Advances in Hematology最新文献_第6页

Clinical Profile and Treatment of Multiple Myeloma at a Tertiary Hospital in Kenya: A Five-Year Retrospective Review 肯尼亚一家三级医院多发性骨髓瘤的临床概况和治疗：五年回顾

Q3 Medicine

Advances in Hematology

Pub Date : 2024-02-12 DOI: 10.1155/2024/3208717

Wanjiku Gichuru, Nicholas Abinya, A. Odhiambo, Fredrick C. F. Otieno, Simon Harrison, Matilda Ong’ondi

Background. Multiple myeloma (MM) is a chronic B-cell malignancy that involves proliferation of neoplastic clonal plasma cells in the bone marrow with circulating monoclonal immunoglobulins or constituent chains in serum or urine or both. It is a rare cancer with a lifetime risk of 0.76% and an age-adjusted incidence rate of 2.5–7.2 per 100,000 in high-income countries. There is a paucity of local data on the morbidity and treatment of MM. Methods. This was a single-centre descriptive retrospective study at the Kenyatta National Hospital (KNH). The study population included inpatients and outpatients with a documented diagnosis of MM managed between 1st January 2014 and 31st December 2018. Demographic data, pathology reports, laboratory results, and clinical findings were transcribed and uploaded to a database, and data analysis was done using Stata 16® software. Results. A total of 207 patient files were reviewed. The median age at presentation was 60 years with a slight male preponderance. Bone pain was the predominant complaint in 59% (139/207) of patients, with 17% of patients presenting with paraparesis or paraplegia. For patients who underwent imaging, osteolytic bone lesions were identified in 90.6% (126/139). Anaemia was present in 71% (147/207) patients, hypercalcemia in 55.4%, and renal dysfunction in 38.2%. There were 25 different treatment regimens prescribed, with 13 patients (7%) being on bortezomib-based triplet therapy. Conclusions. MM in KNH is a disease of the middle aged, affecting men and women almost equally and presenting mainly with bone pain and anaemia. Although there seems to be a general improvement in diagnosis and care, access to novel and less toxic agents for treatment is still wanting.

背景：多发性骨髓瘤（MM）是一种慢性 B 细胞恶性肿瘤。多发性骨髓瘤（MM）是一种慢性 B 细胞恶性肿瘤，包括骨髓中肿瘤性克隆浆细胞的增殖，血清或尿液或两者中均含有循环单克隆免疫球蛋白或组成链。这是一种罕见的癌症，终生患病风险为 0.76%，在高收入国家，经年龄调整后的发病率为每 10 万人中 2.5-7.2 例。有关 MM 发病率和治疗方法的本地数据很少。研究方法。这是一项在肯雅塔国立医院（KNH）进行的单中心描述性回顾性研究。研究对象包括2014年1月1日至2018年12月31日期间确诊为MM的住院和门诊患者。人口统计学数据、病理报告、实验室结果和临床发现均已转录并上传至数据库，数据分析采用Stata 16®软件进行。结果。共查阅了 207 份患者档案。患者的中位年龄为 60 岁，男性略占多数。59%的患者（139/207）以骨痛为主诉，17%的患者伴有截瘫或截瘫。在接受影像学检查的患者中，90.6%（126/139）的患者有溶骨性骨病变。71%的患者（147/207）存在贫血，55.4%的患者存在高钙血症，38.2%的患者存在肾功能障碍。患者接受了25种不同的治疗方案，其中13名患者（7%）接受了以硼替佐米为基础的三联疗法。结论在北卡罗来纳州立医院，MM是一种中老年疾病，对男性和女性的影响几乎相同，主要表现为骨痛和贫血。虽然在诊断和护理方面似乎有了普遍改善，但新型低毒药物的使用仍然匮乏。

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引用次数: 0

An Approach to the Investigation of Thrombocytosis: Differentiating between Essential Thrombocythemia and Secondary Thrombocytosis 研究血小板增多症的方法：区分原发性血小板增多症和继发性血小板增多症

Q3 Medicine

Advances in Hematology

Pub Date : 2024-02-12 DOI: 10.1155/2024/3056216

Ala Almanaseer, B. Chin-Yee, J. Ho, A. Lazo-Langner, Laila Schenkel, P. Bhai, B. Sadikovic, Ian Chin-Yee, Cyrus C. Hsia

