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The Impact of Clinical and Morphometric Parameters on Hematopoietic Engraftment Following High-Dose Chemotherapy and Autologous Stem Cell Transplantation in Germ Cell Tumors.

Background and Objectives: Relapsed or refractory germ cell tumors are commonly treated with HDCT/ASCT, but robust predictors of hematopoietic recovery are limited. Quantitative CT-based metrics of body composition are readily available, but their prognostic value for post-transplant engraftment remains uncertain. We investigated whether muscle and fat indices derived from routine CT scans are associated with the pace of hematologic recovery after HDCT/ASCT. Materials and Methods: This retrospective study analyzed a single-center cohort (n = 43) with relapsed/refractory GCT undergoing HDCT/ASC

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… Platelet engraftment was defined as achieving and maintaining a platelet count > 20,000/mm 3 for at least three consecutive days without platelet transfusions, and neutrophil engraftment as an absolute neutrophil count ≥ 2000/mm 3 maintained for at least three consecutive days without G-CSF. …

Prognostic factors and long-term outcome in dogs diagnosed with primary and secondary immune thrombocytopenia in Ireland.

OBJECTIVES: The objectives of this study were to describe the outcome and prognostic factors in dogs diagnosed with primary and secondary immune thrombocytopenia (ITP). MATERIALS AND METHODS: Medical records of dogs diagnosed with primary and secondary ITP in a referral hospital in Ireland were retrospectively evaluated. Short- and long-term survivals were analysed using Cox proportional-hazards regression models. RESULTS: Medical records from 49 dogs were included. Primary and secondary ITP were diagnosed in 81.25% and 18.75% of dogs, respectively. The survival rate was 69% at 2 weeks (95%

Effectiveness of biosimilar pegfilgrastim in patients with multiple myeloma after high-dose melphalan and autologous stem cell transplantation.

Multiple myeloma (MM) is the main indication for autologous stem cell transplantation (ASCT). Novel supportive therapies (e.g., granulocyte colony-stimulating factor) have significantly improved post-ASCT-related mortality; however, data on biosimilar pegfilgrastim-bmez (BIO/PEG) in this setting is lacking. This prospective cohort study compared Italian patients with MM who received BIO/PEG post-ASCT with data collected retrospectively from historical control groups from the same center who received either filgrastim-sndz (BIO/G-CSF) or pegfilgrastim (PEG; originator). The primary endpoint was

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… Secondary endpoints included the incidence and duration of FN, and the incidence of mucositis, diarrhea, and platelet engraftment (platelet count ≥ 20 × 10 9 /L, not requiring a platelet transfusion in the preceding 7 days). … Transfusions The proportion of patients who underwent RBC or platelet transfusion did not differ between the three treatment groups (Table 2 ), whereas the median number of platelet transfusions among platelet-transfused patients was twofold higher in PEG-treated patients than in the remaining two groups …

Multiple Myeloma Presenting as Lower Gastrointestinal Bleeding: A Case Report.

Multiple myeloma (MM) is a malignant hematologic neoplasm that primarily affects the bone marrow and can invade other organs, leading to diverse clinical manifestations. Presentation with gastrointestinal bleeding as the initial symptom is exceptionally rare. We report a case of MM in a 46-year-old man who presented with gastrointestinal bleeding and severe anemia. Routine endoscopic evaluation was inconclusive, but further hematologic and imaging investigations confirmed multiple myeloma. The patient was successfully treated with bortezomib-based chemotherapy and supportive care. This case em

Heyde Syndrome Unveiled: A Case Report with Current Literature Review and Molecular Insights.

Heyde syndrome, marked by aortic stenosis, gastrointestinal bleeding from angiodysplasia, and acquired von Willebrand syndrome, is often underreported. Shear stress from a narrowed aortic valve degrades von Willebrand factor multimers, leading to angiodysplasia formation and von Willebrand factor deficiency. This case report aims to raise clinician awareness of Heyde syndrome, its complexity, and the need for a multidisciplinary approach. We present a 75-year-old man with aortic stenosis, gastrointestinal bleeding from angiodysplasia, and acquired von Willebrand syndrome type 2A. The patient w

High-dose chemotherapy and autologous stem cell transplantation of patients with multiple myeloma in an outpatient setting.

