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Advancing Palliative Care Integration in Hematology: Building Upon Existing Evidence.

Opinion statementPatients with hematologic malignancies and their families are among the most distressed of all those with cancer. Despite high palliative care-related needs, the integration of palliative care in hematology is underdeveloped. The evidence is clear that the way forward includes standard-of-care PC integration into routine hematologic malignancy care to improve patient and caregiver outcomes. As the PC needs for patients with blood cancer vary significantly by disease, a disease-specific PC integration strategy is needed, allowing for serious illness care interventions to be ind

Thrombin generation in newly diagnosed multiple myeloma during the first three cycles of treatment: An observational cohort study.

BACKGROUND: Multiple myeloma (MM) is associated with a high risk of thrombosis, particularly during the first months of treatment including immunomodulatory drugs (IMiDs). There is no consensus on prevention of thromboembolic risk in patients with de novo MM, and identification of patients requiring anticoagulant thromboprophylaxis remains challenging. Evaluating coagulability by an in vitro thrombin generation (TG) test might be a way of identifying such patients. OBJECTIVE: To determine whether TG assessment could reveal an increase in coagulability during the first three chemotherapy cycle

A Case of Acute Myeloid Leukemia with a Previously Unreported Translocation (14; 15) (q32; q13).

Background. We hereby describe what we believe to be the first reported case of t (14; 15) (q32; q13) associated with acute myeloid leukemia (AML). Methods. PubMed, Embase, and OVID search engines were used to review the related literature and similar published cases. Case. A47-year-old female presented in December 2011 with AML (acute myelomonocytic leukemia) with normal cytogenetics; molecular testing revealed FLT-3 internal tandem duplication (ITD) mutation, while no mutations involving FLT3 D385/I836, NPM1 exon 12, or KIT exons 8 and 17 were detected. She was induced with 7 + 3 (cytarabine

The prevalence and clinical characteristics of cancer among anemia patients treated at an outpatient clinic.

BackgroundAnemia is the most common hematologic condition encountered in outpatient clinics. It is often overlooked because it is common among patients; however, anemia is one of the leading indicators of cancer. This study examined the prevalence and characteristics of cancer among anemia patients who visited an outpatient clinic.MethodsThe data were collected by reviewing the records of an outpatient clinic from January 2007 to December 2011.ResultsIn total, 502 patients (52 males, 450 females) were diagnosed with anemia. Cancer prevalence among anemia patients was 5.57% (25.0%, men; 3.3%, w

Therapeutic Plasma Exchange Using Membrane Plasma Separation Across a Broad Spectrum of Indications: An Eight-Year Single-Center Retrospective Cohort Study.

BACKGROUND: Therapeutic plasma exchange (TPE) removes pathogenic plasma constituents such as autoantibodies, immune complexes and monoclonal proteins. Plasma can be separated by centrifugation or by membrane plasma separation (MPS); although MPS predominates in many centers because it can be delivered at the bedside on standard renal replacement platforms, most published outcome data derive from centrifugal techniques. OBJECTIVE: To describe the indications, complications, laboratory changes and clinician-assessed treatment response of MPS-based TPE in an unselected single-center cohort. MET

Селинксор в сочетании с помалидомидом и дексаметазоном для лечения первичной плазменной лейкемии с 1q21+ аномалией: отчет о деле.

RATALE: Первичная плазменная лейкемия клеток представляет собой редкое и крайне агрессивное нарушение системы крови с быстрым распространением заболеваний и высоким коэффициентом ранней смертности. В настоящее время не существует признанного терапевтического режима, что приводит к принятию стратегий, обычно используемых в отношении множественной миэломы, которая, однако, демонстрирует ограниченную эффективность. Селинксор считается эффективным средством лечения рецидива/рефрактора множественной миеломы, однако в настоящее время нет сообщений о его применении в первичном лейкемии клеток плазмы.

Neutropenic Enterocolitis as a Complication of Autologous Stem Cell Transplant in Patients With Multiple Myeloma: A Case Series.

Neutropenic enterocolitis (NE) is a rare but severe complication occurring in neutropenic patients undergoing intensive chemotherapy. Mortality is high, so early diagnosis is required to start urgent medical or surgical treatment. Data analysis of the development of NE after hematopoietic stem cell transplantation remains scarce. The aim of this case series is to discuss five out of 100 patients receiving autologous stem cell transplants (ASCTs) for multiple myeloma complicated with NE between 2016 and 2020 in the hematology department of the Cheikh Khalifa International University Hospital, C

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… Supportive care is essential and includes platelet transfusions, bowel rest with nasogastric suction, intravenous fluids, and parenteral nutrition if needed [ 15 ]. …

Bortezomib and melphalan as a conditioning regimen for autologous stem cell transplantation in multiple myeloma.

