http://www.mjhid.org/index.php/mjhid/issue/feed Mediterranean Journal of Hematology and Infectious Diseases 2020-07-02T22:30:42+00:00 Giuseppe Leone gleone@mjhid.org Open Journal Systems <p style="font-size: 14px;">The Journal publishes original articles and topical reviews concerning both clinical hematology and infectious diseases. A particular attention will be deserved to original articles focusing on the relationship between blood and infectious diseases.</p> <p><strong>The Mediterranean Journal of Hematology and Infectious Diseases has been selected for coverage in </strong><strong>Clarivate Analytics products and services. <br>Beginning with V. 7 (1) 2015, this publication is indexed and abstracted in:</strong><br><strong>♦ Science Citation Index Expanded</strong><br><strong>♦ Journal Citation Reports/InCites</strong></p> <p><strong>♦ First <strong>2017 <strong>official</strong> </strong>Impact Factor: 1.183</strong></p> <p><strong>♦ Official Impact Factor 2018. 1.586</strong></p> <p><span style="font-size: 12px;"><strong><span class="info_label" style="color: #757472; text-transform: none; text-indent: 0px; letter-spacing: normal; font-family: 'Open Sans',sans-serif,icomoon; font-style: normal; word-spacing: 0px; white-space: normal; background-color: #ffffff;">ISI Journal Citation Reports @ Ranking: 2017</span></strong></span></p> <p><strong>List of contents:</strong></p> <p>&nbsp;</p> <p><strong><a title="Volume 12, Year 2020" href="https://www.mjhid.org/index.php/mjhid/issue/view/91">12:(1) (2020):</a> </strong><strong><a title="Volume 12, Year 2020" href="https://www.mjhid.org/index.php/mjhid/issue/view/91"><img src="/public/site/images/fguidi/FRECCE0014.gif" alt=""></a> <a title="Volume 12, Year 2020" href="https://www.mjhid.org/index.php/mjhid/issue/view/91">ORIGINAL ARTICLES, REVIEWS:</a></strong></p> <p>&nbsp;</p> <p><a title="Volume 11, Year 2019" href="https://www.mjhid.org/index.php/mjhid/issue/view/90"><strong>11:(1) (2019):</strong></a> <strong><a title="Volume 11, Year 2019" href="https://www.mjhid.org/index.php/mjhid/issue/view/90"><img src="/public/site/images/fguidi/FRECCE0014.gif" alt=""></a> ORIGINAL ARTICLES, REVIEWS:</strong></p> <p><strong>Reviews Series</strong></p> <ul> <li class="show">UPDATE ON THALASSEMIA AND HEMOGLOBINOPATHIES. Guest Editor: Raffaella Origa<strong>. </strong><a href="/index.php/mjhid/announcement/view/82">More...</a></li> </ul> <p><strong>10:(1) (2018): <a title="Volume 10, Year 2018" href="https://www.mjhid.org/index.php/mjhid/issue/view/Volume%2010%2C%202018"><img src="/public/site/images/fguidi/FRECCE0014.gif" alt=""></a> ORIGINAL ARTICLES, REVIEWS:</strong></p> <p><strong>Review Topics:</strong></p> <ul> <li class="show">UPDATE ON VIRAL INFECTIONS AND LYMPHOPROLIFERATIVE DISEASES. Guest Editors: M. Luppi and L. Arcaini <a href="/index.php/mjhid/announcement/view/73">More...</a></li> </ul> <p><strong>9:(1) (2017): </strong><strong><a title="Volume 9, Year 2017" href="https://www.mjhid.org/index.php/mjhid/issue/view/9%281%29"><img src="/public/site/images/fguidi/FRECCE0014.gif" alt=""></a>ORIGINAL ARTICLES, REVIEWS:</strong></p> <p><strong>Review Topics:</strong></p> <ul> <li class="show">UPDATE ON SECONDARY LEUKEMIAS. Guest Editor: Richard Larson <a href="/index.php/mjhid/announcement/view/59">More...</a></li> <li class="show">UPDATE on “Rare Plasma Cell Dyscrasias” Guest Editor M.T. PETRUCCI <a href="/index.php/mjhid/announcement/view/49">More...</a></li> </ul> <p><strong>8:(1) (2016): <a title="Volume 8, Year 2016" href="https://www.mjhid.org/index.php/mjhid/issue/view/78"><img src="/public/site/images/fguidi/FRECCE0014.gif" alt=""></a> ORIGINAL ARTICLES, REVIEWS:</strong></p> <p><strong>Review Topics:</strong></p> <ul> <li class="show">HEMATOPOIETIC STEM CELL TRANSPLANTATION AND INFECTIONS. Guest Editor: Miguel Sanz <a href="/index.php/mjhid/announcement/view/37">More...</a></li> <li class="show">REVIEW SERIES: UPDATE ON FOLLICULAR LYMPHOMA. Guest Editor: Corrado Tarella <a href="/index.php/mjhid/announcement/view/39">More...</a></li> </ul> <p><strong>8:(Supplementary Issue) (2016): <a href="https://www.mjhid.org/index.php/mjhid/issue/view/79"><img src="/public/site/images/fguidi/FRECCE0014.gif" alt=""></a> Fifth International Symposium on Secondary Leukemia and Leukemogenesis</strong></p> <p><strong>7:(1) (2015): <a title="Volume 7, Year 2015" href="https://www.mjhid.org/index.php/mjhid/issue/view/75"><img src="/public/site/images/fguidi/FRECCE0014.gif" alt=""></a> ORIGINAL ARTICLES, REVIEWS:</strong></p> <p>Review Topics:</p> <ul> <li class="show">MYELODYSPLASTIC SYNDROMES. AN UPDATE. SINCE 2015. Guest Editors: C. Mecucci and M.T. Voso. <a href="https://www.mjhid.org/index.php/mjhid/announcement/view/24">More...</a></li> <li class="show">BACTERIAL INFECTIONS IN HEMATOLOGIC PATIENTS: AN UPDATE. SINCE 2015.Guest Editors F. Aversa and M. Tumbarello <a href="https://www.mjhid.org/index.php/mjhid/announcement/view/25">More...</a></li> </ul> <p><strong>6:(1) (2014): <a title="Volume 6, Year 2014" href="https://www.mjhid.org/index.php/mjhid/issue/view/39"><img src="/public/site/images/fguidi/FRECCE0013.gif" alt=""></a> ORIGINAL ARTICLES, REVIEWS:</strong></p> <p>Review Topics:</p> <ul> <li class="show">CHRONIC MYELOID LEUKEMIAS: AN UPDATE. Guest Editors: M. Baccarani and F. Pane. <a href="https://www.mjhid.org/index.php/mjhid/announcement/view/21">More...</a></li> <li class="show">UPDATE IN HODGKIN LYMPHOMA. Guest Editor: A. Gallamini <a href="https://www.mjhid.org/index.php/mjhid/announcement/view/22">More...</a></li> <li class="show">ACUTE LYMPHOID LEUKEMIA IN ADULTS: AN UPDATE. Guest Editors: R. Bassan and A.Rambaldi <a href="https://www.mjhid.org/index.php/mjhid/announcement/view/23">More...</a></li> </ul> <p><strong>5:(1) (2013): <a title="Volume 5, Year 2013" href="https://www.mjhid.org/index.php/mjhid/issue/view/20"><img src="/public/site/images/fguidi/FRECCE0012.gif" alt=""></a> ORIGINAL ARTICLES, REVIEWS:</strong></p> <p>Review Topics:</p> <ul> <li class="show">ACUTE MYELOID LEUKEMIA IN THE ELDERLY. Guest Editors: S. Amadori and A. Venditti. <a href="https://www.mjhid.org/index.php/mjhid/announcement/view/19">More...</a></li> <li class="show">VON WILLEBRAND FACTOR UPDATE. Guest Editors: A. Federici and F. Rodeghiero. <a href="https://www.mjhid.org/index.php/mjhid/announcement/view/18">More...</a></li> <li class="show">TUBERCULOSIS UPDATE. Guest Editors: R. Cauda and A. Matteelli. <a href="https://www.mjhid.org/index.php/mjhid/announcement/view/20">More...</a></li> </ul> <p><strong>4:(1) (2012): <a title="Malaria In The World, Chronic Lymphoid Leukemia, Autologous Hemopoietic Stem Cell Transplantation In Leukemia And Lymphoma" href="https://www.mjhid.org/index.php/mjhid/issue/view/19"><img src="/public/site/images/fguidi/FRECCE0011.gif" alt=""></a>ORIGINAL ARTICLES, REVIEWS:</strong></p> <p>Review Topics:</p> <ul> <li class="show">MALARIA IN THE WORLD: 2012 Update. Guest Editors: F. Castelli and E. Pizzigallo <a href="https://www.mjhid.org/index.php/mjhid/announcement/view/12">More...</a></li> <li class="show">CHRONIC LYMPHOID LEUKEMIA: Update on Immunological Dysfunctions and Infections. Guest Editors: D. Efremov and L. Laurenti <a href="https://www.mjhid.org/index.php/mjhid/announcement/view/17">More...</a></li> <li class="show">AUTOLOGOUS HEMOPOIETIC STEM CELL TRANSPLANTATION IN LEUKEMIA AND LYMPHOMA: 2012 UPDATE. Guest Editors: G. Meloni and G. Visani <a href="https://www.mjhid.org/index.php/mjhid/announcement/view/13">More...</a></li> </ul> <p><strong>3:(1) (2011): <a title="Fungal Infections, Thrombosis In The Mediterranean Area, Acute Promyelocytic Leukemia In The Mediterranean Area And In The Developing Countries, Therapy-Related Myeloid Neoplasms." href="https://www.mjhid.org/index.php/mjhid/issue/view/18"><img src="/public/site/images/fguidi/FRECCE001.gif" alt=""></a> ORIGINAL ARTICLES, REVIEWS:</strong></p> <p>Review Topics:</p> <ul> <li class="show">FUNGAL INFECTIONS. Guest Editor: L. Pagano <a style="color: #990000;" href="https://www.mjhid.org/index.php/mjhid/announcement/view/8">More...</a></li> <li class="show">THROMBOSIS IN THE MEDITERRANEAN AREA. Guest Editor: V. De Stefano <a style="color: #990000;" href="https://www.mjhid.org/index.php/mjhid/announcement/view/9">More...</a></li> <li class="show">ACUTE PROMYELOCYTIC LEUKEMIA IN THE MEDITERRANEAN AREA AND IN THE DEVELOPING COUNTRIES: Guest Editors: F. Lo-Coco and G. Avvisati <a style="color: #990000;" href="https://www.mjhid.org/index.php/mjhid/announcement/view/10">More...</a></li> <li class="show">THERAPY-RELATED MYELOID NEOPLASMS: Guest Editor: R. Larson <a style="color: #990000;" href="https://www.mjhid.org/index.php/mjhid/announcement/view/11">More...</a></li> </ul> http://www.mjhid.org/index.php/mjhid/article/view/2020.006 CONCISE REVIEW ON THE FREQUENCY, MAJOR RISK FACTORS AND SURVEILLANCE OF HEPATOCELLULAR CARCINOMA (HCC) IN Β-THALASSEMIAS: PAST, PRESENT AND FUTURE PERSPECTIVES 2020-02-27T12:25:29+00:00 Vincenzo De Sanctis vdesanctis@libero.it <p>Due to the recent alarming increase in the incidence of hepatocellular carcinoma (HCC) in thalassemias, the aim of the present report is to review briefly the frequency, the major risk factors and the surveillance of HCC in β-thalassemias. Over the past 33 years, 153 cases of HCC were reported in patients with thalassemia, mainly in Italy, and Greece. Among HCV-infected patients additional factors promoting development of&nbsp; HCC, included: advanced age, male sex, chronic hepatitis B (CHB) coinfection, and iron overload. For early diagnosis of HCC sequential ultrasound screening&nbsp; is recommended&nbsp; especially for thalassemia patients with chronic hepatitis C (CHC), that coincide with (one or more) additional risk factors for HCC. &nbsp;Here we report also the preliminary data of thalassemic patients, above the age of 30 years, followed in 13 different centers. The total number of enrolled patients was 1,313 (males: 612 and 701 females). The prevalence of HCC in thalassemia major patients [characterized by transfusion-dependency (TDT)] and thalassemia intermedia [characterized by nontransfusion dependency (NTDT)] was 1.68 % and 1.98 % ,respectively The lowest age at diagnosis was 36 years in TDT and 47 years in NTDT patients.We hope that our review can be used to develop more refined and prospective analyses of HCC magnitude and risk in patients with thalassemia, and to define specific international guidelines to support clinicians for an early diagnosis and treatment of HCC in thalassemic patients.</p> 2020-01-01T00:00:00+00:00 Copyright (c) 2020 Vincenzo De Sanctis http://www.mjhid.org/index.php/mjhid/article/view/2020.001 MOLECULAR MECHANISMS OF INHIBITOR DEVELOPMENT IN HEMOPHILIA 2020-02-27T12:26:11+00:00 Davide Matino matinod@mcmaster.ca Paul Tieu davide.matino@gmail.com Antony Chan davide.matino@gmail.com <p>The development of neutralizing antibodies in hemophilia is a serious complication of factor replacement therapy. These antibodies, also known as “inhibitors”, significantly increase morbidity within the hemophilia population and lower the quality of life for these patients. People with severe hemophilia A have an overall 25-40% lifetime risk of inhibitor development, compared to that of 5-15% lifetime risk in those with moderate/mild hemophilia A. The risk is lower in hemophilia B population (about 1-5%) and occurrence of inhibitors is almost only seen in patients with severe hemophilia B. The understanding of the pathophysiological mechanism leading to the development of inhibitors in patients with hemophilia has improved considerably over the last 2 decades. Identification of early biomarkers which predict inhibitor development in previously untreated patients with hemophilia will assist in risk identification and possible early intervention strategies. In this review, we aim to summarize the molecular mechanisms of inhibitor development in hemophilia and to identify potential areas in need of further investigation.