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Pneumonia in Transplant Recipients: A Comprehensive Review of Diagnosis and Management.

Transplant recipients have an increased risk of complications, including graft dysfunction and infections, which can be life-threatening if not recognized early. Pneumonia ranks as one of the most frequent complications in both solid organ and hematopoietic stem cell transplants. Clinical symptoms manifest late during infections in immunocompromised patients. An aggressive approach centered on early confirmatory diagnosis and a low threshold for empiric therapy is often the most effective strategy. The isolation of a pathogen in an upper airway sample does not necessarily mean the same organis

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… In some cases, secondary EBV infections elevate the risk of post-transplant lymphoproliferative disorders, typically B cell lymphomas [ 22 ]. … The post-transplant lymphoproliferative disorder is related to EBV and typically presents during this period as nodular infiltrates. …

Practical guidance for the management of inflammatory bowel disease in patients with cancer. Which treatment?

Clinicians involved in the treatment of inflammatory bowel disease (IBD) increasingly come across patients with current or previous history of malignancies. With increasing and earlier use of immunosuppression and biologics in IBD patients, the question arises whether these treatments further increase the risk of new or recurrent cancers. A number of population-based observational studies have now reported the odds of development of new or recurrent cancers with thiopurines and antitumour necrosis factors (anti-TNFs). These data combined with data arising from treatment registries from other i

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… Lymphoma and other lymphoproliferative disorders in inflammatory bowel disease . Am J Gastroenterol 2011 ; 106 : 2146 – 2153 . 23094824 10.1111/jgh.12015 51 Axelrad J Bernheim O Colombel JF et al . … Lymphoproliferative disorders in rheumatoid arthritis: clinicopathological analysis of 76 cases in relation to methotrexate medication . J Rheumatol 2007 ; 34 : 322 – 331 . 17117491 73 Tortocaaux J Tao Y Tourney E et al . …

Immune-Mediated Dermatoses in Patients with Haematological Malignancies: A Comprehensive Review.

Haematological malignancies induce important alterations of the immune system, which account for the high frequency of autoimmune complications observed in patients. Cutaneous immune-mediated diseases associated with haematological malignancies encompass a heterogeneous group of dermatoses, including, among others, neutrophilic and eosinophilic dermatoses, autoantibody-mediated skin diseases, vasculitis and granulomatous dermatoses. Some of these diseases, such as paraneoplastic pemphigus, are associated with an increased risk of death; others, such as eosinophilic dermatoses of haematological

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… It is interesting to note that both thymoma and HMs, with special regard to lymphoproliferative disorders, induce a similar profile of autoimmune diseases, such as paraneoplastic pemphigus (PNP). … Patients with sarcoidosis harbour a five times higher risk of developing lymphoproliferative disorders, in particular Hodgkin’s lymphoma. …

The Role of mTOR Inhibitors in Hematologic Disease: From Bench to Bedside.

The mTOR pathway plays a central role in many cellular processes, such as cellular growth, protein synthesis, glucose, and lipid metabolism. Aberrant regulation of mTOR is a hallmark of many cancers, including hematological malignancies. mTOR inhibitors, such as Rapamycin and Rapamycin analogs (Rapalogs), have become a promising class of agents to treat malignant blood diseases-either alone or in combination with other treatment regimens. This review highlights experimental evidence underlying the molecular mechanisms of mTOR inhibitors and summarizes their evolving role in the treatment of he

Review Article: Immune Effector Cell-Mediated Enterocolitis Following CAR-T Cell Therapy-Clinical Features, Pathophysiology and Management.

BACKGROUND: Chimeric antigen receptor T-cell (CAR-T) therapy has revolutionised the treatment of hematologic malignancies, and its use is expanding rapidly into numerous other disease states including autoimmune diseases. However, CAR-T therapy is associated with a spectrum of immune-related toxicities. In addition to the already well characterized cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome, it has become apparent that rarely, CAR-T can cause gastrointestinal mucosal inflammation, termed immune effector cell-mediated enterocolitis (IEC-EC). AIMS: This

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… Review by expert gastrointestinal pathologists and hematopathologists is required, especially to exclude post‐CAR‐T lymphoproliferative disorders. … M., and Ozdemirli M., “Is Immune Effector Cell‐Associated Enterocolitis a CAR T‐Cell Lymphoproliferative Disorder?,” Blood Cancer Journal 15 (2025): 117. 42. Mukewar S. …

Review and update on drugs related to the development of osteonecrosis of the jaw.

