Annals of Hematology & Oncology最新文献

{"title":"Effect of Red Blood Cell Transfusion on Central Venous-to-Arterial Carbon Dioxide Difference in Anemic Surgical Patients – A Pilot Study","authors":"Anton Alpatov, Maria Wittmann, Heidi Ehrentraut, Achilles Delis, Jochen Hoch, Andreas C Strauss, H. Bogatsch, P. Meybohm, Markus Velten, Tobias Hilbert","doi":"10.26420/annhematoloncol.2023.1431","DOIUrl":"https://doi.org/10.26420/annhematoloncol.2023.1431","url":null,"abstract":"Background: Biochemical markers for monitoring adequacy of cardiac output and tissue perfusion such as blood lactate and central venous oxygen saturation (ScvO2) are meanwhile well established in clinical routine. In addition, in recent years, the central venous-to-arterial carbon dioxide difference (dCO2) has been evaluated as a further marker, and studies meanwhile have demonstrated the validity of an increased dCO2 to identify capillary perfusion mismatches. However, results from animal studies suggest that dCO2 may be influenced by altered hemoglobin values during severe bleeding. It was the aim of our study to evaluate if dCO2 changes upon Red Blood Cell (RBC) transfusion in humans. Methods: Patients of the ongoing LIBERAL trial were prospectively evaluated. Participants were aged ≥70 years and scheduled for elective intermediate or high risk orthopedic or trauma surgery with the clinical need for invasive blood pressure monitoring and central venous catheterization. During surgery, drop of hemoglobin triggered administration of one single RBC unit, together with arterial and central venous blood analysis immediately before as well as after transfusion. Results: In total, 46 patients were analyzed. Baseline median hemoglobin before RBC transfusion was 8.35 (7.48–8.73)g/dl, while dCO2 was 6.2 (3.4–9.6)mmHg. According to Spearman correlation, there was a linear association between pre-transfusion dCO2 and ScvO2. Transfusion of one RBC unit resulted in a significant increase of median hemoglobin by 1.2 (0.7–1.63)g/dl (p<0.0001), and hemoglobin increase was more pronounced when pre-transfusion hemoglobin was low, as evidenced by a significant negative association between both parameters (r=-0.61, p <0.0001). Neither lactate nor ScvO2 nor dCO2 were significantly influenced by transfusion. When the whole cohort was divided according to pre-transfusion dCO2 levels using a cut-off value of 6 mmHg, median dCO2 decreased significantly more pronounced following RBC transfusion when pre-transfusion values were high (>6 mmHg), compared to those patients with a pre-transfusion dCO2 below 6 mmHg. Conclusions: The results of our study suggest that crude dCO2 is not influenced by moderate hemoglobin increases in orthopedic and trauma surgery patients. However, including dCO2 into the decision whether to administer RBC or not may be an interesting reasonable approach for further investigations on the way towards more individualized transfusion regimens.","PeriodicalId":137690,"journal":{"name":"Annals of Hematology &amp; Oncology","volume":"21 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141640115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of Prethrombotic State Malignant Neoplasms, Including Pancreatic Cancer, Using Clot Waveform Analysis","authors":"Mayu Kobayashi, Hideo Wada, S. Fukui, Yasuaki Shimada, Yuuichi Nakazawa, Hiroki Mizutani, Y. Ichikawa, Yuuki Nishiura, I. Moritani, Yutaka Yamanaka, Hidekazu Inou, M. Shimaoka, Hideto Shimpo, K. Shiraki","doi":"10.26420/annhematoloncol.2024.1444","DOIUrl":"https://doi.org/10.26420/annhematoloncol.2024.1444","url":null,"abstract":"Background: Cancer, especially pancreatic cancer, is frequently associated with thrombosis which is one of the causes of poor outcomes; moreover hypercoagulability can be present in cancer patients. Hypercoagulability is considered to be caused by a thrombin burst. Methods: Activated Partial Tthromboplastin Time (APTT), small amount of tissue factor induced FIX activation assay (sTF/FIXa) and Thrombin Time (TT) assessment using Clot Waveform Analysis (CWA) were performed in 138 patients with malignant neoplasms, including pancreatic cancer. Results: The first derivative peak (1st DP) time (1st DPT), 1st DP height (1st DPH) and 1st DPH/1st DPT ratio were increased in a clotting-factor-FVIII-dependent manner. Thrombosis was frequently associated with pancreatic cancer and was observed in the early stage. CWA-APTT and CWA-sTF/FIXa indicated that the peak times and heights were markedly longer and higher, respectively, in cancer patients, especially pancreas cancer patients, than in patients without cancer. The 1st DPH/1st DPT ratios of CWA-sTF/FIXa were significantly high in patients with pancreas cancer (median value 1.5). CWA-TT showed