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Oral Communication abstracts

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A Case Report of a 58-Year-Old Woman with a Diagnosis of High-Risk Myeloma Refractory to Multiple Line of Therapy and Treated with Selinexor, Bortezomib, and Dexamethasone Prior to Allogeneic Stem Cell Transplantation.

BACKGROUND Approximately 10% to 15% of patients with multiple myeloma (MM) are diagnosed with high-risk disease and have poor prognosis. Clinical trial data supports the combined use of selinexor, bortezomib, and dexamethasone (XVd) for treatment of patients with MM who have received at least 1 prior therapy. Information on the efficacy of XVd and of subsequent allogeneic stem cell transplantation (SCT) in heavily pretreated patients with high-risk MM is limited. CASE REPORT We present a case of a 58-year-old woman with high-risk MM (revised International Staging System Stage III; serum ß₂-mic

Liver failure due to relapsed myeloma and hepatic iron overload.

Multiple myeloma is a hematologic malignancy that classically manifests with hypercalcaemia, renal insufficiency, anaemia and lytic bone lesions. Liver dysfunction in multiple myeloma is a lesser known complication that occurs through biliary obstruction, liver infiltration by plasma cells, amyloid/light chain deposition or due to liver injury from medications. Although transfusion-related hepatic iron overload-leading to significant liver disease-is a recognised complication in certain hematologic malignancies, little is known about transfusional iron overload in patients with multiple myelom

Netupitant/palonosetron without dexamethasone for preventing nausea and vomiting in patients with multiple myeloma receiving high-dose melphalan for autologous stem cell transplantation: a single-center experience.

Chemotherapy-induced nausea and vomiting (CINV) is one of the most frequent adverse events compromising quality of life (QoL) in patients undergoing autologous stem cell transplantation (ASCT). However, CINV prophylaxis is still lacking uniformity for high-dose melphalan (HDM), which is used to condition patients with multiple myeloma (MM). Netupitant/palonosetron (NEPA) is administered with dexamethasone (DEXA) for CINV prevention in several chemotherapy regimens. Our study aims to assess the efficacy of NEPA, without DEXA, in preventing CINV in 106 adult patients with MM receiving HDM and AS

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… The time to platelet engraftment was defined as the interval between day 0 and the first day of a platelet count > 20 × 10 9 /L in the absence of platelet transfusions within the previous 7 days. … transfusions No Yes | 44% 56% Among patients with platelet transfusions | 2 (1–29) Days to ANC ≥ 0.5 × 10 9 L | 10 (9–10) Days to reach platelet count ≥ 20 × 10 [9]/L | 13 (12–15) Days to discharge (after stem cell infusion) | 16 (15–19) NEPA prophylaxis showed a high efficacy in preventing CINV during …

Improved Side Effect Profile of Alternate-Day Dosing of Lenalidomide.

Myelodysplastic syndrome (MDS) is a heterogeneous hematological condition associated with cytopenia, inadequate blood cell synthesis, and the risk of developing acute myeloid leukemia (AML). Patients are divided into risk groups according to the International Prognostic Scoring System (IPSS) to help direct therapy. Allogeneic stem cell transplantation, despite its limitations, is curative. Medical management, such as the use of lenalidomide, has potential benefits but can cause adverse effects that require dose regimen modification. Lenalidomide is approved for low-risk MDS with 5q deletion (5

Co-infusion of mesenchymal stromal cells to prevent GVHD after allogeneic hematopoietic cell transplantation from HLA-mismatched unrelated donors after reduced-intensity conditioning: a double-blind randomized study and literature review.

BackgroundMesenchymal stromal cells (MSC) have immunomodulatory and hematopoiesis-supporting properties that could potentially benefit hematopoietic stem cell (HSC) engraftment and decrease the incidence and/or severity of graft-versus-host disease (GVHD).MethodsBased on our previous pilot study, we established a multicenter, prospective, randomized, double-blind trial evaluating the efficacy of co-infusing third-party MSC (1.5-3 × 106/kg) versus placebo on the day of HSC transplantation (HCT) to prevent GVHD in recipients of HLA-mismatched unrelated donors after reduced-intensity conditioning

