Pub Date : 2024-07-23DOI: 10.18502/ijhoscr.v18i3.16111
Nelson Luis Cahuapaza-Gutierrez, Tsuriel Sofía Campos-Escalante
Aplastic anemia (AA) is the prototypical bone marrow failure syndrome due to the destruction of hematopoietic stem cells by cytotoxic T cells. According to case reports, vaccines could lead to the development of AA. We conducted the present systematic review to evaluate cases of AA following vaccination against coronavirus disease (COVID-19). We searched the following databases: PubMed, Scopus, and EMBASE in English, Portuguese, and Spanish languages until April 24, 2023. Published reports and case series on the occurrence of AA following vaccination against COVID-19 were included. The Joanna Brigs Institute was used to assess study quality and risk of bias. Six studies were selected from 102 research studies and data were extracted according to the inclusion criteria. All case reports and case series reported the occurrence of AA following COVID-19 vaccination. AA events were mainly observed in vaccines with messenger ribonucleic acid technology (Moderna; Pfizer-BioNTech). AA was diagnosed by bone marrow biopsy and severity was determined by Camitta criteria. All cases of AA were properly diagnosed. The sample size was small; therefore, further investigations are required to demonstrate and elucidate the complete pathophysiological mechanisms of AA development after receiving COVID-19 vaccination.
再生障碍性贫血(AA)是由于细胞毒性 T 细胞破坏造血干细胞而导致的典型骨髓衰竭综合征。根据病例报告,疫苗可能导致再生障碍性贫血的发生。我们进行了本系统综述,以评估接种冠状病毒病(COVID-19)疫苗后出现 AA 的病例。我们检索了以下数据库:PubMed、Scopus 和 EMBASE(英文、葡萄牙文和西班牙文),检索时间截至 2023 年 4 月 24 日。纳入了有关接种 COVID-19 疫苗后发生 AA 的已发表报告和系列病例。乔安娜-布里格斯研究所(Joanna Brigs Institute)用于评估研究质量和偏倚风险。从 102 项研究中筛选出 6 项研究,并根据纳入标准提取了数据。所有病例报告和系列病例都报告了接种 COVID-19 疫苗后发生 AA 的情况。AA事件主要出现在采用信使核糖核酸技术(Moderna;辉瑞生物技术公司)的疫苗中。AA通过骨髓活检确诊,严重程度根据卡米塔标准确定。所有 AA 病例均得到正确诊断。由于样本量较小,因此还需要进一步的研究来证明和阐明接种 COVID-19 疫苗后 AA 发病的完整病理生理机制。
{"title":"Aplastic Anemia Following COVID-19 Vaccination: A Systematic Review of Case Reports and Case Series","authors":"Nelson Luis Cahuapaza-Gutierrez, Tsuriel Sofía Campos-Escalante","doi":"10.18502/ijhoscr.v18i3.16111","DOIUrl":"https://doi.org/10.18502/ijhoscr.v18i3.16111","url":null,"abstract":"Aplastic anemia (AA) is the prototypical bone marrow failure syndrome due to the destruction of hematopoietic stem cells by cytotoxic T cells. According to case reports, vaccines could lead to the development of AA. We conducted the present systematic review to evaluate cases of AA following vaccination against coronavirus disease (COVID-19). \u0000We searched the following databases: PubMed, Scopus, and EMBASE in English, Portuguese, and Spanish languages until April 24, 2023. Published reports and case series on the occurrence of AA following vaccination against COVID-19 were included. The Joanna Brigs Institute was used to assess study quality and risk of bias. \u0000Six studies were selected from 102 research studies and data were extracted according to the inclusion criteria. All case reports and case series reported the occurrence of AA following COVID-19 vaccination. AA events were mainly observed in vaccines with messenger ribonucleic acid technology (Moderna; Pfizer-BioNTech). AA was diagnosed by bone marrow biopsy and severity was determined by Camitta criteria. \u0000All cases of AA were properly diagnosed. The sample size was small; therefore, further investigations are required to demonstrate and elucidate the complete pathophysiological mechanisms of AA development after receiving COVID-19 vaccination.","PeriodicalId":94048,"journal":{"name":"International journal of hematology-oncology and stem cell research","volume":"58 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141813217","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 : 2024-07-23DOI: 10.18502/ijhoscr.v18i3.16110
Usama Al‐Jumaily, Hamid D. Habeeb Rjeib, Sabah Al-Mosawy, Safa Faraj, Monika Metzger
Background: Hodgkin lymphoma (HL) management varies throughout developing nations. This observational study aims to present the results of children having HL who received various combinations of chemotherapy treatment. The response-based method was used regardless of the risk classification. Materials and Methods: We recruited patients≤ 18 years of age diagnosed with HL in an Iraqi cancer center between January 2014 and December 2021. By stratifying patients, three risk categories were identified. Every patient initially received two cycles of ABVD as induction chemotherapy. Following induction chemotherapy, patients showing a full radiological response continued on ABVD chemotherapy for 4-6 cycles without receiving radiotherapy. Patients showing a modest initial response received three additional courses of COPDac next to the third cycle of ABVD, followed by radiotherapy. Results: This study included fifty-nine patients with a median age of 7 years. Stage III patients accounted for 33.9% (n=20), then stage II (32.2%). B symptoms were present in 25 patients. Eleven children had initial splenic involvement. Fifty-two individuals (n = 19; 32.2%) had bulky disease. Mixed cellularity was the most prevalent histology (n=44). The median duration of follow-up was 2.7 years. EFS was 78% ±10%, and survival was 92% at 5-year estimation. Bulky disease was the only factor with a substantial unfavorable impact on the result. Conclusion: Response-based approach is a valuable strategy in nations with limited resources to prevent long-term sequelae from unnecessary radiotherapy.