Background. Thrombocytosis is a common reason for referral to Hematology. Differentiating between secondary causes of thrombocytosis and essential thrombocythemia (ET) is often clinically challenging. A practical diagnostic approach to identify secondary thrombocytosis could reduce overinvestigation such as next generation sequencing (NGS) panel. Methods and Results. All adult patients with thrombocytosis (≥450 × 109/L) who underwent molecular testing at a single tertiary care centre between January 1, 2018 and May 31, 2021 were evaluated. Clinical and laboratory variables were compared between patients with secondary thrombocytosis vs. ET. Clinical variables included smoking, thrombosis, splenectomy, active malignancy, chronic inflammatory disease, and iron deficiency anemia. Laboratory variables included complete blood count (CBC), ferritin, and myeloid mutations detected by NGS. The overall yield of molecular testing was 52.4%; 92.1% of which were mutations in JAK2, CALR, and/or MPL. Clinical factors predictive of ET included history of arterial thrombosis (p<0.05); active malignancy, chronic inflammatory disease, splenectomy, and iron deficiency were associated with secondary thrombocytosis (p<0.05). A diagnosis of ET was associated with higher hemoglobin, mean corpuscular volume (MCV), red cell distribution width (RDW), and mean platelet volume (MPV), while secondary thrombocytosis was associated with higher body mass index, white blood cells, and neutrophils (p<0.01). Conclusion. A practical approach to investigating patients with persistent thrombocytosis based on clinical characteristics such as active malignancy, chronic inflammatory disease, splenectomy, and iron deficiency may assist in accurately identifying patients more likely to have secondary causes of thrombocytosis and reduce overinvestigation, particularly costly molecular testing.

背景。血小板增多是血液科转诊的常见原因。在临床上，区分继发性血小板增多和原发性血小板增多症（ET）往往具有挑战性。识别继发性血小板增多症的实用诊断方法可减少过度调查，如下一代测序（NGS）面板。方法与结果。对2018年1月1日至2021年5月31日期间在一家三级医疗中心接受分子检测的所有血小板增多症（≥450 × 109/L）成人患者进行了评估。比较了继发性血小板增多患者与 ET 患者的临床和实验室变量。临床变量包括吸烟、血栓形成、脾切除术、活动性恶性肿瘤、慢性炎症性疾病和缺铁性贫血。实验室变量包括全血细胞计数（CBC）、铁蛋白和 NGS 检测到的骨髓突变。分子检测的总有效率为52.4%，其中92.1%为JAK2、CALR和/或MPL突变。预测 ET 的临床因素包括动脉血栓形成史（P<0.05）；活动性恶性肿瘤、慢性炎症性疾病、脾切除术和缺铁与继发性血小板增多有关（P<0.05）。ET 诊断与较高的血红蛋白、平均血球容积（MCV）、红细胞分布宽度（RDW）和平均血小板容积（MPV）有关，而继发性血小板增多与较高的体重指数、白细胞和中性粒细胞有关（P<0.01）。结论根据临床特征（如活动性恶性肿瘤、慢性炎症性疾病、脾切除术和缺铁）调查持续性血小板增多症患者的实用方法，可能有助于准确识别更有可能继发于血小板增多症的患者，并减少过度调查，尤其是昂贵的分子检测。

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引用次数: 0

Presence and Onset of Chronic Kidney Disease as a Factor Involved in the Poor Prognosis of Patients with Essential Thrombocythemia. 慢性肾病的存在和发病是导致原发性血小板增多症患者预后不良的因素之一

Q3 Medicine

Advances in Hematology

Pub Date : 2024-02-08 eCollection Date: 2024-01-01 DOI: 10.1155/2024/9591497

Yoshinori Hashimoto, Hiromi Omura, Takayuki Tanaka

Chronic kidney disease (CKD) is an important risk factor for cardiovascular disease, thrombosis, and all-cause death. However, few studies have examined the association between CKD and the prognosis of patients with essential thrombocythemia (ET). We collected ET patients who met the WHO classification 2017 and performed a retrospective clinical study to clarify the association between the presence and onset of CKD and prognosis. Of 73 patients who met the diagnostic criteria, 21 (28.8%) had CKD at the time of ET diagnosis. The age of patients with CKD was significantly higher, and a high proportion of these patients had the JAK2V617F gene mutation. The presence of CKD was a risk factor for the prognosis (hazard ratio (HR): 3.750, 95% confidence interval (CI): 1.196-11.760, P=0.023), and the survival curve was significantly poorer. Furthermore, we analyzed patients without CKD at the time of ET diagnosis using the onset of CKD as a time-dependent variable and identified the onset of CKD as a risk factor for the prognosis (HR: 9.155, 95% CI: 1.542-54.370, P=0.005). In patients with renal hypofunction at the time of ET diagnosis or those with a reduction in the kidney function during follow-up, strict renal function monitoring at regular intervals is necessary.

