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Safety and feasibility of outpatient autologous stem cell transplantation in pediatric patients with primary central nervous system tumors.

High-dose chemotherapy with autologous hematopoietic stem cell transplantation (autoHSCT) is a well-established treatment for pediatric central nervous system (CNS) tumors. Given the risks of toxicity and infection, pediatric autoHSCT has been historically performed on hospitalized children. As our practice evolved, some patients were transplanted as outpatients. We performed a retrospective cohort analysis of 37 patients who received 90 transplant procedures (49 outpatient and 41 inpatient) at Children's Hospital Colorado. The most common primary diagnosis was medulloblastoma (51.4%). Of the

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… Platelet transfusions were administered for a platelet count of less than 20,000/mm 3 or symptomatic bleeding. Scheduled and as-needed antiemetics were administered for patients actively receiving chemotherapy and to help control symptoms of nausea and vomiting. …

Non-cryopreserved Autologous Peripheral Blood Stem Cell Transplantation for Lymphoma in a Resource-Limited Setting: Feasibility, Engraftment Kinetics, and Early Outcomes From Kashmir, India.

Background  Autologous stem cell transplantation (ASCT) is a standard consolidation strategy for selected patients with relapsed or high-risk lymphoma, but access remains limited in many low- and middle-income regions because of the cost and infrastructure required for stem cell cryopreservation. Non-cryopreserved ASCT using fresh peripheral blood stem cells stored at 4°C may provide a practical alternative. Methods  We retrospectively analyzed 11 consecutive patients with lymphoma who underwent non-cryopreserved ASCT at the Department of Medical Oncology, Sher-i-Kashmir Institute of Medical S

Disease Activity After Switching From Eculizumab to Ravulizumab in Patients With Paroxysmal Nocturnal Haemoglobinuria: Real World Data From Denmark and Finland.

INTRODUCTION: Ravulizumab replaced eculizumab as the preferred complement inhibitor for Paroxysmal Nocturnal Haemoglobinuria (PNH) in Denmark and Finland after 2020. Data on real-world disease activity after switching are limited. METHODS: We conducted a case series of 20 PNH patients who transitioned from eculizumab to ravulizumab, assessing transfusion needs and breakthrough haemolysis episodes (BTH). RESULTS: In 19 of 20 patients, transfusions and BTH were stable or reduced after switching. Particularly, patients with high transfusion or BTH burden had a marked reduction in these paramete

Supportive Care in Older Lymphoma Patients to Reduce Toxicity and Preserve Quality of Life

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Risks Associated with Surgical Treatment for Appendicitis in Hematologic Patients.

Appendicitis is a prevalent surgical emergency. Although appendectomy has traditionally been the go-to treatment, recent studies suggest antibiotics can be equally effective for uncomplicated cases. However, evidence is scant regarding patients with hematologic disorders. This study delves into the surgical risks tied to appendicitis in patients with underlying hematologic conditions. A retrospective analysis was carried out on patients diagnosed with appendicitis and hematologic disorders from January 2000 to June 2021. Patients were pinpointed using ICD-10 diagnostic codes, and surgical proc

Anticoagulation for Cancer Patients in Special Situations: A Narrative Review of Guidelines and Literature.

Cancer-associated thrombosis (CAT) is a major cause of morbidity and mortality in patients with cancer. The management of special situations-including recurrent venous thromboembolism (VTE), thrombosis at unusual sites, and central venous catheter-associated thrombosis (CVC-AT)-remains particularly challenging because of the limited availability of high-quality evidence. This narrative review synthesizes recommendations from major international and Spanish clinical practice guidelines and expert consensus documents, including those from SEOM, ESMO, ASCO, NCCN, ITAC and SEMI, to provide a struc

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… anticoagulation | 50% LMWH and platelet transfusion to maintain platelet counts > 20,000/μL <25,000/μL 3 in low-risk VTE | No anticoagulation | No anticoagulation Regarding IVCF placement, guidelines provide heterogeneous recommendations. … However, the SEMI-SEOM-SETH strategy may be considered when platelet transfusion is not feasible and platelet counts range between 25,000 and 50,000/μL or in cases of very high thrombotic risk with platelets counts <25,000/μL when IVCF placement is not possible. 3.6. …

A systematic review and meta-analysis of carfilzomib-associated thrombocytopenia as an adverse event in patients with multiple myeloma.

