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Integrative Hematology: State of the Art.

Blood cancers are a group of diseases with thus far frequently poor prognosis. Although many new drugs, including target therapies, have been developed in recent years, there is still a need to expand our therapeutic armamentarium to better deal with these diseases. Integrative hematology was conceived as a discipline that enriches the patient's therapeutic possibilities with the use of supplements, vitamins and a nutritional approach aiming at improving the response to therapies and the clinical outcome. We will analyze the substances that have proved most useful in preclinical and clinical s

Cold versus warm autoimmune hemolytic anemia in diffuse large B cell lymphoma: pathogenic and therapeutic implications: a case series.

BACKGROUND: Autoimmune hemolytic anemia-associated diffuse large B cell lymphoma is rare, with distinct pathogenic mechanisms and therapeutic responses in cold agglutinin syndrome (CAS) and warm autoimmune hemolytic anemia subtypes poorly characterized. This report highlights two novel cases demonstrating subtype-specific molecular drivers and treatment outcomes, underscoring the necessity for precision management. CASE PRESENTATION: Two patients presented with autoimmune hemolytic anemia: a 29-year-old Han male with cold agglutinin syndrome and a 37-year-old Han female with warm autoimmune h

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… Approximately 10%–15% of AIHA cases are secondary to lymphoproliferative disorders, clonal tumor cells secrete pathogenic antibodies, which directly bind to erythrocyte antigens and trigger hemolysis [ 8 ]; second, the tumor microenvironment leads to immune dysregulation, activating polyclonal B cells …

The Use of Bruton Tyrosine Kinase Inhibitors in Waldenström's Macroglobulinemia.

Waldenström's macroglobulinemia (WM) remains an incurable malignancy. However, a number of treatment options exist for patients with WM, including alkylating agents, anti-CD20 monoclonal antibodies, and small molecule inhibitors such as proteasome inhibitors and Bruton tyrosine kinase inhibitors (BTKi). The focus of this review is to highlight the role of BTKi in the management of WM. The first BTKi to receive US Food and Drug Administration approval for WM was ibrutinib. Ibrutinib has been extensively studied in both treatment-naïve WM patients and in those with relapsed/refractory disease. T

Use of Nutraceuticals in Elderly to Fight Inflammation and Immuno-Senescence: A Randomized Case-Control Study.

Elderly people are at high risk of suffering from infection and being affected by severe forms of disease because their immunosystem suffers from aging. The alteration of normal immune functions causes the increase of pro-inflammatory cytokines which can expose these people to increased risk of developing pathologies as cancer, diabetes, and/or arthritis. Some supplements could be helpful for restoring normal immune functions. We conducted a case-control study to evaluate the efficacy of a supplement containing Sambucus nigra, zinc, tyndallized Lactobacillus acidophilus (HA122), arabinogalacta

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… High concentrations of pro-inflammatory cytokines increase the risk of developing cardiovascular diseases [ 25 ], cartilage degeneration [ 26 ], lymphoproliferative disorders, multiple myeloma, osteoporosis, and Alzheimer’s disease [ 27 ]. These conditions might be prevented reducing CRP and IL-6. …

Hematopoietic Tumors

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Comprehensive Diagnosis and Management of POEMS Syndrome.

Polyneuropathy Organomegaly, Endocrinopathy, Monoclonal protein and Skin changes syndrome is a rare multisystem condition with a range of manifestations which are often overlooked as trivial comorbidities, until their whole triggers the possibility of the diagnosis. The diagnosis is typically delayed by 12-16 months, by which time patients can be severely disabled. There are no established consensus guidelines. We provide clinicians a comprehensive blueprint for managing POEMS from diagnostic suspicion through the work-up, selection of therapy, follow-up, and treatment of relapse based on publ

Insights into the Impact of Hesitancy on Cancer Care and COVID-19.

World Health Organization findings indicate that the COVID-19 pandemic adversely affected cancer diagnosis and management. The COVID-19 pandemic disrupted the optimal management of outpatient appointments, scheduled treatments, and hospitalizations for cancer patients because of hesitancy among patients and health-care providers. Travel restrictions and other factors likely affected medical, surgical, and radiation treatments during the COVID-19 pandemic. Cancer patients were more likely to be affected by severe illness and complications if they contracted COVID-19. A compromised immune system

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… Patients with hematologic malignancies, especially lymphoproliferative disorders, have the lowest seroconversion rates. Even after complete immunization, patients with cancer are more likely to get COVID-19 [ 33 ]. …

Compatibility of Biosimilar Filgrastim with Cytotoxic Chemotherapy during the Treatment of Malignant Diseases (VENICE): A Prospective, Multicenter, Non-Interventional, Longitudinal Study.

