Post-COVID-19 Cardiovascular Sequelae and Myocarditis.

BACKGROUND AND AIM: Post coronavirus disease 2019 (COVID-19) cardiovascular (CV) pathological changes, myocarditis, and myocardial infarctions (MIs) are major public health issues. This review discusses acute and chronic COVID-19 cardiac manifestations. METHODS: The devastating impact of COVID-19 on global healthcare and economies has likely been one of humanity's deadliest calamities in recent decades, as multiple literature and databases were searched from 2020 to 2022. RESULTS: As of April 2022, we identified 73 articles in various electronic databases that discussed the details of COVID-19 and cardiac manifestations. Cardiometabolic risk factors should now, more than ever, be a top priority for clinicians, as their potent role in exacerbating COVID-19 illness severity has been conclusively demonstrated. CONCLUSION: This review discusses cardiac pathology changes, CV consequences of acute COVID-19, microvascular injury and cardiac complications linked with SARS-CoV2, COVID-19 linked with chronic CV disease, therapeutic drug effects on heart used in COVID-19, and possible investigational approaches and management strategies for post-COVID-19 CV consequences. Highlights Cardiac pathology changes: Effect of COVID-19. Mechanism of development of CV consequences in acute COVID-19: Including autopsy studies. Microvascular injury and cardiac complications: Linked with SARS-CoV2. COVID-19 linked with chronic CV disease. Therapeutic drug effects on heart used in COVID-19. Possible investigational approaches and management strategies for post-COVID-19 CV consequences.

Predicting risk of progression in relapsed multiple myeloma using traditional risk models, focal lesion assessment with PET-CT and minimal residual disease status.

Not available.

Feasibility of Outpatient Stem Cell Transplantation in Multiple Myeloma and Risk Factors Predictive of Hospital Admission.

High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) remains the standard of care for multiple myeloma (MM) patients. Although outpatient ASCT has been shown to be safe and feasible, the procedure is overall rare with most patients in the US undergoing inpatient ASCT. Furthermore, hospitalization rates for patients that undergo outpatient ASCT remain high. Adequate markers that predict hospitalization during outpatient ASCT are lacking, yet would be of great clinical value to select patients that are suited to outpatient ASCT. In this study we aimed to elucidate differences between planned outpatient and inpatient ASCT and further evaluated clinical characteristics that are significantly associated with hospitalization during planned outpatient hospitalization. Factors that were significantly associated with a planned inpatient ASCT included an advanced MM disease stage, worse performance status as well as non-Caucasian race, while low albumin levels and female gender were significantly associated with hospitalization during outpatient ASCT. The results of this analysis provide crucial knowledge of factors that are associated with planned inpatient ASCT and hospitalization during outpatient ASCT and could guide the treating physician in decision-making and further facilitate outpatient transplantation.

Salvage Autologous Stem Cell Transplantation in Daratumumab-Refractory Multiple Myeloma.

Daratumumab, a CD38-targeting monoclonal antibody, has significantly improved survival rates in multiple myeloma (MM), yet patients who progress on Daratumumab have dismal clinical outcomes with an overall median of less than 10 months. While emerging novel modalities have shown promising results, the current study explores the use of high-dose chemotherapy followed by autologous stem cell transplantation (ASCT) in heavily pretreated Daratumumab-refractory MM patients. We retrospectively investigated the outcome of 69 consecutive patients who received upfront ASCT. The median progression-free survival (PFS) for the entire patient cohort was 7.2 months with a median overall survival (OS) of 19.3 months. For patients with ≥very good partial response (VGPR), median PFS and OS improved to 9 months and 34 months, respectively. Achievement of MRD negativity in ≥VGPR did not further improve the outcome. A better performance status, younger age, longer time interval from initial MM diagnosis/initial ASCT to salvage ASCT and low-risk GEP70 were all associated with improved PFS and OS after salvage ASCT. Our results suggest a role for salvage ASCT in selected heavily pretreated and Daratumumab-refractory patients.