Central nervous system involvement in multiple myeloma (MM) is rare and carries a very poor prognosis. We report the case of a 62-year-old man diagnosed with MM who received induction chemotherapy with bortezomib, cyclophosphamide, and dexamethasone and achieved very good partial response. He developed seizures and altered sensorium while on maintenance chemotherapy. Magnetic resonance imaging of the brain showed leptomeningeal enhancement, and cerebrospinal fluid cytology was positive for plasma cells. His general condition worsened, and he died before starting any specific treatment.
{"title":"Central nervous system relapse in multiple myeloma: An unusual complication","authors":"A. Vasudevan, G. Narayanan, N. Nayak","doi":"10.4103/ijh.ijh_10_21","DOIUrl":"https://doi.org/10.4103/ijh.ijh_10_21","url":null,"abstract":"Central nervous system involvement in multiple myeloma (MM) is rare and carries a very poor prognosis. We report the case of a 62-year-old man diagnosed with MM who received induction chemotherapy with bortezomib, cyclophosphamide, and dexamethasone and achieved very good partial response. He developed seizures and altered sensorium while on maintenance chemotherapy. Magnetic resonance imaging of the brain showed leptomeningeal enhancement, and cerebrospinal fluid cytology was positive for plasma cells. His general condition worsened, and he died before starting any specific treatment.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"11 1","pages":"186 - 188"},"PeriodicalIF":0.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48217550","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}
H. Khudhur, Kawa M. Hasan, R. Polus, Ahmed K. Yassin, N. Mohammad, S. Najmaldeen
BACKGROUND: Adult acute lymphoblastic leukemia (ALL) has a dismal outcome within the optimal situations as the 5-year overall survival (OS) is not reaching 40%. OBJECTIVE: The objective of this study was to evaluate the outcome of adult ALL in Erbil, Iraq, and to see the factors predicting better survival among them. PATIENTS AND METHODS: We analyzed data from 71 adult ALL patients aged 14–81 years (mean age: 28.6 years). Diagnosis is based on the peripheral blood film, bone marrow examination, and flow cytometry. RESULTS: The median OS was 21 months and the median relapse-free survival (RFS) was 13 months. The 3-year OS and the 3-year RFS were 49.3% and 40.8%, respectively, while the 5-year OS and the 5-year RFS were 37.5% and 32.5%, respectively. CONCLUSION: Factors predicting better survival included in the study; age at diagnosis, remission achievement at first induction, risk assessment, and allogeneic stem cell transplantation optimal response.
{"title":"Outcome of adult acute lymphoblastic leukemia, a single-center experience","authors":"H. Khudhur, Kawa M. Hasan, R. Polus, Ahmed K. Yassin, N. Mohammad, S. Najmaldeen","doi":"10.4103/ijh.ijh_41_22","DOIUrl":"https://doi.org/10.4103/ijh.ijh_41_22","url":null,"abstract":"BACKGROUND: Adult acute lymphoblastic leukemia (ALL) has a dismal outcome within the optimal situations as the 5-year overall survival (OS) is not reaching 40%. OBJECTIVE: The objective of this study was to evaluate the outcome of adult ALL in Erbil, Iraq, and to see the factors predicting better survival among them. PATIENTS AND METHODS: We analyzed data from 71 adult ALL patients aged 14–81 years (mean age: 28.6 years). Diagnosis is based on the peripheral blood film, bone marrow examination, and flow cytometry. RESULTS: The median OS was 21 months and the median relapse-free survival (RFS) was 13 months. The 3-year OS and the 3-year RFS were 49.3% and 40.8%, respectively, while the 5-year OS and the 5-year RFS were 37.5% and 32.5%, respectively. CONCLUSION: Factors predicting better survival included in the study; age at diagnosis, remission achievement at first induction, risk assessment, and allogeneic stem cell transplantation optimal response.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"11 1","pages":"151 - 157"},"PeriodicalIF":0.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48221083","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}
K. Balraam, V. Raj, Gurpreet Sagoo, N. Garg, N. Taneja, Alok C. Sen
COVID-19 has wreaked havoc ever since its inception and with the protean manifestations of the disease, it is imperative that progressively data are added to the literature. COVID-19 infection is a multisystem disorder with a wide range of clinical symptomatology. Recent information garnered has laid emphasis on pathological changes at microvascular level causing thrombotic/hemostatic defects, leading to the assorted clinical presentation. We present a consortium of three confirmed COVID-19 cases whose hospital course got convoluted with grave hematological complications in the form of hemolytic uremic syndrome and autoimmune hemolytic anemia. Regrettably, all three patients succumbed to their illness.
