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DNA Damaging Drugs

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… Prophylaxis against Pneumocystis carinii pneumonia is required for all newly diagnosed glioblastoma multiforme patients receiving concomitant temozolomide and radio-therapy for the 42 day regimen. Temozolomide is Pregnancy Category D. …

Overview of infectious complications among CAR T- cell therapy recipients.

Chimeric antigen receptor-modified T cell (CAR T-cell) therapy has revolutionized the management of hematological malignancies. In addition to impressive malignancy-related outcomes, CAR T-cell therapy has significant toxicity-related adverse events, including cytokine release syndrome (CRS), immune effector cell associated neurotoxicity syndrome (ICANS), immune effector cell-associated hematotoxicity (ICAHT), and opportunistic infections. Different CAR T-cell targets have different epidemiology and risk factors for infection, and these targets result in different long-term immunodeficiency st

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… Pneumocystis jirovecii pneumonia and its risk factors PJP has been reported in patients beyond 3 months after CD19-directed CAR T-cell infusion and typically occurs after PJP prophylaxis has been discontinued ( 12 , 35 ) or when prescribed prophylaxis has not been appropriately taken ( 35 ). … Incidence and outcomes of pneumocystis pneumonia following chimeric antigen receptor T-cell therapy: A real-world analysis . Blood . ( 2023 ) 142 : 6897–7 . doi: 10.1182/blood-2023-190785 62 Kampouri E Ibrahimi SS Xie H Wong ER Hecht JB Sekhon MK . …

Complication from Desensitization

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… Rituximab has been associated with serious infections, including Pneumocystis jirovecii pneumonia (PJP) and the reactivation of hepatitis B virus (HBV) and tuberculosis (TB). … One patient death was due to sepsis, while the other three patient deaths were attributable to Pneumocystis jirovecii pneumonia (PcP). …

Spectrum of Movement Disorders in Hematological Malignancies: A Comprehensive Systematic Review of Clinical Phenotypes, Mechanisms, and Outcomes.

BACKGROUND: Movement disorders associated with hematologic malignancies remain incompletely defined. This review synthesized published articles to clarify clinical patterns, mechanisms, and outcomes across hematologic malignancies. METHODS: A PRISMA-compliant systematic search of PubMed, Embase, Scopus, and Google Scholar was conducted to identify reports describing movement disorders associated with hematologic malignancies. Eligible reports were screened according to predefined criteria, and data were extracted on demographics, hematologic diagnosis, central nervous system (CNS) involvement

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… – Magnetic Resonance Imaging; NAD – No Abnormality Detected; NHL – Non-Hodgkin Lymphoma; NK/T – Natural Killer/T-Cell; NOS – Not Otherwise Specified; OMA – Opsoclonus–Myoclonus–Ataxia; PCD – Paraneoplastic Cerebellar Degeneration; PCR – Polymerase Chain Reaction; PCNSL – Primary CNS Lymphoma; PCP – Pneumocystis …

Impact of germline predisposition genes to hematologic malignancies on transplant outcomes and donor selection.

INTRODUCTION: Germline predisposition gene mutations may influence outcomes in patients undergoing hematopoietic stem cell transplantation (HSCT). METHODS: This retrospective study of 558 patients undergoing HSCT (allo-HSCT in 557 cases, auto-HSCT in 1 case) evaluated the impact of germline predisposition gene mutations on outcomes. RESULTS: Enrichment of HAVCR2 mutations in B-NHL and UNC13D mutations in MDS was associated with poorer prognosis. While homozygous mutation carriers (7.5%) overall did not have reduced survival, their outcomes were significantly better with unrelated versus rela

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… Antiviral prophylaxis included acyclovir for herpesvirus infections and trimethoprim−sulfamethoxazole for Pneumocystis jirovecii pneumonia (PCP). …

Перспективы Талкетамаба и его полезности в лечении множественной миеломы: безопасность, эффективность и место в терапии.

