The nutrition risk index is associated with bacteremia within 30 days after autologous stem cell transplantation in patients with multiple myeloma.

OBJECTIVES: To assess whether the nutrition risk index (NRI) is associated with the risk of bacteremia within the first days after autologous stem cell transplantation (ASCT) in patients with multiple myeloma (MM). MATERIALS AND METHODS: Retrospective cohort study of adult patients with MM taken to ASCT at the Hospital Universitario San Ignacio (Bogotá, Colombia) between 2005 and 2019. The outcome of interest was the incidence of bacteremia at 30 days. Multivariate analysis was used to identify whether the NRI was associated with bacteremia, controlling by different confounding variables. RESULTS: One hundred and twenty-four patients with a median age of 58.5 years (IQR: 54-64) were included. 47.1% were in stage ISS III. 36.0% had moderate or severe malnourishment (NRI < 97.5). 11.2% presented bacteremia in the first 30 days after transplantation. In the univariate analysis, the NRI < 97.5 was associated with bacteremia (OR: 1.88; 95% CI: 1.30-2.72, P = .001); however, this association was not significant in the multivariate analysis, unlike the presence of mucositis (OR: 11.59; 95% CI: 1.9-68.3, <0.01), one or more previous lines of therapy (OR: 12.0; 95% CI: 2.1-67.4; P < .01), and duration of aplasia (OR: 1.70; 95% CI: 1.2-2.4, P < .01). CONCLUSIONS: Patients with moderate or severe malnourishment have a higher incidence of bacteremia in the 30 days post-ASCT in patients with MM. Additional risk factors associated with bacteremia include the presence of mucositis, one or more previous lines of therapy, and the duration of aplasia.

Características clínicas y paraclínicas de las neoplasias mieloproliferativas crónicas cromosoma Filadelfia negativas / Clinical and paraclinical characteristics of chronic myeloproliferative neoplasms Philadelphia chromosome negative

Objetivo: describir las características clínicas y paraclínicas de los pacientes con neoplasias mieloproliferativas crónicas cromosoma Filadelfia negativa valorados en la consulta externa de hematología del Hospital de San José desde enero de 2005 hasta mayo de 2010. Material y métodos: estudio de serie de casos en el que se incluyeron los pacientes diagnosticados con neoplasias mieloproliferativas crónicas cromosoma Filadelfia negativas. Resultados: un total de 34 pacientes con neoplasias mieloproliferativas (NM) cromosomas Filadelfia negativas fueron identificados. El principal diagnóstico encontrado fue de trombocitemia esencial en 17 pacientes (50%), policitemia Vera Rubra en seis pacientes (17.6%), neoplasia mieloproliferativa asociadas a eosinofilia en seis pacientes (17.6%), mielofibrosis primaria en tres pacientes (8.8%) Y neoplasias mieloproliferativas no clasificables en dos pacientes (5.8%). La mediana de edad fue de 63.5 años (RIQ: 51 a 74) y 21 pacientes (61.7%) correspondían al sexo femenino. Dos pacientes del número total progresaron a mielofibrosis (5.8%), ningún paciente desarrolló leucemia aguda. Veintisiete pacientes (79.4%) recibieron hidroxiurea como manejo farmacológico principal. Catorce pacientes presentaron complicaciones (41.1%), de los cuales cinco fueron episodios trombóticos (14.7%), tres episodios hemorrágicos (8.8%), tres pacientes presentaron hipertensión pulmonar (8.8%) y un paciente desarrolló vértigo (2.9%). Finalmente el tiempo desde el diagnóstico hasta la aparición de complicaciones fue de 19.55 meses (RIQ: 8-50.23) Conclusiones: las neoplasias mieloproliferativas crónicas cromosoma Filadelfia negativas son patologías muy raras, el mayor número se agrupan en trombocitemia esencial, policitemia Vera y neoplasias asociadas a eosinofilia. La principal opción terapéutica es la hidroxiurea con una baja toxicidad. No es posible analizar la presencia de las mutaciones tirosina-kinasas (JAK2 V617F, PGDFRA, ...

Objective: describe features clinics and patients with chronic myeloproliferative neoplasm chromosome Philadelphia negative valued at the Hospital San Jose hematology outpatient from January 2005 until May 2010. Materials and methods: Studio series case included patients diagnosed with chronic myeloproliferative neoplasm chromosome Philadelphia negative. Results: A total of 34 chronic myeloproliferative neoplasm chromosome Philadelphia negative patients were identified. The main found diagnosis was Essential Thrombocythemia in 17 patients (50%), Polycythemia Rubra Vera in six patients (17.6%), chronic myeloproliferative neoplasm associated with eosinophilia in six patients (17.6%), myelofibrosis primary in three patients (8.8%) and chronic myeloproliferative neoplasm not classifiable in two patients (5.8%). The median age was 63.5 years (R: 51-74) and 21 patients (61.7%) were female. Two patients in the total number progressed Myelofibrosis (5.8%), no patient acute leukemia development. Twenty-seven patients (79.4%) received Hydroxyurea as main pharmacological management. Fourteen patients presented complications (41.1%), of which fve were thrombotic episodes (14.7%), three bleeding episodes (8.8%), three patients had pulmonary hypertension (8.8%) and one patient developed Vertigo (2.9%). Finally the time since diagnosis until the occurrence of complications was 19.55 months (R: 8-50.23). Conclusión: neoplasm Mieloproliferativas Chronicles are very rare pathologies, as many are grouped into essential Thrombocythemia, Polycythemia Vera and neoplasms associated with Eosinophilia. The main therapeutic option is with a low toxicity Hydroxyurea. It is not possible to analyze the presence of mutations tyrosine kinases (JAK2 V617F PGDFRA PDGFRB, FGFR1) because they are tools of recent entry to the diagnostic arsenal and whose impact as a prognostic factor or therapeutic is in studio. Thrombotic venous events are frequently found in these patients. ...