• 제목/요약/키워드: Hematological disorders

검색결과 39건 처리시간 0.04초

Serological response 5 months after the BNT162b2 COVID-19 vaccination in patients with various hematological disorders in Japan

  • Yoshiaki Marumo;Takashi Yoshida;Yuki Furukawa;Kenji Ina;Ayumi Kamiya;Takae Kataoka;Satoshi Kayukawa
    • Clinical and Experimental Vaccine Research
    • /
    • 제12권4호
    • /
    • pp.319-327
    • /
    • 2023
  • Purpose: Patients with hematological malignancies are at an increased risk of severe infection with coronavirus disease 2019 (COVID-19). However, developing an adequate immune response after vaccination is difficult, especially in patients with lymphoid neoplasms. Since the long-term effects of the BNT162b2 vaccine are unclear, the humoral immune response 5 months after the two vaccinations in patients with hematological disorders was analyzed. Materials and Methods: Samples were collected from 96 patients vaccinated twice with BNT162b2 and treated with at least one line of an antitumor or immunosuppressive drug in our hospital from November 2021 to February 2022. Serum anti-severe acute respiratory syndrome coronavirus 2 (anti-SARS-CoV-2) spike (S) antibody titers were analyzed. Patients were age- and sex-matched using propensity matching and compared with a healthy control group. Patients with serum anti-SARS-CoV-2 S antibodies were defined as 'responder' if >50 U/mL. The patients had B-cell non-Hodgkin lymphoma (B-NHL), multiple myeloma, chronic myeloid leukemia, etc. Results: Patients had significantly low antibody levels (median, 55.3 U/mL vs. 809.8 U/mL; p<0.001) and a significantly low response rate (p<0.001). Multivariate analysis showed that patients with B-NHL, aged >72 years, were associated with a low response to vaccination. There were no significant differences between patients with chronic myeloid leukemia and healthy controls. Conclusion: Our study shows that patients with hematological disorders are at risk of developing severe COVID-19 infections because of low responsiveness to vaccination. Moreover, the rate of antibody positivity differed between the disease groups. Further studies are warranted to determine an appropriate preventive method for these patients, especially those with B-NHL.

A Genome-wide Association Study of Copy Number Variation in Hematological Parameters in the Korean Population

  • Kim, Ka-Kyung;Cho, Yoon-Shin;Cho, Nam-H.;Shin, Chol;Kim, Jong-Won
    • Genomics & Informatics
    • /
    • 제8권3호
    • /
    • pp.122-130
    • /
    • 2010
  • Abnormal hematological values are associated with various disorders including cancer and cardiovascular, metabolic, infectious, and immune diseases. We report the copy number variations (CNVs) in clinically relevant hematological parameters, including hemoglobin level, red and white blood cell counts, platelet counts, and red blood cell (RBC) volume. We describe CNVs in several loci associated with these hematological parameters in 8,842 samples from Korean population-based studies. The data that we evaluated included four RBC parameters, one platelet parameter, and one associated with total white blood cell (WBC) count, exceeding the genome-wide significance. We show that CNVs in hematological parameters are associated with some loci, different from previously associated loci reported in single nucleotide polymorphism (SNP) association studies.

Phase II Study on Voriconazole for Treatment of Chinese Patients with Malignant Hematological Disorders and Invasive Aspergillosis

  • Zhang, Xue-Zhong;Huang, Xin-En;Xu, Yan-Li;Zhang, Xiu-Qun;Su, Ai-ling;Shen, Zheng-Shan
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제13권5호
    • /
    • pp.2415-2418
    • /
    • 2012
  • Objective: To investigate the efficacy and safety of voriconazole in treating Chinese patients with hematological malignancies and invasive aspergillosis. Methods: From March 2007 to April 2012, patients with diagnoses confirmed by CT, GM test and/or PCR assays, were recruited into this study. Aspergillosis of all patients were treated with voriconazole 6 mg/kg intravenous infusion (iv) every 12 h for 1 day, followed by 4 mg/kg IV every 12 h for 10-15 days; Then, switch to oral administration that was 200mg every 12h for 4-12 weeks. Efficacy and safety were evaluated according to Practice Guideline of Infectious Diseases Society of America. Results: The overall response rate of 38 patients after voriconazole treatment was 81.6%. The median time to pyretolysis was 4.5 days. Treatment related side effects were mild and found in only 15.8% of cases. No treatment related deaths occurred. Conclusions: Voriconazole can considered to be a safe and effective front-line therapy to treat patients with hematological malignancies and invasive aspergillosis. Alternatively it could be used as a remedial treatment when other antifungal therapies are ineffective.

