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Резюме докладов 2017 Ежегодное совещание Общества общей внутренней медицины.

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Clonal Hematopoiesis and CAR T Cell Therapy: From Biological Crosstalk to Clinical Implications.

Clonal hematopoiesis (CH) is increasingly recognized as a significant biological phenomenon in aging and cancer, marked by the expansion of hematopoietic stem and progenitor cells harboring somatic mutations in genes associated with myeloid neoplasms. While CH is strongly linked to a spectrum of inflammatory diseases and hematologic malignancies, its role in shaping responses to cancer immunotherapy-especially chimeric antigen receptor (CAR) T cell therapy-has only recently begun to emerge. This review explores the interplay between CH and CAR T cell therapy, highlighting CH prevalence in trea

Spinal Cord Compression As the Initial Manifestation of Relapsed Acute Myeloid Leukemia: A Case Report and Literature Review of a Rare Presentation.

Myeloid sarcoma (MS) is a solid mass of myeloid blasts outside the bone marrow (BM). Most cases occur in the setting of intramedullary acute myeloid leukemia (AML), but it can also present in the absence of overt BM disease, as a presentation of newly diagnosed or relapsed AML, or as a progression of myeloproliferative neoplasms or myelodysplastic syndromes. There are a few reports of spinal cord compression due to MS, and there is no consensus regarding its management. Here, we present a case of relapsed AML in the form of MS resulting in spinal cord compression and provide a comprehensive li

Enhancing Immune Response in Non-Small-Cell Lung Cancer Patients: Impact of the 13-Valent Pneumococcal Conjugate Vaccine.

Background: Non-small-cell lung cancer (NSCLC) is one of the most frequently diagnosed diseases among all types of lung cancer. Infectious diseases contribute to morbidity and mortality by delaying appropriate anti-cancer therapy in patients with NSCLC. Methods: The study aimed to evaluate the effectiveness of vaccination with the 13-valent pneumococcal conjugate vaccine (PCV13) in 288 newly diagnosed NSCLC patients. The analysis of the post-vaccination response was performed after vaccination by assessing the frequency of plasmablasts via flow cytometry and by assessing the concentration of s

Donor's age influences outcome in haploidentical hematopoietic stem cell transplantation with post-transplant cyclophosphamide - a single center experience.

Haploidentical stem cell transplantation (haplo-SCT) using post-transplantation cyclophosphamide (post-Cy) is considered a reasonable therapeutic option for patients who lack matched donor or who urgently need transplant procedure due to high risk disease. We analyzed the results of haplo-SCT performed in years 2018-2023. Eighty one patients (46 males) at median age of 52 years underwent haplo-SCT using peripheral blood as a stem cell source in most cases. Indications included hematological malignancies (acute leukemias in 88% of cases). In 25 cases (31%) transplantation was performed in relap

The role of ixazomib as an augmented conditioning therapy in salvage autologous stem cell transplant (ASCT) and as a post-ASCT consolidation and maintenance strategy in patients with relapsed multiple myeloma (ACCoRd [UK-MRA Myeloma XII] trial): study protocol for a Phase III randomised controlled trial.

BACKGROUND: Multiple myeloma (MM) is a plasma cell tumour with an approximate annual incidence of 4500 in the UK. Therapeutic options for patients with MM have changed in the last decade with the arrival of proteasome inhibitors and immunomodulatory drugs. Despite these options, almost all patients will relapse post first-line autologous stem cell transplantation (ASCT). First relapse management (second-line treatment) has evolved in recent years with an expanding portfolio of novel agents, driving response rates influencing the durability of response. A second ASCT, as part of relapsed diseas

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… Platelet transfusions are not allowed within 3 days before registration in order to meet these values 6. Adequate renal function within 14 days before registration: (a) Creatinine clearance ≥ 30 ml/min (calculated according to the Cockcroft-Gault equation or other locally approved formula) 7. …

The Clinical Application of Ozonetherapy

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Catching Them Early: Framework Parameters and Progress for Prenatal and Childhood Application of Advanced Therapies.

