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New insights into CAR T-cell hematological toxicities: manifestations, mechanisms, and effective management strategies.

Chimeric antigen receptor (CAR) T-cell therapy represents a highly efficacious treatment modality demonstrated to enhance outcomes in patients afflicted with malignancies, particularly those enduring relapsed or refractory hematological malignancies. However, the escalating adoption of CAR T-cell therapy has unveiled several life-threatening toxicities, notably cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), infections, and hematological toxicities (HTs), thereby hindering the broad implementation of CAR T-cell therapy. HTs encompass a spectrum

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… Early supportive treatment with pure red blood cell (PRBC) or platelet transfusion is initiated when critical levels are reached to avert fatal bleeding and ameliorate symptoms of anemia. … Sirolimus has been reported to reverse persistent grade 4 thrombocytopenia and severe platelet transfusion requirements in a case of DLBCL patient treated with CAR T-cells, without apparent compromise to CAR T-cell efficacy [ 91 ]. …

Synergistic immunotherapy targeting cancer-associated anemia: prospects of a combination strategy.

Cancer-associated anemia promotes tumor progression, leads to poor quality of life in patients with cancer, and even obstructs the efficacy of immune checkpoint inhibitors therapy. However, the precise mechanism for cancer-associated anemia remains unknown and the feasible strategy to target cancer-associated anemia synergizing immunotherapy needs to be clarified. Here, we review the possible mechanisms of cancer-induced anemia regarding decreased erythropoiesis and increased erythrocyte destruction, and cancer treatment-induced anemia. Moreover, we summarize the current paradigm for cancer-as

Autologous hematopoietic stem cell infusion for sustained myelosuppression after BCMA-CAR-T therapy in patient with relapsed myeloma.

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… Patient developed a grade IV of myelosuppression and was treated with granulocyte-stimulating factor, suspended red blood cells, and platelet transfusion as well as other supportive care. On day 30, BCMA expression disappeared while CAR-T cells remained detectable in BM (Fig. 1d, e ). …

Clinical and hematological evaluation of geriatric anemia.

BACKGROUND: Anemia in the elderly is a cause of concern. It is not merely physiological due to aging and requires appropriate evaluation. Anemia has a significant negative impact on cardiac function, cognition, sleep, frequent hospitalization, mobility, morbidity, and mortality. Anemia in the elderly is attributable to many causes: nutrient deficiencies, chronic inflammatory diseases, thyroid disorders, diabetes mellitus, gastrointestinal (GI) tumors and bleeding, chemotherapy-induced anemia, and drug-induced hemolysis. OBJECTIVES: We aimed to evaluate the clinical and hematological profile o

Expert Perspective: Hematologic Malignancies and Vasculitis.

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Targeting CD38 Across Autoimmune and Plasma Cell-Driven Immune-Mediated Diseases: Rationale, Clinical Evidence, and Emerging Therapeutic Landscape.

Autoimmune diseases remain a major cause of chronic morbidity despite substantial advances in targeted immunomodulatory therapies. In many autoantibody-mediated conditions, disease refractoriness and relapse are driven by long-lived plasma cells, which are largely resistant to conventional immunosuppression and upstream B cell-directed strategies. CD38, a surface molecule highly expressed on plasmablasts and plasma cells and functionally involved in immunometabolic regulation, has emerged as a promising therapeutic target to overcome this limitation. Clinical interest in anti-CD38 therapy has

The 45th Annual Meeting of the European Society for Blood and Marrow Transplantation: Physicians - Oral Session.

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… As supportive measures, red blood cells and platelet transfusions are the mainstay of therapy and patients are often multitransfused, which in turn can lead to anti-human leukocyte (HLA) alloimmunization. …

Analysis of risk factors for PICC-related venous thrombosis in patients with hematological malignancies and establishment of a nomogram prediction model.

ObjectiveTo analyze the independent risk factors for PICC-related venous thrombosis in patients with hematologic malignancies, and to construct and validate a risk prediction model.MethodsThis retrospective study analyzed data from 264 hematologic malignancy patients who received PICC chemotherapy at the Affiliated Hospital of Qingdao University between January 2022 and December 2024. Patients were randomly divided into training and validation sets (7:3), and the incidence of CRT was calculated. In the training set, LASSO regression and multivariable logistic regression identified independent

Adverse Hematological and Non-Hematological Events in Patients With Relapsed/Refractory Multiple Myeloma That Are Responsive to Daratumumab, Pomalidomide and Dexamethasone.

BackgroundDaratumumab, pomalidomide, and dexamethasone (DPd) is an effective option for treatment of patients with relapsed/refractory multiple myeloma (RRMM). In this study, we sought to analyze the risk of hematological and non-hematological toxicities in patients who responded to DPd treatment.MethodsWe analyzed 97 patients with RRMM who were treated with DPd between January 2015 and June 2022. The patients and disease characteristics, as well as safety and efficacy outcomes were summarized as descriptive analysis.ResultsThe overall response rate for the entire group was 74% (n = 72). The m

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… Regarding blood transfusion needs, in the responding group, four patients (6%) received at least one unit of packed red blood cells and one patient (2%) required one unit of platelet transfusion. … In the non-responding group, four patients (16%) required blood and five patients (20%) required platelet transfusion. Overall, no major bleeding events were reported. …

Novel Molecular Therapies and Genetic Landscape in Selected Rare Diseases with Hematologic Manifestations: A Review of the Literature.

