BACKGROUND AND OBJECTIVE: Epidermal growth factor receptor (EGFR) mutations are a common driver of oncogenesis in non-small cell lung cancer (NSCLC). Lazertinib, a third-generation EGFR tyrosine kinase inhibitor (TKI), h...BACKGROUND AND OBJECTIVE: Epidermal growth factor receptor (EGFR) mutations are a common driver of oncogenesis in non-small cell lung cancer (NSCLC). Lazertinib, a third-generation EGFR tyrosine kinase inhibitor (TKI), has shown promise as a first-line treatment for patients with locally advanced or metastatic EGFR-mutated NSCLC. However, the comparative efficacy and safety of lazertinib in this setting have not been thoroughly investigated. This study aims to evaluate the efficacy and safety of lazertinib for EGFR-mutated locally advanced NSCLC. METHOD: This study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We performed a search of PubMed, ProQuest, EBSCO, and ScienceDirect to identify eligible studies based on the PICOTS-SD criteria. The meta-analysis of overall survival (OS), progression-free survival (PFS), and adverse effects was performed using RevMan 5.4 software. RESULTS: This review included a total of three randomized controlled trials. The pooled analysis revealed significant differences in PFS, with a hazard ratio (HR) of 0.44 (95% confidence interval [CI]: 0.37-0.53). However, OS showed no significant differences, with an HR of 0.82 (95% CI: 0.64-1.06). Paresthesia occurred significantly more frequently in the lazertinib group (odds ratio [OR]: 11.30; 95% CI: 7.30-17.49). In contrast, the incidence of diarrhea and increases in Alanine Transaminase (ALT) and Aspartate Aminotransferase (AST) levels were significantly higher in the gefitinib group, with ORs of 0.52 (95% CI: 0.39-0.70), 0.35 (95% CI: 0.25-0.50), and 0.32 (95% CI: 0.22-0.47), respectively. CONCLUSION: Lazertinib demonstrated a greater therapeutic benefit for patients with EGFR-mutated advanced NSCLC compared to first-generation EGFR-TKIs. Further research is needed to validate these findings.
Valencia DM, Builes N, Franco AA
… +9 more, Trujillo A, Niño Quiroga LI, Chaparro M, Escobar-González AF, Manzi E, Muñoz-Caluce D, Beltran E, Zapata AD, Estupiñan M
BACKGROUND: Acquired aplastic anemia (AA) is a life-threatening hematologic disorder characterized by bone marrow failure. This study evaluates clinical outcomes of matched sibling donor hematopoietic stem cell transplan...BACKGROUND: Acquired aplastic anemia (AA) is a life-threatening hematologic disorder characterized by bone marrow failure. This study evaluates clinical outcomes of matched sibling donor hematopoietic stem cell transplantation (MSD-HSCT) and haploidentical HSCT (haplo-HSCT) in pediatric patients with severe (SAA) and very severe aplastic anemia (VSAA) in Colombia. METHODS: A retrospective multicenter study was conducted in four high-complexity centers in Colombia between 2011 and 2021, including 59 pediatric patients with SAA/VSAA who underwent allo-HSCT. Eligible patients were divided into two groups: one group underwent MSD-HSCT and the other haplo-HSCT, either as first-line treatment or after immunosuppressive therapy (IST) failure. Clinical outcomes, graft failure, graft-versus-host disease (GVHD), and overall survival (OS) were analyzed. RESULTS: A total of 59 patients with SAA/VSAA undergoing allo-HSCT were included, 29 undergoing MSD-HSCT and 30 undergoing haplo-HSCT. The 2-year OS for the cohort was 81%, with 85% for MSD-HSCT and 75% for haplo-HSCT. Modified Baltimore-based conditioning regimens in haplo-HSCT showed an OS of 83%. Primary graft failure occurred in two haplo-HSCT patients. Grades III-IV acute GVHD and moderate-severe chronic GVHD were more common in haplo-HSCT. Infection was the leading cause of posttransplant mortality. CONCLUSION: Pediatric SAA patients undergoing MSD-HSCT had better survival outcomes and less incidence of aGVHD compared to haplo-HSCT. Haplo-HSCT with modified Baltimore conditioning offers a viable alternative, particularly when an MSD is unavailable. Prospective studies are needed to confirm these findings.