</p> 2020-01-01T00:00:00+00:00 Copyright (c) 2019 Davide Matino, Paul Tieu, Dr., Antony Chan http://www.mjhid.org/index.php/mjhid/article/view/2020.011 THE HISTORY OF DEFERIPRONE (L1) AND THE COMPLETE TREATMENT OF IRON OVERLOAD IN THALASSAEMIA 2020-02-27T12:25:23+00:00 George J Kontoghiorghes kontoghiorghes.g.j@pri.ac.cy Marios Kleanthous marios@kleanthous.info Christina N. Kontoghiorghe xtina_jt@hotmail.com <p>Deferiprone (L1) was originally designed, synthesised and screened in vitro and in vivo in 1981 by Kontoghiorghes G J following his discovery of the novel alpha-ketohydroxypyridine class of iron chelators (1978-1981), which were intended for clinical use. The journey through the years for the treatment of thalassaemia with L1 has been a very difficult one with intriguing turn of events, which continue until today. Despite many complications, such as the wide use of L1 suboptimal dose protocols, the aim of chelation therapy- namely the complete removal of excess iron in thalassaemia major patients, has been achieved following the introduction of specific L1 and L1/deferoxamine combinations. Many such patients continue to maintain normal iron stores. As a result of the introduction of L1, thalassaemia has changed from a fatal to a chronic disease and thalassaemia patients are active professional members in all sectors of society, have their own families with children and grandchildren and their lifespan is approaching that of normal individuals. No changes in the low toxicity profile of L1 have been observed in more than 30 years of clinical use. Thousands of thalassaemia patients are still denied the cardioprotective and other beneficial effects of L1 therapy. The safety of L1 in thalassaemia and other non-iron loaded diseases resulted in its selection as one of the leading therapeutics for the treatment of Friedreich’s ataxia, pantothenate kinase-associated neurodegeneration and other&nbsp;similar cases. There are also increasing prospects for the application of L1 as a main, alternative or adjuvant therapy in many pathological conditions including cancer, infectious diseases and as a general antioxidant for diseases related to free radical pathology.</p> 2020-01-01T00:00:00+00:00 Copyright (c) 2020 George J Kontoghiorghes, Marios Kleanthous, Christina N. Kontoghiorghe http://www.mjhid.org/index.php/mjhid/article/view/2020.010 THE EVOLVING PHARMACOTHERAPEUTIC LANDSCAPE FOR THE TREATMENT OF SICKLE CELL DISEASE 2020-02-27T12:25:17+00:00 Samir Ballas samir.ballas@jefferson.edu <p>Sickle cell disease (SCD) is an extremely heterogeneous disease that has been associated with global morbidity and early mortality. More effective and inexpensive therapiesare needed. During the last five years the landscape of the pharmacotherapy of SCD has changed dramatically. Currently, there are at least 50 drugs that have been used or under consideration to use for the treatment of SCD. These fall into 3 categories: the first category includes the three drugs (Hydroxyurea, L-Glutamine and Crizanlizumab tmca) that have been approved by the United States Food and Drug Administration (FDA) based on successful clinical trials. The second category includes 22 drugs that failed, discontinued or terminated for now and the third category includes 25 drugs that are actively being considered for the treatment of SCD. New therapies targeting multiple pathways in its complex pathophysiology have been achieved or are under continued investigation. The emerging trend seems to be the use of multimodal drugs (i.e. drugs that have different mechanisms of action) to treat SCD similar to the use of multiple chemotherapeutic agents to treat cancer.</p> 2020-01-01T00:00:00+00:00 Copyright (c) 2020 Samir Ballas http://www.mjhid.org/index.php/mjhid/article/view/2020.009 FEBRILE NEUTROPENIA IN ACUTE LEUKEMIA. EPIDEMIOLOGY, ETIOLOGY, PATHOPHYSIOLOGY AND TREATMENT 2020-02-27T12:26:17+00:00 Bent-Are Hansen Bent-Are.Hansen@haraldsplass.no Øystein Wendelbo Oystein.Wendelbo@helse-bergen.no Øyvind Bruserud Oyvind.Bruserud@helse-bergen.no Anette Lodvir Hemsing Anette.Lodvir.Hemsing@helse-bergen.no Knut Anders Mosevoll Knut.Anders.Mosevoll@helse-bergen.no Håkon Reikvam Hakon.Reikvam@med.uib.no <p>Acute leukemias are a group of aggressive malignant diseases associated with a high degree of morbidity and mortality. An important cause of both the latter is infectious complications. Patients with acute leukemia are highly susceptible to infectious diseases due to factors related to the disease itself, factors attributed to treatment, and specific individual risk factors in each patient. Patients with chemotherapy-induced neutropenia are at particularly high risk, and microbiological agents include viral, bacterial and fungal agents. The etiology is often unknown in infectious complications, although adequate patient evaluation and sampling have diagnostic, prognostic and treatment-related consequences. Bacterial infections include a wide range of potential microbes, both Gram-negative and Gram-positive species, while fungal infections include both mold and yeast. A recurring problem is increasing resistance to antimicrobial agents, and in particular, this applies to extended-spectrum beta-lactamase resistance (ESBL), <em>Pseudomonas aeruginosa</em>, methicillin-resistant <em>Staphylococcus aureus</em> (MRSA), vancomycin-resistant <em>Enterococcus</em> (VRE) and even carbapenemase-producing <em>Enterobacteriaceae</em> (CPE). International guidelines for the treatment of sepsis in leukemia patients include the use of broad-spectrum Pseudomonas-acting antibiotics. However, one should implant the knowledge of local microbiological epidemiology and resistance conditions in treatment decisions. Here, we discuss infectious diseases in acute leukemia with a major focus on febrile neutropenia and sepsis, and we problematize the diagnostic, prognostic, and therapeutic aspects of infectious complications in this patient group. Meticulously and thorough clinical and radiological examination combined with adequate microbiology samples are cornerstones of the examination. Diagnostic and prognostic evaluation includes patient review according to the multinational association for supportive care in cancer (MASCC) and sequential organ failure assessment (SOFA) scoring system. Antimicrobial treatments for important etiological agents are presented. The main challenge for reducing the spread of resistant microbes is to avoid unnecessary antibiotic treatment, but without giving to narrow treatment to the febrile neutropenic patient that reduce the prognosis.</p> 2019-12-30T21:11:05+00:00 Copyright (c) 2020 Bent-Are Hansen, Øystein Wendelbo, Øyvind Bruserud, Anette Lodvir Hemsing, Knut Anders Mosevoll, Håkon Reikvam http://www.mjhid.org/index.php/mjhid/article/view/2020.032 CURRENT ISSUES AND OPTIONS FOR HORMONAL CONTRACEPTION IN ADOLESCENTS AND YOUNG ADULT WOMEN WITH SICKLE CELL DISEASE: AN UPDATE FOR HEALTH CARE PROFESSIONALS 2020-04-28T17:02:23+00:00 Vincenzo De Sanctis vdesanctis@libero.it <p><strong>Abstract.</strong> Women with sickle cell disease (SCD) are of particular concern due to the significantly increased risk of pregnancy-related morbidity, mortality, and adverse outcomes. They have limited knowledge of the risks of pregnancy and childbirth as well as of the benefits and risks from the use of contraceptives. Thus, there is urgent need for appropriate information about reproductive family planning to reduce unintended pregnancy. Any decision regarding the use of contraceptives has to be based on the efficacy and the risks and benefits of the method used. Both the World Health Organization (WHO) and the Center for Disease Control and Prevention (CDC) have developed, published, and updated evidence-based guidelines for medical providers for the use of contraceptives in patients with specific medical chronic conditions. This article provides an overview of the present knowledge for the use of contraceptives in women with SCD. We believe that the collaboration between health care professionals (hematologists, obstetricians, endocrinologists, and primary care providers) can play a major role in identifying the safer contraceptive method to abolish the risks of unintended pregnancy and preserve the health status of patients with SCD.</p> 2020-04-27T22:21:53+00:00 Copyright (c) 2020 Vincenzo De Sanctis http://www.mjhid.org/index.php/mjhid/article/view/2020.041 IRON DEFICIENCY ANEMIA IN CHILDREN RESIDING IN HIGH AND LOW-INCOME COUNTRIES: RISK FACTORS, PREVENTION, DIAGNOSIS AND THERAPY 2020-06-28T17:08:21+00:00 ELPIS MANTADAKIS emantada@med.duth.gr <p><span lang="EN-US">Iron deficiency and iron deficiency anemia (IDA) affect approximately two billion people worldwide and most of them reside in low- and middle-income countries. In these countries, additional causes of anemia include parasitic infections like malaria, other nutritional deficiencies, chronic diseases, hemoglobinopathies and lead poisoning. Maternal anemia in resource-poor nations is associated with low birth weight, increased perinatal mortality and decreased work productivity. Maintaining a normal iron balance in these settings is challenging, as iron-rich foods with good bioavailability are of animal origin that are expensive and/or available in short supply. Apart from infrequent consumption of meat, inadequate vitamin C intake and diets rich in inhibitors of iron absorption are additional important risk factors for IDA in low-income countries. In-home iron fortification of complementary foods with micronutrient powders has been shown to effectively reduce the risk of iron deficiency and IDA in infants and young children in developing countries but is associated with unfavorable changes in gut flora and induction of intestinal inflammation that may lead to diarrhea and hospitalization. In developed countries, iron deficiency is the only frequent micronutrient deficiency. In the industrialized world, IDA is more common in infants beyond the sixth month of life, in adolescent females with heavy menstrual bleeding, in women of childbearing age and elderly people. Other special at-risk populations for IDA in developed countries are regular blood donors, endurance athletes and vegetarians. Several medicinal ferrous or ferric oral iron products exist, and their use is not apparently associated with harmful effects on the overall incidence of infectious illnesses in sideropenic and/or anemic subjects. Further research is needed to clarify the risks and benefits of supplemental iron for children exposed to parasitic infections in the third world, and for children genetically predisposed to iron overload.</span></p> 2020-06-28T11:28:10+00:00 Copyright (c) 2020 ELPIS MANTADAKIS http://www.mjhid.org/index.php/mjhid/article/view/2020.042 CHILDREN IN CORONAVIRUSES’ WONDERLAND: WHAT CLINICIANS NEED TO KNOW 2020-07-02T15:03:25+00:00 Giuseppe Lassandro giuseppelassandro@live.com Valentina Palladino valentinapalladino@hotmail.it Anna Amoruso viviana_palmieri@libero.it Viviana Palmieri viviana_palmieri@libero.it Giovanna Russo diberuss@unict.it Paola Giordano paola.giordano@uniba.it <p>Human coronaviruses (HCoVs) commonly cause mild upper-respiratory tract illnesses but can lead to more severe and diffusive diseases. A variety of signs and symptoms may be present, and infections can range in severity from common cold and sore throat to more serious laryngeal or tracheal infections, bronchitis, and pneumonia. Among the seven coronaviruses that affect humans, (SARS)-CoV, the Middle East respiratory syndrome (MERS)-CoV and the most recent coronavirus disease 2019 (COVID-19) represent potential life-threatening diseases worldwide. In adults they may cause severe pneumonia that evolve in distress respiratory syndrome and multiorgan failure with a high mortality rate. Children appear to be less susceptible to develop severe clinical disease and present usually with mild and aspecific symptoms similar to other respiratory infections typical of childhood. However, some children such as infants, adolescents or those with underlying diseases may be more at-risk categories and require greater caution from clinicians. Available data on pediatric coronavirus infections are rare and scattered in the literature. The purpose of this review is to provide to clinicians a complete and updated panel useful to recognize and characterize the broad spectrum of clinical manifestations of coronavirus infections in the pediatric age.