Mediterranean Journal of Hematology and Infectious Diseases最新文献

{"title":"Sarcoid-like Reactions in Hodgkin Lymphoma Treated with Pembrolizumab.","authors":"Flavia Salvatore, Beatrice Casadei, Camilla Mazzoni, Marianna Gentilini, Lisa Argnani, Pier Luigi Zinzani","doi":"10.4084/MJHID.2026.052","DOIUrl":"10.4084/MJHID.2026.052","url":null,"abstract":"","PeriodicalId":18498,"journal":{"name":"Mediterranean Journal of Hematology and Infectious Diseases","volume":"18 1","pages":"e2026052"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13372095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148456316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Salmonella enteritidis</i> Bacteraemia Presenting as Penile Abscess in an Adolescent with Newly Diagnosed Chronic-Phase CML.","authors":"Yih Hoong Lee, Shan Kai Ing, Kiat Jeng Liew, Jian Yuan Cheng, Andrew Kean Wei Chang, Tze Shin Leong","doi":"10.4084/MJHID.2026.058","DOIUrl":"10.4084/MJHID.2026.058","url":null,"abstract":"","PeriodicalId":18498,"journal":{"name":"Mediterranean Journal of Hematology and Infectious Diseases","volume":"18 1","pages":"e2026058"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13372086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148456388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic Lupus Erythematosus with Nephritis: a Macrophage Activation Syndrome Heralding a New Disease Difficult to Diagnose.","authors":"Alexandros Makis, Ioanna Saougou, Vaios Bebes, Georgios Liapis, Aikaterini Siomou","doi":"10.4084/MJHID.2026.054","DOIUrl":"10.4084/MJHID.2026.054","url":null,"abstract":"","PeriodicalId":18498,"journal":{"name":"Mediterranean Journal of Hematology and Infectious Diseases","volume":"18 1","pages":"e2026054"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13372098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148456371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liver Iron Content in Individuals With B-Thalassemia Trait and Hyperferritinemia: Role of Metabolic Alterations, <i>HFE</i> Genotypes, and Cirrhosis.","authors":"Giulia Risca, Raffaella Mariani, Mara Botti, Sara Pelucchi, Stefania Galimberti, Alberto Piperno","doi":"10.4084/MJHID.2026.051","DOIUrl":"10.4084/MJHID.2026.051","url":null,"abstract":"<p><strong>Background: </strong>An increased serum ferritin is a frequent finding in adults with β-thalassemia trait (BTT). However, whether such an increase is associated with a proportional increase in iron stores is unclear.</p><p><strong>Objectives: </strong>We aimed to evaluate liver iron stores in a consecutive cohort of BTT with hyperferritinemia who underwent magnetic resonance imaging (LIC^MRI) for clinical purposes.</p><p><strong>Methods: </strong>Sixty-six BTT subjects with hyperferritinemia were studied. Clinical, biochemical, and genetic evaluations were done to assess the cause of hyperferritinemia. LICMRI was classified as: grade-1= ≤3 mg/g (normal/mild); grade-2= >3≤7 mg/g (moderate); grade-3= >7 (severe).</p><p><strong>Results: </strong>80.3% showed normal/mild (n=29, 43.9%) or moderate LIC^MRI (n=24, 36.4%), while 19.7% (n=13) showed values >7 mg/g. The latter had lower haemoglobin concentration (p=0.004) and higher transferrin saturation and ferritin compared to subjects with lower LIC^MRI (p<0.001), while steatotic liver disease was more frequent in subjects with lower LIC^MRI grades (p=0.012). Liver cirrhosis was significantly more frequent in subjects with moderate/severe than in those with lower LIC^MRI grades (p=0.001 and p=0.025, respectively). We found a higher frequency of HFE and non-HFE iron-related genotypes (risk genotypes) in LIC^MRI grades 2-3 compared to none in LIC^MRI grade 1 (p=0.003 and p<0.0001, respectively). A regression analysis identified risk genotypes, liver cirrhosis, and BMI as significantly associated with LIC^MRI.</p><p><strong>Conclusions: </strong>Hyperferritinemia is common in BTT subjects, but major iron overload is limited to a minority of cases. They present associated genetic and acquired causes of iron accumulation and increased risk of liver damage.