that the peak times were significantly shorter in cancer patients than in healthy volunteers and that the peak heights were significantly higher in cancer than in benign pancreas diseases. The cutoff value of the 1st DPH/ 1st DPT of sTF/FIXa for cancer patients with thrombosis vs. all patients without cancer was 1.3. Conclusions: Cancer patients, including those with pancreatic cancer were frequently associated with thrombosis due to hypercoagulability caused by thrombin burst detected by CWA. A high 1st DPH/1st DPT ratio of sTF/FIXa may suggest an association with cancer or thrombosis.","PeriodicalId":137690,"journal":{"name":"Annals of Hematology &amp; Oncology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140509139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teclistamab in the Treatment of Multiple Myeloma: Latest Updates from the 2023 EHA Annual Meeting","authors":"Hao Sun, Xingchen Li, Lijie Han, Zhongxin Jiang, Yongping Song, Jifeng Yu","doi":"10.26420/annhematoloncol.2023.1441","DOIUrl":"https://doi.org/10.26420/annhematoloncol.2023.1441","url":null,"abstract":"As a promising novel immunotherapy modality, bispecific antibodies (BsAbs) are actively being evaluated in clinical trials for patients with hematological malignancies. Teclistamab is a T-cell-directed IgG4λ BsAb that recognizes B-Cell Maturation Antigen (BCMA) on target cells and CD3ε on T cells. As one of the promising BsAbs, teclistamab was granted orphan designations for the treatment of Multiple Myeloma (MM) in both the US and EU, the breakthrough-therapy designation for the treatment of relapsed/refractory (RRMM) by the FDA, and a Priority Medicines (PRIME) designation for the treatment of adult patients with MM who previously received ≥3 prior lines of therapy by the EMA. Recent evidence suggests that teclistamab exhibits promising efficacy and low toxicity for patients with Relapsed/Refractory Multiple Myeloma (RRMM), even at late stages. As a recently approved agent by both the FDA and the EU for adult patients with RRMM who previously received ≥3 prior lines of therapy, teclistamab is being investigated as monotherapy and in combination clinical studies in patients with MM. Here we provide an overview of the latest clinical data on teclistamab in MM presented at the 2023 European Hematology Association (EHA) annual meeting.","PeriodicalId":137690,"journal":{"name":"Annals of Hematology &amp; Oncology","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139320419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary Malignancies in Patients after Allogeneic Hematopoietic Cell Transplantation at Triple the Incidence of Malignancies in Their Family Donors","authors":"Santarone S, Angelini S, Natale A, Olioso P, Vaddinelli D, Spadano R, Di Bartolomeo P","doi":"10.26420/annhematoloncol.2023.1438","DOIUrl":"https://doi.org/10.26420/annhematoloncol.2023.1438","url":null,"abstract":"The primary end point of this retrospective study was to determine the incidence, risk factors and clinical outcome of secondary malignancies in 951 patients who were given an allogeneic Hemopoietic Cell Transplantation (HCT) and to compare them with the incidence of malignancy observed in the cohort of 761 stem cell family donors. With a median follow-up of 20 years, 74 HCT recipients (40 males) developed SM at a median of 16.09 years since transplant and at a median age of 47 years. The 35-yr cumulative incidence of SM was 17.0% (95% confidence interval, 12.8-21.6%). In univariate analysis, factors associated with increased incidence of SM were cumulative (limited and extensive) chronic graft-versus-host disease (cGvHD) and duration of cumulative cGvHD >24 months. By multivariate analysis, cumulative cGvHD was the only independent risk factor for SM. Patients with cGvHD had 2.85x higher risk as compared to patients without cGvHD (P<0.001). With a median follow-up of 18 years, 13 family donors (7 males) out of 761 developed malignancy at a median of 15.04 years since stem cell donation and at a median age of 55 years. As compared to the cumulative incidence of SM observed in the cohort of transplant recipients, the cumulative incidence of malignancy in family donors at 35 years since stem cell donation was statistically lower [5.8% vs 17.0% (P=0.001)]. This study demonstrates that HCT recipients have a significantly higher incidence of developing post-transplant malignancy as compared to family donors and that cGvHD is a strong risk factor for SM development.","PeriodicalId":137690,"journal":{"name":"Annals of Hematology &amp; Oncology","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139339234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burkitt’s Lymphoma Presenting as Pancoast Syndrome: A Rare Clinical