bluuebunny/crossref_metadata_2025_split huggingface dataset:
Venous Thromboembolism in Transgender Individuals Receiving Hormone Replacement Therapy in Alberta, Canada
Authors: Shyian Melissa , Wu Cynthia M. , Wynick Chris J 
Published: December 2024

Background:
Hormone therapy is a key component of gender-affirming care for transgender individuals. Estrogen, testosterone, and progestin therapy have been associated with a higher risk of venous thromboembolism (VTE). However, this is largely based on use of these medications in hypogonadism, birth control, and hormone replacement therapy (HRT). There is a lack of information regarding their relation to VTE risk in transgender persons. The aim of this study is to retrospectively examine VTE events for transgender individuals in Alberta, Canada, and their potential association with hormone therapy.
Methods:
Chart review of adult (≥ 18 years of age) transgender individuals was completed using electronic medical records between 2002 and 2021. A list of individuals for the study was provided by a psychiatrist who specializes in transgender care at the Gender Program in Edmonton, Canada. Population included those who were referred for gender affirming surgery. Data collected included age, affirmed gender, VTE events, thrombophilia history, anticoagulation use, and hormone therapy. All data was anonymized prior to analysis. This study was approved by the Alberta Health Ethics Research Board (Pro00114160).
Results:
Fifty-six individuals were identified for this study. Median age as of December 31, 2021 was 27.5 years (range 18-73). Affirmed gender in this cohort included 36 affirmed females (64%), 13 affirmed males (23%), and 7 non-binary individuals (13%). None of the individuals had a history of thrombotic events prior to the study, nor did any have known genetic or acquired thrombophilia. Two of the affirmed female individuals (ages 69 and 73) were on anticoagulation for atrial fibrillation during the study. There were no VTE events (DVT or PE) documented in this cohort.
In terms of HRT, 46 of 56 individuals (82%) were on HRT at some point in the study, including 32/36 affirmed females (89%), 10/13 affirmed males (77%), and 4/7 non-binary individuals (57%). 18/36 of affirmed females (50%) were on combined estradiol and progesterone at some point in the study.
Limitations of this study include the small numbers, retrospective nature and incomplete documentation. Furthermore, transgender individuals must go out of province for gender affirming surgery, and documentation around this strong provoking event was not included as was not accessible in this chart review.
Conclusion:
While there is a known association between hormone supplementation and VTE, there were no documented VTE events in this cohort. Further prospective studies would be ideal to fully characterize other VTE risk factors in this cohort and to monitor for VTE events.
Risk of Venous Thromboembolism in Hospitalized Patients with Chronic Lymphocytic Leukemia Complicated with Autoimmune Hemolytic Anemia
Authors: Eltaher Basant , Mahmoud Amir , Shah Purva 
Published: December 2024

Introduction: Autoimmune hemolytic anemia is a recognized complication of chronic lymphocytic leukemia (CLL). Even though venous thromboembolism (VTE) is a potential complication in CLL patients with superimposed autoimmune hemolytic anemia (AIHA), there are not enough studies on anticoagulation guidelines in these patients including prophylaxis.
Methods: National Inpatient Sample (NIS) ICD-10 codes were used between 2016-2020 to create a cohort of hospitalized patients with CLL and AIHA. Data was analyzed using STAT BE software. We implemented descriptive analysis and logistic regression analysis to examine the risk and outcome of VTE in this patient population. Additionally, we adjusted for confounding factors including hypertension, diabetes, end-stage renal disease, hyperlipidemia, and thrombophilia.
Results: Our analysis included 78,974 hospitalized patients with CLL. The mean age was 75 years, with men (60%) and white race (83%) making up the majority of our cohort. 1,866 hospitalized patients with CLL had AIHA, 13.5% of whom had VTE (Vs 10.3% in patients without AIHA). Pulmonary embolism occurred in 6.8% of CLL patients with AIHA (Vs 4.6% in patients without AIHA). The logistic regression model revealed that CLL patients with AIHA were strongly associated with an increased likelihood of VTE (OR 1.3, 95% CI, 1.2-1.5). Additionally, underlying thrombophilia was associated with a significantly increased risk of VTE (OR 6, 95% CI, 5-7.2), even though they comprised around 0.6% of patients with CLL (Vs 0.9% in CLL patients with AIHA). Patients with CLL and underlying comorbid conditions such as congestive heart failure, end-stage renal disease and thrombophilia significantly increased risk of mortality. However, the presence of AIHA didn't have a significant association with the risk of death.
Conclusion: CLL patients with AIHA have an increased likelihood of developing VTE in comparison to CLL patients without AIHA. This data warrants further investigation regarding anticoagulation in these patients.
Impact of Acute Renal Failure on Clinical Outcomes in Bone Marrow Transplant Patients: A Nationwide Analysis
Authors: Uttam Chandani Kanishka , Agrawal Siddharth pravin , Raval Maharshi , Lotia Dev , Nadeem Ahmed 
Published: December 2024

