RSS 1.0Haematology
Recent Submissions
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A double-centre retrospective study into rates of postpartum haemorrhage in women on low molecular weight heparinHaemostasis and Thrombosis poster abstract 90 of the 55th Annual Scientific Meeting of the British Society for Haematology, 20-22 April 2015, Edinburgh, UK.
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Acquired isodisomy on chromosome 13 at diagnosis results in impaired overall survival in patients with FLT3-ITD mutant acute myeloid leukaemiaInternal tandem duplication (ITD) mutations in the FLT3 gene on chromosome 13 occur in 25% of patients with acute myeloid leukaemia (AML) and result in impaired overall survival (OS). Patients with a high allelic ratio (AR) of ITD mutant to wild-type FLT3 in genomic DNA have an even poorer prognosis. AR may be a predictor of response to FLT3 inhibitors and may also interact with other mutations in influencing disease risk. AR may be dependent on a number of factors including loss of the wild-type allele. Acquired isodisomy (AID) results in loss of the wild-type allele, through duplication of the mutant allele with segmental loss of the wild-type allele. Although studies have shown the importance of AID at chromosome 13 (AID13) at relapse, the impact of AID13 at diagnosis is unclear. The study reported in this Letter to the Editor aimed to identify the relationship between AID13 and FLT3-ITD AR and investigated the outcomes of patients with AID13.
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Steroid refractory autoimmune haemolytic anaemia secondary to sarcoidosis successfully treated with rituximab and mycophenolate mofetilAutoimmune haemolytic anaemia is not a well-recognised complication of sarcoidosis. We describe the case of a 30-year-old female who presented with acute warm haemolytic anaemia and widespread lymphadenopathy. Sarcoidosis was diagnosed on lymph node biopsy and further investigation. The haemolytic anaemia responded only to a high dose of steroids. Evidence regarding treatment of steroid refractory autoimmune haemolysis secondary to sarcoidosis is lacking. Based on the emergent evidence that both disorders share common immunopathogenic mechanisms involving Th1 and Th17 lymphocytes, our patient was given rituximab and mycophenolate mofetil to successfully suppress the haemolysis and sarcoid activity.
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Efficacy and safety of RCEOP chemotherapy in patients with diffuse large cell lymphoma (DLCL) not fit for anthracyclines are comparable to RCHOPPoster abstract 198 in the section 'Lymphoid Malignancy – Clinical' of the XXXVI World Congress of the International Society of Hematology, hosted by the British Society for Haematology, 18–21 April 2016, Glasgow, UK.
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Haemolytic uraemic syndrome associated with docetaxel in breast cancerConference abstract IGCS-0299 of the 16th Biennial Meeting of the International Gynecologic Cancer Society, Lisbon, Portugal, October 28-31, 2016.
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Immune reconstitution at 12 months can predict superior overall survival in reduced intensity alemtuzumab based conditioning transplant recipients for high risk MDS and AML ; a single centre experiencePhysicians Poster Sessions abstract P245 of the 42nd Annual Meeting of the European Society for Blood and Marrow Transplantation, Valencia, Spain, 3–6 April 2016.
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Full donor whole blood chimerism can predict superior progression free survival in reduced intensity alemtuzumab based conditioning transplant recipients for high risk MDS and AML ; a single centre experiencePhysicians Poster Sessions abstract P246 of the 42nd Annual Meeting of the European Society for Blood and Marrow Transplantation, Valencia, Spain, 3–6 April 2016.
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Severe cytomegalovirus reactivation in patient with low-grade non-Hodgkin’s lymphoma after standard chemotherapyClinically significant cytomegalovirus (CMV) reactivation is not uncommon in patients with severe immunodeficiency secondary to underlying medical disorders or following aggressive immunosuppressive therapy. However, it is less frequently found in patients with low-grade haematological malignancies after nonintensive chemotherapy. We treated a patient at our centre for stage IVB follicular lymphoma with standard chemotherapy who successively developed CMV colitis associated with a CMV viral load of >3 million copies/ml. Four lines of antiviral treatment were necessary to obtain biochemical remission with undetectable CMV levels, with an initially insufficient response to valganciclovir despite therapeutic pre- and posttreatment levels. Subsequently, our patient also developed an infection with Pneumocystis jirovecii pneumonia (PJP) as further evidence of severe immune compromise. This case report demonstrates the importance of including investigations for less common sources of infection when confronted with a patient with a low-grade haematological malignancy and a pyrexia of unknown origin.
