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Hemato, Volume 5, Issue 4 (December 2024) – 6 articles

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9 pages, 567 KiB  
Article
Venous Thromboembolism and Decreased Serum Albumin in Children with Acute Lymphoblastic Leukemia: A Challenge for Endothelial Homeostasis?
by Paola Muggeo, Vito Michele Rosario Muggeo, Massimo Grassi, Teresa Perillo, Jessica Forte, Celeste Raguseo and Nicola Santoro
Hemato 2024, 5(4), 434-442; https://doi.org/10.3390/hemato5040032 - 31 Oct 2024
Viewed by 238
Abstract
Background: Serum albumin is crucial for critically ill patients. To date, several reports have focused on the influence of lower albumin levels on poorer prognosis and disease outcome in different subsets of critical clinical conditions varying from sepsis, to cirrhosis, renal failure, and [...] Read more.
Background: Serum albumin is crucial for critically ill patients. To date, several reports have focused on the influence of lower albumin levels on poorer prognosis and disease outcome in different subsets of critical clinical conditions varying from sepsis, to cirrhosis, renal failure, and cancer. In the last few years, investigators reported the role of serum albumin levels in predicting the thrombotic risk in patients with nephrotic syndrome, and, in particular, the degree of hypoalbuminemia seemed to influence the risk of thromboembolism. Decreased serum albumin has been associated with the risk of venous thromboembolism and mortality in adult cancer patients after ending chemotherapy for different malignancies. Aims: We aimed to investigate the role of serum albumin in a cohort of children diagnosed as having VTE (venous thromboembolism) during their treatment for acute lymphoblastic leukemia (ALL) compared to ALL children who did not experience VTE. Methods: A nested case-control study was conducted at the Pediatric Oncology and Hematology Department, University Hospital of Bari. A total of 167 patients were diagnosed as having ALL and treated according to AIEOP-BFM ALL 2000-R2006 protocol. Among these, 12 cases of VTE were recorded and matched to 31 controls, for a total of 43 ALL patients (30 males, aged 1.2–16.6 years) enrolled in the present study. Serum albumin level was collected at diagnosis—before the start of any treatment—(time point 0) and at the moment of the VTE or corresponding time point of the protocol (time point 1). Information on inherited thrombophilia genotype were also recorded. Results: Patients presenting VTE showed a marked reduction of average albumin levels as compared to the control children: t0–t1 1.1 IC (95%) = (0.55, 1.65) vs. 0.31 IC (95%) = (0.08, 0.55); p < 0.005. Conclusions: The reduction of serum albumin levels in our cohort might be an expression of altered vascular and endothelial homeostasis, likely predisposing to VTE. This important clinical observation warrants further larger studies. Full article
(This article belongs to the Section Leukemias)
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14 pages, 439 KiB  
Review
Fasting and Diet: Overview in Chronic Lymphocytic Leukemia
by Alessandra Trojani, Luca Emanuele Bossi and Roberto Cairoli
Hemato 2024, 5(4), 420-433; https://doi.org/10.3390/hemato5040031 - 19 Oct 2024
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Abstract
Background: This review aims to provide an overview of the potential impact of fasting and diet on cancer, and in particular, on chronic lymphocytic leukemia (CLL), which is the most frequent form of leukemia in the Western world. Methods: Experimental and clinical studies [...] Read more.
Background: This review aims to provide an overview of the potential impact of fasting and diet on cancer, and in particular, on chronic lymphocytic leukemia (CLL), which is the most frequent form of leukemia in the Western world. Methods: Experimental and clinical studies have provided evidence of the crucial role of fasting in enhancing cancer treatment and improving outcomes for oncological patients, particularly at the early stages of the disease. Results: Emerging evidence highlights that fasting creates a differential stress response under critical conditions by fostering the survival of normal cells while limiting the survival and growth of cancer cells. Pivotal studies on CLL have highlighted the potential of fasting and dietary components to influence the stromal microenvironment and certain metabolic pathways, thereby affecting cancer cell apoptosis and immune response. In addition, explorative and initial clinical studies suggest that fasting and specific diets can mitigate the toxicity of chemotherapy. Conclusions: Clinical trials are needed to evaluate the efficacy and safety of nutritional and fasting approaches in cancer and CLL. Future investigations could provide new insights into the potential role of diet and fasting in the prevention and treatment of cancer, potentially leading to more effective and personalized therapeutic strategies. Full article
(This article belongs to the Section Leukemias)
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13 pages, 1409 KiB  
Article
Real World Predictors, Timing, and Outcomes of Autologous Stem Cell Transplantation in Patients with Multiple Myeloma
by Lisa Blackburn, Anthony Mansour, Qiuhong Zhao, Francesca Cottini, Abdullah Khan, Naresh Bumma, Srinivas Devarakonda, Elvira Umyarova, Ashley E. Rosko, Jennifer Vaughn, Nidhi Sharma and Don M. Benson, Jr.