{"title":"Response-Based Approach for Pediatric Hodgkin Lymphoma in Nations with Restricted Resources","authors":"Usama Al‐Jumaily, Hamid D. Habeeb Rjeib, Sabah Al-Mosawy, Safa Faraj, Monika Metzger","doi":"10.18502/ijhoscr.v18i3.16110","DOIUrl":"https://doi.org/10.18502/ijhoscr.v18i3.16110","url":null,"abstract":"Background: Hodgkin lymphoma (HL) management varies throughout developing nations. This observational study aims to present the results of children having HL who received various combinations of chemotherapy treatment. The response-based method was used regardless of the risk classification. \u0000Materials and Methods: We recruited patients≤ 18 years of age diagnosed with HL in an Iraqi cancer center between January 2014 and December 2021. By stratifying patients, three risk categories were identified. Every patient initially received two cycles of ABVD as induction chemotherapy. Following induction chemotherapy, patients showing a full radiological response continued on ABVD chemotherapy for 4-6 cycles without receiving radiotherapy. Patients showing a modest initial response received three additional courses of COPDac next to the third cycle of ABVD, followed by radiotherapy. \u0000Results: This study included fifty-nine patients with a median age of 7 years. Stage III patients accounted for 33.9% (n=20), then stage II (32.2%). B symptoms were present in 25 patients. Eleven children had initial splenic involvement. Fifty-two individuals (n = 19; 32.2%) had bulky disease. Mixed cellularity was the most prevalent histology (n=44). The median duration of follow-up was 2.7 years. EFS was 78% ±10%, and survival was 92% at 5-year estimation. Bulky disease was the only factor with a substantial unfavorable impact on the result. \u0000Conclusion: Response-based approach is a valuable strategy in nations with limited resources to prevent long-term sequelae from unnecessary radiotherapy. ","PeriodicalId":94048,"journal":{"name":"International journal of hematology-oncology and stem cell research","volume":"143 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141810832","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 : 2024-07-23DOI: 10.18502/ijhoscr.v18i3.16109
Ayda Baghery Saghchy Khorasani, Mina Soufizomorrod, Davood Bashash
Multiple myeloma (MM) is a malignancy of plasma cells, terminally differentiated B cells, with complications like hypercalcemia, renal failure, anemia, and bone disease, which are also known as CRAB criteria. MM develops from monoclonal gammopathy of unknown significance (MGUS), a pre-malignant plasma cell dyscrasia. Over some time, MGUS has the potential to progress into smoldering multiple myeloma (SMM), which can evolve into MM. MM rarely progresses into plasma cell leukemia (PCL), a condition in which malignant plasma cells no longer stay in the bone marrow niche and circulate in the peripheral blood. In MM, various soluble factors play important roles, and interleukin-6 has different vital roles. Interleukin-6, an inflammatory cytokine, has significant roles in the growth, survival, angiogenesis, metastasis, and apoptosis resistance in MM. Interleukin-6 is produced and secreted by both autocrine from myeloma cells and paracrine from bone marrow stromal cells. To tackle MM, various therapeutic approaches were applied over many years, and according to the results, most patients with MM can respond well to first-line treatment. However, the majority of patients may relapse as conventional treatment may not be curative. So, there is an urgent need for novel cell-based and cell-free therapeutic strategies, such as mesenchymal stem cell-based therapies and their products to offer new therapeutic strategies for MM. Materials and Methods: In the present study, we investigated the impacts of exosomes derived from human placental mesenchymal stem cells (hPMSCs) on apoptosis and interleukin-6 expression in a myeloma cell line, U-266, for the first time. hPMSCs were isolated from the human placenta and cultured in a DMEM medium. After characterizing the cells and acknowledging their identity, they underwent several passages and their supernatant was collected to harvest exosomes. The exosomes were isolated by ultracentrifugation and characterized by DLS and TEM, and their concentration was measured by BCA protein assay. U266 cells were treated with different concentrations of exosomes and then MTT and annexin/propidium iodide flow cytometry tests were performed to evaluate cell viability. Afterward, a real-time PCR test was performed to evaluate interleukin-6 gene expression. Results: According to our findings, treatment of U-266 cells with hPMSCS-derived exosomes led to the preservation of myeloma cells without changes in their cell cycle. Surprisingly, treatments did not hinder the expression of interleukin-6 in the myeloma cells. Conclusion: In MM patients, interleukin-6 plays different roles, and it is a desirable target to design new therapeutic strategies. To evaluate the effects of new therapeutic strategies, we designed and performed our study to estimate the effects of cell-free therapeutic strategy. In the present study, the impacts of hPMSCS-derived exosomes on the viability of MM cells and interleukin-6 gene expression were evaluated.
