64 results on '"Hematologic malignancy"'
Search Results
2. Western variant intravascular large B-cell lymphoma in an Indian man
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Kevin M. Burningham, BS, Ravi R. Patel, MD, Cristian D. Gonzalez, MD, Melissa Mauskar, MD, Travis Vandergriff, MD, and Heather W. Goff, MD, MPH
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case report ,cutaneous lymphoma ,cutaneous manifestation of disease ,hematologic malignancy ,intravascular large B-cell lymphoma ,MR-CHOP ,Dermatology ,RL1-803 - Published
- 2023
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3. Risk of lymphoid malignancies increased after Puumala virus infection in Finland, 2009-2019: A retrospective register-based cohort study
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Sohvi Kääriäinen, Jukka Ollgren, Timothee Dub, Outi Laine, Marjatta Sinisalo, Jussi Hepojoki, Tomas Strandin, Eliisa Kekäläinen, Jussi Sane, and Outi Lyytikäinen
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Cox regression ,Hematologic malignancy ,Hemorrhagic fever with renal syndrome ,Hantavirus ,Lymphoma ,Infectious and parasitic diseases ,RC109-216 - Abstract
Objectives: The Puumala virus (PUUV) is a hantavirus that causes hemorrhagic fever with renal syndrome. Studies showing an increased risk of lymphoid malignancies after hantavirus infection, together with the observation that PUUV infects B cells, motivated us to study the risk of lymphoid malignancies after PUUV infection. Methods: We linked data from the Finnish Cancer Registry and National Infectious Diseases Register for 2009-2019. We used a time-dependent Cox regression model to evaluate the hazard of the lymphoid malignancies grouped according to the HAEMACARE classification. Results: We identified 68 cases of lymphoid malignancies after PUUV infection among 16,075 PUUV-infected individuals during 61,114,826 person-years of observation. A total of 10 cases occurred within 3-
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- 2023
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4. Gram negative pyomyositis: Two case reports and a review of the literature
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Anne M. Meehan, Jeremiah B. Joyce, and Aaron J. Tande
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Gram-negative bacteria ,Muscle ,Infection ,Hematologic malignancy ,Infectious and parasitic diseases ,RC109-216 - Abstract
Pyomyositis due to Gram negative bacteria is rare. Here we describe two cases in immunocompromised hosts. Both were bacteremic with a Gram-negative bacterium and had impaired immunity related to prolonged and ongoing chemotherapy for hematologic malignancies. Both eventually cleared the infection with a combination of local drainage and systemic antibiotics. This unusual diagnosis should be considered in an immunocompromised patient with muscle pain and fever.
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- 2023
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5. Can SARS-CoV-2 induce hematologic malignancies in predisposed individuals? A case series and review of the literature
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Bruno Almeida Costa, Kaiza Vilarinho da Luz, Sarah Emanuelle Viana Campos, Germison Silva Lopes, João Paulo de Vasconcelos Leitão, and Fernando Barroso Duarte
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COVID-19 ,SARS-CoV-2 ,Hematologic malignancy ,Acute leukemia ,Renin-angiotensin system ,Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Introduction: Coronavirus disease 2019 (COVID-19) may present with extrapulmonary manifestations, including hematologic changes. Previous studies suggest that severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) can interact with the renin-angiotensin system, ultimately causing increased production of angiotensin II. By reporting the cases of previously healthy young adults diagnosed with a hematologic malignancy after experiencing COVID-19, we raise the hypothesis that the SARS-Cov-2 infection could act as a trigger for leukemogenesis in predisposed individuals. Methods: This was a case series performed through extraction of relevant clinical information from the medical records of three patients admitted to our Hematology unit between August 2020 and September 2020. Main Results: Considering the relatively rapid development of cytopenias following recovery from COVID-19, it cannot be ruled out that SARS-Cov-2 played a role in leukemogenesis in those patients. Based on previous in vitro studies, the renin-angiotensin system imbalance induced by SARS-CoV-2 could potentially promote in vivo leukemogenesis through several mechanisms. Conclusion: Despite the advances in pathophysiological and clinical characterization of COVID-19, the consequences of the pandemic to the incidence of hematologic diseases are still to be elucidated. In this context, future dissection of the status of the local bone marrow renin-angiotensin system in leukemogenesis is a clinically relevant basic research area.
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- 2022
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6. Clostridioides difficile infection in patients with hematological malignancy: A multicenter study in Taiwan
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Yuan-Pin Hung, Chin-Shiang Tsai, Bo-Yang Tsai, Pei-Jane Tsai, Yuan-Ti Lee, Jen-Chieh Lee, Hsiu-Chuan Liu, Po-Ren Hsueh, Ching-Chi Lee, and Wen-Chien Ko
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Leukocyte count ,Hematologic malignancy ,Severity ,Recurrence ,Clostridioides difficile infection ,Microbiology ,QR1-502 - Abstract
Background: Among the individuals with hematological malignancy (HM) complicated with Clostridioides difficile infection (CDI), the variables associated with in-hospital mortality and recurrence of CDI were investigated. Material and methods: Including adults with HM and those without malignancy suffering from CDI from January 2015 to December 2016 in three hospitals in Taiwan. Results: Totally 314 patients including 77 with HM and 237 patients without malignancy were included. HM patients more often had low leukocyte counts (
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- 2021
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7. Dementia Incidence in Survivors of Multiple Myeloma: A National Case-Control Study Conducted in Korea (The CAREMM-2106 Study).
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Ha J, Choi S, Moon S, Han J, Lee J, Park SS, Wang SM, Han S, and Min CK
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Background: Dementia, a growing global health issue, affects older adults and specific groups like long-term cancer survivors. The link between cancer survival and dementia is debated. Multiple myeloma (MM), a common blood cancer in older adults, is often linked with cognitive issues. This study investigated dementia incidence in long-term MM survivors using Korean national data., Methods: A retrospective case-control study used data from the Korea National Health Insurance Service (KNHIS), covering about 50 million Koreans. Patients diagnosed with MM between 2009 and 2020 formed the case cohort, while the control cohort included matched individuals without MM using propensity-score matching. Analyzing baseline characteristics, comorbidities, and socioeconomic status, the primary outcome was dementia incidence identified via ICD-10 codes. Statistical methods included Kaplan-Meier plots, cause-specific and Fine-Gray subdistribution hazard models, and a 3-year landmark analysis for immortal time bias., Results: The study included 33,864 patients, with 16,932 in each cohort. The overall cumulative dementia incidence was lower in the MM cohort compared to controls. However, in the first 3 years, MM patients had a higher dementia risk (HR: 1.711, 95% CI, 1.562-1.874) than controls. After 3 years, the risk significantly decreased (HR: 0.625, 95% CI, 0.560-0.696). Age-specific analysis showed a consistent pattern, particularly among MM patients aged 70-79, where dementia risk increased post-3 years., Conclusion: This study reveals a lower long-term dementia risk in MM survivors compared to non-MM individuals. Further prospective studies are needed to confirm these findings and explore the underlying mechanisms., Competing Interests: Disclosure The authors have stated that they have no conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)
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- 2024
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8. Fertility preservation parameters in patients with haematologic malignancy: a systematic review and meta-analysis.
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Katzir T, Shrem G, Meirow D, Berkowitz E, Elizur S, Cohen S, Burke Y, Retchkiman M, Or Y, and Volodarsky-Perel A
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- Humans, Female, Anti-Mullerian Hormone blood, Fertility Preservation methods, Hematologic Neoplasms therapy, Hematologic Neoplasms complications, Ovulation Induction methods, Ovarian Reserve
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Patients with haematologic malignancies represent one of the most common groups referred for fertility preservation before gonadotoxic oncological treatment. The aim of this systematic review and meta-analysis was to evaluate the effect of haematologic cancer on ovarian reserve and response to ovarian stimulation compared with healthy controls. A total of eight observative studies were included in the final quantitative analysis. Despite a younger age (mean difference -4.17, 95% CI -6.20 to -2.14; P < 0.0001), patients with haematologic malignancy had lower serum anti-Müllerian hormone levels compared with the control group (MD -1.04, 95% CI -1.80 to -0.29; P = 0.007). The marginally higher total recombinant FSH dose (MD 632.32, 95% CI -187.60 to 1452.24; P = 0.13) and significantly lower peak oestradiol serum level (MD -994.05, 95% CI -1962.09 to -26.02; P = 0.04) were demonstrated in the study group compared with the healthy controls. A similar number of retrieved oocytes were achieved in both groups (MD 0.20, 95% CI -0.80 to 1.20; P = 0.69). In conclusion, haematologic malignancies may detrimentally affect ovarian function manifesting in decreased AMH serum levels despite a younger age compared with healthy controls. This effect can be overcome by the application of relevant IVF protocols and stimulation doses to achieve an adequate oocyte yield., (Copyright © 2024 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.)
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- 2024
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9. A novel psychosocial virtual reality intervention (BMT-VR) for patients undergoing hematopoietic stem cell transplantation: Pilot randomized clinical trial design and methods.
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Amonoo HL, Newcomb R, Lorenz KA, Psenka R, Holmbeck K, Farnam EJ, Tse A, Desai S, Vassev N, Waldman LP, and El-Jawahri A
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- Adult, Female, Humans, Male, Adaptation, Psychological, Feasibility Studies, Hematologic Neoplasms therapy, Hematologic Neoplasms psychology, Hospitalization, Patient Education as Topic methods, Pilot Projects, Psychological Distress, Psychosocial Intervention methods, Self Care methods, Stress, Psychological therapy, Virtual Reality, Hematopoietic Stem Cell Transplantation psychology, Hematopoietic Stem Cell Transplantation methods, Quality of Life
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Background: Although patients undergoing hematopoietic stem cell transplantation (HSCT) must cope with psychological distress and isolation during an extended transplant hospitalization, psychosocial interventions to address these unmet needs are lacking. Virtual reality offers an innovative modality to deliver a patient-centered psychosocial intervention to address psychosocial needs of patients undergoing HSCT. However, there are currently no supportive care interventions leveraging virtual reality in patients undergoing HSCT., Objective: To describe the methods of a randomized clinical trial (RCT) to assess the feasibility and preliminary efficacy of a self-administered, virtual reality-delivered psychosocial intervention (BMT-VR) to improve psychological distress and quality of life (QOL) for patients hospitalized for HSCT., Methods: This study entails a single-center RCT of BMT-VR compared to usual transplant care in 80 patients hospitalized for HSCT. Adult patients with hematologic malignancies hospitalized for autologous or allogeneic HSCT are eligible. BMT-VR includes psychoeducation about the HSCT process, psychosocial skill building to promote effective coping and acceptance, and self-care and positive psychology skills to promote post-HSCT recovery. The primary aim is to assess the feasibility defined a priori as ≥60% of eligible patients enrolling in the study, and of those enrolled and randomized to the BMT-VR, ≥ 60% completing 4/6 BMT-VR modules. Secondary objectives include assessing the preliminary effects on psychological distress and QOL., Discussion: This is the first RCT of a virtual reality-delivered psychosocial intervention for the HSCT population. If deemed feasible, a future larger multi-site clinical trial can evaluate the efficacy of BMT-VR on outcomes for patients hospitalized for HSCT., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr. El-Jawahri serves as a consultant for Incyte Corporation, GSK, and Novartis. All other authors report no conflict of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)
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- 2024
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10. eHealth mindfulness-based music therapy for patients undergoing allogeneic hematopoietic stem cell transplantation: A pilot randomized controlled trial protocol.
