bluuebunny/crossref_metadata_2025_split huggingface dataset:
PB2105 RESULTS OF BONE DENSITOMETRY IN PATIENTS WITH MULTIPLE MYELOMA DURING TREATMENT
Authors: Sergey A. , Troyan V. , Sergey K. , Rukavitsyn O. 
Published: June 2019

Background:Multiple myeloma is a malignant tumor consisting of plasma cells, with infiltration which increases bone resorption, increases the activity of osteoclasts, changes bone mineral density in the form of osteopenia and osteoporosisAims:to evaluate and compare bone density over time in patients with multiple myeloma after high‐dose chemotherapy with autotransplantation of hematopoietic stem cells.MethodsPrior to treatment, all patients (n = 64) were densitometry of the spine, both hip joints in a direct projection and repeated after 7‐12 months (m = 10). The results were evaluated by the T‐test in the values of standard deviations (SD): norm (+ 2.5SD> ‐1SD); osteopenia (<‐1SD> ‐2.5SD); osteoporosis <‐2.5SD. The results of densitometry in patients with multiple myeloma were compared before and after high‐dose chemotherapy with autotransplantation of hematopoietic stem cells, and patients who received standard chemotherapy.Results:Before treatment, the data of densitometry in the group of patients with chemotherapy (n = 35): in 12 (34.2%) patients the norm (‐0.425 ± 0.078SD); 18 (54.4%) patients had osteopenia (‐1.633 ± 0.056 SD); in 5 (14.2%) osteoporosis (‐2.62 ± 0.033 SD). In the group of patients with stem cell transplantation (n = 29), the following results were obtained: the norm (‐0.4 ± 0.145 SD) in 8 (27.5%) people; osteopenia (‐1.831 ± 0.071 SD) ‐ in 16 (55.1%) patients; osteoporosis (‐2.68 ± 0.033 SD) ‐ in 5 (17.4%) people. In the statistical analysis, the median MTF of both groups was m = ‐1.6SD. After the treatment, 10–12 months later, in the control group with chemotherapy (n = 35), the changes were less pronounced: the norm (–0.467 ± 0.077 SD) in 12 (34.2%) patients; in 18 (54.4%) patients with osteopenia (‐1.472 ± 0.056 SD); osteoporosis (‐2.7 ± 0.063 SD) in 5 (14.2%) people. In the group of patients with transplantation after the treatment, the indicators were as follows: T‐criterion is within normal limits (–0.137 ± 0.135 SD); osteopenia (‐1.83 ± 0.071 SD) osteoporosis (‐2.64 ± 0.022 SD). When analyzing the changes in the density level in each specific patient before and after treatment using the Student's t‐criterion, it turned out that in the group with high‐dose chemotherapy, the dynamics of the increase in the density level were significantly better in the groups of patients with initially normal and osteoporotic groups (= 5.77; (p <0.001) and t = 2.45; (p <0.01), respectively, in the studied groups).Summary/Conclusion:After high‐dose chemotherapy with autotransplantation of hematopoietic stem cells, the mineral density of bone tissue increases significantly, which can be assessed by densitometric studies.
PB2136 DO FUNCTIONAL VARIANTS OF MIF AND MBL GENES INFLUENCE OUTCOME IN PATIENTS UNDERWENT AUTOLOGOUS STEM CELL TRANSPLANTATION FOR MULTIPLE MYELOMA?
Authors: Pehlivan M. , Nursal A. F. , Gündeş I. , Oyacı Y. , Kıvanç D. , Pehlivan S. 
Published: June 2019