BACKGROUND: High-flow nasal cannula (HFNC) therapy is an essential tool for managing acute respiratory failure (ARF) in pediatric patients with hematological and oncological conditions. This study aimed to evaluate the H...BACKGROUND: High-flow nasal cannula (HFNC) therapy is an essential tool for managing acute respiratory failure (ARF) in pediatric patients with hematological and oncological conditions. This study aimed to evaluate the HFNC failure rate and identify factors associated with HFNC failure in pediatric hematology/oncology patients admitted to the pediatric intensive care unit (PICU) with ARF. METHODS: This is a retrospective cohort study that included 200 pediatric hematology/oncology patients aged 0-14 years with ARF who underwent HFNC. All patients were admitted to the PICU at the King Fahad National Center for Child Cancer in Saudi Arabia from January 2018 to December 2020. RESULTS: The patient cohort had a median age of 3 years (interquartile range [IQR]: 1.3-7.0), and (61.5%) of patients were males. The key indications for HFNC were pneumonia (48.0%), sepsis (46.0%), and cardiac failure (18.0%). The median duration of HFNC was 36 h (IQR: 20-68), and the median PICU length of stay was 6 days (IQR: 4-16). HFNC failure rate was (27.0%). Air leaks were reported in (2.5%) of patients. The PICU mortality was 29.5% (59/200), including 40 patients (67.8%) with HFNC failure. Required intubation within 48 h was observed in 13.0% (26/200) of patients. Multivariable analysis revealed that the initial pH (p = 0.030), shorter HFNC duration (p < 0.001), cardiac failure (p = 0.009), and sepsis (p = 0.041) were predictors of HFNC failure. CONCLUSION: The HFNC failure rate in this study was 27%, which is within the range of other studies. Thus, HFNC is an acceptable treatment option for pediatric hematology/oncology patients with ARF. However, further investigation is required.
BACKGROUND AND OBJECTIVES: Acute myeloid leukemia (AML) is one of the most common blood malignancies in adults, characterized by the involvement of hematopoietic myeloid progenitors. Numerous studies have demonstrated th...BACKGROUND AND OBJECTIVES: Acute myeloid leukemia (AML) is one of the most common blood malignancies in adults, characterized by the involvement of hematopoietic myeloid progenitors. Numerous studies have demonstrated the involvement of long noncoding RNAs (lncRNAs) in AML pathogenesis. This study aimed to investigate the expression profile of lncRNA small nuclear RNA host gene 14 (SNHG14) and its role in the pathogenesis, clinical features, and prognosis of adult non-M3 AML. MATERIALS AND METHODS: The expression level of SNHG14 was evaluated in bone marrow (BM) samples obtained from 50 adult non-M3 AML patients and 49 healthy controls using Quantitative Reverse Transcription-Polymerase Chain Reaction. We also investigated the correlation between clinicopathological characteristics and SNHG14 expression levels in AML patients. RESULTS: The expression level of SNHG14 was significantly decreased in the BM tissues of adult non-M3 AML patients compared to healthy controls. Patients with low SNHG14 expression were associated with poor overall survival, while no correlation was found between low SNHG14 expression and relapse-free survival. CONCLUSION: Our findings suggest that SNHG14 expression could serve as a potential biomarker for prognosing adult non-M3 AML patients. Furthermore, SNHG14 may offer insights into novel therapeutic targets for this subset of AML patients.
