Various side effects associated with dimethyl sulfoxide (DMSO) which is used for cryopreservation of bone marrow or peripheral blood progenitor cells (PBPCs) have been reported. Among the central nervous system side effects the epileptic seizures, stroke, transient and temporary leucoencephalopathy, and global amnesia are well known. Herein we report a 52-year-old man who experienced tonic-clonic seizure within minutes after the initiation of DMSO cryopreserved autologous PBPC infusion. Unfortunately, he also developed cardiac arrest and required intubation for ventilation after the seizure. Pathophysiology of acute neurological and cardiac toxicity is unclear, but may also be idiosyncratic. Clinicians should be aware of the toxicity of cryoprotectant agents during PBSC infusion. Determining the risk factors associated with increased DMSO toxicity and taking preventive actions is utmost important.
Objective The aim of this study was to examine the effect of coronavirus disease 2019 (COVID-19) on the malignancy-related clinical course and overall survival, and to determine the factors affecting mortality. Methods This retrospective study included 77 patients with hematological cancer and COVID-19. Patients were sub-grouped for analysis as survivors and non-survivors. Results COVID-19 was seen more frequently in myeloproliferative neoplasms (MPN), non-Hodgkin lymphoma (NHL) and multiple myeloma (MM) patients. Mortality rate due to COVID-19 was 20.8%. No statistically significant difference was determined between the survivor and non-survivor groups with respect to age and gender, presence of any comorbidity, leukocyte, neutrophil, lymphocyte, and monocyte values. Platelet count and hemoglobin count were significantly lower in the group with mortality than in the group with recovery. Conclusion It should be kept in mind that low hemoglobin and platelet levels contribute to mortality. In addition, it is important to protect patients with hematological cancer from COVID-19 and undertake effective vaccination due to its mortal course.
Introduction: Bacterial infections and febrile neutropenia (FN) are major causes of morbidity and mortality in patients with hematological malignancy. The aim of this study was to investigate the incidence and risk factors of infections in lymphoma patients. Methodology: This retrospective study was conducted on 200 lymphoma patients diagnosed and treated between January 2009 and December 2017 in Diskapi Yildirim Beyazit Training and Research Hospital, a tertiary referral hospital in Ankara, Turkey. Results: The mean follow-up period was 20.09 ± 19.81 months. The incidence of infection episode (IE) was 32.5% (65/200) and FN was 18.5% (37/200). Analysis of the data revealed that patients with IE had significantly higher rates of diagnosis of primary central nervous system lymphoma (PCNSL), lower baseline hemoglobin, lower baseline hematocrit, higher baseline lactate dehydrogenase levels, higher usage of central cathater, and a higher number of chemotherapy lines compared to patients with no IE. In logistic regression analysis, disease subtype of PCNSL, usage of central catheter and lactate deyhydrogenase (LDH) were found to increase the risk of infection. The odds ratio for PCNSL was 37.866 (p = 0.003), 2.679 for central catheter (p = 0.008) and 1.001 for LDH (p = 0.011). Conclusions: The risk of infection in patients with lymphoma was associated with central catheter usage, higher LDH levels and a diagnosis of PCNSL. Baseline hematological parameters were not determined to have any impact on the occurrence of infection. Patients with these risk factors should be monitored more carefully and the maximum level of infection prevention should be taken.
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