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Low-dose peripheral blood stem cell graft after high-dose chemotherapy - an evaluation of hematopoietic reconstitution.

BackgroundHigh-dose (HD) chemotherapy followed by autologous blood stem-cell transplantation (ASCT) is the standard treatment for multiple myeloma (MM) patients. However, the collection of sufficient peripheral blood stem cell (PBSC) grafts can be challenging, and the question arises whether reinfusion of low-dose grafts will lead to a hematopoietic recovery.MethodsThe hematopoietic recovery of 148 MM patients who underwent HD melphalan chemotherapy and received PBSC transplants with varying CD34+ cells doses (3-4 × 106 [n = 86], 2-2.5 × 106 [n = 53], 6 [n = 9] per kg body weight [bw]) was ana

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… Platelet engraftment was defined as the first day of three consecutive values with platelet count ≥20 × 10 9 /L without previous platelet transfusion for 7 days. … We also calculated days until the platelet count ≥50 × 10 9 /L as a variable for platelet engraftment, as the platelet count in some patients did not drop below 20 × 10 9 /L or was not assessable due to platelet transfusion. …

Testosterone therapy as a novel approach to the management of cytopenias in myelodysplastic neoplasms: a review of literature and case report.

PurposeTo explore the potential of testosterone therapy in managing cytopenias in myelodysplastic neoplasm and investigate the link between hypogonadism and hematologic malignancies.MethodsA case of a patient with intermediate-risk myelodysplastic neoplasm and hypogonadism treated with testosterone replacement therapy is presented. Testosterone, prostate specific antigen, and erythropoietin levels were checked prior to therapy initiation and 3 months after. Blood counts were monitored over time. This is followed by a literature review of testosterone use in myelodysplastic neoplasm and the pre

Clinical guide SEOM on venous thromboembolism in cancer patients.

Venous thromboembolism (VTE) is a common event in cancer patients and one of the major causes of cancer-associated mortality and a leading cause of morbidity. In recent years, the incidence rates of VTE have notably increased; however, VTE is still commonly underestimated by oncologists. VTE is considered an adverse prognostic factor in cancer patients in all settings. In 2011 the Spanish Society of Medical Oncology (SEOM) first published a clinical guideline of prophylaxis and treatment of VTE in cancer patients. In an effort to incorporate evidence obtained since the original publication, SE

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… transfusions Erythropoietic stimulating agents Antiangiogenic agents Thalidomide and lenalidomide Patient-related Older age >65 years Obesity >35 BMI African-American Female Prior VTE history Chronic venous insufficiency Comorbidities/medical problems (infection, pulmonary or renal disease, arterial … In the acute period after VTE (first month), the risk of recurrent VTE is higher and platelet transfusion to maintain platelet counts >50 × 10 9 should be considered to allow maintaining a full-dose anticoagulant treatment. …

Mutations with epigenetic effects in myeloproliferative neoplasms and recent progress in treatment: Proceedings from the 5th International Post-ASH Symposium.

Immediately following the 2010 annual American Society of Hematology (ASH) meeting, the 5th International Post-ASH Symposium on Chronic Myelogenous Leukemia and BCR-ABL1-Negative Myeloproliferative Neoplasms (MPNs) took place on 7-8 December 2010 in Orlando, Florida, USA. During this meeting, the most recent advances in laboratory research and clinical practice, including those that were presented at the 2010 ASH meeting, were discussed among recognized authorities in the field. The current paper summarizes the proceedings of this meeting in BCR-ABL1-negative MPN. We provide a detailed overvie

Прогресс в патофизиологии и лечении анемии в множестве миеломы.

ЦЕЛЬ РАССМОТРЕНИЯ: Анемия является общим признаком во многих миеломах благодаря многофакторным механизмам. Помимо хорошо известных факторов, связанных с этим заболеванием, в последнее время использование ряда новых лекарственных средств в качестве иммунотерапевтических указывает на формирующуюся роль связанных с наркотиками механизмов в патофизиологии анемии у многих пациентов, страдающих миеломой. ПОСЛЕДНИЕ ФИННДИНЫ: Анемия, связанная с иммуномодулятивными препаратами, может быть вызвана как непосредственным воздействием на гематопоиетические клетки потомства, так и косвенным воздействием one

Economic Burden of Intravenous Decitabine Administration in Patients Affected by Acute Myeloid Leukemia Ineligible for Induction Chemotherapy and Impact of Oral Formulation Introduction: A Micro-Costing Study in Italy.

