Background/aim: The aim of the study was to evaluate the effect of Controlling Nutritional Status (CONUT) score on the prognosis in patients with diffuse large B-cell lymphoma (DLBCL). Materials and methods: The present study was a retrospective study. The CONUT score was calculated based on serum albumin, total cholesterol and lymphocyte levels. This study included a total of 266 patients, 131 (49.2%) were female and 135 (50.8%) were male. The median follow-up period was 51 months (range: 1-190). Results: The median age was 64 years. The cut off CONUT was 1.5. There was a significant difference between patients with high (>_ 2) or low (< 2) CONUT scores in terms of overall survival (OS) and progression-free survival (PFS). The 5-year OS and PFS in patients with high CONUT score was 52.1% and 49.7%. The 5-year OS and PFS in patients with low CONUT score was 79.8% and 75.6% (p < 0.001). In the multivariate analysis for OS, age >_ 65 years (HR = 1.80, p = 0.028), Eastern Cooperative Oncology Group (ECOG) > 1 (HR = 2.04, p = 0.006), stage IIIA-IVB disease (HR = 2.75, p = 0.001) and the CONUT score (HR = 1.15, p = 0.003) were found statistically significant. In the multivariate analysis for PFS, age >_ 65 years (HR = 2.02, p = 0.007), stage IIIA-IVB disease (HR = 2.42, p = 0.002) and the CONUT score (HR = 1.19, p = 0.001) were found to be significant parameters. Conclusion: High CONUT score reduces OS and PFS in DLBCL. CONUT score is an independent, strong prognostic index in patients with DLBCL.

The recent inclusion of immune‐privileged site lymphoma in the World Health Organization classification signifies a distinctive entity encompassing the central nervous system and testicles. This classification is rooted in the unique challenges posed by the blood–brain barrier and blood–testis barrier, along with the distinct cancer microenvironment compared to standard lymphomas. These intricacies contribute to the complexity of treatment strategies, and as of now, a standardized protocol remains elusive. Our presented case underscores the critical need for a comprehensive treatment plan in immune‐privileged site lymphomas, where surgery alone, in the form of indolent intervention, may fall short in addressing the underlying aggressive nature of the disease. Failure to administer systemic treatment, where indicated, heightens the risk of aggressive recurrence and substantially elevates mortality rates. Through a detailed examination of our case, we aim to contribute to the evolving body of knowledge surrounding these unique lymphomas, offering valuable insights that may guide future treatment strategies and improve patient outcomes.

Background: Wunderlich syndrome (WS) is a spontaneous, nontraumatic intrarenal or perirenal hemorrhage most commonly related to renal neoplasms, vascular disorders, infection, cyst rupture, or anticoagulation. Clinical severity ranges from self‐limited bleeding to hemorrhagic shock. Case: We report a 58‐year‐old woman with triple‐negative myelofibrosis (MF) who was started on hydroxyurea (HU) 500 mg/day and low‐dose acetylsalicylic acid (ASA). On Day 60, she presented with bilateral perirenal and intrarenal hemorrhage confirmed by contrast‐enhanced abdominal computed tomography. ASA was discontinued and bleeding ceased spontaneously. One month later, she represented with recurrent bilateral hemorrhage without ASA exposure and marked neutrophilic leukocytosis. Concomitant purpuric skin lesions, positive antinuclear antibodies (ANA, 1:160), and low C3 levels raised suspicion for a HU‐associated vasculitic process; HU was discontinued. Coagulation parameters at the time of bleeding (INR: 1.2, aPTT: 26.4 s, fibrinogen: 348 mg/dL, and D‐dimer: 0.6 μg/mL) were not consistent with disseminated intravascular coagulation. Despite supportive management, the patient’s condition deteriorated and she died shortly thereafter. The exact cause of death could not be definitively determined. Conclusion: To our knowledge, this is the first reported case of WS in a patient with MF receiving HU therapy. Clinicians should consider WS in HU‐treated patients presenting with acute flank pain or hematuria and evaluate for potential vasculitic features.

Purpose: New medicines employed in recent years have resulted in significant increases in survival rates for Multiple Myeloma (MM). Daratumumab, a monoclonal antibody against CD38, is utilized in both first-line myeloma treatment and relapsed/refractory illness. Our study aims to assess the clinical features, response to treatment and factors influencing response to treatment in patients who received daratumumab monotherapy or combination therapy at our center. Materials and methods: In the Pamukkale University Faculty of Medicine Hematology clinic between June 2022 and June 2023, 21 patients who were treated with daratumumab after receiving a multiple myeloma diagnosis were included. Demographic features of the patients, disease stage, prior therapies, characteristics of daratumumab treatment, and response rates to treatments were retrospectively analyzed. Results: The patients median age was 65±9.7 years (42-80), with a female/male ratio of 11/10. Treatment with daratumumab: 61.9% was used after two lines of therapy, 23.8% was used in first-line therapy, and 14.28% was used in second-line therapy. The average number of cycles was 4.05±5.06. Of the patients treated with daratumumab, 4.76% were treated as a single agent; 61.9% were treated in combination with immunomodulatory medications, cyclophosphamide and/or melphalan; and 33.4% were treated in conjunction with chemotherapy. When the response to treatment was evaluated, 38.1% of the patients passed away, 38.1% had a very good partial response (VGPR) or better, and 23.8% had a partial response (PR). 42.9% of patients who received daratumumab along with chemotherapy died. With daratumumab-containing regimens, overall response rates increased significantly as the number of cycles increased (ORR) (p=0.026). Conclusion: When daratumumab-containing protocols are used in the treatment of multiple myeloma, it has been observed that overall response rates improve and treatment success increases in direct proportion to the number of cures.

Objectives: This study evaluated whether serum levels of mitochondrial open reading frame of the 12S rRNA-c (MOTS-c) could provide prognostic insights in patients newly diagnosed with multiple myeloma (MM), particularly in relation to therapeutic responsiveness.

Testicular myeloid sarcoma (TMS) is a challenging pathology often posing diagnostic difficulties due to the poorly differentiated nature of tumor cells at the initial presentation. The delay in diagnosis significantly impacts patient life expectancy, emphasizing the need for prompt identification and treatment initiation. In certain cases, the presence of the Fms-like tyrosine kinase (FLT3) mutation adds complexity to the disease, requiring tailored therapeutic approaches. In this report, we present a unique case of bilateral TMS with FLT3 tyrosine kinase domain (TKD) mutation. The patient exhibited an aggressive clinical course, initially misdiagnosed with orchitis during the initial evaluation. Subsequent reevaluation of the testicular biopsy at a second center led to an accurate diagnosis, highlighting the importance of thorough examination in challenging cases. Given the emerging significance of FLT3 mutations in myeloid sarcomas, comprehensive testing for all FLT3 variants is crucial to determine the appropriate treatment modality. This case underscores the need for increased awareness among healthcare professionals regarding the diagnostic nuances and potential genetic variations associated with TMS. Furthermore, the inclusion of tyrosine kinase inhibitors, such as midostaurin or gilteritinib, especially in the presence of FLT3 mutations, may significantly impact treatment outcomes. This report contributes to the growing body of literature on TMS and highlights the importance of considering FLT3 mutations in the diagnostic and therapeutic decision-making process for improved patient care.