Несмотря на недавние достижения, большинство пациентов с множественной миэломой в конечном итоге развивают сопротивление имеющимся методам лечения, подчеркивая необходимость новых терапевтических стратегий. G Класс рецептора с протеиновыми соединениями C 5 Член D (GPRC5D) стал жизнеспособной новой терапевтической целью для клеток миэломы, которая привела к клиническому развитию талькетамаба, первого GPRC5D-directed bi специфичный Т-активист (TCE). В августе Талкетамаб получил ускоренное утверждение 2023 Управление по контролю за продуктами питания и лекарствами. Помимо ожидаемой краткосрочной

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… This recommendation is based on emerging data from several groups demonstrating significant reduction in infection incidence with primary IVIg prophylaxis. 50 , 51 In addition, standard antiviral and pneumocystis prophylactic medications are recommended in all patients. …

Управление неблагоприятными событиями, связанными с комбинациями на основе помалидомида у пациентов с повторной/редактируемой множественной миеломой.

Многоагентные режимы с иммуномодуляционными (IMID) агентами, такими, как палидомид, линалидомид и помалидомид, стали предпочтительным стандартом лечения пациентов с множественной миеломой (MM), что позволило улучшить показатели выживания. В настоящее время существуют three Агенты IMID, утвержденные для лечения MM: талидомид, линалидомид и помалидомид. Леналидомид обычно используется для лечения пациентов с недавно поставленным диагнозом MM, а также для лечения после пересадки стволовых клеток или после рецидива заболевания. Помалидомид, в центре внимания которого находится данный обзор, утверж

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… It is recommended that patients receiving such triplet regimens are given antimicrobial prophylaxis including an antiviral drug such as acyclovir or valacyclovir, as well as an agent to prevent Pneumocystis carinii pneumonia, such as sulfamethoxazole/trimethoprim or dapsone [ 29 ]. …

Какие факторы связаны с неблагоприятным прогнозом у нескольких пациентов с миеломой после операции?

Для изучения прогнозов пациентов с множественной миеломой (ММ) после операции, анализа факторов риска, ведущих к неблагоприятным результатам послеоперационного лечения, и создания номограммы. МЕТОДЫ: Клинические данные 154 пациентов с MM, которые прошли операцию в нашем учреждении между 2007 и 2019 был ретроспективно проанализирован. Оценка и сопоставление уровней боли, качества жизни и функционального состояния пациентов до и после операции (Р) < 0.05) были признаны статистически значимыми. Кривая выживания Каплана-Мейера использовалась для оценки средней продолжительности выживаемости. Отриц

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… Nomograms for death from Pneumocystis Jirovecii Pneumonia in HIV-Uninfected and HIV-Infected patients. Int J Gen Med. 2022;15:3055–67. doi: 10.2147/IJGM.S349786. 54. Shander A. Preoperative anemia and its management. …

Hemophagocytic Lymphohistiocytosis (HLH) in Patients with Tick-Borne Illness: A Scoping Review of 98 Cases.

Hemophagocytic lymphohistiocytosis (HLH) secondary to tick-borne infections is a rare but potentially life-threatening syndrome. We performed a scoping review according to PRISMA guidelines to systematically analyze the existing literature on the topic. A total of 98 patients were included, with a mean age of 43.7 years, of which 64% were men. Most cases, 31%, were reported from the USA. Immunosuppression was present in 21.4%, with the most common cause being previous solid organ transplantation. Constitutional symptoms were the most common, observed in 83.7% of the patients, while fever was r

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… Infectious causes of secondary HLH are commonly viral—Epstein–Barr virus (EBV), human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV)—or bacterial— Mycobacterium tuberculosis and Pneumocystis jiroveci . …

РНК-Сек, базирующаяся на RNA-Seq, обнаруживает воспаление олигодендроглиевой линии в аутоиммунном энцефаломиелите.