Hemato 2024, 5(4), 407-419; https://doi.org/10.3390/hemato5040030 - 14 Oct 2024
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Abstract
Background—Autologous stem cell transplant (ASCT) is integral to the treatment of multiple myeloma (MM), although its absolute necessity in first remission has been recently questioned. We report real-world factors that influence clinical decision-making and outcomes from ASCT in 733 patients with MM. Results—Similar [...] Read more.
Background—Autologous stem cell transplant (ASCT) is integral to the treatment of multiple myeloma (MM), although its absolute necessity in first remission has been recently questioned. We report real-world factors that influence clinical decision-making and outcomes from ASCT in 733 patients with MM. Results—Similar to recent prospective data, we found a significant progression-free survival (PFS) benefit with early versus deferred ASCT (median PFS of 5.1 years versus 2.6 years, p < 0.001); however, there was no significant difference in overall survival (median OS of 8.3 years and 8.6 years, p = 0.21). Patient preference, age, marital status, body mass index, and comorbidities influence ASCT timing. Conclusion—These findings highlight the emerging role of an individualized, shared decision-making model regarding the timing of ASCT between patients and physicians with the myriad of treatment options available in the contemporary era. Full article
(This article belongs to the Section Plasma Cell Disorders)
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11 pages, 1841 KiB  
Article
Molecular Classification of Large B-Cell Lymphoma and High-Grade B-Cell Lymphoma Cases and Association with Outcomes in Morocco
by Mahat Taybi, Zineb Khammar, Noufissa Alami Drideb, Rhizlane Berrady, Sanae Benmiloud, Laila Bouguennouch, Sanae Elfakir, Laila Tahiri, Mohammed Majdoub, Laila Chbani and Nawal Hammas
Hemato 2024, 5(4), 396-406; https://doi.org/10.3390/hemato5040029 - 8 Oct 2024
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Abstract
Background: High-grade B-cell lymphoma with c-MYC and BCL2 and/or BCL6 rearrangements (HGBL-DHL/THL) is a recently identified category in the most recent World Health Organization (WHO) classification. For all tumors displaying the appearance of diffuse large B-cell lymphoma (DLBCL) or high-grade B-cell lymphoma (HGBL), [...] Read more.