多发性骨髓瘤(MM)是一种浆细胞(终末分化的 B 细胞)恶性肿瘤,具有高钙血症、肾功能衰竭、贫血和骨病等并发症,这也被称为 CRAB 标准。MM 是由意义不明的单克隆丙种球蛋白病(MGUS)发展而来的,MGUS 是一种恶性前浆细胞异常。经过一段时间后,MGUS 有可能发展为烟雾型多发性骨髓瘤(SMM),SMM 又可能发展为 MM。MM很少发展为浆细胞白血病(PCL),在这种情况下,恶性浆细胞不再停留在骨髓龛中,而是在外周血中循环。在 MM 中,各种可溶性因子发挥着重要作用,其中白细胞介素-6 发挥着不同的重要作用。 白细胞介素-6 是一种炎性细胞因子,在 MM 的生长、存活、血管生成、转移和抗凋亡中起着重要作用。白细胞介素-6通过骨髓瘤细胞的自分泌和骨髓基质细胞的旁分泌产生和分泌。针对骨髓瘤,多年来人们采用了多种治疗方法,结果表明,大多数骨髓瘤患者对一线治疗反应良好。不過,由於傳統治療未必能根治,大部分病人可能會復發。因此,迫切需要新型的细胞和无细胞治疗策略,如间充质干细胞疗法及其产品,为 MM 提供新的治疗策略。材料与方法:在本研究中,我们首次研究了从人胎盘间充质干细胞(hPMSCs)中提取的外泌体对骨髓瘤细胞系U-266的细胞凋亡和白细胞介素-6表达的影响。在确定细胞特征并确认其身份后,对其进行了多次传代,并收集其上清液以收获外泌体。通过超速离心法分离外泌体,用 DLS 和 TEM 对其进行表征,并用 BCA 蛋白检测法测定其浓度。用不同浓度的外泌体处理 U266 细胞,然后用 MTT 和附件素/碘化丙啶流式细胞术检测细胞活力。之后,进行实时 PCR 检测以评估白细胞介素-6 基因的表达。结果根据我们的研究结果,用源自 hPMSCS 的外泌体处理 U-266 细胞可保存骨髓瘤细胞,且细胞周期不会发生变化。令人惊讶的是,治疗并未阻碍骨髓瘤细胞中白细胞介素-6的表达。结论是在 MM 患者体内,白细胞介素-6 发挥着不同的作用,是设计新治疗策略的理想靶点。为了评估新治疗策略的效果,我们设计并开展了无细胞治疗策略的效果评估研究。 本研究评估了源自 hPMSCS 的外泌体对 MM 细胞活力和白细胞介素-6 基因表达的影响。结果表明,hPMSCS衍生的外泌体可使骨髓瘤细胞存活下来,而细胞周期不会发生变化。 此外,白细胞介素-6基因表达水平也没有发生显著变化。
{"title":"Unleashing the Impact of Exosomes Derived from Human Placental Mesenchymal Stem Cells (hPMSCs) on U-266 Myeloma Cell Line","authors":"Ayda Baghery Saghchy Khorasani, Mina Soufizomorrod, Davood Bashash","doi":"10.18502/ijhoscr.v18i3.16109","DOIUrl":"https://doi.org/10.18502/ijhoscr.v18i3.16109","url":null,"abstract":"Multiple myeloma (MM) is a malignancy of plasma cells, terminally differentiated B cells, with complications like hypercalcemia, renal failure, anemia, and bone disease, which are also known as CRAB criteria. MM develops from monoclonal gammopathy of unknown significance (MGUS), a pre-malignant plasma cell dyscrasia. Over some time, MGUS has the potential to progress into smoldering multiple myeloma (SMM), which can evolve into MM. MM rarely progresses into plasma cell leukemia (PCL), a condition in which malignant plasma cells no longer stay in the bone marrow niche and circulate in the peripheral blood. In MM, various soluble factors play important roles, and interleukin-6 has different vital roles. \u0000 Interleukin-6, an inflammatory cytokine, has significant roles in the growth, survival, angiogenesis, metastasis, and apoptosis resistance in MM. Interleukin-6 is produced and secreted by both autocrine from myeloma cells and paracrine from bone marrow stromal cells. To tackle MM, various therapeutic approaches were applied over many years, and according to the results, most patients with MM can respond well to first-line treatment. However, the majority of patients may relapse as conventional treatment may not be curative. So, there is an urgent need for novel cell-based and cell-free therapeutic strategies, such as mesenchymal stem cell-based therapies and their products to offer new therapeutic strategies for MM. \u0000Materials and Methods: In the present study, we investigated the impacts of exosomes derived from human placental mesenchymal stem cells (hPMSCs) on apoptosis and interleukin-6 expression in a myeloma cell line, U-266, for the first time. hPMSCs were isolated from the human placenta and cultured in a DMEM medium. After characterizing the cells and acknowledging their identity, they underwent several passages and their supernatant was collected to harvest exosomes. The exosomes were isolated by ultracentrifugation and characterized by DLS and TEM, and their concentration was measured by BCA protein assay. U266 cells were treated with different concentrations of exosomes and then MTT and annexin/propidium iodide flow cytometry tests were performed to evaluate cell viability. Afterward, a real-time PCR test was performed to evaluate interleukin-6 gene expression. \u0000Results: According to our findings, treatment of U-266 cells with hPMSCS-derived exosomes led to the preservation of myeloma cells without changes in their cell