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Fleszar-Pavlovic SE, Esquives BN, Brito AE, Sia AM, Kauffman MA, Lopes M, Moreno PI, Koru-Sengul T, Gong R, Wang T, Wieder ED, Rueda-Lara M, Antoni M, Komanduri K, Lesiuk T, and Penedo FJ
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- Adult, Female, Humans, Male, Anxiety therapy, Depression therapy, Feasibility Studies, Meditation methods, Pilot Projects, Telemedicine, Transplantation, Homologous, Randomized Controlled Trials as Topic, Hematologic Neoplasms therapy, Hematologic Neoplasms psychology, Hematopoietic Stem Cell Transplantation methods, Hematopoietic Stem Cell Transplantation psychology, Mindfulness methods, Music Therapy methods, Quality of Life
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Background: Allogeneic stem cell transplantation (allo-SCT) is the preferred therapy for patients with high-risk or relapsed hematologic malignancies, but may be complicated by psychological distress (e.g., depression, anxiety) and symptom burden (e.g., fatigue, pain). Mindfulness-based music therapy (MBMT), a relatively novel integrative medicine intervention that draws from mindfulness and music therapy principles, has shown promise in improving psychosocial outcomes and symptom burden in cancer patients. We outline an eHealth-based MBMT (eMBMT) intervention protocol examining: (1) feasibility, acceptability, and intended effects of eMBMT in improving HRQOL, symptom burden, and clinical markers of disease activity (e.g., infections), and (2) the extent to which eMBMT music therapy component-associated improvements in HRQOL, symptom burden, and disease activity are mediated by improvements in psychosocial and physiological (e.g., systemic inflammation, immune recovery) adaptation., Methods: Participants (n = 60) with a hematologic malignancy undergoing allo-SCT will be randomized to receive eMBMT or an eHealth-based mindfulness meditation (eMM) intervention. eMBMT includes eight 60-min sessions facilitated by a music therapist focusing on mindfulness and music therapy. eMM includes eight 60-min self-led MM practices., Results: Feasibility, acceptability, HRQOL, symptom burden, disease activity, and mediation effects of psychosocial and physiological adaptation will be assessed at baseline, pre-infusion, and post-engraftment with blood collection at baseline and post-engraftment., Conclusion: The current pilot RCT is the first eMBMT intervention to address the HRQOL and symptom burden of patients who are undergoing allo-SCT. Results will inform a fully powered RCT to establish preliminary efficacy of eMBMT on improvements in HRQOL, symptom burden, and disease activity., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)
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- 2024
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11. Late Hepatitis B reactivation after treatment with rituximab
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Sara Lacerda Pereira, Raquel Duro, and António Sarmento
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Rituximab ,HBV reactivation ,Hematologic malignancy ,Infectious and parasitic diseases ,RC109-216 - Abstract
There is a large reservoir of individuals with past hepatitis B virus (HBV) infection that are in risk for HBV reactivation when immunosuppressed. On the setting of hematologic malignancy, the malignancy itself and currently used treatments, especially anti-CD20 agents, have risk of HBV reactivation. Antiviral prophylaxis is recommended by some international societies. We present a case of HBV reactivation more than 12 months after stopping rituximab containing treatment and 6 months of antiviral prophylaxis with entecavir, in a patient with HBV functional cure. The patient was restarted on antivirals and again obtain functional cure. The antiviral was stopped 1 year after seroconversion and the patient followed for another year without evidence of new reactivation. Most literature supports the use of antiviral prophylaxis in patients treated with rituximab. However, there are still conflicting indications and no consensus regarding the duration of prophylaxis. This clinical case and review of the literature supports a longer prophylaxis duration (more than 18 months after finishing rituximab treatments) instead of standard 12 months prophylaxis.
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- 2022
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12. Patient-oncologist discussion of treatment decisions: Exploring the role of a patient-centered communication tool for older adults with acute myeloid leukemia and their caregivers.
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Jensen-Battaglia M, LoCastro M, Oh H, Sanapala C, Flannery M, Mendler JH, Liesveld J, Huselton E, and Loh KP
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- Humans, Aged, Male, Female, Decision Making, Aged, 80 and over, Leukemia, Myeloid, Acute therapy, Leukemia, Myeloid, Acute drug therapy, Caregivers psychology, Communication, Physician-Patient Relations, Patient-Centered Care
- Abstract
Competing Interests: Declaration of Competing Interest Dr. Loh has served as a consultant to Pfizer and Seagen and has received honoraria from Pfizer. All other authors have no relevant conflicts of interest to report.
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- 2024
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13. Fear of cancer recurrence and associated factors in family caregivers of patients with hematologic malignancy receiving chemotherapy: A latent profile analysis.
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Sheng L, Zhu Y, Liu Y, Hua H, Zhou J, and Ye L
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Objective: This study identified the potential subgroups of fear of cancer recurrence (FCR) in family caregivers (FCs) of patients with hematologic malignancies receiving chemotherapy, as well as exploring factors associated with subgroups., Methods: This was a cross-sectional study involving 206 pairs of participating patients with hematologic malignancies receiving chemotherapy and their FCs. Using Mplus 8.3 to perform the latent profile analysis of FCs' FCR, the FCs' burden, quality of life, psychological resilience, and anxiety as well as their demographic characteristics were compared between the subgroups, with a logistic regression analysis being applied to examine the factors associated with the FCR subgroups., Results: A total of 206 FCs were classified into two subgroups: "a low level of FCR" (Class 1, 65.4%) and "a high level of FCR" (Class 2, 34.6%). Quality of life, anxiety, and frequency of chemotherapy were significantly associated with the two subgroups., Conclusions: FCs of patients with hematologic malignancy receiving chemotherapy had two FCR subgroups, "a low level of FCR" and "a high level of FCR", in association with quality of life, anxiety, and frequency of chemotherapy. These findings provide the theoretical foundations for screening the FCR factor of FCs and conducting interventions for them., (© 2024 Published by Elsevier Inc. on behalf of Asian Oncology Nursing Society.)
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- 2024
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14. Efficacy and Safety of Immune Checkpoint Inhibitors in Hematologic Malignancies.
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Bilgihan MT, Eryigit AN, and Ciftciler R
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- Humans, Immune Checkpoint Inhibitors adverse effects, Antibodies, Monoclonal pharmacology, Hematologic Neoplasms therapy, Lymphoma, Non-Hodgkin drug therapy, Lymphoma
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The emergence of immune checkpoint inhibitors (ICIs) has led to a dramatic paradigm shift within the landscape of cancer treatment, igniting significant interest in their potential application in treating hematologic malignancies. This comprehensive review critically has examined the existing body of literature to shed light on the evolving understanding of the efficacy and safety of ICIs, both as a single agent and in combination regimens in hematologic malignancies. Across distinct lymphoma subtypes, the observed treatment responses exhibit diversity, and conflicts. Notably, Hodgkin lymphoma and certain non-Hodgkin lymphomas such as primary mediastinal B-cell lymphoma, emerge as remarkable cases, showing encouraging response rates and outcomes. However, the efficacy of ICIs reveals variations among subtypes such as chronic lymphocytic leukemia and multiple myeloma. Combination therapies consistently demonstrated superior outcomes compared to monotherapy in several malignancies. While the potential benefits of ICIs in hematologic malignancies are evident, the safety profile warrants careful consideration. Immune-related and other adverse events, though generally tolerable and manageable, highlight the necessity of meticulous monitoring and appropriate intervention. The discussions prompted by these findings underscore the need for tailored treatment approaches, driven by disease subtype, patient characteristics, and potential biomarkers. Moreover, the emerging realm of combination therapies involving immune checkpoint inhibitors holds promise for enhanced treatment outcomes, and ongoing research endeavors aim to unravel the optimal strategies., Competing Interests: Disclosure The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)
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- 2024
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15. Multiple Myeloma in Young Patients: A Scoping Review.
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Steinbach M, Neupane K, Aziz M, Lee-Smith W, Julian K, Godara A, McClune B, Kelkar AH, Sborov D, and Mohyuddin GR
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- Young Adult, Humans, Aged, Prognosis, Multiple Myeloma diagnosis, Multiple Myeloma therapy
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Data on the disease course, presenting features, outcomes, and prognosis of younger patients with multiple myeloma (MM) are lacking. Younger patients with MM have historically been considered to have better outcomes primarily based on better tolerance of treatment and lack of medical comorbidities, but the specific age range of this population has not been uniformly defined. Given the lack of consistent data reporting in patients considered to be young MM patients, we performed a scoping review to highlight the research currently available to start drawing conclusions about these patients and highlight unmet areas of need to focus on further investigation. We searched Embase, Cochrane Central Register of Controlled Trials, CINAHL Plus, Web of Science, and the OVID version of MEDLINE including broad terms that embody the concept of young patients with MM. Our final review included 201 studies which were then categorized according to age group, number of patients, outcomes, and comparators to older patients, along with location and database when available. We have chosen to categorize 3 age groupings: <50: young adults with MM (YA MM), 50 to 65: mid-life adults with multiple myeloma (ML MM) and 65+: older adults with multiple myeloma (OA MM). This review demonstrates the heterogeneity that exists in defining and describing young patients with MM, highlights the lack of studies specifically addressing the unique needs of younger patients, and emphasizes areas of future research unique to this population., Competing Interests: Disclosure Mary Steinbach is on speaker's bureau for Janssen, GSK, and has been a consultant for Pfizer. Amandeep Godara reports consulting for Janssen. Douglas Sborov reports consulting/advisory for Janssen, Sanofi, Pfizer, GlaxoSmithKline, Amgen, and Abbvie. Kelley Julian is a consultant for Pfizer., (Copyright © 2023 Elsevier Inc. All rights reserved.)
