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Therapy-related acute myeloid leukemia (t-AML), a life-threatening complication of cytotoxic therapy, represents an emerging challenge of modern oncology.Evaluation of t-AML clinical outcomes, considering genetic changes and treatment intensity.We conducted a retrospective analysis of all consecutive AML patients from one hematology center (hospitalisation between 2000-2021). t-AML diagnosis was established according to the 2016 WHO criteria. Overall survival (OS) and progression free survival (PFS) were defined to evaluate treatment outcomes. Retrospective identification of 17p13 deletion and TP53 mutation was conducted.Among 743 AML patients, 60 (8.1%) were diagnosed with t-AML (63.4% with previous solid tumors). Complex karyotype (CK) and 17p13 deletion were detected in 26.8% and 26.7% of t-AML, respectively, while FLT3-ITD and TP53 mutations occurred in 15.4% and 12.5% t-AML. Median OS and PFS were 13 and 8 months, respectively. Survival outcomes were superior for alloHCT treatment than intensive chemotherapy alone (median OS: 47 vs 7 months, P=0.01). APL patients did not reach median OS and worse survival was noted within CK than non-CK t-AML (median OS: 6 vs 24 months, P=0.02). In intensively treated t-AML, survival was better for patients under 64 years of age (P=0.03). In the multivariable Cox proportional hazards regression model, alloHCT was associated with superior OS (HR=0.19, 95% CI=0.04-0.91, P=0.04). Moreover, we noted high frequency of treatment-related complications of t-AML.Our study revealed that prognosis of t-AML varies. Hence, the treatment strategy should rely on performing alloHCT as soon as possible in patients with adverse genetics.

No epidemiological data exist so far on invasive mucormycosis (IM) in Polish hematopoietic cell transplantation (HCT) and pediatric hemato-oncology (PHO) centers. The objective of this study was to analyze the incidence, clinical course, therapy, and outcome of IM in pediatric and adult patients undergoing HCT and children with hemato-oncological diseases in Poland. A total number of 12425 at-risk patients were retrospectively analyzed, and the period between 2010 and 2019 was included. Patients were analyzed in three groups: nontransplant children with malignancies, children undergoing HCT, and adults after HCT. Twenty-one patients were diagnosed with IM, including 15 children (10 non-HCT, 5 HCT) and 6 HCT adults. Proven IM was confirmed in 18 patients, probable in 2 patients, and possible in 1 patient. Proven IM was diagnosed in 7.1% of all patients with invasive fungal diseases (IFDs), including 8.1% among PHO patients, 5.4% among pediatric HCT patients, and 7.0% among adult HCT patients. Clinically, pneumonia was diagnosed in 10 (47.6%) patients, involvement of the paranasal sinuses was found in 3 (14.3%) patients, gastrointestinal disease was noted in 2 (9.5%) patients, and disseminated mucormycosis was found in 6 (28.6%) patients. The probability of overall survival in IM patients was 0.50 ± 0.11. Infection-related mortality (IRM) was 10% for pediatric nontransplant IM patients and 82% for transplant IM (pediatric + adult) patients (p = 0.004). Among the transplant patients, all adults died within 120 days. IRM for pediatric HCT patients was 60% (p = 0.038). The only prognostic factor was HCT, which adversely influenced survival in IM patients.

