RESUMEN
PURPOSE: Platelet transfusions for patients suffering from severe thrombocytopenia are regulated by clinical bleedings and platelet counts. The aim of this study was to assess the prevalence of retinal hemorrhage in patients with hematologic and oncologic malignancies and severe thrombocytopenia, and to determine the benefit of systematic funduscopic examination in this setting. MATERIALS AND METHODS: Hospitalized patients with hematologic and oncologic malignancies having a platelet count less than 25,000 per µL underwent indirect ophthalmoscopy. The prevalence of retinal hemorrhage and its correlation with different patients' characteristics were determined. The decision to transfuse platelets or not following bedside indirect ophthalmoscopy was left at the discretion of the treating physician. RESULTS: A total of 34 severe thrombocytopenic patients were included in the study. The prevalence of retinal hemorrhage was detected in 10 patients (29.4%). No significant correlation was found between the occurrence of retinal hemorrhage and age, platelet count or thrombocytopenia etiology (P>0.05). No significant difference was found concerning the rate of transfusion between those with and without retinal hemorrhage. CONCLUSION: According to our statistical results, retinal hemorrhage is a frequent finding in severely thrombocytopenic patients. Early detection may lead to an increase in the platelet transfusion threshold from to 30,000 per µL offering additional protection against spontaneous bleedings. Funduscopy is a safe and easy exam to perform systematically in patients with severe thrombocytopenia.
Asunto(s)
Anemia , Neoplasias , Trombocitopenia , Humanos , Oftalmoscopía , Transfusión de Plaquetas/métodos , Estudios Prospectivos , Hemorragia Retiniana/epidemiología , Hemorragia Retiniana/etiología , Trombocitopenia/etiología , Trombocitopenia/terapiaAsunto(s)
COVID-19 , Neoplasias , Telemedicina , Curriculum , Humanos , Neoplasias/terapia , Pandemias , SARS-CoV-2RESUMEN
Aim: This study assessed the efficacy of anti-PD-1/PD-L1 agents in real life when used in second line or beyond. Materials & methods: Patients with advanced non-small-cell lung cancer progressing after standard chemotherapy and receiving immunotherapy in the second line or beyond were included. Results: One hundred and ten patients were included with PD-L1 expression above 50%, between 1-49 and <1% in 38.6, 27.3 and 34.1% of patients, respectively. Checkpoint inhibitors were used as second, third and fourth line in 74.7, 21.8 and 3.5%, respectively. Partial response was observed in 25.6% of patients. Median progression-free survival was 4 months and median overall survival was 8.1 months. Conclusion: Immunotherapies are emerging as important tools in the oncologic field with good responses in real-life practice.