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Clinical and treatment‐related features determining the risk of late relapse in patients with diffuse large B‐cell lymphomaIt is still unclear whether there are clinically exploitable differences in the biology and behaviour of early versus late relapses in diffuse large B-cell lymphoma (DLBCL). The present study aimed to analyse a large population-based DLBCL cohort in order to identify (i) the frequency of late relapses (LR), (ii) parameters influencing the risk of LR, and (iii) the impact of introducing rituximab on the occurrence of LR. The data of 7247 DLBCL patients was obtained from the Danish Lymphoma Group Registry. Patients with LR had a lower International Prognostic Index and better performance score than early relapse (ER) patients. The use of radiotherapy lowered only the rate of ER while the use of rituximab yielded a lower occurrence of both ER and LR (P < 0·0001 and P < 0·0001, respectively), possibly suggesting a longer-lasting biological effect. Additionally, we found a female overrepresentation among LR patients that had received a rituximab-containing first line treatment. It was found that patients with LR had a significantly better 5-year overall survival compared to ER patients. In conclusion, LR was more frequently associated with low-risk features than ER. Furthermore, we found that the use of modern immunochemotherapy regimens in DLBCL lowers the risk of both ER and LR.
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A double centre retrospective study into rates of postpartum haemorrhage in women on low molecular weight heparinAn investigation into the rates of PPH in women prescribed LMWH antenatally at two local hospitals.
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Three-month mixed T-cell chimerism followed by donor lymphocyte infusions is associated with superior outcomes in reduced-intensity alemtuzumab based allogeneic stem cell transplants for haematological malignanciesThis European Society for Blood and Marrow Transplantation conference abstract reports that three-month mixed T-cell chimerism followed by donor lymphocyte infusions is associated with superior outcomes in reduced-intensity alemtuzumab based allogeneic stem cell transplants for haematological malignancies.
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COVID-19 in haematology patients : a multicentre West Midlands clinical outcomes analysis on behalf of the West Midlands Research ConsortiumA retrospective study analysing clinical outcomes of adult patients with both an underlying haematological disorder and confirmed COVID-19.
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Non-Hodgkin lymphoma causing hypopituitarism - can imaging help diagnosis and management?Non-Hodgkin lymphomas of the hypothalamus and pituitary are rare. They usually remain clinically silent until onset of compressive features affecting surrounding structures. When symptomatic, patients most commonly present with diabetes insipidus, headaches, ophthalmoplegia and/or bilateral hemianopia. We report a case of a 67-year-old Caucasian female with a history of B-cell lymphoma in complete remission. She presented with left oculomotor nerve palsy and was subsequently found to have a sellar/suprasellar mass lesion on MRI. Alongside hypocortisolism and hypogonadotropic hypogonadism, she developed transient diabetes insipidus during her illness. Her clinical course was characterized by rapid intracranial progression of the sellar mass. MR spectroscopy suggested a diagnosis of lymphoma. Diagnostic biopsy confirmed high-grade diffuse large B-cell CNS lymphoma; this changed the definitive management from surgical excision to chemotherapy. Despite treatment, she succumbed to her illness within 7 months of initial presentation. This case highlights the aggressive nature of CNS lymphomas and the need for a high index of suspicion in an unusual presentation of sellar/suprasellar mass lesions. Learning points: Novel imaging techniques such as MR spectroscopy might help to differentiate some brain tumours from pituitary macroadenomas, but these are not diagnostic.Tissue diagnosis with biopsy and histopathology is the gold standard for deciding management of pituitary fossa mass lesions with atypical presentation.