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- 2024
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16. Subjective intermittent colour vision loss as the initial presentation of chronic myeloid leukemia
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Solin Saleh, Kaisra Esmail, and Danah Albreiki
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Hyperviscosity syndrome ,Colour vision ,Systemic disease ,Hematologic malignancy ,Leukemia ,Ophthalmology ,RE1-994 - Abstract
Purpose: To report a case of subjective intermittent loss of bilateral colour vision and episodic white-out vision in a patient with undiagnosed chronic myeloid leukemia (CML). Observations: A patient initially diagnosed with diabetic retinopathy presented with a chief complaint of subjective intermittent loss of colour vision in both eyes, as well as intermittent bilateral white-out vision. These symptoms previously went uninvestigated until a thorough history revealed concurrent constitutional symptoms including recent night sweats and fevers. Closer fundus examination revealed that the lesions previously thought to be diabetic retinal hemorrhages were Roth spots. Conclusions: and Importance: An unusual chief complaint of colour vision loss and multiple Roth spots in the context of chronic night sweats and fevers prompted further workup. A CBC with differential revealed a markedly increased WBC count and the patient was diagnosed with CML. Cytoreduction therapy led to complete resolution of the patient's visual symptoms and a return to normal WBC count at the most recent follow up appointment. We report, to our knowledge, the only case of colour vision loss as the initial presenting symptom of CML in the current literature, and reiterate the importance of a thorough history, neuro-ophthalmic examination and relevant investigations in patients with unusual visual symptoms, including intermittent loss of colour vision. In this case, we speculate that hyperviscosity syndrome secondary to CML was the cause of this patient's peculiar visual disturbance.
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- 2020
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17. Differences in characteristics between first and breakthrough neutropenic fever after chemotherapy in patients with hematologic disease
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Eun Young Nam, Kyoung-Ho Song, Nak-Hyun Kim, Moonsuk Kim, Chung-Jong Kim, Jeong-Ok Lee, Pyoeng Gyun Choe, Wan Beom Park, Ji-Hwan Bang, Eu Suk Kim, Sang-Won Park, Hong Bin Kim, Soo-Mee Bang, Nam Joong Kim, and Myoung-don Oh
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Breakthrough infections ,Febrile neutropenia ,Hematologic malignancy ,Infectious and parasitic diseases ,RC109-216 - Abstract
Objective: This study was conducted to compare the clinical and microbiological characteristics of first and breakthrough neutropenic fever in hematologic malignancy patients after chemotherapy. Methods: Breakthrough neutropenic fever was any episode of fever, not present initially, that developed either during antibiotic therapy or within 1 week of discontinuation of therapy. A total of 687 neutropenic fever episodes in 241 patients were observed from April 2003 to March 2014. Results: Blood cultures revealed 210 causative microorganisms: 199 (94.8%) were bacteria and 11 (5.2%) were fungi. Gram-negative bacteria predominated in both types of neutropenic episode (first 75% (120/160) vs. breakthrough 56% (18/32)) and the most common pathogen was Escherichia coli. Antibiotic resistance rates were higher in breakthrough episodes than first episodes (piperacillin/tazobactam 6% vs. 31%, p = 0.006; ceftazidime 9% vs. 31%, p = 0.025). Inappropriate empirical antibiotic treatment was also more frequent (0% vs. 19%, p = 0.001), as was the 30-day mortality rate (4.3% (19/442) vs. 7.9% (19/245), p = 0.058), although the latter effect was not statistically significant. Conclusion: It is concluded that the epidemiological profile of breakthrough neutropenic fever is different from that of first episode fever. These data reinforce the view that pooled reporting of neutropenic fever may be misleading, and that clinicians should approach breakthrough fever as a distinct entity.
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- 2016
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18. Nomogram model for predicting frailty of patients with hematologic malignancies - A cross-sectional survey.
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Luo S, Zhao H, Gan X, He Y, Wu C, and Ying Y
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Objective: This study aimed to develop and validate an assessment tool for predicting and mitigating the risk of frailty in patients diagnosed with hematologic malignancies., Methods: A total of 342 patients with hematologic malignancies participated in this study, providing data on various demographics, disease-related information, daily activities, nutritional status, psychological well-being, frailty assessments, and laboratory indicators. The participants were randomly divided into training and validation groups at a 7:3 ratio. We employed Lasso regression analysis and cross-validation techniques to identify predictive factors. Subsequently, a nomogram prediction model was developed using multivariable logistic regression analysis. Discrimination ability, accuracy, and clinical utility were assessed through receiver operating characteristic (ROC) curves, C-index, calibration curves, and decision curve analysis (DCA)., Results: Seven predictors, namely disease duration of 6-12 months, disease duration exceeding 12 months, Charlson Comorbidity Index (CCI), prealbumin levels, hemoglobin levels, Generalized Anxiety Disorder-7 (GAD-7) scores, and Patient Health Questionnaire-9 (PHQ-9) scores, were identified as influential factors for frailty through Lasso regression analysis. The area under the ROC curve was 0.893 for the training set and 0.891 for the validation set. The Hosmer-Lemeshow goodness-of-fit test confirmed a good model fit. The C-index values for the training and validation sets were 0.889 and 0.811, respectively. The DCA curve illustrated a higher net benefit when using the nomogram prediction model within patients threshold probabilities ranging from 10% to 98%., Conclusions: This study has successfully developed and validated an effective nomogram model for predicting frailty in patients diagnosed with hematologic malignancies. The model incorporates disease duration (6-12 months and>12 months), CCI, prealbumin and hemoglobin levels, GAD-7, and PHQ-9 scores as predictive variables., (© 2023 The Author(s).)
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- 2023
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19. Hepatitis B reactivation in patients with multiple myeloma and isolated positive hepatitis B core antibody: a call for greater cognizance
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Ju Dong Yang, Mohit Girotra, Alejandro Restrepo, Sarah Waheed, Bart Barlogie, and Andres Duarte-Rojo, M.D., M.Sc.
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Viral hepatitis ,Chemotherapy ,Bone marrow transplant ,Hematologic malignancy ,Specialties of internal medicine ,RC581-951 - Abstract
Hepatitis B virus (HBV) reactivation is a well-established complication of severe immunosuppression in patients with hematologic malignancy and positive hepatitis B surface antigen (HBsAg). Patients who receive high-dose chemotherapy, corticosteroids, rituximab, or have a bone marrow transplant are particularly at increased risk for HBV reactivation. However, limited information is available in the literature regarding HBV reactivation in patients with isolated anti-HBc, particularly in the setting of multiple myeloma (MM). We report two cases of HBV reactivation in MM patients with isolated anti-HBc positive with a rather atypical presentation. In conclusion, our cases highlight that clinicians need to be cognizant about this potentially fatal but preventable complication of chemotherapy and immunosuppression.
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- 2014
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20. Long-term maintenance of eosinophilic dermatosis of hematologic malignancy with doxycycline
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Mark Jacobson, Alexandra K. Rzepecki, Beth N. McLellan, Jack Jacob, Karolina Mieczkowska, and Bijal Amin
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medicine.medical_specialty ,Chronic lymphocytic leukemia ,BP, bullous pemphigoid ,Eosinophilic dermatosis ,Case Report ,lymphoma ,Dermatology ,medicine ,Hematologic malignancy ,insect bite–like eruption ,Doxycycline ,eosinophilic dermatosis of hematologic malignancy ,EDHM, eosinophilic dermatosis of hematologic malignancy ,CLL, chronic lymphocytic leukemia ,business.industry ,leukemia ,Long term maintenance ,medicine.disease ,Lymphoma ,Leukemia ,RL1-803 ,chronic lymphocytic leukemia ,Bullous pemphigoid ,business ,medicine.drug - Published
- 2021
21. Quantitative analysis of mRNA-1273 COVID-19 vaccination response in immunocompromised adult hematology patients
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Sabine Haggenburg, Birgit I. Lissenberg-Witte, Rob S. van Binnendijk, Gerco den Hartog, Michel S. Bhoekhan, Nienke J. E. Haverkate, Dennis M. de Rooij, Johan van Meerloo, Jacqueline Cloos, Neeltje A. Kootstra, Dorine Wouters, Suzanne S. Weijers, Ester M. M. van Leeuwen, Hetty J. Bontkes, Saïda Tonouh-Aajoud, Mirjam H. M. Heemskerk, Rogier W. Sanders, Elianne Roelandse-Koop, Quincy Hofsink, Kazimierz Groen, Lucia Çetinel, Louis Schellekens, Yvonne M. den Hartog, Belle Toussaint, Iris M. J. Kant, Thecla Graas, Emma de Pater, Willem A. Dik, Marije D. Engel, Cheyenne R. N. Pierie, Suzanne R. Janssen, Edith van Dijkman, Meliawati Poniman, Judith A. Burger, Joey H. Bouhuijs, Gaby Smits, Nynke Y. Rots, Sonja Zweegman, Arnon P. Kater, Tom van Meerten, Pim G. N. J. Mutsaers, Jaap A. van Doesum, Annoek E. C. Broers, Marit J. van Gils, Abraham Goorhuis, Caroline E. Rutten, Mette D. Hazenberg, Inger S. Nijhof, Hematology laboratory, AII - Cancer immunology, CCA - Cancer biology and immunology, Laboratory Medicine, Amsterdam Gastroenterology Endocrinology Metabolism, Hematology, Immunology, Stem Cell Aging Leukemia and Lymphoma (SALL), Graduate School, Clinical Haematology, Experimental Immunology, APH - Aging & Later Life, AII - Infectious diseases, Laboratory for General Clinical Chemistry, Medical Microbiology and Infection Prevention, Infectious diseases, and APH - Global Health
- Subjects
COVID-19 Vaccines ,SARS-CoV-2 ,COVID-19/prevention & control ,Vaccination ,COVID-19 ,Regular Article ,lymphoma ,Hematology ,acute myeloid leukemia ,myelodysplastic syndrome ,mRNA-1273 ,multiple myeloma ,SDG 3 - Good Health and Well-being ,chronic myeloid leukemia ,humoral immunity ,hemic and lymphatic diseases ,hematopoietic stem cell transplantation ,hematologic malignancy ,chronic lymphocytic leukemia ,CAR T cell therapy ,Humans ,IgG antibodies ,sickle cell disease ,myeloproliferative disease ,2019-nCoV Vaccine mRNA-1273 - Abstract
Vaccination guidelines for patients treated for hematological diseases are typically conservative. Given their high risk for severe COVID-19, it is important to identify those patients that benefit from vaccination. We prospectively quantified serum immunoglobulin G (IgG) antibodies to spike subunit 1 (S1) antigens during and after 2-dose mRNA-1273 (Spikevax/Moderna) vaccination in hematology patients. Obtaining S1 IgG ≥ 300 binding antibody units (BAUs)/mL was considered adequate as it represents the lower level of S1 IgG concentration obtained in healthy individuals, and it correlates with potent virus neutralization. Selected patients (n = 723) were severely immunocompromised owing to their disease or treatment thereof. Nevertheless, >50% of patients obtained S1 IgG ≥ 300 BAUs/mL after 2-dose mRNA-1273. All patients with sickle cell disease or chronic myeloid leukemia obtained adequate antibody concentrations. Around 70% of patients with chronic graft-versus-host disease (cGVHD), multiple myeloma, or untreated chronic lymphocytic leukemia (CLL) obtained S1 IgG ≥ 300 BAUs/mL. Ruxolitinib or hypomethylating therapy but not high-dose chemotherapy blunted responses in myeloid malignancies. Responses in patients with lymphoma, patients with CLL on ibrutinib, and chimeric antigen receptor T-cell recipients were low. The minimal time interval after autologous hematopoietic cell transplantation (HCT) to reach adequate concentrations was
- Published
- 2022
22. Risk of lymphoid malignancies increased after Puumala virus infection in Finland, 2009-2019: A retrospective register-based cohort study.