{"title":"Hemolysis and COVID-19 infection: A fatal combination – An interesting series of three cases","authors":"K. Balraam, V. Raj, Gurpreet Sagoo, N. Garg, N. Taneja, Alok C. Sen","doi":"10.4103/ijh.ijh_26_22","DOIUrl":"https://doi.org/10.4103/ijh.ijh_26_22","url":null,"abstract":"COVID-19 has wreaked havoc ever since its inception and with the protean manifestations of the disease, it is imperative that progressively data are added to the literature. COVID-19 infection is a multisystem disorder with a wide range of clinical symptomatology. Recent information garnered has laid emphasis on pathological changes at microvascular level causing thrombotic/hemostatic defects, leading to the assorted clinical presentation. We present a consortium of three confirmed COVID-19 cases whose hospital course got convoluted with grave hematological complications in the form of hemolytic uremic syndrome and autoimmune hemolytic anemia. Regrettably, all three patients succumbed to their illness.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"11 1","pages":"196 - 200"},"PeriodicalIF":0.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46713378","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}
BACKGROUND: The coronavirus disease pandemic had spread across all countries. SARS-COV-2 infected up to date millions of people and the threat remains there for others. A lot of SARS-19-infected people with critically ill symptoms admitted to intensive care facilities had developed respiratory failure, coagulopathy, and organ failure. AIMS: The aims of this study were to investigate the prevalence and risk factors associated with coagulopathy in COVID-19 patients who were admitted to the Private Nursing Home Hospital in Baghdad/Iraq. PATIENTS AND METHODS: A case series study was conducted in the Nursing Home Hospital in Baghdad, Iraq, from October 2020 to December 2021. A total of 150 cases were included in this study with confirmed COVID-19 infection by polymerase chain reaction of throat or nose swab. These patients were admitted to two isolation wards (isolation intensive care unit for critical cases and medical ward isolation unit for moderately severe cases). Baseline and follow-up characteristics and laboratory parameters of coagulopathy (blood counts, prothrombin time [PT], partial thromboplastin time, D-dimers, and plasma fibrinogen) were obtained for each patient. The ISARIC 4C has been used for risk stratification (4C Mortality Score is a prognostic model for clinical deterioration among hospitalized adults with community-acquired or hospital-acquired COVID-19, it is used for stratifying and predicting mortality in COVID-19 patients on arrival in hospital). RESULTS: The mean age across patients was 56.6 ± 15.7 years (range: 14–90 years). Males were representing the majority of cases (63.3%) with a male-to-female ratio of 2:1. The mean 4C score of patients was 10.3 ± 4.9 (range: 0–20 points). The risk group stratification showed that many patients had high risk (42.7%), and only 10.7% of patients had low scores. There were 86 (57.3%) patients who developed coagulopathy during the follow-up period and 46.7% of total patients died. There was a significant association between developing coagulopathy with higher risk group and death in COVID-19 patients (P < 0.05), while age and gender did not demonstrate a significant association. Furthermore, there was a significant association between respiratory failure, patients with cancer, patients with stroke, higher computed tomography lung involvement, lower SPO2, the presence of shock, and pulmonary embolism with the development of coagulopathy (P < 0.05). There were significant higher baseline levels of the neutrophil count, PT, D-dimer, and ferritin among patients who developed coagulopathy, while there were significant lower baseline levels of platelet count and serum albumin among patients who developed coagulopathy. CONCLUSIONS: The development of coagulopathy in the course of severe SARS-COV-2 infection is associated with different severity biomarkers and is associated with excessive mortality.
