Pub Date : 2025-01-01DOI: 10.1016/j.lrr.2025.100545
Jinghao Nicholas Ngiam , Thuan Tong Tan , Ban Hock Tan , Wenlu Hou , Aloysius Yew Leng Ho , Jeffrey Kim Siang Quek , Yeh Ching Linn , Francesca Lorraine Wei Inng Lim , Hein Than , Shimin Jasmine Chung
Toxoplasmosis is a rare but potentially fatal complication post-allogeneic hematopoietic stem cell transplantation (HSCT), often due to latent reactivation. In Singapore, low seroprevalence limits routine screening and prophylaxis. We report the first reported case of disseminated toxoplasmosis following HSCT in Singapore. A 58-year-old woman with fever and altered mental status two months post-transplant. She had pancytopenia, acute kidney injury, and pneumonitis, with non-specific brain MRI findings. Toxoplasma polymerase chain reaction from serum, bone marrow, and cerebrospinal fluid was positive. Despite treatment with trimethoprim-sulfamethoxazole, pyrimethamine, and sulfadiazine, she developed seizures, intracranial haemorrhage, and nosocomial infections, ultimately succumbing one month later. This case potentially highlights the consideration of routine pre-transplant Toxoplasma screening and prevention strategies, even in regions with low seroprevalence.
{"title":"Fatal case of disseminated toxoplasmosis following allogeneic stem cell transplantation in Singapore – a case report and review of literature","authors":"Jinghao Nicholas Ngiam , Thuan Tong Tan , Ban Hock Tan , Wenlu Hou , Aloysius Yew Leng Ho , Jeffrey Kim Siang Quek , Yeh Ching Linn , Francesca Lorraine Wei Inng Lim , Hein Than , Shimin Jasmine Chung","doi":"10.1016/j.lrr.2025.100545","DOIUrl":"10.1016/j.lrr.2025.100545","url":null,"abstract":"<div><div>Toxoplasmosis is a rare but potentially fatal complication post-allogeneic hematopoietic stem cell transplantation (HSCT), often due to latent reactivation. In Singapore, low seroprevalence limits routine screening and prophylaxis. We report the first reported case of disseminated toxoplasmosis following HSCT in Singapore. A 58-year-old woman with fever and altered mental status two months post-transplant. She had pancytopenia, acute kidney injury, and pneumonitis, with non-specific brain MRI findings. Toxoplasma polymerase chain reaction from serum, bone marrow, and cerebrospinal fluid was positive. Despite treatment with trimethoprim-sulfamethoxazole, pyrimethamine, and sulfadiazine, she developed seizures, intracranial haemorrhage, and nosocomial infections, ultimately succumbing one month later. This case potentially highlights the consideration of routine pre-transplant Toxoplasma screening and prevention strategies, even in regions with low seroprevalence.</div></div>","PeriodicalId":38435,"journal":{"name":"Leukemia Research Reports","volume":"24 ","pages":"Article 100545"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145094823","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}
Pub Date : 2025-01-01DOI: 10.1016/j.lrr.2024.100498
V Da Silva Constante , H Couvert , A Wolfromm , M Ilzkovitz
We describe the case of a female patient with May-Hegglin syndrome who developed peripheral T-cell lymphoma not otherwise specified. The patient presents with systemic lupus erythematous phenotype and myelofibrosis secondary to T-cell lymphoma. Peripheral T-cell lymphoma not otherwise specified, represents 25 % of all peripheral T-cell lymphoma. Its diagnosis remains challenging due to the polymorphous clinical presentation and pathological heterogeneity. Myelofibrosis associated with malignant lymphomas is rare and peripheral T-cell lymphoma is even rarer. To our knowledge, this is the first case to describe an association between May-Hegglin syndrome and a peripheral T-cell lymphoma.
