Hematology, Transfusion and Cell Therapy最新文献

{"title":"HLA variants and inhibitor development in hemophilia A: results from the HEMFIL study group","authors":"Márcio Antônio Portugal Santana , Daniel Gonçalves Chaves , Felipe CB Souza , Suely Meireles Rezende","doi":"10.1016/j.htct.2024.05.015","DOIUrl":"10.1016/j.htct.2024.05.015","url":null,"abstract":"","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"46 ","pages":"Pages S431-S434"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142368026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefits of BV-AVD (Brentuximab vedotin, doxorubicin, vinblastine, and dacarbazine) versus ABVD (doxorubicin hydrochloride, bleomycin sulfate, vinblastine sulfate, dacarbazine) in patients with advanced-stage Hodgkin's lymphoma: an analysis of the ECHELON 1 trial by the GATLA group using the Delphi Method","authors":"Astrid Pavlovsky ,&nbsp;Juan Ignacio Garcia Altuve ,&nbsp;Amalia Cerutti ,&nbsp;Lorena Fiad ,&nbsp;Nicolás Kurgansky ,&nbsp;Fernando Warley ,&nbsp;Florencia Negri Aranguren","doi":"10.1016/j.htct.2024.07.007","DOIUrl":"10.1016/j.htct.2024.07.007","url":null,"abstract":"<div><h3>Introduction</h3><div>The BV-AVD (Brentuximab vedotin, doxorubicin, vinblastine, and dacarbazine) combination for first-line treatment of advanced stage Hodgkin's lymphoma has been approved by regulatory authorities and included in international guidelines. However, several factors influence its incorporation as standard of care.</div></div><div><h3>Materials and Methods</h3><div>A group of experts from different institutions was identified and, using the Delphi method, an analysis of the results of the ECHELON 1 trial for the indication of BV-AVD over ABVD (doxorubicin hydrochloride, bleomycin sulfate, vinblastine sulfate, dacarbazine) in patients with Hodgkin's lymphoma Stages III and IV in Argentina was done. The clinical and academic experience of the authors and the context of the Argentine healthcare system were considered.</div></div><div><h3>Results and discussion</h3><div>Seven statements on general aspects of the management of Hodgkin's lymphoma and nine on specific aspects related to the use of BV-AVD over ABVD reached a consensus of agreement. There was a strong expert consensus in favor of indicating BV-AVD in the presence of extranodal disease or pulmonary disease. Moderate to severe neuropathy, pregnancy and drug allergy were considered absolute contraindications to prescribe BV.</div></div><div><h3>Conclusions</h3><div>The authors agreed that BV-AVD could be considered a new treatment option in high-risk patients. However health system-dependent factors (such as high cost, lack of availability, reimbursement difficulties, irregular delivery, and issues with granulocyte-colony stimulating factor availability) could pose limitations for this prescription. While awaiting new data from clinical trials and real-world studies, these recommendations can represent a useful tool for hematologists in different parts of the world.</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"46 ","pages":"Pages S250-S256"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and prognostic significance of CD27 and CD44 expression patterns in Egyptian pediatric patients with B-precursor acute lymphoblastic leukemia","authors":"Asmaa Abobakr ,&nbsp;Randa A. Osman ,&nbsp;Mohamed A.M. Kamal ,&nbsp;Sayed Abdelhameed ,&nbsp;Hagar Ismail ,&nbsp;Mahmoud M. Kamel ,&nbsp;Khalaf F. Alsharif ,&nbsp;Nema R. Hamad","doi":"10.1016/j.htct.2023.10.003","DOIUrl":"10.1016/j.htct.2023.10.003","url":null,"abstract":"<div><h3>Introduction</h3><div>The expression pattern of CD27 and CD44 was found to correlate with the differentiation stages of B cell precursors, which were known to be involved in a variety of immunological responses.</div></div><div><h3>Aim of the study</h3><div>This study aimed to determine the biological significance of CD27 and CD44 expression in patients with B-precursor acute lymphoblastic leukemia (B-ALL), as well as their association with standard prognostic factors and therapeutic response.</div></div><div><h3>Patients and methods</h3><div>This case-control study included 60 pediatric patients newly diagnosed with B-ALL and 30 pediatric controls. The patient CD27 and CD44 levels were measured using the Beckman Coulter Navios Flow Cytometer.</div></div><div><h3>Results</h3><div>Most malignant cells (91.6 %) expressed CD44, but only 50 % of the patients had CD27 expressed. The positive CD 44 expression was associated with unfavorable prognostic markers, including a decrease</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"46 ","pages":"Pages S27-S35"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138618887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of mass cytometry to characterize hematopoietic stem cells in apheresis products of patients with hematological malignancies","authors":"Carlos Agustin Villegas-Valverde,&nbsp;Antonio Alfonso Bencomo-Hernandez,&nbsp;Yandy M. Castillo-Aleman,&nbsp;Yendry Ventura-Carmenate,&nbsp;Imilla Casado-Hernandez,&nbsp;Rene Antonio Rivero-Jimenez","doi":"10.1016/j.htct.2023.10.008","DOIUrl":"10.1016/j.htct.2023.10.