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The purpose of this article was to present a case of successful long term treatment with azacitidine in patient with Chronic Myelomonocytic Leukemia (CMML) and discussing possible contributing factors for its long term efficacy. Data from our case were compared with similar data available in the literature. Effective treatment with azacitidine resulted in overall survival of 11 years 5 months and we showed that applying multiple cycles of treatment is feasible. Our patient received 71 cycles of treatment with total duration of 7 years and 3 months. Our report about a patient with CMML and a good clinical course revealed, that long term treatment with azacitidine is feasible in some patients. Initially low bone marrow blast count, a relatively small malignant CMML clone, reduction of spleen size and fast platelet response seemed to be factors determining long term response to treatment in our patient. More data on CMML treatment by Hypomethylating Agents and their analysis are needed in order to make firm conclusions. [ABSTRACT FROM AUTHOR]

Copyright of Acta Medica Croatica is the property of Croatian Academy of Medical Sciences 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 Veterinary Archives / Veterinarski Arhiv is the property of University of Zagreb, Faculty of Veterinary Medicine 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.)

The article discusses the impact of subconjunctival transplantation of limbal stem cell allografts on the hematology factors in dogs. Topics discussed include the study proving the potential of the cornea as a major source of stem cells for medicinal use, the study involved dogs suffering from chronic thinning of the central cornea, and results proving that the limbal stem cell allografts did not change haematology factors in dogs.

The article presents a study on harvesting porcine limbal transplants in a controlled environment, wherein the stem cells are studied due to their tissue regeneration capabilities. The porcine limbal stem cells are being analyzed in terms of their functioning patterns and have their development conditions enhanced so that a biomedical template will be designed to analyze the advantages of xenografts using porcine tissues. The study concludes that porcine stem cells are suitable as a reparative medicine for both animals and humans.

Objectives: Port catheters are central venous catheters used as therapeutic devices in oncological patients. They are used for the administration of chemotherapeutic agents, antibiotics infusion, transfusion of blood products or parenteral nutrition1. Their insertion and their use may be associated with serious complications. Port catheters insertion is usually performed by an oncologist, a radiologists or a surgeon1. In our institution a cardiologist implants those devices. The purpose of this study is to determine early complications of port catheter insertion by cardiologists. Patients and Methods: Data from 76 patients with hematological malignancies, who had received a venous port catheter in University Hospital Merkur between October 2013 and May 2017, were collected and analyzed. The port catheter insertion procedure was performed by two cardiologists and all procedures were done through right subclavian venous access under fluoroscopy guidance. Results: Of the 76 patients, 42 (55.2%) were females and 34 (44.7%) males. Mean age was 51 years (range 21-65 years). Total catheter stay time was 897 months and mean time of catheter use was 402 days. A total of 76 port insertion were successful. Pneumothorax was observed in 4 patients (5.2%). Malposition (catheter tip in the left subclavian vein or internal jugular vein) was observed in 3 (3.9%) patients. Pocket hematoma was observed in 3 (3.9%) patients. None of these early complications required catheter extraction. Severe arrhythmia, cardiac perforation, thrombosis, hemothorax, catheter dysfunction, pocket infection were not observed in our study. Conclusion: The implantation of port catheters is a valuable method for long term treatment hematological malignancies. The rate of early complications in our study is comparable to the published data1. So, venous port catheters placement can be performed safely by cardiologists. [ABSTRACT FROM AUTHOR]

Zygomicosis is a fungal disease caused by fungi from the Zygomycota order that are usually airborne spread, with pulmonary and rhinocerebral involvement being the most common. Once in the bloodstream, spores tend to accumulate in vascular tissues leading to thrombosis, infarction, and necrosis of involved tissues. In immunocompromised patients, such as those with hemophagocytic syndrome, zygomicosis is frequently characterized by fulminant disseminated disease, with a 80% mortality rate. We present a 45-year old patient with hemophagocytic syndrome who was treated with steroids, etoposide, and cyclosporine. Two months after the initial treatment, the patient was admitted for a respiratory infection, and was treated with antibiotics and antiviral drugs with a good clinical and laboratory response to the therapy. On the tenth day there was a sudden clinical deterioration with signs of left-sided heart failure, elevated troponin levels, and ECG showing a complete AV block. Right-sided hemiparesis and elevated inflammatory parameters were also present. A temporary pacemaker was placed. A brain MDCT was performed and multiple ischemic and hemorrhagic lesions were found. Emergency echocardiography study showed a semi-mobile, peduncular mass in the left ventricle. It originated from the anterior mitral leaflet, measuring 4x2 cm and protruding to the LV cavity. There were no disorders of myocardial contractility, and ejection fraction was 60% (Figure 1). Echocardiographic features of the mass resembled a myxoma. The patient died three hours later from multiple organ dysfunction syndrome. Autopsy showed disseminated zygomicosis infecting the heart with a mycotic mass in left ventricle. The leptomeninges, brain, and lungs were also infected. Primary heart tumors are rare, accounting for 0.0017-0.19% on unselected biopsies. In immunocompromised patients with a new heart mass, a mycotic mass as a sign of disseminated mycosis should be considered before a primary heart tumor in order to start appropriate treatment. Mortality of patients with disseminated zygomycosis and heart mass is very high and survival is only possible with a combined surgical and antimicrobial approach. The diagnosis of disseminated zygomycosis was considered however due to the patient's abrupt clinical deterioration, and fulminant course cardiothoracic treatment could not to be arranged. [ABSTRACT FROM AUTHOR]

