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The use of apheresis equipment to collect blood components has rapidly increased in the past years. A variety of apheresis instruments are now available on the market for double dose plateletpheresis. We evaluated an apheresis instrument, the Trima Accel, with regard to platelet (PLT) yield, collection efficiency (CE), and collection rate (CR) in a retrospective, randomized study in 110 donors. The Trima Accel cell separator efficiently collected double dose platelets with median PLT yields of 3.7 × 10 11 , mean CE of 74.99 ± 14.40% and mean CR of 0.096 ± 0.012 × 10 11 /min. [ABSTRACT FROM AUTHOR]

Niemann-Pick disease is a rare lipid storage disorder with autosomal recessive inheritance, which is characterised by the accumulation of sphingomyelin and other sphingolipids in macrophages. Kartagener's Syndrome is a syndrome with autosomal recessive inheritance consisting of chronic paranasal sinusitis, situs inversus, and bronchiectasis. Here we reported a case having Kartagener's Syndrome with concomitant Niemann- Pick disease, as such a case has not been reported in the literature. [ABSTRACT FROM AUTHOR]

Abstract: The use of apheresis equipment to collect platelets has rapidly increased in recent years. We compared two apheresis instruments (Haemonetics MCS + and Trima Accel) with regard to platelet (PLT) yield and efficiency, and collection rate (CR) in a retrospective study. Overall 120 data obtained by Haemonetics and Trima systems (N = 60 for each) were randomly selected among 400 plateletpheresis procedures performed at the Apheresis Unit of Kayseri Education and Research Hospital between July 2016 and January 2017. The CR was significantly higher with the Haemonetics compared to the Trima (0.076 ± 0.016 vs. 0.065 ± 0.015 (PLT × 1011/min) respectively; P < 0.001). The PLT yield/unit was higher with the Haemonetics (4.4 ± 0.8 vs. 3.9 ± 0.8 × 1011, P = 0.001). Haemonetics and Trima Accel instruments collected platelets efficiently. We hope that these data will be a guide in selecting equipment for apheresis units. [ABSTRACT FROM AUTHOR]

Diffuse large B-cell lymphoma(DLBCL) is the prototype of aggressive lymphomas. The abnormalities such as translocation, deletion, duplication are stated to affect the progress and the prognosis of the disease. This study investigates the presence and impact on the prognosis of K-ras mutation and C-myc overexpression in patients with DLBCL. Twenty eight patients diagnosed with DLBCL and 29 healthy controls, whose diagnostic lymph node biopsy was reactive, were enrolled in this study. Paraffin blocks were analyzed for K-ras mutations and C-myc expressions. The effects of C-myc and K-ras on overall and disease-free survival were evaluated. Of the 28 patients, three (10.7%) K-ras mutations were detected. K-ras mutation (+) cases have an average survival time of 28 months, while those without the mutation were 49 months. The average duration of disease-free survival was 17.6 months in patients with K-ras mutation, while it has been identified as 45 months in patients without mutations (p= 0.072). C-myc overexpression in 17 patients(61%) was detected. Median overall survival was 33 months in male patients, while it was 65 months in female patients (p= 0.006). The median disease-free survival time was 23 months in male patients, although 64 months in female patients (p= 0.003). Complete remission rate was 30% in C-myc overexpression group, while 69% in remaining group with the cut-off 2.48 (p= 0.02). The presence of K-ras and C-myc overexpression in patients with DLBCL does not affect overall and disease-free survival. C-myc overexpression harms complete remission. Gender was found to be influential on the overall and disease-free survival; meanwhile, the female gender was a better prognosis. [ABSTRACT FROM AUTHOR]