</p>","PeriodicalId":18498,"journal":{"name":"Mediterranean Journal of Hematology and Infectious Diseases","volume":"18 1","pages":"e2026051"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13372105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148456366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic OGTT-Derived Indices Outperform Fasting HOMA-2 for Detecting Dysglycemia in Transfusion-Dependent β-Thalassemia.","authors":"Vincenzo de Sanctis, Shahina Daar, Ploutarchos Tzoulis, Ashraf T Soliman, Ihab Elhakim, Mohammad Faranoush, Christos Kattamis","doi":"10.4084/MJHID.2026.056","DOIUrl":"10.4084/MJHID.2026.056","url":null,"abstract":"<p><strong>Background: </strong>Screening for dysglycemia with an annual oral glucose tolerance test (OGTT) is recommended in transfusion-dependent β-thalassemia (β-TDT), but adherence in routine practice is low. Fasting surrogate indices of β-cell function and insulin sensitivity could offer a less burdensome alternative.</p><p><strong>Aims: </strong>To evaluate in adult β-TDT patients with normal fasting plasma glucose (FPG < 100 mg/dL): (i) the performance of fasting HOMA-2 indices (HOMA2-IR, HOMA2-%β, HOMA2-%S) and their disposition index as predictors of dysglycemia, and (ii) the comparative value of basal versus dynamic OGTT-derived markers (30-min and 1-h plasma glucose, insulinogenic index [IGI], IGI × ISI _Matsuda index and IGI/HOMA2-IR), as predictors of hyperglycemia.</p><p><strong>Methods: </strong>A single-centre retrospective analysis of 42 β-TDT patients (19 males/23 females; mean age 29.2 ± 5.9 yr) with FPG < 100 mg/dL who underwent a standard 75-g 2-h OGTT between January 2011 and September 2025. Patients were classified as those with normal glucose tolerance (NGT; n = 19) or those with impaired glucose tolerance (IGT: n= 20) or thalassemia-related diabetes mellitus (Th-RDM: n = 3). Fasting and dynamic indices were compared by ANOVA and Mann-Whitney U test; associations were tested by Pearson/Spearman correlation and by three sequential exploratory multivariable linear regression models with 2-h plasma glucose as the dependent variable. ROC analysis with Youden's index identified optimal hypothesis-generating cut-offs.</p><p><strong>Results: </strong>Fasting HOMA2-IR, HOMA2-%β and HOMA2-%S did not differ significantly between NGT and hyperglycemic patients and were not independent predictors of 2-h plasma glucose. In contrast, in the total group, 30-min PG, 1-h PG, IGI, IGI × ISI _Matsuda index and IGI/HOMA2-IR all differed significantly between groups (<i>p:</i> ≤ 0.0082) and were inversely correlated with 2-h PG. Receiver operating characteristic (ROC) analysis and area under the curve (AUC-ROC) were used to assess diagnostic performance of the most significant variables. The ROC-AUC cut-offs for predicting dysglycemia were 122.5 mg/dL for 30-min PG (sensitivity 0.91, specificity 0.52), 134 mg/dL for 1-h PG (0.95, 0.10), 5.7 for IGI × ISI _Matsuda index (0.87, 0.47) and 1.33 for IGI/HOMA2-IR (0.87, 0.57).</p><p><strong>Conclusions: </strong>Fasting HOMA-2 indices alone are not reliable predictors of dysglycemia in β-TDT patients with PG < 100 mg/dL. The dynamic IGI/HOMA2-IR ratio and the 30-min/1-h post-load plasma glucose may help risk-stratify patients with β-TDT and normal fasting glucose; however, the proposed cut-offs should be regarded as hypothesis-generating, and prospective multicenter validation is required before these indices can be used to modify current OGTT screening recommendations.</p>","PeriodicalId":18498,"journal":{"name":"Mediterranean Journal of Hematology and Infectious Diseases","volume":"18 1","pages":"e2026056"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13372088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148456324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Qualitative and Quantitative Immunoparesis on Early Infection Risk in Patients with Newly Diagnosed Multiple Myeloma.","authors":"Hongfeng Wang, Jianbin Chen","doi":"10.4084/MJHID.2026.062","DOIUrl":"10.4084/MJHID.2026.062","url":null,"abstract":"<p><strong>Background: </strong>This study explores the impact of different immunoparesis states on early infection risk within 6 months of diagnosis in patients with newly diagnosed multiple myeloma (NDMM), aiming to inform clinical infection prevention strategies.