Data on health problems and fatal complications associated with coronavirus disease (COVID-19) have consistently been reported. Although immune thrombocytopenia has been associated with multiple viral infections, only few studies have shown its association with COVID-19. Here, we have reported a case series of two cases pertaining to patients diagnosed with COVID-19-associated immune thrombocytopenia, elaborating on the clinical course, management, and response to treatment.

Introduction: Central nervous system (CNS) involvement is reported to represent 5% of extranodal diffuse large B cell lymphoma (DLBCL) at diagnosis. To stratify patients’ risk of CNS involvement, the CNS-International Prognostic Index (CNS-IPI) score was developed. Serum uric acid level has not been incorporated into IPI or CNS-IPI score and its correlation with CNS-IPI risk groups and the CNS relapse has not been studied to date. Therefore, we aimed to retrospectively analyze the relationship between uric acid levels and CNS relapse risk in patients with newly diagnosed adult DLBCL. Methods: Ninety-four adult newly diagnosed DLBCL patients were retrospectively assessed via electronic records and patient files. Demographic data, IPI and CNS-IPI scores, hematologic parameters, serum lactate dehydrogenase, beta-2 microglobulin, serum uric acid and creatinine levels at diagnosis were recorded for analysis. Uric acid levels were compared between CNS-IPI low-intermediate and high groups and cumulative incidence of CNS relapses were analyzed between normal and elevated uric acid levels. Results: Uric acid levels were found to be significantly higher in CNS-IPI high-risk patients (p = 0.008). Elevated serum uric acid levels at diagnosis were significantly associated with high CNS-IPI risk in the logistic regression analysis (OR 1.34, 95% CI 1.05–1.78, p = 0.047). Uric acid also higher than 5.39 mg/dL showed a discriminatory ability in ROC analyses (AUC 0.633, 95% CI 0.495–0.771, p = 0.05). In the competing risks regression analysis, accounting for non-CNS-related death and progression as the competing events, CNS-IPI subgroups and uric acid levels were not significantly associated with the cumulative incidence of CNS relapse (SHR 0.81, 95% CI 0.12–5.59; Fine–Gray, p = 0.834), (SHR 0.55, 95% CI 0.09–3.47; Fine–Gray, p = 0.526), respectively. Conclusions: Even though uric acid levels are significantly higher and showed a discriminatory ability to detect the CNS-IPI high subgroup, elevated uric acid levels could not predict the CNS relapses.

Aims: Thrombotic thrombocytopenic purpura (TTP) is a life-threatening thrombotic microangiopathy caused by severe ADAMTS13 deficiency, leading to widespread microvascular thrombosis and requiring urgent therapeutic plasma exchange (TPE) and immunosuppression. Although most patients achieve remission with first-line TPE and corticosteroids, approximately 10–40% develop refractory disease requiring additional therapies. Evidence supporting alternative salvage therapies, including vincristine, remains limited. Methods: We conducted a retrospective single-center study of adult patients diagnosed with TTP between 2020 and 2025. All patients received first-line daily TPE plus corticosteroids. Refractoriness was defined as failure to achieve platelet recovery or biochemical improvement after 5–7 days of therapy. Patients laboratory results were obtained from the hospital's record system. Results: A total of 25 patients were included. First-line therapy achieved remission in 48% of patients (12/25). Among 13 refractory patients, rituximab induced remission in 2 (15%). Eleven patients subsequently received vincristine salvage therapy, of whom 9 (81,8%) achieved complete remission, accompanied by rapid platelet recovery and normalization of lactate dehydrogenase levels. Two elderly patients with severe multisystem involvement died despite salvage therapy. Overall survival for the cohort was 92%. Conclusion: Vincristine was highly effective and well tolerated as a salvage therapy in patients with refractory TTP who failed both TPE and rituximab, achieving remission in more than 80% of cases. These findings support vincristine as a valuable therapeutic option, particularly in settings where caplacizumab or other advanced biologics are unavailable. Larger prospective studies are warranted to better define its optimal timing and comparative efficacy among emerging salvage therapies.