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Hematopoietic stem cell transplantation (HSCT) is a widely used therapy, but its success largely depends on the number and quality of stem cells collected. Current evidence shows the complexity of the hematopoietic system, which implies that, in the quality assurance of the apheresis product, the hematopoietic stem cells are adequately characterized and quantified, in which mass cytometry (MC) can provide its advantages in high-dimensional analysis.</div></div><div><h3>Objective</h3><div>This research aimed to characterize and enumerate CD45^dim/CD34⁺ stem cells using the MC in apheresis product yields from patients with chronic lymphoid malignant diseases undergoing autologous transplantation at the Abu Dhabi Stem Cells Center.</div></div><div><h3>Methods</h3><div>An analytical and cross-sectional study was performed on 31 apheresis products from 15 patients diagnosed with multiple myeloma (<em>n</em> = 9) and non-Hodgkin lymphomas (<em>n</em> = 6) eligible for HSCT. The MC was employed using the MaxPar Kit for stem cell immunophenotyping. The analysis was performed manually in the Kaluza and unsupervised by machine learning in Cytobank Premium.</div></div><div><h3>Results</h3><div>An excellent agreement was found between mass and flow cytometry for the relative and absolute counts of CD45^dim/CD34⁺ cells (Bland-Altman bias: -0.029 and -64, respectively), seven subpopulations were phenotyped and no lineage bias was detected for any of the methods used in the pool of collected cells. A CD34+/CD38+/CD138+ population was seen in the analyses performed on four patients with multiple myeloma.</div></div><div><h3>Conclusions</h3><div>The MC helps to characterize subpopulations of stem cells in apheresis products. It also allows cell quantification by double platform. Unsupervised analysis allows results completion and validation of the manual strategy. The proposed methodology can be extended to apheresis products for purposes other than HSCT.</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"46 ","pages":"Pages S59-S70"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139099423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ST2 and Reg3α: Can they predict aGvHD, steroid refractoriness and transplant-related mortality in pediatric patients after HSCT?","authors":"Gökcan Öztürk ,&nbsp;Deniz Bayrakoğlu ,&nbsp;Şule Haskoloğlu ,&nbsp;Kübra Baskın ,&nbsp;Nazlı Deveci ,&nbsp;Elif İnce ,&nbsp;Talia İleri ,&nbsp;Hasan Çakmaklı ,&nbsp;Mehmet Ertem ,&nbsp;Aydan İkincioğulları ,&nbsp;Figen Doğu","doi":"10.1016/j.htct.2024.02.026","DOIUrl":"10.1016/j.htct.2024.02.026","url":null,"abstract":"<div><h3>Background/aim</h3><div>There are several complications of hematopoietic stem cell transplantation. Without any doubt, most important of these is aGvHD that increases transplant-related mortality. The aim of this study is to investigate whether ST-2 and Reg3α levels measured at an early stage in pediatric patients undergoing allogeneic hematopoietic stem cell transplantation can be individual biomarkers identifying future GvHD and predicting treatment response.</div></div><div><h3>Materials and methods</h3><div>From January 2019 to January 2021, 27 patients undergoing hematopoietic stem cell transplantation for primary immunodeficiency or hematopoietic diseases formed the study group. During their follow-up, the patients were classified into two groups as those developing and those not developing aGvHD. Nineteen healthy volunteers from a similar age group who needed their blood samples drawn for other reasons and who did not have any history of chronic disease, infection or medication use formed the control group. Blood samples of patients scheduled to have allogeneic HSCT were obtained before the administration of the preparative regimen, on Day +7 post-transplant and on the day of diagnosis if they developed aGvHD. Serum samples were stored at -20ºC until the day of processing. ST2 and Reg3α levels were measured using the ELISA method.</div></div><div><h3>Results</h3><div>For patients who developed aGvHD (<em>n</em> = 13), ST2 levels obtained before the transplantation, on Day +7 post-transplant and on the day of aGvHD diagnosis (in patients developing GvHD) were significantly higher compared to the healthy Control Group (<em>p</em>-value &lt;0.05). As regards to the samples obtained on the same days, ST2 levels did not differ significantly among patients who developed and those who did not develop GvHD (<em>n</em> = 14; <em>p</em>-value &gt;0.05). ST2 levels of samples obtained on the days that acute skin and gastrointestinal tract GvHD developed did not differ significantly between these two groups (<em>p</em>-value &gt;0.05). Reg3α levels of the pre-transplant samples, on Day +7 after the transplantation and on the day of aGvHD diagnosis did not show any difference between any of the groups (<em>p</em>-value &gt;0.05). As only two patients died after transplantation, thus correlation of ST2 and Reg3α levels with transplant-related mortality could not be proven.