.
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Background: The term “hematological malignancy” means a cluster of cancer and tumor conditions, including leukemia, lymphoma, myeloproliferative neoplasm, lymphoproliferative disorders, etc., involved with circulatory organs like blood, bone marrow, lymph, and lymph nodes. Introduction: The increase in the number of hematological malignancy-related cases in our modern society urges suitable treatment of such disease. In this current era, there is still a major deficiency in the number of suitable chemotherapeutic agents for the treatment of hematological malignancies. Methods: The researchers were successful in identifying various cellular, extracellular proteins, and cytokines, as well as their involvement in different hematological malignancies via epigenetic modulation and regulation of other proteins and signaling pathways. Here, we have discussed the structural aspects, connection, and pathophysiological contributions of a group of different cellular and extracellular proteins that are regulated and/or have a significant influence on the progression of different hematological malignancies along with their potent inhibitors. Result and Conclusion: The correlation of physiological proteins with cancerous hematological conditions has been discussed here. It can be crucial for the development of potent inhibitors as chemotherapeutic agents to contest such malignancies. This review will also be useful in the chemotherapeutic agent development by providing crucial information about such hematological malignancy-related proteins and their inhibitors. The repurposed drugs with potential for anticancer applications are also discussed.
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Ghimire, Krishna B., and Binay K. Shah. "Second Primary Malignancy in Diffuse Large B Cell Lymphoma (DLBCL)." Blood 124, no. 21 (December 6, 2014): 2606. http://dx.doi.org/10.1182/blood.v124.21.2606.2606.
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Introduction: Patients with non-Hodgkin lymphoma are at significantly increased risk of second primary malignancies (SPM). There are few studies on SPM in diffuse large B-cell lymphoma. We aim to evaluate the risk of SPM after diagnosis of primary DLBCL using Surveillance, Epidemiology and End Results (SEER) database. Methods: We used SEER 13 database to select adult patients with primary DLBCL diagnosed between 1992- 2009. We used SEER*Stat’s Multiple Primary - Standardized Incidence Ratios (MP-SIR) to calculate SPM in DLBCL. We analyzed SPM by age (≥20, 20-59 and ≥60 years), sex and latency. Second primary malignancy was defined as a metachronous malignancy developing six months or more after an index DLBCL. Results: A total of 28,368 adult DLBCL patients were selected for analysis. Among them, 54.4% were male, 44.1% were <60 years of age. The total number (n) of all site SPMs in DLBCL patients was 2,597, an Observed/ Expected (O/E) ratio of 1.22, P< 0.05, excess risk of 30.93. The risk of following SPMs was significantly higher in the patients with DLBCL: head & neck, anus & colorectal, lung, skin (melanoma), kidney, thyroid, Kaposi sarcoma and hematological malignancies. In young DLBCL patients (20-59 years) group, 12,509 patients developed 830 all site SPMs with O/E: 1.56, P value < 0.05, excess risk 37.01. SPMs which were significantly increased as compared to general population were: head & neck, anus & colorectal, lung, kidney, thyroid, Kaposi sarcoma and hematological malignancies. Similarly, 15,859 older (≥60 years) DLBCL patients developed 1,767 all site SPMs with O/E: 1.11, P< 0.05, excess risk 24.07. SPMs which were significantly increased in this age group as compared to general population were: head & neck, skin, colon, kidney, thyroid and hematologic malignancies. There was significantly higher risk of tumors of anus & colorectal, liver, kidney, thyroid, Kaposi sarcoma and hematologic malignancies within 5 years of latency. Malignancies of head & neck, anus &, colorectal, skin, breast, urinary bladder and hematologic malignancies were significantly higher after 5 years of latency. Conclusion: Patients with DLBCL were at significantly increased risk of developing SPMs as compared to general population. Survivors of DLBCL need to be closely followed with special attention to SPM. Disclosures No relevant conflicts of interest to declare.
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Dar, Lior, Niv Ben-Shabat, Shmuel Tiosano, Abdulla Watad, Dennis McGonagle, Doron Komaneshter, Arnon Cohen, Nicola Luigi Bragazzi, and Howard Amital. "The Incidence and Predictors of Solid- and Hematological Malignancies in Patients with Giant Cell Arteritis: A Large Real-World Database Study." International Journal of Environmental Research and Public Health 18, no. 14 (July 16, 2021): 7595. http://dx.doi.org/10.3390/ijerph18147595.
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Background: The association between giant cell arteritis (GCA) and malignancies had been widely investigated with studies reporting conflicting results. Therefore, in this study, we aimed to investigate this association using a large nationwide electronic database. Methods: This study was designed as a retrospective cohort study including GCA patients first diagnosed between 2002–2017 and age, sex and enrollment time-matched controls. Follow-up began at the date of first GCA-diagnosis and continued until first diagnosis of malignancy, death or end of study follow-up. Results: The study enrolled 7213 GCA patients and 32,987 age- and sex-matched controls. The mean age of GCA diagnosis was 72.3 (SD 9.9) years and 69.1% were women. During the follow-up period, 659 (9.1%) of GCA patients were diagnosed with solid malignancies and 144 (2.0%) were diagnosed with hematologic malignancies. In cox-multivariate-analysis the risk of solid- malignancies (HR = 1.12 [95%CI: 1.02–1.22]), specifically renal neoplasms (HR = 1.60 [95%CI: 1.15–2.23]) and sarcomas (HR = 2.14 [95%CI: 1.41–3.24]), and the risk of hematologic malignancies (HR = 2.02 [95%CI: 1.66–2.47]), specifically acute leukemias (HR = 1.81 [95%CI: 1.06–3.07]), chronic leukemias (HR = 1.82 [95%CI: 1.19–2.77]), Hodgkin’s lymphomas (HR = 2.42 [95%CI: 1.12–5.20]), non-Hodgkin’s-lymphomas (HR = 1.66: [95%CI 1.21–2.29]) and multiple myeloma(HR = 2.40 [95%CI: 1.63–3.53]) were significantly increased in GCA patients compared to controls. Older age at GCA-diagnosis (HR = 1.36 [95%CI: 1.25–1.47]), male-gender (HR = 1.46 [95%CI: 1.24–1.72]), smoking (HR = 1.25 [95%CI: 1.04–1.51]) and medium-high socioeconomic status (HR = 1.27 [95%CI: 1.07–1.50]) were independently associated with solid malignancy while age (HR = 1.47 [95%CI: 1.22–1.77]) and male-gender (HR = 1.61 [95%CI: 1.14–2.29]) alone were independently associated with hematologic- malignancies. Conclusion: our study demonstrated higher incidence of hematologic and solid malignancies in GCA patients. Specifically, leukemia, lymphoma, multiple myeloma, kidney malignancies, and sarcomas. Age and male gender were independent risk factors for hematological malignancies among GCA patients, while for solid malignancies, smoking and SES were risk factors as well.
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Orhan, Bedrettin, Fahir Özkalemkaş, Vildan Özkocaman, Büşra Gürbüz, Tuba Ersal, İbrahim Ethem Pınar, Cumali Yalçın, et al. "THE ROLE OF WHITE BLOOD CELL COUNT IN PERIANAL PATHOLOGIES: A RETROSPECTIVE ANALYSIS OF HEMATOLOGIC MALIGNANCIES." Mediterranean Journal of Hematology and Infectious Diseases 14, no. 1 (June 29, 2022): e2022051. http://dx.doi.org/10.4084/mjhid.2022.051.
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Background and Objective: Perianal pathologies are the most common cause of perianal infections in patients with hematological malignancies. Perianal infection diagnosis in this group of patients is difficult, thus careful anorectal examination is necessary, with imaging modalities. The literature revealed a knowledge gap on the approach of anal pathologies in patients with neutropenia during diagnosis or chemotherapy. This study aimed to examine our institutional data of perianal complications and investigate the relationship among the white blood cell-neutrophil count, perianal lesion, and the type of treatment in patients with hematologic malignancies during the neutropenic period.
Methods: Patients with a hematologic malignancy, hospitalized for cytotoxic chemotherapy, complicated by perianal pathology, and documented by at least one imaging method were included in the study.
Results: A total of 42 patients were included in the study. The comparison between the groups revealed no statistical significance between the anal abscess formation and the neutrophil count and previous perianal pathology. A statistical significance in favor of acute myeloid leukemia was found between patient diagnosis and anal abscess development. An inverse relationship was found between the number of white blood cells at hospitalization and having an anal pathology operation. It was observed that patients with high white blood cell count were less operated on due to anal pathology.
Conclusions: In conclusion, this article has shown that white blood cell count at the time of hospitalization in patients with hematological malignancy, can affect the operation status of patients due to anal pathologies that may occur in the neutropenic period.
