Introduction. Due to the significant resources involved in creating HSCT programs there is a significant disparity in the availability of this treatment modality between the developed and developing countries. This manuscript details the process and the outcomes of the first HSCT program in East Africa which was started at Muhimbili National Hospital (MNH) in Dar‐es‐Salaam, Tanzania. Materials and Methods. Information and data were collected on the processes which had been implemented for starting the HSCT program at MNH. The details of the collaborations, training, infrastructure development, and acquisition of the biomedical equipment, as well as the actual process for HSCT, as well as the outcomes of treatment are described. Observations. The project has been detailed in 4 stages for ease of description: Stage 1: Preparatory work which was performed by the Government of Tanzania, as well as the administrators and clinicians from MNH (July 2017‐September 2021). Stage 2: Exploratory gap analysis by the teams from MNH and International Haematology Consortium of HCG Hospital, India (HCG‐IHC) in October 2021. Stage 3: Activities for closure of gaps (November 2021). Stage 4: Stem Cell Transplantation Camps (November 2021 to March 2022). 11 peripheral blood stem cell transplants were done in two camps, November 2021 (5 patients), and February 2022 (6 patients). 10 patients underwent autologous peripheral blood stem cell transplantation for multiple myeloma and 1 for lymphoma. The median duration of hospital stay was 19 ± 6 days. The median time for neutrophil engraftment, it was on 8.8 ± 0.8 days, and for platelet engraftment was 9.6 ± 2.4 days. Progression‐free survival was 100%, and there was no mortality. Conclusion. Commonalities in the socioeconomic challenges in developing countries can be leveraged to create robust HSCT programs in other developing countries.

Allogeneic haematopoietic stem cell transplantation (HSCT) for haematological malignancies can cause acute and chronic graft‐versus‐host disease (GvHD), impacting graft success and mortality. Rabbit anti‐thymocyte globulin (r‐ATG) or post‐transplant cyclophosphamide (PTCy) is effective in reducing GvHD in haploidentical‐HSCT. This review included 17 studies to assess rATG + PTCy for GvHD prophylaxis. Overall acute GvHD grade II‐IV, moderate‐to‐severe chronic GvHD and GvHD‐free relapse‐free survival rates ranged from 11.50%–35.40%, 2.90%–17.78% and 21.80%–63%, respectively. Although r‐ATG + PTCy treatment lowered GvHD incidence and increased survival rates, cytomegalovirus and Epstein–Barr virus reactivation were observed; therefore, more investigations on this treatment are needed, especially on dosing and timing when used for HSCT.

Introduction: Infections due to extended spectrum beta-lactam (ESBL) positive, carbapenemase producing enterobacteriaceae (CPE) and NDM1 resistance Enterobacteriaceae have significantly increased internationally and may account for up to 70% of infections in some geographies. Parallelly, high colistin resistance rates have also been reported. We are reporting the initial results of the first randomized-controlled trial addressing this issue of antibiotic resistant Gram-negative bacteremia (GNB). Objectives: The objective of the study was to assess the efficacy of first-line Ceftazidime–Avibactam with or without Aztreonam in high-risk FN, versus meropenem. Methodology: Adult patients with high-risk FN were randomized to Meropenem, Ceftazidime-Avibactum or Ceftazidime-Avibactum with Aztreonam as the first line antibiotic regimen. Results: Compared to meropenem, there was a trend towards reduced antibiotic failure, as defined by breakthrough fever within 7 days, with ceftazidime-avibactam, with or without aztreonam, although this wasn’t statistically significant, (p value = 0.076). Besides this, antibiotic failure was significantly associated with blood culture positivity (p= 0.015). Also, the presence of lung infiltrates was significantly associated with transfer to ICU (p=0.001). Conclusion: In high-risk FN, there was a trend to a higher incidence of antibiotic failure with first-line therapy with meropenem, compared to ceftazidime-avibactam with or without aztreonam, (p value = 0.076).

This case report describes a rare occurrence of severe respiratory failure in a 4-year-old child with beta-thalassemia after the administration of Furosemide and morphine. The patient experienced hypokalemia (potassium levels - 2.69 mmol/L) following Furosemide administration, which worsened after morphine intake, leading to Type II respiratory failure. Immediate potassium correction and naloxone administration were initiated, but unfortunately, the patient succumbed to complications related to tracheostomy on D + 39. This report emphasizes the potential risks of Furosemide-induced hypokalemia and its interaction with morphine, resulting in severe respiratory depression.

Background: Febrile neutropenia (FN) is a common and potentially life-threatening complication in immunocompromised patients, particularly those undergoing hematopoietic stem cell transplantation (HSCT). Timely identification and intervention are essential to prevent progression to sepsis or multi-organ dysfunction. While conventional monitoring relies on intermittent vital sign assessment, artificial intelligence (AI)-driven remote patient monitoring (RPM) offers a promising adjunct to enhance early detection and clinical decision-making. Case Insight: We present a case involving a young adult female post-HSCT who was monitored using an AI-enabled RPM system. Over a 29-day post-transplant period, the system generated real-time alerts indicating clinical deterioration, including febrile episodes, hypotension, tachycardia, and respiratory distress. These alerts were substantiated by clinical and diagnostic evaluations, leading to prompt escalation of antibiotics and supportive care. The AI system’s continuous surveillance and predictive capability enabled earlier recognition of complications, even when standard bedside monitoring showed minimal change. Conclusion: This paper highlights the potential use of AI-integrated RPM systems to transform the management of FN by enabling earlier intervention especially in high-risk immunocompromised patients. Although the preliminary observations are promising, further prospective studies are certainly required to evaluate and assess the accuracy, clinical outcomes, and resource implications of integration of AI into routine critical care monitoring protocols.

Structural variations (SVs) play a key role in the pathogenicity of hematological malignancies. Optical genome mapping (OGM) is an emerging technology that enables genome-wide detection of all classes of SVs at a high resolution and sensitivity. Identification of cryptic SVs leading to gene disruption or predicted novel gene fusions could be important drivers for cancer development and/or portend a prognostic relevance, which could be used to modify the treatment plan. A cohort of 106 consented cases that had a successful OGM analysis performed were included in the study. Demographic, clinical, laboratory and treatment data were collected. Routine diagnostic and prognostic testing were done on the peripheral blood and bone marrow aspirate as indicated. Additional samples of peripheral blood and/or bone marrow were sent for OGM testing. OGM led to a change in risk stratification in 17/66 (25.75%) of patients with hematological malignancies, the majority of these patients (15/66, 22.72%), having their risk stratification upgraded with a resulting change in treatment of 14 patients. This study highlights the ability of OGM to detect rare, cryptic and clinically relevant variants that potentially impact disease diagnosis, risk stratification and actionable treatment targets.