Hematology Reports

4 pages, 739 KiB

Open AccessCase Report

by María del Carmen Vicente-Ayuso, María García-Roa, Ataúlfo González-Fernández, Ana María Alvarez-Carmona, Celina Benavente-Cuesta, Marta Mateo-Morales, Cristina Pérez-López, Ascensión Peña-Cortijo, Marta Polo Zarzuela, Laura Gutiérrez and Rafael Martínez-Martínez

Hematol. Rep. 2017, 9(3), 7204; https://doi.org/10.4081/hr.2017.7204 - 27 Sep 2017

Cited by 4 | Viewed by 390

Abstract

Acute promyelocytic leukemia (APL) has become a highly curable malignant disease after the introduction of all transretinoic acid (ATRA) to chemotherapy treatment. However, the risk to develop therapy-related myeloid neoplasms (t-MN) has become a matter of concern, as APL patients are otherwise expected [...] Read more.

Acute promyelocytic leukemia (APL) has become a highly curable malignant disease after the introduction of all transretinoic acid (ATRA) to chemotherapy treatment. However, the risk to develop therapy-related myeloid neoplasms (t-MN) has become a matter of concern, as APL patients are otherwise expected to have a good prognosis. We report a patient with APL who achieved complete remission after chemotherapy induction with anthracycline and ATRA, followed by consolidation and maintenance chemotherapy. Two years later, the patient developed t-AML, with MLL rearrangements, without any evidence of relapse of the APL original clone. The increasing incidence of t-MN in oncohematological patients is partly due to the development of safer, more efficient or targeted therapies, which allow better outcomes and lengthened survival amongst treated patients. The identification of genetic factors, mechanisms or prognostic biomarkers in t-MN might open new windows for the development of personalized targeted therapy regimes in this underserved patient population. Full article

3 pages, 622 KiB

Open AccessCase Report

Two Cases of Angioimmunoblastic T-Cell Lymphoma with Concomitant Positive Serology for Acute Epstein-Barr Virus Infection

by Davide Facchinelli, Angela Polino, Francesco Dima, Alice Parisi, Achille Ambrosetti and Dino Veneri

Hematol. Rep. 2017, 9(3), 7088; https://doi.org/10.4081/hr.2017.7088 - 27 Sep 2017

Cited by 6 | Viewed by 349

Abstract

Angioimmunoblastic T-cell lymphoma (AITL) is a rare type of peripheral T-cell lymphoma. Epstein-Barr virus (EBV) is known to be associated with pathogenesis and histological progression of AITL and the onset of the disease often mimics an infectious process. Here we describe two cases [...] Read more.

Angioimmunoblastic T-cell lymphoma (AITL) is a rare type of peripheral T-cell lymphoma. Epstein-Barr virus (EBV) is known to be associated with pathogenesis and histological progression of AITL and the onset of the disease often mimics an infectious process. Here we describe two cases of patients with serology for acute EBV infection at the onset of AITL. Full article

3 pages, 609 KiB

Open AccessCase Report

Gluteal Artery Injuries Including Pseudoaneurysm Associated with Powered Bone Marrow Biopsies

by Aditi P. Singh, Gopichand Pendurti, Shashi Singh, Alexander Shestopalov, Thomas Pacello and Louis Juden Reed

Hematol. Rep. 2017, 9(3), 7131; https://doi.org/10.4081/hr.2017.7131 - 26 Sep 2017

Cited by 4 | Viewed by 447

Abstract

The bone marrow procedure (BMP) is a frequently performed procedure, with over 700,000 recorded in the U.S. annually. It is a fundamental component in the evaluation and management of both malignant and benign hematologic conditions. Adult patients are generally assured that the BMP [...] Read more.