{"title":"Coagulopathy in hospitalized COVID-19 patients: A single-center experience","authors":"Marwa Ahmed, A. Almothaffar","doi":"10.4103/ijh.ijh_33_22","DOIUrl":"https://doi.org/10.4103/ijh.ijh_33_22","url":null,"abstract":"BACKGROUND: The coronavirus disease pandemic had spread across all countries. SARS-COV-2 infected up to date millions of people and the threat remains there for others. A lot of SARS-19-infected people with critically ill symptoms admitted to intensive care facilities had developed respiratory failure, coagulopathy, and organ failure. AIMS: The aims of this study were to investigate the prevalence and risk factors associated with coagulopathy in COVID-19 patients who were admitted to the Private Nursing Home Hospital in Baghdad/Iraq. PATIENTS AND METHODS: A case series study was conducted in the Nursing Home Hospital in Baghdad, Iraq, from October 2020 to December 2021. A total of 150 cases were included in this study with confirmed COVID-19 infection by polymerase chain reaction of throat or nose swab. These patients were admitted to two isolation wards (isolation intensive care unit for critical cases and medical ward isolation unit for moderately severe cases). Baseline and follow-up characteristics and laboratory parameters of coagulopathy (blood counts, prothrombin time [PT], partial thromboplastin time, D-dimers, and plasma fibrinogen) were obtained for each patient. The ISARIC 4C has been used for risk stratification (4C Mortality Score is a prognostic model for clinical deterioration among hospitalized adults with community-acquired or hospital-acquired COVID-19, it is used for stratifying and predicting mortality in COVID-19 patients on arrival in hospital). RESULTS: The mean age across patients was 56.6 ± 15.7 years (range: 14–90 years). Males were representing the majority of cases (63.3%) with a male-to-female ratio of 2:1. The mean 4C score of patients was 10.3 ± 4.9 (range: 0–20 points). The risk group stratification showed that many patients had high risk (42.7%), and only 10.7% of patients had low scores. There were 86 (57.3%) patients who developed coagulopathy during the follow-up period and 46.7% of total patients died. There was a significant association between developing coagulopathy with higher risk group and death in COVID-19 patients (P < 0.05), while age and gender did not demonstrate a significant association. Furthermore, there was a significant association between respiratory failure, patients with cancer, patients with stroke, higher computed tomography lung involvement, lower SPO2, the presence of shock, and pulmonary embolism with the development of coagulopathy (P < 0.05). There were significant higher baseline levels of the neutrophil count, PT, D-dimer, and ferritin among patients who developed coagulopathy, while there were significant lower baseline levels of platelet count and serum albumin among patients who developed coagulopathy. CONCLUSIONS: The development of coagulopathy in the course of severe SARS-COV-2 infection is associated with different severity biomarkers and is associated with excessive mortality.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"11 1","pages":"139 - 144"},"PeriodicalIF":0.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45905185","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}
BACKGROUND: Sickle cell disease (SCD) is a major public health problem in certain states of India associated with morbidity and mortality in children. The characteristics and clinical features of SCD are different in India as compared to those in developed countries with considerable clinical diversity. AIMS: This study aimed to describe clinical features in patients with SCD at the time of diagnosis and first visit. SETTING AND DESIGN: Department of Pediatrics at tertiary care hospital or Sickle-Thal Society Amravati,India (Both Collectively called as Unit). Design: Cross sectional Study. MATERIALS AND METHODS: All SCD patients 0–18 years, attending unit from October 1, 2019, to March 31, 2021, were included in the study. Data collected were based on history, clinical examination, and review of old records. The sample size was 153. STATISTICAL ANALYSIS: Data was analyzed by using software statistical packages in social sciences (SPSS) version 16. Mean, standard deviation (SD), proportions were calculated and Chi -square test of significance was used. RESULTS: Of 157 SCD patients (145 families), 90 (57.32%) were males and 67 (42.68%) females. The mean age of diagnosis and unit visit was 53.59 and 115.74 months, respectively. At diagnosis, paleness (68%), pain (54%), and fever (45%) were common complaints with other nonspecific complaints. Pallor (97.45%) and palpable spleen (53.90%) were common signs at the first unit visit. The spleen was palpable in 65 (42.48%) even after 5 years. CONCLUSION: SCD patients had paleness, pain, and fever as the most common complaints. Palpable spleen was seen even after 5 years of age. Early suspicion is key for diagnosis.