BACKGROUND: Medication-related osteonecrosis of the jaw (MRONJ) is a rare, but serious adverse effect of certain drugs, of which bisphosphonates are the most widely known. This pathology is also associated with other medications such as the biologic antiresorptive agent, denosumab and some antiangiogenics such as sunitinib, bevacizumab or aflibercept. Very recently, new medications have also been associated with osteonecrosis of the jaw (ONJ). The objectives were to update the list of medications associated with ONJ, to analyze the fundamental aspects of this list and to describe the level of

Secondary antibody deficiencies: what's around the corner?

Secondary antibody deficiencies (SADs) are characterized by impaired humoral immunity, which can cause recurrent and severe infections. Several factors may contribute to SAD development, making it difficult to establish a clear etiological classification. This heterogeneity also leads to clinical variability, further complicating patient management and treatment strategies. Various diagnostic and therapeutic algorithms are often adapted from those used in primary antibody deficiencies, potentially resulting in under- or over-treatment. Key points include the decision to initiate Immunoglobulin

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… In these lymphoproliferative disorders, hypogammaglobulinemia can result from both the disease and its treatment, which typically involves medications that target B lymphocytes ( 38 ). … However, patient management cannot occur without a multidisciplinary approach, especially in patients with lymphoproliferative disorders. …

Medical Management of the Kidney Transplant Recipient : Infections and Malignant Neoplasms

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… Leukoplakia and post-transplantation lymphoproliferative disorder (PTLD) may develop in patients with EBV infection (PTLD is discussed in a later section). Commonly encountered bacterial pathogens include Clostridium difficile and Helicobacter pylori . … of posttransplant lymphoproliferative disorders Proc Natl Acad Sci USA 94 2000 4285 10.1073/pnas.080068597 PMC18230 10759564 27 Pascual J Post-transplant lymphoproliferative disorder—the potential of proliferation signal inhibitors Nephrol Dial Transplant 22 Suppl 35 2007 i27 i35 17456616 10.1093/ndt …

Peripheral neuropathy and monoclonal gammopathy of undetermined significance: a population-based study including 15,351 cases and 58,619 matched controls.

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… Risk of lymphoproliferative disorders among firstdegree relatives of lymphoplasmacytic lymphoma / Waldenström macroglobulinemia patients: a population-based study in Sweden. Blood. 2008;112(8):3052-3056. 6. Hanewinckel R, van Oijen M, Ikram MA, van Doorn PA. …

Pathogenetic Mechanisms Linking Sarcoidosis to Lymphoma.

Sarcoidosis and lymphoma share immunopathological characteristics that suggest a complex, interconnected relationship. This article examines the multi-faceted mechanisms linking sarcoidosis to lymphoma, a phenomenon called sarcoidosis-lymphoma syndrome (SLS). SLS is hard to diagnose, requiring distinct criteria and imaging to differentiate overlapping features and histological differences. The co-occurrence of these diseases may be explained by genetic predispositions, immune dysregulation, and environmental factors that enhance malignancy risk. In active sarcoidosis, chronic inflammation and

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… Other hematologic malignancies documented in patients with a prior sarcoidosis diagnosis exceeding one year include myeloma, acute myelogenous leukemia, hairy cell leukemia, chronic myelogenous leukemia, Epstein-Barr virus-associated lymphoproliferative disease, lymphoproliferative disorders, myeloproliferative … Effect of Diet and Oxidative Stress in the Pathogenesis of Lymphoproliferative Disorders Antioxidants 2023 12 1674 10.3390/antiox12091674 37759977 PMC10525385 58. Konigsberg I.R. Maier L.A. Yang I.V. Epigenetics and sarcoidosis Eur. Respir. …

Assessment of kidney transplant suitability for patients with prior cancers: is it time for a rethink?

Kidney transplant recipients have up to a 100-fold greater risk of incident cancer compared with the age/sex-matched general population, attributed largely to chronic immunosuppression. In patients with a prior history of treated cancers, the type, stage and the potential for cancer recurrence post-transplant of prior cancers are important factors when determining transplant suitability. Consequently, one of the predicaments facing transplant clinicians is to determine whether patients with prior cancers are eligible for transplantation, balancing between the accelerated risk of death on dialy

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… Inhibition of mTOR by sirolimus induces remission of post‐transplant lymphoproliferative disorders . … Long‐term follow‐up of kidney transplant patients with posttransplant lymphoproliferative disorder: duration of posttransplant lymphoproliferative disorder‐induced operational graft tolerance, interleukin‐18 course, and results of retransplantation . …

Darbepoetin alpha in the treatment of cancer chemotherapy-induced anemia.