- Author
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Kääriäinen S, Ollgren J, Dub T, Laine O, Sinisalo M, Hepojoki J, Strandin T, Kekäläinen E, Sane J, and Lyytikäinen O
- Subjects
- Humans, Finland epidemiology, Cohort Studies, Retrospective Studies, Puumala virus, Hemorrhagic Fever with Renal Syndrome epidemiology, Hantavirus Infections epidemiology, Neoplasms etiology, Neoplasms complications
- Abstract
Objectives: The Puumala virus (PUUV) is a hantavirus that causes hemorrhagic fever with renal syndrome. Studies showing an increased risk of lymphoid malignancies after hantavirus infection, together with the observation that PUUV infects B cells, motivated us to study the risk of lymphoid malignancies after PUUV infection., Methods: We linked data from the Finnish Cancer Registry and National Infectious Diseases Register for 2009-2019. We used a time-dependent Cox regression model to evaluate the hazard of the lymphoid malignancies grouped according to the HAEMACARE classification., Results: We identified 68 cases of lymphoid malignancies after PUUV infection among 16,075 PUUV-infected individuals during 61,114,826 person-years of observation. A total of 10 cases occurred within 3-<12 months and 38 within 1-<5 years after PUUV infection, and the risk of lymphoid malignancies increased with hazard ratios (HRs) of 2.0 (95% confidence interval [CI], 1.1-3.7) and 1.6 (95% CI, 1.2-2.3), respectively. The group of mature B cell neoplasms showed an increased risk 3-<12 months and 1-<5 years after PUUV infection, HR 2.2 (95% CI, 1.2-4.3) and HR 1.8 (95% CI, 1.3-2.5), respectively., Conclusion: PUUV infection is associated with lymphoid malignancies in the Finnish population, supporting the earlier studies. Further research is required to understand the pathophysiological mechanisms behind this association., Competing Interests: Declaration of competing interest TD works in Monitoring Outbreaks for Disease surveillance in a data science context (MOOD)/Horizon 2020 project, for which funding is received from the Finnish Institute for Health and Welfare and is a member of the executive board of MOOD Horizon 20202. TD also works on a project for vector-borne diseases and climate change in Finland (VECLIMIT), for which funding is received by the Finnish Institute for Health and Welfare from the Academy of Finland. JS owns stocks in a company (Genmab) that is involved in lymphoma drug development. EK reports a grant paid for their institution from the Finnish Society of Sciences and Letters for PUUV research outside of the submitted work., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2023
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23. Baseline risk of hematologic malignancy at initiation of frontline PARP inhibitor maintenance for BRCA1/2-associated ovarian cancer
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Anastasia Navitski, Karen Cadoo, Diana Mandelker, Duaa H. Al-Rawi, Roisin E. O'Cearbhaill, Raajit K. Rampal, Claire F. Friedman, Maria M. Rubinstein, and Ying Liu
- Subjects
Oncology ,medicine.medical_specialty ,endocrine system diseases ,Baseline risk ,Germline ,Ovarian cancer ,Internal medicine ,hemic and lymphatic diseases ,medicine ,Hematologic malignancy ,Case Reports and Case Series ,PARP inhibitors ,RC254-282 ,Acute myeloid leukemia ,business.industry ,Advanced stage ,Clonal hematopoiesis ,BRCA mutation ,Obstetrics and Gynecology ,Myeloid leukemia ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Gynecology and obstetrics ,medicine.disease ,female genital diseases and pregnancy complications ,PARP inhibitor ,RG1-991 ,business ,Myelodysplastic syndrome - Abstract
Highlights • PARP inhibitors (PARPi) reduce the risk of ovarian cancer progression and recurrence after response to platinum chemotherapy. • Rarely, PARPi are associated with increased risk of hematologic malignancies (MDS/AML) in some patients with ovarian cancer. • The causal relationship between PARPi and leukemogenesis is unclear but may be associated with cumulative chemotherapy. • We present 3 patients with germline BRCA-associated ovarian cancer and mutations potentially associated with risk of MDS/AML. • The clinical benefit of PARPi should be viewed with caution in patients with elevated baseline risk of developing MDS/AML., Poly(ADP-ribose) polymerase inhibitors (PARPi) are FDA approved as frontline maintenance for BRCA-associated advanced stage high-grade ovarian cancer (HGOC), having demonstrated an unprecedented improvement in relapse-free survival. Myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) are rare toxicities of PARPi. We describe three patients with germline BRCA-associated (gBRCA+) HGOC and alterations in AML driver genes. Although none evidenced overt hematologic malignancy, PARPi maintenance was cautiously considered given the potential risk of MDS/AML. A better understanding of the role of clonal hematopoiesis in the subsequent development of PARPi-associated MDS/AML will improve management of this patient population.
- Published
- 2021
24. Advance care planning in older patients with acute myeloid leukemia and myelodysplastic syndromes.
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LoCastro M, Sanapala C, Mendler JH, Norton S, Bernacki R, Carroll T, Klepin H, Watson E, Liesveld J, Huselton E, O'Dwyer K, Baran A, Flannery M, Kluger BM, and Loh KP
- Subjects
- Humans, Aged, Delivery of Health Care, Myelodysplastic Syndromes therapy, Leukemia, Myeloid, Acute therapy, Advance Care Planning
- Abstract
Introduction: Older patients with acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) have worse survival rates compared to younger patients, and experience more intense inpatient healthcare at the end of life (EOL) compared to patients with solid tumors. Advance care planning (ACP) has been shown to limit aggressive and burdensome care at EOL for patients with AML and MDS. The purpose of this study was to better understand ACP from the perspective of clinicians, older patients with AML and MDS, and their caregivers., Materials and Methods: We conducted semi-structured interviews with 45 study participants. Interviews were audio-recorded and transcribed. Open coding and focused content analysis were used to organize data and develop and contextualize categories and subcategories., Results: Guided by our specific aims, we developed four themes: (1) The language of ACP and medical order for life-sustaining treatment (MOLST) does not resonate with patients, (2) There is no uniform consensus on when ACP is currently happening, (3) Oncology clinician-perceived barriers to ACP (e.g., patient discomfort, patient lack of knowledge, and lack of time), and (4) Patients felt that they are balancing fear and hope when navigating their AML or MDS diagnosis., Discussion: The results of this study can be used to develop interventions to promote serious illness conversations for patients with AML and MDS and their caregivers to ensure that patient care aligns with patient values., Competing Interests: Declaration of Competing Interest Dr. Loh has served as a consultant to Pfizer and Seattle Genetics and has received honoraria from Pfizer., (Copyright © 2022 Elsevier Ltd. All rights reserved.)
- Published
- 2023
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25. Leukemia Research Reports
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leukemia ,lymphoma ,multiple myeloma ,hematologic malignancy ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Published
- 2015
26. Clinical implementation of genetic testing in adults for hereditary hematologic malignancy syndromes.
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Ansar S, Malcolmson J, Farncombe KM, Yee K, Kim RH, and Sibai H
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- Adult, Humans, Retrospective Studies, Medical History Taking, Bone Marrow, Genetic Predisposition to Disease, Genetic Testing, Hematologic Neoplasms diagnosis, Hematologic Neoplasms genetics, Hematologic Neoplasms epidemiology
- Abstract
Purpose: As research on hereditary hematologic malignancy syndromes (HHMS) are accumulating, cancer genetics clinics are identifying more adult hematology patients with an inherited component to their disease. However, investigations for HHMS are complex, and there is no formal consensus on genetic testing criteria., Methods: We developed genetic testing criteria for adult hematology patients through a comprehensive literature review and our experience at the Princess Margaret Cancer Centre. We validated our criteria by applying them retrospectively to patients referred to our clinic for HHMS assessment., Results: Our genetic testing criteria are comprehensive of myeloid malignancies, lymphoid malignancies, and bone marrow failure, including age at diagnosis, family history, and genetic test results in blood and bone marrow. Of the 104 patients who met the criteria, 26% had at least 1 actionable variant in any gene associated with an increased risk of cancer and 13% had an actionable variant resulting in an HHMS diagnosis. A total of 15 patients had incidental findings, including 11 patients with a pathogenic variant associated with carrier status for an autosomal recessive disorder and 4 patients with a mosaic result., Conclusion: Our high gene positivity rate shows the utility of a broad approach to germline testing in an adult hematology population., Competing Interests: Conflict of Interest The authors declare no conflict of interest., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)
- Published
- 2022
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27. Systematic search for the UBA1 mutation in men after a first episode of venous thromboembolism: A monocentric study.
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Khider L, Templé M, Bally C, Spaeth A, Darnige L, Sanchez O, Planquette B, Mortelette H, Messas E, Smadja DM, Emmerich J, Mirault T, Kosmider O, and Gendron N
- Subjects
- Humans, Male, Factor V genetics, Mutation, Risk Factors, Thrombophilia genetics, Venous Thromboembolism diagnosis, Venous Thromboembolism genetics
- Published
- 2022
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28. Symptom experiences of critically-ill hematologic malignancy patients: A scoping review.
