Evaluation of Serum Paraoxonase, Myeloperoxidase, and HDL-Cholesterol Levels in Acute Myeloid Leukemia.

Inflammation and oxidative stress play a significant role in the pathogenesis of acute myeloid leukemia. While myeloperoxidase carries pro-oxidant effects, HDL-cholesterol and paraoxonase have antioxidant properties. Therefore, we evaluated serum paraoxonase, myeloperoxidase, and HDL-cholesterol levels in cases with acute myeloid leukemia. Myeloperoxidase, paraoxonase, and HDL-cholesterol levels in 40 acute myeloid leukemia patients and 18 healthy individuals were determined. The relationship between these parameters and other prognostic factors, as well as their association with response to chemotherapy, was investigated. Myeloperoxidase levels were higher, while paraoxonase and HDL-cholesterol levels were lower in acute myeloid leukemia cases compared to the control group (p < 0.001, p < 0.001, p = 0.006, respectively). The myeloperoxidase level was significantly negatively correlated with paraoxonase and HDL-c levels (r = - 0.64, p < 0.001; r = - 0.27, p = 0.02, respectively). Paraoxonase level was positively correlated with HDL level (r = 0.34, p = 0.04). Lactate dehydrogenase level was negatively correlated with HDL-c and paraoxonase levels and positively correlated with myeloperoxidase level (r = - 0.37, p = 0.019; r = - 0.35, p = 0.04; r = 0.45, p = 0.03, respectively). Following complete remission induction treatment, cases with complete remission had lower myeloperoxidase levels and higher HDL-cholesterol and paraoxonase levels compared to other cases (p = 0.03, p = 0.01, p = 0.04, respectively). Myeloperoxidase levels are higher, while paraoxonase and HDL-cholesterol levels are lower in acute myeloid leukemia cases. The obtained findings emphasize the potential importance of inflammation and oxidative stress in the pathogenesis of acute myeloid leukemia. These parameters can be used as biomarkers for prognosis prediction and prediction of response to chemotherapy.

Prospective analysis of febrile neutropenia patients with bacteraemia: the results of an international ID-IRI study.

OBJECTIVES: Bacteraemia during the course of neutropenia is often fatal. We aimed to identify factors predicting mortality to have an insight into better clinical management. METHODS: The study has a prospective, observational design using pooled data from febrile neutropenia patients with bacteraemia in 41 centres in 16 countries. Polymicrobial bacteraemias were excluded. It was performed through the Infectious Diseases-International Research Initiative platform between 17 March 2021 and June 2021. Univariate analysis followed by a multivariate binary logistic regression model was used to determine independent predictors of 30-d in-hospital mortality (sensitivity, 81.2%; specificity, 65%). RESULTS: A total of 431 patients were enrolled, and 85 (19.7%) died. Haematological malignancies were detected in 361 (83.7%) patients. Escherichia coli (n = 117, 27.1%), Klebsiellae (n = 95, 22% %), Pseudomonadaceae (n = 63, 14.6%), Coagulase-negative Staphylococci (n = 57, 13.2%), Staphylococcus aureus (n = 30, 7%), and Enterococci (n = 21, 4.9%) were the common pathogens. Meropenem and piperacillin-tazobactam susceptibility, among the isolated pathogens, were only 66.1% and 53.6%, respectively. Pulse rate (odds ratio [OR], 1.018; 95% confidence interval [CI], 1.002-1.034), quick SOFA score (OR, 2.857; 95% CI, 2.120-3.851), inappropriate antimicrobial treatment (OR, 1.774; 95% CI, 1.011-3.851), Gram-negative bacteraemia (OR, 2.894; 95% CI, 1.437-5.825), bacteraemia of non-urinary origin (OR, 11.262; 95% CI, 1.368-92.720), and advancing age (OR, 1.017; 95% CI, 1.001-1.034) were independent predictors of mortality. Bacteraemia in our neutropenic patient population had distinctive characteristics. The severity of infection and the way to control it with appropriate antimicrobials, and local epidemiological data, came forward. CONCLUSIONS: Local antibiotic susceptibility profiles should be integrated into therapeutic recommendations, and infection control and prevention measures should be prioritised in this era of rapidly increasing antibiotic resistance.

The Distribution and Phenotypes of Blood Groups in Hematologic Malignancies.

OBJECTIVE: Blood groups are associated with duodenal ulcer, diabetes mellitus, and urinary tract infection. In some studies, a relationship was detected between hematologic and solid organ malignancies and blood groups. In this study, we investigated the frequency and phenotypes of blood groups (ABO, Kell, Duffy, Rh) in patients with hematologic malignancies. MATERIALS AND METHODS: One hundred sixty-one patients with hematologic malignancy (multiple myeloma, chronic lymphocytic leukemia, and chronic myelocytic leukemia) and 41 healthy people were evaluated prospectively. We determined phenotypes and distribution of ABO, Rh, Kell, and Duffy blood groups in all cases. Chi-square test and 1-way variance analysis were used for statistical analysis. P < .05 value was considered statistically significant. RESULTS: In patients with multiple myeloma, the A blood group was statistically significantly more frequent than in the control group (P = .021). Rh negativity was found more frequent in patients with hematologic malignancy than the control group (P = .009). Kpa and Kpb antigen positivity were found statistically significantly less frequent in patients with hematologic malignancy (P = .013, P = .007; respectively). Fy (a-b-) and K-k+ phenotypes were higher in patients with hematologic cancer than in the control group (P = .045). CONCLUSION: We determined a significant relationship between hematologic malignancies and blood group systems. In our study, due to the low number of cases and few hematological malignancy types, extensive studies with more cases and more hematologic cancer types are needed.