慢性肾脏病（CKD）是心血管疾病、血栓形成和全因死亡的重要危险因素。然而，很少有研究探讨 CKD 与原发性血小板增多症（ET）患者预后之间的关联。我们收集了符合2017年WHO分类的ET患者，并进行了一项回顾性临床研究，以明确CKD的存在和发病与预后之间的关联。在符合诊断标准的73名患者中，21人（28.8%）在确诊ET时患有CKD。患有慢性肾功能衰竭的患者年龄明显偏高，其中很大一部分患者存在 JAK2V617F 基因突变。存在 CKD 是预后的危险因素（危险比 (HR)：3.750，95% 置信区间 (CI)：1.196-11.760，P=0.023），生存曲线明显较差。此外，我们以 CKD 发病时间作为时间依赖变量，对 ET 诊断时无 CKD 的患者进行了分析，结果发现 CKD 发病时间是影响预后的风险因素（HR：9.155，95% CI：1.542-54.370，P=0.005）。对于 ET 诊断时肾功能减退或随访期间肾功能减退的患者，有必要定期进行严格的肾功能监测。

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引用次数: 0

Homozygous Sickle Cell Disease after Age of 40: Follow-Up of a Cohort of 209 Patients in Senegal, West Africa. 40 岁以后的同型镰状细胞病：对西非塞内加尔 209 名患者的队列随访。

Q3 Medicine

Advances in Hematology

Pub Date : 2024-02-06 eCollection Date: 2024-01-01 DOI: 10.1155/2024/7501577

Moussa Seck, Maureen Adéniké Dabo, Elimane Seydi Bousso, Mohamed Keita, Sokhna Aïssatou Touré, Sérigne Mourtalla Guèye, Blaise Félix Faye, Fatma Dieng, Saliou Diop

Objectives: The aim of this study was to describe the morbidity and mortality of homozygous sickle cell disease after the age of 40.

Methods: This was a cohort study of 209 patients followed from 1994 to 2022. All hemoglobin electrophoresis-confirmed SS sickle cell patients over 40 years were included. A descriptive study of epidemiological, diagnostic, therapeutic, and evolutionary data was used to assess morbidity and mortality.

Results: Sex ratio (M/F) was 0.6. Median age was 47 (41-75). According to morbidity, 95.1% had less than 3 vaso-occlusive crises/year. Acute anemia was the most frequent complication (52.63%). Chronic complications were noted in 32.5%. At diagnosis, mean hemoglobin was 8.1 g/dl ± 1.9, HbS was 86.5 ± 10, and HbF was 9.4 ± 7.6. Number of patients transfused was 66%. We noted that 8.1% of patients died, 29.2% were lost to follow-up, and 62.7% were still being followed up. The risk factors identified for death were geographical origin, comorbidity, high HbS, low HbF, and thrombocytosis.

Conclusion: This study shows that homozygous SCD is increasingly becoming an adult disease and that it can be carried into old age in Africa. Advanced age over 40 is marked by an upsurge in chronic complications, making it essential to set up a screening program and to organize multidisciplinary follow-up.

研究目的本研究旨在描述 40 岁以后同型镰状细胞病的发病率和死亡率：这是一项队列研究，对 1994 年至 2022 年期间的 209 名患者进行了随访。所有经血红蛋白电泳确诊的 40 岁以上 SS 镰状细胞病患者均被纳入研究范围。通过对流行病学、诊断、治疗和演变数据进行描述性研究，评估发病率和死亡率：性别比（男/女）为 0.6。中位年龄为 47 岁（41-75 岁）。发病率方面，95.1%的患者每年发生的血管闭塞性危象少于3次。急性贫血是最常见的并发症（52.63%）。32.5%的患者出现慢性并发症。确诊时，平均血红蛋白为 8.1 g/dl ± 1.9，HbS 为 86.5 ± 10，HbF 为 9.4 ± 7.6。输血患者人数占 66%。我们注意到，8.1%的患者死亡，29.2%的患者失去随访，62.7%的患者仍在随访中。死亡的风险因素包括地域、合并症、高 HbS、低 HbF 和血小板增多：这项研究表明，在非洲，同种异体 SCD 正日益成为一种成人疾病，而且这种疾病可延续到老年。40 岁以上的高龄患者慢性并发症激增，因此必须制定筛查计划并组织多学科随访。

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引用次数: 0

Retrospective Study to Reduce Blood Transfusion Waste in Remote Island Healthcare Settings. 减少偏远岛屿医疗机构输血浪费的回顾性研究。

Q3 Medicine

Advances in Hematology

Pub Date : 2023-12-12 eCollection Date: 2023-01-01 DOI: 10.1155/2023/5549655

Takamitsu Sakamoto, Hiroyuki Mizuta, Naohisa Niiro, Teruyoshi Amagai

Background: Tokunoshima is a remote island in the Amami Islands, 470 km southwest of the Kagoshima mainland. It has a population of 23,000 and consists of three towns: Tokunoshima, Isen, and Amagi. Three medical institutions on the island are responsible for blood transfusion medicine, but there is no blood stockpiling station on the island, and blood is stockpiled in each of the hospitals. Although Tokunoshima Tokushukai Hospital is responsible for 70% of transfusion medicine on Tokunoshima, it is difficult to maintain a sufficient amount of blood in stock considering disposal.