Abstract: Aim: We aimed to investigate the change in the number of stem cells and white cells in the early period following blood donation. Patients and Method: 22 male (71%) and 9 female (29%), 31 volunteers in total were included in the study. 450ml of whole blood were collected from each of the volunteers for the donation. Complete blood counts were performed on the volunteers before and at 6 and 24h after the donation and CD34+ cell counts per ml of peripheral blood were measured by flow cytometry technique. Results: There was a statistically significant increase in the number of CD34+ cells in the peripheral blood at 6h following blood donation (p <0.001). At 24h, however, there was a statistically significant decrease in the number of CD34+ cells, compared to 6h (p <0.001). There was a statistically significant increase in the number of leukocytes in the peripheral blood at 6h following blood donation (p <0.001). At 24h, there was a decrease in the number of leukocytes, which was statistically significant compared to 6h (p <0.001). When the difference in CD34+ cell and leukocytes counts before blood donation and at 24h after blood donation were compared, the results were not statistically significant. Conclusion: As the result of this study, a transient increase in the number of CD34+ cells in the peripheral blood after blood donation was demonstrated, with a decline in CD34+ cell counts back to levels prior to donation at 24h. [Copyright &y& Elsevier]

Objectives and aim: Patients affected by hematological malignancies can often benefit from high dose chemotherapy followed by peripheral blood stem cells (PBSCs) transplantation. Different strategies have been used to mobilize an adequate number of PBSC, including granulocyte colony-stimulating factor (G-CSF) alone or chemotherapy plus G-CSF. In this study, we aimed to compare the efficacy profile of different G-CSF agents including filgrastim (Neupogen®), biosimilar filgrastim (Leucostim®) and Lenograstim (Granocyte®) on CD34+ mobilization in patients who underwent autologous hematopoietic stem cell transplantation (autoHSCT). Materials and methods: We retrospectively analysed data of patients who underwent autoHSCT diagnosed with multiple myeloma (MM), Hodgkin Lymphoma (HL), non-Hodgkin Lymphoma (NHL) and others. Data for stem cell mobilization has been obtained from patients’ files. Patients who received Filgrastim (Neupogen®), biosimilar Filgrastim (Leucostim®, Group) and Lenograstim (Granocyte®) were evaluated mainly for total CD34+ cell count at the end of mobilization procedure. Results: A total of 96 patients who underwent autoHSCT were retrospectively analyzed. 27 (28.2%) of the patients were female, and 69 (71.8%) were male. The diagnosis of the patients were; multiple myeloma (39 patients, 40.6%), Hodgkin Lyphoma (23 patients, 23.9%), non-Hodgkin lymphoma (16 patients, 16.6%), and others (18 patients, 18.9%). The median number of leukapheresis cycle necessary to harvest a minimal count of 3×106 CD34+/kg was 2 in Neupogen® (min–max: 1–4) and Granocyte® (min–max: 1–3) groups and 1 (min–max: 1–2) in Leucostim® group. The median doses of G-CSF agents (μg/kg/day) in PBSC collection procedure were; 10.00 (min–max: 7.00–12.00) in the Neupogen® group, 8.00 (min–max: 7.25–9.00) in the Leucostim® group and 8.50 (6.00–9.50) in the Granocyte® group. There was no statistical significance among groups (p =0.067). The number of total collected PB CD34+ cells (×106/kg) was 7.64 (min–max: 4.09–13.86) in the Neupogen® group, 13.43 (min–max: 8.15–23.38) in the Leucostim® group and 5.45 (min–max: 4.28–9.40) in the Granocyte® group. The data showed that patients in the leucostim group had significantly higher PB CD34+ cells compared to patients in the Granocyte® group (p =0.013). Conclusion: Leucostim® was comparable to Neupogen® for PBSC mobilization in patients who underwent autoHSCT. [ABSTRACT FROM AUTHOR]

Abstract: Invasive fungal pneumonia (IFP) has become increasingly common in patients that previously underwent alloHSCT. The aim of this study was to determine the role of hyperferritinemia, via iron overload in invasive fungal pneumonia in patients that underwent alloHSCT. Medical records of 73 patients with pneumonia that underwent alloHSCT were studied retrospectively, whereby a pre-transplantation serum ferritin level measured up to 100days prior to transplantation of patients with invasive fungal pneumonia (IFP) and non-fungal pneumonia (non-IFP) was compared. Patient records revealed 35 and 38 cases of IFP and non-IFP, respectively. In risk evaluation for IFP, age, gender, HLA status, conditioning regimen, smoking history, and underlying disease were not significantly different among groups (p >0.05). However, performance status (Karnofsky) was significantly lower in patients with IFP (p <0.05). The median ferritin levels were 1705ng/ml (41–7198) in the IFP group and 845ng/ml (18–7099) in non-IFP group and the difference was found statistically significant (p =0.001). Elevated pretransplant serum ferritin level is associated with IFP in patients that underwent alloHSCT, in particular when values exceed 1550ng/ml. [Copyright &y& Elsevier]

