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Background: Acute leukemia of ambiguous lineage (ALAL) is infrequent in occurrence with research data available only as small case series, thus leading to a diverse approach in the management. Using "Acute lymphoblastic leukemia (ALL)- type" induction therapy along with a tyrosine kinase inhibitor for t (9,22) has achieved higher remission rates with less toxicity compared with the more intensive AML induction chemotherapy in many case series. The role of immunophenotypic and genetic markers in directing chemotherapy and the utility of targeted therapy is still unknown. In current study, 12 patients who were diagnosed with ALAL have been retrospectively analyzed for patient demographics, hematopathological profile and induction outcomes. Among 12 patients, there were 9 male and 3 female. 25% of the patients showed t (9,22) and 16.6% showed other cytogenetic abnormalities. 5 patients showed remission after induction, 5 failed after induction, 1 expired before induction and 1 deferred chemotherapy. 50% of the patients who were started on ALL- type induction chemotherapy have shown good outcomes. Prospective studies are required to establish the best therapeutic approach in this heterogeneous disease. [ABSTRACT FROM AUTHOR]

Background: Imatinib has changed the treatment of chronic myeloid leukemia (CML) drastically since 15 years. It is usually well tolerated, but severe persistent marrow aplasia is an unusual complication of imatinib while using it in CML. The aim of this study is to describe our experience confronting this rare side effect and review the available data worldwide. Patients and Methods: It was a retrospective analysis conducted at a center from February 2002 to February 2015. This study was endorsed by our Institutional Review Board (IRB) and written consent was taken from all patients. Patients diagnosed as Philadelphia (Ph) chromosome‑positive CML either in chronic phase (CP), accelerated phase (AP), or blastic crisis (BC) were included. There were a total of 1,576 patients with CML treated with imatinib during this period. Karyotyping and quantitative reverse transcriptase polymerase chain reaction (RT‑qPCR) were done at the time of pancytopenia for all patients. Results: In total, 11 (males = 5, females = 6) patients met our inclusion criteria from 1,576 patients of CML. The median age was 58 years (range 32–76). Out of 11 patients 8, 2, and 1 patients were in CP, AP, and BC phases, respectively. The median time of administration of imatinib was 3.3 months(range 1.5–6). The average time of marrow recovery was 10.4 months(range 5–15). Two patients expired (one from septicemia and the other from intracranial hemorrhage). BCR‑ABL transcripts level by RT‑PCR revealed the existence of the disease in all patients. Conclusion: Imatinib is a very well‑tolerated tyrosine kinase inhibitor (TKI), but is associated with persistent myelosuppression when used in older age, advanced phase of the disease, and treated previously. After confirming persistent marrow aplasia, the treatment is mainly supportive. It is striking that the disease is still persistent, which is confirmed by RT‑PCR. There is no consensus regarding recalling imatinib at lower doses or the use of second‑generation TKI (nilotinib, dasatinib) in these patients. [ABSTRACT FROM AUTHOR]

Byline: Andeep. Kukkar, Harsha. Panchal, Asha. Anand Primary neuroendocrine tumors of the thymus are unusual anterior mediastinal tumors with a variable prognosis. A retrospective analysis of five patients with primary [...]

Byline: Rahul. Kulkarni, Sonia. Parikh, Asha. Anand, Harsha. Panchal, Apurva. Patel, Priti. Trivedi, Kshitij. Joshi, Pushpak. Chirmade Solitary plasmacytoma of the bone (SPB) is a rare plasma cell neoplasm representing [...]

BACKGROUND: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired hematological disorder characterized by episodic intravascular hemolysis. Despite newer therapies such as eculizumab, hematopoietic stem cell transplantation (HSCT) remains the only curative therapy. MATERIALS AND METHODS: An observational analytical retrospective study was conducted comprising eight PNH patients who had undergone HSCT at our center. From January 2014 to December 2020, we performed HSCT in 8 PNH patients, 5 female and 3 male, with median age of 32 years (range: 15–38 years). RESULTS: Seven patients had pancytopenia, associated with marrow hypocellularity. One patient presented with a thrombotic episode. Seven had matched sibling donor (MSD) transplant and one underwent haploidentical transplant. The median time from diagnosis to transplant was 7 months (range: 1–38 months). All received reduced intensity conditioning (RIC): Flu-Bu-Cy-A TG for MSD transplants and Flu-A TG-Post Cy in haploidentical transplants. Median CD34+ stem cell dose was 5.5 × 106/kg (range 3.4–5.8 × 106/kg). All had successful engraftment. Acute graft versus host disease (GVHD) Grade I–III occurred in six patients. Chronic GVHD occurred in two patients. One patient succumbed to Grade III liver GVHD. Rest seven patients are alive till date and transfusion independent. The overall survival was 87.5% at a median of 26 months. CONCLUSIONS: HSCT is the only curative therapy for PNH. With the use of RIC, the outcomes of PNH patients can be improved. The incidence of GVHD is high with RIC regimens but can be managed with prompt immunosuppression. [ABSTRACT FROM AUTHOR]