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Extremely Old Patients Hospitalized in Internal Medicine: What about Their Anemia?

In western countries, about half of the hospitalized patients are anemic. Generally, these patients are old, often with multiple diseases, a … a were iron deficiency in 10.6% of patients, other deficiencies in 2.8%, chronic diseases in 38.2%, hematologic neoplasms in 6.1%, multifactorial in 24.1%, and undetermined in 19.9%. The oldest-old have a higher frequency of multifactorial anemia (p=0.04), while hematologic neoplasms were more common in old patients (p=0.03). Most patients with undetermined anemia had …

Melanoma as Subsequent Primary Malignancy in Hematologic Cancer Survivors-A Literature Review.

The occurrence of second primary malignancies is becoming increasingly important among cancer survivors. Melanoma, an aggressive neoplasm originating from the melanocytes, is responsible for most skin cancer-related deaths. This review aims to explore the risk of melanoma occurrence as a second primary cancer after the most common subtypes of hematologic neoplasia, a malignant disease originating from myeloid or lymphocytic cell lineages. Chronic lymphocytic leukemia (CLL) and non-Hodgkin lymphoma (NHL) are among the most associated subtypes with melanoma development. We also discuss the under

Immunotherapy of hematological cancers: PD-1 blockade for the treatment of Hodgkin's lymphoma.

The blockade of immunological checkpoints has been successfully employed for the treatment of various solid neoplasms including melanoma, mesothelioma, non-small cell lung carcinoma, and renal cell carcinoma. A recent study indicates that the vast majority of patients with advanced, heavily pretreated Hodgkin's lymphoma (HL) also respond to a monoclonal antibody targeting programmed cell death 1 (PDCD1, best known as PD-1). Thus, checkpoint blockers may soon become part of our therapeutic armamentarium against hematological tumors. This would be particularly important as it would spare (at lea

Concurrent CML and MBL in a COPD patient: a case of collision hematologic malignancies and opportunistic infection.

BACKGROUND: Collision hematologic malignancies, characterized by the concurrent presence of clonally independent myeloid and lymphoid neoplasms within a single patient, are exceptionally uncommon. Diagnosing these malignancies is particularly challenging when they occur in the context of chronic inflammatory diseases, where distinguishing between reactive and neoplastic processes is complex. CASE PRESENTATION: We present the case of a 66-years-old male patient with COPD, characterized by a 30 pack-year smoking history, who was admitted due to an acute exacerbation of COPD (AECOPD) accompanied

Diagnostic accuracy of automated hematology analyzer abnormal flags for detecting hematological malignancies: A systematic review and meta-analysis.

BACKGROUND: Hematological malignancies including leukemia, lymphoma, and myelodysplastic syndromes, are characterized by clonal proliferation of abnormal blood or bone marrow cells. Early and accurate detection is essential for improving treatment outcomes and survival. Automated hematology analyzers generate abnormal flags that may indicate underlying hematologic malignancies; however, their overall diagnostic accuracy has not been comprehensively evaluated. This systematic review and meta-analysis aimed to assess the diagnostic performance of abnormal flags for detecting hematological malign

JAK2, CALR, and MPL Mutation Profiles in Colombian patients with BCR-ABL Negative Myeloproliferative Neoplasms.

BACKGROUND: Among the chronic myeloproliferative neoplasms (MPNs) not associated with BCR-ABL mutations are polycythemia vera, primary myelofibrosis, and essential thrombocythemia. These diseases are caused by mutations in genes, such as the JAK2, MPL, and CALR genes, which participate in regulating the JAK-STAT signaling pathway. OBJECTIVE: This study aimed to establish the frequencies of mutations in the JAK2, MPL, and CALR genes in a group of Colombian patients with a negative clinical diagnosis of BCR-ABL chronic myeloproliferative neoplasms. METHODS: The JAK2 V617F and MPL W515K mutatio

Recurrence after Long-Term Use of Poly ADP-Ribose Polymerase Inhibitors Triggered by Therapy-Related Myeloid Neoplasms: A Case Report.

INTRODUCTION: Poly ADP-ribose polymerase (PARP) inhibitors are used as maintenance therapy for recurrent ovarian cancer, but their long-term safety, especially the risk of therapy-related myeloid neoplasms, remains a concern. Here, we report a case of disease recurrence and myeloid neoplasms following long-term treatment with PARP inhibitors. CASE PRESENTATION: A 49-year-old woman presented with stage IIIC (FIGO 2014), high-grade serous ovarian carcinoma. After initial surgery and chemotherapy, she achieved a complete response but experienced six recurrences between 2010 and 2017, each treate

Myeloid neoplasm with ETV6::ACSl6 fusion: landscape of molecular and clinical features.