Introduction:
Acute renal failure (ARF) complicates bone marrow transplant (BMT) procedures and significantly affects clinical outcomes. This study examines the impact of ARF on mortality, resource use, and other key outcomes in a nationwide cohort of BMT patients.
Methods:
Data were extracted from the National Inpatient Sample (NIS) database, which includes BMT hospitalizations from 2016 to 2021. Patients were classified into two groups: those with ARF (BMT+ ARF+) and those without ARF (BMT+ ARF-). The analysis compared demographic characteristics, baseline health conditions, and clinical outcomes between these groups. Multivariate logistic regression was employed to analyze outcomes adjusting for potential confounders.
Results:
Among the 139,085 BMT hospitalizations, 32,205 patients were identified with ARF. Patients with ARF were older, with a mean age of 55.58 years compared to 46.49 years for those without ARF. Gender distribution differed between groups, with a higher proportion of males in the ARF group (60.47% vs. 55.30%). Racial composition also varied; ARF patients had a larger proportion of White individuals (69.01% vs. 66.41%) and a smaller proportion of Hispanic individuals (10.93% vs. 13.61%) compared to the non-ARF group.
ARF patients had an odds ratio (OR) of 5.42 for mortality (95% CI 4.77-6.16, p &lt; 0.001). The likelihood of requiring transfusions was increased with an OR of 1.61 (95% CI 1.48-1.75, p &lt; 0.001). Additionally, ARF patients had higher odds of bleeding (OR = 1.63, 95% CI 1.48-1.79, p &lt; 0.001), sepsis (OR = 2.92, 95% CI 2.73-3.13, p &lt; 0.001), and septic shock (OR = 6.97, 95% CI 6.22-7.80, p &lt; 0.001). The odds of myocardial infarction were also elevated (OR = 1.64, 95% CI 1.38-1.93, p &lt; 0.001), while arrhythmia had an OR of 1.32 (95% CI 1.07-1.63, p = 0.01). The risk of BMT infection and BMT failure was higher with ORs of 2.16 (95% CI 1.14-4.08, p = 0.017) and 1.39 (95% CI 1.09-1.79, p = 0.008), respectively. Although the odds of BMT rejection were not significantly different (OR = 1.22, 95% CI 0.77-1.94, p = 0.39). ARF patients also experienced longer hospital stays (mean 11.53 days vs. 6.79 days) and incurred higher total healthcare charges ($202,288 vs. $99,901).
Conclusion:
ARF is associated with worse clinical outcomes in BMT patients, with increased mortality, extended hospital stays, and higher healthcare costs. The study also highlights notable differences in gender and racial composition between ARF and non-ARF patients, suggesting that demographic factors may influence the impact of ARF. These findings underscore the need for tailored management strategies to address ARF effectively and to reduce disparities in care. Further research is necessary to refine these strategies and optimize care for this high-risk population.
FLT3 Inhibitors As Maintenance Therapy Post Allogenic Hematopoietic Stem Cell Transplantation in Acute Myeloid Leukemia Patients with FLT3 Mutations; A Systematic Review and Meta-Analysis
Authors: Ansar Sadia , Keen Mahnoor Asghar , Sukaina Mahnoor , Saeed Muhammad , Rehman Zarlish , Rehman Roshaan , Wahab Qazi Muhammad Farooq , Masaud Faryal , Mumtaz Aqsa , Jatwani Karan , Faisal Muhammad Salman 
Published: December 2024

INTRODUCTION
Approximately 20-30% of adult patients with acute myeloid leukemia (AML) have an FMS-like tyrosine kinase 3 (FLT3) mutation, which falls in the intermediate risk category for relapse and overall survival per ELN 2022 classification, and eligible patients undergo allogeneic hematopoietic cell transplantation (allo-HCT). FLT3 inhibitors (FLT3i) are used in induction and relapsed settings, but recent studies suggest that FLT3i may reduce the risk of post-transplant relapse. We performed this systematic review and meta-analysis to evaluate the efficacy of FLT3i as post-transplant maintenance therapy in AML patients.