Background:Multiple myeloma (MM) is a plasma cell malignancy, with wide survival range and multiple risk factors and staging systems linked to survival. Macrophage migration inhibitory factor (MIF) is a potent proinflammatory cytokine. Mannose‐binding lectin (MBL) enhances opsonization and activates complement.Aims:This analysis was performed to evaluate the relationships of MIF ‐173G/C and MBL codon 54 variants with clinical feaures and susceptibility in patients underwent Autologous stem cell transplantation (ASCT) for MM.MethodsA total of 155 patients (Female/Male:74/81) who underwent ASCT and 200 healthy subjects (Female/Male:99/101) were included. The median follow‐up period was 36 months. Genotyping of these variants was determined by PCR‐RFLP. Genotype and allele frequencies were compared between the study groups using χ2‐test. Kaplan‐Meier curves for Progression‐free survival (PFS) and Overall survival (OS) were compared using a log‐rank test.Results:The median age at diagnosis is 55 years for patients. In all, median OS was 79 months in patients. OS showed that 16.1% patients died. PFS was associated with gender (p = 0.049, 95% Cl:0.258‐0.998). Individuals with BB genotype showed a significant association with 10.607‐fold increased risk of MM (p = 0.001). The genetic analysis association with survival was performed under a recessive genetic model (CC vs. GG/CG). MIF GC/GG genotype was significantly associated with longer OS (median 5 years) compared to CC genotypes (Log Rank p = 0.016).Summary/Conclusion:Our study indicated that the MBL codon 54 functional variant might contribute to MM susceptibility in Turkish population. Also our results imply that the OS in MM patients is associated with the ‐173G/C variant of MIF gene.
PB2182 OUTCOME OF FIRST‐LINE THERAPY FOR PATIENTS WITH SYSTEMIC LIGHT‐CHAIN AMYLOIDOSIS: MONOCENTRIC ANALYSIS
Authors: Fernández R. , Soto A. Silva , Cepeda F. , González A. , Robles V. , Fonseca E. , Sanchez S. , Torres J. , Sarasa M. , Chamorro P. , Álvarez A. , Arias T. , Bobes A. , Fernández A. , Fernández C. , González S. , González M. E. 
Published: June 2019

Background:Systemic light‐chain amyloidosis (AL) is characterised by deposition of misfolded immunoglobulin light chains within organs.Melphalan or cyclophosphamide with dexamethasone in combination with bortezomib are currently recommended first‐line therapy regimens.Aims:To describe the clinical presentation and outcomes for newly diagnosed AL amyloidosis patients.MethodsThis single‐centre retrospective study included all patients diagnosed with AL amyloidosis in our hospital area (300,000 inhabitants) between March 2012 to March 2018. Data regarding demography, diagnosis, treatment and follow‐up were extracted from the clinical history (HC).Survival curves were constructed according to the Kaplan‐Meier method and compared by logarithmic ranking.Time to progression (TTP) was defined as the time from the date of diagnosis or the start of a treatment for a disease until the disease worsens.Results:We analysed 24 patients (15women, 9 men) with newly diagnosed AL amyloidosis. Median age was 66 years (range 42‐82), and 6 pts were considered ASCT candidates. Involvement of kidney, peripheral nerve, heart, liver and other organs were found in 14 (35%), 13 (32.5%), 11 (24.5%), 1 (2.5%) and 1 (2.5%) cases, respectively.According to Mayo Stage 2012: stage 2: 25%, stage3: 33.33% and stage 4: 41.66%First‐line treatments were: regimens based on bortezomib CyBordex (cyclophosphamide, bortezomib and dexamethasone) n =  12, VTD (bortezomib, thalidomide and dexamethasone) n = 2, VMP (bortezomib, melphalan and prednisone) n = 2, BD (bortezomib and dexamethasone) n = 6, MP (melphalan and prednisone) n = 2 and CP (cyclophosphamide and prednisone) n = 1.Haematological responses of CyBordex, VTD, VMP, BD were 33.33%, 100% and 100% and 16.66% respectively.The haematological responses were: RC 25%, VGPR 33.33%, RP 8.33%, NR (no response) 33.33%The organ responses were 45.83% (n = 11). Median follow‐up of 19 months (95% CI 0‐49.9). Median PTT of 19 months (95% CI 0‐41.9).The rate of premature death within the first six months was 29.16%.Summary/Conclusion:Regimens based on bortezomib in newly diagnosed AL amyloidosis show results that seem comparable to those previously published in the literature.Almost a third of patients show no response, and premature death in six months is significative.To improve these outcomes, it is necessary to better define the role of proteasome inhibitors the role of new therapies.Educational interventions are important to optimize the diagnostic process and to reduce the rate of early deaths.
PB2192 GLOBAL COAGULATION CAPACITY OF ESSENTIAL THROMBOCYTHEMIA PATIENTS BY ROTEM ANALYSIS ADJUSTED FOR PLATELET COUNT CORRELATES WITH THROMBOTIC RISK CLASS
Authors: Giaccherini C. , Marchetti M. , Verzeroli C. , Gamba S. , Russo L. , Finazzi G. , Rambaldi A. , Falanga A. 
Published: June 2019

