Highlights Clinical signs are not useful for detecting DVT in critically ill COVID-19 patients DVT occurs despite full dose anticoagulation in critically ill COVID-19 patients Severe COVID-19 patients present a high prevalence of bilateral DVT

La enfermedad grave por coronavirus 2019 está causada por el Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) y predispone a complicaciones trombóticas. En esta revisión se aborda de manera práctica la estrecha relación entre la tromboembolia venosa y la COVID-19, enfatizando aspectos epidemiológicos, factores de riesgo y tromboprofilaxis, así como potenciales opciones de anticoagulación. Actualmente la evidencia científica es muy escasa, pero día a día seguimos aprendiendo, estando atentos a cambios novedosos y dinámicos en esta enfermedad infecciosa e inmunotrombótica emergente.

Acute myeloid leukemia (AML) comprises a heterogeneous group of hematopoietic cell neoplasms of myeloid lineage that arise from the clonal expansion of their precursors in the bone marrow, interfering with cell differentiation, leading to a syndrome of bone marrow failure. AML is a consequence of genetic and epigenetic changes (point mutations, gene rearrangements, deletions, amplifications, and arrangements in epigenetic changes that influence gene expression) in hematopoietic precursor cells, which create a clone of abnormal cells that are capable of proliferating but cannot differentiate into mature hematopoietic cells or undergo programmed cell death. The diagnosis requires more than 20% myeloid blasts in the bone marrow and certain cytogenic abnormalities. Treatment will depend on age, comorbidities, and cytogenetic risk among the most frequent.

Background. In Classic Hodgkin's lymphoma (cHL), malignant cells constitute only about 1% of the bulk of tumor tissue, the rest constitutes the microenvironment and is made up of a compound of inflammatory cells. Lymphocytopenia and increased CD68+ tumor-associated macrophages (TAMs) are adverse prognostic factors in cHL. TAMs are derived from circulating monocytes and are possibly related to absolute monocyte count (AMC). We have sought to investigate the relationship of circulating lymphocytes and monocytes with response and survival in patients. Recently, Porrata et al. reported that a low absolute lymphocyte count/absolute monocyte count at diagnosis [ALC/AMC-Dx] (<1.1) is an independent prognostic factor in cHL. Subsequent studies used different cutoffs for ALC/AMC (1.5 and 2.9). Currently, there are no studies that evaluate the usefulness of the index relative to the overall response. Aim To determine the prognostic value of ALC /AMC at diagnosis in patients with cHL and its impact on treatment response to therapy, progression and overall survival. Methods: We evaluated 262 consecutive individuals with cHL, referred and treated at the National Cancer Institute in Mexico between 2006 to 2013. The great majority of patients were treated with ABVD with or without radiotherapy, and all had available data for ALC/AMC determined at diagnosis. It was made a multivariate analysis and ROC curves for cutoff point of ALC/AMC. Results: Median age was 35 y (14-89), 59.2% of patients were male, 77% had B-symptoms, 36.3% had stage IV disease, 85% had advanced stage (IB,IIB,III,IV), 51.5% had IPS ≥3, 46.2% nodular sclerosing histology and 45.4% mixed cellularity. The overall response (CR + PR) was obtained in 188 patients (72%) and failure (stable disease or progressive disease) in 73 patients (28%). A new cutoff point, 1.77 in ALC/AMC-Dx ratio with area under the curve of 0.62. Multivariate analysis showed that the ALC/AMC-Dx index was an independent predictor for response to treatment, progression as well as overall survival (Table 1). Additionally the IPS≥3 showed to be an independent factor for response 68.8% vs 41.7% in low and high risk, respectively (p<0.0000). Conclusion: In our population ALC/AMC-Dx index was established with a cutoff of 1.77. The group of patient with < 1.77 had a less overall response and overall survival. It proves that ALM/AMC-Dx is an independent predictor of response, progression and overall survival in patients with classical cHL. That differs of other reviews where the cutoff was lower. Table 1. Multivariate analysis according to ALC/AMC-DX ratio ALC/AMC -Dx index p Low< 1.77 High >1.77 Overall Response 58.1% 79.8% OR 0.25-.0.84p 0.011 Overall Survival8 years 81% 94% p 0.004 Disclosures No relevant conflicts of interest to declare.

La tromboembolia pulmonar aguda representa una causa frecuente de morbimortalidad cardiovascular, sólo rebasada por los síndromes coronarios agudos y la enfermedad cerebrovascular. El inicio y la intervención de un equipo multidisciplinario de respuesta rápida en la tromboembolia pulmonar son imperantes para mejorar el pronóstico y reducir al mínimo las posibles secuelas en el subgrupo de pacientes más graves. En este artículo de revisión se describe y revisa de manera general el papel actual y potencial que tienen dichos equipos de respuesta rápida, con un enfoque particular en el perioperatorio.