BACKGROUND: Metastatic lung carcinoids (MLCs) represent a rare subset of lung cancers with distinct histologic subtypes. Survival outcomes and prognostic factors have not been well-studied in the real-world setting. This...BACKGROUND: Metastatic lung carcinoids (MLCs) represent a rare subset of lung cancers with distinct histologic subtypes. Survival outcomes and prognostic factors have not been well-studied in the real-world setting. This study investigates the impact of various treatments, including chemotherapy, hormonal therapy, and no treatment, on the overall survival (OS) of patients with typical and atypical MLC. METHODS: Patients with MLC between 2010 and 2020 were included from the National Cancer Database based on histologic codes ICD-O-3 8240/3 and 8249/3. Kaplan-Meier curves and multivariate Cox proportional hazard regression were used to compare OS and evaluate prognostic factors. RESULTS: The median age at diagnosis was 68 and 69 years for atypical and typical MLC, respectively. The 3-year OS for the atypical MLC cohort was 22.11%, and for typical MLC was 41.94% (P < 0.001). In the atypical MLC cohort, chemotherapy showed a nonsignificant benefit in OS (hazard ratio [HR], 0.89; 95% confidence interval [CI], 0.73-1.05; P = 0.21), whereas hormonal therapy was associated with significantly improved OS (HR, 0.72; 95% CI, 0.52-0.98; P =0.04). However, in the typical MLC cohort, chemotherapy was associated with adverse OS (HR, 2.15; 95% CI, 1.85-2.49; P < 0.0001), and hormonal treatment showed better, albeit nonsignificant OS (HR, 0.84; 95% CI, 0.67-1.05; P = 0.13). CONCLUSION: There is a notable difference in survival outcomes between typical and atypical MLC based on the treatment strategies. While hormonal therapy shows improvement in the OS, the effectiveness of chemotherapy varies depending on the histologic subtype. These findings emphasize the necessity for personalized therapeutic approaches based on the specific characteristics of MLC, ultimately contributing to improved patient outcomes in this challenging oncologic group. Further research is warranted to validate and expand upon these observations.
BACKGROUND: Adverse events (AEs) associated with blood product transfusions have been extensively studied, whereas those associated with cellular therapy products (CTPs) seen in children undergoing hematopoietic stem cel...BACKGROUND: Adverse events (AEs) associated with blood product transfusions have been extensively studied, whereas those associated with cellular therapy products (CTPs) seen in children undergoing hematopoietic stem cell transplantations are not commonly documented and analyzed. PATIENTS AND METHODS: Herein, we retrospectively studied pediatric patients below the age of 14 years for AEs within 48 h of CTP infusions while evaluating them in the context of pre-existing allergies, transplant-related parameters, and the outcome of the events. Data from 656 consecutive pediatric transplants at our institution from 2016 to 2020 was analyzed. Observed events were classified and graded as per CTC AE (Version 5.0) and consolidated into a single binary variable. The incidence of AEs recorded during the first 48 h of infusion was 4.9% (n = 32). RESULTS: Hypertension was the most common AE observed in 28 episodes, followed by hematuria (four episodes). Occurrence of AEs was found to be significantly associated with older age of the recipients (P = 0.048), hemoglobinopathies as a primary indication for transplant (P = 0.016), allogeneic graft type (P = 0.039), bone marrow as a source of the stem cells (P = 0.006), and documented substance allergies prior to infusion (P = 0.001). We did not find any association between children with AEs and the toxicity of dimethyl sulfoxide with the number of bags used for transfusion (single: 17 [56.7%] vs. multiple: 13 [43.3%], P value: NS). CONCLUSION: In conclusion, our patients had low rates of AEs with CTPs. These AEs vary with allergenicity and need to be monitored with similar caution as regular blood products.
In 1903, Dr. John Auer first observed needle-like rods in what he initially mistook for lymphocytes from a patient with fever, coagulopathy, and splenomegaly. Later discovered in myeloblasts, these "Auer rods" emerged as...In 1903, Dr. John Auer first observed needle-like rods in what he initially mistook for lymphocytes from a patient with fever, coagulopathy, and splenomegaly. Later discovered in myeloblasts, these "Auer rods" emerged as a defining feature of myeloid malignancies. Among them, acute promyelocytic leukemia (APL), recognized as a distinct clinical entity in 1957, was once considered the most lethal acute leukemia due to its severe coagulopathy and alarmingly high early mortality rate. However, landmark breakthroughs, particularly the introduction of all-trans retinoic acid in the 1980s and arsenic trioxide in the 1990s, transformed APL into the most curable form of acute leukemia, provided that treatment begins early. This illustrated review highlights over a century since Auer rods were first identified, offering a concise, visually guided overview of APL's epidemiology, clinical presentation, and diagnostic strategies. We explore modern and practical therapeutic approaches, emphasize risk-adapted treatments, and address major complications, including differentiation syndrome, coagulopathy, and central nervous system involvement. The remarkable evolution of APL-from a highly fatal disease to the most treatable leukemia-highlights how our understanding of disease pathophysiology and biology can transform treatment strategies and improve patient outcomes.