Anemia is a common, but underestimated and undertreated, complication of patients with cancer receiving chemo- or radiotherapy, and negatively affects their quality of life (QoL). Erythropoietic proteins (EPS) offer an effective treatment of cancer anemia and ameliorate QoL, although their use requires the correct targeting of hemoglobin increase to avoid thromboembolic complications. Currently the effort is focused on offering patients this effective treatment with reduced frequency of administration. Higher weekly single doses of recombinant human Epo (rHuEpo) either alpha or beta, instead o

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… Whether the measurement of endogenous Epo levels is a useful tool to predict the response in patients with solid cancer or lymphoproliferative disorders is questionable ( Littlewood et al 2003 ; Ludwig et al 2004 ). … Recently Littlewood and colleagues (2006) confirmed the efficacy of darbepoetin in ameliorating fatigue and QoL in patients with lymphoproliferative disorders, in a multicenter randomized trial. …

Case report: Therapeutic use of bortezomib in a patient with Schnitzler syndrome.

Schnitzler syndrome (SchS) is a rare acquired systemic autoinflammatory disorder, characterized by chronic urticarial rash and immunoglobulin M (IgM) monoclonal gammopathy. Anti-interleukin-1 (IL-1) therapies have been shown to be more effective in managing the clinical symptoms of SchS compared to anti-IL-6 therapies. In this case report, we present a male patient with urticarial rash, fever, and arthralgia. Laboratory tests identified the presence of IgMκ monoclonal protein, and the absence of IL-1β in serum. Whole exome sequencing (WES) did not reveal any pathological variants associated wi

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… In addition, to distinguish SchS from lymphoproliferative disorders, which often feature monoclonal gammopathy ( 2 ), MYD88 mutations were sought, predicting the development of WM ( 18 ), and the results were negative. … In certain B cell malignancies and lymphoproliferative disorders, the MYD88 L265P mutation leads to constitutive activation of the NF-κB pathway, resulting in uncontrolled B cell proliferation and survival ( 37 , 38 ). …

Bone Marrow Findings in Patients With Renal Disease: Experience of a Single Tertiary Care Center in Bihar.

Background This study aimed to characterize bone marrow findings in patients with chronic kidney disease (CKD) in Bihar, India, and to identify correlations between these findings and patients' clinical presentations and hematological parameters. Specifically, this study aimed to (1) document the prevalence and patterns of bone marrow abnormalities in CKD patients, (2) analyze associations between bone marrow findings and CKD stages, and (3) investigate relationships between bone marrow changes and hematological parameters, including anemia severity and morphology. Methodology A retrospective,

Schnitzler-Like Syndrome Presenting With IgG Kappa Monoclonal Gammopathy: A Case Report and Review of Diagnostic and Therapeutic Challenges.

Schnitzler syndrome (SS) is a rare autoinflammatory disorder characterized by a constellation of symptoms that include chronic urticarial rash, recurrent fever, arthralgias/arthritis, and monoclonal gammopathy, typically involving immunoglobulin M (IgM). However, cases with overlapping clinical features but lacking specific criteria fall under the umbrella of Schnitzler-like syndromes. This case report describes a 40-year-old male with Schnitzer-like syndrome and underscores the diagnostic complexities and therapeutic challenges of Schnitzer-like syndrome with IgG kappa monoclonal gammopathy,

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… Fine-needle aspiration cytology (FNAC) of the left axillary lymph node was negative for malignancy and lymphoproliferative disorders. Bone marrow biopsy and aspiration showed a small cluster of kappa monotypic plasma cell population involving 2-3% of the bone marrow cells. … The generalized lymphadenopathy and bilateral renal lesions observed in our patient warranted a thorough evaluation to rule out lymphoproliferative disorders and other malignancies. Fine-needle aspiration cytology and a bone marrow biopsy were critical in this assessment. …

Severe infections and infection-related mortality in a large series of haploidentical hematopoietic stem cell transplantation with post-transplant cyclophosphamide.

Severe infections and their attributable mortality are major complications in recipients of allogeneic hematopoietic stem cell transplantation (alloSCT). We herein report 236 adult patients who received haploSCT with PTCy. The median follow-up for survivors was 37 months. The overall incidence of bloodstream infections by gram-positive and gram-negative bacteria at 37 months was 51% and 46%, respectively. The incidence of cytomegalovirus infection was 69%, while Epstein Barr virus infections occurred in 10% of patients and hemorrhagic cystitis in 35% of cases. Invasive fungal infections occurr

Positive Anti-nuclear Antibody in Patients with Polyclonal Hypergammaglobulinemia Suggests the Presence of Multiple Distinct Comorbidities.