</p> 2020-06-28T11:29:36+00:00 Copyright (c) 2020 Giuseppe Lassandro, Valentina  Palladino, Anna Amoruso, Viviana Palmieri, Giovanna Russo, Paola Giordano http://www.mjhid.org/index.php/mjhid/article/view/2020.043 COBALAMIN DEFICIENCY IN THE ELDERLY 2020-07-02T06:21:10+00:00 Giacomo Marchi markallbutone@gmail.com Fabiana Busti fabiana.busti@univr.it Acaynne Lira Zidanes acaynne.lirazidanes@univr.it Alice Vianello vianello.alice@gmail.com Domenico Girelli domenico.girelli@univr.it <p>Older people are at risk for cobalamin (vitamin B<sub>12</sub>) deficiency because of a number of common disorders (e.g. autoimmune gastritis) and drugs (e.g. antacids) that may alter its absorption and utilization. The prevalence of cobalamin deficiency increases with age, resulting particularly elevated in frail and institutionalized subjects. At variance with common sense, the diagnosis is far from simple and requires a high degree of suspicion, due to heterogeneity and non-specificity of the signs and symptoms, ranging from macrocytosis (with or without anemia) to neuropsychiatric manifestations, that characterize several other aging-related disorders, like hematological malignancies, diabetes, hypothyroidism or vasculopathies. Furthermore, the detection of low levels of serum vitamin B<sub>12</sub> appears poorly sensitive and specific. Other biomarkers, like serum homocysteine or methylmalonic acid, have improved the diagnostic possibilities but are expensive, not widely available and may be influenced by some confounders (e.g. folate deficiency, or chronic renal failure). Early recognition and treatment are crucial, since a proportion of patients develop severe complications, such as bone marrow failure and irreversible neurological impairment. High-dose oral treatment has proven to be as effective as the parenteral route even in subjects with malabsorption, ensuring the complete resolution in the majority of cases. In this review, we trace the essential role of cobalamin in humans, the possible causes and impact of deficiency, the diagnostic challenges and the therapeutic options, between old and emerging concepts, with a particular focus on the elderly.</p> 2020-06-28T12:18:15+00:00 Copyright (c) 2020 Giacomo Marchi, Fabiana Busti, Acaynne Lira Zidanes, Alice Vianello, Domenico Girelli http://www.mjhid.org/index.php/mjhid/article/view/2020.045 ACQUIRED HAEMOPHILIA A: AN INTRIGUING DISEASE 2020-07-02T16:36:28+00:00 Maria Gabriella Mazzucconi mazzucconi@bce.uniroma1.it Erminia Baldacci baldacci@bce.uniroma1.it Antonietta Ferretti ferretti@bce.uniroma1.it Cristina Santoro santoro@bce.uniroma1.it <p>Acquired Haemophilia A is a rare acquired bleeding disorder caused by autoantibodies directed against Factor VIII, which neutralize FVIII activity. These inhibitors differ from alloantibodies against FVIII which can occur in congenital Haemophilia A after repeated exposures to plasma-derived or recombinant FVIII products. In most cases the disease occurs suddenly in subjects without personal or familiar history of bleedings, with symptoms that may be mild, moderate or severe. However, only laboratory alterations are present in&nbsp; &nbsp;̴ 30% of patients. The incidence varies from 1 to 4 cases per million/year; more than 80% of patients are elderly, males and females are similarly affected. There is a small peak of incidence related to pregnancy in young women aged 20–40 years. The disease may be underdiagnosed in the elderly. The diagnostic algorithm is based on an isolated prolonged activated partial thromboplastin time, normal thrombin time, absence of Lupus Anticoagulant and a mixing test that reveals the presence of an inhibitor: the finding of reduced FVIII activity and the detection of neutralising autoantibodies against FVIII lead to diagnosis. The disease is idiopathic in &nbsp;&nbsp;44%-63% of cases, while in the others etiological factors are present. Bleeding prevention and treatment are based on therapeutic tools as bypassing agents, recombinant porcine FVIII concentrate or, in a limited number of cases, FVIII concentrates and desmopressin. As soon as the diagnosis has been made, immunosuppressive therapy must be started to eradicate the inhibitor. Better knowledge of the disease, optimal management of bleeding and eradication of the inhibitor have significantly reduced morbidity and mortality in most patients.&nbsp;</p> <p>&nbsp;</p> <p>Keywords: autoantibodies against FVIII, bleeding symptoms, bleeding treatment, eradication therapy.&nbsp;</p> 2020-06-28T12:28:57+00:00 Copyright (c) 2020 Maria Gabriella Mazzucconi, Erminia Baldacci, Antonietta Ferretti, Cristina Santoro http://www.mjhid.org/index.php/mjhid/article/view/2020.039 - KAWASAKI DISEASE AS THE IMMUNE-MEDIATED ECHO OF A VIRAL INFECTION 2020-07-01T14:12:49+00:00 Donato Rigante drigante@gmail.com <p>Although etiology of Kawasaki disease remains elusive, the available evidence indicates that the primum movens might be a dysregulation of immune responses to various microbes, i.e. a kind of immune-mediated response induced by a viral infection. Even if several data might suggest that Kawasaki disease is an infection-related clinical syndrome, which can develop only in children with a predisposing genetic background, our knowledge on both the infectious agents involved and the genetic characteristics of children prone to the disease remains poor.</p> 2020-06-28T00:00:00+00:00 Copyright (c) 2020 Donato Rigante http://www.mjhid.org/index.php/mjhid/article/view/2020.008 CARDIOVASCULAR RISK IN ESSENTIAL THROMBOCYTHEMIA AND POLYCYTHEMIA VERA: THROMBOTIC RISK AND SURVIVAL 2020-06-09T17:31:32+00:00 Vincenzo Accurso vincenzoaccurso@libero.it Marco Santoro marco.santoro03@unipa.it Salvatrice Mancuso salvatrice.mancuso@unipa.it Angelo Davide Contrino angelodavidecontrino@libero.it Paolo Casimio paolo.casimiro@community.unipa.it Mariano Sardo mariano_sardo@hotmail.it Simona Raso simona.raso@unipa.it Florinda Di Piazza florindadipiazza@gmail.com Alessandro Perez ale-like@libero.it Marco Bono marcobono29@gmail.com Antonio Russo antonio.russo@usa.net Sergio Siragusa sergio.siragusa@unipa.it <p class="western"><span style="color: #1c1d1e;"><span style="font-family: Arial, serif;"><span style="font-size: large;"><span lang="en-US"><strong>Abstract</strong></span></span></span></span></p> <p class="western" align="justify"><a name="tw-target-text"></a> <span style="color: #000000;"><span style="font-family: Arial, serif;"><span style="font-size: large;"><span lang="en-US">Thromboembolic and bleeding events pose a severe risk for patients with Polycythemia Vera (PV) and Essential Thrombocythemia (ET). Many factors can contribute to determine the thrombotic event, including the interaction between platelets, leukocytes and endothelium alterations. Moreover, a very important role can be played by cardiovascular risk factors (CV.R) such as cigarette smoking habits, hypertension, diabetes, obesity and dyslipidemia. In this study we evaluated the impact that CV.R plays on thrombotic risk and survival in patients with PV and ET.</span></span></span></span></p> 2020-01-01T00:00:00+00:00 Copyright (c) 2020 Vincenzo Accurso, Maro Santoro, Salvatrice Mancuso, Angelo Davide Contrino, Paolo Casimio, Mariano Sardo, Simona Raso, Florinda Di Piazza, Alessandro Perez, Marco Bono, Antonio Russo, Sergio Siragusa http://www.mjhid.org/index.php/mjhid/article/view/2020.003 CANDIDEMIA IN PATIENTS WITH ACUTE LEUKEMIA: ANALYSIS OF SEVEN YEARS’ EXPERIENCE AT A SINGLE CENTER IN CHINA 2020-02-27T12:25:47+00:00 Xiaoyuan Gong gongxiaoyuan@ihcams.ac.cn mianzeng yang yangwanzeng@ihcams.ac.cn Dong Lin lindong@ihcams.ac.cn Hui Wei weihui@ihcams.ac.cn Ying Wang wangying1@ihcams.ac.cn Bingchen Liu liubingcheng@ihcams.ac.cn Chunlin Zhou zhouchunlin@ihcams.ac.cn Kaiqi Liu liukaiqi@ihcams.ac.cn Shuning Wei weishuning@ihcams.ac.cn Benfa Gong gongbenfa@ihcams.ac.cn Guancji Zhang zhangguangji@ihcams.ac.cn Yuntao Liu liuyuntao@ihcams.ac.cn Yan Li liyan1@ihcams.ac.cn Xingli Zao zhaoxingli@ihcams.ac.cn Shaowei Qiu qiushaowei@ihcams.ac.cn Ruxia Gu gurunxia@ihcams.ac.cn Yingchang Mi ychmin@ihcams.ac.cn Jianxiang Wang wangjx@ihcams.ac.cn <p>The study of candidemia in Chinese leukemia patients has been limited. This retrospective study aims to investigate the characteristics and prognostic factors of candidemia among leukemia patients in a Chinese chemotherapy center.</p> <p>From 2009 to 2015, 30 isolates of candidemia were detected in 19 patients with acute leukemia after chemotherapy. The overall incidence of candidemia was 2.12 episode per 1000 admissions<em>. </em><em>Candida tropicalis</em> was the most common <em>Candida</em> species (n = 17; 89.5%), followed by <em>Candida albicans</em> (n = 2; 10.5%). The most common underlying disease was acute myeloid leukemia (94.7%) and induction chemotherapy phase was the most susceptible stage. The vast majority of candidal infections are endogenous rather than central venous catheter-related. The overall 30-day crude mortality rate was 31.6%. Neutrophil recovery (P = 0.000) and initiation of empiric antifungal treatment before first positive blood culture (P = 0.041) were associated with a significant improvement in overall survival.</p> <p>Although the incidence of candidaemia appears to be quite low in patients with leukemia submitted to intensive chemotherapy, its high mortality rate continues to be a crucial problem despite the availability of new effective antifungal drugs. Early diagnosis followed by rapid antifungal treatment remains the cornerstone of successful management. Catheter removal should be considered on an individual basis. The widespread use of newer antifungal agents as prophylaxis among patients with acute leukemia may result in a decreased candidemia incidence.</p> 2020-01-01T00:00:00+00:00 Copyright (c) 2020 Xiaoyuan Gong, mianzeng yang, Dong Lin, Hui Wei, Ying Wang, Bingchen Liu, Chunlin Zhou, Kaiqi Liu, Shuning Wei, Benfa Gong, Guancji Zhang, Yuntao Liu, Yan Li, Xingli Zao, Shaowei Qiu, Ruxia Gu, Yingchang Mi, Jianxiang Wang http://www.mjhid.org/index.php/mjhid/article/view/2020.004 THE PROGNOSTIC SIGNIFICANCE OF TET2 SINGLE NUCLEOTIDE POLYMORPHISM IN EGYPTIAN CHRONIC MYELOID LEUKEMIA 2020-02-27T12:26:05+00:00 Enas A Dammag enas.alid@yahoo.com Nahla A.M. Hamed drhamedn@gmail.com Nabil A El Halawani nabil.elhalawany@gmail.com Heba S Kassem heba.kassem@gmail.com Mona W Ayad monawagdy16@yahoo.com <p><strong>Background: </strong>Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm. The pathogenesis of CML is based on the oncoprotein termed BCR‐ABL1. TET2 initiates DNA demethylation and is frequently mutated in hematological malignancies including CML.<sup>(1)</sup> The relation between TET2 acquisition and CML transformation and/or imitinab resistance is needed to be investigated. <strong><sup>(2)</sup></strong></p> <p><strong>Aim:</strong> To evaluate Ten Eleven Translocation 2 gene (TET2) single nucleotide polymorphism (SNP) (rs2454206, rs34402524, rs61744960) in chronic myeloid leukemia (CML) in relation to the disease prognostic criteria.</p> <p><strong>Materials &amp; Method:</strong> The study included 84 subjects; 54 CML in chronic phase and 30 healthy subjects as control group matched for age and sex. Routine investigations including CBC, bone marrow aspiration, biochemical investigations and molecular study were performed in CML patients to identify the disease stage. DNA extraction and SNP assay for TET2 gene polymorphism was done using (Thermo-Fisher predesigned SNP, USA) PCR prism 7500.</p> <p><strong>Results:</strong> The mean age was 45.98±15.7 yrs in CML patients and&nbsp;&nbsp; 39.3±6.587 yrs in control group (p&gt;0.05). TET2 SNP rs 34402524 was either heterozygous and homozygous in CML (48%,and 46.2%) but was mainly homozygous among control (80%) group (p=0.012). TET2 SNP rs 2454206 cases within CML (65.4%) and control (63.3%) group had wild patterns (p=0.046). TET2 SNP rs 61744960 showed a homozygous pattern among all groups (CML and control) showing no statistical significance (p=0.528). TET2 SNP in CML cases did not alter the prognostic criteria as no statistical significance was noted (p&gt;0.05) yet, it was significantly related to spleen size in rs 34402524 where homozygous group had huger sizes and higher BCR-ABL1 levels 6 months after starting TKIs (p&lt;0.05).</p> <p><strong>Conclusions/Recommendation:</strong> TET2 SNP is a common in Egyptian chronic myeloid leukemia. TET2 SNP rs 3442524 was associated with huger spleen size and higher BCR-ABL1 levels after 6 months of starting TKIs suggesting disease progression.