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Delayed Presentation of Thymoma-Related Aplastic Anemia: An Unusual Presentation of a Rare Complication.

A 68-year-old Caucasian man presented with gross hematuria and oral mucosal bleeding. The patient was known to have an anterior mediastinal mass, highly suspicious for thymoma, which was incidentally identified on imaging, 8 years prior. The patient then declined treatment and was lost to follow-up. On presentation, imaging re-demonstrated the anterior mediastinal mass and the patient was found to have profound pancytopenia. Bone marrow biopsy confirmed the diagnosis of aplastic anemia (AA). Despite optimal treatment, the patient expired on day 9 of admission. In this case we report an unusual

Свежая (некриотечная) аутологическая трансплантация стволовых клеток в множестве миеломы: ускоренная пересадка и сокращение госпитализации.

Криопрезентативная автологичная трансплантация стволовых клеток с использованием диметила сульфооксида является стандартной в случае множественной миеломы, однако она связана с токсичностью, связанной с вливанием, и высокой стоимостью. Цель этого исследования заключалась в оценке осуществимости, безопасности и результатов аутологической трансплантации стволовых клеток без диметила сульфооксида, свежего (не криопехотного) аутоголита у нескольких пациентов, страдающих миеломой, в одном третичном центре. МЕТОДЫ: В период с 2023 по 2025 год в больнице Университета Докуза Эйлюля был проведен ретрос

Is neutropenic fever an obstacle to effective stem cell harvesting?

IntroductionAutologous stem cell transplantation (ASCT) is a well-established consolidation treatment for many hematologic cancers which delivers prolonged survival. A subset of patients' adequate stem cell harvest is not achievable with a solitary use of granulocyte colony-stimulating agents (G-CSF). Generally, chemomobilization is employed for patients failing G-CSF and its most feared complication febrile neutropenia (FN).Materials and methodsHere, we aimed to investigate the impact of the FN in chemomobilization on apheresis outcomes and engraftment. One hundred and eighty-three patients w

Identifying Hemostatic Thresholds in Cancer Patients Undergoing Coronary Angiography Based on Platelet Count and Thromboelastography.

Objectives: To evaluate the role of platelet count and thromboelastogram (TEG) in the treatment of thrombocytopenic cancer patients with suspected coronary artery disease (CAD). Background: Cancer patients with CAD and thrombocytopenia are often treated non-invasively (i.e., without coronary angiography when clinically indicated) due to perceived high risk of bleeding. We sought to evaluate coagulability based on TEG and determine if platelet count and TEG could predict bleeding risk/mortality among cancer patients undergoing coronary angiography (CA). Methods: Baseline demographics, platelet

Optimal infused CD34+ cell dose in multiple myeloma patients undergoing upfront autologous hematopoietic stem cell transplantation.

Autologous transplantation remains the standard of care for eligible multiple myeloma (MM) patients, yet optimal CD34+ cell dose remains unclear. We conducted a retrospective study on MM patients undergoing upfront transplant between 2005 and 2021 and divided them into low (≤2.5 × 106 cells/kg) and high (>2.5 × 106 cells/kg) CD34+ dose groups. We included 2479 patients, 95 in the low CD34+ group and 2384 in the high CD34+ group. Patients in the low CD34+ group were older (63.2 vs 61.1 years, p = 0.013), more often had R-ISS III (19% vs 9%, p = 0.014), received plerixafor (60% vs 35%, p + group

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… Similarly, those in the low CD34 + dose group received more platelet transfusions, with a median of three units compared to two units in the high-dose CD34 + dose group ( p < 0.001). Engraftment outcomes are summarized in Supplementary Table 2 . …

Expanding role of lenalidomide in hematologic malignancies.

