Clinical hematology international最新文献

{"title":"Management of multiple myeloma presenting as malignant spinal cord compression during pregnancy: a case report.","authors":"Khushnuma Mullanfiroze, Charlotte Jones, David Williams, Matias Vieira, Ashutosh Wechalekar, Xenofon Papanikolaou, Rakesh Popat, Charalampia Kyriakou, Ke Xu","doi":"10.46989/001c.124664","DOIUrl":"10.46989/001c.124664","url":null,"abstract":"<p><p>not included as this is letter to the editor.</p>","PeriodicalId":93942,"journal":{"name":"Clinical hematology international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523868","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":"Overview of approved CAR-T products and utility in clinical practice.","authors":"Shakthi T Bhaskar, Bhagirathbhai Dholaria, Bipin N Savani, Salyka Sengsayadeth, Olalekan Oluwole","doi":"10.46989/001c.124277","DOIUrl":"10.46989/001c.124277","url":null,"abstract":"","PeriodicalId":93942,"journal":{"name":"Clinical hematology international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523870","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":"Multidisciplinary Management of Morbidities Associated with Chronic Graft-Versus-Host Disease.","authors":"Rahul Shah, Danielle Murphy, Melissa Logue, James Jerkins, Andrew Jallouk, Kassim Adetola, Olalekan Oluwole, Reena Jayani, Eden Biltibo, Tae K Kim, Salyka Sengsayadeth, Wichai Chinratanalab, Carrie Kitko, Bipin Savani, Bhagirathbhai Dholaria","doi":"10.46989/001c.124926","DOIUrl":"10.46989/001c.124926","url":null,"abstract":"<p><p>Chronic graft-versus-host disease (cGVHD) represents a common long-term complication after allogeneic hematopoietic stem cell transplantation (HSCT). It imposes a significant morbidity burden and is the leading cause of non-relapse mortality among long-term HSCT survivors. cGVHD can manifest in nearly any organ, severely affecting the quality of life of a transplant survivor. While the mainstay of treatment has remained systemic immunosuppression with glucocorticoids, progress has been made within the last few years with approvals of three oral agents to treat steroid-refractory cGVHD: ibrutinib, ruxolitinib, and belumosudil. Iatrogenesis contributes a significant portion of the morbidity experienced by patients with cGVHD, primarily from glucocorticoids. This review highlights the myriad impacts of cGVHD, including and beyond the traditional organ systems captured by the National Institutes of Health Consensus Criteria, including iatrogenic complications of long-term immunosuppression. It presents the implications of cGVHD and its treatment on cardiovascular and metabolic health, bone density, endocrine function, sexual health, and ocular and pulmonary disease and outlines a framework around the comprehensive multidisciplinary approach for its evaluation and management.</p>","PeriodicalId":93942,"journal":{"name":"Clinical hematology international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523869","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":"Pulmonary GvHD: is it time to change the NIH diagnostic criteria?","authors":"Martina Canichella, Poalo de Fabritiis","doi":"10.46989/001c.124551","DOIUrl":"https://doi.org/10.46989/001c.124551","url":null,"abstract":"","PeriodicalId":93942,"journal":{"name":"Clinical hematology international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11494443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514713","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":"Delivering an impactful presentation: a practical guide.","authors":"Mohamad Mohty","doi":"10.46989/001c.124436","DOIUrl":"https://doi.org/10.46989/001c.124436","url":null,"abstract":"","PeriodicalId":93942,"journal":{"name":"Clinical hematology international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11487326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483193","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":"Daratumumab-Based Therapeutic Approaches and Clinical Outcomes in Multiple Myeloma and other Plasma Cell Dyscrasias: Insights from a Nationwide Real-World Chart Review Study.","authors":"Allison C Y Tso, Wee Joo Chng, Yeow Tee Goh, Melissa G Ooi, Yunxin Chen, Chandramouli Nagarajan, Daryl Tan, Sanchalika Acharyya, Kiat Hoe Ong","doi":"10.46989/001c.124362","DOIUrl":"https://doi.org/10.46989/001c.124362","url":null,"abstract":"<p><p>Singapore leads Southeast Asia in the routine use of daratumumab for multiple myeloma and other plasma cell dyscrasias. This retrospective review analyzed 112 patients who received daratumumab between 2012 and 2020. Tolerability, and efficacy based on prior lines (PL) of therapy, cytogenetic risk group, and the presence of renal impairment were presented. Infusion-related reactions occurred in 26.8% of patients. Grades 1 and 2 hematological and non-hematological adverse events were observed in 14.3% and 33.9% of patients, respectively. After a median follow-up of 16.9 months, there was no significant difference