IntroductionFebrile neutropenia (FN) is a serious and frequent complication of cytotoxic chemotherapy. Biosimilar filgrastim (Nivestim™, Hospira Inc, A Pfizer Company, Lake Forest, IL, USA) is a granulocyte-colony stimulating factor licensed for the treatment of neutropenia and FN induced by myelosuppressive chemotherapy. The primary goal of this VENICE study (ClinicalTrials.gov identifier, NCT01627990) was to observe the tolerability, safety and efficacy of biosimilar filgrastim in patients receiving cancer chemotherapy.MethodsThis was a prospective, multicenter, non-interventional, longitudi

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… Aapro MS Bohlius J Cameron DA 2010 update of EORTC guidelines for the use of granulocyte-colony stimulating factor to reduce the incidence of chemotherapy-induced febrile neutropenia in adult patients with lymphoproliferative disorders and solid tumours Eur J Cancer 2011 47 8 32 10.1016/j.ejca.2010.10.013 …

Orchestrating an immune response against cancer with engineered immune cells expressing αβTCRs, CARs, and innate immune receptors: an immunological and regulatory challenge.

Over half a century ago, the first allogeneic stem cell transplantation (allo-SCT) initiated cellular immunotherapy. For several decades, little progress was made, and toxicity of allo-SCT remained a major challenge. However, recent breakthroughs have opened new avenues to further develop this modality and to provide less toxic and equally efficient interventions for patients suffering from hematological or solid malignancies. Current novel cellular immune interventions include ex vivo expansion and adoptive transfer of tumor-infiltrating immune cells or administration of drugs which antagoniz

Structure, function, and pathology of PHF23.

Plant Homeodomain Finger Protein 23 (PHF23) is a member of the Plant Homeodomain (PHD) finger protein family and has been extensively reported since its discovery. Numerous studies have demonstrated that PHF23 plays a crucial role in various biological processes, such as gene expression regulation, autophagy, and tumorigenesis. Additionally, PHF23 is associated with various diseases including various malignancies, osteoarthritis, and tuberculosis, all of which currently lack effective and targeted treatment options. Therefore, this review systematically summarizes the existing literature on PH

Chimeric Antigen Receptor T-cell Therapy in Hematologic Malignancies and Patient-reported Outcomes: A Scoping Review.

The inclusion of patient-reported outcome (PRO) measures in chimeric antigen receptor (CAR) T-cell therapy research is critical for understanding the impact of this novel approach from a unique patient standpoint. We performed a scoping review to map the available literature on the use of PRO measures in CAR T-cell therapy studies of patients with hematologic malignancies published between January 2015 and July 2022. Fourteen studies were identified, of which 7 (50%) were investigational early-phase trials, 6 (42.9%) were observational studies, and 1 (7.1%) was a pilot study. The EQ-5D and the

Pharmacokinetics of CAR T cells in multiple myeloma - the good, the bad, and the ugly.

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Thrombotic risk in hepatitis C: Interplay between hepatic dysfunction, viral-driven inflammation, and cardiovascular consequences.

Hepatitis C virus (HCV) infection, traditionally regarded as a hepatotropic disease, is increasingly recognized as a systemic condition with significant thrombotic implications. Chronic HCV induces a persistent proinflammatory and prothrombotic state that substantially elevates the risk of both venous and arterial events. Mechanistically, HCV drives endothelial dysfunction, enhances platelet activation, disrupts coagulation and fibrinolytic balance, and promotes immune-mediated vascular injury through cryoglobulinemia and chronic systemic inflammation. Clinical manifestations range from portal

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… This can cause the development of lymphoproliferative disorders, such as cryoglobulinemic vasculitis, non-Hodgkin lymphoma, and monoclonal gammopathies (Waldenstrom’s macroglobulinemia, multiple myeloma, monoclonal gammopathy of undetermined significance)[ 25 , 26 ]. …

Автономная гематопоэтическая трансплантация уменьшает воспаление мозга и аксоглиальные повреждения биомаркеров при множественном склерозе.

Аутологическая трансплантация стволовых клеток (AHSCT) может вызвать долгосрочную иммунную терпимость и остроту болезней у пациентов с сильным множественным склерозом (MS), однако основные механизмы не вполне понятны. Мы гипотезуем, что AHSCT вызовет постоянное снижение в провокационных цитокинах, хемокинах и аксолиальных повреждениях биомаркеров в сыворотке и CSF.МЕТОДЫ: Продольная сыворотка и пробы CSF были получены из 24 :: участники процесса по делу HALT-MS с сильными MS, проходящими через AHSCT ( < < AHSCT > > )NCT00288626), с сывороткой, собираемой в 9 период времени с момент

Survival in adult patients with chronic primary and secondary immune thrombocytopenia: A population-based study.