Background:Essential Thrombocythemia (ET) is characterized by hypercoagulability and increased risk of arterial and venous thrombosis. The thromboelastometry profile by ROTEM, a point of care system for assessment of global coagulation in whole blood, has never been investigated in these patients, who have abnormalities in blood cell counts. This approach is attractive in that the test reflects the activity of both soluble and cellular components of hemostasis. Furthermore, the test is rapid, does not require blood sample centrifugation and may be useful in prospective studies of thrombotic risk assessment in ET patients.Aims:To evaluate the global clotting process in ET patients by thromboelastometry with ROTEM and establish whether and to what extent elevated platelet count and mutational status affect the global hemostasis evaluation.MethodsAnalysis was performed in 52 ET patients using INTEM and EXTEM reagents, to evaluate the intrinsic and extrinsic pathway, respectively. Maximum clot firmness (MCF, [mm]), which reflects the maximum tensile strength of the thrombus, clotting formation time (CFT [sec]), namely the time that clot takes to increase from 2 mm to 20 mm above baseline, and clotting time (CT [sec]), the time to clot initiation, were recorded. Patient thrombotic risk was classified as, i.e.: very low risk (age≤60 yrs, no thrombosis history, JAK2/MPL−), low risk (age≤60 yrs, no thrombosis history, JAK2/MPL+), intermediate risk (age > 60 yrs, no thrombosis history, JAK2/MPL−), and high risk (thrombosis history or age >60 yrs with JAK2/MPL+).Results:ROTEM analysis with both EXTEM and INTEM reagents showed that ET patients had a hypercoagulable profile, characterized by significant (p < 0.01) short CFT and high MCF values compared to healthy subjects. None of the ROTEM parameters per se correlated with classes of thrombotic risk. However, a strong correlation (p < 0.01) was present between platelet count and CFT or MCF (both with EXTEM and INTEM reagents). Therefore, the parameters were adjusted for platelet count. After adjustment, corrected CFT (cCFT) significantly correlated with the patient thrombotic risk category (p < 0.05). Furthermore, corrected MCF (cMCF) was significantly increased in JAK2V617F+/MPL+ compared to CalR+ subjects (p < 0.01).Summary/Conclusion:This study confirms the occurrence of a hypercoagulable state in ET patients and shows that ROTEM parameters are significantly influenced by platelet count. Correction of CFT and MCF values allows a better understanding of global coagulation of ET patients and may potentially better reflect the thrombotic risk in these patients.
PB2208 MOLECULAR PROFILE AND TELOMERE LENGTH ARE USEFUL MARKERS FOR DIFFERENTIAL DIAGNOSIS OF PRE‐FIBROTIC PRIMARY MYELOFIBROSIS VERSUS ESSENTIAL THROMBOCYTHEMIA
Authors: Yun J. , Kim J.‐A. , Yang N. , Ryu S. , Jeong D. , Lee Y. E. , Kim S.‐M. , Lim K. M. , Lee D. S. 
Published: June 2019