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Shrestha, Amar Narayan, Sunil Kumar Singh, Rajiv Kumar Deo, Rinku Joshi, Ayusha Poudel, Barun Babu Aryal, and Anurag Adhikari. "Pattern of hematological malignancy in a tertiary level hospital in Kathmandu." Journal of Pathology of Nepal 9, no. 1 (March 29, 2019): 1457–59. http://dx.doi.org/10.3126/jpn.v9i1.23355.
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Background: Hematological malignancies involve the blood elements, marrow, lymph and lymphatic elements and are among the common malignancies afflicting the human race. They tend to involve the extremes of the ages- the young and the elderly.
Materials and Methods: A hospital register based retrospective study was conducted including the data of five years duration. The confirmation of diagnosis was done with blood smear examination, bone marrow examination and flow-cytometry. The epidemiological parameters were then calculated using Microsoft Excel and SPSS.
Results: Among the total number of cases, 60.7% were males and 39.3% were females. Age group of 50 to 59 years was most commonly involved. Lymphoma (including Hodgkin’s and non-Hodgkin’s) was the most common hematological malignancy.
Conclusions: Males are more afflicted by hematological malignancies and lymphoma was the commonest hematological malignancy.
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Hanif, Umair, Mughees Ahmed, and Imran Hanif. "HEMATOLOGICAL MALIGNANCIES." Professional Medical Journal 22, no. 03 (March 10, 2015): 349–52. http://dx.doi.org/10.29309/tpmj/2015.22.03.1354.
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Infection rate of CMV in adults is approximately 60% in the developed countriesand almost 100% in the developing countries. Objectives: To evaluate the frequency ofcytomegalovirus (CMV) infection in patients with different hematological malignancies. Design:Observational study. Setting: Gulab Devi Chest Hospital & INMOL Hospital Lahore. Period: Sixmonths. Materials and methods: The blood samples were drawn from the selected patientsafter taking their written informed consent. The DNA was extracted from the whole blood andthe polymerase chain reaction was performed for CMV DNA using CMV PCR kit (CinnagenInc. Catalog # PR7836C). The 222bp fragment corresponding to the size marker and positivecontrol was considered as positive. The data was analyzed by SPSS version 16. Results: Themean age of patients was 36 years. Out of 16, 3 were presented with interstitial pneumonitis, 14with retinitis, 3 with esophagitis and 5 were presented with colitis respectively. In this study onesample was tested positive for CMV DNA. Conclusions: CMV infection may be a serious threatfor the patients with compromised immune system such as those receiving chemotherapy. Thescreening for CMV should be done before the blood transfusion to such patients.
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Brenner, Malcolm K. "Hematological malignancies." FASEB Journal 11, no. 8 (July 1997): 640–48. http://dx.doi.org/10.1096/fasebj.11.8.9240966.
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Giagounidis, A. A. N., U. Germing, J. S. Wainscoat, J. Boultwood, and C. Aul. "Hematological Malignancies." Hematology 9, no. 4 (August 2004): 271–77. http://dx.doi.org/10.1080/10245330410001723824.
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Bueso-Ramos, Carlos E., Alessandra Ferrajoli, L. Jeffrey Medeiros, Michael J. Keating, and Zeev Estrov. "Hematological Malignancies." Hematology 9, no. 4 (August 2004): 279–86. http://dx.doi.org/10.1080/10245330410001727046.
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Prajapati, Zankhana, Mayur Kokani, and R. Gonsai. "Clinicoepidemiological profile of hematological malignancies in pediatric age group in Ahmedabad." Asian Journal of Oncology 03, no. 01 (January 2017): 054–58. http://dx.doi.org/10.4103/2454-6798.209330.
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Abstract Background: This hematological malignancy comprises a major health problem in the society due to its high mortality and morbidity. There is a need for the accurate estimation of incidence and prevalence of acute lymphocytic leukemia (ALL), and other hematological malignancies in India to estimate the true disease burden and its impact on the population which may help in formulating the guideline which helps in better risk stratification and treatment. Unfortunately, there is a real paucity if epidemiologic data on pediatric cancers in India and particularly in several parts of Gujarat. Objectives: To find out the prevalence and other epidemiological distribution of hematological malignancy in pediatric age group patients. Furthermore, it was objected to study hematological profile and bone marrow typing in pediatric patients with hematological malignancies. Methodology: A prospective observational study carried out over 2½ years. Confirm cases of hematological malignancies were recruited from the pediatric outpatient and inpatient department. Data recorded in the preformed case record form include demographic data, data of clinical history and clinical examination, laboratory findings such as complete blood count, peripheral smear examinations, bone marrow examination for cellularity and differential count, and immunophenotyping. Fine needle aspiration cytology or biopsy of lymph node was done in suspected lymphoma patients. Observations: ALL is the most common hematological malignancy among pediatric patients in the present study with 122 out of 158 patients (77.21%). Other malignancies are acute myeloid leukemia (AML) (13.29%) and chronic myeloid leukemia (2.59%) and lymphoma (5.69%). Nearly half of the patients were below 5 years of age (51.26%) and males were predominantly affected with frequency of 77.6%. Common clinical features were fatigue, fever, loss of appetite, bone pain, petechies, hepatic and splenomegaly, pallor, and lymphadenopathy. In ALL, most common blast type in bone marrow was L1 type (86.44%), whereas in AML, it is M2 type (80%). Conclusion: The most common type of malignancies in pediatric age group is hematological malignancies with predominant variant is ALL. It is commonly affecting age below 5 years with male predominance.
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Cole, Craig E., Alyson R. Haugen, Michelle A. Mathiason, and Vicki L. McHugh. "Screening for Psychosocial Distress in Patients with Hematological Malignancies and Identifying Specific Factors That Cause Distress throughout Stage of Disease." Blood 118, no. 21 (November 18, 2011): 2086. http://dx.doi.org/10.1182/blood.v118.21.2086.2086.
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Abstract Abstract 2086 Background: Studies incorporating measurement tools for emotional distress into clinical care for hematology patients are rare. We previously reported that distress levels of >5 on the National Comprehensive Cancer Network (NCCN) distress thermometer (DT) were significantly more likely to occur in patients who were seen within the first 30 day of presentation, women, younger patients, those with previous depression/anxiety, and those who are unmarried. However, the diagnosis of malignant or non-malignant hematologic disorder was not associated with DT levels >5. Since this report, the DT indicator of distress was adjusted to ≥4. AIM: To assess and measure psychosocial distress in adult patients with hematological malignancies pertaining to Hodgkin's Lymphoma (HL), Non-Hodgkin's Lymphoma (NHL), Multiple Myeloma (MM), and Chronic Lymphocytic Leukemia (CLL) at a multidisciplinary community-based hematology/oncology clinic, and identify the specific factors of these subjects associated with the most distress. Methods: Consecutive adult subjects with HL, NHL, MM, and CLL (n=302) seen at the Gundersen Lutheran Center for Cancer and Blood Disorders were approached over a period from September 2010 to March 2011. Study subjects consented to a one-time assessment of two prospective surveys that included the DT (scale of 0–10) and the Hospital Anxiety and Depression Scale (HADS), which indicates the specific factors that cause distress in daily life. Subjects were excluded for incomplete surveys. The Charlson Comorbidity Index (CCI) was utilized to assess comorbid conditions at the time of consent and is predictive of mortality within one year. Additional medical information including history of anxiety/depression, as well as disease related information and disease state (diagnosed, observation, remission, treatment) were collected by chart review. A score ≥4 was used an indicator of distress for the DT, and a score of ≥8 was used as a positive indicator of anxiety/depression for the HADS. All prospective surveys were completed prior to the subject's clinic appointment. Results: A total of 190 subjects (63%) consented and completed both the DT and HADS (mean age 65.8±13.4 yrs; 62% men). Subjects were grouped into hematological malignancy cohorts, with 31% having NHL, 25% CLL, 11% HL and MM 20%. The mean DT score was 2.8±2.5 and the mean CCI was 4.5±1.4, with 34% of subjects rating distress ≥4 and 31% of subjects having a positive HADS result. No differences between hematological malignancy cohorts were found for subjects with a history of anxiety/depression (p=0.079), DT ≥4 (p=0.468) or positive HADS results (p=0.079); however, the percentage of subjects with a positive HADS result trended higher in HL subjects (52%). When stratified by DT score (≥4 vs. 0–3), no differences were found for hematological malignancy cohorts, disease state, sex, age, marital status or CCI. However, a positive HADS result was associated with a DT score ≥4 (p=0.001), thereby validating DT as a screening tool for anxiety/depression. Women were more likely to have a history of depression (p=0.008), but a history of anxiety/depression or medication usage was strongly associated with a DT score ≥4 (p=0.001) for the entire population. Conclusion: In subjects with common hematologic malignancies, a history of anxiety/depression was a very strong indicator of distress. Degree of comorbid illness, disease status and type of hematologic malignancy were not associated with distress. Based on these results, patients with hematologic malignancies who have a DT score ≥4 and/or a positive HADS result should be considered for aggressive management of prior anxiety and depression to ensure treatment that encompasses patient-centered care. Disclosures: No relevant conflicts of interest to declare.