Rare diseases affect less than 1 in 2000 people and are characterized by a serious, chronic, and progressive course. Among the described diseases, a mutation in a single gene caused mastocytosis, thrombotic thrombocytopenic purpura, Gaucher disease, and paroxysmal nocturnal hemoglobinuria (KIT, ADAMTS13, GBA1, and PIG-A genes, respectively). In Castleman disease, improper ETS1, PTPN6, TGFBR2, DNMT3A, and PDGFRB genes cause the appearance of symptoms. In histiocytosis, several mutation variants are described: BRAF, MAP2K1, MAP3K1, ARAF, ERBB3, NRAS, KRAS, PICK1, PIK3R2, and PIK3CA. Genes like H

Hemoglobin SS Nigerian Woman First Diagnosed at the Age of 52 years with Manifestation Mimicking Tuberculosis of the Spine.

Sickle cell anemia (SCA) is an inherited disorder of hemoglobin due to the presence of abnormal hemoglobin in a homozygous state. Manifestation is usually in infancy or early childhood due to gradual decrease in hemoglobin F level as age advances. Diagnosis in middle age is unusual. We present a woman who was diagnosed of SCA for the first time at middle age. The aim was to bring to the knowledge of physicians that patients with SCA can also present late so high index of suspicion is required to make diagnosis. A 52-year-old woman presented to orthopedic clinic with complaints of generalized b

Oral formulation of bendamustine hydrochloride for patients with advanced solid tumors; a phase 1 study.

To determine the maximum tolerated dose (MTD) and recommended dose (RD) of orally-administered bendamustine in Japanese patients with advanced solid tumors. The optimal dosing schedule, safety, pharmacokinetics, and preliminary antitumor effects were also evaluated. A multicenter, open-label trial with a standard 3 + 3 design and dose escalation by dose-limiting toxicity (DLT) was conducted. The treatment schedules were once daily for 7, 14, and 21 days every 3 weeks as one cycle. The total dose per cycle was increased from 175 to 840 mg/m2. Eighteen patients were enrolled in this study. DLT o

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… DLT was defined as the following adverse events (AEs) for which a causal relationship to the study drug could not be ruled out: 1) Grade 4 neutrophil count decrease, lasting for more than 8 days; 2) FN; 3) grade ≥ 3 platelet count decrease, requiring platelet transfusion; 4) grade ≥ 3 anemia requiring …

The 4th Global Congress on Sickle Cell Disease Abstract Book 2022

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Венецоклакс в сочетании с азаситидином в лечении вторичного миэлодипластического синдрома после нескольких миелом: доклад о деле и обзор литературы.

Мы провели ретроспективный анализ клинических данных пациента с миелодипластическим синдромом (MDS) вторичной и стабильной миеломой (MM), который лечился вместе с венетоклаксом и азаситидином в Пятом народном госпитале Ченду. Кроме того, мы изучили соответствующую литературу. Пациентка, 74-year-old Мужчина был первоначально диагностирован миеломой (IgA-__, DS IIIA, ISS III, R-ISS II) и получил очень хороший частичный ответ (VGPR) после последовательного лечения в рамках режимов BCTD, RVD и PVD, которые впоследствии получали алидомидную терапию. Несмотря на постоянную ремиссию, у пациента появи

Немецкий многоцентральный анализ талькетамаба в реальном мире 138 - пациенты с повторной/реактивной миеломой.

Удельные Т-клиники (ББТЦ) представляют собой изменение парадигмы в подходе к повторной/охлажденной миеломе (RRMM). Talquetamab, GPRC5DxCD3 BTCE, продемонстрировал многообещающие результаты: MonumenTAL-1 и недавно был одобрен Администрацией продовольствия и лекарств и Европейским агентством по медицине. Однако лечение в реальных условиях может не представлять собой характеристику пациента при клинических испытаниях с ограниченными критериями охвата. Мы провели ретроспективный анализ реального мира, включая 138 Пациенты БРМ лечили талькетамабом 21 Немецкие центры. Излечимых пациентов, 43% ISS II

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… PLT transfusion, platelet transfusion. RBC transfusion, red blood cell transfusion. … A relevant proportion of patients required supportive measures, including growth factors ( n = 18/138; 13%), and red blood cell ( n = 56/138; 41%) and platelet transfusions ( n = 30/138; 22%). Two patients (1%) received thrombopoietin receptor agonists. …

The prevalence of anemia in people with chronic kidney disease after hematopoietic stem cell transplantation.

The hematopoietic stem cell transplantation (HSCT) is performed for various hematological diseases. Chronic kidney disease (CKD) occurs relatively often after HSCT. Anemia after HSCT may be due to CKD and/or other reasons. The aim of this study is to assess the prevalence of anemia and its possible relationship to the presence of CKD in patients at least 3 months after HSCT. The study included 156 patients who underwent allogeneic HSCT treatment in our center in the years 1998 to 2021 due to different hematologic pathologies (acute myeloid leukemia, acute lymphoblastic leukemia, lymphoma, and

EHA Scientific Working Groups: Connecting Science and Spreading Knowledge in Hematology.

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Infections Caused by Acinetobacter baumannii in Recipients of Hematopoietic Stem Cell Transplantation.

Acinetobacter baumannii (A. baumannii) is a Gram-negative, strictly aerobic, non-fermentative coccobacillus, which is widely distributed in nature. Recently, it has emerged as a major cause of health care-associated infections (HCAIs) in addition to its capacity to cause community-acquired infections. Risk factors for A. baumannii infections and bacteremia in recipients of hematopoietic stem cell transplantation include: severe underlying illness such as hematological malignancy, prolonged use of broad-spectrum antibiotics, invasive instrumentation such as central venous catheters or endotrach

Selinexor for myelofibrosis or a drug in search of a disease?

Selinexor for the Treatment of Myelofibrosis. SVR35- spleen volume reduction ≥ 35%, TSS- total symptom score.

Inpatient Medicine

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