Medical Specialties Commons^™

The Not-So-Benign Sickle Cell Trait: A Case Of Renal Medullary Carcinoma, Fatima Halilu, Siddartha Guru, Fuscaldo Joseph

Journal of Community Hospital Internal Medicine Perspectives

Sickle cell trait (SCT) has long been considered a benign carrier state with malarial protection, but carriers can be affected by increased venous thromboembolism, exercise-related injury, renal complications and very rarely a fatal renal malignancy. Renal medullary carcinoma is a very rare and aggressive renal tumor described almost exclusively in sickle cell trait. A review of the current literature provides clues to this link and describes trends expected in these cases. We report a case of renal medullary carcinoma in a 32-year-old female with known sickle trait who presented with cough, hemoptysis, left flank pain and gross hematuria. Initial presentation …

The Role Of Radiotherapy In The Complex Treatment Of Mycosis Fungoides; A Case Report, Laura Florentina Rebegea, Claudia-Elena Pavel, Nadejda Corobcean, Ana Maria Ilie, Dorel Firescu, Madalin Guliciuc, Elena Niculet, Mihaela Dumitru, Daniela Mihalache, Flavius Bulgaru, Roxana-Andreea Rahnea-Nita

Journal of Mind and Medical Sciences

Introduction. Mycosis fungoides (MF) is the most common form of primary cutaneous T-cell lymphoma. Radiotherapy induces excellent response rates in the treatment of localized or extensive lesions of MF, both as monotherapy and as part of a multidisciplinary treatment. Total skin irradiation with electrons or protons is available in a limited number of medical centers and is mainly used in patients with extensive MF. Case presentation. It is presented the case of a 47-year-old patient who developed erythematous papules and plaques on the chest, upper limbs, face and scalp, initially diagnosed as chronic eczema and treated with systemic corticotherapy, antihistamines …

Outcomes Of Multiple Myeloma In Hospitalized Patients With Opioid Use Disorder: A Nationwide Analysis, Saad Javaid, Kelly Frasier, Ammad J. Chaudhary

Journal of Social, Behavioral, and Health Sciences

Multiple myeloma is commonly associated with advanced age. This study aims to investigate how multiple myeloma outcomes are affected by opioid use disorder (OUD) among hospitalized patients. We analyzed the National Inpatient Sample (NIS) for 2019 and 2020 for our retrospective cohort study. International Classification of Diseases Clinical Modification codes (ICD-10-CM) were utilized to identify the population of interest. Primary and secondary outcomes were studied using a multivariate regression model. Among the 38,735 patients hospitalized with multiple myeloma, 350 patients had the concurrent diagnosis of opioid use disorder. OUD patients were found to be at increased risk for major depressive …

Sickle Cell Disease Phenotypes And Obstructive Sleep Apnea; Are They Related?, Suhail Alsaleh, Norah Alshehri, Sara Alsiddiqi, Mohmmed Rayis, Safa Eltahir, Khaled Aldajjam, Mohammed Alzaid, Wadha Alotaibi

Hematology/Oncology and Stem Cell Therapy

ABSTRACT: OBJECTIVE: This study aims to compare the polysomnographic features between Arab-Indian and Benin phenotypes of sickle cell disease (SCD). MATERIALS AND METHODS: This prospective cross-sectional study was conducted in the Children’s Hospital at King Fahad Medical City, in Riyadh where children were recruited from the pediatric hematology clinic and pediatric sleep medicine. All families were approached and patients who met the inclusion criteria and agreed to participate were included in the study. RESULTS: Eighty four children (37 of whom were females) with SCD were included in the study. Their median (interquartile) age was 9 (6.65, 11) years and their …

Outcomes And Long-Term Survival Of Adolescent And Young Adult Patients Admitted To The Intensive Care Unit Following Allogeneic Hematopoietic Stem Cell Transplantation: A Single-Centre Experience Of 152 Patients, Othman M. Solaiman, Tusneem Elhassan, Riad El Fakih, Abdul Mannan, Zainab Alduhailib, Ashwaq A. Mahdali, Hazzaa Alzahrani, Mouhamad Jamil, Naeem Chaudhri, Alyaa Elhazmi, Mohammad Kolko, Fahad Z. Al-Sharif, Abdullah Alrbiaan, Mohammed Shaban, Marwan Shaheen, Nawal Salahuddin, Feras A. Alfraih, Ashraf S. Altarifi, Mona Hassanein, Sulaiman Hosaini, Noura Alhashim, Alaa Abdelhafiz Mohamed, Amr Hanbali, Ali Hussein Aljanoubi, Nadia R. Al-Obaidi, Walid Rasheed, Khalid Maghrabi, Fahad Almohareb, Ayman Soubani, Mahmoud Aljurf, Syed Osman Ahmed