OBJECTIVES: Since the publication of the third edition, the WHO classification of tumors of hematopoietic and lymphoid disorders has introduced the disease entity of 'myeloid/lymphoid neoplasms with eosinophilia and PDGFRB rearrangement', in which the most common chromosomal abnormality is t(5;12) (q32;p13.2), and this abnormality generates the ETV6::PDGFRB fusion gene. However, there have been patients with hematologic features and chromosomal abnormalities that are extremely similar to those carrying ETV6::PDGFRB fusion. These rare disorders harbor ETV6::ACSL6 fusion, and only sporadic cases

Clinical significance of SF3B1 mutations in Korean patients with myelodysplastic syndromes and myelodysplasia/myeloproliferative neoplasms with ring sideroblasts.

Somatic mutations in the SF3B1 gene, a gene encoding the splicing factor 3B subunit 1, were recently reported in myelodysplastic syndromes (MDS), particularly in the presence of ring sideroblasts (RS). The authors investigated the prevalence and clinical significance of SF3B1 mutations in Korean patients with myeloid neoplasms with RS. The study subjects were 43 Korean patients with myeloid neoplasms. Twenty-nine patients (67 %) had 15 % or more RS (high-count RS [HC-RS]), and 14 (33 %) had RS less than 15 % (low-count RS [LC-RS]). Molecular genetic tests were performed to detect SF3B1 mutatio

Severe Folate Deficiency Mimicking Myelodysplastic Syndrome/Acute Myeloid Leukemia: A Case Report.

Folate deficiency is common and often asymptomatic, but severe cases can cause megaloblastic anemia. Rarely, it presents with pancytopenia and bone marrow changes resembling myelodysplastic syndrome/neoplasm (MDS) and/or acute myeloid leukemia (AML), complicating diagnosis and management. We present a case of a patient with severe folate deficiency, in the setting of normal vitamin B12 levels, who presented with hematologic and bone marrow findings initially suggestive of MDS/AML that resolved with folate supplementation. This case highlights that the clinical and morphologic findings associat

Хроническая нейтрофическая лейкемия у пациента с множественной миеломой.

Высокодозированная химиотерапия, применяемая для аутологической трансплантации стволовых клеток (ASCT), часто связана с распространением клеток с неопластическими способностями. В результате может быть расширена одна конкретная линия клеток, т.е. клональная гематомоизис (CH). Частота CH в множестве миеломы (ММ) была зарегистрирована как ~21,6%. Хотя нейтрофия в MM может быть лейкемоидной реакцией, нельзя забывать о таких гематоологических новообразованиях, как хроническая нейтрофильная лейкемия (CNL), которая характеризуется мутации CSF3R и отсутствием цитопении и/или значительного морфологиче

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High-dose chemotherapy used for autologous stem cell transplantation (ASCT) is often associated with the proliferation of cells with neoplas … eported as ~21.6%. Although neutrophilia in MM could be a leukemoid reaction, one should not forget hematologic neoplasms such as chronic neutrophilic leukemia (CNL) - which is characterized by CSF3R mutation, and absence of cytopenia and/or significant morphologic dyspoiesis. In this case report, we describe a 76-year-old female patient (currently 77 years old) who de …

Top Ten Tips Palliative Care Clinicians Should Know About Caring for Patients with Myeloproliferative Neoplasms.

Myeloproliferative neoplasms (MPNs) are a group of rare chronic progressive blood cancers that vary widely in clinical presentation, yet all patients have a risk of disease progression and thrombotic complications. Diseases include primary myelofibrosis, polycythemia vera, and essential thrombocythemia. With current treatment approaches, most patients live a prolonged life, but many experience a complex of symptoms that negatively influence their functional status and quality of life. Although significant advances have been made in preventing arterial and venous complications while mitigating

Challenges in the introduction of next-generation sequencing (NGS) for diagnostics of myeloid malignancies into clinical routine use.

Given the vast phenotypic and genetic heterogeneity of acute and chronic myeloid malignancies, hematologists have eagerly awaited the introduction of next-generation sequencing (NGS) into the routine diagnostic armamentarium to enable a more differentiated disease classification, risk stratification, and improved therapeutic decisions. At present, an increasing number of hematologic laboratories are in the process of integrating NGS procedures into the diagnostic algorithms of patients with acute myeloid leukemia (AML), myelodysplastic syndromes (MDS), and myeloproliferative neoplasms (MPNs).

Invasive pulmonary aspergillosis complicating neoplastic disease.