Hematopoietic cell transplantation is a complex procedure that often places significant emotional, financial, and social stress on patients, their families, and caregivers. The process is demanding, requiring extended ho...Hematopoietic cell transplantation is a complex procedure that often places significant emotional, financial, and social stress on patients, their families, and caregivers. The process is demanding, requiring extended hospital stays, frequent appointments, and ongoing posttransplant care. These challenges are compounded by uncertainty surrounding the outcome as well as financial burden. In this review, we underscore the importance of establishing comprehensive support systems for patients, their families, and caregivers throughout this journey. Providing adequate education and counseling with resources can play a vital role in minimizing the impact on patients and their families.
Acquired factor XIII (FXIII) deficiency is a rare disorder that could be associated with autoimmune and malignant disorders with a high risk of bleeding. In acute leukemias, acquired FXIII deficiency has been reported an...Acquired factor XIII (FXIII) deficiency is a rare disorder that could be associated with autoimmune and malignant disorders with a high risk of bleeding. In acute leukemias, acquired FXIII deficiency has been reported and replacement of FXIII helped to control significant bleeding. Here, we report four cases of myeloid neoplasms to have acquired FXIII deficiency with interesting concomitant RUNX1 mutation in the molecular background of two patients. Correction of bleeding complications was successful in all patients with FXIII substitution by FXIII concentrate in three patients and cryoprecipitate in one patient. Studying the association of FXIII deficiency with molecular abnormalities in such neoplasms is needed for better understanding and detection of common pathophysiologic pathways. This could help to avoid severe bleeding during diagnostic or therapeutic interventions in patients at risk.
BACKGROUND AND OBJECTIVES: The immature platelet fraction (IPF) count is a parameter that quantifies young and reticulated platelets in peripheral blood, which reflects platelet production in the bone marrow. It has been...BACKGROUND AND OBJECTIVES: The immature platelet fraction (IPF) count is a parameter that quantifies young and reticulated platelets in peripheral blood, which reflects platelet production in the bone marrow. It has been used as a predictive model for bone marrow recovery in patients with acute leukemia after high-intensity chemotherapy and/or stem cell transplantation. This study aimed to evaluate IPF as a predictor of hematologic recovery in these patients. MATERIALS AND METHODS: A retrospective analysis of patients with acute leukemias after high-intensity chemotherapy or undergoing stem cell transplantation, treated at the Instituto Nacional de Cancerología (INC) (Bogotá, Colombia) between October 2020 and March 2021.The variables studied included age, sex, type of leukemia, type of treatment, type of chemotherapy, treatment duration, peripheral blood platelet count, percentage of IPF (IPF%), and peripheral blood neutrophil count. Univariate and multivariate analyses were carried out to evaluate the relationship between the IPF behavior and hematologic recovery. Statistical analysis was performed using the R package version 4.2.0® (free license). RESULTS: Between October 2020 and March 2021, 32 patients were analyzed, with a median age of 26 years; the male population was 59.4%. Acute lymphoid leukemia was the most frequent type in 62.5%; 43.7% of patients received chemotherapy, while the others underwent allogeneic stem cell transplantation. Hematologic recovery occurred between days 15 and 30. Spearman's correlation was 0.27 with a p=0.13 for recovery day and IPF% (weak correlation). CONCLUSION: There is limited information regarding the usefulness of IPF% in hematology. The IPF% was not found to be a predictor of hematologic recovery in patients with acute leukemia after chemotherapy and/or allogeneic stem cell transplantation. The lack of correlation does not allow for assuming a reliable cut-off point. Further studies with a larger sample size are needed.