Background: Hodgkin lymphoma (HL) has a bimodal age distribution, and outcomes in patients aged ≥60 years remain inferior to those in younger cohorts because of a higher comorbidity burden, reduced treatment tolerance, and disease biology that is incompletely characterized in real-world elderly cohorts. Methods: We retrospectively analyzed 42 consecutive patients aged ≥60 years with Hodgkin lymphoma. Demographic, clinical, laboratory, and treatment data were extracted from medical records. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan–Meier method and compared with the log-rank test; univariable Cox proportional-hazards regression was used to identify factors associated with OS and PFS. Because complete response and refractory disease are determined only after treatment, and refractory disease is itself a component of the composite PFS endpoint, these two variables were excluded from the Cox and Kaplan–Meier prognostic models and are instead reported descriptively. Results: Median age at diagnosis was 68 years (range, 60–94); 71.4% of patients had a high or very-high Charlson Comorbidity Index, and 95.2% presented with B symptoms. Twenty patients (47.6%) died during follow-up; the Kaplan–Meier median overall survival (OS) was 88 months (95% CI, 25–not reached). Progression-free survival (PFS), defined as the composite of relapse, refractory disease, or death from any cause, whichever occurred first, was reached as an event in 21 patients (50.0%); the Kaplan–Meier median PFS was 72 months (95% CI, 8–not reached). On univariable Cox regression, older age (HR 1.09/year, p = 0.002), ECOG performance status with >50% of the day spent in bed (HR 22.4 for OS, p = 0.003; HR 11.1 for PFS, p = 0.002), high International Prognostic Score (IPS) (HR 11.1 for OS, p = 0.007; HR 17.7 for PFS, p = 0.003), stage IV disease (HR 6.24, p = 0.036), splenic involvement (HR 4.33, p = 0.002), extranodal involvement (HR 6.55, p = 0.001), lower hemoglobin (HR 0.80, p = 0.024), lower albumin (HR 0.32, p = 0.004), lower Prognostic Nutritional Index (HR 0.93, p = 0.006), and higher neutrophil-to-lymphocyte ratio (HR 1.07, p = 0.031) were associated with inferior OS. Complete response was achieved in 28 patients (66.7%) and primary refractory disease occurred in 6 patients (14.3%); both showed a marked descriptive association with outcome, but because these variables are assessed after treatment—and refractory disease is itself part of the PFS event definition—they were excluded from the Cox and Kaplan–Meier prognostic models to avoid guarantee-time bias and circularity, and are reported descriptively only. When PFS was defined using this composite endpoint rather than relapse alone, ECOG performance status, IPS risk group, and Ann Arbor stage were each significantly associated with both OS and PFS on Kaplan–Meier/log-rank testing (all p < 0.05)—indicating that performance status is not dissociated from progression risk, as a relapse-only PFS definition had previously suggested, but instead reflects both survival endpoints. Conclusions: In this real-world elderly HL cohort, performance status, IPS risk group, extranodal/splenic disease involvement, and inflammatory-nutritional biomarkers identified patients at risk of poor survival. The cohort also had a high comorbidity burden (71.4% high-risk and 19.0% very-high-risk Charlson Comorbidity Index), but sparse strata and unstable hazard-ratio estimates meant our data support describing the cohort as highly comorbid without demonstrating a statistically robust CCI–survival association in this dataset. Failure to achieve complete response and primary refractory disease were each associated with markedly worse outcomes descriptively, but were intentionally excluded from the formal prognostic models given their post-treatment, time-dependent nature and circular relationship with the PFS endpoint. These hypothesis-generating findings support incorporating geriatric and biomarker-based risk assessment alongside conventional staging when planning treatment for older patients with Hodgkin lymphoma, and warrant validation in larger prospective cohorts.

Objective: Demographic characteristics, laboratory parameters, applied treatments, and treatment responses of patients diagnosed with multiple myeloma (MM) at the time of diagnosis vary between communities. We aimed to investigate this data of Multiple Myeloma patients and compare it with literature data. Material Method: In this study, we retrospectively examined data of 272 patients diagnosed with MM between January 1st, 2010, and January 31st, 2019 in Dicle University Faculty of Medicine Internal Medicine Hematology Clinic. At the time of diagnosis, general characteristics, laboratory values, treatment options, treatment responses, mean and median survival times, and causes of mortality of the participated patients in the study were investigated. Results: We found that 124 (45.6%) patients had IgG, 50 patients had (18.4%) ıgA, 59 patients had (21.7%) light chain, 21 patients had (7.7%) plasmacytoma, four patients had (1.5%) ıgM, three patients had (1.1%) plasma cell leukemia, and 11 patients had (4%) non-secretory myeloma. 77 patients underwent autologous hematopoietic stem cell transplantation (AHSCT). The average life expectancy in patients with AHSCTwas 68 months, while in patients without AHSCT, this period was determined as 42 months (p<0.001). Conclusion: We see that treatment response rates and average survival times increase with the introduction of new agents.

Background/Objectives: Eltrombopag, a thrombopoietin receptor agonist, is widely used in the treatment of relapsed or refractory (R/R) immune thrombocytopenia (ITP). This study aimed to compare the efficacy, safety, and tolerability of generic eltrombopag (Rompag^®) with original eltrombopag (Revolade^®) in adult patients with R/R ITP. Methods: In this prospective, multicenter study conducted at 10 centers, 104 adult ITP patients were followed for at least 3 months. A total of 35 (33.7%) patients received Rompag^® and 69 (66.3%) received Revolade^®. The primary endpoint was platelet (PLT) response, defined as achieving a PLT count ≥50 × 10⁹/L and at least a twofold increase from baseline, without the need for rescue therapy or transfusion. Secondary endpoints included bleeding rates, fatigue-related quality of life, adverse events (AEs), and rescue therapy requirements. Results: PLT response was achieved in 94.2% of patients in the Revolade^® group and 85.7% in the Rompag^® group (p = 0.16). Bleeding rates decreased significantly in both groups (Revolade^®: 56.5% to 2.9%, p < 0.001; Rompag^®: 62.9% to 2.9%, p < 0.001). Although overall AE rates were similar (30.4% in the Revolade^® group and 42.9% in the Rompag^® group; p = 0.22), arthralgia (28.6% vs. 7.2%, p = 0.01) and vomiting (11.4% vs. 0%, p = 0.008) were more frequent with Rompag^®. Conclusions: Both generic and original eltrombopag demonstrated no statistically significant difference in efficacy in achieving PLT response, reducing bleeding, and improving fatigue-related quality of life in adult patients with R/R ITP. Although minor differences in AE profiles were observed, particularly arthralgia and vomiting, both formulations showed acceptable safety and tolerability.