Клетки олигодендроглиевой линии (ООК) имеют решающее значение для нейронных функций поддержки, включая минелинирование и воспоминание. Появляющиеся данные свидетельствуют об их активной роли в нейроинфламмации, особенно в таких условиях, как Множественный склероз (MS). В рамках этого исследования изучается возбудительный транслатом ОРЦ в начале экспериментального аутоиммунного энцефаломиелита (EAE), который представляет собой установленную модель НР. Использование последовательности РНК на основе RiboTag в генетически модифицированных системах Olig2-Cre Мыши RiboTag, мы опознали 1,556 Регулиру

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… Type I IFNs Act upon Hematopoietic Progenitors To Protect and Maintain Hematopoiesis during Pneumocystis Lung Infection in Mice . Journal of immunology . 2015 ; 195 ( 11 ): 5347 – 57 . doi: 10.4049/jimmunol.1501553 . PMC4655130 26519535 28. …

How I treat cytopenias after CAR T-cell therapy.

Increasing use of chimeric antigen receptor T-cell therapy (CAR-T) has unveiled diverse toxicities warranting specific recognition and management. Cytopenias occurring after CAR-T infusion invariably manifest early (90 days). Variable etiologies of these cytopenias, some of which remain incompletely understood, create clinical conundrums and uncertainties about optimal management strategies. These cytopenias may cause additional sequelae, decreased quality of life, and increased resource use. Early cytopenias are typically attributed to lymphodepletion chemotherapy, however, infections and hyp

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… Although Pneumocystis jirovecii pneumonia (PJP) can present early in severely immunocompromised patients, we typically initiate anti-PJP prophylaxis at day 30 and advocate for a CD4 + count driven approach to its discontinuation when CD4 + T-cell counts are >200, which can take from 1 to 2 years or longer …

Proceedings of the CIMAGO Congress - Environment, Genetics and Oncobiology in the 21st Century - Challenges and Opportunities.

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Infectious Diseases

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Identification of Fatty Acid Metabolism Disorder-Related Gene Signature in Septic Cardiomyopathy.

Evans syndrome (ES) is a rare condition, defined as the presence of 2 autoimmune cytopenias, most frequently autoimmune hemolytic anemia and immune thrombocytopenia (ITP) and rarely autoimmune neutropenia. ES can be classified as primary or secondary to various conditions, including lymphoproliferative disorders, other systemic autoimmune diseases, and primary immunodeficiencies, particularly in children. In adult ES, little is known about clinical features, disease associations, and outcomes. In this retrospective international study, we analyzed 116 adult patients followed at 13 European ter

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… included bacterial pneumonia (n = 13), sepsis with bacteremia (n = 8, including Salmonella , n = 1; Pseudomonas aeruginosa , n = 1; Staphylococcus aureus , n = 3; and Streptococcus pneumoniae , n = 1), urinary tract infection (n = 4), abscess (n = 3, including cutaneous, n = 1; and perianal, n = 2), Pneumocystis …

Daratumumab combined with anti-CD20 therapy in pediatric and adult refractory idiopathic nephrotic syndrome: single-center experience.

BACKGROUND: Refractory idiopathic nephrotic syndrome (INS), in native kidneys or post-transplant, represents a major therapeutic challenge due to its high risk of progressing to end-stage renal disease. Patients often resist anti-CD20 therapy and require prolonged apheresis. Daratumumab, an anti-CD38 monoclonal antibody targeting plasma cells, has demonstrated promising efficacy in case reports when combined with anti-CD20, but evidence remains limited. METHODS: We conducted a single-center retrospective study including four patients (two pediatric, two adult, including one renal transplant)

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… Similarly, Delbet et al. ( 34 ) described a pediatric case of immediate post-transplant recurrence resistant to immunoadsorption, achieving durable complete remission after obinutuzumab–daratumumab therapy, despite Pneumocystis jirovecii pneumonia and persistent hypogammaglobulinemia. …

Stem Cell Mobilization with Ixazomib and G-CSF in Patients with Multiple Myeloma.