BACKGROUND AND OBJECTIVES: The most recent study on pediatric cancer epidemiology in Jordan was published in 2003. This study aims to provide updated epidemiological data for local clinicians, policymakers, and internati...BACKGROUND AND OBJECTIVES: The most recent study on pediatric cancer epidemiology in Jordan was published in 2003. This study aims to provide updated epidemiological data for local clinicians, policymakers, and international physicians interested in Middle Eastern patient populations. MATERIALS AND METHODS: We analyzed data from the Jordanian National Cancer Registry for pediatric patients (ages 0-18) diagnosed between 2000 and 2017, classified according to the International Classification of Childhood Cancer, third edition. RESULTS: Our cohort comprised 7639 patients. The mean age at diagnosis was 8.68 years, with a male-to-female ratio of 1.4 and an annual incidence rate of 191 per million population. We identified significant differences in cancer distribution between Jordan and neighboring Middle Eastern countries, as well as regional discrepancies in the number of diagnosed childhood cancer cases. A comparison of cancer incidence between 1996-1998 and 2000-2017 in Jordan was conducted. Our findings align with established trends, such as the correlation between the male-to-female cancer incidence ratio and GDP per capita. CONCLUSION: This study provides the latest organized and accessible data on childhood malignancies in Jordan.
BACKGROUND: Patients who underwent hematopoietic stem cell transplantation (HSCT) are considered at high risk for pediatric intensive care unit (PICU) admission. Therefore, this study aimed to assess outcomes and mortali...BACKGROUND: Patients who underwent hematopoietic stem cell transplantation (HSCT) are considered at high risk for pediatric intensive care unit (PICU) admission. Therefore, this study aimed to assess outcomes and mortality-related risk factors among pediatric HSCT recipients admitted to the PICU. METHODS: This retrospective cohort study was conducted at a Saudi Arabian tertiary care center and involved pediatric patients (aged 4 weeks to 14 years) who underwent HSCTs between January 2015 and December 2019 and were admitted to the PICU. RESULTS: Of the 173 pediatric HSCT recipients admitted to the PICU, 65.3% were admitted for respiratory failure. Graft-versus-host disease and chronic infections affected 48.6% and 71.7% of the cases, respectively. Pulmonary hemorrhage and veno-occlusive disease occurred in 15.0% and 32.4% of the patients, respectively. Ventilation and inotropic support were administered to 79.8% and 41.0%, respectively. Acute kidney injury (AKI) occurred in 47.4% of the patients, of which 23.2% required continuous renal replacement therapy/hemodialysis. The PICU survival rate was 59.0% (102/173), and the mortality rate was 41.0% (71/173). In the univariate analysis, chronic infection, pulmonary hemorrhage, ventilation, inotropic support, AKI, higher PRISM III score, and prolonged PICU stay were associated with mortality (P < 0.05). In the multivariable analysis, only prolonged PICU stay (P = 0.016), AKI (P = 0.040), inotropic support (P < 0.001), and ventilation (P = 0.017) showed potential association with mortality. CONCLUSION: Early recognition and targeted interventions for these complications are crucial for improving outcomes in this vulnerable population. More research is needed to validate these findings and optimize care practices for HSCT recipients in the PICU setting.
The outcomes of haploidentical hematopoietic cell transplantation (haplo-HCT) have improved with the implication of new in vivo and ex vivo graft-versus-host disease (GVHD) prophylaxis regimens. However, primary graft fa...The outcomes of haploidentical hematopoietic cell transplantation (haplo-HCT) have improved with the implication of new in vivo and ex vivo graft-versus-host disease (GVHD) prophylaxis regimens. However, primary graft failure is still reported more frequently in haplo-HCT compared to a matched donor HCT. We conducted a pilot study (NCT04942730) to evaluate the impact of adding bendamustine to fludarabine and busulfan conditioning on engraftment after haplo-HCT. Bendamustine was administered on days -7 and -6 in the 130 mg/m2 dose. Fifty patients with malignant disorders in complete hematologic response were enrolled. The cumulative incidence of engraftment was 98% (95% confidence interval [CI] 77%-99%) with a median of 20 days. One-year overall survival was 67.9% (95% CI 53.2%-86.7%), event-free survival was 68.1% (95% CI 53.4%-86.8%), the cumulative incidence of relapse was 4.9% (95% CI 0.82%-15%), and nonrelapse mortality was 27% (95% CI 13%-44%). Relatively high incidence of viral reactivations (68%, 95% CI: 52%-79%) and invasive fungal infections (19%, 95% CI: 9.3%-32%) were observed. The study justifies further investigation of fludarabine, busulfan, and bendamustine conditioning in haplo-HCT.