{"title":"When the mask slips: A peripheral T-cell lymphoma disguised as lupus with myelofibrosis in a patient with May-Hegglin syndrome","authors":"V Da Silva Constante , H Couvert , A Wolfromm , M Ilzkovitz","doi":"10.1016/j.lrr.2024.100498","DOIUrl":"10.1016/j.lrr.2024.100498","url":null,"abstract":"<div><div>We describe the case of a female patient with May-Hegglin syndrome who developed peripheral T-cell lymphoma not otherwise specified. The patient presents with systemic lupus erythematous phenotype and myelofibrosis secondary to T-cell lymphoma. Peripheral T-cell lymphoma not otherwise specified, represents 25 % of all peripheral T-cell lymphoma. Its diagnosis remains challenging due to the polymorphous clinical presentation and pathological heterogeneity. Myelofibrosis associated with malignant lymphomas is rare and peripheral T-cell lymphoma is even rarer. To our knowledge, this is the first case to describe an association between May-Hegglin syndrome and a peripheral T-cell lymphoma.</div></div>","PeriodicalId":38435,"journal":{"name":"Leukemia Research Reports","volume":"23 ","pages":"Article 100498"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11728067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979897","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}
Pub Date : 2025-01-01DOI: 10.1016/j.lrr.2025.100514
Ugur Calis , Merve Aydogan , Guldane Cengiz Seval , Klara Dalva , Selami Kocak Toprak
High expression of immune checkpoint markers may leukemic cells to evade the immune system in AML. This study aimed to investigate the relationship between PD-1/PD-L1 expression and treatment outcomes in AML patients.. The study included 21 patients and 18 healthy volunteers. Non-responders exhibited significantly higher PD-1 expression (MFI) in CD3+ and CD4+ T cells. At the time of diagnosis, bone marrow samples from patients exhibited a significantly higher proportion of PD-1 expression in CD3+, CD4+, and CD8+ T lymphocytes than peripheral blood samples. The results revealed an association between PD-1/PD-L1 expression and clinical traits in newly diagnosed AML patients.
{"title":"Impact of PD-1 and PD-L1 expression on treatment outcomes in newly diagnosed acute myeloid leukemia patients","authors":"Ugur Calis , Merve Aydogan , Guldane Cengiz Seval , Klara Dalva , Selami Kocak Toprak","doi":"10.1016/j.lrr.2025.100514","DOIUrl":"10.1016/j.lrr.2025.100514","url":null,"abstract":"<div><div>High expression of immune checkpoint markers may leukemic cells to evade the immune system in AML. This study aimed to investigate the relationship between PD-1/PD-L1 expression and treatment outcomes in AML patients.. The study included 21 patients and 18 healthy volunteers. Non-responders exhibited significantly higher PD-1 expression (MFI) in CD3+ and CD4+ <em>T</em> cells. At the time of diagnosis, bone marrow samples from patients exhibited a significantly higher proportion of PD-1 expression in CD3+, CD4+, and CD8+ <em>T</em> lymphocytes than peripheral blood samples. The results revealed an association between PD-1/PD-L1 expression and clinical traits in newly diagnosed AML patients.</div></div>","PeriodicalId":38435,"journal":{"name":"Leukemia Research Reports","volume":"23 ","pages":"Article 100514"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069448","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}
Pub Date : 2025-01-01DOI: 10.1016/j.lrr.2024.100495
Abdur Jamil , Zaheer Qureshi , Zain Mary El-amir , Gillian Kupakuwana-Suk , Hamzah Akram , Mohsin Ahmad , Eric Huselton
Objective
This mini-review provides an overview of the current evidence for Revumenib, a first-in-class menin inhibitor, in treating AML with KMT2A rearrangements or NPM1 mutations. This therapy represents a promising advancement by selectively disrupting leukemogenic pathways.
Summary
The clinical promise of Revumenib in genetically defined AML highlights its potential role in shaping the future treatment landscape. This mini-review underscores the need for ongoing trials to define optimal dosing, safety protocols, and combination therapies, with the ultimate goal of establishing Revumenib as a standard of care for high-risk AML subsets.