METHODS
A comprehensive search was conducted across PubMed, Embase, Cochrane Library, and Clinicaltrials.gov from inception to March 29, 2024. Studies were included that evaluated response [overall survival (OS), relapse-free survival (RFS), and leukemia-free survival (LFS)], in comparisons between FLT3i and control groups. RevMan version 5.4.1 was used for statistical analysis. A random effect model with inverse variance as the statistical method was used for hazard ratio (HR) and 95% confidence interval (CI).

RESULTS
Of 1698 included studies, the data consists of 13 observational studies, comprising 4402 patients (52% males and 48% females), who met the inclusion criteria. Of the sample size, 36% of patients received FLT3i therapy, while the control group comprised 63.9% of patients. Patient age ranged from 14 to 78 years (median 49 years in intervention). AML subtypes included de novo (29%), secondary to antecedent hematological disorder (AHD) (1.7%), secondary to therapy (0.8%), and unspecified (68.5%). The follow-up period extended from 5.7 to 47.7 months. Nine out of thirteen studies reported cytogenetic risk. The type of FLT3i regimen used was reported as 54% Sorafenib followed by 15% Midostaurin, and only 8% Gilteritinib and Quizartinib. FLTi as maintenance in post-transplant patients significantly improved OS [ HR; 0.56] 95% CI [0.46-0.68], P&lt; 0.00001, I2 31%], RFS [HR 0.56; 95% CI (0.50-0.64), P&lt; 0.00001, I2 0%] and LFS [HR 0.47; 95% CI (0.38-0.57), P&lt; 0.00001, I2 0%] as compared to control.

CONCLUSION
This meta-analysis demonstrates the efficacy of FLT3i as a post-transplant maintenance therapy for preventing relapse in AML patients.
Exploratory Analysis of Biomarkers for Quality Control of Cell Cultures and Prediction of Response to CART Cell Therapy
Authors: Su Guoai , Wu Tong 
Published: December 2024

The factors affecting the curative effect of autologous CART cells, derived from the patients' lymphocyte function and activity themselves, plays a very important role.
We were analyzed retrospectively 20 cases treated with autologous CART cells of the blood system of malignant tumor patients, including B - NHL and multiple myeloma, from March-22 to July-31 in 2024; Combined with peripheral blood flow cytometry before the cytological examination related indicators, CART cell activity and the safety of function and the doping after amplification and curative effect of forecast analysis.
The results of multivariate analysis showed that PD1+TIM3+CD4+ exhausted T cells %, PD1+TIM3+CD8+ exhausted T cells %, CD8 Tcm CD45RA-CCR7+CD27+%, TIM3+ % of total T cells %. Initial CD27 + CD45RA + killer T cells when the CCR7 + % of T cell and the living rate of the CART cells and is directly related to the inside-body amplification.
Conclusions: In order to ensure the success rate of CART preparation, and to predict the maximum curative effect, patients after multi-line treatments or influence T cell function related anti-tumor medicine, can use the PD1 + TIM3 + % of the depletion of CD4 + T cells, PD1 + % depleting the TIM3 + CD8 + T cells, Tcm CD45RA - when the CCR7 CD8 + CD27 + %, TIM3 + % of total T cell, and the initial killer T cells CD27 + CD45RA + CCR7 + % of T cells as predict factors and we need to set up subsequently predictive model, data validation and prospective study.
Feasibility of Co-Administration of Autologous NK Cells and Anti-CD38 Monoclonal Antibody Isatuximab, in Multiple Myeloma Post-Autologous HSCT in a Randomized Phase 2 Clinical Trial
Authors: Lund Johan , Meinke Stephan , Kashif Muhammad , Bohlin Anna , Hellstrom Lindberg Eva , Ljunggren Hans-Gustaf , Alici Evren 
Published: December 2024