Introduction: Autologous peripheral blood stem cell (PBSC) transplantation has become a standard treatment option for certain hematological malignancies. The collection of PBSCs for transplantation is a well-established process and the effectiveness can vary depending on the cell separator. We aimed to compare the effectivity of two devices, the Spectra Optia and the Amicus for autologous PBSC collection. We also evaluated the effect of the peripheral white blood cell (WBC) count on the CD34+ collection efficiency (CE2)., Methods: We retrospectively evaluated 262 apheresis procedures performed in patients between 2015 and 2021 at the Apheresis Unit of our transplantation center. The PBSCs were collected by the Spectra Optia cell separator with continuous Mononuclear Collection (cMNC) (128 procedures) or the Amicus (MNC) (134 procedures). In addition to the apheresis parameters and product characteristics, we also evaluated the effect of the pre-apheresis peripheral WBC count on the CE2., Results: There was no significant difference in the CD34+ CE2 between the Spectra Optia and Amicus devices (median 65.06% and 68.24%, respectively, p = 0.070). In the Amicus group, the CE2 ratio was found to be statistically significantly higher in patients with a pre-apheresis peripheral WBC count of 15 × 10 9 /L (median 81.70%, 68.06%, 61.35% and 58.13%, respectively, p < 0.001)., Conclusion: While both devices collected autologous PBSC effectively and safely, the Amicus provided a higher rate of CE2 at low pre-apheresis WBC counts. To our knowledge, this is the first study to evaluate the CE2 in autologous PBSC collection devices based on pre-apheresis WBC counts., Competing Interests: Conflicts of 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 © 2023 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: Fludarabine, a purine analog, is getting more attention with the increasing use of reduced intensive conditioning regimens in allogeneic hematopoietic stem cell transplantation (allo-HSCT). The side effect of bradycardia was observed in only a few cases reported in the literature. In clinical practice, bradycardia can be asymptomatic or cause syncope and cardiac arrest. This study aimed to evaluate the bradycardia side effect of fludarabine used in the conditioning regimen in allo-HSCT recipients and to increase awareness of this issue., Methods: This retrospective study included 73 patients who received fludarabine in the allo-HSCT conditioning regimen between January 2015 and January 2021. Patients with and without bradycardia were compared regarding demographic data, allo-HSCT characteristics, electrolyte values, fludarabine administration dose and duration, and survival. Univariate and multivariate analyzes were performed to evaluate independent predictors for fludarabine-induced bradycardia., Results: Fludarabine administration doses and days were higher in the bradycardia group, but no statistically significant difference was observed. In the multivariate analysis, age was the only independent predictor of fludarabine-induced bradycardia (odds ratio (OR) 0.93, 95% confidence interval (CI): 0.89-0.98, p = 0.007). The median age in the group with bradycardia was 19 years younger than those without bradycardia (34 (19-49) vs 53 (19-69), p = 0.005). In 11 (84.6%) of the patients who had bradycardia, bradycardia improved with the discontinuation of fludarabine alone, but atropine was administered in 2 (15.4%) patients., Conclusion: Age was the only independent predictor of fludarabine-induced bradycardia; therefore, close heart rate monitoring is recommended during fludarabine administration, especially in younger patients., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Danger-associated molecular patterns (DAMPs) are molecules that can initiate and maintain robust inflammatory responses and were investigated in the pathogenesis of graft versus host disease (GvHD). Uric acid (UA) and fibrinogen (Fib) are DAMPs released from damaged tissue during allogeneic hematopoietic stem cell transplantation (allo-HCT) and GvHD. We aimed to evaluate the effects of UA and Fib levels on survival in GvHD. One hundred seventy-four patients with grade 2-4 acute GvHD were included. UA and Fib levels were evaluated on allo-HCT day 0 and GvHD on days 0, 7, 14, and 28. Fib GvHD day 0 was the independent predictor for overall survival (OS), non-relapse mortality (NRM), and progression-free survival in multivariable models (HR 0.98, p < 0.001; HR 0.98, p = 0.001, HR 0.98, p = 0.006, respectively). Also UA GvHD day 28 was the independent predictor for OS and NRM (HR 0.77, p = 0.004; HR 0.76, p = 0.011, respectively). Our results indicated that hypouricemia and hypofibrinogenemia were associated with a significantly shorter OS and higher NRM. UA and Fib are remarkable molecules in GvHD because they are routinely utilized, readily available, can be therapeutic targets, and have DAMPs and antioxidant features., (© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)