The bone marrow procedure (BMP) is a frequently performed procedure, with over 700,000 recorded in the U.S. annually. It is a fundamental component in the evaluation and management of both malignant and benign hematologic conditions. Adult patients are generally assured that the BMP is a safe procedure with minimal risk, albeit briefly painful. Traditionally performed using a manual Jamshidi needle, the procedure is increasingly being performed using powered bone marrow kits, which have shown consistently good results. In the current review we describe three cases of gluteal artery injuries following the powered driver procedure, one of which resulted in the formation of a pseudoaneurysm requiring radiology-guided intervention. We highlight the need for both hematologists and patients to be aware of this potentially life threatening complication as well as how to recognize it clinically and institute timely diagnostic and therapeutic measures. Full article

4 pages, 624 KiB

Open AccessCase Report

Enterococcus raffinosus Infection with Atypical Hemolytic Uremic Syndrome in a Multiple Myeloma Patient after Autologous Stem Cell Transplant

by Pankaj Mathur, Blake Hollowoa, Nupur Lala, Sharmilan Thanendrarajan, Aasiya Matin, Atul Kothari and Carolina Schinke

Hematol. Rep. 2017, 9(3), 7094; https://doi.org/10.4081/hr.2017.7094 - 26 Sep 2017

Cited by 5 | Viewed by 519

Abstract

Autologous hematopoietic stem cell transplant (AHSCT) is the standard of care in the treatment of multiple myeloma worldwide. Infections are one of the most common complications of the chemotherapy regimen and AHSCT. Thrombotic microangiopathies are one of the rare but potentially life-threatening complications [...] Read more.

Autologous hematopoietic stem cell transplant (AHSCT) is the standard of care in the treatment of multiple myeloma worldwide. Infections are one of the most common complications of the chemotherapy regimen and AHSCT. Thrombotic microangiopathies are one of the rare but potentially life-threatening complications of infections associated with AHSCT. Thrombotic thrombocytopenic purpura and hemolytic uremic syndrome (HUS) are two most common type of thrombotic microangiopathies. The HUS is classically related to diarrheal illness such as with E. coli strain O157: H7 that produce Shiga-like toxins. But it has never been described with Enterococcus raffinosus urinary tract infections (UTI). Here we are describing a case of atypical HUS associated with Enterococcus raffinosus UTI in a patient with multiple myeloma after AHSCT. The management of atypical HUS especially after AHSCT is challenging. Eculizumab, a humanized monoclonal antibody against complement protein C5, and thrombomodulin have emerging role in the management of some cases, but more studies are needed to define evidence-based management of this condition. Full article

4 pages, 94 KiB

Open AccessBrief Report

Managing Acute Promyelocytic Leukemia in Patients Belonging to the Jehovah’s Witness Congregation

by Anand P. Jillella, Martha L. Arellano, Leonard T. Heffner, Manila Gaddh, Amelia A. Langston, Hanna J. Khoury, Abhishek Mangoankar and Vamsi K. Kota

Hematol. Rep. 2017, 9(3), 7083; https://doi.org/10.4081/hr.2017.7083 - 26 Sep 2017

Cited by 4 | Viewed by 515

Abstract

Acute promyelocytic leukemia (APL) is a hyper-acute leukemia and presents with cytopenias and disseminated intravascular coagulation. Jehovah’s Witnesses with APL offer a unique challenge during induction by refusing transfusion and pose a difficult challenge in this curable disease. Our focus over the last [...] Read more.

Acute promyelocytic leukemia (APL) is a hyper-acute leukemia and presents with cytopenias and disseminated intravascular coagulation. Jehovah’s Witnesses with APL offer a unique challenge during induction by refusing transfusion and pose a difficult challenge in this curable disease. Our focus over the last 8 years has been decreasing early deaths in APL in both academic and community centers. As a result we have extensive experience in APL induction with a proven improvement in early deaths. Three patients with APL belonging to the Jehovah’s Witness congregation were treated in our practice and published literature in treating Witnesses with APL was reviewed. It is highly imperative to prevent induction mortality in this patient population. The goal of treatment among the Witnesses is to prevent death during induction and subsequently cure them. We discuss the management and proactive measures to prevent induction mortality in this most curable blood cancer. Full article

1 pages, 82 KiB

Open AccessEditorial

Safety and Efficacy of Ibrutinib in a Patient with Severe Renal Impairment

by Kalman Filanovsky and Lev Shvidel

Hematol. Rep. 2017, 9(3), 7078; https://doi.org/10.4081/hr.2017.7078 - 26 Sep 2017

Cited by 1 | Viewed by 329

Abstract

Ibrutinib (Imbruvica) is a first-in-class oral inhibitor of Bruton’s tyrosine kinase (BTK), an essential enzyme in B-cell receptor signaling pathway [...] Full article