Advanced therapy medicinal products (ATMPs) are medicines for human use based on genes, cells or tissue engineering. After clear successes in adults, the nascent technology now sees increasing pediatric application. For many still untreatable disorders with pre- or perinatal onset, timely intervention is simply indispensable; thus, prenatal and pediatric applications of ATMPs hold great promise for curative treatments. Moreover, for most inherited disorders, early ATMP application may substantially improve efficiency, economy and accessibility compared with application in adults. Vindicating t

Indications for haematopoietic cell transplantation for haematological diseases, solid tumours and immune disorders: current practice in Europe, 2022.

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Chronic pruritus: a narrative review.

Chronic pruritus encompasses a manifestation of several cutaneous, allergic, infectious, neurological, psychological, and systemic conditions, whose etiological investigation and therapeutic strategy can be challenging. This comprehensive review aims to enhance the understanding of pruritus by highlighting important elements in its pathogenesis, including keratinocytes, Merkel cells and mast cells, nerve fibers, histaminergic and nonhistaminergic pathways, and the interaction of itch signals with the central nervous system. Diagnostic evaluation of chronic pruritus may require a meticulous app

Клинические характеристики и прогностические факторы инфекции Клостридий перфрингенов, осложненные массовым внутриваскулярным гемолизом у пациентов с гематологическими заболеваниями: ретроспективное тематическое исследование.

С пищевым отравлением и газовой гангреной обычно ассоциируются анаэробные бактерии с положительным гравием Clostridium perfringens (CP). В редких случаях он может вызывать смертельный массовый внутриваскулярный гемолиз (MIH) — состояние, связанное с чрезвычайно высокой смертностью, которое создает серьезную клиническую проблему. Ретроспективный анализ был проведен с использованием смертельного случая T-лимфоболической лимфомы/лейкемии, осложненной острым гемолизом, связанным с ХП, который лечился в нашем центре в ноябре 2024 , а также сообщения о связанных с КП MIG пациентах-гематологах с янва

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… Case of fatal Clostridium perfringens sepsis with massive hemolysis in the setting of a coincidental platelet transfusion. Lab Med. (2023) 54:e108–10. 10.1093/labmed/lmac135 25. Xia XS. A case of hemolytic Clostridium perfringens in acute leukemia myelosuppressive stage. …

Neutropenic sepsis and septic shock in ICU patients: A single-center experience over the last decade.

PURPOSE: Sepsis and septic shock in patients with neutropenia are associated with high mortality. We investigated the features and outcome predictors of neutropenic sepsis in the last decade. METHODS: Consecutive patients who were admitted to the intensive care unit (ICU) of a French university-affiliated hospital in 2012-2022, met criteria for sepsis or septic shock, and had neutropenia were included retrospectively. Patient features were collected and compared for 2012-2017 and 2018-2022. Factors associated with hospital mortality were sought by univariate and multivariate analyses. RESULT

TEMPI Syndrome: Update on Clinical Features, Management, and Pathogenesis.

TEMPI (telangiectasias, elevated erythropoietin level and erythrocytosis, monoclonal gammopathy, perinephric fluid collections, and intrapulmonary shunting) syndrome is a rare and newly defined multisystemic disease, which belongs to "monoclonal gammopathy of clinical significances". Due to its rarity, the etiology, pathogenesis, and clinical features of this disease remain largely unknown. Owing to its hidden and diverse clinical manifestations, missed diagnosis and misdiagnosis are common. In recent years, as more patients (including three fatal cases) were identified, some special clinical

Phase I study of KW-2478, a novel Hsp90 inhibitor, in patients with B-cell malignancies.

