Background: Recent studies have shown the increased risk of mortality in cases with acute leukemia and iron overload. We aimed to determine the status of iron overload in patients with acute leukemia. Materials & Methods: Patients diagnosed with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) between January 2015 and December 2019 were included in the study. Results: At 6 months, there were statistically more patients with serum ferritin >1000 in the AML group compared to the ALL group (p = 0,011). Conclusion: Iron overload occurs earlier in patients with AML; the difference disappears after 6 months of treatment. It is the correct point to emphasize that iron overload is an important factor of pretransplant morbidity, especially in AML cases.
Introduction: High mobility group box 1 protein (HMGB1) is a non-histone chromosomal protein with dual activity. First within the nucleus, binds to DNA and acts as a regulator and second, outside the cell, interacts with receptors for inflammation as a signal molecule. We aimed to investigate and contribute to the value of extracellular HMGB1 in clinical context of ITP and to flourish future clinical directions to this biomarker. Methods: 50 newly diagnosed and treatment naive patients with ITP and 30 healthy controls were enrolled in our study. Results: Age or gender were not related with HMGB1 levels in patients and controls. Platelet levels were significantly related with HMGB1. Especially in patients with platelet counts below 30.000/mm3 highest levels of HMGB1 were observed. Regarding clinical presentation, bleeding was related with low platelet counts and high HMGB1 levels. Response to corticosteroids was observed to be better in patients with high HMGB1 levels. Conclusion: As a sample of autoinflammatory disorders, we observed a relation with extracellular HMGB1 levels and platelet levels in ITP patients. Corticosteroid response and HMGB1 relation supports the assumption of the value of HMGB1 as a potential surrogate of inflammation. This view should be evaluated with larger scale studies.
Background Invasive pulmonary aspergillosis (IPA) is seen during coronavirus-2019 (COVID-19), has been reported in different incidences, and is defined as COVID-19-associated pulmonary aspergillosis (CAPA). Detection of galactomannan antigen is an important diagnostic step in diagnosing IPA. Enzyme-linked immunoassay (ELISA) is the most frequently used method, and lateral flow assay (LFA) is increasingly used with high sensitivity and specificity for rapid diagnosis. The present study aimed to compare the sensitivity of LFA and ELISA in the diagnosis of CAPA in COVID-19 patients followed in our hospital's ICU for pandemic (ICU-P). Methods This study included patients with a diagnosis of COVID-19 cases confirmed by polymerase chain reaction and were followed up in ICU-P between August 2021 and February 2022 with acute respiratory failure. The diagnosis of CAPA was based on the European Confederation of Medical Mycology (ECMM) and the International Society for Human and Animal Mycology 2020 (ECMM/ ISHAM) guideline. Galactomannan levels were determined using LFA and ELISA in serum samples taken simultaneously from the patients. Results Out of the 174 patients followed in the ICU-P, 56 did not meet any criteria for CAPA and were excluded from the analysis. The rate of patients diagnosed with proven CAPA was 5.7% (10 patients). A statistically significant result was obtained with LFA for the cut-off value of 0.5 ODI in the diagnosis of CAPA (p < 0.001). The same significant statistical relationship was found for the cut-off value of 1.0 ODI for the ELISA (p < 0.01). The sensitivity of LFA was 80% (95% CI: 0.55–1.05, p < 0.05), specificity 94% (95% CI: 0.89–0.98, p < 0.05); PPV 53% (95% CI: 0.28–0.79, p > 0.05) and NPV was 98% (95% CI: 0.95–1.01, p < 0.05). The risk of death was 1.66 (HR: 1.66, 95% CI: 1.02–2.86, p < 0.05) times higher in patients with an LFA result of ≥ 0.5 ODI than those with < 0.5 (p < 0.05). Conclusions It is reckoned that LFA can be used in future clinical practice, particularly given its effectiveness in patients with hematological malignancies and accuracy in diagnosing CAPA.
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