Impact of COVID-19 on Outcomes of Patients with Hematologic Malignancies: A Multicenter, Retrospective Study.

Objectives: Patients with hematological malignancies have a high risk of mortality from coronavirus disease 2019 (COVID-19). This study aimed to investigate the impact of COVID-19 on mortality rates in patients with various hematological malignancies and to determine risk factors associated with all-cause mortality. Methods: A multicenter, observational retrospective analysis of patients with hematological malignancies infected with COVID-19 between July 2020 and December 2021 was performed. Demographic data, clinical characteristics, and laboratory parameters were recorded. Patients were grouped as non-survivors and survivors. All-cause mortality was the primary outcome of the study. Results: There were 569 patients with a median age of 59 years. Non-Hodgkin lymphoma (22.0%) and multiple myelomas (18.1%) were the two most frequent hematological malignancies. The all-cause mortality rate was 29.3%. The highest mortality rates were seen in patients with acute myeloid leukemia (44.3%), acute lymphoid leukemia (40.5%), and non-Hodgkin lymphoma (36.8%). The non-survivors were significantly older (p<0.001) and had more comorbidities (p<0.05). In addition, there were significantly more patients with low lymphocyte percentage (p<0.001), thrombocytopenia (p<0.001), and high CRP (p<0.001) in the non-survived patients. Age ≥ 65years (p=0.017), cardiac comorbidities (p=0.041), and continuation of ongoing active therapy for hematological cancer (p<0.001) were the independent risk factors for the prediction of mortality. Conclusions: In patients with hematological malignancies, coexistent COVID-19 leads to a higher mortality rate in elderly patients with more comorbidities. Acute myeloid and lymphoid leukemia and non-Hodgkin lymphoma have the highest mortality rates. Older age, cardiac diseases, and continuation of ongoing active therapy for hematological cancer are the independent risk factors for mortality in hematological malignancy patients with COVID-19.

Next-Generation Sequencing Panel Test in Myeloid Neoplasms and Evaluation with the Clinical Results.

OBJECTIVE: Myeloid malignancies are heterogeneous disorders due to defective hematopoiesis and myeloid differentiation of hematopoietic stem/progenitor cell. The molecular landscape of the diseases is complex. Molecular alterations are used for classification and evaluation of prognosis and treatment. We aimed to evaluate the advantages of the next-generation sequencing panel testing in myeloid malignancies and clinical outcomes. MATERIALS AND METHODS: We evaluated the results of 54 patients who underwent next-generation sequenc- ing myeloid panel testing, with fluorescent in situ hybridization (FISH), polymerase chain reaction results and the clinical outcomes. Target genes in the panel were ASXL1, CALR, CBL, CEBPA, CSF3R, DNMT3A, EZH2, FLT3, IDH1, IDH2, JAK2, KIT, KRAS, MPL, NPM1, NRAS, RUNX1, SETBP1, SF3B1, SH2B3, SRSF2, TET2, TP53, U2AF1, and ZRSR2. RESULTS: Diagnoses were acute myeloid leukemia, essential thrombocytosis, polistemia vera, primary myelo- fibrosis, hypereosinophilic syndrome (HES), chronic myeloid leukemia, myelodysplastic syndromes, chronic myelomonocytic leukemia. Twenty-eight missense, 8 frameshift, 5 stop gain, and 3 in-frame mutations were detected. A double mutation was detected in JAK-2 with next-generation sequencing in the patient who was given a false negative result due to polymerase chain reaction limitation. CONCLUSION: Screening multiple mutations simultaneously, is time and cost-effective. With the panel test, it is possible to determine the diagnosis, prognosis and targeted treatment options with a single test. Next- generation sequencing myeloid panel tests might be a powerful guide for clinicians.

The clinicopathologic features and response to treatment of patients with Nonhodgkin Lymphoma: A single-center experiment in Turkey.

OBJECTIVE: We aimed to compare laboratory features, histopathological types, response to treatment of patients with non hodgkin lymphoma in our department and other regions. METHODS: A total of 80 patients nonhodgkin lymphoma were evaluated. Because we had only 80 patients with complete data, we used T test for comparison of groups. We evaluated the parameters affecting surveillance with cox regression analysis. RESULTS: The most common histological types of nonhodgkins lymphoma was diffuse large b cell lymphoma (n: 63, 78.75%). Thirty-nine percent of all patients had anemia, 32% had hypoalbunemia, 71.25% had elevated serum LDH, 32.5% had elevated serum ß2 microglobulin value. Advanced age, the presence of bulky disease, elevated Ki-67 level, IPI score, refractory to first line treatment were found to be correlated with shorter survival time. We treated 77 (96.25%) patients with doxorubicin containing regimen. Complete and partial remission rates of first line treatment were 77.5% and 10%, respectively. Seven (8.75%) patients died because of disease progression and 1 (1.25%) patient died due to sepsis. CONCLUSION: The frequency of lymphoma subtypes, clinical characteristics, treatment outcomes and survival rate vary from region to region. Therefore it is important to determine dissimilarity of these parameters for improve of survey.