• Title/Summary/Keyword: hematological malignancy

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Pulmonary Resection for Invasive Pulmonary Aspergillosis in Hematological Malignancy Patients (혈액암 환자에서 합병된 침습성 폐아스페르길루스증의 수술적 치료)

  • Sa, Young-Jo;Kim, Yong-Han;Nam, Sang-Yong;Sim, Sung-Bo;Lee, Sun-Hee;Park, Jae-Kil
    • Journal of Chest Surgery
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    • v.40 no.9
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    • pp.617-623
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    • 2007
  • Background: Invasive pulmonary aspergillosis, a frequent fungal infection in immunocompromised patients, is known to have a poor prognosis despite the use of antifungal therapy in leukemic patients. We studied the outcome of surgical resection of invasive pulmonary aspergillosis where bleeding tendency, localized recurrence of infection, and incidence could be reduced. Material and Method: We retrospectively reviewed 14 patients with a hematological malignancy where invasive pulmonary aspergillosis was diagnosed during the 10 years between 1998 and 2007. From the medical records, we reviewed the type and treatment of the hematological malignancy, including the diagnostic methods of invasive pulmonary aspergillosis, the preoperative hematological conditions and their management, and the surgical methods and records. We also analyzed the development of postoperative complications and patient mortality, the recurrence of postoperative invasive pulmonary aspergillosis, and if the patients had a bone marrow transplant. Result: Fourteen patients with invasive pulmonary aspergillosis and a hematological malignancy underwent a pulmonary lobectomy. One patient had a complication of bronchopleural fistula, but there were no other serious complications such as bleeding or wound infection, and none of the patients died postoperatively. Conclusion: We have shown that pulmonary lobectomy is a safe and effective therapy for invasive pulmonary aspergillosis in patients with hematological malignancies that allow further treatment of the hematological malignancy.

Electrophysiological features and prognosis of peripheral neuropathy associated with IgM monoclonal gammopathy: a single-center analysis in South Korea

  • Sooyoung Kim;Bit Na Lee;Seung Woo Kim;Ha Young Shin
    • Annals of Clinical Neurophysiology
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    • v.25 no.2
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    • pp.84-92
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    • 2023
  • Background: Clinical spectrum of immunoglobulin M (IgM) monoclonal gammopathy varies from IgM monoclonal gammopathy of unknown significance (IgM-MGUS) to hematological malignancies. We evaluated the clinical features, electrophysiological characteristics, and prognosis of patients with peripheral neuropathy associated with IgM monoclonal gammopathy (PN-IgM MG). Methods: We retrospectively evaluated 25 patients with PN-IgM MG. Peripheral neuropathy was classified as axonal, demyelinating, or undetermined, based on electrophysiological studies. We classified the enrolled patients into the IgM-MGUS and malignancy groups, and compared the clinical and electrophysiological features between the groups. Results: Fifteen patients had IgM-MGUS and 10 had hematologic malignancies (Waldenström's macroglobulinemia: two and B-cell non-Hodgkin's lymphoma: eight). In the electrophysiological evaluation, the nerve conduction study (NCS) criteria for demyelination were met in 86.7% of the IgM-MGUS group and 10.0% of the malignancy group. In particular, the distal latencies of the motor NCS in the IgM-MGUS group were significantly prolonged compared to those in the malignancy group (median, 9.1 ± 5.1 [IgM-MGUS], 4.2 ± 1.3 [malignancy], p = 0.003; ulnar, 5.4 ± 1.9 [IgM-MGUS], 2.9 ± 0.9 [malignancy], p = 0.001; fibular, 9.3 ± 5.1 [IgM-MGUS], 3.8 ± 0.3 [malignancy], p = 0.01; P-posterior tibial, 8.3 ± 5.4 [IgM-MGUS], 4.4 ± 1.0 [malignancy], p = 0.04). Overall treatment responses were significantly worse in the malignancy group than in the IgM-MGUS group (p = 0.004), and the modified Rankin Scale score at the last visit was higher in the malignancy group than in the IgM-MGUS group (2.0 ± 1.1 [IgM-MGUS], 4.2 ± 1.7 [malignancy], p = 0.001), although there was no significant difference at the initial assessment. Conclusions: The risk of hematological malignancy should be carefully assessed in patients with PN-IgM MG without electrophysiological demyelination features.

