Hematology, Transfusion and Cell Therapy最新文献

{"title":"Overcoming challenges to reduce time to antibiotic therapy in febrile neutropenic children: insights from a Mexican center","authors":"Julia Esther Colunga-Pedraza ,&nbsp;Ingrid Gabriela Lopez-Reyna ,&nbsp;Denisse Natalie Vaquera-Aparicio ,&nbsp;Samantha Paulina Peña-Lozano ,&nbsp;Jafet Arrieta ,&nbsp;Lucía Elizabeth Hernández-Torres ,&nbsp;Perla Rocío Colunga-Pedraza ,&nbsp;Mónica Regalado ,&nbsp;Yajaira Valentine Jiménez-Antolinez ,&nbsp;Fernando García-Rodríguez ,&nbsp;Oscar González-Llano","doi":"10.1016/j.htct.2024.04.123","DOIUrl":"10.1016/j.htct.2024.04.123","url":null,"abstract":"<div><h3>Background</h3><div>Providing quality supportive therapy for children with cancer is essential to reduce the high mortality rates in low- and middle-income countries. Febrile neutropenia is the most common life-threatening complication of cancer in children. The objective of this study was to evaluate the long-term effectiveness of the ‘Golden Hour’ intervention in reducing the time to administer antibiotics and its impact on clinical outcomes in a Mexican hospital.</div></div><div><h3>Methods</h3><div>A comparative study of children with febrile neutropenia who attended the emergency department at the Hospital Universitario “Dr. José Eleuterio González” was performed between January 2017 and December 2022. In May 2019, this center joined the collaborative ‘Mexico in Alliance with St. Jude’ project. An adapted improvement program was developed based on the implementation of an algorithm comprising institutional guidance, supplies kit, standardization of sample processing, training of healthcare providers, and patient education. The time to antibiotic administration was compared with clinical outcomes between the historical control and post-intervention groups.</div></div><div><h3>Results</h3><div>A total of 291 patients were included, 122 in the pre-intervention period and 169 in the intervention period. Only 5.7 % of the pre-intervention group received the first dose of antibiotics within 60 min of presenting to the emergency department compared to 84.6 % in the intervention group (<em>p</em>-value &lt;0.000). The median times to antibiotic administration in the pre-intervention and post-intervention periods were 269.4 and 50.54 min, respectively (<em>p</em>-value &lt;0.000). Clinical deterioration and admission to the pediatric intensive care unit decreased significantly from 6.6 % to 2.3 % (<em>p</em>-value = 0.03).</div></div><div><h3>Conclusions</h3><div>Sustainability of the quality improvement project ‘Golden Hour’ in low- to mid-income countries demonstrated high effectiveness in reducing time to antibiotic administration among children with febrile neutropenia and improved clinical outcomes over three years of implementation.</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"46 ","pages":"Pages S193-S201"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116466","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":"The survivin/XIAP suppressant YM155 impairs clonal growth and induces apoptosis in JAK2V617F cells","authors":"Jorge Antonio Elias Godoy Carlos ,&nbsp;Keli Lima ,&nbsp;Eduardo Magalhães Rego ,&nbsp;Leticia Veras Costa-Lotufo ,&nbsp;João Agostinho Machado-Neto","doi":"10.1016/j.htct.2024.05.012","DOIUrl":"10.1016/j.htct.2024.05.012","url":null,"abstract":"<div><div>The central role of the control of apoptosis in the pathophysiology of Philadelphia chromosome-negative myeloproliferative neoplasms has recently been reinforced in genetic and pharmacological studies. The inhibitor of apoptosis protein family has eight members and plays an important role in apoptosis, with the most studied being survivin (BIRC5) and X-linked inhibitor of apoptosis (XIAP). YM155 is a small molecule with antineoplastic potential that has been described as a suppressant of survivin and XIAP. In the present study, <em>BIRC5</em> expression was significantly increased in primary myelofibrosis patients compared to healthy donors. On the other hand, <em>XIAP</em> expression was reduced in myeloproliferative neoplasms patients. In JAK2^V617F cells, YM155 reduces cell viability and autonomous clonal growth and induces apoptosis, cell cycle arrest, and autophagy. HEL cells that show greater malignancy are more sensitive to the drug than SET2 cells. In the molecular scenario, YM155 modulates apoptosis-, cell cycle-, DNA damage- and autophagy-related genes. Protein expression analysis corroborates the observed cellular phenotype and exploratory gene expression findings. In summary, our results indicate that survivin/BIRC5 and XIAP are differently expressed in myeloproliferative neoplasms and YM155 has multiple antineoplastic effects on JAK2^V617F cells suggesting that inhibitor of apoptosis proteins may be a target for pharmacological interventions in the treatment of these diseases.