Hematologic malignancies of primary bone marrow involvement: a decade's experience in Bahrain

ABSTRACT Introduction: The data on the pattern of primary hematologic malignancies in Bahrain is sparse, although previously published studies suggested rising trends in their incidence. This study aimed to compare with regional and world data and identify any changing trends. Methods: A retrospective cross-sectional chart analysis study was done on all cases of primary hematologic malignancies of bone marrow origin of Bahraini nationals presenting during the 10-year period from January 2005 to December 2014 at the sole oncology referral center in Bahrain during the study period. Results: In a total of 272 cases, the primary hematologic malignancies in decreasing order of frequency with respective median ages at diagnosis were: acute myeloid leukemia (AML; 26.1%, 39 years), acute lymphoblastic leukemia (ALL; 22.8%, 9 years), multiple myeloma (MM, 16.2%, 57 years), chronic myeloid leukemia (CML, 14%, 39.5 years), myelodysplastic syndromes (MDS; 12.5%, 56 years) and chronic lymphocytic leukemia (CLL; 5.5%, 65 years). The overall crude annual incidence rate of these malignancies was 4.8/105 population. Age-specific incidence rates were found to increase dramatically with age, except for ALL, for which it peaked in the pediatric age group. The age-standardized incidence rates (ASIRs) per 105 per year were 1.47 (AML), 1.13 (MM), 0.93 (ALL), 0.85 (MDS), 0.81 (CML) and 0.44 (CLL). Conclusion: The pattern of primary hematologic malignancies in Bahrain shows unique features that distinguish it from trends reported in Eastern and Western world populations.

SARS-CoV-2 vaccination in patients with lymphoid hematologic malignancies / 白血病·淋巴瘤

Patients with lymphoid hematologic malignancies have a poor prognosis after developing SARS-CoV-2 infection, and their seropositivity rate after SARS-CoV-2 vaccination is lower than that of the healthy population. Since most clinical trials of SARS-CoV-2 vaccines do not include immunodeficient populations, the safety and efficacy of various types of SARS-CoV-2 vaccines for patients with lymphoid hematologic malignancies are unclear. Therefore, physicians should decide whether patients with lymphoid hematologic malignancies receive SARS-CoV-2 vaccination and the timing, type and dose of vaccine after taking into full consideration the patient's immune status, type of treatment and the risk of SARS-CoV-2 infection.

Application of high-throughput next-generation sequencing in diagnosis and treatment of myeloid hematologic malignancies in the era of precision medicine / 白血病·淋巴瘤

With the wide application of high-throughput next-generation sequencing (NGS) and other molecular genetic detection technologies, researchers have a more and more in-depth understanding of the pathogenesis of hematologic malignancies, especially of the myeloid hematologic malignancies, which makes the diagnosis and treatment of myeloid hematologic malignancies into an era of precision medicine. At the 64th American Society of Hematology (ASH) Annual Meeting in 2022, there were a series of new progresses regarding the application of NGS in the diagnosis and classification, risk stratification, treatment guidance, and minimal residual disease monitoring of myeloid hematologic malignancies. This article focuses on the progress of NGS application in acute myeloid leukemia, myelodysplastic syndromes and myeloproliferative neoplasms.

The Risk and Survival Analysis of Multiple Malignancies in Hematologic Malignancy Patients: A Single Chinese Center Retrospective Study, 2009 through 2017 / 中国实验血液学杂志

OBJECTIVE@#To explore the risk and location of multiple malignancies in patients with hematologic malignancies who were followed up for 9 years in Jiangsu Province Hospital and to evaluate the impact of the second primary malignancy on survival of patients.@*METHODS@#The incidence and survival of multiple malignancies in 7 921 patients with hematologic malignancies from 2009 to 2017 were analyzed retrospectively.@*RESULTS@#A total of 180 (2.3%, 180/7 921) patients developed second malignancy, of whom 58 patients were diagnosed with hematologic malignancies as the first primary malignancy, and 98 patients developed hematologic malignancies as second primary malignancy, and the other 24 cases were diagnosed with the second malignancy within 6 months after the first primary malignancy was diagnosed, which was difined as multiple malignancies occurring simultaneously. In 180 patients, 18 cases developed two hematologic malignancies successively, and 11 patients developed more than 3 primary cancers (among them, 2 female patients were diagnosed with 4 primary cancers). Patients with lymphoma and multiple myeloma (MM) as the second primary malignancy had poorer survival than patients with lymphoma and MM as the first primary malignancy. Patients with chronic myeloid leukemia as the second primary malignancy were also associated with inferior overall survival.@*CONCLUSION@#In this study, 2.3% of hematologic malignancy patients had multiple mali-gnancies, lymphoma and MM as the second primary malignancy had poor survival.