Relationship Between Spiritual Health and Depression of Patients with Hematologic Malignancy (혈액 암 환자의 영적건강과 우울의 관계연구)

  • Chong, Sang-Ok;Chang, Soon-Bok;Lee, Won-Hee;Kim, Ju-Hyung
    • Asian Oncology Nursing
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    • v.7 no.1
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    • pp.56-67
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    • 2007
  • Purpose: This study was designed to identify the relationship between spiritual health and depression with the hematological malignancies patients in an isolated room. Method: The obtained data were analyzed using SPSS Win 12.0. For the statistical anayses, Pearson correlation coefficients, multiple linear regression analysis, t-test and ANOVA were calculated. Results: The mean scores of the status of spiritual health, depression were 111.62 and 29.78, respectively. The score of spiritual health was significant differences by the faith (F=19.65, p=0.000). Depression score was significant differences by age (F=4.561, p=0.002) and spiritual state (F=4.843, p=0.004). Spiritual health and depression was moderately correlated (r=-.681, p=.000). Conclusion: From the above results, oncology nurse should consider spiritual health and depression when caring patients with hematological malignancies.

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T-SPOT.TB for Detection of Tuberculosis Infection among Hematological Malignancy Patients and Hematopoietic Stem Cell Transplant Recipients

  • Qin, Li-Li;Wang, Qin-Rong;Wang, Qian;Yao, Hong;Wen, Li-Jun;Wu, Li-Li;Ping, Na-Na;Xie, Jun-Dan;Chen, Mei-Yu;Chen, Su-Ning
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7415-7419
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    • 2013
  • The diagnosis of latent Mycobacterium tuberculosis infection (LTBI) is recommended in hematological malignancy patients and before hematopoietic stem cell transplantation (Guidelines for the prevention and management of infectious complications of solid organ transplantation, 2004). Compared to traditional methods such as tuberculin skin test (TST), T-SPOT.TB has been shown to be more specific. In the present study we enrolled 536 patients for whom T-SPOT.TB was performed, among which 295 patients also received the TST test. The agreement (79%) between T-SPOT.TB and TST was poor (x=0.274, P<0.001). The patients with positive T-SPOT.TB results numbered 62 (11.6%), in which only 20 (48.8%) of the 41 receiving the TST test had positive results. A majority of the patients with T-SPOT.TB positive results had some other evidence ofTB, such as TB history, clinical symptoms and an abnormal chest CT scan. Active TB was found in 9 patients, in which 2 had negative TST results. We followed up the patients and no one developed active TB. Our study suggested that the T-SPOT.TB may be more useful for screening LTBI and active TB in hematological malignancy patients and hematopoietic stem cell transplant recipients than the TST test.

Clinico-Hematological Findings for Classical Hodgkin's Lymphoma: an Institutional Experience