Clinical and Hematologic Characteristics of Temporomandibular Disorders Patients

  • Park, Seo Eun;Kim, Ji Rak;Jo, Jung Hwan;Park, Ji Woon
    • Journal of Oral Medicine and Pain
    • /
    • 제43권2호
    • /
    • pp.41-51
    • /
    • 2018
  • Purpose: The aim of this study was to evaluate the possibility of utilizing blood tests for the diagnosis of temporomandibular disorders (TMDs) by investigating the hematologic characteristics of TMD patients according to the main source and level of TMD pain and analyzing their interrelationship. Methods: Clinical examination following the research diagnostic criteria for TMD and hematological and psychological evaluations were conducted in 357 TMD patients. Patients were divided into groups according to the main source of pain (myogenous, arthrogenous, and combined pain) and the degree of pain according to the graded chronic pain scale (GCPS). Hematological differences among the groups were statistically analyzed. Results: The C-reactive protein (CRP) level was significantly higher in the arthrogenous pain group compared to the combined pain group (p=0.032). There was no significant difference according to the GCPS classification. There were significant correlations between some of the TMD pain indices and the hematologic indices, and also between the psychological indices and the hematologic indices. Conclusions: This study suggests the possibility of applying blood tests to the diagnosis, treatment and prevention of TMD. Further research should be conducted focusing on the role of CRP in TMD pain with more refined methodology and a longitudinal study design.

Association of TAP1 and TAP2 Gene Polymorphisms with Hematological Malignancies

  • Ozbas-Gerceker, Filiz;Bozman, Nazli;Gezici, Sevgi;Pehlivan, Mustafa;Yilmaz, Mehmet;Pehlivan, Sacide;Oguzkan-Balci, Sibel
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제14권9호
    • /
    • pp.5213-5217
    • /
    • 2013
  • Transporter associated with antigen presenting (TAP) 1 and TAP2 genes are localized in the major histocompatability complex (MHC) class II region and form a heterodimer playing a key role in endogenous pathways for antigen presentation. Defects of these genes have been reported to be common in different types of cancer. Polymorphisms identified in these loci have also been investigated and reported to be associated with several autoimmune disorders, viral infections and neoplasms. In the present study, for the first time, the allele and genotype frequencies of TAP1-333, TAP2-565, TAP2-651 and TAP2-665 were determined in patients with hematological malignancies (HM) using a PCR-RFLP method and compared with the frequencies in the control group. Our results suggested an association of TAP1-333 polymorphism with multiple myeloma-MM and TAP2-565 polymorphism with chronic lymphoid leukemia-CLL. In addition, it could be concluded that the TAP2-665 GG genotype might be a risk factor for all types of hematological malignancies included in this study.

Clinical Significance of Smudge Cells in Peripheral Blood Smears in Hematological Malignancies and Other Diseases