Lenalidomide is an immunomodulatory agent that has been approved by the US Food and Drug Administration for treatment of multiple myeloma, deletion 5q myelodysplastic syndrome, and mantle cell lymphoma. In addition, it has clinical activity in lymphoproliferative disorders and acute myeloid leukemia. The mode of action includes immunomodulatory, anti-inflammatory, antiangiogenic, and antiproliferative mechanisms. The antitumor effect is a result of direct interference of key pathways in tumor cells and indirect modulation of the tumor microenvironment. There has been no recent collective revie

Cost of hematopoietic stem cell transplantation in India.

Hematopoietic stem cell transplantation (HSCT) is a definite cure for many hematological diseases. With the increasing indications for HSCT and its relatively low cost in Indian subcontinent, an increasing number of patients are opting for this procedure. We retrospectively analyzed the cost of one hundred sixty two HSCTs done at our center in the last three years. The median cost of autologous transplant was USD, $ 12,500 (range $ 10,331-39,367) and the median cost of allogeneic transplant was $ 17,914 (range $ 10,832-44,701). The cost of HSCT is cheaper here compared to that in developed cou

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… The total cost included the cost of chemotherapy, stem cell/bone marrow harvest, antibiotic usage, supportive care with blood, platelet transfusion and growth factors, the hospital stay charges, the investigation charges and consultation fees. …

Unexpected and Deadly: Three Cases of Bone Marrow Necrosis.

Bone marrow necrosis (BMN) is a rare pathological diagnosis, with an incidence of 0.3% to 2%. It is most often associated with hematological malignancies and less commonly due to solid tumors, infections, medications, sickle cell disease, chemotherapy, radiotherapy, or idiopathic causes. We reviewed bone marrow biopsies performed in our institution from 2009 to 2019 and found three cases of BMN. Two cases were secondary to neoplastic causes, while the third one was possibly from alcohol abuse.

Managing thrombosis in cancer patients.

Venous thromboembolism is a major complication in cancer patients. The basis for the strong association between cancer and thrombosis remains incompletely understood, and the optimal approaches to both the treatment and the prevention of cancer-associated thrombosis are evolving. Here we review several important topics related to cancer-associated thromboembolism, including the pathogenesis, prevention, and management of this disease. Wherever possible, we include evidence from clinical trials, including the results of recently published trials that compared direct oral anticoagulants to low-m

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… Most of the studies in the literature addressing this problem are small and observational, with a great variety of treatment strategies, including different platelet transfusion thresholds and/or different LMWH dose‐adjustments for different levels of thrombocytopenia. 57 LMWH has the most safety data … A recent cohort study investigated the optimal management of prior VTE during the period of thrombocytopenia associated with autologous stem cell transplantation. 60 No differences in the 30‐day bleeding or VTE outcomes were found in patients who were continued on anticoagulation with platelet transfusion …

The Autologous Hematopoietic Stem Cells Transplantation Combination-Based Chimeric Antigen Receptor T-Cell Therapy Improves Outcomes of Relapsed/Refractory Central Nervous System B-Cell Lymphoma.

ObjectiveThe objective is to explore the effectiveness and safety of CAR T-cell therapy in advanced relapsed/refractory central nervous system B-cell lymphoma and compare the impact of autologous stem cell transplantation (ASCT) plus CAR T-cell therapy versus sequential CART therapy on the survival of patients.MethodsThe retrospective analysis was based on the data of 17 patients with advanced relapsed/refractory central nervous system B-cell lymphoma. Bridging chemotherapy was applied before CAR T-cell infusion to further reduce the tumor burden. For patients with autologous hematopoietic ste

Bleeding Propensity in Waldenström Macroglobulinemia: Potential Causes and Evaluation.

Waldenström macroglobulinemia (WM) is a rare, incurable, low-grade, B cell lymphoma. Symptomatic disease commonly results from marrow or organ infiltration and hyperviscosity secondary to immunoglobulin M paraprotein, manifesting as anemia, bleeding and neurological symptoms among others. The causes of the bleeding phenotype in WM are complex and involve several intersecting mechanisms. Evidence of defects in platelet function is lacking in the literature, but factors impacting platelet function and coagulation pathways such as acquired von Willebrand factor syndrome, hyperviscosity, abnormal

Chemotherapy-Associated Thrombotic Microangiopathy.

