Objectives: To the best of our knowledge, data from Gemtuzumab ozogamicin in Acute Myeloid Leukemia (AML) patients with failure of organ functions and poor performance status are extremely lacking. Moreover, the fast recovery from organ failure, after Gemtuzumab ozogamicin administration, has never been reported. This study aimed to demonstrate the efficacy and rapid response of Gemtuzumab ozogamicin in refractory acute myeloid leukemia (AML) patients with pulmonary and kidney failure and poor performance status. Three refractory AML patients, with organ dysfunction, are described. One patient was pre-treated with intensive chemotherapy, and two other patients progressed during Azacitidine treatment. Two patients had respiratory failure grade 2 and one patient suffered from acute kidney insufficiency. Two patients were highly febrile with an elevated C-Reactive Protein (CRP) level. The WHO performance status of three was measured in all patients. Gemtuzumab ozogamicin administration was performed in three patients, followed by a further switch to Gemtuzumab ozogamicin + Azacitidine or "7+3" treatment. Results: Gemtuzumab ozogamicin administration resulted in abrupt fever cessation in two febrile patients simultaneously with a rapid decrease in CRP level and fast resolution of respiratory failure. Recovery of kidney function was noticed rapidly in patients with renal insufficiency. The WHO performance status was elevated in all three patients. No adverse grade II-III effects were noticed. Further treatment made two patients eligible for intensive chemotherapy, one patient underwent allogeneic stem cell transplantation, and the patient with kidney failure obtained complete remission. Conclusions: Gemtuzumab ozogamicin therapy appeared to be safe and highly efficacious in relapsed/refractory AML patients with organ dysfunction, like pulmonary or renal failure and poor performance status, and may contribute to rapid recovery from organ failures.Biology 2020, 9, 28 2 of 8 Relapsed and refractory AML (10-40% of AML) represents the most common group of AML patients with organ dysfunction and poor outcomes [3].Low toxicity of Gemtuzumab ozogamicin (GO) seems to provide a new, promising option for the treatment of highly compromised patients. Amadori et al. reported the results of the GIMEMA trial of GO versus best supportive care in the treatment of unfit for intensive chemotherapy patients in a front-line setting [4]. The toxicity of GO was comparable to best supportive care, whereas a statistically significant increase in overall survival was shown in the GO arm. Moreover, GO has been shown to be an efficacious treatment in relapse/refractory AML patients [5,6]. However, significant organ dysfunction was the exclusion criterion in all these trials. To the best of our knowledge, data of GO in AML patients with organ failure are lacking.Here, we describe three patients with refractory CD 33+ AML and organ failures who benefited from GO use. All of them had uncontrolled leukemic overgrowth. The WHO performance status got ...

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Introduction Community-acquired pneumonia remains a common condition worldwide. It is associated with significant morbidity and mortality. The aim of this study was to evaluate conditions that could predict a poor outcome. Design Retrospective analyse of 69 patients admitted to the ICU from 1996 to 2003. Demographic data included age, sex and medical history. Etiologic agents, multiorgan dysfunction, nosocomial infections, SAPS II and PORT scores were recorded for each patient. For statistical analysis we used a t test, chi-square test and Mann-Whitney U test on SPSS ® . A value of P less than 0.05 was considered significant. Results Forty-seven patients were male and 22 patients were female. Mean age was 52 years. Sixty-seven percent had serious pre-morbid conditions including pulmonary disease (34.8%), cardiac problems (36.2%), diabetes (13%) and chronic liver disease (5.8%); 40.6% were smokers, drug abusers or alcohol dependents. Sixtyeight patients required invasive mechanical ventilation. The average length of ventilation was 13.5 days, median 8 days. The mean SAPS II score was 40.14 and the mean PORT score was 141. The mortality rate was 27.5% (SAPS II estimated mortality, 35%). Complications reported were ARDS (40.6%), septic shock (34.8%), acute renal failure (2.9%), cardiac arrest (8.7%) and nosocomial infeccions (46.4%). Mortality rates were higher for previous hepatic (75%) and metabolic (33%) diseases. We found a close association between crude mortality and SAPS II score (P = 0.003) and development of complications (P = 0.0028). Respiratory dysfunction (P = 0.006) and septic shock (P = 0.022) were most significantly related to mortality. No significant differences were founded regarding age, comorbidities, PORT score, etiologic agents, nosocomial infections and length of invasive mechanical ventilation. Conclusions Previous hepatic chronic disease was strictly related to higher mortality as well as isolation of MRSA. ARDS and septic shock predicted a poor outcome. SAPS II score was the best severity indicator of mortality. P2 Closed endotracheal suction system without periodic change versus open endotracheal system

The aim of our study was to compare different regimes of hematopoietic stem cell (HSC) mobilization, i.e., cyclophosphamide combined with granulocyte colony-stimulating factor (Cy/G-CSF), versus cytarabine with G-CSF (Ara-C/G-CSF). Efficiency and toxicity of these treatment regimens were assessed. Achievement of partial remission of the disease was sufficient for successful mobilization. CD34+ cell numbers in the blood showed a significant correlation with total number of CD34+ yielded by apheresis on the same day. When comparing the two groups of mobilization we have revealed that the patients treated with AraC + G-CSF yielded higher amounts of CD34+ cells in peripheral blood on the first apheresis day. Moreover, lesser occurrence of toxicity was revealed in group of patients treated with AraC-G-CSF.