cycle. Surprisingly, treatments did not hinder the expression of interleukin-6 in the myeloma cells. \u0000Conclusion: In MM patients, interleukin-6 plays different roles, and it is a desirable target to design new therapeutic strategies. To evaluate the effects of new therapeutic strategies, we designed and performed our study to estimate the effects of cell-free therapeutic strategy. In the present study, the impacts of hPMSCS-derived exosomes on the viability of MM cells and interleukin-6 gene expression were evaluated. ","PeriodicalId":94048,"journal":{"name":"International journal of hematology-oncology and stem cell research","volume":"3 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141813722","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 : 2024-07-23DOI: 10.18502/ijhoscr.v18i3.16112
Sogol Zarrabi, Mohammad Vaezi, B. Shahrami
The Article Abstract is not available.
文章摘要不详。
{"title":"Cyclophosphamide- Antifungals Interactions in Patients Undergoing Hematopoietic Stem Cell Transplantation: What Should We Know About it?","authors":"Sogol Zarrabi, Mohammad Vaezi, B. Shahrami","doi":"10.18502/ijhoscr.v18i3.16112","DOIUrl":"https://doi.org/10.18502/ijhoscr.v18i3.16112","url":null,"abstract":"The Article Abstract is not available.","PeriodicalId":94048,"journal":{"name":"International journal of hematology-oncology and stem cell research","volume":"89 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141812726","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 : 2024-07-23DOI: 10.18502/ijhoscr.v18i3.16113
Nur Hürsoy, Merve Solak, Demet Nak
The Article Abstract is not available.
文章摘要不详。
{"title":"Relationship between Breast Cancer and Cardiac Myxoma","authors":"Nur Hürsoy, Merve Solak, Demet Nak","doi":"10.18502/ijhoscr.v18i3.16113","DOIUrl":"https://doi.org/10.18502/ijhoscr.v18i3.16113","url":null,"abstract":"The Article Abstract is not available.","PeriodicalId":94048,"journal":{"name":"International journal of hematology-oncology and stem cell research","volume":"136 52","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141811046","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: Von Willebrand disease (VWD) is one of the most common coagulative diseases, so identifying the effective factors in preventing this complication is essential. The study aimed to evaluate the frequency of demographic and epidemiological findings in VWD patients referred to a hospital in Zahedan, Iran. Materials and Methods: This study was performed on 76 patients with VWD referred to Hazrat Ali-Asghar Hospital in Zahedan City, Sistan, and Baluchestan province. After obtaining consent from the patients, the demographic information and clinical symptoms of the disease were recorded. All statistical analyses were performed using SPSS 22.0 software. All descriptive data were expressed as mean ±SD and percent (%) depending on the continuous and dichotomous variables. A P-value ≤0.05 was considered significant statistically. Results: The present study results showed that the highest age group of VWD patients at the time of disease diagnosis was in the age group 1-5 years (47.3%), and most patients had type III VWD (80.3%). It was also found that 67.1% of patients had a positive family history and their parents' consanguineous marriage (77.6%). The most common complaints were epistaxis (88.15%), cutaneous bleeding (78.94%), and oral cavity bleeding (61.84%), respectively. Conclusion: Due to the high prevalence of VWD in consanguineous marriages and an increase in adverse complications and symptoms in VWD patients, proper diagnosis and screening at an early age, especially in people with family history, is essential. Efforts are needed to develop national registries and widely provide the required and available basic services for diagnosis and treatment.