Thrombotic microangiopathy (TMA) is a syndrome of microangiopathic hemolytic anemia and thrombocytopenia with end-organ dysfunction. Although the advent of plasma exchange, immunosuppression, and complement inhibition has improved morbidity and mortality for primary TMAs, the management of secondary TMAs, particularly drug-induced TMA, remains less clear. TMA related to cancer drugs disrupts the antineoplastic treatment course, increasing the risk of cancer progression. Chemotherapeutic agents such as mitomycin-C, gemcitabine, and platinum-based drugs as well as targeted therapies such as anti

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… Platelet transfusion is generally avoided in TMA in the absence of bleeding because it may worsen microvascular thrombosis. 73 Platelet transfusion has been associated with higher odds of mortality (odds ratio, 4.22; 95% confidence interval, 2.36 to 7.60), although likely as a marker of illness severity … Are platelet transfusions harmful in acquired thrombotic thrombocytopenic purpura at the acute phase? experience of the French thrombotic microangiopathies reference center: platelet Transfusion in Thrombotic Thrombocytopenic Purpura. …

Hematopoietic stem cell transplantation: an Italian monocentric experience on the health assessment and eligibility of adult-related donors.

IntroductionIndications for HSCT are increasing worldwide, paralleled by a growing demand for donors of therapeutic cells.MethodsHerein, we report our real-world experience of adult HPC donor assessment during a 5-year study period (2018-2023): we have retrospectively revised data of 455 potential related stem cell donors, consecutively evaluated at our center. Donor medical history was assessed by a questionnaire and an interview with a trained physician experienced in donation procedures to evaluate donor fitness and medical history. Pre-existing health disorders were fully investigated. Beh

Экулизумаб для связанной с АТКР тромботической микроангиопатии в китайском реципиенте трансплантации почек с типом 2 диабет: отчет по делу.

ЦЕЛЬ: Данное исследование было направлено на изучение эффективности экулизумаба в лечении недавно разработанной тромботической микроангиопатии (TMA), связанной с острым отторжением с помощью Т-клеток (ATCR) у пациентов с типом 2 диабет после трансплантации почек. МЕТОДЫ: Новая тромботическая микроангиопатия после трансплантации почек является относительно редким, но серьезным осложнением, которое клинически трудно уладить и требует своевременного вмешательства для предотвращения пересадки или ранней потери трансплантатата. В настоящее время в клинической практике отсутствует консенсус в отноше

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… transfusion and biopsy timing optimization) ( 8 ). … For counts below this threshold, a comprehensive clinical assessment is essential, with prophylactic platelet transfusion advised when necessary to mitigate bleeding risk. Both laboratory markers and renal transplant Doppler ultrasound demonstrated ATCR prior to TMA diagnosis. …

CAR T-Cell Terrapy Opveiled: Навигация за пределы ССЗ и ИКАНС для решения проблем, связанных с отсроченными последствиями, и оптимизации стратегий управления.

Цимерическая антигенная рецепторная (КАР) T-клетологическая терапия положила начало эпохе преобразований в регулировании рецидивов/отсутствий гематологической гематологии. Кульминацией интенсивных испытаний второго этапа, направленных на борьбу с повторной/охотничьей лимфомой, включая различные подтипы, такие, как диффузная большая лимфома B-клеток, фолликулярная лимфома и лимфома мантичной клетки, а также многочисленные миелома и острая лимфоболическая лейкемия B-клеток, стало одобрение различных продуктов CAR-T-клеток для этих конкретных указаний Администрацией по вопросам продовольствия и н

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… CJ continued to be monitored outpatient twice weekly, requiring granulocyte colony-stimulating factors (G-CSF) and platelet transfusion. In addition, she was initiated on weekly romiplostim for refractory thrombocytopenia. … To date, she remains cytopenic, requiring G-CSF, blood and platelet transfusion, as well as supplementation with vitamin B12 and folic acid. Per infectious disease recommendations, she continued with CMV monitoring weekly. …

Treatment Approaches for Managing Patients with Hematological Malignancies in the Time of COVID-19 Pandemic.