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Moore JE, Munshi L, Mayo SJ, Armstrong G, and Dale CM
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- Case-Control Studies, Critical Care, Humans, Intensive Care Units, Critical Illness, Hematologic Neoplasms complications
- Abstract
Context: Critically-ill patients with hematologic malignancies are increasingly admitted to intensive care units globally. Unrelieved symptoms during intensive care treatment may contribute to poor outcomes., Objective: To better understand the symptom experience(s) for critically-ill patients with hematologic malignancies., Methods: A scoping review was conducted searching Medline, CINAHL, PychInfo, Embase, and ProQuest databases, the Cochrane Library, and the grey literature between January 1st, 1990 and July 15th, 2020. Two authors independently reviewed articles for inclusion and verified abstracted data., Results: Seventeen articles met inclusion criteria, including 11 cohort studies, 1 case-control study, and five review articles. No qualitative or mixed-method studies were retrieved. Symptoms were reported as the primary outcome across two studies (17%). Reported hematologic malignancy subtypes included leukemia and/or myelodysplastic syndrome (9, 53%), lymphoma (8, 47%), multiple myeloma (7, 41%), and aplastic anemia (2, 12%). The principal indication for ICU admission was respiratory failure, followed by cardiogenic shock/cardiac failure, endocrine disturbances, sepsis, and neurological failure. Only one study used validated tools for evaluating symptoms. Thirty-four symptoms were reported: altered level of consciousness/coma (35%); diarrhea (35%); nausea (35%); dyspnea (35%); vomiting (29%); and pain (29%). Two articles (13%) identified symptom clusters., Conclusion: There is minimal research that measures and explores the symptom experiences of critically-ill patients with hematologic malignancies. New research in this domain is needed to inform targeted symptom care for this vulnerable patient population., (Copyright © 2021 Elsevier Ltd. All rights reserved.)
- Published
- 2022
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29. Feasibility of implementing an exercise intervention in older adults with hematologic malignancy.
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Rosko A, Huang Y, Jones D, Presley CJ, Jaggers J, Owens R, Naughton M, and Krok-Schoen JL
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- Aged, Aged, 80 and over, Clinical Trials as Topic, Exercise Therapy, Feasibility Studies, Humans, Middle Aged, Patient Participation, Self Efficacy, Exercise, Hematologic Neoplasms therapy
- Abstract
Older adults with Hematologic Malignancy (HM) are vulnerable to functional decline secondary to disease and treatment. Interventions for physical deconditioning, in concert with routine hematology care are limited. The feasibility of accrual, retention, and demand for an exercise intervention among a high-risk HM population was piloted., Methods: Older adults with HM, on active treatment, with functional impairment were recruited prospectively to participate in a 6-month Otago Exercise Programme (OEP). Measures of motivation, self-efficacy, patient identified barriers to exercise, barriers to clinical trial enrollment, study satisfaction, and serious adverse events were captured., Results: 63 patients were approached, 18 declined trial enrollment, 45 consented, 30 patients enrolled in the exercise program. The main barrier for trial enrollment was transportation/travel concerns (n = 15). Of the 45 consented participants, 8 (12.7%) dropped out due to clinical deterioration, 5 (7.9%) withdrew, and 2 (3.2%) were ineligible prior to exercise-intervention intiation. The median age was 75.5 years (range 62-83) with plasma cell dyscrasia (63%), non-Hodgkin lymphoma (20%) and leukemia (17%). Retention of the physical therapist (PT) led-OEP was 76.6% of patients (n = 23/30), and end-of-study retention was 66.7% (n = 20/30). Of the evaluable patients, 23/29 completed the PE-led OEP yielding a completion rate of 79%. Participants were extremely motivated (72.4%) and strongly intended (89.7%) to engage in regular physical activity. Exercising when tired increased from a median score of 50 at Visit 1 to 70 at Visit 2, but dropped significantly to 45 at Visit 3 (p < 0.001). Participants reported significantly lower self-efficacy to exercise over the next 6 months from Visit 1 to Visit 3 (p = 0.001)., Conclusions: Older patients with HM had higher completion of in-person, PT-led exercise compared to at-home, independent exercise. Older adults were motivated and found the program acceptable, yet the ability to sustain a structured exercise program was challenging due to changes in health status. ClinicalTrials.gov Identifier: NCT02791737., (Copyright © 2021 Elsevier Ltd. All rights reserved.)
- Published
- 2022
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30. The Effects of Exercise Prescription on Aerobic Performance and Quality of Life During the Course of Lymphoma Chemotherapy: Results of a Prospective Controlled Study.
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Sahin U, Dundar I, Celebi MM, Merter M, Oktay EI, Zergeroglu AM, and Ozcan M
- Subjects
- Adult, Female, Humans, Lymphoma pathology, Male, Middle Aged, Prospective Studies, Exercise physiology, Lymphoma drug therapy, Lymphoma therapy, Quality of Life psychology
- Abstract
Background and Aim: This study is designed to investigate the physical, psychological and quality of life (QoL) effects of a 16 week supervised and structured intensive aerobic and strength training during the first line chemotherapy of lymphomas., Patients and Methods: This pre-post study with two groups enrolled ≥18 years of age lymphoma patients scheduled for the first line chemotherapy. Eligible patients were assigned upon patients' preference either to control group (Group C) involving simple counselling, or intervention group (Group I) involving supervised intensive training. Baseline, interim and final evaluations were performed per protocol. Repeated measures analysis of variance was used to investigate the effect of intervention., Results: The mean age of 47 enrolled patients was 44 [standard deviation (SD) ± 17] and 27 (57.4%) of them were male. Patients in Group C (n = 19) and Group I (n = 28) had similar baseline characteristics. T
max was significantly higher in Group I (P = .03) without a significant change during the study course (P = .98). Significant increases were observed in the power of some muscle groups, irrespective of the intervention type. The mean adherence rates were 83.0% (SD ± 22.0) and 54.0% (SD ± 23.0); the discontinuation rates were 10.7% (n = 3) and 42.9% (n = 12), at interim and final evaluations, respectively., Conclusion: Both supervised and structured schemes and simple counselling, prevent further muscle wasting and lead to modest improvements in aerobic performance and muscle strength during lymphoma chemotherapy. These results do not translate into a significant improvement in QoL measures. Non-adherence and discontinuation are important issues to be solved., (Copyright © 2021 Elsevier Ltd. All rights reserved.)- Published
- 2022
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31. COVID-19 in 96 Patients With Hematologic Disease: The First Single-center Experience From the Czech Republic.
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Čerňan M, Szotkowski T, Obr A, Látal V, Hluší A, Krhovská P, Klementová O, Kolář M, Sauer P, Faber E, Fürst T, and Papajík T
- Subjects
- Adult, Aged, Aged, 80 and over, Bone Marrow Failure Disorders complications, Bone Marrow Failure Disorders diagnosis, Bone Marrow Failure Disorders epidemiology, Bone Marrow Failure Disorders therapy, COVID-19 Testing methods, COVID-19 Testing statistics & numerical data, Czech Republic epidemiology, Disease Progression, Female, Hematologic Neoplasms complications, Hematologic Neoplasms diagnosis, Hematologic Neoplasms epidemiology, Hematologic Neoplasms therapy, Hospitalization statistics & numerical data, Humans, Male, Middle Aged, Mortality, Prevalence, SARS-CoV-2 physiology, COVID-19 complications, COVID-19 diagnosis, COVID-19 epidemiology, COVID-19 therapy, Hematologic Diseases complications, Hematologic Diseases diagnosis, Hematologic Diseases epidemiology, Hematologic Diseases therapy
- Abstract
Background: Coronavirus disease 2019 (COVID-19) represents an important infectious complication associated with high mortality rates in patients with hematologic diseases. There have not been published any epidemiologic studies from Czech Republic so far., Patients and Methods: This study is the first analysis of patients with hematologic malignancies and bone marrow failure syndromes treated at single hematology center in the Czech Republic between March 1 and December 31, 2020, in whom COVID-19 infection was confirmed., Results: The sample comprised 96 patients aged 26 to 84 years (median, 66.0 years). At the time of their COVID-19 diagnosis, 75 patients (78.1%) were treated for hematologic diseases. Twenty-seven patients (28.1%) in the sample had complete remission (CR) of their hematologic disease. They were nonsignificantly more likely to have asymptomatic to moderate COVID-19 infection than those who failed to achieve CR (74.1% vs. 56.5%; P = .06). A more severe course of the infection was significantly correlated with older age (P = .047). Lung involvement was also statistically significantly associated with older age (P = .045). Over the study period, a total of 15 patients died. Age greater than 60 years was significantly associated with deaths from COVID-19 (P = .036), with failure to achieve CR having a statistically nonsignificant impact on mortality (P = .22)., Conclusion: These results confirm the prognostic significance of age for achieving treatment response of hematologic disease as well as the severity and mortality of COVID-19 in hematology patients., (Copyright © 2021 Elsevier Ltd. All rights reserved.)
- Published
- 2021
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32. Free of malignancy but not of fears: A closer look at Damocles syndrome in survivors of hematologic malignancies.
- Author
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Alabdaljabar MS, Muhsen IN, Knight JM, Syrjala KL, and Hashmi SK
- Subjects
- Combined Modality Therapy, Disease Management, Disease Progression, Hematologic Neoplasms therapy, Humans, Public Health Surveillance, Quality of Life, Recurrence, Syndrome, Treatment Outcome, Cancer Survivors psychology, Fear psychology, Hematologic Neoplasms epidemiology, Hematologic Neoplasms psychology
- Abstract
Fear of cancer recurrence (FoR) is an important yet underestimated long term sequela that many cancer survivors suffer from. The continuous state of uncertainty the survivors might go through can lead to a serious impact on their quality of life (QoL), which is collectively referred to as Damocles syndrome. Given the increasing numbers of cancer survivors, it is crucial to understand the different psychological issues that face them, including Damocles syndrome. Herein, we review the current literature of Damocles syndrome specifically in hematologic cancer survivors. Although with inconsistent terms, current literature demonstrates the impact and the prevalence of Damocles syndrome on QoL of survivors of leukemia, lymphoma, and hematopoietic cell transplant. Interventional studies are very limited in this area. Moreover, hematologic malignancy survivors can also meet the diagnostic criteria of other psychiatric diseases, including depression, anxiety, and post-traumatic stress disorder, wherein they should be managed accordingly. It is important to increase the awareness about Damocles syndrome and screen patients for it and other related psychological disorders. Additionally, this review has shown the need for standardization of Damocles syndrome definitions. Finally, the lack of interventional studies that target survivors' psychosocial challenges calls for prospective research to better address this rising problem., (Copyright © 2020 Elsevier Ltd. All rights reserved.)