  • Chang, Chih-Chun;Sun, Jen-Tang;Liou, Tse-Hsuan;Kuo, Chin-Fu;Bei, Chia-Hao;Lin, Sheng-Jun;Tsai, Wei-Ting;Tan, N-Chi;Liou, Ching-Biau;Su, Ming-Jang;Yen, Tzung-Hai;Chu, Fang-Yeh
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제17권4호
    • /
    • pp.1847-1850
    • /
    • 2016
  • Background: It is reported that the percentage of smudge cells in the blood smear could be a prognostic indicator in chronic lymphocytic leukemia. However, the clinical significance of smudge cells in other hematological malignancies, solid tumors or non-malignant diseases is less clear. Hence, this study was conducted to survey the clinical significance of smudge cells in hematological cancers and other disorders. Materials and Methods: From January to November, 2015, the clinical data of patients who received blood examination with differential counts for clinical purpose and were found to have smudge cells in the peripheral blood film in Far Eastern Memorial Hospital were selected. The percentage of smudge cells and patient outcomes were evaluated for further univariate and survival analyses. Results: A total of 102 patients with smudge cells in their blood smears were included. Smudge cells were frequently presented in out-of-hospital cardiac arrest (OHCA; n=30), infections (n=23), hematological cancers (n=23) and solid cancers (n=10). There was no relationship between the percentage of smudge cells and the patient mortality in all diseases (OR: 1.08, 95% CI: 0.47-2.48, P=1.000) as well as the OHCA group (OR: 1.91, 95% CI: 0.38-9.60, P=0.694). It was observed that in patients with all cancers with the percentage of smudge cells less than 50% had a lower mortality rate in comparison with those who had the percentage of smudge cells of 50% or more (OR: 22.29, 95% CI: 2.38-208.80, P<0.001). Additionally, it was seemingly that patients with smudge cells of 50% or more had a lower survival rate than those with smudge cells less than 50% in all cancers with follow-up at 2-month intervals, but without statistical significance (P=0.064). Conclusions: Our survey indicated that in all cancers, those who had higher percentage of smudge cells were prone to have poor outcomes when compared with the subjects with lower percentage of smudge cells. This finding was quite different from the results of previous studies in which the race-ethnicity of most study populations was non-Asian; hence, further investigations are required. Besides, there was no apparent association of the percentage of smudge cells with patient outcomes in all diseases, including OHCA.

소아 중환자실에 입원한 혈액-종양 환아에서 발생한 폐 합병증의 원인과 예후에 대한 분석 (Analysis of Etiology and Prognosis of Pulmonary Complications in Children with Hematological or Oncological Disorders in Pediatric Intensive Care Unit)

  • 정진영;홍수종;안영준;김자형;서종진;문형남;김태형
    • Clinical and Experimental Pediatrics
    • /
    • 제45권8호
    • /
    • pp.1000-1006
    • /
    • 2002
  • 목 적 : 혈액-종양 환자에서 항암화학요법으로 치료하는 과정 중에서 중증 폐 질환 합병증이 발생할 수 있다. 그 원인으로는 감염성 또는 비 감염성의 원인들이 있고 특히 이들 환자에서 폐 질환 합병증 또는 호흡부전으로 인한 인공환기 치료시에는 예후가 나쁘다고 알려져 있다. 저자들은 본원 소아 중환자실에 입원한 혈액-종양 환아에서 면역 저하상태(절대 호중구수 < $1,000/mm^3$)의 지표의 하나인 호중구 감소증과 폐합병증의 유무에 따른 원인과 예후를 분석하였다. 방 법: 1997년 1월부터 2001년 5월까지 서울중앙병원 소아 중환자실에 입원한 혈액-종양 환아 95명의 의무기록을 후향적으로 분석하여 폐 합병증의 원인과 진단 방법, 호중구 감소상태와 폐 합병증의 유무에 따른 사망률을 분석하였다. 결 과 : 연령 분포는 생후 2개월에서 18세까지 평균 8.5세였고, 원인 혈액-종양 질환으로는 급성 림프성 백혈병 31명, 급성 골수성 백혈병 9명, 림프선 종양 11명, 뇌종양 8명, 고형종양 25명, 그 외 혈액질환이 11명이었다. 95명의 환아 중 중환자실 입원당시의 원인으로는 패혈증 23명(24%), 패혈증을 동반한 폐렴 22명(23%), 급성 호흡부전 12명(12.5%), 의식소실 16명(17%), 급성 신부전, 심부전의 기타 질환이 15명(16%)이었다. 이들 중에서 폐 합병증을 동반한 환아는 42명(44%), 동반하지 않은 환아는 53명(56%)이었다. 폐 합병증으로는 폐렴, 늑막삼출, 급성호흡부전, 기흉이 있었다. 폐 합병증이 있는 환아 중 호중구 감소상태의 환아는 29명(69%), 호중구 감소상태가 아닌 환아는 13명(31%)이었다. 원인으로는 감염성인 경우가 37명(88%), 비 감염성인 경우가 2명(5%)이었고, 구분이 어려운 경우가 3명(7%)이었다. 시행된 각각의 검체에서 균이 검출된 빈도를 비교하면 혈액배양검사는 42명중 15명(36%), 객담검사는 42명 중 7명(16%), 소변 배양검사는 42명 중 3명(7%), 인공환기요법 중인 환아에서 시행한 기도내 분비물 배양검사는 28명 중 5명(18%)이었다. 주요 원인균으로는 Candida species 12명(33%), MRSA 6명(17%), Pseudomonas aeruginosa 4명(11%), Klebsiella pneumoniae 4명(11%)이었다. 골수이식술을 받은 환자는 모두 10명으로 이중 7명에서 폐 합병증이 있었고, 원인균이 동정된 경우는 모두 3명으로 각각 S.maltophilia, K.pneumoniae, Parainfluenza virus이었다. 10명의 환아 중 8명이 사망하였고 사망 원인으로는 폐혈증이 5명, 급성호흡부전 증후군이 2명, 뇌출혈이 1명이었다. 전체 사망률은 56.8%였고, 사망률을 보면 이중 폐 합병증이 있고 호중구 감소상태의 환아는 76%(22명), 폐 합병증이 있으나 호중구 감소상태가 아닌 환아는 69% (9명), 폐 합병증이 없으나 호중구 감소상태의 환아는 46%(7명), 폐 합병증이 없으며 호중구 감소상태가 아닌 환아는 43%(16명)이었다. 결 론 : 중환자실에 입원한 혈액-종양 환아에서 폐 합병증의 원인으로 감염성인 경우가 많았다. 사망률은 폐 합병증이 있는 경우가 없는 경우에 비해 높았으며, 특히 폐 합병증이 있는 환아 중 호중구 감소상태의 환아에서 사망률이 높았다. 이 결과로 미루어 폐 합병증이 있는 혈액-종양 환자에서 더 적극적인 원인 규명과 치료를 시도해야 할 것으로 생각된다.