Background Multiple myeloma (MM) has become a chronic disease in majority of patients, and remission consolidation with autologous hematopoietic stem cell transplant (ASCT) remains the backbone of treatment in transplant-eligible patients. Objective The aim of this multicenter cross-sectional nationwide retrospective study was to evaluate the epidemiology, etiology, and outcome of infections in patients with MM undergoing ASCT in 13 Polish transplant centers, carried out on behalf of the Infectious Complications Study Group of the Polish Adult Leukemia Group. Methods A total number of consecutive 1374 patients with MM treated in Polish adult transplant centers from 2012 to 2014 were followed for infectious complications up to day +100 after ASCT in nationwide study. Results Altogether 490 infection episodes in 336 patients (49% male, aged 21-72 years) were reported, including 145 episodes of neutropenic fever (103 patients) and 34 episodes of clinically documented infections (CDIs) (27 patients). Among microbiologically confirmed infections there were 251 episodes of bacterial infections (180 patients), 42 episodes of fungal infections (38 patients), and 18 episodes of viral infections (17 patients). The overall incidence of infections reached 13.1% for bacterial, 3.6% for fungal, and 1.3% for viral infections. There were 16 cases of infection-related deaths after ASCT (1.2%). The mortality risk factors included multidrug-resistant bacteria etiology (odds ratio [OR], 3.5; P = .033), coexistence of bacterial and fungal infection (OR, 6.3; P = .002), and CDI (OR, 5.5; P = .007). Conclusion ASCT in patients with MM was connected with low risk of life-threatening infections. However, multidrug-resistant bacteria bacterial etiology, mixed etiology, and CDI increased the risk of fatal outcome.

Post-transplant lymphoproliferative disorder (PTLD) is a rare, but severe Epstein-Barr virus (EPV)-driven disorder that manifest after hematopoietic stem cell transplantation (HSCT) or solid organ transplantation (SOT). This heterogenous disease may manifest as localized or disseminated, and clinical presentation may differ significantly. It may be difficult to early diagnose PTLD, as is may be misdiagnosed as infection or graft rejection. The majority of EBV-PTLD typically occurs within four months following HSCT, and almost all cases present within the first year. EBV-PTLD that manifests > 5 years is considered an exceedingly rare occurrence. We describe a case of 66-year-old male, who was diagnosed with high-risk chronic lymphocytic leukemia (CLL). He underwent allogeneic HSCT from HLA-identical sister, and subsequently developed acute followed by chronic graft-versus-host disease, for which he was long-term treated with immunosuppressants. At 6 years following HSCT, the patient presented with life-threatening perforation of gut. Histological evaluation revealed diffuse large B cell lymphoma. Serum sample test showed positive EBV DNA and diagnosis of probable EBV-PTLD was done. After the treatment with rituximab, along with the reduction of immunosuppression, the patient achieved complete remission. Late onset EBV-PTLD after HSCT is extremely uncommon, and hardly described in literature.