Aim: To determine whether changing the distribution of blood types in a hospital's stockpile would reduce the transfusion disposal rate.

Methods: This was a retrospective survey. By changing the in-house stock of blood products for transfusions delivered to our hospital over 10 years from January 2013 to December 2017 (preintervention) and from January 2018 to December 2022 (postintervention), we compared the cost-saving effects of these two intervention strategies on disposal rates and blood inventories, as well as the survival rates of case profiles requiring transfusion interventions in hospital-donated transfusion and ABO-incompatible transfusion between two periods. The hospital's stock of RBC had changes that storage of type (A, B, O, AB) RBC from (4, 4, 4, 2) units in the pre-interventon to (2, 2, 6, 0) units in the postintervention.

Results: The annual blood product waste rate decreased from 23.4% in the preintervention period to 17.9% in the post-intervention period.

Conclusion: By changing the blood products stockpiled for transfusion medicine in Tokunoshima, the transfusion disposal rate can be reduced.

背景德之岛是奄美群岛中的一个偏远岛屿，位于鹿儿岛大陆西南 470 公里处。该岛人口为 23,000 人，由三个城镇组成：德之岛、伊势恩和天城。岛上有三家医疗机构负责输血医疗，但岛上没有血液储存站，血液储存在各家医院。虽然德之岛德洲会医院承担了德之岛 70% 的输血医疗任务，但考虑到处置问题，很难保持足够数量的血液库存：这是一项回顾性调查。通过改变我院 2013 年 1 月至 2017 年 12 月（干预前）和 2018 年 1 月至 2022 年 12 月（干预后）10 年间输血用血液制品的内部库存，我们比较了这两种干预策略对处置率和血液库存的成本节约效果，以及两个时期内医院捐赠输血和 ABO 血型不合输血中需要输血干预的病例资料的存活率。医院的红细胞库存量发生了变化，（A、B、O、AB）型红细胞的储存量从干预前的（4、4、4、2）个单位变为干预后的（2、2、6、0）个单位：结果：每年的血液制品浪费率从干预前的 23.4% 降至干预后的 17.9%：结论：通过改变德之岛输血用血液制品的储存方式，可以降低输血废弃率。

{"title":"Retrospective Study to Reduce Blood Transfusion Waste in Remote Island Healthcare Settings.","authors":"Takamitsu Sakamoto, Hiroyuki Mizuta, Naohisa Niiro, Teruyoshi Amagai","doi":"10.1155/2023/5549655","DOIUrl":"10.1155/2023/5549655","url":null,"abstract":"Background: Tokunoshima is a remote island in the Amami Islands, 470 km southwest of the Kagoshima mainland. It has a population of 23,000 and consists of three towns: Tokunoshima, Isen, and Amagi. Three medical institutions on the island are responsible for blood transfusion medicine, but there is no blood stockpiling station on the island, and blood is stockpiled in each of the hospitals. Although Tokunoshima Tokushukai Hospital is responsible for 70% of transfusion medicine on Tokunoshima, it is difficult to maintain a sufficient amount of blood in stock considering disposal.Aim: To determine whether changing the distribution of blood types in a hospital's stockpile would reduce the transfusion disposal rate.Methods: This was a retrospective survey. By changing the in-house stock of blood products for transfusions delivered to our hospital over 10 years from January 2013 to December 2017 (preintervention) and from January 2018 to December 2022 (postintervention), we compared the cost-saving effects of these two intervention strategies on disposal rates and blood inventories, as well as the survival rates of case profiles requiring transfusion interventions in hospital-donated transfusion and ABO-incompatible transfusion between two periods. The hospital's stock of RBC had changes that storage of type (A, B, O, AB) RBC from (4, 4, 4, 2) units in the pre-interventon to (2, 2, 6, 0) units in the postintervention.Results: The annual blood product waste rate decreased from 23.4% in the preintervention period to 17.9% in the post-intervention period.Conclusion: By changing the blood products stockpiled for transfusion medicine in Tokunoshima, the transfusion disposal rate can be reduced.","PeriodicalId":7325,"journal":{"name":"Advances in Hematology","volume":"2023 ","pages":"5549655"},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10730247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138795036","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}

引用次数: 0

Anemia Prevalence and Risk Factors in Two of Ethiopia's Most Anemic Regions among Women: A Cross-Sectional Study. 埃塞俄比亚贫血最严重的两个地区妇女的贫血患病率和风险因素：一项横断面研究。

Q3 Medicine

Advances in Hematology

Pub Date : 2023-12-09 eCollection Date: 2023-01-01 DOI: 10.1155/2023/2900483

Gebru Gebremeskel Gebrerufael, Bsrat Tesfay Hagos

Background: In Sub-Saharan African (SSA) nations, including Ethiopia, anemia is a significant public health issue. Ethiopia has continued to bear the enormous burden of anemia infections. Over time, the prevalence of anemia has significantly increased in Ethiopia. In addition, there is a paucity of literature and regional variations in the pace of increment expansion. Therefore, the primary goal of this study was to evaluate the prevalence of anemia and risk factors among women in Ethiopia's two most anemic regions.