Hematology/Oncology and Stem Cell Therapy

Objective: Prognostic factors reliably predicting outcomes for critically ill adolescent and young adult (AYA) patients undergoing allogeneic hematopoietic cell transplantation (allo-HSCT) are lacking. We assessed transplant and intensive care unit (ICU)-related factors impacting patient outcomes. Design: Retrospective review Setting: Tertiary care Centre, during the period of 2003-2013 Patients: AYA patients who underwent allo-HSCT and required ICU admission. Interventions: This was a non-interventional study. Only outcomes after first allo-HSCT and index ICU admissions were analyzed. Disease-, transplant-, and ICU-related variables were analyzed to identify risk factors predictive of survival. Measurements and Main Results: Overall, 152 patients were included (males, 60.5%); median …

Use Of Endpoints In Phase Iii Randomized Controlled Trials For Hematopoietic Stem Cell Transplantation Over The Last 15 Years: A Systematic Review, Moazzam Shahzad, Muhammad Fareed Khalid, Muhammad Kashif Amin, Mohammad Ammad-Ud-Din, Usman Ilyas, Ali H. Mushtaq, Atif Butt, Iqra Anwar, Sibgha Gull Chaudhary, Nausheen Ahmed, Leyla Shune, Anurag K. Singh, Sunil H. Abhyankar, Joseph P. Mcguirk, Muhammad Umair Mushtaq

Hematology/Oncology and Stem Cell Therapy

This systematic review aimed at evaluating the proportion of primary and secondary endpoints in hematopoietic stem cell transplant (HSCT) phase III randomized clinical trials (RCTs) and their trends over time and by study sponsorship status. Chi-square test and logistic regression analyses were performed using SPSS version 28. A total of 147 HSCT phase III RCTs from 2006-2021 that reported 197 primary and 600 secondary endpoints were included for the analysis. Overall survival (OS, 17%), progression-free survival (PFS, 15%), graft-versus-host disease (GVHD, 8%), event-free survival (EFS, 8%), and organ function (8%) were the most common primary endpoints. GVHD (12.3%, n=74), safety/toxicity/adverse …

Predicting Stage Progression In Binet Stage A Chronic Lymphocytic Leukemia, Salem H. Alshemmari, Mazyad Almazyad, Ahmed Alsarraf, Anita Kunhikrishnan, Asha M. Isaac, Andy Kaempf

Hematology/Oncology and Stem Cell Therapy

Introduction: the variable clinical course of chronic lymphocytic leukemia (CLL) and the lack of consensus on follow-up and treatment strategies have necessitated a prognostic model for identifying high-risk patients at the time of diagnosis. Methods: this study involved a retrospective analysis of demographic and clinical characteristics of 212 patients diagnosed with Binet stage A CLL and thus eligible for risk stratification by both the International Prognostic Score for Early-stage CLL (IPS-E) and the alternative IPS-E (AIPS-E). We evaluated the applicability of these prognostic indices in our young, Middle Eastern cohort (median age 59 at diagnosis). Results: during a study period …

Virtual Delivery Of Stress Management And Resiliency Training (Smart) During The Covid-19 Pandemic To Hematology/Oncology Fellows: A Pilot Study, Colt Williams, Sherry Chesak, Deirdre R. Pachman, Ross Dierkhising, Laura Rhee, Konstantinos Leventakos

Journal of Wellness

Introduction: Medical trainees experience a high degree of stress that predisposes them to burnout. This pilot study tested a scalable approach to deliver a validated resilience program (Stress Management and Resiliency Training (SMART)) among Hematology/Oncology fellows at an academic medical center.