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… transfusions days 0–30, median | | Number | 0 | 0 | 0.31 Infections Cumulative incidence of infection | | Rate | 80% | 91% | 0.29 Cumulative incidence of sepsis | | Rate | 33% | 44% | 0.37 Cumulative incidence of CMV infection | | Rate | 33% | 35% | 0.82 Cumulative incidence of other infections … The time required to reach 500 neutrophils/µL or 20,000 platelets/µL (and therefore platelet transfusion independence) was not analyzable because many patients never fell below these thresholds. Neutrophil recovery was complete (2000 neutrophils/µL) in 100% of patients (Table 2 ). …

Is It Better to Mobilize Hematopoietic Stem Cells With Pegfilgrastim in Healthy Donors During Allogeneic Hematopoietic Stem Cell Transplantation?

The mobilization of hematopoietic stem cells (HSCs) using granulocyte colony-stimulating factor is a classic method. Recently, a single injection of pegfilgrastim was used to mobilize CD34+ cells in some small-sample studies. To confirm the efficacy and safety of pegfilgrastim in the mobilization of CD34+ cells from healthy donors, we conducted a retrospective multicenter study. A total of 146 healthy donors who all received subcutaneous pegfilgrastim (12 mg) on day 1 were enrolled in our study. Donor HSC apheresis was conducted on day 5. The primary endpoint was the percentage of donors from

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… The median volume of erythrocyte transfusion was 800 ml, and the median volume of platelet transfusion was 1000 ml. The median time for neutrophil and platelet engraftment was 14.5 days (range, 9–33 days) and 15 days (range, 11–84 days), respectively. … Nevertheless, a case of severe thrombocytopenia caused by G-CSF in a 14-year-old healthy donor was reported, and HSCs were collected after platelet transfusion ( 25 ). This effect was not specific to peg-G-CSF compared with G-CSF. …

The High Effect of Chemomobilization with High-Dose Etopside + Granulocyte-Colony Stimulating Factor in Autologous Hematopoietic Peripheral Blood Stem Cell Transplantation: A Single Center Experience.

Autologous hematopoietic stem cell transplantation (auto-HSCT) provides hematopoietic support after high-dose chemotherapy and is the standard of care for patients with multiple myeloma (MM), chemo sensitive relapsed high or intermediate grade non-Hodgkin's lymphoma (NHL) and Hodgkin's lymphoma (HL). However, yields of hematopoietic stem cells vary greatly between patients, and the optimal strategy to mobilize hematopoietic stem cells into peripheral blood for collection has not been defined yet. We investigated the efficacy and safety of chemo mobilization with an intermediate dose etoposide

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… Platelet transfusions were administered routinely for platelet counts <10.000×10 9 /L, with higher thresholds used for patients at a higher risk for clinically significant bleeding. …

Care of cancer patients at the end of life in a German university hospital: A retrospective observational study from 2014.

BackgroundCancer care including aggressive treatment procedures during the last phase of life in patients with incurable cancer has increasingly come under scrutiny, while integrating specialist palliative care at an early stage is regarded as indication for high quality end-of-life patient care.AimTo describe the demographic and clinical characteristics and the medical care provided at the end of life of cancer patients who died in a German university hospital.MethodsRetrospective cross-sectional study on the basis of anonymized hospital data for cancer patients who died in the Munich Univers

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… In comparison with patients with solid tumors, patients with hematological malignancies were more likely to receive blood transfusions (18.5% vs. 31.8%; p = 0.002), platelet transfusions (5.0% vs. 19.1%; p = 0.001) and renal replacement therapy (9.7% vs. 20.9%; p = 0.001) during their last week of life … Patients with hematological malignancies were more likely than those with solid tumors to have erythrocyte transfusion, platelet transfusion, blood plasma transfusion, renal replacement therapy and extracorporeal membrane oxygenation in the last 30 days of life. …

Оперативная полная ремиссия после one Цикл четырехкратного режима на основе изатуксимаба 1q21-positive первичная плазменная лейкемия: отчет о деле.