BACKGROUND: High-dose (HD) chemotherapy with melphalan and autologous blood stem cell transplantation (ABSCT) for treatment of symptomatic multiple myeloma (MM) on an outpatient basis has been well established in the USA and Canada, whereas in Germany and Western Europe an inpatient setting is the current standard. We report on a German single-centre program to offer the procedure on an outpatient basis to selected patients. METHODS: Major requirements included: patients had to have family and/or other caregivers, had to be able to reach the hospital within 45 min and have an ECOG performance

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… Platelet engraftment was defined as the first of 3 consecutive days on which platelets reached 20 × 10 9 /L without platelet transfusion. … Because the majority of patients ( n = 15, 71%) received a platelet transfusion, platelet recovery ≥20 × 10 9 /L could not be evaluated sufficiently. …

Доклад по делу: Аутологический ускоритель стволовых клеток позволяет выздоровлять гематопоиетически после сильной цитопенсии, вызванной диагностикой антител в нескольких миеломах.

Elranatamab, биконкретный антител, направленный против антигена B-клеток (BCMA) и CD3, продемонстрировал значительную эффективность в рецидивированной или рефрактной множественной миеломе (RRMM). Однако терапия элранатамб также сопряжена с риском гематологической токсичности. В качестве стратегии спасения после цитопенсии, связанной с химической антигенной рецептором Т-клеткой (CAR T-клеткой), было изучено повторное слияние ранее собранных автоматических CD34+ гематопоэтических стволовых клеток. На сегодняшний день его роль после лечения антитела по-прежнему остается неясной. Мы сообщаем о слу

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… Neutrophil engraftment was achieved on day +10 (defined as the day of absolute neutrophil count ≥0.5 × 10 9 /L for three consecutive days), and platelet transfusion independence was reached by day +19. Hemoglobin and platelet counts gradually improved thereafter. … Symbols denote transfusions: red triangle, red blood cell transfusion; black triangle, platelet transfusion. Line graph illustrating changes in neutrophil, hemoglobin, and platelet levels over days from a stem cell boost, with treatments and dosages noted. …

Romiplostim as a treatment for immune thrombocytopenia: a review.

"Immune thrombocytopenia" (ITP) is an autoimmune disorder that leads to peripheral destruction, as well as a decreased production of platelets. ITP most commonly presents as mild mucocutaneous bleeding. Though it is rare, the leading cause of mortality in persons with ITP is intracranial hemorrhage and those that do not respond to therapy are at increased risk. Our understanding of the pathophysiology of ITP has evolved immensely, especially over the last 60 years. The discovery of the platelet-production stimulator, thrombopoietin (TPO), lent clarity to an earlier hypothesis that inhibition o

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… Recombinant human thrombopoietin attenuates carboplatin-induced severe thrombocytopenia and the need for platelet transfusions in patients with gynecologic cancer. Ann Intern Med. 2000;132(5):364–368. doi: 10.7326/0003-4819-132-5-200003070-00005. 42. Komatsu N, Okamoto T, Yoshida T. … Prophylactic platelet transfusions from healthy apheresis platelet donors undergoing treatment with thrombopoietin. Blood. 2001;98(5):1346–1351. doi: 10.1182/blood.v98.5.1346. 45. Kuter DJ, Goodnough LT, Romo J, et al. Thrombopoietin therapy increases platelet yields in healthy platelet donors. …

Recent advances in use of fresh frozen plasma, cryoprecipitate, immunoglobulins, and clotting factors for transfusion support in patients with hematologic disease.

Hematologic diseases include a broad range of acquired and congenital disorders, many of which affect plasma proteins that control hemostasis and immune responses. Therapeutic interventions for these disorders include transfusion of plasma, cryoprecipitate, immunoglobulins, or convalescent plasma-containing therapeutic antibodies from patients recovering from infectious diseases, as well as concentrated pro- or anticoagulant factors. This review will focus on recent advances in the uses of plasma and its derivatives for patients with acquired and congenital hematologic disorders.

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… transfusions [135] . … Fresh-frozen plasma and platelet transfusions are associated with development of acute lung injury in critically ill medical patients. Chest. 2007;131(5):1308–1314. doi: 10.1378/chest.06-3048. 21. Tao J, Bukanova EN, Akhtar S. …

Preserving Continuity of Cancer Therapy in Patients with Hematologic Malignancies and Chronic Subdural Hematomas: Comparative Outcomes of Middle Meningeal Artery Embolization and Surgery.