- Published
- 2021
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33. Secondary pulmonary alveolar proteinosis in hematologic malignancies
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Chakra P Chaulagain, Laurence H. Brinckerhoff, Monika Pilichowska, John K. Erban, and Maher Tabba
- Subjects
Adult ,Bronchoalveolar lavage ,Bendamustine ,Hematologic malignancy ,Pathology ,medicine.medical_specialty ,Chronic lymphocytic leukemia ,medicine.medical_treatment ,Hematopoietic stem cell transplantation ,Pulmonary Alveolar Proteinosis ,lcsh:RC254-282 ,Young Adult ,medicine ,Humans ,Opportunistic infections ,medicine.diagnostic_test ,business.industry ,lcsh:RC633-647.5 ,Hematology ,General Medicine ,lcsh:Diseases of the blood and blood-forming organs ,medicine.disease ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Panmyelosis ,Secondary pulmonary alveolar proteinosis ,Oncology ,Hematologic Neoplasms ,Female ,Rituximab ,Pulmonary alveolar proteinosis ,business ,medicine.drug - Abstract
Pulmonary alveolar proteinosis (PAP), characterized by deposition of intra-alveolar PAS positive protein and lipid rich material, is a rare cause of progressive respiratory failure first described by Rosen et al. in 1958. The intra-alveolar lipoproteinaceous material was subsequently proven to have been derived from pulmonary surfactant in 1980 by Singh et al. Levinson et al. also reported in 1958 the case of 19-year-old female with panmyelosis afflicted with a diffuse pulmonary disease characterized by filling of the alveoli with amorphous material described as “intra-alveolar coagulum”. This is probably the first reported case of PAP in relation to hematologic malignancy. Much progress has been made on PAP first described by Rosen which is currently classified as idiopathic or primary or autoimmune PAP. Idiopathic PAP occurs as a result of auto-antibodies directed against granulocyte–macrophage colony stimulating factor (GM-CSF) impeding the surfactant clearing function of alveolar macrophages leading to progressive respiratory failure. Whole lung lavage and GM-CSF therapy has improved outcomes in patients with idiopathic PAP. Despite major advancement in the management of hematologic malignancy and its complications, little is known about the type of PAP first described by Levinson and now known as secondary PAP; a term also used when PAP occurs due to other causes such as occupational dusts. In this article we review and analyze the limited literature available in secondary PAP due to hematologic malignancies and present a case of PAP associated with chronic lymphocytic leukemia successfully treated with bendamustine and rituximab. Keywords: Secondary pulmonary alveolar proteinosis, Hematologic malignancy, Bronchoalveolar lavage, Opportunistic infections, Hematopoietic stem cell transplantation
- Published
- 2014
34. Casting a wider protective net: Anti-infective vaccine strategies for patients with hematologic malignancy and blood and marrow transplantation.
- Author
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McMasters M, Blair BM, Lazarus HM, and Alonso CD
- Subjects
- Humans, Bone Marrow Transplantation, Hematologic Neoplasms therapy, Hematopoietic Stem Cell Transplantation, Immunomodulation, Infection Control, Infections, Vaccines therapeutic use
- Abstract
Patients who have hematologic malignancies are at high risk for infections but vaccinations may be effective prophylaxis. The increased infection risk derives from immune defects secondary to malignancy, the classic example being CLL, and chemotherapies and immunotherapy used to treat the malignancies. Therapy of hematologic malignancies is being revolutionized by introduction of novel targeted agents and immunomodulatory medications, improving the survival of patients. At the same time those agents uniquely change the infection risk and response to immunizations. This review will summarize current vaccine recommendations for patients with hematologic malignancies including patients who undergo hematopoietic cell transplant., (Copyright © 2020. Published by Elsevier Ltd.)
- Published
- 2021
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35. Burden of Treatment Among Older Adults With Newly Diagnosed Multiple Myeloma.
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Mian HS, Fiala MA, and Wildes TM
- Subjects
- Aged, Aged, 80 and over, Humans, Multiple Myeloma diagnosis, SEER Program statistics & numerical data, United States, Cost of Illness, Multiple Myeloma therapy, Patient Acceptance of Health Care statistics & numerical data
- Abstract
Background: Multiple myeloma is an incurable hematologic malignancy with significant recent treatment advances; however, the magnitude of treatment burden among patients in the first year after diagnosis has yet to be fully researched and reported., Patients and Methods: Patients with multiple myeloma newly diagnosed between 2007 and 2013 were identified in the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked databases. Treatment burden was captured as the number of total days with a health care encounter (including acute care and outpatient visits), oncology and nononcology physician visits, and the number of new prescriptions within the first year after diagnosis. Logistic regression was used to identify factors associated with high treatment burden., Results: A total of 3065 patients were included in the analysis. There was a substantial burden of treatment within the first year after diagnosis (median, 77 days; interquartile range, 55-105 days), which was highest during the first 3 months. Patients with high comorbidities (adjusted odds ratio [aOR] 1.27 per 1-point increase in Charlson comorbidity index, P < .001), poor performance status (aOR 1.85, P < .001), myeloma-related end organ damage, particularly bone disease (aOR 2.28, P < .001), and those who underwent autologous stem-cell transplantation (aOR 2.41, P < .001) were more likely to have a higher treatment burden., Conclusion: There is considerable burden of treatment in patients with newly diagnosed multiple myeloma within the first year after diagnosis, particularly within the first 3 months. Future tailored interventions aimed at optimizing this treatment burden when possible while simultaneously providing support to manage it may improve patient-centered care., (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Published
- 2021
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36. Receipt of Statins Is Associated With Lower Risk of Multiple Myeloma: Systematic Review and Meta-analysis.
- Author
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Ponvilawan B, Charoenngam N, Rittiphairoj T, and Ungprasert P
- Subjects
- Aged, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors pharmacology, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Multiple Myeloma prevention & control
- Abstract
Background: Studies on receipt of statins and risk of multiple myeloma (MM) yielded conflicting results. This systematic review and meta-analysis was conducted in order to comprehensively investigate the relationship between receipt of statins and risk of MM., Patients and Methods: Potentially eligible studies that compared the risk of MM between statin recipients and those who did not receive statins were identified from Medline and Embase databases from inception to August 2019 using a search strategy that comprised terms for "statin" and "multiple myeloma." To be eligible, cohort studies must have recruited 2 groups of participants, statin recipients and nonrecipients, and followed their participants for incident MM. Eligible case-control studies must have recruited cases of MM and controls without MM, and must have explored the history of receipt of statins. Relative risk, hazard risk ratio, standardized incidence ratio, or odds ratio (OR) of this association must be reported. Relative risk and standard error from each study were extracted and combined using random-effect generic inverse variance. Relative risk of cohort study was used as an estimate for OR to calculate the pooled effect estimate along with the OR of the case-control studies., Results: A total of 1744 articles were identified using the search strategy, and 10 studies were included in the meta-analysis. The odds of MM were significantly lower among statin recipients than nonrecipients, with a pooled OR of 0.80 (95% confidence interval, 0.68-0.93; I
2 72%). The funnel plot was relatively symmetrical and did not suggest publication bias., Conclusion: Receipt of statins is associated with a significant 20% reduction in the odds of MM., (Copyright © 2020 Elsevier Inc. All rights reserved.)- Published
- 2020
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37. Bendamustine-rituximab (BR) combined therapy for treatment of immuno-mediated neuropathies associated with hematologic malignancy.
- Author
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Massa F, Zuppa A, Pesce G, Demichelis C, Bergamaschi M, Garnero M, Briani C, Ferrari S, Schenone A, and Benedetti L
- Subjects
- Bendamustine Hydrochloride, Humans, Myelin-Associated Glycoprotein, Neoplasm Recurrence, Local, Rituximab therapeutic use, Hematologic Neoplasms, Polyneuropathies complications, Polyneuropathies drug therapy, Polyradiculoneuropathy, Chronic Inflammatory Demyelinating complications, Polyradiculoneuropathy, Chronic Inflammatory Demyelinating drug therapy
- Abstract
In chronic polyneuropathies associated with hematologic malignancy (HM) the optimal treatment management is primarily focused on the HM, but the parallel response of the neuropathy is still unclear. Rituximab is a recognized therapeutic choice in anti-MAG antibody polyneuropathy, that might be useful also in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) with HM. The efficacy of immunochemotherapy, which is the standard approach to malignant lymphoproliferative diseases, has been poorly investigated in polyneuropathies. We describe a six-months combined bendamustine-rituximab (BR) treatment in nine patients affected by CIDP or paraproteinemic IgM neuropathies with antibodies to peripheral nerve antigens in course of malignant HM. All patients had a long-lasting response with an average relapse free-survival (RFS) time of 31.5 months. Clinical improvement was evident at 6 months from the beginning of therapy, even earlier in 6/9 patients (<2 months). Two patients dramatically improved the disabling attitudinal and intentional tremor and pathogenic autoantibodies significantly declined in 4/5 patients. Neurological relapses occurred in three patients after a mean of 38 months of sustained stability, even if HM remitted. In such cases rituximab was administered but was associated with a shorter RFS time (1 year) compared to the previous BR scheme (3 years). In our case series, the combined BR regimen was a valid option in immune-mediated neuropathies associated with HM. Moreover, in some patients BR scheme allowed an earlier response and a long-lasting improvement than rituximab alone., Competing Interests: Declaration of Competing Interest None declared., (Copyright © 2020 Elsevier B.V. All rights reserved.)
- Published
- 2020
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38. Geriatric assessment among older adults receiving intensive therapy for acute myeloid leukemia: Report of CALGB 361006 (Alliance).