Research Progress of Long Non-Coding RNA in Hematological Tumors --Review / 中国实验血液学杂志

Long non-coding RNA (lncRNA) is a hot topic in the field of researching tumor pathogenesis, and the importance in hematologic malignancies has been gradually being elucidated. LncRNA not only regulates hematological tumorigenesis and progression through affecting various biological processes such as cell proliferation, differentiation, pluripotency and apoptosis; moreover, abnormal expression and mutation of lncRNA are closely related to drug resistance and prognosis. Thus lncRNA can be used as novel biomarker and potential therapeutic target for hematological tumors. In this review, we will focus on the latest progress of lncRNA in hematological tumors to provide new ideas for the clinical diagnosis, prognostic evaluation together with research and development of target drugs for hematologic malignancies.

Pathogenic characteristics of bloodstream infections in patients with hematological diseases and the impact of stem cell transplantation on them / 中国热带医学

@#Abstract: Objective To investigate the epidemiological characteristics of pathogens causing bloodstream infection in hematology patients during treatment and to compare the effects of allogeneic hematopoietic stem cell transplantation (HSCT) on them, so as to provide evidence for the diagnosis and treatment of bloodstream infection. Methods A total of 292 cases with bloodstream infection in hematology wards of the PLA General Hospital were collected from 2017 to 2021, which were divided into HSCT group and N-HSCT group according to whether performed HSCT or not. The epidemiological characteristics and influence of pathogenic bacteria in blood stream infection were analyzed and compared between the two groups. Results A total of 362 strains of pathogenic bacteria were collected from 292 cases, including 106 strains in HSCT group (84 cases) and 256 strains in N-HSCT group (208 cases). Bloodstream infections were more common in acute myeloid leukemia (130/392, 44.52%), followed by non-Hodgkin's lymphoma (74/292, 25.34%). The rate of once bloodstream infection in HSCT group was higher than that in N-HSCT Group, but the rate of twice bloodstream infections in N-HSCT group was higher. Gram-negative Bacilli were the most common pathogens (56.08%), with Escherichia coli being absolutely dominant (109/362, 30.11%), followed by Klebsiella pneumoniae (39/362, 10.77%). Coagulase-negative staphylococci (CoNS) (107/362, 29.56%) were the most common Gram-positive cocci. The detection rate of fungi in HSCT group (10/106, 9.43%) was significantly higher than that in N-HSCT Group (3.52%). The drug resistance rate of the common pathogenic bacteria was at a high level, and there was a certain proportion of multi-drug resistant strains (except for Pseudomonas aeruginosa). The resistance rates of CoNS to penicillin, gentamicin, moxifloxacin, clindamycin and rifampicin in HSCT group were higher than those in N-HSCT Group. The resistance rate of Escherichia coli to piperacillin/tazobactam, cephalosporins and etapenem in HSCT group was significantly higher than that in N-HSCT group. Conclusions The pathogens of blood stream infection in hematology patients are complicated and various. It is difficult for clinical diagnosis and treatment to detect multiple infections and multiple pathogens. HSCT patients have a higher risk of fungal bloodstream infection and more multi-drug resistant strains detected. Therefore, the identification of bloodstream infection and multi-drug resistant strains associated with HSCT patients should prompt surveillance.

Early integration of palliative care in hematology: an urgency for patients, a challenge for physicians

ABSTRACT Introduction: Early integration between palliative care and other medical specialties in the care of patients with serious illnesses is consolidating itself as good medical practice, based on scientific and ethical evidence. Despite this, palliative care is still not part of the routine care of patients with hematological diseases, even in specialized centers. Objective and method: In this article, we review the benefits and the main barriers described in the literature for early integration of hematology and palliative care. We also point out the challenges encountered in clinical practice, such as end-of-life prognosis assessment in patients with hematological diseases and management of the most common symptoms in hematology. Finally, we review models of integration between palliative care and oncology centers in outpatient and inpatient settings. Results and conclusion: Patients with hematological diseases can greatly benefit from early integration with palliative care, with improvement in symptom control, quality of life, reduction of emotional distress and the development of advanced care directives. It is necessary to make hematologists aware of the benefits of palliative care, provide adequate training for multidisciplinary teams and encourage specific studies of palliative care in patients with hematological diseases.

