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Introduction. Acute urinary retention in a child is rare. Haematocolpos can cause a mechanical obstruction, resulting in acute urinary retention. Case Report. A 12-year-old girl presented to the surgical department with a one-day history of acute urinary retention and suprapubic tenderness. She had not started menses but had described period-like pains every month for the past six months. On examination, she had a palpable bladder with over 500mls of residual urine and a bluish-grey bulge posterior to her urethral meatus. An US scan showed a large mass posterior to her bladder resembling a haematocolpos, and this was confirmed with an MRI scan. She was catheterised and eventually underwent a hymenectomy using a cruciate incision. She made a good recovery postoperatively. Conclusion. In the case of a peripubertal female presenting with acute urinary retention, haematocolpos should be considered as a diagnosis. [ABSTRACT FROM AUTHOR]

Keywords: DPACE; DTPACE; efficacy; myeloma; survival; VRDPACE; VTDPACE EN DPACE DTPACE efficacy myeloma survival VRDPACE VTDPACE 231 233 3 07/24/20 20200801 NES 200801 The use of dexamethasone plus thalidomide in combination with a continuous infusion of cisplatin, doxorubicin, cyclophosphamide and etoposide (DTPACE) was first described in relapsed myeloma (MM) and showed effectiveness as induction therapy before autologous stem cell transplant (ASCT).1 The addition of bortezomib to DTPACE (VTDPACE) led to improved outcomes.2,3 Historical indications for DPACE-based therapies include salvage treatment of aggressive MM, plasma cell leukaemia and initial presentation with extra-medullary disease. Baseline patient, disease and treatment characteristics were collected from the local chemotherapy database and patient records between 2009 and 2017. The majority of patients who received >2 lines of therapy had received a prior ASCT (15/17:88.2%) and only a small group (3/17:17.6%) consolidated DPACE with a further ASCT (2 SP nd sp ASCT in all 3 patients). [Extracted from the article]

According to frailty scoring, 72 patients (67.9%) were frail, whilst 34 patients (32.1%) were non-frail. Keywords: frailty; isatuximab; myeloma; pomalidomide; real-world EN frailty isatuximab myeloma pomalidomide real-world 162 167 6 03/30/23 20230401 NES 230401 Multiple myeloma (MM) is primarily a disease of the elderly with 43% of the UK's newly diagnosed (NDMM) patients aged 75 years and over.[1] The highest incidence rates in the UK in both males and females occur in those aged 85-89 years.[1] A structured frailty assessment is needed in elderly myeloma patients in order to individualise treatment decisions.[2] In the relapsed/refractory (RRMM) setting, frailty-based approach to therapy is equally required to devise patient-centred treatment plans, which can reduce the risk of under-treating fit patients and the risk of over-treating frail patients. Baseline patient, disease and treatment characteristics of the different frailty subgroups are fully presented in Table 1. 1 TABLE Baseline patient, disease and treatment characteristics according to frailty subgroups. It is important to bear in mind that comparing the number of episodes between frailty subgroups is limited by the significant difference in cohort size between those subgroups (frail: 72 patients vs. non-frail: 34 patients). [Extracted from the article]

There are no real-world data describing infection morbidity in relapsed/refractory myeloma (RRMM) patients treated with anti-CD38 isatuximab in combination with pomalidomide and dexamethasone (IsaPomDex). In this UK-wide retrospective study, we set out to evaluate infections experienced by routine care patients who received this novel therapy across 24 cancer centres during the COVID-19 pandemic. The primary endpoint was infection morbidity (incidence, grading, hospitalization) as well as infection-related deaths. Secondary outcomes were clinical predictors of increased incidence of any grade (G2–5) and high grade (≥G3) infections. In a total cohort of 107 patients who received a median (IQR) of 4 cycles (2–8), 23.4% of patients experienced ≥1 any grade (G2–5) infections (total of 31 episodes) and 18.7% of patients experienced ≥1 high grade (≥G3) infections (total of 22 episodes). Median time (IQR) from start of therapy to first episode was 29 days (16–75). Six patients experienced COVID-19 infection, of whom 5 were not vaccinated and 1 was fully vaccinated. The cumulative duration of infection-related hospitalizations was 159 days. The multivariate (MVA) Poisson Regression analysis demonstrated that a higher co-morbidity burden with Charlson Co-morbidity Index (CCI) score ≥4 (incidence rate ratio (IRR) = 3, p = 0.012) and sub-optimal myeloma response less than a partial response (