Vibrio vulnificus infection: a persistent threat to public health

  • Yun, Na Ra;Kim, Dong-Min
    • The Korean journal of internal medicine
    • /
    • 제33권6호
    • /
    • pp.1070-1078
    • /
    • 2018
  • Vibrio vulnificus is a gram-negative bacterium that can cause serious, potentially fatal infections. V. vulnificus causes three distinct syndromes: an overwhelming primary septicemia caused by consuming contaminated seafood, wound infections acquired when an open wound is exposed to contaminated warm seawater, and gastrointestinal tract-limited infections. Case-fatality rates are higher than 50% for primary septicemia, and death typically occurs within 72 hours of hospitalization. Risk factors for V. vulnificus infection include chronic liver disease, alcoholism, and hematological disorders. When V. vulnificus infection is suspected, appropriate antibiotic treatment and surgical interventions should be performed immediately. Third-generation cephalosporin with doxycycline, or quinolone with or without third-generation cephalosporin, may be potential treatment options for patients with V. vulnificus infection.

전남지방(全南地方) 유우(乳牛)에 있어서 번식장해(繁殖障害)의 실태(實態) 및 그 혈액치(血液値)에 관(關)한 조사연구(調査硏究) (Studies on Status and hematological Values of Reproductive Disorders in Dairy Cattle of Jeonnam Area)

  • 박영준
    • 대한수의학회지
    • /
    • 제14권2호
    • /
    • pp.253-268
    • /
    • 1974
  • A total of 331 dairy cattle in Jeonnam area were examined for the breeding status and hematological values during the period from June to August. 1971 and 1974. The data obtained were analysed according to the status of breeding and the type of farm management. The results obtained in this work were summarized as follows: 1. 331 dairy cows were grouped as pregnant (63.81%) anestrus after parturition (12.45%), pregnancy unknown (11.48%), repeat breeder (10.32%), and others (1.94%). 2. The summery of reproductive histories and clinical examination were as follows. Average of calving interval was 16.5 months, interval from parturition to first breeding 97 days and postpartum interval to first estrus 72 days. Services per conception was 1.6 rate of postpartum estrus (60 days) 12.0%, and the rate of repent breeder 10.3%. 3. Generally, the blood values of RBC, Hb, serum total protein and A/G ratio were lower than those normal values, especially, the cows which showed abnormal values belonged to the repeat breeder and the unknown to conception group. The mean value for serum inorganic phosphorus was the normal value or hyperphosphatemia, on the other hand, the mean value for serum calcium of the repeat breeder group was the lowest than the other group. 4. Follow-up evaluations on the results of the laboratory tests strongly suggest that the problems of repeat breeder had a tendency to occur more frequently in the large herd (A and B type farm), and the Ca/P ratio of almost all the cows showed abnormal values.

  • PDF