Enfermedad tromboembólica venosa en hemopatías malignas: un enfoque desde la prevención / Venous thromboembolic disease in hematologic malignancies: a preventive approach

Introducción: La enfermedad tromboembólica venosa es una complicación frecuente en las hemopatías malignas, con incidencia similar a la observada en tumores sólidos de alto riesgo trombótico. Objetivo: Describir la influencia de factores de riesgo y biomarcadores de la enfermedad tromboembólica venosa asociada a hemopatías malignas y su aplicación en el diseño de modelos de evaluación de riesgo para la prevención de esta enfermedad. Métodos: Se realizó una revisión exhaustiva en la literatura especializada de artículos publicados sobre la temática a través de las bases de datos: PubMed, SciELO, ScienceDirect, Medline y el motor de búsqueda Google académico. Análisis y síntesis de la información: En pacientes con hemopatías malignas han sido descritos múltiples factores de riesgo para la ocurrencia de eventos tromboembólicos venosos: moleculares, relacionados con el paciente, la enfermedad y el tratamiento, así como biomarcadores de riesgo. Basados en ellos, varias investigaciones han sido desarrolladas para elaborar y validar modelos predictivos de enfermedad tromboembólica venosa que guíen la estratificación del riesgo y el tratamiento profiláctico de esta enfermedad en hemopatías malignas, aunque aún son insuficientes. Enfermedades como los linfomas y el mieloma múltiple tienen más investigaciones en esta área que el resto de las hemopatías malignas. Conclusión: Se necesita diseñar nuevos modelos de riesgo y validar los existentes en un mayor número de casos; así como desarrollar estudios prospectivos en pacientes con riesgo de eventos tromboembólicos y hemopatías malignas, para realizar una estrategia de prevención primaria personalizada con estratificación de la tromboprofilaxis(AU)

Introduction: Venous thromboembolic disease is a frequent complication in hematologic malignancies with incidence similar to that observed in solid tumors with high thrombotic risk. Objective: To describe the influence of risk factors and biomarkers of venous thromboembolic disease associated with hematologic malignancies and their application in the design of risk assessment models for the prevention of this disease. Methods: An exhaustive review was carried out in the specialized literature of articles published on the subject using the following databases: PubMed, SciELO, ScienceDirect, Medline and the academic Google search engine. Analysis and synthesis of the information: Multiple risk factors for the occurrence of venous thromboembolism have been described in patients with hematologic malignancies: patient-related, disease-related, treatment-related and molecular, as well as biomarkers of risk. Based on these, several investigations have been developed to elaborate and validate predictive venous thromboembolism models to guide risk stratification and prophylactic treatment of venous thromboembolic disease in hematologic malignancies, although they are still insufficient. Lymphomas and multiple myeloma have more research in this area than other hematologic malignancies. Conclusion: There is a need to design new risk models and validate existing ones in a larger number of cases, as well as to develop prospective studies in patients at risk of thromboembolic events and hematologic malignancies, to carry out a personalized primary prevention strategy with thromboprophylaxis stratification(AU)

Infección por SARS-COV-2 en pacientes con neoplasias hematológicas y trasplantes / SARS-COV-2 infection in patients with hematological malignancies and transplants

Resumen La infección por SARS-CoV-2 en pacientes con neoplasias hematológicas y trasplantes de células progenitoras hematopoyéticas (TCPH) puede ser grave y con importante mortalidad. Llevamos a cabo un estudio prospectivo y observacional que tuvo como objetivo describir las características clínicas, epide miológicas y la evolución de la infección por SARS-CoV-2 en pacientes con neoplasias hematológicas y TCPH. Se incluyeron 20 pacientes adultos con una mediana de edad de 58 años y una mediana de score de Charlson de 3. Las infecciones fueron de adquisición comunitaria y nosocomial en el 60% y 40% respectivamente, y el 30% de los pacientes tenía antecedente de contacto con una persona infectada por SARS-CoV-2. El 65% pre sentó infiltrados pulmonares, mayormente con patrón de vidrio esmerilado en la tomografía computarizada de tórax. Casi la mitad de los pacientes tuvo enfermedad grave y crítica, y una alta proporción recibió plasma de convalecientes como tratamiento. Presentaron complicaciones e infecciones hospitalarias el 20% y 15% respec tivamente, y tuvieron una mediana de días de internación prolongada. La mortalidad a 30 días fue del 10%. La infección por SARS-CoV-2 en nuestra población tuvo considerable impacto clínico y epidemiológico.