</p> 2020-01-01T00:00:00+00:00 Copyright (c) 2020 Enas A Dammag, Nahla A.M. Hamed, Professor, Nabil A El Halawani, Professor, Heba S Kassem, Professor, Mona W Ayad, Professor http://www.mjhid.org/index.php/mjhid/article/view/2020.012 MICRORNA-181A-3P AS A DIAGNOSTIC AND PROGNOSTIC BIOMARKER FOR ACUTE MYELOID LEUKEMIA 2020-03-02T00:02:43+00:00 Xiaoling Ma maxiaoling@ustc.edu.cn <p><strong>Background:</strong> Micro (mi)RNAs play an important role in the pathogenesis and development of acute myeloid leukemia (AML), and their abnormal expression may be sufficient to predict the prognosis and outcomes in AML patients. We evaluated the clinical diagnostic value of miRNA-181a-3p in predicting prognosis and outcomes in patients with AML.</p> <p><strong>Methods: </strong>A total of 119 newly diagnosed adult patients with AML and 60 healthy controls were recruited. Blood specimens were obtained from all AML patients at diagnosis, and 10 blood specimens were obtained on day 28 after induction chemotherapy. The controls also provided blood samples. MiR-181a-3p expression was quantified by PCR, and relative&nbsp;miRNA&nbsp;expression&nbsp;was determined using the comparative Ct method.</p> <p><strong>Results:</strong> Compared with healthy controls, the expression of miRNA-181a-3p was significantly increased in patients with AML. MiR-181a-3p expression could be used to discriminate AML patients from controls, with up-regulated expression correlating with favorable prognosis. Moreover, miRNA-181a-3p expression was significantly decreased in patients who achieved a complete response after induction chemotherapy. The multivariate Cox analysis highlighted the prognostic value of miR-181a-3p for patients with AML.</p> <p><strong>Conclusions:</strong> MiR-181a-3p may be clinically useful as a disease marker for AML, and enhanced the prediction of patient outcomes to chemotherapy.</p> 2020-02-26T14:27:22+00:00 Copyright (c) 2020 Xiaoling Ma http://www.mjhid.org/index.php/mjhid/article/view/2020.017 The PARTIAL ACHIEVEMENT OF THE 90-90-90 UNAIDS TARGET IN A COHORT OF HIV INFECTED PATIENTS FROM CENTRAL ITALY. 2020-02-27T12:25:04+00:00 Elisabetta Schiaroli elisabettask@libero.it <p>Despite progress in the prevention and treatment of HIV, persistent issues concerning the evaluation of continuum in care from the serological diagnosis to virologic success remain.</p> <p>Considering the UNAIDS target 90-90-90 for 2020 for treatment and viral suppression of people living with HIV (PLVH), our purpose was to verify if, starting from diagnosis, the viral suppression rate of our cohort of new PLWH satisfied the above targets.</p> <p>The aim of this retrospective study was to compare 2005-2017 data collected at the Perugia Infectious Diseases Clinic with the 2020 UNAIDS 90 targets and to identify risk factors that could be associated with failure to reach these targets.</p> <p>Methods:&nbsp; We included all patients aged ≥15 undergoing HIV test at our clinic between January 2005 and December 2017. We evaluated the unclaimed tests, linkage to care, retention in ART and the viral suppression at 1 and 2 years from starting ART. Data were analyzed between Italians and foreigners.</p> <p>Results: We observed 592 new diagnoses for HIV infection: 61.4% on Italian-natives, 38.5% on foreigners. Considering the continuum of care from diagnosis, 88 (15%) PLWHIV were lost to engagement in care: 55 (9.2%) patients didn’t withdraw the test and 33 (5.5%) &nbsp;didn’t link to care.</p> <p>An antiretroviral treatment was started only on 78.8% of the new diagnoses (467/592) and a viral suppression was obtained at 2 years on 82% of PLWH who had started ART (383/467) namely only 64.7% of the new diagnoses instead of the hoped-for 81% of the UNAIDS target. We found no significant differences between Italians and foreigners</p> <p>Conclusions</p> <p>UNAIDS goal was very far to be reached. The main challenges were unreturned tests as well as the retention in ART. Rapid tests for a test-treat strategy and frequent phone communications in the first ART years could facilitate UNAIDS target achievement.</p> 2020-02-26T14:30:17+00:00 Copyright (c) 2020 Elisabetta Schiaroli http://www.mjhid.org/index.php/mjhid/article/view/2020.013 CHARACTERISTICS AND PROGNOSIS OF HEPATOCELLULAR CARCINOMA IN MULTI-TRANSFUSED PATIENTS WITH THALASSEMIA MAJOR. EXPERIENCE OF A SINGLE TERTIARY CENTER. 2020-06-09T17:32:09+00:00 Nikolaos Papadopoulos nipapmed@gmail.com Dimitrios Kountouras kountourasd@gmail.com Katerina Malagari kmalag@otenet.gr Maria Tampaki dc_martam@hotmail.com Maria Theochari mtheochari@gmail.com John Koskinas koskinasj@yahoo.gr <p><strong>Background: </strong>In this retrospective study, records of patients with thalassemia major (TM) diagnosed with hepatocellular carcinoma (HCC) from 2008‐2018 were reviewed in order to determine the survival rate and evaluate possible etiological factors associated with survival.</p> <p><strong>Methods:</strong> Forty-two TM patients who were diagnosed with HCC have been included in the study. Most of our patients (78.5%) were anti-HCV positive, while 16.5% had evidence of resolved HBV infection. At the time of HCC diagnosis, 78.5% of our patients were diagnosed with cirrhosis, while the vast majority (98%) had normal or mild elevated liver iron concentration (LIC) values. According to Barcelona Clinic Liver Cancer (BCLC) grading system patients were classified as 0-A: 28.5%, B: 57% and as C-D: 14.5%.&nbsp; HCC has been treated with loco-regional treatment in 78.5% of our patients, while the rest have been treated with sorafenib.</p> <p><strong>Results:</strong> Twenty-eight patients (66.5%) have eventually died with a median survival time of 6 months (range: 2-60). Using the Cox proportional hazard model, the only factors who have been associated with poor survival were BCLC stages C and D.</p> <p><strong>Conclusions:</strong> In conclusion, BCLC staging is the main prognostic factor of survival in patients with TM who develop HCC, with a median survival time of six months.</p> 2020-02-26T14:34:58+00:00 Copyright (c) 2020 Nikolaos Papadopoulos, Dimitrios Kountouras, Katerina Malagari, Maria Tampaki, Maria Theochari, John Koskinas http://www.mjhid.org/index.php/mjhid/article/view/2020.015 FINE MAPPING OF GLUCOSE 6 PHOSPHATE DEHYDROGENASE (G6PD) DEFICIENCY IN RURAL AREA OF SOUTH WEST ODISHA USING THE CLINICAL, HEMATOLOGICAL AND MOLECULAR APPROACH 2020-03-02T00:10:14+00:00 Ravindra Kumar ravindrachhabra@gmail.com MPSS Singh mpss1968@rediffmail.com Soumendu Mahapatra soumendurealise@gmail.com Sonam Chourasia sonam5star@hotmail.com Malay Kumar Tripathi tripathimalay@yahoo.com John Oommen jcoommen@gmail.com Praveen Kumar Bharti saprapbs@yahoo.co.in Rajasubramaniam Shanmugam raja.rmrct@gmail.com <p><strong>Introduction</strong>: The aim of the study was to enumerate the clinical, hematological and molecular spectrum of G6PD deficiency in malaria endemic regions of south west Odisha.</p> <p><strong>Methods</strong>: Diagnosis of G6PD deficiency was made by using the Di-chloroindophenol Dye test in from two south west districts (Kalahandi and Rayagada) of Odisha State. Demographic and clinical history was taken from each individual using a pre-structured questionnaire. Molecular characterization of G6PD deficiency was done using PCR-RFLP and Sanger sequencing.</p> <p><strong>Results</strong>:&nbsp; A total of 1981 individuals were screened, out of which 59 (2.97%) individuals were found G6PD deficient. Analysis revealed that G6PD deficiency was more in males (4.0%) as compared to females (2.3%). G6PD deficiency was significantly higher in tribal population (4.8%) as compared to non-tribal populations (2.4%) (p=0.012, OR=2.014, 95%CI =1.206-3.365). Individuals with history of malaria and G6PD deficiency have high risk of need of blood transfusion than G6PD normal individuals (p=0.026, OR=3.816, 95%CI=1.079-13.496). Molecular analysis revealed G6PD Orissa as the most common (88%) mutation 88% in the studied cohort. G6PD Kaiping (n=3), G6PD Coimbra (n=2) and G6PD Union (n=1) were also identified in studied cohort.&nbsp;</p> <p><strong>Conclusion</strong>: The cumulative prevalence of G6PD deficiency the present is below the estimated national prevalence. G6PD deficiency was higher in tribes as compared to non-tribes. Rare G6PD Kaiping and G6PD Union variants have been identified.</p> 2020-02-26T14:40:42+00:00 Copyright (c) 2020 Ravindra Kumar, MPSS Singh, Soumendu Mahapatra, Sonam Chourasia, Malay Kumar Tripathi, John Oommen, Praveen Kumar Bharti, Rajasubramaniam Shanmugam http://www.mjhid.org/index.php/mjhid/article/view/2020.014 THE IMPACT OF CHEMOTHERAPY AFTER PEDIATRIC MALIGNANCY ON HUMORAL IMMUNITY TO VACCINE-PREVENTABLE DISEASES 2020-03-02T22:18:25+00:00 Chiara Garonzi garonzi.chiara@gmail.com Rita Balter rita.balter@aovr.veneto.it Gloria Tridello gloria.tridello@aovr.veneto.it Anna Pegoraro anna.pegoraro@aovr.veneto.it Manuela Pegoraro manuela.pegoraro@aovr.veneto.it Monia Pacenti monia.pacenti@aopd.veneto.it Novella Scattolo novella.scattolo@aulss9.veneto.it Simone Cesaro simone.cesaro@aovr.veneto.it <div>Abstract.Background/Aim: The antibody titer of vaccine-preventable disease in pediatric patients who underwent chemotherapy was assessed in order to evaluate the seroprotection after treatment and the feasibility and the efficacy of a policy of revaccination.Methods: Serum antibody titers of55 patients for hepatitis B (HBV), rubella, varicella-zoster (VZV), measles, mumps, polioviruses, Clostridium tetani(C. tetani)and Streptococcus pneumoniae(S. pneumoniae) were analysed.Results: After chemotherapy, a lack of protective antibody titers against HBV, rubella, VZV, measles, mumps, polioviruses, C. tetani, and S. pneumonia was found in 53%, 45%, 46%, 46%, 43%, 21-26%, 88% and 55% of patients, respectively. In 49 of 55 patients who were tested both before and after chemotherapy for at least a pathogen, the loss of immunity for HBV, rubella, VZV, measles, mumps, polioviruses and C. tetani was respectively 39%, 43%, 38%, 42%, 32%, 33%, and 80%. A low number of B-lymphocytes was associated with the loss of immunity against measles (p=0.04) whereas a high number of CD8+ T-lymphocytes was associated with the loss of immunity against VZV (p=0.03). A single booster of vaccine dose resulted in a seroprotection for HBV, rubella, VZV, measles, mumps, polioviruses, C. tetani and S. pneumoniae in 67%, 83%, 80%, 67%, 33%, 100%, 88% and 67% of patients, respectively. Conclusions: We confirm that seroprotection for vaccine-preventable diseases is affected by treatment for pediatric malignancy. A single booster dose of vaccine might be a practical way to restore vaccine immunity in patients after chemotherapy.</div> <div>&nbsp;</div> 2020-02-26T14:43:49+00:00 Copyright (c) 2020 Chiara Garonzi, Rita Balter, Gloria Tridello, Anna Pegoraro, Manuela Pegoraro, Monia Pacenti, Novella Scattolo, Simone Cesaro http://www.mjhid.org/index.php/mjhid/article/view/2020.016 DEVELOPMENT OF AN IMPROVED EPSTEIN-BARR VIRUS (EBV) NEUTRALIZING ANTIBODY ASSAY TO FACILITATE DEVELOPMENT OF A PROPHYLACTIC GP350-SUBUNIT EBV VACCINE 2020-03-02T16:57:24+00:00 Hui Liu kvfg815@astrazeneca.net Lorraine Gemmell lorriegem@yahoo.com Rui Lin ruilin94122@gmail.com Fengrong Zuo FZuo097@avexis.com Henry H. Balfour balfo001@umn.edu Jennifer C. Woo jenniferwoo44@gmail.com Gregory M. Hayes gregorymhayes@att.net <p>No licensed vaccine is available for prevention of EBV-associated diseases, and robust, sensitive, and high-throughput bioanalytical assays are needed to evaluate immunogenicity of gp350 subunit-based candidate EBV vaccines. Here we have developed and improved analytical tools for such a vaccine’s pre-clinical and clinical validation including a gp350-specific antibody detection assay and an EBV-GFP based neutralization assay for measuring EBV specific antibodies in human donors. The sensitivity of our previously published high-throughput EBV-GFP fluorescent focus (FFA)-based neutralization assay was further improved when guinea pig complement was supplemented using a panel of healthy human sera. Anti-gp350 antibody titers, which were evaluated using an anti-gp350 IgG ELISA assay optimized for capture and detection conditions, were moderately correlated to the FFA-based neutralization titers. Overall, these sensitive, and high-throughput bioanalytical assays are capable of characterizing the serologic response to natural EBV infection, with applications in evaluating EBV antibody status in epidemiologic studies and immunogenicity of candidate gp350-subunit EBV vaccines in clinical studies.