BACKGROUND: Few studies have investigated long-term survival in patients with primary immune thrombocytopenia (pITP). Further, changes in prognosis over the past decades and prognosis of secondary immune thrombocytopenia (sITP) are largely unstudied. Our objectives were to study comorbidity-adjusted prognostic changes and causes of death in chronic pITP and sITP patients. STUDY DESIGN/METHODS: Using nationwide Danish health registries 1980-2016, we identified 1762 patients with chronic pITP (median age 58 (IQR, 37-73) years) and 128 with chronic sITP (median age 59 (IQR, 40-73) years). Patien

POEMS SYNDROME: an Update.

POEMS syndrome is a rare, chronic and disabling condition. The causes of this condition remain unknown; however, chronic overproduction of proinflammatory cytokines appears to be a major contributor. Early diagnosis is essential to start treatment before the clinical state of the patient becomes compromised. A complete evaluation of the disease at its onset is critical to the treatment decision. In localized disease, curative doses of radiation (50 Gy) is the recommended therapy. On the other hand, patients with disseminated disease should be given systemic therapy. Treatment-related morbidity

A severe acute respiratory coronavirus virus 2 (SARS-CoV-2) nosocomial cluster with inter-facility spread: Lessons learned.

BackgroundDespite infection control guidance, sporadic nosocomial coronavirus disease 2019 (COVID-19) outbreaks occur. We describe a complex severe acute respiratory coronavirus virus 2 (SARS-CoV-2) cluster with interfacility spread during the SARS-CoV-2 δ (delta) pandemic surge in the Midwest.SettingThis study was conducted in (1) a hematology-oncology ward in a regional academic medical center and (2) a geographically distant acute rehabilitation hospital.MethodsWe conducted contact tracing for each COVID-19 case to identify healthcare exposures within 14 days prior to diagnosis. Liberal tes

Large-scale genome-wide association studies reveal the genetic causal etiology between ankylosing spondylitis and risk of leukemia and lymphocytic malignancies.

BACKGROUND: Evidence from multiple observational studies suggests that ankylosing spondylitis (AS) is associated with leukemia and lymphocytic malignancies. However, the obtained results are inconsistent, and the causal relationship still needs to be determined. In this context, we utilized two-sample Mendelian randomization (MR) to investigate potential causal associations between AS and leukemia and lymphocytic malignancies. METHODS: The analysis was conducted through published genome-wide association studies (GWAS). We obtained genetic data on AS as the exposure and leukemia, including lym

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… AS may increase the risk for the development of malignancies, predominantly lymphoproliferative disorders ( 36 ), and sustained inflammatory activity seems to be the primary risk factor for malignancies in AS. …

"Friends and foes" of multiple myeloma measurable/minimal residual disease evaluation by next generation flow.

Next Generation Flow (NGF) represents a gold standard for the evaluation of Minimal Residual Disease (MRD) in Multiple Myeloma (MM) patients at any stage of treatment. Although the assessment of MRD is still not universally employed in clinical practice, numerous studies have demonstrated the strength of MRD as a reliable predictor of long-term outcome, and its potential to supersede the prognostic value of CR. The possibility to acquire millions of events, in combination with the use of standard reagents and a good expertise in the analysis of rare populations, led to high chance of success a

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… These databases are at disposition for the analysis of Acute Leukemias, Chronic Lymphoproliferative Disorders, Primary Immunodeficiencies and Plasma Cells Dyscrasias, and allows for an automated analysis of the complete BM sample, considering both normal and pathologic populations; in this way, the software …

Over- and under-prophylaxis for chemotherapy-induced (febrile) neutropenia relative to evidence-based guidelines is associated with differences in outcomes: findings from the MONITOR-GCSF study.

PurposeIn the MONITOR-GCSF study of chemotherapy-induced (febrile) neutropenia with biosimilar filgrastim, 56.6% of patients were prophylacted according to amended EORTC guidelines, but 17.4% were prophylacted below and 26.0% above guideline recommendations.MethodsMONITOR-GCSF is a prospective, observational study of 1447 evaluable patients from 140 cancers centers in 12 European countries treated with myelosuppressive chemotherapy for up to 6 cycles receiving biosimilar GCSF prophylaxis. Patients were classified as under-, correctly-, or over-prophylacted with GCSF relative to guideline recom

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… Aapro MS, Bohlius J, Cameron DA, et al. 2010 update of EORTC guidelines for the use of granulocyte- colony stimulating factor to reduce the incidence of chemotherapy-induced febrile neutropenia in adult patients with lymphoproliferative disorders and solid tumours. …