Background and objectives: Patients admitted to the intensive care unit (ICU) have an increased risk of hospital-acquired infection (HAI). A diagnosis of cancer alone increases the risk of sepsis three–five-fold, which further increases the risk of nosocomial infection, subsequently deteriorates results, and leads to high mortality. In this study, we aimed to assess the mortality rate among hematologic oncologic patients with suspected infection who were subsequently admitted to the ICU and the predictive factors that are associated with high ICU mortality. Materials and Methods: This retrospective cohort study was conducted in the hematological oncology critical care unit of a tertiary care hospital between November 2017 and February 2021. We analyzed anonymized medical records of hospitalized hematologic oncologic patients who were suspected or proven to have infection in the hematology-oncology department and were subsequently transferred to the ICU. Results: Both shorter hospitalization and shorter ICU stay length were observed in survivors [9.2 (7.7–10.4)] vs. non-survivors [10 (9.1–12.9), p = 0.004]. Sepsis had the highest hazard ratio (7.38) among all other factors, as patients with sepsis had higher mortality rates (98% among ICU non-survivors and 57% among ICU survivors) than those who had febrile neutropenia. Conclusions: The overall ICU mortality in patients with hematologic malignancies was 66%. Sepsis had the highest hazard ratio among all other predictive factors, as patients with sepsis had higher mortality rates than those who had febrile neutropenia. Chronic hepatitis (HBV and HCV) was significantly associated with higher ICU mortality.

Legionella pneumonia one of the three most common causes of community-acquired pneumonia and is associated with a high morbidity. The reported incidence of Legionella pneumonia is 1.4-1.8 cases per 100.000 people; immunocompromised patients are in high risk of legionella pneumonia development.Clinical presentation. A 55-year-old woman with multiple myeloma admitted to our center for autologous hematopoietic stem cell transplantation. Upon mobilization of hematopoietic stem cells, the patient developed Legionella pneumonia. Based on the clinical manifestations of an unknown pneumonia, it was decided to conduct a test for the Legionella I serotype in urine, and the result was positive. After confirming the diagnosis and prescribing etiotropic therapy, the patient's condition improved.Conclusion. We suggest that in the treatment of patients with immunodeficiency and signs of pneumonia, it is necessary to actively use the available methods of express diagnostics of Legionella pneumophila. This can reduce the mortality rate to 0-5.5%. This case shows that the diagnosis is very important, but also in the case of an unusual clinical manifestation of pneumonia, Legionella should be suspected in immunocompromised patients.Keywords: Legionella pneumonia, Multiple myeloma, immunocompromised, intensive care.

As far as we know, currently there is no evidence for the use of Levosimendan in anthracycline-induced cardiomyopathy and case reports are limited. This paper describes a clinical case of a patient who had heart failure after chemotherapy with Doxorubicin and had been successfully treated with Levosimendan, when low cardiac output resulted in cardiovascular disorders.The present case report indicates that Levosimendan may represent a possible treatment option in patients with anthracycline-related cardiomyopathy, especially in those requiring inotropic support. However, there is a need for more detailed study to assess the effectiveness and safety in terms of Evidence-based medicine.Key words: oncohematology, B-cell lymphoma, high-dose chemotherapy, cardiomyopathy, heart failure.