B-cell-depleting agents are among the most commonly used drugs to treat haemato-oncological and autoimmune diseases. They rapidly induce a state of peripheral B-cell aplasia with the potential to interfere with nascent vaccine responses, particularly to novel antigens. We have examined the relationship between B-cell reconstitution and SARS-CoV-2 vaccine responses in two cohorts of patients previously exposed to B-cell-depleting agents: a cohort of patients treated for haematological B-cell malignancy and another treated for rheumatological disease. B-cell depletion severely impairs vaccine responsiveness in the first 6 months after administration: SARS-CoV-2 antibody seroprevalence was 42.2% and 33.3% in the haemato-oncological patients and rheumatology patients, respectively and 22.7% in patients vaccinated while actively receiving anti-lymphoma chemotherapy. After the first 6 months, vaccine responsiveness significantly improved during early B-cell reconstitution; however, the kinetics of reconstitution was significantly faster in haemato-oncology patients. The AstraZeneca ChAdOx1 nCoV-19 vaccine and the Pfizer BioNTech 162b vaccine induced equivalent vaccine responses; however, shorter intervals between vaccine doses (<1 m) improved the magnitude of the antibody response in haeamto-oncology patients. In a subgroup of haemato-oncology patients, with historic exposure to B-cell-depleting agents (>36 m previously), vaccine non-responsiveness was independent of peripheral B-cell reconstitution. The findings have important implications for primary vaccination and booster vaccination strategies in individuals clinically vulnerable to SARS-CoV-2. B cell depleting drugs including rituximab are commonly used to treat haematological malignancy and autoimmune diseases but may impair the immunological response to vaccination. This study investigates SARS-CoV-2 vaccine responses in individuals with haematological and rheumatological disease with previously exposure to B cell depleting agents. Vaccination within the first 6 months of B cell depletion is associated with significant impairment of vaccine responsiveness; however, rheumatology and haemato-oncological patients display different kinetics of B cell reconstitution corresponding to differential vaccine responsiveness over time. [ABSTRACT FROM AUTHOR]

The present study describes a patient aged 70 with very high-risk AML who successfully received a nonmyeloablative matched unrelated donor allograft shortly following SARS-CoV-2 infection, which manifested with mild cough, interstitial abnormalities on chest CT, and pancytopenia with profound bone marrow biopsy histological alterations. In parallel, our study provides bone marrow biopsy data in a series of contemporary patients with serious haematological diseases who had a bone marrow biopsy performed within two weeks of PCR confirmation of SARS-CoV-2 infection. This study is notable because there are no published data describing the bone marrow biopsy changes observed in patients with haematological malignancies and SARS-CoV-2 infection. Finally, it is suggested that nonmyeloablative hematopoietic stem cell transplantation for very high-risk haematological malignancies can be successfully performed following recovery from SARS-CoV-2 infection. [ABSTRACT FROM AUTHOR]

COVID-19 in bone marrow transplant recipients: reflecting on a single centre experience Keywords: SARS-CoV-2; COVID-19; bone marrow transplantation; post transplant cyclophosphamide; conditioning EN SARS-CoV-2 COVID-19 bone marrow transplantation post transplant cyclophosphamide conditioning e67 e70 4 07/20/20 20200715 NES 200715 Coronavirus disease 2019 (COVID-19) is caused by the novel SARS-CoV-2 virus and has been declared a pandemic on the 9th of March by the WHO. Five out of seven (71%) were in complete remission from underlying disease, and two of them (29%) had relapsed acute myeloid leukaemia (AML) with bone marrow chimerism 79% and 27% donor at COVID-19 diagnosis. [Extracted from the article]