  • Sultan, Sadia;Irfan, Syed Mohammed;Parveen, Saira;Ali, Saif
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.4009-4011
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    • 2016
  • Background: Classical Hodgkin's lymphoma (cHL) is a B-cell lymphoid neoplasm characterized by a distinctive biological behavior with potentially curable disease characteristics. It is an uncommon hematological malignancy which primarily affects younger individuals. The rationale of this study was to determine its clinico-hematological profile along with stage stratification in Pakistani patients. Materials and Methods: In this descriptive study, adult patients with Hodgkin's lymphoma were enrolled from January 2010 to December 2014. Results: Sixty two histopathologically confirmed cases of cHL were identified. There were 42 males and 20 females, with a male to female ratio of 2: 1. The mean age was $29.7{\pm}13.8$ years with the median age of 30 years. B symptoms were present in 72.5% of patients. Histopathologically, the mixed cellularity type constituted 62.9% of cases, followed by nodular sclerosis in 25.8%, lymphocyte predominant in 9.6% and lymphocyte depleted in 1.6%. Stages I and II were present in 43.5% of patients at disease presentation, with 56.4% in stages III and IV. Conclusions: Our analysis shows that clinico-pathological features of Hodgkin's lymphoma in Pakistan are comparable to published data. Mixed cellularity is the commonest histological variant and advanced stage at presentation are common findings in our patients.

Surgical Roles for Spinal Involvement of Hematological Malignancies

  • Kim, Sang-Il;Kim, Young-Hoon;Ha, Kee-Yong;Lee, Jae-Won;Lee, Jin-Woo
    • Journal of Korean Neurosurgical Society
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    • v.60 no.5
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    • pp.534-539
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    • 2017
  • Objective : Patients with hematological malignancies frequently encounter spine-related symptoms, which are caused by disease itself or process of treatment. However, there is still lack of knowledge on their epidemiology and clinical courses. The purpose of this article is to review clinical presentations and surgical results for spinal involvement of hematologic malignancies. Methods : From January 2011 to September 2014, 195 patients (98 males and 97 females) suffering from hematological malignancies combined with spinal problems were retrospectively analyzed for clinical and radiological characteristics and their clinical results. Results : The most common diagnosis of hematological malignancy was multiple myeloma (96 patients, 49.7%), followed by chronic myeloid leukemia (30, 15.2%), acute myeloid leukemia (22, 11.2%), and lymphoma (15, 7.56%). The major presenting symptoms were mechanical axial pain (132, 67.7%) resulting from pathologic fractures, and followed by radiating pain (49, 25.1%). Progressive neurologic deficits were noted in 15 patients (7.7%), which revealed as cord compression by epidural mass or compressive myelopathy combined with pathologic fractures. Reconstructive surgery for neurologic compromise was done in 16 patients. Even though surgical intervention was useful for early paralysis (Frankel grade D or E), neurologic recovery was not satisfactory for the progressed paralysis (Frankel grade A or B). Conclusion : Hematological malignancies may cause various spinal problems related to disease progression or consequences of treatments. Conservative and palliative treatments are mainstay for these lesions. However, timely surgical interventions should be considered for the cases of pathologic fractures with progressive neurologic compromise.

A Case of Severe Hypercalcemia Causing Acute Kidney Injury: An Unusual Presentation of Acute Lymphoblastic Leukemia

  • Hyun, Hye Sun;Park, Peong Gang;Kim, Jae Choon;Hong, Kyun Taek;Kang, Hyoung Jin;Park, Kyung Duk;Shin, Hee Young;Kang, Hee Gyung;Ha, Il Soo;Cheong, Hae Il
    • Childhood Kidney Diseases
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    • v.21 no.1
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    • pp.21-25
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    • 2017
  • Severe hypercalcemia is rarely encountered in children, even though serum calcium concentrations above 15-16 mg/dL could be life-threatening. We present a patient having severe hypercalcemia and azotemia. A 14-year-old boy with no significant past medical history was referred to our hospital with hypercalcemia and azotemia. Laboratory and imaging studies excluded hyperparathyroidism and solid tumor. Other laboratory findings including a peripheral blood profile were unremarkable. His hypercalcemia was not improved with massive hydration, diuretics, or even hemodialysis, but noticeably reversed with administration of calcitonin. A bone marrow biopsy performed to rule out the possibility of hematological malignancy revealed acute lymphoblastic leukemia. His hypercalcemia and azotemia resolved shortly after initiation of induction chemotherapy. Results in this patient indicate that a hematological malignancy could present with severe hypercalcemia even though blast cells have not appeared in the peripheral blood. Therefore, extensive evaluation to determine the cause of hypercalcemia is necessary. Additionally, appropriate treatment, viz., hydration or administration of calcitonin is important to prevent complications of severe hypercalcemia, including renal failure and nephrocalcinosis.