Methods: 2,519 women participated in a community-based cross-sectional study from January 18 to June 27, 2016. In order to determine the causes of anemia in women in two of Ethiopia's most anemic regions, an ordinal logistic regression model was taken into consideration. The applicability of the proportional odds test was evaluated using the chi-square test of the parallelism assumption. A p value of 0.05 or below was used to define crucial and statistically significant predictor variables.

Results: The overall prevalence rate of anemia was 56.8% (95% CI (54.8%-58.7%)). The chi-square test of the parallelism assumption indicated that the odds ratios were constant across all cut-off points of women's anemia levels at a 5% significance level (p value = 0.122). Of the severity of anemia levels among women, 48.2, 46.1, and 5.7% had mild, moderate, and severe anemia levels, respectively. In multivariable ordinal logistic regression analyses, being born (lived) in the Somali region (AOR = 1.6, 95% CI: 1.37, 1.90), having a parity of 4-5 (AOR = 1.3, 95% CI: 1.05, 1.66), and having ≥6 children (AOR = 1.4, 95% CI: 1.1, 1.7), being a contraceptive user (AOR = 3, 95% CI: 2.5, 3.6), being currently pregnant (AOR = 2.8, 95% CI: 2.3, 3.4), having no ANC follow-up (AOR = 1.9, 95% CI: 1.6, 2.3), being married women (AOR = 1.4, 95% CI: 1.1, 1.9), and user of unimproved toilet facility (AOR = 1.3, 95% CI: 1.1, 1.6) were significantly positively associated with anemia.

Conclusions: Finally, the anemia burden was dangerously greater than the national average. The region, usage of contraceptives, being pregnant at the time, ANC follow-up, toilet facilities, parity, and marital status all had a substantial impact on anemia. Therefore, to lessen the prevalence of anemia in certain parts of Ethiopia, public health initiatives that improve maternal health service utilization are required, such as ANC follow-up to minimize parity.

背景：在包括埃塞俄比亚在内的撒哈拉以南非洲（SSA）国家，贫血是一个重大的公共卫生问题。埃塞俄比亚一直承受着贫血感染的巨大负担。随着时间的推移，埃塞俄比亚的贫血患病率大幅上升。此外，文献资料匮乏，各地区增量扩大的速度也不尽相同。因此，本研究的主要目标是评估埃塞俄比亚两个贫血最严重地区妇女的贫血患病率和风险因素。方法：2016 年 1 月 18 日至 6 月 27 日，2519 名妇女参加了一项基于社区的横断面研究。为了确定埃塞俄比亚两个贫血最严重地区妇女贫血的原因，研究人员采用了序数逻辑回归模型。使用平行假设的卡方检验对比例几率检验的适用性进行了评估。P 值在 0.05 或 0.05 以下被用来定义关键的、具有统计意义的预测变量：贫血的总患病率为 56.8%（95% CI (54.8%-58.7%)）。平行假设的卡方检验表明，在 5%的显著性水平下，妇女贫血水平的所有临界点的几率比都是恒定的（P 值 = 0.122）。在女性贫血严重程度中，轻度、中度和重度贫血分别占 48.2%、46.1% 和 5.7%。在多变量序数逻辑回归分析中，在索马里地区出生（居住）（AOR = 1.6，95% CI：1.37，1.90）、4-5 胎（AOR = 1.3，95% CI：1.05，1.66）、≥6 胎（AOR = 1.4，95% CI：1.1，1.7）、使用避孕药具（AOR = 3，95% CI：2.5，3.6）、目前怀孕（AOR = 1.4，95% CI：1.1，1.7）、≥6 胎（AOR = 1.4，95% CI：1.1，1.76）、目前怀孕（AOR = 2.8，95% CI：2.3，3.4）、未接受产前检查随访（AOR = 1.9，95% CI：1.6，2.3）、已婚妇女（AOR = 1.4，95% CI：1.1，1.9）和使用未改良厕所设施（AOR = 1.3，95% CI：1.1，1.6）与贫血呈显著正相关：最后，贫血负担比全国平均水平严重。地区、避孕药具的使用、怀孕时间、产前检查随访、厕所设施、奇偶性和婚姻状况都对贫血有很大影响。因此，为了降低埃塞俄比亚某些地区的贫血患病率，需要采取公共卫生措施，提高孕产妇保健服务的利用率，如产前检查随访，以尽量减少奇偶性。