</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"46 ","pages":"Pages S217-S227"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142304648","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":"Assessment of transfusion-induced iron overload with T2*MRI in survivors of childhood acute lymphoblastic leukemia: A case control study","authors":"Laila M. Sherief ,&nbsp;Mohamed Beshir ,&nbsp;Sahar N Saleem ,&nbsp;Wesam Elmozy ,&nbsp;Mona Elkalioubie ,&nbsp;Basma K Soliman ,&nbsp;Amr M Fawzy ,&nbsp;Mona Alsharkawy ,&nbsp;Diana Hanna","doi":"10.1016/j.htct.2024.09.2478","DOIUrl":"10.1016/j.htct.2024.09.2478","url":null,"abstract":"<div><h3>Introduction</h3><div>Childhood acute lymphoblastic leukemia survivors receiving multiple packed red blood transfusions may be at risk of vital organ iron deposition causing long-term complications. This study was undertaken to assess the prevalence and severity of iron overload in the liver and heart by magnetic resonance imaging.</div></div><div><h3>Methods</h3><div>A case-control study was conducted on 60 acute lymphoblastic leukemia survivors aged from 6 to 18 years and 60 healthy, age- and sex-matched children as a control group. The hematological profile, and serum ferritin was assessed and the iron content of the liver and heart was measured by T2* magnetic resonance imaging.</div></div><div><h3>Results</h3><div>Twenty-six (43.3 %) and two (3.3 %) patients had elevated liver and myocardial iron concentrations, respectively. The statistics show a significantly positive correlation between liver T2* magnetic resonance and serum ferritin. The total volume of blood transfused and duration of follow up were associated with elevated liver iron concentrations (<em>p</em>-values = 0.036 and 0.028 respectively). Myocardial T2* magnetic resonance lacked correlation with serum ferritin and transfusion therapy</div></div><div><h3>Conclusion</h3><div>Liver iron overload was detected in children and adolescents after acute lymphoblastic leukemia therapy. The risk of iron overload was related mainly to the transfusion burden during therapy. These patients need monitoring after therapy to assess their need for future chelation therapy.</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"46 ","pages":"Pages S263-S271"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570803","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":"Assessing treatment response in thrombotic thrombocytopenic purpura: Beyond the platelet count","authors":"Cilomar Martins de Oliveira Filho ,&nbsp;Ibidunni Bode-Sojobi ,&nbsp;Barbara D. Lam ,&nbsp;Stephanie Conrad ,&nbsp;Jonathan Berry ,&nbsp;Brian J. Carney","doi":"10.1016/j.htct.2024.06.012","DOIUrl":"10.1016/j.htct.2024.06.012","url":null,"abstract":"","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"46 ","pages":"Pages S442-S444"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142690173","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":"Pre-emptive increase in the filgrastim dose based on the CD34+ cell count on day four of autologous stem cell mobilization","authors":"Paulla Rayane Chaves Utsch ,&nbsp;Fernando Barroso Duarte ,&nbsp;Abrahão Elias Hallack Neto","doi":"10.1016/j.htct.2024.05.016","DOIUrl":"10.1016/j.htct.2024.05.016","url":null,"abstract":"","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"46 ","pages":"Pages S438-S439"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775969","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":"Applicability and validation of different prognostic scores in allogeneic hematopoietic cell transplant (HCT) in the post-transplant cyclophosphamide era","authors":"María Queralt Salas ,&nbsp;Luis Gerardo Rodríguez-Lobato ,&nbsp;Paola Charry ,&nbsp;Maria Suárez-Lledó ,&nbsp;Alexandra Pedraza ,&nbsp;María Teresa Solano ,&nbsp;Jordi Arcarons ,&nbsp;Joan Cid ,&nbsp;Miquel Lozano ,&nbsp;Laura Rosiñol ,&nbsp;Jordi Esteve ,&nbsp;Enric Carreras ,&nbsp;Francesc Fernández-Avilés ,&nbsp;Carmen