PurposeIntravenous (IV) decitabine is a therapeutic option for patients with newly diagnosed acute myeloid leukemia (AML) ineligible for induction chemotherapy. Recently, the oral formulation of decitabine-cedazuridine demonstrated comparable efficacy and safety to IV decitabine, and pharmacokinetic equivalence. This study estimates the direct non-drug healthcare costs of IV decitabine administration in Italy, including central venous catheter (CVC) and infection management, and assesses the economic impact of oral decitabine introduction.MethodsA micro-costing analysis from the Italian Nation

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… Cost analysis of platelet transfusion in Italy for patients with chronic liver disease and associated thrombocytopenia undergoing elective procedures . CEOR . 2022 ; Volume 14 : 205 – 220 . doi: 10.2147/CEOR.S354470 PMC9005228 35422645 61. Zhu LX , Chen RR , Wang LL , et al. …

Babesia microti-induced fulminant sepsis in an immunocompromised host: A case report and the case-specific literature review.

Babesia microti is an obligate intra-erythrocytic parasite transmitted by infected ticks. B. microti is a eukaryote much larger than prokaryotic microbes and more similar to human hosts in their biochemistry and metabolism. Moreover, Babesia spp. possess various immune evasion mechanisms leading to persistent and sometimes life-threatening diseases in immunocompromised hosts. Chronic lymphocytic leukemia (CLL) is the most prevalent adult B-cell malignancy, and a small percentage of CLL transforms into aggressive lymphomas. CLL also causes immune dysfunction due to the over-expansion of immatur

The 48th Annual Meeting of the European Society for Blood and Marrow Transplantation: Physicians - Poster Session (P001 - P578).

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Cardiac surgery in a patient with idiopathic aplastic anemia: a case report.

Major surgery in a patient with pancytopenia might be associated with increased surgical risks, especially for bleeding and infection. A 66-yr-old man was admitted to the hospital due to shortness of breath. His dyspnea was classified by the New York Heart Association (NYHA) as functional class III. Prior to admission, he had a 5-yr history of medical management for idiopathic aplastic anemia. The severity of aplastic anemia of the patient was graded as non-severe aplastic anemia. Echocardiography revealed reduced left ventricular function and severe aortic valve regurgitation (grade IV) with

Clinical outcomes after idecabtagene vicleucel in older patients with multiple myeloma: a multicenter real-world experience.

AbstractThe safety and efficacy of chimeric antigen receptor T-cell therapy is not well described in older patients, a population that has higher frailty and comorbidities. In this multicenter retrospective study, we evaluated clinical outcomes along with frailty and geriatric characteristics such as comorbidities, polypharmacy, falls, neuropathy, organ dysfunction, and performance status in younger (aged <65 years) vs older (aged ≥65 years) patients who received commercial idecabtagene vicleucel (ide-cel). A total of 156 patients (n = 75, aged ≥65 years) were infused with ide-cel by data cuto

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… All supportive care interventions such as blood or platelet transfusion, use of growth factors, and intravenous immunoglobulin infusion were also captured. … Similarly, rates of growth factor use for neutropenia, blood transfusion for anemia, and platelet transfusion for thrombocytopenia within the first 90 days after CART therapy also did not differ significantly between these 2 age categories. …

Incidence and management of adverse events in patients with relapsed and/or refractory multiple myeloma receiving single-agent carfilzomib.

Carfilzomib, a selective proteasome inhibitor approved in the USA in 2012, is a single agent for relapsed and refractory multiple myeloma. Carfilzomib is administered as a 2-10-minute infusion on days 1, 2, 8, 9, 15, and 16 of a 28-day cycle at a starting dose of 20 mg/m(2) for cycle 1 and a target dose of 27 mg/m(2) thereafter. In the pivotal Phase II study (PX-171-003-A1), carfilzomib 20/27 mg/m(2) provided durable responses in a heavily pretreated population with relapsed and refractory multiple myeloma (n=266), with an overall response rate of 22.9% and a median duration of response of 7.8

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… Decrease in platelet count was generally managed with platelet transfusions as per institutional guidelines, and, rarely, dose reduction. Dose reduction and discontinuation rates due to thrombocytopenic AEs were low (1.1% and 1.0%, respectively). … In clinical practice, carfilzomib should be withheld for grade 4 thrombocytopenia, 10 and platelet transfusion should be considered as indicated (eg, active bleeding, asymptomatic platelet count <10,000/mm 3 ). …

Therapeutic plasma exchange across multiple organ systems in an Egyptian tertiary center: A seven-year real-world cohort study.

BACKGROUND: Real-world evidence on therapeutic plasma exchange (TPE) from low- and middle-income countries remains limited. Egyptian data across multiple organ systems are scarce. This study aimed to evaluate the indications, safety, efficacy, and predictors of outcomes in patients undergoing TPE at a tertiary center in Egypt over 7 years. METHODS AND FINDINGS: This retrospective cohort study included 221 consecutive patients who underwent TPE (2016-2022) at Zagazig University Hospitals, Egypt. Patients were stratified into renal, neurologic, hematologic, and metabolic groups. Primary outcome

PB2456: SURVIVAL OF MULTIPLE MYELOMA PATIENTS YOUNGER AND OLDER THAN 60 YEARS AFTER AUTOLOGOUS HEMATOPOIETIC STEM CELL TRANSPLANTATION

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Induction treatment of acute myeloid leukemia in an elderly patient with intramarrow injection/administration of cytarabine. Second case report.