</div></div><div><h3>Conclusion</h3><div>The results of this study suggest that ST2 and Reg3α levels are neither diagnostic nor prognostic or predictive biomarkers of aGvHD, steroid resistance or transplant-related mortality in pediatric patients. This study can be regarded as a pilot study because of the small patient population; more research involving a larger patient population is required.</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"46 ","pages":"Pages S129-S135"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140767371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of blood cell count using an automatic hematology analyzer to optimize collection of peripheral blood progenitor cells by leukapheresis","authors":"Paula Renata Machado Passos Pederzoli ,&nbsp;Karen de Lima Prata ,&nbsp;Nathália Gomide Cruz ,&nbsp;Pedro Victorio de Almeida Marzano ,&nbsp;Maurício Colombini Martins ,&nbsp;Luciana de Almeida Costa ,&nbsp;Roberta Kelly de Andrade ,&nbsp;Marcia Regina Issa Salomão Libânio ,&nbsp;Brian Custer ,&nbsp;André Rolim Belisário","doi":"10.1016/j.htct.2024.04.117","DOIUrl":"10.1016/j.htct.2024.04.117","url":null,"abstract":"<div><h3>Background</h3><div>Autologous stem cell transplantation is a treatment modality for several diseases. Prediction of successful mobilization may be useful to optimize hematopoietic stem cell collection.</div></div><div><h3>Study design and methods</h3><div>This was a retrospective study with data from transplantation candidates between September 2015 and December 2021 being analyzed. The medical record of each patient was reviewed to mine mobilization information. The laboratory data analyzed were CD34⁺ cell enumeration and pre-collection peripheral blood cell count. The primary outcome, good mobilization, was defined as a CD34⁺ cell count ≥20/μL.</div></div><div><h3>Results</h3><div>This study included 807 patients. Increased patient weight, low mean corpuscular volume, high nucleated red blood cells, peripheral blood mononuclear cell and immature granulocyte counts were significantly associated with good mobilization. In addition, patients diagnosed with multiple myeloma were two times more likely to be good mobilizers than patients with lymphoma. The model was applied to a validation set to identify patients who underwent apheresis (CD34⁺ cell count ≥10 µL), resulting in a sensitivity of 69 %, a specificity of 95 %, positive predictive value of 98 %, and a negative predictive value of 50 %.</div></div><div><h3>Conclusion</h3><div>Success in mobilization was greater in patients who underwent the first mobilization cycle and who had a diagnosis of multiple myeloma. Furthermore, higher body weight, and nucleated red blood cells, immature granulocytes and mononuclear cell counts, as well as low mean corpuscular volumes, were associated with successful mobilization.</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"46 ","pages":"Pages S150-S156"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140893087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SICKLE CELL DISEASE UPDATE: NEW TREATMENTS","authors":"Utku Aygüneş","doi":"10.1016/j.htct.2024.11.089","DOIUrl":"10.1016/j.htct.2024.11.089","url":null,"abstract":"<div><div>Sickle-cell disease is the most common genetic blood disorder, causing blockage of the circulation and resulting painful vaso-occlusive episodes, acute chest syndrome, stroke, chronic anemia, and multiorgan failure, with increased mortality. Three novel medications have been approved in the past five years: L-glutamine in 2017, and voxelotor and crizanlizumab in 2019. L-glutamine treatment was linked to a reduction in the rate of RBC transfusions as well as a decrease in hospitalizations, pain crises, and the period between the first and second crises. By raising adenosine triphosphate and lowering 2,3-diphosphoglycerate, a glycolytic red blood cell intermediate, mitapivat, an oral pyruvate kinase activator, also has therapeutic potential. Crizanlizumab, a P-selectin inhibitor, reduces the grade of inflammation by lowering the adhesion between the endothelium and leukocytes, sickled red blood cells, platelets, and endothelial cells. Crizanlizumab is associated with a decrease in the requirement for opiate use as well as a decrease in the number of pain crises and the time until the first crisis. Adverse effects include infusion reactions, headache, nausea, and insurance difficulty. Voxelotor increases hemoglobin levels and affinity for oxygen, preventing HbS polymerization, and lowering hemolysis indicators in the process and was associated with lower hemolysis indicators and higher hemoglobin. Insurance denial and adverse effects like headache, rash, and diarrhea were obstacles to using Voxelotor. None of these therapies, however, are curative. There are efficient cell-based treatments including red blood cell exchange, and hematopoietic stem cell transplantation is the only treatment that can cure the disease. Gene editing has shown promise in the treatment of β-thalassemias and sickle cell disease.