Entity","authors":"C. Rahmani, Abdellah Enourhbi, H. C. Ahmanna, Y. Elouardi, M. Khallouki","doi":"10.26420/annhematoloncol.2023.1423","DOIUrl":"https://doi.org/10.26420/annhematoloncol.2023.1423","url":null,"abstract":"This article describes a rare clinical presentation of Burkitt’s lymphoma, an aggressive malignancy that presented as an anterior mediastinal mass causing Pancoast syndrome in a 39-year-old pregnant woman. The patient presented with respiratory distress, right upper limb monoparesis, significant weight loss, and multiple bilateral axillary and cervical lymphadenopathies. Blood tests revealed non-regenerative anemia and thrombocytopenia, and a cervico-thoraco-abdomino-pelvic scan showed a lobulated, tissue-dense mass with supraclavicular extension, located at the right paramediastinal apex. The bone marrow biopsy showed disseminated Burkitt lymphoma. The article highlights the diverse clinical manifestations of Burkitt lymphoma and discusses its clinical variants, diagnostic techniques, and symptoms. Early diagnosis and treatment are crucial for a favorable outcome.","PeriodicalId":137690,"journal":{"name":"Annals of Hematology &amp; Oncology","volume":"80 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131319704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CML with De Novo NPM1 Mutation and Rapid Progression to Myeloid Blast Cri-Sis despite Treatment with Imatinib: A Case Report","authors":"Chaudhry B, Parker J, Altohami M, Borghi I","doi":"10.26420/annhematoloncol.2023.1422","DOIUrl":"https://doi.org/10.26420/annhematoloncol.2023.1422","url":null,"abstract":"In this case we present a 41 year old male with chronic myeloid leukaemia who despite scoring low risk for Sokal progressed rapidly to blast crisis without warning and after having achieved a partial response to Imatinib therapy. We investigated using retrospective Next Generation Sequencing (NGS) and identified a novel NPM1 mutation at diagnosis and blast crisis together. We also found tyrosine kinase domain mutations using NGS not found with Sanger sequencing. We believe this case highlights the effectivity of NGS in identifying novel and existing mutations with higher sensitivity, which could help improve existing practice in prognostication and management of CML disease in patients not responding to treatment adequately.","PeriodicalId":137690,"journal":{"name":"Annals of Hematology &amp; Oncology","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128656955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Cancer Patients with Opioid-Induced Constipation (OIC): The Experience of Three Italian Centres","authors":"Guardamagna V, Salé Eo, Paolo Mdp, Nardulli P, Giotta F, Gini G","doi":"10.26420/annhematoloncol.2023.1418","DOIUrl":"https://doi.org/10.26420/annhematoloncol.2023.1418","url":null,"abstract":"Objectives: To present the Training on the field about OIC undertaken by three Italian oncological centres involving professionals of different sub-specialties. Methods: Four on-site interactive meetings of multidisciplinary hospital teams; interactive presentation and discussion, questionnaires administration at the baseline and at the end of the field programme over two years (2019-2021). Outcomes evaluated by estimated increase of OIC diagnosis and OIC treatments. Results: Shared principles about OIC prevention and management in all the steps (from laxatives to PAMORAs), and use of PROMs. Participants were asked about their initial awareness at the inception of the Training on the field programme and their final experiences at the end. Discussion: The experience of this Training on the field underlined the cardinal role of a constant teamwork in the Onco-ematology and Palliative Care Departments and the territory with a shared and tested algorithm. The proposed platform of activities is a call to action to mitigate the burden of pain and OIC if specialists act in concert during all the steps of the trajectory of cancer patients requiring opioid treatment. Multidisciplinary teamwork may help redefine and optimize doses and time schedules tailored to each patient and can contribute to designing controlled studies of OIC","PeriodicalId":137690,"journal":{"name":"Annals of Hematology &amp; Oncology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129211531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of an Aggressive Triple Negative Metastatic Metaplastic Breast Cancer","authors":"Sedloev Ta, Usheva Ss, Spirdonov Jv, Grozdev Ks, Koleva K","doi":"10.26420/annhematoloncol.2023.1419","DOIUrl":"https://doi.org/10.26420/annhematoloncol.2023.1419","url":null,"abstract":"Introduction: We present a case of a 69 years old Bulgarian patient with a Triple Negative (TN) MBC. One year after