{"title":"Targeting menin for precision therapy in high-risk acute myeloid leukemia","authors":"Abdur Jamil , Zaheer Qureshi , Zain Mary El-amir , Gillian Kupakuwana-Suk , Hamzah Akram , Mohsin Ahmad , Eric Huselton","doi":"10.1016/j.lrr.2024.100495","DOIUrl":"10.1016/j.lrr.2024.100495","url":null,"abstract":"<div><h3>Objective</h3><div>This mini-review provides an overview of the current evidence for Revumenib, a first-in-class menin inhibitor, in treating AML with KMT2A rearrangements or NPM1 mutations. This therapy represents a promising advancement by selectively disrupting leukemogenic pathways.</div></div><div><h3>Summary</h3><div>The clinical promise of Revumenib in genetically defined AML highlights its potential role in shaping the future treatment landscape. This mini-review underscores the need for ongoing trials to define optimal dosing, safety protocols, and combination therapies, with the ultimate goal of establishing Revumenib as a standard of care for high-risk AML subsets.</div></div>","PeriodicalId":38435,"journal":{"name":"Leukemia Research Reports","volume":"23 ","pages":"Article 100495"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984840","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}
Pub Date : 2025-01-01DOI: 10.1016/j.lrr.2025.100503
Taner TAN , Genco Gençdal , Ümit Barbaros Üre , Olga Meltem AKAY
{"title":"Case report: Rechallenge with gilteritinib after acute pancreatitis in FLT3-positive AML","authors":"Taner TAN , Genco Gençdal , Ümit Barbaros Üre , Olga Meltem AKAY","doi":"10.1016/j.lrr.2025.100503","DOIUrl":"10.1016/j.lrr.2025.100503","url":null,"abstract":"","PeriodicalId":38435,"journal":{"name":"Leukemia Research Reports","volume":"23 ","pages":"Article 100503"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593398","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}
Pub Date : 2025-01-01DOI: 10.1016/j.lrr.2025.100530
Xing Zou , Mengmeng Gu , Yue Su , Dayong Yao , Hao Gang , Yang Li , Ce Shi
Thymic stromal lymphopoietin (TSLP) is a cytokine expressed by various cell types. It is involved in the development of allergies, autoimmune diseases, and cancers. TSLP affects immune responses and disease pathogenesis by binding to a heterodimeric receptor complex. In leukemia, particularly acute lymphoblastic leukemia (ALL), the importance of TSLP is being increasingly recognized. It has been shown that TSLP promotes leukemia proliferation by regulating different signaling pathways. However, it has also shown that other gene mutations can occur during this proliferative process, making it impossible to completely cure leukemia by targeting TSLP alone. Additionally, effect of TSLP on leukemia was found to be dose dependent. Whilst low doses were found to support the proliferation of leukemia cells, high doses were found to induce apoptosis in leukemia cells. This review focuses on the dual mechanisms of TSLP in leukemia, providing new insights for leukemia treatment.
{"title":"Thymic stromal lymphopoietin in leukemia: A double-edged sword?","authors":"Xing Zou , Mengmeng Gu , Yue Su , Dayong Yao , Hao Gang , Yang Li , Ce Shi","doi":"10.1016/j.lrr.2025.100530","DOIUrl":"10.1016/j.lrr.2025.100530","url":null,"abstract":"<div><div>Thymic stromal lymphopoietin (TSLP) is a cytokine expressed by various cell types. It is involved in the development of allergies, autoimmune diseases, and cancers. TSLP affects immune responses and disease pathogenesis by binding to a heterodimeric receptor complex. In leukemia, particularly acute lymphoblastic leukemia (ALL), the importance of TSLP is being increasingly recognized. It has been shown that TSLP promotes leukemia proliferation by regulating different signaling pathways. However, it has also shown that other gene mutations can occur during this proliferative process, making it impossible to completely cure leukemia by targeting TSLP alone. Additionally, effect of TSLP on leukemia was found to be dose dependent. Whilst low doses were found to support the proliferation of leukemia cells, high doses were found to induce apoptosis in leukemia cells. This review focuses on the dual mechanisms of TSLP in leukemia, providing new insights for leukemia treatment.</div></div>","PeriodicalId":38435,"journal":{"name":"Leukemia Research Reports","volume":"24 ","pages":"Article 100530"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722945","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}
Pub Date : 2024-11-28DOI: 10.1016/j.lrr.2024.100485
Grace S. Park , Himachandana Atluri , Courtney D. DiNardo , Bryan Guillroy , Jean Horak , Effrosyni Apostolidou , Maryam Buni , Guillermo Montalban Bravo , Naveen Pemmaraju
Delayed hemolytic transfusion reaction (DHTR) poses a significant challenge in patients receiving blood transfusions. This case report highlights the complexities of managing DHTR in a newly diagnosed chronic myelomonocytic leukemia (CMML) patient with clinically significant JKa and little c antibodies during induction chemotherapy. A 46-year-old woman with CMML-2 who presented for induction chemotherapy was found to have hemolytic anemia. Due to presence of JKa and little c antibodies, she required intensive monitoring and supportive care measures. The coexistence of JKa and little c antibodies complicates transfusion management and chemotherapy tolerance in CMML patients.