- Author
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Klepin HD, Ritchie E, Major-Elechi B, Le-Rademacher J, Seisler D, Storrick L, Sanford BL, Marcucci G, Zhao W, Geyer SA, Ballman KV, Powell BL, Baer MR, Stock W, Cohen HJ, Stone RM, Larson RA, and Uy GL
- Subjects
- Activities of Daily Living, Aged, Humans, Mental Health, Surveys and Questionnaires, Geriatric Assessment, Leukemia, Myeloid, Acute drug therapy, Leukemia, Myeloid, Acute genetics
- Abstract
Objective: To demonstrate feasibility of performing geriatric assessment (GA) in the National Clinical Trials Network (NCTN) and to explore the utility of GA to characterize treatment tolerance., Materials and Methods: We conducted a multisite companion study (CALGB 361006) to CALGB 11001, a phase 2 trial of adults ≥60 years old with newly diagnosed FLT3- mutated AML, testing the efficacy of adding sorafenib to intensive chemotherapy. On 361006, a GA was administered prior to induction and prior to post-remission therapy. The GA is divided into items requiring administration by a health care professional (HCP) and patient self-administered questionnaires. Feasibility outcomes were recruitment rate, time to GA completion, difficulty with GA administration, percent of patients requiring assistance, and satisfaction. Change in GA measures pre- and post-induction were compared using Wilcoxon signed rank test and McNemar's tests., Results: The recruitment rate was 80% (N = 43, median age 68 years). Median completion time of the GA was 30 min; (10 and 21 min for HCP and patients, respectively). HCP reported no difficulty completing assessments (100%). Most patients completed questionnaires without assistance (77%), and were satisfied with the length (89%). Self-reported physical function, mental health, social activity and nutritional parameters worsened after induction., Conclusion: GA is feasible to administer in the setting of intensive induction for older adults with AML in the NCTN and provides evidence of the impact of induction therapy on physical and emotional health., (Copyright © 2019. Published by Elsevier Ltd.)
- Published
- 2020
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39. Burden of hepatitis E infection and associated healthcare resource utilization among hematological malignancy-related hospitalizations: A national perspective in the United States, 2007-2014.
- Author
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Desai R, Singh S, Zalavadia D, Bansal P, and Goyal H
- Subjects
- Cohort Studies, Hospitalization, Humans, Retrospective Studies, United States, Hematologic Neoplasms, Hepatitis E
- Published
- 2019
- Full Text
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40. Subdural Hematoma in Patients with Hematologic Malignancies: An Outcome Analysis and Examination of Risk Factors of Operative and Nonoperative Management.
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Wright CH, Wright J, Alonso A, Raghavan A, Momotaz H, Burant C, Zhou X, Selman W, Sajatovic M, and Hoffer A
- Subjects
- Adult, Aged, Aged, 80 and over, Case-Control Studies, Female, Hematologic Neoplasms diagnosis, Hematoma, Subdural diagnosis, Humans, Male, Middle Aged, Retrospective Studies, Risk Factors, Treatment Outcome, Disease Management, Hematologic Neoplasms epidemiology, Hematologic Neoplasms therapy, Hematoma, Subdural epidemiology, Hematoma, Subdural therapy
- Abstract
Background: Patients with hematologic disorders who present with subdural hematomas (SDH) present a surgical decision-making challenge. Because of intrinsic coagulopathy, platelet dysfunction, and immunosuppression, surgical intervention poses a unique set of risks., Objective: To describe a clinical sample of patients with hematologic disorders and concurrent SDH, to compare baseline and outcome variables, including complication rates and survival, in surgical versus nonsurgical management, and to identify clinical variables that may predict outcomes., Methods: A 12-year retrospective case-control study was carried out of 50 adult patients with hematologic malignancies and SDH. Patients underwent surgical evacuation for SDH. Controls did not. Outcomes included discharge disposition, Glasgow Outcome Scale score, 30-day mortality, and overall survival. Complications included seizure, reoperation, and readmission. A Fisher exact test or χ
2 analysis compared categorical variables; continuous outcomes were compared with a Student t test. A Kaplan-Meier survival analysis was performed and multivariable Cox logistic regression evaluated variables associated with overall mortality., Results: Surgical and nonsurgical groups differed only by Glasgow Coma Scale score, with slightly lower Glasgow Coma Scale scores in the surgical group. Complication rates did not differ; however, the 30-day reoperation rate was 35% for the surgical cohort. Overall, seizure incidence was 18%, readmission was 30%, 30-day mortality was 38%, median survival was 140.5 days, and 75% had a Glasgow Outcome Scale score of 1-3 at censorship. Increased age, low hemoglobin levels, and low platelet levels were associated with increased risk of mortality., Conclusions: Low platelet and hemoglobin levels are consistent markers of poor prognosis and surgical intervention, either as a proxy of or as a cause for clinical deterioration, is associated with increased mortality risk., (Copyright © 2019 Elsevier Inc. All rights reserved.)- Published
- 2019
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41. Review of the patient-centered communication landscape in multiple myeloma and other hematologic malignancies.
- Author
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LeBlanc TW, Baile WF, Eggly S, Bylund CL, Kurtin S, Khurana M, Najdi R, Blaedel J, Wolf JL, and Fonseca R
- Subjects
- Decision Making, Shared, Humans, United States, Communication, Hematologic Neoplasms therapy, Multiple Myeloma therapy, Patient Education as Topic, Patient-Centered Care, Physician-Patient Relations
- Abstract
Objectives: To identify factors limiting and facilitating patient-centered communication (PCC) in the United States hematology-oncology setting, with a focus on multiple myeloma (MM), given the limited attention to PCC and rapid pace of change that has taken place in this setting., Methods: A literature search was performed from 2007 to 2017 to identify published articles and congress abstracts related to clinician-patient communication and treatment decision-making in oncology. Search results were evaluated by year of publication and disease area. A thematic assessment was performed to identify factors limiting and promoting PCC for patients with MM and other hematologic malignancies., Results: Of the 6673 publications initially retrieved, 18 exclusively reported findings in patients with hematologic malignancies and were included in this review. We identified three critical, but modifiable, barriers to PCC in the hematologic malignancy setting, including insufficient information exchange, treatment goal misalignment, and discordant role preferences in treatment decision-making. Factors that enhanced interaction quality included educational programs for clinicians and patients., Conclusions: Patients with MM and other hematologic malignancies experience a distinct set of challenges that may affect PCC., Practice Implications: Clinicians have the opportunity to improve patient care by proactively addressing the identified barriers and implementing strategies demonstrated to improve PCC., (Copyright © 2019 Elsevier B.V. All rights reserved.)
- Published
- 2019
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42. B-cell acute lymphoblastic leukemia/lymphoma in relapse presenting as a cervical mass: A case report and review of literature.
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Kazma J, Johnson C, Jain N, Gali VL, Young KH, and Jazaeri AA
- Abstract
The involvement of the cervix as a site of relapse for hematologic malignancies is rare. We herein present a case of relapsed B-cell Acute Lymphoblastic Leukemia/Lymphoma (ALL) mimicking advanced cervical cancer. The patient is a 61-year-old female with history B-cell ALL and had multiple relapses confined to the bone marrow and had received several different chemotherapy regimens. She presented with lower abdominal pain after the end of her last cycle for which an MRI abdomen and pelvis was done and it showed the presence of an asymmetrical cervical mass. Further imaging included a PET-CT showing the presence of hypermetabolic cervical mass with left pelvic and retroperitoneal lymph node involvement. She underwent a biopsy of 3 distinct lesions in the cervix and vagina and a diagnosis of relapsed B-cell ALL was confirmed in two out of the three specimens., Competing Interests: We have no conflict of interest to declare.
- Published
- 2019
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43. False-positive blood culture results in patients with hematologic malignancies.
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Ebihara Y, Kobayashi K, Watanabe N, Taji Y, Maeda T, Takahashi N, Ishida A, Asou N, and Ikebuchi K
- Subjects
- Adult, Aged, Automation, Laboratory, Bacteremia microbiology, Blood Culture instrumentation, False Positive Reactions, Female, Humans, Leukemia, Myeloid, Acute complications, Lymphoma, Large B-Cell, Diffuse complications, Male, Bacteremia diagnosis, Bacteriological Techniques methods, Blood Culture methods, Leukemia, Myeloid, Acute blood, Lymphoma, Large B-Cell, Diffuse blood
- Abstract
Blood cultures are the most valuable tool when bacteremia is clinically suspected. Technical advances have led to the development of automated blood culture systems to detect bacterial infections. Usually positive signals in automated blood culture systems result from the proliferation of microorganisms. Cases are classified as false-positive when the automated blood culture system produces a positive signal but no microorganisms are detected on Gram-stained smears and no microorganism growth is observed in blood subcultures. False-positive blood culture results are very rare in patients with hematologic malignancies. Recently, we encountered four patients who had false-positive blood culture results. Two of the patients were diagnosed with acute leukemia, involving hyperleukocytosis and an excess of blasts. The other two patients were diagnosed with acute leukemia and diffuse large B cell lymphoma with leukocytopenia. Although hypercapnia or acidosis, apart from hyperleukocytosis, might also cause false-positive results, our cases clearly did not have these conditions. We should be aware of the possibility that false-positive blood culture results can occur in patients with leukocytopenia, as well as hyperleukocytosis. To understand the mechanisms responsible for the observed false-positive results, additional studies are needed after the accumulation of similar cases., (Copyright © 2019. Published by Elsevier Ltd.)
- Published
- 2019
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44. Acute coronary syndromes in patients with active hematologic malignancies - Incidence, management, and outcomes.
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Park JY, Guo W, Al-Hijji M, El Sabbagh A, Begna KH, Habermann TM, Witzig TE, Lewis BR, Lerman A, and Herrmann J
- Subjects
- Acute Coronary Syndrome etiology, Acute Coronary Syndrome therapy, Adrenergic beta-Antagonists therapeutic use, Adult, Aged, Aged, 80 and over, Angiotensin Receptor Antagonists therapeutic use, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Cause of Death trends, Coronary Angiography, Female, Follow-Up Studies, Hematologic Neoplasms epidemiology, Hospital Mortality trends, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Incidence, Male, Middle Aged, Platelet Aggregation Inhibitors therapeutic use, Prognosis, Retrospective Studies, United States epidemiology, Acute Coronary Syndrome epidemiology, Disease Management, Hematologic Neoplasms complications
- Abstract
Background: Cancer and cardiovascular diseases are the two leading causes of death in industrialized countries. Optimal management of life-threatening presentations of both of their diseases can pose significant challenges. The current study aimed to address the incidence, management, and outcome of acute coronary syndromes (ACS) in patients with active hematological malignancies., Methods: This retrospective registry-based cohort study included adults with active leukemia or lymphoma who were hospitalized at Mayo Clinic Rochester from 01/01/2004 to 12/31/2014. The diagnosis of ST-segment elevation MI (STEMI) or non-ST-segment elevation MI (NSTEMI) was made based on the 3rd Universal Definition for MI, or of unstable angina (UA) in the absence of cardiac troponin elevation. Main outcome measures included all-cause, cardiac, and non-cardiac death in-hospital and at one year., Results: Of 5300 adult patients with active hematological malignancies, 73 (1.4%) were diagnosed with an ACS (78.1% NSTEMI and 13.7% STEMI). 17.5% and 40% of NSTEMI and STEMI patients underwent coronary angiography, with percutaneous coronary intervention in 5.3% and 30%, respectively. While >80% of patients received β-blocker therapy, only half of all and <50% of patients managed "medically" received antiplatelet, anticoagulant, and/or statin therapy. The in-hospital and 1-year mortality was 21.9% and 58.9%, respectively, of which 25% and 15% were cardiac in etiology. Aspirin, beta-blocker, statins, and angiotensin-converting enzyme inhibitor/angiotensin-II receptor blocker were associated with better mortality outcomes., Conclusions: In a large, contemporary study of adults with active hematologic malignancies, ACS was uncommon, but commonly managed not in keeping with societal guideline recommendations., (Copyright © 2018 Elsevier B.V. All rights reserved.)