BackgroundCarfilzomib is a second-generation proteasome inhibitor (PI) used for combination therapy with dexamethasone and/or lenalidomide in patients with relapsed or refractory multiple myeloma. Reports indicate that PIs have a unique toxicity profile that includes thrombocytopenia as a hematologic adverse event; however, its occurrence has not yet been quantified systematically.ObjectivesThe main objective of our systematic review and meta-analysis is to investigate the incidence of thrombocytopenia in patients with multiple myeloma after treatment with carfilzomib.DesignSelection of studie

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… However, the routine use of platelet transfusions is not recommended due to the risk of allosensitization to various platelet antigens, especially in the absence of bleeding indications. … In addition, patients with MM, who experience bortezomib-induced thrombocytopenia, should receive platelet transfusions rather than have treatment reduced or delayed due to thrombocytopenia. 26 Comparison of different doses of carfilzomib showed no significant difference in the risk of high-grade thrombocytopenia …

Гематологические маньяки маскируются как ревматологические заболевания: серия дел и обзор.

RATALE: Гематологическая недостаточность может имитировать ревматологические заболевания, создавая серьезную диагностическую проблему из-за перекрывающихся клинических особенностей. В настоящем исследовании подчеркивается 5 - случаи гематологических маньяков, представляющих собой ревматологические расстройства, и обсуждаются связанные с этим диагностические сложности. БОЛЕЕ ТРУДЯЩИЕСЯ: 64 в адрес 78, с различными рематологическими симптомами, включая полиартрит, васкулит, явление Рейно, и такими систематическими симптомами, как потеря веса, усталость и ночной пот. В ходе первоначальной эксперт

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… Initial treatment included intravenous (IV) methylprednisolone (1 g daily for 3 days), IV immunoglobulin (2 g/kg), tranexamic acid 10mg/kg, and 16 platelet transfusions. …

A case report on the treatment of autoimmune hemolytic anemia after CBT by daratumumab in a mucopolysaccharidosis type III patient.

RATIONALE: Mucopolysaccharidosis type III, also referred to as Sanfilippo disease, is a rare hereditary lysosomal storage illness and one of the more common variants. The illness can affect all tissues and organs of the body, with the central nervous system being the most profoundly impacted. Autoimmune hemolytic anemia (AIHA) is a rare, diverse, antibody-mediated disorder characterized by the production of antibodies that target and destroy red blood cells, leading to their rapid destruction. AIHA is a prevalent and notable complication in recipients following umbilical cord blood stem cell t

Ten- летний опыт ухода на дому за пациентами, страдающими расстройствами плазменных клеток: доставка оптимальной терапии домой.

Ускоренный возраст при диагностике, коморбиде и недействительные симптомы могут привести к дебилитизации нескольких пациентов, страдающих миэломой (ММ) и амилоидозом (AL), что может лишить их доступа к оптимальной терапии. Итальянская ассоциация по борьбе с лейкемией, &quot; Linfomi e Mieloma &quot; (AIL) с тех пор оказывает помощь на дому пациентам-гематологам в Италии. 1993. Между 2014 и 2023, 83 Пациенты MM и AL получали внутрибольничную терапию через AIL в Болонье. Половина была диагностирована, а половина прошла 1-7 предыдущие линии терапии. Средний возраст жителей составил 79 годы и 56%

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… Nineteen patients received 1 to 16 zoledronic acid administrations with AIL (median: 5) and 19 received erythrocyte and/or platelet transfusions. Overall, the median duration of home care was 224 days (range 7–2337). … Three of them also received platelet transfusions (one, three, and 9 units, respectively). Twenty-nine patients (37%) accessed the emergency department at least once, mostly because of infections or renal failure. …

Moxetumomab pasudotox in heavily pre-treated patients with relapsed/refractory hairy cell leukemia (HCL): long-term follow-up from the pivotal trial.