in overall response rates (ORR) (86% versus 76.3%, p = 0.082) or depth of response (≥ complete response (CR), 35.1% versus 28.9%, p = 0.469) between myeloma patients with and without renal dysfunction. Newly diagnosed and relapsed/refractory patients had an ORR of 92% and 76.3%, and a ≥ VGPR (very good partial response) rate of 80% and 55.3%, respectively. Median progression-free survival (PFS) was better for patients with 0/1 PL compared to ≥ 2 PLs (19.8 versus 6.2 months, p < 0.001), with a deeper response (≥ CR, 38.5% versus 16.7%, p = 0.033). Forty-six and a half percentage of patients had high-risk FISH abnormalities, and those with 0/1 PL had a significantly better ORR than those with ≥ 2 PLs (83.3% vsersus 47.1%, p = 0.022), achieving an ORR similar to that of the general cohort (80.2%, p = 0.905). In conclusion, positioning daratumumab in earlier lines of therapy leads to better outcomes and may mitigate the impact of high-risk FISH abnormalities.</p>","PeriodicalId":93942,"journal":{"name":"Clinical hematology international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11477938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483191","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":"Determinants of Outcomes for Acute Myeloid Leukemia Patients Treated in a Community-Based Specialized Versus Non-Specialized Hospital Setting.","authors":"Minoo Battiwalla, Ju-Hsien Chao, Tonya Cox, Jose Carlos Cruz, William B Donnellan, Alireza Eghtedar, Suman Kambhampati, Shahbaz Malik, Michael B Maris, Marcello Rotta, Frank T Slovick, Aravind Ramakrishnan, Vikas Bhushan, Lindsay Sears, Casey Martin, Jared Holder, Angela Junglen, Navneet Majhail, Charles F LeMaistre","doi":"10.46989/001c.124273","DOIUrl":"https://doi.org/10.46989/001c.124273","url":null,"abstract":"<p><p>The treatment setting influences acute myeloid leukemia (AML) outcomes. Most cancer patients receive care in the community, yet few studies have evaluated the effectiveness of clinical programs outside of academic or National Cancer Institute (NCI)-designated cancer centers. This was a multi-level, case-controlled study of real-world outcomes for initial AML treatment in a community-based network for 1,391 patients with AML between 2011 and 2018. We benchmarked survival within our network against the Surveillance, Epidemiology, and End Results (SEER) database. Coarsened exact matching was performed against 17,186 chemotherapy-treated patients in the SEER database. Cox proportional and accelerated failure time multivariable modeling were performed to identify patient, disease, therapy and center characteristics associated with the risk of AML mortality. Within the network, 799 patients were treated at six specialized blood cancer centers and 592 at 63 other hospitals. Patients receiving high-intensity induction at specialized centers had improved median survivals of 31 months versus 18 months [P<0.001] at non-specialized centers. Median survivals were 13 for non-specialized centers versus 10 months for SEER [P<0.001], and 18 for the entire network versus 10 months for SEER [P<0.001]. Multivariable modeling showed significant impacts from age (<i>HR</i> = 1.025), high-intensity induction therapy (<i>HR</i>= .695), diagnosis year (<i>HR</i>= .937), neighborhood income (<i>HR</i> = .997; P<0.01), higher acuity (<i>HR</i> = 1.002) and Charlson comorbidity score (<i>HR</i> = 1.117). AML treatment may be effectively delivered in the community hospital setting, with specialized centers producing better outcomes for higher intensity treatments.</p>","PeriodicalId":93942,"journal":{"name":"Clinical hematology international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11477936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483194","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":"Deep Learning in Hematology: From Molecules to Patients.","authors":"Jiasheng Wang","doi":"10.46989/001c.124131","DOIUrl":"https://doi.org/10.46989/001c.124131","url":null,"abstract":"<p><p>Deep learning (DL), a subfield of machine learning, has made remarkable strides across various aspects of medicine. This review examines DL's applications in hematology, spanning from molecular insights to patient care. The review begins by providing a straightforward introduction to the basics of DL tailored for those without prior knowledge, touching on essential concepts, principal architectures, and prevalent training methods. It then discusses the applications of DL in hematology, concentrating on elucidating the models' architecture, their applications, performance metrics, and inherent limitations. For example, at the molecular level, DL has improved the analysis of multi-omics data and protein structure prediction. For cells and tissues, DL enables the automation of cytomorphology analysis, interpretation of flow cytometry data, and diagnosis from whole slide images. At the patient level, DL's utility extends to analyzing curated clinical data, electronic health records, and clinical notes through large language models. While DL has shown promising results in various hematology applications, challenges remain in model generalizability and explainability. Moreover, the integration of novel DL architectures into hematology has been relatively slow in comparison to that in other medical fields.