BackgroundHigh-dose melphalan (200 mg/m(2)) with autologous stem cell transplantation (ASCT) is the standard treatment for young patients with multiple myeloma (MM). However, the response rates after ASCT are often unsatisfactory. We performed a pilot study by using bortezomib-melphalan as conditioning regimen for ASCT in Korean patients with MM.MethodsThe conditioning regimen consisted of administration of intravenous infusion of bortezomib 1.0 mg/m(2) on days -4 and -1 and melphalan 50 mg/m(2) (day -4) and 150 mg/m(2) (day -1). In this study, we enrolled 6 newly diagnosed patients and 2 pati

Клинические особенности и лечение недавно диагностированной миеломы с вторичным миэлофиброзом: ретроспективное исследование.

Вторичный миэлофиброз (СМФ) характеризуется чрезмерным осаждением волокнистых тканей сверху первичной болезни, что часто приводит к затмению клинических проявлений первичным заболеванием. К сожалению, нынешние системы сборки не включают миэлофиброз, что ведет к потенциальным задержкам в лечении SMF. Оценить прогнозы пациентов с множественной миеломой (ММ), сложной с миэлофиброзом.DESIGN: Исследование включало клинические данные и результаты лечения 208 недавно диагностированные несколько пациентов, страдающих миеломой (НДММ), которые с января лечились в аффилированной больнице Университета Цин

Comprehensive view on chemotherapy-free management of acute myeloid leukemia by using venetoclax in combination with targeted and/or immune therapies.

A hallmark of cancer biology is resistance to apoptosis. BCL-2 is an anti-apoptotic molecule that is being overexpressed in several myeloid diseases, such as acute myeloid leukemia and myelodysplastic syndromes, but also in several lymphoid cancers, such as acute lymphoblastic leukemia, chronic lymphocytic leukemia, non-Hodgkin lymphomas and multiple myeloma. Venetoclax (VEN) is a BCL-2 small molecule inhibitor. Data about its structure, biochemical characteristics and in vitro efficacy against several blood cancer cell lines were first reported in 2013. Shortly after, the first clinical trial

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… In terms of toxicity, early 8-week mortality was significantly decreased (6 vs 16%, P = 0.03) with a reduction in the need for platelet transfusions (62 vs 72%, P = 0.02). … VEN treatment duration | ORR (%) | Complete response rate (%) | MRD-negativity (%) | mPFS (months) | mOS (months) | 2-months mortality (%) | Grade 3 or higher Neutropenia (%) | Grade 3 or higher anemia or RBC transfusion rate (%) | Grade 3 or higher thrombocytopenia or platelet transfusion rate (%) 7 …

Persistent lactic acidosis in ALK-positive anaplastic large cell lymphoma: a case report and literature review.

Lactic acidosis is common in the ICU, but malignancy-associated type B lactic acidosis mediated by the clinical Warburg effect (CWE) is uncommon and easily missed when infection or organ dysfunction dominates the presentation. We report a 35-year-old man with a month of fever and progressive dyspnea who presented with persistent hyperlactatemia (peak 15.46 mmol/L) and markedly elevated LDH despite stable hemodynamics. Imaging revealed generalized lymphadenopathy, multifocal osteolytic lesions, and bilateral pleural effusions; infectious studies were unrevealing apart from chronic hepatitis B.

A Phase I Study of Carfilzomib with Cyclophosphamide and Etoposide in Relapsed and Refractory Leukemia and Solid Tumors.

BackgroundNovel therapies are needed for children, adolescents, and young adults with relapse/refractory leukemia or solid tumors. The proteasome inhibitor carfilzomib has demonstrated pre-clinical activity against several pediatric malignancies when used alone or in combination. Therefore, a multicenter dose-escalation phase 1 study of carfilzomib administered in combination with cyclophosphamide and etoposide was conducted.MethodsStudy eligibility included an age of 6 months to 2/day, etoposide 100 mg/m2/day, and carfilzomib was administered every 28 days with growth factor support. The carf

Early mortality after chemotherapy as a quality indicator-the leukemia perspective.

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… In leukemia, pain is rare and usually alleviated with a short course of steroids, but supportive care involves addressing three common components: red cell transfusions to improve anemia and fatigue/poor quality of life; platelet transfusions for thrombocytopenia and bleeding; and antibiotics to prevent …

Autologous stem cell transplantation for multiple myeloma patients whose myeloma-defining event was SLiM.