{"title":"Epidemiological, Demographic, and Clinical Characteristics of Von Willebrand Disease Patients in Zahedan City, Iran: A Descriptive Study","authors":"Majid Naderi, Benyamin Rhmati, Hoora Ganjali, Saeedeh Yaghoubi, Mohammad Sadra Harifi-Mood, Seyed Ghader Azizi","doi":"10.18502/ijhoscr.v18i3.16102","DOIUrl":"https://doi.org/10.18502/ijhoscr.v18i3.16102","url":null,"abstract":"Background: Von Willebrand disease (VWD) is one of the most common coagulative diseases, so identifying the effective factors in preventing this complication is essential. The study aimed to evaluate the frequency of demographic and epidemiological findings in VWD patients referred to a hospital in Zahedan, Iran. \u0000Materials and Methods: This study was performed on 76 patients with VWD referred to Hazrat Ali-Asghar Hospital in Zahedan City, Sistan, and Baluchestan province. After obtaining consent from the patients, the demographic information and clinical symptoms of the disease were recorded. All statistical analyses were performed using SPSS 22.0 software. All descriptive data were expressed as mean ±SD and percent (%) depending on the continuous and dichotomous variables. A P-value ≤0.05 was considered significant statistically. \u0000Results: The present study results showed that the highest age group of VWD patients at the time of disease diagnosis was in the age group 1-5 years (47.3%), and most patients had type III VWD (80.3%). It was also found that 67.1% of patients had a positive family history and their parents' consanguineous marriage (77.6%). The most common complaints were epistaxis (88.15%), cutaneous bleeding (78.94%), and oral cavity bleeding (61.84%), respectively. \u0000Conclusion: Due to the high prevalence of VWD in consanguineous marriages and an increase in adverse complications and symptoms in VWD patients, proper diagnosis and screening at an early age, especially in people with family history, is essential. Efforts are needed to develop national registries and widely provide the required and available basic services for diagnosis and treatment. \u0000 ","PeriodicalId":94048,"journal":{"name":"International journal of hematology-oncology and stem cell research","volume":"62 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141817630","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 : 2024-07-21DOI: 10.18502/ijhoscr.v18i3.16106
T. Nguyen, Huu Than Huynh, Hung Quang Tran, Quang The Nguyen, P. Huynh, Nam Duy Hoang, Tuan Xuan Ma, Duong Thi Thuy Do, Dung Chi Phu, Man Van Huynh
Background: Busulfan plus cyclophosphamide (Bu/Cy) is considered one of the classical myeloablative conditioning regimens. However, its toxicity can significantly increase mortality rates. To reduce both acute and long-term complications after hematopoietic stem cell transplantation (HSCT), newer conditioning regimens are being investigated. The purposes of this study were to assess the efficacy and safety of busulfan plus cyclophosphamide (Bu/Cy) and busulfan plus fludarabine (Bu/Flu) conditioning regimen for allogeneic HSCT (allo-HSCT) in acute myelogenous leukemia (AML). Materials and Methods: We conducted a single-center, retrospective analysis of AML, both adults and children, who underwent either Bu/Cy or Bu/Flu conditioning regimen for allo-HSCT and received peripheral blood stem cell transplants from HLA-matched donors. Results: From 2005 – 2019, 49 AML patients receiving Bu/Cy and 21 receiving Bu/Flu were identified, meeting inclusion criteria. The two groups showed no significant differences in age, gender, disease status pre-transplant, the median time to neutrophil and platelet engraftment. Bu/Flu patients had a shorter duration of neutropenia (median 7 days vs 10 days, p = 0.001) and shorter duration of thrombocytopenia (median 10 days vs 15 days, p = 0.016) than Bu/Cy. No difference was observed in disease-free survival (DFS) and overall survival (OS) between the two groups. Both univariate and multivariate analyses showed that age, disease status pre-transplant, and chronic graft-versus-host disease (GvHD) are related to worse DFS and OS. Conclusion: With similar efficacy to Bu/Cy but faster neutrophil and platelet recovery time, Bu/Flu is suitable as a pre-HSCT conditioning regimen for patients with AML.
