Efficacy and safety of convalescent plasma therapy in patients with COVID-19: arapid review of case series

Coronavirus disease 2019 (COVID-19) has become a world pandemic since early 2020.Currently, there is no established treatment to combat this potentially fatal disease. Convalescent plasma (CP) therapy has a strong scientific basis and historical perspective to treat previous viral infections such as Ebola, Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS). The aim of this review was to evaluate the efficacy and safety of convalescent plasma CP therapy in patients with COVID-19.We searched for every available study from major databases (CENTRAL, MEDLINE via Ovid, EMBASE) through 20th April 2020. We independently screened, extracted, assessed the risk of bias, analyzed the data using SPSS version 26, and narratively summarized the data. For the outcomes, we wanted to evaluate the changes of clinical parameters, radiological appearance, pulmonary function, the titer of neutralizing antibody, viral load, the disappearance of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) RNA, and adverse events.We found five case series from our literature searching. The overall methodological quality of the case series was moderate. We included 27 patients, and all patients received CP transfusion. All patients experienced improvement of clinical symptoms and pulmonary lesions after receiving 200 to 2400 mL (median 200 mL) of CP transfusion. All patients in reported studies had negative results of reverse transcriptase-polymerase chain reaction(RT-PCR) after 1 to 26 days of transfusion (median 3 days). There was one non-life threatening adverse event reported after CP transfusion (facial red spot). In conclusion, CP therapy in COVID-19 patients showed promising results as it improved clinical symptoms and parameters, and it is well-tolerated based on our included studies. However, further expanded clinical trials with better designs are still required to evaluate the efficacy of this treatment although suchidea will be quite challenging to be conducted in the era of an epidemic

Telomere and telomerase in hematological disorders Focusing on bone marrow failure syndromes and hematological malignancies

ABSTRACTWe review the present knowledge of telomeres and telomerase with special attention to their role in hematological disorders especially bone marrow failure syndromes including acquired aplastic anemia and myelodysplastic syndromes, as well as acute and chronic myeloid leukemia. The current understanding on the role of telomere and telomeres dysfunctions in hematological disorders leads us to a better understanding on the pathology of the diseases as well as considering some possibilities to employ the measurement of telomere length and telomere activity in disease prognostication. Several treatment options targeting telomere and telomerase being developed are also reviewed.Keywords: telomere- telomerase- bone marrow failure syndromes- hematological malignancie

Comparison of Prognostic Scores in Chronic Myeloid Leukemia (Cml) Patients with Bcr-Abl Mutation Types B3a2 and B2a2 in Dr. Sardjito General Hospital

Background. Chronic Myeloid Leukemia (CML) is a myeloproliperative malignancy that is caused byreciprocal translocation between chromosomes 9 and 22 which form the BCR-ABL fusion gene. Most CML patients have a major type of BCR-ABL mutation. There are b3a2 and b2a2 types, which produce different oncoproteins in 25 amino acid elements. The expression of different proteins is thought to cause differences in clinical manifestations, laboratory, and prognosis. In CML, there are several prognostic scoring systems, including Sokal, Hasford, andEUTOS scores which combine clinical and laboratory parameters. The effect of this genomic breakpoint location on clinical and biological characteristics is still controversial.Aims. The aim of this study was to determine the comparison of prognostic scores between CML patients with b3a2 and b2a2 BCR-ABL mutation types in Dr. Sardjito General Hospital.Methods. This study was a cross sectional retrospective study used secondary data from medical records of Dr. Sardjito General Hospital, from March 2014 to April 2016. The prognostic score of Sokal, Hasford, and EUTOS was calculated in the BCR-ABL mutation type groups b3a2 and b2a2. Data were analyzed by Chi Square test.Results. A total of 113 CML patients were analyzed with 74 (65.5%) b3a2 mutation type groups and 39 (34.5%) b2a2 mutation type groups. Hemoglobin levels, leukocytes, platelets, basophils, and eosinophils did not differ significantly between the two groups of mutation types. Meanwhile, the statistical test for the phase of disease when the patient was first diagnosed in both types of mutations showed a significant difference (p = 0.005). More patients with types of b2a2 mutations came in the acceleration and blast crisis phases than b3a2 types. However, Sokal, Hasford, and EUTOS prognostic scores in the b3a2 mutation type group were not significantly different from the b2a2 group (p> 0.05).Conclusions. There was no significant difference in prognostic scores of CML patients with the b3a2 BCRABL mutation type compared with the b2a2 mutation type in Dr. Sardjito General Hospital Yogyakarta

Prognostic Value Of Chemotherapy-Induced Neutropenia In Metastatic Colorectal Cancer At Rsup Dr Sardjito Yogyakarta