Первичная плазменная лейкемия (PPCL) представляет собой редкое и агрессивное нарушение плазменных клеток. Пациенты часто имеют большое число циркуляционных плазменных клеток и на ранней стадии заболевания, что часто сопровождается серьезными инфекциями и дисфункцией органов, что приводит к плохому общему прогнозу. Текущие стратегии лечения ПХХЛ в значительной степени экстраполируются из интенсивных индукционных режимов, используемых для лечения множественной миэломы; однако терапевтические результаты остаются ограниченными, особенно у пациентов с повышенным риском цитогенетических аномалий и н

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… After admission, the patient initially received supportive treatments including platelet transfusion, uric acid–lowering therapy, and empirical anti-infective therapy. Microbiological testing, including sputum cultures, did not identify bacterial or fungal pathogens. … Panel B displays platelet count fluctuations; platelet transfusion was administered only on day 1, and the subsequent sustained platelet elevation was mainly driven by treatment response rather than transfusion support. …

Sphingolipid metabolism and hematologic disorders: current understanding and future directions.

Sphingolipids are not only key structural components of cell membranes but also serve as important signaling molecules, and their metabolic homeostasis is essential for the maintenance of cellular functions. In recent years, with the advancement of technologies such as metabolomics, studies have revealed that sphingolipid metabolic abnormalities are extensively involved in the occurrence and development of various hematological disorders, including immune thrombocytopenia, myeloproliferative neoplasms, graft-versus-host disease, hereditary hematological diseases, and hematologic malignancies.

Superiority of high-dose cytarabine-based mobilisation over cyclophosphamide or plerixafor in primary CNS lymphoma.

High-dose chemotherapy with autologous stem cell transplantation (ASCT) is a key consolidative therapy for primary central nervous system lymphoma (PCNSL). However, the optimal regimen for mobilizing haematopoietic stem cells remains undefined in this population, leading to unpredictable failure rates and suboptimal cell yields. We retrospectively analysed data from 142 patients with histologically confirmed PCNSL who underwent stem-cell mobilisation before ASCT. Three mobilisation strategies were compared: high-dose cytarabine (HD-Ara-C)-based mobilisation (n = 64), plerixafor plus G-CSF (n =

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… This occurred in 18.7% of HD-Ara-C–based mobilisation patients and 5.6% of CTX patients (Fig. 5 C), which aligns with the observation that platelet transfusion requirements were generally low and typically limited to one unit when needed. … Importantly, although thrombocytopenia was frequent, most patients required only a single unit of platelet transfusion, and no major bleeding events or severe infections occurred, indicating that these adverse effects were clinically manageable with standard supportive care, including transfusions and …

High-Dose Continuous Infusion Ifosfamide as Effective Palliation in a Patient With Relapsed Ewing Sarcoma With Bone Marrow Infiltration and Severe Thrombocytopenia: A Case Report.

BackgroundEwing sarcoma is a rare primary mesenchymal tumor of the bone that requires an intensive multimodal therapeutic approach. Multidrug chemotherapy regimens are also the backbone for relapsing/recurring Ewing sarcoma treatment, yet when the disease relapses as bone marrow infiltration, combination chemotherapy might be difficult to administer and prognosis is poor.CaseThis report describes the case of a 22-year-old patient with Ewing sarcoma who developed severe pancytopenia due to bone marrow infiltration, and who was treated with high-dose continuous infusion ifosfamide, obtaining bot

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… High‐dose cyclophosphamide and doxorubicin, commonly used in the treatment of sarcomas, have been associated with an increased need for platelet transfusions during therapy [ 11 ]. …

Myelodysplastic Syndromes: 2026 Update on Diagnosis, Risk-Stratification and Management.

DISEASE OVERVIEW: The myelodysplastic syndromes (MDS) are a heterogeneous group of myeloid disorders characterized by peripheral blood cytopenias and increased risk of transformation to acute myelogenous leukemia (AML). MDS occurs more frequently in older males and in individuals with prior exposure to cytotoxic therapy. DIAGNOSIS: Diagnosis of MDS is based on morphological evidence of dysplasia upon visual examination of a bone marrow aspirate and biopsy. Information obtained from additional studies such as karyotype, flow cytometry, and molecular genetics is usually complementary and may he

Real-world prognostic factors in autotransplanted multiple myeloma patients with severe renal impairment: study of the Polish Myeloma Study Group.