{"title":"Clinical profile of sickle cell disease patients attending pediatric department of a tertiary care hospital and Sickle-Thal center: A cross-sectional study","authors":"N. Tayade, Sanket Pande, M. Deotale","doi":"10.4103/ijh.ijh_11_22","DOIUrl":"https://doi.org/10.4103/ijh.ijh_11_22","url":null,"abstract":"BACKGROUND: Sickle cell disease (SCD) is a major public health problem in certain states of India associated with morbidity and mortality in children. The characteristics and clinical features of SCD are different in India as compared to those in developed countries with considerable clinical diversity. AIMS: This study aimed to describe clinical features in patients with SCD at the time of diagnosis and first visit. SETTING AND DESIGN: Department of Pediatrics at tertiary care hospital or Sickle-Thal Society Amravati,India (Both Collectively called as Unit). Design: Cross sectional Study. MATERIALS AND METHODS: All SCD patients 0–18 years, attending unit from October 1, 2019, to March 31, 2021, were included in the study. Data collected were based on history, clinical examination, and review of old records. The sample size was 153. STATISTICAL ANALYSIS: Data was analyzed by using software statistical packages in social sciences (SPSS) version 16. Mean, standard deviation (SD), proportions were calculated and Chi -square test of significance was used. RESULTS: Of 157 SCD patients (145 families), 90 (57.32%) were males and 67 (42.68%) females. The mean age of diagnosis and unit visit was 53.59 and 115.74 months, respectively. At diagnosis, paleness (68%), pain (54%), and fever (45%) were common complaints with other nonspecific complaints. Pallor (97.45%) and palpable spleen (53.90%) were common signs at the first unit visit. The spleen was palpable in 65 (42.48%) even after 5 years. CONCLUSION: SCD patients had paleness, pain, and fever as the most common complaints. Palpable spleen was seen even after 5 years of age. Early suspicion is key for diagnosis.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"11 1","pages":"98 - 102"},"PeriodicalIF":0.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49123547","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}
G. Kanungo, S. Routray, M. Agrawal, Aruna Sahu, Debasish Mishra
BACKGROUND: Single-donor platelets are most commonly used to prevent and treat bleeding in thrombocytopenic patients. Plateletpheresis machines should take less procedure time, optimal yield, and donor comfort. This study aimed to compare different donor parameters such as predonation platelet count and hematocrit (Hct), blood volume (BV) processed, and blood group association with yield. MATERIALS AND METHODS: A retrospective study was conducted in the transfusion medicine department and blood center for 12 months. One hundred and fifty-nine plateletpheresis procedural data on Trima Accel were collected from the register and compiled in the Excel sheet. Donor procedure variables were calculated as mean ± standard deviation. Correlation between donor parameters with yield and anticoagulant (AC) infused to the donor with run time was analyzed using Pearson correlation coefficient in Excel sheet with Microsoft Windows 7 software. The association between blood group and yield was analyzed in GraphPad 9 software, CA. P < 0.05, <0.001 was statistically significant. RESULTS: Predonation platelet count (r = 0.61, P < 0.001) and BV processed (r = 0.18, P < 0.05) were positively correlated with yield. Predonation hemoglobin, Hct, and Run time was positively correlated with AC infused to the donor (r = 0.72, P < 0.001). Different blood groups had no statistical significance association with yield. CONCLUSION: In our study, predonation platelet count directly relates to yield; hence, donors with high platelet count may be considered for better yield. Run time also had a direct relation with AC going to the donor; minimal run time also had a role in preventing adverse effects on the donor.
