The neutrophil/lymphocyte ratio (NLR) at diagnosis has been shown to be a prognostic factor for survival in solid tumors. The NLR at diagnosis as a prognostic factor for multiple myeloma (MM) has not been studied. Therefore, the focus of the study was the correlation of NLR with the proven prognostic parameters in patients with MM. A total of 151 MM patients who fulfilled the International Myeloma Working Group (IMWG) criteria were enrolled in the study by a retrospective review of the patients' records. One hundred fifty-one age- and gender-matched healthy controls were also included in the study. NLR was calculated using data obtained from the complete blood count (CBC). NLR was significantly higher in MM patients than the control group (2.79 ± 1.82 vs. 1.9 ± 0.61, respectively; p < 0.0001). The median follow-up on living patients in this study was 41 months. NLR at the diagnosis was found to be an independent predictor for overall survival (OS) and event-free survival (EFS) by univariate and multivariate analysis. Patients with a NLR <2 at diagnosis experienced superior OS compared with patients with a NLR ≥2 (5-year OS rates were 87.5 and 42.4 %, respectively; p < 0.0001). In a similar fashion, superior EFS was observed in patients with a NLR <2 at the diagnosis compared with patients with a NLR ≥2 (5-year EFS rates were 88.4 and 41.8 %, respectively, p < 0.0001). This study suggests that NLR at the diagnosis is a simple, inexpensive, possible prognostic factor to assess clinical outcomes in MM patients.

Three pediatric and two adult Turkish patients with Crimean Congo Hemorrhagic Fever (CCHF) induced hemophagocytic syndrome (HPS) were admitted to Ondokuz Mayis University Hospital, which is in the Middle Black Sea Region of Turkey. All of them had remarkable hemophagocytosis in the bone marrow with severe bleeding symptoms along with the other known clinical and laboratory findings of CCHF. We would like to present these patients and to discuss the pathophysiology and the effect of acquired HPS on the severity of the disease. Am. J. Hematol., 2008. © 2007 Wiley‐Liss, Inc.

Background/Aim: The aim of the study was to evaluate the effect of Controlling Nutritional Status (CONUT) score on the prognosis in patients with diffuse large B-cell lymphoma(DLBCL). Materials and Methods:The present study was a retrospective study. The CONUT score was calculated based on serum albumin, total cholesterol and lymphocyte levels. This study included a total of 266 patients, 131(49.2%) were female and 135(50.8%) were male. The median follow-up period was 51 months (range: 1-190). Results:The median age was 64 years. The cut off CONUT was 1.5. There was a significant difference between patients with high (≥2) or low (<2) CONUT scores in terms of overall survival(OS) and progression-free survival(PFS). The 5-year OS and PFS in patients with high CONUT score was 52.1% and 49.7%. The 5-year OS and PFS in patients with low CONUT score was 79.8% and 75.6% (p<0.001). In the multivariate analysis for OS, age ≥65 years (HR=1.80, p=0.028), Eastern Cooperative Oncology Group (ECOG) >1 (HR=2.04, p=0.006), stage IIIA-IVB disease (HR=2.75, p=0.001) and the CONUT score (HR=1.15, p = 0.003) were found statistically significant. In the multivariate analysis for PFS, age ≥65 years (HR=2.02, p=0.007), stage IIIA-IVB disease (HR=2.42, p=0.002) and the CONUT score (HR=1.19, p=0.001) were found to be significant parameters. Conclusion:High CONUT score reduces OS and PFS in DLBCL. CONUT score is an independent, strong prognostic index in patients with DLBCL.

Coronavirus disease 2019 (COVID-19) which causes severe acute respiratory syndrome (SARS) was named as SARS-CoV-2 to distinguish it from the previous SARS-CoV. 1 The rate of acute respiratory distress syndrome (ARDS) is 19.6% in patients with COVID-19 pneumonia and has increased to 61.1% during the time of transfer to intensive care unit (ICU). 2 This ratio is getting higher in non-survivors (81%) and ARDS is becoming a large concern of death in COVID-19. 3 Other remarkable findings which are linked to the severity of disease and the risk of mortality in COVID-19 is the increased level of D-dimer. Increment in the levels of D-dimer, Fibrin Degradation Product (FDP) and decrement in antithrombin (AT) has been seen in patients with COVID-19. Changes in D-dimer and FDP were prominent in severe disease as compared to the mild group. Thrombin time has been detected as shorter in critical patients compared to controls. 4 Prothrombin time and D-dimer values at hospital admission have been shown to be higher in patients who need ICU during the disease process compared to non-ICU patients. 5 Increased levels of D-dimer have been described as risk factors for development of ARDS and especially for death. 6 Hospital death has been found to be associated with levels greater than 1 mg/mL of D-dimer on admission. 7 Gao et al described a cut off value for D-dimer as 0.28 ng/L to predict the severity of disease. 8 Overt-disseminated intravascular coagulation was determined in 71.4% of non-survivors compared to 0.6% of survivors in later stages of COVID-19 pneumonia. 9 Anticoagulant treatment with unfractionated heparin and low molecular weight heparin was shown to decrease mortality. 10 Our hypothesis is that probable mechanisms for the increased D-dimer in COVID-19 may be related to virus life cycle. The apoptotic processes target the endothelial cells of the vascular structure resulting in triggered coagulopathy and the ultimate result of increased D-dimer.Apoptosis is a programmed cell death and has a critical role in the life cycle of viruses. Viruses can't live without a host cell

Babesiosis is a zoonotic disease that may be asymptomatic or result in severe clinical conditions, with severe hemolysis, hepatic, and renal failure, in humans. Clinical symptoms depend on the species and immune status of the host. The disease is especially severe in those of advanced age, those with an immune deficiency, and the splenectomized. A severe case of babesiosis that developed in a splenectomy patient is presented here; the patient was admitted from a rural region with severe anemia and a deterioration in her general condition, with an initial diagnosis of malaria. In such situations, an exchange transfusion (ET), in addition to antimicrobial treatment, could be lifesaving.