7 pages, 657 KiB

Open AccessArticle

Single Step Multiple Genotyping by MALDI-TOF Mass Spectrometry, for Evaluation of Minor Histocompatibility Antigens in Patients Submitted to Allogeneic Stem Cell Transplantation from HLA-Matched Related and Unrelated Donor

by Federica Cattina, Simona Bernardi, Vilma Mantovani, Eleonora Toffoletti, Alessandra Santoro, Domenico Pastore, Bruno Martino, Giuseppe Console, Giovanni Martinelli and Michele Malagola

Hematol. Rep. 2017, 9(3), 7051; https://doi.org/10.4081/hr.2017.7051 - 26 Sep 2017

Cited by 5 | Viewed by 418

Abstract

The outcome of patients underwent to allogeneic stem cell transplantation (allo- SCT) is closely related to graft versus host disease (GvHD) and graft versus leukemia (GvL) effects which can be mediated by mHAgs. 23 mHAgs have been identified and reported to be differently [...] Read more.

The outcome of patients underwent to allogeneic stem cell transplantation (allo- SCT) is closely related to graft versus host disease (GvHD) and graft versus leukemia (GvL) effects which can be mediated by mHAgs. 23 mHAgs have been identified and reported to be differently correlated with GVHD or GVL and the aim of this work was develop a method to genotype the mHAgs described so far. For this study we used MALDI-TOF iPLEX Gold Mass Array technology. We tested 46 donor/recipient matched pairs that underwent allo-SCT because of Philadelphia positive (Ph+) chronic myeloid leukemia (n = 29) or Ph+ acute lymphoblastic leukemia (n =17). Our data show that sibling pairs had a lesser number of mHAgs mismatches compared to MUD pairs. Notably, donor/recipient genomic mismatch on DPH1 was correlated with an increased risk of acute GvHD and LB-ADIR-1R mismatch on graft versus host direction was correlated with a better RFS with no increase of GvHD risk. Our work provides a simple, accurate and highly automatable method for mHAgs genotyping and suggest the role of mHAgs in addressing the immune reaction between donor and host. Full article

4 pages, 228 KiB

Open AccessBrief Report

Clinical and Experimental Efficacy of Gemtuzumab Ozogamicin in Core Binding Factor Acute Myeloid Leukemia

by Michele Gottardi, Federico Mosna, Sergio de Angeli, Cristina Papayannidis, Anna Candoni, Marino Clavio, Cristina Tecchio, Andrea Piccin, Marta Campo dell’Orto, Fabio Benedetti, Giovanni Martinelli and Filippo Gherlinzoni

Hematol. Rep. 2017, 9(3), 7028; https://doi.org/10.4081/hr.2017.7028 - 26 Sep 2017

Cited by 14 | Viewed by 665

Abstract

Leukemia-initiating cells of core binding factor (CBF) acute myeloid leukemia (AML) likely derive from early committed hematopoietic precursors expressing CD33. As such, targeting CD33 could ameliorate the chance of cure of CBF AML patients. We compared 12 CBF AML patients treated with Fludarabine, [...] Read more.

Leukemia-initiating cells of core binding factor (CBF) acute myeloid leukemia (AML) likely derive from early committed hematopoietic precursors expressing CD33. As such, targeting CD33 could ameliorate the chance of cure of CBF AML patients. We compared 12 CBF AML patients treated with Fludarabine, Cytarabine, Idarubicin and Gemtuzumab Ozogamicin (FLAI-GO regimen) with 25 CBF AML patients treated with the same schedule, but without GO. With the limit of small numbers, we observed a consistent trend toward better overall survival, disease free survival and event free survival in the FLAI-GO group. We also demonstrated the ability of GO to induce the disappearance in vitro of the AML1-ETO molecular transcript in a polymerase chain reaction-positive graft without decreasing the clonogenic potential of CD34+/CD38- cells. This represent the proof of principle for using GO in a purging strategy before autologous stem cell transplantation. Therefore, our data argue in favor of the reinstitution of GO in the therapy of CBF AML. Full article

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Hematol. Rep., Volume 9, Issue 3 (September 2017) – 8 articles

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