Abstract. SARS-CoV-2 infection in patients with hematological malignancies and hematopoietic stem cell transplants (HSCT) can be severe and with significant mortality. We carried out a prospective and observational study to describe the clinical and epidemiological characteristics and outcome of SARS-CoV-2 infection in patients with hematological malignancies and HSCT. Twenty adult patients were included with a median age of 58 years and a median Charlson score of 3. Infections were community-acquired and nosocomial in 60% and 40%, respectively, and 30% of the patients had a history of contact with a SARS-CoV-2 infected person. Sixty-five percent had pulmonary infiltrates, mostly with a ground-glass pattern on CT scan. Almost half of the patients had a severe and critical illness, and a high proportion received convalescent plasma as treatment. Twenty percent and 15% had complications and hospital infections, respectively, and had prolonged hospitalization expressed as median days of it. The 30-day mortality was 10%. SARS-CoV-2 infection in our population had a considerable clinical and epidemiological impact.

Research progress of chimeric antigen receptor T cells therapy in hematological malignancies / 中华微生物学和免疫学杂志

From the first time that lymphokine active killer(LAK) cell , were induced in 1982, to the first chimeric antigen receptor T-cell (CAR-T) immunotherapy was used by Dr. Rosenberg in 2010 to successfully treat chronic lymphocytic leukemia (CLL), and Novartis′ CAR-T therapy Kymriah is approved by the FDA for B-lineage acute lymphoblastie leukemia (B-ALL) in 2017, CAR-T immunotherapy has entered a new era. The pipeline of CAR-T therapy is rapidly expanding, including the exploration of new targets. In addition to the research focus on CD19, CD20, CD22 and B cell maturation antigen(BCMA), new research directions such as dual targets, gene edited CAR-T are also constantly advancing. Compared with solid tumors that are limited by factors such as tumors microenvironment, CAR-T immunotherapy has more obvious effects in the field of hematological malignancies, such as the FDA approved CAR-T therapy Yescarta, Kymriah, Tecartus, Breyanzi and Abecma. This article will review the recent research progress of clinical treatment in hematological malignancies.

Leucemia de manifestación aguda y las nuevas alternativas terapéuticas / Leukemia of acute presentation and the new therapeutic alternatives

Resumen La leucemia forma parte de un sinnúmero de malignidades hematológicas que afectan la diferenciación de los leucocitos en la médula ósea. Esta enfermedad se puede clasificar de acuerdo con las características morfológicas, citoquímicas e inmunológicas que expresen los blastos. Las manifestaciones clínicas de la enfermedad, como: anemia, trombocitopenia, dolores óseos, sangrado, procesos infecciosos, hepatoesplenomegalia, entre otros, son consecuencias del proceso de infiltración de los blastos en la médula ósea. La leucemia comprende un grupo heterogéneo de malignidades que representan un desafío diagnóstico y terapéutico, que a la larga generan un efecto biopsicosocial en las familias y los pacientes.

Abstract Leukemia is a part of a lot of hematologic malignancies that affect leukocyte differentiation in the bone marrow. This illness can be classified according to morphologic, cytochemical and immunological characteristics expressed by blast cells. Clinical manifestations, such as: anemia, thrombocytopenia, bone pains, bleeding, infectious processes, hepatosplenomegaly, among others, are a consequence of blast cell infiltration processes in the bone marrow. Leukemia comprises a heterogeneous group of malignancies that represent a diagnostic and therapeutic challenge, which in the long term generates a biospsycosocial impact on families and patients.

Korean Society for Genetic Diagnostics Guidelines for Validation of Next-Generation Sequencing-Based Somatic Variant Detection in Hematologic Malignancies

Next-generation sequencing (NGS) is currently used in the clinical setting for targeted therapies and diagnosis of hematologic malignancies. Accurate detection of somatic variants is challenging because of tumor purity, heterogeneity, and the complexity of genetic alterations, with various issues ranging from high detection design to test implementation. This article presents guidelines developed through consensus among a panel of experts from the Korean Society for Genetic Diagnostics. They are based on experiences with the validation processes of NGS-based somatic panels for hematologic malignancies, with reference to previous international recommendations. These guidelines describe basic parameters with emphasis on the design of a validation protocol for NGS-based somatic panels to be used in practice. In addition, they suggest thresholds of key metrics, including minimum coverage, mean coverage with uniformity index, and minimum variant allele frequency, for the initial diagnosis of hematologic malignancies.