{"title":"Evaluate the Efficacy of Myeloablative Conditioning Regimens for Allogeneic Hematopoietic Stem Cell Transplantation in Acute Myelogenous Leukemia at BTH, Vietnam","authors":"T. Nguyen, Huu Than Huynh, Hung Quang Tran, Quang The Nguyen, P. Huynh, Nam Duy Hoang, Tuan Xuan Ma, Duong Thi Thuy Do, Dung Chi Phu, Man Van Huynh","doi":"10.18502/ijhoscr.v18i3.16106","DOIUrl":"https://doi.org/10.18502/ijhoscr.v18i3.16106","url":null,"abstract":"Background: Busulfan plus cyclophosphamide (Bu/Cy) is considered one of the classical myeloablative conditioning regimens. However, its toxicity can significantly increase mortality rates. To reduce both acute and long-term complications after hematopoietic stem cell transplantation (HSCT), newer conditioning regimens are being investigated. The purposes of this study were to assess the efficacy and safety of busulfan plus cyclophosphamide (Bu/Cy) and busulfan plus fludarabine (Bu/Flu) conditioning regimen for allogeneic HSCT (allo-HSCT) in acute myelogenous leukemia (AML). \u0000Materials and Methods: We conducted a single-center, retrospective analysis of AML, both adults and children, who underwent either Bu/Cy or Bu/Flu conditioning regimen for allo-HSCT and received peripheral blood stem cell transplants from HLA-matched donors. \u0000Results: From 2005 – 2019, 49 AML patients receiving Bu/Cy and 21 receiving Bu/Flu were identified, meeting inclusion criteria. The two groups showed no significant differences in age, gender, disease status pre-transplant, the median time to neutrophil and platelet engraftment. Bu/Flu patients had a shorter duration of neutropenia (median 7 days vs 10 days, p = 0.001) and shorter duration of thrombocytopenia (median 10 days vs 15 days, p = 0.016) than Bu/Cy. No difference was observed in disease-free survival (DFS) and overall survival (OS) between the two groups. Both univariate and multivariate analyses showed that age, disease status pre-transplant, and chronic graft-versus-host disease (GvHD) are related to worse DFS and OS. \u0000Conclusion: With similar efficacy to Bu/Cy but faster neutrophil and platelet recovery time, Bu/Flu is suitable as a pre-HSCT conditioning regimen for patients with AML.","PeriodicalId":94048,"journal":{"name":"International journal of hematology-oncology and stem cell research","volume":"35 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141818489","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 : 2024-07-21DOI: 10.18502/ijhoscr.v18i3.16104
Tayebe Zarekar, Abbas Hajifathali, S. Ahmadizad
Background: Thrombocytopenia is a frequent complication after hematopoietic stem cell transplantation (HSCT). Although platelet transfusion is the most used treatment for severe thrombocytopenia, it is associated with well-established risks. High-intensity interval exercise (HIIE) results in thrombocytosis. Therefore, this study aimed to reduce thrombocytopenia by increasing platelet count through exercise. Materials and Methods: Twenty lymphoma and multiple myeloma patients were divided into HIIE and control groups. To determine the maximal exercise capacity, patients in the HIIE group performed a graded exercise test. All patients received granulocyte colony-stimulating factor for 5 days, followed by a HIIE trial. After 5 min warm up at 10 to 20% of peak power, patients in the HIIE group performed an HIIE protocol that included 12 intervals of one-minute work at 100% peak power interspersed by one-minute active rest at 20% of peak power. Patients in the control group were seated for the same duration without any physical activity. Two blood samples were taken before and immediately after the trials and were analyzed for measuring complete blood count. Results: Platelet count on the day of platelet engraftment in the HIIE group was significantly higher than in the control group (P=0.02). Single-donor platelet transfusion was significantly lower in the HIIE group than in the control group (P=0.05). Conclusion: Based on the findings of the present study, a short bout of HIIE had a positive effect on platelet engraftment through thrombocytosis and reduced platelet transfusion and its complications, which could be a useful strategy for HSCT patients.
{"title":"The effect of High Intensity Interval Exercise on Platelet Engraftment in Autologous Bone Marrow Transplantation (BMT)","authors":"Tayebe Zarekar, Abbas Hajifathali, S. Ahmadizad","doi":"10.18502/ijhoscr.v18i3.16104","DOIUrl":"https://doi.org/10.18502/ijhoscr.v18i3.16104","url":null,"abstract":"Background: Thrombocytopenia is a frequent complication after hematopoietic stem cell transplantation (HSCT). Although platelet transfusion is the most used treatment for severe thrombocytopenia, it is associated with well-established risks. High-intensity interval exercise (HIIE) results in thrombocytosis. Therefore, this study aimed to reduce thrombocytopenia by increasing platelet count through exercise. \u0000Materials and Methods: Twenty lymphoma and multiple myeloma patients were divided into HIIE and control groups. To determine the maximal exercise capacity, patients in the HIIE group performed a graded exercise test. All patients received granulocyte colony-stimulating factor for 5 days, followed by a HIIE trial. After 5 min warm up at 10 to 20% of peak power, patients in the HIIE group performed an HIIE protocol that included 12 intervals of one-minute work at 100% peak power interspersed by one-minute active rest at 20% of peak power. Patients in the control group were seated for the same duration without any physical activity. Two blood samples were taken before and immediately after the trials and were analyzed for measuring complete blood count. \u0000Results: Platelet count on the day of platelet engraftment in the HIIE group was significantly higher than in the control group (P=0.02). Single-donor platelet transfusion was significantly lower in the HIIE group than in the control group (P=0.05). \u0000Conclusion: Based on the findings of the present study, a short bout of HIIE had a positive effect on platelet engraftment through thrombocytosis and reduced platelet transfusion and its complications, which could be a useful strategy for HSCT patients. \u0000 ","PeriodicalId":94048,"journal":{"name":"International journal of hematology-oncology and stem cell research","volume":"57 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141817949","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 : 2024-07-21DOI: 10.18502/ijhoscr.v18i3.16105
Mohammad Jafar Sharifi, Negar Gheibi, Fatemeh Panahi, S. Sharifzadeh, N. Nasiri
Background: Hematological abnormalities in COVID-19 infection included quantitative and qualitative changes and should be further characterized. Evaluation for myelodysplastic syndromes (MDS) is usually prompted by abnormal hematologic findings and the presence of dysplastic morphologies. Viral infections are considered to be the cause of dysplastic morphologies and should be considered by morphologists. There are few reports of dysplastic abnormal morphologies in patients with COVID-19 infection. However, such correlations still have to be clarified. Materials and Methods: In the present study, we examined the granulocyte lineage morphological abnormalities in symptomatic RT-PCR-confirmed COVID patients. Peripheral blood samples were collected from 82 patients with symptomatic COVID-19. Blood smears were prepared according to the standard Wright-Giemsa staining procedure. The morphological examination was carried out by two laboratory experts. Results: Blood smear examination revealed common myelodysplastic syndrome (MDS) type abnormalities including but not limited to pseudo-pelger nuclear lobulation (4.8%), hypogranulation (7.3%), Howell-Jolly-like bodies or detached nuclear segments (6.0%) and elongated and thin nuclear filaments (6.0%). One case of abnormal immature granulocyte and ring form nucleus is also evident. Conclusion: Our results accounted for the possibility of active COVID-19 infection in all subjects with granulocyte dysplasia. These results are of practical importance for patients suspected of having myelodysplastic syndromes or disease processes associated with myeloid malignancies.