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 213 NDMM patients (2016-2024). Immunoparesis was classified qualitatively (no, partial, and full immunoparesis) and quantitatively (with immunoglobulin reduction < 50% and ≥ 50%). Early infection rates and immunoparesis status were assessed using Kaplan-Meier survival curves. Cox regression models were applied to evaluate the independent prognostic effect of immunoparesis on infection risk.</p><p><strong>Results: </strong>Immunoparesis significantly increased the risk of early infections. In the qualitative analysis, infection rates were 15.8% for no immunoparesis, 53.1% for partial, and 53.8% for full immunoparesis (Log-rank P = 0.017). In the quantitative analysis, infection rates were 51.9% for < 50% immunosuppression and 54.2% for ≥ 50% immunosuppression, compared to 15.8% for no immunoparesis (Log-rank P = 0.017). Cox regression analysis showed that partial and full immunoparesis increased the risk of infection by 8.9-fold (HR = 8.9, P = 0.004) and 7.8-fold (HR = 7.8, P = 0.006), respectively. Similarly, < 50% and ≥ 50% immunosuppression increased infection risk by 8.67-fold (HR = 8.67, P = 0.005) and 7.95-fold (HR = 7.95, P = 0.005), respectively.</p><p><strong>Conclusion: </strong>Immunoparesis significantly increases early infection risk in NDMM patients. However, no significant risk gradient was observed relative to the breadth or depth of immunoparesis within this cohort. Monitoring and timely intervention for immunoparesis are essential for infection prevention.</p>","PeriodicalId":18498,"journal":{"name":"Mediterranean Journal of Hematology and Infectious Diseases","volume":"18 1","pages":"e2026062"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13372100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148456359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associated Factors on Cytomegalovirus Reactivation in Patients with COVID-19 in the Intensive Care Unit.","authors":"Sumeyye Kazancioglu, Ebru Ayozturk, Seval Izdes, Rahmet Guner","doi":"10.4084/MJHID.2026.050","DOIUrl":"10.4084/MJHID.2026.050","url":null,"abstract":"<p><strong>Background: </strong>Critically ill patients in intensive care units (ICUs) are susceptible to cytomegalovirus (CMV) reactivation. Previous studies have identified an association between CMV reactivation and increased mortality, length of ICU stay, and duration of mechanical ventilation (MV).</p><p><strong>Methods: </strong>The study compared severe COVID-19 patients who received antiviral therapy (ganciclovir) for CMV reactivation (n=39) with a control group of patients without reactivation (n=39).</p><p><strong>Results: </strong>The reactivation group exhibited higher mortality rates (n=28, 71.8%) than the control group (n=15, 38.5%). Duration of steroid treatment, prolonged MV, and lower hemoglobin levels were identified as factors associated with CMV reactivation. The optimal cut-off value of hemoglobin was found to be ≤ 9.8 g/dL (p<0.001, AUC: 0.708, sensitivity: 56.41, specificity: 84.62). Furthermore, significantly higher ALT (alanine aminotransferase) levels were observed in the reactivation group (p < 0.001), and an association was found between elevated ALT and reactivation (AUC: 0.721). Within the reactivation group, the baseline CMV DNA levels were higher in non-survivors (n=28) than in survivors (n=11), although this difference was not statistically significant. A downward trend in CMV DNA levels was observed during follow-up in both survivors and non-survivors, eventually reaching undetectable levels.</p><p><strong>Conclusions: </strong>In critically ill patients, CMV reactivation was associated with prolonged ICU stay, mechanical ventilation, and steroid therapy. Lower hemoglobin and elevated ALT levels may serve as useful clinical indicators for CMV reactivation.