Meltem Kurt Yüksel

Primary mediastinal large B-cell lymphoma (PMBCL) is an aggressive lymphoma subtype that predominantly affects young adults and is commonly treated with dose-adjusted EPOCH-R (DA-EPOCH-R), which provides high response and cure rates. Despite its efficacy, intensive chemotherapy regimens may lead to rare but clinically significant metabolic and renal complications. Here, we report a case of acute kidney injury (AKI) developing during DA-EPOCH-R therapy, most consistent with isolated acute uric acid nephropathy in the absence of classical tumor lysis syndrome (TLS).

AlloHCT remains a curative option for R/R Hodgkin lymphoma despite advances with BV and CPIs. This study evaluates its role and outcomes in this challenging patient population. This retrospective oligocentric analysis involved 70 patients with R/R classical HL who underwent alloHCT. Patients were split into two treatment cohorts: era1 (2004-2010), 16 patients, and era2 (2011-2021), 54 patients. Among the cohort, sixty-three patients had previously received an autologous stem cell transplant. Forty patients were administered only (n=29) BV or BV preceding CPI (n=11) before alloHCT. A median follow-up of 64 months (40.7-87.3) revealed a 100-day non-relapse mortality (NRM) rate of 26%, with the 3-year overall survival (OS) and progression-free survival (PFS) reported as 39% and 28%, respectively. AlloHCT using haplotype-matched donors was linked to better OS and PFS. Post-transplant cyclophosphamide (post-tx CY) as a prophylactic approach for graft versus host disease (GVHD) significantly improved OS and PFS. A complete response (CR) during the post-transplant phase significantly improved OS and PFS. Indeed, better OS, PFS, and a reduced rate of NRM were observed in the pre/post-alloHCT BV and CPI group, although we could not demonstrate statistical significance. The survival (OS, PFS) curves and NRM rates were similar for both eras. AlloHCT is a potentially practical therapeutic approach in responding to R/R HL patients.

Existence of panel reactive antibodies is the limiting step in both solid-organ and hematopoietic stem cell transplantation. There are hypotheses related to panel reactive antibody formation, but there is no knowledge about its formation in acute leukemia at diagnosis and during the chemotherapy period, in which there is a strong myelosuppression and immunosuppression. We aimed to determine the panel reactive antibodies positivity in acute leukemia patients at diagnosis and during the entire therapy period, including stem cell transplantation. In this single-center prospective study, we enrolled 35 patients with acute leukemia (8 with acute lymphoblastic leukemia, 27 with acute myeloid leukemia). Serum samples were obtained before induction therapy and every 3 months thereafter until the last follow-up or death, for a median of 369 days (minimum-maximum, 9-725 days). Panel reactive antibodies were defined with single-antigen bead assays on a Luminex platform. A total of 10 patients (29%) were found to have panel reactive antibodies at any time point. At diagnosis, 5 patients (14.3%) had antibodies of either class I (n = 2) or II (n = 1) or both (n = 2), and in 4 patients these persisted during median follow-up of 168 days (minimum-maximum, 9-322 days). Among the remaining 30 patients, an additional 5 (17%) developed de novo antibodies. Incidence rate of development of de novo antibodies was 5.5 per 10 000 person-days. There was no effect of transfusion load on the development of panel reactive antibodies. Differences in percentages in males versus females, blood type mismatch, and graftversus-host disease were higher in patients who had de novo antibodies after transplantation. Positivity at any time had no statistically significant effect on overall survival (P = .71). Panel reactive antibodies do not occur frequently in the acute leukemia setting despite intensive transfusions.

Background/Objectives: Eltrombopag, a thrombopoietin receptor agonist, is widely used in the treatment of relapsed or refractory (R/R) immune thrombocytopenia (ITP). This study aimed to compare the efficacy, safety, and tolerability of generic eltrombopag (Rompag^®) with original eltrombopag (Revolade^®) in adult patients with R/R ITP. Methods: In this prospective, multicenter study conducted at 10 centers, 104 adult ITP patients were followed for at least 3 months. A total of 35 (33.7%) patients received Rompag^® and 69 (66.3%) received Revolade^®. The primary endpoint was platelet (PLT) response, defined as achieving a PLT count ≥50 × 10⁹/L and at least a twofold increase from baseline, without the need for rescue therapy or transfusion. Secondary endpoints included bleeding rates, fatigue-related quality of life, adverse events (AEs), and rescue therapy requirements. Results: PLT response was achieved in 94.2% of patients in the Revolade^® group and 85.7% in the Rompag^® group (p = 0.16). Bleeding rates decreased significantly in both groups (Revolade^®: 56.5% to 2.9%, p < 0.001; Rompag^®: 62.9% to 2.9%, p < 0.001). Although overall AE rates were similar (30.4% in the Revolade^® group and 42.9% in the Rompag^® group; p = 0.22), arthralgia (28.6% vs. 7.2%, p = 0.01) and vomiting (11.4% vs. 0%, p = 0.008) were more frequent with Rompag^®. Conclusions: Both generic and original eltrombopag demonstrated no statistically significant difference in efficacy in achieving PLT response, reducing bleeding, and improving fatigue-related quality of life in adult patients with R/R ITP. Although minor differences in AE profiles were observed, particularly arthralgia and vomiting, both formulations showed acceptable safety and tolerability.

Leishmaniasis is a vector-borne parasitic disease transmitted by the bite of infected female sandflies. Leishmania species can cause various clinical manifestations, ranging in severity from spontaneously regressing cutaneous lesions to visceral disease, which is fatal in over 95% of cases if left untreated. Visceral leishmaniasis (VL) presents unexplained

Objectives: During and after allogeneic hematopoietic stem cell donation, donors may experience adverse events. This situation can increase anxiety of candidate donors. Time to return to daily life routine and work, presentation of comorbid diseases in follow-up, and donor opinions are topics of interest. Materials and Methods: We conducted a 14-question survey among related stem cell donors between January 2010 and March 2019 by telephone interview. Results: Of 257 related donors, 175 (68.1%) were interviewed; 87 (49.7%) were female and 88 (50.3%) were male. Among donors interviewed, 144 (82.3%) donated from only peripheral blood. After harvesting of stem cells, adverse events included hip pain (38.7%), bone pain (57.2%) during mobilization, and paresthesia (28.9%) during apheresis. After apheresis, 2 serious adverse events were reported in 2 (1.3%) female donors (1 salpingo-oophorectomy and 1 nephrectomy). Splenomegaly was observed in 1 male donor (0.7%). Among donors interviewed, 77 (44%) reported being able to perform daily activities on the same day. The shortest time to daily activity was in the peripheral blood group, and the longest was in the bone marrow group (P = .001). Among working donors, 23 (27.4%) returned to work on the same day; all were peripheral blood donors. Among donors interviewed, 114 (65.1%) wanted to volunteer to donate again. One donor (0.6%) expressed guilt after donation, and 162 (92.6%) recommended other people to be stem cell donors. During the follow-up period, musculoskeletal-joint diseases increased after donation (P = .012). Conclusions: It is important to raise awareness in society about stem cell donation and to reduce the concerns among donor candidates. Although most of the adverse events after donation are temporary and mild, a few serious adverse events in donors have been observed. Stem cell donation does not cause loss of daily activity or inability to return to the work force.