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Background: Second- and third-generation tyrosine kinase inhibitors (TKIs) are now available to treat chronic-phase chronic myeloid leukemia (CP-CML) in the first and second line. However, vascular adverse events (VAEs) have been reported for patients with CML treated with some TKIs. Methods: We retrospectively evaluated the cumulative incidence (CI) and cardiovascular risk for 210 patients included in the Canarian Registry of CML. Result: With a mean follow up of 6 years, 19/210 (9.1%) patients developed VAEs, all of whom presented at least one cardiovascular risk factor at diagnosis. The mean time to VAE presentation was 54 months from the start of TKI treatment. We found a statistically significant difference between the CI for nilotinib-naïve vs. nilotinib-treated patients (p = 0.005), between dasatinib-naïve and dasatinib-treated patients (p = 0.039), and for patients who received three lines of treatment with first-line imatinib vs. first-line imatinib (p < 0.001). From the multivariable logistic regression analyses, the Framingham risk score (FRS) and patients with three lines of TKI with first-line imatinib were the only variables with statistically significant hazard ratios for VAE development. Significant increases in HDL-C and total cholesterol may also be predictive for VAE. Conclusions: In conclusion, it is important to estimate the cardiovascular risk at the diagnosis of CML as it can help determine whether a patient is likely to develop a VAE during TKI treatment. [ABSTRACT FROM AUTHOR]

Summary: Intravenous Anti‐Rhesus‐D immunoglobulin (Anti‐D) is a first‐line treatment option for immune thrombocytopenia in non‐splenectomised and RhD‐positive patients. In this report, we retrospectively review our experience with intramuscular (IM) Anti‐D treatment in 74 adult patients between 1990 and 2018. We found that 73% of patients showed a response; almost all of them had complete responses (68.9%), and 26% achieved complete responses sustained at least 6 months after treatment discontinuation. [Correction added on 02 December 2022, after first online publication: In the preceding sentence, '(68.89%)' has been corrected to '(68.9%)' in this version.] No significant side effects were observed with no cases of acute haemolysis or anaemia reported. We conclude from this study that IM Anti‐D is an effective and safe treatment for immune thrombocytopenia. [ABSTRACT FROM AUTHOR]

Introduction: The addition of imatinib to the therapeutic arsenal for chronic myeloid leukaemia (CML) has changed the natural course of the disease, in such a way that it is now considered a chronic pathology. However, to achieve therapeutic success, it is necessary to reach adequate plasma concentrations to ensure efficacy and safety. In this study, we aimed to evaluate the plasma concentration of imatinib, analysing its influence on effectiveness and safety in patients with CML. Methods: We performed a descriptive, multicentre study in which imatinib plasma levels from patients diagnosed with CML between 2019–2020 were analysed. An optimal therapeutic range of 750–1500 ng/mL was established for the stratification of patients, according to their minimum plasma concentrations measured at steady state (Cssmin). Results: A total of 28 patients were included, of whom only 39.3% (n = 11) showed Cssmin within the therapeutic range. 100% of patients with Cssmin >750 ng/mL achieved an optimal molecular response, while only 50% of patients with Cssmin <750 ng/mL achieved an optimal molecular response (p = 0.0004). The toxicity rate was 36.4% for patients with Cssmin >1500 ng/mL and 5.9% for those with Cssmin <1500 ng/mL (p = 0.039). Conclusions: This study aimed to describe the correlation between the toxicity and effectiveness of imatinib according to its Cssmin in routine clinical practice conditions. Based on our findings, it would be certainly justified to monitor patient plasma concentrations of imatinib on a daily routine basis in our hospitals. [ABSTRACT FROM AUTHOR]