</p>","PeriodicalId":18498,"journal":{"name":"Mediterranean Journal of Hematology and Infectious Diseases","volume":"18 1","pages":"e2026050"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13372085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148456353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Classical Hodgkin Lymphoma Today.","authors":"Francesco D'Alò, Gabriele Schiaffini, Daniele Mazzoni, Eleonora Alma, Flaminia Bellisario, Marcello Viscovo, Elena Maiolo, Silvia Bellesi, Stefan Hohaus","doi":"10.4084/MJHID.2026.055","DOIUrl":"10.4084/MJHID.2026.055","url":null,"abstract":"<p><p>Classical Hodgkin Lymphoma is one of the most curable neoplasms worldwide, particularly among young adults. Significant advances have been made to maximize treatment efficacy and minimize acute and long-term toxicities, including infertility, cardiovascular complications and secondary primary malignancies. Pretreatment prognostic stratification and <i>interim</i> PET response are the cornerstones of personalized treatment strategies. Circulating tumor cell-free DNA represents an investigational tool for genotyping Hodgkin Lymphoma at diagnosis and monitoring treatment response. An abbreviated course of polychemotherapy followed by involved-site/involved nodal radiotherapy continues to be the gold standard in early-stage diseases, while polychemotherapy remains the mainstay for the treatment of advanced-stage disease with or without the incorporation of novel agents, such as the anti-CD30 antibody-drug conjugate brentuximab-vedotin (BV) or the anti-PD1 checkpoint inhibitors (CPI) nivolumab and pembrolizumab. In elderly patients, treatment requires careful adaptation to minimize acute toxicities, often reducing the chemotherapy load or incorporating new targeted therapies. Although consolidation with autologous stem cell transplantation (ASCT) after salvage chemotherapy remains the standard approach in patients with chemosensitive relapsed/refractory cHL, significant improvements in response rate and duration have been achieved when BV and CPI are integrated into salvage regimens prior to ASCT or as post-transplant maintenance. Both classes of drugs are also approved as monotherapy in patients who are transplant-ineligible or have refractory/relapsed disease. Novel therapeutic approaches, including anti-CD30 CAR-T cells and the combination of the anti-CD30/CD16A bispecific antibody AFM13 with preactivated allogeneic cord blood-derived NK cells, are under investigation for patients who have failed the currently approved treatment options.</p>","PeriodicalId":18498,"journal":{"name":"Mediterranean Journal of Hematology and Infectious Diseases","volume":"18 1","pages":"e2026055"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13372102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148456349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Allogeneic Transplantation in Advanced Systemic Mastocytosis: A Single-Center Case Series Highlighting Gastrointestinal Toxicity and GvHD Risk.","authors":"M Criscuolo, L Fianchi, P Chiusolo, S Sica, L Pagano","doi":"10.4084/MJHID.2026.060","DOIUrl":"10.4084/MJHID.2026.060","url":null,"abstract":"","PeriodicalId":18498,"journal":{"name":"Mediterranean Journal of Hematology and Infectious Diseases","volume":"18 1","pages":"e2026060"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13372087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148456337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cytokine Release Syndrome after Haploidentical Transplantation is Associated with Improved Survival Without Increasing Transplant-Related Mortality.","authors":"Daniele Avenoso, Natalia Difrancesco, Enrico Morello, Gabriele Magliano, Mirko Farina, Vera Radici, Shreyas Hanmantgad, Simona Bernardi, Federica Re, Alessandro Leoni, Domenico Russo, Michele Malagola","doi":"10.4084/MJHID.2026.059","DOIUrl":"10.4084/MJHID.2026.059","url":null,"abstract":"","PeriodicalId":18498,"journal":{"name":"Mediterranean Journal of Hematology and Infectious Diseases","volume":"18 1","pages":"e2026059"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13372104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148456363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}