the Breast-Conserving Surgery (BCS), adjuvant chemo- and radiotherapy she was diagnosed with metastases in the sigmoid colon, mesosigmoid, loco-regional lymph nodes and in the brain. Case report: The patient was initially diagnosed with locally advanced TNBC of the left breast in March 2021. She had undergone 6 courses of neoadjuvant chemotherapy and BCS with axillary lymph node dissection on 15.07.2021. The patient had received 4 courses of CarboTAx and whole breast radiation therapy postoperatively until December 2021. Eight months after that she was diagnosed with large bowel lesion in the sigmoid and a second small one in the mesosigmoid on the follow up PET/CT. She was admitted and had undergone laparoscopic left hemicolectomy. Due to signs of central system disorder (headache, impaired vision and vertigo) she was sent to additional examination with MRI (17.10.2022). Several heterogenous formations were found in the supratentorial space. Discussion: TNBC presents an aggressive subgroup, associated with worse prognosis and in about 30-40% of the cases early metastases and recurrence are observed. MBCs have poor response rates to cytotoxic chemotherapy compared to other types of BC. Conclusion: The presented case is here to show the unpredictable biological behaviour of this pathology regardless of the adequate treatment plan and careful follow up and to remind the physicians to be permanently aware of the numerous manifestations of the disease.","PeriodicalId":137690,"journal":{"name":"Annals of Hematology &amp; Oncology","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121207668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosing, Imaging and Successfully Treating a Debilitating Case of Bing-Neel Syndrome: A Multidisciplinary Feat","authors":"Kerley Rn, O’Donnell N, Lynott F, Mulcahy R, Hennessy B","doi":"10.26420/annhematoloncol.2023.1417","DOIUrl":"https://doi.org/10.26420/annhematoloncol.2023.1417","url":null,"abstract":"Waldenstroms Macroglobulinaemia (WM) is a rare B-cell lymphoma representing ~2% of all haematological malignancies. While most neurological complications of WM are secondary to the overproduction of Immunoglobulin M (IgM), Bing-Neel Syndrome (BNS) is an extremely rare direct Central Nervous System (CNS) infiltration by malignant Lymphoplasmocytic Lymphoma (LPL) cells. Limited information on BNS exists in the literature with sparse case reports and case series. Here we present a diagnostically challenging BNS case successfully treated with systemic chemoimmunotherapy and ibrutinib, with remarkable clinical response.","PeriodicalId":137690,"journal":{"name":"Annals of Hematology &amp; Oncology","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114882900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Jejunal Malignant Peripheral Nerve Sheath Tumor with Preoperative Suspicion of Gastrointestinal Stromal Tumor: Report of a Korean Case and Literature Review","authors":"Yoo Kc, Choe Sy, Byeon Sj, Kim Jw","doi":"10.26420/annhematoloncol.2023.1416","DOIUrl":"https://doi.org/10.26420/annhematoloncol.2023.1416","url":null,"abstract":"Background: Malignant Peripheral Nerve Sheath Tumors (MPNSTs) are defined as malignant tumors arising from a peripheral nerve or displaying nerve sheath differentiation. We report the first Korean case of MPNST of the ileum. Case Presentation: A 33-year-old female without family history of neurofibromatosis type I complained of lower abdominal pain. An abdomen computed tomography and enhanced magnetic resonance imaging of the pelvis confirmed a 5.6 cm heterogenous lobulated lesion in the ileum. Laparoscopic exploration revealed severe adhesion of the main ileal mass to the sigmoid colon. Laparoscopic adhesiolysis and segmental resection with anastomosis of the ileum was performed. On gross examination, the resected specimen was 6.5 cm and the tumor was located 10 cm proximal and 15 cm distal from the resection margins. In microscopic examination, the nucleus of the tumor cells was oval to elongated shape, showing moderate pleomorphism. Immunohistochemical staining showed that the main tumor cells were positive for S100 and about 10% of the tumor cells were positive for Ki-67. During the 12-month follow-up period, she presented no symptoms and the abdomen CT scans showed no evidence of distant metastasis in the thorax or abdominal recurrence. Conclusion: We report a rare case of a young female with a MPNST of jejunum, suspected of having GIST before surgery and an extensive review of the literature for MPNST in intestinal tract.","PeriodicalId":137690,"journal":{"name":"Annals of Hematology &amp; Oncology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128448562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}