背景：单一供体血小板最常用于预防和治疗血小板减少症患者的出血。血小板置换机应该花费更少的手术时间、最佳产量和供体舒适度。本研究旨在比较不同的供体参数，如预采血小板计数和红细胞压积（Hct）、处理的血容量（BV）以及血型与产量的关系。材料和方法：在输血医学科和血液中心进行为期12个月的回顾性研究。从寄存器中收集了关于Trima Accel的一百五十九个平板置换程序数据，并将其汇编在Excel表中。供体程序变量计算为平均值±标准差。使用Excel表格中的Pearson相关系数和Microsoft Windows 7软件分析供体参数与产量和输注抗凝剂（AC）与运行时间的相关性。在GraphPad 9软件CA中分析血型与产量之间的关系。P<0.05，<0.001具有统计学意义。结果：预处理血小板计数（r＝0.61，P＜0.001）和BV处理（r＝0.18，P＜0.05）与产量呈正相关。预处理血红蛋白、Hct和运行时间与输注AC呈正相关（r=0.72，P<0.001）。不同血型与产量无统计学意义。结论：在本研究中，预处理血小板计数与产率直接相关；因此，具有高血小板计数的供体可以被认为具有更好的产率。运行时间也与AC流向捐赠者有直接关系；最短的运行时间在防止对供体的不良影响方面也有作用。
{"title":"Analysis of single-donor plateletpheresis procedure parameters and its association with yield in a blood center of Eastern India","authors":"G. Kanungo, S. Routray, M. Agrawal, Aruna Sahu, Debasish Mishra","doi":"10.4103/ijh.ijh_24_22","DOIUrl":"https://doi.org/10.4103/ijh.ijh_24_22","url":null,"abstract":"BACKGROUND: Single-donor platelets are most commonly used to prevent and treat bleeding in thrombocytopenic patients. Plateletpheresis machines should take less procedure time, optimal yield, and donor comfort. This study aimed to compare different donor parameters such as predonation platelet count and hematocrit (Hct), blood volume (BV) processed, and blood group association with yield. MATERIALS AND METHODS: A retrospective study was conducted in the transfusion medicine department and blood center for 12 months. One hundred and fifty-nine plateletpheresis procedural data on Trima Accel were collected from the register and compiled in the Excel sheet. Donor procedure variables were calculated as mean ± standard deviation. Correlation between donor parameters with yield and anticoagulant (AC) infused to the donor with run time was analyzed using Pearson correlation coefficient in Excel sheet with Microsoft Windows 7 software. The association between blood group and yield was analyzed in GraphPad 9 software, CA. P < 0.05, <0.001 was statistically significant. RESULTS: Predonation platelet count (r = 0.61, P < 0.001) and BV processed (r = 0.18, P < 0.05) were positively correlated with yield. Predonation hemoglobin, Hct, and Run time was positively correlated with AC infused to the donor (r = 0.72, P < 0.001). Different blood groups had no statistical significance association with yield. CONCLUSION: In our study, predonation platelet count directly relates to yield; hence, donors with high platelet count may be considered for better yield. Run time also had a direct relation with AC going to the donor; minimal run time also had a role in preventing adverse effects on the donor.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"11 1","pages":"125 - 129"},"PeriodicalIF":0.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46014095","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}
S. Azeez, Ahmed K. Yassin, N. Mohammad, Kawa Hassan, Z. Mohamed, R. Polus, H. Khudhur
BACKGROUND: The Hodgkin lymphoma (HL) showed a good prognosis in Erbil city. However, a number of deaths were reported. The monitoring and treatment strategies of HL had improved in the last decade. AIMS: The aims of this study were to evaluate the prognostic value of interim positron emission tomography/computed tomography (PET/CT) scan in HL patients and predicting the survival outcome in addition to effect on progression-free survival (PFS) of HL patients. PATIENTS AND METHODS: A retrospective cross-sectional study was conducted in Nanakali Hospital in Erbil city, Kurdistan region, Iraq, through reviewing data of patients with HL from January 1, 2014, to December 31, 2019, on a sample of 75 HL patients. The diagnosis of HL was accomplished by the physician regarding lymph node biopsy by the World Health Organization criteria. The PET/CT scan was done after two treatment cycles. PET/CT of HL patients was done in a private center in Erbil city (Media Diagnostic Center). RESULTS: The mean overall survival duration of HL patients was 5.39 years with an overall survival rate of 92%, and the mean PFS duration of HL patients was 5.04 years with PFS rate of 76%. The mean overall survival of HL patients with positive interim PET/CT (4 years and rate 75%) was lower than the mean overall survival of HL patients with negative interim PET/CT (7.2 years and rate of 95.2%) with a significant difference (P < 0.001). CONCLUSIONS: The interim PET/CT scan is useful in prognosis of patients with HL and predicting overall survival and mortality.