Perianal swabs surveillance cultures of Carbapenem-resistant Enterobacteriaceae(CRE) can be hints for CRE bloodstream infection in patients with hematological diseases / 中华血液学杂志

Objective@#To analyze the hints role of surveillance cultures of Carbapenem-resistant Enterobacteriaceae (CRE) by perianal swabs in patients with hematological diseases, and seek risk factors of CRE bloodstream infection.@*Methods@#The resistance of CRE from 2 914 patients with hematological diseases who cultured perianal swabs, CRE bloodstream infection and risk factors were analyzed during January 2016 to December 2017.@*Results@#In this study, perianal swabs from 2 914 patients with hematological diseases were cultured, 74 patients were CRE positive, and bloodstream infection with CRE was found in 13 of these patients. A total of 87 CRE strains were isolated (The same patient only keep the first one for the same location), including 31 Klebsiella pheuminiae, 43 Escherichia coli, 8 Enterobacter cloacae and 6 other Enterobacteriaceae. The resistance rates to piperacillin / tazobactam, imipenem, meropenam, amikacin, levofloxacin, tigecycline were 91.9%, 74.4%, 98.8%, 17.6%, 74.4% and 8.0%, respectively. Resistance to carbapenem, aminoglycoside, quinolones and tegacycline were highly consistent between two sites from 13 patients, whose both perianal swabs and blood were positive in CRE cultures. Febrile neutropenic time, digestive tract symptoms and perianal infection were independent risk factors for bloodstream infection in patients with perianal swabs positive results, the odds ratios (OR) were 1.10 (P=0.029), 1.13 (P=0.005) and 1.23 (P=0.016), respectively.@*Conclusion@#Perianal swabs surveillance cultures of CRE can be hints for CRE bloodstream infection in patients with hematological diseases, and also can provide suggestions for antibiotics. Long time of febrile neutropenic, digestive tract symptoms and perianal infection can be the early warning for CRE bloodstream infections.

Progress of comprehensive geriatric assessment in elderly patients with hematologic malignancies / 白血病·淋巴瘤

The incidence of hematologic malignancies in elderly is increasing year by year. So for clinicians, it is a problem to assess the tolerance to chemotherapy of elderly patients with hematological cancer. Recently, the comprehensive geriatric assessment has begun to be used in elderly patients with hematological malignancies. The studies have found that the comprehensive geriatric assessment could be used to assess the prognosis, predict the patient's tolerance to treatment, and may also be used as guidelines for making treatment decision. This paper mainly reviews the research status of comprehensive geriatric assessment in elderly patients with hematological malignancies at home and abroad.

Invasive fungal diseases in children with hematologic malignancies / 国际儿科学杂志

Invasive fungal diseases (IFD) are important causes ot morbidity and mortality in children with hematological malignancies.Although Candida remains the most common fungal pathogen in oncology pa tients,the epidemiology has recently shifted toward non-albicans species.However,Aspergillus has also seen a recent rise.Early recognition and prompt antifungal treatment are key to the control of IFD.We provide clinicians with evidence-based recommendations on strategies for disease diagnosis and management in this review.

Progress of immune checkpoint inhibitors in treatment of hematologic malignancies / 白血病·淋巴瘤

In recent years, immunotherapy has become an indispensable part in treatment of cancer, and the immune checkpoint inhibitors are the focus of attention. In the 58th American Society of Hematology (ASH) Annual Meeting, the application of immune checkpoint inhibitors in hematologic malignancies had been widely concerned. The recent progress of immune checkpoint inhibitors in hematologic malignancies in this annual meeting will be briefly introduced.