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Folci, Marco, Giacomo Ramponi, Dana Shiffer, Aurora Zumbo, Michele Agosti, and Enrico Brunetta. "ANCA-Associated Vasculitides and Hematologic Malignancies: Lessons from the Past and Future Perspectives." Journal of Immunology Research 2019 (May 6, 2019): 1–9. http://dx.doi.org/10.1155/2019/1732175.
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The purpose of this paper is to collect and summarize all evidences relating to an association between ANCA-associated vasculitides (AAVs) and hematologic malignancies, in the form of either a paraneoplastic vasculitis or leukemias and lymphomas developing on a preexisting vasculitis. Additionally, the role of cyclophosphamide in vasculitis treatment has been assessed and compared to rituximab. Paraneoplastic AAV seems to be an uncommon presentation of hemopathies. Hematologic malignancy risk in AAV is more likely to be increased by cyclophosphamide, although not yet definitely proven. Furthermore, the pathogenesis of ANCA-associated vasculitis has been reviewed with particular emphasis on the role of proteinase 3 (PR3) in fuelling granulomatosis with polyangiitis (GPA) inflammation. PR3 is a bactericidal protein expressed by neutrophilic granules and on their plasma membrane. Derangements in its expression and function have been linked to leukemias and GPA alike. PR3-derived PR1 peptide is being studied as an immunotherapy target in leukemia and multiple myeloma. This study is aimed at bringing together various evidences from the field of immunological and hematological research, at exposing contradictions, and at revealing novel insights on the association between ANCA-associated vasculitis and hematologic malignancies.
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Bennett, Dimitri, Nittaya Suppapanya, and Kelly Grotzinger. "Thrombocytopenia in hematologic malignancy and solid tumors in the United States." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): e12001-e12001. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e12001.
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e12001 Background: Thrombocytopenia (TCP) frequently occurs in patients with hematologic or solid malignancies resulting from the underlying disease processes or a complication of cancer treatments. Severe TCP may both increase the risk of bleeding, interrupt or reduce optimal dosing with therapies. Epidemiological data on these patients are limited. Therefore, to increase our knowledge, we identified patients with hematologic & solid malignancies & assessed the frequency of primary, secondary & TCP not otherwise classified, following diagnosis & through treatment using a large US claims database. Methods: Hematologic & solid malignancy adult cases were identified during the calendar year 2008 in the Integrated Healthcare Information Service, a medical & prescription claims database comprised of ~101.7 million members from 46 health plans in the US. Malignancies were defined using ICD-9 diagnosis codes; 2 codes were required to confirm cancer. TCP was defined as the presence of at least 2 claims with ICD-9 codes 287.3 or 287.4 or 287.5 within 365 days of the first malignancy diagnosis in 2008. All grades of TCP thus might be reflected as platelet counts were not used to verify diagnostic coding. Adults on active cancer therapy as well as those for whom cancer therapy was not yet initiated & those who have completed their therapeutic regimen are included in the analyses. Results: The frequency of TCP was higher among patients with hematologic malignancies compared to those with solid tumors. Among hematologic cancers, TCP was more common among patients diagnosed with acute myeloid leukemia 33.4% & acute lymphoblastic leukemia 19.1%, followed by aplastic anemia 13.6%, MDS 12.6%, multiple myeloma 9.4%, chronic lymphocytic leukemia 6.9%, chronic myelogenous leukemia 5.9% & non-Hodgkin’s lymphoma 5.1%. Of all patients with solid tumors, the greatest proportion with TCP were observed among those with small cell lung cancer 9.4%; TCP was relatively rare among patients with cancers of the ovary 3.1%, non-small cell lung cancer 2.9%, cervical cancer 2.3%, bladder 1.6%, uterus 1.1%, & breast cancer 0.7%. Conclusions: Overall, TCP occurrence varies widely by cancer type but is commonly higher among patients with hematological malignancies than solid tumors.
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Azhar, Hajra, Hafiz Muhammad Matloob, Nida Khalid, Ayesha Rahman, Javeria Afzal, and Najma Qureshi. "Clinico-Hematological Pattern of Haematological Malignancies in Patients Referred for Bone Marrow Examination." Pakistan Journal of Medical and Health Sciences 17, no. 1 (January 31, 2023): 168–70. http://dx.doi.org/10.53350/pjmhs2023171168.
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Background: Chromosomal translocation is a common cause among hematological malignancies thus. a different diagnostic and treatment approach is required in these cases. Aim: To determine frequencies and clinic-hematological features of different hematological malignancies among patients. Methodology: It was a descriptive cross sectional study. Patients (n=284) with hematological malignancy were enrolled from total 1080 bone marrow biopsies. Detailed history, clinical examination and hematological parameters were recorded at time of presentation. Bone marrow aspiration and trephine biopsy were done as per the clinical indication. Data was evaluated by using SPSS version 23. Chi-square test was applied with p-value of less than 0.05 was considered significant. Results: The study showed the high percentage of hematological malignancies (24%) were observed among enrolled patients with CML being the commonest cancer among them. Practical Implication: This study established the clinic-hematological correlation and provided study based suggestions for better diagnosis and treatment of hematological malignancies while using bone marrow microscopic examination as an important diagnostic tool. Conclusion: It was concluded that acute leukemias were common in younger age whereas chronic leukemias and lymphoproliferative disorders in more advanced ages. Keywords: Hematological Malignancies, Bone Marrow Examination and Diagnosis.
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Lim, Tristan L., David B. Lieberman, Adam R. Davis, Ryan Hausler, Ashkan Bigdeli, Yimei Li, Jacquelyn Powers, et al. "Germline POT1 Variants Can Predispose to a Variety of Hematologic Neoplasms." Blood 136, Supplement 1 (November 5, 2020): 2–4. http://dx.doi.org/10.1182/blood-2020-134160.
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Germline mutations in the shelterin component protection of telomeres 1 (POT1) were recently found to be associated with familial chronic lymphocytic leukemia (CLL), melanoma, glioma, and several other familial cancer syndromes. The role of POT1 mutations in myeloid neoplasms and other hematologic malignancies, however, remains unknown. To explore the role of POT1 variants in hematologic neoplasms, we analyzed POT1 variants in 3323 consecutive patients who underwent next-generation sequencing (NGS) of a panel of hematologic malignancy-associated genes at our institution and characterized the clinical and pathological characteristics of patients with germline and somatic POT1 mutations. Of 3323 consecutive patients who underwent NGS, 2770 patients had a hematologic malignancy (lymphoid n = 1299, myeloid n = 934, and both lymphoid and myeloid n = 537), while 553 patients were evaluated for non-malignant cytopenias. All 57 patients (2.06%) carrying either a POT1 disease-associated variant or variant of uncertain significance had a hematologic malignancy compared to no identified POT1 variants in 553 patients with benign cytopenias (OR = 23.5, p < 0.001), suggesting that the presence of POT1 variants was predictive of a hematologic malignancy. Of 57 patients, 33 had lymphoid malignancies, 23 had myeloid neoplasms, and 2 had a lymphoid and myeloid neoplasm (Fig 1). Patient variants were classified as germline or somatic using constitutional DNA sequencing, POT1 emergence/disappearance over time, or POT1 maintenance in remission. In the absence of these data, likely germline or likely somatic designations were made by assessing variant allele frequencies against clinical/pathologic characteristics. 18 patients (33%) were found to have germline or likely germline POT1 variants (29% and 42% in the lymphoid and myeloid malignancy groups, respectively). Another 6 patients (11%) had variants whose germline status could not be determined. Of the 17 unique germline POT1 variants, 10 were missense and located within mapped functional protein domains, while 7 were classified as predicted loss-of-function (pLOF) due to a disruption of start, premature stop, frameshift, or spice site alteration. Patients with hematological malignancies had a ~5-8x increased odds of having a germline pLOF POT1 variant compared to cancer-free individuals in the Genome Aggregation Database (gnomAD, n = 113,108 exomes, OR = 7.5, p < 0.001) or in the Penn Medicine BioBank (PMBB, n = 7877, OR = 5.0, p = 0.010), with a prevalence of 0.25% compared to 0.03% and 0.05%, respectively. Germline pLOF POT1 variants were significantly more enriched in patients with myeloid (gnomAD: OR = 6.1, p = 0.02) and lymphoid (gnomAD: OR = 9.8, p < 0.001; PMBB: OR = 6.5, p = 0.004) malignancies. In 33 patients with lymphoid malignancies and POT1 variants, the most common diagnoses were CLL/SLL (n = 21, germline n = 6, somatic n = 12), CD5- CD10- indolent B cell neoplasms (n = 4, germline n = 1, somatic n = 3), and multiple myeloma (n = 3, all somatic) (Table 1). Lymphoid malignancies with a germline POT1 variant had a relative paucity of additional mutations; in contrast, somatic POT1 variants frequently co-occurred with other mutations, most commonly with TP53 (Fig 2, n = 5, 23%). Among 23 patients with myeloid malignancies, patients with germline POT1 variants developed malignancies at a significantly younger age compared to those whose POT1 variants were somatic (median age 59.5 vs 70.5 years, p = 0.04). The most common diagnosis in patients with myeloid neoplasms carrying germline POT1 variants was MPN (germline n = 5, somatic n = 1). AML, MDS/MPN, and MDS occurred in 4, 3, and 1 patients respectively. All patients with myeloid neoplasms had additional disease-associated mutations, with the most common co-occurring variants in TET2 (n = 7), JAK2 (n = 6, co-occurring with 50% of germline POT1 myeloid variants), and NRAS (n = 6). In conclusion, this is the first comprehensive analysis of POT1 variants in an unselected hospital-based population undergoing molecular testing for variants associated with hematologic malignancies. Our results show that the presence of POT1 variants is predictive of having a hematologic neoplasm and that over 30% of POT1 variants in hematologic malignancy patients are germline. Our study expands the spectrum of POT1-associated familial neoplasms and highlights the needs for better recognition of familial hematologic cancer syndromes. Disclosures No relevant conflicts of interest to declare.