</p> 2020-02-26T14:46:06+00:00 Copyright (c) 2020 Hui Liu, Henry H. Balfour, Gregory M. Hayes http://www.mjhid.org/index.php/mjhid/article/view/2020.019 DISCOVERY OF TYPE 3 VON WILLEBRAND DISEASE IN A COHORT OF PATIENTS WITH SUSPECTED HEMOPHILIA A IN CÔTE D’IVOIRE 2020-03-02T16:54:22+00:00 Adia Eusèbe Adjambri eusebeadjambri@yahoo.fr Sylvie Bouvier sylvie.bouvier@umontpellier.fr Roseline N'guessan kouameroseline8@gmail.com Emma N’draman-Donou emmandraman@gmail.com Mireille Yayo-Ayé yayoaye@yahoo.fr Marie-France Meledje meledjefr@gmail.com Missa Louis Adjé adjemissa@gmail.com Duni Sawadogo dunisawadogo@gmail.com <p><strong>Abstract</strong></p> <p><strong>Aim&nbsp;:</strong> Type 3 von Willebrand disease (VWD) is the most severe form of VWD, characterized by a near-total absence of von Willebrand factor (vWF) leading to a huge deficiency in plasmatic factor VIII (FVIII). VWD may be confused with hemophilia A, sometimes leading to misdiagnosis. The purpose of this work was to finalize the biological diagnosis of patients with FVIII activity deficiency in Abidjan, in order to guide the best type of management. <strong>Methods:</strong> We conducted a cross-sectional descriptive study from June 2018 to April 2019. Forty-nine patients, all of whom had lower FVIII levels or had been referred for bleeding disorder, were monitored in the clinical hematology service. Pro-coagulant activity of coagulation factors was performed in Abidjan. The assays for von Willebrand antigen and activity were performed at Nîmes University Hospital in France. <strong>Results:</strong> The mean age of patients was 13.8 years (1 – 65) and 86% were Ivorian. FVIII deficiency was discovered during a biological checkup, circumcision or post-traumatic bleeding, in 33%, 31% and 29% respectively. The FVIII level of patients was classified as severe (89.8%), moderate (8.2%) and mild (2%). Only one patient had a quantitative deficiency of von Willebrand factor (vWF: Ag &lt;3%) with undetectable von Willebrand factor activity (vWF: Ac) and an FVIII level &lt;1%. <strong>Conclusion:</strong> Not all of the constitutive deficits of FVIII are hemophilia A. It was very important to assess the Willebrand factor of these patients followed in Côte d'Ivoire for whom hemophilia A had been suspected.</p> 2020-02-26T15:22:13+00:00 Copyright (c) 2020 Adia Eusèbe Adjambri, Sylvie Bouvier, Roseline N'guessan, Emma N’draman-Donou, Mireille Yayo-Ayé, Marie-France Meledje, Missa Louis Adjé, Duni Sawadogo http://www.mjhid.org/index.php/mjhid/article/view/2020.021 THALIDOMIDE FOR PATIENTS WITH THALASSEMIA INTERMEDIA: A RETROSPECTIVE MULTICENTER CLINICAL STUDY 2020-04-28T17:02:27+00:00 Kun Yang 1759874951@qq.com Yi Wu 1748646091@qq.com Yali Zhou 252749070@qq.com Tianhong Zhou 43096013@qq.com Li Wang 281861369@qq.com Zhili Geng 616151489@qq.com Xiaolin Yin yin-xl@163.com <p><strong>Objective</strong><strong>: </strong>This study focused on the efficacy and safety of thalidomide for patients with thalassemia intermedia (TI) in a multicenter trial.</p> <p><strong>Methods</strong><strong>:</strong>Clinical and laboratory data of 62 patients subjected to thalidomide therapy in four centers were retrospectively analyzed. We evaluated the efficacy and safety of thalidomide in the short-term (three months) and long-term follow-up (12 and 24 months). Response to thalidomide was defined as follows: Main Responder (MaR) showing an increase in Hb level of &gt;2.0 g/dl or removal from blood transfusion and Minor Responder (MiR) achieving elevated hemoglobin (Hb) level of 1.0-2.0 g/dl or ≥50% reduction in blood transfusion frequency.</p> <p><strong>Results</strong><strong>:</strong>The overall response rate (ORR) of 62 patients with TI was 93.5% (58/62), with MaR and MiR rates accounting for 62.9% (39/62) and 30.6% (19/62) in short-term follow-up and 66.1% (41/62) and 27.4% (17/62) in long-term follow-up, respectively. The clinical response during long-term follow-up was maintained and the Hb level remained stable during the observation period. The response was still observed in patients with dose reduction despite a slight decrease in Hb level. However, Hb decreased rapidly to the baseline level after drug discontinuation. No effect of thalidomide on spleen size in nonsplenectomized patients was evident. Minimal side-effects were documented throughout, except peripheral neurotoxicity in one patient. Nevertheless, the mean serum ferritin (SF) level was significantly increased after treatment.</p> <p><strong>Conclusion:</strong> Thalidomide had significant therapeutic effects on patients with TI, and the response was sustained with acceptable short-term and long-term adverse reactions. While these preliminary results support the potential long-term efficacy and safety of thalidomide as a therapeutic agent for TI, several issues need to be addressed before its application in the clinic.</p> 2020-04-27T21:41:16+00:00 Copyright (c) 2020 Kun Yang, Yi Wu, Yali Zhou, Tianhong Zhou, Li Wang, Zhili Geng, Xiaolin Yin http://www.mjhid.org/index.php/mjhid/article/view/2020.020 LYON-UNIVERSITY HOSPITAL EXPERIENCE WITH GEMTUZUMAB OZOGAMICIN THERAPY IN ACUTE MYELOID LEUKEMIA: A ‘REAL-LIFE’ STUDY 2020-06-09T17:32:46+00:00 Xavier Thomas xavier.thomas@chu-lyon.fr Marica Laurino maricalaurino@gmail.com sandrine loron sandrine.loron@chu-lyon.fr marie-virginie larcher marie-virginie.larcher@chu-lyon.fr gaëlle fossard gaelle.fossard@chu-lyon.fr mohamed elhamri mohamed.el-hamri@chu-lyon.fr alexandre deloire alexandre.deloire@chu-lyon.fr marie balsat marie.balsat01@chu-lyon.fr fiorenza barraco fiorenza.barraco@chu-lyon.fr hélène labussière helene.labussiere-wallet@chu-lyon.fr sophie ducastelle sophie.ducastelle-lepretre@chu-lyon.fr myriam renault myriam.renault@chu-lyon.fr eric wattel eric.wattel@chu-lyon.fr maël heiblig mael.heiblig@chu-lyon.fr gilles salles gilles.salles@chu-lyon.fr <p>One-hundred and four adults with newly diagnosed or relapsed/refractory acute myeloid leukemia (AML) were treated with fractionated doses of gemtuzumab ozogamicin (GO) at one-single French center over a 10-year period. We attempted to define predictive factors for response and survival. The overall response rate was 70% (86% in newly diagnosed and 67% in relapsed/refractory AML). Disease-free survival (DFS) and overall survival at 3 years after GO treatment was 31% and 29%, respectively. Mortality during induction was 7%. Among remitters, allogeneic hematopoietic stem cell transplantation can be performed in 33 cases (45%). DFS at 3 years was 54%. Incidences of transplant-related mortality, grade ≥ 3 acute graft-versus-host (GvH) disease, and extensive chronic GvH disease were 15%, 12%, and 27%, respectively.No sinusoidal obstruction syndromes were reported among allografted patients as among the other patients in the studied cohort. GO-based chemotherapy is a viable option for treatment of newly diagnosed and relapsed/refractory AML patients, and is a feasible schedule as a bridge to allogeneic transplant.</p> 2020-04-27T21:47:58+00:00 Copyright (c) 2020 Xavier Thomas, Marica Laurino, sandrine loron, marie-virginie larcher, gaëlle fossard, mohamed elhamri, alexandre deloire, marie balsat, fiorenza barraco, hélène labussière, sophie ducastelle, myriam renault, eric wattel, maël heiblig, gilles salles http://www.mjhid.org/index.php/mjhid/article/view/2020.029 The COST-UTILITY ANALYSIS OF FOUR CHELATION REGIMENS FOR Β-THALASSEMIA MAJOR: A CHINESE PERSPECTIVE 2020-05-20T14:12:41+00:00 Jialian Li jialianlily@163.com <p><strong>Background:</strong> The four most commonly used chelation regimens for β-thalassemia major patients in China are a combination therapy of deferoxamine and deferiprone (DFO+DFP), deferoxamine(DFO) monotherapy, deferiprone(DFP) monotherapy and deferasirox(DFX) monotherapy. Such patients use iron chelators their whole lives, resulting in enormous treatment costs. This study analyses the cost-utility of these four regimens from the Chinese healthcare system perspective.</p> <p><strong>Methods:</strong> A Markov decision model was used over a 70-year time horizon and was populated using clinical data from a systematic literature review. We obtained utility data from local and previous research. Costs were estimated using Chinese national sources.</p> <p><strong>Results:</strong> From the base-case analysis results, DFP was the most cost-effective chelation regimen, followed by DFO+DFP, DFO and DFX. DFP had a 99.60%, 78.10% and 64.40% likelihood of being cost-effective versus DFX, DFO and DFO+DFP, respectively, at a payment threshold of 193,932.00 CNY/QALY.</p> <p><strong>Conclusions:</strong> DFP was the most cost-effective chelation regimen for β-thalassemia major patients, followed by DFO+DFP, DFO and DFX. Using DFP as the primary treatment regimen may potentially result in cost-savings and QALY gains for the Chinese healthcare system. To increase these benefits, the Chinese government and clinicians should lower drug costs, increase drug utility and reduce mortality and morbidity. Changes in influential parameters easily affect the results of DFO+DFP versus DFP and of DFP versus DFO; clinicians should focus on such parameters and adjust the regimens accordingly.</p> 2020-04-27T21:52:06+00:00 Copyright (c) 2020 Jialian Li http://www.mjhid.org/index.php/mjhid/article/view/2020.025 CLINICAL USEFULNESS OF BROCHOALVEOLAR LAVAGE IN THE MANAGEMENT OF PULMONARY INFILTRATES IN ADULTS WITH HAEMATOLOGICAL MALIGNANCIES AND STEM CELL TRANSPLANTATION 2020-04-28T17:02:21+00:00 Laura Jorge laurajorge1981@gmail.com Diego Torres diegots23@hotmail.com Agustín Languasco aguslang@yahoo.com Pablo Rodriguez pablorodrig16@gmail.com Pablo Bonvehí pbonvehi@fibertel.com.ar Elena Temporiti guchatemporiti@gmail.com Silvia Relloso srelloso@cemic.edu.ar Cristina Videla cvidela@cemic.edu.ar Fabián Herrera fabian1961@gmail.com <p class="AbstractCxSpFirst"><span lang="EN-GB">Introduction: Pulmonary complications are frequent in patients with hematologic malignancies and stem cell transplantation. Regardless of the microbiological usefulness of bronchoalveolar lavage (BAL), little information exists on both its benefits as a guide for therapeutic decisions and its impact on patients’ clinical outcome.</span></p> <p class="AbstractCxSpMiddle"><span lang="EN-GB">Methods: A prospective observational single center study was performed between July 2011 and July 2015. Consecutive episodes of pulmonary infiltrates were analyzed in subjects over 18 years of age who presented hematologic malignancies and underwent chemotherapy or stem cell transplantation. </span></p> <p class="AbstractCxSpLast"><span lang="EN-GB">Results: Ninety-six episodes of pulmonary infiltrates were analyzed. Acute leukemia was the most frequent underlying condition. Thirty-seven patients (38.5%) received a stem cell transplant. Sixty-one (62.9%) were neutropenic at the moment of inclusion in the study. A definitive etiologic diagnosis was obtained in 41 cases (42.7%), where infection accounted for the vast majority of causes (33 cases, 80.5%). Definitive diagnosis was reached by non-invasive methods in 13 cases (13.5%). BAL was performed in 47 cases, and led to a diagnosis in 40.4% of the cases. BAL results led to therapeutic changes in 27 cases (57.4%), including the addition of new antimicrobials to empiric treatments in 10. Regarding BAL’s safety, 2 patients experienced minor adverse events and 1 a severe adverse event; no procedure-related deaths were observed. </span></p> <p><span lang="EN-GB">Conclusions: Infection was the leading cause of pulmonary infiltrates in patients with hematologic malignancies and stem cell transplantation. BAL was a useful decision-making diagnostic tool, with minor adverse events</span></p> 2020-05-01T00:00:00+00:00 Copyright (c) 2020 Laura Jorge, Diego Torres, Agustín Languasco, Pablo Rodriguez, Pablo Bonvehí, Elena Temporiti, Silvia Relloso, Cristina Videla, Fabián Herrera http://www.mjhid.org/index.php/mjhid/article/view/2020.023 HEMATOPOIETIC STEM CELL TRANSPLANTATION IN EGYPT CHALLENGES AND OPPORTUNITIES 2020-04-30T08:05:28+00:00 Hossam Kamel Mahmoud hossamkamel06@gmail.com Gamaleldin Mohamed Fathy gamalmohamedfathy@gmail.com Alaa Elhaddad alaaelhaddad@hotmail.com Omar Abdelrahman Fahmy faomar007@gmail.com Mohamed Abdelmooti abdelmooti@hotmail.com Raafat Abdelfattah rfatah@gmail.com Mahmoud Tarek Sayed Ahmed Bokhary mahmoud.bokhary@gmail.com <p>Hematopoietic stem cell transplantation (HSCT) is now an established treatment modality with definitive indications for many hematological disorders. However, this line of treatment requires tremendous resources, and it becomes increasingly difficult for transplanters&nbsp; practicing in the developing world to reconcile the difference between what is possible and what is available. On the basis of 30 years of experience and more than 4250 transplants , this article will focus on the challenges faced our HSCT program and how they were solved. The HSCT program in Egypt started in 1989 on a narrow scale and since that time we faced many challenges.In 1997, the transplant rate increased dramatically with the opening of&nbsp; many HSCT units distributed allover Egypt. Our team is registered in the Center for International Blood and Marrow Transplant Research ,and the number of transplants performed till December 2019 exceeded 4000 cases (60% allogeneic and 40% autologous)<strong>.