In 2014, the International Myeloma Working Group (IMWG) updated the criteria for diagnosing myeloma and added three additional criteria to the traditional Calcium elevation, Renal impairment, Anemia, Bone disease (CRAB) criteria, called the Sixty % marrow plama cells, Light chain ratio >60, Mri demonstates lytic lesions (SLiM) criteria (clonal bone marrow plasma cells ≥60%, involved to uninvolved free light chain ratio (FLCr) ≥100 and >1 focal lesion on magnetic resonance imaging (MRI)). We report on the outcomes of 30 patients who underwent autologous stem cell transplantation (ASCT) where th

Plerixafor (a CXCR4 antagonist) following myeloablative allogeneic hematopoietic stem cell transplantation enhances hematopoietic recovery.

BackgroundThe binding of CXCR4 with its ligand (stromal-derived factor-1) maintains hematopoietic stem/progenitor cells (HSPCs) in a quiescent state. We hypothesized that blocking CXCR4/SDF-1 interaction after hematopoietic stem cell transplantation (HSCT) promotes hematopoiesis by inducing HSC proliferation.MethodsWe conducted a phase I/II trial of plerixafor on hematopoietic cell recovery following myeloablative allogeneic HSCT. Patients with hematologic malignancies receiving myeloablative conditioning were enrolled. Plerixafor 240 μg/kg was administered subcutaneously every other day begin

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… Platelet engraftment was defined as platelet count ≥20 × 10 9 /L for three consecutive days without a platelet transfusion for the preceding 7 days with platelet recovery being the first of the three consecutive days. …

Efficacy of nebulized GM-CSF inhalation in preventing oral mucositis in patients undergoing hematopoietic stem cell transplantation: A retrospective study.

ObjectiveTo study the efficacy of oxygen atomization inhalation of granulocyte-macrophage colony-stimulating factor (GM-CSF) for preventing oral mucositis in patients following hematopoietic stem cell transplantation.MethodsData from patients who received hematopoietic stem cell transplantation and were treated with GM-CSF for the prevention/treatment of oral mucositis in our hospital from June 2021 to June 2023 were collected. The enrolled patients were divided into an observation group and a control group according to the use of GM-CSF. The WHO Mucositis Scale Assessment Criteria were utiliz

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… Platelet recovery was defined as the first occurrence of a consecutive three-day period with a platelet count ≥20 × 10^9/L, occurring within 7 days without platelet transfusion [ 26 , 27 ]. …

Pharmacokinetics and outcome of high-dose melphalan followed by autologous stem cell transplantation in dialysis-dependent patients with multiple myeloma.

High-dose melphalan followed by autologous stem cell transplantation (ASCT) remains the standard of care for fit patients with multiple myeloma (MM). However, individuals who are dependent on hemodialysis are frequently excluded from ASCT. Recommendations on chemotherapy dosing and hemodialysis scheduling vary in literature and definite conclusions are impeded by the heterogeneity of cohorts. We aimed to evaluate the safety and efficacy of ASCT in patients with MM and end-stage renal disease and to examine the pharmacokinetics of melphalan on a fixed schedule of melphalan infusion and hemodial

Large sacral/buttocks ulcerations in the setting of coagulopathy: A case series establishing the skin as a target organ of significant damage and potential morbidity in patients with severe COVID-19.

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Proteomic and transcriptomic analyses to explain the pleiotropic effects of Ankaferd blood stopper.

Ankaferd blood stopper is a standardized mixture of the plants Thymus vulgaris, Glycyrrhiza glabra, Vitis vinifera, Alpinia officinarum, and Urtica dioica and has been used as a topical hemostatic agent and with its clinical application established in randomized controlled trials and case reports. Ankaferd has been successfully used in gastrointestinal endobronchial mucosal and cutaneous bleedings and also in abdominal, thoracic, dental and oropharyngeal, and pelvic surgeries. Ankaferd's hemostatic action is thought to form a protein complex with coagulation factors that facilitate adhesion of

Interventional and Non-interventional Medical Rehabilitation Approaches to Axial Spine Pain in Vertebral Metastatic Disease.

As targeted therapies help patients with advanced cancer live longer, interventions for management of axial spine pain will become more common. Unfortunately, the indications for and safety of these procedures have been relatively unexplored compared with non-cancer adults. This review focuses on the following aspects of axial spine pain management in patients with vertebral metastatic disease: (1) pathophysiology and symptoms of cancer- and non-cancer-related spine pain; (2) safety and efficacy of non-interventional rehabilitation approaches to treat this pain; (3) considerations for interven