Sarcopenia during HSCT was affected by oral caloric intake during the preparation regimen and after transplantation. Physical therapy in conjunction with nutritional therapy may help prevent weakness in HSCT recipients.

Although the Sokal and Hasford scoring systems are well-known prognostic models specific to chronic myeloid leukemia (CML), whether they can effectively predict outcomes in elderly CML patients with comorbidities has not been fully elucidated. We evaluated the association between comorbidity at diagnosis with treatment outcome and survival in chronic phase CML patients. A questionnaire was administered to patients diagnosed with CML between 2001 and 2012 and treated with tyrosine kinase inhibitors (TKIs). The Charlson comorbidity index (CCI) was used to determine concomitant diseases. In total, 79 patients (33 females; median age, 57 years) were enrolled. CCI scores at diagnosis were between 2 and 11. At the last follow-up, 46 patients showed a major molecular response. Complete cytogenetic response was achieved in 73.4 % of the cases 12 months after TKI administration. We observed only five deaths during the 55.5-month median follow-up period. The risk categories (low/intermediate/high) associated with Sokal and Hasford scores were 33/27/7 and 21/43/3, respectively. The 27 cases with a CCI score >3 had significantly poorer survival after diagnosis (52 cases had a CCI score <2). CCI scores were inversely associated to overall survival. Concomitant comorbidity at diagnosis is associated with poor outcome in CML patients treated with TKIs.

BackgroundA small number of rhabdomyosarcoma (RMS) cases involve the bone marrow. A leukemic presentation of RMS has been reported in a few case series, although almost all cases of leukemic RMS are not completely mimicking leukemia. We encountered a case with RMS cell infiltration of the bone marrow that resembled floating hematological cells.Case presentationWe encountered a rare case of a 15-year-old boy with a 2-week history of left femoral pain. Upon admission, he was afebrile with no other symptoms. No apparent cause of femoral pain was detected on an initial examination. Laboratory findings revealed normal white blood cell (WBC) count and hemoglobin concentration, with a platelet count of 10.3 × 104/μL. WBCs included 2.0% metamyelocytes, 4.5% myelocytes, and 0.5% blasts. Lactate dehydrogenase concentration was 1299 U/L, creatine kinase was 437 U/L, and C-reactive protein was 1.25 mg/dL. Bone marrow aspiration demonstrated hypercellular marrow (nucleated cell count 1.84 × 104/μL) and 89.0% of blast-like cells of all nucleated cells. The proliferating cells were negative for myeloperoxidase and esterase, and strongly positive for CD56. Positron emission tomography exhibited extensive accumulation of 18F–fludeoxyglucose with a SUVmax of 7.09. Magnetic resonance imaging revealed T1-low intensity, gadolinium-enhanced, diffuse, and irregular lesions on his pelvis and bilateral femurs. These laboratory and imaging findings suggested hematological malignancy with diffuse bone involvement, suggestive of acute leukemia. However, the pathological diagnosis of bone marrow and basal penile muscle biopsy was alveolar RMS. Karyotype analysis of bone marrow cells revealed the characteristic translocation of t(2;13)(q35;q14). The final diagnosis was alveolar RMS with massive involvement of the bone marrow and the primary site in the perineal muscles. The tumor cells both of the primary site and bone marrow were positive for myogenin.ConclusionsA literature review found a misdiagnosed case of completely mimicking leukemic RMS as natural-killer (NK)-cell leukemia. Such a misdiagnosis can have critical consequences. We experienced a rare case of alveolar RMS with symmetrical diffuse bone marrow involvement completely masquerading as acute leukemia. The results of a surface marker study showing that the tumor cells had a near NK-cell phenotype were misleading.

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VRCZ might be metabolized by an enzyme induced by corticosteroid treatment; therefore, intraindividual variation in VRCZ metabolism should be considered prior to concurrent treatment, especially for patients with hematological malignancies treated with corticosteroids.