INTRODUCTION: The prognostic factors in autotransplanted multiple myeloma (MM) patients with concomitant advanced chronic kidney disease (CKD) are poorly understood, limited, and controversial. MATERIAL AND METHODS: We retrospectively analysed 44 patients with MM and CKD (eGFR < 40 ml/min), present both at diagnosis and at autologous stem cell transplantation (ASCT), with no improvement of renal function in-between. RESULTS: Patients exhibiting deeper paraprotein responses to pre-transplant treatment predicted better response post ASCT (odds ratio (OR) = 11.6, p = 0.028) and longer progressi

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… Platelet transfusion and red blood cell transfusions were needed in 37 (77%) and 34 (74%) patients, respectively. …

Defibrotide for prophylaxis of sinusoidal obstruction syndrome/veno-occlusive disease (SOS/VOD) in pediatric high-risk patients: consensus guidelines from the European Society for Blood and Marrow Transplantation (EBMT).

SOS/VOD is a life-threatening complication of hematopoietic stem cell transplantation, especially in children, with incidences reaching up to 15-20%. Despite efforts, SOS/VOD remains unpredictable with significant morbidity and mortality. High-risk criteria are clearly defined, and the pediatric EBMT diagnostic criteria have improved sensitivity, reducing treatment delays and enhancing outcomes. A meta-analysis combining retrospective and prospective studies found a risk ratio of 0.30 for SOS/VOD with defibrotide (DF) prophylaxis. Additionally, two prospective trials were conducted: the pediat

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… While the 1-h corrected count increment is used as the objective measure for alloimmunization post-transplant [ 25 ], SOS/VOD-related tRT, as implemented in the pEBMT criteria, is more a marker of consumptive platelet use that requires increased frequency of platelet transfusions despite an adequate … Leukocyte reduction and ultraviolet B irradiation of platelets to prevent alloimmunization and refractoriness to platelet transfusions. N Engl J Med. 1997;337:1861–9 10.1056/NEJM199712253372601. 26. Richardson PG, Murakami C, Jin Z, Warren DL, Momtaz P, Hoppensteadt D, et al. …

Ensuring the Safety of Hospitalized Oncology Patients During a Pandemic.

Patients with hematologic malignancies present a unique set of circumstances during the COVID-19 pandemic; they are at increased risk of complications and death from COVID-19 infection, but the treatment of their cancer cannot be delayed. This article highlights some of the practice changes made by an inpatient hematology/oncology advanced practice provider team at a large academic institution in Philadelphia, Pennsylvania, at both a hospital-wide and service level. Practice changes have included restructuring the rounding process, imposing visitor restrictions, adjusting blood transfusion par

Артериальный тромбоэмболизм

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Outcomes of VDPACE with an immunomodulatory agent as a salvage therapy in relapsed/refractory multiple myeloma with extramedullary disease.

Extramedullary disease (EMD) is an aggressive form of multiple myeloma (MM). Confirming the presence of plasma cells outside the bone marrow makes the diagnosis of EMD. There is no clear consensus on the management of EMD in MM, and this entity continues to remain an unmet need. Rapidly controlling EMD to prevent end-organ damage is a priority. Retrospectively, we reviewed our database for patients with EMD that received treatment with bortezomib, dexamethasone, cisplatin, doxorubicin, cyclophosphamide, etoposide (VDPACE) plus an immune modulator (IMiD) regimen. We identified 21 patients with

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… Patients received packed red blood cells and pooled platelet transfusions according to prevailing guidelines. Clinicians assessed responses after the first therapy cycle; cycles could be repeated (in 4–6 weeks) after the recovery of ANC to >1 × 10 9 /L and platelet count to >100 × 10 9 /L. … Hematologic AEs were generally reversible and clinically manageable with dose delays, growth factor use, platelet transfusions, and appropriate supportive care. Nonhematologic grade 3/4 AEs were infrequent, with infections being the most common. …

Abstract

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… The primary efficacy endpoint remained the proportion of patients not requiring platelet transfusion or rescue procedure up to 7 days post‐procedure. … Prophylactic platelet transfusions are used to reduce bleeding risk, but have multiple associated safety risks. Aims: Avatrombopag (AVA), an oral thrombopoietin receptor agonist, was studied in 2 Phase 3 studies as an alternative to platelet transfusions for patients with TCP and CLD. …