{"title":"A role of interim positron emission tomography/computed tomography scan in the management of Hodgkin lymphoma: A single-center study in a developing country","authors":"S. Azeez, Ahmed K. Yassin, N. Mohammad, Kawa Hassan, Z. Mohamed, R. Polus, H. Khudhur","doi":"10.4103/ijh.ijh_27_22","DOIUrl":"https://doi.org/10.4103/ijh.ijh_27_22","url":null,"abstract":"BACKGROUND: The Hodgkin lymphoma (HL) showed a good prognosis in Erbil city. However, a number of deaths were reported. The monitoring and treatment strategies of HL had improved in the last decade. AIMS: The aims of this study were to evaluate the prognostic value of interim positron emission tomography/computed tomography (PET/CT) scan in HL patients and predicting the survival outcome in addition to effect on progression-free survival (PFS) of HL patients. PATIENTS AND METHODS: A retrospective cross-sectional study was conducted in Nanakali Hospital in Erbil city, Kurdistan region, Iraq, through reviewing data of patients with HL from January 1, 2014, to December 31, 2019, on a sample of 75 HL patients. The diagnosis of HL was accomplished by the physician regarding lymph node biopsy by the World Health Organization criteria. The PET/CT scan was done after two treatment cycles. PET/CT of HL patients was done in a private center in Erbil city (Media Diagnostic Center). RESULTS: The mean overall survival duration of HL patients was 5.39 years with an overall survival rate of 92%, and the mean PFS duration of HL patients was 5.04 years with PFS rate of 76%. The mean overall survival of HL patients with positive interim PET/CT (4 years and rate 75%) was lower than the mean overall survival of HL patients with negative interim PET/CT (7.2 years and rate of 95.2%) with a significant difference (P < 0.001). CONCLUSIONS: The interim PET/CT scan is useful in prognosis of patients with HL and predicting overall survival and mortality.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"11 1","pages":"118 - 124"},"PeriodicalIF":0.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43564997","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}
S. Yaman, S. Başcı, Gökhan Turan, B. Ulu, T. Yiğenoğlu, T. Bahşi, H. Erdem, M. Dal, M. Çakar, F. Altuntaş
BACKGROUND: Polycythemia is a common reason for patients' admissions. With the introduction of COVID-19, face masks reached very common usage in the population. Masks may cause some degree of hypoxia that may result in high hemoglobin in healthy individuals. Here, we aimed to investigate the frequency of patients applying for high hemoglobin and tested for possible polycythemia vera (PV) in the pandemic era. MATERIALS AND METHODS: We collected patients who applied to the hematology outpatient clinic between March 2019 and April 2021 for the study. The research was carried out at a single center at Ankara Oncology Training and Research Hospital. We collected demographic data such as age and sex, laboratory parameters such as complete blood count and erythropoietin level, concomitant diseases, smoking history, and spleen size. RESULTS: The median age of the cohort was 41 (16–83). Groups were different regarding age (P = 0.04). Groups were similar regarding gender (P = 0.350). Comorbidities were similar in both groups. Smoking was more frequent in the pre-COVID era group (P = 0.046). The frequency of the Janus kinase 2 (JAK2) test order was 102 examinations out of 7920 for the pre-COVID era and 152 examinations out of 6087 for the COVID era; this was statistically significant (P < 0.001). CONCLUSION: Clinicians may need to re-evaluate the threshold of hemoglobin levels to order JAK2 tests in the pandemic era, and the significance of mildly elevated hemoglobin may be neglected while testing for potential PV.
