INFILTRATION OF ROUND BLUE CELL TUMORS IN BONE MARROW

  ABSTRACT: Objective: To identify the different types of Round Blue cell tumors on bone marrow biopsy and their pattern of marrow infiltration. Methodology: This Cross-sectional descriptive study was conducted at the Department of Hematology, Armed Forces Institute of Pathology (AFIP), Rawalpindi from July 2021 to December 2021. A total of 60 diagnosed cases of round blue cell tumors were included in this study. Patients with acute lymphoblastic leukemia (ALL) and patients of round blue cell tumors on treatment were not included in this study.Bone marrow aspiration and biopsy were performed. Peripheral film results, clinical observations, and patterns of marrow infiltration of Round Blue cell malignancies were reported on Statistical Package for the Social Sciences (SPSS) version 23 was used for data analysis. Results:Our investigation revealed a male to female ratio of 2:1, with 40 (66.6%) males and 20 (33.3%) females. The overall average age was 5.695.0years. Ewing sarcoma and Rhabdomyosarcoma patients did not exhibit infiltration, however three instances of retinal blastoma (9.37%) and two cases of Neuroblastoma (10.52%) did. IHC results for Synaptophysin and Chromgranin indicated positive results for Retinoblastoma and Neuroblastoma, while S100 results were positive for Neuroblastoma infiltration and negative for Retinoblastoma.Both Retinoblastoma and Neuroblastoma showed diffuse, focal and interstitial pattern of infiltration on trephine biopsy. Conclusion:Small round blue cell tumors were noted in bone marrow infiltration 5 (8.33%) cases. Early detection of malignant cancers necessitates appropriate medical care and in more severe cases need of neoadjuvant chemotherapy. Key words: Small round blue cell tumors, Neuroblastoma, Retinoblastoma.     &nbsp

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population.The aim of this study was to inform vaccination prioritization by modelling the impact of vaccination on elective inpatient surgery. The study found that patients aged at least 70 years needing elective surgery should be prioritized alongside other high-risk groups during early vaccination programmes. Once vaccines are rolled out to younger populations, prioritizing surgical patients is advantageous