{"title":"Management of hemolytic transfusion reactions in a patient with chronic myelomonocytic leukemia and rare antibodies: A case report","authors":"Grace S. Park , Himachandana Atluri , Courtney D. DiNardo , Bryan Guillroy , Jean Horak , Effrosyni Apostolidou , Maryam Buni , Guillermo Montalban Bravo , Naveen Pemmaraju","doi":"10.1016/j.lrr.2024.100485","DOIUrl":"10.1016/j.lrr.2024.100485","url":null,"abstract":"<div><div>Delayed hemolytic transfusion reaction (DHTR) poses a significant challenge in patients receiving blood transfusions. This case report highlights the complexities of managing DHTR in a newly diagnosed chronic myelomonocytic leukemia (CMML) patient with clinically significant JKa and little c antibodies during induction chemotherapy. A 46-year-old woman with CMML-2 who presented for induction chemotherapy was found to have hemolytic anemia. Due to presence of JKa and little c antibodies, she required intensive monitoring and supportive care measures. The coexistence of JKa and little c antibodies complicates transfusion management and chemotherapy tolerance in CMML patients.</div></div>","PeriodicalId":38435,"journal":{"name":"Leukemia Research Reports","volume":"23 ","pages":"Article 100485"},"PeriodicalIF":0.7,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744315","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}
Acute promyelocytic leukemia (AML-M3), classified as acute Myeloid leukemia with PML RARA according to the 5th edition of the World Health Organization classification of haematolymphoid tumors 2022 [1], is marked by abnormal promyelocyte proliferation and is known for high risks of bleeding and thromboembolic complications. We present a case where lower limb ischemia revealed this leukemia in a child.
Case report
An 11-year-old with minor ankle trauma developed severe lower limb ischemia, leading to the discovery of subtotal femoral artery thrombosis. Blood tests revealed hyperleukocytosis, thrombocytopenia, and anemia with 88 % blasts, confirming acute myeloid leukemia (AML-M3). Karyotyping showed a t(15;17) translocation, and the child was started on emergency chemotherapy.
Discussion
Acute promyelocytic leukemia (APL), classified as AML-M3 with PML-RARA, is characterized by abnormal promyelocytes and accounts for about 10 % of acute leukemias, mostly in middle-aged adults. It has two variants: common hypergranular and rare hypogranular forms. APL can present with bone marrow failure, anemia, bleeding, and occasionally thromboembolic events, as seen in this case. The ischemia mechanism is not fully understood but may involve vessel obstruction by blasts or hypercoagulability. Diagnosis relies on clinical, morphological, phenotypic, and cytogenetic evidence, with treatment involving all-trans retinoic acid (ATRA) and arsenic trioxide (ATO).
Conclusion
Hypogranular acute promyelocytic leukemia (AML3v) is a rare form and is even rarer when it is discovered following an ischaemic event, which is what makes our case so special.