We show for the second time that intramarrow injection/administration of chemotherapeutic agents such as cytarabine (Ara-C) can be used safely and effectively and is associated with no toxicity, promising antileukemic activity and possible improved survival.

Assessment of cyclosporine serum concentrations on the incidence of acute graft versus host disease post hematopoietic stem cell transplantation.

Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative treatment option for hematological disorders. Cyclosporine (CsA) is one of the major immunosuppressive agents for the prophylaxis against graft versus host disease (GvHD). In this retrospective study, we evaluated the effects of CsA serum levels on the incidence of acute GvHD and transplant outcomes. Retrospective study in 103 adult patients received Hematopoitic Stem Cell Transplantation (HSCT) in the Hematology-Oncology, Bone Marrow Transplantation center at Shariati Hospital in Tehran, Iran. All participants received pr

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… Hematopoietic recovery was defined as absolute neutrophil count (ANC) count greater than 0.5×10 9 /L and platelet count greater than 20×10 9 /L without platelet transfusion for 3 consecutive days. …

Anaesthesia as an influence in tumour progression.

PURPOSE: Tumour growth and the formation of metastases are essential elements in the progression of cancer. The centre of treatment is the surgical resection of primary solid tumours. But even if the tumour can be removed without microscopic residual cells, local recurrences and distant metastases occur and determine the patient's fate. During the operation, tumour cells are shed from the primary tumour and released into the circulation. These circulating tumour cells might play an important role in the formation of new tumour sites. Therefore, a functional innate and adaptive immune system is

Effects of erythropoietin receptors and erythropoiesis-stimulating agents on disease progression in cancer.

Erythropoiesis-stimulating agents (ESAs) increase red blood cell (RBC) production in bone marrow by activating the erythropoietin receptor (EpoR) on erythrocytic-progenitor cells. Erythropoiesis-stimulating agents are approved in the United States and Europe for treating anaemia in cancer patients receiving chemotherapy based on randomised, placebo-controlled trials showing that ESAs reduce RBC transfusions. Erythropoiesis-stimulating agent-safety issues include thromboembolic events and concerns regarding whether ESAs increase disease progression and/or mortality in cancer patients. Several t

Azacitidine in 302 patients with WHO-defined acute myeloid leukemia: results from the Austrian Azacitidine Registry of the AGMT-Study Group.

Data on efficacy and safety of azacitidine in acute myeloid leukemia (AML) with >30 % bone marrow (BM) blasts are limited, and the drug can only be used off-label in these patients. We previously reported on the efficacy and safety of azacitidine in 155 AML patients treated within the Austrian Azacitidine Registry (clinicaltrials.gov identifier NCT01595295). We herein update this report with a population almost twice as large (n = 302). This cohort included 172 patients with >30 % BM blasts; 93 % would have been excluded from the pivotal AZA-001 trial (which led to European Medicines Agency (E

Antibiotic Prophylaxis or Granulocyte-Colony Stimulating Factor Support in Multiple Myeloma Patients Undergoing Autologous Stem Cell Transplantation.

We compare, in this manuscript, antibiotic prophylaxis versus granulocyte-colony stimulating factor (G-CSF) support as anti-infective strategies, in patients with multiple myeloma (MM), undergoing high-dose therapy followed by autologous stem cell transplantation (HDT/ASCT). At our institution, antibiotic prophylaxis after HDT/ASCT in MM was stopped in January 2017 and replaced by G-CSF support in March 2017. Consecutive MM patients who received HDT/ASCT between March 2016 and July 2018 were included in this single-center retrospective analysis. In total, 298 patients and 353 individual cases

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… The duration of platelets <20/nL was defined by the time from the first day when platelets declined <20/nL to the first day when platelets rose ≥20/nL, regardless of administered platelet transfusions. … The median number of administered platelet transfusions was one in both groups. …

The Dynamic Endothelial Activation and Stress Index (EASIX) as a Predictor of Early Death and Long-Term Survival in Acute Promyelocytic Leukemia (APL): A Multicenter Study.

Background/Objectives: Early death (ED) remains the primary barrier to long-term survival in acute promyelocytic leukemia (APL). Since current risk stratification models rely solely on static baseline parameters, they fail to capture the high biological volatility during the induction phase. We aimed to evaluate the prognostic value of the dynamic evolution of the endothelial activation and stress index (EASIX). Materials and Methods: This multicenter, retrospective study analyzed 131 newly diagnosed adult APL patients treated with the AIDA protocol. EASIX scores were calculated at admission (

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… Third, since platelet count is a component of the EASIX formula, daily platelet transfusions can potentially affect the score. Although patients received standardized supportive care, our retrospective design prevented adjusting for exact transfusion volumes. …