</strong></p> 2020-04-27T21:49:43+00:00 Copyright (c) 2020 Hossam Kamel Mahmoud, Gamaleldin Mohamed Fathy, Alaa Elhaddad, Omar Abdelrahman Fahmy, Mohamed Abdelmooti, Raafat Abdelfattah, Mahmoud Tarek Sayed Ahmed Bokhary http://www.mjhid.org/index.php/mjhid/article/view/2020.036 HEALTH-RELATED QUALITY OF LIFE IN THAI CHILDREN WITH THALASSEMIA AS EVALUATED BY PEDSQL AND EQ-5D-Y: A SINGLE CENTER EXPERIENCE 2020-06-28T17:08:23+00:00 Pacharapan Surapolchai doctorning@hotmail.com Phakatip Sinlapamongkolkul spakatip@yahoo.com <p><strong>Background</strong><strong>: </strong>Thalassemia remains a chronic challenging disease in Thailand, but national prenatal screening along with better treatment and management may have improved health-related quality of life (HRQoL) for pediatric patients. We aimed to measure the HRQoL of transfusion dependent (TDT) and non-transfusion dependent (NTDT) of these pediatric patients at our institute.</p> <p><strong>Methods</strong><strong>: </strong>We included all patients 2 – 18 years old, with TDT and NTDT, using the Pediatric Quality of Life Inventory 4.0 Generic Core Scales (PedsQL) and the EuroQol Group’s Five Dimensions for Youth (EQ-5D-Y) instruments. Patients and caregivers responded as appropriate for age.</p> <p><strong>Results</strong><strong>: </strong>Mean PedsQL total summary scores (TSS) (SD) of child self-reports and parent proxy-reports were 81.00 (10.94) and 78.84 (16.72) from 150 participants. Mean EQ-5D-Y VAS (SD) for children was 89.27 (11.56) and 86.72 (10.62) for parent proxies. The most problematic EQ-5D-Y dimension was “having pain or discomfort”. These scores had significant correlations between child and parental proxy perspectives, as well as between the PedsQL and EQ-5D-Y. An age of 8 - 12 years and oral chelation therapy predicted lower self-reported PedsQL TSS. Parental proxy-report predictors for reduced PedsQL TSS and EQ-5D-Y VAS were primary school education for children, parental proxy secondary school education, Universal Coverage insurance, and TDT.</p> <p><strong>Conclusion: </strong>HRQoL scores of our pediatric thalassemia patients had improved from the&nbsp;previous decade, and these findings may represent our better standard of care. Some sociodemographic and clinical characteristics may present negative impacts on HRQoL.</p> 2020-06-28T09:27:41+00:00 Copyright (c) 2020 Pacharapan Surapolchai, Phakatip Sinlapamongkolkul http://www.mjhid.org/index.php/mjhid/article/view/2020.037 Association of VDBP rs4701 variant, but not VDR/RXR-α over-expression with bone mineral density in pediatric β-Thalassemia patients 2020-06-28T17:08:22+00:00 Shaimaa Sahmoud sh.sahmoud@gmail.com Mostafa Ibrahim mostafa1sayed@yahoo.com Eman Toraih emantoraih@gmail.com Noha Kamel nkamel30@yahoo.com Manal Fawzy manal2_khashana@ymail.com Samar Elfiky dr_samar.elfiky@yahoo.com <p><strong>Introduction:</strong> The reduced rate of bone formation despite the availability of vitamin D has been reported in β-thalassemia.&nbsp; This suggests genetic factors together with environmental one can be implicated in this condition. Since vitamin D binding protein (VDBP) maintains bioavailability of vitamin D which binds to vitamin D receptor (VDR)-retinoid X receptor alpha (RXRA) heterodimer to exert its molecular actions, we speculated that vitamin D metabolic-axis expression signature and variants could be potential molecular candidates for bone turnover/disease in thalassemia. To this end, this study aims to analyze <em>VDR</em>/<em>RXRA </em>expression signature, and two <em>VDBP</em> variants in a pilot sample of Egyptian β-thalassemia children in correlation with bone mineral density (BMD).</p> <p><strong>Patients and methods:</strong> Forty-four β-thalassemia children and 40 unrelated controls were enrolled. The serum bone chemistry profile was measured. Peripheral blood mononuclear cells (PBMN) <em>VDR</em>/<em>RXRA </em>expression levels were quantified by Real-Time quantitative reverse transcription-polymerase chain reaction (qRT-PCR). <em>VDBP</em> rs7041 and rs4588 variants were identified by Real-Time allelic discrimination assay. All patients were subjected to lumbar-spine Dual-energy X-ray absorptiometry (DEXA).</p> <p><strong>Results:</strong> <em>VDR</em>/<em>RXRA</em> expressions were significantly higher in β-thalassemia children compared to controls (<em>P </em>= 0.001 and &lt;0.001, respectively) and showed higher values in β-thalassemia major relative to β-thalassemia intermedia. Expression levels of both genes were not associated with sex or BMD. However, <em>VDBP </em>rs4701 genotyping revealed lower BMD-L4 and a higher frequency of osteoporosis.</p> <p><strong>Conclusions:</strong> β-Thalassemia children had higher expression levels of PBMN <em>VDR</em>/<em>RXRA</em>. <em>VDBP </em>rs4701 variant was associated with osteoporosis in our β-thalassemia patients on vitamin D supplementation. Further large-scale studies in other ethnic populations are warranted.</p> 2020-06-28T09:29:45+00:00 Copyright (c) 2020 Shaimaa Sahmoud, Mostafa Ibrahim, Eman Toraih, Noha Kamel, Manal Fawzy, Samar Elfiky http://www.mjhid.org/index.php/mjhid/article/view/2020.038 A SEROPREVALENCE OF HBV, HCV AND HIV-1 AND CORRELATION WITH MOLECULAR MARKERS AMONG MULTI-TRANSFUSED THALASSEMIA PATIENTS IN WESTERN INDIA 2020-06-29T09:18:08+00:00 Kanchan Mishra kanchan008@gmail.com Avani Shah avanishah08@gmail.com Krima Patel pkrima@ymail.com Kanjaksha Ghosh kanjakshaghosh@hotmail.com Sumit Bharadva sumit_bharadva@hotmail.com <p><strong>Background: </strong>Blood transfusion is a lifesaving therapy for patients with hemoglobinopathies. However, the need of frequent transfusion carries the risk of transfusion-transmitted infections (TTIs). This study was aimed to determine the seroprevalence of Hep-B, Hep-C and HIV-1infections among the multi-transfused Beta-thalassemic patients and correlate the same with NAT testing.</p> <p><strong>Methods: </strong>Total 196 patients with Beta-thalassemia were included in the study. Patients were screened for the presence of viral markers by third generation ELISA test as well as for viral DNA/RNA by NAT.&nbsp;</p> <p><strong>Results:</strong> Among these 196 multi-transfused Beta-thalassemia patients, 32.1% were females and 67.8% were males. A total of 100 (51.1%) patients were found to be anti-HCV antibody reactive, while HCV-RNA was positive in 66 (33.7 %) of the 196 patients tested. There were 6 (3.1%) patients reactive for anti-HIV-1 antibody, while 8 (4.1%) were positive for HIV-RNA. There were only 3 (1.5%) patients that were found to be reactive for HBsAg, however 5 (2.5%) were positive for HBV-DNA. Two (1%) patients had co-infection of anti-HCV antibody and HBsAg,whereas 6 patients were found co-infected by NAT testing, in-which 3 (1.5%) were positive for HBV-DNA and HCV-RNA, 1 (0.5%) was positive for HIV-RNA and HBV-DNA, and 2 (1%) had co-infection of HIV-RNA and HCV RNA.</p> <p><strong>Conclusion: </strong>Prevalence of HCV among multi-transfused Beta-thalassemia patients is significantly higher than the normal population. On the other hand, the study showed low prevalence of HBV. Therefore, a follow-up schedule and administration of booster dose of HBV vaccine is strongly recommended for thalassemia patients. To the best of our knowledge, this is the foremost work that shows prevalence of HIV, HBV and HCV in thalassemia patients using both serology and molecular markers in Western India.</p> 2020-06-28T09:39:01+00:00 Copyright (c) 2020 Kanchan Mishra, Avani Shah, Krima Patel, Kanjaksha Ghosh, Sumit Bharadva http://www.mjhid.org/index.php/mjhid/article/view/2020.046 A A Multicentre ICET-A Study of Confirmed SARS-CoV-2 Infection in Patients with Hemoglobinopathies: Preliminary Data from 10 Countries 2020-06-28T17:08:19+00:00 Vincenzo De Sanctis vdesanctis@libero.it <p><strong>Objectives: </strong>This study aims to investigate, retrospectively, the epidemiological and clinical characteristics, laboratory results, radiologic findings and outcomes of novel coronavirus disease-19 (COVID-19) in patients with transfusion dependent β thalassemia (β-thalassemia major-TM), non-transfusion dependent β thalassemia (β-thalassemia intermedia -TI) and sickle cell disease (SCD). <strong>Design, setting: </strong>A total of 17 Centers, from 10 countries, following 9,499 patients with hemoglobinopathies participated in the survey. <strong>Main outcome measures: </strong>Clinical, laboratory and radiologic findings and outcomes of patients with COVID-19 were collected<strong> from m</strong>edical records and summarized. <strong>Results: </strong>A total of 13 patients, 7 with TM, 3 with TI and 3 with SCD, with confirmed COVID-19, were identified from 6 Centers from different countries. The overall mean age of patients was 33.7±12.3 years (range:13-66); 9/13 (69.2%) patients were females. The commonest symptoms in the 10 symptomatic patients were: fever (80%), cough (70%), headache (60%), fatigue (60%), gastrointestinal symptoms (diarrhea /vomiting/abdominal pain; 50%), tachypnea/dyspnea (40%), and sore throat (40%). Six patients had pneumonia (unilateral, bilateral or multiple opacity) and 4 needed oxygen therapy. An oxygen saturation ≤ 93% was documented in 3 patients at diagnosis. 6/10 patients had an exacerbation of anemia (2 with SCD, associated with back and chest pain in 1 patient), and 3 (&lt;30%) had a decreased absolute number of lymphocytes. Increased C-reactive protein and D-dimers were the most common laboratory findings (66.6 %). <strong>Conclusions: </strong>The clinical presentation for COVID-19 in patients with β-thalassemia and SCD varies. Patients with mild/ordinary COVID-19 infection appear to have clinical symptoms and laboratory findings common to other viral respiratory infections. One 30 year old TM female patient with diabetes and chronic kidney disease. For a better understanding of COVID-19 in patients with hemoglobinopathies, further epidemiologic and clinical studies in a larger cohort of patients are required.</p> 2020-06-28T13:26:42+00:00 Copyright (c) 2020 Vincenzo De Sanctis http://www.mjhid.org/index.php/mjhid/article/view/2020.018 Archi-Prevaleat project. A National Register of color-Doppler ultrasonography of the epi-aortic vessels in Patients Living with HIV 2020-02-27T12:24:34+00:00 S Martini p_maggi@yahoo.com S Ferrara p_maggi@yahoo.com C Bellacosa p_maggi@yahoo.com B M Ceresia p_maggi@yahoo.com F Taccari p_maggi@yahoo.com G Di Filippo p_maggi@yahoo.com A Tartaglia p_maggi@yahoo.com G Gaeta p_maggi@yahoo.com Paolo Maggi p_maggi@yahoo.com <p>Persons Living with HIV (PLWH) are at higher risk of cardiovascular disease (CVD) than the general population. &nbsp;Carotid ultrasound is a non-invasive diagnostic tool, aimed at the assessment of vascular anatomy and function.&nbsp; Our present aim is to generate a National Register of color-Doppler ultrasonography (Archi-Prevaleat) to better evaluate the characteristics of vascular lesions in PLWH on a large number of data.