Background: Autologous natural killer (NK) cells have been administered as consolidation therapy in multiple myeloma patients following autologous hematopoietic stem cell transplantation (HSCT). Our primary aim was to evaluate the detectability and phenotypic characteristics of transferred NK cells, with a specific focus on CD38 expression.
Methods: NK cells were isolated, expanded as previously described (https://doi.org/10.1016/j.xcrm.2022.100508), and infused into multiple myeloma patients post-HSCT. Phenotypic analysis was performed to assess CD38 expression on the transferred NK cells. Results indicated retention of reduced CD38 expression on the infused NK cells. Based on initial findings, a clinical trial was initiated to investigate the co-administration of autologous NK cells with isatuximab. To date, 18 patients have been enrolled in which 8 patients received a combination therapy of isatuximab and NK cells and 10 patients received isatuximab only. NK cells were administered in three consecutive doses, every other week during every other week isatuximab administration regimen. First two NK cell doses were 30 million cells/kg, and the last dose was up to 100 million cells/kg. Isatuximab treatment was initiated within 103 days after autologous stem cell transplantation (Range 54-103 days). The retention and phenotype of NK cells following anti-CD38 mAb administration was monitored.
Results: Transferred NK cells were detectable in all patients and characterized by low CD38 expression (MFIR: 0.2) This suggested potential compatibility with anti-CD38 mAb therapy. In this clinical trial, co-administration of autologous NK cells with anti-CD38 mAb was well tolerated in all included patients. NK cells were retained up to one month after administration, indicating that the anti-CD38 mAb did not adversely affect infused autologous NK cells' persistence. Only one patient had a grade 3 treatment emergent adverse event, hemolysis, that was attributed to COVID and RSV infections. Infused cells retained their proliferative capacity with a fluctuating receptor profile, including CD16, following isatuximab administrations.
Conclusion: The co-administration of autologous ex vivo expanded and activated NK cells and Isatuximab is feasible and does not result in the loss of NK cells. These findings support further exploration of this combination therapy to enhance consolidation treatment in multiple myeloma patients post-HSCT.
Racial and Socioeconomic Disparities in Survival Outcomes of Mantle Cell Lymphoma: An Analysis of the Surveillance, Epidemiology, and End Results (SEER) Database from 2000 to 2021
Authors: Ogedegbe Oboseh John , Cheema Asfand Yar , Sukhera Ahmed Bashir , Unlu Serhan , Rodriguez Vazquez Jorge , Erazo Gloria , Tabowei Godfrey 
Published: December 2024

Introduction
Mantle Cell Lymphoma (MCL) is a rare class of B-cell non-Hodgkin lymphomas (NHL) characterized by an (11,14) translocation resulting in overexpression of the cyclin D1 (CCND1) gene. Mantle cell lymphoma often follows a difficult clinical course and challenging prognosis. Age and performance status play a role in overall prognosis. There needs to be more data on racial and socioeconomic disparities in the survival outcomes of MCL. Our analysis involved comparing survival outcomes of patients with mantle cell lymphoma based on race, rural-urban, and income.
Methods
Data from the Surveillance, Epidemiology, and End Results (SEER) database program was utilized to obtain the survival analysis data of Mantle Cell Lymphoma. Patient characteristics were expressed in proportions (%). Kaplan-Meier methods were used to estimate 5-year survival rates. Cox proportional hazards regression was used for multivariable modelling of the survival database. The difference between the observed number of events between each group was compared using a log-rank statistical test.
Results
We identified 11,450 patients with complete survival data who were analyzed by our study. 90.4% were whites, 4.1% were blacks, 0.7% were American Indian/Alaska Native, and 4.7% were Asian/Pacific Islander. The one and five-year survival by race/ethnicity were whites (83.6%, 60.3%), Blacks (83.8%, 61.3%), American Indian/Alaska Native (75.8%, 56.4%), Asian or Pacific Islander (82.5%, 60.3%). Urban residency was coded by counties in metropolitan areas with a population greater than 250,000, while non-metropolitan counties coded rural residency. The one and five-year survival by urban (83.8%,61.0%) and rural (82.3%,56.6%) was analyzed. The one and five-year survival by $40,000-$79,999 income (82.9%-58.5%) and &gt;$80,000 income (84.5%, 63.1%) was also calculated. Race was a predictor of worse outcome, Black HR 0.98(95% CI; 0.87-1.1, p = 0.72), American Indian/Alaska Native HR 1.36 (95% CI; 1.02-1.8, p = 0.035), Asian or Pacific Islander HR 0.90 (95% CI; 0.79-1.0, p = 0.075). There was survival disparity by sex, Male (CI 95%; 1.06, 1.00-1.1)
Conclusion
Race and socioeconomic factors play a pertinent role in survival outcomes in patients with mantle cell lymphoma. A survival disparity by sex has also been noted. American Indian/Alaska Natives demonstrated a statistically significant higher hazard ratio compared to Whites, which was the reference.
Advantages of a genomic DNA-based next-generation sequencing assay for detection of mutant NPM1 measurable residual disease in AML
Authors: Vonk Christian M. , Grob Tim , Rijken Melissa , Kavelaars François G. , Konijnenburg Jolinda M. L. , Ossenkoppele Gert J. , Manz Markus G. , Havelange Violaine , Fløisand Yngvar , Löwenberg Bob , Valk Peter J. M. 
Published: December 2024