</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"46 ","pages":"Page S4"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143339721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IS ALL-TRANS RETINOIC ACID EFFECTIVE IN PULMONARY HAEMORRHAGE IN PATIENTS WITH ACUTE PROMYELOBLASTIC LEUKAEMIA?","authors":"Süleyman Atay ,&nbsp;Ganiye Begül Yağcı","doi":"10.1016/j.htct.2024.11.034","DOIUrl":"10.1016/j.htct.2024.11.034","url":null,"abstract":"<div><h3>Objective</h3><div>Acute myeloid leukaemia (AML) develops from myeloid precursor cells in the bone marrow. Acute promyelocytic leukaemia (APL) is an aggressive subtype (5-10%) of AML with the t(15;17) translocation. It is sensitive to all-trans retinoic acid (ATRA). The aim of this article is to emphasise the efficacy of ATRA treatment in pulmonary haemorrhage associated with APL and to contribute to the literature.</div></div><div><h3>Case Report</h3><div>A 14-year-old girl presented with malaise, pallor and bruises since 1 month. On examination, she was pale and had bruises on the trunk and extremities, but no organomegaly.</div><div>Investigations revealed pancytopenia and atypical mononuclear cells in peripheral blood smear. Bone marrow aspirate showed promyeloblasts (80%) and AML-M3 surface markers were positive in flow cytometry. Cytogenetic analysis revealed t(15;17) translocation.</div><div>AML-BFM 2012 chemotherapy protocol was initiated. During induction chemotherapy, the patient developed dyspnoea and pulmonary haemorrhage. The child was transferred to intensive care unit and ATRA was added to the chemotherapy at a dose of 25 mg/m2/day. Coagulation tests improved 2 days after ATRA treatment and clinical findings improved 4 days later. On the 9th day of intensive care unit admission, the patient was transferred to inpatient ward and there was no bleeding during follow-up.</div></div><div><h3>Discussion</h3><div>Haemorrhagic complications are frequent in APL patients and are one of the main causes of early death (5-9%) (1,2).</div><div>Increased plasmin production (60-fold) due to excessive annexin-II receptor expression in promyeloblasts has been shown to cause fibrinolysis. It is thought that patients develop increased hyperfibrinolysis rather than consumption coagulopathy (2). ATRA is highly effective in bleeding control (3).</div></div><div><h3>Conclusion</h3><div>Patients should be monitored with coagulation tests at regular intervals due to the high risk of bleeding. Undesirable haemorrhagic conditions may develop before and during treatment. ATRA can provide effective control in treatment.</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"46 ","pages":"Page S46"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143339819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PLEURAL EFFUSION DEVELOPING AS A CONSEQUENCE OF G-CSF ADMINISTRATION IN A PATIENT UNDERGOING AML TREATMENT","authors":"Ali Turunç ,&nbsp;Birol Güvenç","doi":"10.1016/j.htct.2024.11.026","DOIUrl":"10.1016/j.htct.2024.11.026","url":null,"abstract":"<div><h3>Objective</h3><div>Human granulocyte colony-stimulating factor (G-CSF) plays a vital role in boosting neutrophil production from hematopoietic progenitor cells, both in lab settings and within the human body. Beyond just raising neutrophil counts, G-CSF primes these cells, enhancing their ability to defend the body, making it a key player not only for neutropenic patients but also for those who are immunocompromised but not necessarily neutropenic. G-CSF is widely used in treating acute myeloid leukemia (AML), either alongside or following chemotherapy. One of its primary benefits is to speed up neutrophil recovery after chemotherapy, reducing both the length of hospital stays and the risk of infection.</div><div>Here, we share a case involving a 17-year-old male with AML who developed pleural effusion after receiving G-CSF during his cytotoxic treatment.