ABSTRACT
Patients with hematologic malignancies are particularly vulnerable to severe infectious complications. SARS-CoV-2 infection is associated with a high risk of severe course and death in this patient population. In addition, immune deficits associated with both the blood cancer and the treatment used make vaccination against SARS-CoV-2 less effective than in immunocompetent individuals. Molnupiravir is one of the first oral antiviral drugs to demonstrate a significant benefit in reducing hospitalisation and death in COVID-19 in the general population. In this context, 175 haematology patients with diagnosed COVID-19, and treated with MOL between January and April 2022, came under our scrutiny with a view to defining their clinical characteristics and outcomes. The most common underlying conditions were lymphomas (45%), multiple myelomas (21%) and acute leukaemias or myelodysplastic syndrome (35%). Of all, 77% of the patients were vaccinated, and half of them received a booster. At 28 days after the breakthrough COVID-19 diagnosis, 35 (20%) subjects required hospital admission. Out of those patients, seven (4%) died during the follow-up due to the progression of COVID. Our results corroborate what has been established to date with regard to the positive clinical and safety outcomes of MOL in haematology patients with mild or moderate COVID-19.
Subject(s)
COVID-19 , Hematologic Neoplasms , Humans , COVID-19 Testing , SARS-CoV-2 , Hematologic Neoplasms/complications , Hematologic Neoplasms/drug therapyABSTRACT
AL (light-chain) amyloidosis is a systemic disease in which amyloid fibers are formed from kappa or lambda immunoglobulin light chains, or fragments thereof, produced by a neoplastic clone of plasmocytes. The produced protein is deposited in tissues and organs in the form of extracellular deposits, which leads to impairment of their functions and, consequently, to death. Despite the development of research on pathogenesis and therapy, the mortality rate of patients with late diagnosed amyloidosis is 30%. The diagnosis is delayed due to the complex clinical picture and the slow progression of the disease. This is the type of amyloidosis that most often contributes to cardiac lesions and causes cardiac amyloidosis (CA). Early diagnosis and correct identification of the type of amyloid plays a crucial role in the planning and effectiveness of therapy. In addition to standard histological studies based on Congo red staining, diagnostics are enriched by tests to determine the degree of cardiac involvement. In this paper, we discuss current diagnostic methods used in cardiac light chain amyloidosis and the latest therapies that contribute to an improved patient prognosis.
Subject(s)
Asthma/blood , Asthma/complications , Immunoglobulin G/blood , Methotrexate/therapeutic use , Necrobiotic Xanthogranuloma/diagnosis , Necrobiotic Xanthogranuloma/drug therapy , Necrobiotic Xanthogranuloma/etiology , Aged , Dermatologic Agents/therapeutic use , Eye Diseases/diagnostic imaging , Humans , Male , Necrobiotic Xanthogranuloma/physiopathology , Poland , Rare Diseases/blood , Rare Diseases/diagnosis , Rare Diseases/drug therapy , Treatment OutcomeABSTRACT
Symptoms of multiple myeloma (MM) include bone destruction with pathological fractures, kidney failure and frequent infections, which are the major causes of patient mortality. In our recent research, we demonstrated that the degree of dendritic cell (DC) subpopulation deficit could be related to MM progression, which in consequence may contribute to the MM-related impairment of the immune responses. In the present study, we determined by flow cytometry the frequencies of CD4+ and CD8+ T cells, NK, and NKT-like cells as well as their correlation with myeloid and lymphoid populations of DCs in patients with MM. The study involved 50 patients diagnosed with MM at the Department of Hematology in the Holycross Cancer Center in Kielce. The research samples were collected after the MM diagnosis and before the initiation of anticancer therapy. The obtained results revealed the relations between the percentages of DC subpopulations and lymphocyte subsets, especially the activated ones, in the peripheral blood (PB) and bone marrow (BM). The described role of DCs in the process of the immunological response, either adaptive or innate, leads us to conclude that the decrease of the number or percentage of these cells may have a negative impact on the process of activation of effector cells and, consequently, on the effectiveness of a response to foreign as well as neoplastic antigens in patients with MM.