{"title":"Face masks and polycythemia is the standard hemoglobin cutoff valid in the pandemic?","authors":"S. Yaman, S. Başcı, Gökhan Turan, B. Ulu, T. Yiğenoğlu, T. Bahşi, H. Erdem, M. Dal, M. Çakar, F. Altuntaş","doi":"10.4103/ijh.ijh_30_22","DOIUrl":"https://doi.org/10.4103/ijh.ijh_30_22","url":null,"abstract":"BACKGROUND: Polycythemia is a common reason for patients' admissions. With the introduction of COVID-19, face masks reached very common usage in the population. Masks may cause some degree of hypoxia that may result in high hemoglobin in healthy individuals. Here, we aimed to investigate the frequency of patients applying for high hemoglobin and tested for possible polycythemia vera (PV) in the pandemic era. MATERIALS AND METHODS: We collected patients who applied to the hematology outpatient clinic between March 2019 and April 2021 for the study. The research was carried out at a single center at Ankara Oncology Training and Research Hospital. We collected demographic data such as age and sex, laboratory parameters such as complete blood count and erythropoietin level, concomitant diseases, smoking history, and spleen size. RESULTS: The median age of the cohort was 41 (16–83). Groups were different regarding age (P = 0.04). Groups were similar regarding gender (P = 0.350). Comorbidities were similar in both groups. Smoking was more frequent in the pre-COVID era group (P = 0.046). The frequency of the Janus kinase 2 (JAK2) test order was 102 examinations out of 7920 for the pre-COVID era and 152 examinations out of 6087 for the COVID era; this was statistically significant (P < 0.001). CONCLUSION: Clinicians may need to re-evaluate the threshold of hemoglobin levels to order JAK2 tests in the pandemic era, and the significance of mildly elevated hemoglobin may be neglected while testing for potential PV.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"11 1","pages":"130 - 133"},"PeriodicalIF":0.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41709236","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}
M. Raturi, Y. Dhiman, Mansi Kala, N. Bansal, A. Kusum
BACKGROUND: Amidst the raging coronavirus disease-2019 (COVID-19 pandemic), COVID-19 convalescent plasma (CCP) therapy emerged as an important experimental therapy. The majority of the research studies have focused on determining the safety and efficacy of CCP in the management of COVID-19 and little attention has been paid to the source of CCP, i.e., the CCP donor recruitment. The main challenge at our blood center was maintaining high spirits and continuous motivation among the volunteers to keep donating CCP. With this background, our primary aim was to observe the impetus and impediments of potential CCP donors among the SARS-CoV-2 recovered individuals. MATERIALS AND METHODS: All the potential CCP donors who met the inclusion criteria were telerecruited, i.e., contacted telephonically by trained personnel of the blood center. Donors were informed about CCP and its harvest procedure. Subsequently, donors were presented with 10 statements to assess the potential impetus (motivators) and impediments (barriers) toward donating CCP. In addition, SARS-CoV-2 IgG antibody titers were performed using chemiluminescence assay in donors who passed the predonation screening. RESULTS: Based on their medical records, a total of 96 potential CCP donors were contacted telephonically for inclusion in the study. Among these 68.75% (n = 66/96) individuals expressed their willingness to donate CCP. “Altruism from adversity” was the most common motivational factor among voluntary donors (47.8%), whereas kinship was the strongest motivational factor among replacement donors (40%). Logistical reasons such as their distance from the blood center (33.3%) were the most common reason for not donating CCP. About 21.2% (n = 18/66) of the donors were deferred due to absent or low levels of anti-SARS-CoV-2 IgG antibodies. CONCLUSIONS: Motivation factors such as “altruism from adversity” are more common in CCP donation. At the same time, most of the impediments to CCP donation were similar to those of the routine apheresis procedure. Knowledge of these motivators and barriers should form the cornerstone of plasma therapy-based donation program in any future pandemic.