Effect of Pharmaceutical Consultation on Invasive Fungal Disease in Patients with Hematologic Malignancies / 中国药学杂志

OBJECTIVE: To explore how to carry out pharmaceutical consultation for anti-infection treatment in neutropenic hematological patients with invasive fugal disease and elaborate the value of clinical pharmacists in anti-infection treatment. METHODS: A total of 41 hematologic malignancies patients with invasive fungal disease who were consulted by clinical pharmacist from October 2014 to June 2016 were enrolled into the study. The etiology, bacteria complication, and infection site were summarized. The other 41 agranulocytosis patients complicated with invasive fungal disease without clinical pharmacist consultation randomly sampled by HIS were used as the control. Statistical analysis were carried out to evaluate the effect of anti-infection treatment. The authors also discussed that as a clinical pharmacist how to carry out pharmaceutical consultation through several typical anti-fungal infection cases. RESULTS: Totally 45 strains of fungi were isolated from the secretion specimens obtained from the 41 patients, including Candida albicans, Candida glabrata, Candidakrusei, Candida tropicalis, Aspergillums, and Cryptococcosis, among which Candida albicans accounted for 60.0%, followed by Aspetgillus (13.3%), Candidakrusei (11.1%), Candida glabrata (6.67%), Candida tropicalisi (6.67%), and Cryptococcosis (2.2%). The main infection site was the lung, followed by the digestive tract and blood stream. The positive rate of bacteria culture was 58.5% among the 41 patients, and the major isolated bacteria were Escherichia colis, Pseudomonas aeruginosa, Enterococcus, and Pseudomonas maltophilia. For the antifungal treatment involving the clinical pharmacists, the cure rate was 48.8%, the significant effective rate was 34.2%, the improved effective rate was 7.4%, the total effective rate of treatment was 72.9%, and the failure rate was 9.3%. There was significant difference in the curative effect between the clinical pharmacist consultation group and the control group (P<0.05). CONCLUSION: The incidence of fungal infection in agranulocytosis patients is high, and most of the patients are complicated with bacteria infection. The most frequently infected site is respiratory tract. Clinical pharmacists can play an important role in the treatment of invasive fungal disease in agranulocytosis patients to ensure the treatment safety and efficacy.

Comparison of unrelated cord blood transplantation and HLA-identical sibling peripheral blood stem cell transplantation for the treatment of adult hematological malignancies / 中华血液学杂志

Objective@#To compare the efficacy of unrelated cord blood transplantation (UCBT) and HLA-identical sibling peripheral blood stem cell transplantation (PBSCT) for the treatment of adult hematological malignancies.@*Methods@#From April 2011 to December 2015, a total of 81 patients receiving single-unit UCBT and 57 patients receiving HLA-identical sibling PBSCT were enrolled in this study. All of the patients received myelablative conditioning. Cyclosporine combined with mycophenolate mofetil was adopted for GVHD prophylaxis.@*Results@#The cumulative incidence of neutropil engraftment at day-42 was 95.0% and 100% in UCBT and sibling PBSCT groups, respectively (P=0.863) . Platelet engraftment at day 100 was 87.3% (95%CI 76.8%-93.1%) in UCBT group, which was significantly lower than that of sibling PBSCT group[98.2% (95%CI 87.3%-99.7%) ] (P=0.005) . There were no significant differences in terms of Ⅱ-Ⅳ acute GVHD or Ⅲ-Ⅳ acute GVHD in two groups (P=0.142, 0.521) . The 3-year chronic GVHD and extensive chronic GVHD were 14.9% (95%CI 5.2%-23.5%) and 11.2% (95%CI 2.9%-18.7%) , respectively in UCBT group, which was significantly lower than that of sibling PBSCT group[35.2% (95%CI 19.4%-47.8%) , 31.4% (95%CI 16.2%-43.9%) ] (P=0.008, 0.009) . The 3-year transplant-related mortality (TRM) was similar between two groups (30.1% vs 23.2%, P=0.464) . The relapse rate at 3-year in UCBT group[12.9% (95%CI 6.6%-21.5%) ]was significantly lower than that in sibling PBSCT group[24.3% (95%CI 13.5%-36.8%) ] (P=0.039) . There were no significant differences in terms of overall survival (OS) and disease-free survival (DFS) between two groups (58.6% vs 54.8%, P=0.634; 57.0% vs 52.4%, P=0.563) . But GVHD-free and relapse-free survival (GRFS) in UCBT group [55.7% (95%CI 44.1%-65.8%) ]was significantly higher than that of sibling PBSCT group[42.9% (95%CI 29.8%-55.3%) ] (P=0.047) .@*Conclusions@#For adult hematological malignancies, the incidences of acute GVHD and TRM were similar between UCBT and sibling PBSCT recipients, and the incidences of chronic GVHD and relapse were lower in UCBT recipients. UCBT recipients had higher GRFS rate although OS and DFS were similar between two groups, which may reflect the real recovery and better quality of life following UCBT.