Background:The 2016 revised WHO classification of MPN newly presented pre‐fibrotic PMF. Diagnostic criteria is based on bone marrow morphology, fibrosis, and clinical features (leukoerythroblastosis, anemia, leukocytosis, increased lactate dehydrogenase, and palpable splenomegaly). Since pre‐fibrotic PMF is a new entity characterized by a unique combination of both thrombotic and hemorrhagic risk, a differentiation from essential thrombocythemia (ET) is pivotal for treatment decision. However, the differentiation is difficult in many cases.Aims:In this study, we sought to explore useful markers for the differential diagnosis of ET and pre‐fibrotic PMF. We compared the cytogenetic and molecular profiles, telomere length, survival rate of patients among pre‐fibrotic PMF, overt PMF and ET.Methods:We reviewed BM morphology and clinical data of 59 Korean patients diagnosed with MPN in 2005∼2014. We classified MPN subtypes of them in series of 2001∼2016 WHO criteria. G‐banding/FISH (BCR/ABL1, 20q deletion, 13q deletion) (n = 57), targeted sequencing of 88 genes (n = 59), telomere/centromere ratio using quantitative FISH (n = 44), and survival analysis (n = 59) were performed.Results:Among 15 patients with MPN‐U by WHO 2001∼2014 classification, 7 patients were re‐diagnosed with pre‐fibrotic PMF, 2 with overt PMF, 6 with MPN‐U by WHO 2016 classification. Based on WHO 2016 classification, cytogenetic abnormalities were detected as 0% in ET, 0% in pre‐fibrotic PMF, and 42.3% in overt PMF. The numbers of mutated genes were 1.5 ± 1.3, 2.4 ± 1.3, 2.0 ± 1.2 in ET, pre‐fibrotic PMF, overt PMF, respectively (p = 0.542). The spectrum of mutate genes expanded from ET to overt PMF. Telomere length (telomere/centromere ratio) were 14.5 ± 1.4, 10.1 ± 3.1, 9.2 ± 3.7 in ET, pre‐fibrotic PMF, overt PMF, respectively (p = 0.042). 5‐year survival rates were 100%, 71.4%, 49.5% in ET, pre‐fibrotic PMF, overt PMF, respectively.Summary/Conclusion:Pre‐fibrotic PMF patients were found to harbor more number of mutations than ET. Mutation profile expanded and telomere lengths decreased in order of disease severity. Especially, CSF3R, DNMT3A, SF3B1, SRSF2 mutation can be candidate marker for differential diagnosis between ET and pre‐fibrotic PMF. Telomere length definitely gives information about disease severity, which is a useful indicator in differential diagnosis of MPN.image
PB2259 SIGNIFICANCE OF INCIDENTAL FINDINGS DETECTED ON PET‐CT SCANS PERFORMED IN HAEMATO‐ONCOLOGY: A SINGLE CENTRE EXPERIENCE
Authors: Mackintosh C. , Soutar R. , McCarthy P. , Koumpis A.‐E. 
Published: June 2019

Background:PET‐CTs scans are commonly used in haematological malignancies to stage disease and assess response to therapy. It is not uncommon for PET‐CT to reveal incidental findings, the significance of which is unclear.Aims:This study aimed to determine how common incidental findings are in patients with haematological malignancies, and assess the outcome of the investigations into these findings.Methods:Reports from 212 patients who had a PET‐CT scan reviewed at the departmental haematology‐radiology meeting of the Beatson Oncology Centre, Glasgow, Scotland between May 2015 and May 2018 were reviewed retrospectively. All scans were undertaken at the same site, the West of Scotland PET Centre. For each incidental finding, follow up, diagnosis and outcome was then reviewed. 57% (n = 121) of patients were male and the median age was 57 years. The majority of patients (93%, n = 196) underwent the PET‐CT scan due to underlying lymphoma, 122 (43%) of these were Non‐Hodgkin and 74 (35%) with Hodgkin lymphoma,16 of the patients had underlying myeloma or other suspected malignancies.Results:The study found that 13% (n = 28) of patients that underwent PET‐CT scanning had an incidental finding. The majority of these findings (82%, n = 23) were investigated further. No significant abnormal finding was revealed through further investigation for 43% (n = 10). A pathological finding was found in 57% (n = 13) of scans. Of these 69% (n = 9) had a pre‐malignant or malignant diagnosis: 2 adenocarcinomas and 4 precancerous polyps in the colon and 3 Thy3a in the thyroid. The remaining 4 were benign pathologies including gastric reflux, benign adenomas and a fistula. The incidental findings were in a variety of anatomical sites, the most common being the colon (n = 15 findings), followed by the thyroid (n = 4). Regarding outcome patients with pre‐malignant polyps and adenocarcinomas underwent complete surgical excision, with no disease remaining post operatively. No patient had evidence of progression / relapse of the incidental finding at time of follow up.Summary/Conclusion:Incidental findings on PET‐CT were shown to occur commonly in patients with haematological malignancies. Follow up of these incidental findings is indicated, and appropriate, as it often results in the diagnosis of a treatable, pathological condition. Further investigation in patients with haematological malignancy is particularly important in view of the potential high survival rate from the underlying haematological cancer.
PB2270 THE RELATIONSHIP BETWEEN OXIDATIVE STRESS MARKERS, AGE, NEUTROPHIL‐TO‐LYMPHOCYTE RATION AND OBESITY
Authors: Gaman M.‐A. , Epingeac M. E. , Gaman A. M. 
Published: June 2019