{"title":"Acute lower limb ischemia revealing hypo granular acute promyelocytic leukemia","authors":"Sabrina Belmahi , Zainab Kajeiou , Loubna Yacoubi , Noussaiba Azzi , Mounia Slaoui , Abdelilah Berhili , Mohammed Bensalah , Rachid Seddik","doi":"10.1016/j.lrr.2024.100488","DOIUrl":"10.1016/j.lrr.2024.100488","url":null,"abstract":"<div><h3>Introduction</h3><div>Acute promyelocytic leukemia (AML-M3), classified as acute Myeloid leukemia with PML RARA according to the 5th edition of the World Health Organization classification of haematolymphoid tumors 2022 [1], is marked by abnormal promyelocyte proliferation and is known for high risks of bleeding and thromboembolic complications. We present a case where lower limb ischemia revealed this leukemia in a child.</div></div><div><h3>Case report</h3><div>An 11-year-old with minor ankle trauma developed severe lower limb ischemia, leading to the discovery of subtotal femoral artery thrombosis. Blood tests revealed hyperleukocytosis, thrombocytopenia, and anemia with 88 % blasts, confirming acute myeloid leukemia (AML-M3). Karyotyping showed a t(15;17) translocation, and the child was started on emergency chemotherapy.</div></div><div><h3>Discussion</h3><div>Acute promyelocytic leukemia (APL), classified as AML-M3 with PML-RARA, is characterized by abnormal promyelocytes and accounts for about 10 % of acute leukemias, mostly in middle-aged adults. It has two variants: common hypergranular and rare hypogranular forms. APL can present with bone marrow failure, anemia, bleeding, and occasionally thromboembolic events, as seen in this case. The ischemia mechanism is not fully understood but may involve vessel obstruction by blasts or hypercoagulability. Diagnosis relies on clinical, morphological, phenotypic, and cytogenetic evidence, with treatment involving all-trans retinoic acid (ATRA) and arsenic trioxide (ATO).</div></div><div><h3>Conclusion</h3><div>Hypogranular acute promyelocytic leukemia (AML3v) is a rare form and is even rarer when it is discovered following an ischaemic event, which is what makes our case so special.</div></div>","PeriodicalId":38435,"journal":{"name":"Leukemia Research Reports","volume":"23 ","pages":"Article 100488"},"PeriodicalIF":0.7,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744314","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}
Pub Date : 2024-11-24DOI: 10.1016/j.lrr.2024.100490
Quang Hao Nguyen , Minh Phuong Vu , Ha Trang Kieu , Duc Binh Vu , Ha Thanh Nguyen , Quoc Khanh Bach
Background
Treatment of patients diagnosed with myelodysplastic neoplasms (MDS) is difficult and the outcome is still limited, especially in developing countries. We conducted this study in order to share some experience in treating patients diagnosed with MDS in developing countries.
Methods
This was a retrospective study that included 32 patients with newly MDS. 13 lower-risk patients, including 2 patients with MDS 5q- were treated with erythropoiesis stimulating agent (ESA). 19 patients with higher risk were treated with hypomethylating agent (HMA), which was decitabine.
Results
In the ESA treatment group, the rate of hematologic improvement-erythroid was 69.2 %, the rate of total hematologic improvement (with 3 lineages improvement) was 61.5 %. In the HMA treatment group, the overall response rate was 52.6 %. The follow-up times were 42 months. The overall survival (OS), leukemic transformation-free survival (LFS), and progression-free survival (PFS) of the ESA treatment group were 30.44, 28.91, and 28.29 months; respectively. The OS, LFS, and PFS of the HMA treatment group were 34.27, 31.45, and 26.83 months; respectively.
Conclusions
Patients with lower risk MDS, including MDS 5q-, may benefit from treatment with erythropoiesis stimulating agent (ESA). Patients with higher risk MDS may have a favorable outcome with decitabine (HMA) treatment.