Martínez ,&nbsp;Montserrat Rovira","doi":"10.1016/j.htct.2023.07.008","DOIUrl":"10.1016/j.htct.2023.07.008","url":null,"abstract":"<div><div>We investigated the predictive capacity of six prognostic indices [Karnofsky Performance Status (KPS), Hematopoietic Cell Transplant-Specific Comorbidity Index (HCT-CI), Disease Risk Index (DRI), European Bone Marrow Transplantation (EBMT) and Revised Pre-Transplantation Assessment of Mortality (rPAM) Scores and Endothelial Activation and Stress Index (EASIX)] in 205 adults undergoing post-transplant cyclophosphamide (PTCy)-based allo-HCT. KPS, HCT-CI, DRI and EASIX grouped patients into higher and lower risk strata. KPS and EASIX maintained appropriate discrimination for OS prediction across the first 2 years after allo-HCT [receiver operating characteristic curve (area under the curve (AUC) &gt; 55 %)]. The discriminative capacity of DRI and HCT-CI increased during the post-transplant period, with a peak of prediction at 2 years (AUC of 61.1 % and 61.8 %). The maximum rPAM discriminative capacity was at 1 year (1-year AUC of 58.2 %). The predictive capacity of the EBMT score was not demonstrated. This study validates the discrimination capacity for OS prediction of KPS, HCT-CI, DRI and EASIX in PTCy-based allo-HCT.</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"46 ","pages":"Pages S3-S12"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61567080","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 C-reactive protein and its prognostic relationship in patients with Hodgkin's Lymphoma","authors":"Elizete Negreiros,&nbsp;Talita Máira Bueno da Silveira,&nbsp;Sérgio Costa Fortier,&nbsp;Carlos Sérgio Chiattone","doi":"10.1016/j.htct.2023.11.005","DOIUrl":"10.1016/j.htct.2023.11.005","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the prognostic value of C-Reactive Protein (CRP), at diagnosis and during follow-up, of patients with Hodgkin´s Lymphoma treated at the Hematology Service of the Santa Casa de São Paulo Hospital, and to correlate serum CRP levels with disease stage and treatment response.</div></div><div><h3>Methods</h3><div>A retrospective study involving review of 71 medical records of patients diagnosed with Hodgkin´s Lymphoma between February 2012 and January 2016 was performed. Three patients were subsequently excluded, giving a total of 68 patients for analysis. A level of CRP &gt; 1 mg/dl was considered elevated.</div></div><div><h3>Results</h3><div>Patients were predominantly male (61.8 %) and mean age was 34 years. Fifty-three (78 %) patients had advanced stage and (76.5 %) had B symptoms. Elevated baseline CRP was associated with greater likelihood of B symptoms (<em>p</em> = 0.02) and of advanced stage (<em>p</em> = 0.015). Patients with Low CRP level after 5th and 6th cycles of chemotherapy was associated with complete response (<em>p</em> = 0.04 and <em>p</em> = 0.03, respectively). Treatment-refractory patients had greater risk of death (<em>p</em> = 0.002).</div></div><div><h3>Conclusion</h3><div>CRP is clinically important for follow-up of patients with Hodgkin´s Lymphoma, where high levels were associated with advanced disease and/or presence of B symptoms. CRP level was considered a predictor of treatment response. Persistence of high CRP values during treatment was associated with refractoriness.</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"46 ","pages":"Pages S53-S58"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139192914","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":"Cytogenetic findings in testicular relapse of multiple myeloma: case report and literature review","authors":"Marília Bazzo Catto ,&nbsp;Roberta Maria da Silva Oliveira Safranauskas ,&nbsp;Tarcila Santos Datoguia ,&nbsp;Renata Kiyomi Kishimoto ,&nbsp;Daniela Borri ,&nbsp;Maria Gabriella Cordeiro ,&nbsp;Anna Carolinne Leal do Nascimento ,&nbsp;Nelson Hamerschlak ,&nbsp;Elvira Deolinda Rodrigues Pereira Velloso","doi":"10.1016/j.htct.2023.12.002","DOIUrl":"10.1016/j.htct.2023.12.002","url":null,"abstract":"","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"46 ","pages":"Pages S405-S409"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139944810","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":"Causes and risk factors for early death in adult patients with acute promyelocytic leukemia: a real-life experience","authors":"Heloísa Maria Farias Fontes ,&nbsp;Júlia Peres de Freitas ,&nbsp;José Henrique Vanderlei Oliveira ,&nbsp;Édyla Almeida de Sousa Moraes ,&nbsp;Eduardo Magalhães Rego ,&nbsp;Raul Antônio Morais Melo","doi":"10.1016/j.htct.2024.02.020","DOIUrl":"10.1016/j.htct.2024.02.020","url":null,"abstract":"<div><h3>Introduction</h3><div>Early Death (ED) remains challenging in newly diagnosed acute promyelocytic leukemia (APL), especially in developing countries. The clinical and laboratory profile at diagnosis were evaluated and causes and risk factors were investigated in adult APL patients.