Background: High-grade B-cell lymphoma with c-MYC and BCL2 and/or BCL6 rearrangements (HGBL-DHL/THL) is a recently identified category in the most recent World Health Organization (WHO) classification. For all tumors displaying the appearance of diffuse large B-cell lymphoma (DLBCL) or high-grade B-cell lymphoma (HGBL), it is necessary to perform fluorescence in situ hybridization (FISH) in order to achieve an accurate diagnosis. The findings of FISH and immunohistochemistry (IHC) examinations from 50 DLBCL/HGBL samples obtained from Hassan II University Hospital in Fez/Morocco are reported. Methods: This retrospective study included 50 patients diagnosed with DLBCL/HGBL over a period of nine years (2013–2022) and treated with RCHOP chemotherapy protocol. All patients underwent a histological study followed by an immunohistochemical study to confirm the diagnosis and to classify patients according to cell of origin into non-GCB and GCB subtypes; then, a cytogenetic study using FISH was performed to classify patients according to the presence or absence of rearrangements in the c-MYC, BCL2 and BCL6 genes. A comparison was made between the molecular subtypes of DLBCL/HGBL in relation to clinicopathological features and outcomes. Results: Among the 50 cases studied in our population, we found 5 cases of HGBL with DLBCL morphology and 45 cases of DLBCL, which consisted of 13 cases (28.89%) of GCB subtype and 32 cases (71.11%) of non-GCB subtype based on the immunohistochemistry Hans algorithm. After FISH testing of all cases, we found three cases of double-hit lymphoma (DHL) and one case of triple-hit lymphoma (THL). Thus, HGBL-DHL/THL accounted for 8% of the cases. Furthermore, two cases were detected with only one rearrangement in the BCL2 gene and one case harboring a rearrangement in the BCL6 gene. DHL and THL patients and patients with a single rearrangement (BCL2 or BCL6) have a worse prognosis than patients with no rearrangement. Conclusions: DHL and THL are an aggressive entity of HGBL with poorer outcomes in comparison to DLBCL/HGBL NOS. First-line treatment with the RCHOP chemotherapy protocol may not be effective for all aggressive DLBCL cases. More targeted treatment is crucial for better patient outcomes. Full article
(This article belongs to the Section Lymphomas)
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8 pages, 781 KiB  
Case Report
A Rare Case of Primary Bone Follicular Lymphoma with Multiple Osteolytic Lesions: A Case Report and Review of the Literature
by Chiara Togni, Giacinto La Verde, Sabrina Pelliccia, Maria Paola Bianchi, Arianna Di Napoli, Tiziana Lanzolla, Marta Zerunian, Andrea Laghi, Gianluca Maiorana, Ambra Taglietti and Agostino Tafuri
Hemato 2024, 5(4), 388-395; https://doi.org/10.3390/hemato5040028 - 29 Sep 2024
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Abstract
Introduction: Primary bone lymphoma (PBL) is a rare clinical entity, accounting for less than 5% of all extranodal non-Hodgkin lymphomas and approximately 5% of primary bone tumors. Diffuse large B-cell lymphoma (DLBCL) is the most common histotype, accounting for about 80% of all [...] Read more.
Introduction: Primary bone lymphoma (PBL) is a rare clinical entity, accounting for less than 5% of all extranodal non-Hodgkin lymphomas and approximately 5% of primary bone tumors. Diffuse large B-cell lymphoma (DLBCL) is the most common histotype, accounting for about 80% of all PBL cases. Conversely, the incidence of indolent primary bone lymphomas (iPBL) represents less than 1% of all reported PBL cases, and data on these rarer lymphomas are scarce. Drawing on diagnostic criteria developed by the World Health Organization (WHO) and the International Extranodal Lymphoma Study Group (IELSG), we report a rare case of primary bone follicular lymphoma, focusing specifically on the clinical presentation and treatment. Discussion: Additionally, we provide a systematic review of the literature data on this very rare lymphoproliferative entity. Full article
(This article belongs to the Section Lymphomas)
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8 pages, 696 KiB  
Review
The Role of Machine Learning in the Most Common Hematological Malignancies: A Narrative Review
by Teresa Perillo, Marco de Giorgi, Claudia Giorgio, Carmine Frasca, Renato Cuocolo and Antonio Pinto
Hemato 2024, 5(4), 380-387; https://doi.org/10.3390/hemato5040027 - 24 Sep 2024
Viewed by 319
Abstract
Background: Hematologic malignancies are a group of heterogeneous neoplasms which originate from hematopoietic cells. The most common among them are leukemia, lymphoma, and multiple myeloma. Machine learning (ML) is a subfield of artificial intelligence that enables the analysis of large amounts of data, [...] Read more.
Background: Hematologic malignancies are a group of heterogeneous neoplasms which originate from hematopoietic cells. The most common among them are leukemia, lymphoma, and multiple myeloma. Machine learning (ML) is a subfield of artificial intelligence that enables the analysis of large amounts of data, possibly finding hidden patterns. Methods: We performed a narrative review about recent applications of ML in the most common hematological malignancies. We focused on the most recent scientific literature about this topic. Results: ML tools have proved useful in the most common hematological malignancies, in particular to enhance diagnostic work-up and guide treatment. Conclusions: Although ML has multiple possible applications in this field, there are some issue that have to be fixed before they can be used in daily clinical practice. Full article
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