{"title":"Treatment of Vietnamese patients diagnosed with myelodysplastic neoplasms: Practical experience in a developing country","authors":"Quang Hao Nguyen , Minh Phuong Vu , Ha Trang Kieu , Duc Binh Vu , Ha Thanh Nguyen , Quoc Khanh Bach","doi":"10.1016/j.lrr.2024.100490","DOIUrl":"10.1016/j.lrr.2024.100490","url":null,"abstract":"<div><h3>Background</h3><div>Treatment of patients diagnosed with myelodysplastic neoplasms (MDS) is difficult and the outcome is still limited, especially in developing countries. We conducted this study in order to share some experience in treating patients diagnosed with MDS in developing countries.</div></div><div><h3>Methods</h3><div>This was a retrospective study that included 32 patients with newly MDS. 13 lower-risk patients, including 2 patients with MDS 5q- were treated with erythropoiesis stimulating agent (ESA). 19 patients with higher risk were treated with hypomethylating agent (HMA), which was decitabine.</div></div><div><h3>Results</h3><div>In the ESA treatment group, the rate of hematologic improvement-erythroid was 69.2 %, the rate of total hematologic improvement (with 3 lineages improvement) was 61.5 %. In the HMA treatment group, the overall response rate was 52.6 %. The follow-up times were 42 months. The overall survival (OS), leukemic transformation-free survival (LFS), and progression-free survival (PFS) of the ESA treatment group were 30.44, 28.91, and 28.29 months; respectively. The OS, LFS, and PFS of the HMA treatment group were 34.27, 31.45, and 26.83 months; respectively<strong>.</strong></div></div><div><h3>Conclusions</h3><div>Patients with lower risk MDS, including MDS 5q-, may benefit from treatment with erythropoiesis stimulating agent (ESA). Patients with higher risk MDS may have a favorable outcome with decitabine (HMA) treatment.</div></div>","PeriodicalId":38435,"journal":{"name":"Leukemia Research Reports","volume":"23 ","pages":"Article 100490"},"PeriodicalIF":0.7,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744312","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}
A 63-year-old male received a third allogeneic hematopoietic stem cell transplantation with voriconazole prophylaxis for relapsed acute myeloid leukemia. He developed septic arthritis without any typical skin lesions due to fungal infection on day 42. Treatment with liposomal amphotericin B was initiated following surgical debridement; however, he died of progressive fungal infection. Ribosomal DNA sequencing identified Fusarium solani species complex (FSSC) harboring voriconazole resistance. This clinical course indicates that breakthrough invasive fusariosis (azole-resistant FSSC infection) needs to be considered as a pathogen when patients with hematological malignancies develop septic arthritis without typical skin lesions during voriconazole prophylaxis.
一名 63 岁的男性因急性髓性白血病复发接受了第三次异基因造血干细胞移植，并使用了伏立康唑预防疗法。第 42 天，他因真菌感染出现了化脓性关节炎，但没有任何典型的皮肤损害。手术清创后，他开始接受脂质体两性霉素 B 治疗，但最终死于进行性真菌感染。核糖体 DNA 测序发现茄属镰刀菌种复合体（FSSC）对伏立康唑产生抗药性。这一临床病程表明，当血液恶性肿瘤患者在服用伏立康唑预防期间出现化脓性关节炎而无典型皮损时，突破性侵袭性镰刀菌病（耐唑类药物的 FSSC 感染）需要作为病原体加以考虑。
{"title":"Septic arthritis as breakthrough invasive fusariosis after cord blood transplantation","authors":"Shinichi Katsuoka , Hidehiro Itonaga , Yasushi Sawayama , Masahiko Chiwata , Haruka Watanabe , Yuichi Yamada , Machiko Fujioka , Takeharu Kato , Shinya Sato , Koji Ando , Masato Tashiro , Takahiro Takazono , Yoshitaka Imaizumi , Koichi Izumikawa , Katsunori Yanagihara , Hiroshi Mukae , Yasushi Miyazaki","doi":"10.1016/j.lrr.2024.100483","DOIUrl":"10.1016/j.lrr.2024.100483","url":null,"abstract":"<div><div>A 63-year-old male received a third allogeneic hematopoietic stem cell transplantation with voriconazole prophylaxis for relapsed acute myeloid leukemia. He developed septic arthritis without any typical skin lesions due to fungal infection on day 42. Treatment with liposomal amphotericin B was initiated following surgical debridement; however, he died of progressive fungal infection. Ribosomal DNA sequencing identified <em>Fusarium solani</em> species complex (FSSC) harboring voriconazole resistance. This clinical course indicates that breakthrough invasive fusariosis (azole-resistant FSSC infection) needs to be considered as a pathogen when patients with hematological malignancies develop septic arthritis without typical skin lesions during voriconazole prophylaxis.</div></div>","PeriodicalId":38435,"journal":{"name":"Leukemia Research Reports","volume":"22 ","pages":"Article 100483"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142358671","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}
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