</div></div><div><h3>Case Report</h3><div>The patient, a 17-year-old male, came to our clinic with an elevated white blood cell count and was subsequently diagnosed with acute myeloid leukemia (AML) after a bone marrow aspiration. He was immediately started on the 7+3 induction chemotherapy protocol. During the post-chemotherapy phase, when his neutrophil levels dropped, filgrastim (G-CSF) was introduced to help reduce the risk of infection and shorten the neutropenic period. For the first five days, everything seemed normal, and no side effects were noted. However, after that initial period, the patient began to experience worsening shortness of breath. Imaging revealed a growing pleural effusion on the left side. A diagnostic thoracentesis was performed, and the fluid was drained to provide relief. The analysis confirmed the fluid was transudative, with no signs of infection or malignancy. When the pleural effusion returned, G-CSF was promptly stopped, and the effusion rapidly resolved. After consolidation therapy, G-CSF was reintroduced, and once again, pleural effusion reappeared on the third day of treatment, but this too resolved spontaneously once the G-CSF was discontinued. A pleural biopsy showed no pathological findings, confirming that the G-CSF was likely responsible for the effusion.</div></div><div><h3>Discussion</h3><div>In neutropenic patients, pleural effusion is typically linked to infections, but in this case, no signs of infection or AML involvement were found. The recurring pleural effusion, which resolved after stopping G-CSF, suggests a rare side effect of the treatment. Research indicates that G-CSF may trigger local inflammatory responses, including elevated cytokines like IL-6 and TNF-α, potentially leading to fluid accumulation in the pleura. This case highlights the importance of monitoring for unusual side effects during G-CSF therapy in AML patients.</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"46 ","pages":"Pages S41-S42"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143339828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ACUTE MYELOID LEUKEMIA PRESENTING AS ACUTE PANCREATITIS WITH MULTISYSTEM LEUKEMIC INFILTRATION: A CASE REPORT OF PANCREATIC, BILIARY TRACT AND PULMONARY INVOLVEMENT","authors":"Yusuf Hekimoğlu ,&nbsp;Ethem Ozkaya ,&nbsp;Vehbi Demircan ,&nbsp;Abdullah Karakuş ,&nbsp;Orhan Ayyıldız","doi":"10.1016/j.htct.2024.11.029","DOIUrl":"10.1016/j.htct.2024.11.029","url":null,"abstract":"<div><h3>Objective</h3><div>Acute myeloid leukemia (AML) classically presents with symptoms related to anemia, infections, or bleeding. However, atypical presentations involving abdominal pain, acute pancreatitis, and biliary ducts infiltration are rare but have been documented. These unusual manifestations can complicate the diagnosis and delay recognition of AML. Here, we present a case of a young female patient diagnosed with AML, who initially presented with acute pancreatitis and subsequent findings suggestive of biliary tract infiltration and possible pulmonary involvement.</div></div><div><h3>Case Report</h3><div>A 22-year-old female with no notable medical history presented to a local healthcare facility with abdominal pain and diarrhea. She was diagnosed with acute pancreatitis based on clinical evaluation. Abdominal ultrasonography revealed a mass at the head of the pancreas, along with dilatation of both intrahepatic and extrahepatic bile ducts. The patient was referred to Dicle University Educational Hospital for further investigations, including endoscopic retrograde cholangiopancreatography (ERCP). Upon admission to the general internal medicine clinic, the pancreatic mass and biliary duct dilation were confirmed, and further laboratory investigations showed an elevated white blood cell count as 24.900/mm3. A peripheral blood smear demonstrated abnormal white cells, raising suspicion of a hematologic disorder. A bone marrow biopsy was subsequently performed, confirming the diagnosis of AML. Magnetic resonance cholangiopancreatography (MRCP) was conducted to further assess the pancreatic and biliary tract lesions, revealing findings consistent with extramedullary hematologic infiltration. The patient was started on the 7+3 chemotherapy regimen (cytarabine 200 mg/m2 for 7 days and an idarubicin 12 mg/m2 for 3 days). Following treatment, her abdominal pain and distension improved, and laboratory abnormalities normalized, but She died because of neutropenic sepsis during 35th day of treatment.</div></div><div><h3>Conclusion</h3><div>AML can exhibit extramedullary involvement of any organ, though pancreatic, biliary tract, and hepatic enzyme abnormalities are rare and occurs in approximately 8–10% of cases. A study from one center indicated that the most common sites of extramedullary AML involvement are the skin (65%), the central nervous system (23%), and the pleura (7%) . Multi-organ involvement has been reported in around 9% of cases, but pancreatic and biliary duct infiltration is extremely rare, accounting for only 1% of cases. In our case, the patient exhibited involvement of the pancreas, biliary tracts, spleen, and lungs, a situation that is exceedingly rare, with no similar cases found in the existing literature.</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"46 ","pages":"Page S43"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143339829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}