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Prusila, Roosa Enni Inkeri, Marc Sorigue, Aleksi Postila, Petteri Salmi, Taru Tanhua, Susanna Tikkanen, Sakari Kakko, et al. "Risk of Secondary Hematological Malignancies in Patients with Follicular Lymphoma: A Retrospective Analysis of 1045 Patients Treated in the Rituximab Era." Blood 132, Supplement 1 (November 29, 2018): 5330. http://dx.doi.org/10.1182/blood-2018-99-110129.
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Abstract Introduction Follicular lymphoma (FL) is the most common indolent lymphoma. Majority of the patients with FL have a good respond to first-line treatment. Relapses are common and many patients need to be re-treated (Izutsu K. J Clin Exp Hematop 2014). Treatment results of indolent non-Hodgkin lymphomas have improved vastly in last decades. This is resulting from the use of therapeutic antibodies such as rituximab (Friedberg JW. Haematologica 2008). With improved survival the risk of secondary malignancies may be higher. Some of the regimens used in the treatment of FL, especially alkylating agents, have been associated with the risk of secondary hematological malignancies such as myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). Incidence of secondary MDS/AML peaks 4-6 years after the initial treatment. Secondary MDS/AML have poor prognosis. The incidence of secondary hematological malignancies and the impact of various treatment regimens among different lymphomas is still largely unknown (Friedberg JW. Haematologica 2008). Data of 1045 patients with FL was collected to find out the incidence of secondary hematological malignancies. We also wanted to know if the incidence is related to certain types of treatment or chemotherapy regimens. Methods This is a retrospective registry study. Clinical data was collected from six hospitals in Finland and two hospitals in Spain. We analyzed clinical data from hospital records of all patients with FL diagnosed between 1997 and 2016. Information such as age, stage, details of treatment, possible relapses, current status and details about secondary hematological malignancy were investigated. Results Median follow-up time was 5.6 years. Baseline characteristics and treatment-related data are presented in Table 1. Altogether 984 of all patients received treatment for lymphoma and from all patients 80.1% received rituximab during treatment. In all patients the 1-year PFS was 92.1% and the 5-year PFS 59.8%. The 5-year DSS was 91.6% and the 5-year OS was 84.1%. The incidence of secondary hematological malignancies is presented in Figure 1a. From all patients 15 (1.4%) developed secondary hematological malignancy. There were 5 cases of MDS, 4 AML, 1 acute promyelosytic leukemia, 1 acute lymphoblastic leukemia, 1 chronic lymphosytic leukemia, 1 chronic myelosytic leukemia, 1 large granular lymphosytic leukemia and 1 myeloma. The 5-year risk for secondary hematological malignancy was 1.3% and the approximated 10-year risk was 3.0%. The risk of secondary hematological malignancy was associated with the number of treatment lines (p=0.039), Figure 1b. There was no statistically significant difference between different first-line chemotherapy regimens. However, there was a trend presenting higher risk, when using alkylating regimens in the first line. With CHOP-like treatment the 5-year risk was 1.1% and the approximated 10-year risk was 3.6%. Conclusions This is a retrospective study from rituximab era. The prognosis of follicular lymphoma is good with the current treatment methods and the risk of secondary hematological malignancy seems to be low. Due to low incidence, it seems, that it is not necessary to avoid chemotherapy in the fear of secondary hematological malignancies. However, multiple lines of treatment are associated with higher risk for secondary hematological malignancies. Therefore, the use of regimens with long remission, like rituximab maintenance, would probably reduce the risk of secondary hematological malignancies. Disclosures No relevant conflicts of interest to declare.
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Ceken, Sabahat, Habip Gedik, Gulsen Iskender, Meryem Demirelli, Duygu Mert, Goknur Yapar Toros, Tugce Nur Yigenoglu, Fevzi Altuntas, Berna Oksuzoglu, and Mustafa Ertek. "Evaluation of Risk Factors for Mortality in Febrile Neutropenia." Journal of Infection in Developing Countries 14, no. 08 (August 31, 2020): 886–92. http://dx.doi.org/10.3855/jidc.12520.
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Introduction: We aimed to evaluate the epidemiology of infections and factors associated with mortality in patients with febrile neutropenia (FEN).
Methodology: The adult patients, who developed FEN after chemotherapy due to a hematologic malignancy or a solid tumor in a training and research hospital were evaluated, retrospectively. The demographic data of the patients, underlying malignancy, administered antimicrobial therapy, microbiological findings, and other risk factors associated with mortality were evaluated.
Results: A total of 135 FEN episodes of 115 patients, who comprised of 72 (63%) patients with 89 FEN episodes due to hematologic malignancies (hemato-group) and 43 (37%) patients with 46 FEN episodes due to solid organ cancers (onco-group), were evaluated in the study. The median age was 47 years (range: 17-75 years) and 66 (57%) patients were male. A total of 12 patients (8.8%) died during 135 episodes of FEN including nine cases from hemato-group and three cases from onco-group. Those factors including a presence of pneumonia, advanced age, persistent fever despite an antimicrobial treatment, and need for mechanical ventilation in intensive care unit (ICU) with were determined as risk factors associated with mortality.
Conclusions: Morbidity and mortality are more common in patients with hematological malignancies compared to patients with solid organ cancers due to prolonged neutropenia. In case of persistent fever, an invasive fungal infection (IFI) should be kept in mind in patients with hematologic malignancies and then antifungal treatment should be initiated. Although a persistent fever is also common in patients with solid tumors, the necessity of antifungal therapy is rare due to the short duration of neutropenia.
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Buppanharun, Jirawat, and Jakapat Vanichanan. "1378. Clinical Characteristics of Tuberculosis Among Patients with Cancer in an Endemic Country." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S500—S501. http://dx.doi.org/10.1093/ofid/ofz360.1242.
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Abstract Background Tuberculosis (TB) is an infection caused by reactivation of Mycobacterium tuberculosis. Decreasing host immune system plays an important role in pathophysiology especially in patients with human immunodeficiency virus (HIV) infection and transplant recipients. Exposure to immunosuppressive agents among patients with solid and hematologic malignancy is likely to increase risk of TB. However, characteristics of TB in this population remain scarce. Methods A single-center, retrospective descriptive study was conducted at King Chulalongkorn Memorial Hospital. Adult patients who developed TB between January 2008 and October 2018 after diagnosis of solid or hematologic malignancy were identified using ICD-10 code. Baseline, clinical characteristics, and treatment outcomes were collected. Results A total of 114 patients developed TB after diagnosis of malignancy including, 67 (58.8%) with solid tumor and 47 (41.2%) with hematologic malignancy. Lung cancer was the most common solid malignancy with TB (17.9%) followed by head and neck carcinoma (14.9%) and colorectal cancer (13.4%). For hematologic malignancies, non-Hodgkin’s lymphoma was the most common malignancy (53.2%) followed by leukemia (29.8%) and multiple myeloma (14.9%). Among patients who received immunosuppressive treatment, the mean onset of TB was 4.97 months (range 0.25 to 57 months) and 2.55 months (range 0.1 to 18 months) after treatment of solid and hematologic malignancies. Pulmonary and pleural involvement remained the most common site of infection in both groups. Mortality was highest among patients with hematologic malignancies (40.4%) while mortality in solid malignancies was 11.9%. Conclusion TB in patients with solid and hematologic malignancies contained substantial morbidity and mortality. Immunosuppressive agents and chemotherapy may play an important role especially in the endemic area. Disclosures All authors: No reported disclosures.