Background: Colorectal cancer is the third largest incidence of cancer in the world and is the third most common cause of death in women and men . Five-year overall survival (OS) in colorectal cancer who have undergone metastasis was 10 % . Hematologic toxicity may be a marker of biological activity of cytotoxic drug on various types of cancer . Neutropeniaafter chemotherapy known to be associated with increased patient survival .Objective : To establish whether chemotherapy-induced neutropenia is predictive of better outcome in patients with metastatic colorectal cancer (mCRC).Methods: This research was a case-control study. Subjects were patients with metastatic colorectal cancer in the Cancer Instalation Center Tulip RSUP dr. Sardjito who meet the inclusion and exclusion criteria. Data were analyzed by bivariate analysis using chi square test and multivariate analysis with logistic regression.Results: Neutropenia present in 26 patients (32.5%) of the total 80 patients of the study. Neutropenia were significantly affect OS ( p = 0.001 and OR 7.73, 95% CI: 2.51-23.80). Multivariate logistic regression analysis showed neutropenia and the number of metastases affect OS with p <0.001 and p <0.003.Conclusion: Neutropenia occurring during the two first lines of chemotherapy for metastases colorectal cancer is associated with better survival. Variables that affect OS is the number of metastases and incidence of neutropenia after chemotherapy

Secondary acute myeloblastic leukemia after adjuvant chemotherapy and radiotherapy in breast cancer: A case report

A rising number of long-term survivors and potential long-term outcome related to the treatment isone of the most important issue due to the advances of management in cancer. The development ofsecondary malignancy has been reported in a number of cohorts. We present a case of breast cancerpatient developing acute myeloid leukemia (AML)- M5 within a relatively short interval of two and ahalf years from her primary treatment with adjuvant chemotherapy with 4 cycles of doxorubicin andcyclophosphamide, followed by 4 cycles of three weekly paclitaxel (AC-T) and radiotherapy. Whatcould be attributed to the occurrence of secondary leukemia in this patient will be discussed

A Stability Mathematical Model of Nasopharyngeal Carcinoma on Cellular Level

This paper discussed the stability of “Tumorigenesis Models†to link between EBV and carcinoma of the nasopharyngeal from normal cell to invasive carcinoma. The review on this case accomplished the previous theorem of equilibrium point on “Tumorigenesis Modelsâ€

The Effect of Weight Gain on Recurrence During Hormonal Therapy in Breast Cancer with Positive Estrogen Receptor and Negative Her2 Subtype

Background. Weight gain is found in patients with positive estrogen subtype breast cancer. The effect of weight gain on breast cancer recurrence is still being debated and associated with a poor prognosis. Being overweight is associated with an increase in estrogen production by adipose tissue.Methods. A retrospective and prospective cohort study with data collection was conducted from July 2018 - June 2019 at the outpatient unit of Dr. Sardjito Hospital. We reviewed medical records of patients who came from January 2013 - July 2018.  Three categories of weight gain:  weight loss, increase 0 - 5%, and increase > 5% from baseline will be evaluated.Statistical Analysis. The relationship between weight gain and some risk factors of recurrence was analyzed with cox regression and multivariate logistic regression tests. The Kaplan Meier method is used to show lifetime data.Result. Weight gain in breast cancer patients with positive Her2-negative estrogen receptor subtypes was not associated with recurrence (p = 0.264; HR 0.637; 95% CI 0.289 - 1.405). Patients with body mass index ≥ 25 kg / m2 at diagnosis had a lower risk of relapse than patients with body mass index < 25 kg / m2 (p = 0.026; HR 0.461; 95% CI, 0.234 - 0.912).Conclusions Weight gain after diagnosis in breast cancer patients with positive estrogen receptor-negative Her2 subtypes receiving hormonal therapy is not associated with recurrence

Link of Nasopharyngeal Carcinoma and Epstein-Barr Virus

Nasopharyngeal Carcinoma (NPC) is a cancer that occurs in nasopharynx which is associated with Epstein-Barr Virus (EBV). Mutation agents in nasopharyngeal neoplasms occur because of EBV infection. Transformation of B-cells due to EBV causes hormone imbalance in lymphoid cells or nasopharyngeal epithelial tissue. Rates of EBV infection have been shown to be prognostic to NPC. The basic level of EBV DNA can be used for stratification prognosis, with higher titers showing greater disease severity and worse outcomes. With mathematical models, there is a correlation between the increase in Epstein-Barr Virus and the increase in Invasive Carcinoma Cells or increase in Nasopharyngeal Carcinoma Cells

Analysis of a Mathematical Model of the Interaction between PIP3, AKT, and FOXO3a in Acute Myeloid Leukemia

Yudi Ari Adi, Lina Aryati, Fajar Adi-Kusumo, and Mardiah Suci Hardiant