</p> 2020-02-26T15:15:54+00:00 Copyright (c) 2020 S Martini, S Ferrara, C Bellacosa, B M Ceresia, F Taccari, G Di Filippo, A Tartaglia, G Gaeta, Paolo Maggi http://www.mjhid.org/index.php/mjhid/article/view/2020.022 Calreticulin mutation survey by high resolution melting method associated with unique presentations in essential thrombocythemic patients 2020-04-28T17:02:28+00:00 Yi-Chang Liu ycliu@kmu.edu.tw Ching-Ping Lee 890218@kmuh.org.tw Tsung-Jang Yeh aw7719@gmail.com Yuh-Ching Gau cheesecaketwin@gmail.com Chieh-Yu Hsieh g2985panda@gmail.com Ya-Lun Ke a9601082@gmail.com Jeng-Shiun Du ashiun@gmail.com Ming-Hui Lin lmn7214@gmail.com Hui-Ching Wang joellewang66@gmail.com Shih-Hao Tang shihhao.tang@gmail.com Shih-Feng Cho sifong96@gmail.com Jui-Feng Hsu medcow1978@yahoo.com.tw Samuel Yien Hsiao samhsi19@kas.kh.edu.tw Chin-Mu Hsu e12013@gmail.com Hui-Hua Hsiao huhuhs@kmu.edu.tw <p>Somatic mutations of exon 9 of calreticulin gene (CALR) were diagnosis and prognosis importance found in patients with JAK2V617F-negative essential thrombocythemia (ET). We survey CALR and JAK2 mutations in our ET patients and study the relationship between mutations and clinical presentations.</p> <p>A total of 60 ET patients were enrolled in the study, and CALR mutations were studied by high resolution melting (HRM) methods and sequencing in JAK2V617F-negative group retrospectively. Clinical manifestations were reviewed retrospectively from chart records.</p> <p>Twenty-one CALR mutations showed eight types of specific melting curves detected by the HRM method and sequencing validation among 26 JAK2 V617F-negative patients. Compared with JAK2 mutations, patients with CALR mutations were younger and had a higher platelet count, lower white cell counts, and lower hemoglobin levels significantly (<em>p</em>&lt;0.05).</p> <p>From our study, HRM methods revealed unique curve types in screening for CALR mutations screening even for complicated mutations. The mutations can be identification rapidly, and cost-effectively by HRM method than other tools. The clinical presentations of CALR mutations from JAK2 mutations showed significant differences and should be checked in ET patients.</p> 2020-04-27T21:37:52+00:00 Copyright (c) 2020 Yi-Chang Liu, Ching-Ping Lee, Tsung-Jang Yeh, Yuh-Ching Gau, Chieh-Yu Hsieh, Ya-Lun Ke, Jeng-Shiun Du, Ming-Hui Lin, Hui-Ching Wang, Shih-Hao Tang, Shih-Feng Cho, Jui-Feng Hsu, Samuel Yien Hsiao, Chin-Mu Hsu, Hui-Hua Hsiao http://www.mjhid.org/index.php/mjhid/article/view/2020.024 Limiting the Impact of Methicillin Resistant Staphylococcus Aureus in Patients Undergoing Haploidentical Transplantation 2020-04-28T17:02:25+00:00 SUPARNO CHAKRABARTI supchak@gmail.com Sarita Rani Jaiswal drsaritaranij@gmail.com Gitali Bhagwati gitali.bhagawati.dr@narayanahealth.org 2020-04-27T21:56:19+00:00 Copyright (c) 2020 SUPARNO CHAKRABARTI, Sarita Rani Jaiswal, Gitali Bhagwati http://www.mjhid.org/index.php/mjhid/article/view/2020.030 Extending Long Term Follow-up of Patient With Acute Myeloid Leukemia after Autologous Stem Cell Transplantation: disclosing late mortality and causes of death. 2020-05-20T14:06:24+00:00 Federica Sorà federica.sora@unicatt.it Patrizia Chiusolo patrizia.chiusolo@unicatt.it luca laurenti luca.laurenti@unicatt.it idanna innocenti idanna.innocenti@policlinicogemelli.it francesco autore francesco.autore@policlinicogemelli.it andrea corbingi andrea.corbingi@policlinicogemelli.it andrea corbingi andrea.corbingi@policlinicogemelli.it sabrina giammarco sabrina.giammarco@policlinicogemelli.it elisabetta metafuni elisabetta.metafuni@policlinicogemelli.it andrea bacigalupo andrea.bacigalupo@unicatt.it simona sica simona.sica@unicatt.it 2020-04-27T22:27:58+00:00 Copyright (c) 2020 Federica Sorà, Patrizia Chiusolo, luca laurenti, idanna innocenti, francesco autore, andrea corbingi, andrea corbingi, sabrina giammarco, elisabetta metafuni, andrea bacigalupo, simona sica http://www.mjhid.org/index.php/mjhid/article/view/2020.047 Focusing On A Unique Innate Memory Cell Population Of Natural Killer Cells In The Fight Against COVID-19: Harnessing The Ubiquity Of Cytomegalovirus Exposure 2020-06-28T17:08:22+00:00 SUPARNO CHAKRABARTI supchak@gmail.com 2020-06-28T11:24:59+00:00 Copyright (c) 2020 SUPARNO CHAKRABARTI http://www.mjhid.org/index.php/mjhid/article/view/2020.002 Chronic-graft-versus-host-disease-related polymyositis: a 17-months-old child with a rare and late complication of haematopoietic stem cell transplantation. 2020-02-27T12:25:59+00:00 Matteo Chinello matteo.chinello@aovr.veneto.it Rita Balter rita.balter@aovr.veneto.it Massimiliano De Bortoli massimiliano.debortoli@aovr.veneto.it Virginia Vitale virginia.vitale@aovr.veneto.it Ada Zaccaron ada.zaccaron@aovr.veneto.it Elisa Bonetti elisa.bonetti2@aovr.veneto.it Paola Tonin paola.tonin@aovr.veneto.it Gaetano Vattemi gaetano.vattemi@univr.it Valeria Guglielmi valeria.guglielmi@univr.it Simone Cesaro simone.cesaro@aovr.veneto.it <p align="justify"><a name="__DdeLink__174_756140867"></a> <span style="color: #000000;"><span style="font-family: Courier, 'Courier New', serif;"><span style="font-size: small;"><span style="font-family: 'Times New Roman', serif;"><span style="font-size: medium;"><span lang="en-GB"><strong>Background: </strong></span></span></span><span style="font-family: 'Times New Roman', serif;"><span style="font-size: medium;"><span lang="en-GB">Chronic graft versus host disease (cGVHD) occurs in 20-30% of paediatric patients receiving haemopoietic stem cell transplantation (HSCT). Neuromuscular disorders such as polymyositis are considered a rare and distinctive but non-diagnostic manifestation of cGVHD and, in absence of other characteristic signs and symptoms, biopsy is highly recommended to exclude other causes. </span></span></span></span></span></span></p> <p align="justify"><span style="color: #000000;"><span style="font-family: Courier, 'Courier New', serif;"><span style="font-size: small;"><span style="font-family: 'Times New Roman', serif;"><span style="font-size: medium;"><span lang="en-GB"><strong>Case report:</strong></span></span></span><span style="font-family: 'Times New Roman', serif;"><span style="font-size: medium;"><span lang="en-GB"> We report a case of a 17-months-old child </span></span></span><span style="font-family: 'Times New Roman', serif;"><span style="font-size: medium;"><span lang="en-GB">affected by hemophagocytic </span></span></span><span style="font-family: 'Times New Roman', serif;"><span style="font-size: medium;"><span lang="en-GB">lymphohistiocytosis who</span></span></span> <span style="font-family: 'Times New Roman', serif;"><span style="font-size: medium;"><span lang="en-GB">underwent a matched </span></span></span><span style="font-family: 'Times New Roman', serif;"><span style="font-size: medium;"><span lang="en-GB">unrelated donor </span></span></span><span style="font-family: 'Times New Roman', serif;"><span style="font-size: medium;"><span lang="en-GB">haematopoietic stem cell transplantation (</span></span></span><span style="font-family: 'Times New Roman', serif;"><span style="font-size: medium;"><span lang="en-GB">HSCT). She </span></span></span><span style="font-family: 'Times New Roman', serif;"><span style="font-size: medium;"><span lang="en-GB">developed a severe cGVHD-related polymyositis that was successfully treated with high-dose steroid therapy, rituximab and sirolimus. </span></span></span></span></span></span></p> <p class="western" lang="en-GB" align="justify"><span style="color: #000000;"><span style="font-family: 'Times New Roman', serif;"><strong>Conclusions: </strong></span></span><span style="color: #000000;"><span style="font-family: 'Times New Roman', serif;"><span style="font-size: medium;">This is the first case of cGVHD-related-polymyositis described in a pediatric patient which was successfully treated with rituximab.</span></span></span></p> 2020-01-01T00:00:00+00:00 Copyright (c) 2020 Matteo Chinello, Rita Balter, Massimiliano De Bortoli, Virginia Vitale, Ada Zaccaron, Elisa Bonetti, Paola Tonin, Gaetano Vattemi, Valeria Guglielmi, Simone Cesaro http://www.mjhid.org/index.php/mjhid/article/view/2020.005 Successful planned pregnancy through vitrified-warmed embryo transfer in a woman with chronic myeloid leukemia: case report and literature review 2020-02-27T12:25:36+00:00 Toshifumi Takahashi toshifumi.takahashi@gmail.com <p>A 35-year-old female patient with chronic myeloid leukemia wanted to have a child. She had been treated with imatinib and had achieved major molecular remission, after which imatinib was intentionally discontinued and interferon-α treatment was initiated. After three failed cycles of artificial insemination with her husband’s semen, the patient underwent treatment with assisted reproductive technology. After two cycles of <em>in vitro</em> fertilization, two embryos (8-cell stage and blastocyst) were cryopreserved. The patient again had elevated <em>BCR/ABL</em> mRNA levels; thus, infertility treatment was discontinued. After 18 months of dasatinib treatment, major molecular remission was observed and the patient underwent vitrified–warmed embryo transfer with a single blastocyst. Thereafter, she became pregnant. Discontinuation of tyrosine kinase inhibitors combined with the timely initiation of infertility treatments, including assisted reproductive technology, may be useful for treating women with CML who wish to become pregnant.</p> 2020-01-01T00:00:00+00:00 Copyright (c) 2020 Toshifumi Takahashi http://www.mjhid.org/index.php/mjhid/article/view/2020.007 Hepatic Infiltration with Malignant T-cells Manifesting as Impending Acute Liver failure in Mycosis Fungoides with Large Cell Transformation 2020-02-27T12:25:53+00:00 Yumeng Zhang yumengzhang2009@hotmail.com Jinming Song Jinming.Song@moffitt.org David Rutenberg drutenberg@health.usf.edu Lubomir Sokol lubomir.sokol@moffitt.org <p>Here we described a patient with a history of mycosis fungoides who developed large cell transformation manifesting with generalized erythroderma, lymphocytosis, lymphadenopathy and impending acute liver failure (ALF). Three-phase computed tomography of the liver showed neither mass nor hepatomegaly. Liver biopsy confirmed infiltration with malignant CD4+ clonal T-cells. Combination chemotherapy with gemcitabine, dexamethasone, and cisplatin (GDP) resulted in the recovery of liver function and resolution of skin involvement. In Foundation Medicine Hematology Gene Panel, 31 genetic alterations with 11 clinically relevant mutations were identified including ARID2 mutation frequently observed in hepatocellular carcinoma but rarely observed in hematologic malignancies.</p> 2020-01-01T00:00:00+00:00 Copyright (c) 2020 Yumeng Zhang, Jinming Song, David Rutenberg, Lubomir Sokol http://www.mjhid.org/index.php/mjhid/article/view/2020.026 Isavuconazole therapy of disseminated and encephalic Saprochaete capitata infection in an acute myeloid leukemia patient treated with midostaurin. 2020-04-28T17:02:24+00:00 Salvatore Perrone sperrone@hotmail.it Chiara Lisi lisichiara92@gmail.com Elettra Ortu La Barbera e.ortulabarbera@ausl.latina.it Cristina Luise cl.luise.cl@gmail.com Miriam Lichtner miriam.lichtner@uniroma1.it Corrado Girmenia girmenia@bce.uniroma1.it Giuseppe Cimino cimino@bce.uniroma1.it <p>BACKGROUND<em> Saprochaete capitata</em> is a rare and emerging opportunistic fungus, involving immunocompromised hosts, in particular neutropenic patients after chemotherapy. CASE REPORT We report a case of disseminated and cerebral infection by <em>Saprochaete capitata, </em>in a 68-year-old woman affected by acute myeloid leukemia that was successfully managed with liposomal amphotericin B and isavuconazole. CONCLUSION this case illustrates the feasibility of isavuconazole therapy in the treatment of a <em>S.capitata</em> infection when co-administered with midostaurin.</p> 2020-04-27T22:04:00+00:00 Copyright (c) 2020 Salvatore Perrone, Chiara Lisi, Elettra Ortu La Barbera, Cristina Luise, Miriam Lichtner, Corrado Girmenia, Giuseppe Cimino http://www.mjhid.org/index.php/mjhid/article/view/2020.035 The First Case of Concomitant Mycobacterium genavense lymphadenitis and EBV-positive lymphoproliferative disorder 2020-06-28T17:08:23+00:00 Yusuke Ito yuu.i-56512@hotmail.co.jp Kensuke Takaoka kensuketakaoka@gmail.com Kazuhiro Toyama ktoyama-hok@umin.ac.jp Yoshitaka Wakabayashi wakabayashi-tky@umin.ac.jp Aya Shinozaki-Ushiku ashinozaki-tky@umin.ac.jp Aiko Okazaki hypnerotomachia0poliphili@gmail.com Kinuyo Chikamatsu chikamatsu@jata.or.jp Satoshi Mitarai mitarai@jata.or.jp Tetsuo Ushiku ushikut-pat@h.u-tokyo.ac.jp Mineo Kurokawa kurokawa-tky@umin.ac.jp <p>This is the first case of concurrent <em>Mycobacterium genavense</em> lymphadenitis and Epstein-Barr virus (EBV)-positive lymphoproliferative disorder (LPD) in the same lymph node with no immunocompromised history. <em>M. genavense</em> infection is a rare opportunistic infection mainly for human immunodeficiency virus (HIV)-infected patients. Although no immunodeficiency was detected in our patient, our case indicates that the immunodeficiency in the background of EBV latency type III and the immunosuppression by malignant lymphoma itself might induce the <em>M. genavense</em> lymphadenitis. This case highly alerts clinicians the immunosuppressive state of EBV-positive LPD with latency type III even if any serological immunodeficient factors are not detected.