Hepatitis B and C Seroprevalence in Solid Tumors - Necessity for Screening During Chemotherapy

  • Oguz, Arzu;Aykas, Fatma;Unal, Dilek;Karahan, Samet;Uslu, Emine;Basak, Mustafa;Karaman, Ahmet
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.3
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    • pp.1411-1414
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    • 2014
  • Background: Hepatitis B and C are the leading causes of liver diseases worldwide. For hematological and solid malignancy patients undergoing chemotherapy, increases in HBV DNA and HCV RNA levels can be detected which may result in reactivation and hepatitis-related morbidity and mortality. The aim of this study was to determine the seroprevalence of Hbs ag and Anti HCV positivity in patients with solid malignancies undergoing chemotherapy and consequences during follow-up. Materials and Methods: The files of 914 patients with solid malignancies whose hepatitis markers were determined serologically at diagnosis were reviewed retrospectively. All underwent adjuvant/palliative chemotherapy. For the cases with HBV and/or HCV positivity, HBV DNA and HCV RNA levels, liver function tests at diagnosis and during follow-up and the treatment modalities that were chosen were determined. Results: Of 914 cases, Hbs Ag, anti Hbs and anti HCV positivity were detected in 40 (4.4%), 336 (36.8%) and 26 (2.8%) of the cases respectively. All of the Hbs ag positive patients received prophylactic lamuvidine before the start of chemotherapy. In the Hbs ag and anti HCV positive cases, liver failure was not detected during chemotherapy and a delay in chemotherapy courses because of hepatitis was not encountered. Conclusions: Just as with hematological malignancies, screening for HBV and HCV should also be considered for patients with solid tumors undergoing chemotherapy. Prophylactic antiviral therapy for HBV reduces both the reactivation rates and HBV related mortality and morbidity. The clinical impact of HCV infection on patients undergoing chemotherapy is still not well characterized.

The Effects of Foot Massage on Fatigue and Depression among Patients with Hematological Malignancies (발마사지가 혈액 암 환자의 피로와 우울에 미치는 효과)

  • Sim, Mi Ja;Yoo, Yang Sook;Choe, Da Mi;Chung, Sang Ok;Jung, Jin;Jeon, Jin Yeong;Park, Jeong In;Eun, Bang Hee;Kim, Kwang Sung
    • Journal of Korean Clinical Nursing Research
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    • v.14 no.3
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    • pp.27-36
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    • 2008
  • Purpose: This study was to investigate the effects of foot massage on fatigue and depression among patients undergoing chemotherapy with hematological malignancies. Method: The subjects were 60 patients hospitalized for undergoing chemotherapy from September 2007 to March 2008, and 30 of them were the experimental group and the other 30 were the control group. To the subjects in the experimental group, foot massage was provided for 30 minutes everyday before the chemotherapy at the same time for 4 days, and the effect was measured on Day 4 and 5 after chemotherapy. Fatigue was measured using the Brief Fatigue Inventory (BFI) developed by Mendoza et al. (1999), and depression was measured by psychiatric rating scale SCL-90-R developed by Derogatis (1977) and translated by Kim Gwang il et al. The data were analyzed through $x^2$-test, Fisher's exact test, unpaired t-test and repeated measures ANOVA using SPSS 12.0. Results: Fatigue and depression were significantly lower in the experimental group than in the control group. Even on Day 5, fatigue and depression were significantly lower in the experimental group than in the control after finish foot massage. Conclusion: The findings of the study demonstrated that foot massage would be an effective nursing intervention to reduce fatigue and depression in patients with hematological malignancies.

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