Abstract
Mutations in the nucleophosmin-1 (NPM1) gene are among the most common molecular aberrations in acute myeloid leukemia (AML). Various studies have established mutant NPM1 (mNPM1) as a faithful molecular measurable residual disease (MRD) marker with prognostic significance. Assessment of prognostic mNPM1 is included in the European LeukemiaNet recommendations on MRD detection in AML. Because of recent advancements of promising drugs targeting mNPM1 AML, monitoring of mNPM1 MRD has gained interest, and is generally done by reverse transcriptase quantitative polymerase chain reaction (RT-qPCR). However, these RT-qPCR assays use complementary DNA (cDNA) as input, are based on gene expression levels of mNPM1, and are generally limited to specific mNPM1 gene variants. The main advantages of next-generation sequencing (NGS) using genomic DNA as input are stability, independence of gene expression levels, and the ability to detect any NPM1 variant in a single assay. Here, we comprehensively investigated the applicability of NGS on DNA to detect mNPM1 MRD in a cohort of 119 (cDNA) and 310 (DNA) patients with mNPM1 AML in complete remission after 2 cycles of induction chemotherapy. We demonstrate high correlations in levels and prognostic value between RT-qPCR/cDNA and NGS/DNA approaches, postulating NGS/DNA as an attractive alternative to RT-qPCR. We report that the 2% mNPM1/ABL1 threshold by RT-qPCR/cDNA corresponds to an NGS/DNA variant allele frequency of 0.01%. The NGS/DNA threshold of &gt;0.01% after 2 cycles of induction chemotherapy identifies significantly more patients with AML with an increased relapse risk than current RT-qPCR/cDNA assays. The prognostic significance of mNPM1 MRD appears greatest in patients with AML with FLT3-internal tandem duplications.
Extracorporeal photopheresis for the prevention of rejection after lung transplantation: a prospective randomised controlled trial
Authors: Benazzo Alberto , Cho Ara , Auner Sophia , Schwarz Stefan , Kovacs Zsofia , Ramazanova Dariga , Kolovratova Vera , Branka Manuela , Muraközy Gabriela , Hielle-Wittmann Elisabeth , Aigner Clemens , Hoetzenecker Konrad , Wekerle Thomas , Worel Nina , Knobler Robert , Jaksch Peter 
Published: December 2024

BackgroundLung transplant recipients have the worst long-term outcomes of all solid organs due to acute rejection and chronic lung allograft dysfunction (CLAD). Our objective was to investigate the efficacy of extracorporeal photopheresis (ECP) as a prophylactic treatment to prevent acute cellular rejection (ACR), cytomegalovirus (CMV) infections and reduce the risk of CLAD.MethodsThis was a single-centre prospective randomised controlled trial conducted at the Medical University of Vienna (Vienna, Austria) between 2018 and 2020. It included 31 COPD recipients per group. The treatment group underwent ECP in addition to a standard triple-drug immunosuppression protocol after lung transplantation. The control group received standard triple-drug immunosuppressive therapy. The primary outcome was a composite outcome defined as incidence of high-grade ACR, CMV infection or CLAD within 24 months after lung transplantation.ResultsIn the control group, 19 patients (61.3%) achieved the primary combined end-point compared with only six patients (19.4%) in the treatment group (p<0.001). Freedom from high-grade ACR was significantly greater in the ECP group (p=0.045). Cumulative A scores were significantly lower in the ECP group than in the control group at 3 months (0.18±0.44versus0.56±0.94; p<0.05) and at 12 months (0.25±0.48versus1.0±1.45; p=0.002). The rate of infections was lower in the ECP group with five cases and 67 cumulative hospital days compared with 22 cases and 309 days in the control group (p=0.002). Freedom from CLAD at 3 years was significantly greater in the ECP group (p=0.015).ConclusionAdding ECP to standard triple immunosuppression resulted in a significant reduction of the number of ACR episodes and significantly lower incidence of CLAD.