Iron overload due to red blood cell (RBC) transfusions is associated with morbidity and mortality in lower-risk myelodysplastic syndrome (MDS) patients. Many studies have suggested improved survival after iron chelation therapy (ICT), but valid data are limited. The aim of this study was to assess the effect of ICT on overall survival and hematologic improvement in lower-risk MDS patients in the European MDS registry. We compared chelated patients with a contemporary, non-chelated control group within the European MDS registry, that met the eligibility criteria for starting iron chelation. A Cox proportional hazards model was used to assess overall survival (OS), treating receipt of chelation as a time-varying variable. Additionally, chelated and non-chelated patients were compared using a propensity-score matched model. Of 2,200 patients, 224 received iron chelation. The hazard ratio and 95% confidence interval for OS for chelated patients, adjusted for age, sex, comorbidity, performance status, cumulative RBC transfusions, Revised-International Prognostic Scoring System (IPSS-R), and presence of ringed sideroblasts was 0.50 (0.34-0.74). The propensity-score analysis, matched for age, sex, country, RBC transfusion intensity, ferritin level, comorbidity, performance status, and IPSS-R, and, in addition, corrected for cumulative RBC transfusions and presence of ringed sideroblasts, demonstrated a significantly improved OS for chelated patients with a hazard ratio of 0.42 (0.27-0.63) compared to non-chelated patients. Up to 39% of chelated patients reached an erythroid response. In conclusion, our results suggest that iron chelation may improve OS and hematopoiesis in transfused lower-risk MDS patients. This trial was registered at clinicaltrials.gov identifier: 00600860., (Copyright© 2020 Ferrata Storti Foundation.)

Prognosis of lower-risk (International Prognostic Scoring System [IPSS] low/intermediate-1) myelodysplastic syndrome (MDS) is heterogeneous and relies on steady-state assessment of cytopenias. We analyzed relative drops in neutrophil and platelet counts during the first 6 months of follow-up of lower-risk MDS patients. We performed a landmark analysis of overall survival (OS) of lower-risk MDS patients prospectively included in the European LeukaemiaNet MDS registry having a visit at 6 ± 1 month from inclusion to assess the prognostic relevance of relative drops in neutrophils and platelets, defined as (count at landmark - count at inclusion)/count at inclusion. Of 2102 patients, 807 were eligible for the stringent 6-month landmark analysis. Median age was 73 years. Revised IPSS was very low, low, and intermediate/higher in 26%, 43%, and 31% of patients, respectively. A relative drop in platelets >25% at landmark predicted shorter OS (5-year OS, 21.9% vs 48.6% with platelet drop ≤25%, P < 10 -4 ), regardless of baseline IPSS-revised or absolute platelet counts. Relative neutrophil drop >25% had no significant impact on OS. We built a classifier based on red blood cell transfusion dependence (RBC-TD) and relative platelet drop >25% at landmark. Patients with none (62%), either (27%), or both criteria (11%) had 5-year OS of 53.3%, 32.7%, and 9.0%, respectively ( P < 10 -4 ). This classifier was validated in an independent cohort of 335 patients. Combining relative platelet drop >25% and RBC-TD at 6 months from diagnosis provides an inexpensive and noninvasive way to predict outcome in lower-risk MDS. This study was registered at www.clinicaltrials.gov as #NCT00600860., (© 2018 by The American Society of Hematology.)

Myelodysplastic syndrome Working Group of the Croatian Cooperative Group for Hematologic Diseases (CROHEM), Referral center of the Ministry of Health of the Republic of Croatia for diagnostics and treatment of MDS, as well as the Croatian Society for Haematology of the Croatian Medical Association have made Croatian guidelines for diagnosis and treatment of myelodysplastic syndrome (MDS). MDS is a heterogeneous group of clonal hematopoietic stem cell disorders characterized by ineffective hematopoiesis, dysplasia, cytopenia and risk of transformation to acute myeloid leukemia (AML). Diagnosis is based on morphological characteristics of hematopoietic cells supplemented with the cytogenetic analysis and bone marrow flow cytometry. Due to great differences in the natural course of the disease, i.e. time to progression to AML and the expected time of survival several scoring systems have been developed to determine the disease risk. The treatment of patients with MDS is based on the risk factors of the disease as well as the individual risk of treatment.

Autologous stem cell transplantation represents the gold standard in chemosensitive diffuse B large cell lymphoma in relapse or in refractory setting. The aim of this study was to present the outcome of peripheral autologous stem cell transplantation in patients with refractory or relapsed diffuse large B cell lymphoma. We retrospectively analysed the data of 62 patients, who underwent this procedure for the period 2000-2013. The majority of patients (71%) were treated with miniBEAM salvage chemotherapy and all received BEAM myeloablative protocol followed by the stem cell reinfusion. The overall response rate for autologous transplantation was 75.8%. Median overall survival was 37.2 months. Median event-free survival was 16.9 months. Factors associated with overall survival were state of disease prior to salvage chemotherapy, chemosensitivity of disease, International prognostic index, disease activity at the relapse, response to autologous transplantation and post-transplantation radiotherapy. The use of rituximab was not significantly correlated to the outcome. In this patient group autologous stem cell transplantation was found to be effective in achieving remission and survival showing the adequate role of this procedure in this clinical setting. We stress out that autologous stem cell transplantation was effective in 32.5% patients with chemorefractory disease after salvage therapy.