Background:Obesity is a complex metabolic disease associated with an excessive accumulation of white adipose tissue (WAT). WAT secretes adipokines, which in turn generate reactive oxygen species (ROS) or decrease the total antioxidant capacity (TAC), and pro‐inflammatory cytokines (TNF‐alpha, IL1, IL6), leading to obesity‐induced inflammation.Aims:To evaluate oxidative stress via ROS and TAC measurement and evaluate obesity‐induced inflammation via the neutrophil‐to‐lymphocyte ratio (NLR) in obese patients.Methods:We evaluated oxidative stress and NLR in obese subjects vs. non‐obese controls. Patients were divided by age, sex, and degree of obesity. Obesity was diagnosed according to the WHO criteria, based on the body mass index (BMI). Oxidative stress was evaluated using a CR3000 analyzer via the FORT (Free Oxygen Radical Testing for ROS quantification) and FORD (Free Oxygen Radical Defence for TAC measurement) assays. NLR was evaluated as a marker of chronic inflammation (normal values: 0.78‐3.53). Statistical analysis of data was conducted using the student T‐test and a p‐value < 0.05 was considered significant. The study was approved by the Ethics Committee of the University of Medicine and Pharmacy of Craiova (approval no. 40/27.03.2018) and written informed consent was collected from all subjects involved.Results:The study group involved 85 obese patients (mean age 61.85 ± 10.60 years, age range 24‐82): 17 males (20.00%, mean age 62.65 ± 8.90 years, age range 43‐77) and 68 females (80.00%, mean age 61.65 ± 10.97 years, age range 24‐82). The control group included 30 non‐obese subjects (mean age 44.60 ± 18.45 years, age range 18‐85). Mean BMI was 36.44 ± 3.63 kg/m2 in obese subjects (men: 35.35 ± 3.41 kg/m2, women: 36.71 ± 3.63 kg/m2) vs. 24.56 ± 1.76 kg/m2 in controls (p‐value < 0.0001). Stratification in obesity classes was: 38 patients (44.70%) ‐ class I obesity, 31 patients (36.47%) ‐ class II obesity, 16 patients (18.83%) – class III obesity. FORT values were increased in obese patients vs. controls (3.09 ± 0.36 mmol/L vs. 2.03 ± 0.14 mmol/L, p‐value<0.001). FORD values were decreased in obese patients vs. controls (0.69 ± 0.15 mmol/L vs. 1.27 ± 0.13 mmol/L, p‐value<0.001). We did not record significant differences in terms of NLR in obese subjects vs. controls (2.46 ± 0.96 vs. 2.31 ± 0.26, p = 0.4036). In obese subjects, we found positive correlations between FORT and BMI (r

s
= 0.38407, p = 0.00028), NLR (r

s
= 0.06771, p = 0.5381) and age (r

s
= 0.06781, p = 0.53748). Negative correlations were recorded between FORD and BMI (rs = ‐0.35083, p = 0.001), age (rs = ‐0.04698, p = 0.66942) and NLR (rs = ‐0.06732, p = 0.54045)Summary/Conclusion:In our study group, ROS levels were increased and TAC was decreased in obese patients as compared to healthy controls. ROS levels and TAC correlated with BMI, but not in a significant manner with age or NLR.
PB2364 UNSUCCESSFUL COLLECTION OF AUTOTRANSPLANT DURING THE FIRST SESSION OF LEUKOCYTAPHERESIS IN PATIENTS WITH MULTIPLE MYELOMA AND EFFECTIVE STEM CELL MOBILIZATION
Authors: Kostroma I. , Zhernyakova A. , Romanenko N. , Chubukina Z. , Zapreeva I. , Bessmel’tsev S. , Chechetkin A. , Gritsaev S. 
Published: June 2019