Background: Therapy-related acute myeloid leukemia (t-AML) represents emerging challenge of the modern oncology as a life-threatening complication of cytotoxic therapy. Disease characterises poor prognosis and presence of adverse cytogenetic and genetic abnormalities. The goal of the study: Clinical outcome of t-AML patients with respect to genetic changes and treatment intensity. Patients and methods: Retrospective analysis of all consecutive AML patients treated in years 2000-2021 in one hematological center was performed. Diagnosis of t-AML was established according to WHO 2016 criteria. Overall survival (OS) and progression free survival (PFS) was defined to evaluate treatment outcomes only within t-AML patients undergoing intensive treatment (standard induction/consolidation; allogeneic cell transplantation (alloHCT) if eligible). Results: Among 743 AML patients 60 (8.1%) were diagnosed as t-AML (38 woman) with median age 57 years. Solid tumors (ST) preceded t-AML in 63.3%, hematological neoplasms (HN) in 36.7%. Majority of t-AML was preceded by breast cancer (30.0%), Hodgkin Lymphoma (11.7%), non-Hodgkin Lymphoma (10.0%) and ovarian cancer (10.0%). Median latency time for ST and HN subgroups was 5 vs 7 years respectively (P = .036). Previous cytotoxic therapy consisted of chemotherapy, radiotherapy or combination in 56.6%, 18.3% and 25.0% (autologous cell transplantation was performed in 54.5% of HN). Cytogenetic and molecular biology analysis was performed in 44 and 27 of t-AML respectively. Cytogenetic abnormalities, complex karyotype and normal karyotype occurred in 78.9%, 28.9% and 15.8% patients. KMT2A, RUNX1-RUNX1T1 and PML-RARA rearrangement was found in 21.1%, 18.4% and 7.9% of t-AML. FLT3-ITD, FLT-TKD, NPM1 and C-KIT DNA sequence variant occurred as follows: 14.8%, 7.4%, 3.7% and 3.7% correspondingly. Three pathogenic TP53 DNA sequence variants were detected in t-AML patients: c.711G>A, c.704A>G and c.989T>C (analysis performed on 20 t-AML patients). According ELN2017 genetic risk stratification patients were classified as adverse, intermediate and favorable in 51.4%, 35.1% and 13.5% respectively. Intensive treatment was implemented in 48 patients including alloHCT in 23 of them. Median OS and PFS was 15 and 8 months respectively for whole treated group. Median OS in t-AML undergoing intensive chemotherapy only vs alloHCT was 7 vs 47 months (P = .0025) with 12-year OS after alloHCT- 21.1% (Fig.1A). Among therapy-related acute promyelocytic leukemia (t-APL) patients median OS was not reached, without alloHCT. Median OS was higher for t-AML patients younger than 65 years than older ones: 20 vs 13 months respectively (P = .048) (Fig.1B). Among t-AML median OS in subgroup with adverse ELN 2017 vs intermediate and favorable ELN 2017 was 15 vs 40 months (P = .037) with 5-years OS 8.2% vs 41.0% (Fig.1C). In multivariate Cox proportional hazard regression model alloHCT was the only factor significantly influencing OS (HR = 0.16, 95% CI = 0.05-0.56, P = .004). All patients with TP53 mutations were intensively treated, one patient underwent alloHCT. 66.6% of patients had complex karyotype and any co-occuring DNA sequence variant was detected. Importantly, c.704A>G and c.989T>C TP53 DNA sequence variants were not previously described in AML according Catalogue of Somatic Mutations In Cancer database. Median OS in t-AML with TP53 mutation vs without was 4 vs 7 months (P = .398) (Fig.1D). Conslusions: Our study brings detailed analysis of clinical outcome of t-AML. Patients with t-AML undergoing intensive treatment, younger than 65 years and with t-APL have significantly higher OS rates. On the contrary t-AML patients classified as adverse genetic ELN2017 subgroup have poorer OS rates. Treatment strategy in t-AML should rely on performing alloHCT possibly soon. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

Polska jest w UE od 15 lat i efekty przyst?pienia do wsp?lnoty wida? na ka?dym kroku. Wyra?ny rozw?j infrastruktury drogowej nie tylko w powiecie pilskim, ale tak?e w ca?ym kraju, programy wspieraj?ce przedsi?biorstwa i nauk?. To wszystko sprawia, ?e coraz bardziej optymistycznie mo?emy patrze? w przysz?o??. Polska staje si? coraz mocniejszym pa?stwem na arenie mi?dzynarodowej i coraz mocniejszym partnerem w wielu organizacjach mi?dzynarodowych. Zdecydowany wp?yw na to ma tempo, w jakim nasz kraj si? rozwija. Weszli?my w now? perspektyw? bud?etow? i otrzymali?my najwi?ksze wsparcie spo?r?d cz?onk?w wsp?lnoty. Stanowi to kolejn? szans? na popraw? sytuacji gospodarczej naszego pa?stwa, a co za tym idzie, tak?e jednostek samorz?dowych, kt?rych przyk?adem jest powiat pilski. Programy operacyjne stworzone na potrzeby realizacji inwestycji finansowanych ze ?rodk?w unijnych pomagaj? w efektywny spos?b je wykorzysta?. Ich struktura oraz spos?b funkcjonowania s? zgodne ze wszelkimi normami unijnymi i krajowymi.

Incidence and outcome of microbiologically documented bacterial/viral infections and invasive fungal disease (IFD) in children and adults after hematopoietic cell transplantation (HCT) were compared in 650 children and 3200 adults in multicenter cross-sectional nationwide study. Infections were diagnosed in 60.8% children and 35.0% adults, including respectively 69.1% and 63.5% allo-HCT, and 33.1% and 20.8% auto-HCT patients. The incidence of bacterial infections was higher in children (36.0% vs 27.6%; p 21 days were risk factors for death from infection. In conclusion, pediatric patients have 2.9-fold higher incidence and 2.5-fold better outcome of infections than adults after HCT.

