Hematology Reports

7 pages, 118 KiB

Open AccessReview

The Molecular Pathogenesis of Multiple Myeloma

by Niccolò Bolli, Giovanni Martinelli and Claudio Cerchione

Hematol. Rep. 2020, 12(3), 9054; https://doi.org/10.4081/hr.2020.9054 - 18 Dec 2020

Cited by 11 | Viewed by 1733

Multiple Myeloma (MM) is characterized by uncontrolled proliferation and accumulation of clonal plasma cells within the bone marrow. However, the cell of origin is a B-lymphocyte acquiring aberrant genomic events in the germinal center of a lymph node as off-target events during somatichypermutation and class-switch recombination driven by activation-induced-deaminase. Whether pre-germinal center events are also required for transformation, and which additional events are required for disease progression is still matter of debate. As early treatment in asymptomatic phases is gaining traction in the clinic, a better understanding of the molecular pathogenesis of myeloma progression would allow stratification of patients based on their risk of progression, thus rationalizing efficacy and cost of clinical interventions. In this review, we will discuss the development of MM, from the cell of origin through asymptomatic stages such as monoclonal gammopathy of undetermined significance and smoldering MM, to the development of symptomatic disease. We will explain the genetic heterogeneity of MM, one of the major drivers of disease recurrence. In this context, moreover, we will propose how this knowledge may influence future diagnostic and therapeutic interventions. Full article

6 pages, 439 KiB

Open AccessReview

Elucidating the Pivotal Role of Convalescent Plasma Therapy in Critically Ill COVID-19 Patients: A Review

by Seidu A. Richard, Sylvanus Kampo and Maite Esquijarosa Hechavarria

Hematol. Rep. 2020, 12(3), 8630; https://doi.org/10.4081/hr.2020.8630 - 2 Dec 2020

Cited by 3 | Viewed by 733

Abstract

World Health Organization (WHO) declared coronavirus disease (COVID-19) a pandemic in March 2020. Currently almost every country in the world has reported cases with moderate to high mortality rates. The European Union (EU), the United States of America (USA) and the United Kingdom (UK) are the severely affected countries. Nevertheless, the WHO is very much concern about countries with weak health systems. The clinical characteristics of COVID-19 varies extensively, ranging from asymptomatic infections to severe as well as critical pneumonia with high mortality rates in the elderly and patients with co-morbid medical illness. Convalescent Plasma Therapy (CPT) has been successfully used in treating various viral disease outbreaks such as 1918 influenza pneumonia pandemic, poliomyelitis, measles, mumps, Machupo virus, Junin virus, Lassa virus, Ebola etc. High-titer specific antibodies maybe capable of binding to Coronavirus-19 (CoV-19) and neutralize the viral particles, inhibit entry to uninfected cells, and trigger potent effector mechanisms such as complement activation as well as phagocytosis. Therefore, in most countries with very weak health systems with no Intensive Care Units (ICUs) or trained ICU physicians, early initiation of CPT for severely COVID-19 patients may be rewarding. Therefore, solidarity control trials on CPT for COVID- 19 patients involving large number of patients are urgently needed. Full article

3 pages, 380 KiB

Open AccessReview

Successful Long-Term Treatment with Azacitidine in Patient with Chronic Myelomonocytic Leukemia

by Luka Čemažar, Helena Podgornik, Njetočka Gredelj Šimec and Samo Zver

Hematol. Rep. 2020, 12(3), 8537; https://doi.org/10.4081/hr.2020.8537 - 2 Dec 2020

Cited by 2 | Viewed by 622

Abstract

The purpose of this article was to present a case of successful long term treatment with azacitidine in patient with Chronic Myelomonocytic Leukemia (CMML) and discussing possible contributing factors for its long term efficacy. Data from our case were compared with similar data available in the literature. Effective treatment with azacitidine resulted in overall survival of 11 years 5 months and we showed that applying multiple cycles of treatment is feasible. Our patient received 71 cycles of treatment with total duration of 7 years and 3 months. Our report about a patient with CMML and a good clinical course revealed, that long term treatment with azacitidine is feasible in some patients. Initially low bone marrow blast count, a relatively small malignant CMML clone, reduction of spleen size and fast platelet response seemed to be factors determining long term response to treatment in our patient. More data on CMML treatment by Hypomethylating Agents and their analysis are needed in order to make firm conclusions. Full article

