BackgroundPatients with Ph-negative myeloproliferative neoplasms (MPN), such as polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF), are at increased risk for thrombosis/thromboembolism and major bleeding. Due to the morbidity and mortality of these events, antiplatelet and/or anticoagulant agents are commonly employed as primary and/or secondary prophylaxis. On the other hand, disease-related bleeding complications (i.e., from esophageal varices) are common in patients with MPN. This analysis was performed to define the frequency of such events, identify risk factors, and assess antiplatelet/anticoagulant therapy in a cohort of patients with MPN.MethodsThe MPN registry of the Study Alliance Leukemia is a non-interventional prospective study including adult patients with an MPN according to WHO criteria (2008). For statistical analysis, descriptive methods and tests for significant differences as well as contingency tables were used to identify the odds of potential risk factors for vascular events.ResultsMPN subgroups significantly differed in sex distribution, age at diagnosis, blood counts, LDH levels, JAK2V617F positivity, and spleen size (length). While most thromboembolic events occurred around the time of MPN diagnosis, one third of these events occurred after that date. Splanchnic vein thrombosis was most frequent in post-PV-MF and MPN-U patients. The chance of developing a thromboembolic event was significantly elevated if patients suffered from post-PV-MF (OR 3.43; 95 % CI = 1.39–8.48) and splenomegaly (OR 1.76; 95 % CI = 1.15–2.71). Significant odds for major bleeding were previous thromboembolic events (OR = 2.71; 95 % CI = 1.36–5.40), splenomegaly (OR = 2.22; 95 % CI 1.01–4.89), and the administration of heparin (OR = 5.64; 95 % CI = 1.84–17.34). Major bleeding episodes were significantly less frequent in ET patients compared to other MPN subgroups.ConclusionsTogether, this report on an unselected “real-world” cohort of German MPN patients reveals important data on the prevalence, diagnosis, and treatment of thromboembolic and major bleeding complications of MPN.

Informal e-waste recycling is associated with several health hazards. Thus far, the main focus of research in the e-waste sector has been to assess the exposure site, such as the burden of heavy metals or organic pollutants. The aim of this study was to comprehensively assess the health consequences associated with informal e-waste recycling. A questionnaire-based assessment regarding occupational information, medical history, and current symptoms and complaints was carried out with a group of n = 84 e-waste workers and compared to a control cohort of n = 94 bystanders at the e-waste recycling site Agbogbloshie. E-waste workers suffered significantly more from work-related injuries, back pain, and red itchy eyes in comparison to the control group. In addition, regular drug use was more common in e-waste workers (25% vs. 6.4%). Both groups showed a noticeable high use of pain killers (all workers 79%). The higher frequency of symptoms in the e-waste group can be explained by the specific recycling tasks, such as burning or dismantling. However, the report also indicates that adverse health effects apply frequently to the control group. Occupational safety trainings and the provision of personal protection equipment are needed for all workers.

Dyskeratosis congenita (DKC) is associated with impaired telomere maintenance and with clinical features of premature aging. In this study, we analysed global DNA methylation (DNAm) profiles of DKC patients. Age-associated DNAm changes were not generally accelerated in DKC, but there were significant differences to DNAm patterns of healthy controls, particularly in CpG sites related to an internal promoter region of PR domain containing 8 (PRDM8). Notably, the same genomic region was also hypermethylated in aplastic anemia (AA) – another bone marrow failure syndrome. Site-specific analysis of DNAm level in PRDM8 with pyrosequencing and MassARRAY validated aberrant hypermethylation in 11 DKC patients and 27 AA patients. Telomere length, measured by flow-FISH, did not directly correlate with DNAm in PRDM8. Therefore the two methods may be complementary to also identify patients with still normal telomere length. In conclusion, blood of DKC patients reveals aberrant DNAm patterns, albeit age-associated DNAm patterns are not generally accelerated. Aberrant hypermethylation is particularly observed in PRDM8 and this may support identification and classification of bone marrow failure syndromes.

Overweight and obese patients have an increased risk to develop several malignancies and, additionally, body mass index (BMI) impacts on outcome in several solid tumors. However, little is known for AML. We analyzed a cohort of 3526 patients with AML treated in three prospective multicenter trials within the German Study Alliance Leukemia. In multivariate analyses, we identified BMI as an independent risk factor for both DFS (HR 1.014, P = 0.0217) and OS (HR 1.015, P < 0.0036). Interestingly, overweight and obesity seemed to be a risk factor predominantly in patients with de novo AML younger than 65 yr with intermediate risk and adverse cytogenetics. Overweight with a BMI ≥25 kg/m² best discriminated the worse outcome and led to an absolute reduction in long-term survival of 5-7% in the group of all younger patients (3-yr OS 39.9% vs. 47.3%; 10-yr OS 28.7% vs. 33.8%, P = 0.0002). Additionally, response to induction therapy was significantly reduced in these patients (76.9% vs. 82.8%, P < 0.0001). Thus, in younger patients with de novo AML, overweight and obesity are risk factors for impaired response to induction therapy, DFS and OS. This effect is, in part but not fully, explained by dose reduction such as dose-capping at a body surface area of 2 m².

Misinformation that accompanied the current SARS-CoV-2 pandemic led to an impaired risk perception, resulting in the refusal of personal protection measures, as well as a reduced willingness to receive a vaccination. In order to identify factors that might influence people’s attitudes towards COVID-19 policies and engagement in mitigation measures, we carried out a cross-sectional study in Germany. Altogether, n = 808 participants completed our questionnaire concerning items on demographics, media consumption, risk perception, and trust in health authorities, as well as willingness to receive a vaccination. An overwhelming majority of our participants perceived SARS-CoV-2 as a health threat (85.7%), and almost two thirds (63.5%) mentioned they would get vaccinated against SARS-CoV-2 when a vaccination was available. A greater likelihood of vaccination intention was associated with being male (71.5% male vs. 60% female, p < 0.05), left-wing voting, trusting health authorities, using public media as an information source about COVID-19, and, in particular, perceiving COVID-19 as a health threat. A better understanding of factors that contribute to vaccine hesitancy is indispensable in order to eliminate doubts, increase vaccination rates, and create herd immunity, to stop further virus transmission.