Management of patients with relapsed or refractory (R/R) AL amyloidosis is complex. Some initial reports have shown positive results with daratumumab in heavily pre-treated AL amyloidosis patients. In this retrospective multicentric study, 38 patients (mean age 64 ± 9 years) with R/R AL amyloidosis treated with daratumumab were included. Cardiac and renal involvement was present in 76 and 74% of patients, and 42% had ≥3 organs involved. Median number of previous lines of therapy was 2 (range 1–8). Overall hematological response was 72%, including 28% complete responses. The median time to first hematological response was 2 weeks. A high-quality response (≥very good partial response) was obtained in 65% of patients who had never achieved such depth of response previously. Hematological responses were more frequent among patients receiving daratumumab as second-line therapy compared to subsequent therapies (92 vs. 61%). Cardiac and renal organ response rates were 37 and 59%. At 12 months, overall and progression-free survival were 59% (95%CI: 0.36–0.77) and 52% (95%CI: 0.29–0.70), respectively. Daratumumab is a safe and effective drug in the treatment of R/R AL amyloidosis and should be considered early in the course of the disease. [ABSTRACT FROM AUTHOR]

Vancomycin-resistant enterococci (VRE) infections and outbreaks are still infrequent in Spain. A six-month outbreak, which took place in a haematology ward, its control and management are described in this study. A total of 22 patients were colonised and two bloodstream infections occurred during this period. Even though there were two waves of new colonised patients, a multidisciplinary approach, quick interventions and enhanced infection control policies were required in order to control this outbreak. [ABSTRACT FROM AUTHOR]

Introduction. The brain-derived neurotrophic factor (BDNF) is a neurotrophin that has been linked to the schizophrenia neurodevelopmental hypothesis. Several studies confirm that the BDNF levels in first-episode psychosis (FEP) are lower than in healthy controls (HC). However, data about evolution of BDNF levels after a FEP and about the prognostic value of these levels are controversial. Method. Serum BDNF levels at admission of 28 inpatients with FEP were compared with 28 HC. BDNF was also measured at discharge, three, six, nine and twelve months. BDNF levels are presented in ng/ml. We looked for correlation of BDNF levels with the psychotic symptomatology measured with the Positive and Negative Syndrome Scale (PANSS) and also the prognostic value of basal levels was evaluated to predict poor functionality (measured by the Global Assessment of Functioning) and/or relapse, as well as the subsequent diagnosis of a chronic psychotic disorder. Results. At admission, patients BDNF levels were significantly lower than HC levels (18.52±4.51 vs. 26.55±3.22, p<0.001). At discharge FEP levels increase until HC levels (25.95±3.96 vs. 26.55±3.22, p=0,539). Upon the following determinations, BDNF FEP levels decreased, reaching the admission values, and being significantly lower than the HC and the levels at discharge (patients: three months: 19.68±3.88; six months: 19.02±4.13; nine months: 17.64±5.24; twelve months: 17.51±3.45 vs. HC: 26.55±3.22, all p<0.001). A negative correlation was found between admission BDNF levels and the PANSS negative symptoms subscale score with a trend towards significance (r=-0.303, p=0.093). BDNF levels at admission of patients with por functionality and/or relapse at 12 months were lower than BDNF levels of patients with goof functionality and without relapse, this difference had a trend towards significance. (15.38±4.72 vs. 19.57±4.06; p=0.071). We didn't found differences between basal BDNF levels of patients who developed a chronic psychotic disorder and patients who didn't. Conclusions. Our results reinforce the neurotrophin hypothesis. Basal levels (at diagnosis) of a FEP could predict the prognosis in terms of functionality and risk of relapse in the first year. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 62-year-old male, known hypertensive and diabetic on medication, who was taken up for coronary artery bypass surgery (CABG) after a thorough pre-anaesthetic check-up. It mentions that when drapes were removed after the surgery, the patient's right arm was extremely tense and swollen with cyanosed fingers and absent pulses. It also mentions that prompt recognition and treatment are vital for limb salvage in compartment syndrome.

The article presents a case study of a 35-year-old man who was diagnosed with ileocolonic Crohn's disease. The patient was placed on maintenance therapy with azathioprine (AZA) with no complications after surgery. Activated macrophages and erythrophagocytosis were revealed on bone marrow aspirate. Ganciclovir and intravenous corticosteroids treatment was initiated.