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引用次数: 0

Novel Pharmacological Treatment Options of Steroid-Refractory Graft-versus-Host Disease 类固醇难治性移植物抗宿主病的新型药物治疗方案

Q3 Medicine

Advances in Hematology

Pub Date : 2023-12-06 DOI: 10.1155/2023/9949961

Iuliia Kovalenko, Tabinda Saleem, Mitali Shah, Sara Seyedroudbari, K. Golubykh, Rimsha Ali, Taaha Mirza, Babray Laek, Ahsan Wahab, Asmi Chattaraj, Ekaterina Proskuriakova, Chandi Garg, Rafiullah Khan

Background. Graft-versus-host disease (GVHD) is a potentially fatal complication of allogeneic hematopoietic stem cell transplant. The mainstay of treatment is corticosteroids, which are ineffective in 30–50% of cases. Steroid-refractory GVHD (SR-GVHD) confers a poor prognosis, with high mortality rates despite appropriate therapy. While there is no reliable treatment for SR-GVHD, a variety of novel therapeutic options are slowly emerging and have yet to be examined simultaneously. Objectives. This review evaluates the potential of novel therapeutic options, as well as their efficacy and safety, for the treatment of SR-GVHD. Study Design. The literature search was conducted in PubMed, Cochrane, and Embase, employing MeSH terms and keywords. The studies had to be prospective phases 1, 2, or 3. We excluded retrospective and nonoriginal studies. Results. While the only approved drug for acute GVHD is ruxolitinib with an impressive overall response rate of 73.2% and a complete response of 56.3%, several monoclonal antibodies and other agents are currently under investigation, offering promising results. These include anti-CD2, anti-CD147, IL-2 antagonist, a mixture of anti-CD3 and anti-CD7 antibodies, anti-CD25, monoclonal antibody to a4b7 on T-cells, anti-CD26, pentostatin, sirolimus, denileukin diftitox, infliximab, itacitinib, and alpha-1 antitripsin. However, the toxicities associated with these novel drugs need further investigation. For chronic GVHD, approved options include ruxolitinib with an ORR of up to 62%, ibrutinib with an ORR of up to 77%, and belumosudil with an ORR of up to 77%. Meanwhile, emerging treatments include tyrosine kinase inhibitors such as nilotinib, rituximab, and low-dose IL-2, as well as axatilimab and pomalidomide. Conclusion. While their efficacy needs to be better evaluated through large-scale, multicenter, randomized clinical trials, these novel agents show potential and could provide a better alternative for SR-GVHD treatment in the future.

背景。移植物抗宿主病(GVHD)是异基因造血干细胞移植的潜在致命并发症。主要的治疗方法是皮质类固醇，但在30-50%的病例中无效。类固醇难治性GVHD (SR-GVHD)预后差，尽管进行了适当的治疗，但死亡率很高。虽然SR-GVHD没有可靠的治疗方法，但各种新的治疗选择正在缓慢出现，尚未同时进行检查。目标。本综述评估了治疗SR-GVHD的新治疗方案的潜力，以及它们的有效性和安全性。研究设计。文献检索在PubMed、Cochrane和Embase中进行，采用MeSH术语和关键词。这些研究必须是前瞻性的1、2或3期。我们排除了回顾性和非原创性研究。结果。目前唯一被批准用于治疗急性GVHD的药物是ruxolitinib，其总缓解率为73.2%，完全缓解率为56.3%，目前正在研究几种单克隆抗体和其他药物，提供了令人鼓舞的结果。这些药物包括抗cd2、抗cd147、IL-2拮抗剂、抗cd3和抗cd7抗体的混合物、抗cd25、t细胞上的a4b7单克隆抗体、抗cd26、戊司他汀、西罗莫司、德尼乐金、英夫利昔单抗、伊他替尼和α -1抗tripsin。然而，与这些新药相关的毒性需要进一步研究。对于慢性GVHD，批准的治疗方案包括ORR高达62%的ruxolitinib, ORR高达77%的ibrutinib和ORR高达77%的belumosudil。同时，新兴的治疗方法包括酪氨酸激酶抑制剂，如尼罗替尼、利妥昔单抗和低剂量IL-2，以及阿替利单抗和泊马度胺。结论。虽然它们的疗效需要通过大规模、多中心、随机临床试验来更好地评估，但这些新药显示出潜力，并可能在未来为SR-GVHD治疗提供更好的替代方案。

