Background/Objectives: Chemical and carcinogenic risk in workplace are linked to an increase of the incidence of cancer in exposed workers. The aim of this observational study was to identify an association between exposure to chemical risk and changes in hematochemical parameters of workers exposed. Methods: The study examined blood count parameters performed on 4523 employees of Sapienza University of Rome from September 2019 to February 2020. A total of 1402 workers in research laboratories, exposed to chemical risk and carcinogens, was compared with a cohort of 3121 blood donors, in apparently good health, matched for age, sex, and period of blood collection. Results: Multivariate analysis demonstrated acrylamide is the most frequently associated chemical with significant changes between the groups. It is related to an increase in monocytes and MPV, a reduction of lymphocytes, platelets, and red series values, while MCH remained unchanged. Formaldehyde reveals the same changes as acrylamide, with the exception of the percentage of lymphocytes, red blood cells, and HB, which remain unchanged. Other chemicals and carcinogens show variations for few blood count parameters. Conclusions: The present study found out a significant change in blood count values in workers exposed to acrylamide and formaldehyde. It also showed an increase in the mean monocyte value in employees exposed to carcinogenic risk, compared to non-exposed, with the exception of Trypan Blue. The implementation of efficient health surveillance remains of critical importance. These data should be compared with those from follow-up studies.

Background: Mastocytosis is a rare clonal hematological neoplasm, characterized by cutaneous manifestations in children and categorized as: maculopapular cutaneous mastocytosis (MPCM), diffuse cutaneous mastocytosis (DCM) and mastocytoma. Systemic mastocytosis (SM) typically occurs in adults with c- KIT D816V mutation. Additional genetic mutations ( TET2 , NRAS , SF3B1 , ASXL1 , etc.) have been detected using Next-Generation Sequencing (NGS) in the adult population while limited information is available in the pediatric setting. Methods: 36 patients (pts) with pediatric mastocytosis diagnosed between 1997 and 2021 were included. Peripheral blood samples were collected to detect c- KIT D816V mutation, using both RT-PCR and ddPCR techniques, and to investigate other molecular mutations using NGS panel for rare and myeloid genes. Results: Median age of lesion onset was 4.7 months (range birth-17.8 years). 58% of the cohort underwent cutaneous biopsy after a median 3.77 months from lesion onset (range 2.49 months–11.6 years). 20 (55%) were classified as MPCM, 10 (28%) as DCM and 6 (17%) as mastocytoma. Median tryptase value at the onset was 5 ng/mL: MPCM (range 1.2–141 ng/mL) vs. DCM (range 2.71–19.4 ng/mL) vs. mastocytoma (range 3.8–7.3 ng/mL). Two MPCM pts developed indolent SM (ISM) after 10 and 20 years from the onset of disease. RT-PCR identified c- KIT D816V mutation in 4 pts (2 MPCM, 1 DCM, 1 ISM). NGS revealed the precedent mutation in 3 pts, c- KIT D816Y and c- KIT Y553C in 2 pts. An additional 10 myeloid gene mutations were detected by NGS: 5 already known ( ASXL1 G1397S; JAK2 L393V; c- KIT D816Y; LNK E208Q; TET2 Y867H) and 5 not previously described ( ETV6 A215P; c- KIT Y553C; NFE2 I291T; SH2B3 G382D; SH2B3 L438V). A single mutation was found in 7 pts (3 MPCM, 3 DCM, 1 ISM), while two or more mutations in 3 DCM pts. Overall, 9/36 pts (5 DCM, 3 MPCM, 1 mastocytoma) presented spontaneous complete regression of cutaneous lesions after a median time of 25 months (range 17 months–25 years). Conclusion: c- KIT mutations resulted in 35% of the children tested. The RT-PCR technique resulted more sensitive in finding c- KIT D816V, while NGS in detecting other mutations whose prognostic roles require further investigation.

Background: Approximately one-third of chronic myeloid leukemia (CML) patients may develop resistance and/or intolerance to the current therapies and need to switch to later lines of treatment. However, how to choose a later line of therapy is still a matter of discussion. Methods: A survey was performed by the Gruppo Italiano Malattie Ematologiche dell’Adulto (GIMEMA) to understand how the scenario has changed after the introduction of the first allosteric inhibitor, asciminib, in later lines. Results: The GIMEMA survey aimed to reassess the Italian approach to third-line or later-line treatments in CML. In the whole cohort of 1,637 patients, to treat resistance, ponatinib was used with a mean of 41% [standard deviation (SD) = 29] and a median of 50% (0–100), while asciminib was used with a mean of 27% (SD = 23) and a median of 25% (0–100). Indeed, to treat intolerance, asciminib was the most used with a mean of 32% (SD = 30) and a median of 30 (0–100), followed by bosutinib with a mean of 25% (SD = 25) and a median of 20 (0–90). Several possible treatment sequences were analyzed, and asciminib emerged as the best third-line treatment. Conclusions: The survey attempted to understand the major reasons for treatment switch, how tyrosine kinase inhibitors (TKIs) were selected, and which drug was preferred based on patient and disease characteristics. The current algorithm of treatment seems to have changed in both resistant and intolerant CML patients in later lines. The reduction of TKI dose is a current practice to maintain efficacy while reducing the occurrence of side effects.