Objective Polyclonal hypergammaglobulinemia (PHGG) is a classic problem in internal medicine; however, its conditions and diagnostic procedures have not been well studied. We therefore conducted a retrospective study to characterize the PHGG disease spectrum. Methods We included all patients who underwent serum protein electrophoresis (SPEP) at a hematology tertiary referral center during a five-year period. For these patients, globulin clonality was determined and clinical data were extracted from the records. Results Out of 209 consecutive cases of hypergammaglobulinemia demonstrated by SPEP

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… T-cell lymphoma | 1 | | | Monoclonal gammopathy of undetermined significance | 1 (1)* | Undiagnosed | 5 | | | Polymorphic lymphoproliferative disorders arising in immune deficiency/dysregulation, methotrexate associated | 1 (1)* | | | | | | Clonal cytopenia of undetermined significance | … disorders arising in immune deficiency/dysregulation, posttransplant associated | 1 | | | | | | Mantle cell lymphoma | 1 | | | | | | Autoimmune pancytopenia, post-autologous HSCT | 1 | | | | | Autoimmune and autoinflammatory disorder (10 diseases) | | | | | | | Sjögren’s syndrome …

Managing anemia in lymphoma and multiple myeloma.

Anemia is common in cancer, and lymphoproliferative disease is no exception. Erythropoiesis-stimulating agents (ESA) have been used for renal anemia since 1986, and considerably later in cancer anemia. The first studies were published around 1993, but the use of ESA did not become common in cancer anemia until in the late 1990s. Cancer anemia is still under-treated. This review gives an overview of the use of ESA in hematologic malignancies. A background is given about this treatment in the cancer field generally. The pathophysiology of cancer anemia is described with special emphasis on the d

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… In general, anemia is common in lymphoproliferative disorders (lymphoma and multiple myeloma). Kyle (1975) reported Hb < 12 g/dl in 73% of newly diagnosed myeloma patients and Moullet and colleagues (1998) found Hb < 11 g/dl in 32% of newly diagnosed non-Hodgkin’s lymphoma patients. … disorders by recombinant human erythropoietin: maintenance is necessary to sustain response Leuk Lymphoma 2000 40 1–2 141 7 11426615 10.3109/10428190009054891 Steensma DP Molina R Sloan JA Phase III study of two different dosing schedules of erythropoietin in anemic patients with cancer J Clin Oncol …

Beneath the surface in autoimmune hemolytic anemia: pathogenetic networks, therapeutic advancements and open questions.

In recent years, the pathophysiologic framework of autoimmune hemolytic anemias (AIHAs) has evolved considerably, extending beyond the simplistic paradigm of antibody-mediated red blood cell (RBC) destruction, which is now recognized as a downstream consequence of a broader immune dysregulation. AIHA is fundamentally orchestrated by a complex interplay between innate and adaptive immune components, including autoreactive B and T lymphocytes, macrophages, and the reticuloendothelial system. Central to disease pathogenesis are two interrelated mechanisms: clonal B-cell expansion with autoantibod

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… Although overt lymphoid malignancy is typically absent, most CAD patients harbor a monoclonal IgMκ B-cell population, indicative of an underlying lymphoproliferative disorder ( Figure 1 ). … Signs such as weight loss, lymphadenopathy, hepatosplenomegaly, lymphocytosis, or cytopenias should prompt investigation for lymphoproliferative disorders. …

Diagnostic challenges of systemic juvenile idiopathic arthritis with aberrant M-protein expression: a case report.

BACKGROUND: Systemic juvenile idiopathic arthritis (sJIA), a severe autoinflammatory subtype of JIA, presents diagnostic challenges due to non-specific clinical features and the absence of definitive biomarkers. Current ILAR classification criteria emphasize exclusion of mimicking conditions, yet misdiagnosis rates persist (20%-35%), particularly in early disease stages. CASE PRESENTATION: A 15-year-old female presented with persistent high-grade fever, anemia (Hb: 84→64→73→91 g/L), thrombocytosis (PLT 592→1,044 × 10⁹/L), and iron overload. Initial evaluations excluded infections (CMV-positive

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… This hematologic abnormality serves as a biomarker for lymphoproliferative disorders including multiple myeloma (MM), immunoglobulin light-chain (AL) amyloidosis, and related malignancies. … While monoclonal gammopathy typically prompts consideration of lymphoproliferative disorders [ 8 ], comprehensive evaluation excluded malignancy: bone marrow aspiration revealed 11.5% plasma cells with reactive morphology; immunophenotyping confirmed no evidence of clonal plasma cells (CD56-/CD19+); …