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Saleh, Khalid S., Jabbar S. Hassan, Ali Zaidan, and Rija A. Abdul- Ridha. "The Impact of Vaccination on Severity of COVID-19 Illness in Hematologic Malignancies Patients." Bionatura 7, no. 2 (May 15, 2022): 1–6. http://dx.doi.org/10.21931/rb/2022.07.02.51.
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Covid 19 in hematological cancer patients can lead to a deterioration in the clinical course and a reduction in life expectancy leading high fatality rate. Vaccines developed against the causative virus may reduce the severity of the disease and a decline in mortality rate. This study aims to determine the impact of vaccination on the severity of COVID-19 illness in patients with hematologic malignancies. A multicenter retrospective observational study was conducted on 60 hospitalized patients admitted to intensive care units (ICUs). All patients were previously diagnosed with leukemia or lymphoma and tested positive for COVID-19 by real-time polymerase chain reaction (RT-PCR). Protocol version 8 was used to determine the patients' results, including improvement to discharge criteria or deterioration to death. The most results in this study; The mean age of the patients was 33.63± 16.5 years (range 6-72 years). Diabetes was the most common comorbid illness (10%). The Oxygen saturation range was (70-95%). Among (60) patients enrolled in this study;29(48.33%) was not received any Covid-19 vaccine while 31(51.67%) were fully vaccinated; concerning patients with positive COVID19; the underlying hematological malignancy was leukemia (63.3%) while patients with lymphoma were (36.7%); after 30-day follow up, depending to the outcome. The number of deaths was 14 cases (23.3%) of patients while the other 46 patients (74.7%) survived and were discharged from the hospital. Our study concludes that vaccinating hematological malignancy patients against Covid19 may provide clinical protection from this illness compared to no vaccination patients Keywords. COVID-19 disease, Hematological Malignancy, Vaccine, intensive care units
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Pak, Daniel M., and Maria S. Tretiakova. "An Unusual Manifestation of Blastic Plasmacytoid Dendritic Cell Neoplasm as a Testicular Tumor." Case Reports in Pathology 2019 (October 7, 2019): 1–4. http://dx.doi.org/10.1155/2019/9196167.
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Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a clinically aggressive hematologic malignancy arising from precursors of plasmacytoid dendritic cells that represent less than 1% of hematological malignancies. BPDCN initially presents with cutaneous involvement and a characteristic immunophenotype of CD4, CD56, and CD123 co-expression. Upon disease progression, BPDCN shows a strong predilection for bone marrow, peripheral blood, and lymph nodes, whereas manifestations in visceral organs are rare. Significant heterogeneity in clinical presentation and immunophenotypic profile makes BPDCN challenging to diagnose without an integrated approach based on patient history, clinical features, tumor pathology, and comprehensive immunohistochemical studies. Herein we report the first case of relapsed BPDCN manifesting as a unilateral testicular tumor.
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Singhrao, Ruby, Lisha Capucion, Shikha Chugh, Shuba Krishna, Adama Parham, Amy Harrell, Ranga Yerram, John Duncan, and Manana Javey. "Abstract 5236: Clinical evaluation of somatic genomic alteration annotation for hematological malignancies using tertiary analysis software." Cancer Research 82, no. 12_Supplement (June 15, 2022): 5236. http://dx.doi.org/10.1158/1538-7445.am2022-5236.
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Abstract Introduction: Next Generation Sequencing (NGS) is transitioning from research to routine in clinical practice for hematological malignancies. Data analysis and annotation of variants are significant barriers to NGS adoption. NAVIFY® Mutation Profiler (NMP) is a CE-marked*, cloud-based tertiary analysis software that provides curation, annotation, and reporting of somatic genomic alterations and biomarker signatures identified by NGS. It provides information on genomic variants based on published biomedical literature, public genomic databases, medical guidelines, drug labels, and results of clinical trials. The software leverages classification guidelines based on AMP, to provide information on detected somatic genomic variants, and inform on associated therapies according to region specific approvals. To validate accuracy and reproducibility of the NMP software and curation process for hematologic malignancies, a clinical evaluation study was performed. Methods: NMP 2.1 was used as a tertiary analysis software. A total of 86 variants derived from hematologic malignancies (including myeloid and lymphoid leukemias, B cell lymphomas and multiple myeloma), contrived as 12 VCF files were generated. These comprised of the following classes of genomic alterations: single nucleotide variants, insertions and deletions, fusions, copy number alterations, and indels. Out of 86 variants 42 were Tier 1A and 44 were non-Tier 1A, based on AMP classification. The study was performed at 4 external sites with 7 software users (molecular genetics experts). Users uploaded the VCF files into the NMP software, and processed them with instructions provided. NMP reported AMP tier of variants and associated therapies were evaluated for agreement among the users. Results: For the reproducibility, 100% agreement for the hematologic malignancy cases was achieved for each agreement analysis, demonstrating software users can produce the exact same output, given the same files and condition variables entered into the software. For accuracy, tier classification agreement was 91.34% for Tier IA and 95.02% for all hematologic variants. The agreement on associated therapies for the NMP classified Tier IA hematologic variants was 99.08%. Conclusions: NAVIFY® Mutation Profiler is a robust automated solution for genomic variant reporting of hematologic malignancies. The tier classifications and available therapies resulting from the NMP annotation and curation are highly concordant with molecular genetics experts. With the increasing number of known clinically relevant genomic variants in hematologic malignancies, software capable of automatically identifying and accurately classifying somatic genomic variants, promises to decrease the manual review time necessary in clinical practice. *CE-IVD. United States: Research Use Only. Not for use in diagnostic procedures. Citation Format: Ruby Singhrao, Lisha Capucion, Shikha Chugh, Shuba Krishna, Adama Parham, Amy Harrell, Ranga Yerram, John Duncan, Manana Javey. Clinical evaluation of somatic genomic alteration annotation for hematological malignancies using tertiary analysis software [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5236.
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Oktariana, Desi, Legiran Legiran, Phey Liana, Kemas Y. Rahadiyanto, Gita D. Prasasty, Evi Lusiana, and Nia S. Tamzil. "Transplantasi Stem Cell untuk Keganasan Hematologi." eJournal Kedokteran Indonesia 10, no. 2 (September 5, 2022): 186–93. http://dx.doi.org/10.23886/ejki.10.123.186-93.
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Insiden keganasan hematologi terus bertambah serta memiliki tingkat morbiditas dan mortalitas yang tinggi. Keganasan hematologi adalah kondisi sel-sel hematologi seperti eritrosit, leukosit, dan trombosit, tumbuh tidak terkendali dan tidak mengalami kematian sehingga mendominasi populasinya dan tidak dapat berfungsi normal. Terapi stem cell pada keganasan hematologi yang disebut juga terapi transplantasi sumsum tulang, merupakan modalitas terapi utama untuk gangguan hematologi dan keganasan yang memungkinkan pemulihan komponen seluler darah, termasuk monosit, limfosit, basofil, eosinofil, neutrofil, eritrosit, dan trombosit. Stem cell yang dapat digunakan pada keganasan hematologi adalah kombinasi hematopoietic stem cell (HSC) dan mesenchymal stem cells (MSC) untuk transplantasi sumsum tulang dan pemulihan kekebalan untuk gangguan hematologi. Penggunaan HSC dengan ko-terapi MSC dapat memfasilitasi kelangsungan hidup cangkok dari transplantasi HSC. Kata kunci: keganasan, hematologi, stem cell. Stem Cell Transplantation for Hematology Malignancy Abstract The incidence of hematological malignancies continues to increase and has a high rate of morbidity and mortality. Hematological malignancies are conditions of hematological cells such as erythrocytes, leukocytes, and platelets, growing uncontrollably and not dying so that they dominate the population and cannot work normally. Stem cell therapy in hematological malignancies, also known as bone marrow transplantation therapy, is the main therapeutic modality for hematological disorders and malignancies that supports the restoration of cellular components of blood, including monocytes, lymphocytes, basophils, eosinophils, neutrophils, erythrocytes, and platelets. Stem cells that can be used in hematological malignancies are a combination of hematopoietic stem cells (HSC) and mesenchymal stem cells (MSC) for bone marrow transplantation and immune restoration for hematological disorders. The use of HSCs with MSC co-therapy can help revive grafts from HSC transplants. Key words: malignancy, hematology, stem cell.