Methods: This was a mixed-methods, prospective, single-arm clinical trial involving Hematology/Oncology fellows at Mayo Clinic in Rochester, MN, USA. Four one-hour training sessions were conducted virtually with 26 fellows. Stress, burnout, and emotional resilience were measured at baseline, three months, and six months post-intervention using the Perceived Stress Scale (PSS-10), Maslach Burnout Inventory (MBI-HSS), and Connor-Davidson Resilience …

The Use Of Prognostic Markers To Predict Disease Progression And Clinical Outcome In Monoclonal Gammopathy Of Undetermined Significance, Smouldering Multiple Myeloma And Multiple Myeloma., Róisín C. Mcmonagle

International Undergraduate Journal of Health Sciences

Multiple Myeloma (MM) is an incurable plasma cell malignancy with a complex and incompletely understood molecular pathogenesis. Monoclonal Gammopathy of Undetermined Significance (MGUS) and Smouldering Multiple Myeloma (SMM) precede MM, with variable risks and rates of disease progression. The continuing high relapse and death rate in MM cases has prompted research into more accurate prognostic markers to predict progression from MGUS and SMM to MM, as well as identify MM cases with aggressive disease, in order to begin early, targeted and effective therapeutic intervention. Many studies have focused on utilising current markers more effectively, including M-protein, serum-free light chain ratio, …

Age-Related Morphofunctional Changes In Sickle Cell Mice Bone Marrow Mesenchymal Stromal Cells, Felipe Augusto Rós, Péricles Natan Mendes Da Costa, Jonathan Milhomens, Débora Glenda Lima De La-Roque, Fernanda Ursoli Ferreira, Juliana De Matos Maçonetto, Camila Cristina De Oliveira Menezes Bonaldo, Julianne Vargas De Carvalho, Patrícia Vianna Bonini Palmaa Palma, Wassim El Nemer, Dimas Tadeu Covas, Simone Kashima

Hematology/Oncology and Stem Cell Therapy

Bone marrow mesenchymal stromal cells (BM-MSC) are key elements of the hematopoietic niche and participate in the regulatory mechanisms of hematopoietic stem cells (HSC). Hematological diseases can affect MSCs and their functions. However, the dysregulations caused by sickle cell disease (SCD) are not fully elucidated. This work explored changes in BM-MSC and their relationship with age using sickle cell mice (Townes-SS). BM-MSC were isolated from Townes-SS, and control groups Townes-AA and C57BL/6J at 30- and 60-day-old. The BM-MSCs showed no morphological differences in culture and demonstrated the murine MSC-like immunophenotypic profile (Sca-1+, CD29+, CD44+, CD90.2+, CD31-, CD45- and CD117-). Subsequently, …

Prevalence Of Depression In Patients With Hematologic Diseases In Marrakesh, Morocco: A Single Center Experience, Fatima Zahra Lahlimi, Oumaima Maghnouj, Khawla Khalil, Safaa Chaabane, Illias Tazi

Journal of Community Hospital Internal Medicine Perspectives

Depression in patients with cancer influences negatively their physical symptoms, treatment success, coping, and their quality of life, and it is associated with increased mortality. Reported prevalence of emotional distress in patients followed in hematology varies widely across studies. The present study aimed to investigate the prevalence of depression, and to explore the possible associated factors in patients followed in a hematological department Method: in this descriptive cross-sectional study among patients admitted to the hematology department in the University Hospital Mohammed VI of Marrakech, between August 2020 and December 2020, depression symptoms were assessed using Mini International Neuropsychiatric Interview test …

To Compare The Safety And Efficacy Of Intraluminal Brachytherapy Vs Isolated Percutaneous Transhepatic Biliary Drainage For Unresectable Malignant Biliary Obstruction - A Prospective Observational Study, Shikha Sood, John V Alexander, Manish Gupta, Ashish Chauhan

Hematology/Oncology and Stem Cell Therapy

BACKGROUND: Intraluminal therapies like brachytherapy can locally destroy the obstructing tumour and thus increase the duration of catheter/stent patency in patients with unresectable malignant biliary obstruction (MBO). OBJECTIVES: Evaluate the safety and efficacy of percutaneous transhepatic biliary drainage (PTBD) followed by HDR Intraluminal Brachytherapy (ILBT) in the palliative treatment of malignant biliary obstruction. DESIGN: Prospective observational study SETTING: An academic tertiary care hospital in Himachal Pradesh PATIENT AND METHODS: All consenting consecutive patients of MBO from January 2021 to March 2022, who were unfit for alternate treatment modalities were enrolled in our study and underwent percutaneous transhepatic biliary drainage (PTBD) …