Background/Objective: Hematologic cancer patients are at high risk of developing chronic subdural hematomas (cSDH), and traditional treatment with surgery is potentially risky in this patient population, with associated coagulopathy and thrombocytopenia. Neurointerventional endovascular middle meningeal artery embolization (MMAE) is emerging as a novel minimally invasive treatment method for cSDH, and its efficacy and complication profile has not been evaluated in patients with hematologic cancers. Methods: We conducted a retrospective cohort study of adults with hematologic malignancies and c

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… A baseline count ≤ 50 × 10 9 /L triggered near-universal peri-procedural platelet transfusion and correction (20 of 22 such patients were transfused), so the recorded baseline no longer reflected hemostasis at the time of the procedure, and post-transfusion counts are not routinely rechecked. … This cohort is a focused hematologic malignancy subgroup analysis of our previously reported oncologic cohort; all 67 patients are contained within that 110-patient cohort (43 solid tumors and 67 hematologic malignancies), and the present analysis adds disease-specific coagulopathy, platelet, transfusion …

Daratumumab therapy for post-HSCT immune-mediated cytopenia: experiences from two pediatric cases and review of literature.

BackgroundImmune-mediated cytopenias (AIC) are challenging complications following allogeneic hematopoietic stem cell transplantation (HSCT). While broad-acting immunosuppressive agents like corticosteroids are often standard of care, several novel therapies which target specific immunological pathways have recently been developed and provide hope for patients with steroid-refractory courses and may limit long-term toxicity. The successful off-label use of the plasma cell depleting anti-CD38 antibody daratumumab was published in several case reports, suggesting efficacy, i.e., in patients with

Morphofunctional parameters as predictors of autologous hematopoietic stem cell transplantation outcomes.

IntroductionThere is a lack of predictive factors for specific complications in patients who undergo autologous hematopoietic stem cell transplantation. A complete morphofunctional assessment is not usually performed before the procedure. Malnutrition is related to lower survival in cancer patients. Our aim is to identify both risk and protective factors for such complications to refine management and improve outcomes.MethodsWe have implemented the program 'RHeNutrir', which involves a systematic malnutrition and sarcopenia screening, as well as a complete nutritional and functional assessment

Clinical Practice Guideline: Nosebleed (Epistaxis).

OBJECTIVE: Nosebleed, also known as epistaxis, is a common problem that occurs at some point in at least 60% of people in the United States. While the majority of nosebleeds are limited in severity and duration, about 6% of people who experience nosebleeds will seek medical attention. For the purposes of this guideline, we define the target patient with a nosebleed as a patient with bleeding from the nostril, nasal cavity, or nasopharynx that is sufficient to warrant medical advice or care. This includes bleeding that is severe, persistent, and/or recurrent, as well as bleeding that impacts a

Mobilization and Exercise Intervention for Patients With Multiple Myeloma: Clinical Practice Guidelines Endorsed by the Canadian Physiotherapy Association.

ObjectiveIndividuals with multiple myeloma (MM) often have reduced functional performance due to the cancer itself or as a direct side effect of cancer treatments. Physical therapy is a part of cancer rehabilitation; however, no guidelines are available to provide information and direction for physical therapists managing patients with MM. The goal of this guideline is to provide recommendations based on a systematic review and consensus process that physical therapists can use to manage patients with MM.MethodsA systematic review of the literature published until August 2018 was performed in

Redesigning CAR therapy to tackle immune effector cell-associated hematotoxicity.

Although recognized, the field has yet to fully explore the mechanisms and solutions to Immune effector Cell-Associated Hematotoxicity (ICAHT) - a major contributor to long term morbidity and mortality following CAR therapy. About 20–40% of the patients develop ICAHT of grade 3 or above, with at least 33% developing late ICAHT across both CD28 and 4-1BB CAR. ICAHT post-CAR therapy influences the effectiveness of the subsequent treatment and incidence of secondary malignancies. Aside from CAR-HEMATOTOX model, N-ICAHT and T-ICAHT grading system is engaged to monitor the neutropenia and thrombocy

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… Patients with thrombocytopenia require close monitoring and platelet transfusions to prevent bleeding incidents [ 22 ]. … Transfusions RBC and platelet transfusions are routinely administered to manage anemia and thrombocytopenia. Careful monitoring of cytopenias and potential complications, such as bleeding or cardiovascular events, guides the use of transfusion [ 2 , 4 ]. …

Rituximab and lenalidomide combination treatment for rheumatoid arthritis complicated with myelodysplastic syndrome: A case report.