4 pages, 349 KiB

Open AccessBrief Report

Comparison of Post-Remission Strategies in Acute Myeloid Leukemia: Autologous Hematopoietic Stem Cell Transplantation versus Consolidation Chemotherapy

by Zeynep Arzu Yegin, Asena Dikyar, Lale Aydın Kaynar, Ferda Can, Zübeyde Nur Özkurt and Münci Yağcı

Hematol. Rep. 2020, 12(3), 8380; https://doi.org/10.4081/hr.2020.8380 - 2 Dec 2020

Cited by 2 | Viewed by 553

Abstract

Autologous Hematopoietic Stem Cell Transplantation (auto-HSCT) has become a therapeutic option for first-line consolidation in Acute Myeloid Leukemia (AML) patients with favorable and intermediate risk features. A total of 101 AML patients in first complete remission, who were not eligible for allogeneic HSCT, were randomized to receive intensive cytarabine-based chemotherapy or to undergo auto-HSCT. The probability of LFS was significantly better in auto-HSCT recipients compared to chemotherapy arm (43% vs. 4.8%, p = 0.008). At the end of 915 (30–4470) days of followup, the probability of overall survival was better in auto-HSCT group compared to chemotherapy, without statistical significance (79.2% vs. 38.8%, p = 0.054). Multivariate analysis revealed a significant predictive impact of cytogenetic risk status on OS (p = 0.002, HR: 2.824, 95% CI: 1.445–5.521). Auto-HSCT is considered as an effective consolidation approach in favorable and intermadiate risk AML patients. Full article

5 pages, 361 KiB

Open AccessArticle

Efficacy and Safety of Biosimilar Rituximab (Zytux^TM) in Newly Diagnosed Patients with Non-Hodgkin Lymphoma and Chronic Lymphocytic Leukemia

by Alaa Fadhil Alwan, Manal Ali Abdulsahib, Duaa Dhahir Abbas, Saraa Ali Abdulsattar and Reem Talib Ensaif

Hematol. Rep. 2020, 12(3), 8296; https://doi.org/10.4081/hr.2020.8296 - 2 Dec 2020

Cited by 2 | Viewed by 774

Abstract

Chronic Lymphocytic Leukemia (CLL) and Non-Hodgkin Lymphoma (NHL) are considered parts of mature B cell neoplasms in WHO classification. They are both characterized by accumulation of B cells in blood, lymphoid tissues and bone marrow. Most of treatment protocols of NHL and CLL contain rituximab in addition to chemotherapy, which has been associated with improved survival. The aim of this study was to assess the efficacy and safety of Zytux^TM (AryoGen Pharmed) in newly diagnosed patients with NHL and CLL. A prospective single center study conducted at the National Center of Hematology, Mustansiriyah University, from January 2018 till October 2018. Twenty patients were included in this study, ten of them were NHL and ten patients were CLL. All patients were treated with Zytu^TM in addition to designated protocol. All patient were followed up for 6 months and evaluated at the end of each protocol. There were 20 patients in this study; the overall median age for all patients in this study was 66 years. The median age was 57.5 years for NHL and 68.5 years for CLL. There were 13 males and 7 females in total, with male predominance in both groups. Regarding safety profile, Zytux^TM demonstrated similar adverse reactions in comparison to MabThera^® (Roche Spa). Moreover, the overall response rate in both groups was 85% with complete response achieved in 35% and partial response in remaining 50%.This study concluded that the early results of use of Zytu^TM in NHL and CLL were not inferior to reference drug MabThera^® in contrast it was comparable and even better in term of safety and efficacy. Full article

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Hematol. Rep., Volume 12, Issue 3 (December 2020) – 5 articles

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