Hematology Commons^™

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 …

Sickle Cell Anemia In Hispanic-Americans In South Texas: Two Case Reports, Ashika A. Chacko, Shadi Jafari-Esfahani, Nevin A. Varghese

Research Colloquium

Introduction: Sickle cell anemia and traits are well described in the African-American population. Hispanic Americans are an underappreciated community affected by Sickle cell disease, where it affects about every 1 in 16300 live births compared to 1 in every 365 African-American births.Hence, it is essential to acknowledge the incidence in Latin American origin people to provide competent and specific care to these populations.

Case Description: Case 1: A 28-year-old Latin-American lady with sickle cell anemia, multiple transfusions, and exchange transfusion in the past presented with complaints of lower back and lower extremity pain. The patient got admitted with acute sickle …

Covid-19 As A Second Hit For Anti-Phospholipid Syndrome, Himabindu Kolli, Pooja Maknoor, Celin Rajan, Nevin Varghese

Research Colloquium

Background: Anti-phospholipid syndrome (APS) is an autoimmune disorder characterized by venous and arterial thrombosis, usually in setting of underlying autoimmune disorders. Here, we present a case of anti-phospholipid syndrome post covid infection.

Case Presentation: 41-year-old lady presented to the ER with complaints of left sided facial droop for 3-day duration. On further evaluation, she was found to have subacute ischemic stroke and was managed with anticoagulation and supportive treatment. Past medical history is significant for a recent diagnosis of Covid infection and for subsequent development of lower extremity deep vein thrombosis (DVT). She was started on anticoagulation with rivaroxaban for …

Variant Of Fii Gene Plays A Critical Role In Coagulation Potential In Mexican-Americans, Hoang Anh T. Nguyen, Shuchita Vijay Jhaveri, Marcio A. Almeida, Vincent P. Diego, Satish Kumar, Juan M. Peralta, Joanne E. Curran, Bernadette W. Luu, Donna M. Lehman, Ralph A. Defronzo, Laura Almasy, Sarah Williams-Blangero, Ravi Duggirala, John Blangero, Tom Howard

Research Symposium

Background: Disruption in the balance between coagulation and bleeding can result in varying phenotypes such as hypercoagulability and can lead to the development of cardiovascular disease. In our study utilizing extended families of Mexican-Americans from South Texas, we performed a search for protein-altering variants influencing coagulation potential.

Methods: Mexican-Americans in the study were genotyped using Illumina-(human)-exome-24 chip to screen for protein-altering variants. Variants were analyzed for their association with FII activity, aPTT, and PT. Linear-mixed-model analysis was performed to estimate trait heritabilities and to interrogate single nucleotide variations (SNV) for evidence of genetic association. To control for multiple testing, associations …

A Whole Clotta Pain: A Case Of Ivc Thrombosis Presenting As Severe Abdominal Pain In A Patient With Anti-Phospholipid Syndrome, Mery Bartl, Christine E. Loftis, Josenny Rodriguez-Paez, Emilia C. Dulgheru

Research Symposium

Background: Anti-phospholipid syndrome (APS) is an immune-mediated condition characterized by the presence of antiphospholipid antibodies in the setting of venous and arterial thrombosis and or pregnancy loss [1]. APS can be a primary syndrome or can be associated with connective tissue diseases such as systemic lupus erythematosus. The goal of treatment in patients with APS is to decrease the risk of thromboembolic events and the standard of care is warfarin therapy. We describe a case of a 42-year-old gentleman with a history of APS on anticoagulation with apixaban who presented to the hospital with severe abdominal pain secondary to infrarenal …

Pet Imaging Of Microglia Using Pbr28suv Determines Therapeutic Efficacy Of Autologous Bone Marrow Mononuclear Cells Therapy In Traumatic Brain Injury, Supinder S Bedi, Michael C Scott, Max A Skibber, Akshita Kumar, Henry W Caplan, Hasen Xue, David Sequeira, Alison L Speer, Fanni Cardenas, Franciska Gudenkauf, Karen Uray, Amit K. Srivastava, Alan R Prossin, Charles S Cox

Cardeza Foundation for Hematologic Research

Traumatic brain injury (TBI) results in activated microglia. Activated microglia can be measured in vivo by using positron emission topography (PET) ligand peripheral benzodiazepine receptor standardized uptake values (PBR28suv). Cell based therapies have utilized autologous bone marrow mononuclear cells (BMMNCs) to attenuate activated microglia after TBI. This study aims to utilize in vivo PBR28suv to assess the efficacy of BMMNCs therapy after TBI. Seventy-two hours after CCI injury, BMMNCs were harvested from the tibia and injected via tail-vein at 74 h after injury at a concentration of 2 million cells per kilogram of body weight. There were three groups of …

