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The article compares the first two cases of patients treated with tisagenlecleucel at the Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw in Warsaw, Poland. Topics include the different clinical presentations developed by the two patients after chimeric antigen receptor (CAR)-T infusion, clinical course of patients, and an adverse event (AE) prediction concept developed by research teams worldwide.

Myelodysplastic syndromes (MDS) comprise a heterogeneous group of malignant hematopoietic stem cell disorders that are characterized by ineffective blood cell production and a variable risk of transformation into acute myeloid leukemia. In recent years, significant progress in MDS biological research has allowed the addition of new drugs to the few existing therapeutic options. This article presents the recommendations of MDS experts of the Polish Adult Leukemia Group for the treatment of myelodysplastic syndromes, and for the management of conditions that are particularly common in patients with MDS i.e. infections, iron overload, and disease recurrence after hematopoietic cell transplantation. The aim of this study was to present a clear therapeutic algorithm to facilitate decision-making in everyday practice. [ABSTRACT FROM AUTHOR]

Myelodysplastic syndromes (MDS) are a heterogeneous group of neoplastic diseases of the hematopoietic cells manifested by ineffective hematopoiesis and a tendency to transform into acute myeloid leukemia. MDS should be considered in the differential diagnosis of cytopenia, especially in the elderly. This article presents the recommendations of MDS experts of the Polish Adult Leukemia Group (PALG) for the diagnosis of myelodysplastic syndromes. We present current classifications and prognostic indices, as well as diagnostic examinations recommended for MDS: cytological, histopathological, immunophenotypic, cytogenetic and molecular tests. The aim of the study is to implement up-to-date knowledge about myelodysplastic syndromes into routine clinical practice, from the diagnosis of cytopenia to the specific diagnosis and prognosis in MDS patients. [ABSTRACT FROM AUTHOR]

Copyright of Acta Haematologica Polonica is the property of VM Medica-VM Group (Via Medica) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Haematologica Polonica is the property of VM Medica-VM Group (Via Medica) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Functions of natural killer (NK) cells are regulated by a set of activating and inhibitory receptors, including NKG2D and NKG2A, interacting with MICA/B molecules. Polymorphisms within genes coding for these receptors and their ligands may affect the outcome of allogeneic haematopoietic stem cell transplantation (HSCT). Seven single nucleotide polymorphisms (NKG2D rs1049174, rs1154831; MICA rs1051792, rs1063635; MICB rs1065075, rs3828903 and NKG2A rs7301582) were analysed in 172 HSCT recipients and 102 donors, and genotyping results were compared with clinical data. Additionally, the levels of soluble MICA (sMICA) were assessed in serum collected from 40 patients 30 days after transplantation. CMV infection was more common among recipients carrying the NKG2D rs1049174 GG homozygous genotype (p = 0.036) and the NKG2A rs7301582 TT genotype or T allele (p <0.001, in both cases). Increased risk for CMV infection was also found to be associated with the presence of MICB rs1065075 G allele in either recipient (p = 0.021) or donor (p = 0.037). Moreover, donor MICA rs1051792 GG homozygosity was associated with more frequent development of acute GvHD grades II-IV (p = 0.053) while donor MICB rs1065075 AA genotype with increased risk for chronic GvHD (p = 0.019). The median sMICA level equalled 0.054 pg/μL and was lower (although not statistically significant) than that detected for patients presenting with acute GvHD (0.061 pg/μL) and chronic GvHD (0.083 pg//μL) complications. These results imply that polymorphisms within genes coding for activating NKG2D and inhibitory NKG2A receptors of transplant recipients and both patient and donor MICB genotypes are associated with the risk of CMV infection, while donor MICA and MICB polymorphic variants affect the risk of acute and chronic GvHD, respectively. This study was conducted in collaboration with the Polish Adult Leukemia Group and was supported by the National Science Centre (Poland) project No. 2018/31/B//NZ2/03065. [ABSTRACT FROM AUTHOR]

Introduction: Data concerning the safety and efficacy of SARS-CoV-2 vaccines in patients with paroxysmal nocturnal hemoglobinuria (PNH) are very scarce. It may be anticipated that vaccine can be associated with pharmacodynamic crisis of PNH, as well with other non-PNH-oriented complications. Methods: Retrospective analysis of PNH patients treated with eculizumb, who received any SARS-CoV-2 vaccine, while on eculizumab. Results: Twenty-five patients, 52% males, median age at the first vaccination 37 years (1-76) were included. Patients received median 3 (1-3) doses of SARS-CoV-2 vaccine. Most patients received BNT162b2 (96%) either alone or in combination with other vaccines; 16% patients received at least one dose of mRNA-1273 vaccine, and 4% ChAdOx1-S. Fifty-six percent patients experienced any complication after the first vaccine, 52% after the second, and 50% after the third. The complications were mostly mild and comprised arm pain and fatigue. No cases of patient-reported breakthrough hemolysis were diagnosed, exacerbation of hemolysis in biochemical tests was noted in 24%, 42% and 7% after the first, second and third dose respectively. Three serious adverse events were diagnosed in two patients: one case of possible vaccine-induced immune thrombotic thrombocytopenia (VITT) according to ASH criteria, requiring hospitalization and anti-coagulation after the first dose of BNT162b2; one splenic infarction after the second dose of BNT162b2 with thrombocytopenia complicating heparin treatment and one case of atrial fibrillation after the third dose of BNT162b2. No patient succumbed to complications of SARS-CoV-2 vaccines. Conclusions: SARS-CoV-2 vaccine in patients diagnosed with paroxysmal nocturnal hemoglobinuria may be associated with serious adverse events. Careful monitoring and appropriate treatment of emergent complications are mandatory. [ABSTRACT FROM AUTHOR]

Introduction: Tuberculosis (TB) is an infrequent infectious complication of hematopoietic cell transplantation, either autologous (auto-HCT) or allogeneic (allo-HCT). There is a paucity of data on the frequency and outcome of TB in patients after HCT. Material and methods: Retrospective analysis of patients who developed TB after HCT. The analysis covered the years 1996-2021. Results: Seventeen patients from 11 centers were identified, 9 (53%) females, the median age at TB was 44 years (19-69). Five patients (29.4%) developed TB after auto-HCT, 12 (70.6%) after allo-HCT. The underlying hematological diagnoses were mostly acute leukemias (52.9%). The median time from the most recent HCT to TB diagnosis was 431 days (5-973). Microbiologically proven TB was confirmed in 13 (76.5%) patients. All patients were diagnosed with pulmonary TB; the extrapulmonary sited accompanying the lung involvement were the bones or the joints (18%). The most frequent symptoms were cough (64.7%) and fever (52.9%). 3-drug anti-TB regimen was used in 5 (31.3%), 4-drug regimen (in all patients INH-RIF/Rifabutin-PZA-EMB) in 10 (62.5%) out of 16 patients. Treatment success was obtained in 13 (81.3%) patients. With median follow-up of 48 months (95% CI 19-95 months), the median overall survival (OS) calculated from the time of TB diagnosis was not reached, the 6-month OS was 93.9% (64-99%), the 12-month OS 87.9% (59-96%). One patient (5.9%) succumbed to TB, translating into 1-year cumulative incidence of TB-associated death of 6.25% (95% CI 3.3-9.2%). Conclusions: Tuberculosis is a rare complication of HCT. It can develop anytime, although most frequently it develops after more than a year from the most recent HCT. Treatment success rate is similar to the rate obtained in the general population as reported by the World Health Organization. TB may be associated with death of the affected patients. [ABSTRACT FROM AUTHOR]