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引用次数: 0

Prognostic Factors and Outcome of Patients with Adult Acute Lymphoblastic Leukemia Treated with the Hyper-CVAD Regimen: A Retrospective Study 成人急性淋巴细胞白血病患者接受Hyper-CVAD方案治疗的预后因素和预后:一项回顾性研究

Q3 Medicine

Advances in Hematology

Pub Date : 2023-11-09 DOI: 10.1155/2023/5593635

Zahra Malakoutikhah, Farzaneh Ashrafi, Ali Derakhshandeh

Aim. The Hyper-CVAD regimen has shown promising results for adult patients with acute lymphoblastic leukemia (ALL), as designed by the MD Anderson Cancer Center (MDACC). This treatment has resulted in a complete remission rate of 92% and a 5-year overall survival of 38%. However, given the diversity of patient demographics and institutional methods, outcomes may differ between various institutions. This study will compare the outcome of adult ALL patients treated with the Hyper-CVAD regimen in Iran with those obtained in the original series presented at the MDACC. Patients and Method. In this retrospective study, we evaluated the 2-year leukemia-free survival (LFS) and the 2-year overall survival (OS) of 70 ALL patients treated between 2014 and 2019 in the Seyed Al-Shohada Hospital in Isfahan, Iran. Results. In total, 59 ALL patients (84.28%) achieved complete remission (CR). The CR rate had statistical differences by bone marrow transplantation (BMT) and WBC count. The 2-year LFS and OS were 40% and 42%, respectively. There were significant differences in LFS and OS by BMT, myeloid marker, and WBC count. Conclusion. The outcome of the traditional Hyper-CVAD regimen in treating adult ALL was not satisfying. More efficient therapies should be applied for the treatment of adult ALL.

的目标。由MD安德森癌症中心(MDACC)设计的Hyper-CVAD方案对急性淋巴细胞白血病(ALL)的成年患者显示出有希望的结果。这种治疗导致92%的完全缓解率和38%的5年总生存率。然而，鉴于患者人口统计和机构方法的多样性，不同机构的结果可能不同。本研究将比较伊朗接受Hyper-CVAD方案治疗的成年ALL患者的结果与MDACC上提出的原始系列的结果。患者和方法。在这项回顾性研究中，我们评估了2014年至2019年期间在伊朗伊斯法罕Seyed Al-Shohada医院接受治疗的70例ALL患者的2年无白血病生存期(LFS)和2年总生存期(OS)。结果。59例ALL患者(84.28%)达到完全缓解(CR)。骨髓移植(BMT)和白细胞计数差异有统计学意义。2年LFS和OS分别为40%和42%。BMT、骨髓标志物、白细胞计数在LFS和OS方面存在显著差异。结论。传统的Hyper-CVAD方案治疗成人ALL的结果并不令人满意。成人ALL的治疗应采用更有效的治疗方法。

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引用次数: 0

Association between Blood Group and Change in Coagulation Factors in Plasma Preparations for Transfusion Purpose at Kisii Teaching and Referral Hospital 基思教学转诊医院输血用血浆制剂中凝血因子变化与血型的关系

Q3 Medicine

Advances in Hematology

Pub Date : 2023-11-09 DOI: 10.1155/2023/3749773

Collince Odiwuor Ogolla, Benson Nyanchongi, Rodgers Norman Demba

Background. Blood component therapy helps in managing patients with reduced hematopoiesis, elevated peripheral destruction of cells, and generalized blood loss (bleeding). Increased prevalence of arterial and venous thrombotic disease linked to the impact of ABO blood group on plasma levels of coagulation glycoprotein is demonstrated by blood group non-O persons. Objective. This study had a main objective of determining the association between blood group and change in coagulation factors in plasma preparation for transfusion purpose. Methods. The study employed a longitudinal study design. Factor assay evaluation was done by the use of Erba Mannheim ECL 105 semiautomated coagulation analyzer from India. Thawing meant for consequent coagulation factor analysis and sequential testing of stored cryoprecipitate and fresh frozen plasma was performed by the use of Stericox plasma thawing bath before being analyzed by the coagulation analyzer. Blood group of the collected blood sample in purple EDTA vacutainer was analyzed using blood antisera and a clean white tile, and results were recorded which helped in establishing the association existing between plasma and blood group. The data were fed into Excel and were evaluated by the use of SPSS version 25. Results. There was no significant association between coagulation factors in fresh frozen plasma and blood group, coagulation factors in cryoprecipitate plasma and blood group of the donors showed that the relationship was not significant with, (r = −0.116, −0.097, 0.007 and 0.047 with

p

value (0.900, 0.087, 0.096 and 0.096), respectively, which are greater than 0.005 standard alpha value. Conclusion. This study has shown no significant association existing between blood group and change in coagulation factors in plasma preparations at Kisii Teaching and Referral Hospital.