Despite numerous reports on the procoagulant activities of G-CSF, the effect of plerixafor on the hemostatic system is not clearly understood. This study aims to evaluate the effects of plerixafor on the hemostatic syste...Despite numerous reports on the procoagulant activities of G-CSF, the effect of plerixafor on the hemostatic system is not clearly understood. This study aims to evaluate the effects of plerixafor on the hemostatic system when used for autologous stem cell mobilization (ASCM) for poor mobilizers (PM) with lymphoma and multiple myeloma. Patients who were performed ASCM with plerixafor in combination with GCSF were prospectively enrolled. Cohort A included patients mobilized with G-CSF whereas Cohort B included patients mobilized with G-CSF + plerixafor. Blood samples were obtained before the mobilization regimen and just before apheresis. CBC, coagulation tests, CRP, protein C and S, vWF antigen, and factors VIII and XII were studied. Cohort A (n= 30) of which 9 received chemotherapy + G-CSF. Factor VIII, INR, vWF antigen, and CRP significantly increased after G-CSF compared to baseline. Decreases in protein C and S were significant (p<0.001; p=0.005). In cohort B (n=15) no significant changes were observed in coagulation parameters Factor levels, protein C and S before and after the plerixafor. Fibrinogen decreased slightly after plerixafor administration (4.2773±2.2125 vs. 3.6987±1.5062; p=0.02). remained unchanged. In conclusion the addition of plerixafor to G-CSF did not exert further significant procoagulant effects.
Transfusion of blood products is a common lifesaving medical procedure in clinical practice. However, it poses the risk of potential adverse reactions for the recipient. Transfusion-associated graft-versus-host-disease (...Transfusion of blood products is a common lifesaving medical procedure in clinical practice. However, it poses the risk of potential adverse reactions for the recipient. Transfusion-associated graft-versus-host-disease (TA-GVHD) is a rare adverse event, fatal in >90% of cases. TA-GVHD pathophysiology is not completely understood involving two factors: (i) underlying immunosuppression and (ii) human leukocyte antigen compatibility between blood donor and recipient. Clinical presentation is not specific, and the difficulty in correlating the clinical syndrome to the transfusion renders diagnosis challenging. As no effective treatment exists to date, irradiation of blood products remains the cornerstone of TA-GVHD prevention. Distinct differences emerge in comparing TA-GVHD to GVHD, a common event of the bone marrow graft to the recipient after allogeneic hematopoietic stem cell transplantation; thus, GVHD may be a helpful disease model used to better understand TA-GVHD. This is a review of TA-GVHD in comparison with GVHD.
Greinix HT, Iftikhar R, Chaudhry QUN
… +26 more, Ahmed P, Al-Khabori M, Gaziev J, Hamidieh AA, Hashmi S, Khan M, Poudyal BS, Shaheen M, Rasheed W, Galeano S, Kodera Y, Niederwieser D, Ahmed SO, Atsuta Y, Baldomero H, Frutos C, Iida M, Okamoto S, Rondelli D, Schwartz J, Seber A, Weisdorf D, Worel N, Chatzixiros E, Koh MB, Aljurf M
The eighth workshop of the Worldwide Network for Blood and Marrow Transplantation (WBMT) was held in Islamabad, Pakistan, from September 22 to 23, 2022, aiming to foster hematopoietic stem cell transplant (HSCT) activity...The eighth workshop of the Worldwide Network for Blood and Marrow Transplantation (WBMT) was held in Islamabad, Pakistan, from September 22 to 23, 2022, aiming to foster hematopoietic stem cell transplant (HSCT) activity in the World Health Organization (WHO) Eastern Mediterranean Region (EMRO). Participating countries, including Pakistan, Oman, Iran, and Saudi Arabia, reported increased HSCT in the last few years, whereas others from the EMRO and beyond, including Qatar, United Arab Emirates, Nepal, and Bangladesh, started HSCT recently and have developed HSCT programs with excellent results. During educational sessions and open dialog, participating teams and international experts from the WBMT shared their experience and discussed minimum essential requirements for establishing and expanding HSCT in emerging countries, indications for HSCT training and dissemination of knowledge, stem cell donor selection and safety, quality assurance in transplant centers, and the value and importance of transplant outcome databases. International support, collaboration, and local engagement, including government participation and WHO assistance, are valuable in increasing HSCT access worldwide.