BackgroundMoxetumomab pasudotox is a recombinant CD22-targeting immunotoxin. Here, we present the long-term follow-up analysis of the pivotal, multicenter, open-label trial (NCT01829711) of moxetumomab pasudotox in patients with relapsed/refractory (R/R) hairy cell leukemia (HCL).MethodsEligible patients had received ≥ 2 prior systemic therapies, including ≥ 2 purine nucleoside analogs (PNAs), or ≥ 1 PNA followed by rituximab or a BRAF inhibitor. Patients received 40 µg/kg moxetumomab pasudotox intravenously on Days 1, 3, and 5 of each 28-day cycle for up to six cycles. Disease response and mi

Risk Factors for Catheter-Related Thrombosis in Multiple Myeloma Patients Undergoing Autologous Stem Cell Transplantation.

Background and Objectives: Cancer associated thrombosis (CAT) is a common complication of neoplasms. Multiple myeloma (MM) carries one of the highest risks of CAT, especially in the early phases of treatment. Autologous stem cell transplantation (ASCT) as the standard of care in transplant-eligible patients with MM carries a risk of catheter-related thrombosis (CRT). The aim of this study was identification of the risk factors of CRT in MM patients undergoing ASCT in 2009-2019. Materials and Methods: We retrospectively analyzed patients with MM undergoing ASCT. Each patient had central venous

The feasibility and efficacy of subcutaneous plerixafor for mobilization of peripheral blood stem cells in allogeneic HLA-identical sibling donors: results of the HOVON-107 study.

BackgroundPlerixafor (PFX) mobilizes CD34+ cells into circulation by disrupting the CXCR4 binding of the hematopoietic stem cell in its bone marrow niche.Study design and methodsin the prospective HOVON-107 study (www.hovon.nl) 23 allogeneic HLA-identical sibling donors received one or two subcutaneous (sc) injections of plerixafor 0.320 mg/kg.The primary endpoint, was defined as feasibility to mobilize a minimum of 2.0 x106 CD34+ cells/kg recipient weight obtained by leukopheresis in at least 90% of the donors.Resultsmedian 3.3 x 106 CD34+ cells/kg (1.9-6.5) were collected after 1 (n=12) or 2

Exploring the Rare Etiology of Severe Anemia in an Immunocompromised Patient.

Pure red cell aplasia (PRCA) is a rare cause of profound anemia, marked by very low reticulocyte count and near to complete absence of erythroid precursor cells in the bone marrow. PRCA can be congenital such as in the case of children with Diamond- Blackfan anemia or acquired, which is often triggered by exposure to certain viruses or drugs. Management depends on the underlying etiology of PRCA. Here, we present the case of a young male with underlying acquired immunodeficiency syndrome, who presented with a hemoglobin of 2.6 g/dL, initially thought to be secondary to gastrointestinal blood l

Множественная миелома с психической нефропатией и негативом Бенса-Джонса Протеинурии: Редкое клиническое представление.

Множественная миелома (MM) — злокачественное расстройство плазменных клеток, которое обычно вызывает анемию, боль в костях, гиперкальцемию и почечную недостаточность. Мы сообщаем о случае 55-year-old Мужчина, у которого были в основном острые повреждения почек (АКИ), пинентопенция и системное воспаление без классических особенностей гиперкальцемии или литических повреждений костей. В частности, мочевые белки Бенса-Джонса были отрицательными, несмотря на заметно повышенную сыворотку каппа и аномальный белковый электрофорез (SPEP). Биопсия костного мозга выявила скромный плазмоцитоз, в то время

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… Management comprised ongoing hemodialysis with strict fluid and electrolyte monitoring, initiation of a bortezomib-cyclophosphamide-dexamethasone regimen with a plan for lenalidomide maintenance pending response, and comprehensive supportive care, including platelet transfusions for pancytopenia, bisphosphonates …

Genome-wide DNA methylation analysis pre- and post-lenalidomide treatment in patients with myelodysplastic syndrome with isolated deletion (5q).