Assessing The Efficacy Of Mitoxantrone And Doxorubicin As Frontline Anthracyclines During Induction Therapy Of Newly Diagnosed Acute Promyelocytic Leukemia, José Carlos Jaime-Pérez, Eugenia M. Ramos-Dávila, Jesús D. Meléndez-Flores, Mariana González-Treviño, David Gómez-Almaguer

Hematology/Oncology and Stem Cell Therapy

Background: Therapeutic advances in acute promyelocytic leukemia (APL) have transformed it into today’s most curable form of leukemia. However, recommended agents such as arsenic trioxide, idarubicin or daunorubicin are not easily available in low-middle-income countries, in which outcomes remain suboptimal. We aimed to assess the efficacy and safety of more accessible anthracyclines. Materials: We conducted a retrospective cohort including sixty-one patients diagnosed with APL over a 15-year period. Patients received low-dose all-trans retinoic acid (ATRA, 25mg/m2) with mitoxantrone or doxorubicin as induction to remission therapy. Groups were compared using the χ2 and Student’s T-tests. Kaplan–Meier analysis was used for survival …

Role Of Anti-Cd38 Monoclonal Antibodies In The Treatment Of Adult Immune Hematological Diseases., Erin Huilin Yang, Ibrahim N. Muhsen, Hadeel Samarkandi, Riad El Fakih, Mahmoud Aljurf, Amr Hanbali

Hematology/Oncology and Stem Cell Therapy

Daratumumab is a first-in-class human anti-CD38 IgG1 monoclonal antibody approved for the treatment of newly diagnosed as well as relapsed refractory multiple myeloma. Preclinical data supported dararumumab ability in depleting autoantibodies producing-plasma cells, B-cells as well as NK cells. Those reports showed promising results on the use of daratumumab in autoimmune disorders refractory to multiple lines of therapies, which encouraged the use of daratumumab in various autoimmune conditions that are refractory to standard therapies. The aim of this review is to summarize the literature reporting experience using anti-CD38 antibodies in hematological autoimmune diseases, focusing on the most common autoimmune hematological …

Invasive Pulmonary Aspergillosis In Hospitalized Hematopoietic Stem Cell Transplantation Recipients: Outcomes Based On The United States National Readmission Database, Amir Khalil, Paramveer Singh, Tanveer Mir, Mohammed Uddin, Ayman O. Soubani

Hematology/Oncology and Stem Cell Therapy

Background and Objective: Hematopoietic Stem Cell Transplant (HSCT) is well established treatment for hematologic malignancies and certain autoimmune and congenital conditions. HSCT is associated with immunocompromise and increased risk of infections. Our primary objective was to assess whether invasive pulmonary aspergillosis (IPA) affects in-hospital mortality and 30-day readmission among patients undergoing HSCT. A secondary objective was to examine potential differences in complications between HSCT with IPA and HSCT without IPA. Materials and Methods: A retrospective study of a nationally representative cohort of hospital admissions was conducted, with data collected from the Agency for Healthcare Research and Quality's Healthcare Cost and …

A Single Centre, Real-World Experience Of Chronic Gvhd Treatment Using Ibrutinib, Imatinib And Ruxolitinib And Its Treatment Outcomes, Swe Mar Linn, Igor Novitzky-Basso, Omar Abduljalil, Ivan Pasic, Wilson Lam, Arjun Law, Fotios V. Michelis, Armin Gerbitz, Auro Viswabandya, Jeffrey Lipton, Rajat Kumar, Jonas Mattsson, Dennis Dong Hwan Kim

Hematology/Oncology and Stem Cell Therapy

Background: Chronic graft-versus-host-disease (cGVHD) is a common cause of morbidity and mortality following allogeneic hematopoietic stem cell transplantation (HCT). Tyrosine kinase inhibitors (TKIs), including Ruxolitinib, Imatinib and Ibrutinib, have shown promising efficacy in cGVHD treatment. Method: A total of 43 patients who developed cGVHD and received at least one line of TKI therapy for cGVHD treatment were evaluated retrospectively. Overall response, clinical benefit (CB), corticosteroid dose reduction, failure-free (FFS) and overall survival (OS) were assessed. Result: A total 62 lines of TKI therapy were evaluated, including Ruxolitinib (n=18), Ibrutinib (n=13), and Imatinib (n=31). With a median follow-up duration of 12 …