Chromosomal large fragment deletion induced by CRISPR/Cas9 gene editing system / 中华血液学杂志

Objective@#Using CRISPR-Cas9 gene editing technology to achieve a number of genes co-deletion on the same chromosome.@*Methods@#CRISPR-Cas9 lentiviral plasmid that could induce deletion of Aloxe3-Alox12b-Alox8 cluster genes located on mouse 11B3 chromosome was constructed via molecular clone. HEK293T cells were transfected to package lentivirus of CRISPR or Cas9 cDNA, then mouse NIH3T3 cells were infected by lentivirus and genomic DNA of these cells was extracted. The deleted fragment was amplified by PCR, TA clone, Sanger sequencing and other techniques were used to confirm the deletion of Aloxe3-Alox12b-Alox8 cluster genes.@*Results@#The CRISPR-Cas9 lentiviral plasmid, which could induce deletion of Aloxe3-Alox12b-Alox8 cluster genes, was successfully constructed. Deletion of target chromosome fragment (Aloxe3-Alox12b-Alox8 cluster genes) was verified by PCR. The deletion of Aloxe3-Alox12b-Alox8 cluster genes was affirmed by TA clone, Sanger sequencing, and the breakpoint junctions of the CRISPR-Cas9 system mediate cutting events were accurately recombined, insertion mutation did not occur between two cleavage sites at all.@*Conclusion@#Large fragment deletion of Aloxe3-Alox12b-Alox8 cluster genes located on mouse chromosome 11B3 was successfully induced by CRISPR-Cas9 gene editing system.

Brote de pseudofungemia por fusarium spp. en una unidad oncológica infantil / Outbreak of pseudofungemia by fusarium spp. in a pediatric oncology unit

Introducción: dentro del comportamiento microbiológico de una unidad oncológica pediátrica en Medellín, Colombia, se detectó una presentación inusual de casos de fungemia por Fusarium spp. en un corto periodo. Objetivo: describir un brote hospitalario causado por Fusarium spp. en pacientes pediátricos hospitalizadosen una unidad oncológica en Medellín, Colombia. Materiales y métodos: se realizó un estudio descriptivo sobre un brote hospitalario por Fusarium spp. aislado en sangre de cinco pacientes pediátricos hospitalizados en una unidad de oncología en Medellín, Colombia, entre diciembre de 2012 y febrero de 2013. Resultados: cuatro de los cinco pacientes con hemocultivos positivos para Fusarium spp. tenían acceso venoso central y en tres de ellos el único hemocultivo positivo fue tomado a través de una de las vías del catéter. Dado lo anterior, sumado a que no había correlación con los hallazgos clínicos, tres pacientes se consideraron casos de pseudofungemias y no se les administró tratamiento antifúngico. Dentro de las hipótesis planteadas sobre la causa del brote se confirmó la contaminación del ambiente con el hongo debido a un sistema de ventilación ineficiente. Conclusiones: en la mayoría de los casos del brote Fusarium spp. se consideró contaminante de los dispositivos intravasculares y se asoció a dificultades en el control ambiental de las habitaciones.

Introduction: an unusual presentation of cases of fungemia by Fusarium spp. was detected in pediatric oncology unit of Medellin, Colombia, in a short period. Objective: To describe a hospital outbreak caused by Fusarium spp. in pediatric hospitalized patients in an oncology unit of Medellin, Colombia. Materials and methods: A descriptive study of a hospital outbreak by Fusarium spp. isolated in blood cultures of five pediatric patients hospitalized in an oncology unit of Medellin, Colombia, between December 2012 and February 2013. Results: Four of the five patients with positive blood cultures for Fusarium spp. had central venous access, and in three of them, the unique positive blood culture was taken through one of the catheter tracks. Because of this and considering that there was no correlation with the clinical findings, three cases were determined as pseudofungemia and the antifungal treatment was not administered. Among the hypotheses raised about the outbreak cause, contamination of the environment with the fungus was confirmed due to an inefficient ventilation system. Conclusions: In most outbreak cases, Fusarium spp. was considered a contaminant of intravascular devices and it was associated with difficulties in rooms’ environmental controls.