- Published
- 2019
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45. Blocking "don't eat me" signal of CD47-SIRPα in hematological malignancies, an in-depth review.
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Russ A, Hua AB, Montfort WR, Rahman B, Riaz IB, Khalid MU, Carew JS, Nawrocki ST, Persky D, and Anwer F
- Subjects
- Animals, Antineoplastic Agents pharmacology, Antineoplastic Agents therapeutic use, Apoptosis, Hematologic Neoplasms diagnosis, Hematologic Neoplasms drug therapy, Hematologic Neoplasms etiology, Humans, Immunotherapy methods, Molecular Targeted Therapy, Phagocytosis, Antigens, Differentiation metabolism, CD47 Antigen metabolism, Hematologic Neoplasms metabolism, Receptors, Immunologic metabolism, Signal Transduction drug effects
- Abstract
Hematological malignancies express high levels of CD47 as a mechanism of immune evasion. CD47-SIRPα triggers a cascade of events that inhibit phagocytosis. Preclinical research supports several models of antibody-mediated blockade of CD47-SIRPα resulting in cell death signaling, phagocytosis of cells bearing stress signals, and priming of tumor-specific T cell responses. Four different antibody molecules designed to target the CD47-SIRPα interaction in malignancy are currently being studied in clinical trials: Hu5F9-G4, CC-90002, TTI-621, and ALX-148. Hu5F9-G4, a humanized anti-CD47 blocking antibody is currently being studied in four different Phase I trials. These studies may lay the groundwork for therapeutic bispecific antibodies. Bispecific antibody (CD20-CD47SL) fusion of anti-CD20 (Rituximab) and anti-CD47 also demonstrated a synergistic effect against lymphoma in preclinical models. This review summarizes the large body of preclinical evidence and emerging clinical data supporting the use of antibodies designed to target the CD47-SIRPα interaction in leukemia, lymphoma and multiple myeloma., (Copyright © 2018 Elsevier Ltd. All rights reserved.)
- Published
- 2018
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46. Hematologic Malignancy
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Rodney H. Reznek, Ama Z. S. Rohatiner, and Sarah Vinnicombe
- Subjects
Pathology ,medicine.medical_specialty ,business.industry ,Hematologic malignancy ,medicine ,business - Published
- 2012
47. Anti-cancer vaccine therapy for hematologic malignancies: An evolving era.
- Author
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Nahas MR, Rosenblatt J, Lazarus HM, and Avigan D
- Subjects
- Animals, Dendritic Cells immunology, Humans, Immune System, Immune Tolerance, Molecular Targeted Therapy, Tumor Escape, Tumor Microenvironment immunology, Vaccination, Cancer Vaccines immunology, Cancer Vaccines therapeutic use, Hematologic Neoplasms immunology, Hematologic Neoplasms therapy, Immunotherapy methods
- Abstract
The potential promise of therapeutic vaccination as effective therapy for hematologic malignancies is supported by the observation that allogeneic hematopoietic cell transplantation is curative for a subset of patients due to the graft-versus-tumor effect mediated by alloreactive lymphocytes. Tumor vaccines are being explored as a therapeutic strategy to re-educate host immunity to recognize and target malignant cells through the activation and expansion of effector cell populations. Via several mechanisms, tumor cells induce T cell dysfunction and senescence, amplifying and maintaining tumor cell immunosuppressive effects, resulting in failure of clinical trials of tumor vaccines and adoptive T cell therapies. The fundamental premise of successful vaccine design involves the introduction of tumor-associated antigens in the context of effective antigen presentation so that tolerance can be reversed and a productive response can be generated. With the increasing understanding of the role of both the tumor and tumor microenvironment in fostering immune tolerance, vaccine therapy is being explored in the context of immunomodulatory therapies. The most effective strategy may be to use combination therapies such as anti-cancer vaccines with checkpoint blockade to target critical aspects of this environment in an effort to prevent the re-establishment of tumor tolerance while limiting toxicity associated with autoimmunity., (Copyright © 2018 Elsevier Ltd. All rights reserved.)
- Published
- 2018
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48. Effectiveness and Safety of Therapeutic Regimens for Elderly Patients With Acute Myeloid Leukemia: A Systematic Literature Review.
- Author
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Bell JA, Galaznik A, Huelin R, Stokes M, Guo Y, Fram RJ, and Faller DV
- Subjects
- Antineoplastic Combined Chemotherapy Protocols adverse effects, Clinical Trials as Topic, Female, Humans, Leukemia, Myeloid, Acute diagnosis, Leukemia, Myeloid, Acute mortality, Male, Prognosis, Treatment Outcome, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Leukemia, Myeloid, Acute drug therapy
- Abstract
Acute myeloid leukemia (AML) is the second most common leukemia among adults. Although the median age at diagnosis is 67 years, with approximately one third of patients aged 75 years or older, limited treatment options exist for the elderly, who have 5-year survival rates of only 5%. A systematic review was conducted to examine effectiveness and safety outcomes of treatment regimens in elderly (≥60 years old) patients with AML. Published literature on the topic was scant, and the review included only 22 articles examining outcomes. Twelve studies examined treatment-specific outcomes; most of these examined azacitidine or intensive chemotherapy (IC). An international randomized controlled trial found that azacitidine significantly improved overall survival relative to conventional regimens including IC and low-dose cytarabine in patients aged > 65 years. Similar results in favor of azacitidine were demonstrated in 2 other studies. IC was generally associated with longer survival versus lower-intensity therapy or best supportive care. Findings suggest that azacitidine is a viable option for elderly AML patients who are ineligible for IC, and emerging agents used in combination with azacitidine could have a major impact in this difficult-to-treat population., (Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.)
- Published
- 2018
- Full Text
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49. The Epidemiology and Clinical Associations of Stroke in Patients With Acute Myeloid Leukemia: A Review of 10,972 Admissions From the 2012 National Inpatient Sample.
- Author
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Del Prete C, Kim T, Lansigan F, Shatzel J, and Friedman H
- Subjects
- Female, History, 21st Century, Hospitalization, Humans, Leukemia, Myeloid, Acute pathology, Male, Patient Admission, Stroke pathology, Leukemia, Myeloid, Acute complications, Stroke epidemiology, Stroke etiology
- Abstract
Background: Acute leukemia is known to confer an elevated risk of both hemorrhagic and thrombotic complications, but the development of stroke in this population is poorly characterized. This study assesses clinical and epidemiologic factors in a population of inpatients with acute myeloid leukemia (AML) and stroke., Methods: Using the 2012 National Inpatient Sample, demographic and clinical data including age, gender, race, length of stay, in-hospital procedures, discharge diagnosis, disposition, and mortality incidence were extracted., Results: Of 7,296,968 admissions, 10,984 patients with active AML were analyzed. Of these, 65 patients had a concomitant cerebrovascular accident (CVA) (hemorrhagic or ischemic). There was a 50-fold increase in the risk of stroke in patients with active AML compared with all admissions. Patients with AML and CVAs were found to have significantly higher inpatient mortality than for all admitted patients with stroke (36.9% vs. 6.7%; odds ratio, 5.5; 95% confidence interval, 2.3-8.8; P < .0001). Multivariate logistic regression, after controlling for confounding variables, identified acute renal failure with tubular necrosis, hypernatremia, urinary tract infection, and secondary thrombocytopenia as significant predictors of stroke., Conclusions: Patients with AML have an elevated risk of CVA compared with all inpatients, and mortality in this population is high. Better characterization of risk factors of stroke in this vulnerable population is still needed., (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Published
- 2018
- Full Text
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50. Polypharmacy, potentially inappropriate medications and drug-drug interactions in geriatric patients with hematologic malignancy: Observational single-center study of 122 patients.
- Author
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Leger DY, Moreau S, Signol N, Fargeas JB, Picat MA, Penot A, Abraham J, Laroche ML, and Bordessoule D
- Subjects
- Aged, Aged, 80 and over, Female, Geriatric Assessment, Hematologic Neoplasms complications, Humans, Longitudinal Studies, Male, Medication Reconciliation organization & administration, Pharmacists, Potentially Inappropriate Medication List statistics & numerical data, Drug Interactions, Hematologic Neoplasms drug therapy, Polypharmacy
- Abstract
Objectives: Geriatric patients with hematologic malignancies (HMs) are prescribed targeted and supportive care treatments that add to the preexisting polypharmacy (PP). PP is associated with an increased risk of potentially inappropriate medications (PIM) and drug-drug interactions (DDI) resulting in increased hospitalization and mortality in the elderly. As very few data exist on these medication issues in the context of HMs, the objective of this study was to evaluate prevalence of PP, DDI and PIM use at baseline and 3months among elderly patients with HMs who received baseline geriatric assessment., Methods: PP, DDI and PIM use were assessed by a clinical pharmacist at two time points in patients over 75years with HMs undergoing chemotherapy. PP was defined as the concurrent use of five or more medications. DDIs were evaluated according to the literature and prescription analysis software. PIMs were assessed according to the Laroche list., Results: 122 patients (mean age 81.5; 6.6 medications) were included and after 3months, 86 patients (5.8 medications) were available for a second assessment. Prevalence of PP, PIM and DDI at inclusion was 75.4%, 34.4% and 71.3%, respectively. PP was the only medication risk that was significantly reduced (p<0.05) at 3months (65.1%) compared to admission., Conclusion: This observational study highlighted that PP decreased over time but neither DDI nor PIM use were reduced. A pharmacist-led evaluation might help to manage these medication issues., (Copyright © 2017. Published by Elsevier Ltd.)
- Published
- 2018
- Full Text
- View/download PDF
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