Inflammation plays a crucial role in cancer development. The neutrophil-to-lymphocyte ratio (NLR), a measure of inflammation, is obtained from a complete blood count. However, little is known about the association between NLR and cancer in the general adult population in the United States. This study aimed to evaluate whether NLR is associated with cancer in American adults. This retrospective cross-sectional study included 28,016 adult participants from the National Health and Nutrition Examination Survey (NHANES) dataset spanning 2005 to 2018. Data on demographics (age, sex, race, marital status, Poverty-Income Ratio, education level), lifestyle factors (smoking, alcohol consumption, body mass index), medical conditions (hypertension, diabetes, cardiovascular disease), and laboratory parameters (hemoglobin, platelet count, alanine aminotransferase, creatinine, albumin, and lactate dehydrogenase), were collected. Logistic regression analysis was used to investigate the research objectives. Of the total 28,016 participants, 2639 had cancer. The mean age was 49.6 ± 17.6 years, and 50% were male. A positive association between NLR and cancer risk was observed after multivariate adjustment (OR = 1.20, 95% confidence interval (CI) = 1.05–1.36, p = 0.006). Similar patterns were observed in subgroup analyses (all p-values for interaction > 0.05). A higher NLR was directly correlated with an increased risk of developing cancer in adults.

This study aims to investigate the risk factors for carbapenem-resistant Pseudomonas aeruginosa bloodstream infection (CRPA-BSI) and identify predictors of outcomes among patients with P. aeruginosa bloodstream infection (PA-BSI). A retrospective cohort study was conducted on patients with PA-BSI at Henan Cancer Hospital from 2013 to 2022. Among the 503 incidences analysed, 15.1% of them were CRPA strains. Age, ANC < 100/mmc, receiving antifungal prophylaxis, exposure to carbapenems within the previous 90 days to onset of BSI, and allogeneic HSCT (allo-HSCT) were associated with the development of CRPA-BSI. CRPA-BSI patients experienced significantly higher 28-day mortality rates compared to those with carbapenem-susceptible P. aeruginosa bloodstream infection. Multivariate logistic regression analysis identified age at BSI, active stage of haematological disease, procalcitonin levels, prior corticosteroid treatment, isolation of CRPA, and septic shock as independent predictors of 28-day mortality. Risk factors for CRPA-BSI include age, ANC < 100/mmc, antifungal prophylaxis, exposure to carbapenems, and allo-HSCT. Additionally, age at BSI, active haematological disease, procalcitonin levels, prior corticosteroid treatment, CRPA isolation, and septic shock contribute to increased mortality rates among patients with PA-BSI.

Objective: To analyze the clinical characteristics and prognostic risk factors of carbapenem-resistant Pseudomonas aeruginosa (CRPA) bloodstream infections in patients with hematologic malignancies. Methods: Medical records and drug susceptibility data of patients with hematologic malignancies complicated by CRPA bloodstream infections admitted to the Cancer Hospital of Zhengzhou University between January 1, 2018, and December 31, 2022, were retrospectively analyzed. Results: A total of 64 patients were included in the study, with a mortality rate of 37.5% (24/64) at 28 days after the occurrence of CRPA bloodstream infection. In Cox regression analysis, an absolute neutrophil count < 0.5× 10⁹/L at discharge (HR 0.039, 95% CI 0.006 ~ 0.258, p=0.001), admission to the intensive care unit (HR 7.546, 95% CI 1.345 ~ 42.338, p= 0.022), and a higher Pitt bacteremia score (HR 0.207, 95% CI 0.046 ~ 0.939, p = 0.041) were independent risk factors associated with 28-day mortality. Survival analysis showed that patients receiving ceftazidime-avibactam-based (HR 0.368, 95% CI 0.107~ 1.268, p = 0.023) or polymyxin B (HR 2.561, 95% CI 0.721 ~ 9.101, p = 0.015) therapy had a higher survival rate. Conclusion: Patients with hematologic neoplasms had high mortality from CRPA bloodstream infections, and admission to the intensive care unit, higher Pitt bacteremia score (PBS) scores, granulocyte deficiency, and granulocyte deficiency at discharge were independently associated with higher mortality. Early anti-infective treatment with ceftazidime-avibactam or polymyxin B may improve the clinical prognosis of patients.