{"title":"Assessing the impetus and impediments to donate coronavirus disease-2019 convalescent plasma: A survey study from a tertiary care Indian blood center","authors":"M. Raturi, Y. Dhiman, Mansi Kala, N. Bansal, A. Kusum","doi":"10.4103/ijh.ijh_34_22","DOIUrl":"https://doi.org/10.4103/ijh.ijh_34_22","url":null,"abstract":"BACKGROUND: Amidst the raging coronavirus disease-2019 (COVID-19 pandemic), COVID-19 convalescent plasma (CCP) therapy emerged as an important experimental therapy. The majority of the research studies have focused on determining the safety and efficacy of CCP in the management of COVID-19 and little attention has been paid to the source of CCP, i.e., the CCP donor recruitment. The main challenge at our blood center was maintaining high spirits and continuous motivation among the volunteers to keep donating CCP. With this background, our primary aim was to observe the impetus and impediments of potential CCP donors among the SARS-CoV-2 recovered individuals. MATERIALS AND METHODS: All the potential CCP donors who met the inclusion criteria were telerecruited, i.e., contacted telephonically by trained personnel of the blood center. Donors were informed about CCP and its harvest procedure. Subsequently, donors were presented with 10 statements to assess the potential impetus (motivators) and impediments (barriers) toward donating CCP. In addition, SARS-CoV-2 IgG antibody titers were performed using chemiluminescence assay in donors who passed the predonation screening. RESULTS: Based on their medical records, a total of 96 potential CCP donors were contacted telephonically for inclusion in the study. Among these 68.75% (n = 66/96) individuals expressed their willingness to donate CCP. “Altruism from adversity” was the most common motivational factor among voluntary donors (47.8%), whereas kinship was the strongest motivational factor among replacement donors (40%). Logistical reasons such as their distance from the blood center (33.3%) were the most common reason for not donating CCP. About 21.2% (n = 18/66) of the donors were deferred due to absent or low levels of anti-SARS-CoV-2 IgG antibodies. CONCLUSIONS: Motivation factors such as “altruism from adversity” are more common in CCP donation. At the same time, most of the impediments to CCP donation were similar to those of the routine apheresis procedure. Knowledge of these motivators and barriers should form the cornerstone of plasma therapy-based donation program in any future pandemic.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"11 1","pages":"145 - 150"},"PeriodicalIF":0.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70749858","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}
Aplastic anemia (AA) is a rare hematological disorder which is life-threatening in pregnancy. It is mainly caused by the destruction of pluripotent stem cells of bone marrow. There is high risk in pregnancy due to risk of hemorrhage and infection due to pancytopenia. Fetus is also at high risk of intrauterine growth restriction, risk of intrauterine death, and preterm labor. Hence, managing aplastic anemia in pregnancy is a great challenge for obstetricians. It requires a multidisciplinary approach involving hematologist, obstetrician, and critical care specialist for the management of AA in pregnancy. We report a case of AA with pregnancy diagnosed during first trimester.
{"title":"Aplastic anemia in pregnancy","authors":"V. Zutshi, Nupur Anand, N. Bhagwati, U. Saxena","doi":"10.4103/ijh.ijh_40_21","DOIUrl":"https://doi.org/10.4103/ijh.ijh_40_21","url":null,"abstract":"Aplastic anemia (AA) is a rare hematological disorder which is life-threatening in pregnancy. It is mainly caused by the destruction of pluripotent stem cells of bone marrow. There is high risk in pregnancy due to risk of hemorrhage and infection due to pancytopenia. Fetus is also at high risk of intrauterine growth restriction, risk of intrauterine death, and preterm labor. Hence, managing aplastic anemia in pregnancy is a great challenge for obstetricians. It requires a multidisciplinary approach involving hematologist, obstetrician, and critical care specialist for the management of AA in pregnancy. We report a case of AA with pregnancy diagnosed during first trimester.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"11 1","pages":"86 - 88"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46622014","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}
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