Gomezhester8511
Detection of minimal/measurable residual disease (MRD) in bone marrow specimens by flow cytometry is widely used in patients with T cell acute lymphoblastic leukemia (T-ALL). It plays a central role in guiding treatment and assessing prognosis. However, the occurrence of a normal physiologic reactive immature T-cell population in treated bone marrow is unknown. To investigate this, we examined 14 post chemotherapeutic bone marrow specimens with a T-ALL MRD flow cytometry panel. This included 9 acute myeloid leukemia (AML) and 5 T-ALL cases. Immature T-cells are defined as surface CD3 negative cells that coexpress cytoplasmic CD3 (cyCD3) and terminal deoxynucleotidyl transferase (TdT), or as cells that express CD34 with coexpression of multiple T-cell markers. Immature T-cells were present in 1 of 9 AML cases (11%), between day 20-31 post chemotherapy. Follow-up of this patient who had 4.00% cyCD3+ TdT+ immature T-cells, showed the population gradually decreased to 0.50% at day 31, 0.15% at day 46, and was undetectable (0.00%) at day 116. This population remained undetectable at the most current follow-up on day 147. This pilot study shows that a low level of cyCD3+ TdT+ immature T-cells may be present in post chemotherapeutic regenerating bone marrow and can be detectable by flow cytometry. Thus, extra caution should be taken when interpreting T-ALL MRD results, especially between days 20-31 post chemotherapy.
Myelofibrosis (MF) is a disease in which the grade of bone marrow fibrosis increases in proportion to the degree of extramedullary hematopoiesis and splenomegaly. Selleckchem Fluspirilene Associated with increased cytokines and inflammation, anemia deepens and an increase in serum ferritin levels is also expected. There are no studies addressing the relationship between ferritin and splenomegaly or fibrosis. In this study, the relationship between serum ferritin level and splenomegaly and bone marrow fibrosis was examined.
The study was performed retrospectively in 46 MF cases diagnosed between 2012 and 2020. MF was divided into 3 separate subgroups Primary myelofibrosis, secondary myelofibrosis and myeloproliferative neoplasms (MDS/MPN) with myelodsplastic syndrome.
Thirty (28.3%) of cases were PMF, 26 (56.5%) were SMF and 7 (15.2%) were MDS/MPN. There was no relation found between serum ferritin and splenomegaly in none of the cases or subgroup analysis (for PMF p 0.564, for SMF p 0.192, for MDS/MPN p 0.364). There was a statoup aged 60 years and older. It is an unprecedented study in the literature in terms of both examining the relationship ferritin and fibrosis or splenomegaly and its results.
Infections are major contributor to morbidity and mortality in patients undergoing bone marrow transplant (BMT).
To assess role of serum procalcitonin (PCT) as a useful biomarker for the infections and outcomes in these patients.
Retrospective observational study.
Total 47 patients with febrile episodes were enrolled. Twenty patients underwent autologous BMT and 27 underwent allogeneic BMT. Bacterial infections were documented in 18/47 (38%) patients. Forty patients were neutropenic. The median fever duration was 10 days (range 3-30 days) in positive procalcitonin level group whereas it was 4 days (range 1-18) in negative group. This was statistically significant (P=0.000). Procalcitonin levels were high in 8/9 episodes of sepsis (P=0.029). Intensive care unit transfers and death were significantly higher in PCT positive group as compared to PCT negative group.
Serum procalcitonin levels provide prognostic information of worse outcome in patients undergoing HSCT.
Serum procalcitonin levels provide prognostic information of worse outcome in patients undergoing HSCT.
Severe infections caused by the novel coronavirus 2 display similarities to secondary hemophagocytic lymphohistiocytosis (HLH). However, HLH is a rare disease and has not been well described in critically ill patients.
We used the Nationwide Inpatient Sample (NIS), the largest all-payer inpatient care database publicly available in the United States to identify all adult discharges with Hemophagocytic syndrome (ICD-9 CM code 288.4) between 2007 and 2015. Critical illness was considered present if patient had either ICD-9 CM code indicating the requirement of invasive mechanical ventilation or the presence of shock. We used ICD-9-CM codes to identify various infections (inf-HLH), malignancies (mal-HLH) and autoimmune diseases associated with HLH (MAS-HLH) and classified them in their respective groups. Primary outcome was in-hospital mortality in critically ill patients. We developed multivariable regression model to examine variables associated with mortality in critically ill HLH patients.
value was kother groups of HLH.
Acute myeloid leukemia (AML) is the most common form of hematological malignancy in adults. We aimed to investigate the efficacy of different treatment measures and prognostic factors for elderly patients with AML.
The clinical data of 65 newly diagnosed elderly patients with AML were retrospectively analyzed. Among them, 45 patients received induction chemotherapy including standard cytarabine regimen (n = 21) and low dose cytarabine regimen (n = 24), and 20 patients received palliative treatment. The efficacy and prognosis were compared between the groups.
There were no statistical differences in complete remission, overall survival and the 6-month disease-free survival rates between standard cytarabine group and low dose cytarabine group (
= 0.675,
= 0.775,
= 0.751, respectively). Significant difference in median overall survival and overall survival rate were detected (
< 0.001,
= 0.031, respectively), but no significant difference in early death rate (
= 0.238) was found between induction chemotherapy group and palliative treatment group. Multivariate analysis showed that the white blood cells count ≥ 100.0 × 10
/L was associated with early death.
The induction chemotherapy did not increase the early mortality. The low dose cytarabine regimen can be used as the first-line choice for elderly acute myeloid leukemia patients who are not suitable for intensive chemotherapy.
The induction chemotherapy did not increase the early mortality. The low dose cytarabine regimen can be used as the first-line choice for elderly acute myeloid leukemia patients who are not suitable for intensive chemotherapy.