(1) Background: High-dose chemotherapy (HDCT) followed by autologous stem cell transplantation (ASCT) is the standard consolidation strategy for patients with newly diagnosed multiple myeloma (MM) and for a subset of patients with relapsed/refractory disease. For stem cell mobilization, G-CSF alone or in combination with chemotherapy mobilizing agents and/or plerixafor are commonly used. Ixazomib is an oral proteasome inhibitor with less neurotoxic potential, which previously showed the ability to mobilize stem cells in preclinical studies. (2) Methods: Prospective single-center phase 1 study

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… Sulfamethoxazole-trimethoprim was given as prophylaxis for pneumocystis jiroveci infection from the start of HDCT until 3 weeks after ASCT. …

Periodontal inflamed surface area in oral cavity associated with febrile neutropenia in patients with hematologic malignancy undergoing chemotherapy.

Febrile neutropenia (FN) is an infectious complication that develops during chemotherapy. Although the oral cavity can be an important infection route, it is unknown whether the oral environment is associated with FN. The present study examined the relationship between the oral environment using periodontal inflamed surface area (PISA), a new periodontal disease parameter, and FN in hematologic cancer patients undergoing chemotherapy. In this retrospective cohort study, 157 patients were divided into FN onset during chemotherapy (n = 75) and the FN negative groups (n = 82). The associations of

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… Based on these factors, prophylactic antibiotics other than trimethoprim-sulfamethoxazole as prophylaxis against pneumocystis pneumonia are not given to patients undergoing chemotherapy at our hospital. …

Incidence, Risk Factors, and Outcomes of Idiopathic Pneumonia Syndrome after Allogeneic Hematopoietic Cell Transplantation.

Our current knowledge of idiopathic pneumonia syndrome (IPS) predates improved specificity in the diagnosis of IPS and advances in hematopoietic cell transplantation (HCT) and critical care practices. In this study, we describe and update the incidence, risk factors, and outcomes of IPS. We performed a retrospective cohort study of all adults who underwent allogeneic HCT at the Fred Hutchinson Cancer Research Center between 2006 and 2013 (n = 1829). IPS was defined using the National Heart, Lung, and Blood Institute consensus definition: multilobar airspace opacities on chest imaging, absence

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… performed, were submitted for cytologic and pathologic analyses with conventional staining and culture for bacteria, fungi, mycobacteria, nocardia, and viruses; shell viral centrifugation viral cultures for CMV and respiratory syncytial virus (RSV); and direct fluorescent antibody testing for Legionella , Pneumocystis …

New Treatment Options in Advanced Stage Follicular Lymphoma.

Follicular lymphoma is one of the most common non-Hodgkin's lymphomas with an expected survival of more than 20 years for the majority of patients. This impressive outcome has been achieved with the introduction of immunochemotherapy, as first line treatment with remissions lasting over 8 years, followed by other treatment options at first or subsequent relapse. However, certain groups of patients still have a poor prognosis. In recent years the efficacy of chemotherapy regimens has been augmented by new compounds selectively targeting the cell surface, intracellular pathways, and/or the micro

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… The most common adverse events reported were fatigue, diarrhea, nausea, rash, chills, and pyrexia, whereas the most frequent grade 3 and grade 4 adverse events were diarrhea, pneumonitis, and elevation of liver enzymes. 48 Reports of deaths because of opportunistic infections with Pneumocystis jirovecii …

A phase I/II trial of hydroxychloroquine in conjunction with radiation therapy and concurrent and adjuvant temozolomide in patients with newly diagnosed glioblastoma multiforme.

Preclinical studies indicate autophagy inhibition with hydroxychloroquine (HCQ) can augment the efficacy of DNA-damaging therapy. The primary objective of this trial was to determine the maximum tolerated dose (MTD) and efficacy of HCQ in combination with radiation therapy (RT) and temozolomide (TMZ) for newly diagnosed glioblastoma (GB). A 3 + 3 phase I trial design followed by a noncomparative phase II study was conducted in GB patients after initial resection. Patients received HCQ (200 to 800 mg oral daily) with RT and concurrent and adjuvant TMZ. Quantitative electron microscopy and immun

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… Prophylaxis for pneumocystis jirovecii was mandatory during RT. Daily oral TMZ (75 mg/m 2 ; Merck) was administered 1 h before each RT session or in the AM on ds without RT. …