Invasive pulmonary aspergillosis is a necrotizing pneumonia that is most frequently seen in association with profound granulocytopenia as a consequence of cytotoxic chemotherapy that is used to treat hematologic neoplasms. There is considerable evidence that the incidence of this infection is increasing over the past decade as a result of improved medical support used in the management of "at risk" patients. Heightened clinical awareness coupled with advances in diagnostic techniques have led to earlier treatment and improved outcomes of this once uniformly fatal infection. Amphotericin B rema…

Incidental detection of urinary tract abnormalities with skeletal scintigraphy.

Urinary tract abnormalities are detected as incidental findings in 15% of skeletal scintigraphic studies. Several scintigraphic patterns denote these abnormalities. Bilateral diffuse increased uptake is found in patients who have undergone chemotherapy and those with hyperparathyroidism, hypercalcemia, and sickle cell disease. Bilateral diffuse decreased uptake occurs in patients with end-stage renal disease, extensive metastatic disease to the bone, and various hematologic disorders. Focal increased activity is associated with postoperative changes and effects from radiation therapy. Focal de

Inorganic Polyphosphate in Hematolymphoid Malignancies: Biological Rationale and Emerging Research Gaps.

Inorganic polyphosphates (polyP) are linear phosphate polymers that play essential functions in human physiology, such as coagulation and inflammation. Despite their recognized participation in solid tumor progression, there are few data on hematolymphoid malignancies. Here, we conducted a narrative review of studies investigating polyP functions in mammalian biology, coagulation, and hematologic systems, focusing on research gaps in hematological oncology. PolyP modulates coagulation cascades, platelet activation, and cellular metabolism. In tumors, polyP has been reported to modulate immune

Neutrophilic and eosinophilic dermatoses associated with hematological malignancy.

Cutaneous manifestations of hematologic malignancy represent both a clinical challenge for the treating physician and a pathophysiological model for advancing the knowledge on individual neoplasms. Indeed, a growing body of evidence supports the concept of recurrent molecular defects associating with specific clinical features, as best exemplified by VEXAS. Herein neutrophilic and eosinophilic dermatoses of potential interest for both hematologists and dermatologists will be reviewed, including subcorneal pustular dermatosis-type IgA pemphigus, neutrophilic eccrine hidradenitis, Sweet's syndro

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… Dermatological manifestations of hematologic neoplasms. Part II: nonspecific skin lesions/paraneoplastic diseases . An Bras Dermatol . ( 2023 ) 98 : 141 – 58 . doi: 10.1016/j.abd.2022.08.005 , PMID: 36682966 PMC9984718 23. Pierson JC Helm TN Taylor JS Elston DM Tuthill RJ . … UBA1 screening in sweet syndrome with hematological neoplasms reveals a novel association between VEXAS and chronic Myelomonocytic leukemia . Hema . ( 2022 ) 6 : e775 . doi: 10.1097/HS9.0000000000000775 , PMID: 36187875 PMC9519141 47. Maller B Bigness A Moiño D Greene J . …

Recent developments and persisting challenges in the prevention and treatment of venous thromboembolism in patients with hematological malignancies.

Venous thromboembolism (VTE) is a common complication of cancer. Its treatment is challenging because of the high risk for both VTE recurrence and bleeding. Evidence is particularly scarce for patients with hematological malignancies. This review aims to summarize new developments in anticoagulation for the prevention and treatment of VTE in patients with active cancer, largely derived from the formal introduction of direct anticoagulants (DOACs) in this population. We then offer our recommendations for the thromboprophylaxis and treatment of VTE in patients with hematological disorders (matur

Cutaneous Manifestation of Acute Lymphoblastic Leukemia.

Acute lymphoblastic leukemia (ALL) is a hematological neoplasm characterized by the proliferation of immature lymphoblasts. Although it is more common in children, it can also occur in adults, presenting significant clinical challenges. This case describes a 46-year-old male patient with a history of hypertension and dyslipidemia, whose first clinical manifestation of ALL was cutaneous. The patient showed resistance to initial chemotherapy, leading to complex management and, unfortunately, to a bad outcome.

Diagnosis and classification of hematologic malignancies on the basis of genetics.

Genomic analysis has greatly influenced the diagnosis and clinical management of patients affected by diverse forms of hematologic malignancies. Here, we review how genetic alterations define subclasses of patients with acute leukemias, myelodysplastic syndromes (MDS), myeloproliferative neoplasms (MPNs), non-Hodgkin lymphomas, and classical Hodgkin lymphoma. These include new subtypes of acute myeloid leukemia defined by mutations in RUNX1 or BCR-ABL1 translocations as well as a constellation of somatic structural DNA alterations in acute lymphoblastic leukemia. Among patients with MDS, detec