Background: Factors such as age, underlying hematological disease, chemotherapy and radiotherapy used, and bone marrow infiltration may cause mobilization failure. Several preclinical observed that diabetes mellitus (DM) leads to profound remodeling of the hematopoietic stem cell (HSC) niche, resulting in the impaired release of HSCs. We aim to examine the effect of DM on HSC mobilization and to investigate whether there is a relationship between complications developing in the DM process and drugs used to treat DM and mobilization failure., Methods: In Erciyes University Bone Marrow Transplantation Unit, 218 patients who underwent apheresis for stem cell mobilization between 2011 and 2021 were evaluated retrospectively. One hundred and nine patients had a diagnosis of DM, and 109 did not., Results: Mobilization failure developed in 17 (15.6 %) of the patients in the DM group, while it developed in 7 (6.4 %) patients in the non-DM group (p = 0.03). CD34+ stem cell count was 8.05 (1.3-30.2) × 10 6 /kg in the DM group, while it was 8.2 (1.7-37.3) × 10 6 /kg in the other group (p = 0.55). There was no statistically significant relationship between glucose and hemoglobin A1c levels and the amount of CD34+ cells (p = 0.83 and p = 0.14, respectively). Using sulfonylurea was the only independent predictor of mobilization failure (OR 5.75, 95 % CI: 1.38-24.05, p = 0.02)., Conclusion: DM should be considered a risk factor for mobilization failure. Further research is needed fully to understand the mechanisms underlying the mobilization failure effects of sulfonylureas and to develop strategies to improve stem cell mobilization in diabetic patients., Competing Interests: Declaration of Competing Interest The authors declare that the research was conducted without any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Glofitamab is a CD3xCD20 bi-specific antibody with two fragments directed to the CD20 antigen and a single CD3-binding fragment. Encouraging response and survival rates were recently reported in a pivotal phase II expansion trial conducted in patients with relapsed/refractory (R/R) B-cell lymphoma. However, the real-world data of patients of all ages with no strict selection criteria are still lacking. Herein, this retrospective study aimed to evaluate the outcomes of diffuse large B-cell lymphoma (DLBCL) patients who received glofitamab via compassionate use in Turkey. Forty-three patients from 20 centers who received at least one dose of the treatment were included in this study. The median age was 54 years. The median number of previous therapies was 4, and 23 patients were refractory to first-line treatment. Twenty patients had previously undergone autologous stem cell transplantation. The median follow-up time was 5.7 months. In efficacy-evaluable patients, 21% and 16% of them achieved complete response and partial response, respectively. The median response duration was 6.3 months. The median progression-free survival (PFS) and overall survival (OS) was 3.3 and 8.8 months, respectively. None of the treatment-responsive patients progressed during the study period, and their estimated 1-year PFS and OS rate was 83%. The most frequently reported toxicity was hematological toxicity. Sixteen patients survived, while 27 died at the time of the analysis. The most common cause of death was disease progression. One patient died of cytokine release syndrome during the first cycle after receiving the first dose of glofitamab. Meanwhile, two patients died due to glofitamab-related febrile neutropenia. This is the largest real-world study on the effectiveness and toxicity of glofitamab treatment in R/R DLBCL patients. The median OS of 9 months seems promising in this heavily pretreated group. The toxicity related mortality rates were the primary concerns in this study., (© 2023 The Authors. Hematological Oncology published by John Wiley & Sons Ltd.)