{"title":"MDS-Type Morphologic Abnormalities of Peripheral Blood Granulocytes in Symptomatic COVID-19 Patients","authors":"Mohammad Jafar Sharifi, Negar Gheibi, Fatemeh Panahi, S. Sharifzadeh, N. Nasiri","doi":"10.18502/ijhoscr.v18i3.16105","DOIUrl":"https://doi.org/10.18502/ijhoscr.v18i3.16105","url":null,"abstract":"Background: Hematological abnormalities in COVID-19 infection included quantitative and qualitative changes and should be further characterized. Evaluation for myelodysplastic syndromes (MDS) is usually prompted by abnormal hematologic findings and the presence of dysplastic morphologies. Viral infections are considered to be the cause of dysplastic morphologies and should be considered by morphologists. There are few reports of dysplastic abnormal morphologies in patients with COVID-19 infection. However, such correlations still have to be clarified. \u0000Materials and Methods: In the present study, we examined the granulocyte lineage morphological abnormalities in symptomatic RT-PCR-confirmed COVID patients. Peripheral blood samples were collected from 82 patients with symptomatic COVID-19. Blood smears were prepared according to the standard Wright-Giemsa staining procedure. The morphological examination was carried out by two laboratory experts. \u0000Results: Blood smear examination revealed common myelodysplastic syndrome (MDS) type abnormalities including but not limited to pseudo-pelger nuclear lobulation (4.8%), hypogranulation (7.3%), Howell-Jolly-like bodies or detached nuclear segments (6.0%) and elongated and thin nuclear filaments (6.0%). One case of abnormal immature granulocyte and ring form nucleus is also evident. \u0000Conclusion: Our results accounted for the possibility of active COVID-19 infection in all subjects with granulocyte dysplasia. These results are of practical importance for patients suspected of having myelodysplastic syndromes or disease processes associated with myeloid malignancies.","PeriodicalId":94048,"journal":{"name":"International journal of hematology-oncology and stem cell research","volume":"44 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141818156","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 : 2024-07-21DOI: 10.18502/ijhoscr.v18i3.16103
Murat Yıldırım, S. Sayın, Melda Cömert, Esra Safak Yilmaz, F. Avcu, A. Ural, M. Aylı
Background: Graft Versus Host Disease (GvHD), which can be observed at a rate of 30-80% after allogeneic stem cell transplantation (ASCT) is an important complication that adversely affects the survival and quality of the life of patients. Posttransplant cyclophosphamide (PTCy) effectively prevents GvHD after HLA-haploidentical ASCT. In our study, the use of PTCy in 1-antigen HLA-mismatched unrelated donor (9/10MMUD) ASCT was compared with standard GvHD prophylaxis in HLA-identical related donor (MRD) ASCT. Materials and Methods: We conducted a retrospective study of the comparison of 42 patients with 9/10 MMUD ASCT receiving PTCy+Methotrexate (MTX)+Calcineurin Inhibitor (CNI) and 37 patients with HLA-identical MRD who received MTX+CNI in 3 bone marrow transplantation centers. Results: Cumulative incidences of grade I-II (64.6% vs 45.4%, p=0.187) or grade III to IV acute GvHD (35.4% vs54.6%, p=0.187) and chronic GvHD (11.9% vs 29.7%, p=0.096) were similar in the PTCy group and control group. No statistically significant differences were observed between PTCy and the control group in overall survival rate (52.4% vs 62.2%, p=0.381), progression-free survival (1483.97 vs 1200.70 days, p=0.502), relapsed-related mortality rate (21.4% vs 16.2%, p=0.556) and treatment-related mortality rate (16.7% vs 21.6%, p=0.575). Conclusion: With the addition of PTCy to standard GvHD prophylaxis in 9/10MMUD ASCT, the risk of GvHD due to incompatibility and unrelated transplantation is eliminated, and transplantation success is achieved with MRD ASCT. PTCy-based prophylaxis is an effective and safe strategy to prevent GvHD in 9/10 MMUD ASCT without increasing the risk of relapse and treatment-related mortality.