Is Mixed Chimerism Post Allogeneic Hematopoietic Stem Cell Transplantation In Pediatric Acute Lymphoid Leukemia A Prognostic Factor For Relapse ?, Saadiya Khan, Zainab Alsaif, Khawar Siddiqui, Hawazen Alsaedi, Ali Al-Ahmari, Abdullah Al-Jefri, Ibrahim Ghemlas, Awatif Alanazi, Mouhab Ayas

Hematology/Oncology and Stem Cell Therapy

Hematopoietic Stem Cell Transplantation (HSCT) has been considered curative for children with high-risk acute leukemia (ALL) offering better survival. Short tandem repeat (STR) has been used as a marker of chimerism status after HSCT. The appearance of recipient cells >1% post allogenic stem cell transplant was defined as mixed chimerism (MC). Chimeric studies post HSCT are dynamic. The aim of this study was to study the significance of recipients cells in post-HSCT pediatric ALL patients as a predictor of relapse of their primary disease. Rate of MC was 51.4% (19 out of 37 recipients). It was 48.6% (n=18) during Day+100 …

Mechanical Thrombectomy For Intermediate Risk Pulmonary Embolism, James Peter Meza, Marissa Costello Md, Angela Moughni Md, Nicholus Yee Md

Clinical Research in Practice: The Journal of Team Hippocrates

An informed consent article using a set of publications to develop an informed consent conversation for a patient with an acute pulmonary embolism being considered for pulmonary artery thrombolysis.

Side Effects After Use Of Bedside Thaw Method In An Umbilical Cord Blood Stem Cells For Allogeneic Transplantation In A Children Cohort: A Single-Center Experience., Natalia Builes, Laura Niño-Serna, Juan Felipe Combariza

Hematology/Oncology and Stem Cell Therapy

Background: Several strategies and procedures have been described for thawing umbilical cord blood (UCB) products. The ideal method for each center depends on the resources, staff training and access to each of them. Method: We retrospectively evaluated the incidence of side effects using the bedside thaw method after unrelated UCB transplantation in 34 children. Patient, donor, graft characteristics and side effects were identified. In addition, we attempt to identify the risk factors that could be associated with side effects. Result: Sixty-eight percent of patients experienced any adverse reaction. All the reactions were mild and transient events. The most frequent side …

Analysis Of Macrophage Migration Inhibitory Factor Genotype In Hemophilia A Patients, Murtadha Ali Hadi, Wijdan Nazar Ibrahim, Meaad Kadhum Hassan

Hematology/Oncology and Stem Cell Therapy

Background Hemophilia A, an X-linked bleeding disorder, is caused by a complete or partial deficiency in Factor VIII. Multiple factors play a role in the development and progression of bleeding episodes, especially arthropathy, in hemophilia patients. Objectives Detection of macrophage migration inhibitory factor (MIF)-173 G/C polymorphism in people with hemophilia A (PWH) and the possible associations between the type of MIF gene polymorphism and selected disease-related variables. Subjects and Methods This case–control study included 95 male patients aged 2 months to 63 years with hemophilia A and 95 nonhemophiliac subjects matched for age and sex. Allele-specific polymerase chain reaction (AS-PCR) …

Oncotypedx Testing Does Not Benefit Patients With Grade 1, Estrogen And Progesterone Receptor Positive Breast Cancers: A Tailorx Validated Study, Udai S. Sibia, W. Charles Mylander, Tasha Martin, Martin Rosman, Thomas J. Sanders, Young Lee, Lorraine Tafra, Rubie S. Jackson

Hematology/Oncology and Stem Cell Therapy

Background & Objectives We previously described a predictive AAMC model that identifies patients (grade 1, hormone positive) who would not benefit from OncotypeDX testing. The purpose of this study was to validate the AAMC model by assessing distant recurrence-free interval (DRFI) and invasive disease-free survival (IDFS) using TAILORx clinical trial data. Materials & Methods We retrospectively analyzed TAILORx trial data and categorized patients based on the AAMC model. AAMC low-risk patients are those with grade 1 and hormone positive tumors. Kaplan-Meier curves examined DRFI and IDFS. Results Of the total 9195 cases, 2246 (24.4%) were identified as AAMC low-risk. Among …

Post Autologous Hematopoietic Cell Transplant Care In The “Home Sweet Home” Setting: A Treatment Paradigm Shift, Mohamed A. Kharfan-Dabaja, Vivek Roy, Hemant Murthy, Deborah Fischer, Razan Mohty, Ashley Greathouse, Alethea Brown, Kathryn Moreno, Emily Godsey, Jennifer M. Higginbotham, Ashley Bartholomew, Alexis Jackson, Ricardo A. Torres-Guzman, Antonio J. Forte, Sikander Ailawadhi, Roxana Dronca, Michael Maniaci