Graft versus host disease (GvHD) remains a significant risk for mortality and morbidity following allogeneic hematopoietic stem cell transplantation (HSCT). A growing literature supports successful applications of mesenchymal stromal cells (MSCs) for the treatment of steroid-refractory acute GvHD (aGvHD). However, there is limited knowledge about the effects of MSC treatment on late-acute GvHD (late aGvHD). In this article, we present our multicenter study on the safety and efficacy of MSC therapy for patients with steroid-refractory late aGvHD in comparison to those with aGvHD. The outcome measures include non-relapse mortality (NRM) and survival probability over a 2-year follow-up. The study includes a total of 76 patients with grades III-IV aGvHD (n = 46) or late aGvHD (n = 30), who had been treated with at least two lines of steroid-containing immunosuppressive therapy. Patients received weekly adipose or umbilical cord-derived MSC infusions at a dose of median 1.55 (ranging from 0.84 to 2.56) × 10 6 /kg in the aGvHD group, and 1.64 (ranging from 0.85 to 2.58) × 10 6 /kg in the late aGvHD group. This was an add-on treatment to ongoing conventional pharmaceutical management. In the aGvHD group, 23 patients received one or two infusions, 20 patients had 3-4, and three had ≥ 5. Likewise, in the late aGvHD group, 20 patients received one or two infusions, nine patients had 3-4, and one had ≥ 5. MSC was safe without acute or late adverse effects in 76 patients receiving over 190 infusions. In aGvHD group, 10.9% of the patients had a complete response (CR), 23.9% had a partial response (PR), and 65.2% had no response (NR). On the other hand, in the late aGvHD group, 23.3% of the patients had CR, 36.7% had PR, and the remaining 40% had NR. These findings were statistically significant (p = 0.031). Also, at the 2-year follow-up, the cumulative incidence of NRM was significantly lower in patients with late aGvHD than in patients with aGvHD at 40% (95% CI, 25-62%) versus 71% (95% CI, 59-86%), respectively (p = 0.032). In addition, the probability of survival at 2 years was significantly higher in patients with late aGvHD than in the aGvHD group at 59% (95% CI, 37-74%) versus 28% (95% CI, 13-40%), respectively (p = 0.002). To our knowledge, our study is the first to compare the safety and efficacy of MSC infusion(s) for the treatment of steroid-resistant late aGVHD and aGVHD. There were no infusion-related adverse effects in either group. The response rate to MSC therapy was significantly higher in the late aGvHD group than in the aGvHD group. In addition, at the 2-year follow-up, the survival and NRM rates were more favorable in patients with late aGVHD than in those with aGVHD. Thus, the results are encouraging and warrant further studies to optimize MSC-based treatment for late aGVHD., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.

Introduction: The COVID-19 vaccine is the most essential tool for altering the pandemic's trajectory. The pandemic's control is complicated by society's unwillingness to vaccinate. The aim of this cross-sectional study was to assess patients with hematological malignancies and their attitudes regarding COVID-19 immunization and to investigate COVID-19 anxiety in this susceptible population., Methods: In this cross-sectional study, 165 patients with hematological malignancies were included. COVID-19 anxiety was evaluated with the coronavirus anxiety scale (CAS), and COVID-19 vaccine attitude was evaluated with the Vaccine Attitudes Review (VAX) scale., Results: The mean CAS score was 2.42 (0-17). There were 22 (13%) participants with a mean CAS score of ≥ 9. Half of the participants had a CAS score of 0. The CAS score was higher in females (p = 0.023). Similarly, it was significantly higher in patients who were not in remission for hematological malignancy and who received active chemotherapy (p = 0.010). The mean VAX score was 49.07 ± 8.76 (27-72). Most of the participants (64%) had a neutral attitude toward the COVID-19 vaccination. In a survey of 165 patients, 55% said that they were skeptical about vaccination safety, and 58% said that they were concerned about unintended side effects. In addition, 90% expressed moderate concerns about commercial profiteering. Natural immunity was preferred by 30% of the participants. There was no statistically significant correlation between CAS scores and the Vaccine Attitudes Review (VAX) scale., Conclusion: This study draws attention to the level of anxiety in patients with hematological malignancies during the COVID-19 pandemic. Negative attitudes toward the COVID-19 vaccine are worrisome for at-risk patient groups. We think that patients with hematological malignancies should be informed to eliminate their hesitations about COVID-19 vaccines., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Güven et al.)