The Benefit of Telemonitoring in the Prevention of Septic Shock in a Patient with Aggressive Non-Hodgkin’s Lymphoma

Telemonitoring is a great tool for vital signs monitoring in patients at high risk of severe life-threatening infections, such as haemato-oncological patients. As it can detect early symptoms of an infection, it allows early reaction and, therefore, can help prevent the progression of the infection into severe sepsis. We present a case report of a 69-year-old patient with aggressive non-Hodgkin lymphoma undergoing intensive immunochemotherapy. The treatment was complicated by two episodes of Gram-negative bacterial (G−) infection. During the first episode, the patient was admitted to the hospital only after developing septic shock with multiorgan dysfunction syndrome, which required vasopressor support and multiple broad-spectrum antibiotics and other antimicrobial therapy. Following this episode, the patient was enrolled in our telemonitoring project focusing on early detection of infections in high-risk haemato-oncological patients. The patient later developed another infection with G− bacteremia; however, thanks to the telemonitoring, he was admitted to the hospital within a few hours after developing (and detecting) fever. The therapy was initiated immediately, and the infection was successfully managed with first-choice antibiotics without any further complications. This case illustrates the importance of early detection of infection in high-risk patients, as well as the benefits of telemonitoring. Moreover, avoidance of septic shock and the consequent need for intensive care can significantly reduce healthcare costs

Involvement of Small Non-Coding RNA and Cell Antigens in Pathogenesis of Extramedullary Multiple Myeloma

Extramedullary multiple myeloma (EMD) is an aggressive disease; malignant plasma cells lose their dependence in the bone marrow microenvironment and migrate into tissues. EMD is a negative prognostic factor of survival. Using flow cytometry and next-generation sequencing, we aimed to identify antigens and microRNAs (miRNAs) involved in EMD pathogenesis. Flow cytometry analysis revealed significant differences in the level of clonal plasma cells between MM and EMD patients, while the expression of CD markers was comparable between these two groups. Further, miR-26a-5p and miR-30e-5p were found to be significantly down-regulated in EMD compared to MM. Based on the expression of miR-26a-5p, we were able to distinguish these two groups of patients with high sensitivity and specificity. In addition, the involvement of deregulated miRNAs in cell cycle regulation, ubiquitin-mediated proteolysis and signaling pathways associated with infections or neurological disorders was observed using GO and KEGG pathways enrichment analysis. Subsequently, a correlation between the expression of analyzed miRNAs and the levels of CD molecules was observed. Finally, clinicopathological characteristics as well as CD antigens associated with the prognosis of MM and EMD patients were identified. Altogether, we identified several molecules possibly involved in the transformation of MM into EMD