Survival outcomes of hypomethylating agents maintenance therapy in new diagnosed AML patients: Real experience data

OBJECTIVE: Acute myeloid leukemia (AML) is a hematological malignancy that frequently affects elderly population. With introducing the hypomethylating agents (HMAs) in elderly AML treatment, survival rates and quality of life have improved. However, long-term management in elderly and frail patients is still a challenge. In the present study, we aimed to determine whether HMA maintenance therapy is required until disease progression in frail and elderly AML patients by examining with a real-life data.METHODS: In a multicenter study, we analyzed non-promyelocytic elderly AML patients who were treated with first-line azacitidine or decitabine monotherapy in two different groups, retrospectively. While patients were treated with HMA until progression in the maintenance group, 6+3 cycles of azacitidine or decitabine were administered as a standard care of elderly AML patients in the non-maintenance group. Survival outcomes were compared between the groups.RESULTS: HMA therapy was maintained until progression in 20 patients, and HMA therapy was terminated after 6+3 cycles in 21 patients. Patients received a median of 6 (1-14) HMA cycles during follow-up time. The median 7.5 months of overall survival were observed (2-17 months) in maintenance and 3 months (1-13 months) in non-maintenance groups (p=0.001).CONCLUSION: Despite long-term exposure to HMA may appear as a risk factor for complications and toxicities in elderly and frail AML patients, the maintenance of therapy until disease progression provides a significant survival advantage. Therefore, we suggest that HMA therapy should continue until disease progression regardless the sort of HMA

Relapsed refractory multiple myeloma with CNS involvement successfully treated with Elranatamab: First reported case

Central nervous system (CNS) involvement in multiple myeloma (MM) is a rare and challenging complication associated with poor prognosis and limited treatment options. Emerging T-cell directing therapies, such as bispecific antibodies (bsAbs) and chimeric antigen receptor T cells (CAR-T), have shown remarkable success in treating MM, but their efficacy in CNS involvement remains unclear. Elranatamab, a humanized bispecific antibody targeting B-cell maturation antigen (BCMA) and CD3-expressing T cells, has demonstrated promising results in relapsed refractory MM. However, its efficacy in treating CNS-MM has not been reported. We present a case of a 37-year-old male MM patient with CNS involvement who has been successfully treated with Elranatamab

The prognostic impact of comorbidity, nutritional and performance status on patients with diffuse large B cell lymphoma

Background: The aim of the study was to investigate the impact of nutritional status, comorbidity, and performance status on patients with diffuse large B-cell lymphoma (DLBCL). Methods: A retrospective study was conducted on 112 DLBCL patients who were diagnosed at our center between 2009 and 2018. Demographic and disease characteristics and laboratory test results were recorded. Assessments were made using the age-adjusted Charlson comorbidity index (CCI-A) for comorbidity, albumin level for nutritional status, and Eastern Cooperative Oncology Group (ECOG) score for performance status. Results: The mean age of the patients was found to be 62.63 ± 15.16 years. The ECOG score of 65 patients (69.1%) was in the range of 0-1. The mean follow-up time of the patients was determined to be 25.24 ± 25.11 months, and at the end of the follow-up period, 64 patients (57.1%) were survivors. The progression-free survival (PFS), overall survival (OS), and 5-year OS rates of those with CCI-A > 4 were found to be significantly lower than those with CCI-A score ≤4 (P < 0.05). As a result of the Cox-Regression (Backward: LR method) analysis, ECOG and albumin levels were found to be independent risk factors for both OS and PFS (P < 0.05). Conclusion: This study demonstrated that CCI-A, ECOG, and nutritional status are independent prognostic markers for DLBCL patients. Initial evaluation of these patients should include all these parameters, which are easily available at the time of diagnosis

Does blood type have an effect on the course of COVID-19?

Introduction Predictive parameters that can affect the course of this infection have been the main topic of research since the beginning of the COVID-19 (Coronavirus disease 2019) pandemic. Since the discovery of blood groups, the effect of these on infectious diseases has always been of interest. Objectives To analyze the effect of ABO blood group on mortality, hospitalization duration and hematological and cytokine storm parameters in patients with COVID-19. Patients and methods: This retrospective study was conducted on 140 patients diagnosed with COVID-19. Demographic characteristics, laboratory parameters including ABO blood group, complete blood count (CBC) parameters, biochemical tests, cytokine storm parameters, duration of hospitalization, and final status (discharge or death) were recorded. Results: The 140 patients included in the analysis comprised 72 (51.4%) males and 68 (48.6%) females with a mean age of 66.3±14.0 years. . Age and gender, hospitalization duration and mortality rates were similar in all blood group types. Only D-dimer levels were found to be higher in blood group A compared with other blood groups. Conclusion: Although no difference in mortality was determined between groups, the D-dimer level was statistically significantly higher in COVID-19 patients with A blood group. Larger studies are needed to reflect D-dimer levels on the clinical course of infection, and thus on daily practice

Single Centre Experience: Bening and Malign Hematological Patients with COVID-19

Introduction Coronavirus disease 2019 (COVID-19) were declared as pandemic by World Health Organization. With this study, we aimed to define our patients who were followed up with malign or benign hematological diagnoses and diagnosed with COVID-19; determine the distribution of this infection in patient groups and contribute to the literature by creating descriptive statistics with its clinical and demographic features. Patients and methods: It is planned to retrospectively examine patients with a history of COVID-19 who were followed up in Hematology Department of Dışkapı Yıldırım Beyazıt Training and Research Hospital with benign and malignant diagnoses. Results: 88 patients who had COVID-19 infection while being followed in our clinic due to hematological diseases were included in the study. 77 patients had been followed by hematologic malignancies and 11 patients had been followed by benign hematological disease.In the group with malignancy, COVID was found most frequently in patients diagnosed with Philadelphia chromosome negative myeloproliferative neoplasms (22%), nonhodgkin lymphoma (19%) and multiple myeloma (16%). ITP (64%) was the most common disease in patients with benign hematological disorder who had COVID history. 52 (67%) of the malignant cases and 8 (73%) of the bening cases were found to be followed up with the disease in remission. The all patient's most common symptoms at COVID-19 diagnosis were fever (77%), cough (70%) and weakness (65%). 45% of the patients were isolated at home, 48% were required hospitalization. 49% of patients had mild; 27% had moderate and 24% had severe COVID-19 infection. Almost all of the patients in the moderate and severe disease group were followed up in patients diagnosed with malignant hematological disease. 16 (18%) patients received mechanical ventilation and 16 (18%) patients was transferred intensive care unit. All of the patients who were intubated and needed intensive care were diagnosed with malignant hematological disease. 17 patients died due to COVID-19 infection. The mortality rate was 22% in patients with diagnosis of malignant hematological diseases, and 19% when all patients (malignant and bening) were included. Conclusion: In conclusion, the COVID-19 pandemic is a problem all over the world. Determining the course of the disease in certain diagnostic groups is important in the management of both the main disease and the COVID-19 infection. Therefore, the contribution of such recording studies to the literature is important and valuable