BackgroundKW-2478 is a novel, non-ansamycin, non-purine heat-shock protein 90 (Hsp90) inhibitor.MethodsIn this phase I, multicentre study, KW-2478 was administered intravenously over 1 h at doses ranging from 14 to 176 mg m(-2) once daily on days 1-5 of a 14-day cycle in a standard 3+3 design in 27 patients (22 with multiple myeloma and 5 with non-Hodgkin lymphoma). Patients enrolled had relapsed/refractory disease previously treated with ⩾2 regimens.ResultsThere were no dose-limiting toxicities, thus the maximum-tolerated dose was not reached. KW-2478 was well tolerated and did not manifest s

Clinical utility and patient consideration in the use of lenalidomide for multiple myeloma in Chinese patients.

Multiple myeloma (MM) is an incurable hematologic malignancy caused by the autonomous growth of malignant plasma cells. In the last decade, the introduction of novel targeted agents such as thalidomide, bortezomib, and lenalidomide has dramatically improved the clinical outcome of MM patients in both the frontline and recurrent settings. Lenalidomide is a synthetic derivative of thalidomide, which has been shown to significantly improve overall survival, time to progression, and overall response rates in patients with MM. The China Food and Drug Administration approved the use of lenalidomide

Pericytes as targets in hereditary hemorrhagic telangiectasia.

Defective paracrine Transforming Growth Factor-β (TGF-β) signaling between endothelial cells and the neighboring mural cells have been thought to lead to the development of vascular lesions that are characteristic of Hereditary Hemorrhagic Telangiectasia (HHT). This review highlights recent progress in our understanding of TGF-β signaling in mural cell recruitment and vessel stabilization and how perturbed TGF-β signaling might contribute to defective endothelial-mural cell interaction affecting vessel functionalities. Our recent findings have provided exciting insights into the role of thalid

Efficacy and Safety of Pegfilgrastim in Patients With Severe Congenital Neutropenia.

BACKGROUND: Severe congenital neutropenia (SCN) is commonly treated with granulocyte colony-stimulating factor (G-CSF) to reduce neutropenia and the associated risk of infections. Pegfilgrastim, a long-acting form of G-CSF, provides the benefit of less frequent dosing; however, its application in SCN has not been extensively studied. This study aims to assess the long-term safety and effectiveness of transitioning SCN patients from standard G-CSF therapy to pegfilgrastim. METHODS: We followed eight patients with severe congenital neutropenia (five males, average age 17.8 years) who had been o

The Relationship between Changes in Serum Element Concentrations and Pathological Condition and Disease Status in Japanese Multiple Myeloma Patients: A Pilot Study and Literature Review.

BackgroundMultiple myeloma (MM) is a rare cancer, and information on its pathological condition and serum element levels is lacking. In this pilot study, we examined serum element concentrations in Japanese patients with MM by a comprehensive multi-element analysis.MethodsThis is a case-control study of 12 Japanese patients diagnosed with MM at the Nagoya City University Hospital between 2008 and 2013. Blood samples were taken, at the initial diagnosis and at relapse. The serum concentrations of 12 elements were analyzed by inductively coupled plasma mass spectrometry and compared between MM p

Chimeric antigen receptor T cell: A cancer immunotherapy.

During present decade, targeted drug therapy has been the epitome for treatment of cancer. Drugs like Imatinib, a tyrosine kinase receptor inhibitor and Trastuzumab, an human epidermal growth factor receptor-2/neu inhibitor, has been developed and accepted widely for management of chronic myeloid leukaemia and breast cancer respectively. Recent development among the various immunotherapies is adoptive cell transfer (ACT). Research on development of various types of ACT immunotherapy is going on, but so far, Chimeric antigen receptors T cell therapy (CAR-T) has achieved the maximum advancement

Complete response after autologous stem cell transplant in multiple myeloma.

We evaluated long-term outcome of patients achieving complete response (CR) after autologous stem cell transplantation (ASCT) for multiple myeloma. Between April 1990 and June 2012 191 patients underwent ASCT. The median age was 53 years (range, 26-68 years), 135 were men. Pretransplant, patients received induction therapy with VAD (vincristine, doxorubicin, dexamethasone; n = 77), novel agents (n = 92), or alkylating agent-based, n = 22); 43% received more than one line of induction regimen. Response to transplant was defined as per EBMT criteria. The median follow-up for the entire group was