Background:It is well known that the effectiveness of stem cell collection and the possibility to harvest suboptimal CD34+ cells number during the single apheresis session is dependent on the number of CD34+ cells circulating in the peripheral blood (PB), i.e. on the effectiveness of mobilization regimen.Aims:To determine the rate of unseccessful collections in patients with multiple myeloma (MM) when the number of CD34+ cells circulating in the PB is in accordance with the optimal level 20/1 mkl or more.Methods:Retrospective analyses of autotransplant collection in 55 MM patients have been done. Median age of patients was 56 (31‐67) years. Complete response, very good partial response and partial response were diagnosed in 12 (21.8%), 13 (23.6%) and 30 (54,5%) patients accordingly. 25 (45.5%) patients were treated with lenalidomide previously. Cyclophosphamide 3 g/m2 with granulocyte colony‐stimulating factor (G‐CSF) were used for stem cell mobilization in 28 (50.9%) patients. 26 (47.3%) patients were mobilized with vinorelbine 35 mg/m2 with G‐SCF and G‐SCF monotherapy was used in 1 (1.8%) patient.Results:The number of CD34+ cells circulating in PB at the day of the first apheresis procedure was 5‐694/1 mkl (Me 118). Median number of collected CD34+ cells was 5.53 × 10/6/kg (0.27‐29.23). The correlation between number of circulating CD34+ cells and the quantity of harvested CD34+ cells was confirmed: r = 0.503; p < 0.05. At the same time there were 7 (12.7%) cases in which the number of collected CD34+ cells were lower than suboptimal level (0.25‐1.9 × 10/6/kg, Me 1.33 × 10/6/kg) despite the successful mobilization rate: 26‐118/1 mkl (Me 44). The second procedure of apheresis was done on the next day and in all cases except for the one there was the possibility to harvest CD34+ cell number enough to perform a single stem cell transplantation: 2.58‐3.48 × 10/6/kg. The place of central veun catheterization has been changed in all these cases except for the one.Summary/Conclusion:We suppose that a reason of unseccessful stem cell collection in MM patients with adequate rate of mobilization may be disturbance of the bloodstream speed in the apheresis system due to the anatomical characteristics of subclavia vein localization. A method to correct the problem is relief the central catheter puncture place.
PB2383 FACTORS ASSOCIATED WITH EFFECTIVE HARVESTING AND ENGRAFTMENT OF AUTOTRANSPLANT IN PATIENTS WITH MULTIPLE MYELOMA
Authors: Kostroma I. , Zhernyakova A. , Chebukina Z. , Semenova N. , Zapreeva I. , Tiranova S. , Bessmel’tsev S. , Chechetkin A. , Gritsaev S. 
Published: June 2019

Background:The effectiveness of autologous stem cell transplantation (AutoSCT) depends on the speed of autotransplant engraftment which in return is adjoined by quantity of harvested and infused CD34+ cells.Aims:The aim of the study was to determine predictors of AutoSCT effectiveness in patients with multiple myeloma (MM) as new medicines were introduced in induction therapy and mobilization schemes.Methods:Retrospective analyses of autotransplant harvesting in 75 patients and autotransplant engraftment during 112 AutoCST was performed. Cyclophosphamide and vinorelbine in combination with granulocy colony‐stimulating factor (G‐CSF) were used for mobilization. Conditioning regimens were Mel200, Mel140 and Thio/Mel140. All patients received G‐CSF during posttransplant period. Standard criteria of engraftment were used.Results:One induction scheme (p = 0.0315) and cyclophosphamide in mobilization regimen (p = 0.0001) were the positive predictors of increased number of CD34+ cells in autotransplant. The rate of engraftment was dependent on the serial number of AutoSCT and number of CD34+ cells infused. The role of the serial number of AutoSCT is attributed to the less intensity of the second conditioning regimen: Mel140 versus Mel200 and Thio/Mel140 during the first AutoSCT.Summary/Conclusion:Autotransplant quality and the rate the engraftment in patients with MM are dependent on the fectiveness of induction therapy and intensity of mobilization regimen. So, we conclude that the choice of induction therapy variant and mobilization regimen intensity has to be adapted to the individual patient, prognostic variant of MM, possibility to respond to standad induction therapy and number of planned AutoSCT.