Background: Evidence on the association between prognostic nutritional index (PNI) and prognosis in acute graft-versus-host disease (aGVHD) following allogeneic hematopoietic stem cell transplantation (allo-HSCT) is limited. Objective: This study aims to investigate the relationship between PNI levels and prognosis in patients experiencing aGVHD following allo-HSCT. Methods: We conducted a retrospective cohort study of patients who underwent allo-HSCT at Henan Cancer Hospital from January 2019 to December 2024. Eligible patients were those diagnosed with aGVHD following allo-HSCT. Data on PNI levels, clinical outcomes, and demographics were extracted from medical records. The primary outcomes were overall survival (OS) and event-free survival (EFS). Multivariable Cox regression and subgroup analyses were performed to assess the relationship between PNI levels and prognosis, adjusting for confounders. Results: This study included 109 eligible patients with a mean age of 29.4 ± 15.3 years. Over a 30-month follow-up, there were 69 deaths, 3 relapses/progressions, and 37 survivors. Among the participants, 51 had Grade I-II aGVHD, and 58 had Grade III-IV aGVHD. After adjusting for confounders, the adjusted hazard ratios (HR) for PNI and OS in T2 (35.8–42.5) and T3 (42.5–59.7) were 0.52 (95% CI: 0.23–0.86, p = 0.049) and 0.43 (95% CI: 0.18–0.73, p = 0.013), respectively, compared to individuals with lower T1 (20.2–35.8). For EFS, the adjusted HR values for PNI in T2 (35.8–42.5) and T3 (42.5–59.7) were 0.32 (95% CI: 0.17–0.59, p = 0.026) and 0.31 (95% CI: 0.16–0.56, p = 0.021), respectively, when compared to those with lower T1 (20.2–35.8). These results suggest a potential association between lower PNI levels and poorer prognosis. Kaplan–Meier analysis demonstrated poorer OS ( p = 0.047) and EFS ( p = 0.078) in the lower PNI group. Subgroup and interaction analyses revealed no significant interactions by age, sex, CD34+ count and ABO match (all p > 0.05), confirming the stability of the association. Sensitivity analyses further supported this consistent association. Conclusion: Our study underscores the association between lower PNI levels and poorer prognosis in aGVHD patients following allo-HSCT, emphasizing the need for further research to validate PNI as a reliable prognostic biomarker.

Acute myeloid leukemia (AML) with t (9;11) (p22; q23) presents as a varied hematological malignancy. The t (9;11) (p22; q23) translocation is the most common among 11q23/KMT2A rearrangements in AML. This research aimed to develop a nomogram for precise prediction of overall survival (OS) and cancer-specific survival (CSS) in AML with the t (9;11) (p22; q23) translocation. We utilized the Surveillance, Epidemiology, and End Results (SEER) database to identify patients diagnosed with t (9;11) (p22; q23) AML from 2000 to 2021. Prognostic factors for this AML subtype were determined using least absolute shrinkage and selection operator (LASSO) regression, which guided the creation of prognostic nomograms. To evaluate the model’s discrimination, accuracy, and effectiveness, we employed the concordance index (C-index), calibration charts, receiver operating characteristic curves (ROC), area under the curve (AUC), and decision-curve analysis (DCA). The research was meticulously planned, executed, and documented in full adherence to the TRIPOD guidelines. The nomogram was developed using key variables including age, race, first primary tumor, and chemotherapy. The concordance indices (C-indices) were 0.704 for OS and for 0.686 for CSS. Patients were classified into high-risk and low-risk groups based on nomogram scores, with significant differences in OS and CSS between these groups (P < 0.001). This study developed innovative nomograms that combine clinical and treatment factors to predict 1-, 3-, and 5-year survival rates for patients with t (9;11) (p22; q23) AML.

To evaluate the co-transplantation efficacy of umbilical cord mesenchymal stem cells (UC-MSCs) and peripheral blood stem cells (PBSCs) as a novel approach for refractory or relapsed severe aplastic anemia (R/R SAA) in children and adolescents, thirty-two children and adolescents diagnosed with R/R SAA underwent a retrospective chart review. The patients were categorized into two groups based on the source of PBSCs: the matched sibling donor (MSD) group and the unrelated donor (UD) group. No adverse events related to UC-MSC infusion occurred in any of the patients. The median time for neutrophil engraftment was 13 days (range: 10-23 days), and for platelets, it was 15 days (range: 11-28 days). Acute GVHD of Grade I-II and moderate chronic GVHD were observed in 21.8 and 12.5% of cases, respectively. No statistically significant differences were found between the MSD and UD groups in terms of engraftment, GVHD, and complications, including infection and hemorrhagic cystitis. The median follow-up time was 38.6 months (range: 1.4-140.8 months). As of October 31, 2021, five patients had succumbed, while 27 (84.4%) survived. The 5-year OS rate showed no statistically significant difference between the MSD and UD groups (84.8 +/- 10.0 vs. 82.4 +/- 9.2%, p = 0.674). In conclusion, the application of UC-MSCs in the treatment of R/R SAA in PBSC transplantation is reliable and safe, they had no graft rejection, low incidence of severe GVHD which may have been contributed by the co-infusion of MSC.