Hematology/Oncology and Stem Cell Therapy

Multiple myeloma (MM) is the second most common hematologic malignancy with 34,470 estimated new cases in 2022. High-dose therapy followed by autologous hematopoietic cell transplantation (auto-HCT) is a standard treatment for MM even in the era of novel therapies. This is usually done in hospital-based setting, whether in the inpatient or outpatient units. Advanced Care at Home (ACH) represents a virtual hybrid hospital-at-home program that combines a virtual provider-staffed command center with vendor-mediated supply chain capable of delivering high-acuity care in the comfort of patient’s own homes. In our program, we leveraged the existing ACH platform to deliver post-HCT care …

Cytogenetically Normal Acute Myeloid Leukaemia At A Single Centre In South Africa, Nicholas Jenkins, Lee-Ann Phillips, Marian Stone, Estelle Verburgh, Jenna Oosthuizen, Karen Shires

Hematology/Oncology and Stem Cell Therapy

Background: The heterogeneous molecular landscape of cytogenetically normal acute myeloid leukaemia (CN-AML) renders it an ongoing therapeutic challenge. The European Leukaemia Net 2017 guidelines attempted to address this by guiding post-remission therapy according to six prognostically informative mutations. However, its applicability in a South African setting remains elusive due to limited local data. Objectives: This retrospective study aimed to describe a South African CN-AML cohort according to clinicopathological, molecular and treatment outcomes and consequently investigate the local applicability of a triple-mutation testing approach for risk stratification in accordance with the ELN 2017 guidelines, using nucleophosmin (NPM1), fms-like tyrosine kinase internal …

Peritoneal And Pleural Drains In Pediatric Hematopoietic Cell Transplant Recipients With Veno-Occlusive Disease Are Safe And Do Not Adversely Impact Clinical Outcomes, Hemalatha G. Rangarajan, Vinita B Pai Pharm, Joseph R. Stanek, Cassandra Rush Pharm, Jeffrey Naples, Misti Drope, Veronika Polishchuk, Rolla Abu Arja, Rajinder Ps Bajwa

Hematology/Oncology and Stem Cell Therapy

There is a lack of data on the safety and efficacy of peritoneal drain (PD) and chest tube (CT) in the management of effusions in stem cell transplant recipients with veno-occlusive disease (VOD). In this retrospective pediatric study we compared the clinical outcomes and health resource utilization (HRU) in 32 patients with VOD who had a PD placed (PD+) post HCT with 27 patients who did not (PD-). Nine patients had a CT (7 PD+ and 2 PD-). PD+ patients were more likely than PD- patients to have received myeloablative conditioning (100% vs 85.2%; p=0.04) and have severe or very …

Post-Transplantation Cyclophosphamide Based Graft-Versus-Host-Disease Prophylaxis Compared To Methotrexate-Cyclosporine A In Matched Related Allogeneic Hematopoietic Stem Cell Transplantation, Mohamed Shouman, Osman Mansour, Mosaad M. El Gammal, Raafat Abdel-Fattah, Mohamed A. Samra, Alaa El Haddad, Mohamed Maher, Hossam K. Mahmoud

Hematology/Oncology and Stem Cell Therapy

Background: Post-transplant cyclophosphamide (PTCy) has shown promising results with low rates of severe graft-versus-host-disease (GVHD), either alone or combined with conventional immunosuppression (CIS). However, studies comparing PTCy with CIS as a GVHD prophylaxis are scarce.

Objective: The study aimed to evaluate the rates of GVHD and survival outcomes in patients undergoing peripheral blood stem cell transplant (PBSCT) from HLA matched related donors (MRD) receiving PTCy based GVHD prophylaxis and to compare it with the outcomes of patients receiving methotrexate (MTX) and cyclosporine-A (CsA) as a GVHD prophylaxis.