Rheumatoid arthritis patients might experience several hematologic complications. The development of myelodysplastic syndrome is not clearly associated with RA, even though it has been described in some patients with pre-existing disease. There are only few data available in the literature concerning the therapeutic approach of such patients. Herein, we report a case of RA complicated with progressive MDS, successfully treated with rituximab and lenalidomide combination therapy.

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… Successful use of rituximab in platelet transfusion refractoriness in a multi-transfused patient with myelodysplastic syndrome . Platelets 2015 ; 26 : 195 – 6 . 23634876 10.3109/09537104.2013.789842 16. Liu W Wu D Hu T Ye B. … Efficiency of treatment with rituximab in platelet transfusion refractoriness: a study of 7 cases . Int J Clin Exp Med 2015 ; 8 : 14080 – 4 . 26550372 PMC4613057 17. Dierickx D Kentos A Delannoy A. The role of rituximab in adults with warm antibody autoimmune hemolytic anemia . …

Efficacy of deferred dosing of granulocyte colony-stimulating factor in autologous hematopoietic transplantation for multiple myeloma.

Routine administration of G-CSF following autologous hematopoietic SCT (ASCT) expedites ANC recovery and reduces hospitalization by 1-2 days; it has no impact on febrile neutropenia, infections, morbidity, mortality, event-free survival or OS. To determine whether delayed G-CSF dosage could result in equivalent ANC recovery and thereby improve cost effectiveness, we deferred the administration of G-CSF until WBC recovery had begun. A total of 117 patients with multiple myeloma received ASCT from January 2005 to September 2012. Of these, 52 were in the conventional dosing group (CGD) and receiv

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… Platelet engraftment was defined as platelet counts of >20 000/μL for 3 consecutive days in the absence of platelet transfusions. Cost analysis included cost of G-CSF, cost of intravenous antibiotics and hospital charges for room and board ( Table 2 ). … Nonetheless, there was no difference between the two groups in the incidence of febrile neutropenia or its duration, in time to platelet recovery or the number of platelet transfusions, infections, mucositis, or in day 100 mortality. …

Long-term clinical efficacy and safety of thalidomide in patients with transfusion-dependent β-thalassemia: results from Thal-Thalido study.

Regular blood transfusion is the mainstay of treatment in transfusion-dependent β-thalassemia (TDT); however, transfusions culminate in an array of serious complications. Therefore, a single-arm, non-randomized clinical trial was conducted in hydroxyurea refractory TDT patients to explore the long-term safety and efficacy of thalidomide. The primary outcomes for efficacy were rise in hemoglobin (Hb) level and changes in transfusion frequency. Whereas, several clinical and laboratory parameters were assessed for safety of thalidomide. Secondary outcomes included changes in serum ferritin, serum

Эффективность импульса стволовых клеток (SCB) для химериковой антигенной рецепторной-Т клеточной терапии (CAR-T) в связи с гематологической токсичностью у пациентов с повторной/реактивной множественной миеломой (RRMM)-реальным мировым опытом работы консорциума иммунотерапии США с множественными миеломами.

Продолжительные цитопении - это широко признанное осложнение после лечения CAR-T. Автономный SCB предлагает потенциальную стратегию по содействию быстрому гематологическому восстановлению. Мы провели ретроспективное многоинституциональное сопоставление результатов SCB в сравнении с поддержкой только у пациентов с продолжительными цитопентиями после вливания CAR-T. Пациенты включаются, если они получают SCB внутри 1 год, следующий за коммерческим 6/2021 и 3/2024. Чтобы определить соответствующие механизмы контроля, мы проверили 590 Число получателей ЦАР-Т и отобранных пациентов с ПНК и пороговы

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… Supportive measures include frequent blood and platelet transfusions, antimicrobial prophylaxis and the use of growth factor such as granulocyte colony-stimulating factor (GCSF) or thrombopoietin agonists. … transfusion within the previous 7 days. …

Долговременная гематологическая реакция на милодипластический синдром, связанный с терапией, во время лечения ниволумаба метастатической меланомой: доклад по делу.

Иммунотерапия - это стандартное перспективное лечение метастатической меланомы; однако ее роль в миэлодипластическом синдроме (МДС) остается неопределенной. Мы сообщаем об одном случае, когда ниволумаб, введенный для метастатической меланомы, был связан с заметным улучшением параллельного лечения, связанного с MDS. A 67-year-old человек с историей олигосекретарства с множественными миэломами разработал зависящий от переливания MDS после аутлогической трансплантации стволовых клеток, что потребовало дважды в неделю переливания крови. Впоследствии он разработал метастатическую меланому и был обр