背景:同种异体干细胞移植(ASCT)后,移植物抗宿主疾病(GvHD)的发病率高达30%-80%,它是影响患者生存和生活质量的重要并发症。移植后环磷酰胺(PTCy)可有效预防HLA-同种异体干细胞移植后的GvHD。在我们的研究中,我们将在 1 抗原 HLA 不匹配的非亲属供者(9/10MMUD)ASCT 中使用 PTCy 与在 HLA 相同的亲属供者(MRD)ASCT 中使用标准 GvHD 预防措施进行了比较。材料与方法:我们进行了一项回顾性研究,比较了在 3 个骨髓移植中心接受 PTCy+ 甲氨蝶呤 (MTX)+ 钙嘌呤抑制剂 (CNI) 的 42 例 9/10 MMUD ASCT 患者和接受 MTX+CNI 的 37 例 HLA 相同的 MRD 患者。 研究结果PTCy组和对照组的I-II级(64.6% vs 45.4%,P=0.187)或III-IV级急性GvHD(35.4% vs 54.6%,P=0.187)和慢性GvHD(11.9% vs 29.7%,P=0.096)累积发生率相似。PTCy组与对照组在总生存率(52.4% vs 62.2%,P=0.381)、无进展生存期(1483.97 vs 1200.70天,P=0.502)、复发相关死亡率(21.4% vs 16.2%,P=0.556)和治疗相关死亡率(16.7% vs 21.6%,P=0.575)方面均无统计学差异。结论在9/10MMUD ASCT的标准GvHD预防中加入PTCy,可消除因不相容和非亲缘移植导致的GvHD风险,并通过MRD ASCT获得移植成功。在9/10MMUD ASCT中,以PTCy为基础的预防是预防GvHD的有效而安全的策略,同时不会增加复发风险和治疗相关死亡率。
{"title":"Comparison of Cyclophosphamide-Based Graft Versus Host Disease Prophylaxis after “Allogeneic Stem Cell Transplantation from 9/10HLA Matched Unrelated Donor’’ with Standard Graft Versus Host Disease Prophylaxis after “10/10HLA Matched Relative Donor’’","authors":"Murat Yıldırım, S. Sayın, Melda Cömert, Esra Safak Yilmaz, F. Avcu, A. Ural, M. Aylı","doi":"10.18502/ijhoscr.v18i3.16103","DOIUrl":"https://doi.org/10.18502/ijhoscr.v18i3.16103","url":null,"abstract":" \u0000Background: Graft Versus Host Disease (GvHD), which can be observed at a rate of 30-80% after allogeneic stem cell transplantation (ASCT) is an important complication that adversely affects the survival and quality of the life of patients. Posttransplant cyclophosphamide (PTCy) effectively prevents GvHD after HLA-haploidentical ASCT. In our study, the use of PTCy in 1-antigen HLA-mismatched unrelated donor (9/10MMUD) ASCT was compared with standard GvHD prophylaxis in HLA-identical related donor (MRD) ASCT. \u0000Materials and Methods: We conducted a retrospective study of the comparison of 42 patients with 9/10 MMUD ASCT receiving PTCy+Methotrexate (MTX)+Calcineurin Inhibitor (CNI) and 37 patients with HLA-identical MRD who received MTX+CNI in 3 bone marrow transplantation centers. \u0000Results: Cumulative incidences of grade I-II (64.6% vs 45.4%, p=0.187) or grade III to IV acute GvHD (35.4% vs54.6%, p=0.187) and chronic GvHD (11.9% vs 29.7%, p=0.096) were similar in the PTCy group and control group. No statistically significant differences were observed between PTCy and the control group in overall survival rate (52.4% vs 62.2%, p=0.381), progression-free survival (1483.97 vs 1200.70 days, p=0.502), relapsed-related mortality rate (21.4% vs 16.2%, p=0.556) and treatment-related mortality rate (16.7% vs 21.6%, p=0.575). \u0000Conclusion: With the addition of PTCy to standard GvHD prophylaxis in 9/10MMUD ASCT, the risk of GvHD due to incompatibility and unrelated transplantation is eliminated, and transplantation success is achieved with MRD ASCT. PTCy-based prophylaxis is an effective and safe strategy to prevent GvHD in 9/10 MMUD ASCT without increasing the risk of relapse and treatment-related mortality.","PeriodicalId":94048,"journal":{"name":"International journal of hematology-oncology and stem cell research","volume":"100 40","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141818419","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}