Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin’s lymphoma, characterized by its aggressive nature and heterogeneity. Despite significant advances in understanding DLBCL pathogenesis, there is still a need to elucidate the intricate mechanisms involved in disease progression and identify novel therapeutic targets. Extracellular vesicles (EVs), including exosomes and microvesicles, have emerged as crucial mediators of intercellular communication in various physiological and pathological processes, including cancer. In recent years, evidence has suggested that EVs play a vital role in DLBCL biology by facilitating the exchange of genetic material, especially miRNAs, and proteins and lipids between tumor cells, immune cells, and the tumor microenvironment. We summarize and discuss the biological functions of EVs in DLBCL and their effects on the tumor microenvironment, highlighting their influence on DLBCL pathobiology, immune evasion, angiogenesis, and drug resistance. We also investigated EVs’ diagnostic and prognostic potential as circulating biomarkers in DLBCL, emphasizing their utility in the non-invasive monitoring of the disease status and treatment response. Understanding the complex interplay between EVs and DLBCL may open up new avenues for personalized medicine, improve patient stratification, and facilitate the development of innovative therapeutic interventions in this devastating hematological malignancy.

Background: Cerebral venous sinus thrombosis (CVST) is a rare type of thrombosis that affects the cerebral venous system. The data on neurological outcomes are limited. Objectives: This study aimed to investigate the neurological outcomes of CVST, contributing factors, clinical presentation, treatment and mortality. Methods: This was a single-center, retrospective study at a university-based referral hospital in Thailand. Consecutive patients diagnosed with CVST between January 2010 and December 2020 were included. Outcomes were neurological outcomes measured by modified Rankin Scale (mRS), anticoagulant treatment, recurrence, and mortality. Results: One hundred and seven CVST patients were included with a mean age (± SD) of 42.7 ± 20.4 years. Following the treatment, neurological outcomes significantly improved, with the proportion of patients with mRS 0–1 increasing from 18.7% at diagnosis to 83.2% and 85.1% at three and six months, respectively (P < 0.001). Clinical variables were associated with residual neurological symptoms (mRS≥1) included age ≥ 50 years (OR 4.1, 95% CI; 1.7–9.4, P 0.001), male sex (OR 3.0, 95%CI; 1.4–6.6, P 0.006), the thrombus involvement in deep sinus system (OR 6.1, 95%CI; 1.1–76.9, P 0.04) and cerebral vein and dural sinus thrombosis (CVT) risk score ≥ 1 (OR 3.1, 95%CI; 1.3–7.5, P 0.014). Patients whose CVST was associated with hormonal therapy were found to have a lower risk of residual neurological symptoms (OR 0.2, 95%CI 0.1–0.6, P 0.004). Hormonal therapy was associated with anticoagulant discontinuation (OR 2.7, 95% CI 1.1–7.0; P = 0.04). The presence of malignancy increased the risk of bleeding (OR 5.8, 95% CI 1.4–24.1; P 0.016). Overall mortality was 2.8%. Of which 50% were related to major bleeding. Conclusions: A significant improvement in neurological outcomes was observed at 3 and 6 months after diagnosis. Older age, male sex, thrombus involvement in deep sinus system were associated with residual neurological symptoms.

Background: Autologous stem cell transplantation (ASCT) is the standard treatment for multiple myeloma (MM) and refractory/relapsed (R/R) lymphoma patients. Engraftment syndrome (ES) is a non-infectious febrile syndrome during ASCT. This study focused on the incidence, risk factors, manifestations, and outcomes of patients with ES receiving ASCT. Material/Methods: This retrospective cohort study included MM and R/R lymphoma patients who underwent ASCT at Chiang Mai University Hospital from January 2014 to September 2020. ES was diagnosed by the consensus of independent reviewers based on clinical manifestations, laboratory, and radiological findings. Results: We included 124 patients, of whom 67 (54.1%) had lymphoma. The mean age was 48.0 +/- 12.3 years. The incidence of ES was 36.3%. The ES group had a significantly higher proportion of patients with fever, elevated liver enzymes, elevated bilirubin, hypoalbuminemia, and weight gain compared to the non-ES group. TNC more than 10x10(8) cells/kg was an independent risk factor for ES (odds ratio 2.94 with a 95% confidence interval of 1.15-7.50, P=0.024). ES was associated with longer length of stay (22.5 +/- 8.2 vs 16.9 +/- 6.4 days, P<0.001) but was not associated with overall survival (OS). Conclusions: The incidence of ES in this cohort was 36.3%. Features observed in ES patients were fever, elevated liver enzymes, elevated bilirubin, and hypoalbuminemia. TNC of more than 10x10(8) cells/kg was an independent risk factor. ES was associated with longer length of stay but not survival outcomes.