Background/aimThe COVID-19 pandemic is a unique challenge to the care of patients with hematological malignancies. We aim to provide supportive guidance to clinicians making individual patients decisions during the COVID-19 pandemic, in particular during periods that access to healthcare resources may be limited.ConclusionThis review also provides recommendations, which are convenient in evaluating indications for therapy, reducing therapy-associated immunosuppression, and reducing healthcare utilization in patients with specific hematological malignancies in the COVID-19 era. Specific decisio

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… According to the American Society of Hematology (ASH) recommendations, antifibrinolytics can be given for patients requiring frequent platelet transfusion and/or platelet-transfussion-refractory patients 2 . … The addition of GCSF with this condensed cytarabine schedule has been reported to shorten the time to neutrophil recovery, risk of infection, duration of hospitalization and platelet transfusion requirement 3 . …

Review of Potential Barriers to Effective Hemostatic Management of Acquired Hemophilia A by Non-Hemophilia Experts in the United States.

Acquired hemophilia A (AHA) is an ultra-rare autoimmune disorder caused by autoantibodies against factor VIII. It often presents with life-threatening bleeding to non-hemophilia experts, who have limited awareness of this condition. This review evaluated hemostatic management and identified barriers to optimal management of AHA by non-hemophilia experts in the United States through a literature review. AHA case reports published by non-hemophilia experts from January 2016 through November 2021 in non-hematology journals were critically reviewed for a chronology of clinical course and managemen

Menorrhagia due to uterine amyloidosis in familial Mediterranean fever: case-based review.

Amyloidosis is described by the deposition of misfolded proteins in the tissues. Amyloidoses are classified into two as systemic and localized. Out of the systemic forms, AL (light chain) amyloidosis is the most prevalent type; however, amyloid A (AA) amyloidosis is more frequently encountered in the rheumatology practice. AA amyloidosis stands out as a major complication of familial Mediterranean fever (FMF). Splenic and renal involvement is more likely in FMF-associated systemic amyloidosis. The involvement of thyroid and adrenal glands has also been described, although infrequently. Amyloid

Experience of life quality from patients with aplastic anemia: a descriptive qualitative study.

BackgroundDespite the increasing incidence of aplastic anemia in China, few studies have explored its effect on the patients' quality of life from the perspective of these patients. In fact, patients with aplastic disorder live with the disease for a long time, and need to face a variety of difficult realities, including multiple disease symptoms and drug side effects, heavy burden of medical costs, difficulties in social reintegration, and negative emotional distress. Therefore, this study used descriptive qualitative research to explore the direct and rich quality-of-life experiences of pati

Cell therapies in the clinic.

Cell therapies have emerged as a promising therapeutic modality with the potential to treat and even cure a diverse array of diseases. Cell therapies offer unique clinical and therapeutic advantages over conventional small molecules and the growing number of biologics. Particularly, living cells can simultaneously and dynamically perform complex biological functions in ways that conventional drugs cannot; cell therapies have expanded the spectrum of available therapeutic options to include key cellular functions and processes. As such, cell therapies are currently one of the most investigated

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… Platelet transfusions are indicated for the treatment of thrombocytopenia, which can occur as a result of disease or in response to cancer treatment. Current clinical studies continue to investigate the range of suitable storage conditions and dosing regimens for donor platelets. … Platelet transfusions are investigated clinically for thrombocytopenia and for the induction of blood clotting following trauma. In all these trials, the platelets are administered intravenously. As with RBCs, new dosing regimens for platelet transfusions are also investigated. …