Background: Platelet concentrates are conventionally stored at room temperature (20–24°C), which preserves platelet viability but is associated with progressive metabolic deterioration and increased risk of bacterial contamination. Cold storage (4°C) has re-emerged as a potential alternative strategy; however, its impact on platelet metabolism, activation, and hemostatic function during extended storage remains incompletely characterized. Aim: To evaluate metabolic and functional changes in apheresis platelet concentrates during storage under cold and room temperature conditions. Methods: Apheresis platelet concentrates obtained from two healthy donors were stored in platelet additive solution with or without pathogen inactivation. Platelets were stored at 20–24°C (up to 7 days) or 4°C (up to 21 days). Metabolic parameters (pH, glucose, lactate), activation markers (CD62P, Annexin V), and hemostatic function (thromboelastography) were assessed at predefined time points. Because this was an exploratory pilot study with two independent donors, the analysis was primarily descriptive and no inferential statistical comparisons were performed. Results: Cold storage was associated with slower glucose consumption and lower lactate accumulation during the early storage period, accompanied by a progressive decline in pH during prolonged storage. Cold-stored platelets showed increased CD62P expression and phosphatidylserine exposure, as reflected by Annexin V binding, particularly during prolonged storage. Thromboelastographic analysis showed relative preservation of clot strength during the first 7 days of cold storage, with mean maximum amplitude values remaining approximately 72–79 mm during this period. Conclusion: Cold storage was associated with distinct metabolic and functional changes, including slower early glucose consumption, lower lactate accumulation, increased platelet activation and phosphatidylserine exposure, and relative preservation of clot strength during the first 7 days. Given the exploratory design and limited sample size, these findings should be considered preliminary and require confirmation in larger experimental and clinical studies.

A 55 years old woman with multiple myeloma was referred to us for autologous hematopoietic stem cell transplantation. The patient developed Legionella pneumonia while mobilization of hematopoietic stem cells.we report a case of successful treatment Legionella pneumonia in patient with multiple myeloma.

: Background: Klebsiella pneumoniae is a World Health Organization (WHO) critical priority pathogen, and carbapenem-resistant K. pneumoniae (CRKP) causes 50,000–100,000 attributable deaths annually worldwide. Systematic antimicrobial resistance (AMR) data from Central Asia are virtually absent from the global literature. Methods: Longitudinal surveillance study of routine microbiological data from the National Research Oncology Centre (NROC), Astana, Kazakhstan (January 2022–March 2026). Four data sources were integrated: monthly microbial landscape reports (October 2022–September 2024; n=596 K. pneumoniae isolates), a full-year patient-level clinical register (2025; n=91 isolates), monthly landscape reports for first quarter 2026 (Q1 2026 n=50 isolates), and biannual antibiograms (2022, 2026). Isolates were classified as CRKP (4MRGN), 3MRGN, ESBL-producing, or susceptible. Results: A total of 737 K. pneumoniae isolates were identified across the full study period. CRKP (4MRGN) was the dominant phenotype throughout, peaking at 76.4% in January–September 2024 and remaining at 62.0% in Q1 2026. The aggregate MDR rate (CRKP + 3MRGN + ESBL) was 76–87% across all periods, consistently 2–3 times above the global pooled mean of 28.7%. The highest resistance burden was observed in the bone marrow transplantation department (86–98% MDR) and intensive care units (67–100% MDR). Between 2022 and 2026, a profound shift in reserve antibiotic susceptibility was documented: amikacin resistance rose from 8.5% (2022) to 38.1% (Q1 2026, whole institution) and 60% (Q1 2026, intensive care sector), nearly eliminating the sole previously active antibiotic class. In contrast, polymyxins (colistin R 0%, polymyxin B R 2%) and tigecycline (R 52%) emerged as the only agents with retained activity in 2026. Carbapenem resistance showed a modest partial improvement (meropenem R 72%→64%) but remained critically high. Simultaneously, Escherichia coli (ESBL+/MDR) emerged as the dominant pathogen in haematological and surgical departments by 2025–2026, reflecting a broader Enterobacterales resistance crisis beyond K. pneumoniae alone. Conclusions: This study provides the first systematic published AMR surveillance evidence from Kazakhstan over a four-year period. CRKP dominates the institutional microbiological landscape, and the progressive loss of aminoglycoside activity now leaves polymyxins and tigecycline as the last remaining active agents — a development with profound implications for patient safety. These findings represent a critical call to action for antimicrobial stewardship implementation, carbapenemase genotyping, and integration into national and global AMR surveillance systems in Central Asia.