</p>","PeriodicalId":93942,"journal":{"name":"Clinical hematology international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11477942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483192","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":"Pathophysiology and Treatments of Complications of Waldenström's Macroglobulinemia.","authors":"Nikhil Patel, Samer Al Hadidi, Sarvari Yellapragada","doi":"10.46989/001c.124268","DOIUrl":"https://doi.org/10.46989/001c.124268","url":null,"abstract":"<p><p>Waldenstrom's macroglobulinemia (WM) or lymphoplasmacytic lymphoma is a B-cell malignancy characterized by lymphoplasmacytic cells in the bone marrow that secrete high amounts of immunoglobulin (Ig) M. The large pentameric structure of IgM leads to a variety of unique complications in WM, such as hyperviscosity syndrome, cryoglobulinemia and sensory neuropathy. Furthermore, malignant cells can infiltrate the central nervous system and lead to a variety of neurological complications, also known as Bing Neel Syndrome. Because of the unique pathophysiology of WM and these complications, their diagnostic work up and treatment regimens vary greatly. Given the rarity of the disease and their complications, there are little to no randomized controlled trials regarding treatments of these complications and, therefore, suggested treatment regimens are usually based on observational studies. In this case series, we will present three cases of WM, each with their own unique complication, and discuss the pathophysiology along with current and future treatment options for each of the complications presented.</p>","PeriodicalId":93942,"journal":{"name":"Clinical hematology international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11477924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483195","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":"Prophylactic Cranial Irradiation prior to HCT for Acute Lymphoblastic Leukemia: To Boost or Not To Boost.","authors":"Khalid Halahleh, Mohammad S Makoseh, Ayat M Taqash, Fawzi Abuhijla, Lubna S Ghatasheh, Rozan B Al Far, Lina M Wahbeh, Isra F Muradi, Abdelatif M Almousa, Ramiz A Abu-Hijlih, Hasan Hashem","doi":"10.46989/001c.124270","DOIUrl":"https://doi.org/10.46989/001c.124270","url":null,"abstract":"<p><strong>Background: </strong>Total body irradiation (TBI) with or without cranial radiation boost (CRB) is an integral component of conditioning prior to allogeneic hematopoietic cell transplantation (allo-HCT) in acute lymphoblastic leukemia (ALL). The benefit of CRB is not yet established.</p><p><strong>Methods: </strong>This is a retrospective single center cohort study. Between January of 2003 and April of 2019, electronic medical records of 166 patients with ALL were retrospectively reviewed. One hundred forty-three patients with ALL and no prior central nervous system (CNS) involvement were included. Patients were divided into two cohorts according to cranial radiation boost (cohort-1: CNS-/CRB+ (110/143, 77%) and cohort-2: CNS-/CRB- (n=33/143; 23%). No patients received post-transplant prophylactic intrathecal chemotherapy.</p><p><strong>Results: </strong>Following alloHCT, 15 patients (10.5%) experienced relapse; 11 relapses (10%) in cohort-1, and 4 (12%) in cohort-2. Four patients (26.6%) experienced systemic medullary relapse with initial central nervous system (CNS) involvement. One patient (6.6%) experienced isolated first central nervous system relapse after allotransplant with no difference between the two cohorts (6.6% vs 0; P-0.59). Age at transplant and phenotypic subtype were predictive of first central nervous system relapse after allotransplant with respective P-values of 0.001 and 0.015.At a median follow-up of 30 months (range: 2.5-128 months), the estimated 3-year overall survival was 61% (95% CI: 53-69), relapse free survival was 60% (95% CI: 52-69) and 3-year central nervous system-relapse-free survival was 99% and 100% in in cohort-1 and cohort-2 respectively, when systemic relapses were censored. There was no statistical significant difference in either survival or relapse free survival between the two cohorts (P > 0.69).</p><p><strong>Conclusions: </strong>Our results suggest that augmenting total body irradiation with cranial radiation boost in patients with ALL with no prior CNS involvement did not improve relapse risk in central nervous system or survival outcomes.</p>","PeriodicalId":93942,"journal":{"name":"Clinical hematology international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11477921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483196","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}