BACKGROUND AND OBJECTIVES: Aplastic anemia (AA) is a disease caused by bone marrow (BM) failure. There are many similarities between AA and hypoplastic myelodysplastic syndrome (MDS); hence, differentiating them could be...BACKGROUND AND OBJECTIVES: Aplastic anemia (AA) is a disease caused by bone marrow (BM) failure. There are many similarities between AA and hypoplastic myelodysplastic syndrome (MDS); hence, differentiating them could be problematic. The current study aimed to use the new technique of flow cytometry as a possible diagnostic tool for AA and hypoplastic MDS. PATIENTS AND METHODS: The BM mononuclear cell (BMMC) and blood samples from 44 participants (17 patients with AA, 13 with hypoplastic MDS, and 14 healthy controls) were collected. The flow cytometric analysis of the cluster of differentiation 34 (CD34) levels and cell apoptosis was performed for all sample types. RESULTS: Patients with hypoplastic MDS showed a high percentage of CD34+ cells with low apoptosis, while those with AA showed a low percentage of CD34+ cells with high apoptosis. CONCLUSIONS: Despite the similarity in the clinical presentation of hypoplastic MDS and AA, they are biologically different disorders. Increased CD34+ cell numbers with high viability may provide a useful and accurate tool for the differential diagnosis of hypoplastic MDS from AA.
BACKGROUND AND OBJECTIVE: Rehabilitation therapy plays an important role in treating physical and functional impairments observed in individuals undergoing hematopoietic stem cell transplants (HSCT). This study assessed...BACKGROUND AND OBJECTIVE: Rehabilitation therapy plays an important role in treating physical and functional impairments observed in individuals undergoing hematopoietic stem cell transplants (HSCT). This study assessed the rehabilitation practices implemented in the HSCT population internationally. MATERIALS AND METHODS: A 48-question online survey comprising questions soliciting information regarding patient characteristics, therapy details (timing, indication, and administering providers), outcome measures, and precautions were developed by an international group of cancer rehabilitation physicians. As reported by European registries, surveys were administered to personnel providing care to patients receiving HSCT at cancer centers, which comprised the top 10% of HSCT volume. In addition, emails were sent to National Medical Societies and registries in the Latin America, Asia, and Pacific regions. RESULTS: Forty-three institutions from 18 countries responded to the survey. Half of the centers provided referrals for rehabilitation therapy at the time of admission. Referrals were provided for functional decline (84.5%), risk of falls (53.3%), and discharge planning (42.2%). Rehabilitation therapies were administered by physical therapists (93.0%), occupational therapists (34.9%), therapy aides (14.0%), and speech-language pathologists (11.6%). Approximately 95% of the surveyed centers used objective functional measures such as sit-to-stand (46.5%), grip strength (46.5%), and 6-min walk/gait speed (both 34.9%). The blood counts were monitored to determine the appropriateness of the therapy modalities. CONCLUSION: Rehabilitation practices varied internationally; however, most centers provided skilled therapy during hospitalization for HSCT, utilized objective and patient-reported outcomes, and monitored blood counts to determine the safety of administering therapy.
Fusarium infections have increased, particularly among patients with hematological malignancies and in those receiving hematopoietic stem cell transplantation (HSCT). This meta-summary summarizes the clinical characteris...Fusarium infections have increased, particularly among patients with hematological malignancies and in those receiving hematopoietic stem cell transplantation (HSCT). This meta-summary summarizes the clinical characteristics, treatment, and outcomes of Fusarium infections in HSCT recipients. The PubMed, ScienceDirect, and Ovid SP databases were searched from inception to January 2024 to identify relevant case reports. A total of 31 patients diagnosed with Fusarium infections after HSCT were included. The most common infection sites were the skin and soft tissues (74.2%), blood (54.8%), and lungs (41.9%). Fusarium species complex was identified in 67.7% of the patients, and the most common species was Fusarium solani (51.6%). Of the included patients, 58.1% received antifungal monotherapy, whereas 41.9% received antifungal combination therapy. The overall mortality rate was 74.2%. Cutaneous infection was associated with a low mortality rate. The median time to mortality was 28 days. Fusarium infections commonly present as disseminated infections in HSCT recipients.