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Cooper, Kathrine A., Jonathan Lattell, Beverly Gonzalez, Stephanie Kliethermes, and Sucha Nand. "Prevalence of Multiple Primary Hematologic Malignancies Seen at a Tertiary Care Center." Blood 126, no. 23 (December 3, 2015): 5017. http://dx.doi.org/10.1182/blood.v126.23.5017.5017.
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Abstract Background: There is a paucity of data regarding patients who develop multiple unrelated hematologic malignancies. This study aims to determine the prevalence of two or more hematologic malignancies in the same patient at Loyola University Medical Center (LUMC) over a period of 7 years and to explore associations with certain clinical risk factors. Methods: After obtaining IRB approval, the electronic medical record was queried for various hematologic malignancies according to ICD-9 codes from 2007-2014. Chemotherapy-associated and transformed malignancies were excluded. In addition, the following data were collected: age at first and second diagnoses, gender, ethnicity, HIV, EBV, CMV, hepatitis B or C, JAK2 mutation, or autoimmune disorders. Survival outcomes and presence of coexisting solid tumors were assessed. Results: Of 5902 patients diagnosed with any hematologic malignancy, 27 were found to have more than one. Two patients had three hematologic malignancies (Hodgkin lymphoma, cutaneous t-cell lymphoma, diffuse large B-cell lymphoma; chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), MALT lymphoma, diffuse large B-cell lymphoma). The most common first hematologic malignancy was CLL/SLL (10) followed by chronic myeloid leukemia (CML) (5) and Hodgkin lymphoma (4). The most common second primary hematologic malignancy was Hodgkin lymphoma (5), followed by multiple myeloma or plasmacytoma (4), acute myeloid leukemia (3) and CLL or monoclonal B-cell lymphocytosis (3). Thirty-seven of all malignancies were lymphoid, 16 myeloid and one Kaposi's sarcoma. Fifteen had both a myeloid and lymphoid malignancy; the remaining 12 patients had either two myeloid or two lymphoid malignancies. Seven cases were diagnosed synchronously and 20 metachronously. The median interval between the first and second diagnosis was 3 years (range: 0.19 - 6.26). The average age at diagnosis of the first and second disease was 62.4 and 67.2 years. Although not tested for statistical differences, the median survival after first and second diagnosis was 4.9 and 0.8 years, respectively. Seven patients also had at least one solid tumor malignancy; three had two different solid tumors. One patient had rheumatoid arthritis and hypothyroidism (SLL followed by Hodgkin lymphoma). Two patients had hypothyroidism, and four had type two diabetes. One patient had hepatitis B, and another had hepatitis B and C. Males were five times more likely to die after the first malignancy diagnosis compared to females, irrespective of the type of malignancy (p=0.04). No association was seen between survival and type of first malignancy or whether the second diagnosis was of lymphoid or myeloid lineage. Conclusion: These data show that in patients presenting with a hematologic malignancy, the risk of developing a second hematologic malignancy over a 7 year period was low at 0.005% (27 out of 5902). In about half (15 out of 27) the second hematologic malignancy belonged to a separate lineage and about a quarter (7/27) developed solid tumors. About one fourth of the patients (7/27) had an autoimmune disorder. Males in this cohort had a five-fold increased risk of death compared to females. The second hematologic malignancy was an ominous development and was associated with a median survival of 0.8 years. These observations should be confirmed in a prospective study. Disclosures No relevant conflicts of interest to declare.
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Durand-Onaylı, Valerie, Theresa Haslauer, Andrea Härzschel, and Tanja Hartmann. "Rac GTPases in Hematological Malignancies." International Journal of Molecular Sciences 19, no. 12 (December 14, 2018): 4041. http://dx.doi.org/10.3390/ijms19124041.
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Emerging evidence suggests that crosstalk between hematologic tumor cells and the tumor microenvironment contributes to leukemia and lymphoma cell migration, survival, and proliferation. The supportive tumor cell-microenvironment interactions and the resulting cellular processes require adaptations and modulations of the cytoskeleton. The Rac subfamily of the Rho family GTPases includes key regulators of the cytoskeleton, with essential functions in both normal and transformed leukocytes. Rac proteins function downstream of receptor tyrosine kinases, chemokine receptors, and integrins, orchestrating a multitude of signals arising from the microenvironment. As such, it is not surprising that deregulation of Rac expression and activation plays a role in the development and progression of hematological malignancies. In this review, we will give an overview of the specific contribution of the deregulation of Rac GTPases in hematologic malignancies.
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Knight, Ann, Karin Hjorton, Christer Sundström, Martin Höglund, Carin Backlin, Karin E. Smedby, Johan Askling, and Eva Baecklund. "Leukemia and Myelodysplastic Syndrome in Granulomatosis with Polyangiitis: Subtypes, Clinical Characteristics, and Outcome." Journal of Rheumatology 42, no. 4 (February 1, 2015): 690–94. http://dx.doi.org/10.3899/jrheum.141104.
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Objective.Previous studies have shown that patients with granulomatosis with polyangiitis (GPA) have an increased risk of hematological malignancies, especially leukemia. Our aim was to assess clinical characteristics and treatment of patients with GPA complicated by hematological malignancies with focus on leukemia and to describe these malignancies in more detail.Methods.From the Swedish population-based patient register, all individuals with a diagnosis of GPA from 1964–2012 were identified (n = 3224). Through linkage with the Swedish Cancer Register, we searched for all cases of leukemia [International Classification of Diseases (ICD) 7: 204–207 and corresponding codes ICD 8–10] registered after the first discharge listing GPA. The GPA diagnosis was evaluated using the European Medical Association classification algorithm. To confirm the hematological malignancy, all diagnostic bone marrow samples were reclassified. Clinical data of both the GPA and hematological malignancy were collected from medical files.Results.Twenty-one cases were identified, all of myeloid origin, including 9 with myelodysplastic syndrome developing to acute myeloid leukemia (MDS-AML), 7 AML, 3 MDS, and 2 chronic myeloid leukemia. The median time from GPA diagnosis to hematological malignancy was 8 years (range 5–21). All patients had severe generalized GPA and had received high doses of cyclophosphamide (CYC; median cumulative dose 96.5 g). Cytopenia occurred in 76% of the patients prior to the hematological malignancy.Conclusion.The findings emphasize the longterm risk of leukemia and MDS in CYC-treated, severely ill patients with GPA. Cytopenia during the course of GPA may be a warning sign and warrants a liberal attitude toward bone marrow examination.
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UYSAL, Elmas, Fatih SEĞMEN, Gamze KILIÇARSLAN, and Deniz ERDEM. "The effect of malignancy on prognosis in ICU patients with COVID-19." Anatolian Current Medical Journal 4, no. 3 (July 26, 2022): 284–89. http://dx.doi.org/10.38053/acmj.1117598.
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Background: It is known that COVID-19 has a worse and poorer progression, which often might lead to death in those with comorbidities. Multiple studies have recently examined the clinical course of cancer patients with COVID-19 and new guidelines have been developed to manage this group of patients. This study aimed to evaluate the clinical course and mortality rate of cancer patients admitted to the intensive care unit (ICU) for COVID-19.
Material and Method: The demographic characteristics, detailed medical history and laboratory findings of 140 patients with malignancy, who were treated in the COVID-19 Intensive Care Unit of Ankara City Hospital, were evaluated retrospectively. Gender, age, comorbidity, length of stay in the ICU, mortality rates, length of stay on a mechanical ventilator, cytokine storm scores, ferritin, interleukin 6 (IL-6), C-reactive protein (CRP), procalcitonin (PCT), D-dimer, lactate dehydrogenase (LDH), lymphocyte count and treatment options were compared. The patients were divided into two groups: solid and hematological malignancies.
Results: One hundred eight of 140 patients were diagnosed with solid organ malignancy and 32 with hematological malignancy. The most common comorbidity was found to be hypertension. A total of 94 patients died during their ICU stay. While the most common solid organ malignancies were malignancies of the lower gastrointestinal tract and lung cancers, multiple myeloma (MM) was the most common hematological malignancy. There was no significant difference between the two groups in terms of cytokine storm scores , duration of hospitalization and mechanical ventilation. Levels of Ferritin and LDH were found to be significantly higher in patients with hematological malignancies, while D-dimer was significantly higher in solid organ malignancies. A high level of CRP and IL-6 was associated with COVID-19 mortality. Lymphopenia was associated with increased mortality in patients with solid organ malignancy. However, there was no difference in mortality rate among both groups. Although the mortality was significantly higher in the patient group receiving chemotherapy, there were no significant differences in mortality for the duration of receiving chemotherapy.
Conclusion: The results of this study suggested that cancer was associated with severe clinical outcomes and a 67% mortality rate among patients with COVID-19. However, despite the changes in patients’ demographic, clinical and laboratory characteristics, no difference in mortality rate was detected in patients with hematological and solid organ malignancies due to COVID-19 infection.