Pediatric acute lymphoblastic leukemia (ALL) has a cure rate above 90%, but outcomes in adult remain poor, with 3-year survival around 40%. Adolescents and young adults (AYAs) fall between these groups, often facing worse disease features and treatment-related risks. While pediatric-inspired regimens improve survival in AYAs, they also raise the issue of infection due to treatment intensity. A retrospective analysis was conducted on AYA-ALL patients treated at Chiang Mai University Hospital from 1 January 2007 to 31 December 2023. Data were accessed for research purpose from 10 January 2024 to 31 December 2024. Patients received either pediatric-inspired (TPOG) or adult regimens (Hyper-CVAD or GMALL). Infections were classified as clinically (CDI) or microbiologically documented (MDI). Logistic regression identified infection risk factors. Among 94 patients (62.8% male; median age 22.9 years), 56.4% received TPOG and 43.6% adult regimens. Infections occurred in 79.8%, higher with adult regimens (90.2% vs. 71.7%, p = 0.03). CDI was more frequent in adult regimens (73.4% vs. 52.8%, p = 0.04), while fungal infections predominated in TPOG (26.4% vs. 9.8%, p = 0.04). Adult regimens independently increased infection risk (OR 3.55; 95% CI 1.02-12.36, p = 0.04). Infection peaks occurred during induction (47.8%) and consolidation (51.8%). Gram-negative bacteria were most common (85%), mainly Escherichia coli (27%) and Salmonella spp. (21%). The invasive pulmonary aspergillosis was 11.7%. AYA-ALL patients are highly susceptible to infections, particularly with adult regimens. Fungal infections were more frequent with TPOG. Strengthening infection prevention and providing early treatment are vital.

Aim: Exposure to fine particulate matter, particularly PM2.5, has been associated with increased platelet activation and cardiovascular risks. However, its effect on platelet recovery after transfusion remains unclear. Purpose: This study aims to assess the influence of PM2.5 exposure on platelet recovery in patients with hematologic malignancies receiving prophylactic platelet transfusions. Patients and Methods: We conducted a cross-sectional study involving 66 patients with hematologic malignancies who developed chemotherapy-induced thrombocytopenia and received prophylactic platelet transfusions between January and December 2021. A total of 191 transfusion events were analyzed. Platelet increment and corrected count increment (CCI) were measured one hour post-transfusion. Transfusions were categorized based on mean PM2.5 levels one day prior to platelet collection: the control group (< 37.5 μg/m³) and the case group (≥ 37.5 μg/m³). Multivariate analyses were used to adjust for potential confounders. Results: No significant differences were observed in platelet increment (p = 0.128) or CCI (p = 0.828) between the PM2.5 exposure groups. Correlation analyses showed no significant association between PM2.5 levels and platelet increment (r = 0.0565, p = 0.437) or CCI (r = 0.0370, p = 0.614). These findings suggest that exposure to elevated PM2.5 levels one day before donation does not significantly impair platelet recovery. Conclusion: Short-term exposure to elevated PM2.5 levels does not significantly affect platelet recovery in patients receiving prophylactic platelet transfusions. These results provide important reassurance regarding the immediate effects of air pollution on transfusion outcomes, while highlighting the need for further research into potential long-term impacts.