</p> 2020-06-28T09:19:44+00:00 Copyright (c) 2020 Yusuke Ito, Kensuke Takaoka, Kazuhiro Toyama, Yoshitaka Wakabayashi, Aya Shinozaki-Ushiku, Aiko Okazaki, Kinuyo Chikamatsu, Satoshi Mitarai, Tetsuo Ushiku, Mineo Kurokawa http://www.mjhid.org/index.php/mjhid/article/view/2020.040 Impressive continuous complete response after mogamulizumab in a heavily pre-treated Sézary syndrome patient 2020-06-28T17:08:21+00:00 Pier Luigi Zinzani pierluigi.zinzani@unibo.it Ginevra Lolli ginevra.lolli@studio.unibo.it Beatrice Casadei bea.casadei@gmail.com Lisa Argnani lisa.argnani@unibo.it Laura Nanni laura.nanni6@studio.unibo.it Michele Cavo michele.cavo@unibo.it <p><strong>Background</strong>: Sézary syndrome (SS) is a rare lymphoproliferative neoplasm, almost incurable outside the setting of allogeneic transplantable patients. Prognosis for relapse/refractory patient remains poor, as the available drugs confer short lasting remission. In this setting, the anti-chemokine receptor type 4 (CCR4) monoclonal antibody mogamulizumab demonstrated efficacy in an international, open label, randomized controlled phase 3 trial (MAVORIC) versus vorinostat.</p> <p><strong>Case description: </strong>A heavily pretreated 57-year-old SS woman (stage IVA) was randomized in the mogamulizumab arm of MAVORIC at our Institution. She quickly achieved a response but after 30 cycles she was discontinued from therapy due to cutaneous toxicity. Nevertheless, she is still in complete response (CR).</p> <p><strong>Conclusions</strong>: mogamulizumab is an anti-CCR4 monoclonal antibody that can induce long lasting response also in very heavily pre-treated patients not responding to any previous treatment. The extraordinary characteristic of our patient is that she is still in CR after 2.5 years since treatment discontinuation.</p> 2020-06-28T11:26:33+00:00 Copyright (c) 2020 Pier Luigi Zinzani, Ginevra Lolli, Beatrice Casadei, Lisa Argnani, Laura Nanni, Michele Cavo http://www.mjhid.org/index.php/mjhid/article/view/2020.044 Successful Outcomes of Severe COVID-19 in Patient with Chronic Lymphocytic Leukemia: Diagnostic Challenges in Immunocompromised Hosts 2020-06-28T17:08:20+00:00 Alexandre Malek alexandre.e.malek@uth.tmc.edu <p>The emergence and spread of 2019 novel coronavirus has led to an unprecedented public health crisis around the globe and has threatened the life of millions of people. We report a severe case of COVID-19 in a patient with chronic lymphocytic leukemia and describe primarily the clinical presentation and the challenges encountered in the COVID-19 diagnosis, treatment and specimens sampling pitfalls. This case highlights the importance of a comprehensive diagnostic approach of pneumonia in immunocompromised hosts, including timely and safe bronchoscopy, because the broad differential diagnosis, more challenging with the current outbreak of COVID-19.</p> 2020-06-28T12:41:53+00:00 Copyright (c) 2020 Alexandre Malek http://www.mjhid.org/index.php/mjhid/article/view/2020.027 The efficacy and safety of intralesional sodium stibogluconate for the treatment of cutaneous Leishmaniasis in children under the age of two years 2020-04-28T17:02:24+00:00 Nawfal R Hussein nawfal.hussein@yahoo.com ibrahim naqid Ibrahim.naqid@uoz.edu.krd Haval Salih haval.salih@uoz.edu.krd 2020-04-27T22:09:41+00:00 Copyright (c) 2020 Nawfal R Hussein, ibrahim naqid, Haval Salih http://www.mjhid.org/index.php/mjhid/article/view/2020.028 Covid-19 and Children with Immune Thrombocytopenia: emerging issues 2020-04-28T17:02:23+00:00 Giuseppe Lassandro giuseppelassandro@live.com Valentina Palladino valentinapalladino@hotmail.it Viviana Palmieri viviana_palmieri@libero.it Anna Amoruso amorusoanna@hotmail.it Giovanni Del Vecchio giovannicarlodelvecchio@gmail.com Paola Giordano paola.giordano@uniba.it <p>Letter to Editor</p> 2020-04-27T22:19:04+00:00 Copyright (c) 2020 Giuseppe Lassandro, Valentina Palladino, Viviana Palmieri, Anna Amoruso, Giovanni Del Vecchio, Paola Giordano http://www.mjhid.org/index.php/mjhid/article/view/2020.031 SARS-CoV-2 (COVID-19) and Chronic Myeloid Leukemia (CML): a case report and review of ABL kinase involvement in viral infection 2020-04-28T17:02:22+00:00 Elisabetta Abruzzese elisabetta.abruzzese@uniroma2.it luigia luciano luluciano@unina.it Francesco D'Agostino francesco.dago1993@gmail.com Malgorzata Monika Trawinska mmtrawinska@hotmail.com Fabrizio Pane fpane@unina.it Paolo de Fabritiis paolo.defabritiis@gmail.com <p>no abstract available</p> <p>Aknowledgements:</p> <p>We thank professor Nathan Tubliz, dept. Biology, University of Oregon, for his insightful support.</p> 2020-04-27T22:30:14+00:00 Copyright (c) 2020 Elisabetta Abruzzese, luigia luciano, Francesco D'Agostino, Malgorzata Monika Trawinska, Fabrizio Pane, Paolo de Fabritiis http://www.mjhid.org/index.php/mjhid/article/view/2020.033 Delivery in asymptomatic Italian woman with SARS-CoV-2 infection. 2020-04-28T17:02:21+00:00 Giuseppe Vittorio De Socio giuseppedesocio@yahoo.it Lisa Malincarne lisa.malincarne@unipg.it Saverio Arena saverio.arena@ospedale.perugia.it Stefania Troiani stefania.troiani@ospedale.perugia.it Sara Benedetti sara.benedetti89@libero.it Barbara Camilloni barabara.camilloni@ospedale.perugia.it Giorgio Epicoco giorgio.epicoco@ospedale.perugia.it Antonella Mencacci antonella.mencacci@unipg.it Daniela Francisci daniela.francisci@unipg.it <p>We report a case of a 33-year-old Italian pregnant at 40 weeks of gestation affected by asymptomatic SARS-CoV-2 infection delivering a healthy baby with no evidence of Coronavirus Disease 2019 (COVID-19). Vaginal delivery was uncomplicated, the breastfeeding was permitted under strict measures of infection control. The breast milk was negative for SARS-CoV-2. Control at 7 and 15 days indicated mother and baby good clinical condition, no signs of neonatal infection demonstrated by news oropharyngeal and rectal swab test negative for SARS-CoV-2.</p> 2020-04-27T22:33:29+00:00 Copyright (c) 2020 Giuseppe Vittorio De Socio, Lisa Malincarne, Saverio Arena, Stefania Troiani, Sara Benedetti, Barbara Camilloni, Giorgio Epicoco, Antonella Mencacci, Daniela Francisci http://www.mjhid.org/index.php/mjhid/article/view/2020.034 Burkitt lymphoma as fourth neoplasia in a patient affected by Cowden Syndrome with a novel PTEN germline pathogenic variant 2020-06-28T17:08:24+00:00 Eugenio Galli eug.galli@gmail.com Francesco D’Alò Francesco.Dalo@unicatt.it Annarosa Cuccaro annarosa.cuccaro@gmail.com Eleonora Alma eleonora.alma@gmail.com Elena Maiolo elenam86@hotmail.it Fulvia Brugnoletti fulvia.bru@gmail.com Luigi Maria Larocca LuigiMaria.Larocca@unicatt.it Marcella Zollino Marcella.Zollino@unicatt.it Andrea Paolo Bacigalupo andrea.bacigalupo@unicatt.it Stefan Hohaus Stefan.Hohaus@unicatt.it <p>x</p> 2020-06-28T09:18:04+00:00 Copyright (c) 2020 Eugenio Galli, Francesco D’Alò, Annarosa Cuccaro, Eleonora Alma, Elena Maiolo, Fulvia Brugnoletti, Luigi Maria Larocca, Marcella Zollino, Andrea Paolo Bacigalupo, Stefan Hohaus http://www.mjhid.org/index.php/mjhid/article/view/2020.049 MANAGEMENT OF PEDIATRIC RHEUMATOLOGICAL DISEASES DURING THE OUTBREAK OF COVID-19: OUR EXPERIENCE 2020-06-30T07:48:22+00:00 Romina Gallizzi rgallizzi@unime.it Diana Sutera dianasutera@icloud.com Francesca Mazza francescamazza89@gmail.com Alessandra Spagnolo alessandraspagnolo93@gmail.com Giovanni Battista Pajno giovanni.pajno@unime.it <p>Since the COVID-19 epidemic has evolved rapidly also in Italy, specialists in pediatric rheumatology have found themselves addressing the problems of their patients and in particular how to manage the risk of infection and immunosuppressive treatment.&nbsp;This work aims to make known the experience of our center.</p> 2020-06-28T13:56:15+00:00 Copyright (c) 2020 Romina Gallizzi, Diana Sutera, Francesca Mazza, Alessandra Spagnolo, Giovanni Battista Pajno http://www.mjhid.org/index.php/mjhid/article/view/2020.051 A socioeconomic paradox in the COVID-19 pandemic in Italy: a call to study determinants of disease severity in high and low income Countries 2020-06-30T08:23:59+00:00 Marialaura Bonaccio marialaura.bonaccio@moli-sani.org Licia Iacoviello licia.iacoviello@moli-sani.org Maria Benedetta Donati mbdonati@moli-sani.org Giovanni de Gaetano giovanni.degaetano@moli-sani.org <p>N/A</p> 2020-06-28T00:00:00+00:00 Copyright (c) 2020 Marialaura Bonaccio, Licia Iacoviello, Maria Benedetta Donati, Giovanni de Gaetano http://www.mjhid.org/index.php/mjhid/article/view/2020.054 Spontaneous and severe haematomas in patients with COVID-19 on low-molecular-weight heparin for paroxysmal atrial fibrillation 2020-06-30T09:17:20+00:00 Maria Mazzitelli m.mazzitelli88@gmail.com Francesca Serapide francescaserapide@gmail.com Bruno Tassone tassone.bruno89@gmail.com Domenico Laganà lagana@unicz.it Enrico Maria Trecarichi em.trecarichi@unicz.it Carlo Torti torti@unicz.it <p>x</p> 2020-06-28T14:10:36+00:00 Copyright (c) 2020 Maria Mazzitelli, Francesca Serapide, Bruno Tassone, Domenico Laganà, Enrico Maria Trecarichi, Carlo Torti http://www.mjhid.org/index.php/mjhid/article/view/2020.050 Guidance for Facing Dilemmas of Hematopoietic Stem Cell Transplant Clinicians in the Coronavirus Disease 2019 (COVID-19) Pandemic: An Iranian Consensus 2020-06-28T17:08:18+00:00 Seied Asadollah Mousavi A_mousavi@tums.ac.ir Soroush Rad srad@sina.tums.ac.ir Tahereh Rostami trostami@sina.tums.ac.ir Mohammad Vaezi Vaezi.mohammad@yahoo.com Hosein Kamranzadeh Dr.kamranzadeh@gmail.com Davood Babakhani davoudbabakhani@yahoo.com Sahar Tavakoli stavakoli@sina.tums.ac.ir Maryam Barkhordar Barkhordarm.n@gmail.com Tanaz Bahri Tanaz.bahri@gmail.com Amirabbas Hedayatiasl hedayatiasl@gmail.com azade kiumarsi raha1221@yahoo.com 2020-06-28T14:11:42+00:00 Copyright (c) 2020 Seied Asadollah Mousavi, Soroush Rad, Tahereh Rostami, Mohammad Vaezi, Hosein Kamranzadeh, Davood Babakhani, Sahar Tavakoli, Maryam Barkhordar, Tanaz Bahri, Amirabbas Hedayatiasl, azade kiumarsi http://www.mjhid.org/index.php/mjhid/article/view/2020.053 Severe autoimmune hemolytic anemia in Covid-19 infection 2020-07-02T08:32:34+00:00 Fehmi Hindilerden drfehmi_hindi@yahoo.com Ipek Yonal-Hindilerden ipekyonal@yahoo.com.tr Emre Akar dr.emreakar@gmail.com Zuhal Yesilbag zuhalyes@gmail.com Kadriye Kart-Yasar kadriye.kartyasar@saglik.gov.tr <p>xx</p> 2020-06-28T00:00:00+00:00 Copyright (c) 2020 Fehmi Hindilerden, Ipek Yonal-Hindilerden, Emre Akar, Zuhal Yesilbag, Kadriye Kart-Yasar http://www.mjhid.org/index.php/mjhid/article/view/2020.052 Impact of SARS CoV-2 in hemoglobinopathies: a protective mechanism being from Beta chain Hemoglobin defects? 2020-06-30T10:04:31+00:00 Lorenza Torti lorenza.torti21@gmail.com Laura Maffei laura.maffei@aslroma2.it Francesco Sorrentino francesco.sorrentino@aslroma2.it Paolo De Fabritiis paolo.de.fabritiis@uniroma2.it Rossella Miceli rossella.miceli@aslroma2.it Elisabetta Abruzzese elisabetta.abruzzese@uniroma2.it <p>Not required for Letters</p> 2020-06-28T14:17:00+00:00 Copyright (c) 2020 Lorenza Torti http://www.mjhid.org/index.php/mjhid/article/view/2020.048 Pidotimod in paucisymptomatic SARS-CoV2 infected patients 2020-07-02T22:30:42+00:00 Claudio Ucciferri claudio.ucciferri@unimol.it Barone Mirko mir87mb@libero.it Jacopo Vecchiet jvecchiet@unich.it Katia Falasca k.falasca@unich.it <p><strong>B</strong></p> 2020-06-28T14:13:16+00:00 Copyright (c) 2020 Claudio Ucciferri, Barone Mirko, Jacopo Vecchiet, Katia Falasca http://www.mjhid.org/index.php/mjhid/article/view/2020.000 Cover 2020-03-15T16:58:13+00:00 Francesco Guidi guidif@hotmail.com <p>Printable Cover Vol 12, Year 2020</p> 2020-03-14T17:02:57+00:00 Copyright (c) 2020 Francesco Guidi