</div></div><div><h3>Method</h3><div>A retrospective real-life analysis of 141 medical records was performed of patients diagnosed with APL between 2007 and 2018, whether they were treated with the IC-APL 2006 protocol or not. Risk factors were assessed by univariate and multivariate analysis.</div></div><div><h3>Main results</h3><div>Overall, 112 patients were included in the study. ED occurred in 22.3% of cases, surpassing clinical trial reports, with non-protocol-eligible patients presenting notably higher rates (60%), potentially due to their clinical status. Hemorrhage (60%) and infection (33.3%) were the leading causes of ED. Univariate analysis associated ED to the ECOG score; white blood cell (WBC) count; body mass index; levels of hemoglobin, albumin, uric acid, and creatinine, aPTT and INR and FLT3 mutations. Multivariate analysis identified ECOG score ≥2 and elevated WBC count as independent risk factors.</div></div><div><h3>Conclusion</h3><div>ED remains a substantial challenge in APL, especially in real-world settings with hemorrhage and infection being the leading causes. ECOG status and WBC count emerged as independent risk factors, while age and platelet count lacked a 30-day prognostic correlation. Evaluating prognostic enhancement tools in controlled trials and real-life settings is pivotal to improving APL outcomes.</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"46 ","pages":"Pages S122-S128"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140272263","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":"Treatment with low-dose tyrosine kinase inhibitors due to significant haematologic toxicity in patients with CML with prolonged treatment failure prevents haematologic progression","authors":"Lucia Vráblová ,&nbsp;Hana Klamová ,&nbsp;Ivana Skoumalová ,&nbsp;Jana Navrátilová ,&nbsp;Romana Janská ,&nbsp;Jan Grohmann ,&nbsp;Milena Holzerová ,&nbsp;Edgar Faber","doi":"10.1016/j.htct.2024.03.010","DOIUrl":"10.1016/j.htct.2024.03.010","url":null,"abstract":"<div><h3>Background</h3><div>A lower dosage of tyrosine kinase inhibitors (TKIs) in patients with chronic myeloid leukaemia (CML) has shown efficacy in managing short-term toxicity and maintaining a deep molecular response in patients who fail to achieve treatment-free remission.</div></div><div><h3>Method</h3><div>From over 700 patients with CML who were treated at two centres over the last three decades, this retrospective study identified eight patients characterised by long-term treatment failure and simultaneous prolonged significant haematologic toxicity that prevented the use of the standard tyrosine kinase inhibitor dosage.</div></div><div><h3>Results</h3><div>Patients had a high or intermediate ELTS risk score, and most had significant comorbidities. Two patients were treated previously with busulfan, and four were aged over 70, which might explain the reduced pool of normal haematopoietic stem cells. However, concomitant myelodysplastic syndrome or the presence of clonal haematopoiesis of indeterminate potential was not demonstrated. Despite prolonged treatment failure, the survival of these patients (who were ineligible for stem cell transplantation) ranged from 45-396 months. Neither mutations in the ABL kinase domain nor additional cytogenetic abnormalities developed during the treatment of these patients, prompting speculation about the low selective pressure of low-dose tyrosine kinase inhibitors and/or the absence of mutations at diagnosis.</div></div><div><h3>Conclusion</h3><div>It is important not to stop treatment with tyrosine kinase inhibitors at a low personalised dosage in CML patients with prolonged significant haematologic toxicity despite long-term treatment failure.</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"46 ","pages":"Pages S171-S181"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141851439","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}