背景。血液成分疗法有助于治疗造血功能减少、外周细胞破坏升高和全身性失血(出血)的患者。非o型血的人证实了ABO血型对血浆凝血糖蛋白水平的影响与动脉和静脉血栓形成疾病的患病率增加有关。目标。本研究的主要目的是确定输血血浆制备中血型与凝血因子变化之间的关系。方法。本研究采用纵向研究设计。采用印度Erba Mannheim ECL 105半自动凝血分析仪进行因子分析。使用Stericox等离子体解冻浴对储存的冷冻沉淀和新鲜冷冻血浆进行解冻，用于随后的凝血因子分析和顺序测试，然后使用凝血分析仪进行分析。对紫色EDTA真空抽采器采集的血样，用抗血清和干净的白色瓷砖进行血型分析，并记录结果，有助于建立血浆与血型之间的关系。将数据输入Excel，并使用SPSS版本25进行评估。结果。新鲜冷冻血浆凝血因子与献血者血型无显著相关性，低温沉淀血浆凝血因子与献血者血型无显著相关性(r = - 0.116、- 0.097、0.007、0.047,p值分别为0.900、0.087、0.096、0.096)，均大于0.005标准α值。结论。本研究显示基思教学转诊医院血浆制剂中凝血因子变化与血型无显著相关性。

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引用次数: 0

Exploring Hematological Parameters and Their Prognostic Value in Adult COVID-19 Patients: Insights from Mogadishu, Somalia. 探索成年新冠肺炎患者的血液学参数及其预后价值：来自索马里摩加迪沙的见解。

Q3 Medicine

Advances in Hematology

Pub Date : 2023-10-03 eCollection Date: 2023-01-01 DOI: 10.1155/2023/8862457

Abdirasak Sharif Ali Mude, Abd Elhadi Mohamed Agena Musa

There were no data on SARS-CoV-2 and hematology in Mogadishu, Somalia, despite the fact that many prior investigations of SARS-CoV-2 and hematology have already been conducted in many different parts of the world. As a result, this study aimed to assess hematological changes in COVID-19-infected patients at some selected hospitals in Mogadishu, Somalia. Methods. Outright, 433 COVID-19 patients were included in this study, which used a hospital-based cross-sectional design to investigate hematological alterations using the Mindray full automated hematological analyzer. Furthermore, ethical considerations were taken into account during the study. All individuals provided informed consent prior to participation in the study. Data were analyzed using SPSS. Results. The median age of the current study was 54.65 ± 20.486 years. People with diabetes, high blood pressure, asthma, or heart disease made up 21.2%, 21.2%, 20%, and 2.1% of the study population, respectively. According to the patients' hematological profiles, 89.5% of them had leukopenia, 86.8% had lymphopenia, and 89% had neutrophilia. Monocytes, eosinophils, basophils, and thrombocytes were typically normal although around 50.4% individuals exhibited anemia. Conclusion. Hematological indicators can predict how bad the illness is and how it will turn out, which helps guide clinical therapy. Leukopenia, neutrophilia, lymphopenia, and anemia were found in this study. At the time of admission, a thorough review of laboratory parameters can help clinicians make a treatment plan and quickly give intensive care to the patients who need it most.

索马里摩加迪沙没有关于严重急性呼吸系统综合征冠状病毒2型和血液学的数据，尽管此前已经在世界许多不同地区进行了许多严重急性呼吸系综合征冠状病毒和血液学调查。因此，这项研究旨在评估索马里摩加迪沙一些选定医院感染新冠肺炎患者的血液学变化。方法。本研究包括433名新冠肺炎患者，该研究使用基于医院的横断面设计，使用迈瑞全自动血液分析仪调查血液学变化。此外，在研究过程中还考虑了伦理因素。所有个体在参与研究之前都提供了知情同意书。使用SPSS对数据进行分析。后果本研究的中位年龄为54.65岁 ± 20.486 年。糖尿病、高血压、哮喘或心脏病患者分别占研究人群的21.2%、21.2%、20%和2.1%。根据患者的血液学特征，89.5%的患者患有白细胞减少症，86.8%的患者患有淋巴细胞减少症，89%的患者患有中性粒细胞增多症。单核细胞、嗜酸性粒细胞、嗜碱性粒细胞和血小板通常正常，尽管约50.4%的个体表现出贫血。结论血液学指标可以预测疾病的严重程度和结果，这有助于指导临床治疗。本研究发现白细胞减少症、中性粒细胞增多症、淋巴细胞减少症和贫血。入院时，对实验室参数进行彻底审查可以帮助临床医生制定治疗计划，并迅速为最需要的患者提供重症监护。

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引用次数: 0