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, …

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 …

Impact Of Detectable Monoclonal Protein At Diagnosis On Outcomes In Marginal Zone Lymphoma: A Multicenter Cohort Study, Narendranath Epperla, Qiuhong Zhao, Reem Karmali, Pallawi Torka, Lauren Shea, Timothy S. Oh, Andrea Anampa-Guzmán, Heather Reves, Montreh Tavakkoli, Irl Brian Greenwell, Emily Hansinger, Elvira Umyarova, Kaitlin Annunzio, Yazeed Sawalha, Beth Christian, Colin Thomas, Stefan K. Barta, Praveen Ramakrishnan Geethakumari, Nancy L. Bartlett, Natalie S. Grover, Adam J Olszewski

Department of Medicine Faculty Papers

Given the paucity of data surrounding the prognostic relevance of monoclonal paraprotein (M-protein) in marginal zone lymphoma (MZL), we sought to evaluate the impact of detecting M-protein at diagnosis on outcomes in patients with MZL in a large retrospective cohort. The study included 547 patients receiving first-line therapy for MZL. M-protein was detectable at diagnosis in 173 (32%) patients. There was no significant difference in the time from diagnosis to initiation of any therapy (systemic and local) between the M-protein and no M-protein groups. Patients with M-protein at diagnosis had significantly inferior progression-free survival (PFS) compared with those without M-protein …

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 …

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) …

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 …

Overview Of Iron Deficiency And Iron Deficiency Anemia In Women And Girls Of Reproductive Age, Richard J. Derman, Anmol Patted

Global Health Articles

Over 50% of pregnant women are anemic and the majority of these are iron deficient. Micronutrient deficiency, the symptom of heavy menstrual bleeding in nonpregnant individuals, and loss of blood associated with pregnancy and obstetric delivery contribute to iron deficiency (ID). Poor outcomes with low maternal iron can affect not only the pregnancy but can also have major bearings on the offspring. Correction of ID and iron deficiency anemia (IDA) in pregnant and prepregnant populations with single-dose intravenous iron supplementation may offer improved outcomes. A harmonization process that incorporates all major randomized controlled trials studying the use of single-dose IV …

Using Individual Collector Blood Culture Volume Data To Improve Fill Volume, Richard S. Kirby, Jenna M. Meloni, Karishma B. Naik, Matthew D. Minnear, Matthew A. Pettengill

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

No abstract provided.

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.

Impact Of Second Primary Malignancy Post–Autologous Transplantation On Outcomes Of Multiple Myeloma: A Cibmtr Analysis, Brittany Knick Ragon, Mithun Vinod Shah, Anita D'Souza, Noel Estrada-Merly, Lohith Gowda, Gemlyn George, Marcos De Lima, Shahrukh Hashmi, Mohamed A. Kharfan-Dabaja, Navneet S. Majhail, Rahul Banerjee, Ayman Saad, Gerhard C. Hildebrandt, Hira Mian, Muhammad Bilal Abid, Minoo Battiwalla, Lazaros J. Lekakis, Sagar S. Patel, Hemant S. Murthy, Yago Nieto, Christopher Strouse, Sherif M. Badawy, Samer Al Hadidi, Bhagirathbhai Dholaria, Mahmoud Aljurf, David H. Vesole, Cindy H. Lee, Attaphol Pawarode, Usama Gergis, Kevin C. Miller, Leona A. Holmberg, Aimaz Afrough, Melhem Solh, Pashna N. Munshi, Taiga Nishihori, Larry D. Anderson, Baldeep Wirk, Gurbakhash Kaur, Muzaffar H. Qazilbash, Nina Shah, Shaji K. Kumar, Saad Z. Usmani

Department of Medical Oncology Faculty Papers

The overall survival (OS) has improved significantly in multiple myeloma (MM) over the last decade with the use of proteasome inhibitor and immunomodulatory drug-based combinations, followed by high-dose melphalan and autologous hematopoietic stem cell transplantation (auto-HSCT) and subsequent maintenance therapies in eligible newly diagnosed patients. However, clinical trials using auto-HSCT followed by lenalidomide maintenance have shown an increased risk of second primary malignancies (SPM), including second hematological malignancies (SHM). We evaluated the impact of SPM and SHM on progression-free survival (PFS) and OS in patients with MM after auto-HSCT using CIBMTR registry data. Adult patients with MM who underwent first …

Prevalence Of Iron Deficiency In Patients With Inherited Bleeding Disorders, Thomas Cochran, Brian R. Lee, Shannon L. Carpenter

Posters

Background: Patients with bleeding disorders have greater propensity for blood loss and therefore may have a higher prevalence of iron deficiency (ID) when compared to the general population. However, current literature focuses on adolescent females and few studies have assessed the overall prevalence of ID in children with inherited bleeding disorders. Aims: This study aims to identify the prevalence of ID in children with an inherited bleeding disorder. Methods: A retrospective analysis of children with any inherited bleeding disorder seen in Children’s Mercy Hospital’s Hemophilia Treatment Center between 2010 and 2020 was performed. Iron deficiency was defined by recently published …