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Dimopoulos, M. A., E. Kastritis, and A. Anagnostopoulos. "Hematological malignancies: myeloma." Annals of Oncology 17 (September 2006): x136—x143. http://dx.doi.org/10.1093/annonc/mdl251.
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Dufva, Olli, Petri Pölönen, Oscar Brück, Mikko A. Keränen, Juha Mehtonen, Sanna M. Siitonen, Suvi-Katri Leivonen, et al. "Immunogenomic Landscape of Hematological Malignancies." Blood 132, Supplement 1 (November 29, 2018): 2596. http://dx.doi.org/10.1182/blood-2018-99-118335.
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Abstract Understanding factors that shape the immune landscape across hematological malignancies is essential for immunotherapy development. How cancer-cell intrinsic genomic and epigenetic alterations influence immune signatures in hematological malignancies is not known. Here, we integrated over 8,000 transcriptomes of hematologic cancers and multilevel genomic datasets to investigate associations of immune states to cancer molecular subtypes, genetic and epigenetic alterations, and clinical outcomes. We utilized a resource of over 8,000 transcriptomes collected across 36 hematologic malignancies and normal hematopoietic cells (Hemap), together with multi-omics datasets of acute myeloid leukemia (AML) and diffuse large B-cell lymphoma (DLBCL) from The Cancer Genome Atlas and other sources (Figure). In addition to gene expression data, we integrated somatic DNA alterations, methylation data, multiplex immunohistochemistry (mIHC), and flow cytometry to comprehensively map immune-associated features and validate the robustness of the findings. To characterize the composition of the cytolytic immune infiltrate from bulk transcriptomes, we defined a signature of genes most specifically expressed in cytotoxic CD8+ T lymphocytes and natural killer (NK) cells termed cytolytic score. We found significant heterogeneity in the cytotoxic lymphocyte infiltration signature across hematologic malignancies. Highest cytolytic infiltrate was detected in lymphomas and correlated with IFN-γ and myeloid cell infiltration signatures including CXCL9-11 and IDO1, distinguishing the lymphoma microenvironment from leukemias. In addition to transcriptomic microenvironmental properties, specific genetic alterations were associated with cytotoxic lymphocyte infiltration. In DLBCL, driver alterations enriched in the germinal center B-cell like (GCB) molecular subtype including BCL2 translocations and KMT2D were linked to an immune-cold transcriptomic phenotype. In contrast, DTX1 alterations defined immune-infiltrated lymphomas within the GCB molecular subtype. In AML, TP53 mutations and complex karyotype were enriched in a distinct tSNE-based transcriptomic cluster characterized by increased immune infiltration in the bone marrow (BM). Given the importance of effective antigen presentation for adaptive anti-tumor immune responses, we aimed to understand the transcriptional regulation of HLA genes and co-stimulatory and co-inhibitory signaling in subtypes of hematological malignancies. Downregulation of the antigen-presenting HLA II genes was associated with CpG methylation of the promoter region of the HLA class II master regulator CIITA in distinct transcriptomic clusters of AML harboring PML-RARA or NPM1 alterations. Expression of genes encoding immune checkpoint molecules was strongly influenced by the cell-of-origin and microenvironment of each cancer type. We identified novel associations of inhibitory immune checkpoint molecules to disease subtypes, such as VISTA/PD1-H enriched in myeloid malignancies including AML, CML, and MDS, validated by mIHC performed on BM biopsies. Furthermore, variation in the expression of several genes encoding immune checkpoints was associated with somatic mutations (e.g. CD70 in DLBCL), copy-number alterations (e.g. MICB in DLBCL), and DNA methylation (e.g. PDL1 and PDCD1LG2 in AML). Finally, we integrated GTEx gene expression data across tissues to define cancer-germline antigens (CGAs) with an immune privileged tissue expression pattern. CGAs were frequently expressed in multiple myeloma and DLBCL compared to other hematologic malignancies. CGA expression was associated with cytogenetic alterations and increased MYC activity signature in myeloma and CD58 and KLHL6 mutations in DLBCL. In addition, CGA expression in myeloma and DLBCL was linked to reduced antigen gene promoter methylation and decreased survival. In summary, our findings demonstrate that molecular subtypes of hematological malignancies harbor distinct immunological signatures influenced by genetic and epigenetic alterations. Integrating genetic, epigenetic, and transcriptomic data may facilitate the development of precision immune intervention strategies in hematological malignancies. Figure. Figure. Disclosures Leppa: Bayer: Research Funding; Celgene: Consultancy; Roche: Consultancy, Honoraria, Research Funding; Janssen: Consultancy, Research Funding; Takeda: Consultancy, Research Funding. Mustjoki:Bristol-Myers Squibb: Honoraria, Research Funding; Celgene: Honoraria; Pfizer: Honoraria, Research Funding; Ariad: Research Funding; Novartis: Honoraria, Research Funding.
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Jacobs, Chaja F., Eric Eldering, and Arnon P. Kater. "Kinase inhibitors developed for treatment of hematologic malignancies: implications for immune modulation in COVID-19." Blood Advances 5, no. 3 (February 9, 2021): 913–25. http://dx.doi.org/10.1182/bloodadvances.2020003768.
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Abstract Tyrosine kinase inhibitors (TKIs) are used to target dysregulated signaling pathways in virtually all hematologic malignancies. Many of the targeted signaling pathways are also essential in nonmalignant immune cells. The current coronavirus severe acute respiratory syndrome coronavirus 2 pandemic catalyzed clinical exploration of TKIs in the treatment of the various stages of COVID-19, which are characterized by distinct immune-related complications. Most of the reported effects of TKIs on immune regulation have been explored in vitro, with different class-specific drugs having nonoverlapping target affinities. Moreover, many of the reported in vivo effects are based on artificial animal models or on observations made in symptomatic patients with a hematologic malignancy who often already suffer from disturbed immune regulation. Based on in vitro and clinical observations, we attempt to decipher the impact of the main TKIs approved or in late-stage development for the treatment of hematological malignancies, including inhibitors of Bruton’s tyrosine kinase, spleen tyrosine kinase, BCR-Abl, phosphatidylinositol 3-kinase/ mammalian target of rapamycin, JAK/STAT, and FMS-like tyrosine kinase 3, to provide a rationale for how such inhibitors could modify clinical courses of diseases, such as COVID-19.
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Bachir Bouiadjra, Chahrazed, Oum Kaltoum Seddiki, and Mustapha Bachir Diaf. "Hematologic malignancies in children: Epidemiological aspects in the pediatric oncology department of Oran Anti-Cancerous center, Algeria (2009-2013)." Journal of Drug Delivery and Therapeutics 10, no. 4 (July 15, 2020): 168–74. http://dx.doi.org/10.22270/jddt.v10i4.4248.
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The incidence of the hematological malignacies, cancers of blood and lymphoid organs, has been in continuous increase for the last 20 years. In Algeria, few data on hematologic malignancies are available in the absence of a population register. The aim of this work is to describe the epidemiological aspect of hematologic malignancies in children from northwestern Algeria.
This study was carried out in 366 patients, with hematological malignancies, aged from 1 month to 15 years, over a period of 5 years (2009-2013). The study was carried out in the Anti-Cancerous Centre of Oran, Algeria.
We noted a predominance of male gender comparing to the females with a sex ratio M/F of 1.2. A male predominance was found for all pathologies (sex ratio of 1.08 for acute lymphoid leukemia, ALL) except for acute myeloid leukemia, AML where a female predominance was observed with a sex ratio F/M of 1.21. 0-3 years age group is the most affected by these haemopathies with 34.2%, however, patients older than 10 years are the least affected. The most frequent malignant haemopathies was the ALL with 60.9%, followed by the AML with 16.9%. The mortality rate in all the studied patients is about 8.2%. The mortality rate in patients with chronic myeloid leukemia (CML) was about 20%, which is significantly higher compared to those recorded in patients with ALL and LH (5.4% and 5%, respectively).
This study highlights the need for broader strategies for better understanding of all epidemiological aspects of childhood hematological malignancies and for adopting case management and prevention policies.
Keywords: Hematologic malignancies, epidemiological characteristics, children, acute lymphoblastic leukemia, Oran anti cancerous centre.
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Hagiwara, Shotaro, Yoshinari Suzuki, Akihiro Nakayama, Akihiro Matsunaga, Yutaka Iida, and Mari Shimura. "Multiple Elements Classified Hematological Malignancies from Healthy Population." Blood 124, no. 21 (December 6, 2014): 5959. http://dx.doi.org/10.1182/blood.v124.21.5959.5959.
