No abstract

Objectives This retrospective chart review examined real‐world healthcare resource utilization (HRU) in patients with AML ineligible for intensive therapy who received first‐line systemic therapy or best supportive care (BSC). Methods Data were collected anonymously on patients with AML who initiated first‐line hypomethylating agents (HMA), low‐dose cytarabine (LDAC), other systemic therapy, or BSC. HRU endpoints included hospitalizations, outpatient consultations, transfusions, and supportive care. Results Of 1762 patients included, 46% received HMA, 11% received LDAC, 17% received other systemic therapy, 26% received BSC; median treatment durations were 118, 35, 33, and 57 days, respectively. Most patients were hospitalized, most commonly for treatment administration, transfusion, or infection (HMA 82%, LDAC 93%, other systemic therapy 83%, BSC 83%). A median number of hospitalizations were 2–6 across systemic groups and two for BSC, with median durations of 8–18 days. Transfusion rates and outpatient consultations were highest for HMA (80% and 79%) versus LDAC (57% and 53%), other systemic therapy (57% and 63%), and BSC (71% and 66%). Antivirals/antibiotics and antifungals were used more frequently than growth factors (72–92%, 34–63%, and 7–27%, respectively). Conclusion Patients with AML ineligible for intensive therapy have high HRU; novel therapies are needed to alleviate this burden.

Acquired hemophilia B is a rare bleeding disorder in which circulating specific antibodies inhibit the coagulation factors. Usually, it is associated with autoimmune diseases, malignancy and some infections such as hepatitis B (HBV) and C (HCV) viruses. The association with the human immunodeficiency virus (HIV) is rare. We present the first case of hemophilia B acquired in a patient with HIV. A 36-year-old woman with a history of HIV infection stage 3 acquired immunodeficiency syndrome (AIDS) (CDC 2014) and glomerulopathy secondary to HIV. She consulted for subacute non-dysenteric diarrhea. During her hospitalization, bacteremia by methicillin-sensitive Staphylococcus aureus ( S.au reus) was documented, requiring hemodialysis catheter replacement with profuse bleeding during the procedure. The coagulation tests showed prolonged activated partial thromboplastin time (aPTT), normal prothrombin time (PT), mixing test with Rosner index: 8.8%, negative lupus anticoagulant, and specific tests for normal factor VIII and XI. The activity of factor IX was <50% and the inhibitor was increased, which confirms the diagnosis of hemophilia B. Acquired hemophilia B in a patient with HIV infection is not a frequent association; it should be suspected in the context of bleeding with prolonged aPTT.

Objetivo: La predicción del riesgo de desarrollar enfermedad severa o crítica en pacientes con infección por SARS-CoV2 requiere la utilización de modelos complejos que incluyen variables clínicas y prueba de laboratorio que no estándisponibles en todos los centros que atienden esta población. Diferentes variaciones de la relación entre poblaciones de leucocitos han demostrado tener implicaciones pronosticas, posiblemente asociadas con mecanismos fisiopatológicos. Alser el hemograma una prueba ampliamente disponible el desarrollo de un modelo de asociación para identificar los casos con mayor riesgo de enfermedad severa o crítica basado en las alteraciones propias del mismo, puede permitir su aplicación en diferentes escenarios clínicos con recursos limitados. El objetivo principal de este estudio fue establecer si existía asociación entre la composición de la fórmula leucocitaria al momento del diagnóstico y el desarrollo de enfermedad severa, críticao muerte en pacientes de 18 años o más con diagnóstico confirmado de infección por SARSCoV2. Los objetivos específicos fueron describir los perfiles composicionales de la fórmula leucocitaria al momento de la presentación inicial en pacientescon infección por SARS-CoV2, utilizando los métodos de análisis composicional, describir las características clínicas, alteraciones de laboratorio y supervivencia global de los pacientes mayores de 18 años con infección con SARS-CoV2 e identificar variables clínicas o de laboratorio asociadas con el riesgo de desarrollar enfermedad severa, crítica o muerte en pacientes mayores de 18 años con infección por SARS-CoV2.

No abstract