Myelodysplastic syndrome (MDS) with isolated deletion of chromosome 5q (MDS del5q) is a distinct subtype of MDS with quite favorable prognosis and excellent response to treatment with lenalidomide. Still, a relevant percentage of patients do not respond to lenalidomide and even experience progression to acute myeloid leukemia (AML). In this study, we aimed to investigate whether global DNA methylation patterns could predict response to lenalidomide. Genome-wide DNA methylation analysis using Illumina 450k methylation arrays was performed on n=51 patients with MDS del5q who were uniformly treat

Moving Beyond G-CSF Mobilization-Learning From a 15-Year Experience of Different Stem Cell Mobilization Regimens in Multiple Myeloma.

BackgroundStem-cell mobilization in multiple myeloma is usually done with G-CSF with or without Cyclophosphamide (Cy) based chemotherapy/Plerixafor. Pre-clinical data suggest the role of proteasome inhibitors in mobilization. We previously reported that Bortezomib (Bort) when added to a Cy-based regimen had a better stem-cell yield. Consequent to favorable results with Bort + Cy-G-CSF, we used Bortezomib with G-CSF too. Hence, four different mobilization regimens were used-Bort + G-CSF (Group-1); G-CSF + Plerixafor (Group-2); Bort - Cy-G-CSF (Group-3); Cy + G-CSF (Group-4). We report here our

Прогнозирование неблагоприятных явлений для стратификации риска химиотерапии на основе мобилизации стволовых клеток в множестве миеломы.

Автологическая трансплантация стволовых клеток является фундаментальной терапией для множественных миелом. Хотя стационарная химическая мобилизация стволовых клеток (КЦМ) является в Германии стандартной системой ухода, амбулаторные подходы могут облегчить проблемы, связанные с медицинским обслуживанием. Мы проанализировали 109 Пациенты миэломы проходят курс SCM и коллекционируются в медицинском центре Университета Геттингена на предмет безопасности. Затем мы подготовили модели машинного обучения для прогнозирования неблагоприятных явлений (АЭ), требующих госпитализации, и прогнозирования сроко

Рационализация аферез: Инициатива по повышению качества стволовых ячеек в целях повышения эффективности сбора данных.

Для автоматической трансплантации стволовых клеток (ASCT) требуется эффективный сбор периферийных стволовых клеток крови. В Лондонском научно-медицинском центре (ЛЦЗ) пациенты с высокой степенью риска, страдающие миэломой, регулярно записываются на лечение three- дневные аферозные коллекции для достижения более высоких целевых показателей по количеству клеток CD34+, хотя многим не нужны все запланированные дни, что ведет к неэффективности ресурсов. Была реализована инициатива по повышению качества, направленная на сокращение числа ненужных сессий в рамках two мероприятия:1) снижение целевых по

Raised Serum Levels of Syndecan-1 (CD138), in a Case of Acute Idiopathic Systemic Capillary Leak Syndrome (SCLS) (Clarkson's Disease).

BACKGROUND Systemic capillary leak syndrome (SCLS) (Clarkson's disease) is a rare disorder of unknown etiology, characterized by transient episodes of hypotension, and the microvascular leak of fluids into the peripheral tissues, resulting in edema. Between 80-90% of patients with SCLS have a concomitant monoclonal gammopathy. Although translational in vitro studies have implicated vascular endothelial barrier dysfunction in the etiology of SCLS, the etiology and disease associations in clinical cases remain unknown. CASE REPORT We report a case of SCLS in a 49-year-old woman who initially pre