BACKGROUND: Recent EBMT analysis showed that infections are responsible for 21% of deaths after allo-HCT and 11% after auto-HCT. However, the risk, types and outcome of infections vary between age groups. The aim of the study is the direct comparison of risk factors of incidence and outcome of infections in children and adults. PATIENTS AND METHODS: We analyzed risk factors for the incidence and outcome of bacterial, fungal, and viral infections in 650 children and 3200 adults who received HCT between 2012-2015. The risk factors were determined by multivariable logistic regression analysis. RESULTS: A total number of 395/650 (60.8%) children and 1122/3200 (35.0%) adults were diagnosed for microbiologically confirmed infection, including 345/499 (69.1%) and 679/1070 (63.5%), respectively after allo-HCT, and 50/151 (33.1%) and 443/2130 (20.8%) respectively, after auto-HCT. At 2 years after HCT, the incidences of microbiologically documented bacterial infection were 36.0% and 27.6%, (p21d) hematological recovery (HR=3.3; p21 days (HR=1.4; p=0.038) were associated with increased risk of death from infection. Among patients with bacterial infections, the risk was higher in G- infections (HR=1.6; p=0.031). Among auto-HCT patients, no child died of infection. In adults, the risk of death was higher if duration of treatment of infection was >21 days (HR=1.7; p CONCLUSIONS: The profile of infections and related deaths varies between children and adults. MMUD transplants, diagnosis of acute leukemia, chronic GVHD, CMV reactivation and prolonged infection are relative risk factors for death from infection after HCT. Disclosures Kalwak: Sanofi: Other: travel grants; medac: Other: travel grants.

This text aims to familiarize the reader with a certain way of thinking about the category of meeting, selected pedagogical consequences that can take place as a result of young people’s encounter with texts of popular culture, especially with rock music and film, and to include the recipient in the discussion of the presented issue. The text consists of three parts. The first part is an introduction to the range of questions and treats the meeting as a pedagogical category. The second section focuses on the phenomenon of meeting texts of popular culture, more specifically rock and film narratives, while the third, summarizing part describes the meeting of young people with rock narratives on the basis of the results of the author’s own research.

Artykuł jest głosem w dyskusji skoncentrowanej wokół edukowania przez rockowe ekspresje. Publikacja ma na celu zapoznanie Czytelnika z określoną propozycją edukacyjną, pokazanie, że muzyka rockowa kryje w sobie edukacyjny potencjał, a nie tylko angażuje konsumpcyjnie – na komercyjnych zasadach (jak chcą niektórzy), oraz włączenie Czytelnika w dyskusję nad zaprezentowanym sposobem bycia edukacji. Tekst jest również zaproszeniem do interpretacji własnej przedstawionych w artykule prac studentów Akademii im. Jana Długosza w Częstochowie, w których uzewnętrznili oni edukacyjne sensy rockowych ekspresji. W moim przekonaniu prezentowany sposób bycia edukacji nie tylko pozwala na włączenie młodych ludzi w pedagogiczną autokreację, ale także pozwala nauczycielom na doświadczanie wraz nimi tej niecodziennej wędrówki, wędrówki inspirującej do autorefleksji, odkrywania samego siebie, do ruchu ku „byciu czymś więcej”, „ku zrównoważonemu rozwojowi”. Świadome zgłębianie tej rockowej przestrzeni, poszukiwanie jej edukacyjnych sił, zaangażowana peregrynacja jej zakątków sprawia, że człowiek przestaje być li tylko obserwatorem, a staje się uczestnikiem, „interpretatorem doświadczenia”, interpretatorem tekstów kultury (wydarzeń, zjawisk, wytworów itp.). Odkrywanie owego muzycznego świata w ramach edukacyjnych spotkań ma więc sens. Pozostawione w artykule przestrzenie niedookreślone, kwestie otwarte, niedokończone, czy też nierozstrzygnięte mają zagadywać, zachęcać do zadawania pytań, w szerszym, filozoficznym kontekście.