Patients and Methods: Seventy-five patients with advanced hematologic malignancies who underwent MRD allogeneic …

Rapid Hepatomegaly From Ruxolitinib Discontinuation Syndrome, Ryan Jansen Van Rensburg, Shayna Hale, Anna Calara, Kulveer Dabb, Uday Dandamudi, Parth Desai

HCA Healthcare Journal of Medicine

Introduction

Ruxolitinib (RUX) is a Food and Drug Administration-approved Janus Kinase (JAK) inhibitor shown to be effective in improving hypercatabolic symptoms and splenomegaly in patients with myelofibrosis (MF). RUX therapy provides symptomatic benefits for MF patients but is often discontinued for various reasons including worsening cytopenias. Ruxolitinib Discontinuation Syndrome (RDS) involves an acute cytokine-storm rebound phenomenon that can manifest as an acute relapse of symptoms, worsening splenomegaly, respiratory distress, systemic inflammatory response syndrome, or disseminated intravascular coagulopathy.

Case Presentation

We present the case of a patient with JAK2-positive post-polycythemia vera MF, whose RUX therapy was discontinued due to an active …

Anti-Factor Xa Level Monitoring For Enoxaparin Prophylaxis And Treatment In High-Risk Patient Groups, Lucie Sikes, Kipson Charles, Abigail Antigua, Rima Patel, Selina Imboywa, Pheba Cherian

HCA Healthcare Journal of Medicine

Monitoring anti-factor Xa levels is a controversial topic in the inpatient setting due to resource utilization and unclear conditional guideline recommendations regarding this practice. Enoxaparin dosing in certain high-risk patient populations such as those with low body weight, obesity, renal insufficiency, and pregnancy has not been determined. The objective of this review was to assess the safety and efficacy of enoxaparin monitoring via anti-factor Xa levels in high-risk patient populations.

The PubMed database was searched for articles related to low-molecular-weight heparin monitoring. Randomized controlled trials and meta-analyses that evaluated the safety and efficacy of enoxaparin prophylaxis and treatment in patients …

Covid-19 Coagulopathies: Highlights Of 2020–2021 Reported Data, Shreya Anil Kumar, Anushka Pradhan, Abdelrahman Elsebaie, Karina Fainchtein, Abdelrahman Noureldin, Yousra Tera, Sajida Kazi, Maha Othman

The University of Louisville Journal of Respiratory Infections

Background: The COVID-19 pandemic has evolved dramatically over the past two years, and literature on COVID-19 coagulopathy has been overwhelming, which complicates the process of understanding the literature or assessing the quality of the data available. The objective of this narrative review was to highlight and analyze data reported on COVID-19-induced coagulopathy and its outcomes in patients with severe or critical disease over two years of the pandemic.

Methods: Studies published in high-impact journals reporting on hospitalized adult COVID-19 patients, their coagulation parameters, and their thrombotic complications were included. We searched MEDLINE, Embase, and Ovid between Dec 1, 2019 and …

Attitudes Toward Personal Health Data Sharing Among People Living With Sickle Cell Disorder, Exemplar For Study Of Rare Disease Populations, Rebecca Baines, Sebastian Stevens, Zainab Garba-Sani, Arunangsu Chatterjee, Daniela Austin, Simon Leigh

Journal of Patient-Centered Research and Reviews

Purpose: Rare conditions are often poorly understood, creating barriers in determining the value treatments can provide. This study explored barriers and facilitators to personal health data sharing among those with one particular group of rare hematologic disorders, ie, sickle cell disorder (SCD) and its variants.

Methods: A single online focus group among those > 18 years of age and living with SCD was conducted. Participants (N = 25) were recruited through a United Kingdom-based SCD charity. Discussions were transcribed verbatim, with data therein analyzed using inductive thematic analysis.

Results: Five primary motivators for sharing health data were identified: improving awareness; knowing …

Jak2/Stat5 Pathway Mutation Frequencies In South African Bcr/Abl Negative Mpn Patients, Shires K, Rust A, Harryparsad R, Coburn J, Gopie R

Hematology/Oncology and Stem Cell Therapy

Background: Mutations in JAK2/STAT5 proliferation pathway genes are key in the diagnosis of myeloproliferative neoplasms (MPNBCR/ABLneg), with JAK2V617F being found in 50-97% of MPNBCR/ABLneg subtypes. Low JAK2V617F positivity at our facility suggested that our South African MPNBCR/ABLneg population may have a different mutational landscape. Objectives: We aimed to determine the JAK2/STAT5 mutation frequencies associated with our local MPNBCR/ABLneg population, thus determining the relevance of these molecular tests in this group. We also investigated the haematopathological relevance of each test request, to assess testing practises. Method: This study involved the retrospective audit of 886 patients for whom JAK2V617F mutation testing had …