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Abstract Introduction It is a little known about how multiple elements interacts and functions in cells, although a specific element had already reported to take a role, enzymatic, transcriptional activities, etc. Although, several metals such as cadmium, nickel, lead, and chrome were known as carcinogen, it is also not known about relations of multiple elements in disease mechanisms. To investigate the impact of multiple elements on the features of hematological malignancies, we analyzed the multiple elements in the serum of patients with hematological malignancies and healthy persons. Methods We obtained 47 of peripheral blood samples from 40 patients with hematological malignancies, and 102 of healthy persons: 50 persons who visited to medical check-up and 52 volunteers. Hematological malignancies were 16 acute myeloid leukemia, 5 acute lymphoblastic leukemia, 9 non-Hodgkin's lymphoma, 9 Multiple myeloma, and 1 Chronic myeloid leukemia. Samples were centrifuged, and 1.0-1.5ml of plasma was separated. We measured 23 elements were measured using inductively coupled plasma mass spectrometry. To assess the difference of the element patterns between hematological malignancies and healthy persons, multivariate discrimination analysis was performed. Overall survival of hematological malignancies was assessed by Log-rank test. Multivariate analysis with the elements highly discriminated hematological malignancies from healthy persons' samples. Elements data increased the accuracy to discriminate hematological malignancies from healthy persons close to 100 % in addition to clinical data such as complete blood count, albumin, total bilirubin, blood urine nitrogen, creatinine. To our knowledge, this is the first report on the successful classifying disease from healthy persons by measurements of multiple elements with more than 90% accuracy using peripheral blood serum (Table 1). Five year overall survival of patients with hematological malignancy was likely dependent on this discriminant score. Data suggested the potential interaction between multiple elements and hematological malignancies, and the possibility future applications on diagnosis and prognosis. Table 1. Accuracy of cross-validated classification patients with hematological malignancies and healthy persons by discriminant analysis Accuracy Clinical data Multi-elements Multi-elements + Clinical data % 93.7 91.3 98.9 Disclosures No relevant conflicts of interest to declare.
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Meng, Yee Choon, Mervyn Yong Hwang Koh, Zi Yan Chiam, Jun Jun Zhang, and Yin Mei, Allyn Hum. "A retrospective review of patients with hematological malignancy referred to an inpatient palliative care service in a tertiary hospital." Journal of Clinical Oncology 35, no. 31_suppl (November 1, 2017): 117. http://dx.doi.org/10.1200/jco.2017.35.31_suppl.117.
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117 Background: Patients with hematological malignancies are referred to palliative care service later and less often than patients with solid organ tumor. However, there are no data in Singapore, on the referral pattern among patients with hematological malignancy. The objective of the study is to identify the characteristics and outcomes of patients with hematological malignancy referred to an In-patient Palliative Care Service (PCS). Methods: We performed a retrospective review of all patients with hematological malignancies referred to the in-patient PCS from December 2015 to December 2016. Basic demographics and outcomes of patients’ admission were collected as per protocol. Results: 53 patients were included in the study. 27 (50.9%) patients were male, 49 (92.5%) were ≥60 years old, 20 (37.7%) were receiving cancer treatment at the point of referral, and 24 (45.3%) had Palliative Performance Scale (PPS) ≤ 40%. The most common hematological diagnosis was lymphoma (N = 26, 49.1%). The top 3 reasons for referral were symptom management (N = 44; 83%), advance disease (N = 24; 45.3% and end-of-life discussion (N = 15, 28.3%). Among 44 patients referred for symptom control, 18 (40.9%) had pain, 12 (27.3%) had dyspnoea, 8 (18.2%) had confusion and 6 (13.6%) had fatigue or drowsiness. 30 patients (56.6%) died during the admission. Among 30 patients who died, the mean time from referral to death was 9.8 days; 16 (53.3%) died within 1 week from referral, 9 (30%) died between 1-4 weeks from referral and 5 (16.7%) died beyond 4 weeks after referral.5 patients (9.4%) had Advance Care Planning completed. Conclusions: Our review showed that patients with hematological malignancies are referred late in their disease trajectory and have high Palliative Care needs. Hence, collaborative effort to facilitate timely referral of patients with hematological malignancy to PCS will optimize end-of-life care.
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Guilbert, Marie-Christine, Jason L. Hornick, Sona A. Chikarmane, and Susan C. Lester. "Hematologic Malignancies of the Breast: A Contemporary Series Investigating Incidence, Presentation, Accuracy of Diagnosis on Core Needle Biopsy, and Hormone Receptor Expression." Breast Cancer: Basic and Clinical Research 13 (January 2019): 117822341983098. http://dx.doi.org/10.1177/1178223419830982.
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Background: Distinguishing breast hematologic malignancies in core needle biopsies from other entities can be challenging. Misclassification as a breast carcinoma could result in inappropriate treatment. The aim of this study was to characterize the types, incidence, and helpful diagnostic features of hematologic malignancies of the breast. Design: All hematologic malignancies of the breast diagnosed at our institution from 2004 to 2017 were identified. Clinical notes, imaging, and slides were reviewed. Immunohistochemical analysis of estrogen receptor α (ERα), estrogen receptor β (ERβ), and androgen receptor (AR) was performed when tissue was available. Results: In all, 43 hematologic malignancies from biopsies of 37 women and 6 men were identified. Core needle biopsies (35 or 81%) were more common than excisions (8 or 19%). For 14 patients (40%), the core biopsy was the first diagnosis of a hematologic malignancy. Diagnoses included 37 lymphomas (7 primary), 4 leukemias, and 2 myelomas. There was 1 misdiagnosis of carcinoma. Low positivity for hormone receptors was observed in a minority of lymphomas. A definitive diagnosis of hematologic malignancy was made in 31 (89%) of the core needle biopsies. Only 3 patients undergoing core biopsy required excision for diagnosis. Conclusions: Most of the hematologic malignancies of the breast are currently diagnosed on core needle biopsy and 40% of patients do not have a prior history. To avoid errors, pathologists need to be aware of diagnostic features and morphologic mimics. A hematologic malignancy should be considered if tumor cells are discohesive, carcinoma in situ is absent, and hormone expression is low or absent.
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Wagner, Timothy, Qais Naziri, W. North, Suparna Navale, Alison Klika, Wael Barsoum, Carlos Higuera, and Jared Newman. "Hematologic Malignancies Are Associated with Adverse Perioperative Outcomes following Total Knee Arthroplasty." Journal of Knee Surgery 31, no. 04 (May 23, 2017): 291–301. http://dx.doi.org/10.1055/s-0037-1603335.
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AbstractThe treatment of hematologic malignancies has advanced over the years, resulting in an improved survival of patients. As a result, these patients may be a part of the increasing population requiring total knee arthroplasty (TKA); however, they might be at a higher risk of adverse perioperative outcomes. The purpose of this study was to determine the perioperative outcomes (complications, length of stay [LOS], and costs) of patients with hematologic malignancies following TKA. This study used the Nationwide Inpatient Sample (NIS) to identify patients who underwent TKA in the United States from 2000 to 2011. Patients diagnosed with any hematologic malignancy (N = 24,714) were then stratified by Hodgkin's disease (N = 791), Non-Hodgkin's lymphoma (N = 7,096), plasma cell dyscrasias (N = 1,621), leukemia (N = 8,005), myeloproliferative disease (N = 5,746), and/or myelodysplastic syndromes (N = 1,608) for determining the complications that occurred during admission. Propensity matching was performed for demographics, hospital characteristics, and comorbidities, which yielded 24,491 patients with any hematologic malignancy and 24,458 control patients. Additionally, propensity matching was performed for the hematologic malignancy subtypes. Multivariable regression models were used to analyze the surgical and medical complications, LOS, and costs. The annual frequency of THA in patients with any hematologic malignancy increased from 2000 to 2011 (p < 0.0001). Hematologic malignancies were associated with an increased risk of any surgery-related complication (odds ratio [OR] = 1.31, p < 0.0001) and any general medical complication (OR = 1.38, p < 0.0001). Patients with any hematologic malignancy had increased odds of complications, including acute postoperative anemia (OR = 1.29, p < 0.0001), hematoma/seroma (OR = 1.65, p < 0.02), peripheral vascular disease (OR = 2.23, p = 0.046), deep venous thrombosis (DVT) (OR = 1.95, p = 0.02), and blood transfusion (OR = 1.61, p < 0.0001). Hematologic malignancies were associated with an increased incremental LOS (0.13 d, p < 0.0001) and an increased incremental cost ($788, p < 0.0001). Thus, we conclude that following TKA, patients with hematologic malignancies are at an increased risk of perioperative complications, longer LOS, and higher costs. The risk quantification for adverse perioperative outcomes in association with an increased cost may help design different risk stratification and reimbursement methods in such patients when undergoing TKA.